Post-earthquake Nepal: Acute-on-chronic problems.
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Date
2016-01
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Abstract
POST-EARTHQUAKE NEPAL: ACUTE-ON-CHRONIC
PROBLEMS
It has been over 8 months since the 7.8-magnitude earthquake
devastated Nepal, resulting in almost 9000 deaths, over 23 000
injured and over 2 million displaced people. With the breakdown
in sanitation post-earthquake, the summer and the monsoon rains
could potentially have unleashed many infectious diseases in this
hilly terrain.
Fortunately, Nepal has so far not witnessed any widespread
outbreak of disease and active surveillance for diseases is going
to be critical. The winter months faced the problems of countering
cold and hypothermia especially in the far-flung high altitude
earthquake-ravaged villages. But thousands of orthopaedic injuries
brought on by the earthquake were a good example of acute-onchronic
health problems in Nepal.
Rampant infectious diseases which pre-date the earthquake
such as tuberculosis, typhoid, typhus, brucellosis, etc. make
Nepal a place for helping and studying people with these ailments.
Widespread non-communicable diseases such as diabetes,
myocardial infarction and renal failure are vying with infectious
diseases to cause untold harm and suffering. With focus on the
acute health problems caused by the earthquake, many chronic
health issues are generally neglected.
The earthquake attracted worldwide attention to Nepal and
over US$ 4 billion has been pledged to help Nepal ‘build back
better’. These funds should help the government in implementing
universal health coverage in keeping with the UN’s emerging
Sustainable Development Goals, so that patients can deal with the
acute problems along with chronic diseases.
One of the biggest health problems in Nepal is in dealing with
catastrophic illnesses (defined as severe illnesses requiring
prolonged hospitalization and recovery) since there is hardly any
provision of health insurance. This problem has been exacerbated
by heart-wrenching poverty induced by the earthquake.
I relate below the story of a patient in our hospital who had a
successful outcome despite a devastating illness. Unfortunately,
most patients with such illnesses are not so lucky in our part of the
world.
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Basnyat Buddha. Post-earthquake Nepal: Acute-on-chronic problems. National Medical Journal of India. 2016 Jan-Feb; 29(1): 27.