During the period of epidemic and lockdown, it was reported that the pregnant woman did not get any treatment and the kidney patient had to go to the hospital in Thelgada for dialysis.

The first person to lose her life due to coronavirus in Nepal was a pregnant woman. The government has not confirmed the number of pregnant and lactating women who lost their lives due to untimely treatment.
Similarly, patients with cancer and tuberculosis, AIDS patients and kidney patients had difficulty in getting regular medical treatment and dialysis.

Statistics not available

After the crackdown on coronavirus infection on March 26, the attention of all agencies and health institutions has been focused on the epidemic.
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However, no study has been done on how much it affected pregnant women, cancer and tuberculosis patients, diabetics and other incurable diseases during that period and what kind of long-term problems it may cause in the days to come.
Many pathologists have told the BBC that there is a strong possibility that many people may have hidden the disease or delayed treatment due to the fear of going to the health facility and the inability to go due to non-availability of transport.

Maternal and child health

During the lockdown, especially the regular campaigns for safe motherhood, family planning, vitamin A and measles / rubella vaccination were disrupted. Bhim Singh Tinkari has accepted.
"Initially, it was different. There was an outbreak of measles in Dhading. But now we have regularized all services in a safe manner," he said.
For some years now, Nepal has been receiving praise from the world for reducing the maternal mortality rate.

सुत्केरी महिला

Image caption,
During the lockdown, several pregnant and lactating women had to be airlifted from remote places
According to the latest health survey, the current maternal mortality rate in Nepal is 239 per 100,000 live births due to the increasing trend of visiting trained health workers or giving birth in hospitals.
It may have been affected by landslides and epidemics. News reports said that in many places, pregnant or lactating women lost their lives without treatment.
But the government said the details could not be confirmed.
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Dr. "From Chait to Asar, 44 women have been found dead so far. Two years ago, 53 people were killed in the same period. Therefore, the number does not appear to have increased due to epidemics and landslides," Tinkari said.
He said that in some of the reports, dozens of women were killed in some places, but the local health body did not confirm that later.

The United Nations Children's Fund (UNICEF) has warned that the socio-economic impact of COVID-19 could lead to severe malnutrition in 3.9 million children under the age of five in Nepal and South Asia by 2020.
A quick test is being carried out to find out the extent of such effects and the results will be made public soon. Tinkery explained.

Cancer and tuberculosis

The sudden disruption of regular health services has affected many patients.
Patients with cancer and tuberculosis or kidney and diabetes, who had to undergo continuous treatment, were also affected.


"Cancer is an early detectable disease and it can be difficult to get someone diagnosed in time during this period. It can definitely lead to complications later. The problem we have been facing is the lack of chemo and other drugs. It is still not completely cured," he said. .
"According to our estimates, about 27,000 people were undergoing chemo treatment. There are no definite figures on how much the epidemic has affected," he said. Baral said. According to him, lung, oral, uterine and breast cancers are very common in Nepal.
Dr. President of the Cancer Hospital in Bharatpur. Nirmal Lamichhane said that although there were many problems in the beginning, now all the services have become regular.
"Right now, we're starting to provide coronavirus testing and surgery services to patients who need surgery," he said.

Tuberculosis also kills 6,000 people in Nepal every year. According to the National Tuberculosis Control Center, about 69,000 people are diagnosed with the disease each year and 32,000 are treated under the direct supervision of a physician.
"Our motto is to diagnose and treat the disease at the outset. But the epidemic caused some disruption in the system. Initially, it was difficult to get medical treatment under the supervision of a doctor, so we arranged to send the patients home for a month," said Dr. Navin Prakash Shah said.
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Tuberculosis patients need to take medicine at the right time and if they do not take it, it can lead to other complications. Someone may get drug-resistant tuberculosis.
It is said that the fear of losing the identity of the patient due to lack of regular service will remain the same.

Pressure on the system

Public health experts say that over the past five months, health facilities across the country have come under unprecedented pressure.
"Whether it's a big hospital in the city or a health post in the village, everyone has to bear the brunt of the covid. When all the attention and resources are focused on that, the regular service is disrupted. Sharad Vanta said.
Experts believe that the agility of the system should be seen in such challenges. "But whether it's direct treatment for tuberculosis patients or kidney and diabetes patients, what we've seen is that people in distress have to carry patients on their heads and carts," he said.
"Covid is just another problem. There are a lot of other problems in our public health."

President of Nepal Medical Association Dr. In Lochan Karki's experience, hospitals do not have the same problems as in the early stages of epidemics and lockouts.
"It was completely new at the time and both the patient and the doctor were confused. Due to the lack of supply, we had to face the shortage of many medicines and equipments. That has affected many patients," he said.
But he says most of these epidemics are short-lived, so long-term complications are unlikely.
"I think the long-term problem may be due to mental stress," he said.
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The health system has been plagued by epidemics at a time when the entire system was slowly collapsing into a federal structure.
"It's a double whammy for us. The transition to a federal structure has led to an epidemic as our healthcare reporting or information network is being redistributed to new provincial and local testing systems," he said. Bhim Singh Tinkari shared his experience.
Experts say the country's health system needs to be studied in detail about how it worked during the epidemic and what needs to be done to improve it.

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