Czechs and Slovaks support Nepal's poor

At least a third of Nepal's 29 million inhabitants live below the poverty line, unable to afford medical treatment. But a new clinic just opened in Kathmandu hopes to make a difference. The International Human Diastyle Free Clinic was created by Czechs and Slovaks who visited the country as tourists and wanted to do something for Nepals' poor.

Radio Prague spoke to Dr. Rastislav Madar about the only clinic in the country offering free medical care:

"We decided not to apply for any external sources of finances or foreign funds. We want the people of the Czech Republic and Slovakia to feel that this is their project and that they can personally contribute to this clinic and that each contribution is clear and transparent and visible in terms of help to those poor people who have a health problem."

But the Czech Republic and Slovakia aren't exactly rich countries. Can they really make a difference?

"Yes, very much so. We have to realise that Nepal is a very poor country and the cost of medication is not very high. So, compared to a western European clinic it's very cheap. With the money we get we can run the clinic even with limited resources and of course we cut down expenses as much as possible. For example, we use outsourcing of European doctors so we don't employ much staff. If there is a problem that they cannot solve, they use a coded software system and with this any doctor in the world who has access to it enters a password and can then help solve the diagnostic problem and help with the treatment."

What are the most common illnesses that you are treating?

"We treat all acute and chronic diseases. The acute diseases are mainly infectious diseases that are seasonal. There are more respiratory infections and chicken pox in the winter period and during the hot summer and rainy season we treat mainly diarrhoea, malaria, and typhoid. The chronic diseases mainly include diabetes, hypertension, and asthma. These diseases are thought to be problems of more developed countries but in Nepal and also other poor countries we find them too and that's most probably due to a hereditary genetic burden than due to life style as is the case here."

How many patients do you have a day?

"It differs and is very much influenced by whether or not there is a strike. It's been quite common in recent days. Our clinic works every day with the exception of Saturday, even during the strikes. But we have fewer patients when there is a strike. The clinic is designed for over one hundred patients a day but the average number of patients we have then is around thirty to forty."

Patients come from hundreds and hundreds of kilometres away...

"Yes, very poor people come from very far distances. I'm often surprised to see how far they travel just to reach our clinic and we appreciate it very much. Of course they are poor and desperate. They are very ill and they don't have money, so that's probably the only thing they can do because every extra day that they wait could be fatal."

Is the state itself helping you in any way?

"Not really but I have to say that they are encouraging us. The hospitals that we cooperate with give us discounts for various examinations. For example, we do not have a special x-ray service for which you need expensive machines and more personnel. So, we outsource these examinations. They give us medication with discounts; they provide the services that we outsource with discounts. But we are not supported by the government directly. The situation in Nepal is very unstable. Nobody knows what will happen in six months time. They don't know whether they should be a kingdom or a republic and what kind of a national anthem they have, so they aren't even sure about the basic things.

"The government has many problems just to keep the country running as it is and they cannot support us more actively. But the media are interested and the minister of health and several MPs visited our clinic and they all liked it very much and supported us verbally. But otherwise it's all up to the people from our two countries, the Czech Republic and Slovakia."

And your clinic is the only really free clinic in Nepal?

"Yes indeed. It is the only free clinic. Of course, we provide completely free services including examination, treatment, and all the necessary medication only to those people who are really poor. Those who are employed and can earn some money get a free examination but have to buy the medication themselves. We don't have unlimited resources so we want to use them especially for those who are really needy. For the services that we do not provide, such as very demanding operations, we send the patient with a strip to another hospital. But the patient does not have to pay for it and we cover all expenses later."

And you also provide accommodation to patients who have to stay overnight...

"If they come from a far distance, are very poor, have no one to stay with in Kathmandu, and we need them for more than one day, we have an agreement with a guest house that is just opposite the clinic and we can accommodate them for a very cheap price. So we cover the cost of the accommodation and one meal. Otherwise they would have to stay somewhere on the street."

It seems like Czechs and Slovaks are quite generous when it comes to donations.

"My experience is that people who don't have that much are sometimes more generous than those who are very rich. I would say many of our donors are just regular people of the middle class who are not rich at all and they still donate regularly. They realise that a pack of antibiotics costs about 20 crowns, which is ten or twenty times less than in our country and they know that if they donate one hundred crowns, it can theoretically save five lives."