A family living in Ratna Park in Katmandu, Nepal. © IOM/Matt Graydon 2015
By Maurizio Busatti
Nepal is a country on the move. Since Saturday, when the 7.8 magnitude quake rocked the Himalayan nation, people have been moving – to avoid aftershocks, to find a new place to live, or to find their loved ones.
This prompts major concerns for the immediate future of the country. Yes, we may still be a the emergency stage, and it is even possible that survivors may still be found, but the international community must already take an urgent look at how the exodus from Kathmandu, or the flight from damaged villages, will shape Nepal in the months and years to come.
Kathmandu is a city of migrants. It draws in workers from distant regions, escaping the poverty of rural Nepal. Now those people are headed back to their home towns and villages in huge numbers, in search of safety and their loved ones. They are streaming back to poverty-stricken regions, where the damage caused by last week’s earthquake is still unknown.
It is thought that 100,000 people have already left the capital Kathmandu: some estimates say 300,000 could leave. This is expected – people do leave their homes when there seems to be no other choice. Sometimes families are split apart, with young males staying to guard property. Either way, the population dynamics are thrown out of whack.
We have seen this before in significant disasters across the globe - most recently after the Philippines super-typhoon of 2013. In response, IOM moved quickly to establish Migrant Outflow Desks at key transport points.
By keeping track of movements we are able to provide analytical information on who is going where, as well as providing critical support to unaccompanied minors, ethnic minorities, the marginalized and other vulnerable groups. We are also able to decrease the likelihood of human trafficking, which – tragically – always rises in the wake of humanitarian disasters.
Early data from IOM assessments confirms large population movements. Where are these people going? Have they lost their homes? What about those with no land tenure? Will they be able to come back? What strain will their arrival put on the communities to which they return?
We don’t have the answers yet, but we must urgently ask those questions and more, and seek durable solutions.
Another group that we are extremely concerned about is the injured and all those that have sought hospital services. The most conservative estimates show over 10,000 people were injured – the real figure will be much, much higher. Hospitals are overwhelmed and under pressure to discharge patients to reduce the overflow. Over the past four days, 200 patients with severe injuries have been discharged from just three hospitals alone – 30 per cent of these had spinal injuries.
Where they are going and what follow up they are getting, particularly those with surgical wounds and rehabilitation needs, is a major unknown and a huge risk of lifelong disability or worse. IOM has experience establishing assisted discharge and referral programs that ensure that vulnerable patients are discharged in a safe and dignified manner and followed up throughout their rehabilitation.
Maurizio Busatti is IOM Chief of Mission in Nepal