Understanding Women’s Long-Term Wellbeing in a Nepalese Community Following the 2015 Nepal Earthquake: A Constructivist Case Study

Abstract

Worldwide, natural hazard events have enduring impacts on wellbeing of survivors. These effects vary according to the location, the communities involved in the disaster, and the available health services. Post disaster, women are disproportionately affected, with higher vulnerability compared to men. The immediate impact of 2015 earthquake was profound for rural Nepalese women as they sustained injuries, experienced property damage, and had limited access to basic resources such as food, water, and health resources. Many women needed to cope with additional responsibilities of caring their family members during the hardship. However, whether their wellbeing was influenced over the long-term remains unexplored. This study aimed to understand the long-term wellbeing of Nepalese women following the 2015 earthquake.

Informed by a constructivist paradigm of inquiry, this study employed intrinsic case study methodology guided by the procedure recommended by Stake (1995). The case was women who survived the earthquake of Nepal in 2015 and continued living in Nuwakot, one of the districts most severely affected by the disaster. Data were collected through multiple sources: focus group discussions with women survivors, individual interviews with local health service providers, document reviews examining immediate earthquake impacts and recovery efforts in Nuwakot. Focus groups and interview data were analysed using Braun and Clarke’s six-step reflexive thematic approach, while reviewed documents were analysed using direct interpretation, providing insights into the context of the case. Eleven assertions about the case were derived by finding patterns and correspondence across different data sources.

Five themes were interpreted from the analysis of the focus group discussions. While women’s initial suffering was severe, physical and psychosomatic symptoms persisted over the long-term. Additionally, their socio-economic wellbeing over the long-term was profoundly affected, with ongoing loss of employment opportunities for male family members and increased male migration which caused impaired family functioning. Women’s wellbeing was partially supported through community support, religious faith and optimism, and by accepting recurring adversities as “problems are part of life”. However, enduring long-term influences were evident with critical gaps in health service availability, affordability and accessibility due to resource constraints and geographical barriers. Interviews with health service providers highlighted systemic service fragility and transportation challenges, which hindered equitable public healthcare for the women. The women’s efforts to support their wellbeing were further constrained by deeply entrenched, gender-based domestic roles, positioning them as a hub of family life. Stigma, and hesitancy to discuss health issues with male service providers contributed to delayed health-seeking behavior amongst the women.

The study recommends a comprehensive assessment with the women survivors to understand and best meet their long-term wellbeing needs. Study findings suggested that providing gender specific relief measures, through culturally responsive disaster response and awareness frameworks, and implementation plans can strengthen women’s health care autonomy in promoting their wellbeing in post-disaster context. Findings also suggested the role of local governments in women’s economic empowerment by creating opportunities beyond household responsibilities, such as supporting small-scale farming businesses. These findings contribute to a deeper understanding of women's long-term experiences in post-disaster context and offer evidence-based practical guidance for developing more fair and sustainable disaster recovery strategies that promote women’s long-term wellbeing following disaster events.