Observation and derived feelings ( views are completely personal)

Nepal is one of the world’s least developed countries where denizens of rural part of the country faces real challenge in breaking the barriers placed by geographical feudalism. Villages enveloped by undulating pathways, slope and steep landmarks could be eye pleasing for most of us but that’s challenging for natives of rural area. The wide geographical spread of rural settlements pose particular health problems where  carrying dozens of wood, water pots and cattle fodder and walking miles are some of the daily house hold chores people are engaged in. This kind of practice invites neck, back,  knee osteoarthritis and one of the major challenges that women faces is pelvic organ prolapsed.

29 year old , Parbati BK( name changed)  single mother of 3 says that she is the only bread winner of her family.  Walking for an hour to fill water and gather wood and cattle fodder has been her daily routine.  29 years old , Parbati  is a chronic case of back pain ( posterior intervertebral disc prolapsed, PIVD) . She was handed a lumbar corset and taught appropriate back exercises to easy her pain. In addition she  was also trained on proper ways of carrying load and taking frequent rest between her work. This practice has helped her subside the pain making her more confident and enthusiastic on what she performs. Sad that we cannot modify the topography but somehow it’s possible to train local health providers and support community education program on disease prevention, introducing physiotherapy intervention and educating on ergonomic training and postural care as it’s impossible to suggest natives of rural side, not to perform their activities of daily living.  Sad, we don’t have adequate number of physiotherapists in district level. This had marked a significant gap to transfer the skills and knowledge on physiotherapy service. Teaching them the proper ways of carrying wood and cattle fodder  and useful exercises can somehow offer long term sustainable solutions to Nepal’s health and development challenges. 

 Health is considered as another critical infrastructure of development. It is indeed true that only a person with a sound mind and body can think and act rationally. 

Out of many I would like to list few of the problems in health sector:

·         Physiotherapy treatment and facilities are not available as required

·         Doctors and health workers hesitate to go to remote areas

·         There aren’t enough health posts, sub health posts, primary health centers in remote areas

·         Rural people mostly rely on witch doctors

It seems to me that provision should be made to establish well facilitated health post and hospital in remote areas where physiotherapists and health workers should be encouraged to go to remote areas with good incentives.