Salient points of the report by Oxfam (India) Trust released on Feb.26. For a complete e-copy, send your request to Dr. P. V. Unnikrishnan at: oxfamindia@vsnl.com

Gujarat earthquake took a very heavy toll. It may take several months, perhaps even years, to bring the lives of the affected back into normal. Disasters- natural like earthquakes, floods, cyclones and droughts; human-made disasters like communal riots, conflicts, internal displacement and refugee situations; and other disasters like epidemics, transport and industrial accidents, fire and others take a very heavy toll in India.

In Gujarat, ordinary people have been the real heroes and heroines. The country and the world responded generously to bring in relief and humanitarian assistance for the earthquake affected. Majority of the media also played a very constructive role. But past experience in other disaster situations shows that this gesture is a short-lived phenomenon. The disaster response is not organised and co-ordinated in India. When a disaster strikes, the response is panic and knee-jerk reactions. Everyone is responsible, but the government has a mandate to rectify this. Absence of a rational disaster policy amplifies the sufferings of the survivors. There is an urgent need to correct this.

Oxfam India responded to some of the very basic survival needs of the earthquake affected such as food and drinking water facilities, warm clothes, temporary shelter and specialised medical assistance in some of the neglected pockets. Joining hands with other NGOs, medical and health institutions and international agencies, it also facilitated the organisation of response in Bangalore and Chennai. It also highlighted critical issues in the media to facilitate appropriate relief and advocate humane policy directives.

Oxfam India also put together a multi-disciplinary team to conduct a rapid need assessment of the earthquake-affected areas to develop a long-term intervention strategy. The team comprised of a leading physiotherapist, a gender and rights activist, a medical doctor, a social scientist and others conducted Oxfam India's need-assessment mission. Oxfam India's findings, "Gujarat earthquake: Healing the wounds"- calls for a people-centric long-term rehabilitation plan for the area. "Community-wise rehabilitation and people's participation should find central places in the long-term rehabilitation programme", says the report.

Physiotherapy based intervention to respond to the needs of the physically disabled (especially the paraplegics and those with multiple injuries of spine and limbs); Psycho-social support for the traumatised communities; Access to appropriate information to build earthquake resistant houses with the active involvement of the survivors/ community and campaigns to achieve basic rights of the disaster affected will be the key challenges for those involved in long term rehabilitation", notes the report. Oxfam India, in association with the survivors, leading professional organisations, voluntary agencies and others has developed a long-term intervention plan for select pockets in Gujarat.

Oxfam India appeals the planners and policy makers to be innovative and involve survivors from the area and other earthquake affected places in India in planning and implementation of the rehabilitation. The situation calls for a long-term intervention.

When the situation moves from relief to rehabilitation, Oxfam India feels that the key challenge for humanitarian agencies is to shift gears from charity mode to advocacy and political action to attain basic rights.

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

The objectives:

  a.. To understand the nature, magnitude and impact of the earthquake.

  b.. To map the response by various constituencies.

  c.. To assess the emerging needs of the affected people, especially children, women, elderly and other vulnerable sections of the people - for instance, minorities, dalits and migrants.

  d.. The main areas that the team focussed were health (general health, physical disability and psycho-social consequences), education, shelter, livelihood, basic rights and vulnerability.

  e.. To develop a time-bound people-centric response to meet the medium and long-term needs of the affected community.

OBSERVATIONS:

1. Water and sanitation:
With summer about to step in, the already drought pockets in the earthquake affected areas will have to bear the shortage of water. This must be dealt with extreme urgency.

2. Health issues:
Most of the outside agencies are leaving the place (or are about to leave). There is an urgent need to develop a long-term programme to deal with those who are physically disabled (due to multiple fractures and spine injuries); psychosocial consequences and the health needs of children and women.

3. Physical disability due to fractures and injuries
There are over 90 paraplegics in the Paraplegic Hospital, Ahmedabad alone. Many in villages will also need physiotherapy assistance to get their normal movements back. In Marathwada there are paraplegics awaiting rehabilitation even after 8 years after the devastating 1993 earthquake. Physical disability is not a visible agenda in the rehabilitation package.

4. Psychosocial consequences:
The survivors need assistance to overcome trauma and subsequent psychosocial problems they face. Past experience shows that long -term impacts of psychosocial problems are many-fold. If not handled adequately by cultural, societal and family support, it could lead to long-term emotional problems. In Marathwada, even after 8 years, at least 30 per cent of the affected survivors will require continued mental healthcare. Independent studies point out that in Marathwada, there is a sharp increase in the incidence of alcoholism, upto five times than that of the pre-earthquake situation.

The situation calls for a long-term community-wise rehabilitation.

5. Health issues related to women and children:
Increased incidence of women's health problems were recorded by the team. Incidence of premature deliveries, cases of chicken pox, measles, respiratory complications and water-borne diseases amongst children were also recorded. With no Gynaecologists and women doctors in the relief teams and no visible signs to correct the situation, meeting the health needs of the women will be a challenge. This calls for urgent attention.

6. Temporary Shelter:
The temporary tents that have come up in Adhoi spells disaster. It is a fire risk, lacks sanitation facility and was built without people's involvement. This top down approach must be stopped.

7. Charity Vs Peoples' Basic rights:
When the situation moves from relief to rehabilitation, the key challenge for humanitarian agencies is to shift gears from charity mode to advocacy and political action to attain basic rights.

Other Observations, Comments and Suggestions:

The Role of international agencies: On enquiries, it was clear that many international agencies were in Gujarat with a very short-term agenda. The short-term interventions that most of these agencies make don't keep field level realities. Barring a few specialist medical agencies, whose role is more important in the immediate rescue and relief phase, the situation calls for a long-term commitment by international agencies. Many villages have yet to receive relief. In such situation, long-term commitment is necessary. Oxfam India feels that such agencies need to rethink and redefine their operational mandate to suite the local level realities. While we understand and caution the limited role of external aid agencies, we welcome a synergy between local community-based organisations and International agencies.

Animal care: Need for veterinary doctors: Hundreds of thousands of cattle and other animals were hurt by the falling debris. After the earthquake animals were running helter-skelter in pain, dropping dead in odd places. Even Army personnel found it very difficult to locate and burn carcasses. Medical records: Barring a few camps and medical posts run by the Army and specialist medical agencies, there was no system for documenting the case history of the patients. With new sets of doctors coming in, the patients and doctors had a difficult time to track the clinical and other (including surgical) interventions that have already been made. To correct this, there is an urgent need to print medical record sheets.

Media: The role of the media was good barring few exceptions. It is important to ensure the focus of the media when the rehabilitation begins. Efforts may have to be put to encourage them to visit the other earthquake-affected places in India such as Marathwada, Uttarkashi, Chameli and Jabalpur to report about the plight of the survivors even after so many years. This kind of reportage will help to put the issues in a broader perspective.

Water: There is an urgent need to put in place water-purifying systems in the entire area. Supply of large drums, as temporary water tanks is an urgent need.

Food security: There is no evident effort to streamline food security issues despite the fact that some parts of Gujarat, especially Kutch, are drought prone. This must be dealt with urgency. Livelihood: The weaving and crafts instruments are completely destroyed due to this earthquake. There is no visible effort to resurrect the same. This calls for urgent attention. Efforts may be put to lobby with the Khadi board and other craft co-operatives.

Rapid need assessment report suggests the following interventions

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.

  1.. Community-Based Rehabilitation for the physically disabled.

  2.. Community-Based Rehabilitation of those who need psychosocial
support.

  3.. Capacity building for earthquake resistant houses and community
centres.

  4.. Basic rights campaign and advocacy

  5.. Provision of shelter and livelihood for the most vulnerable in one
or two villages.

Geographical areas of work

Through Samerth: Khodasar, Chandrodi, Pethapar, Manaba (Bhachau) and Balasari, Gagodar (in Rapar)

Through Gujarat Jan Jagran Sangh (GJJS): Villages in the ten blocks of Kutch.

Through Manav Kalyan Trust (MKT): 273 villages of Sabarkanatha and
Banaskantha

Through St. Xavier's Social Service Society: Mainly the city and slums of
Ahmedabad.

Through Development Resource Centre (Mumbai): General coverage for specific activities.

Through Anandi - Swayam Shikshan Prayog (SSP), Mumbai - People's Science Institute (PSI), Dehradun: In Kutch district-50 villages; Rajkot-90 villages; Jamnagar -140 villages; Bhavnagar -70 villages; Surendranagar-
50 villages