Physical Health Nepal Project #7746

Himalayan Healthcare for 5000: Save Lives in Nepal

by PHASE Nepal

Project Report | Dec 5, 2011
Healthworkers as Dentists in Maila

By Jiban Karki | Executive Director, PHASE Nepal

Dear friends

PHASE Nepal specialises in working in extremely remote areas; places without basic infrastructure and services. When PHASE first started working in Maila in 2008, there hadn’t been a functioning health service there for many years. One of the most common complaints was from people suffering from toothache. Toothache is painful and debilitating and can reduce quality of life considerably, especially when there are no dentists and not even access to painkillers.

The PHASE healthworkers in Maila have a very basic level of medical training, but as the only medical staff in a 60km radius they have to act as doctors, midwives, counsellors, paramedics, educators and even dentists. All PHASE healthworkers take a basic course in dentistry, and PHASE healthposts are equipped with a set of dental equipment. Every month, several patients come to the healthpost in Maila with oral health or dental problems.

Bachu Jaisi was one. He is 24 and unmarried. He was suffering from toothache for 4 days before he decided to make the two-and-a-half hour trek to the healthpost in Maila.

“It was really painful,” he remembers. “I couldn’t eat anything at all and my mouth was so swollen I even had problems talking. I made some medicine myself out of local herbs such as titopati and neem, but it didn’t really help. I had heard that the staff in the healthpost had the instruments to pull teeth, and I thought that was what I needed, so I went to see them.”

PHASE healthworker Phelu examined Bachu’s mouth and discovered that the problem was not the tooth but a swollen abscess. Instead of losing the tooth, all Bachu needed was a course of antibiotics and some ibroprofen for the swelling and the pain. He was happy to not to have to lose his tooth!

“The medicine started to work really quickly. Within a few days I could talk and eat like normal. It was such a relief! I won’t bother trying to make medicine at home anymore now I know that the medicine in the healthpost works so well. Also, the workers there are kind and friendly.”

Even more important than the dental treatment provided in the healthpost is the preventative work undertaken by the healthworkers, in the form of oral health education.

“So many people in Maila have problems with their teeth and gums,” says healthworker Deepa. “Even when people come to the healthpost for other reasons I try to talk to them about oral health. Lots of people smoke here, that’s one reason, and just a lack of understanding of how to take care of their teeth.”

Oral hygiene is a common topic for the regular health education sessions in Maila. The healthworkers say that more and more people are being convinced to brush their teeth at least once a day, although they estimate it is still way below half the population. For those not wanting to use scarce resources on a toothbrush and toothpaste, there are local alternatives that work nearly as well. Many people have started to clean their teeth with twigs from the medicinal neem tree, frayed to make a kind of brush, which works nearly as well

Your donation has been crucially important in keeping this essential health service open. The healthpost treats thousands of patients like Bachu, who would otherwise have not been able get relief or treatment for very simple conditions.

To those of you for whom December is a festive period, please consider sharing some of your goodwill and cheer with the people of Maila. As you have seen, a small donation goes a long way – an average consultation, including staffing and medicine, costs under $3 and frequently saves lives.

This December please consider:

Making a small donation for the people of Maila to continue to have a health service over the harsh winter months
Buying healthcare for Maila as a gift for friends and family (comes with personalised card)

Standing in solidarity with the people of Maila,

Jiban, Claire and the PHASE Nepal Team

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Sep 12, 2011
Maila and the 'Crisis of Malnutrition'

By Jiban Karki | Executive Director, PHASE Nepal

Food Aid by Helicopter-this support has now ceased

Dear friends

These last few months, your donation to PHASE Nepal has provided essential healthcare services in the remote community of Maila, in north-western Nepal. PHASE healthworkers Deepa, Phelu and Ritu see between 30 and 60 patients a day, most of whom have walked many miles for treatment.

Life in a community as isolated as Maila is never easy, but it unfortunately became much more challenging in June when the World Food Programme withdrew their support of regular food aid that the community has depended on for the last decade. Previously, rice was flown in by helicopter twice a week, but due to funding constraints this support has now ceased.

‘Donor attention is shifting away from Nepal towards countries where relief and recovery assistance can meet needs that are less chronic in nature.’ (WFP Press release, May 2011). Click here for news reports on this issue.

Malnutrition rates are alarmingly high in Maila, only slightly lower than the Democratic Republic of Congo.– the worst scoring country on the Global Hunger list. Nationally, 41% of children in Nepal are chronically malnourished. In 2008, when PHASE first started working in Maila, this figure stood at a staggering 84%. Many of the patients seen by our staff have health problems relating to malnutrition – especially children.

Sawni Sunar’s (33), 2 year old daughter was suffering from earache and diarrhoea when she came to Maila Healthpost. Malnourished, the child weighed only 7kg – less than half the recommended weight for her age. Although Sawni had been breastfeeding, she could only do so once or twice a day because she spent most of the day in the field growing food for her family. Ritu and Deepa told Sawni to feed her child 4-5 times a day, and provided information on what foods are particularly nutritious. They also gave her vitamins, iron and folic acid and told Sawni to return again with her daughter in a few weeks.

Nutritional awareness is extremely low in remote Nepal. In 2008 PHASE found that only 5.5% of the population of Maila understood the concept of malnutrition. A major role of the healthworkers has been to raise awareness in the community of child nutrition. One of the ways in which they have been doing that is to run demonstration sessions with mothers groups on how to make ‘Sarbotam Pitho’, or Super-flour, a highly nutritious weaning food.

‘It’s very easy to make, with widely available ingredients,’ explains Ritu BC. ‘You just take 1 cup each of 2 kinds of different grains, 1 cup of soya beans and a cup of another kind of bean, and grind it all together’.

Two months later, a calmer and happier Sawni returned to the healthpost. She had fed her daughter frequently and had used the super-flour recipe. The child now weighed a much healthier 10kg and was no longer suffering from any health problems.

Providing health services to the people of Maila is an essential task. It will only become more so as food scarcity increases, so PHASE staff are further prioritising nutrition education activities.

The money we have raised so far will keep this healthpost open for the next few months, but we need to continue our fundraising efforts to secure the healthpost for the whole year.

Ways you can help:

- Buy a gift card for PHASE staff members Claire’s 30^th Birthday (13^th September) or another loved one

- Donate to Global Giving on the 19^th October when all donations will be matched by GlobalGiving

- Continue to help us raise awareness of this important cause

With gratitude and hope

PHASE Nepal and the community of Maila

Teaching mothers to make nutritious 'super flour'

A cheeky toddler, Maila

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Jun 13, 2011
Giving Birth in Maila

By Jiban Karki | Executive Director, PHASE Nepal

Women practicing the tradition of 'Chhaupati'

Dear friends

Just to let you know a bit more about what your kind donation is funding in Nepal, and about an exciting opportunity…

Accessible either by helicopter or an arduous 8-day trek through the snowy Himalayas, Maila village is geographically, socially and economically isolated. There is little infrastructure, few services, and the community depends on rice delivered by the World Food Programme. PHASE healthworkers there find the lifestyle challenging, but extremely rewarding.

‘The people of Maila are some of the most helpful, loving and kind people I know’ says Deepa Pathak. ‘It makes it a delight to work in their community’.

Being so isolated, many traditions that exist are not practiced elsewhere. ‘Chhaupadi’ dictates that menstruating women and those about to give birth should stay far from their families, in cold, unfurnished buffalo sheds. As well as doing all their cooking and washing themselves, they also deliver their babies unaided; hence the rate of maternal and infant mortality in Humla is extremely high.

The presence of PHASE healthworkers in Maila is helping to change things.

Our staff have been raising awareness about the dangers of unattended delivery, and women are becoming more empowered to move against traditional taboos. The healthworkers now attend 10-15 births a month.

‘The idea of antenatal care is new for Maila, but more and more mothers are coming to us for check-ups,’ says PHASE staff Phelu Jiral. ‘Whenever we identify abnormalities we convince the family of the importance of taking the mother to the District Hospital for delivery. The District Hospital is 4 days walk away – if complications are only identified during labour then the mother has no chance.’

Increasing amounts of people are using health services, with staff seeing 40-50 patients a day. Many walk for hours - Jankali Budha, 30, suffered from an obstructed labour, and was carried for 3 hours on a stretcher by her neighbours and husband from the village of Madana. When she arrived she had lost the baby and her life was in danger. PHASE health staff (under careful guidance from doctors in the UK contacted by phone!) brought her out of danger and provided her with counseling about the loss of her baby.

The healthpost in Maila is an essential service, and thanks to your kind support we have raised $8000 towards keeping the service open through 2012.

Life in Humla is going to become even more challenging next year, meaning the work of PHASE will be even more critical. The World Food Programme plan to withdraw food aid support that the community has depended on for the last decade. PHASE is coordinating a response to the impending humanitarian crisis and will be sure to keep you updated.

We have only raised one quarter of the money we need to fund the health service in Maila during 2012, but an interesting opportunity is coming up!

Next Wednesday, 15^th June, Global Giving is match funding all donations made to this project by 30%!! This means that your donation will be worth more!

We know that all of you have already shown huge generosity towards and solidarity with the community of Maila, but if you could publicize our project on this day, convince your friends and family to donate, or post this in your Facebook status, your support will be gratefully received!

With love and thanks

PHASE Nepal and the people of Maila

Mother with new born baby in cowshed

Woman with healthy baby, Maila

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