Project #7746

Himalayan Healthcare for 5000: Save Lives in Nepal

by PHASE Nepal

3 year old girl with pneumonia
Abkati  is 3 years old and lives with her parents and three older siblings in Maila VDC, where PHASE Nepal has been working for over 9 years now. On the 1st of December, Abkati was brought to the PHASE supported health post in Maila by her mother, who was worried about her daughter: Abkati had been ill for 3 days and getting worse, and was even unable to drink water or walk on her own. When she was examined by the PHASE health workers, they found that she was underweight, weighing only 12 kg. Malnutrition is a serious problem in Humla, where many families grow only enough food for 3-4 months of the year and are dependent on subsidized rice for survival. Malnutrition affects children’s immune system, making them more susceptible to common infections and making it harder for them to recover from illness. (PHASE also supports local farmers to produce more vegetables and eggs, but this progamme has only been running for 2 years.)
Abkati’s respiration rate and pulse rate were raised and she had a fever of 105 F, but her hands and feet were cold, suggesting that she was going into shock. Further examination showed chest indrawing and wheezing breath sounds. Abkati was suffering from severe Pneumonia. PHASE Nepal’s health workers, Sarita and Kalpana, immediately gave her an injection of Gentamycin (a broad spectrum antibiotic) along with Paracetamol to control the fever and Salbutamol to relieve the wheezing .

In view of her life threatening condition she was referred to Kolti Primary Healthcare Centre, as she really should be treated in a hospital: Kolti PHC is the nearest community hospital, but it is more than a day's walk from Maila. Abkati’s parents were unable to take her to the PHC, so the health workers gave her Amoxicillin (a second antibiotic) as well as Zinc and Vit A to boost her immune system. Her mother was advised to keep her warm and make sure she got plenty of warm liquids to drink. She was asked to bring the girl for follow up the next day, and when she returned, Abkati looked better. After continuing the treatment at home at follow up on the third day, there was a major improvement in her health. On the fifth day, Abkati came to the health post walking along with her mother! Her health had completely improved and no further medication was required. Her parents thanked PHASE Nepal health workers for saving the life of their daughter.
From the period starting mid-September till mid-December, 114 patients visited the ORC in Maila of which 14 were children under the age of 5 years.
Sarita /Kalpana


PHASE Nepal ad commenced health programme in 6 remote VDCs of Mugu district since April 2016. Till September nearly about 2600 people have received treatment from the Primary Health care centre in the 6 VDCs. A pregnant woman whose delivery date had come started suffering labout pain but due to a condition called Polyhydramenus, a condition in which the water inside the womb is more than the required level, she had complications in her delivery. Ms. Kalika Thakuri upon examining the pregnant woman identified the condition of the woman and referred her to District Hospital for further treatment. PHASE staff coordinated with District Hospital and district hospital coordinated with Bheri Zonal hospital for the treatment of the woman. The efforts showed results and the woman was airlifted from Kotdanda VDC in Mugu district to Bheri Zonal Hospital in Nepalgunj. The woman had complications but timely airlfiting for treatment saved her life although the infant could not be saved.

Purna Kala from Maila
Purna Kala from Maila

Maila is a community of around 800 households in Humla, the district in the most North-Western corner of Nepal. In the North, the border of the district is China, in the West, there is India. Travelling to Humla from Kathmandu, the capital of Nepal, takes several days and due to the extreme climate and the difficult access to the area, the district is amongst the least developed in Nepal. Especially children and women are suffering from the limited access to health services. PHASE Nepal has been working in Maila since 2008 through integrated community projects to improve the health services and support the community through adult literacy and livelihood improvement programmes.

“Dansara Jaisi is a 53 year old woman living in Maila. She got married at the age of 12 but stayed at her parental home until her first menstruation, when she was 14. After that, she went to live with her in-laws and husband.

There were 15 members in the family altogether, and resources were scarce. As traditionally the new daughter-in-law does most of the household work and is the last to eat, Dansara was always tired and hungry. For her, daily chores became more difficulty as she became pregnant just a year later, aged 15. At that time, there was no functioning health post anywhere nearby, so there was no question of having the baby in a health post or hospital. Dansara gave birth to her first baby at home, after seven days of labour pains. Soon after the delivery, she had to pick up her daily chores again and had to leave behind her 5 days old child. She gave birth to 9 children in total, of whom 4 are alive until this day; she lost two children because of miscarriage and the other babies passed away before they reached the age of 1.

Her body started to feel weak soon after she gave birth to her third child. The hard life in the village began to degrade her body's energy creating several problems like pain in her lower belly and back, white discharge and chronic fatigue. In spite of this she conceived six more children, despite all the agony she went through.  She was tolerating all the pain and discomforts to keep a good relation with her husband and family-in-law. But as she wasn’t able to carry heavy loads or work as other women in the village, she soon fell into discredit with her in-laws and lost their respect.  That wasn’t the end of her problems. She started to keep her husband at a distance because of the vaginal discharge which she wanted to hide and felt ashamed about. Her husband married another woman in consent of their family members which caused her great heart-ache. She didn't even think of sharing her problems with other people and thought that all women were suffering the same ordeal as her. Eventually, after many years of daily hard work, she started feeling the symptoms of uterine prolapse – her womb dropping down and forming a lump outside her vagina, causing great discomfort. She used to push it up slowly at night. In silence, she endured the suffering all by herself.

As time passed by, she heard the news of a check-up programme related to uterus prolapse by PHASE Nepal. She consulted about it with the female community health volunteers of her village and they suggested her to visit the health post without any delay. At the post, sisters of PHASE Nepal examined her and gave the necessary treatment by inserting a rubber ring pessary. The woman was advised to visit the health post regularly for follow up. After insertion of the ring pessary, she was finally relieved from the pain she had been enduring and hiding for so long. Slowly, the daily chores, which used to make her exhausted, began to feel easy and effortless. It has been 16 month since she had the ring pessary and she feels like breathing a fresh air of happiness ever since. She also believes that if she had been treated before, she would not be isolated from her family.

She thanks PHASE Nepal for their help and wishes them all the best to serve and help more women like her in future.”

On a recent monitoring visit to the region, Purna Kala Jaishi, Member of Mother’s Group, Maila-3, testified:

“Maternal and Child death rate was high before the intervention of PHASE Nepal’s programme in our VDC. Due to lack of treatment and health post access, there was untimely death of large numbers of mothers and children. But now the situation is different, PHASE Nepal has improved our health and lives with treatment and medicines and made us aware about the importance of savings. Not only this, we are empowered to read and write in general.”     

PHASE Nepal would like to thank you for your support to the people of Maila, Humla district!

Community meeting in Maila
Community meeting in Maila
Meeting with teachers in Maila
Meeting with teachers in Maila
Monitoring of livelihood projects in Maila
Monitoring of livelihood projects in Maila


Sub health post in Maila
Sub health post in Maila

For the reporting period from mid October to mid January, the following numbers have been reported from our health workers in Maila:


  • Our health staff, Junila & Rita were working for 68 days in the sub health post and 4 days in the outreach clinic
  • A total of 1246 patients were seen: 1027 sick patients, 20 came to the clinic for family planning and 199 for prenatal or postnatal check-up, delivery or newborn examination
  • 139 children under 1 and 166 children between 1 and 5 years old were examined and treated
  • 1 child was delivered in the outreach clinic and 13 in the sub health post


Some of the other activities conducted by PHASE Nepal health staff that took place in Maila:


  • 4 village cleaning programmes were conducted
  • 21 door to door health education programmes
  • 2 FCHV – female community health volunteer – meetings
  • 6 school health education programmes
  • 9 community health education programmes
  • 10 clinic health education programmes


4 Village cleaning programmes were conducted. Maila is divided in 9 wards and our staff are organizing cleaning programmes from time to time with the people of the different wards to clean up their own area. In every ward, there is a committee responsible for cleaning paths and public spaces from animal dung, dead plants and the (relatively little) plastic waste that accumulates on the paths. During the cleaning, awareness campaigns are conducted to inform the community about the importance of hygiene.

Door to door health education programmes: PHASE Nepal health staff regularly visit families in their homes to inform them about the ongoing health programme and services that are offered in the health post. Issues that are covered are depending on the needs of the community that can be seen in the visits of the patients to the health posts and in other families while doing door to door visits. The staff talk with families about topics like family planning, hygiene and nutrition and create awareness about certain common diseases.

FCHV meetings are conducted usually monthly to give the female community health volunteers an opportunity to report about their work and to discuss further programmes and interventions. FCHVs are local women with very basic training who give advice to pregnant women about the importance and timings of antenatal checkups and professional help with delivery, they help the professional staff in immunization and Vitamin A programmes and they have access to a limited amount of medicines. - they work closely with our health staff and refer patients to the health centre as needed.

School health education programmes are conducted in the local schools. The content of the programme depends on the age of the children. For primary level, it mainly covers personal hygiene like hand-washing and brushing teeth and the importance of safe water and proper sanitation. For classes of secondary level, issues like reproductive health and family planning are also covered and basic first aid training may be given.

Community health education programmes are conducted in regular intervals in different wards of Maila. These programmes are conducted in the open and are accessible for all members of the community. Subjects are chosen based on needs in community that can be identified by our staff in the course of their work. This can include awareness about pneumonia, communicable diseases, family planning and/or hygiene education as well as health problems caused by alcohol and smoking.

Clinic health education programmes are conducted in the health post when several patients are gathered together, to give more information in an efficient way about certain diseases, nutrition, hygiene, family planning ….

All these activities help to increase the long term impact of our health project in Maila, as the local people, especially women, who often cannot read and write, have little access to any reliable health information. For many, the meetings our health workers organise are the only opportunity they get to learn more about their bodies and to ask questions or get information about the causes and treatment of common health problems.

PHASE Nepal and the community of Maila thank you for your ongoing support!

For more information about our ongoing projects, visit our Website or Subscribe to our newsletter.

Community health education programme in Maila
Community health education programme in Maila
Junila attending a dental training session
Junila attending a dental training session

To offer better services to the remote communities that PHASE Nepal is working in, our front line health workers attend update trainings regularly. Every year between Dashain and Tihar, the main festivals in Nepal in autumn, the field staff come to the main office in Kathmandu and have the opportunity to update their skills according to their needs. Last October, some of our health staff attended dental training and contraceptive implant training. These trainings were conducted outside our main office. Furthermore, our health staff attended training sessions on IMCI (Integrated Management Child Illnesses) and obstetric problems run by our health advisor, Dr. Gerda Pohl, in the main office. Dr. Kashim, an experienced Nepali GP working for NSI in improving rural health, came to give a talk about poisoning, and our health officers Urmila & Sunita ran workshops about reporting and health education. Junila Kokali, auxiliary nurse midwife & SBA (Skilled Birth Attendant) took part in the dental training and is currently providing these services in the health post in Maila, Humla.

Junila has been working with PHASE Nepal for 2 years as a midwife & SBA in Maila village. In November 2015, Junila took part in a 10-day dental training in Haatiban, Kathmandu, conducted by Health & Development Society Nepal. The training consisted of 5 days theory concerning oral hygiene, oral health and tooth extraction, including the technical skills needed for safe local anaesthesia and infection prevention. After the theoretical part, the trainees had 5 days of practical training, providing free dental treatment under supervision to locals in the neighbouring schools.

Junila was very enthusiastic about the training as she acquired essential new knowledge and skills related to oral health, diseases related to insufficient oral hygiene and prevention and treatment of these diseases. Junila feels that this training will be very useful in Maila as many patients come to the health post with toothaches and complaints related to oral health. Until now, she wasn’t able to give these patients any specific treatment so she had to refer them to (dental) hospitals, the nearest of which is about 4 days walk from the village. Due to lack of time and money, villagers often didn’t go to these centres for treatment and small problems could have serious consequences. Now, Junila will be able to treat the people in the community and extract teeth safely and painlessly, so people don’t have to travel such long distances to get this basic treatment.

Sangita Baruwal is supervisor of health in Humla. She supports the frontline PHASE health workers in Maila, Melcham and Jair. Recently, Sangita got the chance to follow a course to become a Skilled Birth Attendant that was offered by the local health authority of Humla district. She attended the 2-month course in Banke at the government hospital.

Skilled birth attendants provide important interventions that improve maternal and neonatal health and reduce maternal and neonatal mortality. The government of Nepal has made the commitment to improve maternal health (Millenium Development Goals) and has been financially supporting trainings for SBA’s. Through her training, Sangita will be able to help more mothers and babies have a safe delivery, and support the PHASE frontline health workers to improve the care they provide.

All the above trainings were funded through a variety of sources, including Global Giving donations, the Burdett Trust for Nursing, and the Government of Nepal.

Dental training session
Dental training session
A mother after giving birth at the centre
A mother after giving birth at the centre



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Organization Information


Location: Kathmandu - Nepal
Website: http:/​/​
Project Leader:
Jiban Karki
Kathmandu, Kathmandu Nepal

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