Tuesday, April 11, 2017

Health Education on Hypertension in Remote Alpine Villages of Nepal

Katherine Garlo, MD
Nephrology Fellow at BWH/MGH

Health Education on Hypertension in Remote Alpine Villages of Nepal
Blog Entry 2

This is my second visit to Nepal and much has changed over three years. The earthquake hit on April 25th 2015 and the country is attempting to recover from its devastating consequences. The tally includes 9,000 people killed and nearly 22,000 with physical injury.  This does not include the victims suffering from severe mental health illness and displacement from their homes.  The earthquake has a reported magnitude of 8.1Ms and the epicenter was located in the Gorkha district very close to the Ganesh Himal mountain ranges greatly affecting the Sertung and Lapa villages. Nearly 250 people went missing after an avalanche in the Langtang valley.  Much of the progress in infrastructure in the villages has been destroyed.  Houses, schools, transportation routes, bridges etc are having to be rebuilt. The country has received humanitarian international aid in the form of food, healthcare, and other services.  Himalayan Health Care has been instrumental in assisting after the earthquake. They have helped to rebuild health posts and schools. They have also had success with toilets, community agriculture, a local wood mill, and veterinary medicine.  Several of our trek members provided medical care in the villages immediately after the earthquake. There has also been an influx of NGOs in attempt to provide relief.

Major differences that I have noticed include increased access to water through pipes and new electrical lines. The electricity runs intermittently for certain hours of the day in some of the villages; it is better than nothing.  In comparison to my last visit, I also observed more diversity in agricultural crops and more farm animals. The priorities for these remote alpine villages remain: sanitation, clean drinking water, childhood vaccination, malnutrition, and infant maternal morbidity.  These factors fall under the umbrella of improved education, access to healthcare, and infrastructure development.

 Local newspaper story on government reconstruction of UNESCO world heritage sites in Kathmandu
Kathmandu has also changed after the earthquake.  Many of the UNESCO world heritage sites of Hindu and Buddhist worship were damaged  Reconstruction at Patan Durbar Square and Boudhanath stupa  is underway.   
Earthquake damage and reconstruction at Patan Durbar Square

Boudhanath stupa in Kathmandu
Kathmandu valley suffers from air pollution, often requiring mask protection.
Hourly air pollution levels in Kathmandu

Selling rice in Kathmandu

Kathmandu street with stupa

However, the government is making efforts to address pollution and waste control.
Local newspaper story on government  project to improve sanitation and clean drinking water through defecation free zones

Trashcans at Swayambhunath Stupa

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