RMF Health Center’s clinical officer with students after a class on personal hygiene
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), 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 opening in January 2016, the RMF Health Clinic has treated 24,941 patients. Of these, RMF’s clinic served 1,778 patients from April to June 2019, of which 950 were female and 828 were male. Infectious disease was the leading health problem registered in the clinic. In addition, the RMF clinical officer conducted a class on personal hygiene for schoolchildren during the reporting period, and the health center has started providing healthcare services from its new building.
Ek Maya Adhikari
Ek Maya Adhikari
Ek Maya Adhikari is a 42-year-old woman from Arupokhari. She had an abscess on her right hand, and she felt tenderness in that area. When Clinical Officer Bishnu checked her hand, the abscess was already full of pus. He incised the abscess under local anesthesia and drained the pus. Paracetamol tablets and amoxicillin were given, and Bishnu advised her to attend the health center every other day for redressing of the injury. After a week of redressing, she is now well.
Anita Surkheti, a 26-year-old woman from Arupokhari village, came to RMF Health Center suffering from a cough and chest pain. RMF Clinical Officer Bishnu checked her and diagnosed provisionally with bronchitis. He prescribed her with an antibiotic and an antihistamine.
Radhika Sodari, a 25-year-old woman from Arupokhari village, came to RMF Health Center suffering from a fever, throat pain, and difficulty swallowing. Auxiliary nurse midwife (ANM) Laxmi checked her and diagnosed her with tonsillitis. She prescribed amoxicillin and paracetamol and advised Radhika to gargle with hot saltwater and drink plenty of water.
On her follow-up visit 3 days later, Radhika had recovered and was feeling well again.
Ranumaya Baram, a 32-year-old woman from Arupokhari, had been suffering from a toothache for few months. She attended RMF Health Center, where Clinical Officer Bishnu checked her and found dental cavities. Her tooth was severely decayed and required an extraction. He gave her cloxacillin and metronidazole for 5 days and advised her to return after 5 days to have the tooth extracted. On 5th day, she returned to RMF Health Center as directed and had her tooth extracted.
Rik Bahadur Adhikari
Rik Bahadur Adhikari
Rik Bahadur Adhikari is a 40-year-old tractor driver. He was involved in an accident while he was driving a tractor near RMF Health Center. Some villagers brought him to the health center, and his left hand and leg were severely injured with a suspected fracture. Clinical Officer Bishnu provided first aid and gave Rik painkillers. He then referred him to the district hospital for the necessary investigations and further management.
Samundra Gurung and his grandmother
Samundra Gurung, a 6-year-old boy, came to RMF Health Center with his grandmother. He had been suffering from fever for 3 days. When Clinical Officer Bishnu checked him, his temperature was 102°F. He was given paracetamol tablets and amoxicillin. After 2 days, he came for a follow-up visit, and his condition had normalized.
Siman Pariyar, a 2-year-old girl, was brought to the RMF clinic by her mother, as she had been suffering from a fever and loss of appetite. She had also vomited a couple of times. There were no other significant symptoms, though the fever was of high grade. Mr. Bishnu only prescribed antipyretics and asked the mother to watch Siman’s condition closely for three more days. He advised her to return immediately in case of worsening symptoms. However, Siman’s symptoms subsided, and her condition improved.
Subin Shrestha and his mother
Subin Shrestha, 6 months old, was brought to the RMF clinic by his mother. He had been suffering from a fever and cough lasting 3 days. Clinical Officer Bishnu assessed the child and diagnosed him with pneumonia according to Community Based Integrated Management of Childhood and Neonatal Illnesses (CB-IMNCI), a protocol followed by all health centers in Nepal for diagnosis and management of childhood illnesses. He also prescribed medications according to the same protocol and asked the mother to take Subin to higher center in case the condition worsened despite the use of medications. However, Subin’s condition improved after treatment.
Sukmaya Surkheti is 61 years old and lives in Arupokhari village. While working in her home, she felt a sprain in her left leg. She came to RMF Health Center, where health workers checked her and bandaged her leg with gauze. She was also given diclofenac tablets and neurobion and referred to a district hospital for an x-ray investigation.
Tara Surkheti is 26 years old. She has two children, a son and a daughter. She thinks two children are sufficient for her family and doesn’t want an additional child. Her youngest baby is less than 1 year of age, so she chose Depo-Provera as a temporary family planning method.
Unik Ale Magar and his mother
Unik Ale Magar
Unik Ale Magar, a 5-month-old baby, was brought to RMF Health Center by his mother. Clinical officer Bishnu assessed the child and diagnosed him with pneumonia. He prescribed medications according to the IMNCI protocol and asked the mother to take him to higher center in case the condition worsened despite the use of medications. However, Unik’s improved after treatment.
- 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.