By Shairose Mawji and Toya Subedi
KATHMANDU, Nepal - On 11 November 2017, UNICEF Nepal handed over a disaster-resilient prefabricated health facility to the local government in Barpak of Gorkha District – the epicentre of the 2015 Nepal earthquake. The health facility, fully equipped with essential equipment and furniture, will provide primary health care services to the residents of Barpak and the neighboring communities. Services provided include general outpatient care, a birthing centre as well as other maternal and child health care related services.
This facility is one of 74 prefabricated health structures that UNICEF is building in nine earthquake-affected districts. The new health centres signify UNICEF’s efforts to ‘build back better’ after the devastation caused by the earthquakes. “The prefabricated structures which are more resilient to withstand severe weather conditions like strong winds, fire and earthquake, can thus become a safe place for community members to heal, to rest and to meet” said Mr Philippe Cori, UNICEF’s Deputy Regional Director for South Asia, during his inaugural remarks in Barpak. In earthquake, close to 1,200 health facilities and over 22,400 school classrooms were destroyed while over 32,900 classrooms were partially damaged. The total economic loss from the earthquakes was estimated at US$7.06 billion.
In addition to the health facilities, the ‘build back better’ concept has been incorporated in other areas including education, water and sanitation, nutrition, child protection and social protection.
UNICEF approach to the 2015 Nepal earthquakes
UNICEF stepped into gear right from day one of the earthquake with its emergency response to address the lifesaving needs of women and children. Staff were quickly deployed to the affected districts. Prepositioned supplies proved a life-saving bridge before additional supplies arrived. The quick start was key to addressing the immediate and most pressing priorities of the communities. Some of the immediate response measures undertaken by UNICEF included airing of key information and preventative messages through radio; provision of clean water to camps and communities; setting up tents to initiate the treatment of the injured; screening children for acute malnutrition and establishing outpatient treatment centres for those identified as malnourished; establishing temporary learning centres to provide children with safe learning spaces and creating child friendly-spaces for children as well as providing them with psychosocial counselling.
A top-up cash grant to an already existing government social protection scheme was an innovation which reached over 434,000 vulnerable adults and children during this initial period. In addition, UNICEF reached more than 500,000 children through a multi-sectoral approach across its various sectors during the response period.
Successful fundraising was key to have achieved the results during response and recovery period. This success was a result of aggressive, proactive and purposive multimedia documentation of response activities which helped the office to raise one third of the total appeal in the first month alone. Aside from this, responding to media requests for interviews and having visibility materials readily available also helped in the office’ fundraising efforts. By the third month mark, 60 per cent of the HAC appeal had been funded.
Moving on to the recovery period, UNICEF initiated construction of semi-permanent health facilities, 74 of them in total, and provided disaster-resilient cold chain equipment to health facilities and hospitals in 22 districts. UNICEF also constructed 650 semi-permanent two-room classrooms in damaged schools and is continuing to build another 250 more classrooms. It distributed education and recreation materials for these semi-permanent classrooms and provided training on disaster risk reduction and school safety to the teachers and school management committees.
For a resource-limited country like Nepal, which is prone to disasters, semi-permanent structures for health facilities and school classrooms can be most appropriate economic alternative for an interim period whilst also ensuring that preparedness at the facility, community and household level takes place.
Other achievements during the recovery period included repairing and reconstructing 148 community water schemes as well as 243 water schemes in schools and health facilities. UNICEF also supported sanitation and hygiene promotion activities; enhanced nutrition interventions at the health facilities while promoting exclusive breastfeeding, complementary feeding, micronutrients supplementation; and initiated supplementary and therapeutic feeding where more than 5,700 children were treated for severe acute malnutrion. The child protection system was enhanced by establishing a case management system, strengthening of the anti-trafficking measures and provision of a cash grant to under-five children as part of the efforts to build a universal programme that can be scaled up nationwide.
All of these measures undertaken provided a way for communities to recover from the earthquake and better prepare them to withstand future shocks.
The experiences from the 2015 Nepal earthquake reinforced the importance of ‘building back better’. As UNICEF completes most its work in the earthquake-affected districts by December 2017, lessons learned during this time underpin the work on building resilience and are being documented in the form of standard operating procedures. This will not only help Nepal Country Office in responding to future disasters but will also act as a guide to other country offices.
 Gorkha Earthquake: Experiences and Learning, MoHA 2073
 Post Disaster Needs Assessment report 2015
 Emergency top up cash was provided to the elderly, widows, Dalit children, people with disability and marginalized ethnic groups, based on the registry of existing Government social protection schemes.