Rehabilitation following natural disasters: Three important lessons from the 2015 earthquake in Nepal

On April 25, 2015, a 7.8 magnitude earthquake occurred in Nepal; then on the afternoon of May 12, 2015, the small Himalayan nation experienced a second 7.3 magnitude earthquake. As of the writing of this commentary, the estimate of casualties has surpassed 8,500 making it the deadliest natural disaster in Nepal over the past 80 years. Technological advances in emergency medicine and emergency preparedness have increased the likelihood of surviving a disaster. The result, however, is that populations often survive with complex disabilities that the health infrastructure struggles to accommodate in the early postdisaster period. Nepal had a relatively poor infrastructure for people with disabilities before the earthquake, and the health system will now will be challenged to meet their needs into the future. In this commentary, we argue that there were at least three main lessons learned for the rehabilitation sector following the 2015 earthquake. First, rehabilitation can facilitate earlier discharge from hospitals thereby improving the overall institutional capacity to treat a higher number of patients; second, rehabilitation can prevent secondary musculoskeletal, integumentary and pulmonary complications; and third, rehabilitation improves function so that individuals can have better access to other essential post-disaster services. While rehabilitation may not directly save ‘lives’ following a natural disaster such as an earthquake, it does save ‘life’ among the survivors. In our opinion, and given what we have learned regarding the role of rehabilitation in Nepal and other disasters, we argue that it is unethical and immoral not to integrate rehabilitation into disaster response.