At a helpdesk in Tribhuvan University Teaching Hospital, a small group of glum-faced people wait their turn to see a doctor, hoping she will free them from a never-ending moment of horror when they lost their homes and loved ones.
As their minds remain locked in a time when the ground shook under their feet, every moment is a prelude to more tremors.
“Whether I walk or sit, I feel the ground is moving,” says Nirmal Thapa, a 29 year old taxi driver who lost his brother in the quake.
“I can’t go into our home. I feel the roof is coming down.”
Millions of quake survivors in Nepal are experiencing “phantom tremors” and other anxieties, in continuing anguish that experts describe as classic symptoms of post traumatic disorder that the country will struggle to deal with.
Nepal has just 90 trained psychiatrists and 300 psychologists. Consider their task: Health experts estimate that about two million Nepalis will probably require basic post traumatic stress disorder counselling. Of these, at least 20% could require short-term medication, according to the Psychiatry Association of Nepal.
“These are conservative figures,” Dr Saroj Prasad Ojha, president of the association, told HT."Whichever way you look at it, we are not equipped to deal with this challenge. The infrastructure is grossly inadequate."
The earthquake is believed to have affected some eight million people and destroyed up to 90% of structures in 35 of Nepal’s worst affected districts. Hundreds of thousands have been forced to live in campsites or under flimsy tarpaulin on road islands and narrow sidewalks.
Yet, the trauma of the disaster goes beyond personal loss and grief. In a country steeped in culture and heritage, the earthquake shook the very foundation of the nation, destroying many landmarks integral to the spiritual and cultural identity of most Nepalis.
“It is a big issue. Psychological trauma is not so much discussed in this country,” says Dr Deepak Prakash Mahra, director of the Tribhuvan university hospital. “But people are coming to us for counselling. Slowly the number of such people is going up -- From six on Day 1 (of the quake) to about 20 today.”
Most of those who are seeking counselling are men between 20 and 40 years, although psychological trauma is known to affect women, children and elderly more, says Dr Ojha.
He says the government was opening up trauma counselling centres in the districts and advertising in newspaper to raise awareness about counselling, besides asking people to stay positive and do a lot of physical exercise and yoga.
In a conservative country like Nepal, psychological counselling carries a social stigma as well.
“People don’t know the distinction between mental disorder and psychological problem,” Dr Ojha says.
“Unless we counsel and/or give suitable medication people can develop chronic depression and can become suicidal. Psychological trauma can live on in a person for year.”
Clearly, for Asha Gurung, another patient at the Tribhuvan hospital, the safety of the hospital hasn’t erased memories. She still refuses to go inside the doctor’s chamber.
“Every time I walk I feel the ground is moving,” she says.
“I feel the walls are falling on me. The roof will come crashing down and I will get killed.”
Full coverage: Nepal earthquake