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.
The RMF Health Clinic is dedicated to providing health services to the residents of Arupokhari and its neighboring villages free of charge. Since opening in January 2016, the RMF Health Clinic has treated 11,527 patients. 2,145 of these patients were treated between July and September 2017, of which 1,109 were female and 1,036 were male. The clinic served 678 patients in July, 750 in August, and 715 in September for a total of 2,145 patients, averaging at 715 per month, the highest number to date.
RMF officer checking Newton’s ear
Treating a Variety of Illnesses
Throughout this reporting period, skin disease was the leading health problem registered at the clinic with 394 patients, followed by fever with 343 patients, respiratory disease with 313 patients, accidents and fall injuries with 219 patients, and digestive system disorders with 208 patients.
Sumita, a 38-year-old woman, came to RMF clinic with a toothache. Clinical Officer Bishnu Sharma checked her condition and found that she was suffering from dental cavities. She was given a course antibiotics and analgesic, and then referred to a dental hospital for further diagnosis and management.
Bamboo Splinter Removal
Dambar Bahadur, a 63-year-old, man, was working in the field when he was pricked by bamboo, leading to an injury. He immediately arrived at RMF clinic for treatment. The RMF clinical officer performed incision and drainage (I&D) and then removed the bamboo under local anesthesia. Analgesic and cloxacillin, an antibiotic, were given for 1 week. He was also called in for daily redressing of the wound for 1 week. After a week, he fully recovered, and now he is well.
Saraswati being treated at RMF clinic
Diarrhea and Abdominal Pain
Saraswati, a 36-year-old woman, was a resident of Arupokhari who was brought to RMF clinic because she was suffering from diarrhea and abdominal pain. When an RMF nurse checked her, her blood pressure was low at 90/60 mmHg, and she was dehydrated and very weak. The nurse opened an IV line and administered intravenous Ringer’s lactate (RL) for rehydration as well as metronidazole, an antibiotic. After 3 pints of RL, her blood pressure returned to normal. She was kept under observation for 24 hours. During discharge, a course of antibiotics, oral rehydration solution (ORS), and a week-long course of metronidazole were given. She was advised to rest and drink plenty of liquids such as water or juice. When she attended the clinic for follow up after 7 days, she was doing well and thanked the RMF staff.
Chitra Bahadur being treated at RMF clinic
Chitra Bahadur, a 48-year-old man, was brought to RMF clinic after suffering from a high fever, headache, and weakness for 5 days. During his checkup, his temperature was 102°F and his heart rate was relatively slow. There is no laboratory service at RMF clinic, and the hospital is very far. Furthermore, he did not have enough money to go to district headquarters for treatment. RMF’s clinical officer provisionally diagnosed him with typhoid and started treatment. He opened an IV line, administered the antibiotic Monocef intravenously, and gave him oral paracetamol. This treatment was continued for 14 days. The clinical officer suggested bed rest and plenty of fluids. During his follow up visit after 14 days, he had fully recovered.
John, a 2.5-year-old boy, was brought to RMF clinic by his mother with a fever and cough. During his physical examination, the clinical officer found that he had a fever of 103°F, chest in-drawing, a cough, a stuffy nose, and fast breathing. He was provisionally diagnosed with pneumonia and given paracetamol, antibiotics, and cough syrup. His mother was advised to provide plenty of liquid food, including breastfeeding. When the clinical officer followed up after 5 days, John’s condition was completely normal.
Anish, a 2-month-old baby boy, was brought to RMF clinic because he was coughing and had fever. The clinical officer diagnosed pneumonia after examination. He had a temperature of 104°F and chest in-drawing, and he was breathing fast and grunting. He was prescribed antibiotics for a week, and paracetamol and cough syrup were also given. His mother was advised to keep him warm and provide plenty of breast milk. During follow up after a week, he was completely well.
Aaita Bahadur at RMF clinic
Aaita Bahadur, a 59-year-old man, fell on the road resulting in a wound on his left leg. It was dressed with the antiseptic betadine, and he was referred to the district hospital with a single dose of antibiotics, because he had very low blood pressure. He was treated in the district hospital for 3 days and came back to RMF clinic after 3 days to have the wound redressed. After 7 days of redressing, the wound has recovered.
Asthma and Hypertension
Aaita Maya, an 88-year-old woman, came to RMF clinic with dizziness, headache, cough, and shortness of breath. She was suffering from asthma and hypertension. The clinical officer prescribed intravenous normal saline (NS) as well as salbutamol to treat her breathing problems. She was advised to monitor her blood pressure regularly and avoid alcohol and smoking. She comes to the clinic regularly to monitor her blood pressure and has decreased her smoking.
Acid Peptic Disease (APD)
Bhagawati, a 78-year-old woman, was brought to RMF clinic with abdominal pain, burning urination, and epigastric burn. After examination, the clinical officer provisionally diagnosed her with acid peptic disease (APD) and a urinary tract infection. Ciprofloxacin, an oral antibiotic, and pantoprazole, a medicine used to treat gastroesophageal conditions, were prescribed for 10 days, and she was advised to avoid oily foods and drink plenty of water. Her health was restored after 10 days.
Chandra Kumari, a 78-year-old woman, was suffering from a fever, headache, body pain, and weakness. The clinical officer diagnosed her provisionally with typhoid and gave her vitamin B complex, chloramphenicol for 10 days, and paracetamol. He also advised her to follow up for a blood pressure checkup and recommended a soft diet and bedrest. She is completely well now.
- 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
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.