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Parasites Telemedicine and Health Needs in Nepal

 


Opportunities in Namsaling

•         Continue parasite testing as the eradication program is underway

•         Train staff in Nepal to continue testing

•         Train staff to teach life cycle

•         School education on parasites

•         Life cycle

•         Awareness

•         Focus groups

•         Find use for Telemeds system

 

Other Opportunities in Namsaling

•         Training for the Health Post workers

•         Training for Midwives

•         Equipment for Midwives

•         Books for Midwives

•         Assessing feasibility and installing Pico Hydro generators

•         Water Sanitation projects

•         Assessing and treating dental needs

 

Other Opportunities in Kathmandu (Kanti Children’s Hospital)

•         Chart review of infections in burn victims to examine standards of care and provide recommendations

•         Chart review of cancer standard of treatment and outcome

•         Study any of the many novel cancers there

•         Study GI problems including the ubiquitous “GASTRICT” syndrome


Our Project

We planed a village health needs assessment survey to take place in Namsaling Nepal a region in the far east bordering India. Despite this plan and all the work that went into it, when we arrived we found that the village and its elders really wanted us to investigate the parasite burden in the community. We teamed with an extremely intelligent school headmaster and a very motivated lab technician from the nearest hospital. Together we put together a plan to test three students from each water source in the Namsaling region of Nepal (slightly over 100 students).

            The community was very supportive of the plan and even provided us with a translator when we went to schools without an English teacher. As part of the assessment, we thought we should explain to the students why they were being asked to provide fecal samples and what we would be doing with their samples. This led to the creation of a two hour presentation, the first hour of which went through the history and development of the microscope and ended with a little hands-on experience for the students. The second hour we taught the students about the parasites in the region as well as the life cycles of the three most common parasites, including methods of transmission. The students and the teachers learned about the health consequences of parasites, especially hookworm which is endemic in the region. At the end of the session we would ask students how they thought we could interrupt the life cycles of these parasites. Their ideas were invigorating as was the feeling that with a complete understanding of the situation they were now motivated to use the latrines NGO’s had been installing in the region for almost ten years.

            The teaching aspect of this project is something we feel very proud of and by the end of my trip the translator could easily teach the class on his own. We hope to make this education an ongoing sustainable project in the region.

The actual testing of students also created a much greater impact on the region that we ever could have imagined. After presenting the elders with our results th

ey were able to get permission from the regional health minister to provide anti-parasite medication to their 2000 student for 2

years. The protocol we suggested was the same as the government sponsored protocol being used to treat children in more affluent regions of Nepal. We will be following up on the community in our fourth year and training many more Nepalies to test stool samples for ovum and parasites. We hope to be able to compare before and after data and to provide the elders with a positive result. We would also like to train these Nepalies to teach the children lessons similar to ones we taught last summer. From what we saw this type of education is the most important tool for preventing parasite transmission in the region.

We also helped set up a telemedicine network linking a health post to a local school, two offices and a private hospital in the nearest town. The network was very finicky due to unreliable power at various locations. We provided training on how to use the software and how to perform basic troubleshooting on it when it fails but we feel that much more work will need to be done in order to make this a reliable network.


For more information, contact mycroft.smith@ucdenver.edu and adam.sinner@ucdenver.edu.


         

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