Sirens blaring, Ganesh   Joshi drenched in sweat inside his PPE, is navigating the streets of Kanchanpur, transporting a critical patient in his ambulance to the district hospital. He and his fellow ambulance drivers, around 9 of them in Bhimdatta municipality get around two to three COVID cases daily. He has not had time to eat his lunch. The little snack he has got on his front seat remains untouched.

He is fearful for his life. He is also fearful if the patient he has dropped off to the hospital will get the required attention or not. The provincial hospital is overflowing with patients. The COVID ward is already full. You can see people sleeping on the corridors or wherever they can find space. The lucky ones have oxygen.

Ganesh has not yet touched the snack on his front seat. He is speeding off to another call.

As the second wave of COVID-19 hit Nepal, the situation got dire very fast. The health system was overwhelmed. Mahakali hospital, the only COVID hospital in Kanchanpur, has a total of six ICU, 15 HDU and 50 isolation beds. All of them were fully occupied during the first weeks of the second wave. COVID patients were being transported to the adjoining hilly districts of Dadeldhura and Baitadi. The second wave had initially impacted the southern districts adjoining India. Through community transmission, the spread was gradually creeping up the hilly and mountain districts. So was the demand for ambulance drivers and its risks along with it. Many drivers were hesitant to ferry COVID patients as they lacked basic gear of PPE. The district Red Cross office made sure that the ambulance drivers were provided with PPE and basic health kits for their day-to-day work.

Mercy Corps Nepal in coordination with district Red Cross offices have provided 510 PPE gowns, 2365 (500ml) hand sanitizers, 48,500 masks, 260 face shields, 25000 bottled water to the Sudurpaschim provincial health cluster. The supplies were distributed through local municipalities to frontline workers, isolation centers and hospitals.

“Me and my fellow drivers were provided PPE gears by the local municipality,” said Hirendra Dhami, Jimuwa Health post ambulance driver. “We have to work round the clock and if we are not provided with the proper safety gear then it will be very difficult to carry our duties. The second wave was very scary but we had to carry our work,” added Dhami.

In many parts of Nepal, Ambulance are just taxi services. Many of the ambulance services lack the adequate health equipment. There are no  s to take care of the patients. “Even in the capital city of the nation, many ambulances are just transport services. They are just old vans and jeeps that have a gurney and an oxygen cylinder,” explains Dr Kulesh Thapa, Medical Director, Nepal Ambulance Service.

For his safety, Ganesh craftily separated the driver compartment and the patient compartment in his ambulance with a plastic sheet. “We have to be careful. We had not anticipated the second wave. Its much deadlier. Many of my relatives and neighbors have died during this second wave. It’s a very difficult time for all of us,” said Ganesh.

After the initial surge of the second wave in late April and the month of May, the number of cases have gradually decreased. The hospitals have fewer critical cases and after a long time you can see empty beds in the COVID ward of Mahakali hospital. After 51 days, the hospital for the first time declared zero COVID related deaths.

“Thankfully the situation has gotten a lot better since last month. The COVID cases have decreased significantly. We are not pressed as we were in the last couple of weeks,” states Ganesh with a sigh of relief.