The pandemic has exposed Nepal’s fragile health system, mainly due to the government’s lack of foresight in maintaining and preserving a much-needed facility. Especially in the rural hinterland, where people have always faced the lack of doctors, medicines or proper care. And for the few people who can access medical care in the nearby district headquarters or in the capital, the round-trip helicopter ride isn’t cheap. For the multitudes, it’s just hoping against hope for a miracle.
With the effects of Omicron on the wane, people have only recently begun to feel some relief from the constant threat of contracting the dreaded virus. But no sooner had the pandemic begun to fade than we witnessed an upsurge in various communicable and non-communicable diseases. Instead of increasing the overall health sector budget to better combat the ills of Covid-19 and other diseases, in a bizarre twist, the Ministry of Health and Population has decided to cut nearly two-thirds the budget for non-communicable drugs. although non-communicable diseases are responsible for almost 66% of the total number of deaths in Nepal.
Another worrying statistic is the increasing number of cases of vector-borne diseases that have in some way an interconnected link to climate change. A recent report of the United Nations states that at least six major vector-borne diseases (VBD) such as Kala azar and dengue have recently appeared in the Himalayan republic and are now considered endemic. Ironically, of the approximately 219 cases reported in 2020-2021, around 21 were reported in Kalikot district where the altitude ranges from 738 to 4,790 meters above sea level. The fact that increasing incidences have been reported in mountainous areas such as Mugu, Jajarkot, Humla, Jumla and Salyan indicates that warmer temperatures are creating fertile ground for the spread of VBDs.
And since the host in these regions is not immunologically prepared, it leaves the host seriously ill. VBDs are not a recent phenomenon in Nepal, but their emergence in areas considered non-endemic in the past will ultimately pose a significant health challenge. If the authorities are not careful enough, we could see a repeat of the situation the capital faced in 2019, when a dengue fever epidemic left more than 8,000 people hospitalized; thus exposing the fragility of the health system in Nepal and the incompetence and lack of preparedness of the authorities in the face of an emergency.
We have witnessed a ruthless approach to maintaining a hygienic standard of living from the authorities and at the level of the citizens; rubbish piled up on street corners reflects the low level of civic awareness in Nepal. And since VBDs mainly result from poorly maintained living conditions such as poorly designed water management systems, poor waste disposal and poor water storage, it is of the utmost importance that authorities s attack head-on the problem of civic ignorance. Unless there is a proactive approach, the question is not if but when.