Health Insurance
Andrew & Ellen Collins – Nepal
Andrew & Ellen Collins – Nepal
One of the things we’ve heard a lot about on the TV and radio since returning from Nepal is the woeful state of the USA’s health care system and the fact that so many Americans cannot afford health insurance. As a community health educator, this subject interests me, and it made me think about a story I’d transcribed this past summer at a special place outside Kathmandu, in the village of Chapagaun.
“My name is Buddhi Ram Bishwakarma. I am 38 years old. I have a wife and five children. The eldest is a 12-year-old son and the youngest is a three-year-old daughter. My home is in Dang district (Five months ago I brought my family here to Chapagaun to work in a brick factory. In my village I have some fields, but I could not raise enough crops to feed my family. Then one day a man came looking for laborers for brick factories in the Kathmandu valley, and so I joined about 150 others to come here.
At the factory, my wife and I and our 12 and 10-year-old children carry bricks. We get Rs. 120 ($1.70) for every 1000 bricks we carry. We have carried 180,000 bricks in the time we have been working here. Each of us receives Rs. 200 ($2.86) a week for food, but this amount is deducted from our total earnings. We work from 4 am until 3 pm. In July, when the brick-making season ends, we will return home to Dang.
Today I am here at Chapagaun Teaching Health Post because my wife and all five of my children have fevers and coughs (pneumonia). A local teashop owner told me about this health post. He said that recently a group of Christian health workers assumed its management, after it had been in the hands of the United Mission to Nepal for several decades. ‘They actually care about poor low-caste people like you,’ the man said. I could hardly believe this, but had no choice but to come and see for myself. There is a health post in our own village, but it lacks manpower and medicines, unlike this health post here. And we were never treated well there. Here, we have been welcomed.
This is what I have done today. I have paid Rs. 120 ($1.70) to purchase health insurance for my family for a year, and I paid Rs. 6 (10 cents) per person to register us here. Then the doctor (actually a paramedic, called a community health assistant) examined us and gave us the medicine we needed. I feel very happy to have health insurance now, and to have received medicine to make my family well. If I had had to buy this medicine somewhere else, it would have cost me much more money (about Rs. 500!)
Until my wife and children recover from their illness things will be hard, because they are unable to carry bricks and therefore can earn nothing. But thanks to Chapagaun Health Post they will soon be well.”
Chapagaun Teaching Health Post, founded by the United Mission to Nepal, is currently owned by the local government, governed by the community, and managed by a Nepali Christian organization called Shanti Nepal (Peace for Nepal). The health post offers integrated primary health care services, including mental health care and dental services. The poor and lower middle class and those marginalized by society are the major beneficiaries of the health post services. While the well-trained and conscientious staff members provide basic curative care and preventive services, they also work with community groups and schools to raise awareness of health issues. Furthermore, Chapagaun Teaching Health Post serves as a source of training for paramedical and nursing students, as well as local midwives and healers. The health insurance system developed at this facility is a model for the country, and has been replicated in other health posts as well.
This is just one little example from one little country of how the needy are receiving health care in a sustainable way that empowers and uplifts. I thank God that I was blessed to have been part of this ministry through Global Ministries over the past 12 years. We, the Collins family, said “good-bye” to Nepal this past summer. We know that God’s hand continues to work in wonderful ways, through the efforts of servants like Shanti Nepal. Our prayer is that the conflict there will cease and that peace—shanti–will soon prevail.
Written by Ellen Collins
Who served with Andy, Christopher and Jonathan in Nepal (1994-2005)
Andrew & Ellen Collins are missionaries with the United Mission to Nepal. Andrew works as an audio-visual consultant with the Development Communications Productions of the United Mission to Nepal in Pokhara. Ellen is responsible for the primary health care training and the development of training skills, curricula and materials in conjunction with the Rural Development Center in Pokhara.