Riusa Bagar, Mugu
MUGUM KARMARONG COMMUNITY HEALTH CENTER

Mugu, the most remote of all districts in Nepal, is known as the least developed due to the lack of education and health facilities. Over 65,000 residents live here, but there is only one doctor. The practices of child marriage, chhaupadi (the banishment of menstruating women and girls to cow sheds), a form of polygamy (a woman must marry all the brothers in a family) and violence against women are unfortunately still widespread.

Previous health care was catastrophic: women in the 15 mountain villages of the Mugum Karmarong district had their babies at home and without the assistance of a midwife or nurse, as there was not a single health post or maternity ward in the entire area. The nearest health post is a 35 kilometer walk south of Rara Lake and is only accessible by steep mountain trails.

Most common diseases: Uterine prolapse (uterine prolapse until discharge), asthma, arthritis, dental problems, pneumonia, bronchitis, lice, skin infections, blood poisoning due to poor wound care.

Project Objectives: Establish & permanently operate a health post including a maternity clinic to ensure access to basic health care for the approximately 5,400 people in the district. Furthermore, to provide optimal care for women and girls before, after and during childbirth by a midwife in a hygienic environment. A stay of several days for the mothers is intended to prevent chronic birth-related diseases such as uterine prolapse or genital infections.

Construction phase: A one-day walk is required from Gamghadi, the district headquarters, and last link on a bumpy dirt road, to Riusa Bagar, the site of the health post. So, the materials for the construction had to be transported first on jeeps or small trucks, and then on the backs of people and mules. Nevertheless, the villagers were incredibly motivated and not only were all the necessary permits and contracts with the Nepalese government arranged in record time, but also the transport of the materials, the digging of the foundations and the pouring of cement were completed in the shortest possible time. The foundation stone had only been laid in March 2018, and just one year later construction was already complete!

In April 2019, the newly built Community Health Center was ceremoniously handed over to Mugum Karmarong Rural Municipality. It has six beds, and is staffed by two nurses, two health assistants and one support staff. Services include free provision of prenatal and postnatal health care, family planning services, training in first aid, health and hygiene with special emphasis on mothers and children, emergency care, and access to free medicines through an in-house pharmacy.

Sustainability: For another year, Chay Ya continued to cover the cost of medicines, but since 2020, all follow-up costs (i.e. including all salaries) have been covered by the Nepalese government.