Amid Nepal earthquake response, echoes of Haiti

Nepal army forces in collaboration with members of an American Search and Rescue team rescue 15 year old Pemba Lama from a collapsed hotel five days after the earthquake hit Nepal on April 30, 2015 in Kathmandu, Nepal.
Nepal army forces in collaboration with members of an American Search and Rescue team rescue 15 year old Pemba Lama from a collapsed hotel five days after the earthquake hit Nepal on April 30, 2015 in Kathmandu, Nepal. Getty Images

As aid continued to trickle Thursday into hard-hit remote villages near the epicenter of Nepal’s 7.8-magnitude earthquake, aid groups including U.N. agencies and nongovernmental organizations found themselves struggling to avoid the mistakes made in response to Haiti’s devastation five years ago.

“There is little sign of a plan or any effective coordination,” said John Bevan who worked in Nepal for the United Nations and in Haiti before and after its 7.0 earthquake on Jan. 12, 2010. “The government seems to be making up policy on the hoof.”

Both Haiti and Nepal are vulnerable to quakes, and had poor infrastructure and building construction before disaster struck. Like in the case of Haiti, Kathmandu’s Tribhuvan International Airport descended into chaos as international rescue teams and aid workers got stuck for hours on the tarmac. On the streets, frustrations mounted as victims expressed anger over perceived government apathy.

On Wednesday, protesters faced-off with police over the slow pace of aid delivery after the Saturday disaster. Meanwhile, significant numbers continued to board buses for remote villages.

“There has been little consideration of what to do about all those leaving the capital,” Bevan said. “In the case of Haiti, giving incentives for people to remain in their places of origin by job creation or other measures could have discouraged many returning to the overcrowded capital. The same seems to be happening here, which has lighter but similar problems of a population with insufficient infrastructure.”

The quake has left more than 5,500 dead and more than 11,000 injured. The United Nations estimates that 8 million people have been affected, including 3 million who have been displaced because their homes were either destroyed or severely damaged.

“The numbers of injuries, fatalities so far are much lower than the worst case scenario,” said Brian Grogan, chief of policy analysis and innovation for the United Nations Office for the Coordination of Humanitarian Affairs. “In Haiti, we lost more than 200,000 people very quickly. It’s not going to be on that scale.”

Grogan did not dispute the logistical problems plaguing the disaster response, which has also been stymied by bad weather. Still, there were lots of lessons learned from Haiti, he said, that are being applied by U.N. agencies, as well as new tactics. They include the use of drones to assess hard hit areas, and Facebook and Skype to help relatives find each other.

“We are looking at not only trying to stay up with the curve but ahead of the curve,” Grogan said. “There is an overall shift in the way we do business. There is a lot more aid being delivered through cash programs, which gives people a bit more dignity so they could go buy something and allows them to prioritize what they need.”

After quickly allocating $15 million, the United Nations this week launched a $415 million appeal to provide assistance for the next three months. Even before the appeal, more than a dozen countries had made pledges,including the United States, which offered up to $10 million in relief assistance. The U.S. Agency for International Development, which led the response in Haiti along with the United Nations, dispatched a 130-member humanitarian team to Nepal consisting of disaster-response experts and search and rescue workers.

However, during a mid-week conference call with the U.N., Nepal’s government de-prioritized search and rescue efforts in favor of scaling up aid and medical teams. It also tapped DHL to coordinate air traffic with the government and decide which flights should have priority to land.

“This tragedy has taught us that we need organizational management in natural disaster management,” Prime Minister Sushil Koirala was quoted in the Washington Post as saying.

Allowing the government to take the lead, is another lesson learned from Haiti, Grogan said.

“We are working much more directly with the government to reinforce rather than trying to replace them at every instance we can,” he said. “What they are prioritizing is the medical teams … we are working hand-in-hand on that prioritization and bringing in groups based on the value they can add. It’s as much about the quality and the value added as it is about anything else.”

On Thursday, a U.S. rescue team pulled 15-year-old Pemba Tamang from the wreckage of a seven-story building in Kathmandu.

While the U.N. has launched its Cluster coordinating system much more quickly than in Haiti, aid groups took the initiative early on to work together, said David Gazashvili, acting director of emergency and humanitarian assistance at CARE USA.

CARE has been in Nepal since 1978. All of its 150 staffers survived the quake and are being used to help provide assistance to those outside of Kathmandu. A major problem in Haiti was caused by the deaths of government workers and U.N. employees, including its top brass.

“It’s very important to have people from the area involved; they know the challenges, the traditions, the customs. They know what is acceptable,” said Gazashvili, hinting at criticism of the Haiti quake response about local communities being shut out of the process.

Another criticism of the Haiti effort was then-Haitian President René Préval’s refusal to accept food aid after the first few weeks. Préval feared that the free food and water would further collapse the economy when the country had ample supplies for people to purchase. Today, not only has the U.N. employed more cash programs in its early response, but the World Food Program also is considering shifting from five-day food rations to cash after a month.

“Sometimes cash is better,” said Alejandro Lopez-Chicheri, WFP spokesman for Latin America and the Caribbean.

Dr. Ciro Ugarte, director of emergency preparedness and disaster Relief from the Pan American Health Organization/World Health Organization, said that Haiti also was a teaching moment for them. For instance, 14 regional medical teams were on standby to fly into Nepal because the government had not yet given the green light.

After Haiti, PAHO/WHO launched a registration system, requiring country medical teams to say what they are bringing and what expertise they were offering before parachuting into a disaster. The new requirement was first tested during the Philippines cyclone, and was activated in Nepal immediately after the disaster.

Another success, he said, is the hospitals, many of which in Katmandu were retrofitted to withstand an eventual earthquake, he said.

“People are saying that 15 hospitals were destroyed, but why don’t we say that 11 hospitals that were retrofitted are up and running?” Ugarte said. “Their reality in the capital in Nepal is different from the reality of the capital of Haiti.”

In Haiti, the country’s main hospital was so badly damaged that medical teams were forced to perform surgeries in the courtyard, which also doubled as an open morgue.

“The reality now in Kathmandu is that all of the critical hospitals were up and running during the disaster. That is the good news inside the bad news,” Ugarte said. “It really shows that when we do the proper things, we are not counting thousands more dead or have people who will suffer complications.”