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“...machinery) that were damaged or destroyed. Loss refers to changes in financial flows due to the temporary absence of infrastructure, increased or new demands (operational costs) due to the disaster, lost revenues, higher expenditures and the cost of maintaining service provision. In addition to reconstruction costs, recovery needs are identified to build back better and are costed accordingly. Each sector has also examined issues of vulnerability and marginalisation, and the need for specific targeting in the implementation of the recovery strategy.
The report covers the following sectors:
A. Social
1. Housing and Human Settlements
2. Health and Population
3. Nutrition
4. Education
5. Cultural Heritage
B. Productive
6. Agriculture
7. Irrigation
8. Commerce and Industries
9. Tourism
10. Financial Sector
C. Infrastructure
11. Electricity
12. Communications
13. Community Infrastructure
14. Transport
15. Water, Sanitation and Hygiene
D. Cross-Cutting
16. Governance
17. Disaster Risk Reduction
18...”
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“...legal framework for citizen engagement in the decision making and resource mobilization based on the principle of subsidiary. The LSGA has mandated Local Bodies (Village Development Committee (VDC), District Development Committee (DDC) and Municipality) mainly for development planning and budgeting, building local infrastructure, providing basic services, maintaining the records and protecting public land, maintaining vital registration, and mobilizing and coordinating local development partners. The Local Bodies are also responsible for implementing land use policy, enforcing and monitoring the building code and ensuring the construction of disaster resilient infrastructure at local level.
The 1999 Building Act promotes safer building practice in the country with four types of buildings: i) International state of the art, ii) professionally engineered buildings; iii) mandatory rule of thumbs and iv) rural buildings. Nepal National Building Code has been developed along these lines. Department...”
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“...valley has changed drastically in the past two decades, with a 211% increase in built up area between 1992 and 2012. This has occurred through an equivalent loss of cultivated land and significant encroachment of open spaces. The loss of open spaces coupled with significantly increasing density has increased the urban risk of Kathmandu Valley.
The Kathmandu Valley Development Authority (KVDA) is in the process of implementing a 20 year Strategic Development Master Plan (SDMP 2015-2035 draft). Infrastructure improvements, environmental improvements, urban regeneration and land use planning are the four major areas of focus of this plan. The land use planning in particular is focussed on risk sensitive land use planning (RSLUP).
2.3.3 National Urban Development Strategy
The National Urban Development Strategy (which is in approval phase) seeks to promote resilience in urban development including climate change adaptation, development in safer locations, the review and enforcement of building codes...”
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“...Total Effect (Damage and Loss)
350,379
Recovery Needs and strategy
The following guiding principles should form the basis of strategy and planning of post disaster recovery:
1. Participation of the community by empowering them to take control of reconstruction of their own houses and ensuring facilitation of owner-driven reconstruction.
2. A comprehensive view of housing reconstruction to include holistic habitat development including basic services and community infrastructure. Building Back Better should translate into a concept of "safer settlements".
3. Reconstruction should be a vehicle to build long-term community resilience. Reducing vulnerabilities and strengthening community capacities to mitigate future disasters by improving construction practices for majority of the building stock in the country.
4. Strengthening the local economy through reconstruction and processes favorable to the poor, marginalized and informal sector. Reconstruction should provide an opportunity for the...”
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“...difficult and disputed if safe available lands have private ownership or is forest land. Relocation is also very costly. The government has identified need for clustering of 22,256 households along with infrastructure provision and settlement planning at the cost of NPRs 10,525 million. This will be vetted through rigorous multi-hazard study of each site.
4.4 Settlement Planning Approach for Rural Housing
It is important that housing reconstruction is taken with a comprehensive view, including community infrastructure within the settlements such as access to water, sanitation, waste disposal, energy, and others, and efforts should be made to promote planning principles. At the local level, consultative processes with the community should be undertaken to identify the community infrastructure that needs to be built, repaired, improved, augmented, or enhanced.
4.5 Risk Sensitive Planning for Urban Areas
Ministry of Urban Development (MoUD) is conceptualizing the norms and standards for 'safer...”
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“...material needs, it is assumed that the choice of rebuilding will shift slightly away from low strength masonry buildings in favor of cement mortared and reinforced concrete buildings.
Needs for repair and seismic retrofitting of partially damaged buildings are estimated at 40% of cost of a core house, or NPRs. 160,000. (NPRs. 50,000 for repairs and NPRs 110,000 for retrofitting).
Needs for clustering of houses in terms of total households and costs are based on MoUD information and also include infrastructure provision. These may later be vetted through a more specific and rigorous
25...”
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“...the VDCs and Urban Health Centers in the Municipalities for the delivery of health care services. Besides this, more than 350 health facilities nationwide in private sector cater the health care demands of the population. Out of the total public health facilities, 19% and 23% of total health facilities are located respectively in highly and moderately affected districts.
Effect of the earthquake: Health and population has been severely affected as evident from damages and losses to health infrastructure and disruption in essential health care services delivery along with the death of 8,702 persons (45% male and 55% female) and 22,303 injured. A total of 446 public health facilities including administrative building (consisting 5 hospitals, 12 Primary Health Care Centers and 417 Health Posts, 12 others) and 16 private facilities are completely destroyed while a total of 765 health facility or administrative (701 public and 64 private) structures are partially damaged. Nearly 84% (375 out...”
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“...owned service providers. While the value of damages is estimated to be 5.2 billion NPR, the estimate of losses is 1.1 billion NPR. Severely affected 14 districts account for around 88% (including 29% of central hospitals and health infrastructures) of the total value of damage and losses while other districts account for 11.4%. Gorkha, Sidhupalchowk and Dolakha are the hardest hit districts in terms effects of the earthquake sharing 22.4% of damages and losses, after the central level health infrastructure which alone account for 29% of damage and losses.
Table SI: Estimates of damages and losses Amount in million
Estimates of damages Public (NPR) Private (NPR) Total (NPR) Total (US$)
Facilities completely destroyed 3,577 608 4,185 41.8
Facilities partially destroyed 479 243 722 7.2
Equipment and logistics 291 0 291 2.9
Total damages 4,346 851 5,197 5.2
Estimates of losses
Demolition and removal of debris 63 16 79 0.8
Treatment services for injured 393 147 540 5.4
Provision service delivery...”
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“...Intermediate term 1,191 173 1,364 13.6
Medium term 4,994 4,759 9,752 17.5
Total needs 6,270 4,999 11,269 11.3
Implementation strategy: Recovery and reconstruction of the health and population sector will be guided by a Central Coordination Committee for Recovery and Reconstruction led by MoHP and includes members of development partners. Based on the finalized implementation plans, budgets will be allocated to districts considering the identified needs and resource availability. While major infrastructure and equipment and routine drugs and supplies and major human resources will be provided from the center, the remaining activities will be accomplished by the Districts based on a guideline to be developed by the MoHP. Recovery and reconstruction initiatives will be implemented over next years requiring approximately 1.4%, 18.1% and 21.9% of the estimated budget respectively in 2014/15, 2015/16 and 2016/17. Rest of the years will require equal proportion of the budget i.e. 19.5% of estimates...”
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“...earthquake. The trauma protocols facilitated the international and national medical teams to proceed for the treatment of the seriously injured people. Further, the HEOC remained the command centre of the Ministry of Health and Population to manage the health response during the first few weeks of the earthquake. At the district level, District Health Office represented health sector as a member of the District Disaster Response Committee.
Post Disaster Context
The assessment shows that existing infrastructure of 5 hospitals, 12 Primary Health Care Centres (PHCCs), 417 Health Posts (HPs) and 12 other facilities are completely damaged in the public sector by the earthquake while a total of 701 public health facility structures are partially damaged. Similarly, reporting from the private sector shows that 16 health facilities are completely damaged while 64 are partially damaged in the private sector including NGO and community institutions. A total of 8,792 deaths have been reported along with 22...”
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“...and updated the situation for the necessary decision and action such as deployment of medical teams and supply of drugs and other logistics. Pre identified six emergency hubs within Kathmandu valley were activated for medical services to the injured including those referred from other districts. High level committee mobilized teams at the central hubs as well as sent officials to the highly affected districts to ensure proper coordination and support districts in responding immediate needs.
Infrastructure and Assets: Damage status of the public health facilities was reported by the respective District (Public) Health Offices which were validated during the field visit by consulting focal persons of districts and health facilities. In addition to complete damage to 446 district and sub district level public health facilities, major blocks of central and regional hospitals (Maternity Hospital, Bir Hospital and Pokhara Regional Hospital) are also severely damaged causing interruption of health...”
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“...5 6 10 26 348 268 12 10 16 64
Other districts 0 13 2 28 69 330 0 0 0 0
Central and Regional level hospital/ administrative buildings 20 0 0 0 0 0 0 0 0
Total 5 39 12 54 417 598 12 10 16 64
Source: Field assessment for 14 districts and D(P)HO reporting for others.
In addition to public facilities, a total of 16 private health facilities have reported complete damage and 64 have reported partial damage.
Health Service Delivery and Access
Assessment of situation and medical needs: Damage of infrastructure and assets disrupted the delivery of services while the demand for the services increased as many people got injured. A total of IS health workers and volunteers lost their lives and 75 got injured due to the earthquake adding further challenges in health services delivery. Considering the immediate needs of the districts, public health and medical officials of the MoHP were sent to highly affected districts to support the district teams for the resumption of health services delivery.
Co...”
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“...3 0 0 56 324 5.1
Okhaldhunga 86 0 0 1 0 18 105 1.7
Ramechhap 159 8 1 0 2 35 204 3.2
Rasuwa 151 3 3 1 1 33 192 3.0
Sindhuli 174 0 1 0 0 36 212 3.3
Sindhupalcho k 345 10 6 2 2 76 441 7.0
Total of 14 districts 3,004 62 38 12 12 648 3,776 59.6
Other districts 588 6 4 1 1 124 724 11.4
Central hospitals 1,393 155 288 1,836 29.0
Grand Total 5,141 223 41 13 14 1,060 6,337 100
Source: Estimates based on damage and losses.
Disaster Effects and Impact
The human loss, injuries and damage to health infrastructure have resulted in major health impact and many years of life lost. Many of the seriously injured people who have undergone major surgeries like amputation and those having severe spinal injury by the earthquake are at risk of long term disability. Death and rise in disability will have detrimental effect on the people's health causing many years of disability adjusted life years. Further, people are at risk of mental trauma and need immediate psychological counselling and mental health in...”
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“...demolition of remaining damaged buildings, doing major repair works and reinstituting health facilities by setting up pre-fabricated structure are the key functions to be carried out under this strategy during a period of one year. Specifically, 40% of the damaged Health Posts and limited structure for damaged PHCCs and hospitals with be reconstructed by pre-fabricated materials.
Based on the technical assessment of the buildings, reconstruction process will also be initiated for concrete infrastructure. Other activities such as purchase of damaged major equipment, outbreak prevention and response and continuation of service delivery will be carried out in the immediate terms.
While the first and second strategies aim to address the immediate and intermediate needs for the recovery, third strategy (2015/16 to 2019/20) is much concerned on the reconstruction of the sector from the longer terms perspective. In this strategy, detail assessment of the existing networks of health facilities and...”
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“...population might have implication in the number of health facility and their capacity and hence cost estimates.
Implementation Arrangements
Recovery and reconstruction of the health and population sector will be guided by a Joint Coordination Committee for Health Sector Recovery and Reconstruction which is led by the chief of Policy, Planning and International Cooperation Division and include members of development partners. The Committee will oversee the standards and specifications for health infrastructure and will be responsible for the reconstruction plan for damaged health facilities.
After the finalization of the implementation plans, budgets will be allocated to districts considering the identified needs and resource availability. While major equipment and common supplies and major human resources will be provided from the center, the remaining activities will be accomplished by the districts based on a guideline developed by the MoHP. Recovery and reconstruction initiatives will be i...”
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“...on the status of damages and needs as per the provided templates. Collected information and field observations were shared by each of field team on 28th of May.
While the field teams were compiling data from the districts, central team in the meantime started preparing the assessment report based on the analysis of secondary data that were already available. All the data collected from the districts were compiled and analysed to produce the summary tables. Unit costs were defined for the infrastructure and major equipment in consultation with experts of the relevant area which was applied to estimate monetary value of damages and reconstruction.
Overall estimates of the cost consist of the damage of buildings (complete and partial) and damages of equipment and other logistics plus losses incurred as an effect of earthquake in terms of treatment cost and management of health sector response. Costing of the damages has been done in a disaggregated by the level of health facilities (i.e. HP...”
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“...area of that institution. Since catchment area of one institution may overlap with another, this deduction must be done to obtain the actually served population. Served population is calculated using GIS tool.
4. Accessibility: The location of the health facility plays an important role in providing effective health service. Besides, availability of adequate physical infrastructure (building, road network and enabling environment) is also important. Hence, to make decision for upgrading and new construction, criteria such as road network, potential for larger service coverage are taken into account. Such potential institution can serve larger population effectively. For this, prioritization is done based on analysis of availability of roads and their hierarchy (highway, secondary road, graveled road, seasonal road, agriculture road). These information are collected from department of roads and the concerned stakeholders which is mapped in GIS system and used for analysis. Besides, availability...”
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“...stunting and wasting that currently stand at 37.5 and 11.3 percent respectively at the national level. The most recently available pre-earthquake data collated from Multiple Indicator Cluster Survey (MICS) 2014 and Small Area Estimation (SAE) 2014 indicated high child undernutrition rates in the affected districts. Infant and Young Child Feeding (IYCF) practices were also found to be sub-optimal in those districts.
Given its cross cutting nature, the nutrition sector does not have separate infrastructure to operate nutrition programming. Nutrition specific interventions are provided through the health facilities and community based extension services provided by Female Community Health Volunteers (FCHVs). Nutrition sensitive interventions are provided through related sectors such as education, agriculture, and water sanitation and hygiene. Hence, the damage caused by the earthquake to these sectors ultimately impact nutrition also. A post-earthquake assessment found that food consumption...”
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“...nutrition for young children and pregnant and lactating women.
The Government of Nepal (GoN) has developed a Multi-sector Nutrition Plan (MSNP) to address the complex set of determining factors for improving nutritional status of families through a multi-sectoral approach. To support the scaling up essential nutrition specific and sensitive interventions listed in the MSNP; many national programmes and large scale projects are currently being implemented in Nepal.
Post Disaster Context
Regarding infrastructure; the nutrition sector does not have separate facilities to operate nutrition programs. Nutrition specific interventions are provided through the health facilities and community based extension services provided by Female Community Health Volunteers (FCHVs). According to recent records; eight health workers and 10 FCHVs died in the earthquake; 68 health workers and seven FCHVs
62...”
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“...after a shock, women that were in the second and third trimester of pregnancy when the disaster occurred have children that are significantly shorter compared to women that did not experience the shock.12 Furthermore shocks can negatively impact maternal health increasing mortality and low birth weight.13
Assessments by other sectors reported large scale losses of food stocks and agricultural assets, household assets, disruption of water systems and damage to sanitation facilities and health infrastructure. Income that may have typically been designated for purchase of household food may be redirected to materials and labor to rebuild homes, replace lost household items or support extended family. Food related coping strategies, such as reducing the size or number of meals consumed, was reported by more than a third of households in the affected areas (35%). Overall loss of income, from lost assets, savings and reduced opportunities to be paid for daily labor, reduces families' purchasing power...”
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