Amppipal Hospital

Amppipal Hospital, Palungtar Municipality - 11, Gorkha, Nepal, telephone: 00977-9846-208709 (unreliable, in case of an emergency only!)

geographical location & political situation:                                                                                                                                                                              Amppipal is a village in the hilly region in the Southwestern part of the district Gorkha in the West of Nepal at the base of the main range of the Himalaya mountains. In the surrounding districts live more than 100.000 inhabitants. The hospital is situated above the river Chepe (say: chaypay) at an altitude of around 1.100 m (approximately 3.300 feet) above sea level. The panoramic view from the hospitals mountain towards the snow mountains of the Annapurna Range and Manaslu Himal is breathtaking. The Amppipal Hospital is currently the only medical place with a continuing surgical treatment in the entire district of Gorkha and neighbouring areas. The majority of the patients comes from the districts of Gorkha, Lamjung and Tanahun with marchs of walking times between 1/2 and more than 12 hours. The hospital is open to everyone. There have been no problems with the Maoist insurgency in this area. Hence, it is a save place for foreigners so far.

the Amppipal Hospital located in the mountains of Nepal                          the moving of a sick person by foot

foundation and service until 2001:
The hospital in Amppipal was founded in 1969 by the "United Mission to Nepal". It replaced a pharmacy, which served there for 12 years as the only medical place in the entire area. In April 1997 the Amppipal Hospital started as the first hospital in Nepal with the "DOTS"-treatment of tuberculosis (Directly Observed Therapy, Short Course). Main goal of the programme is the direct contact between patient and doctor to ensure the adherence of the medication and the observation of the healing process. Usually, the "DOTS"-treatment starts with a two-month period in the hospital (3 months in case of relapse) and is followed by another 6 months medication in out-patient care. The medication of tuberculosis and leprosy is free, funded by the Nepalese government. Patients suffering from tuberculosis receive a discount rate for accomodation of 20 NPR per day.

In September 2001 United Mission suddenly stopped operating the hospital in Amppipal. The reasons are not known to us and give room for speculation. Maybe, there have been problems with the Moaists at this time then or they run into financial turbulences. Today, we see occasionally visitors from United Mission services from former times who are wondering how much the whole hospital compound has changed since the Nepali took control over the hospital in 2001.

the room for physical therapy                                                                              the surgery unit with a new operation table

present day hospital service:                                                                                                                                                                                                 Today, between 50 and 120 patients visit the hospital every day. The most common diagnoses at the hospital are asthma and chronic bronchitis, diarrhoea, typhoid fever, worms, feverish infections. The hospital offers out-patient as well as in-patient services. Facilities include modern x-ray, diagnostic and therapeutic ultrasound and laboratory medicine. Furthermore the hospital offers eye care, dental treatment, family planning, maternity care and vaccinations. The vaccine for children is free of charge. During OPD-hours (= Outpatient Department) a video programme shows various topics of health education. At the moment there are only around 30 of the 46 beds available due to the ongoing construction work. For more information visit the website of the Amppipal Hospital or get a brief overview
of Amppipal Hospital's history (pdf-file).

the hospital budget:                                                                                                                                                                                                               The hospital budget (4,0 million NPR per year) consists of financial resources provided by the Nepalese Ministry of Health (1,4 million NPR), the community of Amppipal (125.000 NPR) and treatment charges (2,0 million NPR). The United Mission still supports the local pharmacy (700.000 NPR) until today. The amount of 2 million NPR which must be collected with treatment charges and bed-charges are a hard burden for the hospital. A medical consultation costs a patient 20,00 NPR. The hospital charges 80,00 NPR per bed and day and the local OT-charges (incl. anaesthesia, material, medication) goes up to 6.000,00 NPR. Donations come occasionally from private donors and continuously from Nepalmed. The donations to Nepalmed are partly used for purchasing medical equipment as well as for financing our charity fund (Nepalmed Fund at the Amppipal Community Hospital) which covers treatment costs for poor patients. After evaluating the financial situation of the applying patient part of the costs for treatment will be covered by the our charity fund. A group of three persons from the hospital board decide about the applicants situation and the amount of money to give. The greatest part of our financial resources is used for the enhancement of the hospitals infrastructure (e.g. road building, facility and waste management, power and water supplies).

With a donation from the city of Warburg a new x-ray from Siemens was installed at the hospital. In co-operation with the NGO "Dentists without limits" a complete dental unit including x-ray and mixer for fillings is now available at Amppipal. Today, a specially trained Nepalese technician treats dental patients at the hospital. Furthermore, European dentists come frequently for short services in order to help the local staff with dental treatment. They use very often their holidays for their commitment at the Amppipal Hospital.

Further support came from the firms ERBE (provided a new diathermia device), Karl Storz (provided a complete procto-rectoscopy unit) and others by organizing a Lumitec infrared coagulator, two incubators and various medical instruments from Aesculap, Martin and KaWeMed.

our help:                                                                                                                                                                                                                                      Nepalmed has invested financial resources as well as lot of time in the maintenance of existing hospital buildings. All wooden parts of the buildings had to be replaced and painted with protective colour against the monsoon rain. Furthermore, all existing toilets have been replaced. The fireplace in the laundry was repaired as well as the ceiling in the main operation unit. A waste disposal pit was constructed in order to establish a local waste management. The most sensitive parts of the hospital were rewired with a back-up battery system due to frequent power shortages.                                                                                                                                                                                                    In order to modernize the entire infrastructure of the hospital Nepalmed organized many items such as: a photocopier, a micro centrifuge, 2 autoclavs, various medical instruments and implants, a new operation table, a delivery bed, an anaesthesiological trolley including equipment, a repair kit for the generator, an ultra-sound, new patient beds and warming quilts, a drinking water filter device, a warm water dispenser for the washroom in the operation unit, another modern incubator and a phototherapy unit for newborns and a laboratory analyzer.
The greatest project so far has been the construction of a road between the village of Amppipal and the hospital on top of the mountains. The road of 2 km length is suitable for all 4-wheel-drive ambulance cars and was entirely financed by our organization Nepalmed. The road opened its operation in December 2005. In 2006 the Amppipal Hospital received a donation of an own ambulance jeep with an oxygen unit and European standard emergency equipment. Furthermore, additional land for the construction of a new multi-purpose building (financed by The World Bank) was acquired. The construction work on this land finished in the year of 2008. Since December 2010 the construction work of the new OT-tract is under way. Nepalmed is supporting this new project with an amount of 40.000 Euros. Another aspect of our help is the training of local staff. We have organized the professional training of several employees (physiotherapy, midwifery, dental and eye care, maternity, STD, surgery and general hospital management).

the current aid projects:                                                                                                                                                                                                  Nepalmed is looking for dedicated personnel. We have need of physiotherapists, who train the local staff at the hospital in a two-weeks-period. Furthermore, we are looking for dentists who run a camp at Amppipal 1 or 2 weeks 3 or 4 times a year. The camps should take place not during the Nepalese school holidays since it is necessary and desirable to check mainly the students (school children) and teach them in dental hygiene. Another hot issue is the training of the staff in the health posts and the medical halls (local pharmacies), who must be trained urgently. In addition it is absolutely necessary to attract a Nepalese surgeon to the Amppipal Hospital.

accomodation:                                                                                                                                                                                                                             There is a little guest house with only 5 beds at Amppipal for visitors of the hospital. Unfortunately, it is not possible to book a room at this guest house from outside of Nepal. Hence, an early co-ordination with our organization Nepalmed is necessary, so we can usually accomodate all doctors, personnel and students there.

price list:                                                                                                                                                                                                                                         A visitor to the hospital who stays at the local guest house must pay 250,00 NPR per night. A tea for breakfast is included. If you would like to eat also Nepalese food, the price per night will be 400,00 NPR. Alternatively, you can bring your own foodstuffs or eat in the local food shops next to the hospital. We remind you kindly to always pay or refill the fridge in the guest house if you take something from the doctors. They all work hard and voluntarily! For a medical elective the hospital charges 1000,00 NPR per month. The ones sent to the hospital by Nepalmed additionally pay an amount of 50,00 Euros to Dr. Starke (hospital director) to support the charity fund.

how to get there:
There are buses from the capital Kathmandu (station: New Bus Park) to the town of Tuture (on the road to Besisahar). From Tuture one must take another bus going to the town of Tatipokhari. The bus from Kathmandu goes only once per day leaving the Capital at 7.45 am. Tickets for a ride should be purchased at the booth with buses going to the town of Besisahar. Alternatively, one can take also a bus going to Pokhara or Besisahar. If you take one of these buses, drop out at Turture and continue the journey by taking another bus to Tatipokhari. From there the road to Amppipal goes to your right across the river. To get finally to the hospital, one can hire a baggage porter (5 NPR per kilogramme of luggage) or if you like the really beautiful but strenous hike uphill to the hospital you should plan around 3 hours for this hike. Another option is taking the Jeep which runs from Dumre to Amppipal. It goes regularly at around 1 pm from the Hotel at Kusum (telephone: 065-580110). Please be aware that jeep drivers like to cheat on foreigners. The regular price for that ride should not be more than 250,00 NPR. Due to regular expected delays on the road bring water and something to eat with you and try to start the journey early in the morning.

donation:                                                                                                                                                                                                                                            If you would like to make a donation for this hospital, please use the following bank details.

bank name: Volks- und Raiffeisenbank Muldental eG
account number: 5000166776
bank code: 86095484
reason for payment: Amppipal + your address (city, postal code, street) / if you wish to receive a contribution receipt 
IBAN: DE67 8609 5484 5000 1667 76

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