A Retrospective Analysis of Mortality From 2015 Gorkha Earthquakes of Nepal: Evidence and Future Recommendations

Abstract

Objective: The aim of this study was to explore the mortality pattern due to Gorkha earthquakes in 2015 and review the response and recovery efforts immediately following the earthquakes. Methods: Data from published reports of the Nepal Police showed over 8000 deaths. These death counts were categorized by gender, ethnicity, and age groups (interval of 5 years). The mortality rate was calculated (per 100 000 population), using the projected population as the denominator as of April 2015. Results: Children < 10 years and older adults > 55 years showed a higher rate of deaths, with similar trends for the most affected districts. Almost 8 more females’ deaths were reported per 100 000 population compared with their male counterparts. There was a higher death rate from Province 3 with a notable gender difference: Nearly 20 more females’ deaths were reported per 100 000 population compared with their male counterparts. There was a higher death rate in mountains (542.4 per 100 000) compared with hills (55.0 per 100 000) and the southern Terai region (0.96 per 100 000) of Nepal. Conclusions: Young and older adults, female, and residents of remote, mountainous regions of Nepal were vulnerable to the earthquakes. Future earthquake preparedness should focus on the vulnerable population by age and gender and the geographical accessibility.

Earthquake rebuilding and response to COVID-19 in Nepal, a country nestled in multiple crises

“…Nepal’s health system suffers from poor coverage and quality of health services particularly at the existing ~ 5000 health facilities [ 4 , 5 ]. Nepal’s already strained health system was worsened by the damages due to the Gorkha earthquakes; and is inevitably going to be impaired by the current pandemic [ 6 ].…”

“…COVID-19 pandemic mirrors the impact of Gorkha earthquakes, with impacts more prominent on vulnerable population living in rural and border areas that includes wage-based labourers returning from India or the stranded population desperately seeking government’s attention. Mortality associated to Gorkha earthquakes was high among vulnerable population that included children <10 years, adults >55 years, females, and from remote mountains [ 5 ]. The higher risk of infections and mortality among these specific population shows important bottlenecks in Nepal’s health system and its ability to plan and prepare for future disasters/pandemics.…”

How should Nepal apply lock-down exit strategy against rising COVID-19 burden in Nepal?

“…Strengthening provincial/local health care system, resources essential for early identification, referral, isolation, and management of cases at a community level is another area which needs utmost attention (Marahatta et al, 2020). As the pandemic has already brought a wave of mortality in even the robust health systems, it is critical for Nepal to prepare and learn from the past disasters (including from these countries) for efficient preparedness and management (Adhikari et al, , 2017(Adhikari et al, , 2020 Amidst these potential constraints that Nepal can face, at least in the nearest term, Nepal should form a capacity through a team of disease specialist (trained personnel), public health specialist, laboratory personnel, and logistics management team, akin to forming a disaster management capacity/workforce . Indeed, such a workforce can remain as a reserve and 'ready to go' to the places where the outbreak of COVID-19 emerges.…”

“…House owners, hotel owners and community members were found to discriminate the health care workers restricting them to stay at their place. Thus, there is a need of more concerted and coordinated actions from all sides, including those who are not directly associated with the health care institutions to ensure that the actions and efforts in fighting against the COVID-19 pandemic occurs in unison (Adhikari et al, , 2017(Adhikari et al, , 2020Adhikari and Mishra, 2019;Cash and Patel, 2020;Marahatta et al, 2020)…”

Post-earthquake Self-Reported Depressive Symptoms and Post-Traumatic Stress Disorder and their Correlates among College-Youths in Kathmandu, Nepal

“…The 2015 earthquakes in Nepal caused massive mortality and morbidity [ 11 ], including among the young population [ 12 ]. Prior studies have indicated that there were 8151 deaths, and mortality was higher among females, ethnic minorities, children under 10 years of age and the elderly [ 13 ]. Post-earthquake mental health outcomes among adults have been reported [ 14 , 15 ], but evidence regarding mental health impacts among youth is limited.…”