Dear donors and supporters

We are making progress!

Today, we can report on our visit in Bhorle from February 3rd till February 16th, 2018.

The purpose of the journey was:

• clarification of the legal prerequisites for building a village clinic in Bhorle

• clarification of the building regulations decreed by the government

• exchange with the clinic committee regarding the nature and scope of the services to be provided by the clinic, regarding the context for the building and regarding the wishes of the population with respect to the provision of care

• exchange with a delegate of the hospital responsible for the area

• meeting between Dr. Kurt Rhyner, the responsible architect of EcoSur, the responsible Nepalese engineer Madhav Prasad Regmi and Ram Kumar Tamang

We are happy that all these goals could be achieved and that the “hot phase” of planning can start now.

The Site

The assigned plot is situated in an abandoned field in the centre of the dispersed village Bhorle and can be reached by all inhabitants equally well. The dedication of the site by the district government in Dunche was presented to us. A nearby road track will greatly simplify the transport of materials and thereby favourably influence the cost of building.

The plot lies directly beneath the school. It measures approx. 250 square meters, 13.5 meters across at the narrowest point, 17.0 m at the widest, and has a length of approx. 16.00 meters.

The Building

Next to the delivery room and the general clinic and pharmacy a room with cooking facility for a nurse will be erected. This will make it attractive to establish a nurse permanently which would mean that also in emergencies somebody is on site.

Bauweise

The walls will be created from bricks. The building will be covered by a gently sloping plane concrete roof. It has more stability against external impacts than a corrugated iron roof, and it provides the option to add another level.

Unlike for the school-building quarry stone will not be used, since due to increased building activity after the earthquake there is not enough quarry stone available at the site. Besides, quarry stone is more difficult to use.

Bricks are manufactured economically near Trichuli Bazar and except for the rainy season they can be delivered over a short route by truck.

Building Phase, Supervision

November 2018 to April 2019

Our Nepalese engineer Madhav Prasad Regmi and Ram Kumar Tamang will live in Bhorle during the building phase. Mr. Regmi already is working in Bhorle for the Nepalese Building Ministry. Together with the population he is building earthquake-proof standard houses and is in the position to supervise the erection of the clinic in parallel. Just like Ram Kumar Tamang he is fully familiar with the conditions and the people in Bhorle.

The governmental conditions with respect to the building were presented to us and can be met without problems.

Personnel

A nurse from the hospital in charge of the region was present at the meeting with the committee. The distance to this hospital is approx. 3 hours walk. From there, one of seven nurses will in future be dispatched to Bhorle.

For house calls and emergencies, the doctors will be available in Bhorle, too. The funding of the nurse will come from the personnel budget of the hospital and has been approved.

Besides providing health care, the nurse will also work on social issues. According to the statements of the nurse who accompanies us in Bhorle, premature marriages, violence at home, abuse always are included among the topics that fall into the scope of her consultancy. Especially in her contact with women the nurse is absolutely trusted and often has more influence than the patient’s own family.

The nurse also is responsible for dispensing drugs.

The Population

The population receives drugs in the clinic free of charge if they are listed among the 49 free medications. Such treatment in the clinic is free whereas accommodation and treatment by doctors in the hospital have to be paid for. Contraceptives are dispensed free of charge. Approx. 50% of the families use contraceptives.

Open Questions

Specifically in view of our experiences with care and maintenance of the school there is the question who in future will be responsible for cleaning, taking care of and maintaining the building. Organizations usually withdraw from the villages and projects when the buildings have been completed. Sustainable backing and guidance for the population are not envisaged.

Gecotec e.V., NEPAL Bildung & Gesundheit and Nepal Helping Education Foundation of Nepal want to take a different route and support the people of Bhorle over a longer period, so they learn to care for and maintain the facilities. Here, too, a debate with the district government and the local committees will be important. There appears to be no financial responsibility for maintenance and there are no positions for cleaning the buildings.

We will keep at it!

Funding

Cost of building, including interior facilities, base option (four rooms, exterior toilets, drainage pit, refuse dump) ca. 50,000€ - 60,000€.

Currently, there is a funding gap of ca. 25,000€.

Dear donors and supporters, as always, without you, we can’t succeed. We ask you to consider our request, to tell others of it, and to continue to support us in building the clinic. Every donation helps, however small!

Once again we want to expressly point out here that the expenses incurred by project trips are born by those involved, and that donations are used exclusively for building the clinic.

The teams of

Gecotec e.V Deutschland,
NEPAL Bildung & Gesundheit Schweiz and
NHEFoN Nepal

give their cordial thanks!