The Government needs to provide masks and sanitizers to all people and take independent action to control the spread of pandemic: Pyakurel

Dr. Sushil Nath Pyakurel is the former Director General of the Health Directorate under the Ministry of Health and Population. He served as a public health expert in health offices of different districts and departments before retiring after 40 years long government service. An expert in the subject matter and a clear speaker, Mr. Pyakurel has been actively contributing by sharing his ideas and knowledge on how the Covid-19 pandemic can be controlled. Being familiar with the government system and having national and international exposure and experience, Mr. Pyakurel’s views are really helpful in this situation. Amid the global pandemic flaring in Nepal as well, the Nepalekhabar team is privileged to chat with him on the current situation and the steps to be taken towards controlling the pandemic. Here are the excerpts:

How do you analyze the Covid-19 situation in Nepal? Do you think the infection has spread to the community?

Although we are yet to do research to ascertain where we are in terms of level of Covid-19 pandemic spread, but while observing the trend I feel that the pandemic has reached the community transmission level as there has been incidents of health workers and security personnel getting infected. Some people are claiming that there is no community transmission, but they also have not done proper research before making such claims.

The government is claiming that the virus transmission is in the second stage, what is your take on it?

Rather than hiding the fact we need to make people aware and enforce safety measures. The government is making such claims without proper analysis of data and research on the issue. Rather than claiming that the pandemic is at the second stage, the government should sensitise the communities about the actual status of the pandemic and caution them to follow safety protocols like wearing masks, maintaining physical distancing and using hand sanitizers where feasible. If there was no community transmission, how are the health workers and security personnel without travel history getting infected; therefore we should analyse the trend before making any statement. We need to give clear information so that people can take precautionary measures. If we say we are in stage two, while we are in stage 3, people may not take this seriously and it might have adverse consequences.

It seems that the government has not done much for controlling the spread of virus, what is your suggestion to them?

Yes, the government has not been able to do much which was expected from them. There are six elements (such as i. Management of Human Resources; ii. Logistics and Infrastructure Management; iii. Information Management; iv. Service Delivery; v. Financial Management and vi. Good Governance) for controlling such pandemic but the government has not enforced it properly. For example, rather than doing PCR tests, the government spent huge resources on RDT tests, which in one way misused the state resources and on the other hand contributed towards the spread of the pandemic. Similarly, there is unclarity on who should take what responsibility and how the information should be disseminated. The government should have come up with clear plans to address the issue rather than indulging in corruption and tussle between which agency should take the leadership in this type of global emergency. Currently the local government are taking lead for controlling the pandemic rather than health offices, which is creating a mess in terms of managing quarantine centres, treating people and other such issues.

How do you foresee the scenario in the days to come?

If we look at the current trend, it appears that the situation will be further deteriorate and the pandemic will spread rapidly. However, if we improve our ways of working, we can control the pandemic. If we take some rapid actions like providing masks and sanitizers to all people and really enforce it, it will help to control the pandemic. If we provide free masks and sanitizers to 23% people, which is around six million people who are below the poverty line, it will not require huge resources but will contribute towards controlling of the disease. The government needs to take leadership role for proper coordination and monitoring. In the meantime, the government can expedite the PCR tests and install other health facilities. As we have been facing public health emergencies, our planning should be to address long term public health emergencies rather than limiting it to Covid-19. For example, we can construct permanent quarantine centres rather than limiting it to Covid-19 and we can form powerful Centre for Disease Control, which will function independently in case of such public health emergencies.

What could be the role of other actors it this situation?

The lone efforts of the government may not be sufficient, so we need coordinated efforts from all actors. For example, all political parties could mobilise their cadres for raising awareness at the community level and support the needy people. It is responsibility of all political parties to raise awareness and support the needy rather than pointing fingers at each other. So far, the situation is not yet beyond our control, so all need to join hands for combating the pandemic. However, the government should coordinate with all sectors. The government should rise beyond the political interests and allow respective mechanisms to perform independently and contribute for controlling the pandemic. The government has formed a committee of experts and they invite other experts periodically, but they do not consider the recommendations of the experts. The government should not limit the pool of experts by considering their political ideology, they should have broader view on it.

Do you feel the Ministry of Health and Population has been able to take the leadership role?

Although efforts have been made from the Ministry, it is not sufficient. I am not saying that all officials at the Ministry and related departments are not capable, but the ministry failed to take leadership role due to various reasons like interests of some people. The Ministry failed to play effective role as the government failed to assign the right persons at the right places. The Ministry should put the right persons at the right places and coordinate with relevant actors. For example, the private sector healthcare facilities are ready to support the government, but I hear that the government has not coordinated with them. Similar is the situation with donors and international and national non-governmental organisations. Due to lack of coordination, the resources are not coordinated and spent differently while the needy people are not getting proper support. There is a need of proper TEAM (Thought, which should be positive; Efforts, all should put their best efforts; Attitude, all should work with positive attitude and Motivation, the team should be motivated) efforts for controlling the pandemic but it should be facilitated by the lead Ministry, but it seems that the ministry has not been able to take leadership role for making a real TEAM. Similarly, people should be cautious about the disease and take precautionary measures for controlling the disease. If they could not follow the rules properly, strict actions should be taken as negligence of people is also responsible for the spread of the disease.

Are you satisfied with the role of political parties and parliamentarians?

There is a huge role of political parties and parliamentarians during this period as they have networking up to the local level. They should not look it from political give and take as this is the time to solve the pressing issues of the country. The political parties should reach out to the people and provide necessary support to the extent possible. It does not need huge resources if the political parties activate their channels and provide necessary support. As the parliament session is on hold now, the parliamentarians can go to their areas, monitor the services provided and support for coordination among different stakeholders. I hope they will better coordinate in the days to come.

What are your major recommendations considering the situation?

The first recommendation is provide at least two masks and sanitizers to the needy people.

The second recommendation is that the government should increase the PCR testing and other necessary resources.

The third recommendation is considering the trend, the government should procure necessary medicine, machines and other essentials and mobilise all state mechanisms for controlling the disease.

And finally, the government should facilitate the role of all actors and provide leadership role for controlling the disease.

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