Gujarat Shattered By A Killer Earthquake:
Oxfam India's Long Term Intervention Strategy And Programme

Long-term rehabilitation is a challenge for the survivors and the
humanitarian agencies. (Strategy note dated Feb 15th).

Responding to the immediate relief needs of the earthquake- devastated people in Gujarat was/ is a daunting task for relief agencies and the government. The first two weeks witnessed overwhelming relief assistance. However, we also found how some remote places were neglected. The scene is changing fast.

Oxfam India responded to some of the very basic survival needs like food, warm clothes, temporary shelter and specialised medical assistance in some of the neglected pockets. It also facilitated the organisation of response in Bangalore and Mumbai. It also highlighted critical issues in the media to facilitate appropriate relief and advocate humane policy directives.

Rapid Need Assessment By a Multi-Disciplinary Professional Team:

Oxfam India also put together a multi-disciplinary team to conduct a rapid need assessment of the earthquake-affected areas to develop our long-term interventions strategy. The multidisciplinary comprised of

Dr. Jacob VC, Mumbai
He is lead physiotherapist and Vice President of Indian Association of Physiotherapists. He has experience of working in Latur.

Mr. Santosh Kalyane, Latur
He is an engineer and development resource person who has worked with communities and women's groups. He is associated with Swayam Sikshan Prayog, an organisation working in Latur for the last 7 years.

Mr. Gabriel Britto, Mumbai
He is a social scientist and is also the director of Development Resource Centre.
Ms. Philomina Christi,Ahmedabad
She is a gender activist associated with St. Xavier's Social Service Society. She has worked on gender, rights and dalits issues.

Dr. Unnikrishnan PV, Bangalore
He is Oxfam India's co-ordinator for Disasters & Emergencies. He is a medical doctor working on health and humanitarian issues, both at the policy and field implementation levels.

Note- 1:
Inputs from a specialist mental health team from National Institute of Mental Health and Neuro Sciences, Bangalore and other experts who are currently in the area are also incorporated in this note.

Note-2:
Inputs of the teams from Swayam Sikshan Prayog, Mumbai; Peoples' Science Institute , Dehradun and Anandi, Bhavnagar are also incorporated especially on sections related to reconstruction, information dissemination and exchange programmes.

METHODOLOGY:

The team visited the affected areas and hospitals in Ahmedabad; remote and other villages; spots where the disaster affected displaced people are located at present, make shift health centres and relief tents. The team also had extensive interviews, interactions and focussed group discussions with affected people- mainly women, children, elderly, ignored sections of the community and other vulnerable groups such as migrants, dalits, minorities; NGOs and international agencies, government, army, medical and health experts, and others working in the area.

The Rapid Assessment Suggests the Following Interventions (For Details, Please Read the Full Report)

One:
Interventions to provide Community Based Rehabilitation for the disabled. Paraplegics and those with limb, multiple and spine injuries, fractures and other disabilities will need physiotherapy assistance to get their lives back into action. Without this intervention and assistance of physiotherapists, the paraplegics and the like will end up their lives in wheel chairs. This service may be required for the next 6 to 12 months and that too at the doorsteps of the needy people as they are immobile and can't commute to hospitals.

This is not a visible agenda for NGOs and government at this stage. Even after 8 years, there are over 20 paraplegics still awaiting rehabilitation in Latur, where a killer earthquake (of a less devastation) struck in 1993.

We need to act fast. Oxfam India is committed to take up this challenge and is finalising a work plan in collaboration with the experts associated with the Indian Association of Physiotherapists. We are also working out the details of setting up a rehabilitation centre at Ahmedabad in association with St. Xavier's Social Service Society, Ahmedabad.

Two:
Intervention to provide psychosocial support for the earthquake affected people who are under shock and trauma. Left unattended initial trauma develops into manifestations that have a long lasting negative impact. School children drop out, increased incidents of divorce; alcoholism and even suicides are some of the manifestations. Moreover, Post Trauma Stress Disorder is common amongst disaster-affected people. Oxfam India's assessment also confirms the increased incidence of premature deliveries in the area.

There are a considerable number of children who have been affected. A specific case is of a 12 year young Nancy Takkar (from Anjar), the only survivor when the killer quake killed over 300 of her schoolmates. She is seen smiling and doing routine regular work! Mental health professionals who have been assessing the psychosocial implications reiterates that her smile is a short-lived phenomenon. They say that she is passing through what is known as the "heroic phase". The survivors need assistance to overcome the trauma and psychosocial problems they face.

The assessment and observations by expert and experienced mental health professionals call for a long- term psychosocial intervention for the disaster affected. This service may be required for the next 6 to 12 months and that too at the community level. This is not a visible agenda for NGOs and government at this stage, especially in some of the remote and "not-so publicised" villages. Even after 8 years, in Latur, the incidence of mental health problems is upto 30 % according to recent scientific reports.

Armed with experience of dealing with such situations in the past, Oxfam India is working out a community-based intervention programme to address the psychosocial needs of the survivors. We are working out a collaborative work with mental health professionals in NIMHANS.

Three:
Awareness campaign to provide appropriate information. Accurate and scientific information will go a long way in rebuilding the lives and homes that the earthquake shattered. Unfortunately need based appropriate information is not available easily. The situation calls for an information and dissemination campaign to meet this urgent need, especially when the reconstruction phase begins. Information regarding earthquake resistant houses will be one focus.

Oxfam India is working towards a strategy to take up this issue actively in select pockets. We are associating with institutions and experts who have experience on this issue. We will bring out information materials like posters, leaf-lets, video films and others in local language.

We are working out the details with other organisations such as (a) Development Resource Centre, Mumbai; (b) Swayam Sikshan Prayog, Mumbai; (c) Peoples' Science Institute, Dehradun and (d) Anandi, Bhavnagar.

Four:
Building community centres and people-exchange programme. There is wealth of knowledge in pockets affected by past earthquakes like Latur. Ordinary people and communities have a wealth of knowledge that can go a long way to improve the rehabilitation process. We are keen to facilitate an exchange programme between people, especially women, masons from other earthquake-affected areas of India and Gujarat.

We will facilitate the building of a multi-purpose community centre with the active participation of the local people. This activity will also will be a demonstration to train the people in building earthquake –resistant houses and other structures.

We are joining hands with organisations like Swayam Shikshan Prayog (Mumbai) to facilitate this.

Five:
Basic Rights Campaign: Earthquake affected people have basic rights. When agencies and NGOs move in a charity mode, they tend to ignore that disaster relief and long-term assistance is a basic right. Rights related to health, education, rights of children and women are issues that Oxfam India will highlight in its basic rights campaign. This will help the communities to be aware of their rights and thus work towards to achieve this.

Six:
Advocacy and lobbying for a disaster management policy and preparedness programme. Looking at the fact that an earthquake hit Gujarat this year; a devastating cyclone in 1998 and an ongoing drought in certain pockets, Oxfam India realises the need to respond to disasters in a wholistic way. We will work towards to develop and lobby a people-centric disaster management policy for the state of Gujarat. We will also work with institutions and NGOs to develop preparedness programme.

The interventions are designed in such way that the local skills could be used to its optimum levels and external interventions minimised. An owner-driven approach, with the active involvement and ownership of local communities will be the spirit of the programme.

Notes:

Apart from the organisations mentioned specifically in each section, we have an understanding with Action Aid to collaborate on some of the above-mentioned issues. The details will be worked out soon.

We have also had discussions with other NGO networks such as "Janvikas/Janpath Citizen's Initiative", Ahmedabad and Kutch Nav Nirman Abhiyan, Bhuj the need and our limited support to develop an intervention plan for some of the above mentioned activities. More directly we work with our partners like Samerth, Gujarat jana Jagaran Sangh, (GJJS), and Manav kalyan Trust(MKT)for integrated work relatingto most of the above interventions particularly in Bachau and Rapar blocks.Such activities will be taken up jointly on a case- to- case basis. Details are still to be worked out.

We are also discussing our initiatives with other agencies that have been part of a co-ordinated relief response at Bangalore and Chennai, especially professional and other organisations. We will be able to make a statement about this, once we work out the details. However, Oxfam India is committed to go ahead even if the response for long-term work from these agencies (in Bangalore and Chennai) is not encouraging.

(Note prepared by Dr. Unnikrishnan PV, Co-ordinator-Disasters & Emergencies, Oxfam India, Bangalore, in consultation with the director and other colleagues in Oxfam India, assessment team and collaborating agencies.)