Ideal Health Centre, Deusa, Solukumbu, near Mt Everest, Nepal

March 2011 - The Ideal Health Centre is being built at Deusa, with the help from the local Youth Club, 50 km from Mt Everest ...as the crow flies! It is a very remote area of Solukumbu with no electricity or phone and everything must be carried by porters, no roads.

Deusa VDC is in the southern part of the Solukhumbu District. It covers a large area and is at an altitude between about 1200m to 2,000m. The village is populated mainly by the Thulung Rai people though there are some other groups like Tamang, Magar, Newar, Kshetri, and so called Dalits who live in the village.

Deusa covers a large hillside area, taking about two hours to pass from one side to the other. It is located about one day's walk east of Salleri, the District Headquarters and about 3-4 days' walk from the nearest road at Jiri in Dolaka. There is a small airstrip at Phaplu near Salleri and another closer but less reliable airstrip at Kangel, about 4 hours' walk away.

Deusa village is made up of a number of smaller hamlets. One secondary school with about 600 students is located in the centre with a couple of nursery schools, four primary schools and a lower secondary school feeding into this school. There are no private schools and the condition of the schools is very poor. Children often have to walk more than an hour to reach their nearest school. There is a sub-healthpost in Deusa.

Phaplu has a rural district hospital, and medical students as part of the government scheme to get doctors into the remote areas are going to be posted here now. A maternity ward is available in the district hospital, but accessibility of local people is difficult. Also an ANM training school which has been running very well the past few years and trains 40 girls a year as ANMs.

There are a few small shops in the village, but for most things, it is necessary to go to the neighbouring village of Nele Bazaar (about 4 hours away) or Salleri (5 hours).

There are about 5,700 people in Deusa VDC, maybe a bit less with all the outward migration, many houses are closed up and the majority of those left are the older people, women whose husbands are working either elsewhere in Nepal or abroad, and simple farming folk who eek out a subsistence existence growing rice, millet and maybe keeping a few buffalo. A lot of Deusa people live in Kathmandu and have done for years now; some live in Salleri, which is only 5 hrs walk (for a Nepali).

Two thirds are Thulung Rai people, with the remaining third being Dalit, Newar, Chhetri and Tamang people. Very little cash crop farming exists, though there's potential for coffee. Most people here are subsistence farmers, with some seasonal employment as guides and porters in the tourism sector helping to supplement incomes. 

Medical supplies are being provided to the healthpost via Rural Assistance Nepal and medical volunteers have been spending varying amounts of time helping at the healthpost (typically for two weeks at a time, with feedback suggesting this is enough, as there aren't so many patients to justify longer). There are typically about 12-15 patients a day, which is fairly usual for a sub-healthpost in a place this size. Healthposts and primary health clinics would receive more patients (20-40). There is a large healthpost at Khastap, Basa, which is probably 5-6 hours walk, though the same distance to Phaplu Hospital means that most people in Deusa probably use the hospital services in preference to the healthpost..

Biggest problems in this village are water, followed by no electricity, no road and the fact it takes about three days to get to the nearest road. Roads are almost complete to Salleri, and are being pushed through to Nele. It is hoped that maybe in 2-3 years, there will be a road from Nele going to Deusa. The nearest electricity is a lot closer - 2-3 hours as Mugli, Nele Bazaar, and all the surrounding villages have power, but there's little chance Deusa will for a few more years. The houses are too scattered and its too far from the river.

There's the Dudh Kosi, a sizeable river down below (about 300-400m lower) which is used for power, but Deusa is too far up and with all the houses scattered as they are, the WWF people who were surveying the area said it would be a while before Deusa might get power. All the other villages around Deusa have electricity, so at night, lights twinkle everywhere but in Deusa.

People take their mobile phones when they go to the weekly market at Nele, so they can recharge; and a few solar batteries also help. No one uses generators here, and not very many are used in Salleri or Nele as backup there either, as where do you get the fuel? This would need to be flown in to Salleri or Nele (Kangel) and then carried.

Water dries up for a few months in several parts of the Deusa village. At the sub-healthpost, for some time of the year it has to be carried in buckets there, even a volunteer did a fantastic job putting in a sink and waterpipe from the nearby tap. Typically 3-4 months there are very dry. There has been a bigger storage tank put in up near the healthpost, which serves the houses nearby, but it is not sufficient.

Toilets are the other big problem as most homes don't have them. Since most people don't have them, the attitude is a bit, why bother and sanitation and hygiene are low on the agenda. At the healthpost there are two toilets that eventually got repaired after years of being abandoned. Part of the problem is lack of water, but the excuse is also that people don't know how to use them.

We have been working for eliminating the current problems. If everything is there, there is no sense of thinking and working. We have to encourage the local people to make toilets and use them. It's impossible to arrange fuel for generating electricity power for the local people. But we can arrange fuel for x-ray and other necessary purposes in the health centre.

Click on Here for more images of the Ideal Health Centre building

Its first mission is to promote maternity care in that mountainous region where it is a 6 hour walk to the nearest hospital and airport. So many women have died in childbirth.

With NZ$8000 of building funds from the Light family of Auckland the building is almost finished. 

Built without cement or steel due to high cost of porter freight there, the Ideal Health Centre is 40' x 25' and made of stone and wood, all hand cut from local trees and rock!

The project manager is Lakpa Rai, originally from the area but now runs the Nepal Mountain Gear business in Kathmandu which supplied the sleeping bags for MEND.

There are 9 builders including one coordinator: Coordinator- Dil Bahadur Rai, members: Bajra Kumar Rai, Kaluman Rai, Narabhakta Rai, Thame Rai, Durge Rai, Tham Kumar Rai, Rupak Rai, Bhupendra Rai.

About Ideal Health Centre:

Ideal Health Centre is a community health centre. It's established by Ideal Youth Club, a non-profit and non-governmental social organization. It's especially established to facilitate the local people and people of the neighbouring villages with better health services.

It has the following objectives:

1. Provide health services to the community people.

2. Take care of the mother and child before and after birth.

3. Provide rehabilitation programs for disabled persons.

4. Provide the patients referral service.

5. Generate and develop a network among donors, specialists, supporters and other concerned agencies.

6. Carry out assessment camps to find out all types of disabilities in the area.

7. Provide the patients affordable medical treatment.

8. Provide free medical treatment to the poorest patients.

We are collecting equipment for this Centre, if you can help, please Contact Us Below a wish list:

Facilities: Probably 2 beds (if possible with removable leg part for breech deliveries eg.) with pillows (washable), draw sheets, fitted sheets, plastic sheets to protect the linen of soaking through, blanket, trolley for delivery equipments, blood pressure machine and Stethoscope, Thermometers, clock, sonycat to listen to fetal heart (battery run) or Fernandoscope, Oximeter, O2 bottle with gadet and mask, Nitrosoxigen in bottle for pain relief, Head lights - battery run, Ventouse hand operated, suction equipments, Glucometer and glucocard and lancetts (to measure blood sugar levels) and Haemocue strips (to measure Haemoglobin after a big bleed) - battery operated

Other equipments: Sterilisation unit, Milton tablets and plastic containers for sterilisation of plastic equipments, speculums different sizes, scale, 

iv material: iv luers, different sizes, alcohol swabs or iodine,syringes and needles, tornicate or plastic strip to stop blood flow, plaster to fix iv luer to skin, iv fluids: Plasmolyte, Normal Saline, Haemacel (Plasma expender),

Medication: Oxytocin, Syntometrin, Misoprostil, Antibiotica, Maxalon

Delivery packs: bowl, gauze, scissors for perineum, scissors for cutting cord, Amniohooks, 2 clamps, cord clamps and cord clamp remover or cord string,

Suture material: Vicryl and Vicryl Rapid 2 and 3, gauze, incontinent sheets, scissors,

Other items: First Aid strips, plaster, urine sticks to measure protein eg. in urine, buggets, gloves (sterile and clean ones), aprons, pads, hot water, hot water bottles, eating facilities, extra linen for baby and mother/bed.

Below: Lakpa Rai with patients