Nepal

In partnership with two local NGOs (SASAJA and Green Path Nepal in Kathmandu) and the Kathmandu and Nepalgunj municipalities, the programme takes a holistic approach, focusing on three main areas of intervention:

• prevention of occupational risks and improving the waste management system;
• access to health services for informal waste collection and recycling workers;
• the structure of the informal waste collection and recycling sector.

In 2021, Médecins du Monde supported the establishment of a coordination platform in Kathmandu and another in Nepalgunj. These platforms bring together public and private agencies, as well as civil society and non-governmental organisations involved in waste collection and recycling. Stakeholders from the sector have had opportunities to meet, share experiences and focus attention on the issues experienced by people working in this area, thereby empowering them to act.

Throughout the year MdM has worked to improve access for waste collectors and recyclers to good quality health services that can address the needs of people working in this sector.

Awareness-raising sessions were organised for the beneficiaries, focusing particularly on avoiding musculoskeletal conditions, risk prevention in relation to waste dismantling, how to prevent animal bites and provision of tetanus vaccinations.

Médecins du Monde has also undertaken capacity-building with health facility staff, focusing on health and safety at work, a relatively new concept in Nepal. Staff are trained to provide medical consultations specifically tailored to people working in waste collection and recycling. In addition, Médecins du Monde has helped the Kathmandu municipality to upgrade a pioneering health centre to create an “urban health promotion centre” which will be accessible both to workers from the waste management sector and to Kathmandu Valley residents.

Waste workers were the group most at risk in urban areas during the Covid-19 epidemic. This was due to their living conditions, the nature and informal character of their work and the everyday discrimination they face, especially in accessing health services.

MdM sought to protect this particularly vulnerable group by distributing personal protective equipment to waste collectors and recyclers and to health centres in Kathmandu and Nepalgunj, including isolation centres for people who tested positive for Covid-19.

We also continued the training and information sessions originally developed in 2020 for these frontline workers on good hygiene practices and protective measures.

In 2021, we:

• educated 1,700 waste collectors and recyclers through 232 information sessions about the risks associated with Covid-19, possible preventative measures and health and safety at work,
• provided 1,250 sets of personal protective equipment to people working in the waste sector and healthcare staff,
• supported 22 health centres, including the urban health promotion centre in Kathmandu, 4 Covid-19 isolation centres and 14 health centres in Nepalgunj,
• trained 67 health centre staff in workplace health and safety