Establishment Of Ophthalmology Ward

Background:
The eye is one of the important sense organs of human beings. Any small change or damage to the normal structures and functions of the eye leads to lifelong disability, sometimes even resulting in the loss of vision. Keeping this fact in mind, special care is to be given while dealing with eyes and issues related to them. This calls for the need for ophthalmologists (eye specialists) and various distinct equipment and machinery, specially designed for the eyes. Also, eye patients cannot be treated in the general ward as the eye is as sensitive as an important organ. Small ignorance and carelessness or disturbance possible in case of treatment on the general ward will not negligible. It is the case in Baiteshwor Hospital. As the hospital lacks a distinct ophthalmology ward, eye patients are also obliged to travel a long way and reach district headquarters, solely for dealing with the abnormalities experienced on the eyes.
Objectives:
 Establishment of ophthalmology ward at Baiteshwor Hospital.
 Appointment of the required number of ophthalmologists.
 Management and Purchase of equipment and machinery required for the ophthalmology ward.
 Ensuring effective eye health facility and treatment, especially targeted to the residence of Gaurishankar rural municipality and Jiri municipality.
Problems:
o Obligations to undergo eye treatment with a general physician.
o Lack of specialists sometimes results in the wrong diagnosis of the problems.
o Lack of proper and specific equipment to undergo diagnosis and treatment.
o Dealing with eye problems is costly as people in this area have to visit the district headquarter or the capital of the country. As a result, poverty-stricken people cannot afford eye treatment and the problem/ disease sustains and increases only.

Project cost :
The local government has arranged an ophthalmologist. A separate ward for an eye is needed, which will be managed by the hospital itself. The contributed cost of the equipment and machinery is USD 5000.

 

Contribution in installation of isolation ward

isolation ward

Background

There should be a separate ward used to isolate patients suffering from infectious diseases in every hospital and in other medical facilities providers. Many wards for individual patients are usually addressed together in an isolation unit. This ward is developed to avoid spreading the risk of transmitting potential harmful infections i.e. Coronavirus (covid 19) to others.

Objective

The main objective of contribution in the installation of the isolation ward is to provide initial care to the covid patient in all the awards of Baiteshwor RM. Other objectives are as stated below:

  • To identify suspected cases as soon as possible to prevent the potential transmission of infection to other patients and staff.
  • Restrict direct physical connection and avoid contact with respiratory and other secretions.
  • To provide psychological support and encourage the patients he/she is in isolation.  
  • To ensure that all employees (including housekeeping staff) are conscious of the correct precautions to be taken.
  • To provide protection to at-risk patients and staff.

Estimation of Cost:

The contributed material and equipment which are necessary to install the isolation ward with their cost are listed on the table:

S.N. Particulars   Unit cost in USD Total Cost in USD
1. Beds for isolation ward (5) 150 750
2. Tray for hospital and isolation ward (10) 50 500
3. ICU/ventilator Monitor for hospital’s emergency ward (2) 1500 3000
  The overall cost in USD 4250

 

Health Camp in Baiteshwor RM

Health Camp in Baiteshwor Rural Municipality on Uterine Prolapse

Background

Healthcare is a basic right of a human being that should be available for everyone and shouldn’t be treated as a commodity only for those who can spend money to buy the services. Even the poorest among us deserve the dignity of equal human rights which cannot be declined.

Uterine prolapse is a kind of hidden health issue of Nepali women, which can be seen high in numbers with women from the age of 40 to 70 years but women with UP may have from the age of 20 (. It is taken as a prestige issue so women, their husbands, and family members keep it hidden in society. The lack of early treatment causes severe problems even to the death of women. Uterine prolapse occurs when the muscles and tissue in your pelvis weaken. This allows the uterus to drop down into the vagina. Common symptoms include leakage of urine, fullness in the pelvis, bulging in the vagina, lower-back pain, and constipation. A study shows that the UP is an outcome of poverty that limits women’s ability to get food, rest, and health treatment timely. (Source: Tribhuvan University Teaching Hospital).

Stages of the UP and level of treatment

  • First degree (mild)—the cervix (the lower opening of the uterus into the vagina) protrudes into the lower third of the vagina. The camp shall make women aware to be careful and not lift heavyweight.    
  • Second degree (moderate)—the cervix protrudes past the vaginal opening. In this stage, a vaginal pessary ring can work for a short time till the woman is ready for the surgery. 
  • Third-degree (severe)—the entire uterus protrudes past the vaginal opening. The women should go with the surgery immediately in such a situation. 

Objectives

The main objective of the health camp is to provide initial care to women suffering from uterine prolapse in all the awards of Baiteshwor RM. Other objectives are as stated below:

  • Provide free and high-quality health services for the women of Baiteshor RM.
  • Raise awareness about UP among women and men in the community and sensitize them to deal with UP. 
  • Identifying the severe cases for further treatment including surgeries if needed to in next events immediately after a few weeks. 

Date and venue 

The health camp has been organized on 31 December 2021 in Mirge and 1 January 2022 in Maina. In order to organize the event, the doctor’s team moved to Maina from Kathmandu on 30 December 2021. The team moved early to Putalikath on 31 December 2021 and returned to Maina on the same date. The camp started at 10 am and ended at 5 pm in Putalikath. 

On 1 January 2022, the health camp was organized in Baiteshwor Hospital, located inward No 5 from 9 am to 4:15 pm. Two Gynecologists including Dr. Deep Mala Karki and Dr. Babita Yadav with medicine contributed to the HC.   

Event Venue Date  Persons cured 
1 Putalikath  31 December 2021 37
2 Maina 1 January 2022 79
Total 116

Geographical coverage and tentative numbers of patients: 

Although the health camp was organized in two locations, the women from almost every ward participated. All the 8 wards of Baiteshwor are focused on the health camp. Among roughly 355 women who were potential with UP-related issues, 115 (33%) got health services from the Camps. The following table gives the details. Considering the health-seeking behavior of Nepali women, UP is a health issue which Nepali women could not express easily, the number of participants is encouraging compared to other health camps.   

Detail of the Health Camp

Graphical coverage/Ward No Potential numbers of women with UP Total
Ward No 2 Ward No 5
Health Camp Venue Ward No 2 office building Baiteshowr Hospital  2 locations
Women attended from ward Nos.  2, 3  3,4,5,6,7 and 8 7 wards 
Total women (116) 37 79 116
Women 50+ years 20 30 50
Women 30-50 years 13 33 46
Women upto 30 years 4 16 20
Dalit (Cast based discriminated) women 4 16 20
Janajati (ethnic) women 33 11 44
Brahmin/Chhetri women (So-called higher cast) 0 52 52

The above table shows that the women from 50+ years have high numbers (43%) of UP affection. This shows that women of the age group above 50 are silent and need more attention in the future. The women from the age 30-50 years seem a little bit lower in numbers having coverage of 40%. The remaining, 17% of women are below 30 years.

While looking at the caste-based data, the number of women from Brahmin Chhetri (so-called higher caste) seemed high. This is realistic because the population of Brahmin/Chhetri is high in Baiteshwor RM followed by Janajati ( ethnic population) and Dalit.    

Reasons for the scenario: 

  • Aged women have high numbers of affection due to the social taboo that blocks them from speaking. Cases were also seen from this age group.
  • The numbers of younger women seem moderate due to early marriage. Some of the women of younger age came to the camp, being aware. Cases of the infection were not found. 
  • Women from the age group 30-50 years seemed high because these women are active for reproduction and also workload is heavy for them. 

Cost estimate 

The total estimated cost for the HC is NRs. 390, 000.00. 

Participation/Sharing

SN. Stakeholders Type of sharing
1 Baiteshwor Hospital Human Resources (Nurse, record keeper, medical equipment as per available, government free supplied medicine), and Project ownership
2 Samundra Nepal Coordination, Facilitating
3 Samundra Belgium  Financial support
4 Rural Municipality/Wards Information sharing through notice,  Mobilizing Community Health Workers
5 Community Health Workers Assisting in the health camp/facilitating women in the venue, information dissemination, collection of data.  

Human Resources

Two Gynecologists and a Physician are proposed to be taken from Kathmandu. Baiteshwor hospital shall contribute a physician and nurses including other personnel as available. They will contribute the medicine free of cost. 

Activities 

  • Briefed about Samundra Belgium and Samundra Nepal at the meeting with the Minister (Birodh Khatiwada) of the Ministry of Health. The Palika chairperson Chhabi Lama, Vice-Chairperson Rabi Chandra Acharya, and other personalities including the journalist visited the camp. But it is coincidental to have them in our health camp in Baiteshwor Hospital. 
  • The minister was known about how Baiteshwor Hospital was established in support of the people from Belgium and the role of Himalayan Care Hands. 
  • Noticed from FM (Jiri FM, Kalinchowk FM, and Sailung FM) published for a week (led by Samundra Nepal)
  • Discussed and arranged Gyno doctors and equipment needed by Baiteshwor Hospital.
  • Dissemination of the information using loudspeakers and Facebook and through community health workers (By Ward No 5).
  • Purchased medicine and equipment (by Samundra Nepal)
  • Arrangement of logistics by Samundra Nepal.
  • The happiness form was filled up.
  • The remaining medicine of the cost of about NRs 53,000.00 has been handed over to Baiteshwor Hospital. 

Outcomes

  • 116 women were made aware through doctor’s counseling on the causes and consequences of UP and ways to prevent from being infected. 
  • Distributed medicine free of as per doctor’s diagnosis
  • Identified 9 affected women with UP in Ward No 5. Three women got the pessary ring. One case is seen as completely prolapsed but could not be treated due to the age factor. Five women were counseled and advised to take care ( Pessary ring not needed). 
  • In Ward No 2, 7 cases of affected women (second degree) were identified who were already using the Pessary ring for 5 years. Their rings were almost ready to spread infection.
  • Palika, wards, and community health workers were sensitized one more time and the camp helped them to realize ‘prevention is better than cure. 

Learning

The Health camp let us know for future replication:

  • Uterine-related health issues in Baiteshwor RM still exist with the aged (<70 years) women whose surgery is not recommended by the doctors considering the age factor.  
  • The impact of the previous initiatives by other donors has been seen clearly as women feel comparatively easy on talking about the issue. 
  • Women from the younger generation are more open and feel easy to talk to. Women from younger ages are aware of UP so found very simple cases. These cases could be treated with a nominal dosage of medication. 
  • Information given through Facebook seems effective. Mobilizing community health workers to disseminate and collect information is effective.   
  • UP cases are seen high in Brahmin/Chhetri class people as poverty exists high with these groups.
  • Two events: one inward No 8 (Chhetrapa) and one in Ward No 7 (Marbu) shall be organized.  
  • No surgery cases to take up incoming events but awareness and curing first-degree cases can be expected.
  • Health camps on focused issues do not allow to have quantity but quality services can be delivered.  

Construction of Birthing Centre in Baiteshwor

Birthing Centre

Background

A birthing center is a healthcare service for obstetric mothers by nurse-midwives and/or obstetricians. They monitor the labor and health of the mother & fetus at the time of birth and during the pregnancy period. The birthing centers are being attached to health posts and health centers to provide the service for 24 hours. The government of Nepal has been focusing on the development of birthing centers in step by step manner in health facilities of rural areas where access to women’s health care is very difficult.

Birthing Centre in Baiteshwor Hospital

Baiteshwor Hospital is providing medical services which are situated at Baiteshwor Rural Municipality of the Dolakha district. Many people from different rural places come there to get medical services.

Baiteshwor Hospital provides all types of medical services. Many people are benefited from this Hospital. Due to the lack of separate buildings of the birthing center, women were deprived of the health services related to reproductive health. They were compelled to use general wards for their deliveries and other sensitive gynecological cases. Due to this problem, some women even prefer not visiting the hospital for their health issues as they are insecure to spill their guts regarding very personal topics like reproductive health. This has hampered their right to live a healthy life.

On the other hand, when the patients from the general ward and birth centers are kept under the same roof for treatment, the general wards are cluttered. Also, the patients from the general ward are deprived of effective health facilities. Thus, there was an urgent need to construct separate buildings for the birth centers only.

Objectives of this Project

  • To provide high-quality health services for women related to gynecology.
  • To ensure and monitor the health of the mother and fetus (child).
  • Help to decrease the number of women who die or are injured during childbirth.

 

Cost estimate 

The total estimated cost for the donation in the construction of the Birthing Centre is USD 5000.