Lifesaving healthcare for remote farming villages

Outreach works!

Judging by patient numbers, our plan to increase outreach efforts into the remote villages of the Rajbash region is bearing fruit. Patient numbers have seen a steep increase during the last quarter.  Injuries from falling lead the list of presenting issues with 15% of cases, followed closely by respiratory and cardiovascular ailments. Four  babies were safely delivered in the hospital by our midwife.  Two additional women about to give birth were transported to Dulikhel and Kathmandu Hospitals, one for intensive care, and the other for a C-section.  All in all our ambulance made 37 trips during the last quarter to transport patients for more specialized care to Kathmandu hospitals.

A two-day Health Camp was conducted at the Kharpani VDC in the Ramechhap district. This location lies high in the mountains, about a 6 hour walk from the Rajbash Hospital. The area has been very isolated until recently a new earthen road track was built, good enough for our four wheel drive ambulance to reach the village in the dry season. 194 villagers, many of them school children and old people, patiently stood in long lines waiting to be seen by our staff. Presenting issues ranged from hypertension and respiratory complaints to gastritis and arthritis. Many were the expressions of gratitude to our medical staff for having undertaken the long journey to this area, and requests were submitted to have regular health camps there as road conditions allow. As we learned today, another Health Camp has been held in the same location since then to care for those who did not have a chance to be seen by a doctor or nurse during our first Camp.

How much our services are needed and appreciated in this remote region of very poor subsistence farming families is illustrated by some of the patient comments I will share with you below:

A 97 yr. old male who sustained cuts and bruises from a fall. Alone with his wife, they have no income and live from the food they grow in their garden.:  “After I had fallen from stairs and got cut injury over whole lower limbs, and there is no ambulance to my house, and I did not have even a penny to pay for transport, I sent my grandson to ask the hospital staff to come to my home. I am thankful that they have come here and treated me, and even now they come to regularly change my dressings. I even can’t explain how much I am thankful to the hospital, god bless them, to help poor people and old age people.”

A father who brought his 10 year old son for treatment: “I was so worried. My son was semiconscious due to diarrhea. I carried him on my shoulder and walked by foot about four hours to the hospital. Now my son is getting well. I am very thankful to DCWC hospital for making my son well. May god bless this hospital family and I still hope to get regular service from this hospital.”

A 40 yr. old female with a deep laceration: “I am feeling quite good now.  I am grateful to the god and thank you for all your help.  I hope all the persons should come here and take the treatment here instead of doing it at the home like me. I had fallen from the top of the hill and got a deep cut on my forehead. I became semiconscious and people took me to this hospital. They removed a piece of glass from the wound. Now my bleeding has stopped and I started healing. This local hospital has helped me even though I am poor and can not pay money.”

It’s these responses from our patients that spur our medical team to find ever more effective ways to reach and treat patients in need day in, day out. 

And to guarantee uninterrupted service delivery in the future, we are so excited to finally proceed with the installation of a Solar Electricity System in our hospital. No more treatments by candlelight, problems with oxygen supply for our patients or x-ray malfunctions. They will be a thing of the past. The installation of our new solar panels will begin within the next two weeks.

We just learned, that the Kavre district, a large area within which the Rajbash hospital is located, has seen an increase in water and food borne illnesses that have actually claimed fatalities. This increase has prompted the Nepali government to organize a workshop at the hospital on the topic of communicable and non-communicable diseases.  It was facilitated by Mr. Surath from the District Health Office in the presence of Dr. Uddhav Lama and Mr. Min Gautam, our health educator. The focus included different types of diseases, their causes and their effects in rural communities, the relationship between non-communicable diseases and nutrition, and the communication and coordination with health service providers.  The 60 plus mandated attendants were women volunteer health workers, staff of various government health posts, teachers, traditional healers and many Dalit and indigenous people. We are heartened by the response of the District Health Office to this crisis and are pleased that our hospital was able to host this educational workshop. We are hopeful that this will lead to more cooperation and some form of partnership with the government in serving this rural population of Nepal. 

In closing I want to extend a heartfelt thank you to all of you who make our continued delivery of health/medical services in the mountains of Nepal possible. Your donations are literally saving lives in one of the poorest regions of the world.

Winter in Rajbash

Winter is a slow season for our hospital.  Our last health camp in October still was very well attended, but colder temperatures now keep people closer to home. While injuries continue to top our list of presenting issues, respiratory illnesses have increased this season. We also saw a greater number of communicable diseases (TB, cholera) and infestations. Our numbers for gynecological services are still not where we would like them to be. An important part of our mission is to improve the health of women and children and to reduce maternal and infant mortality which is considerable in Nepal. Statistics tell us that in Nepal institutional birth is safer than home birth for both mother and child. Proper prenatal care combined with a hospital birth and aftercare enhances health outcomes for all involved. We are determined to continue our outreach into the villages to educate families about the importance of perinatal services.

Our health educator, Mr. Min Prasad, is a vital force for health education in Rajbash as well as the surrounding villages. He brings many years of experience to this endeavor and pursues his vocation with passion and great creativity.  

When we recently visited the hospital we had an opportunity to witness our outreach team in action. Word had reached the hospital that in a distant village seven women were in various stages of pregnancy, none of them receiving any care or planning to have a hospital birth. A plan was hatched to travel to the village for a presentation on the  benefits of perinatal care and institutional births. One staff member was delegated to the village to explain our plan and receive permission for the event from the village elders. Receptivity was enhanced by the promise of an entertaining movie.

On the morning of the presentation Min assembled his props: Computer, cables, projector, microphones and a sheet for a screen. Strapping the large bag to the front of his body he mounted his motorcycle.  On the backseat crouched the local school headmaster carrying a large speaker and additional materials. The headmaster, who is well respected for his position, acts as a liaison between the hospital and the surrounding communities. When needed he accompanies Min Prasad on his outings. With all gear secured, the two set off on the bumpy, dangerous dirt and rock road which eventually took them within sight of the village; the remaining distance to be negotiated on foot. Expectant villagers, were milling around the small village school where the presentation was to take place. (Incidentally, the school is one of many that DCWC has built in the back country of Nepal.) Inside, adults and children alike, eyes wide with curiosity, were following every detail of setting up the equipment, and by the time Min Prasad was ready, only standing room was available in the little classroom. The show could begin!

The movie, both educational and humorous, elaborates on the sanitary and health reasons for building and utilizing toilets as an alternative to the fields. The audience, having very little exposure to electronic entertainment, was mesmerized. But when the movie reached the halfway point, Min stopped the projector and, along with the school headmaster began the presentation on the advantages of institutional birth.  This part truly showed Min’s creativity in getting his point across.  His lecture, aided by powerpoint slides, was interspersed with song, and fanciful acting out, and kept the audience attentive. Finally, the greatly anticipated second half of the movie was shown. A question and answer period at the end showed that the presentation had been received with great interest and open minds. People kept coming up to the hospital staff with questions and to socialize before they finally could repack the equipment and start the arduous journey back to Rajbash.

Village outreach is just one of our efforts to improve the lives of women and children in Nepal.  As some of you might remember, in order to strengthen our department for perinatal services we applied at the beginning of last year with the government of Nepal to be certified as a Government Birthing Center. Under the rules of this program the hospital would receive a payment of NPR 1000 per delivery while a new mother will receive free ambulance transport to and from the hospital as well as NPR 1000 for the first two children delivered at the birthing center. A government shutdown of the program in August dashed our hopes to obtain this certification. However, it appears that now the program has been resurrected. We have reapplied to be considered for this certification and are hoping that the recent addition of a proper birthing bed and an ultrasound machine will make our application so much more compelling.  We will keep you posted!

Lastly, here is an update on our plans to install solar panels on the hospital roof to make us independent of the unreliable electric grid. We are currently studying several bids and hope to select the most suitable one shortly.  As soon as sufficient funds are available we will proceed with this installation.

We want to close with a big THANK YOU to all who are so steadfastly supporting us in making a difference in Nepal. What would we do without you?  May the new year bless you with peace and kindness wherever you are.