A year has passed since Real Medicine Foundation (RMF) started operating a health clinic in Arupokhari, Gorkha. During this time period, the clinic has treated many patients with different health problems. What began as a small initiative with a small budget and a steadfast commitment from RMF and the local community has grown into a lifesaving, easily accessible, much-needed health solution for the community.
Before RMF operated the clinic, the nearest health post was about 4–5 hours away, and any health facilities were few and far between. Now through RMF’s initiative, the people of Arupokhari and neighboring villages have access to a 24/7, free health service facility, as well as basic medicines at a highly-subsidized rate.
During this time period, RMF’s health clinic has treated 7,010 patients, averaging up to 450 patients a month. The people of Arupokhari and surrounding villages are very grateful for RMF’s efforts in providing high quality, free health services, which were previously very hard to come by. The RMF Health Clinic ensures that patients receive free, quality health services, as well as medicines at a very reasonable and subsidized rate, which is why RMF’s clinic is very popular in Arupokhari and neighboring communities.
With this success and popularity, we were able to run the RMF Health Clinic on the revenue collected from sales of medicines, even after providing medicines at a subsidized rate. The RMF Health Clinic was able to achieve self-sustainability within the short span of one year, all because of the efforts and dedication of our clinic staff.
RMF Nepal helped form a Clinic Management Committee and handed over the responsibility of managing the clinic so that the community feels a sense of ownership towards the clinic. Since the handover, the committee has been doing an excellent job managing the clinic, with very little intervention from the RMF Nepal office.
The RMF Health Clinic’s Clinical Officer is the Member Secretary of the committee, and his experience and skill are proving invaluable in better management and guiding the clinic in the right direction.
RMF Nepal envisions establishing an improved, permanent health facility in the community, helping to secure a long-term health solution. With that vision, RMF Nepal now plans to implement a five-year project in Arupokhari so that the community and neighboring communities have access to improved health services and facilities.
Plans are being made, not only to provide better infrastructure, but also to provide sufficient training, workshops, and interactive programs to better prepare the community to operate the clinic if and when RMF hands it over to the people of Arupokhari.
The RMF Nepal office ensures that quality service is provided to the community by the RMF Health Clinic through regular program activities monitoring and monthly reports. We have a highly qualified and experienced Clinical Officer in charge of the Arupokhari clinic, and he is responsible for the reports and data provided to the RMF Nepal office. The Clinical Officer is responsible for treating patients and ensuring the quality of health services received by the visiting patients.
RMF Nepal’s office also makes periodic monitoring visits to the clinic to further ensure that the patients are treated with utmost care and dignity. Any needed assistance is being provided by the supervisors during the field monitoring visits.
Nepal Program Manager Mr. Ganesh Kumar Shrestha and a representative from RMF headquarters, Mr. Amitabh Kumar, made the 7-hour journey from Kathmandu to Arupokhari, Gorkha for the monitoring visit. The monitoring team:
The monitoring team found that the clinic has served the community regularly, the registration of patients was appropriate, and the purchase of needed medicines was carried out after the approval of the Clinic Management Committee and the Nepal office.
After the clinic inspection, the monitoring team interacted with the community people of the clinic’s catchment area. The community people thanked RMF heartily for the health services provided and also requested to continue the services with expansion. The community leader expressed the community’s commitment to provide support to sustain the clinic and its service expansion.
The monitoring team assured the community that the support will be continued and also informed them that a five-year project with additional activities will be implemented soon.
For implementation of this project, a local NGO has been selected that has experience and knowledge in implementing such projects.
System Development Service Center (SDSC) is a non-governmental organization (NGO) with legal recognition from the Government of Nepal. SDSC has experience in several sectors of social upliftment for resource-poor and marginalized communities in creating awareness about health, sanitation, and human rights, as well as income generation and community based, demand based infrastructure development.
The project will start as soon as the necessary approvals from the Ministry of Women, Children, and Social Welfare and the Social Welfare Council have been obtained in writing.
In line with RMF’s concepts and the government of Nepal’s vision for a comprehensive and eventually sustainable Model Village, RMF, in close partnership and collaboration with Sarswati Foundation will be working towards the development of a Model Village in Arupokhari. Sarswati Foundation has been working in Arupokhari, Gorkha since 2009 as a non-profit. This was co-founded by Subhash Ghimire, a native from that village and editor-in-chief of the Republica, Nepal’s leading English daily that publishes with the New York Times in Kathmandu.
Following the devastating earthquake, the non-profit has been actively engaged in relief and reconstruction works in the area, which includes providing food and temporary shelter relief to the affected people. So far, the foundation has delivered 7.5 tons (100 sacks of 30 kg rice, 50 sacks of 50 kg lentils, 500 sacks of 0.5 L of oil, 500 packets of 1 kg salt, 495 blankets, 350 tents) to the community, and aims to rebuild the village as a replicable model, which will include earthquake-safe structures designed by architects and engineers, utilizing local natural and human resources to ensure ownership and sustainability, improved healthcare access, education and livelihood programs, based on the needs of the communities and with the leadership of the local people.
Similarly, the village also holds a huge potential as a thriving Manaslu trekking route, along with a 600-megawatt hydro project being planned around in the area. In addition, the community is also actively engaged in production of local agricultural products and livestock. With a thought-out detailed plan, the opportunities of the village could be tapped in to create a replicable, integrated and sustainable Model Village.
RMF supports the rebuilding of Sarswati Peace School (more than 200 students, mostly from economically and culturally marginalized backgrounds) and Darbar Higher Secondary School (public school with more than 400 students), both of which were badly damaged during the earthquake. The current plan is to demolish the existing damaged structure and construct earthquake resistant buildings.
Along with the support to the reconstruction of the schools, the model village project also seeks to help build at least 100 temporary shelters and 700 permanent houses to the identified most vulnerable households in the community and one earthquake resistant local health center. Health services, education, and the economy will be supported for the long-term as the people of Arupokhari build a stronger future in collaboration with RMF and Sarswati.
As of February 2017, the RMF Health Clinic has treated a total of 7,010 patients.
The clinic averaged about 450 patients per month from December 2016 to February 2017.
Mr. Bharat Surkheti from Arupokhari-1, Gorkha used to work in construction of houses and aluminum sheets. He was injured on his left leg while working with aluminum and cut with glass on the right leg. 13 stiches were done under local anesthesia, a Tetanus Toxoid injection was given, and antibiotics were given for 1 week. Dressing was done daily for 2 weeks. Now he has recovered well.
Mrs. Sita Adhikari from Arupokhari-5, Gorkha reached the clinic with hypotension. Treatment was given with a normal saline IV and a Polybion injection.
Mrs. Sunita Surkheti from Arupokhari-4, Gorkha was suffering from diarrhea and vomiting. She was dehydrated. She was treated with IV fluid, Ringers lactate 3 pints, Metronidazole IV, and Domperidone. During discharge, ORS and Metronidazole tablets were prescribed.
Mr. Gam Bahadur Pariyar from Arupokhari Ward-4, Gorkha attended the RMF Health Clinic with a cut injury on his left leg from a sickle. 3 stiches were done under local anesthesia, a Tetanus Toxoid injection was given, antibiotics were given for 7 days, and daily dressing done. Now sutures are removed and he has recovered health.