Attachments
1. Background and Context
In July 2025, Nepal experienced a severe drought affecting eight districts of Madhesh Province, placing an estimated 1.2 million people at risk. Despite forecasts of above-average rainfall, cumulative precipitation recorded up to 30 August 2025 remained below normal. Madhesh Province experienced particularly limited rainfall, resulting in prolonged dry conditions and the emergence of a severe drought situation across eight districts.
The drought significantly affected agriculture, water availability, sanitation, and livelihoods in Nepal’s primary rice-producing region. Seedbeds dried out, paddy saplings withered, and access to safe drinking water deteriorated as surface and groundwater sources declined. Local government - initiated water supply through existing networks; however, these measures were insufficient to meet minimum drinking, sanitation, and hygiene needs. In densely populated settlements and market areas, communities queued for extended periods of extreme heat to collect limited quantities of water.
On 23 July 2025, the Federal Government of Nepal declared all 136 municipalities across the eight affected districts of Madhesh Province as drought-affected areas1 . Despite the continuation of the monsoon season, rainfall remained below average, and groundwater recharge was insufficient, prolonging water scarcity.
In this context, a surge in Acute Watery Diarrhoea (AWD) cases was reported on 22 August 2025 in Birgunj Metropolitan City, Parsa District. On 26 August 2025, the National Public Health Laboratory confirmed a cholera outbreak2 , which subsequently spread to an adjoining municipality in Bara District. The lack of access to safe drinking water due to drought conditions was identified as a key contributing factor. According to the Epidemiology and Disease Control Division (EDCD), 1,171 AWD/cholera cases were reported between 9 August and 7 September 2025, with cases peaking in late August and sustained transmission observed into early September3 . This situation necessitated an integrated drought and public health response combining water supply, hygiene promotion, health interventions, and community engagement.
In response, the Nepal Red Cross Society (NRCS), with IFRC support, launched its first drought response operation through a DREF allocation of CHF 250,353 (MDRNP019) from July to December 2025, targeting 60,000 people in Bara, Parsa, Rautahat, and Sarlahi districts. The operation focused on water supply, hygiene promotion, and community engagement, with cholera prevention and response activities integrated in Parsa and Bara districts. During implementation, an outbreak of Acute Watery Diarrhoea (AWD), later confirmed as cholera, significantly altered the operational context and necessitated a rapid revision of the response strategy to integrate health interventions alongside WASH activities. The operation was implemented under a temporary operating modality, increasing administrative and operational complexity.
Through this operation, more than 60,000 people were reached through volunteers mobilised by NRCS with access to safe drinking water through water trucking, drilling and installation of boreholes and water tanks, hygiene and sanitation support including temporary latrine construction, and more than 210,000 people from district level massive campaign for cholera oral vaccination. Overall, 34,333 people (6,866 households) across eight municipalities were reached with improved water access, supported by the completion of 14 deep boreholes, installation of 31 water storage tanks, distribution of 2,996 household buckets, and provision of over 515,000 litres of safe water. Water quality testing, chlorination demonstrations, and hygiene promotion activities contributed to reduced risks of waterborne diseases, while the integration of cholera preparedness and response strengthened public health outcomes in high-risk areas. The response was implemented through the mobilization of more than 240 staff and volunteers, ensuring strong community outreach and local engagement.
NRCS organised an IFRCS wide Lessons Learnt Workshop on 23–24 December 2025 in Parsa district to systematically capture learning from the drought and cholera response. The workshop brought together district teams, local government representatives, and community members, who collectively shared their reflections, experiences, challenges, and lessons from the response operations. Furthermore, IFRC and NRCS organized a half-day follow-up and validation meeting on 20 January 2026 with NRCS headquarters, national level authorities and stakeholders on the findings of the lessons learnt workshop done in Parsa in December 2025. This meeting validated the findings of the Parsa lessons learned workshop and support collective learning, accountability, and integration of key recommendations into future response planning.