Response to the Second Wave of COVID-19 Crisis in Nepal

Starting from mid-April, only some weeks after the neighboring India was hit by second wave of the pandemic, Nepal started witnessing a dramatic surge in its COVID-19 cases. By the end of April, daily cases had already increased by seven-fold and by mid-May, the country had a positivity rate of 45%. On April 26, to help slow the spread of infection, the government announced the ongoing lockdown restrictions. With a high-test positivity rate and huge explosion of case load, Nepal is one of the hardest-hit countries by the second wave of COVID-19.

With all the eight districts of Province 2 sharing an open border with India, a fragile health care infrastructure, and relatively lower Human Development Index than the national average, municipalities of Province 2 have been enlisted as highly exposed and with one of the highest vulnerabilities since the first wave of the pandemic. Likewise, local and national media reports soon started highlighting the dire state of Karnali Province as Covid-19 hospital and district hospitals were under equipped with medical equipment and human resources to tackle the second wave of Covid-19. As the most remote provinces and with higher Covid-19 fatality rates, Karnali Province is largely affected by uneven distribution of health care infrastructure and locals soon started facing difficulty accessing treatment and hospitals struggled to cope with increasing number of infections. Beginning from mid-April 2021, hospitals and primary health centers at the local level on both the provinces quickly began getting overwhelmed with a surge in flow of patients.

Province 2 and Karnali Province are two prioritized working areas of Helvetas where local communities have always been put at the core of all our programs. As situation continued to worsen, our local partners and service providers in Province 2 and Karnali Province proactively approached the local government representatives, Covid-19 designated hospitals, and local community members to better understand the impact of this severe outbreak. Likewise, local representatives from our working municipalities also requested Helvetas to reach out to hospitals and health care centers in strengthening their Covid-19 response. Since the beginning of the second wave, Helvetas extended its support to one sub-regional hospital, one provincial hospital, eight municipality/district level hospital, 26 health posts, 11 primary health posts, 19 health units, and four isolation centers in the two provinces with much-needed medical supplies and equipment to the value of NPR 13,104,269 (approximately 100,000 CHF). Besides that, materials related to hygiene and safety control was also provided for the personal safety of mason and workers in the ongoing activities of drinking water schemes in Karnali province with the value of NPR. 293,227 (approximately 2,225 CHF).

In Karnali Province, during the month of May, Helvetas quickly responded to the needs of the provincial hospital and distributed PPE sets, disposable gloves, surgical masks, hand sanitizers, face shields, pulse oximeters with a value of NPR 1,373,350 (approximately 10,425 CHF) which benefitted 350 health workers and administrative staff and approximately 150 infected patients.

In the month of May, to further develop a response plan, a needs assessment of health center and hospitals in twelve working municipalities of five districts (Achham, Dailekh, Jajarkot, Kalikot, and Surkhet) in Karnali Province was conducted. Based on the assessment, Helvetas distributed medical equipment and protective equipment such as PPE sets, BP Sets, face shields, digital thermometers, gloves,  masks, hand sanitizers, hygiene kits, oxygen concentrators, oxygen cylinders, thermometers, vaccine carriers, stretchers, pulse and children oximeters, water dispensers with a value of NPR 8,544,150 (approximately 64,856 CHF) to six district level / municipality level hospitals, 26 Health Post, 11 Primary Health Post, 19 Health Units and  four isolation centers.  This support was able to reach a total of 4,685 individuals including primary health workers, medical frontliners, and Covid-19 infected patients “At a time when we were facing delays to receive support from the Government of Nepal, we are relieved to receive this support from Helvetas to better manage our Covid-19 response.” said Gagan Singh Sunar, the mayor of Lekbeshi Municipality during the handover of medical equipment. Similarly, Dr Ranjana Rokaya, Head of Dullu Hospital also said that they greatly appreciated the initiation of Helvetas, “Helvetas has been making continuous contribution for our hospital and it has been very helpful for us as Dullu is one of the most affected areas by Covid-19.” Dr. Rokaya added that “this health equipment would help to prevent and control infections and save lives.” Helvetas’ comprehensive support at the critical hour was greatly recognized and appreciated by the local representatives, medical workers, media organizations, and other members of the community.

In the month of May, to support the hospitals at the local level in their response to the second wave COVID-19, Helvetas supported Bardibas Hospital and Barahathawa Hospital in Province 2 with a range of medical equipment such as oxygen concentrators, extraction kits, pulse oximeters, 1000 N95 concentrators, PCR test kits, antigen kits, face masks, VTM Tubes, portable suction machines, bed pans, as well as personal protective equipment for health workers with an approximate value of NPR 2,299,024 (approximately 17,451 CHF). The logistics component of the response was led by Helvetas’ existing local non-governmental and private sector partners who ensured timely emergency procurement of the medical supplies. Upon receiving the much-needed supplies, Bidur Karki, the Mayor of Bardibas Municipality who received it on behalf of Bardibas hospital expressed his gratitude towards Helvetas for promptly responding to the municipality’s appeal and joining hands with them in their battle against Covid-19. “The municipality warmly welcomes the generous support of organizations like Helvetas during these uncertain times and it is through these joint efforts that we will stop the spread of Covid."

Similarly, in the month of June, in collaboration with Birgunj Chamber of Commerce- a network of business organizations in Province 2, Helvetas also extended its support to Narayani Sub-Regional Hospital. The hospital had recently added additional beds with the growing number of cases and upon the request of the hospital, Helvetas handed over critical medical equipment like medical oxygen concentrators and patient monitors with a value of NPR 887,745 (approximately 6,739 CHF). Dr. Birendra Pradhan, Medical Superintendent of the hospital who received the equipment on behalf of the hospital thanked the team for their support and said that the equipment would of great help to strengthen their efforts for Covid-19 response.

Even during the initial days of the second wave, Helvetas adopted important safety measures during the implementation of its activities. For instance, to control the spread of transmission, during implementation of drinking water schemes, Helvetas supported to provide hygiene materials in Karnali province where 584 persons (mason, construction workers, and community members) of 44 drinking water schemes. As a part of this support, a total of 644 gloves, 20,750 masks, 910 bottles of sanitizers, and 493 soaps with the value of NPR. 293,227 (approximately 2,225 CHF) was distributed. It was also observed that masons who were earlier hesitant to engage in construction work felt safer to resume their work with the use of protective equipment and became able to support their livelihood.

Almost all the COVID-19 responses in Karnali province, except the support to Jajrkot district and provincial hospital surkhet, were carried out with generous support from charity water’s second cycle grant.

Since the beginning of the pandemic, Helvetas has been committed to support local government and hospitals to strengthen their health system to contain the surge of Covid-19 cases and provide health services to those impacted by it. Besides responding to the immediate needs of the pandemic, Helvetas also strives to strengthen longer term countermeasures to tackle the consequences of Covid-19 in its working areas.