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A quarantine zone at Nepal Army’s headquarters in Tundikhel. Photo: BIKRAM RAI

By now the novel coronavirus pandemic has affected every corner of the globe. If it has not brought disease, it has at least brought the fear of infection. Cities, and indeed entire countries, are in lockdown. Fortress Europe has raised its walls higher. Airlines are grounded. Nepal has banned trunk international routes from Friday night. Even countries with excellent public health facilities and emergency preparedness plans are overwhelmed.

Nepal is now so closely intertwined with globalisation through migration, tourism and trade that its already-fragile economy has been badly hit even before a full-blown health emergency hits. Ironically, less-developed countries seem to have a built-in resilience that comes from being crisis-prone — since they are lower down in the economic ladder, they have a shorter distance to fall.

Read also: Poor health makes Nepalis poorer, Editorial

Despite Nepal’s surprisingly dramatic improvements in mother-child survival over the past two decades, the public health system here is in crisis. State-of-the-art modern hospitals in the city, while reducing the need for Nepalis to go abroad for treatment, are out of reach of a majority of the population. Government health facilities are more affordable, but for the most part medical care there is not up to mark.

 

Nepalis are still afflicted by easily preventable water-borne diseases like typhoid and diarrhoea, vector-borne infections like malaria, encephalitis or dengue, and illnesses like tuberculosis and acute respiratory infections that spread through breathing. Great inroads have been made in reducing the impact of communicable diseases in the past decades through awareness programs, vaccinations and safer drinking water, but children in remoter parts of Nepal are still dying of simple infections.

Read also: A shot in the arm for vaccines in Nepal, Sonia Awale

On top of this, urbanising Nepal now also has the added burden of non-communicable afflictions like diabetes, cardio-vascular ailments and renal disease. As families move from the districts to the cities, changes in diet and more sedentary habits have given rise to an epidemic of lifestyle-related diseases. This is compounded by genetic susceptibility among South Asians for diabetes and heart disease.

For example, a study by the BPKIHS in Dharan showed that while the national average for Type 2 diabetes prevalence is 8.1% of the population, the incidence in Dharan was 14%, while it was only 1% in Taplejung. The prime minister’s own second kidney transplant this month showed that ignoring risk factors and not diagnosing non-communicable diseases can lead to a huge health burden for families and the state. A small percentage of Nepalis have health insurance, so many middle income families fall below the poverty line due to medical expenses. Many Nepali migrant workers have been forced to seek jobs abroad to pay ba


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