A year ago this month the United States just started to wake up to the realities of a pandemic, Covid 19. We were slow to realize the impact it was going to have on our country, our people, and how much death and suffering it would visit upon us. The pandemic moved at its own pace but in time would affect every country on the globe.The small Himalayan country of Nepal was not spared. Covid first started its spread in the few urban centers. Many people fled to their ancestral villages to find safety, however the virus soon caught up with them in remote areas as well.
As soon as the first cases appeared our Rajbash Community Hospital instituted measures to protect staff and patients with masks, PPE, social distancing, diligent hand washing etc. A triage tent was erected on the hospital grounds to separate Covid patients from those being treated for other issues. Our nurses trekked into surrounding villages to identify Covid patients and to teach families how to safely care for themselves and their patients and keep them quarantined in their homes.
By the end of October DCWC met and created a plan to be more proactive and to provide Covid prevention training for the wider rural population we serve. We started by training local municipal staff, volunteers, teachers, and health workers. Those trained could then teach other local groups about infection prevention and management. We felt great about the impact of our efforts, however soon we realized the toll this program was taking on our hospital budget. Everyone involved had to be paid and replenishing our stores of masks, PPE, thermometers and sanitizer all threatened to bring us to our knees. Our inquiries for financial assistance with GlobalGiving had not been hopeful. However, miracles do happen! One January morning we received word that GlobalGiving had decided to support our efforts with a $ 15,000 grant! Our efforts have been recognized and rewarded, and that is most gratifying. We had originally stepped in to help and had no plan for where the money would come from. So for us , this is a tremendous validation of our efforts.
And now on March 7 a Free Covid-19 Vaccination Program was organized by the local municipality and coordinated by our hospital. A total of 90 seniors citizens from various villages were vaccinated at our Hospital. How very exciting and hopeful!
We are grateful to GlobalGiving and we are grateful for all of you supporters. We will continue to serve the people of rural Nepal with all of our energies. If they could give voice to their gratitude, they would say a big “thank you”.
Karin and Patrick
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Today we would like to introduce Dr. Sameer who is currently the doctor at Rajbash hospital. Yet rather than me telling you about him I would like him to tell you his story directly. Afterwards I will provide some context about our dedicated doctors.
Hi, I am Dr. Sameer , a 27 year old aspiring graduate. I was born in a middle class family of small village located in Province no. 3, Banepa-1, Kavrepalanchok district, Bagmati zone of Nepal.
Writing about my childhood, me and my sisters were grown up by working mother and grandmother as my father was far away from home for job. We didn't have luxurious life but they provided us whatever required for our education at any cost. My father has always known about the importance of education thus got my education in private school (Bal Batika Vidhya Mandir) which is in 2 hours walking distance from my village. I have changed 3 schools due to family issue. One day I got sick and admitted at nearest Hospital. At that instance I came to know about doctors (only by profession) and attracted about them. My father knew about my wish. It was getting difficult for us to continue my school, so they rent me a room near by my school. I studied hard and completed my 10th grade.
After completion of my schooling and plus 2 (science), I got more fascinated towards medical science. I explained about my aim to my father, he knew it was difficult for an average family to bear expenses of medical collage, so he took loan from bank. Knowing this I geared up myself to study medicine and got admitted in Lumbini Medical College and Teaching Hospital, Palpa under Kathmandu University. Then, I graduated in 2016. It was happiest moment for all of us plus I became first doctor of my area. After that I worked as a Medical Officer in Department of Anesthesiology and Critical Care, Dhulikhel Hospital, Dhulikhel, Kavre for 7 months. Later, I moved to DVWC (Development of Children and Women Centre), a non-profitable community hospital located in a remote area of Kavre. I have been working here as an Incharge over the past 2 years and treating poor and needy beautiful people of village. As well as this, I am preparing myself to hopefully get scholarship for my post-graduate work in medicine.
I am a seeker, I am an enthusiastic person who loves to take risks and hunt exciting opportunities. I am grateful to who I am today and what I am doing all these days. I must say, this is worth experiencing chapter in my everlasting medical journey.
Regards: Dr. Sameer
Unfortunately, Dr. Sameer will be leaving us at the end of the month to pursue post graduate studies and training - 2 years in Nepal and 2 years in the UK. He has received a generous scholarship to actualize his dream. Dr. Sameer came to us from Dhulikel Hospital, one of the very prominent Hospitals in the Kathmandu area. We think he chose well and it shines on Rajbash that we were his choice. We are proud to have been part of his journey for the last two years and wish him well.
Over its 10 years of operation our hospital had quite a number of talented and dedicated young doctors. Dr. Udav who preceded Dr. Sameer stayed with us for 3 years. However, as a rural hospital we have a hard time retaining this young talent. Most come to us after completing bachelor studies in medicine and surgery (4 to 5 years of study plus 1 year of internship) which in Nepal authorizes a person to dispense basic medical care and perform minor operations. After a year or two of service/practice in a rural area they understandably wish to complete their medical training with a Masters degree which prepares them for full medical practice, including more demanding surgeries. Afterwards most go to work in one of the urban hospitals or practice privately. Both offer better pay and a more diverse environment. While it has been sad to say goodbye to each one of them, we are deeply grateful for their commitment to the rural clientele and the services they have rendered.
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While we had hoped to bring you with this report the newest from Rajbash Hospital, the spread of Covid-19 infections in Nepal has pushed itself into the foreground.
Back in August we reported that Covid-19 cases had moved from only 75 initially in the entire country to 13,000 cases and 45 deaths. As of Oct. 22 Nepal saw an increase of infections to 150,000 cases and 829 deaths and rising. The pandemic has been particularly virulent in urban areas like Kathmandu which is densely populated. As people have fled Kathmandu for the “safety” of the villages they have spread the virus there too.
Many people, especially in rural areas, are not using safety precautions as there is a lack of awareness of face masks, maintaining social distancing, hand washing and sanitizing. This is compounded by lack of information on how to manage infected persons and how to deal with dead bodies.
Nepal’s hospitals have limited beds and were not well prepared for pandemic situations. Isolation beds, ICU and ventilators exist in only very limited numbers and this level of care is unavailable for most infected patients. Instead they are told to stay home and isolate. Government hospitals used to provide free treatment as their capacity allowed. However, recently the government announced that Covid-19 testing and treatment costs will have to be borne by the patient. Private hospitals where Covid-19 treatment is available are very expensive and are beyond the reach of the majority of people.
The economy of Nepal has suffered greatly, as it depends on a host of variables that are all affected by the pandemic. The tourism sector has contracted as travel restrictions have been imposed globally and tourists are absent. The manufacturing sector is experiencing a shortage of raw materials, most of which used to come from China. Exacerbating the situation is the spread of the pandemic to the middle-East which is the main source of remittances and makes up more than half of Nepal’s GDP. Remittances were expected to sharply drop after Nepal suspended issuance of workers permits to Nepalese for all countries. The wholesale and retail sector have also been affected due to the decline of imports from China. The construction sector which imports most of its building materials from China has slowed down. As the Chinese contractors and workers who went home for the Chinese New Year could not return, public construction projects have been put on hold. As immigration for foreign employment came to a halt, airlines were forced to suspend flights to several labor destinations.
Our DCWC Community Hospital in conjunction with local governments and municipalities would like to implement an awareness program for rural villages. Broad in scope it would attempt to provide villages with the information needed to protect rural populations from the spread of Covid-19. At the start the program would be implemented within the service area of the DCWC Community Hospital. However, with economies in free fall it is difficult to mobilize the resources for such an undertaking. Only the crucial support of donors like you will make this important outreach program a reality. Please help us to save more Nepali lives from falling prey to Covid-19.
Rajbash Community Hospital - Covid Update
Our May update about the Covid pandemic in Nepal reported 75 cases in the entire country. No deaths had been reported. As of the beginning of August 13000 cases of Covid have been treated (out of a population of 29 million). 45 of those ended in death.
The country has been under a well observed lockdown until very recently. Our office in Kathmandu reopened just last week. When Covid began many city dwellers returned to their mountain villages to rejoin their families hoping to evade the reach of the virus. As there were suddenly more mouths to feed this ‘migration’ has lead to food shortages in the villages.
We are grateful to report no confirmed Covid cases in the Rajbash area; however the hospital staff joined the Covid prevention fight with numerous awareness programs and ‘fever clinics’ offering Covid testing. Our ambulance was outfitted with a plastic shield separation between the driver and patients who have to be transferred to Kathmandu hospitals.
Our regular patient load has remained steady throughout the pandemic. Only our outreach activities were limited by Covid contact restrictions.
By now we had hoped to report to the results of a study to be undertaken by two young interns, graduates from the UC Berkeley School of Public Health. We had planned to have them spend the summer at the hospital to look for ways to improve our record keeping ability and, as a result, better our patient care performance. Unfortunately our plans were dashed when it became clear we could not guarantee these very motivated volunteers safe travel and safe stay in Nepal at this time. Both though are hoping they will be able to go to Rajbash next summer to execute their planned research.
Also postponed was the hospital’s Ten Year Anniversary Celebration planned for October of this year. Many of Rajbash’s most faithful and longterm supporters were looking forward to a reunion in Nepal for this momentous and joyful occasion. Covid travel restrictions and the uncertainty about the pandemic have made this quite impossible to happen. We now look forward to October 2021 to celebrate 11 years of successfully bringing basic medical care to Nepal’s rural villages.
As always, we extend our deep gratitude for your continued interest in our hospital. It is your financial support that makes this important work possible. We hope to see you in Rajbash in October 2021.
If you too have been wondering how Nepal, a direct neighbor of China, has been affected by covid 19, here is what we know at this point:
As of today, May 4, there have been 75 cases in the country. 16 patients are recovered and 59 cases are still active. No deaths have yet been reported and 63,102 persons out of a population of 29 million have been tested. Kathmandu has been on lockdown for over a month and our partners at DCWC tell us that this normally bustling city is almost empty. Nepalis are taking the shutdown very seriously. Many of the residents have returned to their villages where they feel less threatened by the virus. So far as we hear, there are no cases in Rajbash.
What is most interesting is the timeline for how the Rajbash hospital has prepared for an outbreak.
On January 26, there was a posting from the health ministry that warned about an outbreak of a zoonotic corona virus. They posted information concerning how to prevent the transmission:
washing your hands often with soap and water
avoiding touching eyes, mouth or nose with unwashed hands
avoiding close contact with this who are sick
They explained how the virus is spread and that there is no vaccine to protect against it.
By mid-March there were postings at the hospital showing the proper way to wash hands and our team were ordering masks.
On March 22 our masked staff started screening people and took their temperature before they were allowed access to the hospital.
By the end of March Rajbash staff, in full body protective gear, visited surrounding and outlying communities with a Covid 19 information meeting to inform villagers about the virus and how to protect themselves.
By mid-April a screening tent was erected outside of the hospital. Any person desiring to enter the hospital had to first pass the screening before being allowed to proceed.
It appears that the non-urban mountainous landscape of Nepal with its widely dispersed and often isolated villages is also working in favor of lower infection rates. However, this could change once the urban population returns from the country side into the cities.
We wanted to send you this update as we have been very impressed by Rajbash’s mobilization efforts and adherence to safety procedures. They are taking all of the precautions quite seriously and we can only hope their efforts prove successful.
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