Differences in Biopsychosocial Elements between Earthquake and Unintentional Injuries in Nepal

Background-The global burden of diseases is transitioning from communicable to noncommunicable diseases & injuries. Earthquake can cause lots of injury where it imapcts. Nepal, a low income country is susceptible to earthquake because of its location over sessimic fault line. It was struck by two high intensity earthqakes in April and May 2015 that injured 22303 people. Likewise, unintentional injury accounts for significant DALY and road traffic accidents are alarmingly increased in Nepal. Injury risk, its disabiling effect and possibilities to reintegrate the injured person in society is influnced by biopsychosocial profile of person. Method-This study was conducted using the service delivery data of HI collected from 9 earthquake affected districts of Nepal. Out of 3125 people with injury included in this study, 1282 had earthquake induced injury and 1843 had unintentional injury. Summary statistics and bi-variate analysis were done. Likewise, Chi square test of independence and logistic regression was performed for inferential statistics. Results- Risk factors for earthquake injury were rural residency (OR=6.95, CI=5.64-8.60), having the lowest annual household income (OR= 2.39, CI=1.61-3.56), being elderly (OR=1.98, CI=1.38-2.84) and being relatively disadvanatged Janajatis (OR=1.74, CI=1.14-2.66). Being male was the protective factor (OR= 0.51, CI=0.41-0.64). Unlike unintentional injury, those injured by earthquake were likely to get head injury (OR=4.26, CI=2.19-8.75) and spinal cord injury (OR=3.14, CI=1.24-8.70) than fracture, dislocation & sublaxation. Relationship of injury types with previous disability and new disability severity was not statistically significant. Conclusion- Our data showed high susceptibility of earthquake injury to vulnerable population. This group needs focused screening and interventions as they are not easily detected by as usual humanitarian interventions. High likelihood of sustaining head injury and spinal cord injury by earthquake means more need of specialized medical team for pre-hospital, hospital care and rehabilitation services. It is important to address socioeconomic vulnerabilities to minimize the injury in long run. More researches are needed to further explore nexus of injuries with biospychosocial aspects and quality of life after injury. Key words: Biopsychosocial, Unintentional, Vulnerability, Rehabilitation and Disability