Introduction

Nepal is an area of the world with stark contrasts in access to healthcare. Much of the country’s medical infrastructure and expertise is centred in urban areas at great distance from rural inhabitants. Within Nepal a number of local initiatives exist to encourage medical service provision in areas where it is inaccessible to the population. These initiatives have been supported in some cases by bringing in international assistance in the form of volunteer healthcare professionals (HCPs).
Health Partnership Nepal (HPN) has established an international partnership between those seeking to improve free access to medical services in Nepal and those who would offer their skills to assist from the UK, USA and beyond. Through this partnership we aim to improve healthcare in rural areas, establish a sustainable and mutually-beneficial relationship with HCPs in Nepal and provide an opportunity for St George’s students to learn about medicine in Nepal and the skills of medical practice in the field

Health Partnership

The recently published Crisp Report, “Global Health Partnerships: The UK contribution to health in developing countries”, identified that UK expertise could help in countries abroad by strengthening public health, health systems and institutions, by providing education and training for health workers and by making knowledge, research,evidence and best practice accessible to health workers, policy makers and the public alike by working together in amanner sensitive to culture and environment.

It is our aim to establish a sustainable relationship between St George’s, University of London, Nepal Medical College and Teaching Hospital (NMCTH) and other healthcare providers in Nepal, that concord with the recommendations of the Crisp Report in order that St George’s students can both contribute to and benefit from this partnership for health.
The partnership will operate on the principles of: service to people in need, training for the participants - both local and expatriate and fellowship through exchange. Due to the founding principles of the UK National Health System we will aim to assist in provision and enhancement of care that is free at the point of delivery and are keen to help spread access to such services throughout Nepal. Where possible, teaching and training opportunities will be made broadly accessible but with priority given to those directly involved in the projects.

Access to healthcare

The focus of the project is to support Nepalese provision of healthcare in areas with little access to services. The concept of the project is to take doctors qualified in primary care and a number of specialties to supportand improve existing services, along with students to learn from this so that they might continue the project in the future. Initial planning numbers are for 10 qualified HCPs and 20 students. The aim, initially, is to focus our efforts in the community on select, specific clinical areas in order to set achievable goals. The first, fully-functioning trial clinics will take place in 2009 and are intended to lead to a sustained project at St George’s, repeated each year. To provide sustainability, staff at NMCTH will supervise the project when international volunteers are out of the country and training for local Healthcare Assistants (HCA) in orthopaedics and perinatal care will be incorporated so that a permanent healthcare presence remains.

In order to support and enhance research, knowledge and evidence-based practice in Nepal we are exploring options for research to run alongside healthcare provision. Current possibilities include research into diarrhoeal disease, screening for mouth cancer and a survey to ascertain the burden of musculoskeletal impairment across Nepal.
To promote accountability and delivery of the highest possible standards of healthcare, the team will apply the standards of the Sphere Project, Humanitarian Charter and Minimum Standards in Disaster Response where they are appropriate to our work. Students will be supervised at all times by qualified HCPs and will work within their training and personal limitations. The clinics will be consultant-led in the field.

St. George’s - NMCTH link

The link between the institutions will also provide the basis for an exchange of teaching and training, which will develop as the relationship grows over time. St George’s will benefit from lessons learned from healthcare provision in Nepal and in return will identify whether training assistance can be provided in the areas of advanced trauma, neonatology and infection control.

Health Partnership Nepal is intended to provide a regular, sustainable source of healthcare to people without access, to form a mutually-beneficial relationship with HCPs in Nepal, to introduce UK healthcare students to the field of international medicine and to inspire them to continue humanitarian work into the future. We hope that the relationship forged will prove a lasting opportunity for training and practice, benefiting both countries in the years to come.