Right to health still largely ignored in Nepal

“The health system remains unprepared and unlawfully in defiance of a range of orders of the Supreme Court”

A health camp in rural Nepal. PHOTO: Marty Logan

The right to health in Nepal during Covid-19 remains largely a paper promise. In June I wrote about how the government had largely ignored orders from the Supreme Court to act immediately to meet its health commitments in both international and domestic law.

Today the International Commission of Jurists, whose 2020 briefing paper was the centre point of my article, released an updated version—it is equally depressing.

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A tall order

A couple of decades ago Nepal was a world leader in fighting nutrition, especially stunting (low height for age). Can it regain that position in time to reach targets in 2025 and 2030?

Lunch time at a Mothers Group meeting in Achham District in 2018. PHOTO: Marty Logan

A white-coated nurse holding a blue and white, half-litre bag of milk stands in front of a small group of mothers seated near the entrance of the Nutrition Rehabilitation Home in Kathmandu. 

She is explaining the importance of feeding milk to their children, who are lolling on their mothers’ laps. On a table behind the nurse are containers of pulses and legumes and leaning against the wall, charts displaying leafy vegetables.

But later, listening to the women’s stories, it is apparent that solving their children’s problems will require more than a healthy diet. Through tears, Chandra, 24, says she brought her son Raju, 21 months, to the Home after a routine hospital check-up found that he was malnourished. 

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A towering challenge: get the world to notice Asia’s melting mountains

A view of the Hindu Kush Himalaya. Photo: Alex Treadway/ ICIMOD

It’s not simply that the snow and glaciers on the Hindu Kush Himalaya mountains are melting: they supply water to 3 billion people in Asia. What will they drink when the mountains, also known as the Third Pole, are dry?

And what will happen to the 240 million people who live in the HKH, which stretch from Afghanistan to Myanmar and tower over eight countries in total, including Nepal?

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Introducing Strive podcast

Strive, a new podcast from IPS News, hosted by Marty Logan

This is a short post to announce that I’m hosting a new podcast, Strive, by IPS News. It is similar to Nepal Now, a podcast I created one year ago, but with a global vision.

Our first episode, about a civil-society led campaign to boost mask wearing to fight Covid-19 in South Asia, is online and more will soon follow.

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Right this wrong done to women

I really appreciated this editorial in The Kathmandu Post on Wednesday, 21 July. It linked two things I care about—human rights and maternal health.

A community health unit and a birthing centre were established in Dhiri four months ago but the number of service seekers is minimal. Prakash Baral/TKP

I really appreciated this editorial in The Kathmandu Post on Wednesday, 21 July. It linked two things I care about—human rights and maternal health.

It noted that the United Nations Human Rights Council has just released a statement calling on governments worldwide to ensure that women’s right to sexual and reproductive health is ensured, among other things. The paper linked that with its recent reporting about women in remote areas of Nepal giving birth at home and even in sheds!

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Nepal’s homegrown Covid-19 heroes

Nepalis are not only recipients of humanitarian aid—they lead many such efforts, disaster after disaster, including Covid-19. Watch our short video to learn more.

A few years ago my eyes were opened to the fact that international organizations provide only a fraction of aid that flows into countries after disasters—most of it comes from families, communities, religious institutions, local and national civil society organizations, and governments.

Yet, what I’ve seen online during the Covid-19 pandemic does not reflect that reality, at least not concerning Nepal. Here, for the past year I’ve watched individuals, including an immuno-compromised friend who is unable to get vaccinated, set aside work and family to serve hot food to needy strangers on the streets.

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Activists pursue the right to health in Nepal during Covid-19

As a new surge in cases overwhelms the South Asian country, people are forced to rely on a frail healthcare system and a government remiss in its duties to uphold their right to health

Getting oxygen treatment for Covid-19 in Nepal, May 2021. © Amit Machamasi/Nepali Times

On 3 May, Lok Bahadur Pariyar, 45, arrived at his local pharmacy in southern Nepal complaining of breathing difficulties. He told the pharmacist that he had been suffering from fever, severe body aches, and cold symptoms in recent days.

Suspecting COVID-19, the pharmacist called an ambulance to take Pariyar to the hospital. The next day, when the pharmacist opened his shop, he was surprised to see the man standing outside. He told him he had visited three hospitals the day before and all had turned him away.

Pariyar sat down to catch his breath, and died soon after.

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No magic pill for Nepali women who give birth at home

A lifesaving drug cannot fix the sorts of systemic maternal health issues that I saw on a trip to one village

A screenshot from the Nepal Now podcast episode on misoprostol.

Almost exactly one year ago Nepal’s health department called an urgent meeting of its partners working in maternal health to ask if any of them could supply misoprostol, a drug used to stop excessive bleeding after childbirth. The Covid-19 lockdown had strangled supply and women in rural Nepal were reportedly dying for lack of the drug.

It took nearly six months for a 1-year supply of misoprostol to arrive via the UN Population Fund and an international non-profit, One Heart Worldwide (OHW), again as a result of the pandemic battering global supply chains. I read about this emergency and wanted to track the pills to their end users—women living in Nepal’s villages who were likely to give birth at home without a skilled birth attendant.

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A healthy diet includes social and economic support

I’ve been reading about social determinants of health for some years now, but I had to see this phenomenon in practice before I truly ‘got it’.

A nurse describes the importance of drinking milk at a recent class for guardians of malnourished children at the Nutrition Home in Kathmandu. ©Marty Logan

It’s one thing to understand an issue or fact intellectually, another to experience it first-hand. That’s been made clear to me twice recently concerning health care here in Nepal and what are sometimes called ‘social determinants of health.’

One of my current projects is reporting about malnutrition during Covid-19. I contacted the Nutrition Home close to Kathmandu hoping to speak to the guardian of a child who had been admitted because they were malnourished.

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The people to the rescue in Nepal

The homepage of the citizens’-led Covid Connect Nepal initiative on 17 May. 160 volunteers are working around the clock.

There is no way to sugarcoat this – Nepal is being hammered by Covid-19. Just as in its giant neighbour, places such as the capital Kathmandu and cities bordering India have run out of intensive-care hospital beds and oxygen, extra cremation sites have been set up on the banks of rivers and fewer than 5% of people have been vaccinated, with no new jabs in sight.

Yet, as I’ve written before and talked about on the Nepal Now podcast, it is ordinary people who have stepped up to stop things from getting much much worse, while the politicians turned away from the dead and dying to engage in political power plays, as reported by Nepali Times.

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