Squatters' Health Issues Revealed After Relocation

Kirtipur. Dambar Tamang, found at the holding center in the Radhaswami Satsang complex within the Tribhuvan University campus in Kirtipur, now feels his life will move forward in a new way. He is starting to feel relieved, thinking it won't always be like this. He still remembers the tragedy that used to occur every monsoon season on the banks of the Bagmati River where he lived in Thapathali. Although it was a place to live with his family, they had no ownership. What's the use of having a place to live? It wasn't recognized by any agency or law in the country. Water, electricity, and roads were all informal. Sewage and waste flowed directly into the river. For how many illnesses the Bagmati, carrying the pollution of the Kathmandu Valley residents throughout winter, inflicted upon Dambar and other squatters, no one knew while they lived there. Now, with regular health check-ups at the holding center, many have realized what problems the life on the banks of the Bagmati caused to their bodies. They've come to understand the extent of their illnesses. The collected data of the squatters reveals how risky life on the riverbanks was. Before going to the center, out of 497 people health-checked at Dashrath Rangasala, nearly 30 percent had high blood pressure, and 15 percent had diabetes. Similarly, 16 percent had musculoskeletal problems, 13.5 percent had gastritis, 7 percent had mental health issues, and 4.5 percent had respiratory problems. After reaching the center, almost everyone's health was examined, and the number of problems increased. However, not only have problems been exposed at the center, but treatment has also begun and continues to this day. Doctors found that among those included in the statistics, at least one family member of 38.5 percent had died during their stay on the riverbanks. Of these, nearly 9.5 percent lost their lives due to floods and inundation, and accidents in bridges, roads, and wells. Eight percent died from asthma and pneumonia, and eight percent from sanitation-related infectious diseases like tuberculosis, dengue, and typhoid. The primary cause of most of these was the risky life on the riverbanks. It is natural for vector-borne diseases spread by mosquitoes and other insects to spread among squatters who lived with polluted drinking water and in places where waste and wastewater accumulated. According to Dr. Anup Bastola, director of Shukraraj Tropical and Infectious Disease Hospital, who led the medical team at all six holding centers for squatters, 28 percent of deaths were also due to non-communicable diseases like heart disease, cancer, and high blood pressure. The team, including doctors from Patan Hospital, Maternity Hospital, and the Mental Hospital in Lagankhel, is currently intensifying further examinations and treatment. Dambar at the holding center has retinal problems, making it difficult for him to see and read small objects. If he had received regular health check-ups like this back then, the problem might not have become so severe. After consulting with the doctors at the center, he went to the eye hospital in Tripureshwor. The doctors there referred him to Tilganga. He is now planning to get treatment there. In Thapathali, there are hundreds like Dambar, who considered life to be living on the banks of the Bagmati. Now, everyone feels like they've been uprooted from their homes and are sitting in the middle of nowhere. "The government will surely make some arrangement somewhere," he says. Dambar's wife and children also had their health checked there. Health workers have advised his wife to go to the hospital for heart-related problems. Fifty-year-old Punam Magar, who spent about 20 years in Thapathali, had high blood pressure, diabetes, and nerve problems while living there. She said that when the problems worsened, emergency treatment was provided through the center's initiative. "Many people had their health checked here, and we went to the hospital for treatment," she said. However, she also mentioned the compulsion of having to buy expensive medicines herself after reaching the hospital. Another squatter, Khimbahadur Pulayamagar, said that although they don't get all the medicines after reaching the hospital and treatment for some diseases is somewhat expensive, the squatters have no complaints about the health workers who came to the center. Some of the squatters at the holding center have chronic illnesses, regular health check-ups for whom were impossible while living on the riverbanks in Thapathali. Mothers who have just given birth and are raising young children have not only received regular health check-ups and consultations but also received Lito (a nutritional supplement) for their newborns. Subhasdevi Paswan, met at the center, said that she received Lito for her grandson's health check-up and nutrition. The daily life on the riverbanks has caused not only physical but also mental problems for the squatters brought to the holding center. Doctors who have visited for repeated examinations have closely observed the impact of living in an unmanaged and unsafe environment for a long time on both aspects of health. Some have expressed sadness at having to suddenly leave the place where they had lived for a long time, but they are telling psychologists that many had been suffering from numerous physical and mental complications due to the unsafe living conditions on the banks of the Bagmati. Sulabhraj Upreti, a psychiatrist from Patan Mental Hospital, visited all six holding centers multiple times with a team of specialists to identify and treat potential mental health problems among squatters. He said, "It is natural for those who considered the risky life on the banks of the Bagmati as their life to feel some discomfort. However, such living conditions lead to numerous psychological complications. A large number of such individuals are found." A team comprising four experts and some psychology students identified and counseled over 600 individuals separately in all six camps after recognizing mental health issues. "When we spoke with everyone, along with the discomfort of having to move, a significant number expressed hope that something would happen now and the government would make good arrangements," said psychiatrist Upreti. Based on the conclusions from the conversations, it was found that some require psychosocial counseling and support, while others need medication. He informed that after counseling and support, many individuals have even returned to their regular work. It was also found that concerns about their children's education were reduced as the children started attending nearby schools. The team of psychosocial experts, through mental health examinations and counseling of 553 squatters, found that 82.8 percent of families were forced to live by the river because they had no place to live anywhere else in the country before displacement. Among them, 24.6 percent had spent three generations there. Psychosocial experts say that 3.3 percent lost their lives due to suicide and 3.3 percent due to alcohol-related problems. Peace was certainly absent in life while living by the river. Consequently, about 12 out of 100 people even considered suicide. Similarly, seven out of every hundred required specialized mental health services. After this data emerged, the team of doctors has been providing regular psychiatric counseling at all six holding centers. Psychiatrists have realized that this has instilled hope for brighter days ahead in the minds of squatters who were suddenly brought to the holding centers from their unsafe lives on the riverbanks. In this process, squatters openly shared their past with psychiatrists. From the outside, their risky life on the riverbanks seemed normal, and life in the holding center seemed surprising. However, most squatters are now hopeful that their lives will take a new turn. Since the day the squatters were moved to the holding center, staff have been engaged in conversations with everyone, identifying their problems, and analyzing them. Prakriti Dhakal, an associate secretary from the Prime Minister's Office, involved in this, said, "We have not only identified the diseases of the squatters but are also continuously providing treatment and counseling according to the condition and nature of the illness." She also stated that based on this data, patients with complex diseases like cancer and pneumonia are being treated in various hospitals in the capital, and arrangements will be made for treatment if such complications arise in more squatters.