So many of the HMF’s newsletters over the years have related tragedies in this landlocked Himalayan country which includes floods, avalanches, landslides, earthquakes, political upheaval, power and water shortages, closed borders, and embargos. I could go on but you know the story. However, the year 2019-20 has been a catastrophic year, not just for Kathmandu, Nepal but for the USA and many parts of the world!!
This year our world finds itself in multiple crises with devastating hurricanes, floods, forest fires, and political instability rarely experienced in such a short time and all at once. In addition to all of the world’s current challenges none has had the impact as the deadly worldwide Sars- CoV-2 pandemic. As of the time of this writing, there are over 57,184,355 world- wide cases with 11,364,458 fatalities. It’s is hard to imagine the level of suffering and loss.
This Newsletter will devote itself to what has/is happening in Kathmandu, Nepal from the HMF’s perspective. Kathmandu’s epidemic has a bit of an unusual story.
After the first Lock Down, the air quality of Kathmandu looked like this. Amazing is it not?
Under most circumstances there would be a thick brown haze and the mountains in the distance would be obscured.
The first documented case of COVID in Kathmandu occurred on Jan. 23, 2020 when a 32 year old Nepali male studying in Wuhan China returned to Kathmandu with a cough and fever and was quickly treated at a local Hospital. He did survive. After that life remained the same, there was no outbreak of the virus, Kathmandu was not too concerned, and our HMF clinics were all open and functional.
We also continued to take our portable Dental Units to more remote monasteries, community schools and orphanages. Our two Dentists, Drs. Karma Tashi and Karma Drolmo have been very busy. Using our portable dental units, they moved our dental clinics outdoors under awnings so that they were not doing their work in closed spaces. Our medical clinics continued to operate indoors with the addition of masks and vigorous hand washing.
For awhile, there were no further documented cases of COVID in Kathmandu and it was uncertain how the pandemic would affect Kathmandu in the future. The second documented case of COVID occurred in Nepal on March 23rd. This case came up from India. The virus does not know about borders and once the cases in India started to escalate, so did they in Nepal, first at the border towns and then Kathmandu. Kathmandu valley with over 3.5 million people is a petri dish for COVID. Over population, difficulties with the ability to social distance, severe air pollution problems, and lack of enough hospitals with ICU beds, all contribute to a situation where the cases would rapidly increase. In Nepal there are a total of 194 hospitals with ICUs and a total of 840 ventilators for the entire country. So the situation is a little grave.
On March 23 the number of new cases in Kathmandu started to escalate to over 1,000 cases per day and the government declared a Lock Down. No one could leave their homes except for a few hours in the evening for groceries, supplies, water, etc. All non essential businesses were closed (sound familiar?)
Wisely, all the Monasteries and Nunneries went into a prolonged Lock Down. No Monks or Anis could leave the monastic grounds and it has been this way for close to 8 months. Also, there has been a strict rule about who can enter the gompa grounds. At this time, there has been no significant outbreak of the COVID in the monasteries which is really good news.
Twelve Benchen Gompa monks who were not ill were tested for COVID. All tests were positive. The next day they were all retested and all of them tested negative! So, it appears many of the COVID testing kits in Nepal are unfortunately unreliable. (Sound familiar?)
The big question for the staff of the HMF was how to respond to this new dilemma. The population of Kathmandu was living in a Lock Down status and the police were handing out fines for anyone found out on the streets. So it was difficult for the HMF to fully operate during this time.
After some thought and consideration the HMF staff created a form of Telemedicine, using cell phones, We Chat, and laptops were also used when possible.
The HMF has volunteer medical monks and nuns who live in the Gompas where we have clinics. These are special folks who have a real interest in being of service to others and volunteer their time to help keep the clinics clean, well stocked with medical supplies and medications and over time they have naturally learned how to take care of the more basic and simple medical problems. They also help to manage the inevitable chaos that manifests at most of our clinics when we are open. (It is a Nepali thing and hard to change).
The HMF staff worked out a system where patients with medical problems (mainly monks and nuns) would come to our monastery clinics during the Lock Down period and were seen by our medical assistants who live at the Gompas. They would evaluate the patient and then communicate via We Chat or Laptop with one of our Health Assistants who were not able to be physically present. So the patient was at least seen and then a medication if needed was prescribed. That was about the best we could do during the lock down periods. While certainly not perfect, this approach has worked reasonably well.
This has been a stage of alternating Lock Downs and periods of more relaxed guidelines depending on the COVID statistics. Operating the clinics in this environment has been a real challenge. If you look at the photo of our Benchen Clinic waiting room taken before the pandemic, you will notice most patients are not wearing masks or observing social distance. Living in close quarters is just a fact of life in Kathmandu, considering the population density.
For now the Benchen medical/dental clinics are closed to the general population because many COVID cases would come into the monastery compound and pose a significant risk to the monks who live there.
ADARA is a wonderful humanitarian NGO out of Australia who has worked with the HMF for decades. They generously donated an ample supply of PPEs (Personal Protection Equipment) for the HMF staff. This has allowed the HMF to reopen some clinics where wearing masks and social distancing has been difficult. We have tried to keep patients 6 ft. apart but maintaining this is nearly impossible in some of our clinics.
Health Assistant Bishnu Taking Vital Chhirring Helping Staff HMF Nurse Wearing PPE Gathering Signs of Patient with PPE Patient Information
The COVID-19 virus is very unpredictable, destructive and deadly. It is our hope that through the use of masks, social distancing, restrictions on large gatherings as well as a vaccine, the world can get this terrible pandemic under control.
It appears a vaccine will become available within months in countries such as the USA and Germany. Third world countries unfortunately will not see the introduction of a vaccine until much later. Until the active cases numbers truly decline in Kathmandu, the HMF will continue to adapt and find ways to provide medical and dental care to our patients.
Since it was not possible to travel to Kathmandu this year due to the Pandemic I have fewer photos and stories to share. I went through the HMF photo archives and inserted a few photos of past times.
I hope you enjoy a travel down memory lane.
The HMF staff in Nepal and I would like to express our profound gratitude to you and your generosity in helping the HMF operate over these 27 years. I hope our stories and photos continue to inspire your kind support. The HMF is a 501 c 3 nonprofit organization and all donations are tax deductible. Our operations, staff and budget continue to expand as does our work, so your continual support of our work is greatly appreciated.
Please make a donation via Paypal, or make out a check to the HMF.
Our mailing address is:
The HMF, 608 Portside Court, Lafayette, CO 80026
Dr. Greg at HMF office at Benchen Gompa.
Dr Gregory Rabold, Founder & Medical Director HMF
Phone: 720 387-8087