Nepal Police said at least 95 people were killed after a wall of water surged down the Bhote Koshi River on Wednesday morning, and hundreds more are unaccounted for in valleys where the roads, bridges and power lines rescuers need are gone.
The toll climbed through the day as reports reached Kathmandu from districts farther downstream, moving from seven confirmed deaths in the early afternoon to 22, then 55, before Reuters and AFP cited local police putting the death toll at 95 by Wednesday evening. "So far 95 deaths have been reported," police spokesman Abi Narayan Kafle told AFP, adding that nearly 30 police personnel were among the missing. The Kathmandu Post reported that 32 Nepal Police and Armed Police Force personnel were out of contact in Timure, near the Chinese border.
For families waiting on news, the problem is no longer the water. It is access to care. Nepal's health ministry activated its Health Emergency Operations Center and sent a six-doctor team from the National Trauma Center to Tribhuvan International Airport to be flown into Rasuwa district, ministry spokesperson Dr. Samir Kumar Adhikari said. The emergency departments of five Kathmandu Valley hospitals, Bir Hospital, Tribhuvan University Teaching Hospital, Civil Hospital, the National Trauma Center and Patan Hospital, were placed on alert, along with hospitals closer to the disaster zone in Dhunche, Trishuli and Dhading.
Kathmandu Hospitals Switch to Disaster Mode
Twenty-five injured people had been brought to Kathmandu for treatment by Wednesday evening, Nepal Police spokesperson Superintendent Dan Bahadur Thapa said. Four went to the National Trauma Center, one to Birendra Army Hospital in Chhauni, and the rest to Tribhuvan University Teaching Hospital, which activated its disaster code to prepare for an influx of patients. "The hospital's disaster code is active," spokesperson Dr. Gopal Sedhai said, adding that intensive care beds and ventilators were being held ready and that some arriving patients were in critical condition. The hospital helipad was kept open for further evacuations.
The Nepali Army said it had rescued 88 people by Wednesday afternoon, most of whom were moved to safe locations locally rather than flown out. The cabinet ordered free treatment for the injured through the health ministry, the Nepali Army and government hospitals, and declared local units in the affected districts disaster crisis zones for three months under the country's disaster management law. Ministries were also directed to reopen cut roads, restore electricity and telecommunications, and secure adequate drinking water in the affected areas.
Severed Roads and Power Lines Slow Every Medical Decision
The clinical problem in a flood like this is rarely the treatment. It is the delay before it. Crush injuries, open fractures and near-drownings are time sensitive, and in Rasuwa and Nuwakot the usual ground routes are gone. A 42-kilometer stretch of road linking Betrawati to Rasuwagadhi was washed away, and sections of the Pasang Lhamu Highway toward Syabrubesi were blocked or destroyed.
That leaves air transport as the main route out, and it has been unreliable. Water levels were too high for helicopters to land in the worst-hit settlements of Timure and Syabrubesi. About a dozen helicopters, four of them operated by the Nepali Army and the rest by private companies, were assigned to the rescue, and flights were repeatedly disrupted by poor weather.
Electricity is the second constraint. The Nepal Electricity Authority said about 430 megawatts of production capacity, including hydropower and solar, was damaged, and that the flood had damaged production, transmission and distribution facilities, disrupting supply. Power loss in a district hospital affects oxygen concentrators, sterilization, laboratory testing and the refrigerators holding vaccines, insulin and blood products.
Telecommunications outages compound it. When district health posts cannot report what they are seeing, planners cannot tell whether they are sending enough surgeons, blood or antibiotics to the right valley.
Contaminated Water and Open Wounds Are the Next Threat
The health risk does not end when the river drops. The World Health Organization says the most common risks after flooding are contamination of drinking water supplies and standing water, which can breed mosquitoes, carry chemical hazards and cause injuries. Floods can also increase the spread of water-borne and mosquito-borne illnesses such as typhoid fever, cholera and malaria.
That translates into three overlapping concerns. Diarrheal illness rises when piped supplies break and people fall back on untreated surface water. Wound infections and tetanus risk climb because flood debris causes dirty puncture wounds. Respiratory infections and skin conditions spread in crowded temporary shelters.
None of this is confirmed in Rasuwa yet. No outbreak has been declared, and health authorities have not reported waterborne illness linked to the flood. These are the predictable next problems, and they are why the ministry said it was keeping local and central health institutions on standby for potential health complications.
Older adults, young children, pregnant women, people with diabetes or weakened immune systems, and anyone who lost access to regular medication carry the highest burden, as do rescue and cleanup workers with repeated contact with contaminated water and debris.
Hundreds of Travelers Unaccounted For, Including Americans
The Nepal Tourism Board issued a preliminary list of travelers whose whereabouts and safety were being verified, drawn from agency-by-agency records supplied by tour operators. An initial count of 384 people, 291 of them foreign nationals, was revised later Wednesday to 403 people, including 341 foreign nationals and 62 Nepalis. The earlier list included 105 Indian nationals and 37 non-resident Indians, along with three Americans, 17 Malaysians, 12 Britons, eight South Koreans, four South Africans, one Australian and one Dutch national. Nationalities of more than 100 others had not been established.
Many were Kailash Mansarovar pilgrims who had been due to cross into Tibet through the Rasuwagadhi checkpoint on Wednesday morning. The three Americans were traveling with a Kathmandu company, Fishtail Tour and Travels, which confirmed to ABC News that three of its American clients were among the missing.
Being on that list does not mean someone died. It means a tour company could not reach them in a region where mobile networks are down. The U.S. Embassy in Kathmandu said it was working to account for U.S. citizens and advised Americans in Rasuwa, Nuwakot, Dhading, Gorkha, Chitwan and Tanahun to stay away from riverbanks and low-lying areas and to move to higher ground. Families in the United States trying to trace a relative should work through the tour operator and the embassy rather than social media casualty lists, which are circulating ahead of verified information.
What Investigators Think Set Off the Surge
The cause is still being established. An initial assessment suggests an ice avalanche blocked the Lhende river, letting water build up before it burst downstream, according to Rijan Bhakta Kayastha, a professor and climate researcher at Kathmandu University. "This was not a regular flood," he said, pointing to its sudden onset. The National Disaster Risk Reduction and Management Authority said it had received similar preliminary information through the International Centre for Integrated Mountain Development, which obtained it from sources in China, and cautioned that nothing official had been confirmed.
The U.S. Geological Survey recorded a magnitude 4.4 earthquake in Tibetan territory at 8:37 a.m. local time, about 47 kilometers north of Gosainkunda. Foreign Minister Shishir Khanal told parliament that preliminary information indicated an earthquake had triggered the landslide that blocked the river. A glacial lake outburst has not been ruled out, and Kayastha said it could take several days to determine whether one occurred. Nepal's Department of Hydrology and Meteorology reported no heavy rainfall in the Rasuwa area on Tuesday or Wednesday, which weighs against rain as the main driver. A similar flood struck the same stretch of the Bhote Koshi in July 2025, killing at least nine people, and was later traced to the draining of a supraglacial lake.
Anyone in or returning from the affected districts should treat all floodwater as contaminated, boil or chlorinate water used for drinking, cooking and brushing teeth, wash wounds immediately with clean water and soap, and seek care for fever, spreading redness, swelling or drainage around a wound. Diarrhea with signs of dehydration, difficulty breathing, chest pain, confusion or a rapidly worsening injury needs urgent evaluation. Travelers who develop a fever within two weeks of returning from Nepal should tell their clinician where they were and when.
Rescue operations continued overnight, and authorities said updated casualty figures and damage assessments would follow as helicopter access improves and communications are restored. The counts will change. What is already settled is that a district of about 50,000 people lost its roads, much of its power and part of its hospital access in one morning, and the health consequences will outlast the search.
Key Questions Answered
What happened in Nepal?
A flash flood surged down the Bhote Koshi River from the Tibetan side of the border on Wednesday morning, destroying settlements in Rasuwa district and moving downstream into Nuwakot and Dhading. Officials placed the onset between about 8:30 and 9 a.m. local time. Nepal Police reported at least 95 deaths by Wednesday evening, with counts still changing.
How many people are missing?
The Nepal Tourism Board's preliminary list grew from 384 travelers to 403, including 341 foreign nationals and 62 Nepalis. Roughly 30 security personnel were also reported unaccounted for, along with workers at damaged hydropower sites. These are preliminary lists compiled from tour operator records, not confirmed casualty figures.
Are Americans affected?
Three U.S. nationals traveling with a Kathmandu tour company were listed among the missing. Their status had not been publicly confirmed by U.S. officials when this article was published. The U.S. Embassy in Kathmandu said it was working to account for U.S. citizens in the area.
Where are the injured being treated?
Twenty-five injured people were brought to Kathmandu, mainly to Tribhuvan University Teaching Hospital, with others at the National Trauma Center and Birendra Army Hospital. The government ordered free treatment and placed five Kathmandu Valley hospitals on alert for serious cases.
What health risks come after the water recedes?
The World Health Organization identifies contaminated drinking water as the most common post-flood risk, along with mosquito breeding in standing water, chemical hazards and injuries. Wound infections, diarrheal illness and respiratory infections in shelters are the usual concerns.
Who faces the greatest risk?
Young children, older adults, pregnant women, people with diabetes or weakened immune systems, anyone who lost access to regular medication, and rescue and cleanup workers with repeated contact with floodwater and debris.
What caused the flood?
It remains under investigation. An initial assessment suggests an ice avalanche blocked the Lhende river upstream. The U.S. Geological Survey recorded a magnitude 4.4 earthquake nearby that morning, and Nepal's foreign minister said preliminary information pointed to an earthquake-triggered landslide. A glacial lake outburst has not been ruled out, and rainfall in Rasuwa was minimal.
