Nepal: Model Village
Approval Received for 5-year Health Care System Strengthening and Outreach Program: Q1 2017
June 19, 2017
Ganesh Shrestha, Nepal Program Manager and Pragya Gautam, Program and M&E Coordinator
Summary of Activities
A year has passed since 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 7,568 patients, averaging up to 486 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.
5-year Health Care System
Strengthening and Outreach Program
RMF Nepal has designed a 5-year Health Care System Strengthening and Outreach Program to strengthen the healthcare system in Nepal. Arupokhari, Gorkha is one of the targeted communities where we will implement this program. The program aims to provide the community with infrastructure for operating a health clinic, as well as the knowledge needed to operate the clinic. Project activities have been designed in compliance with the national priorities and to ensure a balance between hardware and software elements.
Supporting Current Projects
During the first quarter of 2017, RMF received approval of our 5-year Health Care System Strengthening and Outreach Program from Nepal’s Ministry of Women, Children, and Social Welfare, and we are now waiting for the Social Welfare Council to sign the project agreement. The Health Care System Strengthening and Outreach Program will support the health component of two of RMF’s current projects: The Model Village Project (Gorkha) and the Kavre Community Outreach Program. As seen in the previous section of this report, the RMF Health Clinic in Arupokhari, Gorkha has been successfully operating for over a year. Once the project agreement is signed by the SWC, we will be able to further improve services and infrastructure in Gorkha and begin full implementation in Kavre.
Partnering with a Local NGO
System Development Service Center
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.
Clinic Management Committee
In another step to achieving self-sustainability, 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.
Ensuring Quality Service
Monitoring of Project Activities
RMF Nepal’s main office ensures that quality service is provided to the community by the RMF Health Clinic through regular program activity 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.
Filling in the Gaps
Medical, Infrastructure, and Technology
In recent years, the country’s development initiatives have been predominantly focused on training and orientations. In order to fill in the gaps created, the project will put a key focus on providing medical services and installing lifesaving infrastructure, while making sure that software elements have not been left out. In order to bridge the gap in software packages, RMF will collaborate with the Government of Nepal, UN agencies, and other development agencies in the districts.
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.
- Rebuild the village as a replicable model, which will include earthquake-safe structures designed by architects and engineers
- Use local natural and human resources to ensure ownership and sustainability
- Improve healthcare access and education based on the needs of the communities and with the leadership of the local people
Click to enlarge
Saroj Surkheti is a seven-year-old, active boy. While playing with friends, he injured his right ankle. Upon arrival at the RMF Health Clinic, he was assessed thoroughly. His ankle was swollen, and he was crying with pain. The pain worsened while moving the injured part, and he could not move his toes. He could not step on the injured foot. Suspecting fracture, he was referred to the district hospital for an x-ray and further management. The x-ray confirmed the fracture, and he had had a plaster cast for six weeks.
Alina Kunwar is a nine-year-old girl who was brought to the RMF Health Clinic complaining of pain in her neck, inability to open her mouth or eat by chewing, and difficulty swallowing. Her cheeks were swollen and warm to the touch. She was prescribed a painkiller to reduce the pain and tape on her swollen cheeks to support the area. A few days later, her swelling had reduced noticeably and she could eat and drink properly.
Vimawati Shrestha is a 20-year-old female resident of Arupokhari. She came to the RMF Health Clinic complaining of redness of the eyes with sticky discharge. She also complained of feeling like grains of sand were in her eyes. She was diagnosed with conjunctivitis. A prescription of antibiotic eye drops six hourly for 5 days was made, and she was also taught about maintaining hygiene to prevent further complications and future infections.
Indra Lal Sodhari
Indra Lal Sodhari is a forty-five-year-old man who is a farmer. He works in his field all day. While using a sickle on the field, he cut his finger and started bleeding. He came to the RMF Health Clinic with the cut injury, which was bleeding. The wound was not deep; thus, it was cleaned and dressed using antiseptic. Injection of tetanus toxoid was also given. He was also called every alternate day for dressing.
Maili Baniya is 73 years of age. She has arthritis, which causes her severe pain and has debilitated her. She cannot walk without aid. She was taken to the hospital for the problem, and the doctors suggested surgery. Her family cannot afford the cost of surgery, and they fear its effect, as she is very old and weak. Her husband simply denied her surgical treatment. She came to the RMF Health Clinic with severe pain. She was assessed and given painkillers for symptomatic treatment.