Douglas Noble was caught with his family in the midst of April’s huge Nepal earthquake. Since then the Oxford alumnus and Unicef health worker has been in the thick of efforts to tackle the ongoing disaster.
By Douglas Noble (Green College, 1999)
On Saturday 25 April, my family and I drove out of Kathmandu for a walk in the hills. We went with a guide for a walk through a narrow path at the side of one of Nepal’s many grand and high hillsides. The views were magnificent, but I was glad when we got to the end of the path and walked into a small village along a dusty road. Then the enormous bang of the 7.8-magnitude earthquake hit. We crouched to the ground, huddled tightly, and my wife prayed fervently as my daughter cried. A house nearby swayed back and forth, and villagers ran for cover.
After an hour we started to walk slowly, crouching for aftershocks, to a local resort where we had left our vehicle. This small collection of cottages had sustained some bad damage, but they were standing. Pulling two single mattresses into the open, the four of us lay covered in duvets, experiencing aftershocks every few hours throughout the night.
In the morning we teamed up with people we had met, and travelled slowly in convoy back to Kathmandu. The journey was littered with destroyed buildings and some cracks in major roads.
We decided to go to our apartment first, and sadly the damage was very extensive — we’ll never live there again and it will likely be demolished in coming weeks. It’s actually a miracle it didn’t collapse and a blessing we were not inside at the time.
The next day I evacuated my family to London and headed to work at Unicef’s regional office for South Asia, where many staff members were encamped on the lawn. I’ve worked with Unicef for almost two years, and although we’d done extensive preparation for an earthquake, it was still a shock when it actually happened.
The last two weeks since the earthquake have been devastating — with thousands dead and injured. Many more people are in trouble. Those most affected number in their millions — including 1.7 million children who are in immediate need of life-saving interventions. Many people are sleeping outside, either because their homes are damaged or because they are afraid to go back inside in case there is another earthquake.
The initial emergency response was swift and impressive. But just as things in Kathmandu were starting to settle down a little, a huge aftershock of magnitude 7.3 occurred on 12 May. This was a big setback. And people who had gone back to their homes were sleeping on the street again.
I’ve been working with the Unicef team on the earthquake response. Unicef started responding immediately using our pre-positioned supplies — tents for hospitals to use, hygiene kits, and water delivery to informal camps in the Kathmandu Valley. We have also flown in aid — including tarpaulins, medical supplies, first-aid kits and water purification tablets — to meet the urgent need.
From a public health perspective, there are lots of challenges. I’m concerned about people sleeping outside of their homes for so long. It raises the risk of diarrhoeal diseases and other infectious diseases such as measles. When I visited an informal camp the biggest needs were water, food, toilets and to confirm if the houses still standing were safe to live in. The risk of measles is high because of crowded conditions.
Unicef has secured half a million measles vaccines for mass vaccination campaigns. With our partners, we’ve reached many people with water, sanitation facilities and hygiene education. But we have to keep moving fast to prevent serious outbreaks of communicable diseases.
I’m also concerned about the health system overall. More than 80 per cent of health facilities have sustained serious damage in the five worst-affected districts. I also discovered, buried deep in recent government-reported figures, evidence that the parts of the health system closest to the people are damaged in high numbers — what we call primary care in the UK. This is worrying. With landslides, roads damaged and mobility reduced, it’s going to be hard to get to see the doctor.
Nepal had been progressing steadily in public health, but the earthquake takes us a step backwards. From the beginning of the relief effort we have to think about the future as well as the immediate emergency needs. Recover and sustain. Unicef and partners will be working to strengthen the whole health system — from skilled birth attendants, to vaccinations, to rebuilt high-quality health facilities, to improving information systems that tell us people’s real health problems.
Unicef has launched a £34 million appeal to support Nepal. Visit www.unicef.org.uk/nepal or (UK only) text DONATE to 70123 to give £5.
Dr Douglas Noble read medicine at Green College (now Green Templeton) and is regional health adviser for Unicef’s regional office for South Asia, based in Kathmandu.
Images, from top:
- Akriti Tamang, 8, searches for her books amid the ruins of her home in Sangachowk village, Sindhupalchowk District, one of the worst-hit areas (© Unicef/Panday).
- Douglas Noble among tents near the Unicef office in Kathmandu (courtesy of Douglas Noble).
- The road into Kathmandu two days after the quake, photographed by Douglas Noble.
- Soldiers and rescue workers among severely damaged buildings in Kathmandu (© Unicef/Nybo).
- A health worker vaccinates two-year-old Zoffin Nakarmi against measles in the village of Bungamati, Kathmandu Valley. Holding him is his mother, Jeena Maharjan, who said: ‘We know disease is a risk. When the earthquake hit, my mother-in-law was on the top floor of the house, but she got out alive. I travelled for two hours to be with my family here in Bungamati as I was afraid. We are living together in a tent in a field.’ (© Unicef/Panday).