The Nepal earthquake of April 2015 shook the country on several occasions up to a magnitude of 7.8. It claimed the lives of almost 9,000 people and caused huge damage to public and private property. The Government of Nepal listed 14 districts as severely damaged by the earthquake; Bhaktapur district, one of three districts of Kathmandu Valley, was among them. Despite being a district in the capital city, people had to wait several days to get access to basic relief materials. This innovation was carried out in Bhaktapur for two reasons:
The weakness of the response during the rescue and relief distribution periods proved that Nepal was poorly prepared for such a disaster, despite the regular warnings that Nepal is prone to devastating earthquakes.
Mental health and psychosocial support for the people who experienced the disaster was initially overshadowed by the dire need for basic material and medical support. KOSHISH, which means “making effort“ in the local Nepali language, in coordination and collaboration with governmental agencies and other humanitarian organizations, was able to initiate such support, making people realize the value of mental health and psychosocial support in the post disaster period. KOSHISH's presence in the community helped people to have access to Psychological First Aid (PFA), counseling, medication and more specialist psychiatric care, which helped people to manage their problems, including those who already had mental illness.
Psychologist and community care
The overall catchment area was divided into four different clusters, based on availability of government health facilities. Each cluster was headed by a psychologist, and each psychologist was mentored by a senior psychologist from the KOSHISH Centre. In the community, one trained counselor and one social worker were mobilized in each cluster. The counselors and social workers were primarily responsible for conducting PFA, carrying out door-to-door visits, providing follow-up, and conduct psychoeducation in the community, and they referred cases requiring a psychologist to the senior psychologist or psychologists for appropriate intervention. For the support that was beyond that which could be offered by KOSHISH staff, a system was in place for referral to the right organizations.
Self help groups
Self help groups were established and were proactive in the community, playing a crucial role to promote awareness in the community, including by highlighting facilitators’ own issues. Many of them had their own story related to the earthquake; some of them lost family members, some had their house and other property damaged severely. By sharing their experiences, they were able to make the community realise that recovery is possible.