Bring healthcare to thousands in rural Nepal

1. Constructionof Toilets :
   50 completed, 277 villagers benefitted directly
   
   In line with HHC’s campaign of ‘one home one toilet’ in the remote Ruby Valley region of central Nepal and the government’s bid to declare the region ODF (open defecation free) a formal request of 700 toilets was sent to HHC by the Ruby Valley Rural Municipality in 2018. HHC partnered with the toilet recipients as well as with the officials of ward 3 of Ruby Valley Rural Municipality during this important campaign.

The DRI supported toilet project though hampered by a long and hard monsoon between June and September of 2018, was completed by the end of December 2018 where 277 inhabitants of 50 households in Sertung village (ward # 3 of Ruby Valley) of now have a permanent toilet at home. 67% of the beneficiaries of these toilets are children.

1. CASE STUDY OF TOILET "After the new toilets, the trails and lanes which were once covered with filth and bad smells are now so clean.  A major problem has been resolved" - Nani M, toilet recipient
   
   
   1. Phe DT, HHC field coordinator
      Kharsa village part of the big village of Sertung has 105 households and 85 were without toilets. Himalayan HealthCare with advice from ward chairman, constructed 60 toilets in Kharsa in 2018. The rest will be built in 2019.

In the words of Nani M, one of the beneficiaries of the 60 toilets in Kharsa:

“My father-in-law Kaman ST is 75 years old and is a former member of the ward committee. He decided to visit the concerned local government bureaus demanding toilet and drinking water but was not successful. But during the visit he heard about HHC and voila! we were suddenly one of the lucky recipients of toilet at home! Our village lacks drinking water and toilets which is a crisis. Our family and neighbors were compelled to defecate on the trail and anywhere we could go. It was especially challenging for the elderly and the children who could not travel long distances. Especially in the dark and in bad weather.  We were always afraid to be embarrassed in the open The makeshift toilet near the house smelled badly and was a place of diseases.”

“HHC not only helped us construct toilets in Kharsa but also taught us how to keep them clean. Also the Gorkha Welfare Organization is installing drinking water so it will make it easy to keep the toilet clean.”

Nani M adds, “Since I had a small baby it was bit difficult while constructing the toilet but now it is so convenient! This has especially helped our senior family members and the young children. The toilets have stopped open-defection and our trails are not filthy anymore. We thank HHC in helping us with the toilet as this has saved us time and has made our environment clean and it has given us a more dignified life.”

The villagers were excited when we granted the toilets to Kharsa and they completed the given tasks within the stipulated time frame. In the past, the trails were covered with excretion but now as Nani M mentioned above, the toilet construction has helped people in day to day life and are able to lead a more dignified life. As the construction of the 60 toilets was so well done, the remaining 25 toilets will also be completed in 2019 within time. I see the enthusiasm of the people. I want to thank the organization and the recipients for this beautiful team work.

 Delays and Challenges:

• Heavy monsoon rains and the big religious holidays caused delays
• The dirt road leading into the northern Dhading region which was temporarily closed over a four months period finally opened in late September thus re-establishing the toilet materials supply.
• Reconstruction of earthquake damaged homes took precedence over the toilets but the recipients worked hard and met our completion dates.

• Photos_of_Toilet_Construction_and_Recipient.pdf (PDF)
  

30 January 2019

Namaste Friends,

Since its inception in 1992, some 26 years ago, HHC continues to respond to the urgent health needs of patients mostly from road-less remote villages of northern Dhading namely Tipling, Sertung and Lapa who are dependent on basic health services from government run village health posts manned by health assistants who are struggling to keep up with a system that is slowly improving but needs major overhauling to make it efficient and patient-centric. 

HHC continues to support the village and district health care facilities with vital services such as care for patients who have little or no financial means through specialized medical camps and also referral to city hospitals for further intervention.

  
Eye Camp in Kintangphedi:
Dec 18^th to 21^st, 2018

After the successful eye camp conducted in Jharlang of Khaniyabas Rural Municipality conducted in April 2018, HHC carried out the second eye camp for 2018 in the remote but road connected small town of Kintangphedi, which is a part of the newly formed Netrawati Rural Municipality in central Nepal northwest of Kathmandu. HHC’s eye team headed by Dr. Kamal K. was able to carry out a successful cataract camp from December 18^th to 21^st targeting as many patients as possible from five rural municipalities in this region of Dhading district which is home for over 50,000 people.

We carried out a house-to-house survey with the help of our very proactive staff who reached out to every possible contact and volunteers in the region. The eye camp was furthered publicized with the help of two FM radio stations as well as banners and posters put up in the five rural municipalities of Netrawati, Ruby Valley, Ganga Jamuna, Khaniyabas and Tripura Sundari. After a month long publicity campaign, the camp was able to draw 611 eye patients who were treated by six member ophthalmic team. 122 cataract surgeries were carried out at the Managala Devi Secondary School building which was recreated to be a field operating facility. Most of the patients were from rural places with little or no financial capacity to avail the surgery in the city. Several of the patients were bilaterally blind and the surgery has transformed their lives. HHC is grateful to Dr. Kamal Khadka, a Nepali ophthalmologist and his eye team for their service. HHC is also grateful to DRI for their financial support and to all the local volunteers, school committee and the HHC staff.

Other than cataract surgery, patients were also treated for refractive error and provided glasses. Presbyopia, conjunctivitis, blepharitis, dry eye, glaucoma, chalazion, etc., were some of the other ailments that were also treated at the camp.

A follow-up checkup camp for the cataract surgery patients was carried Dr. Rajesh S. with HHC’s help at the same school out by the HHC as scheduled for 4^th to 6^th January 2019. 98 cataract surgery patients were examined with excellent result while three new patients with cataract were referred to Kathmandu for further investigations.

OB/GYNE Training for Village Midwife
Nov 28^th to Dec 8^th, 2018

HHC also conducted an eight day gynecological training camp for ten village midwives from three rural municipalities namely Khaniyabas, Ruby Valley and Ganga Jamuna of Dhading district. The training was carried out by HHC consultants Drs. Rakshya P and Nesuma S, two gynecologists who travelled and trekked from Kathmandu for three days to reach the HHC center in Sertung where the midwives also gathered from various remote village health centers for the training.

The training was hands-on and therefore the trainees were divided into two small groups of five each and trained separately back to back. The midwife trainees who were only trained in obstetrical care were taught to carry out gynecological history taking and physical examination independently with patients who presented specific problems. Pelvic organ prolapse (POP) which was significant in the region was tackled. Its identification and conservative management which included pelvic floor exercise and ring pessary as well as referrals was discussed in details to provide confidence to the midwives to help POP patients. The basics of cervical cancer screening with visual inspection with acetic acid (VIA) and the importance of timely referral to a well-equipped centers for further workup of VIA positively tested cases was taught to the trainees. 35 gynecological patients were examined and treated by the trainees and the specialists. Three of the patients were also advised and referred for surgical intervention. At the end of the training, the trainees were gifted with an OB/GYNE kit. A follow-up refresher training will be conducted by the same specialists for the same trainees in March of 2019 to help the midwives with new challenges and reaffirmation of their newly acquired skills. The camp was officially launched by the municipal ward chairman of Ruby Valley 3.

Health Infrastructure:
29^th Oct 2018

HHC handed over the newly constructed Outpatient Patient Building (OPD) and Staff Quarter of the Dhading District Hospital in central Nepal to the government on 29 October 2018 at Dhadingbesi. The program was chaired by the Mayor of Neelkanta Municipality Mr. Bhim D & Dr. Surendra KY, the State Minister of Health of Nepal was the chief guest at the handover ceremony. The program was also attended by the Chief District Officer, District Health Officer, Chief of the Coordination Committee, Chief of the Police & Nepal Army, politicians, social workers, journalists, NGO/INGO representatives, hospital staff and the local community. Altogether there were 150 attendees at the function. The OPD building and Staff Quarter was financed by AmeriCares Foundation and the furniture and medical equipment was provided by Direct Relief International. HHC is grateful to both the foundations for their financial support. The new OPD building will directly benefit 50,000 patients annually. The well-lit and ventilated, temperature controlled modern design of the building will be an asset in the warm months of summer in this low lying center in central Nepal.

We thank you all for your continued support of our health programs that support serve communities who are in desperate need especially after the massive earthwuake of 2015.

Himalayan HealthCare