Healthcare & Education in the Hidden Himalayas

Dear Friends and Supporters

From previous reports you are well aware of the difficulties of working in such a remote area as Humla. It's a fact of life for the inhabitants  who are adapted to the many difficulties of surviving in this mountainess district. The Nepal Trust is lucky to have an excellent delivery partner in Self Help Initiative Promotion Centre Nepal (SHIP-Nepal) who are working in the 8 health posts constructed and supplied by the Nepal Trust, under the guidance of the District Health Officer.

Following are some extracts from a Field Report provided by SHIP-Nepal covering the period 2019 to 2022. It has been edited to improve readability. It will give you an indication of how successful our intervention has been in improving general health standards, particularly at a time of a global pandemic.

Background: Humla is a remote Himalayan district. The Nepal government has not been able to provide health services in all areas. The local government here is also weak. Due to public awareness and lack of finances, many people here get sick. Before this, many people died prematurely if they did not receive timely medical treatment. The average life expectancy of the people here is 50 to 60 years. With the financial support of The Nepal Trust and NDF since 2019 Self Help Initiative Promotion Center (SHIP-Nepal) Humla has been providing medicine and health services at birthing centers in Limi, Yari, Kermi, Bargaon, Sarkegad, Piplang, Tumcha and Maspur.

Through this program, to prevent the spread of the epidemic of COVID-19 at the community level, COVID-19 materials, medicine and health services were provided. This program has so far been successful in controlling the spread of COVID-19 at the community level.

Due to regular health services through birthing centers, mothers, children and the elderly did not die prematurely. At present, the local government and people are very happy with this program or donor. He says that this program is related to the survival of poor people. They have requested to continue the health program. SHIP Nepal Humla will be dedicated for successful implementation if financial support from donor agencies is continuously available.

Before the health program was implemented.

1. Before 1999 in Humla district, the government of Nepal provided health services only in limited places including the district hospital. When a person was sick, he would be carried to the district hospital. Some died on the way and some died without treatment. But this was not possible for the poor people.
2. At that time, when people were sick, they used herbal medicine according to local custom.
3. It was customary to give child birth at home unsafely and many mothers and children were at risk of life and death.
4. During that period only the Nepal Trust provided regular health services. People suffered from many types of diseases and there was little or no information about medical treatments.
5. Among the eight birthing centers currently being run by The Nepal Trust and SHIP Nepal, there was the only government health post in Sarkegad before 1999 where general medicine treatment was available.

Achievements:

1. With the financial support of Nepal Trust, regular health services were provided after the construction of health posts in Maspur, Tumcha, Piplang, Kermi and Yari. Now the Nepal government has established and recognized all health posts formal health care is provided.
2. After providing regular health services at the health post, the number of patients and deaths at the community level has decreased.
3. Since births started at the birthing centers the health of mother and child has improved and there has been no death of mother or child.This is a very important achievement.
4. Due to increased awareness of health and sanitation at the community level, outbreaks of diseases and the number of infected people have decreased. 
5. Due to increased awareness of health and sanitation at the community level, outbreaks of diseases and the number of infected people have decreased. This is very good indicator of health program.
6. Earlier, everyone gave birth at home, so there were no facilities. Now everyone gives birth at the Birthing Canter so that they get all the services provided by the government.
7. Due to the regular facilitation of SHIP- Nepal, the health management committee has coordinated with the local government and other stakeholders to continue health services at all health posts.
8. Before 2019, the peoples of Piplang used to walk for three hours to Pali health post and Loti medical for treatment when they were sick.Since 2020, Piplang residents have started receiving health services free of cost from Piplang health post.They said we are very happy. It has saved us life, money and time.
9. Before 2019, the peoples of Tumcha used to walk for four hours to Jaira health post and Sarkegad medical for treatment when they were sick.Since 2020, Tumcha residents have started receiving health services free of cost from Tumcha health post. They said we are very happy. It has saved us life, money and time.
10. Before 2019, the peoples of Maspur used to walk for one day to Maila health post and Bajura district hospital for treatment when they were sick.Since 2020, Maspur residents have started receiving health servicesfree of cost from Maspur health post. They said we are very happy. It has saved us life, money and time.
11. With the financial support of the Nepal Trust, from 2019 to 2022, medicine, health equipment and health awareness programs were regularly provided to 8 health posts from Limi to Maspur, so there was no human loss due to the covid-19 pandemic. This is the second important achievement of the health program.

We hope these brief extracts give you some feeling for the problems of living and working in Humla, a beautiful but very harsh environment. The people, Buddhist and Hindu, have adapted over centuries but suddenly face major changes to their way of life. They have successfully managed to curb the spread of Covid but must remain alert.

Thank you for all your help and support and we hope you can continue to support our work and spread the news to all your friends and colleagues. Every penny you send will go to helping these beautiful people to adapt to modern life.

Best wishes and Namaste

Dear Friends and Supporters

I hope you are all well and managing to deal with the horrendous Covid pandemic which seems to be hanging around. It is causing big disruptions in all aspects of our lives and bringing grief to many. Imagine living in one of the remotest corners of the world with only minimal health services to support you. This is, unfortunately, the reality of living in Humla in NW Nepal. For a long time its remoteness and isolation was an advantage and the virus was kept at arms length but this has changed with a serious outbreak at Kermi where we have an health clinic. A large number of infections have occured and a number of deaths although it is not yet clear if these are Covid related. Our excellent delivery partner, SHIP, will report once they have more evidence. Nationwide the government is trying to contain the virus against difficult odds. To date there has been nearly 1million confirmed cases and there has been 12000 deaths.

On the wider health front our partner SHIP continues to provide an excellent service at our 8 clinics and birthing centres - Limi, Yari, Kermi, Bargaun, Sarkegad, Piplang, Tumcha and Maspur - all operating under the watchful eye of the government and the Humla District Health Officer and local village health committees.

The main health problems are very closely related to basic unhealthy living conditions. Salmonella, gastro enteritis, worms and diarrhoea together with other food and waterborne diseases are very prevalent. Respiratory diseases such as asthma are common and a reflection of living in smoky homes. Skin and ENT infections are very common. Children under 5 years of age suffer widely from diarrhea, worms, ear infections and pneumonia. Our very popular Little Doctors health training programme for 10-15 year old school pupils was popular and very effective  in changing  and improving general health. Unfortunately, schools have been closed for 2 years and the programme has been stopped for now. We hope to start again soon. Family planning advice and support is becoming more popular and helping to reduce the problem for poor families of too many mouths to feed.

Thanks to all of you for your help and support. We hope you can stay with us as we try to navigate  difficult times. We are making a difference by spreading knowledge and help in this remote area. Tell your friends about us and try and encourage them to chip in as well. We do struggle to keep our heads above the financial pond  so any support is very welcome.

Namaste