The earthquake that hit Nepal in 2015 received worldwide attention for the devastation it caused to lives and infrastructures. Yet, the impact of it on people with disabilities and experiences of emergency responders and humanitarian assistance providers have remained under-researched. This study aims to explore first-hand experiences faced by emergency responders and humanitarian assistance providers to evaluate the effectiveness in the implementation of inclusive and accessible emergency response during disasters. In addition, this paper will identify good practices and barriers faced by them in facilitating inclusive and accessible recovery and rehabilitation post-disaster.
Lessons learnt from barriers and challenges faced by the service providers, when addressed, will promote improved policies, processes and programmes around inclusive and accessible emergency and humanitarian response, recovery, and rehabilitation. This study is based on semi-structured interviews with 20 key informants and thematic analysis of data. Findings suggest that most stakeholders were engaged in inclusive disaster risk management (DiDRM), capacity building, and resilience developing awareness campaigns. However, there are significant gaps in policies, training, and practices. These gaps include, a dire lack of inclusive and accessible equipment and resources; lack of and failure to implement and utilize knowledge and resources available; lack of data and guidelines on disability inclusive emergency response (DIER); and lack of communication and coordination between emergency responders and DPOs.
These challenges hindered the search and rescue (SAR) and relief efforts, which resulted in the slow recovery and rehabilitation of persons with disabilities. This study recommends including persons with disabilities in planning, designing, and building inclusive and accessible emergency preparedness, response, SAR toolkit, and emergency shelters. Nepal now has opportunities to integrate accessible infrastructures, DiDRM and implementation at the community level. One way of achieving DiDRM at the community level could be building a bank of desegregated data, skilled volunteers, and accessible equipment meet the emergency needs of persons with disabilities.
Keywords: Nepal Earthquake, Accessibility, Humanitarian Assistance, Persons with Disabilities, Inclusive Emergency Response
A major earthquake on the 25th of April 2015 (addressed as ‘Nepal earthquake’ hereafter) resulted in the deaths of 9,000 and injured over 23,000 people . The earthquake and an estimated 300 aftershocks destroyed infrastructures and livelihoods of approximately 2.8 million people and affected a further estimated 8 million . In addition, it stretched the capacity of every humanitarian agency involved. Persons with disabilities were one of the severely-affected groups during and post-earthquake , however, the number of persons with disabilities affected, their experiences and the experiences of emergency responders and humanitarian assistance providers are barely focused in the academe.
Earthquakes and other natural disasters have detrimental consequences on the health, social, and economic welfare of persons with disabilities . This vulnerable group is disproportionately disadvantaged in humanitarian crises due to underlying disaster risk drivers such as their inherent and existing conditions, social inequalities, and disparity in accessible humanitarian assistance provided. This not only constrains their responses to the disaster, but also shapes and deepens their vulnerability to further hazards in the post-disaster stage. Therefore, inclusive and accessible emergency response for persons with disabilities and the role of emergency responders and humanitarian assistance providers are crucial to ensure that the suffering of persons with disabilities are minimized at the time of disaster.
Nepal’s institutional setup for disaster management dates back to 1982 with the National Calamity Relief Act and since then it has made progress in developing disaster risk reduction (DRR) policies and programmes. Nepal has ratified the Convention on the Rights of Persons with Disabilities 2006 (CRPD) and adopted disaster management frameworks such as Hyogo Framework for Action 2005-2015 and Sendai Framework for Disaster Risk Reduction 2015-2030. These frameworks have played a significant role in advancing the agenda for DiDRM in Nepal. Several DRR programmes facilitated by governmental and non-governmental organisations indicated that Nepal had been actively involved in pre-earthquake DiDRM campaigns. However, despite international frameworks and national policies governing DiDRM and preparedness programmes, Nepal was considered unprepared for the earthquake and was extremely challenged in providing accessible and inclusive emergency response to persons with disabilities .
Objectives and Rationale of the Study
This study aims to explore first hand experiences faced by emergency responders and humanitarian assistance providers that, when addressed, will promote improved policies, processes and programmes around inclusive and accessible emergency and humanitarian response, recovery and rehabilitation. In order to achieve the above objective, this study aims to:
Evaluate the effectiveness of implementation of disability inclusive and accessible emergency response during disaster.
Identify good practices and barriers faced by emergency responders and humanitarian assistance providers in facilitating inclusive and accessible recovery and rehabilitation post disaster.
For the purpose of this study, Kathmandu valley is selected as the research site as it covers some of the hardest earthquake-hit areas (Kathmandu, Bhaktapur, Lalitpur, Kritipur, and Madhyapur Thimi) (Figure 1) with the second highest death toll and the highest number of injury; 1,751 deaths and 13,102 injuries (Figure 2) . Kathmandu valley, a capital city and hub for all development organizations, is expected to be the most prepared district in Nepal. However, it is also the most populated and hardest to evacuate at the time of earthquake due to its densely built-up area and narrow streets. This setting allows the study to explore experiences faced by emergency responders and humanitarian assistance providers in assisting persons with disabilities during and post-earthquake.
This study employs a qualitative methodological approach using semi-structured interviews with 20 key stakeholders representing DPOs, DRR policy makers, Nepal government’s emergency response team and international humanitarian assistance providers. Interviews took place between June 2016 and March 2018. Stakeholders were recruited through purposive sampling facilitated through main researcher’s professional links and networks. Semi-structured interview method has been a powerful yet flexible tool for capturing the stakeholder’s experiences. It is powerful in the sense that it has eliminated the risk of deviating from the topics or themes closely related to the research questions. It is flexible because it has allowed the researcher to be reflexive during and after each interview. Data was coded manually and analysed using thematic analysis.
Three key themes and six subthemes emerged from the stakeholder interviews.
Inclusive Emergency Preparedness
Theme ‘Inclusive Emergency Preparedness’ emerged from discussions around DiDRM and preparedness programmes. These discussions also raised questions about awareness campaigns, accessible resources available to match preparedness plans and emergency needs of persons with disabilities.
The majority of stakeholders mentioned awareness initiatives from both government and non-governmental organisations and some believed that these efforts might have mitigated the extent of devastation.
“If awareness about inclusive disaster risk reduction and earthquake safety had not been circulated through national, local and community radios and television, I think, the devastation would have been 20 times bigger.” (R 1)
“Awareness and preparedness programs have definitely helped the government run hospitals to react to the emergency situation effectively.” (R 2)
All stakeholders reported to have attended numerous awareness raising workshops, conferences and consultations. Some were critical of these being non-inclusive and non-country specific.
Awareness to Inclusive Preparedness
Whilst awareness efforts had been apparent, this study identifies gaps between awareness campaigns, training, policies and practice. A majority of emergency responders reported inclusive emergency preparedness in practice as “negligible” and “focus-less”.
“All the workshops and seminars I attended mainly talked about infection control and managing emergency cares in hospitals. They did not address the issues around inclusive and accessible preparedness and recovery processes.”(R 4)
“For Armed Police Force the financial and resource focus has always been around peace building and response to disasters; inclusive preparedness is discussed more during seminars, trainings and in policies but less in actual implementation.” (R 15)
The only stakeholders reported to have some elements of DiDRMprogrammes and some accessible resources were DPOs. Despite awareness, none of the stakeholders reported of having a disability-inclusive emergency action plan for earthquake or any other natural disaster. The lack of planning is reported to have led to making emergency short-term decisions and an inability to provide appropriate and accessible services to persons with disabilities.
During Earthquake and Aftershocks
This theme emerged from discussions around execution and effectiveness of inclusive SAR. Emergency responders reported that numerous aftershocks made SAR challenging and risky and those persons with disabilities ‘were not prioritised’.
Most emergency responders reported ‘not’ to have assisted in evacuation of persons with disabilities due to the sudden and unpredictable nature of the earthquake.
“Everybody needed help at that time. We did not have special provision to look for people with disabilities. We did not have any record of where they lived, so how could we look for them?” (R 12)
Only stakeholders who provided living accommodation for persons with disabilities pre-earthquake were involved in evacuation.
“We evacuated all our residents. However, aftershocks made evacuating people extremely hard; there was no safe space to take persons with disabilities from our shelter to.” (R 5)
Those who evacuated persons with disabilities reported of the lack of emergency evacuation mechanism/ equipment and lack of accessible emergency shelters.
Search, Rescue and Recovery
Several emergency responders reported of struggle in search, rescue and recovery of persons with disabilities because to inadequacy of data on where they lived and lack of accessible equipment. Many had to wait for the international team to arrive with their equipment before being able conduct proper SAR and recovery.
“There was this paralyzed man in my ward, their house was completely destroyed. His family members managed to get out but we could not dig him out from the ruins. Chinese team recovered his body on the fifth day.”(R 3)
“We were notified of a trapped disabled 5 year old child under a badly damaged building on the second day of the first earthquake. We could hear a faint cry but could not locate where it was coming from. The cry got weaker. It took us two days to find the body of the child.” (R 11)
DPOs reported that they did not reach out for persons with disabilities who were not in their contact list and acknowledged that persons with disabilities who lived alone or relied on family support or those who begged for living were not provided with any emergency accessible relief supplies. Stakeholders also reported deaths of many persons with disabilities however; no official records have been located.
This theme emerged from stakeholder discussions about their experiences of providing immediate and long-term accessible relief support, rehabilitation and reconstruction aid, and lessons learnt.
Relief and Immediate Response
Many stakeholders reported a severe lack of coordination between the government, INGOs and DPOs initially, which resulted in a wide variation and duplication in distribution of relief materials and services. Eventually, when coordinated cluster’s relief distribution started, it only covered PWDs affiliated with DPOs or who made formal requests.
Psychological impacts caused by the lack of accessible facilities in temporary shelters noted were obvious.
“PWDs who stayed in our camp were so scared by the earthquake and stressed by the lack of accessible facilities that they struggled to sleep at night. Continuous aftershocks made their stress worse; they were in total panic.” (R 7)
Some facilitated counseling within the camps whilst others reported using group activities like singing and quizzes to help manage trauma.
“Because our tents were on bare grounds, there was no access to water and sanitation. Toilets for wheelchair users were the biggest problems as the makeshift toilets were just a whole in the ground and some plastic sheets wrapped around some bamboo sticks.” (R 4)
All reported problems with providing and managing accessible toilets and washing facilities in temporary shelters especially for wheelchair users and women with disabilities.
Ongoing Rehabilitation and Reconstruction
Many DPOs reported to have continued with inclusive and accessible recovery and rehabilitation programmes including financial aid as well as psychological counselling.Despite this experience of earthquake, none of the stakeholders reported to have designed any action plan for future natural disaster/earthquakes.
“We are focused on rehabilitations and reconstructions. We do not know how to design inclusive action plan for future disasters.” (R 7)
Since the earthquake, there has been accelerated advocacy efforts from DPOs calling state to construct accessible infrastructures.
This study identifies that the Nepal government with the aid of UN agencies, bilateral agencies and international organisations have worked on improving DiDRM policies, programmes and practices to strengthen inclusive disaster preparedness. However, a serious gap lies between policies, preparedness and the execution of it at the time of disaster, especially for persons with disabilities.
These gaps include a dire lack of inclusive and accessible equipment and resources; lack of and failure to implement and utilize knowledge and resources available; lack of data and guidelines on DIER and SAR to emergency responders; and lack of communication and coordination between emergency responders and DPOs. It was evident that Nepal had progressed notably in relation to policy formation to include the rights, needs, and dignity of PWDs in line with CRPD, Hyogo Framework for Action and Sendai Framework for Disaster Risk Reduction. However, it was equally evident that the participation of persons with disabilities in policy drafting and phases of disaster preparedness and management process was minimal, leading to gaps in policy implementation and inadequate inclusive and accessible emergency service design and delivery. Many DiDRM activities treated persons with disabilities as mere recipients of the services resulting in segregation from mainstream policies and programmes.
The government has recently developed a Post Disaster Recovery Framework , which includes the needs of persons with disabilities. Many DPOs and INGOs have accelerated their efforts in needs assessment, situation analysis and DiDRM to bridge knowledge and resources gaps since the earthquake. It is clear that without channeling local, national, multilateral, and bilateral implementation in shaping Nepal’s ability to prevent, mitigate, and prepare to respond to disasters, Nepal will have a major challenge ahead in implementing the Sendai Framework for Disaster Risk Reduction.
Nationwide disability inclusive and accessible emergency preparedness, response and SAR toolkit that will serve as a resource for emergency responders, humanitarian assistance providers and DPOs to prepare comprehensive SAR, evacuation and recovery plans
Including persons with disabilities in planning, designing and building disability inclusive and accessible emergency shelters.
Building a bank of desegregated data, skilled volunteers and accessible equipment to meet the emergency needs of persons with disabilities at every level of state and community.
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Sapana Basnet Bista is a PhD candidate at Public Health Institute, Liverpool John Moores University, UK. Sapana holds a MA in Children, Youth and International Development and another MA in Creative and Transactional Writing both from Brunel University in the United Kingdom. Currently, Sapana also works at Green Tara Nepal as a Research Associate, is a founding member of Global Consortium for Public Health Research and President of Nepal Study Society at Liverpool John Moores University. She has previously worked in Liverpool John Moores University UK as a Research Associate, The Sethi Partnership Solicitors UK as an Asylum and Immigration Case Worker and other private and charity sectors including Anti-Slavery International UK, Oxfam UK, Nepal Red Cross Society and Whitbread PLC UK. Her publication and research interests include international public health and wellbeing during crisis and conflict, gender development, mental health, natural disaster and crisis preparedness, displacement, and disabilities.