Nepal: Model Village

Preventing and Treating WASH-Related Diseases: October-December 2018

December 05, 2018

Pragya Gautam

RMF Nurse Laxmi inserts an IV to administer antibiotics for patient Kul Prasad

RMF Nurse Laxmi inserts an IV to administer antibiotics for patient Kul Prasad

RMF’s Presence

Working to Fight Disease

Soon after the 2015 earthquake, RMF began providing much-needed emergency support to the people of Arupokhari, a remote village in Gorkha District, and the RMF Health Clinic has been providing free health services to the people of Arupokhari and its neighboring villages since January 2016. In only two years, the clinic has become one of the most popular institutions in the area, as even the government health facility has been unable to provide such dignified, accessible, around-the-clock care to the locals, even during rainy season. With dedicated RMF staff, the clinic has been operating in a temporary structure in the rustic area of Arupokhari. The previous health clinic had been destroyed by the megaquake and aftershocks in April 2015, with the epicenter being nearby. The structure was rendered useful for the RMF Health Clinic by installing metal roofing sheets in place of the walls. The temporary, 2-room structure is still in use as RMF’s clinic building, and construction of a new, earthquake-resistant facility is underway.

In the remote village of Arupokhari, Gorkha, where most of the limited infrastructure was damaged or destroyed by the 2015 earthquake, RMF Health Clinic staff is always concerned about the health of community members, as the village lacks water, both for drinking and for performing household chores. Even before the earthquake, villagers collected rain water during the monsoon season to continue using later in the year. Otherwise, villagers have to travel a significant distance to fetch drinking water from the nearest stream. In this context, the health of community members is always at risk due to water, sanitation, and hygiene- (WASH) related diseases, and RMF Health Clinic staff is working to fight these diseases through health education in schools and the community, early detection, and treatment to improve the health of the people of Arupokhari.

Patient Treated for Enteric Fever

Kul Prasad

Kul Prasad, a 48-year-old laborer, arrived at the RMF Health Clinic with symptoms of a continuous, high fever, loss of appetite, abdominal pain, vomiting, and headache. After careful assessment, RMF Clinical Officer Bishnu Sharma diagnosed him with enteric fever and prescribed antibiotics for a week. RMF Nurse Laxmi Gurung gave Kul the antibiotics as prescribed. It was expected that his condition would improve, but even after 72 hours of treatment with the antibiotics, Kul’s symptoms were getting worse, and Clinical Officer Bishnu was called to Kul’s home. He did not want to risk the patient’s life, as there are no advanced diagnostic services at the RMF Health Clinic; therefore, Clinical Officer Bishnu explained the situation to the patient and his family and referred him to a hospital in Kathmandu. Living in the remote mountain village of Arupokhari, Kul’s family is not affluent, and to save the life of their breadwinner, they made compromises and arranged for his treatment in Kathmandu by asking for loans in the village.

When Kul returned to the village, he explained that he was admitted to the hospital in Kathmandu for 14 days, where he was treated for enteric fever. He was amazed how Clinical Officer Bishnu could detect the disease without the help of any laboratory tests and other facilities available in the bigger hospitals.

He thanked Clinical Officer Bishnu for the accurate treatment and for being at the RMF Health Clinic so that the people of Arupokhari and neighboring villages can access unmatched health services from such an experienced professional. Kul considers the people of Arupokhari very lucky to have the RMF Health Clinic within their reach and says that the people there should treat the RMF Health Clinic as their own and contribute to its betterment.

Health Center Progress

Expanding Services

As construction of the new, earthquake-resistant building for the RMF Health Clinic continues to make good progress, services are expected to expand and further improve in the coming days. The new clinic will include much-needed medical laboratory facilities and the first birthing center in the area, allowing more patients like Kul to avoid costly referrals and providing access to dignified maternity care. In the third quarter of 2018, July to September, 2,618 patients received free health services from the RMF Health Clinic in Arupokhari, Gorkha.

  • 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.