One Heart Worldwide (OHW) urgently needs your help! 

COVID-19 is an international public health emergency which is poised to hit Nepal. It will be particularly devastating the vulnerable communities in the rural areas of Nepal who are already underserved and lack access to quality healthcare. 

OHW is one of the largest International Non-Governmental Organizations (INGOs) in Nepal and one of the major partners of the Government of Nepal. In 2015, we successfully stepped in to support the Nepali Government’s responses to the devastating earthquakes that ravaged the country. 

Since the beginning of COVID-10 pandemic, OHW has been part of the task force for emergency preparedness called by the Ministry of Health & Population (MoHP) and as such is uniquely positioned to support the efforts of the Nepali Government as they ramp up their response to the upcoming COVID-19 outbreak. 

The Nepali Government has asked OHW to support their COVID-19 response in the 19 districts where OHW currently operates. We are looking to raise a one time total donation of $326,000 in response to their request. We already have received a preliminary commitment of $22,500 towards parts of this effort. We are asking for your support so that One Heart Worldwide can help the Government of Nepal prepare effectively and mitigate the impact of the likely upcoming COVID-19 outbreak and ensure the safety of the vulnerable pregnant women we serve, their families, and our field staff in Nepal.

Coronaviruses (CoV) are a large family of zoonotic (transmitted between animals and people) viruses that cause illness ranging from the common cold to more severe diseases such as Severe Acute Respiratory Syndrome (SARS-CoV). SARS-CoV-2 (more commonly known as COVID-19) is a novel strain that was discovered in 2019 and had not been previously identified in humans. The virus is highly contagious and is rapidly spreading throughout the world. As of March 25, 2020, the World Health Organization (WHO) reported 413,467 confirmed cases and 18,433 deaths worldwide, and this number is rapidly increasing every day.

Common signs of COVID-19 infection include fever, cough, shortness of breath, and breathing difficulties. In more severe cases, infection can lead to pneumonia, severe acute respiratory syndrome, kidney failure and death. Initial data seemed to indicate a high incidence of severe cases among older people (60 and up) and among immuno-compromised patients or patients with other pre-existing conditions (heart disease, diabetes, cancer). While the mortality risk is still highest among the elderly, recent CDC data indicates that 40% of the patients in the US who required hospitalization due to COVID-19 were between the ages of 20-54 years old. This recent finding is deeply concerning for One Heart as pregnant women are within that age range. 

In Nepal, the first COVID-19 case was confirmed on January 23, 2020 in a 32 year-old man returning from Wuhan, China. The patient is stable and as of today, his contacts are still asymptomatic. The second case was identified on March 23, as a female student returning from France. Unfortunately, testing capability is still very limited in Nepal and only 2 cases have been identified so far. Despite these low numbers and because of the impact of the pandemic in neighboring China, the Government of Nepal is preparing for a widespread pandemic. 

As of March 23, the Government of Nepal:

  • Closed its borders and has forbidden all travel (except with China)
  • Imposed a full lockdown effective until at least March 31. No one is allowed to leave their houses except to seek medical care or purchase food. Only essential services are allowed.
  • Designated six hospitals in the Kathmandu Valley as the main treatment and isolation centers for any upcoming cases.
  • Is preparing 25 Referral Hospitals across the country in terms of infection prevention and control measures, ICU beds, and equipment availability
  • Hired several new surveillance officers for prevention, control, and surveillance of new cases.
  • Formed a committee to coordinate the preparedness and response efforts of the various Ministries, Army, Police, and Armed Police Force.

Because the number of cases appear relatively limited in Nepal, it is crucial that adequate measures are immediately put in place while the outbreak is still potentially controllable. 

There are several immediate concerns for Nepal:

  1. Until the government border lockdown, there was a lot of travel between Nepal and neighboring countries like India and China, many foreign tourists visiting Nepal, and Nepali students studying abroad. While the government has instituted a full lockdown, it is possible that many cases might already be present in Nepal as asymptomatic or milder versions of the disease. Additionally, the government reopened its border with China to allow the import of protective equipment and supplies required.
  2. Very few tests have been conducted so far due to limited laboratory capacity, availability of trained staff, and availability of testing kits.
  3. The existing health infrastructure is very poor outside the main hospitals. Health care providers in rural health facilities have very limited access to Personal Protective Equipment (PPE), much less the resources needed to manage severe cases. The government has announced the establishment of several isolation wards but their capacity is very limited in terms of space, equipment, and staffing, and would be easily overwhelmed in a larger outbreak. 

Fear of the novel Coronavirus is fast spreading throughout the country as Nepal witnesses the impact of the pandemic worldwide. OHW is very concerned that the pregnant women in the rural districts where we operate will refuse to seek care due to this fear. This would then translate into a sharp increase in the number of home deliveries, thereby increasing the likelihood of adverse health effects and deaths during and immediately after childbirth, for pregnant mothers and their fragile newborn infants. 

In addition, OHW is very concerned that the health facilities in the rural districts where we operate will be overlooked by the Government of Nepal, as most health facilities in the more remote areas often are, and as a result, might not receive enough appropriate protection equipment and supplies to deal with cases of COVID-19 without contributing to the virus’ transmission and spread. 

To best support the Government of Nepal’s preparedness plan to minimize potential cases and casualties due to COVID-19, OHW is therefore proposing to provide essential equipment and supplies to prevent the spread of COVID-19 in the health facilities of our program districts and provide FM radio-based prevention messaging in all of our program districts.

Personal Protective Equipment (PPE) and Supplies to Health Facilities

Many health facilities and communities in remote rural areas of the country have reported shortages of PPE, especially masks, hand sanitizer, and gloves. Because we want to ensure that the pregnant women who attend our birthing centers feel safe, we are proposing to address this scarcity by supporting the health facilities in the districts where we are currently operating. 

  • For the District (Referral) Hospitals and Larger Clinics: We are proposing to provide full PPE (N95 mask; gowns; face shields; disposable booties, caps & gloves) to the healthcare personnel with potential for direct exposure to cases or infectious materials while performing their duties. In addition, we are also requesting surgical masks, disposable gloves, and hand sanitizer for any healthcare personnel with potential for indirect exposure to infection and for any symptomatic patients (cough or fever) to limit potential transmission. We are also requesting Virex to disinfect surfaces and infrared thermometers to facilitate case detection. 
  • For the more remote Health Posts: gloves, surgical masks, hand sanitizer, bleach, and soap for the health providers of our Birthing Centers. All patients and attending family members will be required to wash their hands thoroughly as they enter the BC. Any patient or family member with symptoms (cough or fever) will be required to wear a mask and be immediately referred to the district hospital.
  • Last but not least, we are requesting funding to cover the transport costs of all this equipment and supplies to our program districts (allocating $1,000 per district). OHW will oversee the transport to ensure the timely delivery of these much needed items.

Community Awareness Messaging

OHW is proposing to continuously air messages through local FM radio (as we do for safe motherhood messages) in our project districts. The messages will relay easy to understand information to the general public on COVID-19 symptoms (fever, dry cough), and standard infection prevention measures such as regular hand washing, avoid touching your face, cleaning frequently used surfaces, covering mouth and nose when coughing, practicing social distancing, and avoiding close contact with anyone showing symptoms. The message will also explain what to do in case of suspected infection. We will also add a message for all pregnant women, recommending that they do not skip care in fear of COVID-19 contagion and explaining how they can protect themselves during their visit to the BC’s.

Misoprostol Support

We are also requesting funding to provide for Misoprostol tablets to be distributed to all of the pregnant women in our program districts. Misoprostol tablets are essential to the prevention of postpartum hemorrhage and is given to all pregnant women in Nepal before delivery. The Misoprostol is distributed to Female Community Health Volunteers (FCHVs) by the health provider based at the birthing center. Each FCHV is  assigned to a BC where she reports regularly (every two-three weeks). They inform the health workers about what is happening in the community and inform them of new pregnancies. Once a FCHV reports a pregnancy, she is given the Misoprostol to provide to the pregnant mother along with her safe motherhood messages. During an emergency such as the COVID-19 outbreak, most funds tend to be re-allocated to emergency response and as a result, there is a very real risk for our health facilities to run out of some of the live saving medicines such as Misoprostol that every Birthing Center should have on hand.

Transparency

As needs are changing on a day-to-day (sometimes hour-to-hour!) basis, we will be using all donations to this fund to respond to the changing environment in Nepal and for Nepali health personnel. We will leave all donations to this fund listed as “unrestricted" so that if the needs change in a day’s, week’s, or month’s time, we will be able to allocate funds accordingly. We hope you understand our limitations regarding this and can trust OHW to distribute the funds in an appropriate manner. 

For further inquiry on this matter, please reach out to info@oneheartworldwide.org and one of our US staff will respond during our SF Office business hours, Monday-Thursday, 8am – 6pm PST.

MARCH 25

COVID-19 Samples tested: 687
Negative: 684
Positive: 3 (1 recovered, 2 in isolation)

OHW Response

  • OHW Nepal team is working solidarity with the Government of Nepal to fight COVID-19 by actively participating in the coordination meeting of the Ministry of Health and Population, the Ministry of Women, Children, and Senior Citizens, and the Social Welfare Council Association of International NGO’s to discuss COVID-19 response strategies
  • Regular coordination with relevant stakeholders at central, province, and district levels about their needs and response
  • COVID-19 related messages broadcast via local FM radios in project districts
  • COVID-19 related messages disseminated in carious forums through community, municipality, and district level activities
  • Copy of materials (both electronic + print) from the Ministry of Health and Population provided to health workers for broader dissemination
  • Purchasing of Personal Protective Equipment (PPE), Infrared thermometers, gloves, masks, hand sanitizer, etc. in process
  • Working on equipment distribution plan

OHW Nepal Staff

  • Work from home throughout working districts for two weeks
  • OHW is playing a crucial role to coordinate among AIN MoHP, the Ministry of Women, Children, and Senior Citizens, and the Social Welfare Council.
  • Executive Director, Surya Bhatta, participated in a coordination meeting yesterday (March 24) with the Women, Children, and Senior Citizens Minister, the Association of INGOs in Nepal, and the Social Welfare Council high officials, including Member Secretary, to discuss the next steps of COVID-19 Response
  • Facilitating the supply chain issue locally + internationally
  • Working on equipment distribution plan, under this, we have purchased the following supplies: 
  • 2,000 Disposable gowns
  • 500 packs Disposable gloves
  • 4,000 pairs of Disposable medical booties
  • 2,000 Disposable medical caps
  • 220 Bottles of Hand Sanitizer (500ml)
  • 6,000 Surgical Masks

All above mentioned supplies are in the packaging process and the remaining PPE necessities are in the procurement process.

OHW Work + Coordination at the District Level

  • OHW district staff participated in the meeting organized by various government agencies related to prevention and response of COVID-19. In such meetings, major points of discussion included arrangement of necessary PPE for health workers, other prevention related logistics, and how to raise awareness in the community
  • The District team also participated in and provided technical assistance in the meeting of the District Rapid Response Team
  • OHW District Staff oriented health workers on prevention and management of COVID-19. They also discussed these measures with community people during their community level activities (such as mothers group meetings, community perception on MNH collection, etc.)
  • OHW District Staff are in close contact with the management team of the District Hospital and Health Offices regarding preparation and response to COVID-19
  • District staff are providing technical input to the health facility staff to establish hand washing corners, isolation rooms, as well as strengthening their infection prevention practice
  • Messages on COVID-19 prevention have been broadcast to the local FM stations
  •  

Nepal Lockdown, March 24-31

To Read in Nepali, click here / नेपालीमा पढ्न, यहाँ क्लिक गर्नुहोस्

March 23, 2020

As per the authority given by the Infectious Disease Act, 2020 BS (1964), the Government has decided to impose a virus lockdown for a week to combat the possible outbreak of the new Coronavirus infection in Nepal.

The government has urged all citizens to abide by the following decisions:

  • No one is allowed to leave their houses except for urgent matters such as medical emergency, purchase of daily consumable essential items.
  • All vehicular movement of private and public sectors will be halted except emergency vehicles, including those holding special permits, security personnel, and medics.
  • All domestic commercial flights will be grounded except the ones used by security agencies.
  • Other than employees working in essential sectors such as health, security, consumable goods, drinking water, dairy, electricity, telecommunications, customs, quarantine, and waste management; employees working in other sectors. will only be mobilized as per the need by their respective offices.
  • Other than employees working industries including pharmaceuticals and health equipment, food items, drinking water, dairy, and petroleum; provisions must be made to grant leave to those working in other private sector industries and factories during the outbreak.
  • Traders must ensure regular procurement of medicine and other medical items; the Government will take stern action against traders involved in creating artificial shortage, black-marketing and hoarding essential and life-saving drugs during the difficult times; the Government will seize the stocked items and mobilize them in the treatment of patients during the outbreak.
  • To implement this decision in line with Clause 2 and Sub-Clause 2 of the Infectious Disease Act, the Government will mobilize all the Chief District Officers across the country, and if need be, will also make use of the provisions mentioned in the Local Administration Act (2028 BS).
  • If anyone is found violating these directives, the government will take stern actions against them under the prevailing laws.

Moreover, the Government has also decided to approve the COVID-19 related Quarantine Management Standards-2076 BS proposed by the taskforce formed under the coordination of the Minister for Culture, Tourism, and Civil Aviation.

Under the guidance of the Ministry of Health and Population, measures will now be initiated for the prevention, control, and treatment of COVID-19 related cases from the hospitals in the country with the coordination of Nepal Army health professionals and with the support of Nepal Police, Armed Police Force, along with doctors, nurses, and other health personnel from the Government, community level, and private sectors, as per need.

Further support will be provided by the Defense, Home, Foreign, and Finance Ministries.