Publications
International Activity Report 2008
Nepal
MSF in Nepal, 2008
Field Staff: 114
Reason for Intervention:
- Armed conflict
- Natural Disaster
- Endemic/Epidemic disease
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Decades of neglect have hampered the development and improvement of health care in Nepal. Local health authorities are under-equipped and lack dedicated staff. Doctors Without Borders/Médecins Sans Frontières (MSF) has been in the mountainous Kalikot district since 2005, upgrading the local health center into a district hospital and providing primary and secondary health care.
In the outpatient department, MSF’s team, alongside medical staff from the Nepalese ministry of health, conducted over 22,000 consultations. Free medication was given after consultation. The hospital admitted 1,346 people, 170 surgeries were performed, and 66 women delivered via Caesarean section.
Patients in mobile clinics
MSF started a new project in Central Terai in 2008 in response to internal disturbances prompted by ethnic tension. MSF provided health care through mobile clinics, and saw some 12,000 patients during the year. This project has recently been expanded to support the inpatient department of the district hospital, particularly the maternal and child healthcare and obstetric emergency surgeries.
Safe deliveries
Nepalese women have little access to skilled birth attendants. Adherence to traditional practices can lead to high maternal and neonatal mortality rates. Operational manager Katrien Coppens was shocked after she met women in Terai. “Without exception, they had all lost at least one child during pregnancy or just after delivery," Coppens said. "One woman even told me how she had lost four of her babies. Especially in this area it is so important for expectant mothers and newborn babies to have regular check-ups.”
MSF raises awareness among the community about the need for women to seek care at medical facilities in good time, and provides among others things family planning and antenatal care. November saw the opening of a patient waiting house for pregnant women in high-risk situations such as those expecting twins or with a co-existing medical condition. By staying in the waiting house some time before the expected delivery date, women increase their chances of a safe delivery.
Responding to malnutrition and cholera
Malnutrition has been a particular concern throughout 2008, with a so-called mid-upper arm circumference (MUAC) screening disclosing a global acute malnutrition incidence of 10.8 percent. MSF has treated several thousands of children through mobile therapeutic feeding programs. In one extremely remote location, accessible only via a two-day walk on steep mountain trails, MSF opened a seasonal clinic. MSF teams also prepared emergency facilities to combat cholera in a location that has been particularly vulnerable to the disease due to a lack of water, inadequate sanitation, and poor hygiene practices. More than 2,200 consultations were carried out, and more than 450 children were admitted to the nutritional program.
Koshi floods
On August 18, 2008, the Koshi River broke its banks. Some two million people were affected in Nepal and India. MSF dispatched a team to the Nepalese side of the border, where about 50,000 people were directly affected. For two months, teams focused on medical emergencies and cholera prevention.
In 2009, MSF is planning to hand over its project in Kalikot to the Nepalese ministry of health. MSF will maintain its presence in Terai and retain a capacity for a quick response to emergencies.
MSF has worked in Nepal since 2002.
