Nine years ago, it was rare to see a patient at Namche Area Health Post. Despite being the only health post in Namche Bazaar, its cabinets had only few medicines and supplies. It was difficult for the only Auxiliary Nurse Midwife (ANM) at the post to provide even basic health services to the few patients that came in. Few years ago, the post shifted to its own building from a rented one. However, the changes in infrastructure did not translate to better services.

"Although a new building had been set up, all we received in the name of support from the government were medicines like paracetamols and painkillers," says Lama Kazi Sherpa, chairman of the post's management committee.

Continued government apathy towards the health post prompted the local community to take charge alongisde Himalayan Health and Environmental Services Solu Khumbu. According to Sherpa, locals raised about Rs 4 million to upgrade the facility at the clinic which now boasts of a doctor, nurse and health assistant.

Today the health post serves over two dozen patients in a day and offers services to locally treatable diseases along with emergency services related to altitude sickness. "Tourists who had to be airlifted from Namche and taken to the cities even for altitude sickness, can now be treated here," says Sherpa. "The income we earn is used to pay the operating costs."

Locals who come to the clinic are charged a nominal fee. "A patient needs to pay only Rs 50 and we provide free services to those who cannot afford the standard rate," says Ang Gelu, the sole doctor at the health post. Its extended pharmacy is now equipped with more medicines which are sold at the same price as in Kathmandu. A large number of people visit the post complaining of respiratory diseases and the managing committee plans to add a fully functional operation theatre in the near future.

Sushila Pariyar (see box), the longest serving staff, says the health post has undergone notable changes, "With better facilities there has been a significant rise in the number of locals seeking basic healthcare in the past one year."

Forty-year-old Sangye Sherpa, a cook for a mountaineering expedition team, is at the health post for whooping cough. "Earlier I had to travel to Kunde hospital for even minor illnesses since the health post had no doctors and limited medicine," recalls Sherpa. "This has been a blessing for us locals". According to the staff, patients from as far as Monju and Phakding come to Namche for treatment.

However, the health post is unable to perform medical evacuations for critical cases or provide complicated emergency services due to the lack of infrastructure. Gelu laments: "Things have improved significantly, but we still cannot provide certain crucial services. The only thing we can do is refer patients to hospitals in Kathmandu, and not all of them have the means to make it there".

Nursing Namche to health

Sushila Pariyar has single-handedly run the clinic for many years and played an instrumental role in establishing the Namche health post as the leading healthcare provider in the community. She was assigned to Namche as an ANM after clearing her civil service exams in 2002. "There were two other staff who started out with me, but they left in less than a year," recalls Pariyar who lives Salleri in Solu Khumbu district. She worked relentlessly in the rundown building, without a doctor or proper equipment and showed great dedication towards her patients. "Since we could not deliver babies at our health post, I would go from home to home and help women with their deliveries," says Pariyar. After working at Namche for nine years she considers the clinic her second home and is pleased to see the transformation. Says Pariyar: "Although we are far from being a full-fledged hospital, I feel like our perseverance and hard work has paid off."

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