The Harsh Reality for the People of Rural Nepal

The featured image above is a labour bed. This is where mothers of the region give birth – if they go to the hospital at all.

At Access Health Care Nepal we believe that health care is a human right: Everyone has the right to the highest attainable standard of physical and mental health, which includes access to all medical services, sanitation, adequate food, decent housing, healthy working conditions, and a clean environment.

After seeing the current state of the Salle Bajjar District Hospital however, we had to conclude, that if one of us was a patient in this region, we would avoid all contact with its health care system if possible at all. Looking through this gallery speaks for it self. You don’t have to ask yourself whether or not you would like to be admitted here to know the answer. This is the largest public hospital in Rukum and the condition of it is devastating for the people.

After an initial meeting with the doctors of the hospital we were given a tour of the hospital. A quick inventory (made during the tour) showed that more than 66% of the equipment is out of order – and we were not counting the piles of broken equipment in the storeroom as the storekeeper was on leave.

The hospital has 15 beds and an occupancy rate at all time of at least 150% – and 200-300% is not uncommon. The hospital has no biomedical engineering staff and in consequence they have no preventive maintenance program. If something breaks, a request for new equipment is made to the government. Whether the request is met or not is completely unpredictable.

During the Maoist insurgency Doctors Without Borders were active in the region and the hospital was quite well off. However, since activity of the Maoists came to an end around 2011, the activity of Doctors Without Borders did the same, and today the hospital has become completely neglected.

At a hospital like Salle Bajjar District Hospital, the presence of Access Health Care Nepal as well as Engineering World Health would not only be helpful, but would be a part of fulfilling every individual’s fundamental human right to health care.

A central aim of for Access Health Care Nepal is to create awareness of the health care circumstances in rural Nepal. You can help us by sharing this article.

AHCN #8 – Meeting with the Local Development Officer of Rukum

Before proceeding to Rukumkot, we had a meeting with Mr. Bharat Sharma, the Local Development Officer of Rukum, to talk about the health care needs of the district, and about and how AHCN and possibly also EWH could help the region. We agreed with Mr. Bharat Sharma to arrange a visit to the Salle Bajjar District Hospital that very same day (post about the visit coming up tomorrow). Furthermore Mr. Bharat Sharma ensured that it would be possible to bring EWH volunteers to the region and we agreed to collaborate in phase 2 and 3 of the AHCN effort in Rukum.

AHCN #7 Musikot

Musikot (in the same area as Jumlikhalanga and Salle Bajjar) is the administrative centre of Rukum. Dr. Justin of our team lived here while still a child, before moving to Kathmandu. During our visit we stayed at their beautiful traditional Nepali house, where Justins grandmother still lives.

During our stay we also met Mr. Chandra Bahadur Malla, a teacher from Rukumkot, who would be our guide on the way to Sisne and back the following 3 days.

AHCN # 6 Reaching Rukum on Impossible Roads.

On the third day of our trip we would emerge from the flat Terai region in south into the mountains and on the fourth we would have to drive on roads so poor, that it took us 8 hours to drive 35 kilometres.

At times the road would be too narrow for two vehicles and either one or the other would have to back up several hundred meters to find a spot with sufficient room to pass. Seeing people sitting on the top of busses and jeeps in this setting plainly seemed extremely dangerous.

Mountain side terrace-farms were everywhere on the way. We came across numerous small villages and we met many local people. We came across some view points as well and several times Sisne, the tallest peak in Rukum of 5916 metres, would reveal it self in the north. At one of the viewpoints we were lucky to catch an absolutely beautiful sunset over the peak.

We reached Rukumkot, the last location in Rukum that can be reached by car, in the dark at about 9 pm. We received a warm welcome in the village where we stayed with relatives of Dr. Justin Jung Malla.

AHCN in Rukum #4 – Getting there and Team Profiles

As some of you may have read, the current AHCN effort in Nepal is comprised of three phases:  1) documenting the health care needs of rural Nepal, 2) conducting rigorous in-field medical, biomedical engineering and public health research 3) providing sustainable solutions for rural health care services and financing hereof in regions of interest.

Of these, our project in Rukum makes up the first phase. In the following days we will post about from our work in Rukum. This first post is a collection of photos of getting from Kathmandu to Rukum. This took three days as we had several stops on the way: the first day we visited Chitwan Medical College Teaching Hospital and agreed to collaborate in this project and in the future. The second day we visited the Nepal Youth Foundation nutrition centre in Dang and that night we would arrive in Musikot/Jumlikhalanga, the administrative centre of Rukum.

Before we start writing about our actual work, we wish to present out team. Hereby short profiles on each member of the in-field team that conducted phase one of our project:
Dr. Justin Jung Malla, M.B.B.S, Licensed Doctor: N.M.C no. 11941. Position at AHCN: Founder and Field Clinical Expert.
Experience:

  • Emergency Dept. Besi Sahar Hospital, Lamjung, Nepal (6 months)
  • Emergency Dept. Chitwan Medical College Teaching Hospital, Chitwan Nepal (6 months)
  • Emergency Dept. Norvic International Hospital Nepal (14 months)

Dr. Saujan Shrestha (M.B.B.S),  Licensed Doctor: N.M.C-no.12162. Position at AHCN: Field Clinical Expert.

Experience:

  • Chitwan Medical College Teaching Hospital, Emergency Department , Chitwan, Nepal (6 months)
  • Neuro Cardio Multi-speciality Hospital, Biratnagar, Nepal (6 months)
  • Emergency dept. and General medicine dept., Biratnagar Hospital Pvt. Ltd. Biratnagar, Nepal (14 months)

Mr. Rajkumar Silwal, MBA graduate from University of West London with great enthusiasm to support and improve health care in rural Nepal. Good management skills with a combination of leadership, communication, strategic planning and effective decision-making attributes. Experienced semi-professional photographer.
Position at AHCN: Director of Finance and Administration. Photographer. 

Mr. David Kovacs, B.Sc of Biomedical Engineering from the Technical University of Denmark and University of Copenhagen. Position at AHCN: Founder and President. 

Experience:

  • President of Engineering World Health at the Technical University of Denmark (10 months)
  • DUKE-EWH Summer Institute in Tanzania 2014 participant (2 months)
  • Volunteer at Chitwan Medical College Teaching Hospital (4 months)
  • Research Assistant at Rigshospitalet, Copenhagen University Hospital (12 months)
  • Accepted as On the Ground Assistant at EWH Gutatemala Winter Institute 2014/2015 (to be 1 month)

The following gallery is a collection of pictures of our team on our way to Rukum.

The mission of AHCN

“Access Health Care Nepal mobilises national and international medical practitioners, biomedical engineers and other health care workers to provide research for development in rural areas of Nepal. The current AHCN effort is established in three phases: 1) documenting the health care needs of rural Nepal, 2) conducting rigorous in-field medical, biomedical engineering and public health research 3) providing sustainable solutions for rural health care services and financing hereof in regions of interest.”