Health in a country is normally determined by the number of indicators showing the major health concerns of individuals. The major indicators include life expectancy, infant mortality, maternal mortality and the child mortality of age under 5. The government and non-government organizations (NGOs level) have developed plans after analyzing these basic indicators and the remedial measure in order to ensure good health service and improve the quality of living in Nepal, Bangladesh and Pakistan.
Health is one of the significant basic issues in Nepal. Health in Nepal is affected by three major factors: the high rate of poverty, illiteracy, and lack of proper sanitation (waste management). In a survey conducted during period 2000-2013 that indicated that the life expectancy rate is low with a maximum of about 55 years; even the women' life expectancy is much lower than men that are alarming. It clearly shows that health care for men is given more priority than women. The highest risk group for poor health is of children having aged less than five years, and this again includes a higher rate of girls and other is females of maturity age. The mortality rate of female is higher than male by 24%.
Waste and Sludge Management
Nepal is, unfortunately, one of the least developed countries of the world, and 60 percent of their population lives below the poverty line along with a high level of illiteracy. The health and education are correlated. Health care measures, preventive health measures, control of communicable diseases and healthy nutritional programs all depend on the education level of people. They would better understand the importance of health and life through proper education. The control of these chronic diseases is also dependent on the availability of safe and pure drinking water, proper sanitation, sludge and waste management facilities. Many of the diseases are infectious, so it is important to design preventive measure by the proper development of the sewerage system, waste and sludge disposal that would result in a hygienic environment in Nepal. It is mentioned in a report that about 37% of the Nepal population (34% rural and 66% urban) have access to safe and clean drinking water and 6% have access to proper sanitation facilities.
In addition, the abundant use of septic tanks in urban areas and waste dumping give rise to sludge management problem. That generated sludge without treatment has become one of the most significant challenges in the context of waste management, in Nepal. The untreated disposals of sewage sludge generate significant amounts of greenhouse gases as well as posing health and other environmental problems. People of Nepal due to lack of education and proper understanding of how to dump their waste and sludge The waste includes kitchen and human solid waste, used water from kitchen and garbage. There is no proper sludge dumping mechanism and is thrown in a large big ground making the soil infertile. The sludge creates an ideal environment for nourishment of bacteria and virus. The standard practices of sludge disposal need to be exercised including composting and incineration. Composted sludge can be used for soil conditioner as green fertilizers in gardens and vegetation.
Proper waste bins are needed to be installed at least one in every group of 10 houses. It will help them to throw solid waste in those bins that can be then either burnt or dumped off by Government bodies or private bodies. A common practice is Nepal is to use human and animal excreta as a fertilizer in fields. They think this practice makes the soil fertile, but they do not know about associated serious diseases. That is again due to lack of education. Proper training mechanism must be ensured to educate rural people how to manage waste. There is no proper inflowing water for homes through proper pipelines. People are forced to drink this water and women also wash clothes on those streams, cleaning of their livestock is also done there along with bathing practice. Using same impure water for drinking is linked with many stomach and skin diseases.
The use of human waste as an agricultural fertilizer is common in Nepal. Many health risks are associated with this practice. Burning eyes, lung diseases, and skin rashes have been found in farmers and residents who use human waste as fertilizer. The geographic distribution of Nepal is another major obstacle in transporting proper health services to each and every part of the country. More than eighty percent of the populace lives in urban areas especially hilly areas that rely only on agriculture. Although there are many problems for the people living on hilly areas but the most serious concerns are due to lack of proper sanitation and waste management. That is the major causes of many health issues among the people living in these places. People normally cook insides of their wooden homes using natural resources for fire as animal waste. Due to the congested and less airy architecture of homes and the burning of animal waste that generates dangerous smoke is the cause of lung diseases among many villagers.
However, there are few NGOs active in designing plans to introduce techniques in rural areas that could improve the quality of living. Such techniques include the architecture change of home so that it becomes airier. Consequently, smoke could not be retained inside home, proper sewerage mechanism to discharge waste water in an efficient way, implement waste and sludge management plans and to highlight the importance of hygiene by designing techniques for sludge disposal. It is not the responsibility of the private sector alone. The government of Nepal must also play its role and support such efforts of NGOs to improve the living quality of the people
