In these most turbulent of times, this page will include updates about the INF family’s response to the coronavirus (Covid-19) pandemic in Nepal.

Find out more on our dedicated Coronavirus webpage www.inf.org.uk/covid19, including how to pray and give.

 

Update from INF Nepal on Tuesday 14th July:

There are currently almost 17,000 confirmed cases across the country and sadly now 38 people have died. This week the effects of the virus struck home in INF as five people from our Shining Hospital in Surkhet were tested positive. All are now in isolation, although none have shown any symptoms and all are fine. The local health authorities followed up with contact tracing and testing and no one else has tested positive. For the first few days the hospital closed but with the contact tests coming back clear, low-key outpatient services are now resuming. The ambulance there is still being used on a regular basis to transport people to isolation centres who have tested positive.

Our community teams have continued to donate hygiene items to quarantine centres. In Dang we have helped 10 centres with items such as soap, toothbrushes and toothpaste as well as food. In Banke we will be delivering food items to households in our working areas.

At Green Pastures Hospital, a more permanent system has now been established for checking temperatures, collecting details and washing hands. Near the gate a series of proper wash basins have been installed and the fever checking and registration for Outpatient Departments are now taking place in a building near the gate. Recognising that this situation is going to be around for a long time, the GPH team did some rearranging and renovation to ensure better service for patients and staff.

Nepal is now facing another threat that will cause death and destruction across the country. The annual monsoon season has begun and already in several places torrential rain has caused flooding and triggered landslides that have taken lives and destroyed homes, land and crops. From 8th July to date, based on government figures, 52 people have died through landslides and floods. The worst affected areas are spread across the country but there have been some deadly landslides in Kaski district, not far from Pokhara where our head office and Green Pastures Hospital are based. Another of our working districts, Kalikot, has also seen flooding and landslides. In addition to the dead, another 45 people are currently missing and 244 houses have been damaged or destroyed. We are currently seeing how best we can help the affected communities.

Pokhara Christian Community / Asal Chhimekee Nepal gave more detail about the situation in Nepal and their relief efforts on Sunday 12th July:

Lockdown has been eased in some areas, based on the prevalence of cases. Small construction works have started such as road constructions, building constructions and so on. Hotels, tourism industry, and mass production factories are still closed. The movement of people seems very risky in the market, shopping centres, government offices and public service centres. Schools, churches and other public places where people would gather in mass are still prohibited to meet. The Government of Nepal has been bringing back stranded Nepali workers from other countries such as the Middle East, Malaysia and Korea. Their conditions in foreign countries has been really miserable, as they have been waiting to be rescued – without jobs, food and any help for months.

ACN started their Covid-19 response hoping to help 250 families in the beginning, then 500. To date, they have been able to serve the needs of 2,043 families (about 10,000 people) with food supplies – 605 of these families received food packages thanks to your donations to INF/UK. We are so thankful to God for his faithfulness and for the people who gave for this purpose.

 

Update from INF Nepal on Tuesday 30th June:

The number of people testing positive continues to rise rapidly, and we now have more than 13,000 confirmed cases and sadly 29 people have died. On the positive side, more than 3,000 have officially recovered after contracting the virus.

As the government has announced a loosening of the lockdown restrictions, we are tentatively restarting some activities in our community projects. This will be in line with local restriction guidelines and in discussion with local authorities. Each office will be completing a local risk assessment as they start their activities again.

Our community teams have been supporting some quarantine centres in their areas at the request of local authorities. In Banke, in our working area of Raptisonary, we donated hygiene items such as soap, toothbrushes, toothpaste and sanitary pads, as well as masks, mosquito nets and water tanks and equipment to make hand washing stations. Similar items were also donated to a quarantine centre in Mugu along with food packages for approximately 90 people staying in the centre. Our team in Surkhet donated the same sort of hygiene items to seven smaller isolation centres in their area.  In Bajura the team are also helping a local quarantine centre with WASH activities such as building latrines and hand washing facilities as well as providing materials such as soap, masks and also PPEs for the centre staff and volunteers. We are now receiving requests to support quarantine centres in some of our other working areas and will be assessing the requests in the Covid response team meetings.

In Banke food packages and masks were donated to another quarantine centre and in Bajura we will be donating food and hygiene packages to up to 625 households.

In Green Pastures Hospital, overall outpatient numbers are staying at about 80% of what we would expect under normal conditions but it is only about 50% in the Ear Centre. The telehealth and community outreach services are ongoing and to date 180 people with disabilities have been contacted and supported remotely. Nineteen people with spinal cord injuries have had a visit from the community outreach team and during the visit they were given a care package as they are unable to get out for essential supplies such as catheters, tubes and gloves. The palliative care team have increased the frequency of their community visits and are finding people with developing complications as local facilities are not providing the regular care that such people need. There is also a noticeable fear in some communities that a hospital vehicle will bring coronavirus to their areas and as a result some people are actually refusing visits from the team.

 

Update from INF Nepal on Tuesday 16th June:

The number of people testing positive continues to rise rapidly, with the total more than doubling in the last week to 6,211 as of today. Nineteen people have died.

The government has outlined its plans for the new modality lockdown. There is a general easing of restrictions across the country but it the amount of easing depends on the number of cases in an area. Travel between districts is still restricted although some public transport is allowed within district.

The team in Banke distributed food packages to 150 households in one of our working areas in Banke district, at the request of the local Rural Municipality.

The ambulances in Banke and Surkhet are continuing to transport people who have been tested positive to isolation centres. Up to last week the Banke ambulance had transported 148 people and the Surkhet ambulance 53.

In Green Pastures Hospital the number of outpatients is staying steady at about 110 per day but this is still much fewer than previously. The community outreach services are continuing – reaching out to those people who cannot get to the hospital. At the same time we are making some permanent changes to the way people come into the hospital by making some fixed wash basins for handwashing on arrival, and a new registration system to help speed up the process up and still maintain handwashing and temperature taking protocols at the gate. Some of our doctors recently visited the isolation unit at the local government hospital in Pokhara for information and learning.

 

Update from INF Nepal on Friday 5th June:

The last week has seen a large increase in the number of people testing positive for coronavirus. Most days of the week have seen well over 150 new cases per day and that number is still rising, with 288 new cases identified on Thursday, bringing the total to over 2,600.

The lockdown is in place until 14th June and the ban on international flights has been extended to the end of the month, except for repatriation and cargo planes. There are increasing calls from businesses for the government to come up with new ideas other than extending the lockdown, and the government themselves have said they are considering a ‘new modality’ for lockdown.

Cases in our working areas continue to rise and restrictions in some areas are very tight, even with curfews in some places. Most districts have traffic bans across their borders and special permission is needed to travel between districts. In some places the army is being deployed to manage migrants returning, to run quarantine camps and to patrol national and internal borders.

It’s been a quiet week in our community teams but there have been some requests from local authorities for food relief which we will be responding to in the coming week.

At Green Pastures Hospital (GPH) there was an orientation programme on disability inclusion and rehabilitation in Covid response for nurses and paramedics of hospitals that will be front-line Covid hospitals.  Medical staff from three Pokhara hospitals attended.

The telehealth services are continuing from GPH and both the Palliative Care and the Rehab Community Teams have been out visiting clients who cannot get to the hospital because of lockdown or their personal circumstances. The Palliative Care Team have doubled the amount of visits they are doing and the Rehab Team went out for the first time, having contacted 20 people with spinal cord injuries who requested support.

 

Update from INF Nepal on Friday 29th May:

The past week has seen the biggest increase of confirmed cases here, with the number standing at 1,042 at the time of writing, an increase of over 500 in a week.

Thousands of labour migrants are now making their way back to Nepal over the Indian border, where some are being held in quarantine camps either on the border or at internal provincial borders. Others are having to spend nights out in the open as they are being prevented from continuing their journey home because of the clampdown on travel, but they are also not being given shelter, food or water in the places where they are held. There have been many news reports covering their plight during the week.

Cases in our working areas are rising and both the Banke and Surkhet ambulances have been involved in carrying people who have tested positive to isolation centres. The drivers of both ambulances have been given training and support in how to protect themselves and to clean the vehicle afterwards.

We have continued to give out food packages to needy families at the request of local authorities. In Rolpa this week we delivered food packages to 79 households. The local NGO Federation of Bajura district met in the INF office there to plan how they, as local organisations, could coordinate their response in that district.

One INF staff member from Green Pastures Hospital (GPH) has received training in conducting tests for corona virus, after which we were given some testing kits, and so GPH now has some capacity to test our own patients that may be corona suspects.

All people reporting to GPH as inpatients now have to wear masks while they are on site. Those that don’t bring one with them are being provided with masks.

As the telehealth services expand at GPH we are also planning to provide some community support to clients who cannot come to the hospital because of their circumstances and lockdown. Both our Palliative Care team and Rehabilitation Team will be increasing their community outreach – if people can’t come to us, we are trying to get to them. The outreach team is also planning training for staff from the government-identified ‘Covid hospitals’ in the Pokhara area on how to care for people with disabilities.

 

Update from INF Nepal on Friday 22nd May:

The government has extended the lockdown until at least Monday 2nd June. Cases are continuing to rise across the country and, at the time of writing, the official figures stand at 487 confirmed cases and since the last update, sadly, three people have died.

With more confirmed cases of community transmission in the country, Green Pastures Hospital (GPH) has reviewed its protocols and while we were encouraging more outpatient visits in the last few weeks, we will seek to maintain a lower level again. The telehealth services will continue and patients will be invited to attend the outpatients department but we won’t be openly advertising our services. The GPH isolation ward has been brought into use to monitor all new inpatients for 48 hours before they move to the normal wards and other inpatients who have a fever or who may have other higher risk factors will be kept in isolation.

Staff in the INF Ear Centre, part of GPH, are trying to develop special face masks with clear plastic inserts that protect and yet allow the person’s mouth to be seen so that speech therapy and lip reading can carry on.

The Shining Hospital INF Banke ambulance was used to carry a person who tested positive in Banke to an isolation hospital in Dang district, as there were no beds available in Banke district.

INF’s hospitals in Banke and Surkhet have started a low level of outpatient clinics for check-ups for existing clients and medicine reviews. All visitors are having temperature checks and hand washing protocols are enforced.

In Surkhet, Jumla and Mugu our teams are delivering essential food packages to the houses of people with disabilities and their families. A total of 100 families will be receiving packages during the distribution programmes.

There are some areas that are being identified as Covid ‘hotspots’ across the country. These are places where the number of confirmed cases is higher than other areas and where the numbers are continuing to increase. Two of these are also INF Nepal’s working areas, namely Kapilvastu and Banke.  Another cause for concern for our community teams is that there are increasing numbers of people coming back into the country from India illegally. All returnees should go into quarantine for 14 days before being allowed to return to their homes, however with increasing numbers sneaking back in at night and avoiding all checks, there is a very high risk that infected people are returning home without thought of quarantine or self-isolation on arrival. People smuggling is on the increase as are cases of human trafficking and sexual assault. Our community teams continue to receive requests for help and are monitoring their project areas by keeping in contact, as best they can, with the self-help group members.

As always, thank you for your ongoing interest and support for all that INF Nepal is doing.

 

Updated on Monday 18th May:

The Nepal Government has extended the nationwide lockdown until Tuesday 2nd June. Official figures show there has been a rise in confirmed cases across the country with the number now standing at 295. Over the weekend the first 2 deaths caused by coronavirus were recorded in Nepal.

Update from INF Nepal (on Friday 15th May):

We realise that in comparison to most countries the number of confirmed cases is very low but as the numbers keep rising, despite the lockdown, so the tension, fear and false information continues to spread.

The INF Covid-19 Response Team meets regularly and one of its functions is to keep INF staff informed about the realities of the Covid situation. We have produced guidelines and protocols for staff on staying safe during food distribution programmes, how to sterilise equipment including vehicles, as well as the ongoing training for medical staff on a variety of Covid related issues.

The Shining Hospital INF Banke (SHIB) ambulance has been used to carry a few more positive cases from their homes to the quarantine centre. A ‘fever clinic’ has been set up in SHIB as we are now reopening the outpatient department for its normal dermatology/leprosy services.

Outpatients are starting to come in increased numbers to Green Pastures Hospital (GPH) but, as lockdown continues, we are seeing less than 50% of our normal case load. This is obviously having a serious impact on the hospital income, which we are monitoring closely. With efforts focused on Covid response and the drop in income, there are also fears that other services will be affected, such as our ability to help poor patients through our Medical Charity Fund. We are using the Medical Charity Fund at this time to cover additional costs such as food for relatives and transport for inpatients to return home, as there are no public vehicles.

With help from WHO, GPH is running a telehealth service to help persons with disabilities (PWDs).  This service will benefit hundreds of patients in our records from the last five years, through the calls from our end, discussing their issues and also providing orientation on health hygiene in the current situation.

Some of our community teams have been busy providing support to the local government in distributing food packages. This week we helped:

• 75 households in Mugu, 37 in Bajura, 140 in Banke, and 294 in Kapilvastu.
• 25 PPEs were also handed over to the Health Directorate in Pokhara.

Our Communications Team has now produced two videos along with the local Ministry of Health and the WHO.

 

Update from INF Nepal on Thursday 7th May:

We heard yesterday that the lockdown has now been extended until 18th May. Although some areas have no confirmed cases, there are other places where more have been detected and so the government decided to carry on with the lockdown in all areas. The city of Nepalgunj, where one of our leprosy hospitals is based, has even been placed under curfew as a number of people were tested positive there in the last few days. Official figures say there are now 99 confirmed cases across the country.

The INF team in Nepalgunj has been requested to provide our ambulance for transporting people who have been tested positive to the government isolation hospital.  Most of those who have tested positive come from one community, which is causing some tension within the area. In Surkhet, where INF has another hospital, we have also been providing our ambulance for transporting people from the quarantine centre to the government hospital.

We are receiving more requests to support local governments with humanitarian aid and other equipment. In Jumla, we have provided tarpaulins for a quarantine centre. In the next few days we will also be supporting food distributions in Mugu, Banke and Kapilvastu districts. Exact numbers are yet to be confirmed but we will be helping more than 400 households in total.

Despite the lockdown restrictions, we are now seeing an increase in the number of outpatients coming to Green Pastures Hospital (GPH) in Pokhara. With no public transport available many people still cannot reach the hospital and so telephone consultations also continue. We’ve also been able to admit some inpatients for surgery. GPH community outreach have also been contacting and offering support and advice over the phone to people on our books who are leprosy affected or who have a disability. Whatsapp and Viber groups are being set up to send out helpful information.

We have recently been able to purchase more supplies of PPEs and other essential equipment. We have agreed to give 25 PPE sets to the local health department in Pokhara, and we will also supply the government regional hospital in Pokhara with PPEs and medical equipment in the coming days.

Members of our Communications Team have been working closely with the local Ministry of Health and also the WHO. Part of their work has been to produce information videos for people with disabilities.  You can see the results here.

Once again, on behalf of everyone in INF Nepal, thank you for your continued interest and support.

 

Update from INF Nepal on Wednesday 29th April:

At the time of writing there have now been 54 confirmed cases of Covid-19 in Nepal but still, thankfully, no deaths. We are still not hearing reports of any increase in lung-related emergency cases across the country. Lockdown has been extended up to 7th May.

Our community teams have been supporting the people in their working areas in various ways at the request of the local authorities. Here in Nepal there is a ‘one-door’ system for humanitarian assistance, meaning that no organisation should work independently but that all have to coordinate with the requests of the local government. So far in our working areas, across the western part of Nepal, our teams have responded to local requests by providing:

• Over 300 face masks and 15 full PPE sets to government health staff and police
• 125 bars of soap to local government offices
• 215 food packages to needy families
• Tarpaulins, blankets and water tanks for quarantine centres

We are continuing to respond to requests as we receive them.

Green Pastures Hospital continues to run the ‘fever clinic’ as directed by the local health authority and the rest of the hospital is as prepared for an outbreak as it can be, should that happen. The GPH medical team is conducting regular training and drill sessions for handling possible Covid-19 patients from triage booths, fever clinics and all the way to the wards that have been prepared. We are now seeing a steady stream of outpatients returning to our specialised services such as dermatology, audiology and orthopaedics. Entry to the hospital is still strictly controlled and all arrivals have to get their temperature checked. This week has also seen the restart of some necessary surgical operations, which had been on hold since the start of lockdown. Another innovation for this lockdown time has been the introduction of telephone consultations and support for patients who cannot get to the oupatient clinics.

 

Update from INF Nepal on Friday 17th April:

There has been a slight increase in recorded COVID-19 cases across the country but the number still only stand at sixteen and there is still no noticeable increase in lung-related emergency cases in hospitals across the country.

In Green Pastures Hospital, since the lockdown began, all visitors have to wash their hands at the entrance gate and have their temperature checked. There are restrictions on visitors for inpatients. The ‘fever clinic’ is running as directed by the local health authority and the Ear Centre is fully prepared as an isolation centre.

INF currently runs the only non-cancer palliative care service in this part of the country and a brand new unit was under construction and due to be completed in May. However, until that unit can be finished, we are anticipating an expected increase in need for palliative care services, should there be a serious outbreak of COVID-19 in Nepal, by preparing the another ward within the Green Pastures complex as a palliative care unit, in order to take any patients in need of that level of care.

As directed by the Ministry of Health, Green Pastures is carefully re-opening a low level of outpatient services. All had been stopped during the lockdown which began on 24th March, but as from this week some services have re-started, with patients being called in for appointments on an individual basis, after first having a telephone consultation.

A round-up of other INF Nepal activities:

•  INF’s Dang office has provided 125 N95 masks to local health officials and community health workers, and also provided transportation for local food distribution.
•  INF’s Bajura office provided 65 families with food packages at the request of the local government.
•  Two new specific Covid-19 projects are being prepared with the support of two partners, in existing projects areas.
•  We are providing much-needed food packages to households at the request of local authorities in the Pokhara area.

 

 

Updated on Thursday 16th April:

The Nepali government has extended the lockdown until 27th April, and there will be no international flights before 30th April. There are now 16 confirmed cases of coronavirus in Nepal, with 15 patients still in isolation in hospitals across four provinces.

INF is still running inpatient services at Green Pastures Hospital (as well as in Surkhet and Banke) and is able to deliver some outpatient appointments for leprosy and ear services, with all patients being checked at the fever clinic which is in operation at the hospital gate. There are of course significant pressures on medical staff at this time and INF Nepal is doing all it can to support them.

In community projects, most activities have had to pause due to the lockdown. However INF’s community offices are working closely with local governments and are ready to respond to requests for assistance where possible, for example food relief has been supplied to 65 families in Bajura. The lockdown means that some planned activities in districts such as Bajura and Kalikot will need to be delayed or even re-shaped to meet the needs of this developing crisis. However, in these remote districts INF will be well placed to help respond to whatever impact coronavirus has, especially as the extent and depth of poverty in Nepal is likely to increase.

 

Updated on Wednesday 8th April:

As the Coronavirus pandemic continues to spread around the world, Nepal is doing all it can to contain any outbreak in the country.  In an address to the nation, Prime Minister KP Oli announced yesterday that the official lockdown has been extended until 15th April, and international flights have been cancelled until the end of April. However, foreign governments can extract their citizens who have been stranded in Nepal due to lockdowns back home.

So far there have been 9 confirmed cases of COVID-19 in Nepal and no deaths. There are now a total 10 labs in 7 provinces for sample testing; so far 2,122 samples have been tested.

As the nationwide lockdown to contain the spread of COVID-19 enters its third week, the challenges will only continue to grow over access to food supplies and with more people still stuck at the Indian border trying to get home.

The latest information from INF Nepal includes the following information:

• The Government of Nepal extending the lockdown was expected, given three new positive cases found in the far west of Nepal last Saturday (4^th April), including the first locally transmitted case within Nepal.
• The Government has also decided to conduct the rapid diagnostic test on all the people in the quarantine, those who returned from India, and those who came in contact with the positive confirmed people in Kailali, Kanchapur and Baglung districts.
• The next few weeks are going to be very challenging as thousands of people have come across the borders; few are in quarantine while the majority are already in the villages especially in Sudurpashchim [the most westerly province, including the district of Bajura]. Authorities have already tightened the cross border travel across provinces, districts or even at a local level.
• Some essential factories, related to food production, sugar, tea, brick manufacturing, and seasonal agricultural activities (e.g. rice cultivation) and some repair workshops can still operate with the safety measures and social distancing in place.

 

Updated on Thursday 2nd April:

The nationwide lockdown has now been extended by the Nepali government until 7th April, with no international flights until 15th April.

Pokhara now has its own coronavirus testing equipment and more essential medical supplies (for example, 1,000 sets of personal protective equipment), which have been flown in from Kathmnadu. INF has set up tents at the gates of Green Pastures Hospital for a fever clinic (to screen patients who arrive at the hospital). Any suspected cases of COVID-19 are referred for testing at other hospitals in the province which have been selected as the pre-isolation and referral hospitals for COVID-19 patients.

In their regular healthcare services, Green Pastures is using video for a daily dermatology clinic, which will allow the hospital to continue its service for leprosy patients.

Meanwhile, staff at the hospital are being added to the Gandaki provincial government’s roster of medical personnel, to be available as required. Some health workers do not want to go home so they do not expose their elderly parents to the virus – in such cases, they can use IIFS Guest Houses on the Green Pastures site.

All community work in Nepal has been suspended under the lockdown, so INF Nepal staff based in communities are preparing individual contingency plans based on the local situation. The Community Programmes team and Partnership team are also evaluating the potential long-term impacts of the lockdown on the communities we serve.

INF’s district offices have also had requests for help: Kalikot has received the request to provide some tarpaulin to help establish a quarantine centre; Banke has already donated 100 surgical masks and four N95 masks from its stock; and Bajura also donated some blankets to the nearby quarantine centre that has been set up recently.

 

Updated on Wednesday 25th March:

As of yesterday morning (24th March), the whole of Nepal is in a week-long lockdown and has since announced its third confirmed case of COVID-19. From the latest we’ve heard, it appears that the first day of lockdown seemed to be effective in most parts of the country, even though it was implemented at very short notice. The administration has clarified there is no curfew and that essential services and stores will still open, however in reality people were facing some difficulties getting supplies and moving around.

Testing for the virus is very limited and there are obvious concerns (as in many developing nations) about how quickly the healthcare system could get overrun if the disease spreads.

Green Pastures Hospital is still open and medical workers can go to work, but all other movements are strictly prohibited.

However, what’s reassuring is to hear how INF is contributing to Nepal’s national and regional response to the pandemic. Here’s more detail from Thomas Meier (INF Nepal’s Partnership and Communications Director):

“The Gandaki Provincial Government is coordinating with national governmental agencies, hospitals, and non-governmental organisations – such as INF Nepal, Red Cross, and the World Health Organisation – to respond to the coronavirus outbreak.

“INF Nepal has partnered with the government to ensure critical supplies are available to conduct testing, managing quarantine and provide medical intervention as needed. INF Nepal is also assisting by sharing its extensive clinical knowledge with government staff. INF’s communications team is also working closely with the government to develop and promote public health and hygiene messages across communities.

“It is a compelling example of the trust and respect for INF that we are the only local NGO to have partnered with the government in this way.

“INF Nepal has also formed its own task force and prepared contingency plans for responding to the coronavirus; protecting patients and hospital staff; liaising with government and communicating with staff, patients, communities and the public.”

In the wider country we are starting to see the impact of the national lockdown and India closing its border with Nepal. As we have seen in the past, this will lead to shortages and price increases. In response, the government of Nepal is preparing to distribute essential food items to the neediest people through local governments, with NGOs that are able to help working with them. INF Nepal is acutely aware of the needs of the poorest and most marginalised in their working areas and is working to see how it can best support them.

Some of INF Nepal’s expats have already travelled home to be closer to family members, but the plans of others to get flights today are now in major doubt. Some have chosen to stay put, despite knowing that it could be many months before they could leave the country. Please do pray for all affected by the lockdown announcement.