Boosting the cold chain in far-west Nepal
New solar-powered vaccine refrigerators, among other support provided by the Government of Japan to Nepal through UNICEF, are proving key to ensuring continued progress of COVID-19 vaccination as well as routine immunization across the country
Darchula, Nepal: For Birendra Bhatta, the past two and a half years have comprised a period marked on one hand by immense challenges, but also great learning and progress on the other.
With his appointment as the immunization focal person at the District Health Office (DHO) in Darchula District almost directly coinciding with the start of the COVID-19 crisis, Birendra was a frontline witness to how the pandemic put the country’s health system – including its cold chain capacity – to the test. This challenge was even more evident in a district like Darchula, located in Nepal’s remote far-west, where the rugged topography and poor road access has meant the transport of medical supplies to far-flung communities has always been difficult.
“The pandemic made it obvious that there was a lot to be done,” Birendra says.
“From capacity building of healthworkers in immunization, creation of detailed vaccination micro-plans, to improved management of the District Vaccine Store – these were some of the key areas that we decided to prioritize at the DHO."
Indeed, the safe storage of vaccines became an area of particular importance as the COVID-19 vaccination campaign kicked off in the country in January 2021, and a range of new vaccines began to pour into the country in addition to the supply of routine vaccines. Birendra and his team had to work to manage space for these in the vaccine store, which included rearranging the facilities and existing supplies, as well as upgrading the flooring to keep materials dry.
In early 2022, to further boost these efforts, UNICEF delivered a solar-powered vaccine refrigerator – provided with generous grant assistance from the Government of Japan – to the DHO. The refrigerator, which has 34-liter net capacity volume and stores over 5,000 – 8,000 COVID 19 vaccines, has proved a great support, according to Birendra.
“The electricity here is very unreliable, especially when the weather conditions are bad – so the staff would always be anxious about how this would affect the potency of the vaccines,” he says.
There had been an incident in 2017 when a massive flood had hit Darchula and damaged a great deal of health infrastructure and equipment. Vaccines had to be stored in cold boxes at the time since electricity was down and there was no solar-operated equipment.
“Having this new cold chain equipment means we are more confident that we can deal with such emergencies now,” Birendra says.
As part of the grant, Japan has provided 38 such solar-driven refrigerators, nine walk-in-coolers, 1,109 long-range vaccine carriers and 53 cold boxes, which have been distributed to health offices and facilities around the country. The grant also supports human resource development for operation and maintenance of cold chain equipment as well as monitoring for effective management of routine and COVID-19 vaccines by UNICEF.
Thanks to the efforts of Birendra and his team, the commitment and hard work of health workers, and support from different partners, the DHO has been successfully running the COVID-19 vaccine drive and routine immunization programme across the district.
“Japan’s generous support delivered through UNICEF, is not just crucial to the continued progress of the COVID-19 campaign, but also in strengthening routine vaccination efforts,” says Budhi Setiawan, Chief of Health at UNICEF Nepal. “This is especially key in places like Darchula, in ensuring children and families in hard-to-reach communities can be protected.”