Nepal: Orphanage Support
First HIV/AIDS Camp at Orphanage Successful: Q2 2017
August 01, 2017
Ganesh Shrestha and Pragya Gautam
Summary of Activities
Currently, RMF supports two NCO children’s homes in Kathmandu, located at Naxal and Sifal, with 2 nurses and 1 auxiliary nurse. RMF’s nurses provide 24-hour, daily care for the 118 children sheltered in these homes. Nurses provide both preventive and curative health services to all the children as well as 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 the children with chronic diseases and special needs. There are currently about 9 infants and 11 children with special needs in NCO, Kathmandu. These children are more vulnerable to infections and require special care.
During this quarter:
- Immediate and appropriate treatment for injuries and accidents
- Routine deworming of the NCO children and staff every six months
- Celebration of significant events such as World Environment Day with event-specific programs designed for children
- Provision of voluntary services at health camps organized by NCO
World Environment Day
Against all odds, NCO creates an environment in which the children learn the essences of life. One way that NCO achieves this is by celebrating significant days and teaching the children the importance of each event as well as their own roles in the celebration. On June 5, 2017, each NCO home celebrated World Environment Day. On this day, the children were taught the value of healthy environment and their roles in maintaining the natural world. RMF nurses taught them how to maintain their personal hygiene and keep the environment clean by picking up and disposing of waste properly. They also taught the children about global warming and the importance of preserving the environment for healthful living.
This year’s theme for World Environment Day was ‘Connecting People to Nature’ which was aimed at motivating people to go outdoors and explore nature as well as helping people understand nature conservation and their role in it. The children at NCO observed this occasion by cleaning the NCO premises.
All NCO children were provided with albendazole tablets for routine deworming. RMF nurses also arranged for anti-helminthic medication which they administered to the children in order to treat any helminthic infestations.
NCO had previously asked the NCO administration to submit an official request to the District Public Health Office to supply anti-helminthic medications, and as a result they are able to receive and administer the medicines every six months. NCO appreciates the RMF nurses’ noble efforts which have somewhat improved morbidity rates among the children.
HIV/AIDS Health Camp
A few months ago, 2-year-old Prapti Balika, who was adopted by NCO, was found to be HIV positive. Because the NCO staff treats the children living there as a family, they take care of them as if in a family home, i.e. without using universal precautions. The child’s diagnosis imposed a health risk on the staff, which is why NCO in collaboration with an NGO organized a health camp with SPARSHA Nepal, an organization which works in the field of HIV/AIDS. The main objective of the camp was to screen NCO staff and children for HIV/AIDS. The camp was organized on June 24, 2017, and RMF nurses also participated in the camp by providing voluntary services. The camp was a great success as none of the children or staff members tested positive.
RMF nurses informed the NCO administration that there is always a risk for HIV as they receive children from various sources, and HIV also has a long window period when it cannot be detected. Thus, they advised that HIV screening tests should be done every six months for everyone at NCO. Following the advice, NCO met with SPARSHA Nepal’s team and has planned to conduct another camp at NCO Siphal and conduct similar events every six months in the future. Thanks to the RMF nurses, a new health venture has been started at NCO.
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
Click to enlarge
Kamana B.K. has been in the custodial care of NCO since she was three months old and is now 15 months old. When she fell sick with a fever, she cried and refused to eat, and then she suddenly she began to convulse. The caretakers and RMF nurse were shocked to see her quivering and turning blue and her eyes rolling back.
She was taken to the Kanti Children’s Hospital at once, and there she was diagnosed with a febrile seizure. She tested positive for Creactive protein (CRP) which indicates presence of an infection. Kamana did not have another seizure in the hospital, but the doctors informed RMF and NCO team members that convulsive episodes can have serious consequences for a child of this age, which is why they elected to keep her in observation for 24 hours. After taking the prescribed antibiotics, she has now recovered.
Prerana Chand, who lives at NCO Siphal, was doing her chores when a monkey suddenly attacked her. She was very frightened but bravely fought the monkey. Despite her efforts, the monkey had already bitten her on the right shoulder by the time others came to help. She sustained a large wound that was bleeding profusely.
RMF Nurse Pushpa immediately responded to the situation by cleaning the wound with soap and running water and applying povidone-iodine solution. She then covered the wound with a soft bandage and injected a tetanus vaccine. When Prerana continued to feel discomfort and pain, an RMF nurse took her to the hospital for a rabies vaccine. After 5 doses of the rabies vaccine and continuous care from Nurse Pushpa, Prerana has completely recovered.
9 Years Old
In February 2017 when 9-year-old Rabindra Lama was brought to NCO home after losing his parents. During his thorough physical assessment, RMF Nurse Pushpa discovered he had a fever as well as a long scar in the middle of his chest which looked like an incision mark from surgery. When Nurse Pushpa asked him about it, Rabindra told her that he had had surgery during his early childhood. After informing the NCO officials, Nurse Pushpa made arrangements to talk to his distant relatives who confirmed that he had open heart surgery for a congenital heart condition years ago. Rabindra also revealed that he is taking medication. After obtaining a clear picture of his health history, Pushpa took him to Shahid Gangalal National Heart Center for a check-up and to update his medications. There he underwent multiple blood tests, an electrocardiogram, and an echocardiogram for reassessment of his heart health as well as the reconfirmation of his diagnosis after surgery. He is now healthy and still on medication for his heart condition. Thanks to a perfectly timed careful assessment and the tactful decision-making of RMF Nurse Pushpa, Rabindra was able to continue living healthfully after he was orphaned.
Akash Balak and Ayush Bala
Bitten by a Stray Dog
NCO Naxal home has a vast outdoor area where children are encouraged to play on a daily basis in order to promote their proper growth and development. On May 19, 2017, Akash Balak and Ayush Balak were playing outdoors when one of them happened to step on a dog’s tail. The dog angrily attacked the 4-year-old boys who were frightened and screaming when other came to help. They sustained wounds on their calves, and RMF Nurses Sanskriti and Bina took charge to clean the wounds with soap and running water. After the wounds were cleaned, they were dressed with antiseptic solution and left open. Both of the boys received tetanus vaccinations as well as a routine courses of 5 doses of the rabies vaccine. Their wounds have healed, and they are now very frightened of the dogs due to the attack.
7 Years Old
Anita Jaisi, who we believe is 7 years old, was adopted by NCO at the end of May 2017. When she arrived at NCO, she was found to be underdeveloped and her appearance was that of a 5-year-old. She also had an abnormally protruding abdomen. According to the doctor at NCO, she also had arrhythmia, which RMF nurses also confirmed in a thorough physical examination.
The NCO doctor suggested a detailed heart health screening, and RMF Nurse Sanskriti took her to Shahid Gangalal National Heart Center where an echocardiogram and chest x-rays were done. The tests revealed that there was fluid accumulation in her heart capsule. They conducted further testing and additional blood tests including total blood count and thyroid function tests as well as an ultra-sonogram. Surprisingly, the test results were normal but her abdominal distension has not subsided. She is due for a consultation with an endocrinologist and a second echocardiogram. RMF Nurses Sanskriti and Bina, as well as the rest of the NCO staff, are taking good care of her by monitoring her nutrition and activities. Anita has told the staff that she feels better as a result of the love and care of the RMF nurses.