Nepal, Sept. 22 -- Disasters are often measured in lives lost, property damaged and infrastructure destroyed. However, something deeper must accompany the assessment: the strength and resilience of the institutions responsible for response. How effectively can these systems keep functioning when normal conditions collapse? Nepal's recent Bhotekoshi flood became a real-time examination of the disaster health preparedness, leadership, coordination and resilience of the state and, by association, its institutions.

The response of our health system in particular was encouraging. It responded far more effectively than it might have a decade ago. The Health Emergency Operations Centre (HEOC) was activated, hospitals continued accepting referra...