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Duke doctor aids ongoing Nepalese earthquake relief

<p>An earthquake measuring 7.8 on the Richter scale hit central Nepal in April. Duke Hospital’s Mike Landry has continued to help survivors recover and  re-integrate into the community.</p>

An earthquake measuring 7.8 on the Richter scale hit central Nepal in April. Duke Hospital’s Mike Landry has continued to help survivors recover and re-integrate into the community.

After a devastating earthquake hit Nepal earlier this year, a Duke doctor has been hard at work trying to rehabilitate damaged communities.

In April 2015, an earthquake measuring 7.8 on the Richter scale struck central Nepal, killing 9,000 people and leaving over 23,000 injured. Mike Landry—chief of the Doctor of Physical Therapy Division at Duke Hospital—was in Bangladesh at the time but soon left for Nepal. Since then, he has worked with multiple organizations to aid in the recovery process.

“Nepal is on one of the most active fault lines in the world, so it’s not ‘if’ it’s going to happen again—it’s simply ‘when,’ and we want to be ready.” Landry said.

Landry was first approached by Handicap International—a non-governmental organization that assists survivors recovering from natural and manmade disasters—but has since worked primarily as an injury and rehabilitation consultant with the World Health Organization.

A central concern has been reintegrating survivors into the community, Landry said, as keeping them in hospitals is not always the best course of action.

“Many of these patients do not need to be in acute care hospitals,” Landry said. “They should be in the community, but the limiting factor is that many of them have lost their home, lost their families and don’t often have a place to go home to.”

To address this issue, Landry and WHO have collaborated with other organizations—including the International Organization for Migration—to create step-down facilities.

“A step-down facility is for people who are well enough that they don’t have to be in an acute care hospital but aren’t ready to go home yet,” Landry explained. “They come into these step-down facilities for high-intensity rehabilitation to improve their function so that they’re ready to go home.”

Long-term, Landry hopes to improve the situation of Nepal’s disabled community, which he estimated to be about 20 to 25 percent of Nepal’s total population.

Landry and WHO are currently working with multiple government ministries on a joint policy that approaches both the psychosocial and medical aspects of disability. They are aiming for an April 2016 launch date.

Landry is not the only Duke doctor to have taken an interest in Nepal. Dr. Brandon Kohrt—assistant professor of psychiatry, global health and cultural anthropology—has been working on mental health issues in Nepal since 1996. After the earthquake, he worked with WHO and Transcultural Psychosocial Organization, a Nepalese NGO, on mental health programming in Nepal.

“When I first started working in Nepal 20 years ago, I never could have imagined that one day I would be sitting in a room with 14 psychiatrists brainstorming about how we can provide services for the millions of earthquake survivors,” Kohrt wrote in an email.

Students have also been active in helping Nepal recover from the tragedy. Four Duke students from Nepal created a GoFundMe campaign in April that raised $29,581 in a month. The money was used to purchase materials for rebuilding villages affected by the quake.

Working in Nepal has been fraught with political tension. The country’s government recently adopted a new constitution, but numerous ethnic groups displeased with it are calling for national strikes—which has limited aid work by restricting travel.

Apart from the political difficulties, policy development is inherently a slow process, Landry said.

“Policy development is sort of like watching the grass grow,” Landry explained. “You could do it very quickly, but how useful would that be? The only way to really create effective policies is to have local policymakers engaged in the process.”

Landry will give a talk Oct. 27 after returning from Nepal. The talk will be the second and last part of his “Healing After Disaster: A Two-Part Series on Duke’s Global Health Work in Nepal Following the 2015 Earthquake” lecture series.

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