COVID Emergency Response to NEPAL’s Chisapani, Ramechhap

COVID Emergency Response Project to increase access of people in Nepal's Chisapani of Ramechhap to

- basic medicines advised by doctors in Nepal and those which are available in Nepal to boost immunity of COVID suspected patients

- basic safety equipments to people (health personnel, youths) who are responsible and willing to help COVID suspected patients to get their PCR tested at Manthali town (headquarter of the district which is a 45 minute drive if any vehicle is available)

- set up telemedicine so that the scarcity of medical human resources at the village can be tackled with

- arrange for vehicles to transport COVID patient to District Hospital in Manathali and COVID hospitals in Dhulikhel and Banepa of Kavre district.

Rationale

Health personnel in Health post of Chisapani - 8 (which is also partially serving Chispani -9 and neighboring wards) - one of Nepal's remote villages - are in quarantine leading up to the shut down of the Health Post services, to the entire village comprising over 300 households. As a result, this is denying people basic medicines, consultations and services.

The health post can give 39 basic medicines but they have only Cetamol and Zinc in their stock, even that's running out of stock. They have to make a request to District Health Office to procure them. But that will take time. With the recent political developments in the national politics, we are not hopeful that government initiatives might be prompt.

The population comprises mostly of old people as youths are out in the capital of the country. And many of them have shown symptoms of cold and some symptoms of COVID new variant. As of 12 May, almost one third of the people who went for PCR test were diagnosed COVID positive. But they went their in their own initiation and costs as PCR testing is still not as wide as needed. They have to walk 3 hours to the nearest PCR testing centres. Many are reluctant to go despite suspecting COVID symptoms. Also, the associated stigma surrounding being COVID positive and limited support to anyone who is positive from the existing health infrastructure adds to the burden. They too do not have youths in their own families who could help them with transportation to Manthali, Headquarter of Ramechhap. Hospitals are turning away patients in Nepal, for the stated lack of beds, oxygen cylinders and ventilators.

Now that Nepal is one of the countries facing the highest spread, the new federal structures are not pro-active, and the government is struggling to secure oxygen cylinders and vaccines and manage ICU beds, we need to intervene locally so that the links that are broken to secure basic health services are connected, COVID-spread locally controlled, and most important of all, the people who are in village are not panicked by symptoms, and are offered basic health services and medicines to boost their immunity.

Developments

I and the youths of Chisapani living in Kathmandu, Nepal have raised some funds to get the help started. But it was just enough to provide some medicines for a hundre households, PPE sets and emergency kits like Oximeter, Thermal Gun, Masks and Gloves to the health personnel. the few youths who are in village currently volunteering to carry medicines, helping people with COVID-19 symptoms to go to District Hospital in Manthali, helping coordinate transport of patients to nearby hospital (Dhulikhel hospital which is a 4 hour drive if ambulance is available but there is only one COVID Ambulance available in the entire district of Ramechhap). Our target is to reach 200 more households and ensure safety of the volunteers.

People are joining in offering their personal vehicles to carry COVID patients.

However, the funds were not enough for getting basic medicines, arranging for telemedicine support and authorized medical personnel to serve the village. There is also a need for more PPE sets and other safety tools.

Some youths in the village are taking in-charge of monitoring the spread of COVID and identifying people who need help.

People in the village are waiting for the basic medicines like cetamol, vitamin supplements. And youths are helping the Covid suspected people without PPE sets and using the little resources they have for transportation. These will prove vital until the village can have access to testing, vaccines, Covid medicines from the government as the international community offers support.

We are trying to break the chain, and make health infrastructure of Nepal responsive to the changing needs at local level in collaboration with the Ward offices, medical personnel, and the youths.