Kathmandu, Nepal – The Sukraraj Tropical and Infectious Diseases Hospital in the Nepalese capital, Kathmandu, is full, so full that in many cases two patients share a bed, as a second wave of COVID-19 overwhelms the country’s health infrastructure.
Health experts and front-line medical workers have described the situation as “almost apocalyptic” as they face shortages of hospital beds and oxygen, the national vaccination campaign is virtually halted and the death toll it is so high that retained mass cremations are taking place.
“We have been treating patients in every corner of the hospital facilities. We even use the garage to admit as many patients as possible, ”said Beli Poudel, a nurse in Sukraraj.
“We don’t sideline any patients, we try to accommodate them despite our limited capacity,” Poudel told Al Jazeera, adding that more than 120 COVID-19 patients are being treated at the 104-bed hospital, which has only 24 ICU beds. The hospital, which experienced a large influx of severely affected patients in the second wave of the pandemic, had already doubled in capacity.
For several weeks now, many staff at Sukraraj, Nepal’s only facility specializing in tropical and infectious diseases, have been living in hostels or hospitals away from their families.
With just over 21,000 tests on May 19, Nepal recorded 8,173 cases of COVID and 246 deaths, the highest figure since the pandemic erupted last year. Health experts believe the actual figures could be much higher as tests remain low. More than 5,600 people have died since the pandemic began, nearly 2,000 in recent weeks alone, according to official data.
The pandemic has especially affected the Kathmandu valley and the western lowlands of the country bordering the Indian state of Uttar Pradesh. The region is one of the least developed in Nepal, with a large concentration of indigenous and ethnic and religious minorities.
Shahbaz Ahmed, a resident of Nepalgunj in western Nepal, lost his three brothers – Zahir, Ejaz and Imtiyaz – to the coronavirus in the first week of May.
The three forty-year-old brothers were receiving treatment at Bheri government hospital after health complications.
“The doctors could not save them despite doing their best. Maybe it was Allah’s wish, “Shahbaz told Al Jazeera by telephone.
Zahir, the youngest of seven siblings, was a former member of the national under-19 cricket team. “He (Zahir) was the most fit among all the brothers,” Shahbaz said.
Shahbaz, who cries in isolation like the rest of his family, ruined the paralyzed health infrastructure.
“I am grateful to the health workers because they are risking their lives to save others. But I think the government and politicians are not doing their job, ”he said.
Biren Budhathoki, a resident of Dang in western Nepal, said a delayed diagnosis led to the death of his 38-year-old cousin on May 14.
Most hospitals, except large cities, do not have a polymerase chain reaction (PCR) testing machine, which is essential for timely diagnosis and to prevent preventable death.
“When we got the result of the PCR test, my cousin had already developed pneumonia. He died shortly after being taken to COVID-19 Hospital from a nursing home located in Salyan, ”Budhathoki said.
The rising number of cases in the country has sounded the alarm, with Prime Minister Khadga Prasad Sharma Oli and the Health Minister publicly admitting that hospitals were overwhelmed by patients.
“The number of infections is straining the healthcare system; it has become difficult to provide patients with the hospital beds they need,” Oli wrote in an opinion piece in the Guardian newspaper, urging the international community to help her.
Experts have linked Nepal’s rise to the devastating second wave of its northern neighbor, India. Until mid-April, deaths from COVID had been limited to a single digit. At 6.51, Nepal’s daily death rate per million is now the worst in South Asia.
Bed shortages are a common problem throughout Nepal, which has approximately 18,900 general beds, 1,450 ICUs and 630 ventilation beds across the country. New Delhi, the capital of India with a smaller population, has over 4,000 ICU beds.
Anup Bastola, chief consultant at Sukraraj Hospital, told Al Jazeera that all ICU patients were in critical condition.
“Even though we have 24 ICU beds, we only have 12 fans. They all need fans, but we couldn’t provide them, ”he said.
Nepal’s number of doctors per capita is also one of the lowest in the world, with 0.17 doctors per 1,000 people, while India has 1.34 doctors per 1,000 inhabitants.
According to the media, at least 12 patients with ICU have lost their lives due to oxygen shortages since last week reports.
Pramod Paudel, a doctor at Bharatpur Hospital in central Nepal, said his hospital admitted fewer patients than its actual capacity, and that it only accepted 144 patients despite the capacity of 200, due to supply disruptions. of oxygen.
“Sometimes, when our oxygen supplies are about to run out, we worry about whether we will get more for our patients needs. We can’t take more patients because of the oxygen shortage, ”Paudel told Al Jazeera.
In recent weeks, medical care, including oxygen tanks, has been spreading from around the world, but officials say it is not close enough to meet demand. Many Nepalese living abroad have settled. Almost a third of Nepalese work abroad.
On Wednesday, the Ministry of Health and Population confirmed that it had detected a third variant of COVID in the country, B.1.617.2, a variant first detected in India that is considered highly contagious. The new variant was detected in 97 percent of the samples collected in 35 districts of the country. The other two variants are B.1.617.1 and B.1.1.7.
“We could be somewhere around the peak, because according to the government’s own conservative estimates, the infection rate is between 40 and 50 percent,” said Basu Dev Pandey, one of the leading virologists in the country. Nepal and former head of the Division of Epidemiology and Disease Control of Nepal Ministry of Health and Population.
According to epidemiologists, more than 80% of those infected will recover, but the recovery rate is not an indicator to measure the impact of the pandemic.
It is the deaths per million that indicate the good or bad situation of the situation.
Nepal is the worst in South Asia. pic.twitter.com/NuhGUbYyAn
– Arpan Shrestha (arpanshr) May 20, 2021
“The severity of the infection is very similar in India. In addition, we also share a long open border where cross-border movement remains largely unregulated. Flights between the two countries are still in operation, “said Pandey. Kathmandu has banned other international flights.
Nepal’s health experts had warned in March about the danger of a more lethal variant of the coronavirus entering through India.
The warning was not unjustified, as Nepal shared a porous border of about 1,700 km (1,100 miles) with India. Millions of Nepalese work in Indian cities like Delhi and Mumbai and many began returning in April as several Indian states imposed closures following the country’s devastating second COVID wave.
Meanwhile, Prime Minister Oli has been attacked for prioritizing politics over the country’s pandemic response: dissolving parliament and dividing political opponents trying to oust him from office. At the same time, the Prime Minister continues to recommend untested herbal medicines, going so far as to say that Nepalese have better immunity to withstand the virus.
At a function in Kathmandu last month, the prime minister said, albeit with a warning, that gargling with hot water in which guava leaves had been boiled could keep COVID at bay. “Even vaccines cannot guarantee 100% protection,” Oli said.
Gehendra Lal Malla, a political science professor at Tribhuvan University in Kathmandu, said Oil’s unfounded remedies and slight observations about the immune system had tricked people into taking the virus lightly.
“It was understandable that Nepal did not have a good medical infrastructure like the West, or China and India, but there was enough time and money to buy beds and ventilators from the ICU. But Oli was more concerned with securing his position than saving lives, ”Malla told Al Jazeera.
Although experts have called on the government to expedite vaccinations, the claim of vaccination has been lower than expected after the Indian Serum Institute (IBS) suspended the supply of AstraZeneca jabs, despite receiving payment in advance. SII, the world’s largest vaccine maker, halted exports to give priority to India, which has seen tens of thousands killed in the past two months.
Nepal, a poor country of 30 million, has vaccinated just two million people, mostly front-line workers, since vaccinations began on January 27th. To date, the country has acquired more than three million vaccines, including 800,000 doses from China and 348,000 doses from the WHO-run COVAX facility.
Defending the government’s management of the COVID situation, former Minister Mani Chandra Thapa told Al Jazeera that all political parties should be blamed for focusing more on power games rather than the pandemic.
“It is true that the government could have worked more effectively. But let’s not forget that other parties created obstacles by trying to oust the government in the midst of the pandemic. So we all have to take the blame and move forward to fight the virus, ”Thapa said.