From the Streets of the Bronx to the Mountains of Nepal

Nyaya Health Develops Model for Health Care Delivery

by Dr. Bijay Acharya

When not on the wards and clinics of Bronx-Lebanon Hospital as a PGY2, I sit on the Board of Directors of Nyaya Health, a unique and innovative non-profit public health organization.

Nyaya Health is a collaboration between Nepali and United States public health experts to provide services to the Achham region of Nepal. My involvement with Nyaya Health started in the summer of 2006 while I was working as a volunteer physician in Nepal for a non-profit HIV/AIDS clinic in my hometown of Pokhara, Nepal.We worked in an extremely rural and impoverished region in the west of the country, with some of the highest rates of maternal mortality, and poorest public health statistics in Asia.

Prior to Nyaya’s opening of the first clinic in 2008, there was no doctor in a region of over 250,000 people. We began with a single clinic in a renovated grain shed; now we operate a full hospital, which is completely free for all patients. Services include a full out patient and inpatient department, 24 hour labor/delivery and emergency care, a pharmacy, and a network of community health workers for health outreach and follow-up in the surrounding communities. Nyaya is presently scaling up its services and plans incoming years to offer surgical services, as well as expanded public health programs for the region.

Our mission is two-fold: to work in collaboration with the Nepali government to develop health care infrastructure, and to utilize our experiences working in Nepal to develop a scalable model for health care delivery in similar resource-limited settings around the world.

Nyaya also works to communicate with the international global health community more broadly. A core element of our work is the development of a Web site (http://wiki.nyayahealth.org/) through which we share all clinical and administrative protocols, operations research, and health and financial data, in a further effort to offer our work as a model for other organizations doing similar work.

My work with Nyaya is important to me. I am busy developing programs and protocols and dealing with bureaucratic and legal issues in running the organization. I feel that my work, both in rural Nepal and the South Bronx is shaping up my training, career and life.My involvement with CIR has added to my advocacy skills and my passion for “just” health care wherever I practice.

You can find more information at www.nyayahealth.org