As the April 25 earthquake and its aftershocks rendered a majority of health institutions in 14 quake-hit districts unsafe, the Ministry of Health and Population (MoHP) is preparing to provide health services from tents throughout the monsoon.
Over 300 health centres, including hospitals, primary health care centres (PHCs) and health posts, in the districts have been reduced to rubble while additional 200 facilities have sustained damages requiring immediate overhaul. The worst affected districts, including Sindhupalchok, Dolakha, Kavre, Gorkha and Nuwakot, have very few health centres standing, presenting the government with a challenging task of catering to the need of the people in monsoon when there is sharp increase in communicable diseases.
Among the total 78 health posts in Sindhupalchok, 63 are destroyed while nine have suffered damages. None of the three PHCs are functional in this district and the only district hospital has also collapsed.
In Dolakha, the district hospital, two PHCs and 47 health posts have all been destroyed.
Once the monsoon is over, the government plans to reconstruct the buildings using prefab structure. Authorities said large hospital tents house all range of medical facilities—out-patient-department, male and female admission wards to surgical room—while there will be arrangement of extra tents for doctors and medics to live in and toilets in the vicinity. “As the monsoon is approaching, we are pressed for time. Immediate rebuilding of the damaged structure requires over two years,” said Mahendra Shrestha, chief of Policy, Planning and International Cooperation Division (PPICD) at the ministry. “For now, operating through tents is the only viable option.”
To this end, the MoHP has begun arranging tents from various donors and UN agencies. The Foreign Medical Teams (FMTs) working in the country have set up field hospitals that will provide services in districts. The World Health Organisation has pledged to provide 50 such big tents, worth US$ 20,000 each, from where the services of PHCs will be delivered.
Unicef has already distributed over 200 tents of various sizes (from 72 square meter for hospitals to 24 square meters for health posts) while additional 300 will also arrive soon. According to Unicef, 35 big tents have been provided to hospitals, 60 medium sized (42 square meters) to birthing centres and 132 small tents for health posts.
As of Tuesday, a total of 33 FMTs, comprising 871 health professionals including 294 doctors and 274 nurses, are working in the quake‐affected districts.
MoHP officials fear surge in the number of water-borne diseases, including cholera and diarrhoea, during the monsoon as many people are living in the open without safe drinking water and sanitation arrangements. What accentuates the fear is the recent MoHP survey result which has stated that a majority of tap and ground water cannot be consumed given the high bacterial presence.
New health post building designs prepared
The MoHP plans to start rebuilding health infrastructures, mainly primary health care centres and health posts, using prefab structures, once the monsoon is over. The Department of Urban Development and Building Construction (DUDBC) has already forwarded the design details of such new structures to the health ministry. As per the proposed design, a single-storey health post, including staff quarter and toilets, will have 238 square metres area. Meera Gyawali, senior divisional engineer at the DUDBC, said that around Rs 10 million will be required to construct each building. The primary health care centres, with 442 square metres area each, will also have separate quarter for the doctor. Officials said the prefabricated structure can last five to 10 years. (PR)