DHANGADHI, DECEMBER 11

Renuka Dhungel, a health volunteer from a small town south of Dhangadi near the Indian border, used to watch neighbours struggle every time someone needed medical attention. "Earlier, locals had to travel 17 kilometres to Seti Provincial Hospital for advanced health screening. It was a hassle. Our community health post lacked even basic equipment," she said.

Now, her town has gender equality and social inclusion responsive health screening desks, with separate spaces for men and women. A multipurpose shelter stands nearby with 16 hospital beds and oxygen support.

"I can get the same services here that I would at Seti Hospital," she said. "It's a relief for everyone."

Her town is part of the Prevention and Control of COVID-19 through WASH and Health Initiative in Secondary and Small Towns, known as PCCWHISST.

The five-year project was fully funded by the Japan Fund for Prosperous and Resilient Asia and the Pacific and administered by the Asian Development Bank. It aimed to strengthen local governments' capacity to prevent COVID-19 and respond to future health emergencies.

Its total funding was $5.5 million, with $5 million from the Japan Fund for Poverty Reduction and $0.5 million from the Government of Nepal.

All 20 multipurpose shelters, including two in Dhangadi, have been completed and handed over to municipalities. Each shelter accommodates 16 beds with oxygen support.

Yogesh Awasthi, chief of the Environment, Drinking Water and Sanitation Unit at Dhangadi Sub-metropolitan City, said the shelter functions like a small hospital. "It includes X ray, ECG, lab, and pharmacy for emergencies. We also plan gynaecology, fertility, and sanitation awareness programmes," he said. "We have announced vacancies for one MD in General Practice and Emergency Medicine and two MBBS doctors. They are expected to join in January."

ADB designed the project to meet GESI standards through accessible layouts and separate sanitation spaces. Municipal staff and sanitation workers received training to deliver services in a GESI responsive way. Women, marginalised groups, and persons with disabilities were consulted during site selection and planning. The project also introduced GESI sensitive health and safety protocols, trained women from vulnerable groups in home based soap production, and strengthened skills of sanitation and waste workers, one third of whom were women.

Shuveccha Khadka, senior gender and social development officer at ADB, said inclusion was central to the design. "We focused on universal access, privacy, and safety so that women, persons with disabilities, and vulnerable groups are not left out during emergencies. These services now support daily life and will remain critical in future health crises," she said.

Meanwhile, the multipurpose shelter near Dhangadi Airport is being used as the Ward 13 office after the original office was vandalised during the GenZ movement.

"We are temporarily operating administrative activities from here. We are using one hall and two rooms in full operation," said Lal Bahadur Chaudhary, executive member of Ward No 13 of Dhangadi Sub-metropolitan City.

Across 15 towns, including Dhangadi, the project has produced visible changes. Streets that once had open defecation now have public and mobile toilets. Children wash their hands before going to school. Vendors maintain cleaner stalls.

Pratima Kumari Chaudhary, a student in Motichowk, said the improvement is clear. "People used to urinate in the open spaces. Now we have a proper public toilet. It feels safer now," she said.

Construction of all 15 public toilets is complete. All 30 mobile toilets have been delivered.

In Dhangadi, two mobile toilets are used during public events. The sub-metropolis charges Rs 5,000 per event.

All 128 handwashing stations have been installed. Daily routines have changed as hygiene has improved. Schools promote handwashing. Municipal staff can now plan and manage public health responses more effectively.

Awasthi said the improvements had strengthened officials' confidence to respond faster to outbreaks, communicate with residents, and keep public spaces clean.

The COVID 19 pandemic hit Nepal's economy hard. Tourism, retail, and transport suffered to a colossal extent. Nepal recorded 595,364 confirmed cases and 8,098 deaths as of June 8, 2021.

PCCWHISST aimed to restore stability through stronger basic services and simple health practices.

Roman Bhattarai, project analyst at the ADB Nepal Resident Mission, said the project tackled the gaps exposed during the pandemic. "PCCWHISST helped towns like Dhangadi fix gaps that became visible during the COVID-19 pandemic. Local governments did not have resilient infrastructure, proper hygiene facilities, or the capacity to respond fast," he said.

He said ADB focused on building municipal capacity to operate and maintain WASH and health facilities, strengthening community engagement, and integrating services into local plans with budgets for maintenance.

A total of five secondary towns now have a five-year emergency and preparedness plan with GESI responsive measures.

Bhattarai said the project also offered lessons for future emergencies. Inclusive WASH facilities increase resilience. Community engagement supports behaviour change. Handwashing remains the most effective preventive measure. Small towns need strong systems because they act as first responders for nearby rural areas.