Kathmandu, Nepal – The Sukraraj Tropical and Infectious Disease Hospital in Kathmandu, the capital of Nepal, is crowded with people. In many cases, two patients share the same bed. The second wave of COVID-19 flooded the country’s medical infrastructure.

Health experts and front-line medical staff described the situation as “near the end” because they were facing bed and oxygen shortages, the national vaccination campaign was almost stagnant, and the death toll was so high that it caused mass cremation. hold.

“We have been treating patients in every corner of the hospital. Sukraraj nurse Beli Poudel said: “We are even using the garage to accommodate as many patients as possible. “

Poudel told Al Jazeera: “Despite the limited capacity, we will not reject any patients. We will try to accommodate them.” He added that there are only 120 ICUs out of 104 beds and more than 120 COVID-19 patients are being treated. The hospital was flooded with severely affected patients during the second wave of the pandemic, and its capacity has doubled.

For several weeks, many staff in Sukraraj (they are the only facility in Nepal that specializes in tropical and infectious diseases) have lived in hotels or hospitals away from their families.

Nepal conducted more than 21,000 inspections on May 19, recording 8,173 COVID cases and 246 deaths, which is the highest record since the outbreak of the pandemic last year. Health experts believe that because the detection rate is still low, the actual number may be higher. Official data show that more than 5,600 people have died since the pandemic began, and nearly 2,000 have died in the past few weeks alone.

This pandemic particularly affected the Kathmandu Valley and the western lowlands of the country bordering Uttar Pradesh, India. This area is one of the least developed areas in Nepal, with a large local population, including many ethnic and religious minorities.

Shahbaz Ahmed is a resident of Nepalgunj in western Nepal. In the first week of May, his three brothers Zahir, Ejaz and Imtiyaz died of the coronavirus.

From left: Imtiyaz Ahmed, Ejaz Ahmed and Zahir Ahmed [Courtesy: Shahbaz Ahmed]

Due to health problems, all three brothers in their forties were treated at the Bheri Government Hospital.

Despite their best efforts, the doctor could not save them. Maybe this is Allah’s wish. “Shahbaz told Al Jazeera by phone.

Zahir is the youngest brother of the seven compatriots. He was a member of the national cricket team under the age of 19. Shabaz said: “He (Zahir) is the most suitable of all the brothers.”

Shabaz mourned alone like his family, and he condemned the paralyzed medical infrastructure.

“I thank the health workers because they risked their lives to save others. But I think the government and politicians are not fulfilling their duties,” he said.

Health experts and frontline medical staff described the situation as “near the end of the world” [File: Prakash Mathema/AFP]

Biren Budhathoki, a resident of Dang in western Nepal, said the delay in diagnosis resulted in the death of his 38-year-old cousin on May 14.

Except for large hospitals in cities, most hospitals do not have machines for polymerase chain reaction (PCR) testing, which is essential for timely diagnosis and avoiding preventable deaths.

“By the time we got the PCR test results, my cousin had already contracted pneumonia. He passed away shortly after we transferred him from a local nursing home in Salyan to the COVID-19 hospital.” Budhathoki said.

The growing number of cases in the country raised alarm bells, with Prime Minister Khad Prasad Sharma Oli and the Minister of Health publicly admitting that hospitals were overwhelmed.

Family members are standing outside the crematorium, waiting for the bodies of relatives who died of COVID to arrive in Kathmandu. [File: Navesh Chitrakar/Reuters]

“The number of infections strains the healthcare system; Ollie wrote in an opinion article in The Guardian that it has become increasingly difficult to provide patients with the beds they need. He urged the international community to help.

Experts connected the peak in Nepal with the second wave of the northern neighbour India. As of mid-April, deaths from COVID were limited to single digits. The daily death rate per million in Nepal is 6.51, which is the worst day in South Asia.

The shortage of beds is a common problem throughout Nepal. There are approximately 18,900 ordinary beds, 1,450 ICUs and 630 breathing machines in Nepal. New Delhi, the capital of India, has a relatively small population and has more than 4,000 ICU beds.

Anup Bastola, the chief consultant of Sukraraj Hospital, told Al Jazeera that all patients in the ICU are in critical condition.

“Although we have 24 ICU beds, we only have 12 ventilators. They all need ventilators, but we cannot provide them,” he said.

The number of doctors per capita in Nepal is also one of the lowest in the world, with 0.17 doctors per thousand people, while India has 1.34 doctors per thousand people.

According to media reports, since last week, at least 12 ICU patients have lost their lives due to hypoxia report.

Pramod Paudel, a doctor at the Bharatpur Hospital in central Nepal, said that due to the interruption of oxygen supply, his hospital accepted fewer patients than the actual capacity. Although the capacity was 200, it only admitted 144 patients. Although the capacity is 200.

“Sometimes oxygen reserves are about to run out, and we worry about whether we can provide more oxygen to patients in need.” Due to oxygen shortages, we cannot accommodate more patients,” Podell told Al Jazeera.

In the case of oxygen shortage, a woman held the oxygen cylinder after reinstalling the oxygen cylinder at the factory [File: Navesh Chitrakar/Reuters]

In recent weeks, medical aid, including oxygen tanks, is flooding the world, but officials say the aid is far from enough. Many Nepalese living abroad participated. Nearly one-third of Nepalese work abroad.

On Wednesday, the Ministry of Health and Population confirmed that the third COVID variant B.1.617.2 has been detected in the country, which is the first highly contagious variant found in India. New mutations were detected in 97% of samples collected from 35 regions of the country. The other two variants are B.1.617.1 and B.1.1.7.

“We may be near the peak, because according to the government’s own conservative estimates, the infection rate is between 40% and 50%,” said Basu, one of Nepal’s most important virologists and former head of Nepal’s epidemiology and disease control department. Dev Pandey said. Ministry of Health and Population.

According to epidemiologists, more than 80% of infected people can recover, but the recovery rate is not an indicator of the impact of a pandemic.

The number of deaths per million indicates how good the situation is.

Nepal’s fare is the worst in South Asia. pic.twitter.com/NuhGUbYyAn

-Arpan Shrestha (arpanshr) May 20, 2021

“The severity of the infection is very similar to India. In addition, we also have a long open border, and cross-border movements are largely unregulated. Flights between the two countries are still operating.” Pandey said. Kathmandu has banned other international flights.

Health experts in Nepal warned in March that the coronavirus could enter a more deadly variant through India.

The warning is not unfounded. Nepal and India share a porous border of nearly 1,700 kilometers (1,100 miles). In Indian cities (such as Delhi and Mumbai), millions of Nepalese jobs began to return in April due to lockdowns in several Indian states after the country’s devastating second wave of COVID.

At the same time, Prime Minister Ollie came under fire for putting politics above the country’s pandemic response-dissolving parliament and splitting the political opposition that tried to remove him. At the same time, the Prime Minister continued to recommend unproven herbal medicines, and it can even be said that Nepalese people have better immunity to this virus.

Prime Minister Ollie has been criticized for putting politics above pandemic response [File: Navesh Chitrakar/Reuters]

At an event held in Kathmandu last month, the prime minister claimed that despite a little warning, gargle with hot water boiled with guava leaves can keep the COVID in a lingering state. “Even vaccines cannot guarantee 100% protection,” Ollie said.

Gehendra Lal Malla, professor of political science at Tribhuvan University in Kathmandu, said Ollie’s unfounded remedies and light comments on the immune system misled people to despise the virus.

“Understandably, Nepal does not have a good medical infrastructure like the West, nor does it have China or India, but Nepal has enough time and money to buy ICU beds and ventilators. But Oli is more focused on ensuring his status. Not to save lives.” Mara told Al Jazeera.

Although experts called on the government to speed up vaccination, after the Serum Institute of India (SII) suspended the supply of AstraZeneca, despite the advance payment, the much-hyped vaccination campaign still failed to meet expectations. SII, the world’s largest vaccine manufacturer, has stopped exports and made India a priority. In the past few months, thousands of people have died in India.

Nepal is a country with 30 million poor people. Since the start of vaccination on January 27, almost 2 million people have not been vaccinated, mainly front-line workers. So far, the country has purchased 3 million vaccines, including 800,000 doses of vaccines from China and 348,000 doses provided by the COVAX agency led by WHO.

Former Minister Mani Chandra Thapa told Al Jazeera to defend the government’s handling of the COVID situation that all political parties should be condemned for focusing more on power games than on the pandemic .

“It is true that the government could have done its work more efficiently. But please don’t forget that other parties are creating obstacles by trying to drive the government out of the pandemic. Therefore, all of us should blame and continue to fight the virus.” Tapa said.