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दिव्य रोशनी / २०१९ डिसेम्बर महिनाको अन्त्यमा चाइनाको वुहान सहरमा देखापरेको कोरोना भाइरस (कोभिड १९) विश्वव्यापी महामारीको रुपमा फैलिएको छ। यो भाइरसले लगभग सबै देशमा असर पारी ठूलो जनधनको क्षतिका साथै चलायामान विश्वको अर्थतन्त्रमा ह्रास ल्याएको छ।
विश्वका शक्तिशाली भनिएका र स्वास्थ क्षेत्रमा अब्बल मानिएका राष्ट्रहरुले पनि यो महामारी विरुद्धको लडाइँमा प्रभावशाली कदम चाल्न सकेका छैनन् । यसबाट नेपालमा पनि आउन सक्ने विकराल परिस्थितिको सजिलै अनुमान लगाउन सकिन्छ ।
महामारीको संकेत सुरुदेखि नै पाउँदापाउँदै पनि त्यसलाई गम्भीरतापूर्वक लिन नसक्दा नेपाल सरकार अहिले पूर्वतयारीदेखि लिएर महामारी सामना गर्ने योजनामा नराम्ररी चुकेको छ। अहिले अन्तिम क्षणमा आएर अत्तालिँदै तयारी गरेको जस्तो देखिएको छ । सरकारी तयारीबाट न जनता आश्वस्त हुन सकेका छन् न त्यसको सामना गर्न अग्रपंक्तिमा रहेका स्वास्थ्यकर्मीले हौसला पाउन सकेका छन् । उल्टो, यस्तो विषम परिस्थितिमा सरकारमा रहेका जिम्मेवार व्यक्तिहरुबाट गैरजिम्मेवार अभिव्यक्ति आउँदा जनता निराश भएका छन् । अनि स्वास्थ्यकर्मी झन् निरुत्साहित भएका छन्।
आफ्नो र आफ्नो परिवारको ज्यानलाई नै धरापमा राखेर चिकित्सकीय धर्मको पालना गर्दै बिरामीको सेवामा खटिएका स्वास्थ्यकर्मीलाई हौसला दिनको साट्टो उल्टो धम्क्याएरै कजाउन सकिन्छ भन्ने दुई तिहाइको दम्भ भएको सरकारले कसैका कुरा सुन्छ जस्तो त लाग्दैन । त्यहीँ पनि नेपालमा आउनसक्ने महामारीको विकराल परिस्थिति सामना गर्न सीमित स्रोतसाधनमा कसरी पूर्वतयारी गर्न सकिन्छ भन्ने सुझाव एक सचेत नागरिकको हैसियतले प्रस्तुत गरेको छु ।
बर्तमान परिप्रेक्ष्यमा पूर्वतयारी न्यून हुँदा पनि यही तयारीमा आउन लागेको परिस्थितिको सामना गर्नुपर्छ। सुरक्षा उपकरणको अभाव, रोगको विश्वस्तरमा रहेको आँकडा हेर्दा यसको ल्याएको डर आफ्नो ठाउँमा छ। यससँगै अन्य रोगका मानिसलाई पनि उचित देखभालको व्यवस्थापन गर्नु उत्तिकै महत्वपूर्ण हुन्छ।
सम्पूर्ण बिरामीको व्यवस्थापन गर्न यो महामारीको अवधिमा स्वास्थ्य व्यवस्थापनबारे उचित दिशानिर्देश हुनुपर्छ। जस्तो कि, प्रत्येक केन्द्रमा ए, बी, सी लेबल लगाएर काम बाँडफाँड गर्नुपर्छ।
केन्द्र एः त्यहाँ कोभिड १९ संक्रमित बिरामीको मात्र स्याहार गर्ने निश्चित केन्द्रहरू हुनुपर्छ । प्रत्येक जिल्लामा करिब १ केन्द्र हुनुपर्छ र उही जिल्लाका अन्य केन्द्रहरूको लागि उक्त केन्द्र रेफरल केन्द्र हुनुपर्छ । उक्त केन्द्रमा अन्य बिरामीहरूको हेरचाहको काम रोकेर, कोभिड १९को संक्रमित बिरामीको मात्र उपचारको लागि तोकिनु पर्छ । त्यस केन्द्रमा सफाइ गर्ने कर्मचारी र गार्ड सहित सम्पूर्ण स्वास्थ्यकर्मीलाई सुरक्षात्मक उपकरण (पिपिई) प्रदान गरिनु पर्छ। जिल्लामा अन्य केन्द्रहरूले पनि काम गर्नुपर्ने हुन्छ। यसले पिपिई र अन्य आवश्यक आपूर्तिहरूको माग घटाउँछ, जुन पछि महामारी फैलिएमा आवश्यक पर्ने हुनसक्छ।
केन्द्र बीः यसमा कोभिड १९का बिरामीको लागि तोकिएको केन्द्र बाहेक अरू सबै केन्द्रहरू पर्छन्, जसमा अन्य सरकारीका साथै प्राइभेट अस्पताल पनि समावेश हुन सक्छन्। जिल्लाका कोरोना विशेष तोकिएको बाहेकका अन्य केन्द्रहरूले अन्य बिरामीहरू जस्तै इमर्जेन्सी, गर्भावस्था साथै अरु आवश्यक औषधि वितरण इत्यादि बिरामीको हेरचाह गर्नुपर्दछ। यसले अन्य बिरामी, इमर्जेन्सी र गर्भावस्थाका बिरामीहरूको हेरचाह गर्न मद्दत गर्छ। यी केन्द्रहरूबाट कोभिड १९का शंकास्पद बिरामीहरूलाई रेफरलको व्यवस्था मिलाएर उचित तरिकाले कोरोना विशेष अस्पतालमा रिफरल गर्नुपर्छ। यी केन्द्रहरू सीमित सुरक्षात्मक उपकरणहरू जस्तै एन ९५ मास्क र सरल गाउन प्रदान गरिनु पर्छ ।
केन्द्र सी ः माथिका समावेश नभएका अन्य केन्द्रहरू जस्तै पिएचसी, स्वास्थ्य चौकी र स्वयंसेविका लगायत स्थानीय स्वास्थ्यकर्मीहरूलाई कोभिड १९का शंकास्पद केसहरू र त्यसका सक्रिय केसका बारे जानकारी सम्बन्धित निकायमा गराउनु पर्ने छ। र, आवश्यक परेमा कोभिड १९ विशेष अस्पतालको सम्पर्क खोज्नुपर्छ। तिनीहरू स्थानीय तहसँग समन्वय गरी सामान्य बिरामीको उपचारमा सामेल हुनुका साथै शंकास्पद बिरामीको अवलोकन गर्नुपर्छ। यसले शंकास्पद केस निगरानी गरेर सक्रिय केस पत्ता लगाउन मद्दत गर्छ।
कोभिड १९ का शंकास्पद बिरामी ओसारपसार गर्न निश्चित एम्बुलेन्सहरू तथा सवारीहरू तोकिनुपर्छ र कोभिड १९ बोक्ने गाडीको रूपमा चिह्न लगाउनुपर्छ। त्यसको लागि प्रत्येक जिल्लामा २÷३ सवारी साधन पर्याप्त हुन्छ। तिनीहरू बिरामीहरुलाई केन्द्र “बी” र “सी”बाट सार्न र शंकास्पद स्थानबाट केन्द्र “ए” सम्म पुर्याउन संलग्न हुनुपर्दछ। यी एम्बुलेन्स ड्राइभर पूर्ण सुरक्षात्मक उपकरण (पिपिई) प्रदान गर्नुपर्नेछ। हरेक केन्द्रहरूमा यी एम्बुलेन्सको सम्पर्क नम्बर प्रदान गरिनुपर्छ। अनि जिल्लाका अन्य एम्बुलेन्सहरू अन्य बिरामीहरूको यातायातमा संलग्न हुनुपर्छ। हेल्पलाइन नम्बर प्रत्येक प्रदेश, जिल्ला, तथा कोभिड १९ विशेश केन्द्रले जारी गर्नुपर्दछ, ताकि कुनै पनि शंकास्पद घटनाहरू सूचित गर्न साथै केन्द्र एमा सरुवा गर्न सकिन्छ। त्यस्तो सूचना प्राप्त गर्ने उक्त केन्द्रमा आबद्ध व्यक्तिले चिह्नित एम्बुलेन्सलाई कोभिड १९को शंकास्पद बिरामीहरूलाई समुदाय, केन्द्र बी र सीबाट केन्द्र एमा पुर्याउन सूचित गर्दछ।
प्रत्येक प्रदेशमा कम्तीमा एउटा ल्याब हुनुपर्छ, जसले कोभिड १९ बिरामीको नमूना जाँच गर्दछ। त्यो ल्याबमा आबद्ध व्यक्तिलाई सुरक्षात्मक उपकरण (पिपिई) प्रदान गर्नुपर्छ। केन्द्र ए बाट संकलन गरिएको नमुना प्रयोगशालामा हस्तान्तरण गर्नुपर्नेछ। जसले गर्दा यस प्रकारको योजनाले स्वास्थ्य केन्द्रहरु र स्वास्थ्यकर्मीहरुको तनाव कम गर्न मद्दत पुर्याउँछ र सबै बिरामीहरुलाई उचित हेरविचार हुन्छ।
अझै पनि ढिला भएको छैन। त्यसैले कृपया उचित दिशानिर्देश लागू गर्नुहोस र कार्य वितरण लगाउनुहोस।

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