Tragedies in the hills – experience with health (right) status in Dolakha

Dolakha is around 170 km away from Kathmandu – but a staggering 7 hours drive thanks to the tortuous mountain roads .The dusty roads is a signature of mountains in Nepal. But the purpose of the travel, my companions made it all worthwhile.

I went to Charikot and Jiri and got to know more about the places and people there as a volunteer of Medication for Nepal (MFN). We went there to attend a program organized by LEO youth camp. It was good to meet so many people looking and willing to be part of the change, but I was completely taken aback, and ministers would come via helicopter to just inaugurate the program. At times it hit me, probably the cost of that heli-ride would have enough to fund the district hospital for few weeks? I do not know, but surely I was surprised to see that ministers had time to inaugurate.

Before joining MFN, if someone had asked me anything related to health rights then my expression and response would be the same as people around me – ‘I don’t know’. I find several others educated people of my generation unaware about health rights. Having worked for MFN, now I feel deeply connected to the issue. It has become my passion!

Before my journey to Charikot and Jiri, I had met several people and conducted various sessions regarding information dissemination – the campaign of making people aware about their basics health rights, which is categorized into 4 terms: children, women, general people and elder citizens.  We have posted here: https://www.facebook.com/medicationforNepal/posts/1102905069818583. I have been a part of these campaigns from the beginning and it has not been easy. Basically, we go to schools, youth groups, or women’s groups and before starting every session I ask them ‘Do you know your health rights?’ Then they answer with a big NO, which always makes me sad. Until we know what our rights are, how do even get them?

My second question follows ‘Have you ever received any free medicines from the hospitals? The usual answer from Kathmandu is “really there is something for free!!” from the people outside Kathmandu, the answer is usually “Cetamol, Jevanjal, Worm tablets, Iron tablets and Tuberculosis medication”. Besides these in my past 5 months of going around, I have never heard any other answers.

While this session in Dolakha and Jiri went as expected, I didn’t have answers to many of the questions they asked. I came back with more questions. A student from class 9 at Charikot School questioned me: ‘Maam, do you know there are so many people who have sold their kidney on their own and some people unknowingly. They might have kidney issues in the future. Will they get transplant services for free because they are from impoverished group? Will they get free Dialysis services?’ I was very surprised, sad and happy at the same time. How sensible question a young boy asked me. I have always heard complains about the ministry or criticism from many people but this question really amazed me. Then I came to know this is not only a Charikot story.

A detailed and chilling detail of how Nepal is being used in trafficking of human organs can be found in this report published in dailymail.com http://www.dailymail.co.uk/news/article-3155817/Nepalese-village-sold-kidneys-organ-traffickers-buy-house-destroyed-devastating-earthquake.html

http://setopati.com/chapa-bata/62688/ This is however, just a small glimpse of how terribly Nepal is lacking in basic health information and awareness.

 

 

Onwards from Dolakha, we went to  District hospital Dolakha,Jiri. We spoke with Dr. Nishant Dhakal, general practitioner at District hospital Dolakha, Jiri and Tanka Jirel (Chairman of operating and management committee at  District Hospital Dolakha,Jiri).Dr. Dhakal mentioned, a snake bite requires a 3 hour travel to another hospital, because all they don’t have the required medication, though the cases of snake bites are not that common. What surprises me is recently we have heard so many announcements from the Ministry of Health regarding free medicines for yet other diseases, which is fantastic. But perhaps more worthwhile effort will be to see if the previous commitments have been fulfilled properly. How easy it is to say that we are providing so many facilities for free but if we look closely most of the ‘free’ facilities are not been provided.Ref: https://thehimalayantimes.com/nepal/drugs-crunch-hits-parsa-health-centres/, http://setopati.net/society/19649/

We are making very small steps towards making government more responsible by telling people about their rights in the step-by-step detail. But it is a hard process and we have faced it. It is hard to get young people in Kathmandu to engage. It is not enough to know, but to act upon. But it does start with knowing. I have passionately adopted the agenda of “My heath, my rights”. We need more activism and a way to get the policies implemented.

 

With members of LEO club
With members of LEO club

 

 

at the LEO program
Information dissemination session

Outcomes of the “Conference on Public Healthcare” – September 11th, 2016

confConstitution of Nepal states that everyone has the right to free basic healthcare. Yet, the most remote and marginalized people – those in most need of these rights – are largely unaware of those rights. The survey in Helambu’s 5 VDC showed that everybody was purchasing medications that they were supposed to get for free such as Cetamol, ORS, and cold tablets. They were traveling to Banepa and Kathmandu to get plasters on their broken limbs and for baby delivery.

confere

Experts have spoken from different angles about those health rights, and there is a consensus that more needs to be done to close this knowledge gap and to help people access those rights. The goal of the conference was to invite health rights experts, constitution rights experts, and government officials to help us understand the rights and how to access those rights. Furthermore, we featured young initiatives and youth who are leading by examples. We invited:

  • Dr. Nastu Sharma, Country Director of One Heart World Wide, who presented comprehensively about the different health provisions in places by Government of Nepal.
  • Indu Tuladhar, Human Rights Lawyer, spoke about the provision our constitution provides to patients and every citizens.
  • Dr. Surendra Bhandari, Constitutional Lawyer, presented his views on future of public health sector.
  • Prakash Ghimire, Senior Auxiliary Health Worker from Management Division of Nepal, who shed light on some of the most evasive topic such as who is considered “Bippana barga” – ultra poor. Apparently, it is self-declared in Nepal.
  • Grishma Maharjan and Sangita KC of Nepal Psychological Society, who are working to improve the mental health education system and awareness of importance of mental health.
  • Dr. Kshitiz C Paudel, medical director of Amppipal Community Hospital, and MD (General Practice), who inspired the entire audience on the need to work for the greater good of the community. Watch the video here
  • Dr. Sarad Baral, DHO of Accham, who has been serving the community in one of the most remote parts of Nepal. He believes the way to improve health care is community supervision because he says he can’t be everywhere, “It greatly helps me to supervise when the community starts supervising the health sector as well”.
  • Dr. Saroj Dhital, Founder of Kathmandu Model Hospital, and a surgeon who has been working to create a strong community of professionals to improve the health care system of Nepal.

For the audience, the key take away was very clear – lots needs to be done to strengthen the health care system of Nepal and there is a lot of non-medical professionals can do to support the health care system.

We will be creating lots of new multimedia content about what we learned from the conference and forming partnerships across the board to make sure we try to reach every corner of Nepal.

The Change agents-MFN’s Student Ambassadors Orientation successfully held

2MFN has launched Student Ambassador Programme to start engaging the most creative sector of the society to think about how they can be involved to strengthen the public healthcare system of Nepal. It starts with learning about health rights, how to access them and then finally how to creatively disseminate. But it doesn’t stop here. MFN’s ambassadors are the torch bearers of discussion of Nepal’s health policies and their active engagement now will ensure better implementation of such policies.

6The Ambassador Programme addresses to high school and college students who are willing to take initiative to share their knowledge about health rights among their peers and at their respective schools/colleges. To ensure this process MFN encourages their Ambassadors to work closely with their school’s or college’s administration. From MFN’s perspective knowing our health rights is the first step in accessing them. Claiming our health rights can provide the basis for further development/improvement of the dysfunctional healthcare system of Nepal.

The new ambassadors already have great plans and their personal roles to support the health agenda of MFN.We look forward to working with each one of them and making sure we as a society come together to support public health care system and let everyone realize health is an investment not an expenditure

Conference on Public Health Care – Current State and Possibilities to be held

Medication for Nepal has had the honor of consulting some of the most esteemed doctors, health experts and dedicated social sector professionals who have been wholeheartedly doing everything they can to improve the health sector of Nepal. The amount of knowledge and information that we gained through these meetings were enormous, and to build on that and take the knowledge flow and expertise sharing to the next level, we want to once again bring together these experts to debunk and discuss health care rights in Nepal.
On September 11th 2016, an event has been organized by Medication for Nepal, where experts from different fields – Health, Media, Engineering, and Social Sector will come together to create an aligned strategy to improve the health care system in Nepal. After gathering information about Health Rights, Policies and how to access them, we will get help from engineers, and technology experts, to develop partnerships that help us make health rights a priority agenda item across industries, and to create new channels to disseminate health rights information to the masses via new or local media. The event will be held at Leapfrog Technology Offices, Charkhal from 9:30am to 2pm.
With this event, we aim to grant every individual access to simple and factual information about their health rights.
We ran a survey in Helambu (5 VDCs) to get a sense of health rights awareness with a health of partner organization, and we found out that everyone purchased basic medicines – Cetamol, ORS, cold medicines, that they are supposed to get for free, 75% of the population were oblivious to the fact that Government of Nepal provides up to 1 lakh of treatment support for nine different disease areas. 25% people knew about this provision however none had ever seen it in practice. They are largely unaware of having any health rights at all, let alone how to claim them or file a complaint for non-compliance.
People are unaware about other important health information such as, basic essential medications to be available for free in public health posts, free heart surgery treatment for children below 15 years, free Dialysis treatment for diabetic patients and many more. MFN would like to fill this information gap with this event by collecting and disseminating valuable health information to the public. Our mission is to ultimately strengthen the public health care system of Nepal.