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.
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.
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.
Child marriage has risen in many countries since the world started locking down earlier this year. In fact, the UN Population Fund (UNFPA) is predicting that if conditions don’t change, the pandemic will contribute to an additional 13 million marriages of children (mostly under 18) in the next decade.
The causes of child marriage are many and complex — economic, social and cultural. In Nepal, girls are often seen as a burden: raised by their parents only to be sent away to live with their husband’s family, and on top of that a girl is usually expected to carry with her a dowry for the groom’s family, which can amount to a huge amount of cash and goods, big enough to put her family in debt for many years.
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.
Experiences from other Asian countries show that people who have gone abroad to work can be reintegrated into the economies of their home countries but it’s a complex process that requires government leadership.
Researching this article for The New Humanitarian it became clearer than ever that the status of maternal health in Nepal is cloudy at the best of times since accurate data is unavailable. In the COVID-19 pandemic, it’s really a guess.
Researching this article for The New Humanitarian it became clearer than ever that the status of maternal health in Nepal is cloudy at the best of times since accurate data is unavailable. In the COVID-19 pandemic, it’s really a guess: everyone assumes it’s getting worse but no one is sure. The local office of the UN Population Fund (UNFPA) was supposed to start an assessment with the Government of Nepal late in June but it has yet to begin. Read on:
As home births rise in Nepal, so do fears for maternal health
Home births are rising in Nepal as fewer pregnant women visit hospitals, fuelling fears that the coronavirus pandemic could reverse years of progress on maternal health in the South Asian nation.
The government says less than half of pregnancies are now taking place in health facilities, compared with about 70 percent before coronavirus lockdowns began in March. A separate survey of health facilities across Nepal, conducted by the UN Population Fund (UNFPA) in April, found that visits by pregnant women had dropped as much as 50 percent.
In June, Nirmala Joshi, 24, walked two hours to her nearest hospital in Baitadi, a mountainous district in Nepal’s remote far west, for her first prenatal check-up.
COVID-19 is laying waste to international cooperation as well as health systems, as countries raise barriers and retreat into themselves. Or is it?
A shorter version of this article was published in the Nepali Times, but this one includes the role of the media, a point I had to cut from the published version because it was too long. Please let me know if you agree.
COVID-19 is laying waste to international cooperation as well as health systems. Countries have retreated into themselves, barring makers of medical equipment from exporting goods and in some cases hijacking shipments en route to other countries. The Trump administration has exited the World Health Organization (WHO) and is leading an attack on the organisation’s credibility. Internationalism is on its deathbed.
Or is it?
It’s a conclusion you can easily draw from media reports, which thrive on drama and conflict. “During this global pandemic there’s been precious little sign of intergovernmental collaboration and collective leadership. Instead the worldwide response has been characterized by national self-interest, mutual suspicion and recrimination,” intoned Stephen Sackur, host of BBC’s HardTalk, while interviewing former UK Foreign Minister David Miliband recently.
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.
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.