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It has been over four months since the first outbreak of the novel coronavirus was reported in Wuhan of Hubei province, China. On January 24 Nepal recorded its first Covid-19 case. Any way you look at it, Nepal had sufficient time to prepare, including on the purchase of medicines and medical kits. Yet most of this precious time was wasted.   

Medical doctors, nurses, and other frontline health workers say they are desperately short on gloves, medical masks, respirators, goggles, face shields, gowns, and aprons. Other urgent needs are ventilators, testing kits, Personal Protective Equipment (PPE), and medicines. The testing process has been painfully slow due to the lack of sufficient test kits and other supporting equipment.  

Nepal has fallen far short of testing all corona suspects, which is vital to curtailing the spread of the virus. Right now only those who came to Nepal from abroad after the second week of March are being tested. Public health experts say low testing levels could be a reason behind the paucity of detected cases in Nepal, even when compared to other South Asian countries. Similarly, due to the lack of PPE, doctors and other health workers are reluctant to treat those suspected of corona or any other infectious disease. 

A doctor at the Kathmandu Medical College (KMC) says that the hospital staff has been told to prepare for the testing and treatment of possible Covid-19 patients, even as they are short on PPE and other protective gear. “Doctors, nurses and other working staffs worry they will be asked to tend to suspected Covid-19 patients even without these protective gears,” the doctor says, requesting anonymity.  

The situation is worse outside Kathmandu. For example, in the vulnerable Province 2, there are just 11 ventilators and testing level is slow. Various local governments have also complained of insufficient test kits. 

Long and short of it

Dr. Lochan Karki, President of Nepal Medical Association (NMC), acknowledges a slight improvement in the delivery of PPE. “In the initial days, the situation was dire. Things now are better, but we still don’t have sufficient stock if the number of coronavirus cases shoots up,” Karki says. He says still both private and government hospitals are short of vital medical equipment. Some private hospitals are thus trying to get supplies from private companies abroad. 
A rising global demand and severe disruptions in global PPE supply chains maybe a reason for the delay in their import in Nepal. But the federal government’s mishandling of the purchasing process is undoubtedly more responsible. First, the government initiated the process too late. Second, the decision to allow a private company to make these imports without due process invited controversy. The contract was scrapped and another one started, which also took time. 

To fast track the process, a government-to-government (G2G) purchase was initiated. On March 29, the cabinet instructed Nepal Army to do so. The army wrote to China, India, Israel, Singapore and South Korea, requesting for the needed medical supplies. 
The army took nearly three weeks to complete paperwork. Even after this, Foreign Minister Pradeep Gyawali had to talk to high-level Indian and Chinese officials to hurry things up. Of the five countries, there has been some progress on the purchase of test kits and medical equipment from China, while some medicines have also been imported from India.  

Nepal Army completed paperwork to purchase kits and medicine from China on April 20, and the army says it will take another two weeks for the first consignment to arrive. Chinese companies have informed that they are under pressure to deliver to other countries as well. In total, the army will be importing 340 tons of medical supplies worth some Rs 2.24 billion from China—and in multiple stages. The first consignment will be via a charter flight and the subsequent ones will be imported via road. 

Wait and watch, not  

On the purchase of medicines from India, there has been no substantial progress. Nepal Army has dispatched a list of medicines and equipment but is yet to receive specific prices for those items, says army Spokesperson Bigyan Dev Pandey. India is itself purchasing medical supplies, including test kits, from China. Government officials have not shared details about the progress in bringing medical supplies from Israel, Singapore, and South Korea. 
Despite the initial controversy, private companies are also being used for the imports. The Department of Health Services has signed three separate agreements with Om Surgical, Hamro Medi Concern, and Lumbini Health Care for the import of medical goods. These companies are expected to bring medical equipment worth Rs 300 million from China within next two weeks. They could yet take some time to arrive. 

As the World Health Organization puts it, the disruptions in the global supply of PPE and other medical supplies owes to, “…rising demand, panic buying and to some extent misuse of those equipment. Supplies can take months to deliver and market manipulation is widespread, with stocks frequently sold to the highest bidder.” 
To meet rising global demand, says WHO, the medical industry needs to crack up manufacturing by 40 percent. 
Nepal must increase its imports amid all these challenges. Its lethargic health bureaucracy needs to step up its game if Nepal is to tide over the corona crisis with limited damage. 

Garbage collectors of Biratnagar are forced to work under unsafe conditions as they struggle to keep themselves safe against the novel coronavirus. With little in terms of protective gear, they are under high risk of infection.

The workers are out in the field early morning every day, with only ordinary masks and surgical gloves in the name of protective gear. Personal Protective Equipment (PPE), glasses, sanitizer, and surgical masks are the minimum they need in terms of safety gear.

The Biratnagar Metropolitan City has awarded Waste Management Group, a private company, the contract of collecting and disposing garbage from the city. The company deploys 220 workers to collect garbage from the houses, streets and public places across the 19 wards of the city.

“We have been trying to save ourselves from the danger with what we have been given,” says Shyam Raut, who has been working as a garbage collector for the last 15 years. “We have asked the company to give us proper gear against the coronavirus infection.”

“We work under constant fear,” says 36-year-old Raut. His colleague, 44-year-old Suresh Paswan, adds: “All we get are two pairs of gloves, an identity card, and ordinary masks. I am worried about my safety.”

“It is dangerous to pick garbage from the houses of potentially infected people. And we cannot keep distance from others when we collect and dispose off garbage,” adds Paswan.

Surya Tamang, another garbage collector says lack of protection imperils their families and their neighborhoods as well. As most workers are poorly informed on the health hazards they face, the concerned bodies should pay more attention, he adds.

Devi Acharya, chief of the contracting company, says the workers are given gloves and sanitizers as and when needed. “Some workers use them, some don’t,” he adds. “We are aware that the workers need to handle the garbage all the time. We are doing our best to protect them. But the Metropolitan City should also think about worker safety.”

The Metropolitan City, on the other hand, says it is the contractor’s responsibility to ensure worker safety. Hira Yadav, chief of its waste management department, claims the workers have been given masks right from the beginning to stave off possible infection. “Now it is up to the contractor to provide other materials. They have to see to it that the workers are safe.”

The city produces approximately 150 metric tons of garbage every day. The amount has decreased by 50 percent after the government imposed a lockdown to stop possible spread of Covid-19. Workers think it is due to the corona scare that people have limited their activities, producing less waste. Many households have told the garbage collectors to stop coming to their homes saying, “we will manage our garbage ourselves.” The house-owners may be worried that the waste management workers may be carrying the virus, the workers think.

With the entire country on a lockdown, Tribhuvan University (TU) has postponed all its exams until further notice. With regular and partial exams being put off, students are in a dilemma. TU has taken an immediate crisis measure, but has failed to adopt a solid opt-out strategy for the long run. 

Laxmi Bahadur Pachhai, an MBS fourth semester student at Shankar Dev Campus in Kathmandu, says it feels like being chained in one spot, from where you can neither go forward nor backward. Two of his three exams were postponed. “Half a year of hard work seems to be going to waste,” he says. He hopes TU will soon make another decision on exams. 

Different countries are starting to roll back school lockdowns. In Denmark, young children are already in their schools, and Germany intends to partially open its from May 4. At higher levels, many countries have resorted to online classes and exams. However, for TU, Nepal’s oldest and largest public university with nearly 400,000 students, going online is not easy. 

Bidya Nath Koirala, an educationist, suggests that the university should think of alternatives to traditional exams. “It is futile to wait for the situation to normalize. It would be wise to come up with innovative ways on our own,” he says. 

The university can take the help of technology, he suggests. “But, first, the university should assess student access to technology, either by going through its records, or by directly checking with them,” he says. 

“As per an estimate, only five percent of the students enrolled in TU come from ‘poor’ backgrounds. That implies the TU cannot make an excuse that ‘the students don’t have access to technology’,” Koirala adds. 

Despite repeated attempts to contact them, TU officials were not available for comment on the university’s plan to restart stalled classes and exams. 

Online exams are not exempt from complications though. Students can ‘cheat’ and plagiarize due to lack of proper supervision. Koirala acknowledges such a possibility, and suggests preventive measures. “To prevent cheating, we can have more critical and research-oriented questions. Oral examination is also an option.”

There may be some students with no access to technology and devices whatsoever. In that case, “written exams can be conducted or assignments given to a few students who are called to class each day. Later, there can be an oral assessment,” argues Alok Lamsal, a lecturer at Kathmandu-based Ratnarajya Laxmi Campus. “Also, the questions should test comprehension, not student’s memory.”

Lamsal thinks much time has already been wasted. So “rather than halting studies indefinitely, we should be trying to find solutions, however time-consuming the quest maybe,” Lamsal adds.

Online exams aren’t as easy to conduct as online classes. Given our limited broadband connectivity, online exams may be beset with problems. Due to Nepal’s traditional education system, too, regular written exams are still the most suitable to test student competence. According to educationist Koirala, for students in remote villages, taking an online examination may even be impossible. 

“Internet is just a small tool to help with our education. We shouldn’t completely rely on it,” argues Lamsal. And yet in the case the university decides to conduct exams with tech support, going online could an option, if not for everyone. For others, Koirala adds, other means of communication like telephone and radio could be handy.

Uncertainty about exams and studies will have a negative impact on student minds. Koirala fears more about their social and personal impacts in the days ahead. Students get older by the day, and that puts them in a difficult situation. As he puts it, “Girls’ parents start pressing them to marry as they grow older. And for boys, they are under pressure to get a job. When the exams are stalled, they may feel pretty helpless.” 

In Koirala's  view, as education is the foundation of development, delaying studies and exams could be counterproductive for the country. “The TU should realize the gravity of the matter,” he advises.

Last summer I wrote about an ‘endangered’ species—the plastic straw. I noted that in Kathmandu use of plastic straws was dying out. Indeed, most cafes and restaurants were turning towards either metal straws or paper ones. I also noted that across many countries the plastic bag was also on its way out. We were encouraged to bring our own cloth bags to supermarkets and were likely to get a thick paper bag in clothes shop.

Meantime in Kathmandu many of the small shops continued to give out plastic bags with every purchase of two or three vegetables. Which was, I hate to admit it, fine with me as I use plastic bags to package up my rubbish to set outside for the garbage collection people. And plastic bags are great for putting dirty gym clothes, wet swimsuits, kids’ lunches, etc. In that case, as long as you keep using the same bag time and time again, there is some justification in it.

However, even in Kathmandu the larger supermarkets stopped giving plastic bags at the checkouts. Customers who didn’t have their own bags, or couldn’t find a box (rare themselves these days) to carry their purchases home, were obliged to buy a cloth bag. So when my mother mentioned that in the UK, where she is in lockdown, when she gets her delivery from the supermarket, everything comes, once again, in plastic bags, a light bulb went off.  

I realized that the deliveries I have had here in Kathmandu during lockdown have indeed come in plastic bags. Which hadn’t registered with me until my mother mentioned it. So I carried out a quick survey among friends around the world. Which countries have reverted back to plastic bags and which were maintaining their eco-friendliness through non-plastic bags?

Most countries allow people to go to supermarkets to shop during lockdown.  And in those cases, it was business as usual. People were carrying their own cloth bags as previously. Except supermarkets in Canada, which are telling people NOT to bring cloth bags unless they pack everything themselves. They do not want their staff touching bags coming in from outside. 

But among friends who have goods delivered here is the unofficial, tiny sample sized results of my survey: Canada—plastic bags; Belgium—cardboard cartons; France—thick paper bags; the UK—plastic bags; the US—plastic bags. It seems Europe has come out on top!  

So while the air is fresher with fewer vehicles on the road and less planes in the sky, the land is getting time to breathe without construction, logging, fracking etc, and wildlife is getting a much needed respite from mankind, this might all be undone with the Return of the Plastic Bag. (Cue eerie post-apocalypse music.)