4 Building resilience: lessons from public-private collaboration in rehabilitation of earthquake-injured persons in Nepal

<h3>Background</h3> Nepal experienced a devastating earthquake in April 2015. The disaster resulted in a staggering number of deaths, injuries and disabilities. There was an exponential rise in the demand of injury management and rehabilitation, overwhelming the healthcare system. <h3>Objective</h3> To improve the mobility and functional independence of persons who sustained injuries during the 2015 earthquake through a sustainable, integrated, public-private rehabilitation system. <h3>Programme Description</h3> The Ministry of Health and Population (MoHP) established a National Emergency Health Operations Center (NEHOC). NEHOC served as the central hub for information dissemination, resource mobilization, and coordination of health services. MoHP operated field hospitals and medical camps in the affected districts. These temporary healthcare facilities provided essential services, including emergency medical care, surgical interventions, and post-operative management. They were staffed by healthcare professionals from both public and private sectors, working collaboratively to deliver healthcare services to the injured individuals. Additionally, rehabilitation centers were established to provide comprehensive care, including physiotherapy, occupational therapy, and prosthetic services to earthquake-injured individuals. Under the health cluster, injury rehabilitation sub-cluster was formed, led by Leprosy Control and Disability Management Section. The section conducted training of physiotherapists and female community health volunteers on trauma management and supported prosthetic and orthotic consumables in the earthquake affected districts. <h3>Outcomes and Learnings</h3> The strengthened collaboration among various stakeholders improved access to injury management services and timely emergency response at the time of disaster. Municipalities are now including rehabilitation activities in their annual work plan, integrating rehabilitation services into the public health system. The government, in collaboration with NGOs and international partners, should provide sustainable support for the injured population. <h3>Implications</h3> Nepalese health system implemented several strategies to provide medical assistance and support to the earthquake injured individuals The success of the public-private collaboration in Nepal serves as a model for future disaster response efforts in other countries prone to seismic activities. <h3>Conclusions</h3> The response to the earthquake-injured people in Nepal showcased the resilience and adaptability of the Nepalese health system. Through effective public-private collaboration, Nepal was able to address the immediate medical needs alongside prioritizing rehabilitation and long-term care of the earthquake-injured individuals.