Establishing Basic Medical Care and Health Education in North Gorkha
Community Action Nepal [CAN] has committed to providing access to basic medical care and health education to the remote North Gorkha valleys of Nubri and Tsum. Given their remote locations and distance from road infrastructure their voices were easily lost post-earthquake. CANs ambition is to build and run health posts throughout the valley, establishing their running and management before handing them over to the district governments.
History in North Gorkha
CAN had successfully operated the Lihi Gaun Health Post in the Gorkha District of Nepal for 10 years when it was approached by a number of Village Development Committees (VDCs) and District Health Offices to take over the running of four other Health Posts in the region which had been previously run by PHASE Nepal. As a result, CAN took over operational responsibility for these Health Posts on January 1st, 2014. The health posts are located in the high and remote areas of Lho (3,100m), Prok (2,847m), Sama Gaun (3,530m) and Bihi Phedi (2,130m), which all fall in the shadow of Mount Manaslu, the eighth highest mountain in the world.
Pre-earthquake it was decided that all these health posts were not fit for purpose and a planned rebuilding programme was initiated. This was disrupted by the earthquake in April 2015, but all the health posts have now been successfully rebuilt and incorporate earthquake resistant features and provide the base for our nursing staff to deliver essential care and health promotion. Following the earthquake CAN was requested to take over the running of Health Posts at Chumling and Chhokomparo in Tsum valley. More recently (April 2018) CAN was requested by the villagers of Nile if it could provide health provision within the village.
Health spend in Nepal is just over $2 per person, with nine doctors in the Gorkha district serving a population of over 270,000 people. Evidence suggests that the Gorkha district is amongst the worst in Nepal for maternal, neonatal and postnatal health, malnutrition and child mortality, with only 15% of deliveries attended by a skilled birth attendant.
People living in this remote mountainous area face challenging living conditions, due to isolation and lack of basic infrastructure, roads and safe drinking water. The provision of these local health posts allows local people to have easier access to health care, thus avoiding a 6-day walk to the nearest road to access transport to the district hospital at Gorkha.
Bihi Health Post
Bihi health post was at the foundation stage of being rebuilt in 2015 when the earthquake struck and escaped serious damage. However, it was then possible to apply the mantra ‘build back better’ incorporating into the design all those features that will help the building stand up to any future shock. This included building a structure which is basically a box, a simple rectangular shape which has been found stands up better to seismic activity. The strength of the building and resistance to shock is reinforced with ring beams tied together with through stones. Additionally, CAN health posts have been rebuilt – wherever possible – as single storey buildings with the use of wood replacing stone above head height
The personal element at Bihi is that CAN’s wonderful nurse, Ranjana Basnet travelling, during the monsoon season, from this remote community for training in Kathmandu was swept away by a landslide into the Gandaki river in 2016.
CAN has built a memorial stupa in memory of Ranjana. It may be that trekkers visiting the village may wish to pay their respect at the stupa built in Ranjana’s memory.
Additionally, and supported by funds from the Big Lottery, a fantastic kitchen garden has thrived and been developed by Junior Technical Assistants. The success of the garden means the nurses are able not only to dispense pills but also share the plants and seeds around the villagers widening the variety of veggies on offer.
CAN has committed to providing access to basic medical care and health education to the remote North Gorkha valleys of Nubri and Tsum. Given their remote locations and distance from road infrastructure their voices were easily lost post-earthquake. CANs ambition is to build and run health posts throughout the valley, establishing their running and management before handing them over to the district governments.
Who are Community Action Nepal (CAN)?
Community Action Nepal is a UK-based charity, founded by British mountaineer Doug Scott CBE, which works to improve living and working conditions of the indigenous mountain people of Nepal. It works in partnership with remote mountain villages and communities to provide vital local healthcare, education, income generation, cultural and mountain porter welfare facilities.