NEPAL ORTHOPAEDIC HOSPITAL Nepal Orthopaedic Hospital ...noh.org.np/materials/Annual report 2007-08 NOH .pdf · 1 Nepal Orthopaedic Hospital Doctors € 1 Dr. Saju Pradhan Medical

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Doctors 1 Dr. Saju Pradhan Medical Director2 Dr. Anil Bahadur Shrestha Consultant3 Dr. Pierre Soete Volunteer

OrthopaedicSurgeon (from Belgium)

4 Dr. Rajesh Maharjan Registrar5 Dr. Yubaraj Kharel Registrar6 Dr. Kailash Kumar Bhandari Registrar7 Dr. Mukti Nath Timilsina Jr. Registrar8 Dr. Roshan Piya Anaesthetist (MO)9 Dr. Purushottam Manandhar Orthopaedic

Surgeon (MO)10 Dr. Dinesh Kumar Shrestha (Orthopaedic

Surgeon (MO)11 Dr. Rajiv Prashad Shrestha Medical Officer12 Dr. Sonam Zangbu Sherpa Medical Officer13 Dr. Sujan Man Singh Medical Officer14 Dr. Chhatra Krishna Shrestha Anaesthetist

(Visiting Consultant)15 Dr. Amir Babu Shrestha Anaesthetist

(Visiting Consultant)16 Dr. Ravi Ram Shrestha Anaesthetist

(Visiting Consultant)17 Dr. Sujita Manandhar Anaesthetist

(Visiting Consultant)18 Dr. Ratna Mani Gajurel Physician

(Visiting Consultant)

Nursing StaffNursing StaffNursing StaffNursing StaffNursing Staff 19 Mrs. Ocky Pladet Volunteer Infection

Control Supervisor(Holland)

20 Mrs. Meena Gurung A. Matron21 Mrs. Pratibha Gautam Sister22 Mrs. Suman B.C. Acting Sister23 Mrs. Kalpana Pant Sr. Staff Nurse24 Miss Anita Gurung Sr. Staff Nurse25 Miss Regina Dhakal Sr. Staff Nurse26 Miss Sushma Baruwal Staff Nurse27 Miss Sabitri Mahat Staff Nurse28 Miss Kristi Bhandari Staff Nurse29 Mrs. Meena Thapa Staff Nurse30 Miss Rolina Karki Staff Nurse31 Mrs.Kalpana Poudel Staff Nurse32 Miss Subjana Maharjan Staff Nurse

33 Miss Rama Budathoki Staff Nurse34 Miss Muna Awale Staff Nurse35 Mrs. Sabita Shah Thakuri Staff Nurse36 Mrs.Srijana Sapkota Staff Nurse37 Miss Rita Pokhrel Staff Nurse38 Miss Muna Lama Staff Nurse39 Miss Laxmi Khatiwada Staff Nurse40 Miss Srijana Khanal Staff Nurse41 Miss Laxmi Acharya Staff Nurse42 Miss Rama Pudasaini Staff Nurse

43 Miss Anita Limbu Staff Nurse

44 Miss Sulochana Karki Staff Nurse45 Miss Alisha Guvaju Staff Nurse46 Miss Nirjala Pokhrel Staff Nurse47 Miss Sita Lama Staff Nurse48 Miss Usha Subedi Staff Nurse49 Mrs. Sharmila Sharma Staff Nurse50 Miss Kuncha Lama Staff Nurse

Technical Staff51 Mrs. Kanchan Sangroula Sr. Physiotherapist52 Mr. Narendra Kr. Chaudhary Sr. Radiographer53 Mr. Dharma Gopal Shreshta Lab Technician54 Mr. Alok Kumar Jha Asst.

Physiotherapist55 Mrs. Bina Upadhyaya Pharmacist PCL56 Mrs. Radhika Khagi Pharmacist PCL57 Mr. Pawan Kumar Chhetri Lab Assistant58 Mrs. Bidhya Pandey Asst.

Physiotherapist59 Mr. Dhurba Giri Sr. Electrician60 Mr. Som Pd. Upadhaya Bio-medical

Technician61 Mr. Sushil Maharjan Jr. Radiography

Technician

62 Mr. Shyam Maharjan Dark RoomAssistant

63 Mr. Bikash Joshi Dark RoomAssistant

64 Mr. Laxman Gyawali Sr. CMA (ER, Ward)65 Mr. Kailash Chandra Lama CMA “” “”66 Mr. Kedar Raj Giri CMA”” “”67 Mr. Sudeep Chalishe CMA”” “”68 Mr. Ganesh Raj Shrestha CMA Pharmacy69 Mr. Dinesh Basnet CMA Pharmacy

NEPAL ORTHOPAEDIC HOSPITALSTAFF FAMILYNepal Orthopaedic Hospital

Staff Family

S. No. Name Designation S. No. Name Designation

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Administrative Staff70 Mr. Shyam Prasad Rupakheti Administrative

Officer71 Mr. Saroj Satyal Sr. Office Assistant72 Miss Shanti Tamang Office Assistant73 Mr. Santosh Badal Office Assistant74 Miss Pragya Guragain Sharma Office Assistant75 Miss Parumala Adhikari Office Assistant7 6 Miss Sangita Thakuri Office Assistant77 Mrs. Urmila Shrestha Receptionist78 Mr. Dil Bd. Thapa Sr. Driver79 Mr. Badri Khadka Sr. Driver80 Mr. Sukulal Tamang Security Guard81 Mr. Madhu Pariyar Security Guard82 Mr. Rajendra Karki Security Guard83 Mr. Amrit Sing Tamang Security Guard

Housekeeping Staff84 Mrs. Sabitri Dulal Sr. CSSD Assistant85 Mr. Rajan Dulal Sr. Helper86 Mr. Dharma Das Chaudhari Sr. Helper87 Mrs. Til Maya Gautam Sr. Helper88 Mrs. Parbati Karki Sr. Helper89 Mr. Nayandra Baral Sr. Helper90 Mr. Lok Nath Badal Sr. Helper91 Mrs. Pabitra Timilsina Sr. Helper

92 Mr. Surath Bdr. Thapa Sr. Helper93 Mr. Bishnu Bdr. Magar Sr. Helper94 Mr. Ram Krishna Raut Gardener

(Sr. Helper)95 Mrs. Krishna Kumari Ghimire Sr. Helper96 Mr. Devlal Pode Sr. Helper97 Mr. Arjun Nagarkoti Helper98 Mr. Leela Nath Pokhrel Helper99 Mrs. Kumari Majhi Helper

100 Mr. Manahari Dahal Helper101 Mr. Dharma Raj Ghimire Helper102 Mr. Rama Damai Helper103 Mr. Ramesh Sapkota Helper104 Mr. Gopal Pudasaini Helper105 Mr. Ramu Khanga Helper106 Miss Radhika Acharya Helper107 Mr. Kedar Nath Poudel Helper108 Miss Ajita Karki Helper109 Mr. Bhakta Bdr. Karki Helper110 Mrs. Ramila Shrestha Helper111 Mrs. Rama Pandit Helper112 Miss Meena Choudhary Helper113 Mrs. Saraswati Chalishe Helper114 Mr. Bharat Kr. Lama Helper115 Mr. Khum Bdr. Thapa Helper116 Miss Saraswati Uprety Helper

S. No. Name Designation S. No. Name Designation

Congratulations

NEPAL ORTHOPAEDIC HOSPITAL

ForForForForFor

Completing Ten Years ofCompleting Ten Years ofCompleting Ten Years ofCompleting Ten Years ofCompleting Ten Years ofSelfless Service !!!Selfless Service !!!Selfless Service !!!Selfless Service !!!Selfless Service !!!

From

ROTROTROTROTROTARARARARARY CLY CLY CLY CLY CLUB OF PAUB OF PAUB OF PAUB OF PAUB OF PATTTTTANANANANANDistrict 3292, Club No. 23126, Hotel Himalayan, Kupundol, Lalitpur.

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It is my great pleasure and pride to be associated with theNepal Orthopaedic Hospital. As chairman of NOH and also theNepal Disabled Association, I pledge to do my utmost to helpin any way to guide and help the NOH administration. I haveseen a lot of productive work put together by the hard workingstaffs of the hospital. I congratulate all the staffs of the hospital,all the well wishers of the hospital, all the donors and the restof the management committee for having been there alongsideNOH during its ten years of glorious and selfless service to theneedy people. I also want to personally thank Dr. Anil Shresthawho was the medical director for the last ten years. His work ismost commendable.

Also I congratulate Dr. Saju Pradhan who is the new medicaldirector on assuming his new responsibility. I have completefaith in his abilities and I ask all concerned people to co-operatewith him. I hope and pray that this institute will continue to growand work to make sure that it does not forget its charitableroots.

Gajendra Kumar LamaChairmanNepal Disabled AssociationNepal Orthopaedic Hospital

Message from the chairman


I congratulate all my colleagues and co-workers for havingfinished one more working year in a successful manner. I wouldalso like to thank the donors, the board members and otherpertinent people who were there to support and guide us duringthe last ten years.

The hospital is trying its best to achieve total self-dependencefinancially. We are getting more private ward patients and weare planning to do surgeries at least five days a week to enhanceincome. The surgeons are working harder to do more surgeriesin a given day as well as increase the range of services. Spinalsurgery, Ilizarov surgery and total knee and hip replacementsare being done more frequently.

Collaboration with other service providers has made it possibleto have a steady flow of patients in our hospital. Attempt atreduction of cost of care has been made knowingly to makeservices more affordable for our less-privileged patients. Wehope to expand our bed capacity in the near future, given thatdemands for beds increase and also given that our well-wishersand donors continue to help us.

Dr. Saju PradhanMedical DirectorNepal Orthopaedic Hospital

Message from the medical director

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Nepal Orthopedic Hospital has come a long way since it openedits door to its first patient on 14th August, 1998. From a smallhospital with just 20 beds and very little infrastructures, thehospital is now a well-equipped, modern institute with 75 beds.This has been possible only through the kind contributionsof our donors, the guidance of our management committeemembers, the dedication of all the staff and finally the trust andconfidence of our patients. We should also not forget thoseindividuals and institutions that first conceptualized this projectand made the first designs, raised the initial funds and laid thefirst bricks.

When I started as the medical director of the hospital, my mainobjectives were two folds – one was never to deviate from ourmission of providing appropriate orthopedic care to everyoneat an affordable cost and second to make the hospital self reliantwithin 10 years. We have adhered to the first and are almostthere on the second.

The leadership has now been handed over to Dr. Saju Pradhan,who I am sure is capable of taking this hospital to newer heightswith his new vigor and drive. To reach where we are now, wehad to overcome many hurdles. Now the challenges aredifferent. If we all strive together, I am sure we can achievemore. The past 10 years have been a great learning experiencefor me. I personally would like to thank everyone with whom Ihave been associated and also those who have helped me inbringing Nepal Orthopedic Hospital to its present stage.

Dr. Anil Bahadur ShresthaConsultant Orthopaedic SurgeonImmediate-Past Medical DirectorNepal Orthopaedic Hospital

Message from the immediate-past medical director


It gives me immense pleasure to congratulate NepalOrthopaedic Hospital for completing ten years of selflessservice. I want to wish the Hospital and its staff all the best inmoving towards its 11th year of service. The Rotary Club ofPatan appreciates and condones the charitable work bestowedto the poor and needy people. I commend the great work doneby the hospital.

I must congratulate Dr. Anil Bahadur Shrestha for his ten yearsof dedicated work as a Medical Director. Also I wish all my bestto the new Medical Director, Dr. Saju Pradhan in carrying outhis job successfully and responsibly.

I assure you that Rotary Club of Patan will continue allcooperation and support to Nepal Orthopaedic Hospital andthe new Medical Director as was being done in the past.

Santa Kumar ShresthaPresident 2009-009Rotary Club of Patan

Message from the presidentRotary Club of Patan

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Dr. Anil Shrestha, the medical director stepped down from his post after serving the hospitalsuccessfully for ten years. On September 26th 2008, Dr. Anil Shrestha announced his resignationfrom the post during the official ceremony of the ‘Tenth Year Anniversary’. Dr.Anil’s resignationwas a pre-planned decision. He felt that he had done enough and he recommended that a newleadership take over.

After much deliberation, the management committee and Chairman Mr. Gajendra Kumar Lama,decided to appoint Dr. Saju Pradhan who was the Deputy Medical Director since the past threeyears as ‘Acting Medical Director’ on the same day, that is 26th September 2008 ( Kartik 1st2065 ) . Dr. Saju Pradhan was officially appointed as ‘Medical Director’ of the Nepal OrthopaedicHospital on 12th November 2008 (Kartik 17th 2065) by another meeting of the managementcommittee.

Dr. Saju Pradhan, the new Medical Director, has been working in this hospital in various capacitiessince the very first day of the hospital’s establishment. Dr. Anil is still working in the NepalOrthopaedic Hospital in the capacity of Consultant Orthopaedic Surgeon and is advising thenew director on hospital affairs.

Appointment of the newmedical director

We commend the entire family of Nepal Orthopaedic Hospital on the excellentand meaningful services provided to thousands of Nepalese over the past tenyears.

We are proud to be associated with this hospital as suppliers of qualityorthopaedic appliances and implants from S.H. Pitkar Orthotools Pvt Ltd. Pune,since a number of years.

We sincerely extend to you our best wishes and hope that you will be able tomake your quality services available to more people in the years to come.

GREAGREAGREAGREAGREAT HIMALT HIMALT HIMALT HIMALT HIMAL AAAAAYYYYYAN TRADERS PVTAN TRADERS PVTAN TRADERS PVTAN TRADERS PVTAN TRADERS PVT. L. L. L. L. LTD.TD.TD.TD.TD.Dillibazar, Kathmandu, Phone: 00977-1-4422654


History of the hospital

NOH became operational since August 1998.What was it before? It was a concept, only agood concept! Nothing more! The concept wasto build an adult 16 bedded hospital tocomplement the already existing children’srehabilitation center. The concept was foundedby the eminent leaders of the Nepal DisabledAssociation of the time and the Rotary Club ofPatan and Jim Sinclair (USA). Then we hadthe arrival of Dr Anil and his small team ofdoctors and nurses and a few administrativestaff which was supported by the financialbacking of Mr. Luc Salens from Belgium whichstarted the ball rolling towards the presentevolution of the hospital. In the last ten yearsthe hospital has been able to shed its donordependency to almost nil and in the last tenyears the quality of the service has risen frommeager quality to almost oneof the best in the nation. Thenumber of staffs has risen fromaround ten to almost onehundred twenty. We have beenable to develop good labservices, good radiologyservices, good physiotherapyservices and good emergencyservices. At the same time webelieve there is ample room forimprovement in all thesesectors.

Who made this possible? Whoguided us during our difficultperiod? We have many peopleto thank for all thecontributions made during thatevolving period.

Vision for the near and farfuture of the hospital

The main objective of the hospital has been toprovide comprehensive and standard healthcare in the field of orthopedics andrehabilitation. The purpose of the hospital hasbeen to provide quality care at affordable priceto the needy. As the world is modernizing, thereare more and more cases of vehicularaccidents requiring specialized handling andcare. Nepal has been no exception to that andmore and more road traffic accidents arereported everyday with more and more traumacases. Nepal being a poorly developed country,there are a fairly large number of patients withbirth deformities, complications of previoussurgeries and other diverse orthopedicproblems that have not been addressed. NepalOrthopedic Hospital has this specific role of

Vision for theNepal Orthopaedic Hospital

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being a tertiary care center where all kinds ofcomplicated patients can be treated and alsosome form of financial support can be given topoorer patients on a need basis. Charity hasalways been in the center of all the things thatwe do for our patients. In fact we havedeliberately kept the price of surgery for all ourgeneral patients below the level of real costand in addition we have been processing partialor full charity through our adult and children’scharity funds. The private ward costs forsurgery have also been kept below that of allprivate hospitals so that we can have acompetitive edge. In spite of all this the overallcosts including all the logistical support makesthe cost of care much higher .We have verylittle control here as we need to give our staffsa good salary so that they are happy and arewilling to work efficiently.

Growing needs demand the urgency forexpansion of existing facilities mainly in theform of addition of newer technology, trainingof our existing manpower and also the additionof beds and wards. Also there is always theneed to collaborate with other medical institutesto keep up with the current trends and also togarner support for our cause.

Infrastructure

The hospital’s infrastructure remains the mostexpensive of all our investments. Generators,laundry machines, incinerator, x-ray machines,c-arm fluoroscopes, anesthesia machines, airconditioning units and other machinery itemscost a huge sum of money. These are alreadyinstalled but we have to remember they havelimited life-spans and need to be periodicallymaintained and upgraded. The presentrevenue generated by the hospital is justenough to cover for our operational costsincluding the salary. Some cheaperinfrastructure items have been periodicallymaintained and bought by the hospital’s ownrevenue. We need to constantly garnerfinancial help from our donors so that we areable to replace failing infrastructure items. Agood example would be that of our back-upgenerator failing in this period of constant load-shedding. If tomorrow this generator fails, wefail to operate our hospital in a huge way and

that would be a big problem to solve. Thus theneed to think now in terms of future needs formaintenance is vital. Development of ourinfrastructure needs to be discussed with ourpartners and also with the board of directorsso that we can manage to find support whenwe are in need.

Personnel

The hospital currently has two consultantorthopedic surgeons and one voluntary Belgianorthopedic consultant surgeon (who will beleaving shortly). Three registrars areimmediately below them, who are also qualifiedorthopedic surgeons. There are twoorthopaedic surgeons who have been hired assimple medical officers and this situation cannot go on for long because they will surely goaway if we train them to be good surgeons andkeep them in that post for long. There is onedoctor who is being sent for post graduatetraining in orthopedics .Finally there are fourmedical officers without post graduate degrees.We have sent one of our doctors for anesthesiatraining and he should finish his master’sdegree in a couple of months. Till now we havebeen hiring anesthetists from outside for thesurgeries that we conduct. There are onemaster’s in nursing and three bachelors innursing and two nurses are in the process offinishing their bachelor’s through in-servicetraining. We have one radiographer and threedark room assistants to run the x-raydepartment and we have one lab assistantrunning the laboratory. There is one bachelorlevel physiotherapist and one diploma levelphysiotherapist plus two physio-aides workingin the physiotherapy department.

The need for the future is to have qualifiedpersonnel working in all departments. Thereis need for upgrading of registrars on the basisof qualification, performance and seniority tothe level of junior consultants. The qualifiedmedical officers should be upgraded to the postof registrars or junior registrars so that they donot defect to other hospitals. Junior registraris a post we need to urgently create and placeour younger orthopedic surgeons so they canhave a dignified post. The nursing side is fullyqualified and we need not add many more


super qualified people there. Radiology needsone more trained radiographer. Lab needs awell-trained technician and we plan to send onelab assistant for in-service training.

There will be periodic need to train or hirenewer and qualified personnel to keep ourhospital abreast with all the newerdevelopments in the field of medicine. Alsothere is this need to recognize and preventmigration of our skilled personnel.

This requires understanding of the need to trainour staff and promotion of deserving staffs tohigher posts. The management committeeneeds to carefully understand this and co-operate with the hospital administration inpersonnel management.

Administration

Right now the hospital administration has onemedical director, one administrator of levelseven and six office assistants, and onereceptionist working in the outpatientsdepartment. For this size of the hospital, oneofficer level for administration is not enough.The accounts should be seen by at least oneofficer level staff. The Administrator shouldbe sent for some short term training in hospitalmanagement in a good institute in order toimprove his efficiency and vision.

In hospital work there is need to deal withvarious other organizations like the HandicapInternational, the Kinderberg International andvarious other national and internationalorganizations .There is need to have a welltrained public relations officer to handledealings with these organizations.

Staff meetings to sort out problems and singleout opportunities should be held on a regularbasis. Information dissemination should bemore efficient and the administration needs towork more hard on this matter.

Financial status of the hospital should bediscussed frequently and the regular provisionof provident funds and gratuity funds shouldbe checked and maintained.

Growth projection

The hospital services need to be upgradedaccording to the statistics of growth. In the lastten years the number of surgeries and thenumber of outpatients have been increasingsteadily. One cannot remain static with thecurrent infrastructure and personnel to meetthe growing demands. There needs to be morediscussion regarding the future growthprojection of the hospital as it affects alldepartments of the hospital. There needs tobe thought about the addition of a general wardbecause the need for more general beds isalready mounting. A little groundwork hasalready been done in that area.

Charity

The hospital has been providing charity toneedy patients since the very beginning.Charity will always remain one of the primarygoals of the hospital. There is constantly a needto find funds for adult and children’s charityfunds through foreign and national donors.Plans need to be made to organize fund raisingevents in the near future.

The hospital needs to have a policy of providingcharity to needy patients in a fair andtransparent way. Recently such a modality hasbeen developed, so that charity given isreceived by genuinely poor patients, and thisformat has been in effect since the last coupleof months.

Cost of care

The cost of care needs to be kept as low aspossible given that operating costs are met.Lower cost and good quality service give addedadvantage to attract more clients.

Salary

The hospital should always try to give a fairsalary to its staffs. Incentives should be givenwhen the performance is good and these canbe in the form of money or other benefits or apromotion to a higher post. Low pay should

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not be a reason for skilled staff resigning andleaving for greener pastures.

Private patients

Private ward patients pay more for the servicesgiven. Admission of private ward patients needto be encouraged and promoted. Moneygenerated from the private ward shouldsubsidize for the loss incurred from thetreatment of general ward patients and thecharity patients.

Satellite clinic

The need for a satellite clinic has beendiscussed extensively. A physiotherapy clinicrun by the Nepal Orthopaedic Hospital at theBluebird Mall on the third floor in conjunctionwith the Bluebird International Clinic is beingplanned and that clinic should be running verysoon. Many of the hospital’s patients havecomplained that it is too far away and richerpatients have also suggested that services runby NOH in the city center would be moreamenable to them. Thus this course of actionis being implemented to augment the alreadyexisting services. The city clinic should workas a beacon to attract more-affording patientsto the hospital’s private wards.

Threats

The hospital should identify that the threat tothe functioning of the hospital long term wouldonly arise if the number of patients decline.The number of patients can be always kept onthe increasing side we if we get intoarrangements with other organizations as theircare-provider (e.g. agreements with ‘YatayatByabasayi Sangh’, Handicap International,Kinderberg International and other suchorganizations).

The staffs should all be kept happy and anyunpopular decision should only be madeafter thoroughly studying the situation. Otherservice providers could become externalthreats when they provide similar kinds ofservices. These institutes could attract moreof our patients because their services are

cheaper, better or friendlier or better managedor simply because they are located very nearaccessible areas. More and more hospitals aresprouting every where in Nepal and NOHshould be maintaining links with peripheralhealth outlets to promote itself as a tertiaryreferral care centre.

Defection of skilled employees needs to beprevented as far as possible. Newer labourlaws and unionism should be tackled withutmost care, and here the managementcommittee is most needed in guiding theadministration through difficult times.

Maintenance

Regular maintenance of machinery andbuilding structure needs to be done and hereextra funds will be needed. Two maintenancestaffs are looking after the minor maintenancework. One is a trained electrician who can lookafter electrical faults as well as somemechanical faults. The other is a BMET(biomedical equipment technician) from theNick Simon’s Institute. Mechanical andelectronic devices are costly and therefore thehospital needs to have annual maintenancecontracts with other professionals too.

Fund-raising

Although the hospital is more or less self-sufficient now, the need for fund raising is stillthere. Good relations need to be maintainedwith known donors and organizations whichhave funded hospital projects. The hospitalitself can conduct fund-raising events in thefuture too.

Training institute

The hospital can be developed into an institutefor training nurses, paramedics and also forspecialization in orthopedics. Doctors, nursesand other staffs should be encouraged andfunded to be sent for training whenever thereis such an opportunity. There is need forupgrading of knowledge and skills of thesurgeons in the latest techniques so thatthey can remain competent in their respectivefield.


NOH was conceived as a world communityservice project of various Rotary Clubs(RC) in 1992. Rotary Club Patan (RCP)and Nepal Disabled Association (NDA)were the local partners. US$ 225,000 wasraised to construct the building.

Construction of NOH building was startedin 1993.

The construction of NOH building wascompleted in 1995 with the jointmanagement of NDA and RCP. Thehospital building stood idle for three yearsbefore it could start because there was noplan to bring equipment and there was lackof leadership for the project.

In the year 1996, through Rotarian JamesSinclair, RC Mount Baker, USA, US $12,800 was provided under MatchingGrant Number 6042 (MG # 6042) toprocure Hospital furniture and beds. Thelocal partner was RCP.

Dr. Anil Shrestha took up leadership then,and in1998, Rotarian Luc Salens fromBelgium raised US$ 40,000 to start thehospital and also shipped a 40 feetcontainer from Europe which was full ofhospital accessories and equipment.

Dr. Anil Shrestha became the foundingmedical director of the Nepal OrthopaedicHospital. The hospital became operationalon 14th August 1998 and at the same timeconducted a five day free orthopaediccamp. Outpatient service was started on23rd August and inpatient service wasstarted from 25th October. OperationTheatre became operational after thewards were opened.

A blood donation camp was organized inthe premises of the hospital on December3rd 1998 and ever since then, the hospitalhas been organizing blood donation campson December 3rd which happens to be theWorld Disabled Day.

In the year 1999, the Foundation Help forNepal, Holland raised more than 30,000US Dollar to construct a new block forphysiotherapy, x-ray and laboratory andalso provided money to buy a new x-raymachine.

Members of the foundation Help for Nepal(Fenna Snater and Mrijam Bloom), visitedthe NOH on March 2001. Handoverceremony of the constructed building tookplace and Consul of the Netherlands andthe director of SNV, Mr. Jan de Wittehanded over the keys of the lab, xray, ERbuilding.

Ocky Pladet, a citizen of Holland workedas a volunteer in this hospital from 25th

March 2001. She helped by collecting Rs.136,640 for the installation of the solarheating system in the laundry section andfor painting works in the hospital.

Matching Grant fund for enabling thehospital to buy hospital necessities wasendorsed through the office of the RCPDistrict 3290.

Rotary Club Patan handed over the keysof the hospital bus, hospital motorcycle,orthopaedic equipment and an anestheticmonitor to the hospital which was boughtfrom the MG fund of US$ 39,314.61. TheMatching Grant was processed fromRotary Foundation through RC Maldegem,

Historical events and activitiesin the last ten years

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Belgium. Rotarian Luc Salens wasinstrumental in bringing in the help.

In the year 2002, again through Mr. LucSalens, RC Mount Baker, USA district5050, eight other Rotary Clubs of District5050, DDF of RI 5050 and RotaryFoundation provided US$ 35,000 toprocure major physiotherapy and exerciseequipment, defibrillator etc.

The “foundation-laying-ceremony” for the2nd floor expansion of the NOH was

On 10th August 2002 a BIKATHON wasorganized by St. Xavier’s College AlumniAssociation to help raise funds for thehospital. Rs. 180,000 was raised from thebicycle rally.

Ex-King Gyanendra Bir Bikram Shahinaugurated the fully functional hospitalbuilding on 16th April 2004.

In 2005 the hospital received 78,000 Eurosfrom the Foundation Help for Nepal toinstall AC units, a 55 KVA generator andan elevator.

The hospital received a matching grant ofUS $ 150,000 to buy medical equipmentand furnishings through the initiation ofRotary Club of Maldegem, Belgium andRotary Club of Kasthamandap.

Dr. Pierre Soete, a Belgian volunteerorthopaedic surgeon, has been activelyinvolved in the development and evolutionof the hospital. H e has been working sincethe last nine years in the hospital. He wasinvolved in planning of crucial evolutionarystages; he was involved in seeing out-patients; and he did complicated surgeries,organized health camps and mostimportantly he contributed huge amountsof money through his many personalcontacts from Belgium. Total amount of hiscontribution at various stages haveamounted to US$ 469,800.

NOH completed its ten years of serviceon 14th August 2008 and a big 10th

anniversary event was organized on 26th

September 2008 to mark the occasion.Dr. Anil resigned as medical director onthe same day and paved the way for Dr.Saju Pradhan to become medical director.

undertaken on 20th March 2002. Theestimated cost of the project was aboutRs. 3.5 crores (US$ 457,000). Expansionconstruction project was started in themonth of May 2002.

The hospital received US $ 26,000 to installan incinerator to dispose the hospital wastescientifically. Funds were received throughThe Foundation Help for Nepal.


1. Free Artificial Limb andCrutches Distribution

This programme wasconducted with thehelp of Rotary Club ofKathmandu andRotary Club ofKathmandu Westand organized byOrthotic andProsthetic center,Jorpati and NOH on27th June 2008.Twenty disabledindividuals weregiven artificial limbsand or crutches on this occasion.

2. Free OPD camp

The NOH received a Matching Grant (MG#66779) of US $11,750 through Rotary Club,Mount Baker, USA to conduct a freeOrthopaedic Camp at Nepal OrthopaedicHospital. The local partner for the MG wasRotary Club of Kathmandu West. The campwas conducted from 14th August 2008 till 3rd

December 2008. The hospital provided freeOPD check-up, Laboratory Check-up, X-Rayand Physiotherapy service. 1100 patientsbenefitted from the services provided then and15 patients were operated free of cost amongstthem.

3. Foot and Ankle Surgery

The Foot and Ankle Camp was conducted by‘Healing the Children USA’ for one week at thehospital premises from 20th September till 27th

September 2008. Many patients withdisabilities in the foot and ankle were screenedbefore they arrived and finally fifteen patientswere selected for surgery. The surgeriesinvolved very difficult neglected clubfeet, other

congenital and acquired deformities of the footand ankle. The surgeries were all done free ofcost. The team donated a lot of medicalequipment and accessories to the hospitalcosting around US$ 125,000. Dr Steven Millerwas the team leader and Dr. Matt Williams,Dr. Kai Olms, Dr. Dan Baldini, Dr. TomBalestreri, Dr. Elizabeth Lin, Dr. Craig ACamasta and Dr. Lopa Dalmia were all involvedin the surgeries.

Major events in 2008

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4. 10th Anniversary Celebrations

The hospital celebrated its Tenth Anniversaryon September 26, 2008 by hosting severalevents. The event was marked by the arrivalof many national and international figures. Mr.and Mrs. Luc Salens, Miss Fenna Snater, Mr.and Mrs. Keith Sinclair representing Mr. JimSinclair , all the management committeemembers, Rotarians from various clubs aroundKathmandu and the officials from relatedorganizations, staff members of the hospital,patients and disabled people etc. There wasa small official event where important guestsand officials spoke about the achievementsmade by the hospital and also about thechallenges to be faced in the future.

Free Wheelchair Distribution

During the celebration of the 10th Anniversaryof NOH, free wheelchairs were distributed on26th September 2008. 360 wheelchairs weredistributed to the needy in total. Somewheelchairs were sent out of the valleythrough various clubs, Rotary Clubs, YouthClubs, and Social Institutions etc. The co-ordination for wheelchair distribution wasdone by RC Kathmandu west and NOH. Thewheelchairs were all sent by RC of FidalgoIsland, USA and RC of Saskatoon, Canada.

Painting Work-shop

During the celebration of 10th Anniversary, apainting workshop was organized at thehospital on 26th September 2008. The chiefguest was His Excellency Mr. Gilles HenryGarault, the French Ambassador to Nepal. 35renowned and professional artists like KiranManandhar, Uttam Nepali, Sashi Shah, RaghiniUpadhyay etc. were involved. The paintings areplanned to be exhibited and sold to raise funds

for children undergoing surgery in the hospital.Altogether 37 paintings were created from the

artists who were painting pictures in variouslocations of the hospital. The whole eventwas very exciting both for the staffs andthe patients all along. Indeed it addedmuch color to the drab atmosphere of thehospital.

5. Camp in Phaplu

The camp was held on 8th November to 15th

November 2008. Dr. Pierre Soete organizedthe camp. In that camp one doctor, twosisters and one CMA were involved. Manypatients were seen and nearly 60 surgerieswere conducted.


6. RI President Visit

RI President Mr. Dong Kurn Lee and first LadyYoung Ja visited the hospital on 17th November2008. Mr. Lee distributed fruits and food to theadmitted patients and he also planted a‘Rudraksha’ sapling in the NOH garden duringthe same occasion.

7. Camp in Tistung

The camp in Tistung was conducted from 27th

November 2008 till 4th December 2008.The camp was organized by Kinderberg

International, Rotary Club of Kathmandu Westand Nepal Orthopaedic Hospital at BajrabarahiSub-Health Post, Tistung, in Makawanpurdistrict. A total of 336 patients were seen and80 surgeries were done there.

8. Blood Donation Camp

As always, on 3rd December 2008 the hospitalcelebrated the 17th International Disabled Dayby organizing a blood donation programme.There were altogether 32 blood donors. NepalRed Cross Society sent a technical team forcollection of blood.

Dealers of:- Full Range of Orthopaedic instrument & implants- Sushrut-Adler Trauma products including Zeta Spine

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(Electronic & Battery Operated)- Manman Craniotome & Perforator System- Pneumatic Tourniquet (Electric & Manual)- VISSCO Rehabilitation Aids & Physiotherapy

Products- Surgical Instrument of all sorts (Pakistan & Germany

Made)

- Dental Units and other Dental Instrument &supplies(J.Morita)

- Anesthesia Unit, Ventilator, Infusion Pump, PatientMonitor,

- ECG machine, Pulse Oxymeter, Defibrillator, TMTetc.

- Steelcraft Hospital Furnitures, OT Table & OT Light- Suture, Catguts (Dolphin Brand) and other

Disposable products- Laboratory & Blood Bank Equipment, Diagnostic Kits

(Elisa/Rapid)- Vaccines and Specialized Drugs

With Best WishesFrom

Mediaids (Nuraz) Pte. Ltd.

New Arrival: OK Meter (No.1 Blood Glucose Monitor), Handheld Pulse Oximeter, ECG machine, Patient Monitor

New Office & Show RoomNo. 108,Ground Floor, JDA Office Complex (Infront of China Town Shopping Centre)

Baghdurbar, PO Box 21896, Kathmandu, Nepal, Tel.: 4251922, 4265245 Fax: +977-1-4218379E-Mail: [email protected]

17Nepal

OrthopaedicHospital

PROFILE 1

Thirty two years oldHira Devi is amother of threechildren fromHetauda. Herhusband left herand the family afew years ago. Shehas got a smallwooden house andshe sellsvegetables in themarket to supporther family.

Almost nineteen months back, she had a roadtraffic accident and she broke her leg. She hadto spend almost eight months in a local hospitalfor her treatment. She had to spend a lot ofmoney for her treatment yet her fractured legdid not heal and when she presented to theNepal Orthopaedic Hospital, she had a non-union of her right tibia with a discharging sinus.She was admitted for debridement of herwound and an Ilizarov fixator was put on herleg following a fibulotomy .Bone transport wasdone to bridge the bony defect.

She stayed in hospital for 230 days and hertreatment was successful. The fixator wasremoved and she was able to walk normallylater on. She now has started earning moneyfor her family and her family is very happy.

She paid Rs 9,000 for all her treatmentwhereas the total bill amounted to almost Rs.80,000. The rest of the money was cleared ascharity by our charity desk.

PROFILE 2

Thirty two yearsP u s h k a rKhadga is fromDolakha and hewas admitted inthe hospital forthe second time.He has fivechildren, oneson and fourdaughters. Twodaughters arealready married.One son andtwo daughters

are studying in school. He is a primary schoolteacher in his village.

He had a very bad intra-articular fracture ofhis femoral condyles and he was first treatedby an Ilizarov fixator which was kept for quitesome time during his first stay in the hospital.Things were going quite smooth but thefracture refused to heal fully and thus herequired a second admission. and he wasoperated

A sequestrectomy, and application of arailfixator was done later. The cost of thesetwo surgeries and the hardware used was toomuch for him to afford and thus he applied forcharity which was processed by our charitydesk. He stayed for 90 days in the hospital andcharity amounting to nearly 38000 rupees waswaived. He now comes for regular follow-upand he is walking with a single crutch and allthe hardware from his limb has been removed.He is about to begin his teaching career again.

Charity patient profiles


PROFILE 3

Pratima Sunwar who is four years old lives inRamechhap which is in the eastern part ofNepal. She is studying in nursery segment ofher local school. Her father works in a localcarpet factory on adaily wage basis.She had bilateralc o n g e n i t a ldislocation of herpatella and shewas finding itdifficult to squatand to sit properly.

She was operatedfor her problem inthe hospital andalmost full amountof the bill was givenas charity in hercase (Rs. 16,700). She stayed in the hospitalfor ten days and she is now coming for regularpost-operative follow-ups. She is happy andher parents are happy and she has started tojoin her nursery classes.

PROFILE 4

Thirteen years old Jung Bahadur Majhi is astudent from Ramechhap. He has two brothersand a sister. His father is a subsistence farmer.He had broken his left leg about eleven months

back while playingfootball in school andhe was unable towalk since then.Treatment donelocally resulted in anon-union of his tibiaand fibula. He wasoperated in thehospital and a plateand screw fixationwas done. His follow-ups were good. Hisfracture has unitedand finally he is ableto walk normally.

His father is very happy and Jung Bahadur hasstarted resuming classes in school. Partialcharity was provided to the family for hissurgery.

WE WISH THEWE WISH THEWE WISH THEWE WISH THEWE WISH THENEPAL ORTHOPAEDIC HOSPITALNEPAL ORTHOPAEDIC HOSPITALNEPAL ORTHOPAEDIC HOSPITALNEPAL ORTHOPAEDIC HOSPITALNEPAL ORTHOPAEDIC HOSPITAL

SUCCESS AND HOPE TO CONTINUESUCCESS AND HOPE TO CONTINUESUCCESS AND HOPE TO CONTINUESUCCESS AND HOPE TO CONTINUESUCCESS AND HOPE TO CONTINUEPARTNERING IN THE FIELDPARTNERING IN THE FIELDPARTNERING IN THE FIELDPARTNERING IN THE FIELDPARTNERING IN THE FIELD

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19Nepal

OrthopaedicHospital

Affiliation with other organizations

The Nepal Orthopaedic Hospital has otherpartner organizations which are workingalongside us. The relationship with theseother organizations are symbiotic in nature asthey are all working for the betterment ofhealth in the Nepali society and all of thembelieve in doing charity work. The hospitalhas good working relationships withorganizations like SIGN, Handicap

International, Kinderberg International,Comunity Based Rehabiltation networks invarious parts of the country. Our doctors aregoing out to do health camps with theseorganizations or are doing surgeries onpatients referred by them. Our hospital doctorsare also working in Butwal hospital to increaseour reach so that we can make ourselves feltpresent even outside the valley.

ASIANPharmaceuticals Pvt. Ltd.

In Quest of Excel lence

With Best Complimentsfrom

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21Nepal

OrthopaedicHospital

Award for ten years of selfless service

A view of the children’s ward Mr. and Mrs. Luc Salens are very pleased

French ambassador inaugurates painting workshop

Ilizarov fixator for knee contracture

What can be done in such a patient ?? Dr Steve Miller from Foot and Ankle Surgical Teamwith the Medical Director

Surgeons at work

Photo Feature


Function for 10th Anniversary Free Medicine Distribution to the Patients

A patient of Children’s WardSpinal Injury Patient

Peace walk from Bashantapur to Patan Mangal Bazar. Team for Futsal

23Nepal

OrthopaedicHospital

Treating patient at camp NOH OT room

One of the founding fathers of NOH (Mr. and Mrs.Jim Sinclair)

Discussing matters with staff Physiotherapy treatment


NOH ward Treating patient by Dr. Soete

Dr. Pramod from Management Committee advisingthe doctors of NOH

Team NOH enjoying the win over a football match

NOH staff enjoying the picnic NOH administrative staff

25Nepal

OrthopaedicHospital

The hospital in-patient service1998-2008

The hospital just finished celebrating ten yearsof glorious service. The hospital wasestablished on 14th August 1998 and theoutpatient services were started from 23rdAugust onwards. The inpatient services werestarted from 25th October 1998 onwards andsince then there has been no looking back tothe development of the hospital. The NepalOrthopaedic Hospital is a service-orientedorganization that is intended to serve but notmake profits. Its objective from inception hasbeen that of ‘quality service at affordable costand charity on need basis.

Originally the hospital was designed to run with16 beds but 4 more beds were added to bringthe number of beds to 20 during the start ofthe inpatient services. Later on the infection

ward came into operation so that all infectivepatients could be segregated to protect all otherclean cases. In 2004, the hospital expandedand brought into operation the private ward,the children’s ward and the post operativeward. Altogether the hospital has a capacity of75 beds.

General ward : 26 bedsPrivate ward : 30 bedsChildren ward : 13 bedsPost-operative ward : 6 beds

During these ten years of service, the hospitalhas evolved from a small unit into a wellorganized tertiary care centre. The NOH isoffering services from the followingdepartments:

Outpatient serviceIn-patient serviceSurgeryPhysiotherapyLaboratoryPharmacyRadiologyOrthotics / prostheticsPharmacySocial serviceEmergency

There are eight orthopaedic surgeons, fouranesthetists, five medical officers and onedoctor training for his post graduate mastersin orthopaedics and one doctor finishing hismasters in anesthesiology. There is one matronwho has done her master’s level in nursing andshe is in charge of all the nursing staffs. Thereare two nurses who have completed theirbachelor’s in nursing and they are currently


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operation theatre. Thereare two physio-therapistswho have done theirgraduation in physiotherapyand two physio-aides who aremanning the physiotherapydepartment. There is oneradiographer and threedark-room assistants runningthe X-ray department whilethere are four CMA’s onduty in the emergency. Thereare two certificate-levelpharmacists along with a fewother helping staff runningthe pharmacy. The wholetechnical manpower issupported by administrativepersonnel to complete thelogistical support for thehospital. There is one lab

technician and another lab assistantundergoing in-service training to become a labtechnician.

holding the post of ‘sister’ and ‘acting sister’.They have in total twenty other nurses workingunder them in the different wards and the

27Nepal

OrthopaedicHospital

Table 1 Distribution of Admitted Patients according to district1998-2008)

1 Achham 4 0.05 2 Arghakhanchi 21 0.26 3 Baglung 18 0.22 4 Baitadi 5 0.06 5 Bajhang 1 0.01 6 Bajura 4 0.05 7 Banke 9 0.11 8 Bara 91 1.16 9 Bardiya 18 0.22 10 Bhaktapur 409 5.22 11 Bhojpur 45 0.57 12 Chitwan 171 2.18 13 Dadeldhura 8 0.10 14 Dailekh 2 0.02 15 Dang 94 1.19 16 Darchula 6 0.07 17 Dhading 450 5.74 18 Dhankuta 20 0.25 19 Dhanusa 26 0.33 20 Dolakha 224 2.85 21 Dolpa 3 0.0322 Doti 6 0.0723 Gorkha 141 1.79 24 Gulmi 26 0.33 25 Humla 7 0.08 26 Ilam 7 0.08 27 Jajarkot 1 0.01 28 Jhapa 69 0.88 29 Jumla 4 0.05 30 Kailali 21 0.26 31 Kalikot 4 0.05 32 Kanchanpur 52 0.66 33 Kapilbastu 23 0.29 34 Kaski 51 0.65 35 Kathmandu 2181 27.84 36 Kavre 251 3.2037 Khotang 51 0.65 38 Lalitpur 294 3.75 39 Lamjung 48 0.61 40 Mahotarri 27 0.34 41 Makwanpur 336 4.28 42 Manang 3 0.03 43 Morang 67 0.8544 Mugu 6 0.0745 Mustang 0 0 46 Myagdi 20 0.25

S. No. Name of District No. of Patients Percentage (%) Remarks

In the last ten years of service a lot of data have been collected and the following figures will tellus in perspective what has transpired in those bygone years.


47 Nawalparasi 129 1.64 48 Nuwakot 408 5.2049 Okhaldunga 103 1.31 50 Palpa 39 0.49 51 Panchthar 7 0.089 52 Parbat 9 0.11 53 Parsa 48 0.61 54 Pyuthan 32 0.40 55 Ramechhap 300 3.82 56 Rasuwa 43 0.54 57 Rautahat 104 1.32 58 Rolpa 17 0.21 59 Rukum 10 0.12 60 Rupandehi 115 1.46 61 Salyan 9 0.11 62 Sankhuwasabha 44 0.56 63 Saptari 40 0.51 64 Sarlahi 123 1.57 65 Sindhuli 149 1.90 66 Sindhupalchok 330 4.21 67 Siraha 32 0.40 68 Solukhumbu 126 1.60 69 Sunsari 24 0.30 70 Surkhet 10 0.12 71 Syangja 20 0.25 72 Tanahu 53 0.67 73 Taplejung 5 0.06 74 Tehrathum 8 0.10 75 Udayapur 62 0.79 76 Other Countries 27 0.34

Total 7,751 100.00

S. No. Name of District No. of Patients Percentage (%) Remarks

It is interesting to see that NOH has served people living in all 75 districts of Nepal and ofcourse there are patients from India and other countries of the world.

CONGRATULATIONS !!!NEPAL ORTHOPAEDIC HOSPITAL

FORCOMPLETING TEN GLORIOUS YEARS OF SERVICE IN THE FIELD OF PATIENT CARE.

TYNOR ORTHOTICS LTD – PB (INDIA)FOR GENUINE ORTHO AND SURGICAL IMPLANTS INSTRUMENTS &

REHABILITATION AIDS

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Mobile: 9841 229673Email: [email protected]

29Nepal

OrthopaedicHospital

1. 0-10 1292 16.66 916 16.91 376 16.09

2. 11-20 1629 21.01 1199 22.14 430 18.40

3. 21-30 1440 18.57 1094 20.20 346 14.81

4. 31-40 1035 13.35 773 14.27 262 11.21

5. 41-50 813 10.48 595 10.98 218 9.33

6. 51-60 587 7.57 340 6.27 247 10.57

7. 61-70 468 6.03 233 4.30 235 10.05

8. 71-80 338 4.36 189 3.49 149 6.37

9. 81-90 128 1.65 65 1.20 63 2.69

10 91+ 21 0.27 11 0.20 10 0.42

Total 7751 100 5415 100 2336 100

Table 3 Distribution of Services Provided On The Basis OfGender(1998-2008)

Table 2 Percentage Distribution of Patients According to AgeGroup (1998-2008)

S. No. AgeGroup

Total Male Female

PercentageNumberPercentageNumberPercentageNumber

1. Admission 7751 5374 69.33 2377 30.66

2. Surgery 10137 7254 71.55 2883 28.44

3. OPD service 109710 60104 54.78 49606 45.21

S. No. Description TotalMale Female

PercentageNumberPercentageNumber

The 0-30 year’s age group is highest in percentage (16.66%, 21.01%, and 18.57%) of patientswho came in the hospital for treatment. This is because they are young, more active, mobileand more likely to be vulnerable for trauma.

The table shows the percentage distribution of services, in which seven thousand seven hundredand fifty one patients were admitted, ten thousand one hundred and thirty seven patientsunderwent different types of surgery and one hundred nine thousand seven hundred and tenpatients had received OPD services between 1998 and 2008. Not all patients needed to beadmitted for surgery and they were treated on a day-care basis.

The table also shows sex distribution of our patient population. Male patients dominated ininpatients service, surgery and OPD services. Regarding admission of patients, male femaleratio is 2.2:1; in surgical management, male female ratio is 2.5:1. In OPD services male femaleratio is almost equal (M:F=1.2:1).


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Figure No. 1

Bed occupancy was steady at around 75% throughout the last ten years !

Figure No. 2

The number of surgeries that NOH is carrying out every year similarly is increasing every yearbut certainly there will be a limit to what can be achieved with the present hospital infrastructureand manpower available. 1600 operations per year is the current trend.

S.No. Categories of Surgery No. of Patients Percentage

1. Major 3702 37%

2. Intermediate 3041 30%

3. Minor 3394 33%

Total 10137

Table 4 Distribution of Surgical Categories (1998-2008)

This table shows the categories of surgery. The highest percentage i.e. 37% of the patient hadreceived major surgery. Least percentage of the patient i.e. 30% of the patients had undergoneintermediate surgery.

31Nepal

OrthopaedicHospital

Statistics for 2008

1500 patients are seen on average in a month.

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140 surgeries are done on average in a month.


Statistical records

Every year there has been a steady growth of patients in OPD.

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SIGN surgeries have been started in this hospital from August 11, 2003. Till the end of 2008,413 SIGN surgeries have been done at the Nepal Orthopaedic Hospital. With the theme “creatingequality of fracture care throughout the world”, SIGN was officially established in January of1999. The system is specifically designed for use in hospitals in developing countries wherereal time imaging and power equipment are not available.

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33Nepal

OrthopaedicHospital

Germany (32), UK(45), USA (19), Belgium (2), Canada (5), Netherlands (5), Denmark (1),Korea (2), Singapore (1), France (3), Austria (3), Bulgaria (1), Australia (1)

Many foreign students whether they be medical students, premedical students, physiotherapystudents or nursing students have come to know about our hospital through the website orthrough other organizations. NOH is happy to enroll these students and volunteers as there ismutual interaction and learning involved.

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Month No. of Patients Charity Amount (Rs) Total Cost (Rs)

January 26 129,678.00 608,732.00

February 20 89,979.00 437,235.00

March 35 162,737.00 634,018.00

April 18 77,945.00 320,420.00

May 35 123,719.00 690,215.00

June 36 225,242.00 870,135.00

July 23 191,245.00 597,104.00

August 15 47,790.00 212,380.00

September 27 145,065.00 563,918.00

October 26 152,383.00 408,350.00

November 22 971,147.00 490,088.00

December 26 157,493.00 618,700.00

Total 309 2,474,423.00 6,451,295.00

No. of Surgeries done in the year 2008 : 1679No. of Adult Charity Patients in the year 2008 : 309Adult Patients who got charity in the year 2008 : 18.40 %

Children charity statement for the year 2008

Adult charity statement for the year 2008

Total No. of Surgeries done during the year 2008 : 1,679Total No. of Children Charity Patients during the year 2008 : 150Children who got charity in the year 2008 : 8.93%

January 6 68,181.00 246,090.00

February 3 30,225.00 45,240.00

March 7 19,920.00 93,945.00

April 14 70,711.00 178,250.00

May 18 59,615.00 218,060.00

June 20 97,766.00 290,573.00

July 15 42,907.00 188,175.00

August 17 50,280.00 231,210.00

September 11 118,551.00 210,496.00

October 10 39,063.00 140,040.00

November 17 45,175.00 221,930.00

December 12 53,355.00 154,705.00

Total 150 695,749.00 2,218,714.00

Month No. of Patients Charity Amount (Rs) Total Cost (Rs)

35Nepal

OrthopaedicHospital

The hospital is providing OPD services fromten in the morning till three in the afternoon.The emergency is open twenty four hours forall situations. The physiotherapy services alsostart from nine in the morning till four in theafternoon. Also physiotherapy services areopen in the early morning hours of Saturdaywhich normally is a public holiday.

The hospital has a basic laboratory forevaluating outpatients as well as inpatients.The lab is slowly growing and putting on newermachines and more modern services. The x-ray department is open 24 hours and isequipped with very new and modern x-raymachines. The emergency is manned by anon-call doctor and is run by very well-trainedCMA’s.

Altogether in the last ten years 109,710 patientshave been seen in the OPD and nowadays on

average doctors are seeing at least 60 patientsin a day.

The hospital employs doctors trained inorthopaedics from Nepal, China, Germany,Belgium and Australia.

There are three state-of-the art operationtheatres in the hospital, all equipped withmodern monitors and the surgery isaugmented by the use of the c-armfluoroscope. There are four consultantanesthetists and eight orthopaedic surgeonsworking in the hospital. The hospital alsoemploys many other medical officers, andnurses who have done their master’s andbachelor’s degrees as well as other staffnurses. All in all a very good medical teamhas been set up in the Nepal OrthopaedicHospital.

Services provided by the NOH

Physiotherapy Treatment Seeing out-patients


Emergency Procedure

Taking X-ray

The total number of surgeries done in thehospital since the last ten years has been10,137. On average 140 surgeries are donein one month nowadays.

The quality of the surgery has also markedlyimproved and the list of different types ofsurgeries is beyond this space to describehere. Generally all types of trauma surgeriesare done e.g. deformity correction,

clubfoot surgery, Ilizarov surgery, spinalinstrumentation, arthroscopy, total hip and kneereplacement etc are now being done routinely.

There are altogether 75 beds in the hospital ofwhich these have been segregated intothe general male and female wards, infectionward, childrens’ ward, the private singleand double cabins as well as the four-bedded cabins and also the post operativeward.

Hearty Congratulations!!!

NIVARAK TEL (60 ml / 30 ml) NIVARAK GEL (30 gm)

Fleur Himalayan LimitedHerbal Health Care Division

Jeetpur, Bara, Nepal.

&

to

Nepal Orthopaedic Hospitalfor

Successful completion of 10 years of dedicated service.From the makers of

37Nepal

OrthopaedicHospital

1998

December 05: Lions club of Nuwakot alongwith NOH organized a free orthopaedic campwhere 500 patients benefited from the servicesgiven. This was held in Trishuli.

December 26: A free health camp was held inAlapot with Bhagwan club as the local partner.

1999

December 25 & 26: A free orthopaedic campwas held in Melamchi, Sindhupalchowk withLeo Club of Jorpati as co-partner.

2003

February 8-10: A free Orthopaedic camp washeld at Sera Sindhupalchowk.

April 5-6 and June 7-8: A free OrthopaedicCamp was held in Bandipur. The camp wasdone in conjunction with Dr. Madan Piya whois a Rotarian and also a resident of the town.

May 24: A free health camp was held inSamakhusi, Raanibari in conjunction withRanibari Yuba Club.

August 23: A free orthopaedic camp wasorganized in Madhyapur Health Sewa Kendraof Madhyapur Thimi.

Health camps

2005

March 12-18: A free Orthopaedic Camp inPhaplu district hospital was conducted alongwith Himali Health Society as local partner. 902patients were seen in the camp and altogether35 patients were successfully operated forvarious orthopaedic problems.

2008

November 27 to December 4: A freeorthopaedic and plastic health camp wasorganized jointly by NOH and KinderbergInternational in Tistung. All together 336patients were seen and surgeries were donewhich included general surgery, plastic surgeryand orthopaedic surgery. Many patients werereferred to the NOH for further care.

November 8 – November 15: A freeorthopaedic camp was organized in PhapluHospital. The camp was headed by Dr. Soeteand the other team members included Dr. RaviShrestha as anesthesiologist, Dr. SonamSherpa as medical officer and it also includedstaff nurse Achala Gautam, Muna Awale andCMA Kedar Raj Giri. The camp was verysuccessful and hundreds of outpatients wereseen and almost sixty surgeries were done.


Dr. Pierre Soete, a Belgian orthopaedic surgeon has been involved in the development of thehospital since the last nine years. He is nearly sixty years old and has four children, three sonsand one daughter. He first came to Nepal as a mountaineer to climb the Kanchanjunga andEverest in the late eighties. Dr. Soete has been working in the Nepal Orthopaedic Hospitalsince November 2000 till now.

He was instrumental in theevolution of the hospital interms of addition ofinfrastructure, the expansionof the hospital, the repair andmaintenance of the hospitaland of course theintroduction of new surgicaltechniques and training ofyounger colleagues.

Dr. Soete was veryinterested in doing a lot ofdifficult surgery and he wascrucial in training thesurgeons on how to do hipand shoulder surgeries. Hestarted the total knee and hipreplacement surgeries in thehospital. The hospitalmanagement is foreverindebted to his contributionand all the staffs in thehospital will have an indelible memory of him.

Dr. Soete is shortly leaving the hospital and is again planning to restart his life back in Belgiumshortly after he goes to the USA to receive the Unsung Heroes Award from the Dalai Lama inApril end.

Training and studiesSom Prasad Upadhyay went for in-servicetraining and obtained the BMET(Biomedical Equipment Training)certificate by training for one year underthe Nick Simons Institute .

Dr. Mukti Timalsena is undergoing histhree year post graduate training inorthopaedic in China.

Dr. Roshan Piya is undergoing his post-graduate training in anesthesia and he willbe finishing his studies and joining hospitalduties in Baisakh 2066.

Staff nurse Anita Gurung and ReginaDhakal are doing their Bachelor’s inNursing. Currently they are in their secondyear of their study.

MÉRCI AND AU REVOIR DR. SOETE

39Nepal

OrthopaedicHospital

DR. SOETE AND FRIENDS’ INVOLVEMENT IN NOH

N. B. The surgical and patient care work done amounts to an infinite amount in terms of dedicationand this also needs to be seen in perspective to see Dr. Soete’s contribution for the hospital.

Building Extension of the hospital 2002-2004 165,000

Skylight aluminium work children’s ward and 4,000post operative ward.

Renovation work 2009 22,000

Container equipment OT tables, surgical tools etc 95,000

New equipment Philips X-Ray machine 50,000

Back-up inverter for OT 45,000

Computer for Administration 600

Siemens X-Ray machine 22,000

Orthopaedic camps Sera Helambu 2003 1,500

Phaplu 2005 3,000

Phaplu 2006 5,000

Phaplu 2007 7,000

Phaplu 2008 6,500

Lukla 2007 5,500

Lukla 2009 5,000

Dhanghadi 2009 5,500

Charity fund Children 2006 3,000

Adult 2007 1,200

Adult 2008 1,000

Staff training Doctors, nurses and technician (anesthaesia, 24,000orthopaedics, bachelor in nursing and BMET)

TOTAL : 469,800

Particulars USD


Mr. Raghu Ghimire, a development consultantwas appointed by the management board tostudy the hospital and to prepare a final drafthighlighting the different issues that requireddiscussion and to make an external audit ofthe hospital so that the managementcommittee could make decisions in a moreperspective manner. The report was made afterfourteen working days by direct observationand direct interviews with both senior and juniorlevel employees as well as by questionnaire.

The report pointed out on ways to curbemployee dissatisfaction with the managementby giving incentives to good employees andalso by making clear to employees their careerpath in advance. It also suggested ways toimprove the function of the administration by

A consultant’s independentaudit of the hospital

planning for the short and long termdevelopment of the hospital. It also suggestedthe hospital management to stick to its policyof providing charity. Also it pointed out thenecessity for the hospital to stay independentin its functions and stick by the memorandumof understanding between the NepalOrthopaedic Hospital and the Nepal DisabledAssociation.

A triangulated interoperations reveals that thehospital is performing well even while the staffsare not that happy with the benefit packageand even as other management functions aremoderately performed. The key to success canthen be assumed as team work, dedication andleadership commitment besides others.

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41Nepal

OrthopaedicHospital

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43Nepal

OrthopaedicHospital


High priority want list forthe hospitalThe hospital is in dire need of these hardware items. The hospital is fullyindependent to finance its operational costs but it constantly needs to upgradeits infra-structure. Donations are needed from national and internationalorganizations and we urge and request you if possible to help us acquire thesehardware items.

1. 100ma portable X-ray machine2. Well equipped ambulance3. Anaesthesia machine with ventilator4. Patient monitors5. Generator6. Addition of general ward7. Staff vehicle

Your name and financial amount given for the child

can be kept anonymous or as desired. Any amount

can be given as support for a needy child.(Normal rate for any major surgery is Rs. 35,000.00)

Please contact the hospital if you want to sponsor a child:

Nepal Orthopaedic HospitalKhagendra New Life CentreJorpati-4, Kathmandu Nepal

Tel: 00977-1-4911725, 4911274, 4910505 Fax: 49114679841400004, 9851048373, 9841202891 (mobile)

E-mail: [email protected] Website: www.noh.org.np

Would you like to sponsor a poor and needychild for surgical treatment ?!{ {

Documents

NEPAL ORTHOPAEDIC HOSPITAL Nepal Orthopaedic Hospital ...noh.org.np/materials/Annual report 2007-08 NOH .pdf · 1 Nepal Orthopaedic Hospital Doctors € 1 Dr. Saju Pradhan Medical