International Nepal Fellowship - www.inf.org

International Nepal Fellowship has been working in Mid-West Nepal since 1952 with disease control and treatment of tuberculosis and leprosy; leprosy services extend into Far West Nepal. It runs its own TB and leprosy clinics and supervises other clinics at government health posts. By the end of 2005 INF will have handed over support for TB and leprosy field work to government agencies but will continue to second staff to provide essential training.

In addition it provides:

• community health and development programmes with marginalised communities;
• medical camps in remote areas;
• hospital and rehabilitation services for people with disabilities;
• assistance for other organisations working for people with disabilities;
• HIV / AIDS education, testing, counselling and care;
• help for displaced people and internal refugees created by the Maoist insurgency.

Green Pastures hospital in Pokhara was opened in 1957 as a leprosy hospital. It has now broadened its scope, helping people with all kinds of disability, and has been renamed the Green Pastures Hospital and Rehabilitation Centre. It now provides in- and out-patient leprosy services, reconstructive surgery, nursing care, laboratory services, counselling and health education, in- and out-patient rehabilitation including orthopaedic appliances, physiotherapy and occupation therapy. It provides beds for patients with leprosy and other disabilities, many of whom are too poor to afford treatment.

Donor agencies have recently cut funding for leprosy services and Green Pastures has met this challenge with a Buy-a-Bed campaign. Even after large donor subsidy, one bed costs £1,000 a year. The campaign advert shows an elderly Nepali lady who is so poor that she has to sell her bed – to you! Half the bed or even just part of the bed can be purchased. In 2004 the Everest Marathon Fund bought two and a half beds for a year! Money raised by the 2005 race will be used to buy a bed for two years.

In 1997 the Everest Marathon Fund purchased a motorbike (able to navigate good trails) to reduce travelling time for INF staff to 168 monthly TB and leprosy clinics.

With early diagnosis and treatment, leprosy can be cured but damage to sensory nerves causes loss of sensation so that injuries are not felt; small blisters develop into chronic deep ulcers which eat into the bone causing deformity and disability. INF started a footwear and appliance department which provides leprosy sufferers with a variety of footwear, as well as appliances for those who have had amputations. Simple and inexpensive items are specially made rubber flip flops, special insoles for canvas bootees, moulded shoes and various orthoses. By becoming more mobile, lepers can play a more useful part in society, increase their own self-respect and reduce the discrimination caused by disability.

This was felt to be a particularly suitable project for marathon runners who spend such a great deal of time caring for their own feet, who may well know the agony of foot injury, and who spend so much money on their own footwear. In 1998 £3,500 was sent to buy multi cellular rubber to make the special footwear. A further donation of £2,500 was spent on a special room at the Ghorahi clinic for the shoemaker and his clients.

In 1999 we provided rubber, leather and shoemaking tools for a new footwear centre in Surkhet, 3 colorimeters for doing essential blood tests for TB and leprosy, £1,500 for a new accounting software package, £800 for a video and TV for staff training and almost £2,000 towards leprosy rehabilitation work.

In 2001 we paid for a second motorbike and £1,000 was spent at the INF clinic in Jumla, home of Everest Marathon champion, Hari Roka. This money was spent building a paved walkway at the clinic to provide easier access for those with foot/leg impairments and crutches. The rest of the money was spent on five solar cookers to provide inpatient meals and boiled drinking water: a real benefit in an area which suffers from deforestation.

The INF clinic at Surkhet treats about 12,000 patients each year; there are 44 beds, a small laboratory, physiotherpay and footwear departments. Money from the race in 2002 was spent on an autoclave steriliser, an oxygen concentrator to assist TB patients with severe breathing difficulties, and a computer printer for maintaining patient records.

Recently there has been a major administrative overhaul of TLP and INF projects in West Nepal. The aim is to provide medical centres in each area to cover a range of services, rather than the previous specialist centres.. The region has been severely affected by the Maoist insurgency but there has been little disruption to the services provided. One result has been an influx of refugees from the villages into the towns: the refugees are living in squalor and the town medical facilities are over-stretched.

Money from the race in 2003 was given to buy physiotherapy equipment for the clinic in Jumla which is now providing a wider range of medical services in an area where there has been considerable violence, and to the Jumla Poor Fund which helps the internal refugees who have crowded into the town. £2,000 from the 2005 race will also go to the Jumla Poor Fund. Many patients require surgery and/or rehabilitation which is not available in this remote area. This money will be used to cover the cost of transport to specialist centres, such as the TB clinic in Banke, the leprosy centre in Surkhet, or Green Pastures Hospital in Pokhara.