Emergency and humanitarian action

In Nepal mobile health clinics show the way to build back better

Accessing health care in Nepal’s Western district of Gorkha can be difficult at the best of times. The district’s terrain is marked by steep mountains and plunging valleys, while a lack of motor-able roads means travel is slow, laborious and inconvenient. As with the rest of Nepal, qualified doctors are present only at the primary level and above, meaning that for much of Gorkha’s 271 000 residents they are often tough to access. After Nepal’s 25 April and 12 May earthquakes, the need to overcome these systemic challenges and encourage health-seeking behavior has never been clearer.

On 15 July, Gorkha’s District Public Health Office (DPHO) held a mobile health clinic in Bhumlichok, a Village Development Committee in the district’s south with a population of approximately 5000. Despite being just a few kilometers from the country’s mid-hill Prithvi Highway, Bhumlichok is marked by poor health indicators. After arriving at midday, the DPHO team, comprising of a general practitioner, two eye doctors, a lung disease expert, a lab technician, and a reproductive health expert, arrived at Bhumlichok’s makeshift health post and began receiving patients. Around 300 people showed up – a figure that the health assistant in-charge Nara Rawat was pleased with.

According to WHO Surveillance Medical Officer Usha Kiran, who accompanied the mobile health clinic, before leaving Gorkha Bazaar the team made sure they procured the necessary supplies to restock the health post. “District officials have been in touch with the health post to register what they are short of. This a good opportunity to deliver medicines and supplies,” she says while helping to unload two pick-ups full of medical items including surgical blades, antibiotics, doxycycline, antacid and paracetamol.
WHO/M. Vurens van Es
34-year old lab technician Narayan Babu Aryal (out of picture) says that mobile health clinics provide opportunities to find and treat TB cases. According to Aryal, health authorities estimate that 10% of the people in Nepal have TB, though only 2-3% of cases are known. “I smear the sputum, collect and bring samples to the Gorkha DPHO and test them,” he says. “If they are TB positive we start the TB treatment regiment. The medicines are available at health posts accessible to villagers.” Since the 25 April earthquake, there has been a total of 85 mobile clinics in Gorkha District.
WHO/M. Vurens van Es
This Ropai – Nepal’s annual rice-planting season – Shanta Maya Kumari struggled to perform her farming work due to vision problems. According to the 49-year-old, the mobile health clinic’s visit was an opportunity she couldn’t pass up. “My eyes are not good and I cannot see things clearly. This affects my farming work,” she says. After consultations with the clinic’s specialist eye doctors, Kumari was provided prescription glasses free of charge. “My vision is now clear. I’m happy with the glasses which are useful for my day to day activities”, she says.
WHO/M. Vurens van Es
Bhojraj Gautam (pictured), outreach coordinator at Pokhara’s Himalaya Eye Hospital, says that beyond poor vision many of the villagers face more serious eye problems such as cataracts or conjunctivitis. “Usually when we conduct the eye camp we find cataracts. Often traditional practices used to treat eye problems cause further problems,” he says, adding, “A lot of people are suffering from eye problems and are unaware of of it. They also do not know where to seek treatment.” According to the 32-year-old, by day’s end he had referred 13 patients to Himalaya Eye Hospital to have their cataracts operated free of cost.
WHO/M. Vurens van Es
Samundra Chepang, 60, says that though she visited the mobile clinic to receive treatment for her own ailments, the services offered are important for her family. “I’m finding the health clinic good, and the target on reproductive health is nice, especially for my son and daughter-in-law’s baby,” she says while motioning toward her family. Her daughter-in-law is 20 years old and has three kids, none of whom had supervised births. “This kind of camp does make us want to access facilities more,” Samundra says.
WHO/M. Vurens van Es
Dhiraj Chepang 26, regularly uses the health services present in Bhumlichok, however limited they may be. Regardless of the mobile clinic’s visit, Dhiraj says he was planning to come to the facility for his seven-year-old child to have a health check-up. “I’m happy with the services provided in the village, but we often have to buy the medicines,” he says. “I’m pleased that the mobile health camp came as I was able to get my child’s medicines for free.”
WHO/M. Vurens van Es
In the days preceding the mobile clinic’s visit, Bhumlichok’s health in-charge Nara Rawat visited settlements to make sure people are aware of the opportunity to receive care from qualified physicians. According to Rawat, for many, it is often difficult to come to the health post for treatment. “The topographical characteristics are challenging, as is the lack of transportation,” he says. Despite these hurdles, Rawat thinks the turnout for the mobile clinic has been good, and hopes it will promote greater awareness within the community regarding health issues and the avenues available to seek treatment.
WHO/M. Vurens van Es
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