Hasilo Nepal: Fighting Child Malnutrition One Toothbrush at a Time

Hasilo Nepal: Fighting Child Malnutrition One Toothbrush at a Time

Berkeley, United StatesKatmandu and Sindhupalchok District, Nepal
Organization type: 
nonprofit/ngo/citizen sector
Project Stage:
Start-Up
Budget: 
$1,000 - $10,000
Project Summary
Elevator Pitch

Concise Summary: Help us pitch this solution! Provide an explanation within 3-4 short sentences.

Hasilo Nepal is a 3-year program focused on fighting child malnutrition through oral healthcare preventative services and education.

About Project

Problem: What problem is this project trying to address?

According to WHO, over 39% of children in Nepal are underweight and malnourished. Poor oral health and tooth decay—the most common chronic disease worldwide, affecting 50-95% of children—may be an overlooked cause of malnutrition, which could occur through the inability to eat due to mouth pain, and the effects of a chronic state of inflammation stemming from oral infection. Preliminary results from Nepal reveal that 64% of the children reportedly eat candy 1 or more times per day and 63% of children 6 years and under have untreated tooth decay. This project is focused on understanding the contributing factors to poor oral health and how these factors are related to malnutrition in Nepali children, and implementing an intervention to reduce early childhood tooth decay and malnutrition.

Solution: What is the proposed solution? Please be specific!

To reduce childhood malnutrition and improve children’s overall health, U.S. dentists and volunteers work with local Nepali dentists, community health workers, and a local Nepali NGO, Self Reliant Center, to provide health camps targeting children under 7 in both urban sites in Kathmandu and in rural ones in Sindupulchok. The health camps focus on preventing tooth decay and malnutrition by educating families about good nutrition and oral hygiene (e.g. limiting sugary snacks and soda and ensuring proper tooth-brushing techniques), supplying toothbrushes and toothpaste for the entire family, applying fluoride varnish to children’s teeth 2-3 times a year (a proven caries-prevention measure), providing dental examinations, and referring children with severe tooth decay to local dentists for treatment. The program provides a new way to reduce childhood malnutrition; it is economical, easy to implement, and effective.
Impact: How does it Work

Example: Walk us through a specific example(s) of how this solution makes a difference; include its primary activities.

Our intervention includes nutrition and oral health education, an application of fluoride varnish 2-3 times per year, distribution of toothbrushes and toothpaste, and discounted dental care referrals. During our bi-annual camp, children under the age of 7 and their mothers walk through a series of stations, which include an interview regarding nutrition and oral hygiene practices, tooth-brushing instruction, height and weight measurement, dental exam, fluoride varnish application, and nutritional and oral hygiene education. Along with the opportunity to talk to a dentist about a child’s current problems, the camp provides its participants with education and the supplies needed to prevent further tooth decay. Yearly follow-up interviews and exams document the success of the intervention in improving oral health and nutrition. Our intervention has shown to improve diet and oral hygiene through a limitation on sugary snacks, return to more traditional diets, and an improvement in toothbrushing practices. These preventive measures in turn lead to stronger tooth structure, less mouth pain, and less chronic inflammation. Preliminary results of our sister project in El Salvador show dramatic improvements in children’s oral health and nutrition- a reduction in tooth decay from 85% to 50% of children, a reduction in mouth pain from 47% to 21% of children, and a reduction in moderate-severe weight for height malnutrition from 16% to 2% of children.
Sustainability

Marketplace: Who else is addressing the problem outlined here? How does the proposed project differ from these approaches?

Other programs focus on treatment and tooth extractions while the goal of this project is to use education and prevention as the main mechanism for change. We want to provide sustainable practices to children and their families to help them for their entire lives. Secondly, this project focuses on children under the age of 7 while other projects focus on children who are 7 or older. By age 7, many children are already experiencing severe tooth decay and mouth pain and oral hygiene habits, or lack thereof, are harder to influence. This project focuses on a younger generation to maximize chances of preventing tooth decay and instilling strong oral hygiene habits.
Team

Founding Story

As a Nepali-American and former college undergraduate when starting this project, I wanted to start a program in Nepal that was simple, yet very effective. My idea to bring this project to Nepal was sparked by a 5-year study that was completed by Dr. Karen Sokal-Gutierrez. Results from her 5-year intervention in El Salvador suggest the link between early childhood tooth decay and malnutrition, and the potential to reduce early childhood malnutrition by focusing on preventing tooth decay. Dr. Sokal-Gutierrez’s work in El Salvador was the perfect project to emulate. I completed background research on the status of children’s oral health and nutrition in Nepal and used my own experiences from traveling there to visit family and volunteer at a local hospital to envision the potential of this program.
About You
Organization:
Hasilo Nepal
About You
First Name

Sidhanta

Last Name

Gurung

About Your Organization
Organization Name

Hasilo Nepal

Organization Country

, CA, Berkeley, Alameda County

Country where this project is creating social impact

, XX, Katmandu and Sindhupalchok District

How long has your organization been operating?

1‐5 years

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Innovation
How long have you been in operation?

Operating for 1‐5 years

Which of the following best describes the barrier(s) your innovation addresses? Choose up to two

Access.

Social Impact
Please describe the goal of your initiative; outline what you are trying to achieve

Hasilo Nepal is a 3-year project aimed to sustainably foster community empowerment by working with local community health workers and non-profit organizations in Nepal to improve oral hygiene and nutrition in young children by focusing on preventative measures. To create sustainability, we focus on training community health workers, who then teach the parents and children about good oral hygiene, proper toothbrushing techniques and nutrition education. Additionally, the team is dialoguing with UNICEF and Ministry of Health to incorporate the program on a national level. This project aims to alleviate malnutrition and improve oral health in children by nutrition and oral hygiene education, application of fluoride varnish, dental examinations, and distribution of toothbrushes and toothpaste.

What has been the impact of your solution to date?

Over the past 2 years, we have educated Nepali health workers, parents and children on nutrition and oral health, and provided toothbrushes, toothpaste and fluoride varnish, at a cost of $5 per child per year. The health workers have taken full initiative of our program even in the absence of the US team—by fully embracing and taking ownership, they have shown how this project has the potential to succeed in bettering the health of individuals and communities in Nepal after the project concludes.
In addition, some schools sites embraced the project’s message, instituting policies, such as banning junk food and candy and embracing healthier alternatives. By using this method, we hope to collaborate with teachers and program leaders to initiate school-wide policies that incorporate the message of our project. Lastly, we are working with UNICEF and the Ministry of Health to incorporate an oral health intervention with existing nutrition programs geared towards the same age group.

What is your projected impact over the next five years?

The ultimate goal of the project is to expand the services to children all over Nepal by incorporating this program into national health programs. Strategies for reaching this goal revolve around collaborating with government and non-government agencies involved in health and education. Preliminary meetings to introduce this program have been held with the Nepal Ministry of Health and UNICEF. In addition, the project team would like to develop a "Best Practices Toolkit" to help start this project in other countries. Childhood malnutrition is a persistent global health issue, with over 146 million underweight children worldwide. Oral health is often overlooked as a contributing factor to malnutrition and this strategy can and has already been implemented in multiple countries.

What barriers might hinder the success of your project? How do you plan to overcome them?

Barriers hindering the success of our project are ubiquitous advertising of low-nutrient junk foods that has in many cases taken over the Nepali diet, the Nepali community’s continued compliance in buying products from large commercial corporations, and the financial cost of dental care. We aim to implement discussions at our sites to stress the importance of maintaining diets consisting of traditional meals and explain the negative impacts of eating processed foods in combination with not maintaining sound oral health practices. Lastly, we hope to overcome financial distress from dental care costs by including our dentists in a practical intervention component in a way that would not diminish the importance of prevention.

Winning entries present a strong plan for how they will achieve and track growth. Identify your six-month milestone for growing your impact

Implement follow-up health camps this summer and continue to reach out to larger organizations regarding project adoption.

Identify three major tasks you will have to complete to reach your six-month milestone
Task 1

Maintain frequent communication Self-Reliant Center leading up to and during the health camps.

Task 2

Fund-raise to cover expenses of summer health camps.

Task 3

Continuing to grow relationship with larger organizations through sharing preliminary data.

Now think bigger! Identify your 12-month impact milestone

Convince organizations to adopt and incorporate this program into national programs and complete the final year of health camps.

Identify three major tasks you will have to complete to reach your 12-month milestone
Task 1

Analyze data from the past two years to allow us to present project’s impact when the opportunity arises.

Task 2

Coordinate times and dates to meet with representatives from these organizations.

Task 3

Fund-raise to cover expenses of final health camps.

Sustainability
Tell us about your partnerships

Our main partner in Nepal is the Self-Reliant Center, an NGO that helps maternal and child health projects by providing community health workers and local expertise. We also work with local schools to set up dental camps. Many of our supplies come from donations from individuals, dental supply companies and non-profit organizations like Global Grins, Global Healing and American Nepal Medical Foundation. Himal Dental Clinic gives discounts to children referred by our team. We are currently in the process of partnering with Nepal’s Ministries of Health and of Education to scale up the project.

Are you currently targeting other specific populations, locations, or markets for your innovation? If so, where and why?

Currently, we are reaching out to the academic community at UC Berkeley as well as the local dental community here not only for financial support in the forms of grants and donations but for further education on the issue of malnutrition and oral health care. We are also connecting with the Nepali community in the San Francisco Bay Area for financial support and awareness. In addition, we have met with UNICEF and the Ministry of Health in Nepal to incorporate the project on a larger scale nationwide and are hoping to ensure the continuation of the project through our collaboration with them.

What type of operating environment and internal organizational factors make your innovation successful?

Our project is managed effectively through collaboration and constant communication between the team in the US and the team based in Nepal (our dentists and Self-Reliant Center). All of our team members have a strong interest in public health and prevention and our team brings together people of multiple backgrounds. Our team consists of medical school professors, undergraduate volunteers at UC Berkeley, dentists, a medical student, and dentists based in Nepal and the US. This diversity brings new ideas and innovation that may not have been seen otherwise.

Please elaborate on any needs or offers you have mentioned above and/or suggest categories of support that aren't specified within the list

Our goal in applying for this award is to expand our project to broaden the population we reach and also to act on the new ideas and improvements that we would like to make to the program.

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