On Sunday, International Health Regulation alerted the Epidemiology and Disease Control Division under the Department of Health Services about the detection of the monkeypox virus, a virus similar to human smallpox, in an air passenger arriving at the Tribhuvan International Airport in Kathmandu.

The alert was issued following the detection of the monkeypox virus in a 38-year-old Nigerian man, who had attended a workshop in Singapore on 28 April, 2019. The International Health Regulation, an international legal instrument that helps prevent and respond to acute public health risks, had alerted Nepal, as Nepal is a World Health Organizations’ member state.

However, the health desk at the TIA did not respond to the alert because the health desk at Tribhuvan International Airport, is currently operating out of a makeshift shack near the arrival area of the international terminal— a spot passengers rarely visit. It was moved from its previous location to accommodate the construction of the new arrival building.

Although the chances of the virus spreading are low (since it does not transmit from one person to another easily), the lack of preparedness on the health desk raises doubt on the authorities’ ability to tackle the possible outbreak of communicable diseases.

“We ask passengers to fill a health assessment form if someone approaches us with a concern,” Gopal Prasad Pandey, coordinator of the TIA health desk, told the Post. “But no one has approached us since the time of the Ebola epidemic in 2014.”

The health desk was set up, at the directions of the World Health Organization, at the time of Ebola epidemic that gripped some Western African countries in 2014. The UN health agency also provided two thermal imaging cameras, an infrared gun and other protective gear to be used at the health desks.

Thermal imaging cameras are used to screen body temperatures of incoming passengers as a safety precaution in international airports. But of the two cameras placed at the health desk, one was destroyed during the earthquake of April 25, 2015, and the health desk returned the other to the division.

“The thermal imaging cameras need to be kept in a temperature controlled setup; it needs to be kept in an airconditioned room. Since we didn’t have the required facilities, we weren’t using those cameras,” said Pandey, “Now that we are working out of a makeshift shelter, we have no use for them.”

Some six months ago, the UN health body had alerted Nepal about the resurgence of Ebola, but the health workers at TIA have so far only made general announcements asking incoming passengers to fill out the health assessment forms available at the health desk.

Health experts say that the chances of deadly diseases arriving in the country are very high, as hundreds of Nepali peacekeepers are serving in disease-hit African countries.

Dr Samir Kumar Adhikari, Chief of Zoonotic and other communicable disease Management Section, concedes that the health desk at the international airport is defunct since it’s not even in a position to provide 24-hour service due to lack of manpower.

Of the eight health workers deployed at the health desk, four have been transferred to local units, and the adjustment list for the remaining four health workers have been published. If the employee adjustment list published by the Health Ministry is implemented, the desk will no longer have any staff.

There is only one health worker at a time manning the health desk working in shifts to cover 15 hours daily.

Likewise, health desks at border checkpoints too are not in operation due to a lack of health workers.

“I have requested the Health Ministry to create a permanent post for health workers at the health desks, but the ministry has not forwarded the files to the cabinet,” said Adhikari.

The division had also suggested building health facilities at the  under-construction Gautam Buddha and Pokhara international airports but the request is yet to be taken into consideration by the Ministry, according to Adhikari.