Dear friends,

Thank you for supporting Possible over the past decade! Your confidence has inspired us to expand healthcare in some of the most underserved communities in the world.

Many of you have visited Nepal and have seen the stunning Himalayan foothills of the Far West— the winding rivers, the brilliant mustard flowers, the fantastic green of rice, the deep pine forests. This breathtaking landscape, however, also makes access to timely care particularly challenging.

We started comprehensive primary services in Achham in 2008. At the time, all we had was an invitation from the Government of Nepal to operate a facility that was unused and in disrepair. With local Achhami leaders, we committed to building health systems that secured quality healthcare for populations that until then did not have access to basic services.

We were told it would be difficult to manage logistics, find talent, and coordinate transportation in a place so remote that getting there from Kathmandu took over 30 hours by car. But you stood by us, knowing that if we solved for patients most in need, we could get closer to making healthcare work for all.

Like the terrain of Far West Nepal with dizzying peaks interspersed with deep chasms, our journey has been one of extremes. On one hand, there has been an urgency to meet the needs of pregnant women, children with bone fractures, the elderly, and others for whom transportation and costs stood in the way of life-saving treatments. Yet at the same time, we have considered the long arc of nyaya (justice) and are building institutions that can meet both current gaps and needs unforeseen. It is at that intersection, of service delivery and systems change, that we have worked.

We have achieved much in these ten years. Bayalpata is now under the new democratic Federal system, formally a Provincial Hospital, that serves the community healthcare, outpatient, inpatient, and surgical needs of patients from Achham and beyond.

Bayalpata’s catchment area has seen a notable reduction in under-two mortality - and, equally important, we have developed a system that reliably, affordably, and accurately captures pediatric mortality at both a household and population level.

When the devastating earthquakes of 2015 forced us to consider our role in rebuilding health systems that were decimated, you were with us as we committed to Dolakha, not just for the short-term, but for the long-haul. We have brought lessons from Achham to Dolakha and Dolakha back to Achham with your support.

Today, the 350+ staff across the two provinces annually deliver home-to-hospital integrated care for over 200,000 individuals, and attend to over 150,000 hospital visits. We continue to partner with municipal, provincial, and federal institutions to improve our services and identify scalable solutions, with government adoption as the endgame.

We know our path forward is long and we will stumble along the way. We hope for your continued partnership as we advance integrated care delivery systems in Nepal that can be beacons for health systems globally.

We have made this progress because of your support. Thank you.

Duncan Maru
Possible, CEO

S.P. Kalaunee
Nyaya Health Nepal, Executive Director