When disasters and emergencies strike, hospitals become critical points of care. Effective coordination among health workers, facilities and different levels of government, along with clear referral pathways, reliable communication and resilient infrastructure is essential to ensure patients receive timely, life-saving care and to reduce preventable deaths and disabilities.
In Nepal, the importance of preparedness was clearly demonstrated in two very different but equally challenging scenarios in recent years: the 2023 Jajarkot earthquake and the recent youth public demonstration. Together, the health response to these events showed how advance planning and trained health workers can transform chaos into coordinated action.
Following the devastating Jajarkot earthquake, hospitals faced an unprecedented surge of patients amid damaged infrastructure, disrupted transport and limited resources. Facilities equipped with Hospital Disaster Preparedness and Response Plans (HDPRP) and trained staff were able to respond more effectively, rapidly triaging patients, following established treatment and referral protocols, and coordinating with internal teams and external partners.
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Dr Padam Giri, an orthopedic surgeon and Disaster Focal Person at Province Hospital, Surkhet, examining a patient admitted to the hospital. Photo credit: WHO Nepal
Dr Padam Giri, an orthopedic surgeon and disaster focal person, at Province Hospital in Surkhet, which treated the majority of the earthquake victims, recalls the impact of having structured plans in place. “Having well-trained teams and clear plans enabled us to effectively triage victims, deploy human resources efficiently and ultimately save the lives of more than 50 critically injured patients through timely care,” he says. Dr Giri credits the wide scope of trainings that he and his team had received through a project supported by WHO and the European Commission, for the hospital’s strong response. These trainings, he says, not only strengthened the hospital’s emergency response capacity but also built confidence in managing future crises.
Preparedness proved just as critical during the recent youth public demonstration movement. According to Suchana Sapkota, senior nursing administrator at the National Trauma Center, the hospital initially anticipated to manage mostly minor injuries, as seen during previous protests. However, the situation quickly turned overwhelming, she notes. Because disaster response plans were activated and staff had been trained through the Hospital Preparedness for Emergencies (HOPE) programme, the hospital responded swiftly: routine services were halted, critical cases were prioritized and minor injuries were treated separately.
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Ms Suchana Sapkota (right), Senior Nursing Administrator at the National Trauma Center, monitoring and supervising health workers of Emergency Department as part of a routine readiness assessment. Photo credit: WHO Nepal
“Preparedness turned a potentially chaotic situation into an organized, life-saving response,” Sapkota says, emphasizing that prior planning and clear designation of roles were key to saving lives and preventing long-term disabilities.
Building on lessons from past disasters and public health emergencies, the Ministry of Health and Population (MoHP), in collaboration with WHO Nepal and with financial support from the European Commission, has led efforts to strengthen hospital preparedness coordination nationwide since 2020. Central to this work are the development and regular updating of HDPRPs, the delivery of HOPE trainings programmes, and tabletop exercises and drills.
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Participants and facilitators actively collaborating on the development of hospital-specific disaster preparedness and response plans during training programmes conducted in Lumbini, Sudurpaschim and Karnali provinces in 2024. Photo credit: WHO Nepal
Supported by WHO, the MoHP has developed/updated HDPRPs for 25 hub hospitals in 2022 and 44 satellite hospitals in Sudurpashchim, Karnali and Lumbini provinces during 2024-2025. WHO also provided support to an additional 53 hub and satellite hospitals in the remaining four provinces for HDPRP development with assistance from other partners. Altogether, 122 hospitals now have HDPRPs, including disaster, surge and epidemic emergency unit plans tailored to different risk scenarios. These activities align with the National Disaster Risk Reduction and Management Act and the Nepal Health Sector Strategic Plan (2023–2030), which mandate all hospitals to develop Hospital Disaster Preparedness and Response Plans (HDRP) aligned with national, provincial and local frameworks.
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Hospital Preparedness for Emergencies (HOPE) training conducted in Nagarkot, Bagmati Province, in September 2025, featuring live actors simulating real-life emergency scenarios to enable participants to practice rapid decision-making and response. Photo credit: WHO Nepal/Sujan Govinda Amatya
To translate planning into practice, WHO supported the MoHP to conduct three tabletop exercises and three drills with 21 hospitals across the three provinces. These exercises tested responses to mass casualty incidents, hospital evacuations and disease outbreaks, highlighting how gaps in communication or unclear roles can affect the entire response system. Similarly, more than 400 health workers and decision-makers have been trained through HOPE trainings conducted between 2022 and 2025. Together, these initiatives demonstrate that effective emergency response depends on strong coordination across hospitals, provincial authorities and national leadership.
As Dr Allison Gocotano, Acting WHO Representative to Nepal and the team lead for the WHO Health Emergencies Programme in Nepal, says: “Emergencies remind us that preparedness is a shared responsibility. Through collective action, sustained investment and strong partnerships, this government-led initiative, supported by WHO and the European Commission, is ensuring that when disasters strike, health workers and hospital officials are fully equipped, aligned and ready to act swiftly to protect lives."