Author: Troels

Oxford-forsker om vaccine-situationen i Nepal

Forskeren Andrew J. Pollard har været med til at udvikle Oxford-AstraZeneca/Covishield vaccinen. Det har han selvfølgelig faglige vinkler på, men han har også relationer til nepalesere og Nepal der går mange år tilbage.

Andrew Pollards indlæg er i Nepali Times er på engelsk. Læs hele indlægget her.

>>While the vaccine roll out in high income countries is a remarkable success story measured in doses given, cases prevented, lives saved, and the green shoots of economic recovery, giving us hope for the future, it also reveals a serious concern when looked at in the context of global equity. 

Some countries have vaccinated a high proportion of their citizens, while the pandemic continues to rage elsewhere. Many Nepalis have written to me asking why this situation is allowed to continue and asking what I am doing about it. Like you, I feel powerless.
(…)
Whilst the pandemic has brought us closer together in a shared suffering, it has also shown how far apart we are when it comes to sharing health.

Professor Andrew J Pollard is Director of the Oxford Vaccine Group, University of Oxford, UK.<<

Forskere, organisationer og frivillige knyttet til Nepal: Covid-19 hærger Nepal. Danmark må hjælpe

En appel – trykt i Politiken 21/5-21

Vi skriver på vegne af forskere, organisationer og frivillige med tilknytning til Nepal for at anmode den danske stat om at yde Nepal øjeblikkelig støtte i forbindelse med den voldsomme eskalering af covid-19 i landet igennem de seneste uger.

Der har med god grund været stor global bevågenhed om den dramatiske udvikling af anden bølge i Indien. Vi anerkender og værdsætter den hjælp, som den danske stat allerede har ydet Indien, men er samtidig dybt bekymrede for, at nabolandet Nepal, som er endnu dårligere rustet til at håndtere epidemien, bliver overset.

Vi skriver i forlængelse dels af premierminister K.P. Olis appel i The Guardian 10. majom nødvendigheden af øjeblikkelig international støtte, dels af de utallige personlige beretninger, vi alle modtager dagligt om familie, venner og kolleger, der ikke kan få den nødvendige behandling, og som følge heraf mister livet.

Situationen er, som beskrevet af Jeremy Farrar, direktør for Wellcome Trust, UK, beyond frightening . Nepal har en af de højeste covid-19-reproduktionsrater i verden med en positivprocent på 47 og registrerer 8-9.000 smittede per døgn. De reelle tal vurderes dog at være betragteligt højere.

Nepal deler en 1.880 kilometer lang åben grænse med Indien, og forholdet mellem befolkningen i grænseområderne er karakteriseret ved tætte kulturelle, økonomiske og familiebaserede bånd. Virus kender ikke landegrænser, og krisen må løses samtidigt på begge sider af grænsen.

Den nuværende bølge af infektioner i Nepal vurderes at være cirka to uger forsinket i forhold til i Indien. Den gennemsnitlige positivprocent har over de sidste to uger været på ca. 45 og er betragteligt højere i landsbyer og byer nær den indiske grænse. Positivprocenten i hovedstaden Katmandu er over 50.

Sundhedssystemet er reelt brudt sammen: Der er på nationalt plan færre end 1.600 intensivpladser, hospitalerne må afvise patienter ved døren, der er alarmerende mangel på ilt, medicin og basal pleje, og på mange hospitaler må covid-19-smittede læger og sygeplejersker passe patienter. Det skal ses i lyset af, at Nepals læge-patient-ratio (1:1.724) i forvejen er en af de laveste i verden, endnu lavere end Indiens (1:1.456).

Endvidere er planlagte vaccineleverancer fra Indien stoppet, hvilket betyder, at de få, der har fået første dosis, ikke kan blive færdigvaccineret, medmindre der åbnes for alternative leverancer.

Det nepalesiske sundhedsministerium skønner, at antallet af nye smittede kan nå 800.000 medio juli. Der er udsigt til en humanitær katastrofe, som kræver øjeblikkelig handling fra det internationale samfund.

Danmark har været en vigtig støtte af Nepals demokratiske og økonomiske udvikling siden begyndelsen af 1990’erne. Ønsket om forandring var bredt funderet i befolkningen, og dansk bistand støttede op herom igennem forskellige projekter og programmer.

Selv om der var udfordringer undervejs – bl.a. borgerkrig og jordskælv – gjorde den danske bistand en forskel. Med covid-19 undermineres mange af udviklingsgevinsterne. Risikoen er, at økonomien svækkes, fattigdommen stiger, social og økonomisk ulighed øges, og at samfundet som helhed destabiliseres yderligere.

Covid-19 tager i udgangspunktet ikke hensyn til kaste, køn, klasse, etnicitet eller religion i Nepal, men som det er set andre steder i verden, forstærker pandemien ikke desto mindre allerede eksisterende ulighed. Mange er ikke i stand til at betale for behandling af covid-19 og har opgivet at søge hjælp.

SELV OM Danmark er holdt op med at give bilateral bistand til Nepal, fortsætter de gode relationer mellem de to lande.

Vi opfordrer Danmark til at yde akut humanitær støtte til den nepalesiske befolkning i form af: medicinsk udstyr som respiratorer, iltudstyr og tests; overskydende vacciner, som er trukket ud af det danske vaccinationsprogram, men som kunne gøre meget stor gavn i Nepal ved at fylde det aktuelle hul i forsyningen, inden tidsrammen for anden dosis overskrides; at Danmark bidrager til at sætte fokus på situationen i Nepal i internationale fora som EU og FN.

Appellen er underskrevet af:

Rajeshwar Acharya, ph.d.-studerende, Aarhus Universitet; Jytte Agergaard, lektor, Københavns Universitet; Inger Marie Arildsen, forperson, Dansk Nepalesisk Selskab; Rune Bennike, adjunkt, Københavns Universitet; Torsten Rødel Berg, forskningsrådgiver, Aarhus Universitet; Stephen Carney, professor mso, Roskilde Universitet; Ravi Chettri, forsker, DTU/forperson, Nepalese Scientific-Academic Panel in Denmark; Dan V. Hirslund, lektor, Københavns Universitet; Rabindra Khadka, forperson, Non-resident Nepali Association Denmark; Pernille Kruse Madsen, direktør, Human Practice Foundation; Ulla Ambrosius Madsen, lektor, Roskilde Universitet; Lone Petersen, forperson, Jysk Landsbyudvikling i Nepal; Mariève Pouliet, lektor, Københavns Universitet; Rebecca L. Rutt, adjunkt, Københavns Universitet; Jens Seeberg, professor mso, Aarhus Universitet; Carsten Smith-Hall, professor, Københavns Universitet; Flemming Topsøe, prof.em., Københavns Universitet/forperson, BelhiGruppen Nepal; Pia Torp, forperson, Chimalaya Charity; Thorsten Treue, lektor, Københavns Universitet; Karen Valentin, lektor, Aarhus Universitet; Todd Wallenius, ph.d.-studerende, Aarhus Universitet; Cameron David Warner, lektor, Aarhus Universitet; Neil Webster, seniorforsker, Dansk Institut for Internationale Studier; Tim Whyte, generalsekretær, Mellemfolkeligt Samvirke

FAN – Missions, Options, Perspective

Flying Aid Nepal

Flying Aid Nepal, FAN, is an informal network, also referred to as FAN-net. It was formed May 5th, 2021 and consists of the following eight Danish organizations 

FAN1: BelhiGruppen Nepal, www.bgnepal.dk;
FAN2: Dansk Nepalesisk Selskab, www.nepal.dk;
FAN3: Himalayan Project, www.nepalhelp.org; 
FAN4: Human Practice Foundation, www.humanpractice.org;
FAN5: Jysk Landsbyudvikling I Nepal, www.kantipur.dk; 
FAN6: Rigshospitalet, MedTek Huset, www.rigshospitalet.dk/medtek;
FAN7: Seniorer uden Grænser, www.seniorerudengraenser.dk;
FAN8: Trianglen, www.site.trianglen.nu.

Initiator and spokesperson for FAN-net:
Flemming Topsoe, flemming@topsoefamily.dk, +45 21332508.  

BACKGROUND

Right from the beginning of May this year the Covid-19 pandemic exploded in Nepal. Everyone with activities in the country received alarming messages from friends and collaboration partners. But for others, the disaster is overshadowed by the disaster next door, in India. Few years ago, in April 2015, Nepal was struck by a devastating earthquake. However, the impact of the present pandemic is orders of magnitude more serious with long term after effects. The health system has broken down, the economy is in ruins, food is scarce, severe famine is threatening.  

REACTIONS

Lovers of Nepal around the world have reacted as best they could. In Denmark, the FAN-initiative is one such example, emerging from several groups of volunteers as well as professionals engaged in development work with a holistic drive, believing that the path to sustainability has to take all aspects into account in order to succeed, be it agriculture, health, education, job-creation, capacity building or culture, always in respect of local conditions, social and cultural structures and providing terms as set by the authorities. When disaster hits you simply must act. That is how FAN came about.

Mission

The national vision for Nepal is an efficient, sustainable and proud nation, accommodating its many different peoples in mutual respect and joint efforts. Nepal is on its way but, seeing the nation severely threatened by the Covid-19 pandemic, FAN-net has set a more targeted narrow mission:

The FAN-mission is to exploit its many-level contacts in order to provide aid quickly in remedy of the present Covid-19 crisis, with a focus on what the need is and where it is most urgent, always seeking local collaboration in understanding with the authorities. 

Guiding principles for FAN-activities:

  • Transparency. The execution of activities as well as the flow of money will follow as simple procedures as possible, considering circumstances, thus resulting in a pronounced degree of transparency.
  • Openness. Full information is provided to organizations who seek it, be it SWC (Social Welfare Council), United Nations, ActionAid or other larger and smaller organizations.
  • Professional administration is financed exclusively by internal means, not by donor money. This also includes the cost of evaluation and reporting.
  • Flexibility is shown towards initiators of activities who seek support from FAN-net by accepting lower standards of applications than for ordinary development projects. This concerns requirements to budgeting, timelines and other in principle desirable planning features. 
  • Realizing the urgency of actions, the go/no-go of suggested initiatives will often be based much on trust, previous acquaintance and recommendations (e.g. from NIC – for those who do not know about NIC, consult https://www.nicnepal.org  or simply search the net for information about Mahabir Pun). 
  • Approval of initiatives will, typically, be incremental by releasing quickly a preliminary drawing right on one of the two central FAN-accounts, in Denmark and in Nepal, with the possibility of extending the drawing right as the initiative unfolds and as donations are received.
  • Speed is prioritized over service to donors, thus donors are encouraged to pool their donations and accept that the actual desired use of the donation cannot be guaranteed, though this will be attempted.
  • Non-exclusivity. Other activities with the same goals are welcomed and may be supported.
  • Realizing the catastrophe-type of activity, it was from the outset found that the activity should be limited in time to a few months. In case activities are closed down, prevailing funds will be distributed according to an agreement which we hope can be negotiated between the Denmark Nepal Society and the Nepalese Ambassador to Denmark.

Options

Essentially, our options lie in activating our network contacts in pursuance of our mission. This has, more concretely, resulted in the following:

  • Contacting the Danish Foreign Ministry, making them aware of our activities.
  • Contacting major Danish aid organizations where, presently, e.g. exchange of information with ActionAid Denmark (“Mellemfolkeligt Samvirke”) which may lead to support of activities planned by ActionAid Nepal, a major difficulty being to avoid an extra administrative fee.
  • Capitalizing on the insight of the many individuals in our network, reaching out to localities in Nepal not always accessible to larger humanitarian organizations, and, at the same time also benefitting from information available from the larger organizations, we have a good dynamic picture of the situation regarding needs and opportunities and how they change in time.
  • Supporting an appeal to the Danish Government and political parties, published in the press (“Politiken”), May 21st, https://politiken.dk/debat/debatindlaeg/art8214467/Covid-19-h%C3%A6rger-Nepal.-Danmark-m%C3%A5-hj%C3%A6lpe.
  • Among the various options to spread information and trigger collaboration we have launched the homepage https://nepal.dk/flyingaidnepal  which may become a source of information for Nepalese social workers and health authorities, with a potential to provide service and information based on Danish experience in the treatment of Covid-19 and its after-effects.
  • Existing already strong independent contacts to UNDP Nepal and to NIC (National Innovation Center, founded by Mahabir Pun) have been further strengthened;
  • Capitalizing on the status as a commercial foundation of one of the FAN-organizations, Human Practice Foundation (HPF), HPF has organized an officially recognized collection of money in support of FAN-activities which allows tax deduction of donations. Also, HPF has made available to FAN-net their administrative set-up so that the basic money flow goes through two accounts set up by HPF, in Denmark and in Nepal where the HPF country manager, Shiva Rayamajhi in collaboration also with Mahabir Pun and NIC acts partly as a “clearing agent” for FAN-net. This is found to be a very strong set-up contributing to the credibility of our activity, locally in Nepal as well as among donors in Denmark and elsewhere.

Perspective

Sadly, the perspective is gruesome. Yes, we can assist with aid here and now, but the crisis will have a long term impact as also indicated in the introduction. How best to react to this realization is not clear at present. Should we stick to the informality of FAN-net and focus on the many contacts to good forces and activity “on the ground” or is a formalization some way or other to prefer? To be considered.  

FAN-management, May 23rd , 2021