Smiling Again in Nepal


Seven-year-old Nirmala was visiting Kathmandu when the earth began to shake on April 25 in a violent, 7.8-magnitude earthquake. The baby of the family, she is from Nepal’s Okhaldhunga district, where she lived with her parents and three siblings.

As the earth rumbled, she scrambled to get outside. But before she reached safety, a wall fell on her leg. Neighbors ran to her aid, and took her to the Bir Trauma Center Hospital, where doctors immediately made the decision to amputate her leg.

The next day, HI’s physical therapists were by her side, starting rehabilitation to strengthen the muscles in her good leg. “Under normal circumstances, rehabilitation begins before a patient undergoes surgery to have their leg or legs amputated,” explains Sunil Pokhrel, the HI Senior Physical Therapist with USAID'S STRIDE project. “We counsel the person about the rehabilitation process and teach them upper limb exercises as well as breathing exercises to help them feel relaxed and energized. This was not always possible with survivors of the Nepal earthquake, but we tried to begin rehabilitation as soon as possible.”

Today, Nirmala takes part in rehabilitation sessions twice a day at the hospital. She tries very hard and gives it her full attention. Crutches help her move around more easily. Sudan Rimal, one of Handicap International’s physical therapists, is very positive. “She’s getting a lot better,” he says. “She can move around without help now, by hopping. She uses her crutches really well. She’s enjoying life again and can play with the other children. I’m feeling confident about her. The next step will be to fit her prosthesis.”

Nirmala’s parents are equally impressed. “It’s a big relief,” they say. “The physical therapists take care of Nirmala every single day. They tell us how to use the crutches, and the sort of care we can provide. The help they give our daughter is essential.”

Nirmala’s parents are never far from her side. “Our house was totally destroyed, we have nowhere to go,” they explain. “We don’t work, so we live here, at the hospital. Fortunately, our daughter, a cleaner, and our two sons, who are tailors, give us a little money. They work hard for the whole family.”

When they start thinking about the future, things seem less bright for Nirmala's family. “We’re hoping for the best; we’d like her to do her studies. But we’re wondering, ‘what’s going to happen to her. Will she manage to fit in? Will she feel different?’ We’re afraid she’s not going to get any support once she leaves hospital. Who’s going to take care of her new prosthesis? Who’s going to pay for her care?

“All we want is for Nirmala to walk again; we want to return to our peaceful and happy lives, as quickly as possible.”

 Photo: Nirmala, left, shown with her friend Khembro, age six.

Rehabilitation project

In the first three months after the 2015 earthquakes, an HI team of physical therapists provided care to more than 1,500 victims in 11 hospitals in Kathmandu Valley, in hospitals in the districts of Nuwakot (Bidur/Trisuli) and Sindhupalchok, and communities in seven other districts. Teams provided post-traumatic care (for head injuries and open wounds), conducted more than 5,900 rehabilitation sessions, and distributed nearly 1,000 mobility aids like wheelchairs, crutches, walkers, and splints.

Our teams also provided one-on-one or group psychosocial support to help victims overcome their trauma. They also directed these individuals towards other operators, who were able to meet other specific needs, such as social support.

By the numbers
(as of July 12)

Rehabilitation conducted by Handicap International since April 25, first day of the earthquake:



Rehabilitation sessions


Mobility aids


Physical therapists



Besides people injured in the earthquake, others who had been living with chronic conditions came to take benefit of the rehabilitation services.



Spinal injuries


Head injuries