Strengthening poison and toxicology care
THE PROBLEM
1 in 4
suicide deaths in Nepal result from poisoning, most by concentrated agricultural pesticides
~250
snakebites per 100,000 people in Nepal's flat regions
0
formal medical toxicology training programs in the country
Sources: BMC Public Health 2021 · Toxicology Communications 2025 · Global Health: Science and Practice 2024
HAPSA'S RESPONSE
Poisoning is one of Nepal's most under-recognized public health threats. In 2021, the Nepal Ministry of Health and Population and the WHO listed having a 24/7 poison information center as a top emergency care strengthening priority for Nepal.
The Poison Center Collaborative builds the infrastructure Nepal has lacked: poison information centers providers can call, surveillance that shows where cases occur, training that prepares clinicians to treat them, research that drives toxicology innovation, and advocacy for long term sustainability.
Our team piloted and validated a model for first institutional poison information center in Nepal in partnership with Tribhuvan University Teaching Hospital and ASK Foundation. Subsequently, with support from America Nepal Medical Foundation, we established a sustained model of 24/7 PIC at Dhulikhel Hospital.
Dr Ramu Kharel, Founder of HAPSA discussing Posion Information Center with representatives from Dhulikel Hospital
DHULIKEL HOSPITAL POISON INFORMATION CENTER
A collaboration between HAPSA's PCC and the Emergency Department of Dhulikhel Hospital, initially supported by America Nepal Medical Foundation, provides 24/7 telephone consultation for poisoning emergencies, clinical support for diagnosis and treatment, poison surveillance, prevention campaigns, and training for healthcare providers.
Landline:
WhatsApp/Viber:
Email:
info@hapsanepal.org
dhulikhelpoisoninfo@gmail.com
dhulikhelpoisoninfo@dhulikhelhospital.org
HOW A CALL GETS ANSWERED
Specialists in Poison Information answer first, backed by TOXBASE.
A Nepali expert group in emergency medicine, critical care, and snake and plant identification supports them over WhatsApp.
Seventeen volunteer toxicologists worldwide, spanning eight time zones, provide near 24/7 specialist cover.
8.9 minutes
median time for an international specialist's answer to reach Nepal
During the center's pilot phase, 28 percent of cases drew on international experts.
FOCUS AREAS
Lead poisoning
No level of Lead is safe. Lead poisoning is a major but preventable environmental health threat, with particularly serious consequences for children. HAPSA, through partnerships with MENATox, Emory University Section of Toxicology and Oman Poison Center, collaborates on Lead prevention clinical webinars in the annual world lead poisoning prevention week. Additionally, we have conducted a review of the burden of Lead in Nepal, and have hosted lead clinical management training through our webinars. HAPSA is commited to improving clinical pathway, recognization and prevention.
Snake Bites
Snakebite is a neglected tropical disease, and Nepal's Terai has a high burden of snakebites. The care pathway is often fragmented because of limited antivenom availability, inappropriate first-response care, or inappropriate transfers between facilities. Our poison center guides snakebite patients to appropriate pathways. We have also developed audiovisual first-aid materials for snakebite care. We have mapped antivenom availability and are building an interactive, GIS-enabled map that lets patients and providers find the nearest snakebite and antivenom center.
Toxicology Education & Capacity building
We host a monthly toxicology webinar featuring an international toxicology expert and a national provider to discuss major toxicology burdens in Nepal. Webinars are free and open to all clinical providers across Nepal. These webinars are available on YouTube.
In 2026, we launched the toxicology fellowship program in partnership with Emory University, selecting two fellows to participate in a 1-year longitudinal toxicology training program. These programs allow us to improve toxicology care by building human capacity and expertise within the country.
Monthly Webinar by HAPSA: Lead Poisoning
Monthly Webinar by HAPSA: Snake Bites
Monthly Webinar by HAPSA: Toxicology Education
More Than a Dozen Past Webinars on HAPSA's YouTube Channel
Explore our full library of recorded toxicology webinars featuring international experts and national providers, free to watch anytime on YouTube.
Upcoming Webinars
All future webinars are announced in the Events section of the HAPSA website. See what's coming up below.
Winner of BMJ Awards 2025
Our innovative work testing a model of a poison information center won the South Asia BMJ Award for Primary Care. The BMJ Awards South Asia, the regional edition of the UK's BMJ Awards, honour healthcare teams across South Asia whose work has a meaningful, measurable impact on patient outcomes, healthcare delivery, and community health.
