झाडापखाला प्रभावित क्षेत्रका तीन ठाउँमा उपचार शिविर सञ्चालन गरिएको छ । गल्धा गाविसमा दुई साताअघि सुरु भएको झाडापखाला नियन्त्रणमा नआएपछि सोमबार पुगेका चिकित्सक टोलीले महामारी प्रकोप व्यवस्थापन शिविर खडा गरेको हो ।
राइकोट निमावि र कठैडाँडा हेल्थपोस्टमा शिविर राखिएको छ । बेलडाँडामा स्वास्थ्यकर्मीको घुम्ती टोली परिचालित छ । तीन जनाको मृत्युपछि जिल्ला स्वास्थ्यबाट टोली आइपुगेको हो । राइकोट निमाविमा पहिलो दिन ६० जनाको परीक्षण गरी औषधिसमेत वितरण गरेको डा. प्रशान्त बज्राचार्यले बताए । झाडापखालाले खर्कडाँडामा दुई र बेल्डाँडामा एक जनाको ज्यान गएपछि स्वास्थ्य टोली पठाएको स्वास्थ्य कार्यालयका प्रमुख महेन्द्रध्वज अधिकारीले बताए । तानसेनबाट कच्ची सडक ६० किमि गाडीमा र चार घन्टा पैदल हिंडेर स्वास्थ्यकर्मी र सञ्चारकर्मीको टोली प्रभावित क्षेत्र पुगेको थियो । उक्त टोलीमा डा. बज्राचार्य, हेल्थ असिस्टेन्ट गणेश गैरे, रेमबहादुर दिशा, मासिका लक्ष्मी अर्याल, सहयोगी बाबुराम खड्का, जिल्ला महामारी रोग नियन्त्रण तथा व्यवस्थापन संयोजक मीनबहादुर विष्ट छन् । राइकोटमा मात्रै जीवनजल ३ सय पोका, मेट्रोन, जिंक ट्यावलेटलगायत वितरण गरिएको व्यवस्थापन संयोजक बिष्टले बताए । गल्धाको राइकोट, खर्कडाँडा, गावुडाँडालगायत गाउँका १ सय ५० परिवार झाडापखालाबाट प्रभावित छन् । वषर्ाको समयमा दूषित पानीको प्रयोगपछि झाडापखाला फैलिएको हुनसक्ने स्थानीय इन्द्रबहादुर राईले बताए । मित्यालको झ्याल्टुङबाट ल्याएको पानी गल्धाको डेढ सय परिवारले पिउने गर्छन् । १० दिनयता निजी मेडिकलमा ८० जनाभन्दा बढी बिरामी उपचारमा गएको स्थानीय बासिन्दाले बताए ।
स्वास्थ्यकर्मी नहुनु दुःखद्
यसैबीच गल्धा गाविसस्थित स्वास्थ्यचौकीमा स्वास्थ्यकर्मी र अत्यावश्यक औषधिसमेत नभएर झाडापखालाबाट तीन जनाको ज्यान जानु दुःखद भएको अनौपचारिक क्षेत्र सेवा केन्द्र इन्सेकले जनाएको छ । यस घटनाबाट सरकारले जति सेवा सुविधा उपलब्ध गराएको दाबी गरे पनि सर्वसाधारण राज्यबाट पाउनुपनर्ेे न्यूनतम सेवाबाट अझै टाढा रहेको इन्सेकद्वारा जारी विज्ञप्तिमा भनिएको छ । मासिका र पियनका भरमा स्वास्थ्यचौकी छाड्ने लापरबाहीप्रति ध्यानाकर्षण गर्दै आगामी दिनमा नागरिकले उपचार र औषधि अभावमा ज्यान गुमाउनु नपरोस् भन्दै अनुरोध गरिएको छ ।
जिल्लाका एक दर्जनभन्दा बढी गाविसमा भाइरल ज्वरो, टाइफाइड र झाडापखालाको प्रकोप देखिएको छ ।
मुसीकोटसहित भलाक्चा, रुघा, खारा, साँख, वाफिकोटलगायत दर्जनभन्दा बढी गाविसमा उक्त रोगका बिरामी बढ्न थालेका छन् । जिल्ला स्वास्थ्य कार्यालयले महिला र युवामा भाइरल ज्वरो, वृद्धमा टाइफाइड र बालबालिकामा झाडापखाला बढ्दै गएको जनाएको छ ।
कार्यालयका प्रमुख डा. विनोद गिरीका अनुसार दुई सातायता जिल्ल्ाा अस्पतालमा बिरामीको चाप बढ्न थालेको हो । बिरामी बढेपछि शैया अभावमा भुइँमा उपचार हुने गरेको गिरीले बताए । 'बढ्दो गर्मीसँगै सदरमुकाम आसपास क्षेत्रबाट दैनिक पचासभन्दा बढी बिरामी टाइफाइड र झाडापखालाका आउने गरेका छन् । गाउँका स्वास्थ्य चौकीमा पनि बिरामी चाप ह्वात्तै बढेको छ', उनले भने ।
Kathmandu, Feb 25: It sounds strange that people get paid for just urinating in a toilet but it is true. A local organization in Darechowk, Chitwan is offering a rupee to the person urinating in the toilet. “People got curious why the organization is offering a rupee just for urinating in the toilet and this curiosity made the people to construct ECOSAN toilets in their houses,” says Mr. Shreerendra Prakash Pokharel, President of SEWA Nepal, while addressing the talk programme entitled, “Take a pee, Make a rupee” Urine Harvesting for Sustainable Sanitation and Entrepreneurship organised by Paschim Paaila in collaboration with Environment and Public Health Organization (ENPHO).
Sharing about the success story of ‘Take a pee, make a rupee’ campaign launched in Darechowk of Chitwan, Mr. Pokhrel told that he promoted ECOSAN toilet not just as a toilet but as a factory to produce fertilizer for their fields. He added that the acceptance of urine in the society has also made it easier for him to persuade the locals there to construct ECOSAN toilets. “Urine is socially accepted as a disinfectant. People of Darechowk used to use urine on bruises and eye infections. Therefore it was easy to convince people that urine too can be used as a fertiliser in their fields,” he adds. He further added that the campaign was so successful that, every house in Darechowk now owns an ECOSAN toilet. They enjoy better yields from their fields, and the situation is such that, urine is being stolen nowadays. He shared an interesting fact that the urine produced by a person in a year is enough to fertilize 1 ropani of land and 1 ropani of land can feed one person for a year. There is so much scarcity of fertilizers in Nepal, yet unknowingly people are wasting valuable fertilizers (urine) everyday. Almost 3 billion Nepalese rupees, is spent on chemical fertilizers every year, therefore harvesting urine, could save this sum which in turn can be used for other development activities, said Mr. Pokhrel.
Mr. Nawal Kishore Mishra, Director of Central Human Resource Development Unit (CHRDU) of Department of Water Supply and Sewerage shared his valuable life experiences on how he first started to experiment with urine in his own garden at his house in Baneshwor. He explained how he was embarrassed at first and would secretly check if anyone was looking before pouring urine on his plants. However, after he saw marvellous results, he has since then been proudly advocating the use of urine as fertilizer. Although the importance of using urine as fertilizer was realized not long ago in Germany, an interesting fact he shared was that, ancient farmers of Nepal had realized the potential of urine 100s of years ago; they used to make manure by mixing urine and ash below their staircase.
Many initiatives have been taken since the establishment of the first ECOSAN toilet in Siddhipur, there are over 2000 ECOSAN toilets all over Nepal today. However, he also stated the sad fact that, ECOSAN toilets and the concept of using urine is still a new concept and still not widely accepted because of lack of awareness and disgust towards urine. There is a high need to promote ECOSAN projects and to do this he suggested that there should be proper co-operation and co-ordination between policy makers, government and the users.
The universal response of colleagues when they heard of the cholera outbreak in Haiti was ``Oh, no! Not another curse on that country!''
With cholera, coming after political unrest and the earthquake, the theory that ``Haiti's cursed'' gained ground again. The truth, however, is that most of Haiti's curses, cholera included, are the consequences of the actions of men. Errors of omission and commission not just exacerbated the epidemic but also contributed to its cause and explosive spread.
The first cases were reported in small villages near the mouth of the Artibonite, Haiti's largest river, about 60 miles from Port-au-Prince -- a pastoral setting of small villages surrounded by irrigation canals and rice paddies. On Oct. 20, small clinics there reported being overwhelmed by about 50 patients with fever, vomiting and diarrhea. There were also reports of people found dead by the side of the road -- a macabre signal of just how quickly this disease could suck the life out of its victims.
By the second day, the public hospital in Saint Marc was overwhelmed, with more than 500 cases and more than 100 deaths. The next day, cases were also reported in Mirebalais, which sits on the Artibonite. Sanitation has long been neglected in the Artibonite, and the people routinely bathe and drink from the river. The outbreak occurred at the end of the rainy season, when the water table, at its crest, floods the makeshift latrines. All of this, however, begs the question: Why there?
The Haitians, of course, knew -- the reason was the Nepalese U.N. camp in Mirebalais. The United Nations denied it, in spite of the Associated Press reporting raw sewage dumped from the camp's latrines into a tributary of the Artibonite. Cholera is endemic to Nepal. When tests showed the strain causing the epidemic was endemic to ``South Asia,'' the U.N. countered that none of the soldiers they tested carried the strain. Recently, The Miami Herald reported that a French epidemiologist has strong evidence that cholera originated in the MINUSTAH camp.
The origin of the epidemic was important for two reasons. First, having already been stigmatized unjustly for HIV/AIDS, Haitians should not be blamed for cholera. More important, the U.N. should be held accountable. The Haitians knew all along the U.N. sites were dumping raw sewage into the river, and no one listened. The least the U.N. camps can do is to create adequate sanitation in their own areas. Better would be to make amends by pitching in, digging latrines and wells throughout the country.
Two caveats to this development:
• Cholera is not the fault of the Nepalese soldiers, but the result of a pervasive attitude among contractors that say ``Hey, it's Haiti! We can cut corners! No one will care!''
• We fund the U.N. and we need to hold its members accountable. Even if their camps are not the source, they shouldn't be dumping sewage into Haiti's rivers.
If humans cause Haiti's curses, they can also lift them. Sixteen years ago, Dr. Barth Green and I established a foundation to help Haiti called Project Medishare. Through the years it has grown to be an important contributor to Haiti's health.
You may have heard of Medishare's heroic work after the earthquake. You may not, however, have heard of our community-health project in the Central Plateau. Medishare's presence there, as well as its decade-long experience with community health, made it ideally suited to respond. We immediately deployed community health workers to the Artibonite. Armed with bullhorns and packets of oral-rehydration therapy, as well as donations of bleach and soap, our teams initiated a community education campaign, one small village at a time.
One of our tents used as a field hospital after the earthquake was set up in Mirebalais and, within a week of the outbreak, Medishare and Partners in Health opened a Cholera Treatment Center there. One month into the outbreak, we had already treated more than 2,500 patients, with only six deaths.
Other areas in Haiti, however, will not be so fortunate -- cholera will make 500,000 to 800,000 people ill and claim tens of thousands of lives; a curse not of divine, but of human, origin.
(Dr. Arthur M. Fournier is Associate Dean for Community Health Affairs at the University of Miami Miller School of Medicine and co-founder of Project Medishare.)
सदरमुकाम मुसीकोटलगायत आधा दर्जन गाविसमा झाडापखालाका बिरामी देखिन थालेका छन् ।
झाडापखालाका कारण दुई सातामा २ बालबालिकाको उपचार अभावमा मृत्यु भएको छ । खलंगा, बाफिकोट, कोटजहारी, भलाक्चा, पेउघा, आठविसकोटलगायत आधा दर्जन गाविसमा ५० भन्दा बढी बिरामी परेको जिल्ला स्वास्थ्यका प्रमुख विनोद गिरीले बताए ।
गाउँका स्वास्थ्य चौकीमा औषधि अभाव भएपछि बिरामीहरू स्थानीय मेडिकलमा महँगो शुल्क तिरेर उपचार गराउन बाध्य छन् । 'प्रकोपका रूप नलिए पनि झाडापखालाका बिरामी बढेका छन् ।' गिरीले भने, 'जाडो मौसम भए पनि दिउँसो गर्मी बढेकाले रोग बढेको हो ।'
जिल्ला अस्पताल सल्लेमा सदरमुकाम आसपासबाट दैनिक १० जना झाडापखालाका बिरामी आउने गरेका छन् । अस्पतालका अनुसार बिरामी पर्नेमा बालबालिका बढी छन् । 'झाडापखालाका बिरामी दिनदिनै बढे पनि सरकारी निकायबाट कुनै चासो भएको छैन,' खलंगा ६ का ओपेन्द्र शर्माले भने, 'घरघरमा बिरामी देखिन थालेका छन् ।' 'दूषित पानी र फोहोर खानेकुराका कारण बिरामी बढेका हुन्,' गिरीले कान्तिपुरसित भने, 'चिसोका कारण पनि बालबालिकामा झाडापखाला लाग्ने गरेको छ ।' कोटजहारीस्थित प्राथमिक स्वास्थ्य केन्द्रमा पनि १२ भन्दा बढी बिरामी दैनिकजसो आउने गरेका छन् । झाडापखाला जाडो मौसममा बढीमात्रामा बालबालिकामा हुने स्वास्थ्यले जनाएको छ ।
रोग देखिन थालेपछि सबै स्वास्थ्य चौकीमा औषधि पठाउन थालिएको र अरू बढ्न नदिन सबै सावधानी अपनाएको स्वास्थ्य कार्यालयले जनाएको छ । 'झाडापखाला फैलन नदिन खानेपानीको क्षेत्रमा काम गर्ने निकायको विशेष ध्यान जानुपर्छ,' डा. गिरीले भने, 'स्वास्थ्यले विभिन्न निकायसँग समन्वय गरी जनचेतनामूलक कार्यक्रम सञ्चालन गर्न थालेको छ ।'
Solar disinfection of water could prevent epidemics
Kathmandu, Jan 7 -
Environment and Public Health Organization (ENPHO) and EAWAG/ SANDEC are jointly moving ahead with the strategic plan to promote Solar Water Disinfection Technique (SODIS) in Nepal.
Sharing their experiences gained in last 10 years of SODIS project in Nepal on Friday, various experts said that SODIS technique could play a pivotal role for increasing the public health status and help to control the regular outbreak of water borne epidemics. Presenting her working paper in the workshop, Biju Dangol, senior programme officer of ENPHO informed that by realizing the need to improve water quality at households through cheap and effective techniques, SODIS programme had been implemented in 20 communities in different parts of Nepal, especially in squatters’ settlements and small farmers’ communities.
For institutionalizing SODIS for its recognition and promotion on a regular basis through government institutions, her organization had been working in partnership with Ministry of Health, Ministry of Education and Metropolitan offices of Kathmandu, Bahktapur, Laitpur, Kritipur, Madhyapur Thimi and Hetauda, she said. Dangol, further, said that the ENPHO established a partnership with five NGO’s and other organization working at grassroots level to promote and disseminate knowledge of SODIS on water and sanitation. Dangol said during the period of 2001-2002 they conducted research and piloting at different mountainous, hilly and Terai regions.
In 2005, they implemented the programmes in different communities and they focused on investment to institutionalize SODIS during the 2006-2010.
Madhav Pahari, Project Officer of UNICEF, said that the projects should be implemented with a new dimension by mobilizing schools and teachers, where they could teach their students about improving local water systems in more effectively. Because the teachers are the agent of social change, he added. He informed that to empower the students, his organization had introduced SODIS techniques in 200 schools of four districts and sum of 8,045 SODIS bottles were distributed among the school children.
