Mwr Diarrhoea Report

Consolidated report of Mid Western Region Diarrhoeal Epidemic

Comprehensive Report of

Mid Western Region Diarrhoea Epidemic

Date of Compilation of Report: 28th August 2009

Prepared By:

Sujit Kumar Sah (Epidemiologist, AICP/MWRHD) Pranab Koirala (IT Manager, AICP/MWRHD)


Government of Nepal Ministry of Health and Population

Mid Western Regional Health Directorate Birendranagar, Surkhet

Districtwise Overview of Diarrheal Epidemic in Mid-Western Region Total Number of Diarrhoeal Deaths in Mid-Western Region: 261 Total Number of Non-Diarrhoeal Deaths: 15 Total Deaths: 276 Total Morbidity till date: 48901 Jajarkot The total number of casualties in Jajarkot district till date is 154. Out of this number, the diarrhoeal deaths toll 144 and the remaining 10 casualties have succumbed to other diseases. The current situation of the district is under control and stable. As far as the morbidity is concerned, for the last 2 weeks or so, it remains steady. The total number of treated cases since the outbreak hit for the first time in Rokayagaun VDC, is 25,171. Out of 154 deaths, 82 are female and 72 are male. Similary, 66 are dalits, 59 Brahmin/Chhetri/Thakuri and remaining 29 are Janjatis. Rukum The total number of casualties in Rukum district till date is 51. All 51 deaths have succumbed to diarrhea. Currently, 5 VDCs are affected with only a few cases. However, the morbidity of rest of the VDCs is steady. The total number of treated cases in Rukum district till date is 12,605. Out of 51 deaths in Rukum, 27 are male and 24 are female. Similarly, 26 are dalits, 6 janajati and remaining 19 are Brahmin/chhetri/Thakuri. Dailekh The total number of casualties in Dailekh District till date is 29. Out of this number, the diarrhoeal deaths toll 28 and remaining 1 casualty has succumbed to other diseases. The diarrhoeal cases in some VDCs in Dailekh are sporadic. However, the morbidity of rest of the VDCs is steady. The total number of treated cases in Dailekh district till date is 5733. Out of 29 deaths in Dailekh, 14 are male and the rest 15 are female. Surkhet The total number of casualties in Surkhet District till date is 14. Out of this number, 10 have succumbed to diarrhea and the remaining 4 are casualties of other diseases. Currently, 5 VDCs are moderately affected with only few sporadic cases. The rest of the VDCs are relieved as the diarrhoeal cases remain steady. The total number of treated cases in Surkhet district till date is 3619. Out of 14 deaths in Surkhet, male and female share equal proportion.


Dolpa The total number of deaths in Dolpa district till date is 6. All 6 have given in to diarrhea. The current situation is absolutely normal with no new cases of diarrhea. 501 diarrhoeal cases have been treated in Dolpa district till date. Salyan The total number of deaths in Salyan District till date is 5. All 5 have given in to diarrhea. The current situation in Salyan is absolutely normal with no new cases of diarrhea. 658 diarrhoeal cases have been treates so far in Salyan district. Rolpa The total number of deaths in Rolpa district is 6. All 6 deaths are cases of diarrhea. Normalcy has crept in all the VDCs in Rolpa district as far as diarrhea is concerned. The total number of treated cases till date in Rolpa district is 347. Pyuthan The total mortality in Pyuthan district till date is 4. All 4 have succumbed to diarrhea. The situation of Pyuthan district is pretty normal with no new cases of diarrhea observed. The total number of treated cases till date in Pyuthan is 105. Humla Humla District has had the setback of diarrhoeal outbreak recently. Only 1 VDC (Kalika) has been affected from diarrhea with deaths tolling 5. According to a recent report from DHO Humla, 6 deaths of infants (under 6 months of age) have occurred by some other cause. The deaths of infants have however occurred in earlier dates (about 3 months earlier). The situation is fairly in control after health personnel have been mobilized to the affected areas with essential drugs and commodities. Total 164 cases have been treated so far. Kalikot The total number of casualties in Kalikot district is 1. The situation is absolutely normal with no new cases of diarrhea. Total treated cases till date in Kalikot district is 73. Dang The total number of casualties in Dang district is 1. The situation is pretty steady and in control as far as diarrhoeal morbidity is concerned in Dang district. The total no.of treated cases in Dang district so far is 65.


Central Response for the control of Diarrhoeal Epidemic in the Mid Western Region

o Ministry of Health and Population, in instigation of Epidemiology and Disease Control Division, has been consistently coordinating with various government and non-government organizations for human resource mobilization, logistic coordination and communication in Jajarkot and Rukum districts to control the diarrhoeal epidemic. The overall response has been incredible.

o On 2066/01/31 Hon. Minister for Health and Population visited outbreak affected

areas to observe outbreak control activities. Similarly, medical doctors with drugs deployed to the outbreak affected areas.

o The central teams have been involved in the treatment of diarrhea affected people

and also have been collecting sample of stool, water and food to find out the cause of the outbreak.

o Maximum amount of Chloriform (180+) unearthed in water.

o On 2066/03/29, EDCD deployed 20 health personnel to the outbreak affected

areas. Similarly, a 27-member team deployed from Nepalgunj. o Department of Health Services (DoHS) deployed 9 health personnel including 2

doctors to Jajarkot.

o Ministry of Health and Population has contributed in sending human resource and drugs to the inaccessible VDCs of Jajarkot and Rukum districts by managing army helicopters.

o On 2066/04/05 Hon. Prime Minister with his team visited the outbreak affected

VDCs of Jajarkot, Rukum and Rolpa districts to scrutinize outbreak control activities and distributed drugs and essential commodities.

Regional Response for the control of Diarrhoeal Epidemic in the Mid Western Region

o On 2066/01/20 Diarrhoeal Outbreak hit for the first time in Rokayagaun VDC of Jajarkot district and straight away 3 other VDCs namely Ramidada, Sakala and Ragda were affected by the diarhoeal outbreak.

o On 2066/01/22 DHO Jajarkot mobilized a team of 6 health personnel with

essential drugs to the affected VDCs.


o On 2066/01/25 RHD deployed a team of 3 health personnel to the district and the team conducted a meeting with district stakeholders and health workers about Outbreak Management and Control.

o On 2066/02/01 RHD deployed 6 health personnel including a medical doctor with

700 kgs of drugs in Jajarkot district. o On 2066/03/10, 4 more health personnel were sent to Jajarkot district bagging 800

kgs of drugs. o On 2066/03/18, 4 health workers with 8 cartons of medicine were deployed to

Jajarkot district in addition to the medicines supplied from Regional Medical Store, Nepalgunj.

o On 2066/03/22, RHD mobilized a team of 6 health personnel to Jajarkot district. o On 2066/03/25, RHD deployed a 2-member team to Rukum district. The team

bagged medicines supplied by ADRA. On 2066/03/26 the team organized meeting with district stakeholders and health workers and urged everyone for support in outbreak management and control. The team made necessary arrangements for deployed health workers from the district to 7 different affected VDCs of Rukum district. The team even managed ways for sample collection, storage and transportation.

o On 2066/04/03, RHD mobilized 8 health personnel to Jajarkot District for

organizing health awareness campaigns. The team organized radio programme about diarrhea, distributed posters and pamphlets to different affected VDCs, enlightened locals about Household water treatment and Environmental Sanitation. Similarly, coordinated with district stakeholders and provided various curative services.

o RHD has been in close coordination with different NGOs and INGOs and has

been consistently urging for logistics and other supports. The support has been remarkable from them as well.

o On 2066/03/21, a combined meeting with different NGOs, INGOs was conducted

in the chairmanship of Regional Director, Dr. Anand Kumar Shrestha and initation of Regional Medical Store. The following assessments were drawn:

1. All organizations should be in close coordination with each other. 2. All organizations should inform formally to RHD and Regional Medical

Store while providing technical and logistics assistance. 3. Emphasis should be first given in Research Mechanism to find out the

cause of the diarrhoeal outbreak and then go into the curative process. 4. Miking technologies should be adopted for proving health education

regarding hygiene and sanitation. 5. Consistency should be maintained in the supply of drugs not letting the

drugs to be scarce in diarrhea affected districts at any time.


o RHD, in coordination with RMS, has been consistently supplying drugs to control

diarrhoeal outbreak in different districts. o On 2066/04/02 MWRHD established a 24-hrs working Control Room for

immediate response and timely communication and transmission of information.

o On 2066/04/05, a team of 3 health personnel deployed to Rukum District for outbreak control and management.

o On 2066/04/6, a 2-member team mobilized to Rukum District for outbreak

investigation and management. Details about human resources deployed from MW-RHD in Jajarkot District for diarrhea outbreak management and control (from 3rd week of Baisakh till date) First team-2066/1/25

1. Mr. Sujit Kumar Sah - Epidemiologist 2. Mr. Pranab Koirala - I.T. Manager 3. Mr. Ram Bahadur Chand - Sr. AHW Second team-2066/2/1 1. Dr. Khagendra Jung Shah - MO 2. Dhanram Oli - Sr. AHW 3. Man Singh Nepali - Sr.AHW 4. Yagya Bd. Gurung - H.E.T. 5. Prachand Gautam - H.A. 6. Manbahadur Nepali – AHW Third Team-2066/2/21 1. Mr. Mahesh Kumar Puri-TLO, MWRHD 2. Mr. Padam Bahadur KC-TLO, DoHS Fourth - 2066/3/10

1. Dev Narayan Upadhaya - AHW 2. Nand Giri - AHW 3. Kapil Dev Acaraya - AHW 4. Birjung Shah - AHW


Fifth team -2066/3/18 1. Daya Ram Naupane - PHI 2. Ramesh Khakurel - PHI 3. Ganesh Shrestha - H.A. 4. Baleshwar Yadav -Sr. AHW Sixth team -2066/3/22 1. Dir Jung Shah - Sr. PHO 2. Jit lal Dhakal - EPI officer 3. Hasta Raj Giri - AHW 4. Gagandev Giri - AHW 5. Ramesh Gautam - AHW 6. Mohan Singh Rana – Office Aid Seventh team - 2066/4/3 1. Yagya Bahadur Gurung - HET 2. Jit Lal Dhakal -EPI officer 3. Shyam Lal Achraya - VC 4. Tirth Bahadur Rana - Typist 5. Khadak Bahadur Shahi - AHW 6. Pashupati Shahi - AHW 7. Dirgh Nepali - AHW 8. Rabindra Sejuwal - AHW Details about human resources deployed from MW-RHD in Rukum District for diarrhea outbreak management and control (from 3rd week of Ashar till date) First team-2066/3/25

1. Mr. Sujit Kumar Sah - Epidemiologist 2. Mr. Pranab Koirala - I.T. Manager 3. Dr. Nand Lal Sikarmi - SMO- WHO/ IPD Second team - Deployed Human resource in Rukum District of Athbisdandagaun and Bhimchaur - 2066/3/30 1. Dr. Suwarn Acharaya - MO 2. Sita Ram Chaudhary - H.A. 3. Prem Chaudhary - AHW 4. Hot Ram Khatri - AHW Third team - 2066/4/5


1. Anant Bahadur Khatri - AHW 2. Rupa Bhandari - AHW

Details about human resources deployed from Nepal Army Helicopter in Jajarkot District for diarrhea outbreak management and control (2066/3/30) First team -2066/3/30 ( Bhur VDC of Jajarkot)

1. Dr. Santosh Chaudhary - MO 2. Gahendra K.C. - AHW 3. Radhe Kishun Chaudhary - AHW 4. Suman Chaudhary -AHW 5. Himal Chaudhary - AHW

Second team-2066/3/30 (Bhagbati VDC of Jajarkot)

1. Dr. Lalit Suri - MO (Nepaljung Medical College) 2. Prem B.K. - H.A. 3. Prem Pangali AHW 4. Dilli Chaudhry - AHW 5. Nabin Rana - AHW Third team -2066/3/30 ( Garkhakot - Budhidanda) 1. Dr. Madhu Arayal - MO 2. Chot Ram Chaudhary - H.A. 3. Ram Bahadur Chand - Sr.AHW 4. Mahesh Chaudhary -AHW 5. Raju Chaudhary - AHW 6. Sen Manandhar - AHW

Details about human resources deployed from DHO Rukum for diarrhea outbreak management and control. Gotamkot VDC -2066/3/26 1. Dr. Binod Kumar Giri - DHO-Rukum

2. Sakuntala Khanal - Staff Nurse 3. Usha Chand - ANM 4. Mani Raj Shah -AHW

Athbiskot - 2066/3/27 1. Nand Lal Mahato - Sr.AHW 2. Shiv Narayan Rajak - Sr.AHW


3. Hira Pun - ANM

Baphikot - 2066/3/27 1. Janki Malla - ANM 2. Megha Raj Soni - AHW Garayala - 2066/3/28 Karna Bahadur Budhathoki - AHW

Athbiskot, Jhimchaur - 2066/3/28 1. Patrika pun - ANM 2. Surendra Yadav - H.A. 3. Sunita Acharaya - ANM 4. Kamal Budhathoki - AHW Purtimkanda - 2066/3/29 1. Pradeep K.C. - AHW

Aathbisdandagaun - 2066/3/29 1. Bibek B.M. - AHW Local Health Workers Details about human resources deployed from RHD to Dailekh (2066/05/06) 1. Dr. Ashok G. Chettri – Medical Doctor/Epidemiologist SUPPORT FROM DIFFERENT NGOs/INGOs AND OTHERS WHO, NEPAL

WHO Nepal has played a vital role in providing human resource and logistics to MoHP, RHD and outbreak affected districts. WHO Regional Office, Nepalgunj supported in outbreak investigation and response by providing 54000 Aquatabs and deploying Surveillance Medical Officers in Jajarkot and Rukum Districts.


WHO supplied Diarrhoeal kit to Jajarkot district which assisted in the treatment of 100 severe cases and approx. 500 mild cases of diarrhoea. A team of WHO Surveillance Medical Officer and NPHL Officer collected samples to find out the sources of infection and distributed drugs in Jajarkot district. WHO, in request to EDCD, has recruited a Medical Doctor/ Epidemiologist for three months to assist the region in Disease Surveillance and Outbreak Investigation. SAVE THE CHILDREN Emergency Support in Jajarkot and Rukum districts. Save the Children has supported in the diarrhoeal epidemic in Jajarkot and Rukum by supplying the following: S.N. ITEM QUANTITY REMARKS 1 Inj. Ringer's Lactate 1512 bottle 2 Inj. Ciprofloxacin(500mg) 1000vial 3 Inj.Metronidazole(500mg) 1500vial 4 Tab.Ciprofloxacin(500mg) 1500tab 5 Tab.Metronidazole(200mg,400mg) 1500tab 6 Nawajeewan(ORS) 1000packet 7 Cap.Doxycycline(100mg) 1500cap 8 Cap Tetracycline(250mg,500mg) 1000 cap 9 Piyush solution 500 bottle For water

purification 10 IV cannula 500 piece Including 20%

butterfly cannula for children.

11 IV set 400piece Note: Save the Children has also supported by sending human resources in Jajarkot district (2 health personnel) and Rukum district (2 health personnel), and drugs worth Rs. 350 Lakhs. UNICEF UNICEF has played a tremendous role in humanitarian assistance to districts affected by diarrhoeal epidemic. UNICEF has supported in various aspects of health interventions, WASH interventions, health education and awareness campaigns by supplying logistics, drugs and essential commodities. The support is worth Rs. 7,310,786 in Mid and Far West Regions. Similarly, UNICEF’s Hand Washing and POU Water Treatment IEC Materials Support in Jajarkot, Rukum and Achham Districs is worth Rs. 293,646. Developments project services Centre (DEPROSC) DEPROSC distributed 2000 ORS, 3000 soaps and IEC Materials through implementing partners in Jajarkot district.


Nepal Water for Health (NEWAH) Response Summary:

NEWAH has been implementing the WASH emergency response activities

supported by the CONCERN and Water Aid Nepal since mid of July 2009 in 4 VDCs ( Dasera ,Salma,Suwanauli and Majhkot )

NEWAH/Concern and water Aid has been responsible of social mobilization in 4 VDCs of Jajarkot district(Majkot, Dasera, Suwanauli and Salma).

Distribution of Pictorial IEC materials on 5 key health and hygiene message and water purification pamphlet.

Health and Hygiene messages are being relayed through Radio Sarada, Salyan and Radio Krishna Sagar.

26 human resources mobilized; 11 CMAs, 8 health and sanitation facilitator, 2 NEWAH staffs, 4 technicians from local NGOs.

Mr. Man Bal Wagle of NEWAH had visited Khalanga jajrkot for WASH coordination and information sharing.

Commodity Support S. N. Commodities Concern WATER AID UNICEF DWSO

Jajarkot 1 Water Guard 1600 - - - 2 Piyush - 2500 - - 3 Hand miking 11 4 Soap 2000 5 IEC Flex 102 40 6 IEC Pamphlet 1000 2150 7 ORS 2000 2000 8 Chlorine Liquid 50 L 9 Vile 250 10 Aqua tab 77000 30000 12 Cell battery 1000 13 CMA/ HR 6 6 - - ADRA ADRA has contributed with the supply of logistics, medicines, IEC Materials in different diarrhoeal affected districts of Mid Western Region worth Rs. 8, 06,673 Walter Reed/AFRIMS, Research unit Nepal (WARUN)


Supported by supplying sample collection kits for virology tests in Jajarkot and Rukum Districts. Nepal Red cross society (NRCS)] Provided 100 blankets, 100 tarpaulins, 50 stretchers, IEC materials and human resource support as well. INF (International Nepal Fellowship) Supported by mobilizing 6-member response team (Doctor, H.A, Nurse, Team coordinator & Support Staffs) in the outbreak affected VDCs Bhur and Karkigaun of Jajarkot district and provided drugs worth Rs. 70,000. HELVETAS Nepal Supported by providing drugs worth Rs. 250 lakh and also assisted by deploying 6 member medical team (including 2 doctors) in the outbreak affected areas of Jajarkot district. DFID Community Programme (CSP) Supplied 85000 chlorine tablets, 20,000 ORS packets and 15 hand-held speakers in Jajarkot district. CARE Nepal Supported by mobilizing 8-member team in Jajarkot district and supplied drugs worth Rs. 4 lakhs. NFHP Supported NRCS in Diarrhoea Awareness Campaign with activities like community mobilization, awareness campaigns and monitoring of ongoing activities. ENPHO Helped in outbreak control in Surkhet, Jajarkot, Rukum and Dailekh districts by deploying 38 members youth volunteers for awareness campaigns. Lions Club Groups of Banke and Surkhet Supported by providing 18 petis drugs to RHD. Safe Motherhood Network Federation (SMNF)] Conducted Health and hygiene education in Rukum District. Korea International Cooperation Agency (KOICA) A 14 member team (including 2 doctors), had been deployed by KOICA and helped the local people affected from diarrhea by conducting Medical Camp in Dailekh District. Local NGOs in Rukum District


Provided 108,000 aquatabs and 3000 ORS, Sanitation and hygiene volunteers. Support from ex-MP(RPP) Mr. Govinda Bikram Shah, ex. MP, supported the Diarrhoeal Epidemic Control by supplying 29 petis drugs. Support from United NCPM and PLA NCPM and PLA supported the Diarrhoeal Epidemic Control in Humla District by supplying 1 quintal and 2 quintal drugs respectively. Support from Medical Colleges 1. Nepalgunj Medical College: Nepalgunj Medical College supported in the control of diarrhoeal outbreak in jajarkot district by deploying a 8 member medical team. 2. Birgunj Medical College Birgunj Medical College supported in the control of diarrhoeal outbreak in Dailekh district by deploying a medical team of 8 doctors and supplying medicines worth Rs. 1.5 lakhs. Drugs Supply from Regional Medical Store, Nepaljung

Regional Medical Store, Nepalgunj has sent different items of drugs to the all diarrhea affected districts for controlling diarrhoeal outbreak in the mid-western Region. Districtwise Supply status of Epidemic Drugs District by RMS Nepaljung S.No Date District K.G./Box Remarks

1 17/5/2065 Banke 26 2 4/13/2065 Banke 80 3 13/8/2065 Banke 30 4 26/12/2065 Banke 12 5 14/4/2066 Bardiya 34 6 14/4/2065 Bardiya 95 7 10/8/2065 Bardiya 95 8 26/12/2065 Dailekh 30 9 13/5/2065 Dailekh 30

10 8/8/2065 Dailekh 45 11 27/12/2065 Dailekh 40 12 24/2/2066 Dailekh 13 13 11/3/2066 Dailekh 11 14 31/3/2066 Dailekh 20


15 18/4/2066 Dailekh 182 16 22/4/2066 Dailekh 15 17 32/4/2066 Dang 252 18 16/8/2065 Dang 91 19 3/1/2066 Dang 45 20 16/4/2065 Dang 17 21 27/4/2065 Dang 25 22 23/3/2066 Dang 18 23 20/4/2066 Dolpa 9 24 22/4/2065 Dolpa 908 25 5/8/2065 Dolpa 1262 26 6/1/2065 Dolpa 485 27 20/4/2066 Dolpa 369 28 25/4/2066 Dolpa 729 29 26/4/2066 Dolpa 22 30 19/4/2065 Humla 194 31 5/8/2065 Humla 1448 32 6/1/2066 Humla 502 33 9/5/2066 Humla 35 34 10/5/2066 Humla 364 35 2/5/2065 Jajarkot 346 36 21/7/2065 Jajarkot 805 37 31/12/2065 Jajarkot 586 38 21/3/2066 Jajarkot 1263 39 29/3/2066 Jajarkot 158 40 29/3/2066 Jajarkot 158 41 29/3/2066 Jajarkot 158 42 29/3/2066 Jajarkot 546 43 29/3/2066 Jajarkot 546 44 22/3/2066 Jajarkot 15 45 21/3/2066 Jajarkot 1568 46 31/3/2066 Jajarkot 1568 47 31/3/2066 Jajarkot 314 48 3/4/2066 Jajarkot 700 49 9/4/2066 Jajarkot 3302 50 21/4/2066 Jajarkot 755 51 9/5/2066 Jajarkot 75 52 20/4/2065 Jumla 894 53 26/7/2065 Jumla 1022 54 28/12/2065 Jumla 422 55 16/4/2066 Jumla 394 56 19/4/2065 Kalikot 361 57 25/7/2065 Kalikot 1172 58 30/12/2065 Kalikot 663 59 18/4/2066 Kalikot 401 60 14/4/2065 Mugu 679 61 1/8/2065 Mugu 1274 62 4/1/2066 Mugu 582 63 11/5/2065 Pyuthan 25 64 6/8/2065 Pyuthan 85


65 7/1/2066 Pyuthan 40 66 5/4/2066 Pyuthan 3 67 4/5/2066 Pyuthan 90 68 28/4/2065 Rolpa 25 69 8/8/2065 Rolpa 91 70 7/1/2066 Rolpa 42 71 8/4/2066 Rolpa 5 72 6/8/2065 Rukum 2305 73 2/1/2066 Rukum 654 74 26/3/2066 Rukum 876 75 29/3/2066 Rukum 158 76 29/3/2066 Rukum 546 77 29/3/2066 Rukum 363 78 26/3/2066 Rukum 399 79 31/3/2066 Rukum 480 80 9/4/2066 Rukum 3140 81 27/4/2066 Rukum 718 82 7/5/2066 Rukum 2418 83 2/5/2065 Salyan 27 84 16/8/2065 Salyan 87 85 3/1/2066 Salyan 45 86 13/4/2066 Salyan 16 87 19/4/2065 Surkhet 29 88 8/8/2065 Surkhet 86 89 27/12/2065 Surkhet 51 90 9/4/2066 Surkhet 25 91 13/4/2066 Surkhet 37 92 18/4/2066 Surkhet 72 93 7/5/2066 Surkhet 36

Total: 41234 Current Status of Drugs Available at Regional Medical Store, Nepalgunj (2066/05/11) S.N. Drugs Name Stock Unit

1 0.9 % NaCl 540mm (NS) 116 Bottles 2 NaCl 0.9%, 5% Dextrose (DNS)

540 mm 250 Bottles

3 5 % Dextrose 450 mm 720 Bottles 4 RL 2647 5 Inj. Cipro 100 ml 1170 Vial 6 Amoxycilline 500mg Cap. 1500 Cap. 7 Amoxycilline 250 mg Cap. 140200 Cap. 8 Ciprofloxacine 250mg Tab. 5000 Tabs. 9 Ciprofloxacine HCl 500mg 5000 Tabs. 10 Cotrim DS tabs. 0 Tabs. 11 Cap. Doxycilline 100mg 9200 Cap.


12 Metronidazole 200mg 296350 Tabs. 13 Metronidazole 400mg Tab 214750 Tabs 14 Sulphamethoxazole Sus. 200 mg

& Trimmethoprim 40mg/5ml 500 Bottles

15 Sulphamethoxazole 400 mg & Trimmethorprim 80mg

10000 Tabs.

16 Paracetamol 500mg Tabs. 348800 Tabs 17 Tetracyclline 250mg caps 5300 Cap. 18 Tetracyclline 500mg Caps. 8400 Cap. 19 ORS 1000 ml 65730 Pkts. 20 Amoxycilline 150 mg/5 ml Dry

Suspension 0 Bottles

21 Metronidazole 100 mg/ 5ml Syrup

590 Bottles.

22 Syrup Paracetamol 125 mg/5ml 7140 Bottles. 23 Compound Sodium Lactate

Solution 540mm 20579 Vial

24 Syringe 5ml 13594 Pieces. 25 Adhesive tape 10 cm/5m 605 Pieces 26 IV Infusion set with needle 3174 Pieces 27 10% Dextrose 450mm 0 Bottles 28 Citrizine HCl 10mg 5200 Tabs. 29 Vitamin B-Complex 97000 Tabs 30 Metachlopromide Inj. 450 Amp. 31 Methylated Spirit 450 ml 137 Bottles. 32 AB Cotton 400 gm 980 Roll 33 Butterfly Needle 500 Pcs 34 Gloves 330 Pair 35 IV Canula D Size 1373 Pc 36 Diarrhoeal kit 1 Set

Details of Stock and Demand of Drugs/Items in the Mid Western Region

SN Drugs

Current Stock in RMS

Districts Demand Deficit

1 NS 116 1250 1134 2 DNS 250 500 250 3 RL 2647 21980 19333 4 Inj.Cipro. 1170 6590 5420 5 Tab.Amoxy 500mg 1500 55000 53500 6 Tab.Amoxy 250mg 140200 30000 -110200 7 Tab Cipro.250mg 5000 57000 52000 8 Tab.cipro 500mg 5000 198370 193370 9 Tab.Cotrim DS 10000 157440 147440


10 Tab.Doxy.100mg 9200 15500 6300 11 Tab.Metro 200mg 296350 317650 21300 12 Tab.Metro.400mg 214750 326350 111600 13 Tab.Paracetamol 500mg 348800 145000 -203800 14 Cap.tetracycline 500mg 8400 23000 14600 15 Tab.Tertracycline 250mg 5300 23000 17700 16 ORS 65730 155000 89270 17 Syp.Metro. 0 3000 3000 18 Syp.paracetamol 7140 1500 -5640 19 Inj.metaclopromide 450 1000 550 20 Inj. Metro 0 7590 7590 21 IV Cannula 20, 22, 24 G 1373 5450 4077 22 Tab. Perinorm 0 8515 8515 23 Tab. Buscopan 0 2000 2000 24 Tab. Cortim SS 0 164700 164700 25 Tab. Cortim PD 0 25000 25000 26 Tab Cortim P 0 20000 20000 27 Syp. Perinorm 0 1500 1500 28 Tab. Albendazole 0 12000 12000 29 Inj Aciloc 0 200 200 30 IV Set 3174 5725 2551 31 Syr. Norfloxacin 60 ml 0 300 300 32 Tab. Zinc 0 265150 265150 33 Adhesive tape 605 204 -401 34 Cotton 980 4 -976 35 Disposable Syringe 13594 2100 -11494 36 Tab. Metaclopromide 0 2000 2000 37 Sus. Cotrim 500 2830 2330 38 Tab. Ranitadine 150mg 0 15000 15000 39 Inj. Gentamycine 80 mg 0 442 442 40 Inj. Dexona 0 100 100 41 Oflaxicine Sus. 100 ml 0 100 100 42 Butterfly Needle 500 0 -500 43 Methylated Spirit 450 ml 137 0 -137 44 Diarrhoeal Kit 1 0 -1 45 Gloves 330 0 -330

Note: ‘-‘ indicates drugs/items available at RMS to fulfil the demands of the district. Other items are not enough to fulfil the districts’ demands. Details of Visits from Higher Authority in the Diarrhoea Affected Districts RHD, Surkhet SN Date of Visit Name/Post Supervised

VDCs/Place 1. 2066/04/02 Dr. Laxmi Raj Pathak, Co-ordinator, MWR Diarrheal

Epidemic Management and Control Dailekh, Jajarkot, Surkhet

2. 2066/05/02 Dr. Sambhu Saran Tiwari, Director, MD


Rukum District S.N. Date of

Visit Name/Post Supervised

VDCs Feedback

1 2066/04/05 Hon. Prime Minister Madhav Kumar Nepal

District head quarter Rukum & Aathbiskot VDC

Strengthen coordination

2 04/05 Hon. Health Minister Umakanta Chaudhary

" " "

3 04/05 Dr. Govind Prasad Ojha-DG-DoHS

" " Strengthen coordination & work, mobilization of FCHVs

4 04/04 Dr. GD Thakur-Director-DoHS DHO Rukum Regular monitoring and coordination

5 04/07 Mr. Dev Raj Dhakal-CDO, Rukum

Gotamkot, Aathbiskot

Drugs in Aathbiskot needed

6 04/07 Mr. Malla, Army Brigadier General, Tulsipur, Dang


Drugs in Aathbiskot needed

7 04/07 Mr. Rabindra Bd. Dhanuk-DSP, Rukum


"

8 04/15 Mrs. Sangita GC- Lab Tech., EDCD

DHO, Rukum and Chhibang SHP

Stool and water sample collection

9 04/17 Kamala Pandey, Med. Tech. NPHL, Teku

DHO, Rukum and Chhibang SHP

Stool and water sample collection

10 2066/04/26 Hon. Health Minister Umakanta Chaudhary

District HQ Rukum and Aathbiskot

Strengthen Coordination

11 2066/4/26 Ex. Hon. Minister for Peace and Recreation, Mr. Janardan Sharma

District HQ Rukum, chaurjhari and Kotjari VDC

Strengthen Coordination

12 2066/04/26 Parliamentary Mrs Bimala KC Different VDCs Regular drugs supply and coordination

13 04/26 Parliamentary Mrs. Jun Kumari Roka

Different VDCs Regular drugs supply and coordination

14 04/26 Parliamentary Mrs Kamala Roka

Different VDCs Regular drugs supply and coordination

15 04/29 Mr. Arjun Bdr. Singh, Director NHTC

Kot PHC IEC Needed and HR Management

16 04/29 Mr. Rajaram KC, Nepal Army Kot PHC IEC Needed and HR Management

17 04/31 Parliamentary District HQ Coordination Jajarkot District SN Date of Visit Name/Post Supervised

VDCs 1. 2066/01/31 Ex. Health Minister Mr. Giriraj Mani Pokhrel Rokayagaun 2. 2066/01/31 Dr. Shankar Shreshta, EDCS Rokayagaun 3. 2066/03/23 Hon. Health Minister Mr. Umankanta Chaudhary Khalanga, Dashera 4. 2066/03/23 Hon. State Health Minister Khadga Bahadur Basyal Khalanga, Dashera 5. 2066/03/23 Hon. MP Mr. Kali Bahadur Malla Khalanga, Dashera


6. 2066/03/23 Secretary MoHP Dr. Dirgha Singh Bam Khalanga, Dashera 7. 2066/03/23 Dr. Ishwar Prasad Upadhyaya, EDCD Khalanga, Dashera 8. 2066/04/05 Hon. Prime Minister Mr. Madhav Kumar Nepal Khalanga 9. 2066/04/05 Hon. Health Minister Mr. Umakanta Chaudhary Khalanga 10. 2066/04/05 Director General DoHS, Dr. Govinda Prasad Ojha Khalanga 11. 2066/04/05 Regional Administrator, Mr. Binod Gyawali Khalanga 12. 2066/04/09 Dr. Laxmi Raj Pathak, Coordinator, MWR Diarrhoeal

Epidemic Management and Control Khalanga

13. 2066/03/20 Dr. Padam Bahadur Chand, DoHS DHO, Jajarkot 14. 2066/04/24 Dr. Bhim Acharya, Sr. PHA, DoHS DHO, Jajarkot Dailekh District SN Date of Visit Name/Post Supervised

VDCs/Place 1. 2066/04/09 Dr. Laxmi Raj Pathak, Co-ordinator, MWR Diarrheal

Epidemic Management and Control Dailekh District Hospital

2. 2066/04/21 Dr. Mahesh Maskey, President, NHRC Dailekh District Hospital

Districtwise Details of Human Resource Mobilization for Diarrhoea Outbreak Control District: Dailekh . S.N.

VDC

Deployed Team DHO

Post

Date

1

Bhairikalikathum-7

1.Dal Bahadur Nepali 2.Rohit Thapa

Sr. AHW AHW

2066/3/10,11

2 Baluwatar-9 1. Dirgh Bd. Budhamagar

AHW 2066/3/18,20

3

Mehaltoli-6,7,8

1. Madam Kumar Shrestha 2.Promod Koirala

Sr. AHW AHW

2066/3/23,24

4

Jagnath-5,6,7,8

1.Rohit Thapa 2.Thirraj Regmi

AHW, AHW

2066/3/23,25

5 Katti-2,7,9 Bed Bd. Thapa Sr.AHW 2066/3/23


6 Narayan nagarpalika -ward no. 2

Thir raj ragmi AHW 2066/3/31

7 Mehaltoli-6,7,8,9 1.Nagandra B. Hamal 2.Pramod Koilara

Sr.AHW AHW

2066/4/4,5,6

8 Latibindrasaini-2,4,6,8,4 1.Narotam B. Rawal 2.Thirraj Regmi

Sr.AHW AHW

2066/4/5 till date

9 Gamaudi-2,4,6,7,8,9 Local Health Workers

2066/4/13

10 Chhiudpushikot Local Health Worker Dal Bdr. Nepali

Sr.AHW AHW

-

11 Gauri-2,3 Local Health Worker - -

12 Satala Rohita Thapa AHW 2066/4/10

13 Jaganath-2,3 Thir Raj Regmi AHW 2066/4/11

14 Jambukandh-8 Local Health Worker AHW

15 Bhairikalikathum-7

Dharm Raj Jaisi Local Health Worker

Sr. AHW 2066/4/12

16. Bhairikalikathum-4,6,8 Dharm Raj Jaisi and HW

Sr. AHW 2066/04/12

17 Pipalkot-3,6,9 1. Dharm Raj Jaisi 2. Surya Bd. Thapa 3. Bakhat K.C.

Sr. AHW AHW AHW

2066/04/14

18 Jambukandh-6 1. Ramesh Bhandari 2. Local HW

H.A. AHW

2066/04/14

19 Goganpani-7 Local Health Workers

2066/04/8

20 Badalamji Local Health Workers

2066/04/15

21 Rawatkot-3,4 " 2066/04/18

22 Naule-5,8,9 " 2066/04/18


Details of Human Resource Mobilization for Diarrhoea Outbreak Control District: Dolpa

. S.N.

VDC

Deployed Team DHO

Post

Date

1 Dunai-Thala tol 4 members lead by Sanjay Kumar Mandal

H.A.

2066/3/4

2 Jufal- Dangiwada 2 members lead by Ashok Kumar Yadav

AHW 2066/3/29

3 Lawan- Khani tol Dhannath Yogi Sr. AHW

2066/3/24

4 Jufal- Motipur 1. Budhi Dharal 2. Bholanath Ghimire

AHW AHW

2066/4/4

5 Dunai- Tipla 1. Ran B. Budha 2. Arun Kumar Thapa

AHW 2066/4/4

6 Jufal -1, Airport Budhi Dharal

AHW 2066/4/12

Details of Human Resource Mobilization for Diarrhoea Outbreak Control District: Rukum

SN Date of movement Place No.of staffs

Name of staffs

1 2066/03/26 & 2066/3/27

Gotamkot 8 Dr Binod Kumar Giri (DHO) Sakuntala Khanal (SN) Usha Chand (ANM) Maniraj Shah(AHW) Karna Bdr KC(AHW) Krishna Bdr KC(AHW) Nepal Army Team -2

2 2066/03/23 Aathbishkot 3 Shiv Narayan Rajak(SAHW)

Nandlal Mahato (SAHW) Hira Pun(ANM)

3 2066/03/26 Simritu 2 Bhim Bdr Chand (SAHW) Tabilal Khadaka (AHW)

4 2066/03/27 Baphikot 2 Janaki Malla(ANM) Meghraj Soni(AHW)


5 2066/03/28 Garaila 2 Karna Bdr Budhathoki Mina khatri (MCHW)

6 2066/03/28 Aathbishkot-9 Jhinchaur 12 Surendra Yadav (SAHW) Sunita Achrya (ANM) Dibit Rawal(HA/Redcross) Shova Ram KC (Asst/Redcross) Kamal Budhathoki(Peon) Nepal Police Team -7

7 2066/03/28 Purtimkada 2 Pradeep KC(AHW) Laxmi Pun (MCHW)

8 2066/03/29 Aathbishdadagaun 3 Bibek BM(AHW) Bimala Chand (VHW) Amrita KC(MCHV)

9 2066/03/29 Magma 4 Sarita Gautam (AHW) Karna Bdr Khadaka (AHW)

10 2066/03/30 Ghetma 2 Gopal Singh Oli (AHW) Rajendra Bdr Dhing (VHW)

11 2066/03/30 Duli 1 Shashi Ram Budhathoki 12 2066/03/30 Arma 2 Karma Bdr KC (AHW)

Parsha Bdr dangi (AHW) 13 2066/03/30 Chunbang 3 Gobinda Paghe (AHW)

Man Kumar Pun (MCHW) Aash Bdr Pun (peon )

14 2066/03/30 Baphikot,Magma 15 Nepal Army with 1 Doctor 15 2066/04/01 Morabang, Quangsi 2 Upengra Yadav (SAHW)

Dipendra Yadav (AHW) 16 2066/04/01 Morabang 2 Binit Shah (AHW)

Sukmaya Roka (MCHW) 17 2066/04/02 Aathbishdadagaun-9,

Barkhu 2 Sunita Achrya

(ANM/SMFN) Dibit Rawal (HA/Redcross)

18 2066/04/05 Gotamkot 5 Volunteers from UMB Party 19 2066/04/05 Aathbishkot 5 Volunteers from UMB Party 20 2066/04/06 Purtimdada 5 Nepal army Team -6 21 2066/04/07 Arma 8 Hari Bdr KC (SAHW)

Annant KC(SAHW) Nepal Army Team -6

22 2066/04/13 Gotamkot 5 SAWH-3, Dor Bd. Khadaka

(Lab Asst.), Rambahadur Khatri (Peon)

23 2066/04/16 Chibang, Simli, Arma, Purtimkada, Garaila, Kotjhari with 13 VDCs

147 (9 Team)

Nepal Army Mobile Team-9, Army Health Person-17, Total Army staffs-147


Details of Human Resource Mobilization for Diarrhoea Outbreak Control District: Rolpa S.N. VDCs Date Deployed Team 1 Khugri-3 066/03/16 Dr. Shishir Dahal, Ishwari

Gautam(Sr,AHW)-3 2 Uwa-4,6,3 066/4/3,066/4/20 Dr. Shishir Dahal, Rajendra Hamal,

Kamal Pariyar (AHW)-5 3 Kureli 066/4/6 Local Health Workers 4 Kotgaun-4,6 Local Health Workers 5 Dhawang-1,2 066/3/16 Yogendra Rijal, Amar Narayan

Chaudhary, Suman Achrya -AHW, Tulsi Ram Achraya-VHW-5

6

Gajul-5 066/4/16 Bhakta Bahadur Thapa-VHW

7 Pachhawang Dilli Achraya, Bharat Chaudhary (AHW)-3

Details of Human Resource Mobilization for Diarrhoea Outbreak Control District: Kalikot House to house visit for hygiene, sanitation and health education team

First Aid Team Clorination team at hospital

Clinical Team for treatement

1. Katak B. Mahat 2. Rajendra Chaudhary 3. Laxmi Psd. Pandey

1. Md. Ozain Alam 2. Bhanubhakta Sanjyal 3. Nawa Raj Shahi

1. Chandra Shahi 2. Krishna Neupane 3. Bir Singh Shahi

1. Dr. Bhawani Pd. Sharma 2. Rishiram Sharma 3. Tanka Pd. Pangali 4. Morcha Shahi 5. Pradip Kr. Shahi

Details of Human Resource Mobilization for Diarrhoea Outbreak Control District: Jajarkot

S.No. Location VDC Health Personnel/Team 1. Bahunthana SHP Khalanga AHW- Laxmi Sharma

VHW-Narvada Karki MCHW- Narayani Shah

2. Kudu HP Jagatipur AHW Khem Bdr Pun ANM – Kaushila Batala AHW – Hira Lal Acharya AHW – Binod Aryal AHW- Chhatra Bdr Karki


3. Jagatipur SHP Jagatipur AHW- Padam Gurung VHW- Krishna Kumari Shah MCHW – Dilsari Batala

4 Punma SHP Punma AHW- Chandra Bdr Khadka VHW – Khadga Bdr Gharti MCHW-Ganga Kumari Regmi AHW Uddav Karki (RHD)

Bherya Dr. Lalit Suri ? HA Prem BK AHW Sita Ram Chaudhary AHW Navin Ranamagar

5. Bhoor HP Bhoor Sr.AHW Birendra Kumar Sharma AHW Lal Bdr Khadka ANM Lali R.C. VHW Ain Singh Thakuri

Ghorneta HA Bharat Kanwar AHW Yadhav Joshi

6. Karkigaun SHP Karkigaun AHW Dhanish Khadka MCHW Bishnu Karki AHW Bir Bahadur Khatry (VDC) AHW Danda Bir Nepali

7. Jhapra SHP Jhapra AHW Bishnu Giri AHWPoorna bdr Shahi MCHW Rama Shah VHW Hari Bdr Basnet (VDC)

8. Sima HP Sima AHW Amarraj Sejuwal ANM Gita Bhusal VHW Arun Kumar Malla Nepal Army Team

9. Thalaraikar SHP Thalaraikar AHW Hari Prasad Pokharel VHW Man Bdr Budha MCHW Radha Devi Sharma

10 Jungathapachaur SHP Jungathapachaur AHW Krishna Bdr Thapa VHW Ganga Bdr Shahi MCHW Parbati Sharma

11.

Dasera HP Dasera Sr AHW Amar Bdr Rana AHW Ram Bdr Thapa ANM Rawal AHW Jaya Bdr. Thapa (VDC) VHW Nar Bdr Chanda

Thala AHW Narayan Psd Pokharel Nepal Army

12. Salma SHP Salma AHW Om Bdr Rana Chhettry VHW Bhim Bdr BC MCHW Kaushila K Sharma

13. Suwanauli SHP Suwanauli AHW (Recruited by RHD) MCHW Padma Kumari Thapa

14. Majhkot SHP Majhkot AHW Hari Prasad Lamichhane VHW Lok Bdr Oli


MCH Bishnu Kumari Shahi Dr.Ishori Upadya ANM Sita Thapa ANM Sumitra shrestha AHW Krishna Bdr Shahi

15. Gharanga HP Gharanga AHW Shah Dev Basnet ANM Chanda Tiwari

Samahila

AHW GaganDev Giri AHW Hasta Raj Giri

16. Dhime SHP Dhime VHW Madhav Karki MCHW Nirmala Kumari Thapa AHW Ram Prasad Sharma AHW kali Bdr Chalawane

Bharma Dr. Subash Acharya S I Gam Bdr Thami AHW Bhaskar Poudel AHW Arjun Ghimire AHW Nawal Kishor Mahato

17 Paink SHP Paink AHW Yagya Nath Gautam AHW Birendra Raj Giri VHW Bal Bdr RC MCHW Chandra Kumari Rokaya

18 Talegaun SHP Talegaun AHW Resham Lal Gautam AHW Gopal Bdr Shahi MCHW Hridaya Kumari Singh

19 Archhani SHP Archhani Dr. Avash Joshi Team AHW Keshav Khadka AHW Krishna Bdr Rokaya VHW Ganga Ram Aacharya MCHW Hari Kala Shahi

20 Garkhakot PHC Garkhakot AHW Bal Bdr Shahi AHW Prem Bdr Shahi ANM Sita Singh Lab Asst Dabal Bdr BC VHW Govinda Bdr Shahi

Matela AHW Tej Bdr Shahi 21 Pajaru –Ka SHP Pajaru VHW Obiram Pun

MCHW Chhita Adhikari 22 Pajaru – Kha SHP Pajaru AHW Khimraj Thapa

AHW Prakash Adhikari MCHW Pan Kumari Pun

23 Daha SHP Daha AHW Birendra Pun MCHW Saraswati Shahi Nepal Army Team

24 Kortang SHP Kortang AHW Keshav Prasad Dahal MCHW Satya Devi Shahi Dr Yek Raj Luitel KP Upreti Krishna Dhital KB Chand

25 Limsa PHC Rokayagaun AHW Ram Bdr Rokaya ANM Sushila Budhathoki ANM Rem Kali Sunar


AHW Sushil Pun 26 Nayakwada SHP Nayakwada AHW Mis Bishumaya Bhudha

AHW Deepak Bdr Khadka AHW Mis Bishumaya Bhudha AHW Deepak Bdr Khadka

27 Ramidanda SHP Ramidanda AHW Bishnu Jyoti MCHW Ambika Kumari Giri Nepal Army Team

28 Sakla HP Sakla AHW Bir Raj Singh ANM Meera Shahi VHW Surita Karki AHW Ujjwal Kumar Shaarma AHW Khuva Raj Aacharya AHW Lok Bdr Nepali AHW Pandav Baral

29 Laha SHP Laha AHW Ganesh Bdr Oli VHW Krishna Bdr Shah

30 Dalli HP Khagenkot AHW Prem Chand ANM Nirmala Khanal VHW Bharat Kumar Bhadel Sr AHW Surya Lal Sht AHW Yuva Raj Timilsina Dr. Pankaj Chaudhary Pushpa Raj Adhikary Topendra Raj Basnet Gajendra Singh Kunwar HA Deepak Dhungana

31 Bhagawati SHP Bhagawati AHW Basanta Devkota VHW Ganga Ram Acharya

32 Ragda SHP Ragda AHW Dhruva Khanal MCHW Sun Kumari Singh

33 Dandagaun – Ka SHP Dandagaun AHW Bhagawati Singh MCHW Dhan Kala Pun

Karuwa AHW Takta Bdr Pun 34 Dandagaun - Kha Dandagaun AHW Bir Man Budhathoki

VHW Deepak Jung Shah MCHW Shobha Singh

35 District Hospital, Jajarkot Jajarkot MO Dr Krishna Hari Subedi AHW Prachanda Karki AHW Toya Nath Sharma ANM Sabitri Kafle ANM Jaya Khadka ANM Jun Kumari Shahi ANM Tika Rawal ANM Tila Devi Rijal Lab Asst Krishna Bdr Khattry Radiographer Shailendra Karki Dr. Uttam Ghimire ANM Durga Devkota

36. District Health Office Jajarkot FPO Rajendra Bdr Shah DTLO Bhuvan Mitra Rana EPIO Ram Pukar Shah PHNO Sarita Chand CCA Vijaya Shankar Thakur MI Kamal Chand Kharidar Sudha Hamal


Details of Health Camp in Jajarkot District

VDC Name Health Camp Location

Name of Doctors Team Members Organization

Bhagawati

Bhagawati Dr. S.P Rimal Prakash Ghimire, Khagendra Paudel

NMA

Katikurta Dr. Suman Adhikary Dr. Sachin Gurung, Radhae Krishna Chaudhary, Suman Chaudhary

NMA

Bhur Dr. Dinesh Gautam Karna Gurung- Camp Coordinator, Udaya Nath Yogi, Manju Sahi

INF

Dasera Health Workers DPHO

Dhime

Garkhakot Dr. Sabin Shreatha Tirtha Acharya, Lila Ram Thapa, Surendra Shrestha NMA

Jungathapachaur Dr. Ram Krishna Baral K.B. Basu, K.B. Mahara, R.K. Sedai APF

Karkigaun HELVETAS

Khagenakot Dr. Pankaj Chaudhary NP

Kortang Dr. Yak Raj Luitel K. P. Upreti, Krishna Dhital, K.B. Chand APF

Majkot Dr. Madhu Acharya Prem pangali, Hota Ram Khatri Sen Manandhar NMC

Paik Dr. Uttam Ghimirae Arjun Ghimirae, Bhaskar Paudel, Nawal Kishor Mahato EDCD

Punma Bharae Dr. Lalit Suri Prem B.K, Sitram

Ramidanda Health Workers

DPHO

Sakla Dr. Subash Acharya NP Ramidada Nepal Army Thala Nepal Army Daha Nepal Army Karkigaoun Khalaphara Nepal Army Sima Nepal Army Khalanga Distirct

Hospital Dr. Santosh Dahal, Dr. Partha Bhurtel

Dil Kumar Duwal, Yam Bahadur Darlami, Sundar Hari Shrestha, Sangam Kaiju, Anil Dhungel,

Khalanga Bahunthana Dr. Santosh Chaudhary Mahesh Chaudhary, Raj Kumar Chaudhary, ChautRam Chaudhary NMA

Dr. Rina Yadav/ Dr. Vivek NMA,

Sub Acc Lab Bikram Shahi Supporting Admin Nayab Subba Sagar KC


Details of Human Resource Mobilization for Diarrhoea Outbreak Control Jajarkot District

S.No. Name of the Institutions

VDCs Health Personnels Deployed Team

1. Bahunthana SHP Khalanga AHW- Laxmi Sharma VHW-Narvada Karki MCHW- Narayani Shah

Dr. Santosh Chaudhary HA- Chaut Ram Chaudhary AHW-Mahesh Chaudhary AHW Raj Kumar Chaudhary

2. Kudu HP Jagatipur AHW Khem Bdr Pun ANM – Kaushila Batala

AHW – Binod Aryal AHW- Chhatra Bdr Karki

3. Jagatipur SHP Jagatipur AHW Padam Gurung VHW- Krishna Kumari Shah MCHW – Dilsari Batala

4 Punma SHP Punma AHW- Chandra Bdr Khadka VHW – Khadga Bdr Gharti MCHW-Ganga Kumari Regmi

Dr. Lalit Suri HA Prem BK AHW Uddav Karki AHW Sita Ram Chaudhary AHW Navin Ranamagar

5. Bhoor HP Bhoor Sr.AHW Birendra Kumar Sharma AHW Lal Bdr Khadka VHW Ain Singh Thakuri

6. Karkigaun SHP Karkigaun AHW Dhanish Khadka MCHW Bishnu Karki

AHW Danda Bir Nepali (Local Recruitment in 2066/04/08)

7. Jhapra SHP Jhapra AHW Bishnu Giri MCHW Rama Shah

8. Sima HP Sima AHW Amarraj Sejuwal ANM Gita Bhusal VHW Arun Kumar Malla

Nepal Army Team

9. Thalaraikar SHP Thalaraikar AHW Hari Prasad Pokharel VHW Man Bdr Budha MCHW Radha Devi Sharma

10 Jungathapachaur SHP

Jungathapachaur

AHW Krishna Bdr Thapa VHW Ganga Bdr Shahi MCHW Parbati Sharma

Dr. Ram Krshna Baral AHW KB Basu AHW KB Mahara AHW RK Sedhain

11.

Dasera HP Dasera Sr AHW Amar Bdr Rana AHW Ram Bdr Thapa VHW Nar Bdr Chanda

12. Salma SHP Salma AHW Om Bdr Rana Chhettry VHW Bhim Bdr BC MCHW Kaushila K Sharma

13. Suwanauli SHP Suwanauli AHW (Recruited by RHD) MCHW Padma Kumari Thapa

14. Majhkot SHP Majhkot AHW Hari Prasad Lamichhane

Sr. AHW Ram Kumar Sharma


VHW Lok Bdr Oli MCH Bishnu Kumari Shahi

15. Gharanga HP Gharanga AHW Shah Dev Basnet ANM Chanda Tiwari

AHW Resham Lal Gautam AHW GaganDev Giri AHW Hasta Raj Giri

16. Dhime SHP Dhime VHW Madhav Karki MCHW Nirmala Kumari Thapa

AHW Ram Prasad Sharma ( Moved on 2066/04/09) PLA Team – 13 members

17 Paink SHP Paink AHW Yagya Nath Gautam VHW Bal Bdr RC MCHW Chandra Kumari Rokaya

AHW Bhaskar Poudel AHW Arjun Ghimire AHW Nawal Kishor Mahat AHW Birendra Raj Giri Recruitment in 2066/04/09)

18 Talegaun SHP Talegaun MCHW Hridaya Kumari Singh

AHW Gopal Bdr Shshi Recruitment in 2066/04/09)

19 Archhani SHP Archhani AHW Krishna Bdr Rokaya VHW Ganga Ram Aacharya MCHW Hari Kala Shahi

Dr. Avash Joshi Team

20 Garkhakot PHC Garkhakot AHW Bal Bdr Shahi AHW Prem Bdr Shahi ANM Sita Singh Lab Asst Dabal Bdr BC VHW Govinda Bdr Shahi

Dr. Sabin Shrestha AHW Tirtha Acharya AHW Lila Ram Thapa AHW Surendra Shrestha

21 Pajaru –Ka SHP Pajaru AHW Narayan Psd Pokharel VHW Obiram Pun MCHW Chhita Adhikari

AHW Tej Bdr. Shahi Recruitment in 2066/04/09)

22 Pajaru – Kha SHP Pajaru AHW Khimraj Thapa MCHW Pan Kumari Pun

23 Daha SHP Daha AHW Birendra Pun MCHW Saraswati Shahi

Nepal Army Team

24 Kortang SHP Kortang AHW Keshav Prasad Dahal MCHW Satya Devi Shahi

Dr Yek Raj Luitel KP Upreti Krishna Dhital KB Chand

25 Limsa PHC Rokayagaun AHW Ram Bdr Rokaya ANM Sushila Budhathoki ANM Rem Kali Sunar

26 Nayakwada SHP Nayakwada AHW Ram Naryan Chaudhary MCHW Lila Kumari Shah

27 Ramidanda SHP Ramidanda AHW Bishnu Jyoti MCHW Ambika Kumari Giri

Nepal Army Team

28 Sakla HP Sakla AHW Bir Raj Singh ANM Meera Shahi VHW Surita Karki

AHW Ujjwal Kumar Sharma AHW Khuva Raj Acharya AHW Pandav Raj Baral

29 Laha SHP Laha AHW Ganesh Bdr Oli VHW Krishna Bdr Shah

AHW Takta Bdr Pun Recruitment in 2066/04/09)

30 Dalli HP Khagenkot AHW Prem Chand ANM Nirmala Khanal VHW Bharat Kumar Bhadel

Sr. AHW Surya Lal Sht Yuva Raj Timilsina Dr. Pankag Chaudhary Pupa Raj Adhikari Topendra Raj Basnet Gajendra Singh Kunwar

31 Bhagawati SHP Bhagawati AHW Basanta Devkota AHW Hikmat Oli


VHW Ganga Ram Acharya AHW Nageshwor Rijal 32 Ragda SHP Ragda AHW Dhruva Khanal

MCHW Sun Kumari Singh

33 Dandagaun – Ka SHP

Dandagaun AHW Bhagawati Singh MCHW Dhan Kala Pun

34 Dandagaun – Kha Dandagaun AHW Bir Man Budhathoki VHW Deepak Jung Shah MCHW Shobha Singh

35 District Hospital, Jajarkot

Jajarkot MO Dr Krishna Hari Subedi HA Deepak Dhungana AHW Prachanda Karki AHW Toya Nath Sharma ANM Sabitri Kafle ANM Jaya Khadka ANM Jun Kumari Shahi ANM Tika Rawal ANM Tila Devi Rijal Lab Asst Krishna Bdr Khattry Radiographer Shailendra Karki

Dr. Ishwor Upadhaya Dr. Uttam Ghimire ANM Durga Devkota ANM Sumitra Shrestha

36. District Health Office

Jajarkot FPO Rajendra Bdr Shah DTLO Bhuvan Mitra Rana EPIO Ram Pukar Shah PHNO Sarita Chand CCA Vijaya Shankar Thakur MI Kamal Chand Kharidar Sudha Hamal Sub Acc Lab Bikram Shahi Supporting Admin Nayab Subba Sagar KC

Director Dr. Padam Bdr Chand (MoHP) Sr. HEO Laxmi Raj Joshi (NHEIC) Sr. PHO Jiwan Kumar Malla (DoHS, Mgmt Div) Sr. AHWO Ram Bdr Chand (DPHO, Banke)

Details of Human Resource Mobilization for Diarrhoea Outbreak Control District: Salyan

S.N. Name of VDC Type of Disease

Date of deployed HWs

Name list of deployed HWs

Post

1 Kalagaun Diarrhoea 2066/3/25 1. Aati Ram Bist 2. Mina Budhathoki 3. Bal Bd. Shahi

1. SAHW 2. ANM 3. Office Aid

2 Marmparikada Diarrhoea 2066/4/5 1. Liladhar Budhathoki 2. Mohan Bd. Yari 3. Menka Bali

1. AHW 2. VHW 3. ANM

3 Tharmare Diarrhoea 2066/4/5 Dhaniram K.C. Sr. AHW 4 Swikot

Diarrhoea 2066/03/19 1. Bal Bd. Khatri

2. Tek Bd. Gosai 1. AHW


2. VHW 5 Darmakot Ati Ram Bist AHW 6 Bajhakot Chandra Bd. Khatri AHW 7 Kabhrechaur Diarrhoea 2066/04/11

Details of Human Resource Mobilization for Diarrhoea Outbreak Control District: Surkhet

Affected VDCs Date of onset of Epidemic Local HWs External Deployed Health

Workers

Ghoreta Ward no-6,7 2066.3.21 to 27 All Bhim Bahadur Nepali, Kafalkot

Mehelkuna-6 2066.3.24 to 31 All Nabin Regmi, Ramghat

Lekhparajul-2 2066.3.30 to 4.4 All Kumbha Paudel, Bhola B.K

Taranga-2,3,4,5,6 2066.3.31 to 4.10 All Nandaram Buda, Mahendra Khatri, Hariharpur PLA Deployed]

Mehelkuna-7 2066.4.8 All Kumbha Paudel, Bhupendra Dev Giri Chinchu', Arun Chaudhary Dahachaur

Tatapani-1,2,3,4 2066.4.8 All Laxman Darai- NFHP

Uttarganga-6,7,8 2066.4.8 All Nawa Jyoti Kendra

Lagam 2066.3.30 All Yam Prasad Adhikari, Lekhpharsa{

Ramghat 2066.4.5 All Note: - Local health workers-47, District and external -21 and other NGOs/INGOs-31

Ghatgaun 2066.4.10 All

Regional Hospital 2066.4.1 All

Details of Human Resource Mobilization for Diarrhoea Outbreak Control District: Humla

. S.N.

VDC

Deployed Team DHO

Date

1 Kalika VDC-2,4,5,6,7 1 HA and 3 AHWs from DHO and 1 AHW from Shreenagar HP.

2066/05/07


2 Kalika VDC PLA Team 2066/05/10

Drugs supplied in different VDCs in diarrhea epidemic by Helicopter and Porter

District: Rukum S.N. Date of drugs

supply Name of VDC Avg. weight in Kg Mode of

transportation Remarks

1 2066/3/23,26,27 & 04/02,05,07,13

Gotamkot 125+210+340+120 +265+160=1220

Helicopter & Porter-11

Seven shift

2 2066/03/23,28,30 & 04//5,7,15

Aathbiskot 145+240+450 +60+120=1050

Helicopter & Porter-10

Six Shift

3 2066/03/26,30 Simritu 200+130=330 Porter-6 Two shift 4 2066/03/27 & 04/02 Baphikot 230+370=600 Helicopter &

Porter-3 Two shift

5 2066/3/24 Ranmamaikot 115 Porter-3 6 2066/3/26 Rukumkot 145 Porter-3 7 2066/3/28 Garaila 180 Porter-4 8 2066/3/28 Aathbiskot-9,

Jhinchaur

140 Porter-3

9 2066/3/28 & 4/5,7 Purtimkada 120+540+50=710 Helicopter & Porter-3

Three shift

10 2066/3/29 Aathbisdandagaun 340 Helicopter & Porter-2

Two shift

11 2066/3/29 Magma 90 Porter-2 12 2066/3/30 Ghetma 115 Porter-3 13 2066/3/30, 04/17 Duli 135+45=180 Porter-4 Two shift 14 2066/3/30 &

04//07,14,16 Arma 140+100+110+140

+120+45=655 Porter-8 Five shift

15 2066/3/30 Chunbang 120 Porter-3 16 2066/3/31 Mahat 130 Porter-3 17 2066/3/31 Ranshi 145 Porter-3 18 2066/4/1 Morabang, Quangsi 125 Porter-3 19 2066/04/01 Morbang 115 Porter-3 20 2066/04/06,08 Nuwakot 140+110=250 Porter-5 Two shift 21 2066/04/06 Hukam 125 Porter-3 22 2066/04/06,15 Khara 165+120=285 Porter-6 Two shift 23 2066/04/06 Kakre 160 Porter-4 24 2066/04/08 Simli 110 Porter-2 25 2066/04/08 Kotjhari 215 Helicopter 26 2066/04/13 MusikotH.P. 110 Porter-2 27 2066/04/16,17 Chibang, Simli, Arma,

Purtimkada, Garaila, Kotjhari with 13 VDCs

300+250=550 Army Jawan Two shift

Total 8215 Kgs. Drugs supplied in different VDCs in diarrhea epidemic by Helicopter and Porter

District: Jajarkot


S.N. Date of drugs supply

Name of VDC/Place

Avg. weight in Kg Mode of transportation

Remarks

Details Not

Available Total

MID WESTERN REGION DISTRICTWISE SITUATION OF DIARRHOEAL EPIDEMIC

District: Kalikot Trend of flow of cases in Manma VDC-5,2,7 of Kalikot District from 2066/04/17- 2066/04/28

SN Date Total Treated by Result Total cases

of Dalit Population

M F IV Infusion

Others

1. 2066/4/17 7 13 15 5 Cured 16 2. 2066/4/18 6 6 7 5 " 9 3. 2066/4/19 6 3 2 7 " 7 4. 2066/4/20 2 2 1 3 3 5. 2066/4/21 4 2 3 3 5 6. 2066/4/22 0 1 1 0 1 7. 2066/4/23 2 0 2 0 2 8. 2066/4/24 0 1 1 0 1 9. 2066/4/25 5 0 3 2 2

10. 2066/4/26 3 3 0 6 3 11. 2066/4/27 2 0 0 2 2 12. 2066/4/28 0 5 3 2 3 13. 2066/4/ 14. 2066/4/

Total 37 36 37 36 54 Number of cases and Deaths in Manma VDC of Kalikot District till date Date Morbidity Mortality IV ORS Dalit Population 15/4/2066 20 1 15 5 16 18/4/2066 10 7 3 9 19/4/2066 8 2 6 6


Number of cases and Deaths in Kalikot District

20

1

15

5

16

10

7

3

98

2

6 6

0

5

10

15

20

25

Morbidity Mortality IV ORS DalitPopulation

Num

ber 15/4/2066

18/4/206619/4/2066

District : Surkhet

VDCWise Morbidity and Mortality in Surkhet District SN Affected VDC Date of onset of

epidemic No. of treated cases

Death Details Ward no. No.

1 Ghoreta Ward No. 7 and 8

2066/3/21 to 2066/3/27

98 8 1

2 Mehelkuna Ward No. 6

2066/3/24 to 2066/3/31

157

3 Lekhparajul-2 2066/3/30-2066/4/4

193 2 1

4 Taranga Ward No. 1,2,3,4,5,6

2066/3/31-2066/4/10

237 5,6 5

5 Mehelkuna-7,8 2066/4/4 806

6 Tatapani-1,2,3,4 2066/4/8 112 4 1

7 Malarani 4th Week 106 7 1 8 Ghatgaun 4th Week 213 2 2 9 Uttarganga 6,7,8 2066/4/8 144

10 Lagam 2066/3/30 345 3 2 11 Ramghat 2066/4/5 41


12 Hariharpur 2066/4/2 283 13 Chinchu 2066/4/17 176 14 Kunathari 2066/4/12-

2066/4/13 35

15 Matela 3rd Week 62 16 Regional

Hospital 2066/4/1-2066/4/10

137

17 Betan 2066/4/29-2066/4/3

99

18 Satakhani " 97 4 1 19 Kalyan " 102 20 Latikoili " 80 21 Jarbutta " 50 22 Dasrathpur " 46 Total 3619 14

VDCWise Morbidity and Mortality in Surkhet District

VDCs Morbidity Mortality (other deaths included)

Ghoreta 98 1 Mehelkuna 963 0 Lekhparajul 193 1

Taranga 237 5 Tatapani 112 1 Malarani 106 1 Ghatgaun 213 2

Uttarganga 144 0 Lagam 345 2

Ramghat 41 0 Hariharpur 283 0

Chinchu 176 0 Kunathari 35 0

Matela 62 0 Regional Hospital 137 0

Betan 99 Satakhani 97 1

Kalyan 102 Latikoili 80 Jarbutta 50


Dasrathpur 46 Total 3619 14

(Note: Diarrhoeal including other deaths have been shown here)

Diarrheal Deaths No: 10

Weekly Trend of Diarrhoeal Outbreak in Surkhet District

450

1363

646

262

537

261

100 11

0

5

11

5

0

1

2

3

4

5

6

7

Asar 3rd w eek Asar 4th w eek Shraw an 1stw eek

Shraw an 2ndw eek

Shraw an 3rdw eek

Shraw an 4thWeek

Bhadra 1stw eek

Weeks

Num

ber

0

200

400

600

800

1000

1200

1400

MorbidityMortality

VDCWise Morbidity N Mortality in Surkhet District

98

963

193

112 106

213144

345

41

283

176

35

62

13799 97 102

80

50 46

237

1

0

1 1 1

2

0

2

0 0 0 0 0 0

1

5

1

10

100

1000

Ghoret

a Meh

elkuna

Le

khpa

rajul

Tarang

a Tata

pani

Malaran

iGha

tgaun

Uttarga

nga

Laga

mRam

ghat

Hariha

rpur

Chinch

uKun

athari

Matela

Region

al Hosp

ital

Betan

Satak

hani

Kalyan

Latik

oili

Jarbu

ttaDas

rathpu

r

VDCs

Num

ber

0

4

8

12

Morbidity Mortality (other deaths included)


Deaths in Diarrhoea Epidemic in Surkhet District S.N. Name of

Casualties Caste Age Sex VDCs Name Date of Death Cause of

Death 1 Laxmi Rana Thakuri 25 F Ghoreta-8 15/3/2066 Diarrhoea

2 Jaimane Budha Chhetri M Lagam-3 29/3/2066 "

3 Bhakta Bahadur Budha

Chhetri 40 M Lagam-3 9/4/2066 Diarrhoea

4 Sher Bahadur Budha Chhetri 35 M Lekhparajul-2 29/3/2066 "

5 Kopila Rokaya Dalit 73 F Taranga-5 28/3/2066 "

6 Devi Ram B.K. Dalit 55 M Taranga-6 30/3/2066 "

7 Ashish Rana Magar Janjati 7 M Taranga-4 30/3/2066 "

8 Dil Bahadur Sunar Dalit 60 M Taranga-3 2/4/2066 "

9 Abala Giri Chhetri 45 F Taranga-1 5/4/2066 "

10 Suk Lal Basayal 69 M Malarani-7 2/4/2066 Chronic disease

11 Dilu Kumari B.K. Dalit 2 F Ghatgaun-2 6/4/2066 Malnutrition

12 Jhankar B.K. Dalit 28 M Ghatgaun-2 6/4/2066 Jaundice

13 Jhanka Mijar Dalit 53 M Tatapani-4 15/4/2066 Diarrhoea

14 Devisara Acharya Brahmin 35 F Satakhani-4, Chandrapur

26/4/2066 Diarrhoea

District: Salyan Name of Causalities of Diarrhea Epidemic in Salyan District S.N. Name of

Casualties Caste Age Sex VDCs Name Date of

Death Cause of Death

1 Manjit Kasera Dalit 52 M Kalagaun-6 2066/03/26 Diarrhoea 2 Santosh BK " 10 M Siwakot-5 2066/03/14 " 3 Kali

Budhathoki Chhetri 35 F Siwakot-1 2066/04/04 Diarrhoea

(Pregnant Women)

4 Birma Pariyar Dalit 43 F Kabhrechaur-4 2066/04/12 Diarrhoea Other Deaths S.N. Name of

Casualties Caste Age Sex VDCs Name Date of


1 Amrita Bohora Chhetri 15 F Mulkhola-7 2066/4/24 Mushroom Poison


VDCWise Morbidity and Mortality in Salyan District VDCs Morbidity Mortality

Kalagaun 115 1 Marmaparikaada 145

Tharmarey 11 Swikot 80 2

Darmakot 10 Bajhkot 20

Kabhrechaur 41 1 Mulkhola 236 1

Total 658 5

VDCWise Morbidity and Mortality in Salyan District

115

145

11

80

1020

41

236

1

2

1

000 0

1

0

0.5

1

1.5

2

2.5

Kalaga

un

Marmap

arika

ada

Tharm

arey

Swikot

Darmak

ot

Bajhko

t

Kabhre

chau

r

Mulkhola

VDCs

Num

ber

0

50

100

150

200

250

MorbidityMortality

District: Dolpa Name of Casualties of Diarrhoea Epidemic in Dolpa District S.N Name of the death

persons Age Sex Date of the

death Lawan VDC ward no.1 khani

1 Jigme kyojo 2 M 2066/3/20 2 Himali thapa 2 F 2066/3/18


3 Pemba thapa 1 F 2066/3/21 Juphaldandiwada-8

4 Kusal daygi 4 M 2066/3/28 5 Bisnu daygi 3 M 2066/3/27 6 Junu shreshtha 4 M 2066/3/17

VDCWise Morbidity and Mortality in Dolpa District SN Affected VDC Date of onset

of epidemic No. of treated cases

Death Details Ward

no. No.

1 Dunai-Thala tol 4/3/2066 90 2 Jufal-

Dangiwada 29/3/2066 46 3

3 Lawan- Khani tol

24/3/2066 40 3

4 Jufal- Motipur 4/4/2066 34 5 Dunai- Tipla 4/4/2066 81 6 Jufal -1, Airport 12/4/2066 210 Total 501 6

VDCwise Morbidity and Mortality in Dolpa

90

46 40 34

81

210

3 30

50

100

150

200

250

Dunai-Thala tol

Jufal-Dangiwada

Lawan-Khani tol

Jufal-Motipur

Dunai-Tipla

Jufal -1,Airport

VDCs

Num

ber

Morbidity

Mortality


District: Dailekh Name of Casualties of Diarrhoea Epidemic in Dailekh District S.N. Name of

Death Person

Caste Age Sex VDCs Name Date of Death Cause of Death

1 Sita BK Dalit 22 F Jagnath-7 22/3/2066 Dirrhoea 2 Dhansara BK " 60 F Jagnath-8 19/3/2066 Chronic disease 3 Jaisara BC Chhetri 30 F Jagnath-4 26/3/2066 Diarrhoea 4 Lalisara

Chunara Dalit 46 F Jagnath-2 3/4/2066 "

5 Anajana Sarki Dalit 5 F Chhiudipusakot-1 2/4/2066 Food poison 6 Ragadari Bist Dalit 81 M Bhairikalikathum-7 10/4/2066 Other 7 Dilli Pd.

Upadhaya Brahmin 68 M Bhairikalikathum-4 2066/04/12 Diarrhoea

8 Lila Ram Puri Dalit 75 M Gamaudi-6 4/13/2066 Chro. Diarrhoea 9 Tuli B.K. Dalit 35 F JambuKandh-6 14/4/2066 Due to over diet 10 Bharu B.K. Dalit 5 M " " " " Diarrhoea 11 Kaushila

Upadhya Brahmin 52 F Bhairikalikathum-4

15/4/2066 "

12 Kure Thapa Chhetri 82 M Bhairikalikathum-8 16/4/2066 Chronic Disease 13 Aabi Jaisi Chhetri 45 M Bhairikalikathum-3

18/4/2066 Diarrhoea

14 Upendra Bist " 47 M Bhairikalikathum-7 18/4/2066 " 15 Namkala Jaisi " 70 F Bhairikalikathum--

3 19/4/2066 "

16 Man Bd. Shahi

Chhetri 72 M Lakandra-9 17/4/2066 "

17 Bibek Shahi " 4 M Latibindrasaini-7 21/4/2066

"

18 Jhupa Bista Chhetri 78 M Bhairikalikathum-7 25/4/2066 Diarrhoea 19 Binda Bika Dalit 30 F Paduka-7 24/4/2066 Diarrhoea 20 Dirgha Sarki Dalit M Nepa-7 26/4/2066 Diarrhoea 21 Laxmi Nepali Dalit 5 M Nepa-1 066/4/29 Diarrhoea 22 Tilbir Sunar Dalit 50 M Banshi-2 32/4/066 Diarrhoea 23 Bhadra Sarki Dalit 32 F Nepa-7 32/4/066 Diarrhoea 24 Debisara

Nepali Dalit 5 F Lyatibindrasaini-5

02/05/066 Diarrhoea

25 Tulcha Sunar Dalit 3 F Kharigaira-3 04/05/066 Diarrhoea

26 Pana B.K. Dalit 42 F Paduka-9 2/5/2066

Diarrhoea 27 Bima B.K Dalit 70 F Lakandra-6

6/5/2066 Diarrhoea

28 Janaki Nepali Dalit 5 F Lyatibindrasaini-8 8/5/2066

Diarrhoea

29 Jaisara Singh Thakuri 6 F Baluwatar 7/5/2066

Diarrhoea


VDCwise Morbidity n Mortality in Dailekh VDCs Morbidity Mortality Bhairikalikathum 769 8 Jagnath 78 4 Latibindraseini 885 3 Gamaudi 200 1 Jambukandh 389 2 Lakandra 112 2 Paduka 142 2 Nepa 34 3 Kharigaira 14 1 Baanshi 1 Baluwatar 15 1 Total 2638 28

Note: The above data does not include 1 non-diarrhoeal death from dailekh. Note: The above data includes details only from those VDCs where deaths have occurred. The Morbidity details of Baanshi VDC has not been received yet.

VDCWise Morbidity N Mortality in Dailekh District

769

78

885

200

389

112142

34

14 15

8

4

3

1

2 2

3

1 11

2

0

3

6

9

Bhairik

alikath

umJa

gnath

Latib

indras

eini

Gamau

diJa

mbuka

ndh

Laka

ndra

Paduk

a

Nepa

Kharig

aira

Baluw

atar

Baansh

i

VDCs

Num

ber

1

10

100

1000

Morbidity

Mortality


District: Rukum Namelist of Casualites in Rukum District

S.N. Name of Deaths person

Sex Age Address Date of Death

Cause of Death

1 Pyaro Bohora Male 55 Syalakhadi-3 14/2/2066 Diarrhoea

2 Subash B.K. M 11mon. " 15/02/2066 Diarrhoea

3 Dhanbir B.K. M 1 " 15/02/2066 Diarrhoea

4 Harka Bahadur Bohara

M 50 Gotamkot-4 31/02/2066 Diarrhoea

5 Tika Ram Jaishi M 8 Gotamkot-2 2/3/2066 Diarrhoea

6 Dipak B.K. M 25 Baphikot-1 8/3/2066 Diarrhoea

7 Balaram Pun M 48 Ghetma-1 13/03/2066 Diarrhoea

8 Kali Devi B.K. F 32 Magma-4 14/03/2066 Diarrhoea

9 Lalit Malla M 5 Gotamkot-5 15/03/2066 Diarrhoea

10 Jit Nath M 15 " 16/03/2066 Diarrhoea

11 Gaje Kami M 68 Gotamkot-2 17/03/2066 Diarrhoea

12 Pashupati B.K. F 35 Garayala-9 18/03/2066 Diarrhoea

13 Bale Kami M 54 Gotamkot-2 20/03/2066 Diarrhoea

14 Jay Mati B.K. F 11 " 20/03/2066 Diarrhoea

15 Deurupa Pariyar F 51 Purtimkada-5 20/03/2066 Diarrhoea

16 Tulsa Oli F 9 Garayala-9 21/03/2066 Diarrhoea

17 Najari Basnet F 12 Gotamkot-2 24/03/2066 Diarrhoea

18 Kali B.k. F 40 " 24/03/2066 Diarrhoea

19 Lalsari B.K. F 38 " 25/03/2066 Diarrhoea

20 Maheshwari B.K. F 36 " 25/03/2066 Diarrhoea

21 Dirgha Mahalara M 60 Purtimkada-5 27/03/2066 Diarrhoea

22 Bale Basnet M 45 Gotamkot-7 27/03/2066 Diarrhoea

23 Laxmi Basnet F 23 Gotamkot-2 28/03/2066 Diarrhoea

24 Prajit B.K. M 45 Aathbishdadagaun-9

28/03/2066 Diarrhoea

25 Rupa Sari Kami F 18 " 28/03/2066 Diarrhoea

26 Rupa Budha F 13 Aathbishko-4 28/03/2066 Diarrhoea

27 Ramit Roka M 10mon. Hukam-4 28/03/2066 Diarrhoea

28 Puni Damai F 70 Aathbishdadagaun-9

1/4/2066 Diarrhoea

29 Duji Pun F 51 Aathbishdadagaun-9

1/4/2066 Diarrhoea


30 Ananta Pun M 48 Aathbishdadagaun-8

1/4/2066 Diarrhoea

31 Rita Giri F 35 Aathbishdadagaun-8

3/4/2066 Diarrhoea

32 Indra Khadaka F 8 Purtimkada-8 5/4/2066 Diarrhoea

33 Hari Sarki M 70 Kholagaun-6 5/4/2066 Diarrhoea

34 Bhimi B.K. F 26 Arma-5 (Nuwakot-1)

7/4/2066 Diarrhoea

35 Arjun Karki M 37 Gotamkot-3 7/4/2066 Diarrhoea

36 Khamba Khadaka M 48 Chhibang-2 9/4/2066 Diarrhoea

37 Jaymati Nath F 7 Gotamkot-5 9/4/2066 Diarrhoea

38 Bin kumari Sharki F 2 " 10/4/2066 Diarrhoea

39 Tashbir Damai M 65 Aathbishkot-2 13/04/2066 Diarrhoea

40 Kale Nepali M 4 " 13/04/2066 Diarrhoea

41 Gopal K.C. M 4 Ghetma-8 16/04/2066 Diarrhoea

42 Ragbir Sunar M 65 Chhibang-2 16/04/2066 Diarrhoea

43 Gopal Sunar M 55 Sovaban-1 16/04/2066 Typhoid

44 Chiuri Buda F 48 Godamkot-5 17/04/2066 Diarrhoea

45 Sital Sarki F 3 Aathbiskot-8 18/04/2066 Other

46 Bali Damai F 31 Aathbiskot-8 20/04/2066 Diarrhoea

47 Lalsari Bhandari F 60 Godamkot-5 21/04/2066 Other

48 Maniraj Sarki M 4 Godamkot-5 21/04/2066 Diarrhoea

49 Karna Bahadur Khatri

M 38 Aathbiskot-7 29/04/2066 Diarrhoea

50 Khali Thapa M 4 Gotamkot-6 14/03/2066 Diarrhoea

51 Dhan Bahadur Sarki M 13 Gotamkot-5 4/5/2066 Diarrhoea

VDCwise Morbidity in Rukum District SN VDC Total

case IV

Cases

1 Gotamkot 1982 607 2 Aathbishkot 1872 342 3 Baphikot 1122 236 4 Garaila 602 36 5 Purtimkada 453 104 6 Asthbishdandagaun 967 213

7 Simrutu 532 58


8 Magma 386 48 9 Arma 427 96

10 Duli 185 4 11 Chunbang 403 7 12 Morabang 512 - 13 Khadisyala 397 31 14 Ghetma 236 3 15 Syalakhadi 120 - 16 Hukam 110 - 17 Ranmamaikot 50 - 18 Nuwakot 80 - 19 District Hospital 1247 73

20 Chaujhari Hospital 182 -

21 Kotjhari 307 23 22 Kholagaun 236 3 23 Chhibang 197 17

Total 12605 1901

VDC Cases and Deaths in Rukum District

1076

307453

769386 427

236120 110

236 197

17821665

3

21

6

33

6

12

1 12 1 1

0

7

14

21

Gotamko

tAath

bishk

ot

Baphik

ot

Garaila

Purtim

kada

Asthbis

hdan

daga

un

Magma

Arma

Ghetm

a

Syalakh

adi

Hukam

Kholag

aun

Chhiba

ng

VDCs

Num

ber

1

10

100

1000

10000

Total case

Deaths


Weekly trend of Morbidity and Mortality in Rukum District

120

240403

182

62244490

946

4

12

5812

14

1

4

1

10

100

1000

Jestha 3rd Asar 1st Asar 2nd Asar 3rd Asar 4th Sraw an 1st Sraw an 2nd Sraw an 3rd Sr. 4th/Bhr. 1st

Weeks

Num

ber

1

10

100

1000

10000

MorbidityMortality

VDC wise details of deaths in diarrhoeal epidemic in Rukum District SN VDC M F Male child Female child Total

<5yr 5-15yr <5yr 5-15yr 1 Gotamkot 5 4 3 4 1 3 20 2 Aathbishdadagaun 2 4 - - 1 - 7 3 Syalakhadi 1 - 2 - - - 3 4 Garaila - 1 - - - 1 2 5 Purtimkada 1 1 - - - 1 3 6 Baphikot 1 - - - - - 1 7 Magma - 1 - - - - 1 8 Asthbishkot 2 1 1 - 1 1 6 9 Hukam - - 1 - - - 1 10 Ghetma 1 - 1 - - - 2 11 Kholagaun 1 - - - - - 1 12 Arma - 1 - - - - 1 13 Chhibang 2 - - - - 2 14 Shova 1 1

Total 17 13 8 4 3 6 51


Organizations supporting in control of diarrhoeal epidemic in Rukum

S.N. Name of the organization

VDC No. of Staff

Post/Team Date Type of work

1 Dist.Admin office

2066/03/01 Coordination, guidance &IEC

2 Nepal Army Dr./Nursing/Army Jawan

2066/03/01 Curative, Preventive, Transportation & IEC

3 DDC " Coordination, Volunteer & IEC

4 Nepal Police " Preventive, Volunteer & IEC

5 Redcross, Rukum 20 VDCs

172 HA/AHW/JRC/URC 2066/03/28 2066/04/12

Curative, Preventive, & IEC

6 ADRA-Nepal 2066/03/25 Drugs 7 SMNF/VCP ANM 2066/03/28 Curative,

Preventive, drugs & IEC

8 District Water Supply, Rukum

4 VDCs 4 Tech. Staff 2066/03/22, 04/11

Water purification, water quality test &IEC

9 DEPROSC-Nepal

4VDCs 8 Health Workers 2066/04/2,11 Sanitation, IEC

10 SIWIN Nepal 2066/03/11 Water guard, ORS

11 UMB Volunteer 2 VDCs 10 Health Workers 2066/04/11 Curative, Preventive, & IEC

12 UMN Rukum 2066/03/11 IEC 13 School Teachers Health teachers " Preventive &

IEC 14 News Reporter 2066/03/15 IEC

Organizations helping in drug supply in Rukum District

1. MOH &P/RMS,GoN. 2. ADRA Nepal-Drugs. 3. CSP/DFID Rukum-Drugs, IV set/IV canula. 4. District Water Supply and Sanitation office Rukum -Aqua tab & ORS. 5. Redcross Rukum - water guard/ORS. 6. NSMF Kathmandu


Currently functioning RRT camp (Date: 2066/05/09)

S.N Date Place Organization Remarks 1 2066/04/05 Gotamkot DHO/ 5 Volunteers from UMB Party 2 2066/04/05 Aathbiskot DHO/5 Volunteers rom UMB Party 3 2066/04/06 Purtimdada Nepal Army team with one Dr. 4 2066/04/06 Arma DHO/Nepal Army Team-6

District: Jajarkot VDCWise Morbidity and Mortality in Jajarkot District

S.No. Morbidity Mortality 1 Archhani 786 6 2 Bhagawati 202 4 3 Bhur 175 1 4 Daha 423 5 5 Dadaguan 306 1 6 Dasera 1660 8 7 Dhime 762 8 8 Garkhakot 296 4 9 Jaktipur 430 0

10 Khalanga 1493 1 11 Jhapra 340 1 12 Jungathapachaur 647 3 13 Karkiguan 945 1 14 Khagenkot 524 2 15 Kortang 895 12 16 Laha 1105 3 17 Majhkot 3570 20 18 Nayakwada 1281 12 19 Pajaru 776 1 20 Paink 1273 10 21 Ragda 388 2 22 Ramidanda 1490 11 23 Sakla 1260 6 24 Salma 727 1 25 Sima 224 0 26 Suwanauli 201 10 27 Talegaun 178 4 28 Thalaraikar 325 6 29 Rokayagaun 1968 7 30 Punma 521 4

Total 25171 154


VDCs Morbidity and Mortality in Jajarkot District

786

202 175

423306

1660

762

296430

1493

340

647945

524

8951105

3570

1281

776

1273

388

1490 1260

727

224 201 178

325

1968

521

4

1

5

1

8 8

4

01 1

3

12

12

3

20

12

1

10

2

11

6

10

10

4

67

4

6

0

4

8

12

16

20

24

28

Archha

niBha

gawatiBhu

rDah

aDad

agua

nDas

eraDhim

eGark

hako

tJa

ktipu

rKha

langa

Jhap

ra

Jung

athap

acha

urKark

iguan

Khage

nkot

Kortan

gLa

haMajh

kot

Nayak

wada

Pajaru

Paink

Ragda

Ramida

nda

Sakla

Salma

Sima

Suwan

auli

Taleg

aunTh

alarai

kar

Rokay

agau

nPun

ma

VDCs

Num

ber

1

10

100

1000

10000

Morbidity

Mortality

Monthly Trend of Mortality in Jajarkot District S No. Death

Number % of death

1 Baishakha 8 5.23 2 Jaistha 7 4.58 3 Ashar 112 73.20 4 Shrawan 24 15.69 5 Bhadra till date 1 0.65 6 No death-date

reported 2 1.31

Total 154 100.00


Monthly trend of deaths in Jajarkot District

8 7

112

24

1 2

0

20

40

60

80

100

120

Baishakha Jaistha Ashar Shraw an Bhadra till date No death-date reportedWeeks

Num

ber Death Number

Weekly Trend of Mortality in Jajarkot District S No. Death

Number 1 Baisakh to Jestha 15 2 Asar 1st 4 3 Asar 2nd 11 4 Asar 3rd 22 5 Asar 4th 75 6 Srawan 1st 17 7 Srawan 2nd 4 8 Srawan 3rd 2 9 Srawan 4th 1

10 Bhadra 1st 1 Total 152

Note: The date of 2 deaths in Jajarkot district is unknown.


Weekly trend of deaths in Jajarkot District

15

4

11

22

75

2 1 1

17

4

0

10

20

30

40

50

60

70

80

Baisakh toJestha

Asar 1st Asar 2nd Asar 3rd Asar 4th Sraw an1st

Sraw an2nd

Sraw an3rd

Sraw an4th

Bhadra1stWeeks

Num

ber

Death Number

Datewise Trend of New Cases in Jajarkot District

928

10223

790

1592

317

1388

2199

464

3691

22

1770

433163

1205

0

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

2066

/1/21

-3/30

31/3/

2066

6/4/206

6

7/4/206

6

9/4/206

6

10/4/

2066

12/4/

2066

13/4/

2066

15/4/

2066

18/4/

2066

20/4/

2066

21/4/

2066

27/4/

2066

8/5/206

6

Date

Num

ber

Cases


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District: Rolpa Name of Casualties in Rolpa District S.N. Name of Death

person Caste Age Sex VDCs Name Date of


1 Kumari Singh Thakuri

Thakuri 57 F Khungri-3 2066/03/16 Diarrhoea

2 Jun Kumari Pun Chhetri 5 F Uba-4 2066/04/3 " ( All deaths in home)

3 Mast B.K. Dalit 65 M Uba-3 2066/04/20 ” 4 Dalli Damini Dalit 71 M Dhawang-2 2066/3/16 " 5 Bhima Nepali Dalit 68 M Gajul-5 2066/4/16 " 6 Jasmali Roka Dalit F Kureli 2066/4/6 " VDCwise Details of Epidemic in Rolpa District S.N. Affected

VDCs Morbidity Death

No. Date of Death

Deployed Team Cause of Deaths

1 Khugri-3 22 1 066/03/16 Dr. Shishir Dahal, Ishwari Gautam(Sr,AHW)-3

Diarrhoea

2 Uwa-4,6,3 210 2 066/4/3,066/4/20 Dr. Shishir Dahal, Rajendra Hamal, Kamal Pariyar (AHW)-5

"

3 Kureli 16 1 066/4/6 Local Health Workers 4 Kotgaun-4,6 55 Local Health Workers 5 Dhawang-

1,2 120 1 066/3/16 Yogendra Rijal, Amar

Narayan Chaudhary, Suman Achrya -AHW, Tulsi Ram Achraya-VHW-5

"

6

Gajul-5 16 1 066/4/16 Bhakta Bahadur Thapa-VHW

"

7 Pachhawang 85 2 Dilli Achraya, Bharat Chaudhary (AHW)-3

Total 524 6

District: Humla Diarrhoeal Epidemic Mortality Details in Humla District

SN Name of Casualties Gender Age Name of VDC Date of Death Cause of Death

1 Aaitey Kulal Male 70 Kalika (Palsagaun) 066/05/05 Diarrhoea 2 Shivakala Kulal Female 41 Kalika (Palsagaun) 066/05/06 Diarrhoea 3 Nijra Budha Female 35 Kalika (Palsagaun) 066/05/06 Diarrhoea

4 Ram Bhakta Luhar Male 10

months Kalika (Palsagaun) NA Diarrhoea 5 Lotey Damai Male 48 Kalika (Palsagaun) 066/05/07 Diarrhoea

Note: Total Morbidity in Kalika VDC=164 (As of date 2066/05/11) 5 health personnel from DHO and a team of PLA , have been deployed in the affected VDC


Other Deaths in Humla District SN Name of Casualties Gender Age Name of VDC Date of Death Cause of Death

1 Mashi Shahi Female 2 months Kalika Previous dates (missing)

Other than diarrhea

2 Lakhi Shahi Female 3 months Kalika “” “” 3 Akhil Shahi Male 4 months Kalika “” “” 4 Bakhal Shahi Male 4 months Kalika “” “" 5 Manjan Shahi Male 6 months Kalika “” “” 6 Jip Shahi Male 6 months “” “” “”

District: Pyuthan

Diarrhoeal Epidemic Mortality Details in Pyuthan District SN Name of Casualties Gender Age Name of VDC Date of Death Cause of Death

1 Seti Sharma Female 72 Pakala-2 16/04/2066 Diarrhoea 2 Mankala Shrestha Female 76 Pakala 17/04/2066 Diarrhoea 3 Gani Ghartimagar Male 23 Tiram-7 7/5/2066 Diarrhoea 4 Tulsa Devi Sharma Female 68 Chuja-9 6/4/2066 Diarrhoea

Note: Total Morbidity in Pyuthan District= 105 Recent death in Pyuthan is on 7th Bhadra 2066. The other 3 deaths are missing deaths from previous dates. Total affected VDCs in Pyuthan District=3

Mid Western Region Districtwise Diarrhoeal Morbidity and Mortality Districtwise Diarrhoeal Morbidity n Mortality in Mid Western Region Districts Morbidity Mortality Jajarkot 25171 144 Rukum 12605 51 Dailekh 5733 28 Surkhet 3619 10 Dolpa 501 6 Salyan 658 5 Rolpa 347 6 Dang 65 1 Pyuthan 105 4 Kalikot 73 1 24 5 Total 48901 261


Districtwise Cases n Deaths in MWR

12605

5733

3619

65865 73 164

105347501

144

51

28

510

6 5 61

4 10

30

60

90

120

150

Jajarkot Rukum Dailekh Surkhet Dolpa Salyan Rolpa Dang Pyuthan Kalikot Humla

Districts

No.

0

5000

10000

15000

20000

25000

MorbidityMortality

(Note: The above data shows only diarrhoeal deaths, 10 non-diarrhoeal deaths from Jajarkot, 4 from surkhet and 1 from dialekh not included) Affected VDCs and Health Camps in Mid Western Region Districts Affected VDCs Health Camps

JJaajjaarrkkoott 3300 4411 RRuukkuumm 4433 2233 DDaaiilleekkhh 3311 2299 SSuurrkkhheett 1166 44 DDoollppaa 1111 77 SSaallyyaann 66 22 RRoollppaa 66 66 DDaanngg 11 22 PPyyuutthhaann 22 22 KKaalliikkoott 22 22 HHuummllaa 11 TToottaall 114499 111188


Districts Affected VDCs n Health Camps in MWR

30

43

31

16

11

6 6

1 2 2 1

41

23

29

4

7

2

6

2 2 2

0

5

10

15

20

25

30

35

40

45

50

Jajar

kot

Rukum

Dailek

h

Surkhe

tDolp

a

Salyan

Rolpa

Dang

Pyutha

n

Kaliko

t

Humla

Districts

Num

ber

Affected VDCs

Health Camps

Draft of Meeting Minutes of Regional Health Coordination Team (RHCT)

25th July 2009 at Shreesthan Hotel, Surkhet

In response to current alarming situation of diarrhoea outbreak in Jajarkot and neighboring districts, an emergency meeting of RHCT in presence of Dr. Laxmi Raj Pathak- MWR coordinator of this epidemic from MoHP was called by Dr Anand K. Shrestha, RHD Mid-West Region to review, discuss and find out gaps for further actions. Situations update and gap analysis

In Jajarkot, between1st May to 27th July 2009, total deaths due to Acute Watery Diarrhoea outbreak toll reached up to 128. Percentage of male and female deaths is almost equal (M-67, F-71) and around 50 % of them are Dalit. Similarly reported death cases are 5 in Salyan, 6 in Surkhet, 1 in Dang, 2 in Rolpa and 26 in Rukum.


There is no drug scarcity in Rukum and Jajarkot. About 8731 kg drugs supplied in Jajarkot and 5781 kg in Rukum. The major problem is in local transportation and distribution to affected settlements due to geographical conditions.

Although the number of deaths is in decreasing pattern, there is need to focus on preventive measures and awareness part.

Need to intensify the district and regional level coordination. Simultaneously reinforce the community/VDC level coordination mechanism for information management, supply of drugs and commodities and social mobilization for preventive measures and awareness messages dissemination.

Water purification/treatment measures are also need to go parallel to stop the chain effects of outbreak. Chlorination of water source/intakes, reservoir tank and its surrounding is needed to be done in effective way.

Very poor quality of food or food deficit, unsafe drinking water and unhygienic food behaviors are the major factors of this outbreak situation. Volunteer services to sensitize them practically about the sanitation measures are urgently needed.

Although only three cases of vibrio cholerae identified by WHO investigation in Jajarkot, an alert group with comprehensive emergency plan must be in stand-by position to respond the worst case scenario (catastrophic situation).

Decisions

1. All kind of emergency supports and initiations from national and international organizations are highly appreciable.

2. Intensify and reinforce the local level interventions and social mobilization through district and community level coordination mechanism i.e use District Disaster Relief Committee (DDRC), NRCS, mother groups/FCHV and youth volunteers.

3. All information related to Diarrhoea outbreak will be shared and informed through control room established at RHD, Surkhet.

4. Preventive and sanitation interventions will be reinforced by WASH Unicef, DFID in coordination of water supply division, NEWA and others.

5. Surveillance and others lead by WHO 6. Curative measures lead by DPHO/ DHO, MoHP Medical Team and Health camps

supported by national and international organizations. 7. All supports in supply of drugs and human resources i.e. health personnel will be

coordinated by outbreak response team from MoHP and RHD at Surkhet and by DDRC at districts. Information and overall coordination will be done by RHD, OCHA, GTZ and RMS.

8. Role of media is important to provide correct information to the public; therefore, we should have to update information to the media persons at least once a week.


Major cause of outbreak is as follows:- Unsafe drinking water consume by local people and open defecation. Delay in raining and sudden changes in climatic condition due to that all the

sources of water are contaminated. Habit of food intake is unripe, not cleaning food material, not getting sufficient

food materials. Nutritious food is not available. So, malnutrition is one of vital cause of outbreak. Jajarkot district's habitants are reluctant to change their behavior in spite of

getting heath education provided by different NGOs, INGOs and Government level as well.

There is lack of coordination and cooperation among stakeholders and health agencies. So, application control measure is very tedious task in the community level.

Almost all deaths related to diarrhea are not occurred in the health institution. These deaths occurred either on the way or home or delay in shifting or referred to health institution.

Due to geographical constraint, there is problem of transportation. Strong social stigma is prevailing i.e., in the preparation food, health behavior etc. Dalit are more vulnerable from this epidemic because of unhygienic style of

living. In spite of availability of drugs and health workers, case load and mortality are

not decreasing because they are not caring about environmental sanitation, sources of water and personal hygiene.

Timely supply of water purifier, chlorine tabs, aquatabs at the community level on of the major cause increasing in cases and mortality.

Prepared By: Approved By: Mr. Sujit Kr. Sah Dr. Sambhu Saran Tiwari Epidemiologist Director, Management Division Mr. Pranab Koirala Coordinator for MWR Diarrhea Epidemic Control IT Manager AICP/MWRHD

Documents

Mwr Diarrhoea Report