When those who care also need support: health workers after Nepal’s floods

Following the devastating floods in Nepal, health workers have continued serving their communities despite facing personal loss, displacement and uncertainty.

However, prolonged pressure and long work hours without adequate support can harm their mental health and psychosocial well-being, affecting their ability to deliver essential healthcare.

To address this, the Government of Nepal, with support from WHO and partners, has been providing mental health and psychosocial support (MHPSS) services in flood-affected areas.

Below, health workers in Nuwakot share their experiences, highlighting why mental health and psychosocial support (MHPSS) is important for those on the front lines as well.

Charu Thapa Magar

Charu Thapa Magar, a hospital nurse inspector, exits the operating theatre at Trishuli Hospital, Nuwakot. Photo credit: WHO Nepal/Sulav Shrestha

A hospital nurse inspector at Trishuli Hospital, Charu Thapa Magar, was attending a meeting when phones started ringing and an alarm sounded: the Trishuli River had flooded.

Her training immediately kicked in. As the person in charge of the operating theatre, a designated red zone during emergencies, she knew the hospital would soon receive critically injured patients. Having served in previous disasters, she began preparing for what lay ahead.

But nothing prepared her for what came next. “The survivors arrived in such a condition after being swept away by the flood that it was difficult to recognize their faces. My own neighbour was brought in that state,” she recalls.

Among those affected was a junior colleague she worked with, who disappeared in the flood and remains missing. At the same time, Magar’s own home and neighbourhood were swept away. “When I watched videos of the flood, I could make out some of my neighbours’ houses, but mine was nowhere to be seen,” she says.

Charu Thapa Magar checks on a patient's medication in the recovery room at Trishuli Hospital in Nuwakot. Photo credit: WHO Nepal/Sulav Shrestha

Despite her personal loss, she felt a responsibility to continue serving those affected by the disaster. For the next 16 days, she stayed at the hospital looking after patients. And she continues to fulfill her responsibility in the operating theatre.

But grief lingers on. “Although I work, it is difficult to concentrate. The body is here but the mind is elsewhere,” she says. In quieter moments, her thoughts go back to those she has lost. “Because their bodies remain missing,” she says,“I keep thinking one day they’ll come to meet me."

Krishna Rijal

Krishna Rijal, a laboratory technician officer, looks out over the Trishuli River from the balcony of the Ayurveda and Alternative Hospital, Nuwakot. Photo credit: WHO Nepal/Sulav Shrestha

It was a phone call that saved Krishna Rijal’s life. He was riding his motorbike when he received a call warning him about a flood. At that moment, he looked up and saw the river heading towards him. Without a second thought, he turned around and sped in the other direction.

“The flood missed me by a few inches,” says Rijal.

But the bridge connecting his home and workplace across the Trishuli River had been washed away. A lab technician inspector at the Public Health Office-Nuwakot (PHO), Rijal had no way of reaching either his office or his home.

Instead, he headed to the Chief District Officer’s office, where he joined an emergency coordination meeting on behalf of the PHO. Soon afterward, he helped establish a temporary office at the Ayurveda and Alternative Hospital.

Yet even as he responded to the crisis, Rijal could not stop worrying about his family. Their neighbourhood was also affected by the floods.

Krishna Rijal speaks to his wife during a video call. His family was evacuated to Kathmandu after the flood. Photo credit: WHO Nepal/Sulav Shrestha

“That whole night I could not sleep,” he says. “I was worried that my family would ignore safety risks and return to our damaged house.”  He remained sleepless for the next few days, until his family was evacuated to Kathmandu.

Unable to go home, Rijal stayed with friends before eventually moving to a small room at the hospital, which he shares with a medical officer. When he is alone, his mind sometimes drifts back to his home, his neighbourhood and the life he left behind.

 “The terror of narrowly escaping the flood, the fear for my family, having to coordinate with the office and fulfill my responsibilities at work, affected my mental wellbeing,” he says. “I try to find solace among my friends and work.”

Amrit Maharjan

Amrit Maharjan attends a work call at his desk at the Public Health Office, Nuwakot. He has been sleeping in his office since the flood. Photo credit: WHO Nepal/Sulav Shrestha

If it had been any other day, Amrit Maharjan isn’t sure if he would have survived the flash floods that swept away his home in Nuwakot.  An immunization officer at the Public Health Office in Nuwakot, he would normally have gone home for lunch. But because there was a meeting at the office that day, he stayed behind.

Suddenly, he heard people running and shouting. Maharjan could not believe what he saw. “When I looked towards my house, everything was gone,” he says. “My ears felt clogged. I couldn’t figure out if it was river or sea.”

His immediate thought was of survival. With his house gone, he wondered what would come next, how he would rebuild his house. As the day went by, more news arrived of people losing their homes and families.

Amrit Maharjan looks at the remains of his flood-damaged house in Nuwakot. Photo credit: WHO Nepal/Sulav Shrestha

“There were people who lost more than I did, so I consoled myself and continued to work,” says Maharjan.

With nowhere else to go, he spends his nights sleeping on a couch in his office and his days supporting vaccination campaigns. He feels he could not lose hope because his family and community looked to him for comfort and reassurance.

“My family and I are alive and that is what matters most,” he says. “I am about to retire, I will rebuild my house with my pension money. I must keep a strong mind and focus on my work.”

Dr Shitanshu Dhakal

Dr Shitanshu Dhakal attends to a patient in the emergency department at Trishuli Hospital, Nuwakot. Photo credit: WHO Nepal/Sulav Shrestha

It had been just over a month since Dr Shitanshu Dhakal joined Trishuli Hospital as a medical officer when the flash flood struck Nuwakot.

“When I look back, all I remember is absolute chaos,” says Dhakal.

The first few hours passed in a flurry of activity, followed by a wave of rumors and fear. “There were rumors that another flood was coming,” she says, “There was no electricity, no internet and the phones were not working. Because we were completely cut off, we did not know what to believe.”

Some nights, the hospital staff ran uphill with their patients after hearing fresh warnings of another oncoming flood. “The rumors added to the distress we were already experiencing,” she says.

Dr Shitanshu Dhakal discusses treatment options with a patient in the Emergency Department at Trishuli Hospital. Photo credit: WHO Nepal/Sulav Shrestha

When phone services were finally restored, Dhakal heard the worried voices of her parents in Kathmandu, urging her to stay safe. In the days that followed, there were moments when she wanted nothing more than to return home and be with her family. But she stayed on, continuing to care for the patients despite the uncertainty and the psychological toll of the disaster.

“I think the distress still exists,” says Dhakal. “We need to take the mental health of the health professionals and the frontline workers into consideration, and we need to provide psychological first aid for them as well, because they are the ones who have to keep going. And we need to ensure they also have sustained mental health support.”

Those who responded to the disaster continue to feel the impact nearly two months after the floodwaters receded. Along with the physical demands of working through an emergency, health workers and frontline responders often face a range of mental health and psychosocial issues that can persist long after the crisis has passed.

Recognizing these needs is an important part of the recovery process. Access to MHPSS services can help them cope with distress, strengthen their well-being and navigate the challenges.

As recovery continues, the Government of Nepal, with support from WHO and partners, is working to embed mental health and psychosocial support across the broader response, ensuring that those who care for others receive the sustained care and support they also need.