Sundhedssektoren i Bakanje Kommune English Deutch

Himalayan Project har holdt sig langt væk fra projekter i sundhedssektoren, fordi det er meningsløst at starte en lille klinik, hvis man ikke også sørger for at den kan fungere. Og at hjælpe den i få år og så trække sig ud, næsten altid fører til at den bliver lukket. Og så er det dyrt at drive en lille klinik med personale og medicin. Men i 2008 turde vi så alligevel gå ind i et projekt i afsidesliggende Chhirringkharka, fordi vi tror på, at de selv kan og vil stå for driften.

Men før vi gik i gang med projektet ville vi være sikre på, hvad vi gik ind til. Derfor gennemførte vi en undersøgelse i hele kommunen Bakanje og især i Chhirringkharka for at afdække de akutte behov og også for at finde ud af om befolkningen overhovedet havde en fornemmelse af, hvilke økonomiske behov der ligger bag en klinik. Undersøgelsen blev gennemført under ledelse af 19-årige Sonam Doka Sherpa, som netop havde afsluttet sin uddannelse som Staff Nurse med støtte af HP (se under scholarship). Det gjorde hun særdeles godt, hvilket fremgår af hendes rapport Bakanje Health Survey 2008. Denne undersøgelse blev gennemført med støtte af PONA-Foundation.

I 2010 kunne vi så indvie klinikken i Chhirringkharka, som herefter blev overdraget til bygden selv at drive videre. Samtidig støtter vi uddannelsen af 3 jordemødre, som skal arbejde i hver sin klinik i Chhirringkharka, Sagar-Bakanje og Kenja. Og ikke mindst vore Pilot-WEP 2010 og det fremtidige Women Empowerment Project (WEP) skal arbejde på at bevidstgøre kvinderne om deres eget ansvar for familiens sundhed, men også for driften og bevarelsen af deres lokale sundheds-institutioner. Vi besluttede også at bygge en bolig for Health Worker i Sagar-Bakanje, så denne klinik kan blive ordentligt betjent af en fast ansat.

I 2011 vil vi gennemføre et generelt projekt, der skal føre hele sundhedssektoren i kommunen op på et acceptabelt niveau. Først og fremmest vil vi forsyne alle klinikkerne med klinikudstyr, der passer til det forventede fremtidige niveau i klinikken. Derudover give specialundervisning til de 3 jordemødre og uddannelse af en Health Worker. Med dette projekt forventer vi at de centrale sundhedsmyndigheder vil yde deres del, hvilket vi allerede har fået forhandlet nogenlunde på plads. Hvis vi kan se at både myndigheder og lokalbefolkning vil yde deres bidrag, så slutter vi af med at rive Kenja Hospital ned og bygge en ny magen til den i Chhirringkharka. Læs om dette projekt i Bakanje Health Upgrade Project, November 2010.

I forbindelse med WEP Fase 1-1 havde vi ansat Staff Nurse Samjhana Lama som Health Facilitator. Hun udgav en rapport om sine 6 uger i Bakanje: Health Report Phase 1-1 - 2012

I 2014 kunne vi konkludere at det er vanskeligt at arbejde i sundhedssektoren. De tre jordemødre, som vi uddannede, kom ikke til at gøre varig gavn, blandt andet også fordi fødselstallet er faldet dramatisk. Men den ene blev gift i Sotang, den anden rejste til Kathmandu efter at have betjent klinikken et år og den sidste åbnede et lille apotek i Kenja. Vi nåede at uddanne en Health Assistant, men umiddelbart efter at han kom tilbage fra uddannelsesstedet blev han syg med encephalitis (Japansk Hjernebetændelse), blev debiliseret og døde efter et år. Men lægeboligen fik vi da bygget, men indtil nu har der ikke været ansat nogen sundhedsperson til at bebo den. Vores WEP-projekt forsøgte at bevidstgøre kvinderne om deres eget ansvar for den lokale klinik. Det lykkedes til en vis grad, men ikke med den dybe forståelse, for næsten alle udtrykte at en konsultation skal være gratis eller i det mindste meget billig. Det har ikke været muligt for os at få sundhedsmyndighederne til at tage et større ansvar. Så for tiden lader vi vores indsats på sundhedsområdet være på stand-by.

English The health sector in Bakanje Municipality

Himalayan Project have kept far away from projects in the health sector, because it is pointless to start a small clinic, if we don't ensure that it can function. And to help it in a few years and then pull out, almost always leads to it being closed. And it is expensive to operate a small clinic with staff and medicine. But in 2008 we dared anyhow to go into a project in remote Chhirringkharka, because we believed that they can and will be in charge of the daily operation.

But before we went ahead with the project, we wanted to learn about the premisses. Therefore, we conducted a survey in the entire municipality of Bakanje and especially in Chhirringkharka in order to uncover the acute needs and also to find out how far the people at all had a sense of what economic needs that lies behind a clinic. The study was conducted under the leadership of the 19-year-old Sonam Doka Sherpa, who had just completed her training as a Staff Nurse with the support of HP (see scholarship). She did very well, as evidenced by her report Bakanje Health Survey 2008. This study was conducted with the support of PONA-Foundation.

In 2010, we could inaugurate the clinic in Chhirringkharka, which was handed over to the village to operate on own behalf. At the same time, we support the training of 3 midwives to work in each of its clinic in Chhirringkharka, Sagar-Bakanje and Kenja. And, not least, our Pilot-WEP 2010 and the future of Women Empowerment Project (WEP) should work on making the women aware about their own responsibility for the family's health, but also for the operation and maintenance of their local health institutions. We also decided to build a home for Health Worker in Sagar-Bakanje, so this clinic can be properly served by a full-time health person.

In 2011 we planned to implement an overall project to bring the entire health care sector in the municipality up to an acceptable level. First and foremost, we would supply all the clinics with equipment to suit the expected future level in the clinic. In addition, provide further special education for the 3 midwives and training of a Health Assistant. With this project, we expect that the central health authorities will do their part, as we have already been negotiated fairly with them. If we can see that both the authorities and the local population will make their contribution then we wanted to continue to tear down and build a new Kenja Hospital similar to the one in Chhirringkharka. Read about this project in Bakanje Health Upgrade Project, November 2010.

In connection with WEP Phase 1-1 we had employed Staff Nurse Samjhana Lama as Health Facilitator. She published a report on her 6 weeks in Bakanje: Health Report Phase 1-1-2012

In 2014, we could conclude that it is difficult to work in the health sector. The three midwives we trained, did not come to give lasting benefit, among other things, also because the birth rate has fallen dramatically. But the one were married in Sotang, the other went to Kathmandu after having operated the clinic a year and the last opened a small pharmacy in Kenja. We managed to train a Health Assistant, but immediately after he came back from the education, he became ill with encephalitis (Japanese encephalitis), became mentally retarded and died after one year. But we did build the health worker quarter, but until now there has not been any medical professional to inhabit it. Our WEP project tried to make the women aware about their own responsibility for the local clinic. It succeeded to a degree, but not with the deep understanding as almost all expressed that a consultation should be for free or at least very inexpensive. It has not been possible for us to make the health authorities to take greater responsibility. So for the time being we let our efforts in the field of health to be on stand-by.

 

 

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