Our Visit to Tipeni Health Post

“Please be prepared to cancel your trip to Tipeni if it rains. There are continuous landslides throughout the road,” said Mr. Mohan Dhakal, warning us of road conditions. Mr. Dhakal is the Program Coordinator for the Indrawati Jana-Sewa Samiti, which runs the community health post in Tipeni, Bhotenamlang-9 in Sindhupalchowk district. Our team - members of the Global Shapers Kathmandu Hub, some volunteers, and members of our implementing partner NGO Clean Up Nepal, were headed towards Tipeni, carrying medical supplies donated by the Sri Lankan Embassy and water purifying tablets provided by the Winning Edge Society in India, hoping the weather would hold up for a safe trip.

Despite the warnings from Mr. Dhakal, nothing could have prepared me for the view of landslides both left and right of us, as we headed to Tipeni. To cover a 9-kilometer distance from Melamchi to Tipeni, it took almost an hour and 15 minutes, even on an SUV. When we finally got to the health post, Mr. Mohan Dhakal was there to welcome us. The facility was completely destroyed by the first earthquake, sparing only 2 toilets, and a small open space on the ground floor. The health post is positioned on a plateau, a 5-minute hike behind a government school that was also completely destroyed by the earthquake. The school ground was where a team of medical doctors sent by Global Shapers from India, PHECT Nepal and Bangladesh set up a medical camp, spending five days in challenging conditions, successfully treating over 4000 patients. The health post team supported the medical camp team to from village to village to bring in serious patients and also to spread awareness on hygiene and sanitation and how to prevent the spread of diseases.

At the health post, Mr. Mohan Dhakal and Mrs. Shanti Dhakal have been actively treating medical cases since the earthquake, despite being victims of the earthquake themselves. The duo each have  over two  decades of work experience and training in both family planning and reproductive health. Before the quake, the Tipeni Community Health Post was a structure with 14 rooms (just over 5000 sq. feet service area) including a delivery room, post natal care room, store room, staff rooms, kitchen, guest rooms, and two rooms that accomodated six beds to hold in-patients. Although they are  only supposed to treat patients from four Village Development Committees (VDCs) - Bhotenamlang, Lagarche, Thangpaldhap and Banskharka; the facility caters to patients from 10 VDCs (or 90 wards). Annually, the health post provides services more than 18,000 patients from the area. The number including visitors and indirect beneficiaries reaches 36,000 individuals annually.

The team includes an Auxillary Nurse Midwife (ANM), a nursing support staff, and a helper -  all of whom continue to work day and night to support the needs of their community. Despite the destruction around them, the team has managed to organize a delivery bed, and salvage the neo-natal bed and some other basic equipment. They have also set up a tent with 5 makeshift beds using salvaged bricks and plywood; and another tent for storing supplies. Mrs. Shanta Dhakal shared quietly that they were blessed that a lot of the emergency medicine and first aid necessary did not get buried in the rubble. 

What shines through clearly is the team’s commitment to provide service to this remote community as well as educate adolescent girls in the nearby school on reproductive health and safety practices.

The Global Shapers Kathmandu Hub will partner with this community based organization, working tirelessly since the day of the earthquake, to rebuild their Healthpost, so that they can continue their high quality service delivery to residents of the area, who cannot afford to travel for treatment and also prefer to come here for low cost high quality service. The nearest hospital is in Dhulikhel which is a 3 hour drive. Seven weeks since the first earthquake, patients continue to trickle into the health post from 10-15 individuals per day complaining of diarrhea, fever and infected wounds.

The Global Shapers team’s plan is to come up with a schematic for the new health post structure while we wait for specific design guidelines from the government for a more permanent structure and get the necessary approvals from the District Level bodies. Simultaneously, an engineer will conduct an on-site sub-structure assessment as well as recommend what material can be salvaged and reused, and what needs to be disposed. A sizeable part of the expenses will also be used to remove the debris, as well as help clear the road to the health post as it going up to the health post has been washed away by repeated landslides.

Jana- Sewa, in Nepali, translates to “serving the people”. The health post is a testament to the resilience and courage of the committee running the facility despite constant reminders of the destruction that the earthquake has left behind. The Shapers are committed to helping Jana-Sewa recover and rebuild. With a twinkle in his eyes, Mr. Mohan Dhakal shared that he looked forward to meeting our young group with the same enthusiasm and zest as one waits for Dashain, Nepal’s most celebrated festival. We hope that by working with this community-led organization for the next 18 months, we will be able to rebuild the health post so it can provide the same quality health care service focusing on maternal health and deliveries, as well as community health. By the time the next festival season comes around, we can all celebrate in a resilient physical infrastructure held up by their even stronger team. The rebuilt health post will not just be a place where the sick come to get healed, but also a sign that the community is slowly but surely, getting back on its feet.

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