Health & Rehabilitation

Survey: In 2016, the project identified persons with disabilities in the two districts Mahottari and Makawanpur. This covered 101 VDCs and 5 Municipalities (66 VDCs & 3 Municipalities in Mahottari and 35 VDCs & 2 Municipalities in Makawanpur).  This survey was conducted in cooperation with local governments in both districts, Plan International Nepal and Save the Children Nepal. The findings of the visually impaired were verified in 2017 when the project identified if the blindness was curable or incurable. Altogether, 2106 (1033M/1073F) have been identified incurable blind in the two districts and 9592 as curable blind. The project has in 2017 started its journey to assist these 11698 visually impaired persons to prosper in their communities. 104 (62F/42M) enumerators were trained and door-to-door survey completed in the two districts by September 2016. The survey took 5 months to complete due to rainfall and flood. It increased the cost and caused the delay in project implementation and results achievement. Total population 1094 964 surveyed of whom 821 233(75%) tested vision equity/e-chart during the survey from 202 808 households.

Counselling service: The rehabilitation Programme provided counselling to 2106 incurable BPS persons, of whom 1073 were female (51%). They were provided counselling services on orientation & mobility, income generation activity, education, disability card, membership of branches, saving credit etc. Counselling for eye treatment was also provided to people with curable vision problems, to 9592 people.

Orientation & Mobility (O& M) and DLS training: Altogether 1794 BPS (M961/833F), children and adults received training on orientation & mobility and 2106 BPS received DLS training.

As a result, they are now able to walk independently with the support of white cane and seek the opportunities. The trainees are also able to maintain their physical hygiene, cooking food and washing clothes.

Free eye surgery: 2340 (1280F/1060M)

OPD: 13718 (7081F/6637)

In total 2340 persons can see again after free surgery from the project among 9592 curable BPS including 5138 female in which OPD patients were 13718 including 7090 female. In 2019, NAB conducted 16 eye camps in different locations of Mahottari district in cooperation with Bardibas Eye Hospital and Janaki Eye Hospital. In the camps, the total number of OPD patients were admitted 2,829 (1,707 female). Among these, 741 cataract cases were identified and 422 (56% female) received operation (this proportion of cases/surgeries is normal when camps are conducted during the summer season).

In Makwanpur: NAB Rehabilitation conducted 16 eye screening and surgery camp in remote villages of the district. Total OPD patients were admitted 1,570 (675 male and 895 female). Among them, 727 (372 male and 355 female) curable blindness/cataract restored their vision through operation in a hospital with the support of Hetauda community eye Hospital and Kritipur Eye Hospital. In those all camps, Hospitals had beared the cost of surgery while NAB beard the cost of lab test and Municipality beared the cost of food.

Inclusive education: The door- to – door survey found 492 (186F) school-aged (5 – 17 yrs) BPS children in both districts. Among them, 149 (55F) children were already enrolled in school when the programme launched in 2016. After the re-assessment in 2017, the new result was 347 (194F) are the school-aged BPS children below 17. As of 2019, 279 BPS children have access to School with 106 girls.

In order to achieve these results, NAB conducted the following activities:

  • Time to time home visit to do counselling the children and parents for the School enrolment
  • Initiation of new resource class at Janata School Gauridanda Mahottari to increase the access of BPS girls
  • Mobilize the stakeholders for the construction of hostel building at Janata School from Bardibas Municipality, Save the children Bardibas and NABP Norway 
  • Equip the computer in 4 resource Schools with the support of Citizen Bank Bardibas, Prayatna Nepal Kathmandu, Loharpatti Municipality, Ramgopalpur Municipality and INFIL, Norway
  • Provide computer training to the resource teachers of 4 resource classes and students
  • Educational materials (writing slates/stylus, Perkins brailler, braille textbooks, reference books, audio tape-recorder,  musical instruments, model and puppets
  • Provide teacher training to the resource teacher
  • Support volunteer teachers to improve the braille and computer of BPS students

In addition, project also supported scholarship to 10 with 4 female BPS students for higher study. 

Challenges: The main challenges are motivating the parents for the school enrolment of their children, managing the cost for the training to the teacher, school management committee and local education authority. Another big challenge is very few schools take ownership of resource class. To overcome the challenges, the project has mobilised the teacher and students to motivate the parents for the school enrolment. The project has worked to mobilise the resources from municipalities and other NGOs for the hostel furnishing, equipping the computers and building hostel. In Mahottari, there are yet 14 blind children to admit to the resource class for braille literacy. Another 52 children with low-vision are still out of school.

There were two resource classes for the BPS students in Mahottari.  Only 3 BPS girls were studying in one of the school. While Bherukhi School does not have the space for BPS girls. Thus the project initiated 3rd resource class in Janata school Gauridanda with 5 students in a rented flat.  Today, there are 13 students with 7 girls in own hostel building with 3 bedrooms, two toilets and kitchen/dining.   This has been possible with the support of Bardibas municipality, Save The Children and NABP Norway.

Vocational skills and seed fund support:                                              

Total: 442 (198F/244M)

Seed fund Support:

TOTAL: 188 (77F/111M) 

Altogether 442 BPS have been trained in different vocational and business skills. Such as, livestock, grocery shop, grinding mill, incense stick making, herpic production, phenyl making, agriculture, vegetable farming, motorbike repairing, Bamboo stool making and marketing skills. 188 trained BPS has received an interest-free loan to utilize the learnt skills. According to the debtors of Makawanpur,  their average monthly income ranges   Rs. 20,000-25,000 from Motorbike repairing,    Grocery Shop  Rs. 4000-5000,  buffalo  Rs. 15,000-20,000 annually, Goat keeping Rs. 6000-8000 annually,  Incense sticks Rs. 4000-6000,  Agriculture/Vegetable Rs. 4000-6000 seasonally,  Fish keeping Rs. 8,000-10,000, and poultry farming Rs. 8,000-10,000. Some of them have started a small business solely with the loan amount provided by NAB. While some of the persons have taken loan to increase their on-going business.

In Mahottari, tea, tent rental, vegetable farming and grocery shops are found to be more profitable. Those who run tea shop and grocery shop, they earn daily Rs. 500. Vegetable farming is a seasonal business. Normally, there can be 3 seasons in vegetable farming.   In a season, they earn Rs. 30,000-40,000. Tent rental is also seasonal business. During the season, they can earn Rs. 15,000-20,000.

Saving and credit groups:

Total: 312

In Mahottari, the project formed five self-help groups at Pipara, Bardibas, Gaushala, Mahottari and Baluwa municipalities.

Makawanpur has formed 4 groups at Hetauda sub-metropolitan city, Thaha municipality, Bakaiya rural municipality and Manahari Rural Municipality. In both districts, there are 312 Self-help group members.

Human rights advocate:

Total number of members at Mahottari & Makwanpur: 158 (53, female)

Total number of board members at Mahottari & Makwanpur: 18 (7 female)

Total number of staff: 25 (9 female)                        

Re-formation of the local branch

Mahottari branch was legally found in 2003. But the branch was totally passive without regular renew since 2011. Today, the branch is duly audited and regularly renewed.

Makawanpur branch was formed in 2015 as an ad hoc committee. But it was not in existence. It was reactivated in 2016 with the new committee members. However, the official registration process was completed in 2017. The branch held its 1st General Assembly in 2018 with 93 members. It has new board members in the leadership of Mr. Toran Bahadur Ojha.


Local resource mobilization


During the period, visible result can be seen in local resource mobilization in both programme districts. In Makawanpur, past DDC,  Plan Nepal, Hetauda sub-metropolitan city, Thaha Municipality, Bhimphedi rural Municipality, Manahari rural Municipality and Bakaiya rural Municipality supported Rs. 5,93,000 for the printing of survey questionnaires,  data entry, survey report publication, General Assembly of NAB, assistive devices, secretarial expenses of MAB, vocational and mobility training.

In Mahottari,

NAB received  Rs. 17,20,000.00 from the past DDC, Save The Children, Bardibas Municipality, Gaushala Municipality, Bhangaha Municipality, Manara Shishuwa Municipality and Ekdara rural municipality for the printing of survey questionnaires, data entry, printing of survey report, conducting vocational training,  O & M training, annual meeting of NAB, distribution of assistive devices and observing the International Day of Persons with Disabilities. These achievements came up with the result of the continuous advocacy intervention of the project. Mainly to say that there was 0 balances, 0 income and 0 expenses of Mahottari Association of the Blind till 2016. Now they have a surplus fund of Rs. 241,500 in their bank account.

With the support of municipalities, 108 persons with disabilities have received different assistive devices as per their demand. Such as wheelchairs tricycle, crutches, toilet chairs, elbow crutches and white cane. The national disabled relief fund, National disability rehabilitation centre Kathmandu have also been a vital for these devices.  46 persons with disabled got the vocational training. 35 blind people got mobility training.

Lessons learned:

Survey work before raining season

The project had started the survey in Makawanpur from April and in Mahottari from May. It took 5 months to complete due to rainfall and flood. It increased the cost and caused the delay in project implementation. In Makawanpur, it was more challenging to walk around the village due to landslide. Learning from this bitter experience, the survey work must be completed before raining season so that rehabilitation activities can be commenced from the middle of the year.

Partnership with the municipalities

Mahottari and Makawanpur performed various activities such as vocational training, O & M training, distribution of assistive devices to the blind and physical disabled,  observing the International day of disabled,  annual meeting of NAB in partnership with the municipalities. For the purpose, municipalities had supported Rs. 23,8000. This was possible with the continuous advocacy intervention. It has been easier to deal with the elected bodies. Most of the municipalities are found to be positive in budget allocation for the persons with disabled. It is believed that there will be more progress in the days to come. Hence, we should work jointly with municipalities to promote rehabilitation activities. This is in line with their CBR programme as they have already allocated the budget Rs. 66000 in each municipality. This budget may gradually increase. Ultimately, the municipality may take over the programme after the phase-out of the project.

Mobilization of resource teacher and BPS student for counselling and motivation

In Mahottari, there are yet 14 blind children to admit to the resource class for braille literacy.   Another 52 children with low-vision are still out of school. At the same time, the Dropout rate is also high due to overage, over the protection of mother and lack of awareness among the parents and BPS children. As per the LTP, (2016-19) 90% of the children must have been enrolled in school by the end of the project period. Many visits have been made to the parents to bring BPS children in school. Sometimes field worker alone, Sometimes joint visits with BPS students and resource teacher. This short of the joint visit has really been effective to show the example. There has been a gradual change among the parents for educating the BPS child. It is better to continue the same counselling strategy in the field.

Collaboration and harmonization

The rehabilitation programme had always tried to maintain good relation, cooperation and harmony with municipalities, administrative office, political leaders,   social workers and eye hospitals for advocacy, ownership and cataract operation.  The regular Project Advisory Committee (PAC) meetings both at the central and district level have been providing guidelines to implement the programme effectively and achieve better result, better coordination and networking in central and district level. As a result, the rehabilitation programme has been running smoothly and successfully. It has also kept a positive image in the community. The Rehabilitation programme has achieved different supports and donations from local government agencies in cash.  The collaborative approach was a sign that the program will go well and bring better results in future.


                                          Thanking You!!!