Sunday, 5 April, 2020
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INTERVIEW

Measures in place to stop coronavirus



measures-in-place-to-stop-coronavirus

Preparations to fight it
On December 31 last year, Coronavirus was first declared to have been found in China. By now it has spread globally and as of today around 106,000 people have been infected in more than 90 countries. Around 3600 people have already died.
On the satisfactory and crucial note, more than 60,000 people have received treatment and are recovering amidst the initial suspicion that this is a life-taking disease and anyone infected will die. Besides the 6000 who are at high-risk, the rest are reported to be undergoing treatment.
The World Health Organisation (WHO) has not yet banned travel and business, but it has cautiously said it is a high global risk. Nepal too has been listed as a high-risk country. At a time, when even developed, super powerful and rich nations, have not been able to fully control it, so in the case of our country, being a bit backward, and a least developed country like ours, I think it is normal to hear speculations, debate and concerns expressed in the public about the consequences on how we can possibly contain it, if infections surface here.
In regards to Nepal’s case, a Nepali student from China returned on January and on 13 January his throat swab was examined and it was seen positive; and then he was kept under observation at Teku Hospital for 10 days. However, later that positive turned out to be negative.
Till date in Nepal, around 433 people have been examined for COVID-19, including the 175 students the government evacuated from China. And it’s a matter of relief that none of them was tested positive so far.
When COVID-19 was still within and had not yet spread outside China-our northern neighbour with which we share a common border and we do have deep social, religious and trade relations. Besides trade and business people, even among the Nepalese living in China, the majority are medical students studying medicine there, so it seemed we had comparatively less intensive presence of Nepali population in China, so the obvious pressure on us then was only to bring our students back home.
But now since it has spread outside China to South Korea, Japan and Iran, among other nations and where we have a slightly higher and intensive Nepali population’s presence.
For example in Korea, more than 45,000 Nepalese are legally present there for work, studies, trade. So the spread of the disease in these nations pose a high risk to us, and thus we have now put 5 nations as being under-risk in terms of travels. When the Nepalis return home from the infected countries where it’s spreading rapidly, it’s a matter of concern for us.
Lately, as reported, in India around 34 people have tested positive, and considering our open border, and close social and economic relations, the risk of spread from the southern border is high, this is a matter of the highest concern for us . In this context, we have realised that existing preparations may not be sufficient for us in the days to come.
On what we are doing upon the leadership of the Prime Minister, we have held four crucial meetings of all stakeholders and related ministries, not just MoHP. We have mobilised all government agencies in an integrated manner. Be it the Kharipati quarantine center decision or other preparations, we have done under the initiative of the PM. Besides the MoHP, other agencies working in health service such as the Nepal Army and police who have been providing hospital services, are working hard.
The last weeks’ cabinet meeting, before the PM was admitted to the TUTH, decided to form a high-level committee led by Deputy PM and Defense Minister, including the ministers looking after the Home, Foreign Affairs, Education, Health, Tourism Ministry, Finance, Communication, Agriculture and the Industry ministries, with the Chief Secretary as its member secretary. That committee has been given the mandate to take decisions regarding the prevention of coronavirus on behalf of the government.
At the federal MoHP level, there is a directing committee led by the Health Minister to mobilise and coordinate and direct all health-related agencies.
Also, there is a secretariat committee led by the Chief Secretary which will facilitate and coordinate the implementation of all decisions from the high-level committee to nationwide implementation up to the local level. Likewise, there is a MOHP Secretary-led committee that looks at the technical preparations aspects to coordinate with other related line ministries,
Nepali Army, police, NGOs, and
all other agencies working in the
health sector.
Similarly, there is also a specialized committee led by a specialist regarding quarantine, hospital preparations
and other technical aspects, led by our 12th level specialist, on behalf of the MoHP.
At the State level, in order to implement these central-level decisions, we have formed a structure to be chaired by the chief minister or a designated minister.
At the local level, a committee will be chaired by the local level chair, to conduct awareness, as well as to conduct health checks in cases of areas that share borders. Also, beside the customs border points, we have around 37 entry border points where we have set up health desks to screen foreigners entering Nepal by land from the neighbouring countries.
For international airlines passengers, we have a health desk. We have thermal scanner at the Tribhuvan International Airport (TIA), which will scan and measure body temperature. However, it seems we are not able to publicise all these preparations to the public as much as we wished.

More on government preparations
Rather than making the society scared, our attention should be and is focused on preparations and taking precautions. Since the start of the COVID-19, we have taken serious steps, be it holding meetings daily or more. Also, every day on behalf of the MoHP, we publish health bulletin which clearly shows what the government has done and has information on what to do in case of confusion.
For treatment purpose, Teku Hospital is our first point, as it is a well-equipped and most reliable hospital that has lab facilities. Second, we have Patan Hospital and others. So far, we have 155 isolated beds in ready condition. We have instructed all government and private hospitals to be in ready state by preparing isolated beds as well as isolated wards. In the Kathmandu Valley, we have plans to designate seven hub hospitals for this purpose.
The preparation is implemented in three stages. First, not to let this virus enter Nepal at all, so ‘no entry’ is our first priority. Second, unfortunately if it does enter, in that situation and after declaration of state of health emergency, we may have to dedicate and limit all hospitals just for this treatment. Third, in case we reach worst situation, we may have to utilise hotels, apartments for quarantine purpose; and if it worsens, we may have to even utilise our schools also for quarantine purpose. But for now let’s not talk about the third option, but rather focus on the first stage.
We are not in the mood of advertising, but rather focusing on actions; we heard people blaming us on the delay in bringing back students from China, but we did and we had praise for the good service at Kharipati quarantine centre. So our main priority and of the high-level committee is not to let the virus enter Nepal at all. I have said so even at the Parliament.
On international flights: I myself am not aware of any formal declaration by the government to stop flights to any destination or nation yet.
May be the airlines companies are talking about it.
At the TIA now, every person is being checked. Our policy is not to encourage anyone to travel abroad, except in extreme emergency, or for people to come to Nepal.
We have also postponed our
first Sagarmatha Sambad; also there will be no participation by our Nepali delegation in international conferences or meetings.
For conferences planned here in Nepal, we have requested the organisers to postpone them. We have discouraged crowds, big gatherings. We have encouraged people to exercise all possible cautious, be careful on hygiene, sanitation, food etc. as primary precaution.
Message to the public
Panic is unnecessarily being spread which is sad For example, in Nuwakot around 50-60 people and in a village in Sindhupalchok, 100-150 people had cough and cold, but that came out in the news as a coronavirus which was later verified to be false.
On daily commodities and utilities like gas, medicine, masks; there were news about shortage on products coming from India. However, on behalf of the government we took diplomatic initiative and have clarified and received commitment from India that there will be no change in supply for Nepal. However, this positive news does not get out, but rather just the news on shortage made headlines. Whatever is reported as shortage, we will do our best not to let that happen, and that we will show from our action.
We plan to hold all-party meetings, structure it as our common problem, so we are committed to deal with it. We need to be united and everyone, every party in the parliament, people should join hands.
For medicine and equipment, WHO and international organisations have committed to help us in case of need. Since WHO has already listed us as high-risk, we do expect to be accorded high priority in supporting, and we have established easy access and we have made similar approaches and taken necessary initiatives in that regards. Whatever technology we lack, we will take initiative to bring it in.

Things to improve at MoHP
Of course there is room to improve things at MoHP, as it’s a huge ministry that has direct contact and serves citizens daily. A big commitment is needed to change and overcome challenges. And I am committed to do that during my tenure. For example, I did not call any hospital officials to my office, but rather I myself went to take briefings in the hospitals, where I knew I could see and meet and interact with more than 100 or people and patients, so they won’t be able to hide much as I can see myself.

Circular to stop misuse of flag and GoN logo
I am trying to do my best to correct things, be it a bout staff conduct or over participation in development partner agency meetings or the misuse of Nepal’s flag and government logo and inappropriately use of protocol.
To check the misuse of our national flag and governent logo in programmes of donors or NGOs, MoHP has issued a 7-point circular on the use of GoN logo. So I have freed MoHP from the burden of having our logo put parallel to donors’s name. Now onwards, only MoHP- authorised or approved programs, or only authentic programs will be allowed to use our flag and logo.
The ministry itself can organise programmes and meetings, it is not good to approach donor for sponsorship of food or lunch at a hotel and have its name in the poster as organiser rather than have MoHP as organiser. We need to change this mindset. We should seek donors or development partners support in policy level and meaningful assistance, not for lunch sponsor.

Staff adjustment
Frankly, the topic of staff adjustment can take a whole day, so I will just say for now that I am doing my best to address the problems and staff grievances. Whatever was done legally in the past remains legal and can’t be undone.
When I assumed my office, there were around 7000 cases of grievances, of which 4000 have been resolved. There were 2000 cases where by there was one-step downgrade issue for health staffs; I addressed that and took it to the cabinet to agree to give them their existing level and step.
MoHP is a big agency with around 31,592 staffs, so when they are adjusted and deployed to state and local level, MoHP will be down to 2631 staffs at the federal level.

PM’s kidney transplant and health condition
The Prime Minister had a successful kidney second transplant last Wednesday. Seven doctors were involved. Two teams were formed. Our senior doctors, Dr. Uttam Sharma, Dr. Prem Gyawali, Dr. Dibya Singh among others were involved. Also, one doctor from India who had previously led and carried out PM’s first transplant was present as a back-up expert.
With PM’s high will power, strong confidence, and desire, the transplant was carried out at TUTH. It was his strong will and trust on our own Nepali doctors and institutions and desire to carry out the transplant here in Nepal that made it possible.
He was confident that our doctors can do it. Despite having world-class doctors and services at TUTH, it had not been publicised well, but now that has been proven.
This has sent a clear message to everyone who was critical of leaders going abroad for treatment as well as it has increased the trust and message to the international community of our own capability and of TUTH. If the PM can be treated here, why not us?
The PM is recovering very well since the transplant and has shown great level of improvement since day 1 and he has been taking normal meal. I was there at TUTH, the whole day yesterday and he is eager to return to work at the earliest.

How do you feel after reading this news?