Nepal faces an ever-increasing demand of health care services from both the urban and rural populations. The health care system also has to face the numerous challenges that constantly affect the delivery of effective and efficient health care services. Numerous calamities have hit the country in the recent past. Every year, mountain water in monsoon cause flooding problems like the spread of water-borne diseases and limited access to the affected areas by health care providers. Respiratory infections have also become a killer of Nepalese people in remote villages as well as big cities.

Though public health care plans and programs were introduced in Nepal a long time ago, they recorded unsatisfactory performance in regards to effectively serving the needs of the public, especially the poorest of the poor. However, in 1991 the government did something that changed the state of the health care system. It introduced a health policy that opened doors to the private sector. NGOs started partnering with other private sector participants and the government to improve the access and delivery of healthcare services to the people of Nepal.

Health Care Foundation-Nepal (HECAF-Nepal) was established in 1997 with an aim of providing more affordable healthcare services that were urgently needed in Nepal at the time. The NGO is registered in Kathmandu District Administration Office and provides services in three areas: health care, emergency medicine, and environmental health.

HECAF-Nepal currently has 5 activity wings that facilitate its operations. These are:

National kidney center Health care waste management programEmergency Medical Response ProgramNagarkot Community ClinicHealth Magazine Publication

National Kidney Center (NKC)

NKC provides dialysis services to Kidney patients infected with Hepatitis B and C, and HIV/AIDS. It is the only center in Nepal that provides such services and also the largest dialysis center in the country. With the capacity to offer haemodialysis service to up to 130 patients per day, NKC forms an integral part of the kidney health community. The development of the center has been driven by the desire to share compassion with Nepalese people who are diagnosed with kidney disorders. Whenever possible, the center also performs early screening, detection and awareness creation in a bid to reduce the prevalence of kidney issues.

The center also trains nurses and students on Haemodialysis to build a more knowledgeable human capital who can provide quality healthcare service in Nepal’s dynamic health care environment. NKC runs OPD clinic every day of the week except Saturdays. Senior and qualified doctors provide consultation services during these days.

Healthcare Waste Management

Healthcare waste includes sharps, non-sharps, body parts, blood, chemicals, medical devices, pharmaceuticals and radioactive materials. Proper management of these by-products is required for the safety of healthcare workers, patients, waste handlers and the public. Poor healthcare waste management can expose individuals to injuries, toxic effects, and infections.

HECAF-Nepal promotes various methods and technologies for proper management of healthcare waste. These include:

– Non-burn technology: For a developing country like Nepal, the choice of technology for waste management is of great concern. HECAF promotes autoclave to treat infectious waste because it’s user-friendly.

– The 3R principle “Reduce, Reuse and Recycle”: HECAF has developed a healthcare waste management system based on this principle. According to practice, this principle is very effective in managing about 80% of the total waste generation in hospitals.

– Occupational health and safety: The safety of healthcare workers is the first consideration of a healthcare waste management program. HECAF conducts an occupational survey prior to implementation of the program in a healthcare facility.

Emergency Medical Response Program

Emergency Medical Service (EMS) System is a fundamental component of any health system. In Nepal, the situation of EMS is far from effective. Only a few patients with life-threatening conditions have access to ambulances. Most of them use taxis. HECAF-Nepal aims at running an EMS system that provides affordable and reliable 24/7 medical emergency services to Nepalese people. A dedicated team of medical professionals is mandated to:

Assess patients in critical conditionsRespond to childbirth situationsRespond to cardiac emergenciesTreat illnesses and injuries such as shock, bleeding, tissue, muscle, head, bone and spinal injuriesPerform first aid and other EMS operations in remote locations

Nagarkot Community Clinic

HECAF-Nepal in coordination with the local Village Development Committee Nagarkot runs the Nagarkot Community Clinic. The clinic was established in 2001 and became the first community health center to extend quality healthcare services to the local people. The main objectives of the clinic include:

– Providing primary healthcare

– Offering health education

– Organizing specialty health camps to treat villagers at a reduced cost or free of charge

– Providing regular immunization and family planning advice and devices

– Operating ambulance service to address medical emergencies

– Partnering with other NGOs in Nagarkot in social work

The Nagarkot Community Clinic has an ambulance that helps to meet the emergency needs of the people of Nagarkot. With the support of various local organizations like the Rotary Club of Kathmandu and national and international donors, the clinic has been able to acquire medicine and equipment and this support has been instrumental to the achievement of the clinic’s objectives.

Health Magazine Publication

Improving the access of information about health is critical to the development of an effective healthcare system. Nepalese people need more education about their health and how to prevent common illnesses. HECAF –Nepal uses healthcare magazines as one way of disseminating information about healthcare services, events, news and other issues concerning health. When individuals and families in Nepal get more enlightened about health and lifestyle matters, HECAF-Nepal is at a better position to provide quality services and improve the life of the people.

Notable improvements in healthcare have been made in Nepal. Mortality rate during childbirth, under-five mortality, infant mortality and child malnutrition have reduced significantly over the last two decades. Life expectancy and human development index have increased. These are indications that the public-private mix in the provision of health care in Nepal that took effect in the early 90s has born fruits.

HECAF-Nepal is steadfast in its service to the people of Nepal. Through its experience in the country, HECAF has come to see what efficient health care delivery involves. It’s all about putting resilient effort to improve remote rural energy, incorporating innovative strategies to face challenges of the harsh working environment as well as building an extensive network of health workers to facilitate the timely identification and follow-up of patients.