Nepal: Model Village
1,560 Patients Treated at RMF Clinic: Q4 2018
February 01, 2019
Summary of Activities
Soon after the earthquake, RMF began providing much-needed emergency health support to the people of Arupokhari, a remote village in Gorkha district. With the long-term vision of establishing, operating, and sustaining quality health services in the region, in January 2016, RMF opened a health clinic in Arupokhari. The health clinic that was previously operating in the region was severely damaged due to the earthquake, and it had since remained closed. RMF constructed a temporary structure in the same location and has been providing health services such as an outpatient department (OPD) and emergency services, first aid, family planning and counseling, antenatal and postnatal care services, and a supply of pharmaceutical drugs. Health services are provided to the community for free, while pharmaceuticals are supplied at a subsidized rate. However, if any patient is unable to pay for the medicines, RMF provides them for free.
Since the devastating earthquake of 2015, the RMF Health Clinic has been operating in a small, temporary structure. RMF is in the process of constructing a permanent concrete structure and will provide all health services from a single building. Global Engineering Consultants Private Limited has been chosen as the contractor for the project.
As per RMF’s plan, construction of the clinic building has been ongoing during the reporting period. Between October and December 2018, door and window panels were installed in the new building, and it was painted.
A total of 1,560 patients visited RMF clinic in the last quarter of 2018, for an average of 520 patients per month. Infectious diseases had the highest number of registered cases at 445 patients. The gender ratio of patients was exactly balanced at 50% male and 50% female.
Woman Seeks Help
Aita Maya Baram, a 92-year-old woman, visited RMF clinic for discomfort in her upper abdomen. She reported that the pain was mild but persistent. Her appetite had also reduced, and she felt nauseous. In the absence of other symptoms, she was diagnosed with gastritis and was given antacids for the problem. After a few days, Mr. Bishnu himself visited Aita Maya at her home to check whether her condition was improving. She was very happy to see him and reported that she was feeling much better with the medication. She blessed Mr. Bishnu for taking away her pain.
In line with RMF’s concepts and the government of Nepal’s vision for a comprehensive and eventually sustainable Model Village, RMF, in close partnership and collaboration with Sarswati Foundation will be working towards the development of a Model Village in Arupokhari. Sarswati Foundation has been working in Arupokhari, Gorkha since 2009 as a non-profit. This was co-founded by Subhash Ghimire, a native from that village and editor-in-chief of the Republica, Nepal’s leading English daily that publishes with the New York Times in Kathmandu.
Following the devastating earthquake, the non-profit has been actively engaged in relief and reconstruction works in the area, which includes providing food and temporary shelter relief to the affected people. So far, the foundation has delivered 7.5 tons (100 sacks of 30 kg rice, 50 sacks of 50 kg lentils, 500 sacks of 0.5 L of oil, 500 packets of 1 kg salt, 495 blankets, 350 tents) to the community, and aims to rebuild the village as a replicable model, which will include earthquake-safe structures designed by architects and engineers, utilizing local natural and human resources to ensure ownership and sustainability, improved healthcare access, education and livelihood programs, based on the needs of the communities and with the leadership of the local people.
Similarly, the village also holds a huge potential as a thriving Manaslu trekking route, along with a 600-megawatt hydro project being planned around in the area. In addition, the community is also actively engaged in production of local agricultural products and livestock. With a thought-out detailed plan, the opportunities of the village could be tapped in to create a replicable, integrated and sustainable Model Village.
RMF supports the rebuilding of Sarswati Peace School (more than 200 students, mostly from economically and culturally marginalized backgrounds) and Darbar Higher Secondary School (public school with more than 400 students), both of which were badly damaged during the earthquake. The current plan is to demolish the existing damaged structure and construct earthquake resistant buildings.
Along with the support to the reconstruction of the schools, the model village project also seeks to help build at least 100 temporary shelters and 700 permanent houses to the identified most vulnerable households in the community and one earthquake resistant local health center. Health services, education, and the economy will be supported for the long-term as the people of Arupokhari build a stronger future in collaboration with RMF and Sarswati.
- Rebuild the village as a replicable model, which will include earthquake-safe structures designed by architects and engineers
- Use local natural and human resources to ensure ownership and sustainability
- Improve healthcare access and education based on the needs of the communities and with the leadership of the local people
Click to enlarge
Sita Ram Adhikari
Sita Ram Adhikari was returning after visiting his in-laws in Sisneri, a neighboring village of Arupokhari. It was time of Dashain, a major festival during which people are in high spirits, and he had traveled to receive tika, which is one of the holiday’s traditions. On his way back home, he had to walk on foot for a couple of hours. The local roads are in poor condition, and there are places on these roads which are very far from human habitation. It was dusk when 3 unknown men emerged from the forest, attacked his head with sharp weapons, and stole his money and the gold ornaments he was wearing. He was able to shout, and some nearby people came to help. The attackers had fled the scene, and the people rushed him to RMF clinic for emergency treatment.
By the time he was received at RMF clinic by Clinical Officer Bishnu, he had been bleeding profusely and was severely disoriented. Mr. Bishnu immediately bandaged the wounds, applying enough pressure to prevent further blood loss. After applying the bandages, he assessed the patient’s vital signs which suggested hypotension and administered intravenous normal saline.
By then, a crowd had gathered to witness the victim of this blasphemous act. One of them identified the patient and summoned Sita’s family members. The patient’s son arrived at the clinic, and, after briefing him about his father’s condition, Mr. Bishnu said that it was best to rush him to a tertiary center with neurological care facilities. Furthermore, Mr. Bishnu told Sita’s son that had he had informed the police about the case, as it is illegal to treat a physical assault victim without reporting the incident. The patient’s son was very thankful to Mr. Bishnu for being available to treat an emergency case during the festival. There are no other emergency services in the area except RMF Clinic which was able to save yet another life on this night thanks to Mr. Bishnu’s diligent efforts.
Supriya Surkheti is a 4-year-old girl who was brought to RMF clinic with a fever, cough, and rapid breathing. On examination, her respiratory rate was more than 40 breaths per minute, which confirmed that she had pneumonia according to Community Based Integrated Management of Childhood and Neonatal Illnesses (CBIMNCI), a protocol followed by all health centers in Nepal for diagnosis and management of childhood illnesses. Supriya was given antibiotics as well as antipyretics to reduce her fever. Her mother was counseled about the preparation, dosage, and duration of the medication. She was also briefed about the potential complications of the condition and advised to take Supriya back to the clinic or to a higher center for further management if her condition does not improve with antibiotics.
Fever and Infection
Ayush Gurung, a toddler, was brought to RMF clinic with a fever and an infection in his left eye. Although he was febrile, he was still as active as usual. He was assessed and diagnosed with a lower respiratory tract infection, after which he was given antibiotics and antipyretics for his chest infection and antibiotic eye-drops for his eye infection. RMF Nurse Laxmi counseled the mother about the medication, dosage, and duration as well as danger signs and follow-up instructions.
Pancha Maya Baram
Pancha Maya Baram had a long cut injury on her right forearm. She was hurt when her granddaughter accidentally found a sickle played with it. When Pancha Maya saw her granddaughter pick it up, she rushed to prevent her from getting injured with the sharp weapon and tried to take it away from her, but the child had a firm grip on it, and it happened to cut her forearm. It immediately started to bleed heavily, and she ran to RMF clinic while pressing the wound with a piece of cloth. RMF Clinical Officer Bishnu first attended to her and sutured her wound. He also prescribed her with antibiotics to prevent the infection of the suture and promote rapid healing. She came to the RMF clinic daily to have the wound redressed. She said that if it were not for RMF clinicians, she would have bled to death. Each time she returned she always blessed the clinic staff. She was very impressed that such a deep cut was healing rapidly, as RMF clinicians did their jobs very well.
Yam Bahadur Shrestha
Yam Bahadur Shrestha is a laborer in the village. He has been actively involved in building houses since the massive earthquake in April 2015. He was busy with his job when suddenly a sharp-edged instrument cut his right hand just below the thumb. Whenever a client comes to RMF Clinic with a cut injury, the clinic staff always advises applying pressure to the wound, and thus, most of RMF Clinic’s clients already know to do this. Similarly, Yam Bahadur was aware of this method, and due to proper pressure application on the way to the clinic, the bleeding had stopped. Clinical Officer Bishnu cleaned and sutured the wound and prescribed antibiotics and analgesics. He also advised him to rest and avoid doing strenuous work with his right hand as the sutures could be dislodged. Yam Bahadur was also asked to return to the clinic daily to have the wound redressed.