MWR Diarrhoea Report

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)
Consolidated report of Mid Western Region Diarrhoeal Epidemic
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 Consolidated report of Mid Western Region Diarrhoeal Epidemic
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. 1 2 3 4 5 6 7 8 9 10 ITEM Inj. Ringer's Lactate Inj. Ciprofloxacin(500mg) Inj.Metronidazole(500mg) Tab.Ciprofloxacin(500mg) Tab.Metronidazole(200mg,400mg) Nawajeewan(ORS) Cap.Doxycycline(100mg) Cap Tetracycline(250mg,500mg) Piyush solution IV cannula QUANTITY 1512 bottle 1000vial 1500vial 1500tab 1500tab 1000packet 1500cap 1000 cap 500 bottle 500 piece REMARKS
For water purification 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, UNICEFs 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 1 2 3 4 5 6 7 8 9 10 12 13 Water Guard Piyush Hand miking Soap IEC Flex IEC Pamphlet ORS Chlorine Liquid Vile Aqua tab Cell battery CMA/ HR Concern 1600 11 2000 102 2000 WATER AID UNICEF DWSO Jajarkot 2500 -
1000 2000 50 L 250
40 2150
77000 1000 6 6 -
30000 -
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 1 2 3 4 5 6 7 8 9 10 11 12 13 14 Date 17/5/2065 4/13/2065 13/8/2065 26/12/2065 14/4/2066 14/4/2065 10/8/2065 26/12/2065 13/5/2065 8/8/2065 27/12/2065 24/2/2066 11/3/2066 31/3/2066 District Banke Banke Banke Banke Bardiya Bardiya Bardiya Dailekh Dailekh Dailekh Dailekh Dailekh Dailekh Dailekh K.G./Box 26 80 30 12 34 95 95 30 30 45 40 13 11 20 Remarks
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64
18/4/2066 22/4/2066 32/4/2066 16/8/2065 3/1/2066 16/4/2065 27/4/2065 23/3/2066 20/4/2066 22/4/2065 5/8/2065 6/1/2065 20/4/2066 25/4/2066 26/4/2066 19/4/2065 5/8/2065 6/1/2066 9/5/2066 10/5/2066 2/5/2065 21/7/2065 31/12/2065 21/3/2066 29/3/2066 29/3/2066 29/3/2066 29/3/2066 29/3/2066 22/3/2066 21/3/2066 31/3/2066 31/3/2066 3/4/2066 9/4/2066 21/4/2066 9/5/2066 20/4/2065 26/7/2065 28/12/2065 16/4/2066 19/4/2065 25/7/2065 30/12/2065 18/4/2066 14/4/2065 1/8/2065 4/1/2066 11/5/2065 6/8/2065
Dailekh Dailekh Dang Dang Dang Dang Dang Dang Dolpa Dolpa Dolpa Dolpa Dolpa Dolpa Dolpa Humla Humla Humla Humla Humla Jajarkot Jajarkot Jajarkot Jajarkot Jajarkot Jajarkot Jajarkot Jajarkot Jajarkot Jajarkot Jajarkot Jajarkot Jajarkot Jajarkot Jajarkot Jajarkot Jajarkot Jumla Jumla Jumla Jumla Kalikot Kalikot Kalikot Kalikot Mugu Mugu Mugu Pyuthan Pyuthan
182 15 252 91 45 17 25 18 9 908 1262 485 369 729 22 194 1448 502 35 364 346 805 586 1263 158 158 158 546 546 15 1568 1568 314 700 3302 755 75 894 1022 422 394 361 1172 663 401 679 1274 582 25 85
65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93
7/1/2066 5/4/2066 4/5/2066 28/4/2065 8/8/2065 7/1/2066 8/4/2066 6/8/2065 2/1/2066 26/3/2066 29/3/2066 29/3/2066 29/3/2066 26/3/2066 31/3/2066 9/4/2066 27/4/2066 7/5/2066 2/5/2065 16/8/2065 3/1/2066 13/4/2066 19/4/2065 8/8/2065 27/12/2065 9/4/2066 13/4/2066 18/4/2066 7/5/2066
Pyuthan Pyuthan Pyuthan Rolpa Rolpa Rolpa Rolpa Rukum Rukum Rukum Rukum Rukum Rukum Rukum Rukum Rukum Rukum Rukum Salyan Salyan Salyan Salyan Surkhet Surkhet Surkhet Surkhet Surkhet Surkhet Surkhet Total:
40 3 90 25 91 42 5 2305 654 876 158 546 363 399 480 3140 718 2418 27 87 45 16 29 86 51 25 37 72 36 41234
Current Status of Drugs Available at Regional Medical Store, Nepalgunj (2066/05/11)

S.N. 1 2 3 4 5 6 7 8 9 10 11 Drugs Name 0.9 % NaCl 540mm (NS) NaCl 0.9%, 5% Dextrose (DNS) 540 mm 5 % Dextrose 450 mm RL Inj. Cipro 100 ml Amoxycilline 500mg Cap. Amoxycilline 250 mg Cap. Ciprofloxacine 250mg Tab. Ciprofloxacine HCl 500mg Cotrim DS tabs. Cap. Doxycilline 100mg Stock 116 250 720 2647 1170 1500 140200 5000 5000 0 9200 Unit Bottles Bottles Bottles Vial Cap. Cap. Tabs. Tabs. Tabs. Cap.
12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36
Metronidazole 200mg Metronidazole 400mg Tab Sulphamethoxazole Sus. 200 mg & Trimmethoprim 40mg/5ml Sulphamethoxazole 400 mg & Trimmethorprim 80mg Paracetamol 500mg Tabs. Tetracyclline 250mg caps Tetracyclline 500mg Caps. ORS 1000 ml Amoxycilline 150 mg/5 ml Dry Suspension Metronidazole 100 mg/ 5ml Syrup Syrup Paracetamol 125 mg/5ml Compound Sodium Lactate Solution 540mm Syringe 5ml Adhesive tape 10 cm/5m IV Infusion set with needle 10% Dextrose 450mm Citrizine HCl 10mg Vitamin B-Complex Metachlopromide Inj. Methylated Spirit 450 ml AB Cotton 400 gm Butterfly Needle Gloves IV Canula D Size Diarrhoeal kit
296350 214750 500 10000 348800 5300 8400 65730 0 590 7140 20579 13594 605 3174 0 5200 97000 450 137 980 500 330 1373 1
Tabs. Tabs Bottles Tabs. Tabs Cap. Cap. Pkts. Bottles Bottles. Bottles. Vial Pieces. Pieces Pieces Bottles Tabs. Tabs Amp. Bottles. Roll Pcs Pair Pc Set
Details of Stock and Demand of Drugs/Items in the Mid Western Region

Current Stock in RMS 116 250 2647 1170 1500 140200 5000 5000 10000 Districts Demand 1250 500 21980 6590 55000 30000 57000 198370 157440
SN 1 2 3 4 5 6 7 8 9
Drugs NS DNS RL Inj.Cipro. Tab.Amoxy 500mg Tab.Amoxy 250mg Tab Cipro.250mg Tab.cipro 500mg Tab.Cotrim DS
Deficit 1134 250 19333 5420 53500 -110200 52000 193370 147440
10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45
Tab.Doxy.100mg Tab.Metro 200mg Tab.Metro.400mg Tab.Paracetamol 500mg Cap.tetracycline 500mg Tab.Tertracycline 250mg ORS Syp.Metro. Syp.paracetamol Inj.metaclopromide Inj. Metro IV Cannula 20, 22, 24 G Tab. Perinorm Tab. Buscopan Tab. Cortim SS Tab. Cortim PD Tab Cortim P Syp. Perinorm Tab. Albendazole Inj Aciloc IV Set Syr. Norfloxacin 60 ml Tab. Zinc Adhesive tape Cotton Disposable Syringe Tab. Metaclopromide Sus. Cotrim Tab. Ranitadine 150mg Inj. Gentamycine 80 mg Inj. Dexona Oflaxicine Sus. 100 ml Butterfly Needle Methylated Spirit 450 ml Diarrhoeal Kit Gloves
9200 296350 214750 348800 8400 5300 65730 0 7140 450 0 1373 0 0 0 0 0 0 0 0 3174 0 0 605 980 13594 0 500 0 0 0 0 500 137 1 330
15500 317650 326350 145000 23000 23000 155000 3000 1500 1000 7590 5450 8515 2000 164700 25000 20000 1500 12000 200 5725 300 265150 204 4 2100 2000 2830 15000 442 100 100 0 0 0 0
6300 21300 111600 -203800 14600 17700 89270 3000 -5640 550 7590 4077 8515 2000 164700 25000 20000 1500 12000 200 2551 300 265150 -401 -976 -11494 2000 2330 15000 442 100 100 -500 -137 -1 -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
1. 2.
Date of Visit
2066/04/02 2066/05/02
Name/Post
Dr. Laxmi Raj Pathak, Co-ordinator, MWR Diarrheal Epidemic Management and Control Dr. Sambhu Saran Tiwari, Director, MD
Supervised VDCs/Place
Dailekh, Jajarkot, Surkhet
Rukum District
S.N.
1
Date of Visit
2066/04/05
Name/Post
Hon. Prime Minister Madhav Kumar Nepal Hon. Health Minister Umakanta Chaudhary Dr. Govind Prasad Ojha-DGDoHS Dr. GD Thakur-Director-DoHS Mr. Dev Raj Dhakal-CDO, Rukum Mr. Malla, Army Brigadier General, Tulsipur, Dang Mr. Rabindra Bd. Dhanuk-DSP, Rukum Mrs. Sangita GC- Lab Tech., EDCD Kamala Pandey, Med. Tech. NPHL, Teku Hon. Health Minister Umakanta Chaudhary Ex. Hon. Minister for Peace and Recreation, Mr. Janardan Sharma Parliamentary Mrs Bimala KC Parliamentary Mrs. Jun Kumari Roka Parliamentary Mrs Kamala Roka Mr. Arjun Bdr. Singh, Director NHTC Mr. Rajaram KC, Nepal Army Parliamentary
Supervised VDCs
District head quarter Rukum & Aathbiskot VDC " " " "
Feedback
Strengthen coordination
2 3
04/05 04/05
" Strengthen coordination & work, mobilization of FCHVs Regular monitoring and coordination Drugs in Aathbiskot needed Drugs in Aathbiskot needed " Stool and water sample collection Stool and water sample collection Strengthen Coordination Strengthen Coordination
4 5 6 7 8 9 10 11
04/04 04/07 04/07 04/07 04/15 04/17 2066/04/26 2066/4/26
DHO Rukum Gotamkot, Aathbiskot Gotamkot, Aathbiskot Gotamkot, Aathbiskot DHO, Rukum and Chhibang SHP DHO, Rukum and Chhibang SHP District HQ Rukum and Aathbiskot District HQ Rukum, chaurjhari and Kotjari VDC Different VDCs Different VDCs Different VDCs Kot PHC Kot PHC District HQ
12 13 14 15 16 17
2066/04/26 04/26 04/26 04/29 04/29 04/31
Regular drugs supply and coordination Regular drugs supply and coordination Regular drugs supply and coordination IEC Needed and HR Management IEC Needed and HR Management Coordination
Jajarkot District
SN
1. 2. 3. 4. 5.
Date of Visit
2066/01/31 2066/01/31 2066/03/23 2066/03/23 2066/03/23
Name/Post
Ex. Health Minister Mr. Giriraj Mani Pokhrel Dr. Shankar Shreshta, EDCS Hon. Health Minister Mr. Umankanta Chaudhary Hon. State Health Minister Khadga Bahadur Basyal Hon. MP Mr. Kali Bahadur Malla
Supervised VDCs
Rokayagaun Rokayagaun Khalanga, Dashera Khalanga, Dashera Khalanga, Dashera
6. 7. 8. 9. 10. 11. 12. 13. 14.
2066/03/23 2066/03/23 2066/04/05 2066/04/05 2066/04/05 2066/04/05 2066/04/09 2066/03/20 2066/04/24
Secretary MoHP Dr. Dirgha Singh Bam Dr. Ishwar Prasad Upadhyaya, EDCD Hon. Prime Minister Mr. Madhav Kumar Nepal Hon. Health Minister Mr. Umakanta Chaudhary Director General DoHS, Dr. Govinda Prasad Ojha Regional Administrator, Mr. Binod Gyawali Dr. Laxmi Raj Pathak, Coordinator, MWR Diarrhoeal Epidemic Management and Control Dr. Padam Bahadur Chand, DoHS Dr. Bhim Acharya, Sr. PHA, DoHS
Khalanga, Dashera Khalanga, Dashera Khalanga Khalanga Khalanga Khalanga Khalanga DHO, Jajarkot DHO, Jajarkot
Dailekh District
SN
1. 2.
Date of Visit
2066/04/09 2066/04/21
Name/Post
Dr. Laxmi Raj Pathak, Co-ordinator, MWR Diarrheal Epidemic Management and Control Dr. Mahesh Maskey, President, NHRC
Supervised VDCs/Place
Dailekh District Hospital Dailekh District Hospital
Districtwise Details of Human Resource Mobilization for Diarrhoea Outbreak Control

District: Dailekh
. S.N.
1
VDC
Bhairikalikathum-7
Deployed Team DHO

1.Dal Bahadur Nepali
Post
Sr. AHW
Date
2066/3/10,11
Baluwatar-9
Mehaltoli-6,7,8
2.Rohit Thapa 1. Dirgh Bd. Budhamagar 1. Madam Kumar Shrestha 2.Promod Koirala
AHW AHW Sr. AHW
2066/3/18,20 2066/3/23,24
AHW
Jagnath-5,6,7,8
1.Rohit Thapa 2.Thirraj Regmi
AHW, AHW Sr.AHW
2066/3/23,25
Katti-2,7,9
Bed Bd. Thapa
2066/3/23
Narayan nagarpalika -ward no. 2
Thir raj ragmi
AHW
2066/3/31
Mehaltoli-6,7,8,9
1.Nagandra B. Hamal 2.Pramod Koilara
Sr.AHW
2066/4/4,5,6
AHW 8 Latibindrasaini-2,4,6,8,4 1.Narotam B. Rawal 2.Thirraj Regmi 9 10 Gamaudi-2,4,6,7,8,9 Chhiudpushikot Local Health Workers Local Health Worker Dal Bdr. Nepali Local Health Worker Rohita Thapa Thir Raj Regmi Local Health Worker Dharm Raj Jaisi Local Health Worker Dharm Raj Jaisi and HW 1. Dharm Raj Jaisi 2. Surya Bd. Thapa 3. Bakhat K.C. 1. Ramesh Bhandari 2. Local HW Local Health Workers Local Health Workers " " Sr.AHW AHW 2066/4/13 Sr.AHW AHW AHW AHW AHW Sr. AHW Sr. AHW Sr. AHW AHW AHW H.A. AHW 2066/04/8 2066/04/15 2066/04/18 2066/04/18 2066/4/12 2066/04/12 2066/04/14 2066/4/5 till date
11 12 13 14 15 16. 17
Gauri-2,3 Satala Jaganath-2,3 Jambukandh-8 Bhairikalikathum-7 Bhairikalikathum-4,6,8 Pipalkot-3,6,9
2066/4/10 2066/4/11
18
Jambukandh-6
2066/04/14
19 20 21 22
Goganpani-7 Badalamji Rawatkot-3,4 Naule-5,8,9
Details of Human Resource Mobilization for Diarrhoea Outbreak Control District: Dolpa
.
S.N. 1 2 3 4
VDC Dunai-Thala tol Jufal- Dangiwada Lawan- Khani tol Jufal- Motipur
Deployed Team DHO 4 members lead by Sanjay Kumar Mandal 2 members lead by Ashok Kumar Yadav Dhannath Yogi 1. Budhi Dharal 2. Bholanath Ghimire
Post H.A. AHW Sr. AHW AHW
Date 2066/3/4 2066/3/29 2066/3/24
2066/4/4 AHW AHW AHW 2066/4/4 2066/4/12
5 6
Dunai- Tipla Jufal -1, Airport
1. Ran B. Budha 2. Arun Kumar Thapa Budhi Dharal
Details of Human Resource Mobilization for Diarrhoea Outbreak Control District: Rukum
SN 1 Date of movement 2066/03/26 & 2066/3/27 Place Gotamkot No.of staffs 8 Name of staffs 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 Shiv Narayan Rajak(SAHW) Nandlal Mahato (SAHW) Hira Pun(ANM) Bhim Bdr Chand (SAHW) Tabilal Khadaka (AHW) Janaki Malla(ANM) Meghraj Soni(AHW)
2066/03/23
Aathbishkot
3 4
2066/03/26 2066/03/27
Simritu Baphikot
2 2
5 6
2066/03/28 2066/03/28
Garaila Aathbishkot-9 Jhinchaur
2 12
7 8
2066/03/28 2066/03/29
Purtimkada Aathbishdadagaun
2 3
9 10 11 12 13
2066/03/29 2066/03/30 2066/03/30 2066/03/30 2066/03/30
Magma Ghetma Duli Arma Chunbang
4 2 1 2 3
14 15 16 17
2066/03/30 2066/04/01 2066/04/01 2066/04/02
Baphikot,Magma Morabang, Quangsi Morabang Aathbishdadagaun-9, Barkhu Gotamkot Aathbishkot Purtimdada Arma
15 2 2 2
18 19 20 21
2066/04/05 2066/04/05 2066/04/06 2066/04/07
5 5 5 8
Karna Bdr Budhathoki Mina khatri (MCHW) Surendra Yadav (SAHW) Sunita Achrya (ANM) Dibit Rawal(HA/Redcross) Shova Ram KC (Asst/Redcross) Kamal Budhathoki(Peon) Nepal Police Team -7 Pradeep KC(AHW) Laxmi Pun (MCHW) Bibek BM(AHW) Bimala Chand (VHW) Amrita KC(MCHV) Sarita Gautam (AHW) Karna Bdr Khadaka (AHW) Gopal Singh Oli (AHW) Rajendra Bdr Dhing (VHW) Shashi Ram Budhathoki Karma Bdr KC (AHW) Parsha Bdr dangi (AHW) Gobinda Paghe (AHW) Man Kumar Pun (MCHW) Aash Bdr Pun (peon ) Nepal Army with 1 Doctor Upengra Yadav (SAHW) Dipendra Yadav (AHW) Binit Shah (AHW) Sukmaya Roka (MCHW) Sunita Achrya (ANM/SMFN) Dibit Rawal (HA/Redcross) Volunteers from UMB Party Volunteers from UMB Party Nepal army Team -6 Hari Bdr KC (SAHW) Annant KC(SAHW) Nepal Army Team -6 SAWH-3, Dor Bd. Khadaka (Lab Asst.), Rambahadur Khatri (Peon) Nepal Army Mobile Team-9, Army Health Person-17, Total Army staffs-147
22
2066/04/13
Gotamkot
23
2066/04/16
Chibang, Simli, Arma, Purtimkada, Garaila, Kotjhari with 13 VDCs
147 (9 Team)
Details of Human Resource Mobilization for Diarrhoea Outbreak Control District: Rolpa
S.N. VDCs 1 Khugri-3 2 3 4 5 Uwa-4,6,3 Kureli Kotgaun-4,6 Dhawang-1,2 Date 066/03/16 066/4/3,066/4/20 066/4/6 066/3/16 Deployed Team Dr. Shishir Dahal, Ishwari Gautam(Sr,AHW)-3 Dr. Shishir Dahal, Rajendra Hamal, Kamal Pariyar (AHW)-5 Local Health Workers Local Health Workers Yogendra Rijal, Amar Narayan Chaudhary, Suman Achrya -AHW, Tulsi Ram Achraya-VHW-5 Bhakta Bahadur Thapa-VHW Dilli Achraya, Bharat Chaudhary (AHW)-3
6 7
Gajul-5 Pachhawang
066/4/16
Details of Human Resource Mobilization for Diarrhoea Outbreak Control District: Kalikot
House to house visit for hygiene, sanitation and health education team
1. Katak B. Mahat 2. Rajendra Chaudhary 3. Laxmi Psd. Pandey
First Aid Team
Clorination team at Clinical Team for hospital treatement
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.
1.
Location
Bahunthana SHP
VDC
Khalanga
Health Personnel/Team
AHW- Laxmi Sharma VHW-Narvada Karki MCHW- Narayani Shah AHW Khem Bdr Pun ANM Kaushila Batala AHW Hira Lal Acharya AHW Binod Aryal AHW- Chhatra Bdr Karki
2.
Kudu HP
Jagatipur
3.
Jagatipur SHP
Jagatipur
AHW- Padam Gurung VHW- Krishna Kumari Shah MCHW Dilsari Batala AHW- Chandra Bdr Khadka VHW Khadga Bdr Gharti MCHW-Ganga Kumari Regmi AHW Uddav Karki (RHD) Dr. Lalit Suri ? HA Prem BK AHW Sita Ram Chaudhary AHW Navin Ranamagar
Punma SHP
Punma
Bherya
5.
Bhoor HP
Bhoor
Ghorneta
Sr.AHW Birendra Kumar Sharma AHW Lal Bdr Khadka ANM Lali R.C. VHW Ain Singh Thakuri HA Bharat Kanwar AHW Yadhav Joshi AHW Dhanish Khadka MCHW Bishnu Karki AHW Bir Bahadur Khatry (VDC) AHW Danda Bir Nepali AHW Bishnu Giri AHWPoorna bdr Shahi MCHW Rama Shah VHW Hari Bdr Basnet (VDC)
6.
Karkigaun SHP
Karkigaun
7.
Jhapra SHP
Jhapra
8.
Sima HP
Sima
9.
Thalaraikar SHP
Thalaraikar
10
Jungathapachaur SHP
Jungathapachaur
11.
Dasera HP
Dasera
Thala
AHW Amarraj Sejuwal ANM Gita Bhusal VHW Arun Kumar Malla Nepal Army Team AHW Hari Prasad Pokharel VHW Man Bdr Budha MCHW Radha Devi Sharma AHW Krishna Bdr Thapa VHW Ganga Bdr Shahi MCHW Parbati Sharma Sr AHW Amar Bdr Rana AHW Ram Bdr Thapa ANM Rawal AHW Jaya Bdr. Thapa (VDC) VHW Nar Bdr Chanda AHW Narayan Psd Pokharel Nepal Army AHW Om Bdr Rana Chhettry VHW Bhim Bdr BC MCHW Kaushila K Sharma AHW (Recruited by RHD) MCHW Padma Kumari Thapa AHW Hari Prasad Lamichhane VHW Lok Bdr Oli
12.
Salma SHP
Salma
13. 14.
Suwanauli SHP Majhkot SHP
Suwanauli Majhkot
15.
Gharanga HP Samahila
Gharanga
16.
Dhime SHP
Dhime
Bharma
MCH Bishnu Kumari Shahi Dr.Ishori Upadya ANM Sita Thapa ANM Sumitra shrestha AHW Krishna Bdr Shahi AHW Shah Dev Basnet ANM Chanda Tiwari AHW GaganDev Giri AHW Hasta Raj Giri VHW Madhav Karki MCHW Nirmala Kumari Thapa AHW Ram Prasad Sharma AHW kali Bdr Chalawane Dr. Subash Acharya S I Gam Bdr Thami AHW Bhaskar Poudel AHW Arjun Ghimire AHW Nawal Kishor Mahato AHW Yagya Nath Gautam AHW Birendra Raj Giri VHW Bal Bdr RC MCHW Chandra Kumari Rokaya AHW Resham Lal Gautam AHW Gopal Bdr Shahi MCHW Hridaya Kumari Singh Dr. Avash Joshi Team AHW Keshav Khadka AHW Krishna Bdr Rokaya VHW Ganga Ram Aacharya MCHW Hari Kala Shahi AHW Bal Bdr Shahi AHW Prem Bdr Shahi ANM Sita Singh Lab Asst Dabal Bdr BC VHW Govinda Bdr Shahi AHW Tej Bdr Shahi VHW Obiram Pun MCHW Chhita Adhikari AHW Khimraj Thapa AHW Prakash Adhikari MCHW Pan Kumari Pun AHW Birendra Pun MCHW Saraswati Shahi Nepal Army Team AHW Keshav Prasad Dahal MCHW Satya Devi Shahi Dr Yek Raj Luitel KP Upreti Krishna Dhital KB Chand AHW Ram Bdr Rokaya ANM Sushila Budhathoki ANM Rem Kali Sunar
17
Paink SHP
Paink
18
Talegaun SHP
Talegaun
19
Archhani SHP
Archhani
20
Garkhakot PHC
Garkhakot
21 22
Matela Pajaru Ka SHP Pajaru Kha SHP
Pajaru Pajaru
23
Daha SHP
Daha
24
Kortang SHP
Kortang
25
Limsa PHC
Rokayagaun
26
Nayakwada SHP
Nayakwada
27
Ramidanda SHP
Ramidanda
28
Sakla HP
Sakla
AHW Sushil Pun AHW Mis Bishumaya Bhudha AHW Deepak Bdr Khadka AHW Mis Bishumaya Bhudha AHW Deepak Bdr Khadka AHW Bishnu Jyoti MCHW Ambika Kumari Giri Nepal Army Team 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 AHW Ganesh Bdr Oli VHW Krishna Bdr Shah 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 AHW Basanta Devkota VHW Ganga Ram Acharya AHW Dhruva Khanal MCHW Sun Kumari Singh AHW Bhagawati Singh MCHW Dhan Kala Pun AHW Takta Bdr Pun AHW Bir Man Budhathoki VHW Deepak Jung Shah MCHW Shobha Singh 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 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
29 30
Laha SHP Dalli HP
Laha Khagenkot
31 32 33
Bhagawati SHP Ragda SHP Dandagaun Ka SHP Karuwa Dandagaun - Kha
Bhagawati Ragda Dandagaun
34
Dandagaun
35
District Hospital, Jajarkot
Jajarkot
36.
District Health Office
Jajarkot
Sub Acc Lab Bikram Shahi Supporting Admin Nayab Subba Sagar KC
Details of Health Camp in Jajarkot District

VDC Name Health Camp Location Bhagawati Bhagawati Katikurta Dr. Suman Adhikary Name of Doctors Dr. S.P Rimal Team Members Prakash Paudel Ghimire, Khagendra Radhae Suman Organization NMA NMA
Dr. Sachin Gurung, Krishna Chaudhary, Chaudhary
Bhur Dasera Dhime Garkhakot Jungathapachaur Karkigaun Khagenakot Kortang Majkot Paik Punma Ramidanda Sakla Ramidada Thala Daha Karkigaoun Sima Khalanga Bharae Health Workers Health Workers
Dr. Dinesh Gautam
Karna GurungCamp Coordinator, Udaya Nath Yogi, Manju Sahi
INF DPHO
Dr. Sabin Shreatha Dr. Ram Krishna Baral
Tirtha Acharya, Lila Ram Thapa, Surendra Shrestha K.B. Basu, K.B. Mahara, R.K. Sedai
NMA APF HELVETAS
Dr. Pankaj Chaudhary Dr. Yak Raj Luitel Dr. Madhu Acharya Dr. Uttam Ghimirae Dr. Lalit Suri K. P. Upreti, Krishna Dhital, K.B. Chand Prem pangali, Hota Ram Khatri Sen Manandhar Arjun Ghimirae, Bhaskar Paudel, Nawal Kishor Mahato Prem B.K, Sitram
NP APF NMC EDCD
DPHO Dr. Subash Acharya NP Nepal Army Nepal Army Nepal Army Nepal Army Nepal Army Dil Kumar Duwal, Yam Bahadur Darlami, Sundar Hari Shrestha, Sangam Kaiju, Anil Dhungel, Mahesh Chaudhary, Raj Kumar Chaudhary, ChautRam Chaudhary
Khalaphara Distirct Hospital Dr. Santosh Dahal, Dr. Partha Bhurtel
Khalanga
Bahunthana
Dr. Santosh Chaudhary Dr. Rina Yadav/ Dr. Vivek
NMA NMA,
Details of Human Resource Mobilization for Diarrhoea Outbreak Control Jajarkot District
S.No. 1. Name of the Institutions Bahunthana SHP VDCs Khalanga Health Personnels AHW- Laxmi Sharma VHW-Narvada Karki MCHW- Narayani Shah AHW Khem Bdr Pun ANM Kaushila Batala AHW Padam Gurung VHW- Krishna Kumari Shah MCHW Dilsari Batala AHW- Chandra Bdr Khadka VHW Khadga Bdr Gharti MCHW-Ganga Kumari Regmi Sr.AHW Birendra Kumar Sharma AHW Lal Bdr Khadka VHW Ain Singh Thakuri AHW Dhanish Khadka MCHW Bishnu Karki AHW Bishnu Giri MCHW Rama Shah AHW Amarraj Sejuwal ANM Gita Bhusal VHW Arun Kumar Malla AHW Hari Prasad Pokharel VHW Man Bdr Budha MCHW Radha Devi Sharma AHW Krishna Bdr Thapa VHW Ganga Bdr Shahi MCHW Parbati Sharma Sr AHW Amar Bdr Rana AHW Ram Bdr Thapa VHW Nar Bdr Chanda AHW Om Bdr Rana Chhettry VHW Bhim Bdr BC MCHW Kaushila K Sharma AHW (Recruited by RHD) MCHW Padma Kumari Thapa AHW Hari Prasad Lamichhane Deployed Team Dr. Santosh Chaudhary HA- Chaut Ram Chaudhary AHW-Mahesh Chaudhary AHW Raj Kumar Chaudhary AHW Binod Aryal AHW- Chhatra Bdr Karki
2.
Kudu HP
Jagatipur
3.
Jagatipur SHP
Jagatipur
Punma SHP
Punma
Dr. Lalit Suri HA Prem BK AHW Uddav Karki AHW Sita Ram Chaudhary AHW Navin Ranamagar
5.
Bhoor HP
Bhoor
6. 7. 8.
Karkigaun SHP Jhapra SHP Sima HP
Karkigaun Jhapra Sima
AHW Danda Bir Nepali (Local Recruitment in 2066/04/08)
Nepal Army Team
9.
Thalaraikar SHP
Thalaraikar
10
Jungathapachaur SHP
Jungathapac haur
Dr. Ram Krshna Baral AHW KB Basu AHW KB Mahara AHW RK Sedhain
11.
Dasera HP
Dasera
12.
Salma SHP
Salma
13.
Suwanauli SHP
Suwanauli
14.
Majhkot SHP
Majhkot
Sr. AHW Ram Kumar Sharma
15.
Gharanga HP
Gharanga
VHW Lok Bdr Oli MCH Bishnu Kumari Shahi AHW Shah Dev Basnet ANM Chanda Tiwari VHW Madhav Karki MCHW Nirmala Kumari Thapa AHW Yagya Nath Gautam VHW Bal Bdr RC MCHW Chandra Kumari Rokaya MCHW Hridaya Kumari Singh AHW Krishna Bdr Rokaya VHW Ganga Ram Aacharya MCHW Hari Kala Shahi AHW Bal Bdr Shahi AHW Prem Bdr Shahi ANM Sita Singh Lab Asst Dabal Bdr BC VHW Govinda Bdr Shahi AHW Narayan Psd Pokharel VHW Obiram Pun MCHW Chhita Adhikari AHW Khimraj Thapa MCHW Pan Kumari Pun AHW Birendra Pun MCHW Saraswati Shahi AHW Keshav Prasad Dahal MCHW Satya Devi Shahi
16.
Dhime SHP
Dhime
AHW Resham Lal Gautam AHW GaganDev Giri AHW Hasta Raj Giri AHW Ram Prasad Sharma ( Moved on 2066/04/09) PLA Team 13 members AHW Bhaskar Poudel AHW Arjun Ghimire AHW Nawal Kishor Mahat AHW Birendra Raj Giri Recruitment in 2066/04/09) AHW Gopal Bdr Shshi Recruitment in 2066/04/09) Dr. Avash Joshi Team
17
Paink SHP
Paink
18 19
Talegaun SHP Archhani SHP
Talegaun Archhani
20
Garkhakot PHC
Garkhakot
Dr. Sabin Shrestha AHW Tirtha Acharya AHW Lila Ram Thapa AHW Surendra Shrestha AHW Tej Bdr. Shahi Recruitment in 2066/04/09)
21
Pajaru Ka SHP
Pajaru
22 23 24
Pajaru Kha SHP Daha SHP Kortang SHP
Pajaru Daha Kortang
Nepal Army Team Dr Yek Raj Luitel KP Upreti Krishna Dhital KB Chand
25
Limsa PHC
Rokayagaun
26
Nayakwada SHP
Nayakwada
27
Ramidanda SHP
Ramidanda
28
Sakla HP
Sakla
29 30
Laha SHP Dalli HP
Laha Khagenkot
AHW Ram Bdr Rokaya ANM Sushila Budhathoki ANM Rem Kali Sunar AHW Ram Naryan Chaudhary MCHW Lila Kumari Shah AHW Bishnu Jyoti MCHW Ambika Kumari Giri AHW Bir Raj Singh ANM Meera Shahi VHW Surita Karki AHW Ganesh Bdr Oli VHW Krishna Bdr Shah AHW Prem Chand ANM Nirmala Khanal VHW Bharat Kumar Bhadel
Nepal Army Team
31
Bhagawati SHP
Bhagawati
AHW Basanta Devkota
AHW Ujjwal Kumar Sharma AHW Khuva Raj Acharya AHW Pandav Raj Baral AHW Takta Bdr Pun Recruitment in 2066/04/09) Sr. AHW Surya Lal Sht Yuva Raj Timilsina Dr. Pankag Chaudhary Pupa Raj Adhikari Topendra Raj Basnet Gajendra Singh Kunwar AHW Hikmat Oli
32 33 34
Ragda SHP Dandagaun Ka SHP Dandagaun Kha
Ragda Dandagaun Dandagaun
VHW Ganga Ram Acharya AHW Dhruva Khanal MCHW Sun Kumari Singh AHW Bhagawati Singh MCHW Dhan Kala Pun AHW Bir Man Budhathoki VHW Deepak Jung Shah MCHW Shobha Singh
AHW Nageshwor Rijal
35
District Hospital, Jajarkot
Jajarkot
36.
District Health Office
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 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
Dr. Ishwor Upadhaya Dr. Uttam Ghimire ANM Durga Devkota ANM Sumitra Shrestha
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
Diarrhoea
Date of deployed HWs

2066/3/25
Name list of deployed HWs

1. Aati Ram Bist 2. Mina Budhathoki 3. Bal Bd. Shahi
Post
Kalagaun
1. SAHW 2. ANM 3. Office Aid 1. AHW 2. VHW 3. ANM Sr. AHW 1. AHW
Marmparikada
Diarrhoea
2066/4/5
1. Liladhar Budhathoki 2. Mohan Bd. Yari 3. Menka Bali
3 4
Tharmare Swikot
Diarrhoea Diarrhoea
2066/4/5 2066/03/19
Dhaniram K.C. 1. Bal Bd. Khatri 2. Tek Bd. Gosai
5 6 7
Darmakot Bajhakot Kabhrechaur
Ati Ram Bist Chandra Bd. Khatri Diarrhoea 2066/04/11
2. VHW AHW AHW
Details of Human Resource Mobilization for Diarrhoea Outbreak Control District: Surkhet
Affected VDCs
Ghoreta Ward no-6,7 Mehelkuna-6 Lekhparajul-2
Date of onset of Epidemic

2066.3.21 to 27 2066.3.24 to 31 2066.3.30 to 4.4
Local HWs
All All All
External Deployed Health Workers

Bhim Bahadur Nepali, Kafalkot Nabin Regmi, Ramghat Kumbha Paudel, Bhola B.K
Taranga-2,3,4,5,6 Mehelkuna-7 Tatapani-1,2,3,4 Uttarganga-6,7,8 Lagam Ramghat Ghatgaun Regional Hospital
2066.3.31 to 4.10 2066.4.8 2066.4.8 2066.4.8 2066.3.30 2066.4.5 2066.4.10 2066.4.1
All All All All All All All All
Nandaram Buda, Mahendra Khatri, Hariharpur PLA Deployed] Kumbha Paudel, Bhupendra Dev Giri Chinchu', Arun Chaudhary Dahachaur Laxman Darai- NFHP Nawa Jyoti Kendra Yam Prasad Adhikari, Lekhpharsa{
Note: - Local health workers-47, District and external -21 and other NGOs/INGOs-31
Details of Human Resource Mobilization for Diarrhoea Outbreak Control District: Humla
.
S.N. 1
VDC Kalika VDC-2,4,5,6,7
Deployed Team DHO 1 HA and 3 AHWs from DHO and 1 AHW from Shreenagar HP.
Date 2066/05/07
Kalika VDC
PLA Team
2066/05/10
Drugs supplied in different VDCs in diarrhea epidemic by Helicopter and Porter
District: Rukum
S.N.
1 2 3 4 5 6 7 8
Date of drugs supply

2066/3/23,26,27 & 04/02,05,07,13 2066/03/23,28,30 & 04//5,7,15 2066/03/26,30 2066/03/27 & 04/02 2066/3/24 2066/3/26 2066/3/28 2066/3/28
Name of VDC
Gotamkot Aathbiskot Simritu Baphikot Ranmamaikot Rukumkot Garaila Aathbiskot-9, Jhinchaur Purtimkada Aathbisdandagaun Magma Ghetma Duli Arma Chunbang Mahat Ranshi Morabang, Quangsi Morbang Nuwakot Hukam Khara Kakre Simli Kotjhari MusikotH.P. Chibang, Simli, Arma, Purtimkada, Garaila, Kotjhari with 13 VDCs Total
Avg. weight in Kg
125+210+340+120 +265+160=1220 145+240+450 +60+120=1050 200+130=330 230+370=600 115 145 180 140
Mode of transportation
Helicopter & Porter-11 Helicopter & Porter-10 Porter-6 Helicopter & Porter-3 Porter-3 Porter-3 Porter-4 Porter-3
Remarks
Seven shift Six Shift Two shift Two shift
9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27
2066/3/28 & 4/5,7 2066/3/29 2066/3/29 2066/3/30 2066/3/30, 04/17 2066/3/30 & 04//07,14,16 2066/3/30 2066/3/31 2066/3/31 2066/4/1 2066/04/01 2066/04/06,08 2066/04/06 2066/04/06,15 2066/04/06 2066/04/08 2066/04/08 2066/04/13 2066/04/16,17
120+540+50=710 340 90 115 135+45=180 140+100+110+140 +120+45=655 120 130 145 125 115 140+110=250 125 165+120=285 160 110 215 110 300+250=550
Helicopter & Porter-3 Helicopter & Porter-2 Porter-2 Porter-3 Porter-4 Porter-8 Porter-3 Porter-3 Porter-3 Porter-3 Porter-3 Porter-5 Porter-3 Porter-6 Porter-4 Porter-2 Helicopter Porter-2 Army Jawan
Three shift Two shift
Two shift Five shift
Two shift Two shift
Two shift
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 M F 7 6 6 2 4 0 2 0 5 3 2 0 13 6 3 2 2 1 0 1 0 3 0 5
1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14.
2066/4/17 2066/4/18 2066/4/19 2066/4/20 2066/4/21 2066/4/22 2066/4/23 2066/4/24 2066/4/25 2066/4/26 2066/4/27 2066/4/28 2066/4/ 2066/4/ Total
Treated by IV Others Infusion 15 5 7 5 2 7 1 3 3 3 1 0 2 0 1 0 3 2 0 6 0 2 3 2
Result
Cured " "
Total cases of Dalit Population 16 9 7 3 5 1 2 1 2 3 2 3
37
36
37
36
54
Number of cases and Deaths in Manma VDC of Kalikot District till date Date 15/4/2066 18/4/2066 19/4/2066 Morbidity 20 10 8 Mortality 1 IV 15 7 2 ORS 5 3 6 Dalit Population 16 9 6
Number of cases and Deaths in Kalikot District

25 20 20 15
Num ber
16 15/4/2066 9 7 5 2 3 6 6 18/4/2066 19/4/2066
15 10 10 5 1 0 Morbidity Mortality IV ORS Dalit Population 8
District : Surkhet
VDCWise Morbidity and Mortality in Surkhet District
SN
Affected VDC
Date of onset of epidemic 2066/3/21 to 2066/3/27 2066/3/24 to 2066/3/31 2066/3/302066/4/4 2066/3/312066/4/10 2066/4/4 2066/4/8 4th Week 4th Week 2066/4/8 2066/3/30 2066/4/5
1 2 3 4
Ghoreta Ward No. 7 and 8 Mehelkuna Ward No. 6 Lekhparajul-2 Taranga Ward No. 1,2,3,4,5,6 Mehelkuna-7,8 Tatapani-1,2,3,4 Malarani Ghatgaun Uttarganga 6,7,8 Lagam Ramghat
No. of treated cases 98 157 193 237
Death Details Ward no. No. 8 1
2 5,6
1 5
5 6 7 8 9 10 11
806 112 106 213 144 345 41 4 7 2 1 1 2
12 13 14 15 16 17 18 19 20 21 22
Hariharpur Chinchu Kunathari Matela Regional Hospital Betan Satakhani Kalyan Latikoili Jarbutta Dasrathpur
2066/4/2 2066/4/17 2066/4/122066/4/13 3rd Week 2066/4/12066/4/10 2066/4/292066/4/3 " " " " " Total
283 176 35 62 137 99 97 102 80 50 46 3619 4 1
14
VDCWise Morbidity and Mortality in Surkhet District Mortality (other deaths included) 1 0 1 5 1 1 2 0 2 0 0 0 0 0 0
VDCs
Morbidity 98 963 193 237
Ghoreta Mehelkuna Lekhparajul Taranga Tatapani Malarani Ghatgaun Uttarganga Lagam Ramghat Hariharpur Chinchu Kunathari Matela Regional Hospital Betan Satakhani Kalyan Latikoili Jarbutta
112 106 213 144 345 41 283 176 35 62 137 99 97 102 80 50
Dasrathpur Total
46
3619 14
(Note: Diarrhoeal including other deaths have been shown here) Diarrheal Deaths No: 10
VDCWise Morbidity N Mortality in Surkhet District

Morbidity Mortality (other deaths included)
1000
963
12 237 193 213 112 106 144 345
283 176 137 99 62 41 35 97 102 80 50 46 8
98 100
Number
5 10 2 1 0 1
et a eh el ku Le na kh pa ra ju l Ta ra ng a Ta ta pa ni M al ar an G i ha tg au U n tta rg an ga La ga m R am gh H at ar ih ar pu r C hi nc hu Ku na th ar i R M eg at io el na a lH os pi ta l Be ta n Sa ta kh an i Ka ly an La ti k oi li Ja rb ut D ta as ra th pu r ho r
4 2 1 0 0 0 0 0 0 0 0
VDCs
Weekly Trend of Diarrhoeal Outbreak in Surkhet District

7 6 5 1363
1400 1200
5 5
1000
646 537
Number
4 3 2 1 100 0 Asar 3rd w eek Asar 4th w eek Shraw an 1st w eek 450
800 600
261
262
400 0 200 0
1
Shraw an 2nd w eek
1
Shraw an 3rd w eek Shraw an 4th Week
Bhadra 1st w eek
Weeks
Morbidity Mortality
Deaths in Diarrhoea Epidemic in Surkhet District

S.N. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 Name of Casualties Laxmi Rana Jaimane Budha Bhakta Bahadur Budha Sher Bahadur Budha Kopila Rokaya Devi Ram B.K. Ashish Rana Magar Dil Bahadur Sunar Abala Giri Suk Lal Basayal Dilu Kumari B.K. Jhankar B.K. Jhanka Mijar Devisara Acharya Dalit Dalit Dalit Brahmin Caste Thakuri Chhetri Chhetri Chhetri Dalit Dalit Janjati Dalit Chhetri 40 35 73 55 7 60 45 69 2 28 53 35 Age 25 Sex F M M M F M M M F M F M M F VDCs Name Ghoreta-8 Lagam-3 Lagam-3 Lekhparajul-2 Taranga-5 Taranga-6 Taranga-4 Taranga-3 Taranga-1 Malarani-7 Ghatgaun-2 Ghatgaun-2 Tatapani-4 Satakhani-4, Chandrapur Date of Death 15/3/2066 29/3/2066 9/4/2066 29/3/2066 28/3/2066 30/3/2066 30/3/2066 2/4/2066 5/4/2066 2/4/2066 6/4/2066 6/4/2066 15/4/2066 26/4/2066 Cause of Death Diarrhoea " Diarrhoea " " " " " " Chronic disease Malnutrition Jaundice Diarrhoea Diarrhoea
District: Salyan
Name of Causalities of Diarrhea Epidemic in Salyan District S.N.
1 2 3
Name of Casualties
Manjit Kasera Santosh BK Kali Budhathoki Birma Pariyar
Caste
Dalit " Chhetri
Age
52 10 35
Sex
M M F
VDCs Name
Kalagaun-6 Siwakot-5 Siwakot-1
Date of Death
2066/03/26 2066/03/14 2066/04/04
Cause of Death
Diarrhoea " Diarrhoea (Pregnant Women) Diarrhoea
Dalit
43
Kabhrechaur-4
2066/04/12
Other Deaths S.N.

1
Name of Casualties
Amrita Bohora
Caste
Chhetri
Age
15
Sex
F
VDCs Name
Mulkhola-7
Date of Death
2066/4/24
Cause of Death
Mushroom Poison
VDCWise Morbidity and Mortality in Salyan District VDCs Morbidity 115 145 11 80 10 20 41 236 658 1 1 5 2 Mortality 1
Kalagaun Marmaparikaada Tharmarey Swikot Darmakot Bajhkot Kabhrechaur Mulkhola Total
VDCWise Morbidity and Mortality in Salyan District

2.5 236 250
200
Number
1.5 115
145
150 1
80 41 11 0 10 20 0 0
100
0.5 0 0
50
n au ag l Ka M m ar
a ad ka i ar ap
rm ha T
ey ar
t ko wi S
rm Da
ot ak B
ot hk aj
ur ha c re bh Ka
a ol lkh u
VDCs
Morbidity Mortality
District: Dolpa
Name of Casualties of Diarrhoea Epidemic in Dolpa District S.N
1 2
Name of the death persons

Jigme kyojo Himali thapa
Age
Sex
Date of the death

2066/3/20 2066/3/18
Lawan VDC ward no.1 khani 2 M 2 F
3 4 5 6
Pemba thapa Kusal daygi Bisnu daygi Junu shreshtha
1 Juphaldandiwada-8 4 3 4
F M M M
2066/3/21 2066/3/28 2066/3/27 2066/3/17
VDCWise Morbidity and Mortality in Dolpa District
SN
Affected VDC
Date of onset of epidemic 4/3/2066 29/3/2066 24/3/2066 4/4/2066 4/4/2066 12/4/2066 Total
No. of treated cases 90 46 40 34 81 210 501
Death Details Ward No. no. 3 3
1 2 3 4 5 6
Dunai-Thala tol JufalDangiwada Lawan- Khani tol Jufal- Motipur Dunai- Tipla Jufal -1, Airport
VDCwise Morbidity and Mortality in Dolpa

250
Morbidity
210
200
Mortality
Num ber
150
100
90
81 46
50
40 3 3 LawanKhani tol
34
0 DunaiThala tol JufalDangiwada JufalMotipur DunaiTipla Jufal -1, Airport
VDCs
District: Dailekh Name of Casualties of Diarrhoea Epidemic in Dailekh District

S.N. Name of Death Person
Sita BK Dhansara BK Jaisara BC Lalisara Chunara Anajana Sarki Ragadari Bist Dilli Pd. Upadhaya Lila Ram Puri Tuli B.K. Bharu B.K. Kaushila Upadhya Kure Thapa Aabi Jaisi Upendra Bist Namkala Jaisi Man Bd. Shahi Bibek Shahi Jhupa Bista Binda Bika Dirgha Sarki Laxmi Nepali Tilbir Sunar Bhadra Sarki Debisara Nepali Tulcha Sunar Pana B.K. Bima B.K Janaki Nepali Jaisara Singh
Caste
Age
Sex
VDCs Name
Date of Death
Cause of Death
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29
Dalit " Chhetri Dalit Dalit Dalit Brahmin Dalit Dalit Dalit Brahmin Chhetri Chhetri " " Chhetri " Chhetri Dalit Dalit Dalit Dalit Dalit Dalit Dalit Dalit Dalit Dalit Thakuri
22 60 30 46 5 81 68 75 35 5 52 82 45 47 70 72 4 78 30 5 50 32 5 3 42 70 5 6
F F F F F M M M F M F M M M F M M M F M M M F F F F F F F
Jagnath-7 Jagnath-8 Jagnath-4 Jagnath-2 Chhiudipusakot-1 Bhairikalikathum-7 Bhairikalikathum-4 Gamaudi-6 JambuKandh-6 " " Bhairikalikathum-4
22/3/2066 19/3/2066 26/3/2066 3/4/2066 2/4/2066 10/4/2066 2066/04/12 4/13/2066 14/4/2066 " "
Dirrhoea Chronic disease Diarrhoea " Food poison Other Diarrhoea Chro. Diarrhoea Due to over diet Diarrhoea "
15/4/2066 Bhairikalikathum-8 Bhairikalikathum-3 18/4/2066 Bhairikalikathum-7 Bhairikalikathum-3 Lakandra-9

Latibindrasaini-7
16/4/2066
Chronic Disease Diarrhoea
18/4/2066 19/4/2066 17/4/2066 21/4/2066
" " " " Diarrhoea Diarrhoea Diarrhoea Diarrhoea Diarrhoea Diarrhoea Diarrhoea Diarrhoea Diarrhoea Diarrhoea Diarrhoea Diarrhoea
Bhairikalikathum-7 Paduka-7 Nepa-7 Nepa-1 Banshi-2 Nepa-7 Lyatibindrasaini-5 Kharigaira-3 Paduka-9 Lakandra-6 Lyatibindrasaini-8 Baluwatar
25/4/2066
24/4/2066 26/4/2066 066/4/29 32/4/066 32/4/066 02/05/066 04/05/066 2/5/2066 6/5/2066 8/5/2066 7/5/2066
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

9 769 8 200 112 6 78 34 4 3 3 2 1 0
ali ka th um La tib ind ra se in i G am au di Ja m bu ka nd h La ka nd ra Pa du ka Ja gn at h Ne pa Kh ar ig air a Ba lu wa ta r Ba an sh i
885 389
1000
142 100
Number
14 3 2 2 1
15 10
1 1
Bh ai rik
Morbidity
VDCs
Mortality
District: Rukum
Namelist of Casualites in Rukum District S.N.
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29
Name of Deaths person

Pyaro Bohora Subash B.K. Dhanbir B.K. Harka Bahadur Bohara Tika Ram Jaishi Dipak B.K. Balaram Pun Kali Devi B.K. Lalit Malla Jit Nath Gaje Kami Pashupati B.K. Bale Kami Jay Mati B.K. Deurupa Pariyar Tulsa Oli Najari Basnet Kali B.k. Lalsari B.K. Maheshwari B.K. Dirgha Mahalara Bale Basnet Laxmi Basnet Prajit B.K. Rupa Sari Kami Rupa Budha Ramit Roka Puni Damai Duji Pun
Sex
Male M M M M M M F M M M F M F F F F F F F M M F M F F M F F
Age
55 11mon. 1 50 8 25 48 32 5 15 68 35 54 11 51 9 12 40 38 36 60 45 23 45 18 13 10mon. 70 51
Address
Syalakhadi-3 " " Gotamkot-4 Gotamkot-2 Baphikot-1 Ghetma-1 Magma-4 Gotamkot-5 " Gotamkot-2 Garayala-9 Gotamkot-2 " Purtimkada-5 Garayala-9 Gotamkot-2 " " " Purtimkada-5 Gotamkot-7 Gotamkot-2 Aathbishdadagaun9 " Aathbishko-4 Hukam-4 Aathbishdadagaun9 Aathbishdadagaun9
Date of Death
14/2/2066 15/02/2066 15/02/2066 31/02/2066 2/3/2066 8/3/2066 13/03/2066 14/03/2066 15/03/2066 16/03/2066 17/03/2066 18/03/2066 20/03/2066 20/03/2066 20/03/2066 21/03/2066 24/03/2066 24/03/2066 25/03/2066 25/03/2066 27/03/2066 27/03/2066 28/03/2066 28/03/2066 28/03/2066 28/03/2066 28/03/2066 1/4/2066 1/4/2066
Cause of Death
Diarrhoea Diarrhoea Diarrhoea Diarrhoea Diarrhoea Diarrhoea Diarrhoea Diarrhoea Diarrhoea Diarrhoea Diarrhoea Diarrhoea Diarrhoea Diarrhoea Diarrhoea Diarrhoea Diarrhoea Diarrhoea Diarrhoea Diarrhoea Diarrhoea Diarrhoea Diarrhoea Diarrhoea Diarrhoea Diarrhoea Diarrhoea Diarrhoea Diarrhoea
30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51
Ananta Pun Rita Giri Indra Khadaka Hari Sarki Bhimi B.K. Arjun Karki Khamba Khadaka Jaymati Nath Bin kumari Sharki Tashbir Damai Kale Nepali Gopal K.C. Ragbir Sunar Gopal Sunar Chiuri Buda Sital Sarki Bali Damai Lalsari Bhandari Maniraj Sarki Karna Bahadur Khatri Khali Thapa Dhan Bahadur Sarki
M F F M F M M F F M M M M M F F F F M M M M
48 35 8 70 26 37 48 7 2 65 4 4 65 55 48 3 31 60 4 38 4 13
Aathbishdadagaun8 Aathbishdadagaun8 Purtimkada-8 Kholagaun-6 Arma-5 (Nuwakot1) Gotamkot-3 Chhibang-2 Gotamkot-5 " Aathbishkot-2 " Ghetma-8 Chhibang-2 Sovaban-1 Godamkot-5 Aathbiskot-8 Aathbiskot-8 Godamkot-5 Godamkot-5 Aathbiskot-7 Gotamkot-6 Gotamkot-5
1/4/2066 3/4/2066 5/4/2066 5/4/2066 7/4/2066 7/4/2066 9/4/2066 9/4/2066 10/4/2066 13/04/2066 13/04/2066 16/04/2066 16/04/2066 16/04/2066 17/04/2066 18/04/2066 20/04/2066 21/04/2066 21/04/2066 29/04/2066 14/03/2066 4/5/2066
Diarrhoea Diarrhoea Diarrhoea Diarrhoea Diarrhoea Diarrhoea Diarrhoea Diarrhoea Diarrhoea Diarrhoea Diarrhoea Diarrhoea Diarrhoea Typhoid Diarrhoea Other Diarrhoea Other Diarrhoea Diarrhoea Diarrhoea Diarrhoea
VDCwise Morbidity in Rukum District SN VDC Total case
IV Cases
1 2 3 4 5 6 7
Gotamkot Aathbishkot Baphikot Garaila Purtimkada Asthbishdandagaun Simrutu
1982 1872 1122 602 453 967 532
607 342 236 36 104 213 58
8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
Magma Arma Duli Chunbang Morabang Khadisyala Ghetma Syalakhadi Hukam Ranmamaikot Nuwakot District Hospital Chaujhari Hospital Kotjhari Kholagaun Chhibang Total
386 427 185 403 512 397 236 120 110 50 80 1247 182 307 236 197 12605
48 96 4 7 31 3 73 23 3 17 1901
VDC Cases and Deaths in Rukum District

Total case 21 21 1782 14 1665 1076 307 453 769 386 427 236 120 110 100 7 6 10 2 1 0
ot am ko t m ka da H uk am Sy al ak ha di Aa th bi sh ko t C hh ib an g a Ba ph ik ot da ga un M ag m ag au n he tm a ar ai la Ar m a
Deaths
10000
1000 236 197
Number
6 3
3 1 1 2 1 1
3 1
As t
hb is hd an
VDCs
Kh ol
Pu r ti
Weekly trend of Morbidity and Mortality in Rukum District

1000 6224
10000
4490
Morbidity
946 403 240 182
1000
Number
100 120
Mortality
100 14 12 4 1
1 Jestha 3rd Asar 1st Asar 2nd Asar 3rd Asar 4th Sraw an 1st Sraw an 2nd Sraw an 3rd Sr. 4th/Bhr. 1st
10
5 2
10
1 1
Weeks
VDC wise details of deaths in diarrhoeal epidemic in Rukum District SN VDC M F Male child Female child <5yr 5-15yr <5yr 5-15yr 1 Gotamkot 5 4 3 4 1 3 2 Aathbishdadagaun 2 4 1 3 Syalakhadi 1 2 4 Garaila 1 1 5 Purtimkada 1 1 1 6 Baphikot 1 7 Magma 1 8 Asthbishkot 2 1 1 1 1 9 Hukam 1 10 Ghetma 1 1 11 Kholagaun 1 12 Arma 1 13 Chhibang 2 14 Shova 1 Total 17 13 8 4 3 6
Total 20 7 3 2 3 1 1 6 1 2 1 1 2 1 51
Organizations supporting in control of diarrhoeal epidemic in Rukum

S.N. Name of the organization
Dist.Admin office Nepal Army
VDC
No. of Staff
Post/Team
Date
Type of work
Coordination, guidance &IEC Curative, Preventive, Transportation & IEC Coordination, Volunteer & IEC Preventive, Volunteer & IEC Curative, Preventive, & IEC Drugs Curative, Preventive, drugs & IEC Water purification, water quality test &IEC Sanitation, IEC Water guard, ORS Curative, Preventive, & IEC IEC Preventive & IEC IEC
1 2
2066/03/01 Dr./Nursing/Army Jawan 2066/03/01
DDC
"
Nepal Police
"
Redcross, Rukum
20 VDCs
172
HA/AHW/JRC/URC
2066/03/28 2066/04/12 2066/03/25 2066/03/28
6 7
ADRA-Nepal SMNF/VCP
ANM
District Water Supply, Rukum
4 VDCs
Tech. Staff
2066/03/22, 04/11
9 10 11
DEPROSCNepal SIWIN Nepal UMB Volunteer
4VDCs
Health Workers
2066/04/2,11 2066/03/11
2 VDCs
10
Health Workers
2066/04/11
12 13 14
UMN Rukum School Teachers News Reporter
Health teachers
2066/03/11 " 2066/03/15
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
1 2 3 4
Date
2066/04/05 2066/04/05 2066/04/06 2066/04/06
Place
Gotamkot Aathbiskot Purtimdada Arma
Organization
DHO/ 5 Volunteers from UMB Party DHO/5 Volunteers rom UMB Party Nepal Army team with one Dr. DHO/Nepal Army Team-6
Remarks
District: Jajarkot
VDCWise Morbidity and Mortality in Jajarkot District
S.No.
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30
Archhani Bhagawati Bhur Daha Dadaguan Dasera Dhime Garkhakot Jaktipur Khalanga Jhapra Jungathapachaur Karkiguan Khagenkot Kortang Laha Majhkot Nayakwada Pajaru Paink Ragda Ramidanda Sakla Salma Sima Suwanauli Talegaun Thalaraikar Rokayagaun Punma Total
Morbidity 786 202 175 423 306 1660 762 296 430 1493 340 647 945 524 895 1105 3570 1281 776 1273 388 1490 1260 727 224 201 178 325 1968 521 25171
Mortality 6 4 1 5 1 8 8 4 0 1 1 3 1 2 12 3 20 12 1 10 2 11 6 1 0 10 4 6 7 4 154
28
VDCs Morbidity and Mortality in Jajarkot District

3570
10000
24
786
1660 762 423 306 202 296 175 430
1968 1493 945 647 340 524 388 224 201 178 325 895 1105 1281 1273 776 1490 1260 727 521
20
1000
20
N u m b er
16
100
12
12 10 11 10 7 6 6 4 4
10
12
8
8
6 4
4
4 3 3 1 2 1 2 1 0 1 0 1 1
1
0
Monthly Trend of Mortality in Jajarkot District
S No. 1 2 3 4 5 6 Baishakha Jaistha Ashar Shrawan Bhadra till date No death-date reported
Ar c B h hhan ag i aw at i Bh ur Da Da da ha gu Da an se r Dh a G a im e rk ha J a k ot k K h t ipur a la ng Ju a ng a th J h a a p p ra ac K a hau rk r K h igu a ag n en K o ko t rta ng La ha M N a ajhk y a ot kw ad Pa a j ar u Pa i nk R R a agd m ida a nd a Sa k la Sa lm a Si Su m wa a n Ta a u l i leg Th a u a n R o lara k a ik a ya r ga u Pu n nm a
Morbidity Mortality
VDCs
Death Number 8 7 112 24 1 2
% of death 5.23 4.58 73.20 15.69 0.65 1.31
Total
154
100.00
Monthly trend of deaths in Jajarkot District

120
112
100
80
Number
Death Number 60
40 24 20 8 0
Baishakha Jaistha Ashar We eks Shraw an Bhadra till date No death-date reported
7 1
Weekly Trend of Mortality in Jajarkot District
S No. 1 2 3 4 5 6 7 8 9 10 Baisakh to Jestha Asar 1st Asar 2nd Asar 3rd Asar 4th Srawan 1st Srawan 2nd Srawan 3rd Srawan 4th Bhadra 1st
Death Number 15 4 11 22 75 17 4 2 1 1
Total
152
Note: The date of 2 deaths in Jajarkot district is unknown.
Weekly trend of deaths in Jajarkot District 80

75
Death Number
70
60
50
Number
40
30
22 17
20
15 11
10
4
4 2 1 Sraw an 4th 1 Bhadra 1st
0
Baisakh to Asar 1st Jestha Asar 2nd Asar 3rd Asar 4th We eks Sraw an 1st Sraw an 2nd Sraw an 3rd
Datewise Tre nd of Ne w Case s in Jajarkot District

10223 Cases
10000 9000 8000 7000

Number
6000 5000 4000 3000 1770 2000 1000 0

20 66 /1 /2 13/ 30 31 /3 /2 06 6
3691
1205 1592 163 433 928 790 317 1388
2199
464
22
6/ 4/ 20 66 7/ 4/ 20 66 9/ 4/ 20 66 10 /4 /2 06 6 12 /4 /2 06 6 13 /4 /2 06 6 15 /4 /2 06 6 18 /4 /2 06 6 20 /4 /2 06 6 21 /4 /2 06 6 27 /4 /2 06 6 8/ 5/ 20 66
Date
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District: Rolpa
Name of Casualties in Rolpa District
S.N. 1 2 3 4 5 6 Name of Death Caste Age person Kumari Singh Thakuri 57 Thakuri Jun Kumari Pun Chhetri 5 Mast B.K. Dalli Damini Bhima Nepali Jasmali Roka Dalit Dalit Dalit Dalit 65 71 68 Sex F F M M M F VDCs Name Date of Death Khungri-3 2066/03/16 Uba-4 Uba-3 Dhawang-2 Gajul-5 Kureli 2066/04/3 2066/04/20 2066/3/16 2066/4/16 2066/4/6 Cause of Death Diarrhoea " ( All deaths in home) " " "
VDCwise Details of Epidemic in Rolpa District

S.N. Affected VDCs
1 2 Khugri-3 Uwa-4,6,3
Morbidity
22 210
Death No.
1 2
Date of Death
066/03/16 066/4/3,066/4/20
Deployed Team
Dr. Shishir Dahal, Ishwari Gautam(Sr,AHW)-3 Dr. Shishir Dahal, Rajendra Hamal, Kamal Pariyar (AHW)-5 Local Health Workers Local Health Workers Yogendra Rijal, Amar Narayan Chaudhary, Suman Achrya -AHW, Tulsi Ram Achraya-VHW5 Bhakta Bahadur ThapaVHW Dilli Achraya, Bharat Chaudhary (AHW)-3
Cause of Deaths
Diarrhoea "
3 4 5
Kureli Kotgaun-4,6 Dhawang1,2
16 55 120
1 1
066/4/6 066/3/16
"
6 7
Gajul-5 Pachhawang Total
16 85 524
1 2 6
066/4/16
"
District: Humla
Diarrhoeal Epidemic Mortality Details in Humla District

SN 1 2 3 4 5 Name of Casualties Aaitey Kulal Shivakala Kulal Nijra Budha Ram Bhakta Luhar Lotey Damai Gender Male Female Female Male Male Age 70 41 35 10 months 48 Name of VDC Kalika (Palsagaun) Kalika (Palsagaun) Kalika (Palsagaun) Kalika (Palsagaun) Kalika (Palsagaun) Date of Death 066/05/05 066/05/06 066/05/06 NA 066/05/07 Cause of Death Diarrhoea Diarrhoea Diarrhoea Diarrhoea 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 1 2 3 4 5 6 Name of Casualties Mashi Shahi Lakhi Shahi Akhil Shahi Bakhal Shahi Manjan Shahi Jip Shahi Gender Female Female Male Male Male Male Age 2 months 3 months 4 months 4 months 6 months 6 months Name of VDC Kalika Kalika Kalika Kalika Kalika Date of Death Previous dates (missing) Cause of Death Other than diarrhea "
District: Pyuthan
Diarrhoeal Epidemic Mortality Details in Pyuthan District

SN 1 2 3 4 Name of Casualties Seti Sharma Mankala Shrestha Gani Ghartimagar Tulsa Devi Sharma Gender Female Female Male Female Age 72 76 23 68 Name of VDC Pakala-2 Pakala Tiram-7 Chuja-9 Date of Death 16/04/2066 17/04/2066 7/5/2066 6/4/2066 Cause of Death Diarrhoea Diarrhoea Diarrhoea 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 Rukum 12605 Dailekh 5733 Surkhet 3619 Dolpa 501 Salyan 658 Rolpa 347 Dang 65 Pyuthan 105 Kalikot 73 24 Total 48901
144 51 28 10 6 5 6 1 4 1 5 261
Districtwise Cases n Deaths in MWR

150
144
25000
120
Morbidity Mortality
20000
90
15000
12605
No.
60
10000
51 5733
30
28
3619 10 501 105 65 1
5000
658 5
347 6
73 1
164 5
0 Jajarkot Rukum Dailekh Surkhet Dolpa Salyan Rolpa
Dang Pyuthan Kalikot Humla
Districts
(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 Jajarkot Rukum Dailekh Surkhet Dolpa Salyan Rolpa Dang Pyuthan Kalikot Humla Affected VDCs 30 43 31 16 11 6 6 1 2 2 1 Health Camps 41 23 29 4 7 2 6 2 2 2
Total
149
118
Districts Affected VDCs n Health Camps in MWR

50 Af fected VDCs 45 41 40 35 30 30 31 29 43 Health Camps
Number
25 20
23
16 15 11 10 5 0
D an g Py ut ha Ja ja r R uk Su rk R ol D ai Sa l Ka l D H um la um ko t h pa a ya n he t n le k ol p ik o t
7 4
6 2
6 6 1 2 2 2 2 2 1
Districts
Draft of Meeting Minutes of Regional Health Coordination Team (RHCT) th 25 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:
Mr. Sujit Kr. Sah Epidemiologist Mr. Pranab Koirala IT Manager AICP/MWRHD
Approved By:
Dr. Sambhu Saran Tiwari Director, Management Division Coordinator for MWR Diarrhea Epidemic Control

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Comprehensive Report

Date of Compilation of Report: 28th August 2009

Consolidated report of Mid Western Region Diarrhoeal Epidemic

Ministry of Health and Population

Mid Western Regional Health Directorate

Districtwise Overview of Diarrheal Epidemic in Mid-Western Region

Consolidated report of Mid Western Region Diarrhoeal Epidemic

Consolidated report of Mid Western Region Diarrhoeal Epidemic

Consolidated report of Mid Western Region Diarrhoeal Epidemic

Consolidated report of Mid Western Region Diarrhoeal Epidemic

Consolidated report of Mid Western Region Diarrhoeal Epidemic

Consolidated report of Mid Western Region Diarrhoeal Epidemic

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

3. Hira Pun - ANM

Details about human resources deployed from RHD to Dailekh (2066/05/06)

SUPPORT FROM DIFFERENT NGOs/INGOs AND OTHERS

Consolidated report of Mid Western Region Diarrhoeal Epidemic

SAVE THE CHILDREN

For water purification Including 20% butterfly cannula for children.

Developments project services Centre (DEPROSC)

Consolidated report of Mid Western Region Diarrhoeal Epidemic

Nepal Water for Health (NEWAH)

1000 2000 50 L 250

Walter Reed/AFRIMS, Research unit Nepal (WARUN)

Nepal Red cross society (NRCS)]

INF (International Nepal Fellowship)

DFID Community Programme (CSP)

Lions Club Groups of Banke and Surkhet

Safe Motherhood Network Federation (SMNF)]

Korea International Cooperation Agency (KOICA)

Local NGOs in Rukum District

Support from ex-MP(RPP)

Support from United NCPM and PLA

Support from Medical Colleges

2. Birgunj Medical College

Drugs Supply from Regional Medical Store, Nepaljung

Consolidated report of Mid Western Region Diarrhoeal Epidemic

Consolidated report of Mid Western Region Diarrhoeal Epidemic

Current Status of Drugs Available at Regional Medical Store, Nepalgunj (2066/05/11)

Consolidated report of Mid Western Region Diarrhoeal Epidemic

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

Consolidated report of Mid Western Region Diarrhoeal Epidemic

Details of Visits from Higher Authority in the Diarrhoea Affected Districts

Consolidated report of Mid Western Region Diarrhoeal Epidemic

04/04 04/07 04/07 04/07 04/15 04/17 2066/04/26 2066/4/26

2066/04/26 04/26 04/26 04/29 04/29 04/31

Consolidated report of Mid Western Region Diarrhoeal Epidemic

6. 7. 8. 9. 10. 11. 12. 13. 14.

2066/03/23 2066/03/23 2066/04/05 2066/04/05 2066/04/05 2066/04/05 2066/04/09 2066/03/20 2066/04/24

Districtwise Details of Human Resource Mobilization for Diarrhoea Outbreak Control

Deployed Team DHO

AHW AHW Sr. AHW

1.Rohit Thapa 2.Thirraj Regmi

AHW, AHW Sr.AHW

Bed Bd. Thapa

Consolidated report of Mid Western Region Diarrhoeal Epidemic

Narayan nagarpalika -ward no. 2

Thir raj ragmi

1.Nagandra B. Hamal 2.Pramod Koilara

Gauri-2,3 Satala Jaganath-2,3 Jambukandh-8 Bhairikalikathum-7 Bhairikalikathum-4,6,8 Pipalkot-3,6,9

Goganpani-7 Badalamji Rawatkot-3,4 Naule-5,8,9

Consolidated report of Mid Western Region Diarrhoeal Epidemic