Helambu Rural Municipality in Sindhupalchok district has been short of at least eight health workers for months. The local unit’s attempts to recruit the staff failed due to the local level elections held on May 13, officials said.

“We are aware of the upcoming monsoon and associated challenges,” Gyanendra Sigdel, chief of the health section of the said rural municipality, told the Post over the phone from Helambu. “As the local elections are over, we will start the process to hire health workers soon.”

Monsoon, considered an epidemic season in Nepal, is imminent. Along with the rains, the season also brings a number of diseases.

Like Helambu Rural Municipality, many state-run health facilities throughout the country lack health workers to serve.

What is concerning is that the Ministry of Health and Population said that it is unaware of the vacancies of health workers in the local units.

“We don’t know which health facilities lack health workers,” said Dr Samir Kumar Adhikari, joint spokesperson for the ministry. “Local governments are responsible for hiring health workers.”

Given the possibility of a spread of monsoon diseases, agencies under the Health Ministry used to make preparations and mobilise officials, including vector control inspectors, to deal with possible epidemics. The ministry also halted the transfer of health workers and barred them from going on long leaves in view of possible emergencies.

“This year too, we have alerted the agencies concerned about possible epidemics and disaster events and asked them to make contingency plans as per the risk assessment,” said Adhikari. “We have asked local authorities to hire health workers if there are vacancies.”

Officials at the Epidemiology and Disease Control Division said that local and provincial governments are responsible for purchasing medicines required for a possible disease outbreak, launching campaigns to make people aware of the risks and ensuring the presence of health workers at health facilities in the local and provincial health institutions.

“We are aware of the possible risks and have alerted all the agencies to start preparations accordingly,” said Dr Gokarna Dahal, chief of the Vector-borne Disease Control Section of the Division. “We are planning to organise an orientation programme soon to sensitise officials at the agencies concerned about the risk of vector-borne disease outbreaks.”

As pre-monsoon rainfall has started and monsoon is about to start, Nepal is highly vulnerable to both water-borne and vector-borne diseases including diarrhoea, dysentery, typhoid, hepatitis, cholera, dengue, malaria, Kala-Azar and scrub typhus. Early and heavier-than-usual monsoon has been forecast this year.

Although sporadic cases of dengue, scrub typhus and diarrhoeal problems have been reported from many districts, Dahal said there has been no major outbreak so far this year.

According to data from the Ministry of Health and Population, over 270 people have been infected with the disease since the start of 2022. Several cases of dengue and diarrhoeal problems have also been reported.

As the epidemic season has started, doctors ask for increased surveillance and vigilance to contain possible outbreaks and lessen the loss.

“The number of diarrhoeal cases has already started to spike at our hospital. We all know that only those who become severe come to hospital for treatment of diarrhoeal diseases,” said Dr Sher Bahadur Pun, chief of the Clinical Research Unit at Sukraraj Tropical and Infectious Disease Hospital. “Problems, which seem minor, could be too costly for us.”

Thousands of people get infected with waterborne and vector-borne diseases every monsoon. Despite huge investments over the years, the water and sanitation conditions have not improved in the country noticeably, doctors say.