I would like to start with a quote from Late Mahatma Gandhi.

The best way to find yourself is to lose yourself in the service of others.

This quote tells it all the essence of our foundation.

ANMF is a volunteer-run 501(c)(3) non-profit organization.The mission of ANMF is to promote the advancement of healthcare, medical training and practice in Nepal.

ANMF’s Enduring Support for Nepal’s Health Care

Since its inception, the America Nepal Medical Foundation (ANMF) has been a steadfast champion for improved healthcare in Nepal. ANMF has supported over 300 projects across various areas, including:

• Capacity Building: Infrastructure development, manpower training, education programs
• Research: Fostering research initiatives to advance medical knowledge
• Telemedicine: Expanding access to healthcare through telemedicine solutions
• Knowledge Exchange: Facilitating knowledge sharing between Nepali and international medical professionals
• Public Health Initiatives: Supporting public health programs to improve overall health outcomes
• Disaster Management: Providing critical support during natural disasters like the earthquakes, COVID-19 Pandemic.

Landmark Projects:

ANMF’s impact extends beyond funding. Here are a few notable examples:

• Pioneering Speech Therapy: ANMF introduced the first-ever speech therapy training program in Nepal at Kathmandu Model Hospital (2004).
• Addressing Uterine Prolapse: ANMF’s Uterine Prolapse Project at Gauri Shankar Hospital (2005-2006) played a pivotal role in raising awareness and prompting the government to address this public health issue.The Government of Nepal embedded this program into the Women’s and Child Healthcare Policy by providing free surgeries for any woman.
• Empowering Rural Healthcare: ANMF’s seed funding for NYAYA Health (2007) established a unique public-private partnership model for rural healthcare delivery.
• Investing in Manpower Training: ANMF’s focus on rural healthcare manpower training led to guidance and support in forming the mission of the Nick Simon Institute (2006), first headed by Dr Mark Zimmerman, a former ANMF board member.
• Enhancing Clinical Expertise: ANMF has continuously supported Continuing Medical Education (CME) and training sessions for Nepali clinicians.
• Saving Lives Through Pediatric Care: ANMF’s support for NICU/PICU training at Patan Hospital (2009) and the establishment of Nepal’s first PICU fellowship program is expected to significantly improve access to neonatal and pediatric intensive care.
• Expanding Corneal Transplants: ANMF facilitated the establishment of the first corneal transplant unit in Nepal’s Terai region at Lumbini Eye Hospital (2009-2010).
• Post-Earthquake Relief: Following the 2015 and 2023 earthquake, ANMF raised a total of almost two million USD for critical relief efforts and rebuilding health posts across Nepal.
• Oxygen Plant Initiative: ANMF spearheaded an initiative to build oxygen plants in hospitals across Nepal, promoting self-sufficiency in oxygen supply. The first plant was built at Tribhuvan University Teaching Hospital (TUTH), followed by six others in various regions. This movement significantly impacted Nepal’s healthcare infrastructure, as government district hospitals are now required to have their own oxygen plants.
• COVID-19 Relief Efforts: ANMF played a pivotal role in combating the COVID-19 pandemic in Nepal. By raising over $500,000, ANMF funded various critical initiatives. This included knowledge sharing by ANMF experts to support Nepali clinicians treating patients during the pandemic.
• Modernizing Healthcare Facilities: ANMF’s contributions extend beyond immediate relief efforts. In 2020, ANMF supported the construction of a state-of-the-art simulation lab at Bir Hospital, which has become a vital training resource for healthcare providers across Nepal.
• Enhancing Burn Care: ANMF’s nearly $100,000 contribution to the Burn ICU at Kirtipur Hospital in 2023 is expected to revolutionize burn victim care in Nepal.
• Improving Rural Healthcare: In 2024, ANMF decided to provide nearly $100,000 to the Karnali Academy of Health Sciences for building a blood bank. This initiative is expected to significantly improve healthcare delivery in the rural Karnali province.

Looking Ahead: Building a Resilient Healthcare System

ANMF remains dedicated to advancing healthcare in Nepal. Here are their key focus areas for the future:

• Increased Visibility: Highlighting successful projects and celebrating achievements.
• Expanding Membership: Recruiting members from diverse backgrounds and fostering future leaders through youth volunteer programs.
• Building Expertise: Leveraging collective knowledge to create resilient healthcare systems through knowledge sharing, capacity building, education, and research.
• Retaining Expertise: Activating the Executive Liaison Council (ELC) to engage past board members and other talents and utilize their expertise to advance the mission of ANMF.
• Financial Sustainability: Exploring avenues for recurring revenue streams to support impactful projects.
• Physician Collaboration: Collaborating with all the stakeholders in Nepal to carve a predictable pathway so that physicians of Nepali origin in the USA can easily practice and contribute to healthcare in Nepal.
• Strategic Partnerships: Building strong and transparent relationships with like-minded organizations in the USA and Nepal to avoid duplication of efforts and maximize impact.
• Donor Recognition: Establishing the ANMF Wall of Donors and offering various recognition opportunities for high-level contributions.
• Disaster Preparedness: Creating a dedicated disaster relief fund to ensure preparedness for future emergencies.

America Nepal Medical Foundation (ANMF) was established in 1997 by a group of Nepalese doctors, originally from Nepal, and American doctors who loved Nepal. Dr Arjun Karki was the founding president.

The idea for the America Nepal Medical Foundation (ANMF) emerged in the early 1990s when Arjun Karki began his residency in New York City. With Sunil Sharma’s encouragement to transfer to Syracuse, Karki secured a PGY2 position at SUNY Upstate Medical Center in 1993. Another resident, Sanjay Khanal, also participated and shared in the idea of improving healthcare in Nepal through mobilizing those in the US with similar interests. Next year the discussion group grew, as Mark Zimmerman took leave from his post as medical director of Patan Hospital to learn echocardiography and other skills at SUNY.

As the vision took shape in Syracuse, New York. Donald Blair, ANMF mentor and professor of medicine at SUNY, generously offered his office space and time, facilitating the foundation’s incorporation in 1996 with the assistance of Tara Niraula and Vijay Sigdel, who provided legal help from New York City. Dr. Karki became the founding president.

The inaugural ANMF conference was held in 1997 at Brandeis University in collaboration with the Association of Nepalis in America. Here, Libby Wilson and Kristen Stueber, pioneers of reconstructive surgery training in Nepal, joined the ANMF and became long-standing board members. Other early members include Gaury Adhikari, Brendon Thompson, Bhargav Dixit, Janak and Sangita Koirala and Dick Katzman. In 2000, Fred and Julia Shepardson joined and provided invaluable wisdom and administrative support that formed the backbone of the organization. The organization has continued to grow and has been able to provide support for many programs that are contributing to improved health care in Nepal.

The first meeting was held in Boston that led to the first conference in Boston from July 5th 1997 at Brandeis University with the theme of  “Strengthening Nepal’s Medical Capabilities”

1. Shankar Rai, MD (Assistant Professor, Dept. of Surgery, Tribhuvan University Teaching Hospital (TUTH) at Kathmandu and currently a clinical fellow in the division of plastic surgery at Cleveland Clinic Foundation) spoke on “Enhancing the technical skills of Nepali doctors working in the remote district hospitals of Nepal” where he depicted the difficulties such physicians facing.
2. Joseph Rosen, MD (Plastic Surgeon, Dartmouth Hitchcock Medical Center, New Hampshire) talked on ” Enabling Nepali physicians to utilize telemedicine through World Wide Web, the medical electronic linkage program”. Dr. Rosen and his team have already established the basic technical infrastructure in four hospitals in Nepal enabling the physicians there to communicate their difficult patient problems with their colleagues in America.
3. Drs. Norman Coleman and Asa Nixon (Professor and Assistant Professor of Radiation Oncology, respectively, at Joint Center for Radiation Therapy, Harvard Medical School, Boston, MA) made a presentation on the topic ” Building a radiation therapy center in Nepal : a great hope for cancer patients” and briefed the audience about the on going effort to establish a Radiation Therapy Center on the premises of Tribhuvan University Teaching Hospital (TUTH) Kathmandu, Nepal. So far the group has raised about a half million dollars and would appreciate any help the Nepali community, or well wishers of Nepal, can give to this project.
4. Arjun Karki, MD (Pulmonary/Critical Care Fellow at the Brown University, Providence, Rhode island) spoke on the topic “Institutionalizing the transfer of medical expertise: the role of ANMF” highlighting the need for, and the goals of the ANMF. It was emphasized that the ANMF is not here to fix all the health problems of Nepal, but it wishes to be a partner in the improvement of Nepal’s health situation.
5. Kristin Stueber, MD (Plastic Surgeon, Bay State Medical Center, Springfield, MA) expressed her opinion on the topic ” America Nepal Medical Foundation : American Perspective “. She thought that the ANMF was most worthwhile initiative in the light of current medical scenario in Nepal.

Due to the severe time constraints, not all questions from the audience could be entertained in that session. However, Dr. Mrigendra Raj Pandey, a senior Nepali physician on a visit to USA, who also happened to attend the session praised the program and the effort of ANMF profusely.

B. BUSINESS SESSION

It was attended primarily by ANMF participants: Nepali & American physicians (primarily), Nurses, Public Health specialists and others (about 40 altogether) coming from California,Illinois, Indiana, Maine, Massachusetts, Michigan, New Hampshire, New Jersey, New York, Ohio, Pennsylvania & Rhode Island.

• Dr. Karki presented a brief review of the current status of ANMF and its accomplishments including: its publicity among a larger Nepali community living in North America but also in other countries, registration of ANMF in New York State, creation of a database of North America based Nepali physicians / health professionals and others with an interest in ANMF, collection and dispatch of medical journals for the medical school library in Kathmandu. An ANMF website has been created. Above all, he emphasized that this particular gathering itself is a living proof that the ANMF will continue to get the needed love and support as it embarks to pursue its goals. Lastly, on behalf of the ANMF he expressed the gratitude to Dr. Blair for kindly continuing to host the ANMF secretariat at his office.
• Vijaya Sigdel, who was instrumental in obtaining help from the lawyers free of cost, both for the ANMF registration and the formulation of ANMF bylaws, presented the main concepts and provision of draft bylaws which were distributed to all the participants.
• Dr. Rai, the chairman of the nominating committee, presented a list of the individuals for the position of board of directors and executive Committee which was unanimously endorsed by the participants present in the session. Since this was the first event in the history of ANMF, Dr. Rai mentioned that the list was based on the responses received from the ANMF supporters to the questionnaire distributed about 2 months ago, keeping in mind the overall interests of the ANMF.
• Although no formal membership was issued so far, given that the bylaws are in evolution, that process should be started soon. A draft copy of the membership application was distributed to all the participants to that effect. It was unanimously agreed that there should be a membership fee and the annual membership rate would be as following:$10.00 / yr for students.
  $25.00 / yr for physicians in training (Residents, Fellows).
  $50.00 / yr for others.The issue of life memberships and honorary membership was raised and will be dealt with in the bylaws in greater detail.
• Following were the programs that the participants of the meeting thought the ANMF should undertake in the next few years:
  • Continue to procure and send medical learning resource materials to the medical school library in Kathmandu (TUTH). This will include, but is not limited to, core standard textbooks (current edition), peer reviewed professional journals (old series are OK provided they are a complete set), audiovisuals and CD ROM series in all the major clinical and basic science disciplines. Donations from individual subscribers are encouraged, but a subscription can also be purchased if, and as, needed. The local ANMF support group in Nepal will, in consultation with the TUTH librarian and the program directors of various ongoing undergraduate and postgraduate medical training programs, prepare and submit the list of materials needed as we move along. The ANMF Executive Committee will soon designate a person to coordinate this program.
  • Organize a Continuing Medical Education (CME) program, on a regular basis in Nepal. The speakers will mainly be from USA and possibly Canada, willing to go there and share their knowledge and skills for the benefit of local physicians colleagues there. The expenses incurred in the process will be borne by the individual speakers. The first CME program is scheduled for November, 1998. Drs. Roshan Shrestha (from Denver, CO) and Brendan Thomson (from Phoenix, AZ) are working together to make it happen. Dr. Prativa Pandey is working closely with the Dept. of Medical Education of the medical school and other local professional bodies in Nepal to identify the areas/ topics to be covered the program.
  • Explore the opportunities for, and facilitate the training of, Nepali professionals in North America in areas that are considered a priority need for Nepal. The field of Biomedical Engineering is one such area currently identified. Dr. Gauri Shankar Adhikary is making preliminary enquiries with the concerned authorities of the University of Michigan. ANMF executive committee will soon designate a person to coordinate this program.
  • Support for/collaborate with the following ongoing or upcoming medical projects that are directed towards the strengthening the medical capabilities of Nepal:
    • 1. Telemedicine through WWW: the medical electronic linkage program initiated by Joseph Rosen, MD and associates.
    • 2. Nepal Radiotherapy Cancer Center project initiated by Norman Coleman, MD and associates.
    • 3. Improving the emergency medical services in Nepal initiated by David Wachter, MD and associates.
    • 4. Drs. Larry Herman and Lewis Clayman from Health Volunteer overseas have expressed their interest to collaborate with Nepal in the field of Dental health. The specific details needs to be discussed further.
• Dr. Charles Richert has already set up a web site for ANMF: http://car.upmc.edu/anmf In addition, he is also working on to establish an e-mail communication system among the ANMF members.
• The following decisions were also made : Proceed with the necessary paper work to obtain tax exempt status for ANMF. Raise $ 700 to cover the fees for the above process. Decide upon the date/venue of next ANMF annual meeting. Form a fund raising committee.

Following concluding remarks by Dr. Blair, the session ended around 7:30 PM. Dr.Tulsi Maharjan was the moderator of the second session.

(Compiled and prepared by Sanjaya Khanal, MD. Edited by Bijay Acharya, MD)

Capacity building Kathmandu University Medical School (KUMS) and Nick Simon Institute

As Dr. Karki started to set up KUMS, he made calls to the Foundation for the necessary assistance in small and bigger measures. The Foundation first decided to help with the University library for the medical school and shipped many books (this was pre-pendrives and CD ROM days!). This was followed up by discussing the possibility of building a hospital for KUMS under the American Schools and Hospitals Abroad (ASHA) Grant (1). Prof Donald Blair visited Kathmandu University and the KUMS to gather a real feel for the project. Geoffrey Tabin, MD, Board member of ANMF, was an old friend of Nepal through his works with Himalayan Cataract Project and Tilganga Hospital(2). He introduced his brother Prof. Clifford Tabin to the Foundation. Prof Clifford Tabin, MD of Harvard Medical School created a program to send postdoctoral fellows at Harvard Medical School to teach basic science at KUMS for next two years. This program was so successful that philanthropist Dr. Jim Simon got interested in working in Nepal through ANMF. His representative attended the ANMF meeting in Boston, MA. Originally, Mr. Simon tried to help finance and develop KUMS under Dr. Karki’s leadership, but for some technical difficulty at KU, this could not be achieved at the time. However, Mr Simon built and developed the child and maternity wing at Patan Hospital and subsequently, he established the Nick Simon Institute to help develop manpower for rural Nepal under the leadership of Dr. Mark Zimmerman, who is also a member of ANMF/Nepal (3).

Targeted Projects:

Uterine Prolapse Project: Prof. Murari Subedi of Michigan State University discovered women’s health issues, Urogenital Prolapse while developing a running water project for his village of Hanshapur in western Nepal. He made a moving presentation about this hidden issue of women’s health at an ANMF conference (Toronto 2007). ANMF followed up and subsequently undertook this matter and implemented a pilot project. The first health camp to address uterine prolapse in the community was initiated at the GauriShankar Hospital in Dolakha, under Dr. Ganesh Dangal’s leadership. Thanks to ANMF board members, Marvin and Allison Brustin of Chicago, who raised funds to successfully implement this project. After tremendous success of this pilot project, Nepal government made it a priority to prevent and cure this health concern among rural Nepali women population.

Nyaya Health (now Possible)– Bayalpata Hospital in Achham: ANMF provided seed money at clutch time for this project which has been very successful to provide quality health care in rural Achham. Possible is now starting a new project in Dolakha district. ANMF once again provided the seed money for this venture. Richard Katzman, MD is the coordinator for this project.

Pediatric Intensive Care Unit and Neonatal Intensive Care Unit (PICU/ NICU): This project in Patan Hospital was executed by ANMF board member and current President Dr. Sangita Basnet (4). ANMF provided logistical and seed money for this project as well.

The following are some of selected projects and their coordinators:

1. Speech Therapy for Post Surgical Cleft Palate/Lip Repair: Dr. Shankar Rai and Dr. Libby Wilson.
2. Skin Bank Project: Dr. Shankar Rai and Dr. Libby Wilson.
3. Snakebite Project in Chitwan: Dr. Dev Pandey.
4. Anesthesia machine to Hospital and rehabilitation centre for the disabled children,Banepa
5. Generator to Bhaktapur Cancer Hospital: Dr. Bob Gerzoff.
6. Smriti Bhawan for Bhaktapur Cancer Hospital: Dr Bibek Pradhan of United Kingdom was main supporter and Dr. Gaury S. Adhikary raised funds within USA for this project.
7. Electrophysiology (EP) Fellowship for Gangalal Heart Hospital: Prof. Bhagwan Koirala Dr. Sujeeb Rajbhandari was funded for one year fellowship program at National University Hospital and Heart institute, Singapore. Upon his return, Dr Rajbhandari established a well functioning EP Cardiology department at Gangalal Hospital in Kathmandu.
8. Eye bank project at Lumbini Eye Institute: Dr. Manoj Sharma and Gaury S Adhikary.
9. Book keeping: To run a voluntary non profit organization, accounting requires special rigor to keep track of the flow of money. Over the years, ANMF has been lucky to find diligent board members to step in to keep the account current and transparent: Dr. Kristin Steuber, Julia Shepardson, Dr. Rupa Hamal, Dr. Dinesh Mainali have provided their valuable time and skill to do the job over the years(5).

References –

1. http://www.usaid.gov/work-usaid/get-grant-or-contract/opportunities-funding
2. http://en.wikipedia.org/wiki/Himalayan_Cataract_Project Nick Simon Institute
3. http://www.nsi.edu.np State of Pediatric ICU in Nepal, ANMF’s Role.
4. http://www.anmf.org/news/ terevaka.net/anmf/boardballots/ballot.htm.
5. http://www.almanacnews.com/morgue/2001/2001_07_25.julia.html