Project – Maila, Humla: Providing Healthcare in Remote Villages

Based on Community Interaction: A conversation with the Health Facility Management Committee Chairperson Mr Hari Lal Sarki and community member Mr Ramlal Jaisi.

Maila is a remote but beautiful cluster of villages in the Humla district of Nepal. The musical rhythm of Karnali River and panoramic views of huge mountains surrounding the villages gives this location its incredible beauty. People here have a difficult life, but they have benefitted from the services provided by PHASE Nepal.

Ramlal Jaisi, a local resident, said: “Before PHASE was here, we had to reach Nepalgunj for health care which was really difficult for us – it is a three day continuous walk followed by an hour’s flight, however planes are irregular and we often waited days for one. Many people died because of the unavailability of basic primary health services in the village as well as poor economic conditions. Many women here died because of complications during pregnancy and delivery. The condition of infant health was poor. Maternal and child mortality rates were very high. We weren’t even able to receive a tablet of analgesic medicine (paracetamol) when we had a headache.”

“We did not have a great deal of hygiene or sanitation awareness, and faced many epidemics. There was no alternative treatment. People had to accept death. I have seen many deaths because of diarrheal diseases. People here used to believe in dhaami-jhankri treatment (healing rituals) since they weren’t aware of, or didn’t have access to, health centres. If someone suffered from a disease then they were more likely to lose their life than receive treatment. But now the situation has improved and we are receiving good services. PHASE Nepal has brought us happiness and added precious beauty to our place.”

“Now, the situation has improved. Most importantly, PHASE has provided us with a variety of medicines and competent health staff who remain in the clinic to provide services throughout the year. PHASE has brought many positive changes here through awareness-raising activities in the community. People’s attitudes regarding visiting health centres for treatment has increased and, as a result, most of the pregnant women go for health check-ups, and send their children to attend school. We now see people starting to visit these medical centres when they fall sick. People are more aware of family planning and personal hygiene, which they teach to their children as well. Already we have noticed that there has been a drastic improvement in the hygiene and nutrition levels of babies.”

The Health Facility Management Committee Chairperson, Mr. Hari Lal Sarki explained: “Since its inception in Maila, PHASE Nepal has provided quality service to the people here. We have learned healthy behaviours through community health education, clinic health education and school health education sessions. In particular, family planning awareness and services have had a hugely positive impact in the community. Before PHASE, most people used to have more than half a dozen children in their house, but now a pregnancy gap is maintained and our birth rate is more controlled. Open defecation was common but now it is also more carefully managed. On average, 50-60 patients are receiving health services daily from the clinic in Maila, and 10-12 women visit the clinic for delivery services on a monthly basis. Monthly meetings of Female Community Health Volunteers, Health Facility Management Committees and mothers’ groups have been systematised – they are now independently capable of organising meetings and making decisions.”

Both Hari and Ramlal conclude that PHASE is still a very important service provider in the Maila cluster of villages as there is no regular service from the government. People from neighbouring villages, such as Madana, Srinagar, and Kalika, are also benefitting from PHASE’s services. We genuinely thank PHASE and its supporters for their generous contribution to these isolated places.