Skip to main content

From remote Nepal, a warning against ahistorical disaster relief

Nepal Earthquake
APTOPIX Nepal Earthquake

April 29, 2015

UW Nepal Studies Initiative co-director David Citrin is in Nepal right now. He recently compiled his thoughts in the immediate aftermath for a thoughtful article for Humanosphere and includes in it advice for supporting Nepal’s recovery:

The question at hand now is what to do, and what not do. Here, I humbly offer some guiding principles, and compile my and others’ thoughts on ways to channel efforts and resources:

  1. Coordination. The deluge of international aid and relief efforts already underway in Nepal are rooted in global citizenry, in personal connections to Nepal, in love and in sadness. This challenge of coordination will be nearly as herculean as the heroic relief efforts to rescue those still trapped under rubble, and to treat the 10,000+ injured. Nepal is a country already brimming with NGOs; some put the actual figure at around40,000, constituting what the late Nepali anthropologist Saubhagya Shah referred to as a veritable “NGOdom.” The efforts of international relief organizations and NGOs will need to be systematically coordinated: we must act with conviction, but we must act together, lest we run the risk of tectonically colliding with one another, collapsing the potential multiplicative effect of our efforts.
  1. Transparency. We must heed the lessons learned from the 2010 earthquake that devastated Port Au Prince, where only 1% of the 3.6 billion dollars that went to Haiti through international donors for immediate disaster relief and recovery went to the government. Online one can already see the pleas to avoid giving money to the Nepali government for fear of corruption and misuse. We must reject these claims; this is a matter of autonomy and governance. Ultimately it will be the Nepali government charged with rebuilding a home for its people. Please make sure to coordinate efforts with Nepal’s National Emergency Operation Centre, and find transparent organizations that have deep connections to the country and/or specialize in effective disaster relief management. Working with engineers from Google, the American Nepal Medical Foundation is operating a real time needs assessment to coordinate efficient supply chain management with hospitals and care teams to treat trauma victims. The international organization Médicins San Frontièrs is another reputable organization with personnel currently on the ground, as is the Red Cross. But, don’t simply go with the big names out there, it is most important that you find an organization you, or someone you know with a deep understanding of Nepal, can trust.
  1. Avoid medical voluntourism. All non-Nepali medical practitioners going to Nepal to engage in direct service delivery are obligated to register with the Nepal Medical Council. This regulation rightly remains in place even in the face of such a tragedy when medical skillsets and supplies are so widely and immediately needed. Reports from colleagues working closely with the government on response efforts confirm that there are ample Nepali medical professionals to deploy, though, again, the challenge remains in coordination. If you are a non-Nepali credentialed professionals (no students, please!) going to Nepal, remember that this is not about you or your feelings of guilt or competency. Remember to ‘first do no harm.’ Defer to local Nepali medical professionals about how you can best support their existing efforts. Match specializations with need. Consider staying home and sending the money you would have spent on a flight to support the efforts. As Dr. Stephen Bezruchka reminds us, “Don’t just do something, stand there’ — unless it is obvious that doing something will help.”
  1. Reach the rural poor. The loss of historical monuments and UNESCO world heritage sites are immeasurable. Still, reports of villages outside the Kathmandu Valley remind us that the true loss of livelihood will most certainly be concentrated in rural parts of the country. In the words of Sienna Craig, “True to the logic of structural violence, women, children, and those at the bottom of Nepal’s socioeconomic and caste hierarchies will be severely impacted. ”We must focus on ensuring essential material resources—food, medicines, water and shelter—reach the rural poor. The ethnically Tibetan community of Bridim in Rasuwa district north of Kathmandu where, in 2001, I spent a week during my first trip to Nepal is reported to have been “virtually flattened.” Our relief efforts must extend to these areas if they are to roll back up steep gradients of inequality; this challenge will be monumental.
  1. Build back better. Nepal only seems to make the international headlines when there is a royal massacre, a Maoist war, an avalanche on Everest, or a devastating earthquake. As a global collective consciousness, we have a rather short attention span, and as the headlines fade from the newspaper in the coming weeks, so will the immediacy of crisis. The real challenge now lies in rebuilding Nepal’s roads and infrastructure, which some estimate might cost up to around $USD 10 billion, or approximately 20% of the country’s GDP. My own government, the United States, should be ashamed of the pittance $1mm donated to Nepal. We must ensure that, alongside the pressing need to solve for people suffering right now, we also commence the work of addressing the longstanding unmet basic material and nonmaterial needs of Nepali people. We can do this by working alongside the Government of Nepal to build structures and systems that will not collapse. In this there is hope, and renewal.

Read the entire article here