When Prime Minister KP Oli was inaugurating the Dharahara tower in Kathmandu even before its construction was completed, Nepalgunj, a border town in western Nepal, was reeling under a severe crisis.
More than 1,000 cases of Covid-19 were being reported a day in the city of 1.3 million people. Nepalgunj Sub-metropolitan City lobbied with the federal government to lock-down the town, to no avail.
The District Covid Crisis Management Committee (DCCMC), headed in the district by a representative of the federal government, decided to impose a lockdown in the city only after April 25 when hospitals’ resources were spread thin as they tended to a surging number of terminally-ill patients.
Constitutionally, all three tiers of government—the local, provincial and federal—are free to exercise their executive rights. But the prevailing pandemic law doesn’t allow local governments to act independently in pandemic-containment or in any other crisis.
According to Annex 5 of the constitution, the federal government reserves the right to prepare health protocols and policies to control infectious diseases.
Soon, the city became a Covid-19 hotspot.
“We had for long been requesting for a lockdown and the closure of border crossing with India. Had the DCCMC acted on time, our city may not have faced a disaster-like situation,” says Uma Thapamagar, deputy mayor of Nepalgunj Sub-metropolitan City.
Against all odds, Nepalgunj Mayor Dhawal Shumsher Rana decided to mobilize available resources to tackle the Covid-19 crisis.
“Unlike during the first wave, the local government this time had to manage hospital beds and oxygen for Covid-19 patients,” says Thapamagar, who also visited isolation centers and hospitals each day to observe the treatment of Covid-19 patients.
After a surge in Covid-19 cases in India, early warnings were issued by experts in Nepal as well. But the government failed to regulate the open border and adopt other precautionary measures. The education minister insisted that the schools remain.
Infectious diseases expert Dr Anup Bastola wrote on his Facebook on April 9, three weeks before prohibitory orders were issued in Kathmandu and major cities, “An alarm bell has already been rung that a second wave [of Covid-19 infections] cannot be avoided in densely populated areas. Let’s not neglect safety protocols.”
Driving the change
As hospitals across the country struggled to isolate and treat the infected, local representatives sprang into action. A local representative in Khotang district even carried Covid-19 patients on his back and drove them to the hospital on his official vehicle.
According to Rai, when the sole ambulance in the local unit became dysfunctional at the peak of the Covid-19 crisis, Rai turned his official vehicle into an ambulance and started carrying Covid-19 patients with severe symptoms to hospitals wearing a PPE.
“People’s cries don’t reach Singha Durbar. The local representatives who have to work with people every day are concerned about their wellbeing,” says Rai. “I had no option but to take some risk to save my people.”
Rai is not the only one to turn official vehicles into ambulances to ferry Covid-19 patients. Dozens of local representatives have done so, including chiefs and deputy chiefs of Jaljala Rural Municipality, Parbat, Mathargadi Rural Municipality, Palpa, and other local units.
Hira Kewat, Chairperson of Omsatiya Rural Municipality in Rupandehi district, drove the body of a deceased Covid-19-infected person to the cremation site on a tractor.
“I got a call from the ward chairman about the situation. As the army would take time to get there and as the locals were not ready to cremate the body, I donned a PPE and drove the body on a tractor,” he says.
He had heard from doctors that chances of contracting Covid-19 from a dead body were minimal.
“I was socially excluded when I was infected during the first wave. So I could feel the pain of the family members of all those who were later infected,” he says.
To boost the morale of covid patients local bodies adopted all possible measures ranging from mobilizing doctors for door-to-door treatment services to the distribution of essential meals to psychosocial counseling.
Local representatives of Chandannath municipality in Jumla district distributing food to those in home-isolation.
Kantika Sejuwal, mayor of Chandannath Municipality Julma, decided to visit Covid-19 patients in home isolation with medicines and food rich in protein.
“We were not prepared for the second wave. Our isolation center was not even ready. So I decided to visit patients at home,” Sejuwal says.
According to Sejuwal, local governments are handling the worst crisis they have faced since their formation in 2017.
“The federal and provincial government representatives are busy fighting for power and the local units are paying the price,” she says.
Local representatives of Bheriganga Municipality in Surkhet distributed food and medicines to Covid-19 patients. They visited Covid patients in home-isolation with health workers for counseling.
Dharma Bahadur KC of Banphikot Rural municipality Rukum visited Covid patients with a health worker’s team, counseling them and spreading awareness among villagers. Representatives of Butwal Sub-metropolitan city did the same.
Visits and sympathy from local representatives boost the morale of covid patients that is vital to fighting the disease as well as any social stigma it might bring.
Nepalgunj Sub-metropolitan City also initiated drive-through treatment of Covid patients in home isolation.
Prime Minister Oli decided to seek a vote of confidence from Parliament on May 10 at a time when the country was reporting over 9,000 daily Covid-19 cases, and test positivity had reached 40 percent.
“The central and provincial governments, caught up in bitter power tussles, could do little and we had to shoulder the bulk of the responsibility,” says Kantika Sejuwal of Chandannath municipality.
According to Uma Thapamagar of Nepalgunj, had the federal and provincial governments acted on time, losses from the second wave of Covid-19 could have been minimized.
“Almost all local governments, including Nepalgunj, prepared isolation centers for the treatment of Covid-19 patients and managed oxygen on their own, by going beyond their constitutional and legal jurisdiction,” says Thapamagar. “The federal government just watched from the sidelines.”
Madhyapur Municipality in Bhaktapur started its oxygen plant when the country was facing an acute oxygen shortage.
Almost all local governments established isolation centers for the treatment of Covid patients as major hospitals were running out of beds and oxygen.
“The federal government has undermined the role of local units even in the ordinance on Covid-19 management,” says Ashok Byanju, chairperson of the Municipal Association Nepal.
“If infectious disease management is the federal government’s absolute domain, it should manage the emergency on its own. If not, local governments should be adequately empowered,” he adds.
According to him, local governments have yet to recover the Rs 12 billion they spent on covid-management last year.
Some local governments have also sought the federal government’s permission to purchase Covid-19 vaccines. But health ministry officials say local units simply don’t have the wherewithal to do so.