Dhulikhel Hospital believes on prevention rather than cure. On this basis, the Department of Community Programs (DCP) was created to educate and enforce the importance of hygiene and sanitation, women’s health, and disease to name just a few subjects we try to tackle. From this department, staff at Dhulikhel Hospital coordinate many teaching programmes designed to uplift communities by improving their standard of living. The DCP runs programs all the year long. These programs have included various public health programs such as plantation programs around schools and villages; first aid training; hygiene and sanitation teaching for school children; awareness programs for women ( such as cervical cancer, breast cancer, uterine prolapse etc.) and mental health awareness programs for both women and school childrens. Our hope is that we can raise awareness of such issues so that they will be discussed in the community for generations to come.
Plantation programs is one of the Department of Community Programme’s newest initiatives. The idea behind it was to raise awareness on deforestation and climate change in the rural communities and to incorporate it in school-teaching for children. Nepal loses an alarming average of 91,700 hectares of forest per year which reflects the lack of knowledge on people regarding deforestation and climate change. Deforestation is a rising issue in Nepal as most of the rural population still rely on burning wood fire. This program changes the attitude towards forestry as a replaceable commodity in the community by involving villagers and school children in the planting process. Thus far, we have been involved with two schools in the community, and planted more than 1,005 trees.
Micro-finance program started on 2008 starting from Bahunepati Health Centre. This program is incorporated with the awareness program which is provided by the residential paramedic staff within a outeach centre. Because of the awareness program, many female patient visited to the hospital for the treatment into the earlier date. Today, Dhulikhel Hospital has 31 microfinance groups into the five outreach centers (Bahunipati, Kattike Deurali, Dapcha, Solombhu, Baluwa outreach centers).
Our micro-finance programs were created to financially assist women in rural communities, in order for them to gain stability and independence for the long run. We feel that women are the backbone of every family, and by supporting them, we are essentially caring for the whole family. Each micro-finance group consists of 10 women with a nominated leader from their own community, who ensures that the loan is paid back in monthly instalments, with an additional four percent interest rate. The interest in turn generates a sum of money for another woman to join the group, and places value on the loans. The women from our micro-finance groups have gone on to purchase animals for livestock farming such as pigs, goats and chickens, or have invested in materials to start their own small businesses, for example, candle-making. To date, we have helped over 300 women gain independence through financial stability.
The Department of Community Programs have plans to conduct handicraft training, mushroom farming, organic farming, veterinary training and bee-farming in the near future.
Micro-insurance programs was launched as a new initiative at the end of 2010 to reduce poverty and vulnerability to disease in target groups of residents near our outreaches and making financially independent for seeking health services. Alongside, the micro-finance programs, the hospital has changed the face of rural healthcare through its micro-insurance programs. Micro-insurance has ensured that all the women involved in the micro-finance programs and their children are covered for basic medical healthcare – for just 50 rupees per month. Dhulikhel Hospital’s Micro-insurance program has removed financial constraints from the list of reasons why low-income families do not seek professional healthcare.
We run various programmes aimed at empowering and educating women in society, particularly in poorer rural areas in Nepal. Our staff from the Department of Community Programs and the Gynaecology/Obstetrics department work together within the community to find out the needs of women and how we can help them.
In 2011-2012 total 29,681 women from different rural vicinities were benifited on the awareness programs. The major topics discussed were: cervical cancer, uterine prolapse, breast cancer, menstural hygiene, tuberculosis etc. Focusing adolescents, the Department of Community Programs is raising awareness on teenage pregnancies, dysmenorrhoea, family planning, sexually transmitted infections all year around.
Uterine prolapse is the major issue in rural communities where women return to work almost immediately after giving birth. Many women are still too ashamed to come forward for medical help due to the social stigma attached to such an intimate condition. Dhulikhel Hospital operates on all prolapse cases without charge, but for many women in rural areas who are unable to speak out about it, cases often progress to stage three; the worst and final stage of uterine prolapse. Since 2008, the department has specifically recruited nurses from the hospital for awareness programmes on uterine prolapse in the community.
The Department has been implementing various preventive and promotive aspects of health throughout rural Nepal by organising School Health Programs. For over two and a half years, we have been organising the programs as a means of promoting positive change in rural settlements through education. Our aim is to become ambassadors of community development through spreading the word on the importance of hygiene and healthcare with school children and teachers. Many people in rural Nepal still have very little contact with professional healthcare and medical staff, which is why our school health programs are focused on encouraging education on topics such as hygiene, toilet use, first aid and minor injuries for example.
Besides working directly with children in schools, we know how young adults can be great messengers of health and hygiene, and the power they have to uplift their communities – which is why we have also worked with the District Government Office to coordinate Adolescent Health Programs and extra-curricular School Health Clubs. Furthermore, we have provided First Aid training for teachers from 11 schools in cooperation with local government health centre staff. Between 2011 and 2012 our department ran 72 various health programs at 120 different schools in the community. Similarly, 10,9384 students were screened on dental, ENT, opthalmic areas. This year, we have added an extra 10 schools to our program.
Many farmers in Nepal face severe health risks due to their heavy use of pesticides in crop farming. They rely on pesticides more and more to meet turnover and consumption demands. Therefore, the Department of Community Programs is conducting awareness programs targeting these farmers, with regards to the judicious and proper use of pesticides in crop farming. We understand the challenges we face in phasing out the use of pesticides completely, but our programs aim to first raise the issue of pesticides as a health hazard amongst farmers and their families first, and then tackle the increasingly widespread and improper use of pesticides.