Nepal: Orphanage Support
358 Children Treated: Q2 2018
July 30, 2018
Ganesh Shrestha and Pragya Gautam
Summary of Activities
Currently, RMF supports two NCO children’s homes in Kathmandu, located at Naxal and Sifal, with 1 nurse and 2 auxiliary nurses. RMF’s nurses provide 24-hour, daily care for the children sheltered in these homes. Nurses provide both preventive and curative health services to all the children as well as the staff of NCO.
As a result of their continuous presence, they are able to diagnose children more efficiently, leading to earlier diagnosis and treatment. RMF’s nurses are especially committed to providing care for children with chronic diseases and special needs, as these children are more vulnerable to infections and require special care.
Apart from providing nursing staff for these two NCO children’s homes, RMF also provides financial support for more extensive medical treatment. When a child has a serious illness, his or her case is taken over by RMF. The child is treated at the appropriate hospital in Kathmandu, and RMF bears all the costs of investigation, treatment, and hospitalization.
During this reporting period:
- 358 children were provided with nursing care
- 343 children were independently treated by RMF nurses while 15 were taken to the hospital for treatment
- RMF Pediatricians from Kanti Children’s Hospital continued to visit NCO homes on a weekly basis
Overcoming Health Problems
RMF Nurses Working Diligently
Due to summer rains and crowded conditions at NCO homes, children have been especially vulnerable to respiratory problems during this reporting period. Fewer resources, buildings damaged by earthquakes, a lack of nutritious food, and other factors are the other main causes of illness. RMF nurses have been working diligently to prevent and treat these health problems, despite the many challenges they face in their work.
New Nurse at NCO
Ranjana is an Auxiliary Nurse Midwife (ANM) who graduated with distinction from her ANM course at Lalit Polytechnic Training Institute in Lalitpur, Nepal in 2016. She has completed 3 months of on-the-job training at Kathmandu Model Hospital where she practiced patient care in different settings.
Ranjana is now working as a residential nurse at NCO as a part of RMF’s support to the organization. She will provide care to children of all ages with or without disabilities. She will also provide health education and assistance to the in-house NCO mothers (caregivers).
Providing Holistic Care
Ensuring Proper Development
NCO not only provides shelter for children, but also all provisions necessary to ensure proper growth and development including formal school education, staff who care for children full time, an environment for physical activities, and psychological support. NCO also provides treatment and care to sick children at their homes and, if necessary, at various hospitals. This organization respects the rights of children and aims to help them grow to become responsible citizens.
Established in 1964, Nepal Children’s Organization (NCO), also known as Balmandir (The Children’s Temple) is one of the oldest non-profit organizations in Nepal working for the protection and promotion of childrens’ rights and providing residential care to the children at risk. This includes orphans, differently-abled, abandoned and conflict affected children.
After the devastating earthquake on April 25th, followed by another strong earthquake on May 12th, an estimated 2,023 children have been confirmed dead. Likewise, the number of the injured children has been established at 876 and approximately, 200 children have lost their mothers and 112 have lost their fathers. Nearly 2 million children are said to have been affected by this mega quake and the powerful aftershocks thereafter. (Ministry of Women, Children and Social Welfare, June 2015)
Among those children who lost their parents, many have come under the tutelage of NCO, whose own shelter home was heavily destroyed by the disaster. Currently, through their 10 children’s homes within and outside Kathmandu valley, NCO has been caring for 280 children, including the earthquake-affected.
RMF will be supporting NCO in improving orphanage-based children’s health by providing better quality primary health care, including nutrition, sanitation and hygiene.
- Provide psychosocial counseling to deeply affected children
- Construct a room for infants
- Health and sanitation trainings for house mothers and children
- Construct a room for differently-abled children
- Provide better quality primary healthcare
- Provide qualified staff nurses at NCO’s centers
- Enhance knowledge and awareness of health and nutrition
Newborn Sameer Balak
Treated in Hospital
Sameer Balak was 5 days old when he was received by NCO. When he arrived, he had yellow discoloration all over his body and he was lethargic. RMF Nurse Bina took him to Kanti Children’s Hospital where he was diagnosed with jaundice and kept in neonatal ICU for 5 days. His condition slowly improved and he was discharged. As they do with all NCO children who have recently been discharged from the hospital, the RMF nurses took special care of Sameer when he returned to the NCO home.
Begins Nutritional Therapy
Sophiya Balika is 4 months old. She was 1 month old when she was brought to NCO by the police. They learned that the mother asked a pedestrian to carry her child, claiming an emergency, and fled the scene. That person gave Sophiya to police and police who handed her to NCO.
Upon her arrival, Sophiya was very frail and staff members believed she may not live much longer. She weighed just 1300g. Dr. Shreeram was worried about the child’s stiff joints and overall condition and asked RMF Nurse Bina to take the child to Kanti Children’s Hospital to consult a senior pediatrician. The senior pediatrician prescribed her multivitamin powder rather than medication.
Once Nurse Bina started giving Sophiya the multivitamin powder with her milk, her condition started improving. She will continue the nutritional therapy for six months. Her condition is gradually improving, and the nurses are taking good care of her.
Receives Crucial Surgery
Asim Balak is 14 months old. He was brought to NCO from Patan Hospital at the age of 4 months because his parents fled the hospital knowing their child had multiple health problems at birth, and they could not afford the treatment. He was born with a hernia and hydrocele (scrotal swelling).
At NCO, RMF pediatrician Dr. Shreeram examined him and informed the NCO authority that the child needed surgery. Kanti Children’s Hospital also advised surgery, but Asim’s weight was too low for anesthesia; he was scheduled for surgery once he reached 12 months or weighed 10kg.
However, when he turned 12 months old, the surgery department at Kanti Children’s Hospital had a large number of cases, so Asim was added to the wait list. Dr. Shreeram personally took charge by admitting him to the hospital, where he received the necessary surgery. Asim was saved from a life of disability and is now doing well.
HIV Status Investigated
Now 4 months old, Aman Balak was just 17 days old when he was received at NCO home Bal Mandir. Since the time of his adoption, he needed hospitalization and intensive care. However, even with medication, his health did not improve. The doctors decided to check his HIV status, and unfortunately, the test came back positive.
This was alarming to the caregivers because they care for children at NCO in the style of a family home, which means that they had not used the recommended precautions or barriers. It would also be risky to keep Aman at the home because NCO does not have the necessary provisions to care for a child with HIV.
RMF Nurse Bina was also concerned because, due to her extensive experience working with children, she knew that very few institutions would accommodate a child with HIV. Her intuition told her to have Aman tested for HIV again to confirm the results. Incredibly, the second test came back negative.
Although Nurse Bina and the other staff members were relieved, the differing test results left Aman’s HIV status ambiguous. The test was repeated a third time and came back negative again. Nurse Bina’s action and intuition led to this final diagnosis, which prevented Aman from facing serious problems. He has remained with NCO.
Treated for Chronic Conditions
Goma Adhikari is a 13-year-old girl who was adopted by NCO home Siphal in April with a diagnosis of type 1 diabetes. She was using 20 units of insulin in the morning and 8 units in the evening. She was very ill when she was adopted and was immediately rushed to hospital where it was discovered that her blood sugar was dangerously high at 500mg/dl.
Further tests revealed a thyroid disease for which she had been previously medicated, but her medications were discontinued, which led to health consequences. When Goma was discharged from the hospital, RMF nurse Pushpa took charge by preparing a dietary schedule for her and teaching her to administer insulin by herself. She is now taking her medications and doing very well. “Thanks to sister Pushpa, she helped me so much,” said Goma.