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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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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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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Premature births, stillbirths rise in Nepal during pandemic — Lancet

A report in the journal The Lancet Global Health has confirmed initial figures: child deaths are rising in Nepal as anxious, pregnant women avoid health facilities during the Covid19 pandemic.

A pregnant woman undergoes a checkup at Baitadi District Hospital in June 2020 © Ganesh Shahi/ UNFPA.

This article was published in Nepali Times online, 14 August 2020.

A report published online in the journal The Lancet Global Health this week revealed that the COVID-19 pandemic has caused 50% fewer women in Nepal than usual to give birth in hospitals, resulting in higher risks for premature births, stillborn deliveries and newborn deaths.

The study, conducted in nine hospitals across Nepal found that the stillbirth rate at hospitals and birthing centres increased from 14 per 1,000 before the lockdown to 21, and the neonatal mortality increased from 13 per 1,000 livebirths to 40.

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Covid-19 cases soar in Nepal as migrant workers return from India

As many as 7,500 people are now crossing into Nepal daily. Since Monday, 283 new cases have been confirmed country-wide, including 114 on Wednesday, the highest one-day tally to date. The returnees are some of the roughly 2 million Nepalis forced to migrate to India because they can’t earn livelihoods at home.

People returning from India, line up at the border point in Birgunj, on Wednesday, 27 May 2020. Photo: Ram Sarraf/THT

The wait-and-see is over. Many of us living in Kathmandu have speculated during the past four months about where and when multiple cases of Covid-19 would finally appear after Nepal confirmed its first infection on 23 January, a student from from the disease’s epicentre in Wuhan. Small numbers of infected people have been sneaking across the Indian border despite it being closed since 24 March, but this week the trickle became a surge.

As many as 7,500 people are now crossing into Nepal daily, according to media reports. Some are not being screened for the coronavirus or put into quarantine, and of those who are being confined, some say conditions are not safe or comfortable and that they are not being provided food.

The returnees are some of the roughly 2 million Nepalis forced to migrate to India for months and even years at a time because they can’t earn livelihoods at home. Many are daily wage earners, whose work dried up soon after India went into lockdown on 24 March and have been making their way homeward ever since. Some have been forced to wait for weeks at the Indian border.

‘We have failed’ new mothers

It was startling to learn that Nepal Prime Minister KP Oli admitted in Parliament on Tuesday that Nepal’s two coronavirus deaths to date represent a failure of his government. This raises the question: when will a leader apologise for the more than 1,200 women who die every year giving birth?

Members of a mothers group in Banke district, Nepal, 2018. © Marty Logan

When will a Nepali leader apologise for the 1,200-plus women who die giving birth yearly?

The headline of this story refers to Nepal Prime Minister KP Oli, who a couple of weeks ago admitted in Parliament that his government had failed to prevent COVID-19 deaths. (As I write this Nepal has four COVID deaths). When the article was published on the Nepali Times website the headline was changed, removing that point. Regardless, too many women, and other Nepalis, continue dying because of the broken health system.

It shouldn’t be surprising that Nepal’s first COVID-19 death was that of a new mother. It was startling to learn that Prime Minister Oli admitted in Parliament on Tuesday that Nepal’s two coronavirus deaths to date represent a failure of his government. This raises the question: when will a leader apologise for the more than 1,200 women who die every year giving birth? Continue reading “‘We have failed’ new mothers”