Read the story in Nepali: प्रकोप प्रभावितहरूको मनको चोट पुर्ने छैन संयन्त्र

Chanute Bazaar is located 40 kilometers northeast of the capital Kathmandu, on the banks of the Melamchi River. Mahankalphant is located above Chanute Bazaar, which is reached by following the Melamchi River from Melamchi Bazaar, which was destroyed by the floods on June 15, 2021.

Tiksani Tamang (30) lives in a tent made of tin on this field. The mother of five daughters, she spends her days in this tent with her husband and children.

Tiksani is the youngest daughter of Saili Tamang (50), who went missing in the Melamchi flood. Before her mother (Saili) went missing, Tiksani lived with her parents and brothers in the same house. She has not been able to forget the day her mother went missing and the hardships she has faced since then.

As usual during the monsoon, the Melamchi River was flowing with muddy water that day. After finishing her morning chores, she went to plant paddy in the field. When she returned home after planting, there was a light rain and the water level in the river was rising. The residents of this area used to collect the driftwood brought by the Melamchi River during the monsoon and store it for the whole year. After seeing the flood, she also went towards the river to collect driftwood. Both mother and daughter sat on either side of the river and started taking out driftwood.

Before they knew it, the river started to rise. The villagers who were collecting driftwoodon the river bank started running away. She also climbed up. "There was a smell like gas exploding in the river, and the ground was shaking as if there was an earthquake," she recalls the day of the flood, having experienced the 2015 earthquake as well.

Those who were collecting driftwood in the river a while ago had already reached the hillside. When she looked up, she saw a flood of mud and debris flowing far above her own house. She looked across at her mother, who was gathering driftwood. But the flood was coming in a smoky way from the river, and nothing could be seen. She looked for her mother, but could not find her. "I shouted at my mother to run away, others also told her to climb to higher ground when the river got bigger, but she didn't listen, maybe because she was taking out the driftwood that had come into the river," she says, "The flood came down suddenly. It must have taken her somewhere. There was no one to see, and no one to pull her out even if she was buried."

Both the house and her mother she had seen just a while ago disappeared in an instant. She remembers spending many days after that sleeping on straw. "What a terrible disaster, what a terrible disaster," Tiksani says, feeling discouraged, "If it had been someone else, I guess it would have been time to die..., they probably would have died."

The body of her mother, who went missing in the flood, has not been found yet. Even though the body has not been found, the family has performed her 'Ghewa' (last rites) according to Buddhist culture, believing that she died in the flood. But still, she cannot forget her mother. "It feels like my mother is here, just unseen. It feels like she is walking around there," she said, pointing forward with her finger, "Many things play in my mind. I can't sleep for many nights when I go there." She said that she has not been able to go to Palchoksera, the place where her mother was swept away, and her birth home in Helambu-6.

According to her, there is a world of difference in her life with and without her mother. "My mother was a world of work, she never kept her hands idle for a moment," Tiksani says, "When my mother was there, the house was full of food, now I have neither my mother nor my house."

She says that she feels like she has lost her whole world since her mother is gone. "Everyone has their share of joys and sorrows in life, but after losing my mother, the world feels empty," she said, "I don't even feel like celebrating festivals."

In the flood of June 15, 2021, five people died and 20 went missing. All of them were from the Helambu area, according to the Helambu Rural Municipality.

Like Tiksani, families who have lost loved ones in the Melamchi flood are found to be going through various stresses. A study conducted by Prakriti Resources Center focusing on the Melamchi area (titled "Assessment of Local Leadership in Financing Disaster Risk Reduction in Nepal: The Case of the 2021 Melamchi Flood") also shows that flood victims have mental health problems. The report concludes that 85% of the flood-affected participants in the 539 households surveyed showed signs of mental health problems.

The report mentions that not only the family members of the missing and deceased, but also those who lost their businesses, homes and crops due to the flood, have been experiencing problems with sleeplessness due to anxiety, mental stress, and fear.

Families who lost relatives in the flood have faced social and practical problems, cultural obstacles, displacement and migration in their daily lives after becoming mentally distraught. All of these are non-economic losses caused by climate change-induced disasters and their aftermath. These cannot be directly compared to economic losses in monetary terms. However, their impact is much greater than economic losses. The United Nations has also considered the damage to human life and health caused by floods as non-economic losses. A study conducted by ICIMOD has called the Melamchi flood a result of human and climate factors and processes.

Four years after the flood, the mental health problems of the residents of the Melamchi Helambu area have reached a dangerous level, says Pravin Man Singh, director of Prakriti Resources Center. He says, "The flood-affected people seem to be suffering from two types of mental health problems."

According to him, one type of problem has arisen from the fear of seeing the flood, while another type of stress is seen in those who have lost their relatives, sources of livelihood, and businesses in the flood as they see a bleak future.

Pangs of Loss

Among those who went missing in the Melamchi flood was Madhav Bhandari (32) of Kiul, Helambu Rural Municipality-2. Madhav's father, Baburam Bhandari, witnessed Madhav being swept away by the flood. After seeing two people, trying to cross the river and getting caught in the middle of the flood, Madhav called the police for rescue. Then, handing his mobile phone to his father, Baburam, he left to block the river flow coming to the local trout fish farm, when he was enveloped by river flood.

"He had only gone about 5 meters down, I was standing and watching, and while I was still saying 'Hey, hey,' he was gone. He disappeared right before my eyes," Baburam was speechless.

After a moment of silence, he spoke, "Whether it rained from the sky or boiled up from below, the river changed its course unexpectedly, coming around from this side (towards the settlement) in a way no one could have imagined."

With tears in his eyes, he was silent for a while, then spoke again, "...it was written in his [Madhav’s] fate."

In the Melamchi flood, Baburam lost his young son, who was his support in his old age. His two-and-a-half-story concrete house, which he had rebuilt after it was damaged in the 2015 earthquake by taking loans, 12 ropanis of land, buffalo farm, trout fish farm, and mill were all washed away.

Baburam, who lost his home, his profession, his source of income, and his son, whom he considered the pillar of his house, is also worried about the future of his daughter-in-law (Madhav's wife) and his grandson.

"My daughter-in-law works as a cleaner in the same municipality, and the household expenses are somehow managed," he says, "I need to educate my grandson and help him stand on his feet, but she is not in a position to do that. There is no one to help."

He is saddened that even though many organizations have come to understand the problems in the three years since the flood, he has not received any help from anywhere. He says, "In society, there are only those who say 'how pitiful,' and the government is as if it doesn't exist for us."

Additional Hardships

Ganesh Jyoti, who was running a fish farm on the banks of the Melamchi River in Kiul, Helambu-2, also went missing in the same flood. Ganesh's wife, Kanchi Maya Jyoti, has not yet been able to forget the sight of her husband being swept away before her very eyes. She says, "After muddy water came into the river, he went to stop the water. He had come right near the farm after stopping the water. It was probably a distance of 10 meters, my daughter pulled me up. He disappeared right there before my very eyes."

Kanchi Maya's problems are different. She not only lost her husband, but her house is mortgaged at the bank, and her fish farm and farmland were lost in the flood. She knew that along with fish farming, Ganesh had taken a loan by mortgaging the land and was involved in other businesses too, however, Kanchi Maya was unaware of other transactions.

"He used to collect and sell rice from the village. Within a month of his death, people started coming to the house to collect the money for the rice," she recalls, "Their words and behavior were difficult to bear. Even when I went out into the village, they would make snide remarks."

At the same time, she was frustrated by the notices and phone calls the bank sent every week. Her family was not in a position to pay the bank installments. She says, "The bank blacklisted everyone in the family. Where could we go? There was nowhere to go. I so wished that I could get lost in the sky or sink into the ground."

Kanchi Maya says that after Ganesh's loan was transferred to the name of his mother, Bel Kumari, in whose name the land was registered, Bel Kumari also passed away while the bank was in the process of putting the land in auction, after which the land registration was transferred in the name of a neighbor who had stood witness while obtaining the bank loan, on the condition that the latter would pay back the loan.

She says that after the bank auctioned off the land, she is now making a living by farming other people's fields. The responsibility of raising and educating her two daughters and one son rests on her shoulders. "The person who took responsibility for the family is gone, my heart breaks when I remember," she laments.

Leaving One's Homeland

Dil Kumari Khadka, from Jai Bagheshwari Trout Farm on the banks of the Melamchi River in Palchok Sera, went missing in the flood. Her daughter-in-law was also trapped in the flood. She was rescued by neighbors, but Dil Kumari was late to escape and disappeared forever. After the flood swept away his mother, house, business and farmland, her son and daughter-in-law left their homeland and moved to Kathmandu.

According to them, the river is now flowing over where their house and business used to be. A pile of sand has accumulated in the field. There is no way to return to the village.

"The city is not like the village; we have to live like squatters with nothing," says Maiya Khadka, Dil Kumari's daughter-in-law. "There is no social feeling here like in the village, where everyone unites when someone has a problem, sharing each other's joys and sorrows."

The river is flowing over their old home. There is a pile of sand on the remaining land. She says that there is no condition to go and live there. Their neighbors are also in the same situation. Almost all families have left their homeland and moved elsewhere. But the municipality does not have any data on where some families have moved.

ICIMOD's study, "Melamchi Flood Disaster: Cascading Hazards and the Need for Multi-Hazard Risk Management," also predicts that those affected will be forced to relocate. According to the study, the flood displaced various groups, particularly families engaged in subsistence farming.  It has affected their livelihoods as valuable agricultural land has been turned into barren land. ICIMOD's study mentions that this could lead to migration.

Toll on Rituals

Gyanendra Kakshapati, a fish businessman, went missing after going to save workers who were trapped after the flood. His son, Upendra, says, "We searched for the body for the final rites, but it was not found."

According to Hindu tradition, the death rituals must be completed on the 12th day. Upendra explains that even after they could not locate his father’s body for nine days, they created a symbolic representation of the body using Kusha grass (Darbha grass) and performed the final rites.

Upendra informed us that the final rites for his father were performed in Kathmandu because the flood had also damaged the structures on the river bank that had been set up for performing final rites.

"We moved to Kathmandu after August my mother came here only after two years. I, on the other hand, returned after a month to manage things," Upendra said. "Where we used to have our house, fields, and business, there is now just a pile of sand and stones."

Like Upendra, the locals of the Helambu-Melamchi region have lost the places where they used to perform final rites according to their traditions. More than 20 cremation sites and buildings have been damaged in the Helambu-Melamchi area.

The Melamchi Municipality has stated that 10 cremation sites and buildings in the Melamchi area, the Krishna Temple in Melamchi Dobhan, and a Radhe Radhe building have been damaged by the flood.

Similarly, Top Bahadur Adhikari, information officer of Helambu Rural Municipality, informed that the flood has damaged more than 10 cremation sites and buildings in the Helambu Rural Municipality area. He also said that cultural structures such as the Ganesh temple in the Helambu area and the Radha Krishna temple in Chanute were also lost in the flood. He said that the local residents are also under stress due to the loss of their cultural heritage.

Rising Risks, Weak Policies

Looking at the events of the last 10 years, it is clear that the damage to lives and property from floods and landslides is increasing every year. Floods cause death, injury, and economic and social disruption.

Data visualization of fatalities due to floods and landslides in the last 10 years.

Studies have shown that families who have suffered human loss due to floods experience trauma from losing loved ones and the consequences that follow. A study published in the International Journal of Social Science, titled "Counseling to Reduce Psychosocial Trauma of Flood Disaster Victims," shows that deaths and property damage caused by floods affect both men and women psychologically.

The study concludes that professional counseling is necessary for victims who have experienced trauma. Various studies have concluded that natural disasters occur without warning, and the distressing experiences of those affected can lead to post-traumatic stress disorder.

In Nepal, there is no clear policy on providing need-based psychosocial counseling to communities after a flood. The National Health Policy (2019) mentions that cooperation and coordination will be done to mitigate the adverse effects of climate change on health. The National Mental Health Strategy and Action Plan (2020) states that mental health prevention, treatment and rehabilitation programs will be conducted by local levels for vulnerable communities or groups, including victims of natural disasters.

However, Gyanendra Sigdel, Senior Health Officer of the Health Post of Melamchi Municipality, said that these policies and action plans are not effective. He was the head of the health post of Helambu Rural Municipality when the flood hit the Helambu Melamchi area. He says that the responsible bodies have not been able to address it. According to him, they now have to rely on non-governmental organizations. Even those have limitations.

The state of psychosocial counseling in Nepal is quite weak. "The government has neither a clear policy nor manpower regarding the provision of psychosocial counseling services, and all three levels of government have failed in this," he says. "Even the local government can take the initiative to produce mental health counselors by investing something in health workers."

Anup Acharya, a psychologist at Koshish Nepal, which has started the work of providing psychosocial counseling in disasters, says, "There is a great need for psychosocial counseling in the society. There is still a lot of work to be done for that."

Due to a lack of policy and manpower, those affected are not getting the counseling they need because help cannot reach the affected areas.  Psychological first aid is needed at the community level in disaster-stricken areas. In some cases, there are also complex problems. Counseling alone is not enough for them, and they need to see a psychiatrist.

Dr. Pomawati Thapa, head of the mental health department, said that the government has not appointed any manpower in any local level focusing on the problems of disasters at the community level. She said that psychosocial counseling is being provided at disaster sites in coordination with non-governmental organizations.

She acknowledges that the current efforts are insufficient. According to her, given the annual investment the government allocates to the Ministry of Health, there is no possibility of increasing investment in mental health. Similarly, there is also a shortage of skilled manpower to address mental health problems.

Urgent Need for Counseling

"Those affected have suffered loss of life and property, and because they have witnessed the disaster firsthand, their minds are also deeply wounded," says psychologist Acharya. "Mental health problems appear when the loss in personal life causes even more stress." He said that in such a situation, counseling services are provided after initially assessing the need for counseling in the community.

Some people experience complex trauma due to the disaster, which requires medication. Stress and anxiety can be resolved with counseling. However, those with complex anxiety, depression, psychosis, and other problems need to see a psychiatrist and take medication.

Senior Health Officer Sigdel said that some non-governmental organizations came to provide mental health counseling after the flood in the Helambu/Melamchi area. He said that there was no mental health counseling service from the government's side.

According to him, some of the people who received services from non-governmental organizations were found to be in a condition requiring medication. According to Sigdel, who was the head of the Helambu health post during the flood, one organization arrived with a three-day program at that time. They provided counseling to about 45 people.

A meta-analysis study on post-traumatic stress disorder rates after floods, published in PubMed, has shown that flood victims have a high rate of post-traumatic stress disorder (PTSD). This has been found to affect their habits, interests and lifestyles. This emphasizes the need for medical assistance. The study highlights the need for developing countries like Nepal to formulate policies for flood victims and provide timely treatment to reduce psychological consequences.

The study conducted a meta-analysis of 23 events to identify the prevalence of post-flood PTSD in flood victims. The study found a high rate of PTSD at 29.48%.  The study found that the prevalence of PTSD in Asia was higher than in other regions. The highest prevalence in Asia, 57.35, was associated with natural disasters. The study showed that Asia experiences a high rate of natural disasters, and women experience more trauma. The study showed that the frequency and severity of disasters in Asia contribute to the increasing incidence of PTSD.

A study titled "The impact of floods on life and human health" states that in the past 40 years, crisis prevention efforts in wealthy countries have helped maintain lower mortality rates. According to the study, to prevent human loss, it is important to prioritize data collection, analysis, and interpretation of population safety, and to identify weaknesses and behaviors for risk prevention. It is necessary to focus on the humanitarian risks posed by the effects of unexpected floods and to address the health impacts.

Floods, landslides, heavy rainfall and droughts are some of the effects Nepal has been experiencing. As a result, local people have been suffering from psychosocial problems. Nepal, as a developing country, despite having minimal greenhouse gas emissions, has become a victim of its effects. Due to this, issues of non-economic loss, such as psychosocial impact, are still in the shadows.

No initiative has been taken at the national and international levels to identify the psychosocial condition and help them adapt. As a result, disaster-affected people are deprived of psychosocial support from the local level.

Dr. Thapa says that to solve this problem, it is necessary to first study what kind of problems are seen in the disaster area. She says that she will take the initiative to formulate policies based on that. Believing that the service can be started from even one affected local level and that it can be expanded, she says that to solve the problem, it is necessary to go for a public-private partnership model.

This story was produced under the NIMJN-CANSA Fellowship Program. Please adhere to our republishing policy if you'd like to republish this story. You can find the guidelines here.