In the past 8 months, the month of May recorded the highest number of bandhs (strikes) due to an extension of time allotted for drafting the national constitution. Many parts of the country have been reeling from the almost daily bandhs during the past few weeks, which have created a shortage of essential commodities like food, provisions, and medicines in many places. The constitution has yet to take a final shape, but the country is already burning and there have been moments in which the entire nation has come to a standstill.
The Far Western Region of Nepal has been in the bandh for more than two weeks, due to people demanding an indivisible Far Western Region, and others demanding a Tharu Province within that region. Bayalpata Hospital (Achham) and its services have also been affected lately due to the ongoing indefinite strike.
[The following post was adapted from a series of update emails sent from Achham during the recent bandh (strike).]
Mark Arnoldy, Executive Director
May 13, 2012
Our Nepal team has been without internet and phone for the last 5-6 days, and just briefly picked up the ability to make a few calls. The region is in day 16 of an indefinite bandh. The report is that everyone is safe but there has been some violence and possibly a few deaths in Dhangadi. Achham, some 10+ hours by vehicle from Dhangadi, has not been impacted by violence, but has disrupted supply chains and the inability to move out of the district (our ambulance included).
Bibhusan Basnet, Medical Director
May 17, 2012
The bandh has been continuous in Nepal and our services are very much affected by the strike.
We have medical supplies left just for 4-5 more days. Recently our solar power has been out of order and we have had to rely upon electricity for our lab reports and X-rays. We have electricity for just a few hours a day and no fuel supply for our generator. Because of this, the patient reporting is not done on time these days. We are short on food supplies and fuel for cooking. The ambulance service is even being hampered by the bandh. We have patients with suspected extradural hematoma, post-dated pregnancy in need of caesarean section, and traumatic subcutaneous emphysema in our inpatient department waiting for the ambulance services. Our internet service was also out of order but recently we have been able to use our NTC internet, though the broadband is still out of order. At least we are in touch to the rest of the world now. The situation is bad but we still have hope.
Gregory Karelas, Country Director
May 18, 2012
1. The CDO has agreed to turn power on to our hospital for increased hours until fuel has arrived. He is making a special exception for our Hospital given the dire need and shortage of meds at BH.
2. Rumor has it that Dhangadhi strikers will open a window for vehicle passage to other areas of the Far West in the next 1-2 days, allowing petrol to reach Sanfe.
3. Our vendors are currently collecting a 1 month supply of our most commonly used and necessary drugs for release as soon as the bandh opens.
4. We have personally contacted the Storekeeper at the District Health Office in Mangalsen to release any medications possible. Since we do have diesel, the Ambulance has received approval for this pick-up right away.
Indeed, these are further iterations of the unexpected challenges we face in Achham.
With thanks to Dr. Bibhusan and all of BH’s amazing staff, who overcome these challenges daily. Their dedication is inspiring.
Bibhusan Basnet, Medical Director
May 24, 2012
Even during the bandh, we have been able to move some supplies during the night. The medications have started arriving. We have decided to procure extra medications for the next 10 days, and hope that the medications arrive tomorrow or the day after.
Regarding the cases that were in the hospital waiting for ambulance services:
- The lady with post-dated pregnancy was induced, and had a male child who was treated for suspected neonatal sepsis and sent home a few days ago;
- The boy with suspected extradural hematoma improved with mannitol, phenytoin, and prophylactic antibiotics, and was sent home after 7 days as an inpatient. We are thankful that the child improved. He is on our CHW follow up list.
- Sadly, the lady with subcutaneous emphysema passed away.
The ambulances are now able to travel for referrals. Our ambulance will even be sent out of the district for service as soon as the ambulance is maintained and in order. Until then, the ambulance is in service within the district due to the ongoing bandh.
We have electricity about 4-5 hours a day (8-11 a.m. and 3-6 p.m. inconsistently). The electric plant in Achham does not have enough capacity to send us more electricity. We can now run the hospital’s generator a few hours a day for laboratory and X-ray services.
Food supplies and gas cylinders have been supplied by our local vendor, so there is no food shortage at Bayalpata Hospital (BH) these days. Despite the continuous bandh, BH has improved conditions and services, and life has gotten better. I am inspired by the teamwork of the BH staffs, who work so hard under any circumstances.
Jesse Brady is the Blog Editor of Nyaya Health and is currently pursuing her MS in International Medicine at Montana State University.
Dr. Bibhusan Basnet , MBBS graduated from B.P Koirala Institute of Health Sciences,Nepal. He has a special interest in Emergency Medicine and Psychiatry and is currently the Medical Director for Nyaya Health.