Supporting COVID-19 prevention and testing in NepalPublished: Sep 13, 2021 Reading time: 7 minutes
In May of this year, People in Need (PIN) launched a public appeal aimed at members of the PIN Club of Friends and the general public of Czech Republic to support Nepal in combating its second wave of COVID-19. Within a few days, the Czech people had donated more than NPR 34 million (approximately 245,000 Euro) toward the effort.
PIN used these funds in the first phase to purchase essential materials such as antigen test kits, oximeters, personal protective equipment including masks, sanitisers, face shields, and surgical gloves, beds, stretchers, and other materials required for the prevention and treatment of COVID-19 in Nepal’s capital, Kathmandu. The medical kits were purchased after consultations with the local authorities and health personnel to ensure they addressed the community’s most urgent needs. The health materials have since been delivered to rural municipalities, ward offices, and health posts that are running isolation centres and providing health services to communities in the districts of Bara, Rautahat, Sindhupalchowk, and Dolakha.
Jampa Tsering Lama, PIN Disaster Risk Reduction and Emergency Coordinator, says: “PIN designed the intervention to include the entirety of the rural municipalities being targeted, despite their remoteness, and to address their particular needs. It takes two to three days for people living in remote areas to travel to their district headquarters and perform PCR tests, and then they must wait two to three days until they receive the results. This time increases the risk not only to the patients themselves, but also to the general public. Therefore, PIN, together with local health personnel, designed a robust and comprehensive medical kit which includes an antigen test kit and other medical supplies such as masks, hand sanitizers, gloves, and stretchers.”
The materials were successfully distributed in the districts of Bara, Rautahat, Sindhupalchowk, and Dolakha, covering eight rural municipalities, 64 wards, 58 health posts, and seven isolation centres. We interviewed health service providers and government officials about the support provided by PIN and the situation on the ground. We found that the materials provided by PIN provided significant incentives for the local authorities, isolation centres, and health posts to improve their standards of service.
Testimonies from the field
Ishwor Kumar Khadka, Health Coordinator of Bigu Rural Municipality, Dolakha
"The COVID-19 situation seems normal and cases are going down. The support we received will help us continue to fight against COVID-19. The antigen kits in the package will be useful because we don't have PCR testing facilities nearby. Previously, we had to send PCR tests to Dhulikhel and wait at least a week for the results. But now, we can test anywhere and get a result within a few minutes, which enables us to identify positive cases. We can then isolate those who test positive immediately, helping to limit additional cases."
Arun Kumar Mishara, Health Coordinator of Tamakoshi Rural Municipality, Dolakha
"When there are enough resources, it is easier for us health workers to run the isolation centres. Your comprehensive packages for ward offices, isolation centres, municipal offices, and health posts have helped us a lot. It would be difficult for us to provide services in the different units without your support. We are planning to use these materials efficiently and only where they are needed. We will save some of the items for worst-case scenarios in the future. As we received plenty of antigen kits, we are planning to assign a focal person in each ward health post for COVID-19 testing, so that people can get the service at their doorsteps. Diagnosis is quick and the chance of spread is therefore limited. PCR testing was difficult, as we have to send the samples to Charikot and wait several days for the results. The collection of PCR samples requires a specialised person and a temperature-controlled box for storage, making it difficult for testing to take place where it was required."
Sangita Basnet, Bhirkot Health Post, Tamakoshi Rural Municipality, Dolakha
"We are very happy to receive this support in such difficult times. We did not have a stretcher for carrying patients before. This is especially useful for carrying pregnant women from villages where there is no road access. We will be using these items to limit the spread of COVID-19 and provide care to COVID-19-positive patients."
Paras Raj Yadav, Health Coordinator of the Isolation Centre, Aadarsh Kotwal Rural Municipality, Bara
“Initially, the situation was hard to manage due to the new variant of COVID-19. The number of cases rose to 60 this year, with three deaths, which is more compared to last year. We used to collect the samples and send them to the lab, but it takes a minimum of three to four days for the final results. It was difficult to manage people’s curiosity until we received the results. The antigen kits will be useful as we will have the results in just a few minutes.”
Rambabu Pd Sah, Chief Administrative Officer, Maulapur Municipality, Rautahat
"There has been no social distancing. People have been gathering, attending wedding ceremonies and rallies. There is not much awareness of COVID-19 in the community. A few people came into the health centre for a PCR test, but we had problems with contact tracing. We were in need of these essential materials, especially the medical beds PIN provided, as we only had non-medical beds. We will also use the masks and sanitiser at the office, and we will provide it to staff and the public during meetings, programs, and trainings."
Surendra Sah, Isolation Centre, Maulapur Municipality, Rautahat
"This is first time we are receiving aid, we have not received any support from agencies in the past. We had some supplies at the isolation centre from last year, so we used those supplies and mobilised health workers when the second wave began. We managed to buy some supplies from the municipality, but we only had five beds and five oxygen cylinders, which would not be enough if the number of patients increased. We now have 50 cylinders, and with the 25 medical beds we received from PIN, we can make the isolation centre more like a hospital."
Saru Poudel, Case Investigating and Contact Tracing (CICT) focal person, Gaur District Health Office
“The case load is low, but that doesn't mean the pandemic is under control. In fact, there is very little contract tracing these days, so it may seem as though the cases are decreasing. But in reality, infection rates are still high in the community. The recovery rates are better compared to April and May, but on the other hand, there has not been much PCR testing. People wore masks during the previous outbreak out of fear, but now, with most restrictions lifted, people have stopped wearing masks and taking preventive measures.”
PIN has collaborated with the local authorities in all of the districts we work in, and supported them with COVID-19 supplies at the local and ward levels. We also distributed masks and soap to 775 vulnerable persons in the areas where we installed handwashing stations in 2020.
PIN has also adjusted our current programmes immediately to the COVID-19 pandemic second wave. Through our inclusive education-focused Aarambha project in Terai, we have been airing radio programs on COVID-19 preventive measures, and using loudspeakers in the villages to spread messages about the importance of educating girls and the risks of early childhood marriage.
Real time information related to COVID-19
Within the first phase, PIN has also supported National Disaster Risk Reduction Management Authority ‘s (NDRRMA) COVID-19 dashboard under BIPAD Portal. PIN provided technical expertise as well as financed in incorporating additional new features like COVID-19 vaccine related information (first dose or second dose), Health Infrastructure related information (Oxygen Cylinder, Ambulance, Ventilator, ICU Bed, HDU Bed, Normal Bed), PCT Test related data (like Antigen Test, Antigen Positive) to the COVID-19 dashboard. Officials from all the 77 districts of Nepal can update data in the portal. People now have real time information related to COVID-19.
In June-July 2021 PIN carried out a comprehensive assessment of the secondary impacts of COVID-19 in Rautahat, Bara, Sindhupalchok, Dolakha. Kathmandu, Bhaktapur and Lalitpur districts to identify the needs and priorities of households and communities under the pandemic focusing on livelihood, economy, food security and protection concerns of the households, local government’s COVID-19 response management capacities, including planning, coordination, monitoring, gaps, challenges and needs; and psychological impact, emotional effects and wellbeing status of PIN Nepal’s beneficiary girls.
Simultaneously, PIN has carried out Barrier Analysis to understand the barriers and enablers to follow safety measures of COVID-19 along with probable rumours regarding COVID-19. The results of this assessment are now being analysed to inform the organization’s program adaptation and to kick start the second phase of COVID-19 response.