Nepal

Location
Pokhara, Nepal

Site Institution
Institute of Social and Environmental Research—Nepal.

U.S. Institution
UC Berkeley, School of Public Health

U.S. Based Mentor

Michael N Bates, MSc, MPH, Ph.D.
Adjunct Professor of Epidemiology School of Public Health.
E-mail: m_bates@berkeley.edu
http://sph.berkeley.edu/michael-bates

 

Local Mentor

Dirgha J. Ghimire, PhD
Executive Director, Institute for Social and Environmental Research, Nepal
Email: nepdjg@umich.edu
http://www.psc.isr.umich.edu/people/profile/36/Dirgha_Ghimire

 

Research Areas
Health effects of household air pollution exposure
Health impacts of heavy load carrying

Site and Background
Our research facility in Pokhara city, Kaski District, Nepal, is run by the Institute for Social and Environmental Reseach—Nepal (ISER-N).  It includes:

  • Study headquarters, a 3-storey house from which the staff operate.  The building has been fully equipped with office equipment, including desks, tables, chairs, filing cabinets, computers and a refrigerator for samples.  We have installed a generator and storage batteries with an inverter to ensure electricity supply during the frequent periods (half the day or more) that electricity supply is not functioning.
  • A team of 12 well-trained staff, comprising a local study manager, 4 interviewer/phlebotomists, 3 air pollution measurement technicians, 2 drivers, an office assistant and a security guard.
  • A van and a jeep to transport staff into the field-the van for urban travel and the jeep for rural areas.
  • An extensive range of equipment for monitoring appliance usage and air pollution, mainly particulates and carbon monoxide. Equipment includes ToxiRAE real-time, electrochemical carbon monoxide sensors; the UCB-PATS (Particle and Temperature Sensor); RTI MicroPEMs , a small particulate sampler with integrated real time and gravimetric PM2.5 monitoring capabilities; iButtons, small, data-logging thermometers, used as Stove Use Monitors (SUMs); and gravimetric pumps, cyclones, and Teflon filters.
  • Well-developed relationships with local community leaders, public health system officials, and Manipal Teaching Hospital.

Current and Planned Projects

  • A case-control study of the relationship between household air pollution and both pulmonary tuberculosis disease and TB infection.  Field work for this study has been continuing since 2012 and aims to recruit 650 TB cases and 1,300 controls.
  • A case-control study of age-related macular degeneration and household air pollution, which aims to recruit 300 cases and 300 controls.  This study will begin in late 2015 and is in conjunction with the Department of Ophthalmology at Manipal Teaching Hospital.
  • A cross-sectional epidemiologic study primarily focused on the relationship between household air pollution and cataract and dry eye disease in 900 women aged 40-70.  This study will begin in late 2015 and is in conjunction with the Department of Ophthalmology at Manipal Teaching Hospital, Pokhara.
  • We have recently been funded by the Global Alliance for Clean Cookstoves to carry out a study of cardiopulmonary effects of household air pollution.  This study will be conducted in conjunction with the cross-sectional study of eye diseases.
  • We are also interested in carrying out projects to investigate the health impacts of carrying heavy loads.  This is related to our research on household air pollution, because women often carry heavy loads of firewood to their homes.  Because the road system is not very well developed in Nepal, it is very common for people, both men and women, to carry very heavy loads using a namlo, a band looped over the forehead, often carrying a basket, called a doko, on the back.  There has been little investigation of the health impacts of this practice.  However, we would like to investigate its relationship with uterine prolapse, a very common condition among Nepalese women, and with back pain, a major cause of disability in the world.