Thursday 24 March was world TB day and, given the extent to which People Living With HIV & AIDS are co-infected with tuberculosis, the project that I work with (Sakriya Plus Nepal) went to an event to mark the ‘Patient’s Charter for Tuberculosis Care – Rights and Responsibilities’, and to pay tribute to people who have died with TB. TB is a major public health problem in Nepal. It is estimated that between 14 & 19 people die every day with TB, which is between 5000-7000 lives lost each year. For more information, follow this link.
This was essentially a day of activism and awareness raising. On the back of this, a health camp was organised jointly by medical staff from the Siddhi Memorial Hospital in Bhaktapur, medical & pharmacy students from Kathmandu University and staff from Sakriya Plus Nepal in the Panchkhal VDC. The aim is to provide advice and information around TB, but also to use this as a springboard for getting villagers seen by a medical practitioner for basic health checks. Some 80 villagers came to the health camp today, (Saturday 26 March), of which 27 took up the opportunity to receive voluntary counselling & testing in respect of TB and/or HIV.
The health camp is no more than a potential gateway into mainstream health services, since there are no diagnostic facilities available here. Conditions requiring further medical intervention, (high blood pressure and a possible thyroid problem being two such examples that came up today), will be referred to a hospital outpatient department…and therein lies one of the difficulties.
One of the primary reasons why villagers tend to come to these health camps is because over the counter medications such as analgesics and gastric medications are available free of charge. Consequently most, if not all of those presenting are likely to have a minor ailment for which they can receive some medication free of charge. Talking with two of the doctors here, they said that this sometimes/often translates into a general view held by villagers that there is a ‘pill for every ill’. I’m personally aware of at least two occasions today when a parent asked for medication which would increase their child’s appetite…Malnourished children, a poor diet, and lack of awareness/education on matters of nutrition lurk like Banquo’s ghost, seemingly invisible to all but a few.
A trip to a hospital outpatients will incur additional costs, and any medications which are not on the Nepal government’s list of essential medications will not be available free of charge. Thats not to say that the Nepal Government isn’t aware of the shortcomings, as this extract from the most recent strategic health plan attest.
“ (The)…vision or goal is to improve the health and nutritional status of the Nepali population, especially for the poor and excluded. The Government will contribute to poverty reduction by providing equal opportunity for all to receive high-quality and affordable health care services. The three objectives set out in the results framework are:
To increase access to and utilisation of quality essential health care services.
To reduce cultural and economic barriers to accessing health care services and harmful cultural practices in partnership with non-state actors.
To improve the health system to achieve universal coverage of essential health services”
Upwards & onwards indeed….
And I particularly like this photograph from today too, but it doesn’t ‘fit’ within the context of this particular blog entry…