During times of disaster, hospitals play an integral role within the healthcare system by providing essential care to their communities. Without appropriate planning for disasters, however, health systems can be overwhelmed during a critical event, like an earthquake.
To enhance the readiness of health facilities to cope with the challenges of a disaster, amongst many capacity-building activities, WHO, Country Office for Nepal, has been supporting the Ministry of Health and Population (MoHP) in developing and updating the Hospital Disaster Preparedness and Response Plan (HDRRP) - an integral component of the hospital emergency response checklist, for all the 25 hub (referral) hospitals across the country.
Dr Padam Giri, Hub Focal Person of Province Hospital, Surkhet, shares how the HDPRP has proven crucial in improving hospital response during disasters as evidenced in the aftermath of the earthquake that hit Nepal's Karnali Province last month.
“Although we have prior experiences of dealing with disasters, having the HDPRP has made a noticeable difference in our response to the recent earthquake. It facilitated timely response, smooth communication, and sharing of resources and expertise among hospitals so that the disaster-affected communities benefited at the maximum level," says Dr Giri, who oversaw the treatment of over 40 patients in the first few days of the earthquake.
After a 6.4 magnitude earthquake hit western Nepal on 3 November 2023, Surkhet Province Hospital received over 40 patients for treatment. Photo credit: WHO Nepal
"By the time there was an influx of patients, all the essential medicines had been stockpiled, the treatment areas had been identified, and human resources had been designated," he adds.
The early preparedness helped the hospital to manage the triaging and tagging of patients swiftly. In addition, the Emergency Medical Team, deployed at affected district hospitals right after the earthquake, helped with onsite triage and prioritized the transfer of the patients accordingly. Patients who needed immediate treatment and care were referred to the hub hospitals, and cases with minor injuries were managed locally. This resulted in a reduced caseload in the hub hospitals and optimized quality care.
Dr Padam Giri and the team at Surkhet Province Hospital treating a patient who sustained injuries in the earthquake. Photo credit: WHO Nepal
As part of the efforts to strengthen emergency preparedness and response, WHO supported the MoHP to train over 400 hospital personnel (medical superintendents, emergency in-charge, nursing in-charge, doctors, nurses stationed in emergency wards, administration staff, and store staff) on Hospital Disaster Preparedness and Response Plan Development last year.
Participants were trained to devise disaster plans; implement the Hospital Incident Command System; identify roles and workspace; designate routes; triage; and manage public relations. They were also trained to manage surge capacity, set up satellite-hub-Health Emergency Operation Center (HEOC) communication mechanism, develop an early deployment plan, and determine hospital capacity to optimize patient care and save as many lives as possible during emergencies.
Similarly, WHO has supported the MoHP in capacity building of health care workers through Hospital Preparedness for Emergencies (HOPE) training, strengthening hub and satellite hospital networks coordination, prepositioning of emergency medical logistics at strategic locations for timely response, and deployment of Emergency Medical Teams.
A separate treatment area was designated for the earthquake survivors at Surkhet Province Hospital after triaging and tagging of the patients. Photo credit: WHO Nepal
Following the trainings, the 25 designated hub hospitals have been working with WHO and MoHP to regularly update their individual HDPRPs, taking into consideration the findings and recommendations from the assessment conducted to study the hospitals' capacity to respond to potential disasters. The hospitals are now equipped with triage for disaster management and plan for effective, efficient, and coordinated response.
Starting early next year, MoHP plans to devise a uniform HDPRP in all satellite/district-level hospitals and continue the strengthening of hospital preparedness and response. WHO, Country Office for Nepal, is committed to support the MoHP to conduct similar workshops and capacitate the hospitals to draft plans, implement, and update them whenever required.
“As a country vulnerable to disasters, Nepal has implemented various programs to mitigate, prepare, respond, and recover from disastrous events. Hospital Disaster Preparedness and Response Plan is one of the key interventions to strengthen communication, coordination, and deployment of resources in the time of disasters. WHO will continue to provide support to revise plans, update inventories, organize coordination meetings, and accelerate the capacity building of the healthcare workers on disaster management," says Dr Rajesh Sambhajirao Pandav, WHO Representative to Nepal.
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