The Phuleli Community Health Center provides much needed free healthcare services to several village communities in the southern Solukhumbhu region of Nepal, where other healthcare facilities are currently nonexistent. Construction of the facility is completed and The Small World is now entering the implementation phase of the programs at the health center, including the purchasing of equipment/supplies, staffing, facility management/upkeep, and the delivery of healthcare services. Our goal is to bring basic, affordable, and quality healthcare to multiple rural communities in Nepal where individuals are often required to travel hours to days by foot for their medical needs.
Challenge
As a country, Nepal has 0.67 doctors/1000 people, which is nearly 4 times lower than WHO’s recommended ratio. This ratio becomes significantly lower in the rural areas since most of the healthcare infrastructure is centralized away from them in the Kathmandu valley. Many rural communities lack healthcare facilities completely and the villagers must travel, often by foot, to receive needed care. This results in a rural population that has increased risks of developing infections and mortalities from communicable diseases, malnutrition, and other serious medical conditions. Children in the rural areas of Nepal are more likely to be stunted and underweight. The recent COVID-19 surge in Nepal has greatly added to the healthcare burden in these communities. These villagers currently experience limited or no access to basic healthcare due to relative high cost, low or no availability, and lack of education.
Solution
The Phuleli Community Health Center will provide much needed healthcare services to more than 32,000 individuals from the villages of Taksindu, Waku, Basa, Kaku, and Juving, all located in the southern Solukhumbhu region of Nepal. The services provided will include COVID-19 relief (including a vaccination program in conjunction with the local governments), emergency care, maternal and child healthcare, safe deliveries, immunizations, family planning, pharmacy services, dental services, healthcare education programs, and community outreach. The clinic will house an OPD room, four inpatient beds, a procedure room, a delivery/gynecological room, an immunization room, a dental room, a sterilization room, a lab, a pharmacy, a meeting/training room, and accommodations for local staff and volunteers. Our facility will be permanently staffed with local employees and periodically with international volunteers. Services will be available 7 days/week, 24 hours/day. The sustainable operations of the health center will be provided by The Small World and the local community governments.
Long-Term Impact
The goal of the Phuleli Community Health Center is to improve the current low healthcare outcomes in rural communities that lack basic healthcare infrastructure. The prevention, early diagnosis, and treatment of all medical conditions will lead to healthier, more productive and engaged communities. Healthy children are less likely to be stunted and underweight, will stay enrolled and function better in school, and have the chance to become more successful adults in the future. The immediate use of the center to function as a COVID-19 relief and vaccination facility will help reduce the infection surge that is currently ongoing in Nepal and facilitate treatment for those that are already infected. This project will help to eliminate the unequal distribution of healthcare provision in Nepal resulting in reduced unnecessary morbidities and mortalities that currently exist. Villagers in these communities that are not receiving healthcare due to lack of resources and/or availability will now have free healthcare close to their homes.
Program Delivery
The monthly cost to operate the Health Center is $1,500
Monthly operational costs include:
- Salary for nurse = $300
- Salary for health assistant = $200
- Electricity, medicine and medical supplies = $1,000
Timeline in Photographs
May 2019: CONSTRUCTION BEGINS!
In May 2019 we broke ground on the health center! It was a very exciting time for us and for the community of Phuleli to see this project becoming a reality.
Autumn 2019: Health post is over half done!
The construction of the Phuleli health post is over half done. A huge thanks to Dr. Bart Roach for his support of this project and spearheading our ability to construct the facility!

February 2020: Even Closer!
We are well into the second level of the health post.

March 2020: Looking good!

March 2021: Finishing the inside!
BUILDING PLAN:
• 1 OPD room
• 2 In-patient rooms with 2 beds in each room
• 1 procedure room
• 1 Pharmacy
• 1 Lab
• 1 dental room
• 1 delivery / gynecological examination room
• 1 ANC/PNC and immunization room
• 1 Sterilization room
• 1 waiting area
• 1 store room
• 1 Meeting room plus training hall
• 2 toilets
INFRASTRUCTURE FOR STAFF QUARTERS & VOLUNTEERS:
• 3 rooms for local medical staff
• 3-5 rooms for volunteer housing
OUR SERVICES:
• OPD 7 days a week
• In-patient care, 24 hours
• Laboratory
• Emergency 24 hour services
• Family Planning Services
• Safe motherhood
• Reproductive health
• Dental services
• Maternal & Child health program/ immunization
• School Health program
• Specialized health services once per month
STAFFING:
• 1 Registered Nurse
• 1 Health Assistant
CATCHMENT/ BENEFICIARY AREA:
Over 32,000 thousand remote Himalayan community people will be benefiting from this project. This health post will serve the following areas:
- Taksindu with population of 6000 people
- Waku with population of 8000 people
- Basa with population of 7000 people
- Kaku with population of 6000 people
- Juving with population of 5000 people
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