The Consequences of Survival

An AmeriCares team arrived in Kathmandu, Nepal, just 48 hours after the April 25 earthquake. AmeriCares teams have been holding mobile health clinics for survivors and traveling to rural areas with stocks of medicine and supplies, to treat survivors and assess needs at hospitals and clinics.

On Day 5 after the earthquake, patients were still sleeping in the waiting room of the hospital –afraid to sleep in the wards, in case they couldn’t escape in time if there was another earthquake. As the aftershocks continue, the impact of the earthquake is not just the people killed or injured or the buildings damaged but the psychological trauma of what has happened and the fear of what is still to come. Many buildings were completely destroyed but many, many more have been partially damaged. Some of those structures that were partially damaged are still being used. Even our hotel had cracks in the wall and floor. With each aftershock, we would check to see if the cracks were wider.

The first earthquakes and most of the more severe aftershocks have happened during the day, not at night. During the day, at least those who are mobile can scurry outside into the sunshine. It is harder for those who are in a hospital or disabled to leave in time. “Everyone” predicts that the fault lines in the area haven’t yet stabilized. I don’t know if it is true, but in terms of the emotional impact of the aftershocks, it is immaterial whether geologists predict another big one. The belief that there is more to come is resurrected and reinforced with every big aftershock. The little ones occur every day, but the bigger ones come just infrequently enough that people begin to feel comfortable again, thinking that they are safe, and then a larger aftershock shatters their sense of safety, toppling walls or a building or two, killing a few more people.

Those with limited mobility worry day and night whether they can get out in time. Tents and tarps are not really home, but they feel safer. For the mobile person the worry is that if the next big quake hits at night instead of during the day, many would die before they could get out, especially from already damaged buildings. The constant anxiety and fear, which seems just below the surface, is justifiable, and it does not go away. For those who survive, this fear leaves deep psychological wounds that will be slow to heal. And they will need help.