Posted by Duncan Maru
With the strong support of local community members and the ministry of health, Nyaya Health has begun preliminary planning for renovating and staffing a long-abandoned hospital complex near to our clinic. This is a long-term project requiring increasing our fundraising base, receiving all the necessary government approvals, improving upon our existing logistics systems, and recruiting staff. As with all our work, our planning process is open-source; please see our current status at: http://wiki.nyayahealth.org/SurgicalServices.
View of the Bayalpata Hospital Complex
From the executive summary:
Through our experiences caring for the community in Achham, and through our discussion with the local community and government, it has become clear that essential inpatient and surgical services must be provided to make a significant and comprehensive public health impact in the region. The maternal health situation is particularly dire in this area, with best estimates indicating that a pregnant woman is 100 times more likely to die in childbirth in Achham (nearly one in 100 pregnancies) than in the United States. The high maternal mortality rate, coupled with the lack of essential health delivery infrastructure, has been our primary motivation for working in the region. We have begun to address the lack of infrastructure through our primary care clinic, staffed by an all-Nepali team of healthcare professionals. The clinic currently provides care to approximately 60 patients a day and includes 24-hour labor and delivery services. We are rapidly reaching capacity, however, and will expand in a timely and responsible manner to meet the growing need for both healthcare delivery services, and the training of new Nepali healthcare workers.
Local citizens and government officials have offered to us an abandoned hospital near to our current clinic to renovate and deploy essential inpatient and surgical services, as well as training programs. In keeping with the model we have developed at our clinic, the expansion to provide these services will complement general primary care and serve as a community-driven initiative to provide training, sustainable infrastructure, and high-quality medical standards for service delivery in the region. This will involve the following key actions, listed in the order of their planned implementation:
- renovating the abandoned government hospital in the neighboring village of Bayalpata;
- expanding primary care, normal delivery services, and community health worker programs to the hospital;
- deploying diagnostic ultrasound (currently unavailable for a region of approximately one million people);
- establishing X-Ray services;
- building a 14-bed inpatient ward to support our existing 24-hour maternal services;
- establishing blood transfusion capacity;
- expanding our existing high-quality laboratory services, including culture microbiology;
- developing a surgical team capable of delivering essential surgical services including Cesarean sections, appendectomies, and basic orthopedic procedures.This team would be led by a generalist Nepali physician trained through the national MD-GP (general practitioner) program.