2015 Annual Impact Report

August 1, 2014–July 31, 2015

This has been the most challenging year our organization has ever faced.
But when it comes to solving for the patient, it has also been the most impactful.

We believe in proving it’s possible to deliver high-quality,
low-cost healthcare to the world’s poor.

 verb: to increase in extent, size, volume, scope

This year, we broke ground to turn our hospital hub into the leading rural teaching hospital in Nepal. We treated 69,505 patients, added 39 people to our team, and overall funding grew over 150%, with a 7-fold increase in government support. We also expanded our healthcare model to another district after the earthquakes struck.
“Before the first earthquake on April 25th, we had already broken ground to turn our hospital hub into a leading rural teaching hospital using earthquake-resistant design. After witnessing the devastation, we committed to rebuild the healthcare system in one of the worst hit districts where 87% of the facilities were damaged.

With your support, we've made it a mission to expand our durable healthcare model further than previously imagined—inspired by the patients who need care and by the health workers who are advocating for safer, better healthcare system to be built with an urgency that matches the need they see on their doorstep.”

—Mark Arnoldy, CEO

Our durable model means healthcare does not end at the hospital. Patients receive the care they need closer to their home through an integrated system of hospitals, clinics, and community health workers.


Bayalpata Hospital is the hub of our healthcare system, where we treated over 69,000 patients this year. We offer a set of advanced services—from surgery to lab work, digital x-rays to dentistry.

Key Performance Indicators

You can't improve what you can't measure.

It's our job to prove possibility with data. We use these six KPI's because they can be feasibly collected in rural impoverished areas and reflect the overall performance of the healthcare system. The Nepali government only pays us when we hit these indicated targets, showing we're improving population health outcomes.


Surgery Access

Target: 95%
A full set of resources and people to perform surgeries were available every day.



Target: 1.0
Marginalized patients accessed our healthcare system 60% more frequently than non-marginalized patients.


Safe Birth

Target: 95%
76% of women gave birth in a healthcare facility with a trained clinician in the past year.


Follow Up

Target: 90%
50% of our total chronic disease patients had a follow-up interaction with a provider.


Outpatient Use

Target: 1.3
On average, each person in our catchment area visited one of our healthcare facilities nearly 2 times.


Family Planning

Target: 75%
34% of reproductive aged women who delivered in the past 2 years are using contraceptive methods.

Key Performance Indicator Progress Q1–Q4

*We can only show quarterly progress for four of our six KPIs. The remaining two KPIs, Safe Birth and Family Planning, are measured annually in the January-March timeframe.

Hospital Expansion

We broke ground on Nepal's leading rural teaching hospital—using a design approach that strives to become a national model for safe healthcare facilities.

Team Housing

Having dignified, comfortable housing at the hospital hub ensures we can better serve our patients and attract top Nepali healthcare leaders.

Smart Design

The benefit of using stabilized rammed earth technique for construction is its high thermal mass, which reduces the need for air conditioning and heating and saves energy. 

Looking into 2016

We are about to break ground on a brand new inpatient and outpatient department, meaning we can significantly increase our number of services, patient treatments, and academic spaces.



Patients Treated this Year

90% Outpatient care
7% Emergency care
3% Inpatient care (inpatients + HIV + deliveries)

This year there was a 49% increase in surgeries. We use this data to evaluate surgical usage and capacity, and to create a baseline for necessary follow up.


Surgical Procedures


Babies Delivered 

In our hospital alone there was a 25% increase in safe deliveries. We also completed 1,538 antenatal care visits for expecting mothers, critical for mapping institutional birth rate and evaluating new areas of intervention.

There was a 74% increase in digital x-rays this year, which has significantly improved patient care. Having specific technologies ensures operations function properly and we can meet patient demand.


Digital X-Rays


Communities are at the heart of our model.
We work to transform primary clinics into accountable, fully staffed, stocked, and connected facilities. Currently, we operate in 13 health clinics in order to bring immediate and follow-up care closer to the home.

Outpatient Visits

More than 30,000 patients visited these clinics versus traveling far distances to our hospital hub.


Deliveries Performed

Over 300 mothers had safe births at our clinics equipped with a skilled birth attendant.


New Antenatal Care Patients

We enrolled nearly 600 expecting mothers into our antenatal care program. 

Improving Access

Hills are often a patient's path to healthcare. Strengthening clinics makes this path faster and safer.

Group Antenatal Care (ANC)

Group antenatal care meetings provide expecting mothers with the valuable information and care they need to have a safe pregnancy with a trained clinician.‍

Powered by Solar

Our partnership with Sunfarmer enables  clinics to be powered fully by solar energy. We have generated enough electricity to power 5,256,000 hours of light, or enough electricity to power 1,539 C-sections.

community health

One of the most important aspects of our model is the integration with Nepal’s Community Health Worker (CHW) network and our home-visits program. CHW’s live and work in the surrounding villages performing triage, providing referrals, and managing follow-up care.
“No one should fall through the cracks of any healthcare system. Our Community Health Program prioritizes supporting patients and their families to overcome the social and contextual barriers that prevent them from accessing care—both at healthcare facilities and patients homes.”

—Isha Nirola, Director of Community Health


We increased our Community Health Worker Leaders to 20 and Community Health Workers to 164.


Home Visits 

We visited and treated over 20,000 pregnant and chronic disease patients at their home.


Group ANC Sessions

We held 234 group antenatal care sessions for pregnant mothers.


Completed ANC Visits

In 234 sessions, we had over 500 pregnant mothers complete all four classes in the program. 

First Specialized Nail Surgery

19-year-old Nabina broke her right leg when she fell returning home from school. She went to a traditional district hospital, was given a cast, but showed no signs of improvement a month later. One of our community health workers from her village referred her to our hospital. A digital x-ray revealed a fracture that hadn’t healed. Our team had recently received tools and instruments from SIGN Fracture Care International for nail placement surgeries. This is the first time our hospital performed a nail surgery, which allowed Nabina to use her right leg within three months.

Bringing Care to the Patient

Our Community Health team met Padma during her first group antenatal care (ANC) visit. We discovered she had a prolapsed uterus and began closely monitoring her health at ANC visits and at her home. Padma ended up going into early labor. A Community Health Worker alerted Dr. Bishal, along with our nurse, Sonu, and they drove straight to Padma's house, where she was bleeding and in great pain. Our medical team immediately went to work and brought her to our hospital, where Padma delivered a baby boy.‍

Digital X-Rays in Rural Nepal

‍Imagine This Scenario:
A mother walks for two days to bring her 5-year-old son, who has a broken arm, to our hospital hub. The boy’s x-ray is taken and the image is saved electronically. Our orthopedic surgeon examines the x-ray on her computer through the boy’s patient ID and recommends a treatment.
Ever since our team procured a digital x-ray, this scenario has become a reality. Every day, our x-ray department takes up to 50 images for fractures, chronic obstructive pulmonary diseases (COPD), tuberculosis, and various pulmonary infections prevalent in HIV-positive patients.
As our surgical and orthopedic services expand, it’s essential we have specific technologies to ensure operations function well and we can meet our patient demand.

Remarkable moments

Deployed An Electronic Health Record (EHR)

This is the first integrated EHR system in Nepal, where we strive to enhance patient care by utilizing data.

Conducted First Digital Household Census

Using smartphones, we collected data from over 7,500 homes to measure impact across the tiers of our work.

Formalized a Community Advisory Board

The board provides critical advice and feedback on the relevance and feasibility of our community programs.

Signed a Gov't Contract to Rebuild Post-Earthquake

This enables us to expand our Public-Private-Partnership and begin rebuilding 21 health clinics.

Broke Ground On Our Hospital-Hub Expansion

We began construction to turn our facility into the leading rural teaching hospital in Nepal.

Funneled $20MM Dollars in In-Kind Disaster Relief

We worked with partners after the earthquakes to move $20MM dollars to high-impact relief organizations.

Hired Nepal's First Female Orthopedic Surgeon

Dr. Aaradhana's specialization meant we could take care of major trauma cases without the need to refer patients to urban hospitals.

Enrolled Our First MD General Practice Resident‍

We formalized a partnership to enroll MDGP residents  at our rural teaching hospital.

Earthquake Response

On April 25th, in a single moment of tectonic unrest, all of our lives changed.

In response to the series of over 400 earthquakes that struck this spring, we expanded our work in Nepal and are rebuilding the healthcare system in one of the worst-hit districts. We chose Dolakha District, where 87% of its healthcare facilities were damaged or destroyed, and 40% of people now lack access to healthcare.

We signed a contract with the Government of Nepal and immediately began rebuilding 21 clinics, installing solar electricity, and ensuring supplies reach facilities via the supply chain.

More importantly, we began laying down the foundation for a long-term healthcare system in Dolakha that is resilient in the face of future natural disasters and can transform the lives of hundreds of thousands of people.

We signed a contract with the Government of Nepal to start rebuilding 21 clinics

Our partners have committed to fund more than $2.5 MM to our rebuilding efforts

We’re laying the foundation for a long term, resilient healthcare system

Lakuridanda Health Clinic, old site, Dolakha District

Damaged Health Post 
After Earthquake

Lakuridanda Health Clinic, new site, Dolakha District

Setting a New Foundation to 
Rebuild the Healthcare System
“In one terrible moment of tectonic unrest, all of our lives changed. It is incomparable, and incomprehensible, to experience the unstoppable moving of the earth with the immediate passing of over 7,000 fellow human beings. We can never again gaze out across the landscape where our patients live and work without a deeper sense of the transience and sheer power of the earth.”

—Duncan Maru, Chief Strategy Officer

Rebuilding Partners


August 1, 2014–July 31, 2015
Transparency is a moral must.

Foundations + Partners $2,041,267: 50%
Individual Gifts $874,050: 22%
Nepali Government $514,409: 13%
Research $474,299: 12%
Corporate Gifts $146,847: 4%
Programs $2,335,714: 83%
Management & Administration $357,698: 13%
Fundraising $122,528: 4%

In addition to significant in-kind support, Nepal's government invested $514K in cash FY 2015, a 390% increase from FY 2014 that represents the current strength of our PPP and the opportunities for deeper public-sector commitment as we continue to expand.

FY 2014

FY 2015

= Government Cash Percentage of Nepal Expenses

*This financial overview represents the combined unaudited financials for the U.S. 501c3 and Nepal-based NGO. Audited financials will be available for each entity on our website as soon as the audits are completed.


Our entire team is here for one purpose: to solve for the patient. This means making healthcare more accessible and tailored to a patient's specific needs, and delivering it in a dignified way.


Our Nepali team makes up 97% of our organization. We invest heavily in local leaders.


Full-Time & Part-Time Employees

Board of Directors

Dileep Agrawal
Amit Aryal, MPH
Saroj Dhital, MD
Kunda Dixit
Agya Mahat, BDS, MPH
Bhaskar Raj Pant
Subina Shrestha
Aruna Uprety
Suraj Vaidya


Our global team acts as the fuel to push forward remarkable results in Nepal.


Full-Time & Part-Time Employees

Board of Directors

Muna Bhanji
Gabrielle Haddad
Beth Kitzinger
Jeff Kaplan
Sandro Lazzarini
Duncan Maru, MD, PhD
Eswar Priyadarshan


Here's how we spread our work and vision around the world.


Last December we launched our monthly giving program of Possibilists, who are proving it's possible to build Nepal's leading rural teaching hospital in one of the world's most impossible places.


We worked with Venmo, the world's leading mobile payment app, so users could directly support our work. In nine months, we raised over $270,000 and interacted with more than 67,000 Venmo users.

Cathay Pacific Airways

We launched our partnership with Cathay Pacific Airways to support earthquake rebuilding. Now our team can travel back and forth from Nepal free of cost, which allows us to use the money saved on airfare directly for patient care.


214% Growth


34% Growth


22% Growth

Campaign Partners



John Cary



2  Degrees Food
 A to Z Impact Fund
 Alwaleed Bin Talal Foundations  America Nepal Medical  Foundation
 Benevity Community Impact Fund  Boston Consulting Group
Bright Funds
 Cordes Foundation
 Deerfield Foundation
 Elmo Foundation
 Fidelity Charitable Fund  FireTree Asia Foundation
 Fresh Leaf Charitable  Foundation
 Gardner Grout Foundation
Goggio Family Foundation

Goradia Charitable Foundation
 Green Farms Academy  International Foundation  International Reporting  Project
 Jasmine Social Investments  Jewish Communal Fund
 Keeney Investments
 Kettering Family Foundation
Latika & Rajiv Jain  Foundation
Merck Philanthropy
 Morgan Stanley
 Mulago Foundation
 National Christian Foundation
National Philanthropic Trust

Newman's  Own Foundation
 Nick Simons Foundation
 Open Road Alliance
 Peter Bennett Foundation
 Pew Charitable Trust
 Planet Wheeler Foundation
Plato Malozemoff Foundation
Pro Victimis Foundation
Radfall Charitable Trust
Robert Wood Johnson Foundation
 Rotary Foundation
 Salesforce Foundation
 Sall Family Foundation
 Schwab Charitable Fund
 Silicon Valley Community  Foundation

SRS Investment Management
Temple Bar Bolzano
The Charitable Foundation
The Good Works Institute
The Shelley and Donald Rubin Foundation
The Tides Foundation
United Way
Vanguard Charitable Trust Venmo
Walk for Nepal
Weyerhaeuser Family Foundation
William H. Prusoff Foundation
Yale Philanthropy in Action

Abbot Laboratories
Amali NYC
Blue Bottle Coffee
Buddha Air

Cathay Pacific Airways Copilevitz & Canter, LLC
Dhulikhel Hospital Dropbox.com

Insource Services InterContinental Doha Hotel Karma
K108 Hotel
QBC Diagnostics
Salesforce Foundation

Sherin & Lodgen
Small Improvements
Sun Edison
SunBridge Solar

Brigham and Women's Hospital
Children's Hospital Boston 




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