Shanti Upadhaya has lived with diabetes for over a decade and used to go on daily walks to help maintain her sugar level. After the nationwide COVID-19 lockdown went into effect on 24 March, she has not been able to exercise regularly.
To stay physically active, Upadhaya has added more workout routines at home. Besides breathing exercises, she has does more physical and muscle building workouts. There are many Nepalis with chronic illnesses like her, especially in cities, who have not been able to get regular checkups and are forced to work out at home to stay physically fit.
“I used to go on walks daily, but once the lockdown started, it has reduced, and I feel that besides physical exertion, these exercises help me feel mentally and emotionally well,” says Upadhaya.
Nepalis with chronic illnesses and lifestyle diseases, especially among the elderly, are more susceptible to coronavirus infection which confines them to their homes. But this also make them more susceptible to pre-existing conditions.
In addition, many have not visited hospitals for their regular checkups, or visited their doctors for fear of the infection. Kathmandu hospitals report that the number of patients in their OPD and elective surgeries are down to 10% of normal levels.
Chronic diseases like diabetes, cardiovasular ailments, kidney failures had seen a dramatic rise in Nepal even before the coronavirus scare because of changes in lifestyle and urban living. South Asians are already genetically susceptible to cardiovascular diseases and diabetes, and these conditions have been made worse by smoking, alcohol consumption, and lately a more sedentary lifestyle due to the lockdown.
“Not being able to go on evening or morning walks for our patients due to the lockdown has a huge health impact across the board,” explains endocrinologist Anshu Mani Joshi.
While city dwellers have been affected, in rural parts of Nepal there has been a big drop in institutional delivery and a concurrent rise in maternal mortality as mothers have not been able to get pre-natal checkups, have been delivering babies at home due to fear of the virus, or have gone to hospitals too late after complications because of the lack of transportation.
Children have also not been getting their vaccines because of the lockdown, with a measles outbreak already reported and a danger of typhoid spreading when the monsoon sets in. There have already been local outbreaks of dengue, malaria and other infectious diseases this year because of unusually wet April and May.
Back in Kathmandu, gyms have all been closed now for 10 weeks, and many of their clients who used to come for fitness exercises have been confined to their homes. According to the government’s proposed easing of restrictions, gyms will be allowed to open only in the fourth stage – which means mid-August.
Gym instructor Ujjwal Ratna Bajcharcharya at Bajra Nanita Fitness says his clients averaged two hours of daily cardio and light-weight lifting before the gym had to close. He adds: “In the first month of the lockdown, we kept regular contact and trained our people online. Even if the contact is less, they follow the routines, diet plan, and video clips that we have set up.”
The lockdown has affected those with more serious ailments like cancer because pharmacies have run out of medicines which need to be imported. There are horror stories of kidney dialysis patients have to cut down on their sessions because of the queue, and also not finding or being able to afford ambulances to take them to hospital twice a week.
Eight percent of Nepal’s adult population has diabetes, which is about 2.5 million people. The proportion is higher at 14% in cities and increasing due to high carbohydrate intake and lack of exercise. Similarly, 17% of women and 23% of men in Nepal age 15 and above have hypertension, according to the Demographic and Health Survey, and these patients are also affected if they cannot get enough exercise.
An increasing number of people in Kathmandu also suffer from respiratory ailments including asthma because of air pollution. However, they cannot take full advantage of the cleaner air for outdoor exercise because of the lockdown.
Beni Basnet is a retired civil servant and has a combination of hypertension, diabetes and high cholesterol and, following his doctor’s advice, used to take a 90 minute walk every day. After the lockdown, he switched to yoga. Others have turned to climbing up and down staircases at home, getting apps for online workout sessions, watching YouTube videos for aerobics or Zumba, and skipping.
But Husla Paudyal, a physiotherapist at Handicap International, warns that people with chronic illnesses tend to get tired faster, increasing the chance of them fainting or having difficulty in breathing from heavy exercise. “We recommend that they use pacing techniques, where they take breaks and do breathing exercises in between workouts,” she cautions.
Health experts also warn about mental stress affecting the wellbeing of patients. While many people are adjusting to the new normal post-lockdown, the constant bombardment of negative news about the pandemic from Nepal and abroad, can have a negative health impact.
Says Joshi: “We provide online counseling via Viber based on our internal files on patients to discuss their physical health problems like diabetes and also try to calm their mental state.”
Civil servant Beni Basnet used to become so tense after watching the news, or scrolling through social media platforms, that he has decided to put himself on a ‘media diet’ limiting exposure to tv and the internet.
He adds: “I try only to avoid bingeing on news, limit my news updates to one new channel in the evening. Instead, I watching movies like South Indian films.”
from Nepali Times https://ift.tt/2MKG2Ic
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