National 4 (Spotlight Weekly)

"Women And Children Face Major Health Challenges In Nepal" — Narayan Shrestha

Narayan Shrestha is the president of Helping Hands Nepal. The Helping Hands is one of the largest health service organization established by private effort. In conducting various health activities, Shrestha -an American citizen originally from Khandbari, Nepal - has traveled to the nooks and corners of this country. His organization has already organized more than 100 camps. He spoke to THAKUR AMGAI this week. Excerpts:

What are the current projects of Helping Hands?

I am here to inaugurate the new clinic of Helping Hands at Phalewas, Parbat district. A truckload of equipment and supplies has been sent. The building is already ready. Next week a couple of doctors and technicians are going to install the equipment. Secondly, there is a huge building being constructed in Dharmasthali of Kathmandu to house a clinic of helping hands. In Khandbari there is a permanent clinic, in Indrayani there is another clinic. And there is a headquarters of helping hands in Chabahil with a clinic. We have almost 18-19 doctors, dentists, eye specialists, dieticians, surgeons. Helping hands sends doctors and nurses to educate them abroad. Once a year we sponsor a new doctor to study medicine with a bond that they will work for Helping Hands after finishing the schooling.

How have the activities of Helping Hands helped to change the health status of the country?

Helping hands does not believe that we can entirely change the health sector on our own. Our contribution is just in a small area out of a vast sector. In every village I visit, I find many people who have never seen a doctor in their life. Such situation exists in many villages of Nepal. Helping hands has been a kind of leader in this kind of program in going back to the villages, showing the importance of helping each other and also providing the inexpensive and the best way by opening a clinic in their own backyard, which makes a lot of difference for them. With clinics in their villages, rural people no longer need to come to the city, which costs them a lot in terms of transportation, lodging and fooding even for small diagnostic tests and simple treatments.

What are the major challenges in health sector confronting the country?

There are many. Especially, for children and women. I have been visiting the villages of Nepal since 1990 bringing thousands of volunteers from around the world mostly from USA. I found that women have a lot of problem. They die even with small complications during childbirth. They start working immediately after the child is born before their would has healed. She carries that wound of uterus. It is called prolapsed uterus. As the uterus has not settled back to its position, it falls or hangs. Thousands of women carry that kind of wound in the villages of Nepal. We have been conducting health camps where we perform the surgery to treat these problems. In March I am coming back with 19 volunteers from the United States. We are going to Khandbari especially to the women's surgical work.

In Nepal one in five child dies before reaching the age of five years.

What do you think the quick solution to the people of Nepal would be?

We should train the doctors and nurses in such a way that they develop a habit of going back to their villages and working there. Health Camps can help to provide relief to the people but only for short term. In places where there are no health institutions, follow ups cannot be performed. Camps like that in Khandbari are helpful as the clinic there can follow up the patients. In places where there are no local clinics, it is difficult to assess the problems.

What problems have you noticed in the government health administration?

The number one problem is Kathmandu, i.e. centralization. Everyone wants to stay in Kathmandu. Secondly, the professionals are not paid well and not given incentives for going to remote areas in the far east or far west. There is no guarantee of better life for them in the future. These are the major elements. The irregularity starts from Kathmandu. Say, if the government quota of medicines is 5 lakhs, they will send only 2 lakhs worth of medicines to the villages. Moreover, half of this medicine ends up at private shops. So the remaining medicine has to last for the whole year. While prescribing medicines, doctors usually refer to the medicines available in the shop or the company, which gives them best commission. This is the truth. We need to correct this right from the center.

They make great policies but they cannot implement. They introduced beautiful ideas -like health assistants in every village and doctors in every districts.

What kind of attitude have you found in the Nepalis living in other countries, particularly US towards helping their country?

I am sad to say that Nepalis going abroad are not united. They categorize themselves in terms of caste, political affiliations and so on. They waste time in gossip and other stuff, but they do not have time to think about their own village. Sometimes they do not even think of their own family living in that village. Many people who send money back home and are helping their family members cannot come back to their village. Because they are either waiting for green card or work permit or they are living there illegally. Last year we celebrated the Nepali new year by bringing out rallies, with Nepali flags. I requested verbally to the mayor of the city (Boulder, Colarado) to declare the third Sunday of April as Nepal Day and he did stood on the dais and announced the day as Nepal day. Now it is marked in the calendar as Nepal day. This is an example of unity. But even for this some Nepali people accused me of working for my interest.

Then, how do you generate funds for helping hands if the Nepali Diaspora does not cooperate?

Let me stress this. I have not collected a penny from any other Nepali people or community. The money I collect for helping hands is from individual citizens of America. So far, 95 per cent of the American volunteers who have visited Nepal during the health camps have donated. They donate and they come here to see with their eyes the difficulties faced by Nepali people. They return satisfied with a feeling that their money has been well spent. In many cases, they keep coming back. For example, three surgeons are coming back again for the health camp in March.

How easy is it to convince the volunteers to help Nepalese?

I take pictures of my village and other villages of Nepal and of the programs we have done in the past and show them during talk programs in Universities and hospitals. I use documentaries and other materials produced on these issues. Once I give a speech and make a presentation, they respond. However, these days it is becoming difficult to organize health camps in rural Nepal due to the situation of conflict. In the last three years, we could only organize four health camps.

Being a businessman what prompted you to engage in social service?

I was born with an attitude to help others. Since my childhood I have felt strongly by the pain, sorrow, and poverty of this country. I always thought I should do something. I opened an elementary school in my village at first. Then gradually, I broadened the horizon towards other regions and villages. And now it has grown.

What are the future projects of the Helping Hands?

I have made a road map. And one day it will be implemented if circumstances permit after the peace is restored. The plan is that we will have fully established and fully equipped hospitals in all the 14 zones and we will reach out to the districts as well. We will work in cooperation with the government health institutions. And once we are in the districts we are planning to use the same policy that the government of Nepal has used. Once we have a district clinic, then we will have satellite clinics in other villages. The satellite clinics will have five staffs each - health assistant, nurse, assistant physical therapist, dental assistant and lab assistant and they will have a telephone system connected to our district hospital, which will always have at least a doctor. Patients will initially report to the satellite clinics if any complication comes they will then contact the district. For smaller cases doctors can direct and suggest the treatment, if he thinks it is more complicated he will then ask the patient to be brought to the district.

It will make a very efficient and effective service.

Price of Cooking Gas and Kerosene Decreased

The government has decided to decrease the price of kerosene and cooking gas to provide relief to the people. The price of kerosene has been decreased by Rs 2 per liter whereas the price of cooking gas has been decreased by Rs 50 per cylinder effective immediately. Now the kerosene will cost Rs 34 per liter and the gas will cost Rs 800 per cylinder.

“We made this decision after conducting enough homework. This is not a mere populist decision. We decided to decrease because we could,” said Tanka Dhakal, government spokesperson and Information Minister. “We are also doing homework and looking at international trend to see if we can bring down the price of petrol and diesel,” he added.

In January, the previous Deuba government had announced substantial increase in the prices of petroleum products saying that the hike was necessary to prevent the total collapse of the state-owned Nepal Oil Corporation (NOC), which was under tremendous financial strain.

Deuba government’s decision had drawn strong public criticism at that time. “With the new price review, the NOC would be able to achieve break even, but it cannot recover the past losses,” said Dinesh Chandra Pyakurel, Secretary at the Ministry of Industry, Commerce and Supplies. Pyakurel said that the cumulative losses can be covered in future. “This decision would not affect the financial condition of the NOC,” Pyakurel said. He added that the capital consumes 20 million liter of kerosene and 470,000 cylinders of cooking gas every month.