Providing Free Health Services to 10,000 Villagers

Real Medicine Foundation’s clinic in Arupokhari, Gorkha started providing health services in a temporary structure after the devastating earthquake of 2015. Since that time, the RMF Health Clinic has treated a total of 8,757 patients, and 1,747 of these patients were treated during the period of March 2017 to May 2017.

In addition to the curative and family planning services provided by the clinic, RMF has expanded its health awareness program in the community and schools, starting in April 2017. 72 students and their families from 2 schools in the clinic’s catchment area benefited from RMF’s health education program. The sessions were conducted on personal hygiene and sanitation.

Morbidity:

As of May 2017, the RMF Health Clinic has treated a total of 8,757 patients, and 1,747 of these patients were treated from the month of March 2017 to May 2017. The clinic averaged about 582 patients per month from March to May 2017.

There has been a significant increase in patients with fall and cut injuries. 220 patients were treated for fall and cut injuries at clinic during this quarter.

The monthly number of patients registered and provisional diagnoses treated at the RMF Health Clinic are shown in Table 1 and Chart 1 (a). Similarly, the top 10 diseases diagnosed at the clinic are shown in Chart 1 (b).

School Health Education Program:

RMF began providing health education to children in Arupokhari area schools in April 2017. Health workers teach students about personal hygiene, as well as communicable and noncommunicable diseases. School health education programs can reduce health risk behaviors such as tobacco use, poor nutrition, lack of physical activity, and drug and alcohol abuse, as well as actions that increase stress, risk of injury, and violence.

RMF health workers conducted school health education sessions at 2 schools in the Arupokhari area: Bal Udaya School and Saraswati Shanti School. A total of 72 students directly benefited from the sessions. The health workers taught the process of handwashing and staying safe. 

Success Stories:

Radhika

Radhika, an elderly, 70-year-old woman, visited the RMF Health Clinic because of excruciating dental pain due to dental caries. On examination, we found that the tooth had a large cavity and the gums surrounding it were swollen with pus. For her problem, she was prescribed analgesics to subdue the pain and antibiotics for the oral infection. She was also told to gargle every 4 hours with warm salt water, which would provide additional relief, and to visit after a week. On the follow-up visit, her pain had subsided.

Anu

Anu is a 6-year-old girl whose mother brought her to the RMF Health Clinic with a bleeding wound. The little girl was playing in a field, when she fell and hit her head. The cut was superficial. RMF staff received the patient, and cleaned and dressed her wound. She was instructed to return for a follow-up every alternate day for one week for dressing the wound. Her wound is healing and she is happy about the treatment.

Nabina

Nabina is a toddler who was brought to the RMF clinic by her parents. On arrival, she was assessed, and we found that her respiration was rapid and she had a slight temperature. She was lethargic. Her respiration rate was found to be 56 breaths per minute; thus, she was diagnosed with pneumonia according to IMNCI (Integrated Management of Neonatal and Childhood Illnesses) guidelines and antibiotics were prescribed accordingly. Her parents were also counseled on the importance of nutrition and hygiene for proper growth and development. Her condition is improving.

Nabaraj

A 4-year-old boy, Nabaraj was brought to the RMF clinic with the complaint of ear discharge. Both of his ears had pus discharge which was foul-smelling. He was prescribed oral antibiotics for one week as well as antibiotic ear drops. His parents were taught not to insert anything in his ears and not to use anything other than medicines. Nabaraj was also told to cover his ears while bathing, as water may enter the ear and cause further infection, which can lead to complications. On the follow-up visit, there was no discharge from his ears.

Sitaram

Sitaram is a 64-year-old farmer, who hails from Arughat-7. As the reconstruction work is going on in Gorkha after the destructive earthquake of 2015, Sitaram is also involved in construction in the village. While working in the construction area, he fell and cut a deep wound in his forehead with an iron rod. He was brought to the RMF clinic, where RMF Clinical Officer Bishnu Sharma at once started his treatment. The wound was cleaned and 5 stitches were applied. Then the wound was dressed and bandaged. A single dose of tetanus toxoid injection was also given for prophylaxis. As it was a case of head injury, the patient was kept a few hours for observation. There were no warning signs such as loss of vision, vomiting, bleeding from nose or ears, or loss of consciousness. After resting for few hours, the patient was able to get up, and then he was informed about the prescribed medicines, which included antibiotics and painkillers. On discharging, he was requested to visit the clinic every day for a week for dressing the wound.  Now the wound has healed and he has no problems with the injury.

Bishnu

Bishnu is a 42-year-old man from Gorkha. A few months ago, he had to lie down all the time due to a neurological problem in his spine. He could not stand up, and walking was out of the question. Hearing about the goodwill of RMF’s clinic in Arupokhari, Gorkha, and the family called RMF Clinical Officer Bishnu Sharma for a home visit. RMF’s Clinical Officer visited Bishnu Bahadur Ale at his home, where he assessed the patient and told him that the problem could only be solved in the capital city of Kathmandu. He explained that the problem is neurological, and it may improve with proper and immediate treatment. He then referred the patient to Neuro Hospital Kathmandu. In this hospital, Bishnu Bahadur Ale received an operation, and after physiotherapy, he was cured. Now the patient visits RMF’s clinic on his own. It is a success story in which RMF Clinical Officer Bishnu Sharma played a crucial role in the diagnosis and treatment of the patient and saved him from being handicapped.

Dinesh

Dinesh is an active, 7-year-old child. He was playing at his home, when he fell and cut his left hand on a stone. He was bleeding and crying with pain and fear when he was brought to the RMF clinic. The child was not ready to listen to anyone and continued crying, so his parents brought him a sweet drink from a shop nearby, which distracted him from the pain. Then RMF’s Clinical Officer cleaned the wound, applied 4 stitches, and dressed it. Dinesh was prescribed antibiotics for a week and given a single dose of tetanus toxoid injection. With daily cleaning and dressing of the wound, it was healed after a week

Thuli Maya 

Thuli Maya , a middle-aged, 58-year-old woman, was brought to RMF’s clinic complaining of profound weakness due to diarrhea. She said that she had passed loose stool 8 times that day, and then she felt dizzy. On examination, her blood pressure was 90/50 mmHg, and she had a pulse of 104/minute. She was immediately started on intravenous Ringer's lactate. Along with the fluid, she was also infused with metronidazole. After receiving 2 bottles of Ringer’s lactate intravenously, she felt better. Then she was given ORS (oral rehydration salts) to drink, and when her blood pressure had stabilized, she was sent home. She was instructed to make ORS solution and drink more. She was also counseled about the importance of personal hygiene and cleanliness of the environment to promote good health and prevent diarrhea.

Buddhi Bahadur

While working in a field, 58-year-old Buddhi Bahadur was bitten by a snake on the right hand. Immediately after the snakebite, he went home and tied a cloth around his wrist, and his wife made some herbal medicine and applied it to the bite. Then he came to the RMF Health Clinic and told us what had happened. RMF’s Clinical Officer assessed his general condition. He had no complaints of dizziness, severe pain, or loss of consciousness. His vital signs were stable. He was given a dose of tetanus toxoid injection for prophylaxis. Because the snake’s characteristics were not known, Buddhi Bahadur Gurung was kept under observation for several hours. He did not show any signs of neurological or cardiac impairment due to the snakebite. Thus, it was concluded that the snake was non-venomous, and the patient was discharged. He was educated about the warning signs and advised to be taken to Chitwan for further treatment.