Event/CSR/Technical Paper

 

Brief Report on the Support to Diarrhea Epidemic

 in Rukum and Jajarkot Districts

Background
Upon breaking out of diarrhea and cholera in the mid west and far west regions of Nepal claiming more than 400 lives (132 in Jajarkot, 33 in Rukum), Annapurna Post of Asia Pacific Communication Association (APCA) through its campaign “Sahayogi Haatharu” has publicly announced fund collection for immediate relief and recovery.  

Development Project Service Centre (DEPROSC Nepal), a non-government organization has been supporting deprived communities in 41 districts with main goals of empowering rural people for attaining self-sustaining socio-economic uplift through a package of policy research, action research, humanitarian assistance and training. It has been constantly working in the mid west and far west region since 2002 including Rukum and Jajarkot - the most diarrhea affected districts. Even during that outbreak it has been implementing ‘Social mobilization and Hygiene promotion campaign for diarrhea control and prevention in Rukum, Jajarkot and Humla districts’ based on which Annapurna Post assigned the responsibility of mobilizing its existing human resources and network for the diarrhea relief and recovery.

Alliance and Coordination
Annapurna post, Norvic Hospital, UNICEF and DEPROSC Nepal have joined hands together to functionalize the efforts. Annapurna post raised fund, DEPROSC Nepal procured items, facilitate for transportation, identified households and distributed the materials to diarrhea affected people. UNICEF as cluster coordinator took lead at the national level in coordinating things. District Health Office (DHO), District Water Supply and Sanitation Office (DWSSO) and District Disaster Rehabilitation Committee (DDRC) led the activities at the district level identifying partners, allocation of working areas among them and overall coordination.

Support and Supply
As an immediate support and relief, some basic diarrhea and cholera controlling medicines and precautionary items such as ORS suspension, water purifying chlorine solution (Water guard and Piyush) and hand washing soap were identified as crucial ones and supported to each and every affected household of Rukum and Jajarkot districts. Support was done with better coordination of DHO, DWSSO, Local NGOs, Nepal Army, Nepal Red Cross Society and other NGOs/INGOs.

Methodology of Distribution
DEPROSC Nepal Head office Kathmandu, its Regional Office in Nepalgunj and District Offices were involved at different points. Existing staff and additional 50 Volunteers / Supervisors were involved in distributing the materials at the household level. Materials purchased and received in Kathmandu were transported to Nepalgunj using the DEPROSC Nepal and UNICEF’s delivery means. Those later transported to the respective field using tractors, mules and porters. Each and every household of the identified 21 VDCs were provided with 5 sachets of ORS, 2 pieces of lifebuoy soap and 2 bottles of Piyush.

DEPROSC Nepal hired and trained hygiene supervisors and village facilitators - previously phased-out - for this purpose. Teams comprised of one to three members depending upon the settlement and household of VDCs (one hygiene supervisor/volunteer and village facilitator and/or social mobilizer in each VDC), other field staffs were mobilized depending upon the situation of the targeted areas.

As a part of social mobilization, the entire district team was fully mobilized at the targeted VDCs and headed forward in close coordination with SHP/HP and other stakeholders while performing the assigned tasks. Existing community networks (COs, child clubs, mother groups, formed WASH community) were also mobilized as per necessity. The team at first conducted the settlement level orientation and awareness raising activities then distributed IEC materials, display of information banners, flax, flipcharts at strategic locations within the VDCs; and also demonstrated on how to purify water using chlorine product in each and every settlement of targeted VDCs. Utilization of the materials distributed were tracked down up to the household level. The distribution records are maintained using Bharpai.

Distribution
Materials received in kind from various organizations and procured from the market with the funds received from APCA have been distributed in Rukum and Jajarkot at the household level. The table below shows details of total procured, total received in kind and distributed to the households of Rukum and Jajarkot.

Table 1: Diarrhea Relief and Recovery Materials Distribution

Item	Particulars	Total Procure	Received in Kind	Total available	Distributed in Rukum	Distributed in Jajarkot
1	Soap (Lifebuoy)	15261	15001	16761	15761	1000
2	ORS Sachet	49600	30002	52600	24340	28260
3	Water purifier (Piyush)	27616	0	27616	27616	0
4	Medicines3	The list of medicines and the hand-over letter are included in the annex.

Monitoring
District team regularly coordinated with DDRC, DHO, DWSSO, DDC, VDC, SHP/HP, WASH community and other respective stakeholders, then assisted to organize/facilitate coordination meeting. Monitoring and supervision task was smoothly carried out; it helped to identify and address gaps at the community level to meet current life saving needs. Personal hygiene message, point of water use, preparation of ORS, use of Zink tabs, Brest feeding for children and its importance; all these key and important messages were given through door to door visit. It was a successful effort in supporting diarrhea affected people during that epidemic period.

Forward
It has been obvious that such epidemics are broken out in the rural areas where awareness level is quite low, personal health and hygiene is severely poor and the community is embedded with various superstition and taboos. Therefore, we need to put focus on raising awareness on personal health and hygiene, use of safe drinking water and preparedness for such outbreak in the future which would definitely minimize the risk of claiming life. 

Annexes:
Photographs:

District level Orientation to Supervisors, Rukum		Distribution of support materials with orientation to the community, Rukum
Materials distribution with receipt, Rukum
Picture of materials distribution with orientation, Rukum

Annex II: List of Medicines

57 varieties of physician’s samples and 14 varieties of other medicines received in kind from Norvic International Escorts Hospital have been handed over to Government’s Mid-western Regional Medical Store, Nepalgunj:

Physician’s Samples:

S.N	Name of Medicine	Unit	Total Quantity
1	Ambroxol Hydrochloride Syrup (AMIBRODIL)	Pcs	4
2	Amoxycillin & Dicloxacillin Capsule	Capsule	200
3	Amoxycillin for oral suspension IP (ARISTOMOX)	Pcs	4
4	APET	Bottle	43
5	Bismuth subalicylate Suspenoion (170) (Pepto Norm) (170ml)	Pcs	20
6	Cifran 250	Pcs	97
7	Cifran 500	Pcs	99
8	Ciproffaxcion tab (ALCIPRO 500)	Tablets	40
9	Cledomox (Amoxycilli & potassium clavulanate	Pcs	50
10	Cyclo mps	Bottle	2
11	DJ-Citral	Bottle	10
12	DROSTAT 80	Tablets	20
13	Entazyle	Bottle	1
14	Entazyle AF	Bottle	7
15	FAM-O 20	Pcs	18
16	Fenceta Ibuproten & paracetamol	Tablets	600
17	Flontin 500	Pkt	35
18	Fluconazole Tab. (Fungilasm 150)	Pcs	50
19	Foltab	Pkt	5
20	Fortiplex	Pkt	12
21	Fortiplex-m	Pkt	8
22	Fortivit Vitamin B Complex	Pkt	15
23	HISTAC 150	Tablets	1800
24	Injection of vitamin Bcomplex with vitamin B12(polybion)	Pcs	300
25	kethin	Pcs	25
26	Lysovit Drops (15ml)	Bottle	10
27	Lysovit Vitamin B	Bottle	10
28	Medicath	Pcs	18
29	Mediflon plus	Pcs	60
30	MEDIKIT	Pc	1
31	Medikit	Set	24
32	Moxyrex plus	Pkt	8
33	Neocan plus	Pcs	33
34	Nepoten-k	Pkt	10
35	Norflaxacion Suspension	Bottle	4
36	Oflontin	Bottle	10
37	Oflontin 200	Pkt	30
38	Ofloxacin suspension 50	Pcs	36
39	Ofloxacin tablets IP	Pkt	44
40	Paracetamol & Chlorzoxazone Tab	Tablets	100
41	Pepto Norm	Bottle	15
42	Peptozyme 100ml	Bottle	7
43	Peptozyme 200ml	Bottle	6
44	Peptozyme Drops	Bottle	13
45	Peptozyme fungal Diastaset pessin	Pkt	14
46	Protogyl DF	Pkt	9
47	Protozgyl	Bottle	32
48	Protozgyl DF	Bottle	22
49	Protyzyl DF	Bottle	10
50	Safecan	Pcs	25
51	Sporidex 125	Pcs	60
52	Sporidex AF-375	Pcs	5
53	Tinidazole GAT 500	Pcs	80
54	Trimethoprime salphame thoxazole tab (Tabrol- DS)	Tablets	100
55	Vitamin B- complex with c (Omniplex)	Pcs	16
56	Zinc DT -20	Tablets	200
57	Zulid 250	Capsule	144

Non-Physician’s Samples:

S.N	Name of Medicine	Unit	Total Quantity
1	Albendazole chewable tab	Pcs	200
2	Aqua tab (water purifier)	Pcs	38
3	Cipromax Injection	Bottle	20
4	Cirofloxacin injection IP (0.2%wv) (Nircip)	Pcs	60
5	Cirofloxacin injection IP (NIRCIP)	Pcs	60
6	Cirofloxacin injection IP (NIRCIP)	Pcs	120
7	Compound Sodium lactate INJ IP (Nirlite)	Pcs	125
8	Compound Sodium lactate Intravenous Infusion BP 1000Ml (Claris)	Pcs	60
	Dexoride (DNS INJ 1Ltr)	Pcs	25
9	Dizithro 250	Pcs	18
10	Intravenous Infusion BP (Lactoride)	Pcs	102
11	Metriz 400 (Metronidazole tab)	Pcs	680
12	Metronidazole INJ IP ( NIRMET)	Pcs	240
13	Metronidazole INJ IP ( NIRMET)	Pcs	60
14	Oyster Infusion set-vented	Pcs	100