Building Earthquake Resistant Healthcare Systems in Nepal


The earthquakes that have struck Nepal since the first 7.8 quake on April 25th represent the greatest natural disasters to befall Nepal in modern history.

The earthquakes have killed more than 8,500 people, injured 103,000, and left an estimated 2.8 million people in need of humanitarian assistance. Over 1,100 healthcare facilities have been damaged.

A woman points towards cracks on the wall of the Bir Hospital that appeared after the April 15th earthquake in Kathmandu, Nepal. Image: AP,

The Urgent Need

They have left the country in a scenario we call “acute on chronic,” meaning an acute emergency has been layered on top of a chronic one.

Nepal already had a weak healthcare system before the earthquakes. Now, there are over 1,100 healthcare facilities damaged or destroyed and an increased burden of disease and disability.

The Falling Down of Things, The Building Up of Things

To respond to this crisis, we are expanding our work in Nepal and rebuilding the healthcare system in one of the worst-hit districts.

We built our existing healthcare model in a region of Nepal that had been devastated by a civil war and lacked a single healthcare provider for over 250,000 people. Our seven years of experience building a healthcare system from the bottom up in that region is very similar to the challenges faced in the districts most directly impacted by the earthquakes.

We know what it takes to build a system from the bottom-up, where there is damaged infrastructure and a shortage of human capital.

We also know how to build with earthquake-resistant design:

Our hospital expansion in rural Nepal is already being built with the resilience to resist any future natural disaster.

How are our buildings
earthquake-resistant?

  • We are using stabilized rammed earth walls, which are reinforced vertically and horizontally. The stabilizer will provide better mix with higher capacity, and the reinforcement will keep the wall in shape in the event another earthquake takes place.
  • We are using ring beams on the top and bottom of every wall. Having concrete beams at the seismic bandwidth, such as at the roof level and the base level, allows the building to resist the loading created during the earthquake.
Plans from Sharon Davis Design, which shows details for foundation, concrete grade beams, and walls
  • The wall and the ring beam sits on cement mortared rubble foundation, which is about a meter deep. We’ve also added dowels from the foundation into the wall, which will help anchor the structure to the foundation during the earthquake.
  • Finally, the roof of the building is steel deck supported on steel beams, which is a light structural system. Having light structure for the roof lessons the force created due to the acceleration during the earthquake, thus the overall impact on the building will be less severe.

Building Back Differently

Now is the time to build the kind of healthcare system that can serve the poorest and be resilient in the face of future natural disasters.

We are working closely with our partners in Nepal to rebuild the healthcare system comprehensively through our durable healthcare model. We will work with the Nepali government to ensure damaged hospitals and clinics get rebuilt with earthquake-resistant design, and then we will manage the healthcare system in that region across hospitals, clinics, and community health workers.

Rebuild With Us

The road ahead for Nepal is uncertain. But the need is not.

Never before has it been so vital to prove it’s possible to build back the healthcare system differently. Support Nepal today by donating to Possible’s Rebuilding Fund.

All money raised will go towards rebuilding the healthcare system in one of Nepal’s worst hit districts.

Learn more about our rebuilding plans

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