Ensuring continuity of basic health services after the earthquake in western Nepal

Following the devastating 6.4 magnitude earthquake that struck Nepal's Karnali District on November 3, 2023, more than 70 health facilities were damaged, severely hampering the delivery of essential health services.

“After the earthquake, we were in a difficult situation as two of our buildings were completely damaged. We had to shift patients to temporary tents and deal with the influx of patients,” said Rajesh Singh, acting head of Dali Primary Hospital, Nalgad Municipality, Jajarkot.

A patient is taken to the medical camp cluster set up in Nalgad Municipality, Karnali District. Image source: WHO Nepal/PRAY

In response to the urgent need to continue medical services in severely affected areas such as the base hospital in Nalgad, WHO has established three temporary health facilities using camp medical kits, at the request of the Ministry of Health and Population. .

The MCKs – two in Jajarkot district and one in Western Rukum district – collectively serve 60,000 individuals residing in these hard-to-reach areas of Nepal.

Monitoring and surveillance centers were first introduced in Nepal following the 2015 earthquake, when WHO supported the Ministry of Health and Population to establish 41 monitoring and surveillance centers in the 14 most affected districts. These facilities have proven their vital importance in restoring primary health care services in a timely manner.

Handover ceremony of medical camp kits by WHO to local representatives in Barikot Rural Municipality (top left) and Nalgad Municipality (top right) in Jajarkot District, and Athbiskot Municipality in Rukum West (bottom). Image source: WHO Nepal/PRAY

The healthcare centres, consisting of various tents, provide a suitable environment for health services while the permanent structures are rebuilt – a process expected to take between one and two years. Tents have also been customized to accommodate seasonal changes in Nepal.

Facilities available include a range of departments providing outpatient services, laboratories, pregnancy and breastfeeding screening, administrative functions and storage needs. In addition, they are equipped with supplementary items such as stretcher carts, metal boxes, water jerrycans, garbage cans, community water filters, camp beds, foldable plastic beds, blood pressure equipment, individual tents and other necessities.

An aerial view of the earthquake-damaged base hospital and medical camp kit set up in Barikot Rural Municipality (left). A closer look at the tents installed in the municipality (right). Image source: WHO Nepal/PRAY

The first MCK center was established in the Primary Hospital Building, Limsa, Barikot Rural Municipality. This MCK centre, consisting of six tents, offers a range of services including outpatient consultations, laboratory and maternity care to 40-50 patients daily. Furthermore, the facility is equipped with a six-module solar electricity system, ensuring uninterrupted power supply for vital medical equipment in the birthing

Aerial view of the medical camp cluster in Nalgad municipality. Image source: WHO Nepal/PRAY

The second MCK system was installed at the Primary Hospital Building, Dali, Nalgad Municipality, which also serves about 50 patients daily. The MCK center consists of five tents, which are used to operate the emergency ward, inpatient ward, outpatient consultation room, administration and storage room. The MCK is also equipped with hand washing facilities and solar energy for lighting and powering essential appliances.

The first kit for panel-based medical camps in Nepal has been set up at Gitma Health Center in Rukum West. Image source: WHO Nepal/PRAY

The third MCK centre, which is also the first panel-based MCK center in Nepal, has been established in Athbiskot municipality in Rukum West. The panel-based medical camp kit consists of three rooms, capable of accommodating eight patient beds, with outpatient services set up at the Gitma Health Center in the municipality.

WHO has also provided a complete set of Inter-Agency Emergency Health Kits (IEHK) to ensure a fully functional health facility is established in each of the emergency healthcare centres. IIEHK includes essential medicines and essential medical supplies to meet the health needs of a population of 10,000 individuals for three months.

Post-earthquake, these MCKs support bridging the gap towards the continuation of basic health services, but more importantly, a sense of security for the people of Jajarkot and Rukum West as they focus on rebuilding permanent infrastructure.

Janaki Khatri, a resident of Nalgad Municipality, takes a pregnancy test at the medical camp set up within the municipality. Image source: WHO Nepal/PRAY

“We were able to quickly respond to the request of the Ministry of Health and Population and deploy these medical camp kits in the worst affected areas due to our previous experience in the 2015 earthquake. I am happy to say that we were able to support Nepal during “When needed to ensure the continuity of health services.”

Funded by the Southeast Asia Regional Health Emergency Fund (SEARHEF) and the Emergency Contingency Fund (CEF), these MCKs represent a commitment to rapidly respond to healthcare needs in times of disasters and public health emergencies.

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