Providing Free Health Services to 10,000 Villagers

RMF Clinic: A Step towards Self-Sustainability

Background

After the devastating earthquake that hit Nepal in April 2015, Real Medicine Foundation (RMF) began providing much needed emergency health support to the people of Arupokhari, a remote village in Gorkha district. With the long-term vision of establishing, operating, and sustaining quality health services in the region, Real Medicine Foundation then began operating a health clinic from January 2016 in Arupokhari VDC, which is situated approximately 45.6 km from the earthquake’s epicenter in Gorkha district.

The health clinic that was previously operating in the region was severely damaged due to the earthquake, and it had since remained closed. Real Medicine Foundation 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 counselling, antenatal and postnatal care services, and 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 pharmaceutical drugs are supplied at a subsidized rate to the patients. However, if any patient is unable to pay for the medicines, Real Medicine Foundation (RMF) provides the service and medicine for free.

The RMF Health Clinic provides free health services around the clock through the hard work of three experienced team members. The three staff members include Bishnu Prasad Sharma, RMF Clinical Officer and Auxiliary Health Worker (AHW). He has 35 years of experience in the field and is in charge of the RMF Health Clinic in Arupokhari. The team also includes Binita Sapkota, Registered Nurse, who has experience working as a postnatal nurse in one of the most reputable hospitals in Kathmandu valley. She also has midwifery experience. Lastly, Krishna Bahadur Baram is our dedicated, energetic RMF Health Clinic Assistant who completes the RMF Health Clinic team.

Recent Updates

Building Expansion and Plans to Expand Service

Currently, the RMF Health Clinic is operating from a narrow, temporary structure. Real Medicine Foundation is committed to building a permanent structure for the health clinic to provide even more health services, which are currently not available. 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.

Recently, the Clinic Management Committee played a vital role in securing a large piece of land from local authorities with a total area of 1,526 square meters for construction of the RMF Health Clinic. RMF Nepal Program Manager Mr. Ganesh Shrestha visited Arupokhari, Gorkha from December 13^th to December 15^th, 2016 to assess the land and announce the construction of the health clinic to the community and local leaders. Work on the design of the building is underway. Before the end 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 and Self-Sustainability

With the vision of a self-sustainable health clinic, Real Medicine Foundation opted to work in partnership with the local community so that the operation and functionality of the health clinic rest within the community. Real Medicine Foundation 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. The composition of the committee is as followings:

Chairperson – Mr. Hom Bahadur Ale, Social Worker

Member Secretary – Mr. Bishnu Sharma (RMF Clinical Officer in charge of the health clinic)

Advisors – Mr. Iswar Adhikari, Mr. Rana Bahadur Baram, Ms. Tukmaya Baram

Members – Mr. Man Bahadur Gurung,  Mrs. Rajmati Surkheti, Mrs. Saroja Adhikari, Mr. Durga Ramtel, Mr. Fatta Bahadur Baram, Mr. Ram Krishna Shrestha, Mr. Lal Bahadur Kunwar, Mrs. Parbati Neupane

For the long-term operation and survival of the clinic, Real Medicine Foundation understands the roles and responsibilities of the community in its operation. Real Medicine Foundation previously purchased all medical supplies for the clinic. However, in November 2016, the clinic was able to purchase the medicines with their own funds, which were accumulated by the distribution of the medicines on a cost to cost basis, and 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 Mr. Shrestha, RMF Nepal Program Manager, when he committed to hand 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. The RMF Clinical Officer in charge of the health clinic has the responsibility of handling these funds until the bank account is opened. The bank account will be operated with the joint signature of the RMF Clinical Officer and the chairman of the committee.

Real Medicine Foundation will continue to help the health clinic and the community to streamline the clinic’s operations and also continue to involve the community in the operation of the clinic so that a smooth handover can eventually take place.

During his short visit to Arupokhari, Mr. Shrestha also called a meeting with local community leaders to discuss the current status and construction project of Real Medicine Foundation. He found that the community is very happy with the services provided by the health clinic and the contributions of Real Medicine Foundation towards this endeavor.

Mr. Shrestha also examined the health service provided by the clinic and inspected the medicines that are in stock, as well as the medical equipment and instruments.

Overall, the RMF Health Clinic has been able to provide quality health service to the people in Arupokhari, Gorkha. The clinic has earned a very good reputation for providing quality health services, so much so that people from neighboring villages such as Pandrung, Tandrung, and Panch Khuwa Deurali also come to the RMF Health Clinic.

Media Coverage

A national newspaper recently published a story on the RMF Health Clinic and its popularity with the local people (Figure 6). The newspaper article was published by Daraudi National Daily on December 16^th, 2016. The article mentions the reaction of local people towards the RMF Health Clinic and how it is benefiting the community.

Morbidity Report

From September 2016 to November 2016, a total of 1,805 patients (982 female and 823 male patients) have benefited from the RMF Health Clinic in Arupokhari. The patient flow was high in the months of August and September, and then the number of patients decreased gradually. This was caused by the rainy season (August-September), when there was an increased 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.

The monthly number of patients and provisional diagnoses treated in the RMF Health Clinic are shown in Table 1 and Charts 1a & 1b.

The number of patients by gender is shown in Table 2 and Chart 2.