How is lung cancer treated? Let's go into detail

 How is lung cancer treated? Let's go into detail

Surgery can be an important treatment when the cancer is confined to the lungs and the patient can tolerate surgery.

Lung cancer may not have symptoms in the early stages, so if you have a cough, chest pain, or blood in your sputum, you should see your doctor.

Lung cancer is one of the most serious health problems worldwide. Since there may be no obvious symptoms in its early stages, many people are diagnosed only after the disease has spread. People who smoke for a long time are especially at risk. However, even non-smokers can get lung cancer. Timely diagnosis of the disease and starting the correct treatment according to the type and condition of cancer is considered very important for the treatment results.

Lung cancer is mainly of two types, non-small cell lung cancer and small cell lung cancer. Non-small cell lung cancer is seen relatively more. These two types of cancer may differ in growth, spread and treatment. Therefore, all patients with lung cancer are not treated in the same way.

Why does lung cancer occur?

The most important risk factor for lung cancer is smoking. Consumption of cigarettes, bindis and other tobacco products increases its risk. Second-hand smoke can also increase the risk of living with a smoker for long periods of time.

Similarly, exposure to air pollution, long-term contact with some industrial chemicals, radon gas, and some types of dust or toxic substances in the workplace can also increase the risk. Although the risk increases with age, lung cancer can occur in people of any age.

What are the initial symptoms?

In the early stages of lung cancer, there may be no symptoms. Symptoms may include prolonged coughing, changes in the appearance of an old cough, difficulty breathing, chest pain, blood in the sputum, frequent lung infections, changes in voice, abnormal weight loss, loss of appetite, and excessive fatigue.

The presence of any of these symptoms does not necessarily mean that cancer is present. These symptoms can also be seen in many other diseases. But if the symptoms persist for a long time, it is necessary to check with a doctor.

How is cancer diagnosed before treatment?

If lung cancer is suspected, the doctor will conduct necessary tests after obtaining information about the patient's health history, smoking status and symptoms. Usually, imaging tests such as chest X-rays and CT scans can look for abnormal lumps or other changes in the lungs.

But imaging tests alone do not definitively confirm cancer. Biopsy is done if necessary. In this, tissue or cells are removed from the suspicious part and tested in the laboratory.

In some cases, the necessary tissue can be removed by viewing the inside of the trachea and lungs through bronchoscopy. In some cases, a sample is taken from the lung nodule through a needle. Sputum cytology can also be done to see if there are cancer cells in the stool.

Why is it important to find out the stage of cancer?

The next important step after cancer is confirmed is staging. That is, how big the cancer is, whether it has spread to nearby lymph nodes and whether it has reached other parts of the body is found out.

For this, tests such as CT scan, PET scan, MRI of the brain can be done as needed. Knowing the stage of cancer makes it easier to plan the right treatment.

Generally, lung cancer is classified into different stages from early stage to advanced stage. In the early stages, the cancer may be limited to the lungs, while in the advanced stage, it may spread to nearby lymph nodes or other parts of the body.

Why are biomarker and gene testing important?

Especially in non-small cell lung cancer, molecular or biomarker tests can be important in choosing treatment. Cancer cells can be tested for certain gene changes such as EGFR, ALK, ROS, BRAF, KRAS, MET, RET, and NTRK. Similarly, in some cases, biomarkers such as PD-L1 are also tested.

Such tests help the doctor to decide which of the targeted drugs or immunotherapy might be useful. So just knowing the name of the cancer is not enough when the cancer is confirmed; It may also be important to understand its biological characteristics.

How is lung cancer treated?

Lung cancer treatment is not the same for all patients. Treatment is selected based on the type of cancer, stage, gene mutation, tumor location, patient's age, lung function and overall health.

1. Surgery

Surgery can be an important treatment when the cancer is confined to the lungs and the patient can tolerate surgery. In surgery, the cancerous part is removed.

Wedge resection or segmentectomy can be done in small tumors. A lobectomy is performed in cases where the entire lobe with cancer needs to be removed. In special circumstances, pneumonectomy is performed when the entire lung needs to be removed. During surgery, nearby lymph nodes can also be removed to check if the cancer has spread.

2. Chemotherapy

In chemotherapy, drugs are used to stop or destroy the growth of cancer cells. Medicines are usually given intravenously, but some medicines can also be taken orally are Chemotherapy may be used to reduce the size of the tumor before surgery or to destroy cancer cells that may remain in the body after surgery. In advanced cases, it is also used to control the growth of the disease and reduce the symptoms.

Side effects such as fatigue, nausea, loss of appetite, hair loss and decrease in the number of blood cells may occur during chemotherapy. But not all side effects are seen in all patients and many can be controlled with medication and other supportive treatments.

3. Radiation therapy

In radiation therapy, an attempt is made to destroy or control cancer cells by targeting high-energy rays at the cancerous part. It can be used before or after surgery. Radiation may be the main treatment for some early cancers that cannot be operated on. In advanced cases, radiation can also be used to reduce pain, bleeding, or other symptoms caused by the spread of cancer.

4. Stereotactic body radiotherapy

Stereotactic body radiotherapy is a very precise technique of radiation therapy. In this, a high dose of radiation is targeted at a specific location with a small tumor and an attempt is made to protect the surrounding healthy tissue as much as possible. This treatment may be useful in some early-stage non-small cell lung cancer patients who cannot undergo surgery.

5. Targeted drug therapy

Targeted therapy can be used if certain gene changes or other specific biological changes are found in cancer cells. Its purpose is to target specific processes that cause cancer to grow compared to normal cells. But targeted drugs are not effective for all patients who do not have gene changes. Therefore, it is important to test the necessary biomarkers before treatment.

6. Immunotherapy

Immunotherapy helps the body's immune system to work effectively against cancer cells. In some types of advanced lung cancer, immunotherapy may be used alone or in combination with chemotherapy. The doctor decides which patient to give this treatment based on the type of cancer, stage and necessary biomarker tests.

7. Supportive care is also important during treatment

Cancer treatment is not only about removing the tumor or stopping the growth of cancer. Management of problems such as pain, difficulty breathing, nausea, loss of appetite, weakness and mental stress during treatment is also important.

This is called supportive or palliative care. Such care can be initiated not only at the end of treatment but also as needed along with cancer treatment. Its purpose is to improve the patient's quality of life and control symptoms.

Why is regular follow-up necessary after treatment?

Even after the treatment is completed, regular follow-up is necessary. The doctor can perform a physical examination, necessary imaging and other tests based on the patient's condition. From this, it can be evaluated whether the cancer has reappeared, whether the treatment has long-term effects, and whether additional treatment is necessary.

What can be done to prevent lung cancer?

Not all lung cancer risks can be prevented, but many significant risks can be reduced. One of the most important steps a smoker can take is to quit smoking. Stay away from other people's smoke as much as possible.

People who come into contact with dust, chemicals or other hazardous substances in the workplace must use the necessary protective equipment. In case of high air pollution, it is also useful to take measures to reduce the risk.

Treatment is not the same for everyone

The treatment of lung cancer is now more developed than ever before. New treatments such as surgery, chemotherapy, and radiation therapy, along with targeted drugs and immunotherapy, have expanded treatment options for many patients. But the treatment is not the same for all patients. Based on the type of cancer, stage, biomarkers, patient's health condition and response to treatment, the expert doctor decides the treatment plan.

Therefore, symptoms such as prolonged coughing, blood in the sputum, chest pain, difficulty in breathing or weight loss without any reason should not be ignored. Medical examination should be done on time.

Why does the body move by itself, and who takes away the control of the body?

 Why does the body move by itself, and who takes away the control of the body?

Physiotherapy, vocational rehabilitation, speech therapy and regular exercise also improve quality of life.

Why does the body move by itself, and who takes away the control of the body?

Uncontrolled changes in body movements are called movement disorders, which are caused by disturbances in the nervous system of the brain.

Many of us have seen the problem of someone's hands constantly shaking, neck twitching, face twitching involuntarily, hands not moving when trying to write or legs moving at night when trying to sleep.

Most people ignore these symptoms as the effects of aging, weakness, stress or vitamin deficiency. But such symptoms can be a sign of a disturbance in the system that controls the movement of the brain. This problem is called 'movement disorder' in medical language, i.e. disease related to uncontrollable movement.

The human brain is the most complex and amazing part of the body. Walking, running, writing, speaking, smiling, eating or even the smallest activities are controlled by the brain in a very subtle way.

Some special parts of the brain, especially the basal ganglia, cerebellum and the nerve network connecting them, are making the movement of the body balanced, smooth and coordinated. When there is a problem in these parts, the body starts to move against the patient's will.

The most common problem is tremor. When drinking tea, holding a spoon or signing, the hands may tremble, sometimes even the head or voice may tremble. Essential tremor and Parkinson's disease seen in many elderly people are the main causes.

Not all tremors are Parkinson's, therefore, an accurate diagnosis is essential. Parkinson's disease is one of the major neurological diseases that increase with age. Symptoms such as slow movement of limbs, body stiffness, hand tremors when resting, loss of balance and reduced facial expression are seen.

Previously, this disease was considered very complicated, but now, thanks to effective drugs, restorative treatments and modern surgical techniques, patients can live an active and dignified life for a long time.

Another important problem is dystonia. In this, some muscles of the body contract uncontrollably, so the neck becomes bent, the eyes keep closing by themselves, the mouth or voice changes, or the hands go into an unnatural state. Its special type is writer's cramp.

In such a condition, the person can do all other work normally, but only after starting to write, the hand becomes stiff, the fingers become crooked and it becomes difficult to hold the pen. This problem can be seen in students, teachers, bank employees, writers and people who have to write a lot.

It is ignored for years as a simple weakness or mental stress, while with timely treatment, good improvement is possible.

In some patients, the limbs of the body move irregularly like dancing. It is called Korea. Slow jerking movements are called athetosis and sudden jerking movements are called myoclonus.

Some children and young people have the habit of blinking their eyes, opening their mouths, shaking their necks or making noises. Such conditions are called tics. Most of these are treatable.

Restless legs syndrome is a problem that many people experience but is less discussed. It has a strong urge to move the legs especially in the evening or when resting at night. The patient feels crawling, tingling, burning or pulling in the legs.

Moving the legs gives relief for some time, but when resting again, the problem recurs. As a result, sleep is disturbed, fatigue throughout the day, irritability and reduced ability to work. Most people don't care, thinking of it as a habit or a gas problem. But it is also a neurological disease and effective treatment is available.

Why do these diseases appear?

There can be many reasons. Changes in brain cells with age, hereditary effects, stroke, brain injury, long-term use of certain drugs, lack of iron in the body, diabetes, kidney disease or other neurological diseases can also cause uncontrolled movement.

Identification and treatment

To identify the disease, the patient's history, neurological examination, blood test if necessary, MRI, CT scan and other special tests are done. The most important thing is not to self-medicate and consult a specialist without delay.

As far as treatment is concerned, it varies according to the disease. Many patients get better with medicine. Botulinum toxin injections are very effective in many patients with dystonia.

Physiotherapy, vocational rehabilitation, speech therapy and regular exercise also improve quality of life. When drugs don't work enough, modern functional neurosurgery offers new hope. Its most successful technique is Deep Brain Stimulation.

In this, a small electrode is placed in a certain part of the brain and a light electrical stimulation is given by a battery connected under the skin. It can significantly improve Parkinson's disease, essential tremor, dystonia and some other movement related diseases by controlling abnormal nerve signals.

This treatment is successfully available not only in the developed countries of the world, but also in Nepal. Deep Brain Stimulation services are regularly available with us, and most patients have seen significant improvement and encouraging results from this treatment.

In society, such diseases are still considered to be the effects of old age, devastation, weakness or mental problems There is a tendency to misunderstand it. Due to such confusion, many patients are deprived of treatment.

The reality is, most movement disorders can be controlled if detected early, and many patients can return to a normal life.

If any part of the body starts shaking for no reason, if it is difficult to write, if the neck or face starts bending on its own, if there are uncontrollable tremors, or if there is a problem of moving the legs at night, it should not be considered normal. It is wise to consult a neurologist or neurosurgeon in time.

Only with a health-conscious citizenry, timely diagnosis and access to modern treatment can we reduce the disability caused by uncontrolled movement disorders.

Why eat light food in July? Such is the advice of Ayurveda

 Why eat light food in July? Such is the advice of Ayurveda

According to Ayurveda, since the digestive power is weak during the rainy season, health experts have suggested eating light, fresh and sattvic food in the month of July.

The month of July is considered special for religious faith, fasting and Shiva worship. But according to Ayurveda, its importance is not limited to religious aspects only. It is advised to eat light, fresh and sattvic food keeping in mind the biological changes in the body during the monsoon month of July.

Ayurveda has explained this season as a time when the risk of disease increases in the body. It is said that due to excessive humidity in the environment, low sunlight, fluctuations in temperature and the digestive system is weakened due to contaminated water and food, special care should be taken in eating.

Why is the digestive power weak?

According to Ayurveda, the whole health of our body depends on 'Jatharagni' i.e. digestive power. During rainy season, due to increase in humidity in the environment, change in body temperature and changes in daily lifestyle, this digestive fire naturally slows down.

When the digestive power is weak, the food eaten cannot be digested properly, which causes the body to produce common 'undigested toxins'. Ayurveda considers this mango as the main cause of many diseases.

For this reason, excessive oil, ghee, spices, red meat, fast food and many starchy foods are difficult to digest. If you eat such food regularly, you may experience problems such as heaviness in the stomach, increased gas, acidity, constipation, indigestion, stomach ache, nausea and feeling lethargic.

Imbalance comes in Tridosha

According to Ayurveda, the body operates in the balance of three doshas: Vata, Pitta and Kapha. Vata dosha is especially likely to increase during rainy season and pitta dosha becomes unbalanced. It can cause joint pain, flatulence, acidity, skin problems, headache, fatigue and various digestive problems.

In addition, health experts say that the growth of bacteria, viruses and fungi is faster during the rainy season, so the risk of diarrhoea, food poisoning, typhoid, cholera and other infections also increases. Therefore, it is necessary to pay special attention to the quality, cleanliness and freshness of food during this season.

What kind of food is suitable in July?

Ayurveda recommends eating sattvic, fresh and easily digestible food in Sauna. Sattvic food not only provides the necessary nutrition to the body, but also does not burden the digestive system unnecessarily.

During this period, it is considered beneficial to consume freshly cooked pulses, rice, roti, green vegetables, gourds, parsley, giraunla, parval, parsley, seasonal fruits, semolina instead of curd, hot soup, porridge, khichdi and enough boiled or safe drinking water. It is better to cook food fresh, using less oil and less spices.

Also, using natural spices like ginger, cumin, coriander, turmeric, fenugreek, black pepper in limited quantities can help improve digestion.

What foods to stay away from?

Ayurveda advises to avoid stale food, highly spicy food, highly starchy food, highly greasy food, junk food, cold drinks, excessive sweets and food made in unhygienic places as much as possible. Such foods can create more pressure on an already weakened digestive system.

Health benefits of sattvic food

Light and sattvic food relaxes the digestive system and also provides the necessary energy to the body. As such food keeps the stomach light, laziness and lethargy are reduced, the body remains active throughout the day and mental freshness is also maintained.

Since immunity is weakened during rainy season, sattvic diet can help in strengthening the immune system. Also, Ayurveda believes in helping the detox process naturally without allowing unnecessary toxins to accumulate in the body.

Positive effects on mental health as well

Ayurveda links sattvic food not only with physical health, but also mentions that it has a positive effect on mental health. A light and balanced diet is believed to help calm the mind, reduce stress and help focus. That is why sattvik food is especially associated with worship, meditation, chanting and spiritual practice during the month of Saun.

These habits should also be adopted to stay healthy

In July, it is necessary to pay attention to lifestyle along with diet. Eating on time, not eating too much, getting enough sleep, regular light exercise or yoga, drinking clean and boiled water, not eating stale food and paying attention to personal hygiene can prevent many health problems during rainy season.

Overall, the tradition of eating light and sattvic food in Saun is deeply connected not only to religious beliefs but also to health protection. According to Ayurveda, it is best to choose light, fresh and nutritious food as the digestive power of the body is weak during rainy season.

In addition to keeping the digestive system healthy, it can play an important role in reducing the risk of infection, strengthening immunity, maintaining mental peace and improving overall health.

Why is the coordination of science, spirituality, and human consciousness necessary in education?

 Why is the coordination of science, spirituality, and human consciousness necessary in education?

We have a rich Eastern knowledge tradition, but the ability to communicate with modern science is also developing.

Why is the coordination of science, spirituality, and human consciousness necessary in education?

It is essential to include the human and psychological aspects in health education, including palliative care and the experience of the last stages of life.

Nepal's education system is currently at a critical juncture of change. Artificial intelligence, biotechnology, neuroscience, mental health, and global social change have changed the situation. Education can no longer be just a means of passing exams, getting jobs, or teaching technical skills.

Today's generation needs not only knowledge, but also the ability to understand life, mental strength, moral decision-making ability, compassion, self-discipline, and the skill of remaining balanced in uncertain situations.

Many countries around the world have begun to recognize this need. Mindfulness, stress management, socio-emotional learning, palliative care, positive psychology, end-of-life care, and consciousness-related studies are gradually expanding in schools and universities. Modern science is also studying the relationship between the body, brain, emotions, and behavior in greater depth than ever before.

In such a situation, an important question arises—can Nepal develop an education system that establishes a balanced dialogue between its own knowledge tradition and modern science?

Nepal is not only a country of mountains and natural beauty; it is also an important center of Vedic, Upanishadic, Yogic, and Buddhist knowledge traditions. Thousands of years ago, sages and sages deeply pondered on the fundamental questions of human life, nature, consciousness, health, ethics, and the universe.

The ideas developed in the Vedas, Upanishads, Bhagavad Gita, Patanjali Yoga Sutras, Ayurveda, and other ancient texts about the body, mind, breath, self-discipline, meditation, compassion, life, and death have enriched the knowledge tradition. These texts are still studied today as important sources for understanding the development of philosophy, history, culture, and human thought.

Similarly, yoga is not just a method of physical exercise; it has traditionally been interpreted as a holistic way of life that disciplines the body, mind, and behavior. Practices such as pranayama, meditation, introspection, restraint, and compassion emphasize the inner development of the individual. Modern science has begun to study some aspects of these practices—especially meditation, mindfulness, and controlled breathing exercises—and the potential health effects of these practices. While positive evidence has been found in some areas, many questions are still the subject of research.

Therefore, the need today is not to accept ancient knowledge as superstition or to completely reject it in the name of modern science. What is needed is to conduct critical and evidence-based studies of these knowledge traditions in dialogue with history, philosophy, culture, and contemporary scientific research. It is necessary to creatively connect the wealth of knowledge developed by the sages and sages with modern research, neuroscience, psychology, medical science, and pedagogy. If this can be done, it will give a new direction to the national education system and create the possibility of establishing Nepal's unique identity in the global knowledge community.

This does not mean making religious/religious education mandatory in the curriculum. Nor does it mean presenting any religious or spiritual belief as scientific truth. Rather, it is about creating an environment where the various perspectives that human civilization has developed on life, health, consciousness, and death are studied based on evidence, history, philosophy, and critical thinking.

For example, thousands of scientific studies have been published on meditation and controlled breathing exercises in the last three decades. Some studies have shown that regular meditation practice can help reduce stress, anxiety, and emotional imbalance. There is also increasing evidence that controlled breathing exercises can have a positive effect on the autonomic nervous system, heart rate variability, and physical responses to stress. However, not all claims of all types of yoga or pranayama have been scientifically confirmed.

Therefore, where the evidence is strong, it should be taught based on evidence; where research is ongoing, it should be presented as a subject of open research.

Another important aspect is health education. Today, most students studying medicine, nursing, pharmacy, public health, physiotherapy, etc. receive education focused on the diagnosis, treatment and life-saving skills of disease. This is very necessary. But not every treatment is successful, and every human life ends in death one day. Therefore, future health workers need to understand death not only as a biological event, but also as a deeply human, psychological, social and cultural experience for the patient and his family.

In many universities around the world, subjects such as palliative care, grief management, sensitive communication with patients, end-of-life decisions and death studies are gradually being made an important part of health education. It is time for Nepal to think about including such subjects according to its own cultural context.

Similarly, the body is not only a biological structure that can get sick It is not enough to understand only the brain. Science has proven that thousands of biochemical reactions are taking place inside the body every moment. Chemicals like dopamine, serotonin, oxytocin, endorphins, cortisol, melatonin affect our emotions, thinking, memory, sleep, immune system and behavior.

Nutrition, exercise, sleep, stress, social relationships and lifestyle also affect these biochemical processes. This is why the concept of ‘holistic health’ is becoming important again in health science today.

Eastern yoga and meditation traditions have also emphasized breathing, self-discipline, diet, meditation and mental balance for thousands of years. The relationship between modern science and these traditions is not yet fully established, but the field of dialogue and research is expanding rapidly. Nepalese students should have the opportunity to study both sides from a critical, evidence-based and open perspective.

Another interesting topic is consciousness. Modern neuroscience is studying the brain processes related to consciousness, while philosophy, psychology, Vedanta, and Buddhist thought offer different explanations about the nature of consciousness. So far, a complete scientific explanation of consciousness is not available. For this reason, consciousness studies are developing as an interdisciplinary research field in prestigious universities around the world. Nepal can also explore the possibilities of research, dialogue, and educational development in this area.

Some may understand such a proposal as an attempt to expand religious education. But that is not the real purpose. The basis of the education system should always be the scientific method, critical thinking, evaluation of evidence, and intellectual freedom. No philosophical or spiritual concept should be studied as the ultimate truth, but as ideas developed by human civilization. Similarly, claims that are not confirmed by science should not be presented as scientific facts. This balance makes the education system credible.

Nepal has a rare opportunity. We have a rich Eastern knowledge tradition, but the ability to communicate with modern science is also developing. If these two can be connected on the basis of research, evidence, philosophy and critical thinking, Nepal can present a new educational model not only for its students, but also for the world.

The education of the future should not be just a means of producing good engineers, doctors, teachers or administrators. It should produce citizens who are scientifically minded, culturally aware, mentally strong, compassionate and able to maturely engage with the complex questions of life.

Education should teach technology, but also self-discipline. It should teach science, but also ethics. It should teach research, but also compassion. And along with preparation for life, it should also develop the ability to understand the final journey of life with dignity.

Where the ultimate goal of education is not just to produce successful professionals, but to produce holistically developed, responsible and humane citizens.

Has the role of the health system against gender-based violence been exhausted?

 Has the role of the health system against gender-based violence been exhausted?

One-stop crisis management centers are operating in 97 hospitals across the country to provide health care and legal assistance to victims of violence.

To make the campaign against gender-based violence effective, it needs to be permanently included in the organizational structure of the Ministry of Health and Population.

Any type of humiliating, painful or threatening behavior that occurs or may occur on the basis of gender is gender-based violence. The act of pressure, coercion or arbitrary deprivation of freedom also falls under gender-based violence.

Gender-based violence is deeply embedded in our society. It begins at the fetal stage. Abortion based on gender identity is the first stage of violence. Family and social discrimination during childhood and adolescence is the next stage.

After this, discrimination occurs at the reproductive age, sexual violence or discrimination is deprived of property and resources in old age.

A question that always arises in everyone's mind: Are only women victims of violence?

Answer: ‘No’.

Men and sexual and gender minorities are also victims, which is also confirmed by the data available in our regular health system. About 10 percent of those who seek services from one-stop crisis management centers due to gender-based violence are men. About 3-4 percent are sexual and gender minorities, while the rest are women. Even when analyzing this data, women are more likely to be affected.

Gender-based violence is an issue related to public health, human rights, and social justice. Domestic violence, sexual violence, child marriage, human trafficking, harmful traditional practices, and other forms of gender-based violence have long-term effects on women’s physical, mental, social, and sexual and reproductive health.

More than 60 percent of violence is perpetrated by acquaintances and acquaintances. Violence against women can occur in the public, private, and at any time in life.

There is a gender inequality gap in society. Different gender identities are also a major cause of discrimination. According to the Nepal Demographic Health Survey 2022, 23 percent of women aged 15 to 49 in Nepal have experienced physical violence.

The report states that 8 percent of women have experienced sexual violence in their lifetime. 27 percent have experienced physical, mental or sexual violence in their lifetime. 17 percent of women have experienced violence from their partners in the last 12 months. Of the women who have experienced sexual violence, 58 percent have neither told anyone about their pain nor sought any kind of help.

Similarly, the report shows that 14 percent do not seek help even if they tell someone, such as a friend or neighbor, about their pain. However, 28 percent of women seem to have sought help after violence. Since health institutions are the first contact and service center for victims of violence, the role of the health sector is not limited to treatment alone, but also includes psychosocial counseling, forensic evidence collection, safe referral, rehabilitation and multi-sectoral coordination, implemented by the Government of Nepal through the One-Stop Crisis Management Center (OCMC).

What is the One-Stop Crisis Management Center?

It is a multi-sectoral service system that provides free access to health care and other essential services to victims or affected persons through a single door. Through this, victims are provided with emergency health care, mental health and psychosocial counseling, forensic examination, legal aid, safe shelter, and effective referral services to the police, judicial bodies, and social rehabilitation services as needed.

The OCMC, which operates with the privacy, dignity, safety, and rights of the victim at the center, has been playing a significant role in making the health response to gender-based violence effective, accessible, and coordinated.

Is it necessary or not to provide the role of the health system against gender-based violence in the organizational structure of the Ministry of Health and Food Hygiene?

Currently, 97 hospitals across the country have one-stop crisis management centers, which is a significant achievement. This achievement needs further strengthening of its leadership, coordination, monitoring, and program management in the federal structure. This issue does not seem to have found a place in the newly approved structure of the Ministry.

It is necessary to make policy arrangements to effectively implement the right to health, gender equality, the right to a life free from violence guaranteed by the constitution, and the commitments made by Nepal at the international level.

The main foundations of which are presented below:-

- The health sector is the first and most important service point for victims of gender-based violence, which cannot be done by other sectors.

- A permanent structure is necessary to make services including the One-Stop Crisis Management Center sustainable and institutionalized.

- There is a need for clear leadership and coordination of this issue and the One-Stop Crisis Management Center service between the federal, provincial, and local levels.

- It is necessary to coordinate the role of the policy level to provide integrated management of health services related to gender-based violence, mental health, sexual and reproductive health, and forensic services, etc.

A health structure with clear responsibilities of the health sector is necessary for the implementation of national and international commitments, because since no single sector can cover the campaign against gender-based violence, it is called multi-sectoral.

Sarkar The response that the health sector has so far provided is only 28 percent of the access to the One-Stop Crisis Management Center, which is being provided by the health sector. This tells us that there is still work to be done.

To date, among the sectors that have presented some progress and achievements on behalf of Nepal in international forums on gender equality or gender-based violence, the One-Stop Crisis Management Center system and service is also a major achievement.

If this issue is not included in the structure of the health sector for a policy and coordinating role in the federal structure of such an important service, it will be a leadership crisis for this sector itself.

Health response to gender-based violence is an integral part of the health service system. Therefore, it is necessary to institutionalize it within the permanent organizational structure of the Ministry of Health and Food Hygiene, not as a project or temporary program, with clear responsibilities, sufficient human resources, a sustainable budget, and an effective monitoring system.