Rakesh Bohara, aged 15, is a seventh grader at the Chainpur-based Balmandir Basic School. Rakesh, a permanent resident of Dogadi village in ward 2 of Surma Rural Municipality, suffers from severe chest pain when walking uphill. “It feels like a needle stabbing my heart when I run or carry heavy things. I feel pain in the left side of my chest even while walking briskly,” said Rakesh who lives in a rented room in Chainpur, the district headquarters of Bajhang.

Eight-year-old Bhuwan BK of Ghogada village in the same ward also studies at Balmandir Basic School in grade one. Although he wants to play with his friends, he can’t join them. He often watches from a corner as his friends play on the ground. “I want to play, but I get out of breath and struggle to breathe when I run or walk briskly,” laments Bhuwan.

Rakesh, Bhuwan and eight other students of Balmandir Basic School in Chainpur were diagnosed with heart ailments during a health camp organised by Nepal Heart Foundation in the school on June 7. Doctors recommended an immediate heart surgery for Rakesh and advised several other students to visit well facilitated hospitals in Kathmandu or other places for further checkup.

But the ailing students’ guardians have not taken any initiatives for their treatment. Most of the guardians have not even collected the medical prescription from the school administration.

“The doctors advised us to take the students to Kathmandu immediately, warning that delaying treatment could worsen their condition. We have repeatedly informed the guardians about this issue. But nobody has taken their ailing wards to the hospital so far,” said Tek Bahadur Singh, headmaster at the school. “The guardians of four students with serious heart conditions have not even collected the medical prescription issued by the doctors during the health camp.”

But the guardians have their own stories to share. They say that they don’t have money to take their wards to hospitals in Kathmandu. “The school telephoned me several times urging me to take my son to Kathmandu as soon as possible for treatment. I need some Rs50,000-60,000 for the treatment. I am desperately looking for a loan but unable to find one,” said Gajendra Bohara, Rakesh’s father.

Gajendra works as a daily wage earner at the Nepal Electricity Authority’s substation in Chainpur. “My meager income is hardly enough to support and educate six children. I will take my son to hospital whenever I can manage enough money for his treatment,” he lamented.

Bhuwan’s guardian faces similar financial hardships in arranging for his treatment. “Bhuwan’s father has gone to Dhuli of Saipal Rural Municipality for work. We are planning to take him to Kathmandu as soon as we have enough money,” said Bhuwan’s grandfather Mohan BK.

There are 12 members in the BK family. Bhuwan’s mother is receiving treatment for a pinched nerve in her lower back. The impoverished family feels the urgency for the boy’s treatment but they are yet to gather the necessary funds.

The Nepal Heart Foundation organised a health camp in two community schools in Bajhang, a remote district of Sudurpaschim Province, in the second week of June. According to Mohan Shrestha, a heart disease technician at the foundation, as many as 40 students were diagnosed with various heart ailments. “Eight of them need to undergo surgery soon. The remaining patients should take medicines and undergo health checkups every year,” said Shrestha.

“There are various reasons for heart problems in children. Lack of timely treatment of tonsillitis can also lead to heart problems. Some children may have congenital heart issues, mainly due to lack of nutrition during pregnancy. The incidence of congenital heart conditions is quite high in Bajhang,” said Shrestha.

Heart ailments in children is a serious health issue not only in Bajhang but also in several districts of the Sudurpaschim Province. According to health workers, the condition of patients further deteriorates as they cannot get timely treatment in remote parts of the country.

“On the one hand people lack awareness about health. On the other hand, people in remote areas do not know about the government benefits available to heart patients. The number of heart patients is on the rise in remote districts as medicines are not easily available at the local level,” said Prof Dr Prakash Raj Regmi, a cardiologist of Sahid Gangalal National Heart Centre who examined patients during the health camps in Bajhang.