There is a beautiful spot called Sundarijal in the north east corner of Kathmandu, which was largely inhabited by the Tamang people. Modern medicines were unknown to them. The Trust has constructed a building and runs a daily clinic over there. The local elite run the day to day activity. The central committee of the Trust gives financial grants and monitors its activity. It is running well under the elected local committee. For the spiritual health of the people the Trust has constructed a temple of Lord Krishna and Radha where a daily prayer meeting is held. Epics are recited, from time to time, specially on festive occasions.
Chhaimale and Talku Dundechaur Health Service Center
On the southern side of Kathmandu, two villages (VDC's) have been adopted by the Trust - Chhaimale and Talku Dundechaur, where there are free clinics, pediatric clinic and public health programs. This is the place where the first community based Acute Respiratory Infection (ARI) management program was initiated in Nepal in 1982 and was one of the first 2 or 3 programs in the whole South East Asia Region. And later on, the program was expanded to Jumla - one of the project sites. The pioneering works on ARI done in Chhaimale and Talku Dundechaur has played a very important roles in formulating in our child survival National program, W.H.O. and UNICEF policies on ARI.
The local body there was quite active and doing excellent social and community level research activities. Now the clinics in Chhaimale and Talku Dundechaur are continuing and run by Assistant Health workers on a regular basis. The diabetes clinic at Jamal is being run by the Diabetic Society, which was created by the Trust with the idea of diabetic patients themselves running the organization.
The central body of the Trust provides grants to local committees on a quarterly basis, now functioning autonomously. Buildings in our other service sites were built by the Trust about 20-30 years back. The central body of the Trust does not interfere in their work but helps them with advice and support, if requested. Now the Trust's activities are limited to awarding honors, prizes, scholarships, grants and conducting health camps and other social services. We are still active in our awareness-raising program that is so vital for real social development in the country. We are also planning to collaborate with other likeminded organizations.
Jumla Community Health Program (JCHP)
Jumla is one of the remotest district of Mid Western Development region of Nepal. The district lies in the mountain region of the country and the altitude ranges from 2500 meters. There are 30 Village Development Committees (VDCs). The total area of the district is 2531 sq. km. and the total population is about 1 lakh and the number of under five children are about 15 thousand. MSMT's involvement in Jumla started in the 1981 when it carried out the historical survey of chronic bronchitis, cor pulmonale and infant morbidity in 1981. At 2500 meters,
Jumla, one of our research sites, was accessible only by air or after many days of arduous walk on foot. One had to wait for weeks to obtain air tickets or walk 8-9 days from the nearest road. Equally difficult was the task of transporting equipments like x-ray, Electrocardiogram (ECG) and Pulmonary Function Test (PFT) machines and heavy generators for power supply. Often the plane would take off from Kathmandu but would not be able to land at Jumla airport due to unpredictable enroute weather phenomenon. The team consisting of Dr. Kapil Dev Upadhyaya, Dr. Prakash Sayami, Mr Ram Pd. Neupane, Ms Amsuka Rajopadhyaya accompanied by half a dozen paramedical workers was able to land at Jumla after four
attempts in four successive days. It was scary. Life in Jumla was also hard for us, spoilt as we had been by the comforts of Kathmandu. However, we did not compromise on our sincerity and seriousness in the research work. To successfully complete the research under the circumstances was no mean feat. The survey revealed unacceptably high infant mortality of 336 per thousand. Tobacco smoking was very common and so was the prevalence of chronic bronchitis from the year 1981. So we carried out a community based pneumonia management project with support from USAID. It has been successful in reducing the infant mortality. Selected child survival interventions were added, for example, Vit 'A' supplementation program in 1989 and Diarrhea Management in 1991. Since 1992, Jumla Community Health Program (JCHP) was launched consisting of above child survival strategies. Under five mortality came down from 336 to 97 but the morbidity pattern did not improve. From September 1994 with the approval from MoH, MSMT ran the program from its own resources with some financial help from Health Tax Fund of Ministry of Heath. In August 1997 the prevention of tobacco smoking and (mgmt of ) childhood pneumonia program was the financial help from Health Tax Fund Nepal. The Trust strived to generate resources and give local responsibility in the management and the Jumla model came into existence. The Jumla Model advocates for a sustainable framework for the main health problems in a resource constrained remote areas like Jumla. This incorporates cost effective approach through cost sharing partnership, locally recruited, trained and adequately supervised health workers. Apart from child survival, we also ran a COPD clinic.
The ARI and child survival program in Jumla is now being run by the government of Nepal. The awareness program on domestic smoke and tobacco smoking is being run by the Trust, throughout the district with special focus on 3 VDCs. Recently, the Trust with the help of local people has built a community building for the Trust at Jumla.
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