15-21 April 2016 #804

Building back healthier

Non-governments work with government to overhaul medical services in quake-hit districts
Sahina Shrestha

Jiri Hospital
NEW PARTNERS: The out-patient department of Jiri Hospital in Dolakha was rehabilitated with a prefab building by the Nick Simons Institute (NSI).

Whatever wasn’t destroyed in Charikot by the earthquake on 25 April last year was brought down in the 7.3 magnitude aftershock two weeks later. The damage to hospitals and health posts in Dolakha and Sindhupalchok was widespread.

The hospital in Jiri, the district hospital in Chautara and the primary health care centre in Charikot were uninhabitable. In a unique example of public-private partnership, the group Possible turned the disaster into an opportunity to build a better health care system.

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Possible has experience in providing free medical care through the district health care system in Achham, and decided to replicate the model in Dolakha. The Charikot health post was repaired, and the group signed an MoU with the government to upgrade it to a district hospital and run it for ten years.

“Along with building back better with a stronger quake-resistant structure, our aim is to fulfil the people's right to accessible medidcal care using our experience in health care management in Achham,” explains Busan Prasain of Possible.

The proposed hospital has already added orthopedics, a 24-hour emergency service, surgery equipment for cesarean sections, and an in-patient department. It has replicated the electronic health record system perfected in Achham to track patient history. The number of patients in Charikot has grown five-fold in the past two months.

Possible repaired the Charikot health post, and the group has signed an MoU with the government to upgrade it to a district hospital and run it for ten years .

Possible is rebuilding 20 other health posts in remote villages of the district that were destroyed in the earthquakes. The health post in Boch has been inaugurated, and two others in Mali and Rakuridanda are ready for handover.

The earthquakes destroyed 392 health facilities in 14 districts: six hospitals, 12 primary health care centres and 374 health posts, another130 birthing centers were damaged. Although only 31 health facilities have been repaired, the government says the delay was caused by the fuel shortage and the need to build safer structures.

The Nick Simons Institute (NSI) is also working with the Ministry of Health in Dolakha, rehabilitating the out-patient department of Jiri Hospital with a prefab building in January.

“It’s a small support from our side to a hospital with a proven track record on which most of the population in the area depended,” said NSI’s Mohammad Kashim Shah which is also rebuilding the staff quarters and integrating its medical team with the government's health personnel.

Last September, the Tilganga Institute of Opthalmology in Kathmandu set up a community eye care center in Jiri Hospital which serves patients from outlying areas of Dolakha, as well as Ramechhap, Okhaldhunga and Solukhumbu.

“It is an opportunity to rebuild from ground up,” says Deepak Raj Sapkota of Karuna Foundation. “Apart from building structures that are earthquake resistant, it is a chance to build inclusive, accessible structures that are disabled and senior citizen friendly.”

The Ramche health post in Rasuwa rebuilt by Karuna was handed over to the government in February. It is equipped with a ramp for easy access and serves 600 households. Karuna Foundation is rebuilding 11 health facilities and repairing three health posts and a primary health care centre in Rasuwa.

The America Nepal Medical Foundation (ANMF) was involved in setting up the Chautara health post after the hospital was destroyed. “Rebuilding health posts that are accessible to the majority has been a priority of ANMF. Since Sindupalchok is closer to the capital, it is logistically easier to our volunteers for oversight" says Santosh Sapkota of ANMF. Chautara Hospital has an out-patient department, an operation theatre, and a labour room in the multipurpose prefab unit. ANMF is rebuilding ten more health posts in Sindhupalchok. The work has progressed rapidly and the Ministry of Health and Population has requested ANMF to rebuild three health facilities in Nuwakot as well.

Global Shapers Kathmandu inaugurated the Indrawati Jana Sewa Samiti Health Post in Sindhupalchok which has a birthing centre, ultrasound and family planning facilities that will serve a population of 40,000.

The Ministry of Health and Population has set mid-July as the deadline for the reconstruction of around 300 health facilities for which MoUs have been signed with non-profits. There are hitches like acquiring land, and increase in the price of building material, and the lack of expertise in prefabricated constriction.

Says Sapkota of the Karuna Foundation: “There is a lot more to be done and reconstruction could be a lot faster if the government leadership was stronger.”

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