Community Health Workers in the 2015 Earthquake in Nepal
On April 25, 2015, Nepal experienced a major earthquake and ensuing aftershocks that killed nearly 9,000 people, injured greater than 22,000 others, and partially or fully destroyed more than one million homes.
After the earthquake, FCHVs were able to provide assistance for many of the new problems in the community, mostly without formal instruction from their supervisors. The major issues that arose pertained to shelter, water, food, latrines, and illness, including mental health and pediatric concerns.

After the 2015 earthquake, FCHVs continued their regular duties and started assessing for malnourishment by measuring the mid-upper arm circumference (MUAC) of children ages six months to five years.

Without instruction, FCHVs provided basic first aid, assisted with transport of the severely wounded, participated in search and rescue of people who were trapped, suggested proper management of human and animal corpses, helped distribute and ration available food, aided construction of temporary shelters, and salvaged useful materials from partially-collapsed houses. Perhaps most importantly, they took it upon themselves to share messages of psychological support, telling mothers and children to remain calm and reassuring them that they were safe
  • New roles
  • Expanded roles
  • Community Health Workers
With over 1.3 million community health workers (CHWs) globally, this cadre is an untapped resource that may be able to contribute considerably to disaster risk reduction, preparedness, and response.

In Nepal, the CHW role is filled by approximately 50,0000 female community health volunteers (FCHVs) under the direction of the Ministry of Health and Population (Kathmandu, Nepal), supervised monthly by medical professionals at the local
government level

The FCHVs, like most CHWs worldwide, are trained to assist households with family planning services, track immunizations, and treat respiratory infections and diarrhea, in addition to providing education on newborn care, nutrition, proper hygiene, and safer motherhood
  • Community Health Services
  • Remote
FCHV training programs are largely focused on maternal and child health and do not include sessions on disaster management
Research Intervention - outcome data available
Fredricks, K., Dinh, H., Kusi, M., Yogal, C., Karmacharya, B. M., Burke, T. F., & Nelson, B. D. (2017). Community Health Workers and Disasters: Lessons Learned from the 2015 Earthquake in Nepal. Prehospital and disaster medicine, 32(6), 604–609.
Karla Fredricks, MD, MPH
Massachusetts General Hospital
Published Literature

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