Nepal: Model Village
Growing Vision of Self-Sustainable Health Clinic: August – December 2016
January 19, 2017
Gaurav Pradhan
Summary of Activities
The health clinic that was previously operating in the region was severely damaged due to the earthquake, and it had since remained closed. RMF constructed a temporary structure in the same location and has been providing health services such as:
- OPD (outpatient department)
- emergency services
- first aid
- family planning and counseling
- antenatal and postnatal care services
- the supply of pharmaceutical drugs
With the purpose of providing access to much needed health services in the area, these services are provided to the community for free, while pharmaceuticals are supplied at a subsidized rate. However, if any patient is unable to pay for the medicines, RMF provides them for free.
The RMF Health Clinic provides free health services around the clock through the hard work of three experienced team members:
- Bishnu Prasad Sharma – RMF Clinical Officer and Auxiliary Health Worker (AHW), has 35 years of experience in the field and is in charge of the RMF Health Clinic in Arupokhari.
- Registered Nurse Binita Sapkota – who has experience working as a postnatal nurse in one of the most reputable hospitals in Kathmandu valley. She also has midwifery experience.
- Krishna Bahadur Baram – our dedicated, energetic RMF Health Clinic Assistant who completes the RMF Health Clinic team.

Results &
ACCOMPLISHMENTS

Building Expansion
Plans to Expand Service
Real Medicine Foundation is committed to building a permanent structure for the health clinic to provide additional health services. The new health clinic will include a birthing center, which is needed in the region; the village had 96 births in the last calendar year.
Work on the design of the building is underway. In the course of 2017, we are expecting to move from the temporary structure to the new building and continue providing health services from there.

Long-Term Goals
Self-Sustainability
With the vision of a self-sustainable health clinic, RMF opted to work in partnership with the local community so that the operation and functionality of the health clinic rest within the community. RMF has formed a Clinic Management Committee including representatives from the community, clinic staff, and nearby government health authorities so that the major decisions for the operation of the RMF Health Clinic rest with the community itself.

Media Coverage
Praise from the Community
A national newspaper recently* published a story on the RMF Health Clinic and its popularity* with the local people. The newspaper article was published by Daraudi National Daily on December 16th, 2016. The article mentions the reaction of local people towards the RMF Health Clinic and how it is benefiting the community.
From the article:
"This clinic has saved people’s lives here." – local resident, Ram Bahadur Baram

Health Awareness Programs
Educating the Community
RMF’s team has organized many one-on-one sessions, group sessions, and awareness programs on multiple health issues, in all the wards of Arupokhari village.
Session topics generally include:
- Personal hygiene and environmental sanitation
- Communicable diseases and how to avoid them
- Immunization of newborns
- Malnutrition and training on how to prepare nutritious food at home with locally available resources
- Awareness of health hazards from alcohol and smoking

Morbidity Report
January – November 2016
From January 2016 to November 2016, a total of 5,688 patients (2,872 female and 2,776 male) benefited from the RMF Health Clinic in Arupokhari. The patient flow was especially high in the months of August and September. This is because of the rainy season, when there is a higher possibility of water contamination and other favorable environments for communicable diseases. The winter starts in October, so the number of patients with communicable diseases has been decreasing.

Financial Responsibilities
Clinic Developing Independence
RMF previously purchased all medical supplies for the clinic. However, in November 2016, the clinic was able to purchase the medicines with its own funds, which were accumulated by the distribution of medicines on a cost to cost basis. There are also surplus funds of USD 2,000 maintained in a safe box in the clinic. This huge achievement of self-sustainability was highlighted by RMF Nepal Program Manager Ganesh Shrestha, when he handed over the surplus funds to the committee and advised them to open a separate bank account so that the funds collected from distribution of the medicines can be deposited.

Background
& Objectives
Background
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.
Objectives
- 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

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