What We Do

Friends of NAS provides NAS with financial backing for operational expenses including salaries, clinical advice, emergency medical technician (EMT) training and support, emergency medical equipment donations and managerial guidance.

Friends of NAS has also collected clinical audit and operational data in Nepal and observed NAS in action. This has allowed Friends of NAS to identify areas for improvement in the pre-hospital care delivered in Nepal and provide guidance to NAS on the same.

Earthquake Emergency

Friends of NAS also provides emergency support to NAS. On 25 April 2015, Nepal suffered a magnitude 7.8 earthquake. In the weeks that followed, the country endured several large aftershocks. Immediately after the earthquake, NAS ambulances performed heroically. For the first 48 hours—until international disaster relief experts were able to enter the country—NAS ambulances and crews were the only trained and equipped emergency medical technicians on the scene working alongside the Nepalese Army and Nepal Police to rescue and assist victims.

Friends of NAS mounted an immediate emergency response by sending relief in the form of a field tent to serve as a temporary command and control structure to replace NAS’ earthquake damaged dispatch centre.

Soon afterwards…

Friends of NAS sent a highly experienced UK paramedic to Kathmandu to help NAS assess its disaster management response. This review enhanced NAS’ clinical effectiveness and improved its logistical capability, for example, by better managing the appropriate restocking of ambulances and updating the equipment on board NAS ambulances.

Also post earthquake, Friends of NAS supplied NAS crews and vehicles with supplementary equipment including blood glucose monitors, portable airway suction devices, extra linen and stethoscopes. These items were purchased both locally in Nepal and in the UK. Notably, a considerable amount of medical equipment required for effective pre-hospital care is not currently available in Nepal, hence the importance of Friends of NAS’ role in supply and resupply.

Board of directors

NAS operations are overseen by its board of directors – prominent medical and business professionals and recognized community leaders. The president of NAS is Om Rajbhandary, entrepreneur and real estate developer. Om is chairman of the Brihat Group of companies.

NAS president emeritus is Dr Rajesh Gongal, general surgeon and former medical director of Patan Hospital in Kathmandu. Dr Gongal also served as Dean of Patan Academy of Health Sciences and is now working in palliative care in Belfast, Northern Ireland.

Clinical Guidelines and NAS Expansion

Friends of NAS has also assisted NAS with the development of clinical guidelines to be used on NAS ambulances with the aim of implementing best clinical practice by the Nepali clinical staff.

Recently NAS expanded its services to Nepal’s second largest city, Pokhara, where Friends of NAS is the lead international partner with NAS. Friends of NAS’ recent contributions include a portable AED unit (an automatic defibrillator for treatment of sudden cardiac arrest) and a training mannequin for teaching EMT crews essential hands-on techniques like intubation and how to use of splints and braces.

Challenges

The remoteness of much of Nepal’s population in the mountainous terrain beyond established road networks makes access to health infrastructure difficult. While a truly professional air ambulance service would be a major improvement to the ad hoc model of freelance helicopter response currently in place, Friends of NAS want to explore completely new models of EMS for Nepal.

The “doko” – traditional mountain ambulance

Friends of NAS are open to the idea that the special needs of Nepal might require an EMS capacity distinct from the ambulance/hospital-hub model of the developed world. Dr Seth Collings Hawkins, a Friends of NAS trustee, has considerable experience in implementing developing world EMS programmes and is keen on leading an inquiry into this.

Where roads do exist in Nepal, road safety is atrocious and accidents resulting in major trauma are common. And in a country with no health and safety standards, construction accidents resulting in serious injury are frequent. It is without question that the need for a specialized well trained professional EMS in Nepal is great.

If you were to visit Kathmandu today you might at first notice numerous ambulances plying the streets. Look closely, however, and you’ll see that there are no medical professionals on board nor is there any emergency equipment or medication. In addition, it is still unfortunately true that most people who present themselves to emergency departments in Kathmandu actually arrive by taxi.

Compounding this problem is that many Nepalis believe that emergency care begins only when you get to hospital and will risk aggravating traumatic injuries bouncing along in a taxi or pickup truck to get to the ED as soon as possible.

Since its very inception…

NAS has enjoyed the support of Stanford Emergency Medicine International (SEMI), an academic outreach arm of the Department of Emergency Medicine at Stanford University School of Medicine in the US. SEMI was the lead partner responsible for training all NAS’ EMTs in 2010 and again in 2016-2017.

In 2016-17, Friends of NAS supported SEMI’s training of 50 additional EMTs by funding a senior UK advanced paramedic to work alongside the Stanford Medical School in preparing a new class of NAS EMTs.

UK senior paramedic and FoNAS member Bernie Garrett, centre, with fellow EMT trainers from Stanford Medical School faculty and NAS executives.

The lack of awareness among the general public, community leaders, politicians and even the Nepali medical community about the importance of pre-hospital emergency care—and the fact that it is already available today in NAS ambulances—is a constraint to the long term success of NAS. This information deficiency is a challenge that Friends of NAS hope to address.

Friends of NAS also organise medical electives in Nepal for UK medical students interested in practical professional experience within a challenging developing world environment. These unique electives also offer students the chance to live, work and travel in one of the world’s most fascinating countries.

Friends of NAS can arrange medical elective experiences in pre-hospital emergency care as well as several areas of public health. Research, data collection and the creation of public information and awareness programmes are essential to the promotion of pre-hospital emergency care among populations long accustomed to the belief that medical help is available only in a hospital setting. For more on this topic click Medical Electives.

Securing stable long term financing for NAS is a major priority. Friends of NAS are developing several grant applications with major institutional donors. For updates on this aspect of Friends of NAS support for Nepal Ambulance Service see Grants for more information.

ABOUT US

Friends of NAS is a 100% volunteer organisation. More than 95% of all donations to Friends of NAS go directly to support Nepal Ambulance Service.

SUPPORT US

Your support is crucial to Friends of NAS UK’s efforts to assist ‘Nepal Ambulance Service.

We thank you for your support.