As Nepal moves towards recovery after the devastating 7.8-magnitude earthquake in April 2015 and its aftershocks, which claimed nearly 9,000 lives, protecting the health of its youngest citizens is a key priority. Supported by the Nepal Red Cross Society, the government has been moving forward with a programme of total immunisation for all children under two in the 14 worst-hit districts. One of them is the area around the town of Ramechhap, a four-hour drive from Kathmandu:
Nilam Sah, 22, holds her baby daughter, Akhil, as she serves customers at her wooden snack stand. It sits just outside her temporary home of timber and corrugated iron, which seems to tumble down the hillside. "With twelve people crammed inside, it's easy for illnesses to spread," she says. She's not too worried about the little girl right now, because at least Akhil has been immunised against the most common preventable diseases - although she still has a few followup shots to come. "She did have a rash and other side effects in reaction to the vaccines, so I took her to the local health centre, but the doctors said it was nothing to worry about."
Today in Ramechhap, dozens of Female Community Health volunteers, marching behind a Red Cross flag, process through the dusty streets on their way to a celebration, marking the achievement of total immunisation of the town's children under two. "In the post-earthquake landscape, immunisation has taken on an increased importance because of the new migration patterns after the disaster and because of the damage to our health infrastructure," says Dr Mausam Bohara, head of the Nepal Red Cross Society's health department. The contact which Red Cross and other volunteers have with hundreds of thousands of families in towns and the countryside throughout Nepal "is particularly important as an entry point for our work going forward," says Dr Mausam. "We will increasingly move from providing mainly psychosocial support to more of a community health model with local health officers and health posts."
The immunisation drive - several other districts have also already marked total immunisation also “sends a signal that we are clearly moving from the post-disaster relief phase, towards the recovery phase, focused on rebuilding homes and social and economic infrastructure,” says Michael Higginson, programme coordinator in Nepal for the International Federation of Red Cross and Red Crescent Societies.
Nowhere are these more crucial than in areas like the village of Hattachaur, which sits below Ramechhap town on the floor of the river valley and is home to some of the poorest families, who traditionally make their living from seasonal fishing and farming rice paddy and maize. The sandy soil here has meant that many more houses were reduced to ruins by the earthquake, leaving many local people squatting for months in the shelter of a covered market, before they could cobble together temporary homes out of wood, metal or bamboo. Local villagers are keenly waiting for progress on rebuilding their homes. But of course they also have their worries.
Farmer Lal Bahadur Manjhi, 60, is concerned about the cost of demolishing his damaged house before he can rebuild and tractor driver Damber Khadka says he worries it will be difficult to find masons to work on his house in a village about 90 minutes drive from Ramechhap. Water is another major concern, with local villagers forming a cooperative to pump it from the nearest well in order to irrigate their crops. "There is hardly enough to drink, so how can there be enough for irrigation," says Khadka.
Despite the hardships and frustrations, spirits seem to be holding up, though, and anticipating more progress, even if local people's estimates of how long it will take for the town's life to get back to normal range between two and five years. "Even when we Nepalis are suffering, we laugh," as one middle-aged woman in the village sums it up. Humour may be an unquantifiable input, compared with cement or drinking water, but most psychologists would agree it can only have a positive impact on people’s post disaster recovery.
