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?
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.
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
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.
A lifesaving drug cannot fix the sorts of systemic maternal health issues that I saw on a trip to one village
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.
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’.
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.
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.
The Twitter post stopped my scrolling thumb in mid-air. I don’t remember who wrote it, but it said something like, “You don’t need to speak up for marginalized people — just pass the microphone so they can speak for themselves.”
Wow! It was one of those moments when you can almost feel your mind shift.
Globally there are signs that some countries are taking policy decisions that will advance sustainable development post-Covid-19, including the United States under the new Biden administration, but as a non-expert I feel pretty confident to say the evidence is inconclusive that the world will be on a greener path.
So given how hard it seems to be for rich countries to turn that corner, it seems unlikely that a ‘developing’ country like Nepal could make it happen. Although it was progressing before the pandemic, the challenges were enormous and included climate change (evidenced by melting glaciers) high unemployment that was sending more and more young people abroad to find work, and stalled progress in terms of mother and child health after decades of impressive results.