Nepal

MAF (Mission Aviation Fellowship) seeks to increase the capacity of humanitarian development agencies working in Nepal through reliable flight service to remote locations where no other flight service exists.

THE NEED

Nepal is a landlocked Himalayan country in South Asia, bordered by China (Tibet) to the north and by India to the south, east, and west. Eight of the world's ten highest mountains are in Nepal, including Mount Everest standing at 29,029 feet. Kathmandu is Nepal's capital and largest city. The Terai zone, Nepal's flat southern region, is a belt of marshy grasslands, savannas, and forests at the base of the Himalaya range. It is inundated yearly by the monsoon-swollen rivers of the Himalayas. The scenic beauty is one of the nation's greatest natural resources; however, it also erects formidable barriers leaving most of the country inaccessible by roads.

Poverty
Among the poorest and least developed countries in the world, more than a third of Nepal's population lives below the poverty line.

Agriculture is the mainstay of its economy, accounting for 38 percent of its gross domestic product (GDP). However, a major part of the country is mountainous with little arable land. Although 76 percent of Nepalese are engaged in agriculture, the population suffers from malnutrition due to low crop yields. While manufacturing industries include carpet, textile, cement, and brick, travel to areas other than local markets is nearly impossible.

Recent political instabilities, including the Maoist insurgency (since 1996) and the massacre of the royal family (June 2001), threaten tourism, a key source of foreign exchange.

Lack of Medical Care
The current healthcare system dates back to failed government efforts in 1951 that called for establishing various health institutions throughout the country. As a result ...

• Most of the village subhealth posts are poorly managed. Community participation, crucial to their success, is often unavailable.
• Frequently, there are no physicians in primary healthcare centers that are staffed by poorly trained healthcare workers. Likewise, many of the district hospitals lack physicians, and diagnostic resources are limited.
• Extensive policies for healthcare planning are put forward but rarely implemented or fully integrated.
• Many households in Nepal’s villages are unaware of the presence of the health posts.
• In rural areas, government health services are underutilized.
• More than one-third of the population has no access to safe water. Unsafe drinking water and primitive sewage disposal methods account for the prevalence of many diseases, including cholera, typhoid, and hepatitis A.
• Open sewers are found in half of Nepal’s urban areas and 88 percent of its rural villages.
• The lack of knowledge about healthcare and nutrition accounts for widespread malnutrition. More than one-third of Nepal’s children between one to five years of age are mildly malnourished, while another 12 percent suffer from severe malnutrition.
• Nepal’s hazardous geography and reliance on kerosene for energy contribute significantly to orthopedic injuries and burns.
• Prevalent orthopedic injuries are secondary to congenital disorders, burns, untreated osteomyelitis, and neglected trauma.

Primitive Emergency Medicine Delivery

• Recent graduates, with one year of internship, staff the rural emergency medical clinics. Unfortunately, they lack any formal training in emergency medicine.
• There is limited access to formal continuing medical education (CME) training.
• Essential basic emergency equipment, such as central line kits, tube thoracostomy trays, oxygen saturation monitoring devices, and ventilators, is unavailable.

THE SOLUTION

MAF has been invited to fulfill a strategic role in Nepal by providing reliable air service on a variety of domestic routes at an affordable price. Although small domestic operators provide service between Kathmandu and large centers, most of Nepal's neediest people live in isolated areas. The demand for air service in Nepal is steadily increasing as private aid organizations and businesses work more and more in remote areas.

By providing reliable flight service to development agencies and Nepalese living in the remote regions of the west, midwest, and far west, MAF will contribute to Nepal's economic growth and development. Areas served will be selected based on existing development projects where no other flight service exists.

To that end, the overall objective of MAF in Nepal is to build communities through affordable flight service as follows:

1. Increase the capacity of development agencies working in Nepal through reliable flight services to remote locations. By serving development agencies and the people living in isolated areas, MAF will significantly advance the economic growth and development of Nepal.
2. Support and enhance the rural medical health services through aviation services. This will be accomplished by regular air deliveries of equipment, medical and other supplies, as well as the transport of staff, consultants, technical experts, patients, and other necessary freight and passengers.
3. Enable the improvement of the rural infrastructure through air support of agencies, NGOs, and government departments based in remote locations.
4. Provide logistical and other support to people living in isolated communities.

MAF will enable projects in medicine, education, agriculture, water, literacy, community development, and disaster relief. Subsidized MAF charter flights will support hospitals and medical clinics, medical evacuations, humanitarian catastrophes, NGOs, and other community development organizations. As appropriate, MAF will also offer its services to the government in order to further assist in Nepal’s development.

In Nepal, MAF efforts will focus on the following:

1. Medical Assistance
   • Air and logistical support for remote hospitals—includes transporting medical workers, medical supplies, and medical equipment.
   • Patient referrals—transport of patients to other hospitals as requested by senior medical staff.
   • Medical evacuations—air ambulance service from remote communities to the nearest suitable medical facility.
   • Air transport of supervisory consultants and specialized medical teams to rural hospitals and health centers, as well as medical teams to conduct clinics in remote areas.
   • Facilitation of remedial and ongoing training for rural health workers at training centers by providing affordable transportation.
2. Community Development
   • Air transport of supplies and staff to support the activities of humanitarian organizations working in agriculture, education, water engineering, and community development.
3. Disaster Response
   • Emergency air and communications services following natural disasters such as earthquakes, floods, landslides, fires, or famine.

In December 2007, an MAF family was placed in Kathmandu, Nepal, to initiate the application for the required Air Operating Certificate (AOC). A second family joined them in October 2008. These families are attending language school and developing relationships within the country.

KEY GOALS 2009

• Submit the AOC application. Create the necessary manuals.
• Establish an advisory committee, comprised of local church leaders, to advise MAF on church activity and ministry needs.
• Prepare for the arrival of additional missionary staff.
• Begin staff training in preparation for the arrival of a KODIAK 100 aircraft in mid-2009.
• Commence flight operations.

A complete implementation plan is available upon request.

THE COST

This year, it will require $319,310 to fund startup operations in Nepal. Total funding from field revenue and support raised by MAF staff amounts to $190,290—or 60 percent of total operating costs.

We seek the remaining 40 percent—or $129,020—from caring partners: individuals, churches, and foundations.

MAF STAFF SERVING IN NEPAL

• Tim & Karen Chase
• Stan & Ronda Unruh

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