Dr. Keidan's Field Report from Nepal

March, 2012

Hello everyone, I have just finished a busy week in Kathmandu, and am off to Khotang. I would like to give all of you a brief summary of what has occurred to date.

Working with my brother Namgyal Sherpa has been great. He has been working so hard serving as our liason for MLNFHE here in Kathmandu during my absence. As always, he has arranged all preparation and support for our upcoming trip to Khotang. He has also had the preliminary meetings with the Nepal Public Health Foundation in anticipation of my arrival.

I met with Ben Ayers and his staff at the Dzi Foundation. as all of you know, Ben has been my mentor, and he and his staff continue to provide unbelievable support for MLNFHE. as always, his advice this trip has been valuable.

I had a fascinating meeting with Robin Houston from USAID. Robin will soon be completing a five year project regarding family planning and maternal/child health care in 22 districts in Nepal. It was so informative listening to him, and he provided me with lots of written information that will be very useful in our endeavors in Khotang.

I had meetings with the Nepal Public Health Foundation during the last 6 days. They are a young foundation, and very eager to collaborate with us in Khotang. they too are committed to improving public health and health care in rural Nepal. they are early into their course, so i believe they are not overburdened with current projects. they will be sending two staff members with us to Khotang this trip, and continue to help us with our assessment of the status quo, and help us generate a short and long term plan. we have discussed a long term collaboration, with subsequent trips to the field to accomplish this plan. they will then work with us to design projects, implement them while empowering the locals such as the mothers groups and the female volunteer health care workers along with the mid level health care workers, assess their efficacy, and work with sustainability, etc.... all early indicators are that this should be an exciting collaboration.

I met with a plastic surgeon here in Kathmandu yesterday whose childhood home is in Khotang. He does all reconstructive surgery, all on indigent patients at no charge, and has outreach programs . he is very excited to work with us down the road . he offered bringing his team to Khotang's district hospital to perform surgeries for cleft lip, burn contractures, and other deformities. he would at the same time attempt to teach the local staff in some techniques. and he would absorb all the costs! Very exciting for down the road!

met with a member of paliament who grew up in khotang and "has been to all 70 or so Ivillages, and knows everybody". He told me that "if you have any problems in Khotang, if someone gives you any trouble, just call me and i will fix it"! he gave me his cell phone number. i got the feel he was the godfather of Khotang. MLNFHE is now part of the "family". we didn't discuss protection money yet.....

we had very intense meetings with the Patan Academy of Health Sciences (PAHS), trying to further our relationship and potential collaboration. I will forward my communication to Arjun the vice chancellor of PAHS for your review.

My niece Gayle has been in Kathmandu for a month now. she has been coming to most of my meetings, and will accompany me in Khotang. She has really embraced being here. She has a passion for social justice and human rights. She has been working in a safe house for women who have been trafficked or are at risk. She is teaching the girls in the morning , and helping with organization/strucure/tech support etc.. during the afternoon. As you know, she has identified the two sisters who we will attempt to sponsor their education. their older sister Sita was sent from the village to Khatmandu to work and send money home to help support the family. The dad is in prison for murder. As commonly happens, Sita and her family were "duped", and she was sent to work in a '''cabin restaurant", a front for forced prostitution. She is now safe at Gayles' house. Her two younger sisters' Manisha and Geeta are here now too. Gayle is trying to arrange private school education for these two when they soon return to their home in the village, otherwise, they will return to the village to just work and support the family with no hope for the future (they are aged 6 and ten). Gayle is single-handedly trying to arrange appropriate assurances and a contract to make this happen. I am so proud of Gayle, and love her so much.

Namgyal, Gayle, the two public health docs, and myself leave for khotang tomorrow morning. We will review current projects, entertain new projects, and continue our work on our medical initiative.

When i return from khotang, I will have wrap up meetings with PAHS and NPHF . I will also be meeting with Mark Zimmerman, director of Nick Simons Institute. as you may recall, nsi is dedicated to educating mid level health care workers, general practitioners, and medical doctors in the villages . Their input will be vital to our mission down the road as we progress.

When we generate our report (with the help of NPHF) from our upcoming trip to Khotang, i will circulate it to you.

Sincerely,

Richard Keidan, MD