Deadly Diarrhoea: Where has all the money gone?

KATHMANDU: Diarrhoea has been spreading in the mid-west and far-west districts but the government claims the disease is under control. A hefty sum has been spent in the name of healthcare facilities for the afflicted but more than 270 persons have succumbed to the disease in Jajarkot, Rukum, Dailekh, Surkhet, Dolpa, Sal-yan, Rolpa, Dadeldhura, Achh-am, Bajura, Baitadi and Bajhang in the last three months.

Thousands of people are suffering from the disease. Officials say only three deaths have been reported in the health camps and that the rest succumbed to the disease without availing of the health facilities.

The government spent more than US$ 26,140 on arranging VIP visits to the affected region. The Ministry of Health and Population (MoHP) has disbursed more than US$ 352,941 (Rs 30,000,000 plus) for medicines for the affected areas. UNICEF mobilised US$ 93,330 from internal funds — US$ 82,560 for water, sanitation and hygiene (WASH) activities and US$ 10,770 for health-related activities — to respond to the diarrhoea outbreak. The Action by Churches Together (ACT) Co-ordinating Office has approved the use of US$ 59,637 from its Rapid Response Fund.

Nepal Red Cross Society (NRCS) requested in-country partners and partner National Red Cross Societies to chip in US $256,930 for its operation in response to the outbreak. Save the Children (SC) Nepal required US$ 100,000 to cover the funding gap for its planned activities against the diarrhoea outbreak. It channelled US$ 10,000 from regular programmes for the diarrhoea outbreak response. It received US$ 3,000 from Save the Children Headquarters and US$ 15,000 from the Halady Murchy Fund, SC US, to support activities in line with the government’s short-term and long-term plans.

The Swiss Red Cross has committed Rs 1.5 million for volunteer mobilisation activities in the affected districts. UNICEF has agreed to provide a small-scale grant of around Rs 252,200 for volunteer mobilisation in Jajarkot. Nepal Family Health Programme has agreed to provide Rs 199,500 support for conducting sanitation and hygiene campaign in the affected areas. WHO, which mobilised only two medical officers in Jajarkot, said it also supplied 54,000 Aquatabs tablet in the diarrhoea-hit region.

Epidemiology and Disease Control Division (EDCD), WHO, International Nepal Fellowship (INF), Helvetas and CARE Nepal have been coordinating with health workers. MoHP, EDCD, WHO, NRCS, UNICEF, DEPROSC, NEWAH, Save the Children, MALIN, and ADRA Nepal are providing medical supplies. WSSDO, DHO, NRCS, UNICEF, DFID, GTZ, USAID, DEPROSC, HRDC, YARCN, NEWAH supported by Concern Worldwide, ADRA Nepal, Paschim Pailla, and the National Health Education Information and

Communication Centre (NHEICC) have been spending money to support hygiene promotion in Jajarkot and Rukum. Social welfare campaigns have also been launched to collect funds for diarrhoea-hit people. Over 50 (I)NGOs have been running health-related projects in the mid-west and far-west regions for years.

Media and reliable reports compiled by the community-based organisations show that scores of patients have been deprived of proper healthcare. This begs a question: Where has all the money meant to combat the disease gone? Has it benefitted the intended

target? Dr Laxmi Raj Pathak, focal person of Outbreak Response Team, said lack of preparedness resulted in spending hefty sums in the region. “The government delayed its response to the disease,” he said, adding that the disease could have been under control had the amount been spent on providing safe drinking water and sanitation facilities. He, however, added that the government initiative provided health treatment to more than 29,000 residents in the region.

Rajendra Bikram Shahi, chairman of the Civil Society, Jajarkot, condemned the government for its failure to address the crisis. He claimed that the fund meant for the diarrhoea-hit region had been embezzled. Thousands of bedridden people have been deprived of treatment, he

said, alleging that health officials sold the medicines to

private medical operators.

The aid agencies have been spending the money on their field workers rather than providing health facilities to patients, he claimed.

British PM’s offer

British Prime Minister Gordon Brown has written to the Government of Nepal urging it to consider making healthcare free and offered Britain’s help in the transition period. He also offered to help Nepal make healthcare free - starting with pregnant women and children - in a push to widen access to doctors across the country. DFID has also pledged to spend £ 6 billion on health in the poorest countries in Asia and Africa by 2015. It has adopted a new approach: Free public healthcare should be the norm for the poorest countries; fees for health are lethal. Britain also plans to make free healthcare in developing countries one of its key campaigning issues in the run-up to the G20 meeting in the US, in September.

In 2007, the government had come up with a plan to make health facilities and medicines available at all health posts free of cost but the recent diarrhoea outbreak proves otherwise.

DFID has earmarked $30 million for a period of five years from 2005-2010 in support of the government’s HIV/AIDS programme. It had invested $100 million in Nepal’s health sector over the past five years.

Sarah lucky, not Bagmati

Sarah Sanyahumbi, head of DFID, Nepal in her latest blog wrote: I’ve been thinking about health a lot. I have two small children who are both adapting well to life in Nepal. Both my children were ill this week (mid-May), and I took them to a local baby clinic here in Kathmandu, where both received good care and medicines. And in the way that healthy children do, both bounced back to health quickly. But they are definitely the lucky ones. Each day in Nepal 200 children under five years of age die.”

But the reality is far worse than what Sarah has admitted. Hari Bahadur Nepali, 55, a resident of Jajarkot’s Dhime VDC, lost three members of his family in two weeks. His wife Gauri Nepali, 35, eldest son Dhan Bahadur, 13, and daughter Kali, 7 succumbed to diarrhoea due to lack of treatment. Thirteen-year-old Bagmati Devi BK of Gotamkot in Rukum district has been left to fend for herself as her parents lost their lives to diarrhoea without getting medical facilities.

Saraha further wrote: “So, while I feel incredibly lucky that my family and I have access to good medical care here in Kathmandu, I’m also proud to be part of something that is trying to provide a better level of care to poor people all over this beautiful country.”