One of the major challenges faced during the COVID-19 response in Nepal has been the management of quarantine facilities. With the huge influx of returnee migrant at the beginning of lockdown, and now, with the COVID-19 community transmission, the number of infected people has been increasing at an alarming number.
As part of the effort to support the early intervention for COVID-19 response, DCA along with its local partners have been working in supporting to improve quarantine facilities with medical and non-medical supplies in nine districts.
Dhading is one of the districts where DCA is actively working for the COVID-19 response.
“We talked with the local government and assessed the immediate needs to improve the quarantine facilities. The two most urgent needs we identified were psycho-social support and WASH,” informed Prakash Gurung, Project Coordinator, WASH & Quarantine. At Dhading, the response is also focused on Quarantine Governance and WASH Facilities enhancement in the quarantine centres.
This response is implemented by DCA in Dhading through its local partner Action Nepal. The intervention is part of the UK Aid funded PURNIMA project, managed by Mott MacDonald.
The support is being conducted in seven Rural Municipalities (RM) of Dhading - Khaniyabas and Ganga Jamuna, located in the Northern part, while Gajuri, Thakre, Galchhi, Benighat Rorang, Jwalamukhi are in the Central and Southern part of the district.
Pratima Pandey, a psycho-social counsellor works in two of the RMs of Dhading, Gajuri and Benighat Rorang. She states, “People living in quarantine feel stressed. We organize psycho-social counselling for them, maintaining the COVID-19 safety guidelines. In the session, we talk about stress management and teach them about ways to maintain both mental and physical health.”
During the sessions, the counsellors also inquire the needs of the people, in terms of recreational activities that can help make their stay better. “People request for fun activities such as games due to the monotonousness at the centres. So, as part of the project, we have provided the centres with speakers, and games,” informed Pratima.
The quarantine facilities of Gajuri and Benighat Rorang have a capacity to house 15 people at present. Besides the sessions, psycho-social counsellors encourage the individuals to reach out to them through phone calls. “During the group sessions, some might find it uneasy to open up about their challenges, so we give them our contact number. They can call us anytime, and this has worked.”
Bikram Shrestha, another psycho-social counsellor working at Galchi and Thakre RM also stresses the importance of having access to counselling over the phone.
“The quarantine facility at Galchi is being relocated to another location. Since I started working for the response from August 14, I have been offering counselling to people over the phone. We got their contact numbers from the local authorities.” Bikram has counselled a total of 26 people, who have left the quarantine facility and gone back home.
Bikram states, “We constantly follow up with them after they leave the centres. A lot of people have stress and fear of facing stigma when they go back home, as everyone in the village would know that they had been in the quarantine centre.”
The counsellors listen to the individuals and offer them suggestions about helping to manage their stress. Both Pratima and Bikram state that, the individuals they counselled have stated that the sessions have helped improve their stress and the local communities have also become aware and are informed about COVID-19 which has helped them reintegrate into society.
Besides psycho-social counselling, the response also provides hygiene kits to the individuals at the centres. Most returnee migrants do not have personal hygiene kit besides their clothes or a small sanitizer which is not adequate for the 14 day quarantine.
“When I came back home from Gujrat India, I just had a small sanitizer besides my clothes. The hygiene kit provided by the organization was a blessing and I felt safer, “Buddhi Nepali, a returnee migrant who came to the Benighat Rorang stated. The hygiene kit provided includes items as per the Nepal WASH Cluster and government of Nepal with additional of sets of masks, protective hand gloves and a digital thermometer.
“We also have recreational activities here. We have a speaker and we can enjoy music and books, so it didn’t feel monotonous,” he further stated.
At the start of the pandemic, quarantine centres were housed in schools and colleges. As per the recent government decision to reopen the schools, Palikas are planning to close quarantine centres at education centre.
The local government is now focused on improving the infrastructure of health care centres as well as community buildings, to be used as quarantine and isolation centres. Therefore, there is an immediate need to build temporary infrastructure for WASH facilities.
“As part of the project, we are building semi-permanent toilet and temporary bathroom spaces, separate for male and females, for people staying at the centre as well as staffs,” informed Prakash Gurung.
Besides this, the team is also placing a 200 litre PVC tank with foot operated pedal, touchless hand washing facilities, as well as, supporting the improvement of drinking water system at the quarantine centres.
“As part of the project, besides the infrastructural support, we are also working with the local government to technically support the improvement and development of quarantine management Standard Operating Procedure (SOP) with clear roles, responsivities as per the requirement of Palikas and Code of Conduct (COC) on preventing gender-based violence, sexual exploitation, abuse and harassment”, stated Prakash Gurung
To develop the SOP and COC, focus group discussion (FGD) and key informant interview (KII) in six palika (Thakre, Galchi, Gajuri, Benighat Rorang, Ganga Jamuna & Khaniyabas) were conducted with various stakeholders, and also with women groups.
Currently, implementation of WASH facilities has started at quarantine centres of Thakre, Benighat Rorang and Jwalamukhi Gaupalika. These facilities will be operationalized soon, with quarantine facilities having capacity to house 24-30 people.
With the increasing number of cases and increased infection rate through community transmission, the development of quarantine centres is sure to add relief to the challenged health care services in the rural areas of Nepal.