Disability in Disaster

Project Details

Coordination of care after rapid-onset disaster: Transition to rehabilitation after injuries in Nepal’s mega-earthquakes.

Nossal Institute is building evidence and capacity to support disability inclusion and rehabilitation planning in emergency responses.

August 2016

Up to 20,000 people experienced injuries in the April and May 2015 earthquakes in the Kathmandu valley of Nepal. Up to 12,000 people will require long-term care, including rehabilitation. 

Rehabilitation can help restore lost function and minimise long-term disability and health problems. For people with new disabilities, rehabilitation can often be a catalyst to accessing support services and can help people access their right to full and equal inclusion in society. 

A boy recovered from rubble after the earthquake gets acute medical care on the floor of a teaching hospital

In settings where health care in general and rehabilitation in particular are limited, there is currently limited evidence about long-term rehabilitation needs, and how best to provide them after large-scale disasters.

After the 2015 earthquakes, a number of international agencies sought to provide quality, coordinated care for newly injured people. These agencies were coordinated through a rehabilitation sub-cluster within the UN health cluster.

It can be challenging to define and measure the timeliness of services, and to understand why there might be delays and barriers. There are no agreed measures of coordination of care, and solutions used in high-income settings do not translate well to low and middle income settings or disaster responses.

To address these challenges, Nossal Institute will work with Handicap International Nepal and the Disability and Rehabilitation Focal Unit at the Ministry of Health and Population of Nepal to review coordination of care in the year since the earthquakes. A cross sectional retrospective survey will provide evidence, which will contribute to future plans for rehabilitation, support current policy reform in rehabilitation management in rapid onset disasters, and provide useful methodological information that will improve future research in this field.  

This research is important because rehabilitation is increasingly recognised as being a crucial part of the large-scale response after emergencies to ensure people are afforded the best opportunity for recovery, delay progression of disabilities, and transition to long-term services. Rehabilitation is now recognised in the World Health Organization minimum standards for Foreign Medical Teams: this implies evidence-based policy will be required to inform the development of rehabilitation care.

An elderly women waits on the side of the road

This research will help understand pathways of acute and long-term health care after large-scale disaster, and determine correlates of disability in newly injured people. The survey will use a Washington Group question set understand disabling consequences of injuries, and a recalled-history of care-pathway to understand transitions between acute and chronic services, as well as barriers and facilitators.

At the conclusion of data collection in the disability survey, Nossal Institute will present the data in practical ways to Nepali and International stakeholders, who will use data to inform better preparedness strategies and response protocols for future emergencies.


Wesley Pryor

Matthew Reeve


Ministry of Health, Nepal 

Handicap International Federation

Research Group

Disability Inclusion for Health and Development

School Research Themes

Disparities, disadvantage and effective health care

Key Contact

For further information about this research, please contact the research group leader.

Department / Centre

Nossal Institute for Global Health

Unit / Centre

Disability Inclusion for Health and Development