Due to the success of the Centre for the past three years, a formal review by the original promoters was conducted in early January 2008. This also included a visit to the Kunde Hospital in the Khumbu Region, run by the Himalayan Trust. The Kunde Hospital has operated successfully for the past 41 years. KPHMN is modeled on a similar basis.

Several strategic decisions have resulted which are designed to ensure that the Centre’s function going forward can be sustainable and the transparency and accountability of its management be enhanced to ensure ongoing foreign donor support.

Measures taken Include:

1. Restructuring the Solukumbu Beni 5 Local Health Post Management Committee to ensure that it is representative of all Villages serviced by the Centre and to empower the Committee to adopt a more direct management role in all facets of the Centre’s operation. This includes a more direct function in addressing maintenance and operational issues required as well as local fund raising.

The Committee will conduct monthly meetings and a report submitted to the KPHMN.

2. Applying for a long term lease from the Nepal Government Department of Heath for occupancy as well as the ability to run the Centre as a business unit.

Outlined in the operational review below are major areas of health risk faced by the community as well as the issues noted by the medical staff over the past twelve months. One very apparent trend has been that through the provision of free medical consultation, and particularly free medicine, that the free issue of medicine to a broader number of people has occurred, and to some extent there is a growing concern that patients are not taking a more responsible approach to their health requirements. Based on this experience as well as advice from Kunde it has been decided that the charging of some minor cost for medicine and consultation is necessary to ensure that responsibility by a patient for their own health is adopted.

Permission from the government is required to ensure that this practice does not contravene any regulations.

Confirmation from the Accountant & Auditor has been received that the KPHMN is a non-profit organization and is exempt from tax.

3. Revising the arrangement of the Centre to include:

• an in-house residence for the Doctor and Nursing staff,
• re-location of the delivery room,
• reconfigured dressing room with inclusion of new laboratory equipment,
• allowance for a new X-ray room
• renovated medical store
• installation of a new verandah area to provide for all weather protection and a waiting area for patients.
• Upgrading of flooring.

4. Introduction of formal record keeping:

• Files to be kept for each patient.

Currently the Doctor keeps a record of each treatment but not a file per patient. A new record system of personal files will commence on receipt of the physical filing system from the promoter.

• Stock record system for the recording of medicine stores.

This includes a weekly stock register as well as the introduction of a formal purchase order system for replacement medicine.

5. Introduction of additional Health Education programs. Useful work has already been undertaken with local school children and at the Thupteng Choling Monastery, however further programs are necessary. Teeth hygiene for Children has been identified for major work and most importantly Alcoholism is a major issue with older adults.

6. Reliable electrical supply needs to be secured. Two areas have been identified, one being the installation of a new solar panel, courtesy of a World Expeditions program and discussions for regular supply from the Monastery have to be held.

Operational review for the 2007 year:

1. The Doctor has treated 230-240 people per month, based on a 26 working day month.

2. The major health issues in priority order are:

• Cut injuries and fall cases e.g. limbs fracture, sprains and dislocation. Many cases require local anesthetic and stitching.
• Gastritis and ulcers. This related to consumption of alcohol.

In fact alcoholism is a major issue, particularly with older people and was identified as the major health issue at Kunde Hospital. This is a major cultural issue and an educational program has to be devised by the Medical staff to educate the community into this issue.

• Hypertension with older people, partly related to the issue of alcohol.
• Arthritis, due to cold conditions and alcohol related.
• Tooth disease.
• Infections, particularly respiratory tract, ear and eye.
• Fungal infections.
• Family planning services, mainly issue of contraception injections and condoms.

3. Major types of drugs used:

• Analgesics / antipyretic (mainly paracetemol).
• Antibiotics
• Antiulcer drugs
• Antihypertension drugs
• Anti-inflamatory drugs

Urgently Required Equipment has been bought in Kathmandu recently.

• Blood testing lab equipment. The District Health office has been provided some lab equipments.
• A new X-ray machine has been donated in Kathmandu recently.
• E.C.G. Equipment Donated.
• Oxygen concentrator donated.

Business Plan for 2008/2009

Budget 2008/2009
for the period 1st July 2008 to 30th June 2009