Thursday, April 28, 2011

too long betwen drinks/ a lesson on delivering health care in Nepal pt 1

I had intended to psot this all as one, but its long. I'm at work and procrastinating and havent yet had a chance to get my photos from my computer to my laptop to the interwebs. will post soon.

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walking through the Himalayas, or the foothills of the Himalayas gives you an appreciation of how easy life can be and an understanding of the difficulties of delivering health care in Nepal.
My parents had planned a trip to nepal that happened to conincide with the first round of the 2011 National vitamin A program. Which the Nepali organisation i work for is heavily involved in, I had planned to travel to the far east of nepal to observe the Female Community Health workers distribute vitamin A to children between 6 months and 59 months, (all in all more than 3 million children are dosed twice a year in an internationally lauded program that delivers vitamin supplements through community health staff). but things being as they are, and this being Nepal, my plans changed and I ended up incorporating the Vitamin A distribution into a 5 day trek, or a 5 day trek into the Vitamin A. Carrying along with my thermals, boots, sleeping bag and assorted technical gear, I had  a shoulder bag full of vitamin A, albendazole (the children are also given a dose of albendazole for deworming) communications materials and a few other bits and pieces. Stopping as my parents stopped for water and tea to ask the local female community health volunteers if they had enough supplies, and talking to mothers and young women about the supplementation, I am happy to be away form my desk, writing reports, and actually observing how it is possible to deliver health care to remote (and not so remote ) communities. the NVAP reaches something like 96% of Nepali children, which given the terrain of much of Nepal is quite an incredible success when you realise how far people have to go for health services. Asking one lady where she goes for health care if necessary, she names a village . How far is that? I ask. 2 days walk she responds.
Keeping in mind that I am on a heavily walked trekking route not to far from a main town , you can easily double or triple the days walk to  health facilities in the remote mid and far west regions (which i've talked about here) FCHVs are the frontline of medical care in nepal, 48000 women across nepal provide basic (and increasingly) technical medical and health care, these women give families, mothers and children essential supplies of ORS, iron supplements, zinc supplements, deworming tablets and vitamin a, pneumonia medications, and family planning advice in the remotest parts of nepal.


I arrived in the village of Ghandruk, (above)  after a ong (9hour) absolutely amazing. I asked along the way for the health post and the local mahila swayamsevika (pardon my nepali spelling) or FCHV/. Trying to explain that no I wasn't sick but had come to meet with the FCHV I was taken by a friendly mother of 5 who was suffering from a chest infection to the FCHVs house, marked by the same sign all across nepal.  I was greeted by a friendly middle aged Gururg woman who had been working for 22 years as a FCHV, and had 3 children of her own, one working in brisbane of all places. On top of her regular business as mother, wife, and guesthouse proprietor this woman spent 5-8 hours a week in her role as an FCV. Delivering community based health care in the form of iron pills for pregnant women, management of childhood illnesses, family planning and other assorted tasks. I asked if i could join her the next day as delivered some of the capsules that I carted through the mountains.

...part 2.....the distribution and photos to come..... 

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