Health a casualty of Maoist attacks in Nepal
Attacks by Maoist guerrillas in remote regions have destroyed scores of health posts, leaving them powerless and deserted, with hapless villagers forced to fend for themselves.
Increasing attacks by Maoist guerrillas in remote regions of Nepal have destroyed scores of health posts, leaving them powerless and deserted, with hapless villagers forced to fend for themselves.
Several rural workers are fleeing health posts, of which Nepal has around 700. Many prefer staying in district capitals. Over a dozen health workers were among around 8,000 people killed in the eight years of Maoist insurgency, OneWorld reports.
A spokesperson for the president of the Nepal Paramedical Association said: "We are unsafe in the rural hinterland. Security forces and Maoist rebels both keenly monitor our movements."
The problem is exacerbated by the absence of local government bodies, whose terms expired and were not renewed in July 2002 because of political instability in the country. Several remote rural areas are under Maoist control.
In a desperate bid to improve the situation, the government has launched mobile health camps to cater to the population in remote, insurgency-affected areas. But these are not a viable solution to the pressing problem.
Information and Communication Minister Kamal Thapa said: "One of the aims of the mobile health camps is to provide services at the doorstep of the rural population. Tens of thousands of people have already benefited from such camps. Our aim is to continue to offer all kinds of services to the rural population."
According to the health ministry, over 1,000 community health service centres have already been destroyed. Since they are usually attached to buildings of village development committees -- a favourite Maoist target -- they are easy prey.
The World Bank's country assistance strategy progress report 2003 for Nepal revealed that the recent escalation of violence has destroyed one-third of the country's 3,900 village development committee buildings.
Around 85 percent of Nepal's population lives in rural areas.
The World Bank has now pledged to support the government's efforts to hand over sub-health posts to local communities, beginning with relinquishing charge over 500 such posts by the yearend.
The bank has proposed to upgrade the status of 150 mother and child health workers, construct 250 buildings by 2005 and vaccinate 250,000 people.
The lack of healthcare has taken a toll on the country's population, with the maternal mortality rate a shocking 830 per 10,000 and child mortality at 95 per 1,000.
Health ministry spokesman Hari Narayan Acharya admitted: "We're aware that many of our health centres are running without any trained manpower. The government is working out a plan to force health workers to work in remote parts of the country.
"The problem right now is to protect the existing health infrastructure as well as fill in vacant posts."
Maoists recently abducted the head of a health post in Baglung, west of Kathmandu. His whereabouts remain unknown. They stole medicines from a primary health camp in Pala of Baglung district and stopped it from functioning.
In the insurgency-affected district of Rukum, the main hospital has minimal manpower and equipment. It does not even have an X-ray machine. Of 249 health workers' posts in Rukum, only 159 are occupied.
Ramechhaap district, east of Kathmandu, is facing similar problems.
Kumar Kanel, from the village of Tokarpur, complained: "We have to undertake a day-long trek to the district headquarters for minor ailments because workers at a nearby health post deserted it a year ago."
According to the annual report of the Health Services Department, many rural health centres and hospitals do not have trained health assistants and lab technicians.
Roshan Karki, president of the NGO Ama Milan Kendra, which works with pregnant women, explained that trained health workers are reluctant to visit rural areas and local networks are unable to perform health services like administering vaccines.
Apart from regular health initiatives, polio eradication and national immunisation programmes have also received a major setback.
At a time when impoverished Nepal's health system is struggling to provide adequate healthcare, the insurgency has increased the woes of the population, especially the poor living in rural areas.