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Christmas can be a very difficult time for many and especially so this year. We would therefore like to express our sincere gratitude to all those who have supported The Nestling Trust in whatever way throughout the past year, so that  our vital work in Nepal has been able to continue.
May the Christmas blessings of Peace and Love shine throughout the world, so that suffering can be eased as a New Year dawns.

The BigGive 2020 ends tomorrow 8th Dec. '20 at 12.00 midday. Thank you so much to all who have already donated. Should anyone who has not seen this wish to help fund The Children’s Home Sustainability Horticultural Project please click on the link to donate before tomorrow midday.
https://donate.thebiggive.org.uk/campaign/a051r00001fHRuyAAG

For more details about the project please check out our website www.nestlingtrust.co.uk

The Children’s Home Horticultural Project
‘Grow our own’ nutritious food, self-sufficiency, and sustainability
 
In a year when we have been unable to hold our normal fundraising events this 'Match Funded' Big Give Christmas Campaign  provides a great opportunity.
 
Please help us reach our £10,000 target
One donation Twice the Impact! 
 
The project will improve the sustainability of our Children’s home in Sarangkot by providing organic fresh fruit and vegetables for the Home and local villagers, as well as generating an income to offset other expenditure such as clothes, education etc. Land at the home is exposed to adverse weather and as a consequence crops in the garden often fail. Water supplies are scarce and unreliable. Fruit and vegetables have to be bought at considerable cost and at some distance.
 
The project involves building protected ‘pit greenhouses’ which will provide fresh produce for the home and local villagers but also training opportunities and work for those who have lost their jobs as a consequence of the pandemic.

Proposed site for the 3 Pit Greenhouses - below the playground area of the Children's Home.

Children's Home livestock would provide organic fertiliser!

Bijendra Aryal, Nestling Trust director in Nepal has been to visit Bikram Bhadel, a pharmacist whose workplace is opposite the Tribhuvan University Teaching Hospital in Kathmandu. The visit was the result of the Nestling Trust seeing the following article:
(https://apnews.com/c1cd52ef723a5435aef7dd339a99af23?fbclid=IwAR0Gxd19tIvWBVWXC1aq6qQT7EfSJmWToDNIy52bVDjzewfB6dTb9E_Ii28)
The following was reported:
 KATHMANDU, Nepal (AP) — From his pharmacy outside Tribhuvan University Teaching Hospital, Bikram Bhadel saw what happened when coronavirus lockdowns closed the facility’s cafeteria and nearby cafes.
“Every day I watched the patients, their families, doctors and other health workers struggling to get a good meal,” Bhadel said. “They were already having a tough time and the food situation was making it worse. This is where I decided that I need to step in and help out.”
He took 1 million rupees ($8,333) out of his family’s savings. And with the help of his friend Indra Kumar Newar -- a taxi driver who had no work in recent months due to the lockdowns -- he rented a vacant restaurant across the street from the hospital, bought groceries and hired a few helpers.
Now, at one of Nepal’s largest hospitals, more than 200 COVID-19 patients, doctors, nurses and workers get hot, tasty and nutritious food three times a day.
“I have heard there is no medicine for the COVID-19 patients and the only thing to do is to take care of them and give them health food to help recover and regain their immunity. This is what we are trying to do to help,” Bhadel said.
The meals are vegetarian, prepared after consulting with nutritionists. They offer a combination of rice, lentil, beans, vegetables, fruit and salad for brunch and dinner, and snacks in afternoon.
They begin their day early in the morning. preparing hundreds of meals. Food is packed in disposable packets and carried by Bhadel and Newar to the hospital reception area, where the staff eagerly awaits.
“The doctors and health workers have been working risking their own lives and away from their families. It was time to do something for them when they need them,” Newar said.
Staffers work and stay at the hospital for a week on duty and then another week in quarantine before they are allowed to return home for a week off work. While they are at the hospital, their only access to hot meals has been what the team delivers.
Nepal -- which has 49,219 confirmed cases of the coronavirus and 312 deaths -- first imposed a lockdown in March, which lasted for four months. A second lockdown was set last month in nearly half the country when the numbers kept rising.
Bhadel and Newar estimate they spend about 50,000 rupees ($416) a day for groceries. They have hired 11 cooks and helpers, all of them paid minimum wage and are regularly tested for the virus.
Families, friends and neighbours have donated food, money and supplies. Bhadel and Newar have paid the rent for three months.
“We are hopeful the situation will get better in three months,” Bhadel said, “but if that does not happen, we will continue our work.”

KATHMANDU:  The Health Ministry has reported 1,325 new cases of coronavirus infection in the last 24 hours taking the national tally to 64,122.

Today’s reported infections in the Kathmandu valley is 59.05 per cent of the country’s total cases.
11 more Covid-19 fatalities were recorded on Saturday bringing the total nationwide death toll to 427. Despite the escalating figures the government released the lockdown in Nepal on Thursday. Thousands have already lost jobs and livelihoods due to the lockdown which has been in place since March.
It has been reported in the Himalayan Times that 400 Nepalese people per day are risking the high prevalence of Coronavirus in India (cases now estimated as 90,000), and are returning in order to find jobs.

​The girls are taught cooking skills and love to prepare Nepali food. Today Panipuri is on the menu, a delicious recipe of chopped mixed vegetables and spices inside a pastry crust.

The Himalayan times reported today that the total number of people infected with coronavirus has increased to 50,465. 1246 new infections were reported in the last 24 hours.
The death toll now stands at 317.
The lockdown is beginning to be eased albeit with restrictions.

The Health Ministry on Wednesday reported 1120 new cases of coronavirus infection from across the country. Nepal’s Covid-19 tally now stands at 41,649 with 251 deaths. Lockdown has now been extended until at least 9th September '20, causing extreme hardship for families who now have no work. Schools remain closed and children from the poorer backgrounds are unable to access distance online learning.

Krishna is now eight years old and continues to flourish with his friends at SERC School for children with special needs, in Kathmandu.
Once unable to stand, walk, talk or move his arms or hands, Krishna is now able to join in games, is learning how to read and write, is independent in dressing and feeding himself, and manages four-word sentences.
The Nestling Trust (TNT) found Krishna two weeks before a devastating earthquake destroyed the home where he lived with his Grandfather. To ensure his safety his grandfather would tie him to the verandah while he made pots, to earn money for food. He had no hope of any medical intervention to help his development.
With Krishna's Grandfather's permission, TNT was able to have Krishna assessed and he was welcomed into Serc school. TNT is most grateful to all the staff at SERC for all they have done to help Krishna, their care, unwavering patience, and skills have enabled Krishna to make amazing strides towards independence, as well as a happy childhood. Krishna's Grandfather is able to visit.
TNT with SITARA, our partner NGO, has established a Health Post in Marbu, the remote village where Krishna was born, as well as Health Posts in four other remote villages in Nepal, altogether serving approximately 28,000 people who would otherwise have no medical facility. (See 'health Initiative' section)
Should you wish to help TNT in this work, we'd be immensely grateful for any donation.

Those known to have Coronavirus has now reached 29,645 with numbers escalating daily especially in the Kathmandu valley. This has led the government to announce a week long prohibitory order enforced in Kathmandu valley effective from Wednesday 19th August at midnight.
The Himalayan Times reports that the prohibitory order has been issued to 'discourage unwarranted movement of people in order to control the increasing spread of coronavirus infection in Kathmandu, Lalitpur and Bhaktapur....'

 I am Dr. Arun Upreti.
​ I am currently working as a Staff Physician in Charikot Hospital from Nyaya Health Nepal. Previously I worked as a medical officer for Government of Nepal in the same institute for 2 years. Charikot Hospital is operated in by Nepal Government in Partnership with Nyaya Health Nepal. Charikot Hospital is the largest health care provider in the district and provides health care services to over 50,000 annually. 

COVID has been a unique challenge for Nepalese health care system. The rural health care system which is run mostly by paramedics, nurses and fresh MBBS graduates is particularly vulnerable due to lack of adequately trained human resource, unavailability of COVID tests, under funded quarantine and isolation centers.

Nepal government’s policies and guidelines are not replicated at the local level. I have now been working here for 2 months during the COVID pandemic - the only protection that I use is a N95 mask and gloves. The fever clinic is almost non functional. We feared working like that initially but now it has become a norm. There is a little difference between us practicing medicine pre and post COVID.

Other public health measures like point of entry testing, community screening, contact tracing and surveillance do not meet the standards recommended in national protocols. Most teams are formed with inadequately trained staffs without proper IT and communication facilities.

However there has been vast community engagement, thanks largely to the lockdowns which has completely changed the lives of everyone. Agencies and health care workers across all level are engaged in health education about COVID. Use of masks and hand washing has been prompted at all levels through available health facilities and FCHVs.

While lockdowns have been important in curbing the spread of COVID, it has brought several impediments to health seeking behaviour of people. Due to unavailability of transportation facilities the number of patients in our OPDs has halved. The obstetric cases have been on the rise probably due to lack of services in other centers and people not having access to higher centers. As many complicated obstetric cases cannot go to higher centers in Kathmandu, our CS rate has also been on the rise. We have also seen too many cases of ruptured appendix, strangulated hernia all probably due to lack of elective procedures.

Mental health is an aspect that has been overlooked. We have seen a significant rise in suicides in the district. We have been performing autopsies almost everyday, and the average autopsies for suicides has almost doubled in the last few months.

The elderly and single women have also been significantly affected by the lockdowns. Many of them cannot get the health care they need. We had one elderly women who presented to our center with fractured femur, which needed operative management. None of her family members were willing to take her to higher center for treatment. We get similar stories almost everyday. Some day its a fracture needing operative management, other days it COPD requiring ICU admissions. Most have given up on treatment for the elderly because of lack of transport and risk of COVID infection.

I strongly believe these are the areas that needs significant work and should be important part of the COVID response. I believe we need community based programs that are related to mental health. Also assistance to elderly, single women and pregnant mothers especially for transportation would be particularly helpful in the lockdown.