Two doctors, a dispenser and an assistant dispenser attend the clinic in Rakkar 5 days a week from 9 am to 5 pm and half days on Saturdays. They see an average of 40 patients daily. Night emergency calls are attended by a doctor in the clinic. Consultation and medicines are provided at nominal rates whilst the very poor, especially widows, who are unable to pay, are treated without charge. Patients who have to be referred to other medical facilities are given every assistance to avail of the services they need if they are unable to afford them. Particular help is offered to those who come from far - many patients are carried from remote villages in the mountains and are able to avail of our small in-patients facility which is able to accommodate up to 6 patients. In many cases of acute or long-term illnesses, the strain on the family and the difficulty of managing patients in very poor living conditions makes a facility such as ours, within the village, invaluable.

Medications

A range of medications and treatments including western medicine, homeopathy, ayurveda and acupuncture are provided, the highest importance being placed on determining the appropriate treatment for each individual patient.

Patient’s Records

In order to assist the process of diagnosis, prescription and follow up, carefully filed record cards for each and every patient who visits our clinic are maintained. Those who need to be transferred to the nearest government hospital or to specialist private clinics are extended every assistance including transportation, accompaniment and financial assistance to enable them to do so. Emphasis is placed on prevention of disease. Patients are informed about nutrition, hygiene, clean water and the use of condoms, which are provided free in the clinic.

Health Education

Diseases such as skin ailments, HIV, hepatitis, malaria and chronic gastro-intestinal problems can only be addressed with full awareness and understanding of the people concerned their cultural background and their environmental and economic restrictions. Meeting with community groups both in the community centre and in their villages and learning about the difficulties, traditions and issues related to those communities enables us to understand and work effectively both to empower and enable as well as by disseminating medical, hygiene and nutritional information.

Local Outreach – Our staff and members of the youth club set up stalls at the local fairs in which all kinds of literature, attractive posters, food items and our shopping bags were displayed and sold to promote awareness of health issues: HIV/AIDS, alcohol and smoking, nutrition, diahrrea prevention and hygiene. Open days and village and youth events also serve as opportunities to disseminate information. Each year before the diarrhoea season we conduct house to house campaigns to inform local families about hygiene, protecting babies from flies and prevention by using our filtered water tapping points

Clean water campaign – We have been conducting a campaign for clean water for the village both by conducting scientific surveys of the water supplied, lobbying the government department responsible, and alerting the people to the danger of drinking untreated tap water. Some positive response from the government has recently been seen and we are hopeful that the water catchment and storage tanks will be improved to prevent contamination.

Women’s Health Workshops and training sessions are held regularly. Topics include body literacy, gender sensitisation, family planning and empowerment and self defence. These are especially aimed at soon to be married and recently married women as well as single women and mothers. Similar workshops for boys have also been held.

Medicine and self help trainings – A team of homeopathic doctors from Europe visit in November each year to intensively practice homeopathy in this stimulating situation. This is of great benefit to many of out chronically ill patients. Massage, yoga, akido and similar self help trainings are also held when trainers are available.

First Aid Training – In February ’06 Dr Kusum and Ram Chand attended a three day intensive training in First aid and Health and Safety organised by the St John’s Ambulance team. This invaluable skill building opportunity gives them both a greater sense of confidence when encountering serious medical cases.

Ayurvedic medicine courses and events are held to tap into local knowledge of medicinal plants, to encourage women to use safe traditional healing medicines and impart a working understanding of Ayurvedic principles and practice for the management of primary health care problems.

Research Project

Our patient research project which has now been running for three years collects demographic information about the patients who come to the clinic as well as gathering data about what ailments they present to the doctors and how they are being treated. More than 7,000 patients have now been documented. The analysis of this data is currently being undertaken to enable us to understand the needs and problems of the community better in order to focus our activities to combat perceived issues and problem areas.

Health Clinic Staff

		Dr Kusum Thapa, B.A.M.S. is a respected member of the local Nepali community, trained in Ayurvedic medicine. She has worked alongside Dr Barbara for 14 years. She also practices acupuncture, prepares herbal medicines and works with the local people on health education and nutrition.
		Ram Chand, RMP, clinic compounder and dispenser receives patients as they enter the clinic, keeps their medical record cards, and dispenses medicines and advice as they leave. He has worked with Dr Barbara for 21 years.
		Mohinder Kumar MA Hindi, is our Accountant and Project Officer who also assists in the clinic dispensary and drives the car when required. He is particularly active in organising youth and environmental activities as well as carrying out his extensive duties as office manager.
		Suresh Kumar is our assistant dispenser who also looks after the maintenance and smooth running of the clinic. He used to work in the local slate mines so relates well to the local people and appreciates the opportunity to help them. He is keenly engaged in the production of herbal medicines and is a famously excellent cook for local weddings and functions.
		Subhash Chand is the clinic jeep driver, transporting patients and doing the shopping. He also assists in the clinic when necessary and works with the school children's nutrition programme.
		Rasma Devi and Surinder Devi are the two part-time clinic cleaners responsible for the noteworthy hygiene maintained in the building. Surinder Devi also actively engages in maintaining the clinic herbal garden.

Construction

The clinic building was designed and constructed by Didi Contractor, an American born artist and designer who has been resident in India since 1952. Her philosophy is to draw on traditional techniques and materials as much as possible enhancing them with ecologically appropriate modern building technology wherever necessary. Local labour were employed in the construction ensuring that the construction process was an interactive event between the organisation and the local community and that our intrusion on the land was as gentle and accommodating of the locality as possible.