Origin, Magnitude, Distribution and Impact

Nepal lies in a major earthquake belt. As the collision of the India and Eurasia plates occur, pressure is released in the form of earthquakes. The constant crashing of the two plates formed the Himalayan ranges.^{[1, 2]} In geological terms, the tremor occurred every 81 years, the region's last earthquake of such magnitude in 1934.

Record dating to 1255 indicates the region - known as the Indus-Yarlung Suture Zone - experiences a magnitude 8 earthquake approximately every 75 years, according to Nepal's National Society for Earthquake Technology.
Earthquake started at 11:56 A.M with its epicenter in Gorkha of Richter scale 7.6 - 7.9 on Saturday, April 25, 2015. Approximately, 110 aftershocks of more than 4 Richter scale were recorded between 11:56 A.M, 25th April to 1:29 A.M, Thursday, 30th April, as of National Earthquake Center, Kathmandu.^[3]

The authors experienced and discussed odd weathers (unexpected rain, temperature fluctuation) preceding the quake. We noted unusual cry of birds and bark of dogs as well as strange sound of wind immediately before and after the earthquake. The first few days following quake we observed unusual weather pattern in Kathmandu valley.

The total number of districts with recorded deaths are 31 and the death toll as of May 1st, 2015 was 6,166 and injured 13,232.[4] The 31 districts with deaths are: (1) Sindhupalchok, (2) Kathmandu, (3) Nuwakot, (4) Gorkha, (5) Dhading, (6) Rasuwa (7) Kavre, (8) Bhaktapur, (9) Lalitpur, (10) Dolakha, (11) Makwanpur, (12) Ramechhap, (13) Solukhkhumbu, (14) Okhaldhunga, (15) Sindhuli, (16) Sunsari, (17) Chitwan, (18) Bara, (19) Parsa, (20) Lamjung, (21) Kaski, (22) Morang, (23) Bhojpur, (24) Sarlahi, (25) Dhanusa, (26) Taplejung, (27) Tanahun, (28) Nawalparasi, (29) Rukum, (30) Rolpa, (31) Rautahat.

The total household and total population of the mentioned 31 districts were 2878319 (53.03% of total household) and 13652804 (51.53% of total population), respectively.^[5] World Heritage Sites (Kathmandu Durbar Square, Lalitpur Durbar Square, Bhaktapur Durbar Square, Pashupatinath Temple, Changu Narayan Temple, Swayambhunath Stupa, Bouddhanath Stupa) and other national heritages such as Dharahara (Bhimsen Tower), several temples, stupas and historical monuments were affected severely. Fear was rampant in the affected areas. Injuries, suffocation, shock, acute anxiety, phobia, acute posttraumatic stress disorders, gastroenteritis, acute respiratory infections were observed to the affected population.^[6,7,8]

We noted that in almost all temporary camp dwellings drinking water was deficient in an already water deficit Kathmandu. The authors went in search of drinking water but all shops were closed. Electricity supply was interrupted for various durations depending upon the locality. Telephones were functioning well despite the nature of the earthquake. Government declared a state of emergency but no basic facilities were available in the ravaged area. No leaders of any political party has participated in the basic public services or given a speech to the media. The best rescue work was provided by individuals, families, neighbors.

Rescue operations by several national and international agencies have been involved in the severed areas. Security agencies such as Armed Police Force (APF), Nepal Army (NA), Nepal Police and Radio Nepal have been performing exemplarily. Nepal government has released Rs 1.3 billion for immediate relief.^[10]

AMDA activities in Nepal

AMDA started its relief activities within 48 hours of earthquake in Nepal.^[11] AMDA Nepal mobilized all its resources. Several activities were conducted. AMDA Nepal got involved in medical and humanitarian rescue in Dhobidhara, Sakhu of Kathmandu (April 26), Gorkha (April 27), Sindhupalchok (April 29), Sankhu and Visinity of Kathmandu (April 28), Gongabu, Narayangopalchowk, Chuchepati of Kathmandu (April 30), Kalopati, Jhounkel, Changu, Byasi of Bhaktapur (May 1), Pashupatinath Temple area and Kirtipur of Kathmandu, Khokana and Lubu of Lalitpur (May 2) and Dharmasthali of Kathmandu (May 3).

AMDA Nepal members, members of AMDA International and volunteers involved directly in the field were Dr. Saroj Ojha, Dr. Sangeeta Baral Basnet, Dr. Narayan Bahadur Basnet, Dr. Durga Bhandari, Dr. Nibha, Dr. Santosh Pokhrel, Dr. Tiwari, Dr. Navin Dhakal, Mr. Sudesh Regmi, Ms. Tomoko Omasa, Abhishek Singh Basnet, Ms. Kie Kanda Rawal, Abhilasha Basnet, Ms. Sibata, Ms Renuka, Sumi Dahal and Barun. AMDA doctors working in various hospitals have been working their best in respective hospitals. Considering the gravity and the magnitude of the situation, AMDA International President Dr. Suganami arrived in Kathmandu on May 1st with his team.

Exemplary work was conducted by AMDA Nepal along with CMDC ^[8] in Changu Narayan area where very negligible support from government, NGOs/INGOs had reached. AMDA distributed oral rehydration solution (ORS), paracetamol tablets, antibiotic ointments, antacid, mineral water along with dry food. AMDA members sympathized as well as motivated the victims.

Needs

Immediate (0-4 weeks) observed needs are removal and cremation of the dead, treatment of the injured/victims, mass mobilization of medical support, alertness of fire brigade, security of victims/affected population, control of infectious diseases, preventive measures, mass awareness, prompt communication and transportation, distribution of rescue materials, safe management of air, water, toilet, crowd, shelter and fear. Mass communication of the incidence and prevention of rumors is equally important.

Government security organizations, general people, international organizations are working hard to achieve the mentioned needs. Governmental organizations lacked rescue operations in several areas as per the need of the hour according to many people and media. Fast methodology instead of old bureaucracy is required for smooth rescue operation in this geographically diverse country.^[12]

Health and medical activities, treatment and prevention of psychological trauma, material supports were noted as short term needs (4 to 12 weeks). A long term planning, awareness and research is mandatory in the geologically disaster-prone area.^[13]

Summary

Since Nepal is located in an earthquake zone she should always remain alert. AMDA stands for emergency humanitarian support and has a long history of rescue activities. It started its activities from day two of The Great Earthquake Nepal, April 2015 through its dedicated members.

Prompt, integrated, coordinated and precise rescue operation was urgent to reduce mortality, morbidity, disability, stress disorder and material loss. We observed courageous helping individuals/ families rising to the needs of their countrymen. Immediate rescue services, financial support directly to the affected individuals, families and institutions in a transparent and sincere manner are recommended. Communication therapy helps to prevent undue stress in the public.

Art and culture is not sustainable long without proper utilization of science and technology neither can it uplift the living standard of people. Also, a need to distinguish residential, business, industrial zones were noted to prevent further damage in the future. Spending a lot of money in reconstructing lost monuments may invite further poverty in this scientifically poorly aware society.

Prompt rescue, scientific awareness, disaster preparedness, renovation, reconstruction, innovation and better life can be achieved by performing what one thinks and talks. Peace of mind, healthy body and environment are the tools to achieve these goals in this globally popular country.

REFERENCES

1. Mclain S, Wang SS. How the Nepal earthquake happened [The Wall Street Journal 2015]. The Kathmandu Post; Tuesday, April 28, 2015, p5.
2. U.S. Geological Survey. http://www.usgs.gov/
3. Sakidai Gae Jhatka [Diminishing aftershocks]. Kantipur; Friday May 1, 2015 [Baisakh 18, 2072], p19.
4. Mounting loss. The Kathmandu Post; Friday May 1, 2015, p4.
5. National Population and Housing Census 2011. Vol 02, NPHC 2011. Central Bureau of Statistics, National Planning Commission Secretariat, Government of Nepal.
6. Donatell L. Perseverance in Nepal. The Kathmandu Post; Tuesday, April 28, 2015, p5.
7. Wiwanitkit V. Medical concerns and practical points in post-earthquake management. Archives of Hellenic Medicine, Athens Medical Society. [http://www.mednet.gr/archives/2011-6/pdf/829.pdf]
8. Naghii MR. Public health impact and medical consequences of earthquakes. Rev Panam Salud Publica/Pan Am J Public Health 2005;18(3), 216-221.
9. www.cmdc.com.np
10. Govt releases Rs 1.3 billion for immediate relief. The Kathmandu Post; Sunday May 3, 2015, p1.
11. AMDA Nepal Jorpati Office, Kathmandu, Nepal.
12. Relief goods for quake victims held up at customs: UN. The Himalayan; Sunday, May 03, 2015,p1.
13. Park K. Chapter 14: Disaster management. In: Park’s Text Book of Preventive and Social Medicine [18th ed.]. M/S Banarsidas Bhanot Publishers, Jabalpur, India, 2005.