Nepal's flood camps are running out of water and medicine, and the doctors are warning about an epidemic

Six days after the water, the thing most likely to kill someone else in Rasuwa and Nuwakot is no longer the river. It is the drinking water, the camp toilets and the empty pharmacy shelf — and the doctors running the one hospital still working inside the flood corridor have now said out loud that an epidemic is possible. On 30 August the World Health Organization released US$150,000 in emergency funds specifically to stop that from happening.

The hospital that lost its bridges and its blood-pressure drugs

Trishuli Hospital in Nuwakot is the anchor of the whole story. It survived the 26 August flood that came down the Bhote Koshi at roughly 50 metres per second, but the bridges around it did not. With every bridge in the area gone, the hospital has been severed from the district headquarters, and moving a patient in or out now means waiting for a helicopter.

Inside, the shortage is mundane and dangerous. Hospital pharmacist Maheshwar Yadav told the Kathmandu Post that medicines for hypertension — atenolol and losartan among them — were simply unavailable. The people in the camps are not only the injured. They are diabetics, asthmatics, cardiac and thyroid patients who ran out of the house with nothing and have now gone days without the drugs that keep them stable.

Three camps sit in the Baghtaar area beside the hospital: Bhairung Secondary School, a covered hall and Bethan Academy. Roughly a thousand people are in them, including pregnant women and new mothers. Two of the area’s water sources are gone — a canal serving the Trishuli hydropower project and a pipeline through Tupche — and drainage from the camp toilets is poor.

That combination is what alarmed the hospital’s medical superintendent, Rajendra Lama. “With so many people living together in one place, there is a risk of disease spreading,” he said, adding that “the lack of safe drinking water and proper toilets raises the possibility of an epidemic.” When the person running the hospital says the word epidemic on the record, that is the story.

What the WHO money is actually buying

The US$150,000 released on 30 August came from the South-East Asia Regional Health Emergency Fund. It is small money against a disaster estimated at around Rs 200 billion, and it is deliberately unglamorous: an Interagency Emergency Health Kit sized for about 10,000 people for three months, surgical masks, gloves, hand sanitiser, body bags and six multipurpose tents.

The stated priorities are the ones that matter in week two, not week one — disease surveillance, diarrhoeal and respiratory illness, water- and food-borne disease, vector-borne disease and mental health.

Why the silt is a medical problem, not a cleaning job

Silt has been reported more than 1.5 metres deep across the worst of the disaster zone, and every excavator working in Timure, Betrawati and Trishuli Bazaar is digging through it. That mud is not inert. It sits on top of collapsed latrines, drowned livestock and, in a flood that carried bodies as far as Nawalparasi, human remains. Every shallow well and spring intake underneath it should now be assumed contaminated until somebody tests it.

On 30 August the Kathmandu Post ran an editorial pressing the government to keep purification supplies, essential medicines and equipped health workers at ward level rather than centralised in Kathmandu. It pointed at the 2023 Jajarkot earthquake, where more than 30 people died of cold exposure after the shaking stopped. The secondary death toll is the preventable one, and the one that gets less attention once the helicopters stop flying.

What this means for trekkers

Nothing about this changes the trekking map. The Everest and Annapurna regions were never in the flood path, their trailheads are reached by different roads and flights, and every one of our autumn departures outside the Langtang and Rasuwa corridor is running. What has changed is what a well-meaning traveller should and should not do about it.

Is there a confirmed disease outbreak in the flood camps?

No. As of 31 August there is no confirmed outbreak. What exists is a stated risk from the medical superintendent of Trishuli Hospital, and a WHO response funded specifically around surveillance and prevention. We will update this page if that changes.

Which health facilities are gone?

WHO reports four health facilities completely destroyed in Rasuwa and two partially damaged in Dhading, with hospitals in Dhading and Trishuli standing but unreachable by road. Those numbers are provisional and have moved as assessment teams reach more wards.

Is the drinking water safe in the affected districts?

Assume it is not, anywhere in the Bhote Koshi–Trishuli corridor. Two of the main supply lines around Trishuli were destroyed and the silt layer sits over the shallow sources. Everywhere else in Nepal, including Kathmandu, Pokhara, the Khumbu and the Annapurnas, treat water exactly as you normally would.

Can I still trek in Nepal this autumn?

Yes, outside the Langtang and Rasuwa region, which is where our own bookings are paused. Everest Base Camp, Annapurna Base Camp, the Annapurna Circuit, Manaslu, Mustang and the Khumbu peaks are all operating normally.

Where should I send money?

To organisations that were already operating in these districts before 26 August and are inside the government’s health cluster. We keep a checked list on where to donate for the Nepal floods rather than repeating whatever is trending.

What we are watching next

Three things will tell you whether the second disaster is being avoided: whether the Health Emergency Operation Centre publishes camp-level surveillance rather than district totals, whether purification supplies and chronic-disease medicines get past Trishuli to ward-level health posts, and whether the bridge repairs get far enough that a patient no longer needs a helicopter to leave a hospital.

We are running the full toll, road status and trek-by-trek position on our Nepal floods live updates page, which is updated as NDRRMA and the ministries release figures.