The 2010 earthquake in Haiti and the subsequent cholera outbreak taught us multiple lessons on how we might better avert cholera outbreaks, beyond simply improving access to clean water and sanitation . Post-earthquake Nepal is now a test of how well we learned these lessons (Fig 1). Earthquake-associated mortality generally progresses in well-defined phases that ultimately give way to longer-lasting periods of new and complex health needs. The first phase is caused by the immediate kinetic trauma. The second is a product of infectious complications from the bodily trauma. The third is linked to infectious disease outbreaks enabled by the destroyed infrastructure; many of these latter diseases are now vaccine preventable, including cholera.