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Workshop Training for using Assessment Toolkit
on"Monitoring for Ensured Communicable Disease
Control on Evacuation Sites by Domestic Nurses"

17th 19th September 2015


Hosted by: NAN, DNGL
Sponsored by: JST

Report prepared by : Sushila Paudel, Epinurse Center, Nursing Association of Nepal (NAN)
epinursenepal@gmail.com

Organizing Committee
Japan Principal investigators
Associate Professor Sakiko Kanbara, University of Kochi
Associate Professor Sachiko Hirono, University of Kochi
Researcher Dr. Archana Shrestha Joshi, Okayama Prefectual University
Associate Professor Shoko Miyagawa, Keio University

Nepal Principal Investigators


Associate Professor Tara Pokharel, Presisent of Nursing Association of Nepal (NAN)
Associate Professor Chandrakala Sharma, President of Nepal Nursing Council (NNC)
Lecturer Apsara Pandey, Vice-president of Nursing Association of Nepal (NAN)

Page | 2

Contents

Page number

Background

Objectives

DAY I

DAY II

6
6

Session I : Introduction
Session II : Inauguration

Session III : Presentation

Session IV : Speech

Session V : Monitoring toolkit skill training

10

Session VI : Distribution of monitoring toolbag

13

DAY III

14

Discussion

14

Closing Ceremony

19

ANNEXES
Annex I

20

Annex II

21

Annex III

21

Annex IV

24

Photo Feature

32

Page | 3

Background
Disaster nursing is a crucial element of disaster response, and training nurses to obtain human
security information through use of an ordinary technology to provide actionable information
that impact the future practice of disaster response from experiences of daily monitoring. The
population density in the evacuation sites is also extraordinary for the survivors. They have to
pay more attention towards the hygiene control to maintain a minimum health safety. Domestic
nurses can share the responsibility for carrying out the monitoring community.
This project is one of J-RAPID Programmes. The Japan Science and Technology Agency (JST),
in collaboration with three Nepalese governmental institutions, initiated support to 5 projects
related to the magnitude 7.8 earthquake that struck Nepal in April 2015, within the framework of
the J-RAPID Program that supports urgent international collaborative research.
This program was supervised by committee (chair is MOSTE) to research/investigation that
contributes to the collection of scientifically important but short-lived data, speedy restoration
after disasters and improvement of disaster preparedness in the future.
Project Partners from Japan include Disaster Nursing Global Leadership Program, University of
Kochi (DNGL), The Japan Society of Disaster Nursing (JSDN), and World Society of Disaster
Nursing

(WSDN),

Partner

from

Nepal

include

Nursing

Association

Nepal

(NAN), Tribhuvan University, School of Nursing and Global Partner include Ebayanihan,
Ateneo De Manila University, WHO WPRO.
This project aims to visualize and summarize prevention of communicable diseases through
communication in real time with Nepali nurses who will be conducting the monitoring, so
that the information can be delivered to health cluster who can make informed decisions in order
to protect and promote health & safety of people and the community during disasters.
The most critical challenge is data collection to generate reasonable information that can be used
in predicting whether something is likely to occur. Our interest lies in collecting information on
the items to A) ensure adequate water and sanitation facilities, B) availability of food, C) control
vectors, and D) syndromic surveillance focused on the most common health conditions,
encountered after disaster, for preventing communicable disease rather than detecting outbreak
by dispatched nurses. So, the action plan was to establish health coordination mechanism and
development of the toolkit after visiting the model site, and pre-meeting with NAN, as consulted
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by

leading organizations (WHO, MoHP, JICA, MOH) and to conduct Disaster Nursing

Workshop to train Nepali Nurses for using toolkit, in Kathmandu.

Sakiko Kanbara, University of Kochi, Japan

Tara pokharel, President, Nursing Association of Nepal (NAN)

Objectives of the Workshop

To gather details of the shelter/s from the disaster affected areas representative Nurses.

To introduce the survey Monitoring for Ensured Communicable Disease Control on


Evacuation Sites by Domestic Nurses.

To discuss about survey tool and provide tool kit skill training for monitoring and rapid
assessment.

To distribute survey toolkit and J-rapid Monitoring tool bag.

DAY I
The training workshop was attended by 25 representative Nurses from disaster affected districts
of Nepal. Districts represented were Kathmandu, Lalitpur, Bhaktapur, Nuwakot, Dhading,
Gorkha, Rasuwa, Kavrepalanchok, Sindhupalchok and Dolakha. Day 1st was a warm up session
where participants informally interacted with each other. Registration was done by Epinurse
Sushila Paudel where the participants, one by one, were requested to provide their name, living
address, email, contact number, their working office, working status, past experiences, including
the Shelter/s name, Shelter address and the number of Shelter they covered. The participants list
is attached as Annex II.

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DAY II
SESSION I : INTRODUCTION
The training workshop session was opened at 10:30 am with a warm welcome by Mrs.
Rajkumari Gyawali, Secretary of Nursing Association of Nepal. She asked participants and all
other members present, to introduce themselves. Participants were asked to give a brief
description about the epidemiological conditions of their respective districts/shelters as resulted
by the devastating earthquake and aftershocks.
The inaugural session was postponed for a while due to Chief guest's absence. Till then Sakiko
Kanbara provided the participants with materials like paper handouts, toolkit, diaries, pen and
Disaster Nursing Global leader Degree Program overview Prospectus.
Archana Joshi distributed the form containing shelter characteristics. Participants were divided
into groups representing their district and were required to fill the details of the Shelter they
covered, including Shelter mapping. There were altogether 40 shelters covered. Shelter
Characteristics form is attached as Annexe IV.

SESSION II : INAUGURATION
The Inaugural session was chaired by Associate Professor Tara Pokharel, President of Nursing
Association of Nepal. The chief guest of the session was Dr. Baburam Marasini, Chief of
Epidemiology and Disease Control Division, Nepal. The other diginitaries on the dais were
Associate Professor Sakiko Kanbara, University of Kochiko, Japan and Associate Professor
Chandrakala Sharma, President of Nepal Nursing Council. The session was hosted by Rajkumari
Gyawali, secretary of NAN.

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SESSION III: PRESENTATION


Associate Professor Sakiko Kanbara presented a paper on Introduction of J-rapid Epinurse.
She outlined the objectives of rapid assessment as:
to assess the extent of the emergency and the communicable disease threat to the
population;
to define the type and size of interventions and priority activities;
to pass the implementation of these activities;
to pass information to the government, donors and the media in order to mobilize
human and financial resources.

She showed framework of the new initiatives.

Fig: Framework of the New Initiatives.

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Kanbara explained about the initial preparations done like getting information from Epinurse
Center and collecting background geopolitical and health data along with review of existing
information, visual inspection of the affected areas, interviews with key informants and ethical
approval. After the workshop training, nurses will be dispatched to their site and with
investigation toolkit, they will be monitoring the living environment, SPEED and EWARS by
WHO, MOH.
Kanbara highlighted that the assigned tasks should be reported by the surveyors i.e. participated
nurses, per week or even soon for any changes within the time frame of three months. After
assessment, all the datas, informations and opinions collected will be aggregated from individual
case report sheet and analysed collaboratively by Epinurse Center, NAN and Japanese team
members. Datas will be analysed into demographic pyramids, priority health interventions and
identification of high risk groups. As an expected outcome, these informations will be shared
with other health sectors, MoHP and WHO, to integrate with their own data, and supply relevant
information into central and actionable form for community leaders so as to prevent unnecessary
deaths, through early detection of cases of diseases, having outbreak potentials. Likewise,
informations will be passed to the PH Centers, Hospitals, Government, donors, NGOs, INGOs,
media and the concerned authorities, so that the encountered problems of the disaster affected
areas can be sort out through new interventions, programmes and launching further projects. She
also mentioned that the budget for this survey is limited upto monitoring living environment and
communicable disease by domestic nurse. Kanbara concluded her presentation showing the next
challenge, i.e.

How To Care Co

u ity People a d

ake Health Village?

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SESSION IV: SPEECH


Associate Professor Chandrakala Sharma, President of Nepal Nursing Council, who is also a
member of Nepal Health Research Center (NHRC) and one of the Principal Investigators from
Nepal gave a brief overview of Nepal Nursing Council as the legal body of Nursing profession
which registers nurses and ANM, accrediates all nursing education programmes and strengthens
nursing services within health institutions. She briefed the background and said that this is
preliminary survey and highlighted with the participants to call it as a survey rather than a
research.
A representative speaker from the overall participants, on her remarks said that it gave all of
them a great pleasure and honor to be in this very important workshop and they will have their
best to mark it a success.
Dr. Baburam Marasini, Chief Guest of the workshop on his speech said that the Surviellance is
the heart of public health. Earthquake April 2015 resulted many epidemic outbreaks like
Hepatitis.A in Gorkha, Brucellosis in Kavrepalanchok , Dysentery in Kakani, and few cases of
cholera in Kathmandu. Further he stated that surveillance alone is not a big deal but to response
is a big deal. So he requested participants to apply whatever theyve learnt, and for the problems
encountered, using vertical channel collaboration, solutions can be sought soon. He extended his
vote of thanks to Japanese team and the organizing committee and ended his speech with the
expectation that this gathering will be fruitful and will be able to come up with important
solutions to overcome the problems.
Associate Professor Tara Pokharel, President of Nursing Association of Nepal, and one of the
Principal Investigators from Nepal gave overview about NAN as the professional Organization
of the nurses in Nepal which became the member of International Council of Nurses (ICN) in
1969 A.D and it works to protect, promote and develop the professional right and interests of all
nurses in country and to raise health standard of people. She explained that the nurses are playing
vital role in monitoring and promoting health of people at disaster affected sites. Most of the
remote nurses were called for participation because they have better ideas of their sites. A
teacher from Dhading was also included as she was monitoring and providing health care and
education to the affected children in school. She added that this is a great opportunity for Nurses
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to be the part of this national level disaster survey. She ended her speech encouraging the
participant nurses to do their best, so as to get the next best project in days to come, that works
for health preservation and promotion of people.
After speech session,Dr. Baburam Marasini displayed the J-rapid t-shirt designed for this survey,
along with diginitaries Sakiko Kanbara, Tara Pokharel and Chandrakala Sharma.
During lunch break, participants and other members enjoyed dance and songs on the auspicious
occasion of women Teej and Panchami.

SESSION V: MONITORING TOOLKIT SKILL TRAINING


Guidance for nurses to use the survey toolkit was the core objective of the workshop. Researcher
Dr. Archana Shrestha Joshi, requested participants to have a glance at the survey toolkit. She told
them to go through all the contents and to clarify their confusions, if any. She described the ways
of using tool, for whom, when and how to monitor. She explained that participant nurses at their
respective shelters needed to have a clear assessment of the following:
A) Living Environment Assessment
I. WASH services
II. Shelter status
III. Sleeping room
IV. Companion animals
V. Health & Nutrition
B) SPEED
C) EWARS by WHO, MOH
D) Nursing Assessment Sheet

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For three months, Datas have to be reported per week or even soon for any changes to Sushila
Paudel at Epinurse Center, NAN either through email,facebook, phone or sms.
Associate

Professor

Shoko

Miyagawa,

Keio

University

gave

the

URL

address

surveymonkey.com for the smartphone users. Some participants performed trial to get the tool
containing their shelter address, make entries and report to Epinurse center.
Sushila Paudel read the tool again and described each of the headings, subheadings and every
contents in simple clear nepali language and in comprehensible ways to ensure that all the
participant nurses have understood well. Further, for their convenience, she made the new tool
having questions written in both English and Nepali Language, in simple format, without making
any sense of changes to its meanings.
Participants questions and confusions regarding the tool were highly welcomed and clarified.
Toolkit is attached as Annex III.

SESSION VI: DISTRIBUTION OF MONITORING TOOLBAG


After the toolkit guidance session, Associate Professor Sachiko Hirono, University of Kochi
and Shoko Miyagawa, Keio University distributed J-rapid monitoring tool bag which contained:
Bag
T Shirts
Stethoscope
Sphygmomanometer-B.P
Towel
Basal thermometer
Alcohol/Spirit
Torch
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Globes
Mask
Weighing machine
Soap
Thermostate
Measuring tape
At the end, Sushila Paudel summed up the session and thanked all the participants for their day.

DAY III
At 8 am, Participants were welcomed by Archana Joshi. She asked them regarding any
confusions and clarified all their queries. Then the participants were requested to be divided into
their district groups and some of the questions regarding living environment assessment added
by Sakiko Kabara were asked to be filled up again. questions added were main source of
drinking water, fuel usually used for cooking and lighting, households with and without toilet
facility and household having facilities like radio, television, computer, motorcycle, refrigerator,
etc. After filling form district wise, they were told to mark on their shelters on district map.

DISCUSSION
The session then continued with the questions:

What are the main health issues of your district?

How to improve?

Where to report?

What kind of information feedback needed?

How to report?

Participants had group discussion and then district wise presentation.

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Sindhupalchok (Maya Shrestha, Roshani Shrestha, Srijana khadka, Chandramaya Dangal,


Indramaya Gurung )
Main health issue

Safety and security, Communicable disease, Sanitation problem


Toilet/drainage problem, Scarcity of drinking water
Psychosocial problem, Starvation
Economic disease ( diarrhea, measles, dysentery)
Family crisis, Over crowding

How to improve?

Mobilise community leaders, FCHV


Health survey, Data analysis
Health action as per priority
Implementation , Health education
Coordinate with DPHO, INGO, NGO, local leaders, social workers
and so on

Where to report ?

Health center, Local leaders, DPHO, NAN


Epidemiology department/MOH

What kind of

Human resources, Money

information

Communication materials, Monthly supervision

feedback needed?

Medicines, Referral format

How to report ?

Sms email phone

Dolakha (Pramila Jirel , Sanumaya Khadka )


Main health issue

Unsafe Drinking water, Sanitation, Handwashing


Fever, injury, diarrhea

How to improve?

SODIS, chlorine tablets


Dressing
Medicine

Where to report ?

--------

What kind of

Health education

information needed?

Counselling

How to report ?

Phone, Sms, viver


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Kathmandu ( Ram kumara Luitel, Jasmaya Jirel, Samjhana Kunwar, Babita Jirel, Sunita Panthi,
Thakchi Sherpa)
Main health issue

earthquake fear , sanitation, Handwashing


Fever, diarrhea with fever,dysentery, insomnia, eye/ear infection, skin
disease, headache, epigastric pain, ANC/PNC/family planning,
gynaecological problems, worm infestation, Malnutrition, jaundice,
asthma/cCOPD, injury

How to improve?

Health education
Counselling
Money
Medicines/ Aqua water distribution/ bottle water supply

Where to report ?

Food/masks
Vaccination Programme
Health campaign, committee formation

What kind of

Protocol

information

Medicine, Vaccine, Money man material, Food/ cloth

feedback needed?

Bp instrument, umbrella, raincoat, sleeping bag

How to report ?

Office Incharge, Phone


Sms, facebook, skype, viver

Rasuwa (Sarita Dhakal)


Main health issue

Psychological problems, Safety/security, Diarrhoea , Skin problems


Severe Gastritis , Reproductive Health, Insufficient Latrines
Environmental sanitation, Lack of proper nutrition, problem on
Infection Prevention

How to improve?

Community diagnosis, Planning, health education, health strategies


from local level, MOHP, EDCD, supportive group

Where to report ?

MOHP, WHO, Unicef

How to report ?

Phone, Sms , Email

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Dhading (Sarita Dhungana, Sarada Barakoti, Sundari tamang, Urmila chitrakar, Madhu Gomja )
Main health issue

Communicable disease threats, Unsafe Drinking water, Poor


Sanitation, Poor Hygiene,Overcrowding, malnutrition , viral
fever, typhoid fever, jaundice, diarrhoea, skin problems

How to improve?

Awareness programme
Mobilize community leader
Treat the water source/ use purification methods
Sanitation improvement Programme
Solid waste disposal, Latrine
Hand washing technique/ personal hygiene
Safe storing and serving food
Assess the nutrition status
Counselling for nutrition
Refer to nutrition rehabilitation
Campaign programme

Where to report ?

Community leader
Local health institution
District health office, NAN
MOH/Epidemiological section

What kind of information

IEC material,

feedback needed?

Medicine (first aid)


Handwashing material
Water treatment materials, Water bins
Electronic communication material
Assesssment and referral formats

How to report ?

As necessary (weekly/monthly
Immediately if any outbreak
As government HMIS system
By phone, sms, email

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Nuwakot (Devaki Khatiwada, Sreemaya Jirel)


Main health issue

Fever, ARI, AGE, open wound cuts, skin diseases like allergies,
scabies, eye infections, Acute peptic diseases, smoking, alcoholism

How to improve?

Awareness programme
School health programme
Coordination with VDC chairperson, local leaders

Where to report ?

District health office, NAN

How to report ?

Phone, Sms , Email, Written report

Kavrepalanchok ( Sumala Basnet )


Main health issue

Fever, Headache, Muscle pain, Eye irritation, Jaundice, Skin rash


Diarrhea, Scabies, Fracture, Conjunctivitis, Wounds,
High blood pressure

How to improve?

Awareness in hygiene and sanitation


School health program

Where to report ?

District health office

How to report ?

Phone, Monthly written report, sms ,Email

Gorkha ( Saran Khanal )


Main health issue

Drinking water,
Sanitation,
Latrines

How to improve?

Health education
Co-ordination

Where to report ?

VDC chair person


District public health office
Female community health volunteer

How to report ?

Phone, Sms ,Email, Pamphlet

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Lalitpur /Bhaktapur(Lumbini Shakya, Indramaya Shrestha)


Main health issue

Allergies, Allergic Rhinitis, peptic diseases, COPD, Anxiety,


depression, abortion, premature delivery, water born disease, ARI,
STI, eye infections, hazardious health habits

How to improve?

Health education
School health programme
Water purification
Temporary latrine construction
Immunization Campaign for under 5 children/regular immunization
Immediate report to higher health center

Where to report ?

Local health insttute


Local leader
VDC/ municipality/ward
District health office

What kind of

Health History

information

Health checkup

feedback needed?

Environmental sanitation
Water resources
Available health facilities
Logistic support
Financial support

How to report ?

Phone, email, sms, record keeping/reporting

CLOSING CEREMONY
Participants were given the instrument tool and a permission letter to the district. Queries
regarding reporting datas were clarified again by Sushila Paudel. Sakiko Kanbara, Archana
Shrestha Joshi and Sushila Paudel provided their contact and email address. President of NAN
Tara Pokharel wrapped up the session by summing up the two days workshop. She wished all a
good luck and gave thanks to all for their support in delivering 2 days workshop training.
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Annex I
Agendas (September 18th)
10:00- Opening Remark
10:30 Introduction
11:00- Inauguration
12:00- Presentation
13:00- Monitoring tool kit skill training
15:00- Distribution of Monitoring toolbag

Agendas (September 19th)


10:00- Discussion
12:00- Wrap up and Closing

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Annex II
Name of
Participants

Age
(yrs)

Living Address

Office

Status

experience year

Sarada Barakoti

30

Salyantar-7, Dhading

Staff Nurse

10

Sundari Tamang

21

Nilkantha-3, Dhading

Staff Nurse

Urmila Chitrakar

20

Staff Nurse

18 months

Sarita Dhungana

45

Nilkantha-3, Dhading
Chhatradeurali-2,
Dhading

ANM

14

Pramila Jirel

24

Jiri, Dolakha

Shreemaya Jirel

50

Kharanitar, Nuwakot

ANM
Senior
ANM,6th Level

Salyantar PHC, Dhading


District Hospital
Dhading
District Hospital
Dhading
Chhatra Deurali HP
Dhading
Jiri Dolakha District
Hospital,Jiri
Kharanitar PHC
Nuwakot

Devaki Khatiwada

42

20

Babita Jirel

28

Deurali PHC, Nuwakot


Sankhu Ilaka HP
Kathmandu

Staff Nurse

Bidur-3, Nuwakot
Bajrayogini-1,
sankhu, Kathmandu

ANM

Lumbini Shakya

49

Sunita Panthi

52

Staff Nurse
Senior
ANM,6th Level

11

37

Staff Nurse

17

12

Roshani Shrestha
Chandramaya
Dangal

ANM

19

13

Indramaya Gurung

42

Maya Shrestha

54

15

45

16

Sharan Khanal
Indramaya
Shrestha
Ram kumari Luitel

45

ANM
Senior ANM,
6th level

18

Samjhana Kunwar

43

ANM

20

19

Thakchi Sherpa

37

Senior ANM

17

20

Sumala Basnet

39

Gorkha DPHO, Gorkha


Nagarkot HP,
Bhaktapur
Dharmasthali HP
Kathmandu
Budanilkantha HP
Kathmandu
Friends of
Shantabhawan, Jorpati
Sunthan PHC
Kavrepalanchok

27

17

Haramtari, Gorkha
Kamalbinayak,
Bhaktapur
Saraswotinagar ,
Kathmandu
Budhanilkantha,
Kathmandu
Bouddha-6,
Kathmandu
Panauti-5, kapalkot,
Kavrepalanchok

ANM
Staff Nurse,
6th level
Public Health
Nurse

10

14

Lubhoo PHC Lalitpur


Chalnakhel PHC
Kathmandu
Melamchi PHC
Sindhupalchok
Mahankal HP,
Sindhupalchok
Melamchi PHC
Sindhupalchok
Chautara DH,
Sindhupalchok

25

10

Luboo, Lalitpur
Chalnakhel-2,
Kathmandu
Melamchi,
Sindhupalchok
Mahankal-1,
Sindhupalchok
Melamchi-5,
Sindhupalchok
Chautara,
Sindhupalchok

ANM

13

21

Sanumaya khadka

52

lamabogar, Dolakha

Lamabogar HP, Dolakha

Senior ANM

27

S.N

43

48

20

20

33
22

27

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22

Jasmaya Jirel

48

Balaju-16,
Kathmandu

23

Srijana Khadka

33

Ramche-7, Bahrabise

24

Sarita Dhakal

43

25

Madhu Gomja

21

Dhunche-5, Rasuwa
Damgade-12,
Dhading

S.N

Gordhunga HP,
Kathmandu
Barhabise PHC,
Ramche7Sindhupalchok
Rasuwa District
Hospital
Dhading Damgade
School

Name of Shelter covered

Name of
Participants

Sarada Barakoti

Lapa Basti

Sundari Tamang

ANM

18 months

Staff Nurse

21

Teacher

shelter
experience

shelter address

August

Sankosh-12

Sankos-12 Dhading

Apr-25

Urmila Chitrakar

Sankosh-12

Sankosh-12 Dhading

Apr-25

Sarita Dhungana

Ramche

Ramche Dhading

Apr-25

Pramila Jirel

Shikri Gaun Jiri

Shriki Gaun, Jiri

May-13

Shreemaya Jirel

Bangetar-1

Bangetar, Kharane,
Nuwakot

Apr-25

Devaki
Khatiwada

Deurali-8

Deurali-8, Nuwakot

Apr-25

sankhu, Kathmandu

Apr-25

Mahalaxmi,Luboo,
Lalitpur

Apr-25

Dakshinkali, Kathmandu

Apr-25

Melamchi-2,
Sindhupalchok

Apr-25

Mahankal,
Sindhupalchok

Apr-25
Apr-25

Babita Jirel

SankhuBajra-1

Lumbini Shakya

Mahalaxmi-8

Sunita Panthi

Boshan

10

28

lapabasti Dhading

Senior ANM,
6th level

Kharane-6

Sankhu
Bajra-2

Khahare

Sankhu
Bajra-3

Gwalda

11

Roshani Shrestha

Melamchi-2

12

Chandramaya
Dangal

Mahankal-1

13

Indramaya
Gurung

Melamchi 5

Melamchi-5
Sindhupalchok

14

Maya Shrestha

Chautara 3

Chautara,
sindhupalchok

Apr-25

15

Sharan Khanal

Simalgaire
Alegaun

Simalgaire Alegaun,
Gorkha

Apr-25

16

Indramaya
Shrestha

Lamatol -4

Lamatol-4 Nagarkot,
Bhaktapur

Apr-25

17

Ram kumari
Luitel

Dharmasthali-3

Dharmasthali,
Kathmandu

Apr-25

Mahankal-9

Dharmasthal
i-4

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18

Samjhana
Kunwar

Thulogaun-4

19

Thakchi Sherpa

Phulpinkatti

20

Sumala Basnet

Sunthan-10,
Panauti

21

Sanumaya
khadka

Gongar Tol-5

Jagat-9

22

Jasmaya Jirel

Phuyalthok-9

Dhitalthok

Tembathang

Gorkana
Camp

Bihanibast
i-4

Thali
Camp

Padma
Tower

Thulogaun,
Budanilkantha

Apr-25

Jorpati, Gokarna,
Kathmandu

Apr-25

sunthan-10, Panauti,
Kavrepalanchok

Apr-25

Gongar, Jagat, Dolakha

Apr-25

Gordhunga, Kathmandu

Apr-25
September

23

Srijana Khadka

Plykarkhana

Ramche-7,Bahrabise,
Sindhupalchok

24

Sarita Dhakal

Dhunche-5

Dhunche-5, Rasuwa

May-14

25

Madhu Gomja

Damgade

Damgade, Chabedada,
Dhading

May-01

Chabedanda

Page | 23

Annex III
Name :

Form Number :

District :

Date of data collection :

A) Living Environment and Population Characteristics


I.WASH Services (Water, Sanitation, Hygiene)
Drinking Water ( )
1.Type of drinking water source

2.Adequate water supply

3.Quality / safety checked assured



4.Average amount / person/ day

5.Distance water dwelling place


Bottle

Tap

Yes

No

Yes

No

Specify.........................
..............
Specify........................
.............

Other: ...........................
: .......................
Not Available/ Unknown
/
Not Available/ Unknown
Not Available/ Unknown
Not Available/ Unknown

Washing Water ( Bathing/ Laundry) ( / )


6. source

7.Adequate water supply

8.Distance water dwelling place


None

Tap

Yes

No

Specify........................
.............

Other: ...........................
: .......................
Not Available/ Unknown
/
Not Available/ Unknown
/

Management of solid waste ( )


9. Waste Collectors

10Adequate number of collectors


?
11.Separation of waste type
?
12. Appropriate waste storage

Yes

No

Yes

No

Yes

No

Yes

No

Not Available/ Unknown


/
Not Available/ Unknown
/
Not Available/ Unknown
/
Not Available/ Unknown
Page | 24


?
13.Appropriate waste disposal
?

Yes

No

/
Not Available/ Unknown
/

Latrines / Toilets and hand washing supplies ( )


14. Toilets Available
?
15.Adequate number of Toilet
?
16.Average number of person/ toilet

17. Distance toilet dwelling place


?
18. Detergent / soap available
/ ?

Yes

No

Yes

No

Specify........................
.............
Specify........................
.............
Yes

No

Not Available/ Unknown


/
Not Available/ Unknown
/
Not Available/ Unknown
/
Not Available/ Unknown
/
Not Available/ Unknown
/

II.Shelter Status ( )
19. Type of shelter

20. Damaged
/
21. Security / Safety Assured
?
22. Adequate Ventilation

23. Adequate space per person per family


?
24. Free of hazard(s)

25. Free of Vector(s)


26. Acceptable indoor temperature


?
27. Acceptable Cleanliness
?
28. Source of light ( Electricity)

Specify........................
.............
Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

29. Generator in use

Yes

No

30. Designate smoking area


Yes

No

Not Available/ Unknown


/
Not Available/ Unknown
/
Not Available/ Unknown
/
Not Available/ Unknown
/
Not Available/ Unknown
/
Not Available/ Unknown
/
Not Available/ Unknown
/
Not Available/ Unknown
/
Not Available/ Unknown
/
Not Available/ Unknown
/
Not Available/ Unknown
/
Not Available/ Unknown
/
Page | 25

III.Sleeping Room ( )
31. Acceptable Number of Mats /Beds
/
32. Acceptable spacing

Yes

No

Yes

No

33. Acceptable Cleaniness

Yes

No

34. Blanket or other items


/

Yes

No

35. Presence

Yes

No

36. Animal Care Available


Yes

No

V. Health and Nutrition ( )


37. Unusal disease / event , outbreak
/
If Yes , Specify:

..............................................................
38. Health Care services on site

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Not Available/ Unknown


/
Not Available/ Unknown
/
Not Available/ Unknown
/
Not Available/ Unknown
/

IV. Companion Animals ( )

39. Psychological support / counselling

40. Nursing care ( Community Health,


Preventive care ) provided

If Yes give details:


.
........................................................................
.......................................................
41. Safe and clean food items provision

42. Cook food served on site

43. Common kitchen available



44. Personal/ family kitchen
/
45. Appropriate food storage

46. Handwashing facilities


Not Available/ Unknown


/
Not Available/ Unknown
/

Not Available/ Unknown


/
Not Available/ Unknown
/
Not Available/ Unknown
/

Not Available/ Unknown


/

Not Available/ Unknown


/
Not Available/ Unknown
/
Not Available/ Unknown
/
Not Available/ Unknown
/
Not Available/ Unknown
/
Not Available/ Unknown
/
Page | 26

B) SPEED

S.
N

Disease Syndrome/ Health Event

12

Fever (FEV)

Cough, Colds or Sore throat with or without fever


(ARI)


Fever with rash (MEA)

Fever with spontaneous bleeding(i.e. Nose bleeding ,


Gum bleeding ) (AHF)
()
>12 month and over: sudden onset of fever (>38C)
with severe headache and stiff neck
: 38C,


<12 months : Fever (>38)with bulging fontanel , or
refusal to suckle (MEN)
38C,

Fever with headache , muscle pain and any of the
following: Eye irritation , jaundice , skin rash, scanty
urination (LAP)

,
, ,
, ,
Yellow eyes or skin with or without fever (AJS)

Fever with other symptoms not listed above (FOS)

Loose stools 3 or more in the past 24 hours with or


without dehydration(AWD)
,

Loose stools with visible blood (ABD)

Open wounds and bruises / burns (WBS)

,
Fractures (FRS)

13

Skin Diseases (STS)

1
2
3
4

7
8

10
11

<5 Years old



Cases
Deaths

5 years old

Cases
Deaths

Page | 27

14
15
16
17
18
19
20

21
22

Animals bites (ANB)

Eye itchiness, redness with or without discharge(CON)


, ,
Spasms of neck and jaw (Lock jaw )(TET)

High blood pressure (140/90 (HBP)


/,
Known diabetes (KDM)
/
Difficulty in breathing and wheezing (AAA)

Floppy paralysis of the limbs which occurred recently
in a child <15 years which previously normal (AFP)

Visible wasting with or without by pedal pitting edema
(AMN)
,
Others (Please specify):
( ):
-

Page | 28

C) EWARS by WHO MOH

S.N.

Disease Syndrome

1.

Total OPD cases (medical, pediatric and general) and


emergency patients treated on this day

2.

Influenza like Illness

3.

Severe acute respiratory infection

4.

Acute watery Diarrhoea

5.

Acute Bloody Diarrhoea

6.

Suspected cholera

7.

Fever with Jaundice

8.

Fever with rash

9.

Fever without rash and Jaundice

Of NEW cases in medical and general OPD and


Emergency

<5 Years old


5 years old

Total

Page | 29

Appendix) Nursing Assessment Form


Daily Habit ( )

Smoke ( )
Drink ( )

Anamnesis ()

DM ( )
Hypertension ( )
Liver Disease ( )
Stroke ( )

History of present illness

Appetite ( )
Sleep ( )
Urination ( )
Defecation( )
Numbness of limbs
Gait disturbance ( )
Conversation Discomfort ( )
Cough ( )
Breath ( )

Inspection ( )

Measurement ()

Face ( )
Trauma ( )
Skin ( )
Measure ( )
Weight ()
Body temperature ( )
BP ( )

Palpation ()

Pain (
)

Page | 30

Annex IV

Page | 31

Photo
Feature

Page | 32

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THANKYOU

Page | 42

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