Many Nepalis woke up on Wednesday to an early-morning SMS from the Ministry of Health and Population: ‘Let’s wash our hands with soap and water regularly and if possible refrain from going to crowded places to be safe from coronavirus disease. Cover your mouth and nose while coughing or sneezing.’
The public service announcement was aimed at stopping the spread of COVID-19, but will revive Nepal’s hand-washing drive to control other infections like diarrohea and typhoid that kill mainly children.
COVID-19 has now hit 78 countries. New infections and fatalities are tapering off in China, but the outbreak is spreading in Iran, Europe and the United States. Visit Nepal Year 2020 has been shelved, the Sagarmatha Sambaad postponed, and the US Embassy has put off its Independence Day celebration at Phora Darbar.
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“There is still widespread lack of awareness about hand-washing, even right here in Kathmandu among marginalised communities,” says Diwakar Acharya, principal of Pulchoki School in Godavari. “Schools play an important role in educating children, their families and the community as a whole. This becomes especially important with the rise of new emerging diseases like coronavirus.”
Nicky Lama of Eco Soap Bank Nepal, which supplies recycled hotel soap to schools, has been visiting government schools in Kathmandu to train children in hand hygiene. “We have been training students and teachers so parents are also sensitised. It is a protective measure against not only coronavirus but already existing seasonal flus and common infections like typhoid,” says Lama.
Nepal was declared free of open defecation last year, and is a model for the region. While this is dramatic progress from 1990 when only 6% of households had toilets, public health experts have raised questions about poorly maintained toilets and lack of water supply.
In a 2018 study, the Global Sanitation Fund Programme found that 3% of households in communities declared ‘open defecation free’ did not in fact have toilets, and that in 5% of families who had a toilet at home, at least one member continued to defecate outdoors.
“Despite declaring open defecation free, toilet infrastructure is not always optimum, septic tanks are now filling up and availability and quality of water is questionable, particularly in urban slums,” says Sandhya Chaulagain, Hygiene officer at WaterAid Nepal. “But most health workers are focused on curative measures and often wait for the outbreaks to happen instead of preventing them.”
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The additional challenge for the WASH (Water, Sanitation and Hygiene) campaign in Nepal comes from the lack of clarity about jurisdiction and roles of each tier of government in the new federal structure. A new bill on WASH is undergoing review at the parliament.
Good news is that some municipalities have started collecting household-level sanitation, hygiene and water data using the GIS-based app NWASH. Says Govind Shrestha, policy specialist at the NGO WaterAid Nepal, “Moving ahead we need to find and then reach all the areas that do not have proper water and sanitation facilities yet. The challenge is to reach all 753 local bodies and as soon as possible.”