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Communities reliant on subsistence and small-scale production are typically more vulnerable than others to disasters such as earthquakes. We study the earthquakes that struck Nepal in the spring of 2015 to investigate their impacts on smallholder communities and the diverse trajectories of recovery at the household and community levels. We focus on the first year following the earthquakes because this is when households were still devastated, yet beginning to recover and adapt. Through survey questionnaires, focus group discussions, open-ended interviews, and observations at public meetings we analyze physical impacts to farming systems and cropping cycles. We investigate respondent reports of loss and recovery through a new social-ecological recovery assessment instrument and find that diversification of livelihoods and access to common resources, alongside robust community institutions, were critical components of coping and recovery. There was widespread damage to subsistence farming infrastructure, which potentially accelerated ongoing transitions to cash crop adoption. We also find that perceptions of recovery varied widely among and within the typical predictors of recovery, such as caste and farm size, in sometimes unexpected ways. Although postdisaster recovery has material and psychosocial dimensions, our work shows that these may not change in the same direction.

In Spring 2015, a series of earthquakes and aftershocks struck Nepal. The earthquakes caused significant changes in labor and land availability, cash income needs, and land quality. We examine how these post-earthquake impacts converged with ongoing agricultural shifts. Earthquake-related socio-economic and landscape changes specifically motivate the adoption of cardamom, Amomum subulatum, a high-value ecologically beneficial, and low labor commercial crop. We investigate reasons for the increased interest in cardamom post-earthquake, and challenges associated with it. We find that adopting cardamom serves as an important post-disaster adaptation. However, more broadly, unevenly distributed interventions coupled with the high capital costs of agricultural transition exacerbate social differentiation in communities after the disaster. Adoption is often limited to economically better off smallholder farmers. This paper extends previous research on disasters and smallholder farming by highlighting the specific potential of disasters to accelerate agricultural transitions and resulting inequality from the changes.

PurposeIn response to the growing burden of breast and cervical cancers, low- and middle-income countries (LMICs) are beginning to implement national cancer prevention programs. We reviewed the literature on information and communication technology (ICT) applications in the prevention of breast and cervical cancers in LMICs to examine their potential to enhance cancer prevention efforts.MethodsTen databases of peer-reviewed and gray literature were searched using an automated strategy for English-language articles on the use of mobile health (mHealth) and telemedicine in breast and cervical cancer prevention (screening and early detection) published between 2005 and 2015. Articles that described the rationale for using these ICTs and/or implementation experiences (successes, challenges, and outcomes) were reviewed. Bibliographies of articles that matched the eligibility criteria were reviewed to identify additional relevant references.ResultsOf the initial 285 citations identified, eight met the inclusion criteria. Of these, four used primary data, two were overviews of ICT applications, and two were commentaries. Articles described the potential for mHealth and telemedicine to address both demand- and supply-side challenges to cancer prevention, such as awareness, access, and cost, in LMICs. However, there was a dearth of evidence to support these hypotheses.ConclusionThis review indicates that there are few publications that reflect specifically on the role of mHealth and telemedicine in cancer prevention and even fewer that describe or evaluate interventions. Although articles suggest that mHealth and telemedicine can enhance the implementation and use of cancer prevention interventions, more evidence is needed.

Environmental disasters, such as hurricanes, landslides, and earthquakes, are pervasive and disproportionately affect rural and poor populations. The concept of resilience is typically used in disaster scenarios to describe how a community or person is able to “bounce back” from a disaster event. At the same time, resilience theory also contends that disasters, or environmental shocks, can produce or initiate profound changes in social and ecological systems. This case uses a post-disaster resilience assessment to examine how the series of earthquakes that hit central Nepal in 2015 impacted farming communities. Mid-montane smallholder farming communities near the epicenters of the earthquakes were the most affected and the associated damages impeded traditional and subsistence agricultural practices. Our results show how some aspects of the Nepali farming social–ecological system (SES) bounced back more quickly than others and how farmers used various types of coping strategies, including the adoption of labor-saving cash crops as part of their post-disaster recovery. The increased interest in cash crops after the earthquake accelerates an ongoing transition toward more market activities in subsistence communities and illustrates the potential of environmental shocks to transform and change SESs.