The History of BNMT 2000 to 2008

A Rights-Based Approach to Improving Health

2000 – Integration of TB/leprosy services into the Government system completed in eight hill districts and support for the National TB Programme in the Central Development Region increased. A Community Health and Development Programme training team established in Sankhuwasabha and Khotang districts. The Community Hill Drug Scheme implemented in 16 sub-health posts and the Cost Sharing Drug Scheme in 5 districts of Khotang, Bhojpur, Panchthar, Tehrathum and Sankhuwasabha. Senior staff members move from Biratnagar in the Eastern Development Region to Kathmandu to improve development networking and liaison.

2001 – Majority of senior staff members are now Nepalese. TB/HIV/AIDS focused pilot project started in Sunsari District. The Community Health and Development Programme moves away from direct implementation to training and support of local partners. The Community Hill Drug Scheme is operating in 22 sub-health posts.

The Nepali Royal Family massacred and Prince Gyanendra is crowned king. General strike called by Maoists brings the country to a virtual standstill. Government arrests anti-government demonstrators, including student and opposition leaders. The deteriorating security situation prompts the development of security and emergency guidelines.

2002 – A new strategy which introduces health rights-based activities and an integrated programme of management of new and existing work for 2003-07 developed. BNMT’s drug stores handed over to drug suppliers selected by District Health Coordinating Committee. The TB/HIV pilot project encourages increased numbers of patient to seek health checks and treatment for sexually transmitted diseases. Responsibility for TB hostels handed over to the Government. Leprosy virtually eliminated in the hill districts and responsibility handed over to Netherlands Leprosy Relief.

Clashes between the military and Maoists of increasingly violent intensity. Concern over US and UK support for “Nepal’s war on terrorism.”

2003 – Chanda Devi Rai appointed BNMT’s first Chief Executive Officer. Five year Health Improvement Programme started. 152 health institutions delivering WHO’s essential drugs through cost sharing drug schemes in six districts. A health education programme in five schools organised. BNMT expands support for the national TB programme to two more districts, Okhaldunga and Solukhumbu. Urban TB programmes started in Jhapa, Morang and Sunsari. Drop-in centres for injecting drug users started in collaboration with local organisations. Malaria eradication programmes through mothers’ groups implemented in the lowlands.

Internal armed conflict continues, moving from Western to Central and Eastern Nepal. BNMT adopts a “neutral” approach in its work.

2004 – A wide ranging survey of health needs of disadvantages and other communities in all 16 districts of the Eastern Development Region, as a baseline and planning tool, completed in association with partner organisations. The Safer Motherhood Innovation Project started in collaboration with ADRA Nepal in six districts. Based on survey findings, the Health Improvement Programme explicitly focuses on assisting disadvantaged groups.

Security remains a major problem: Kathmandu blockaded for a week. BNMT assists the UK’s Department for International Development with an Immediate Action Programme to bring essential drugs and some reconstruction of clinics to districts affected by the conflict.

2005 – A mid-term evaluation of the Safer Motherhood project finds increased awareness of maternity problems and distribution of home delivery kits amongst mothers, but notes an insufficient supply of trained health post staff. Responsibility for implementation of TB control services is handed over to district health authorities. Survey on access to and uptake of services related to HIV highlights need for harm reduction services and attention to stigma and discrimination. Friends of BNMT a Nepal-based group begin to meet on a periodic basis to provide advice and support to BNMT’s CEO.

King Gyanendra dismisses the government, declares a state of emergency and assumes direct power. A government attempt to impose a “Code of Conduct” to control the activities of International NGOs is met with universal condemnation. Student and public opposition to the King’s rule leads to increasing strikes and public protest. Maoists announce a ceasefire prior to the Dasain/Tihar Holidays and join the major political parties with 12 point plan to restore democracy.

2006 – Following a mid-term assessment of BNMT’s five-year plan, operations are re-established in Biratnagar, with the Kathmandu office retained for networking and advocacy. The programme is scaled-back to 8 districts; and district-level offices are bolstered to support partners in their organizational development. TB control activities focus on quality assurance and training with safer motherhood emphasizing training and community awareness. The Biratnagar-based regional drug store is handed over to a local NGO. Focus for monitoring and evaluation shifts from activity to come. Friends of BNMT , becomes an ad hoc committee of BNMT’s Board of Directors, is expanded, and begins meeting on a regular basis. Following an international search, BNMT appoints its second CEO, Dr. Anil Subedi.

A Maoist-opposition alliance call off weeks of strikes and protests after the King agrees to reinstate parliament. The Maoist initiated ceasefire continues. Parliament curtails the King’s political powers, including his command over the army. An agreement is reached to bring the Maoists into an interim government and the government and Maoists sign a peace accord raising hopes of a durable peace at last.

2007 – Nepal’s fragile peace holds, though ongoing “challenges” include difficulty in accommodating Maoist demands in the interim government and civil strife in Eastern Nepal. Towards the end of the year, agreement is reached to abolish the monarchy with “His Majesty’s Government” becoming “Government of Nepal.”

BNMT begins an exploration of how it might align its next programme during the strategic period of 2009-2014. Focus centres on consideration of the underlying determinants of health status including nutrition, food security and livelihoods, a logical extension of BNMT’s current rights-based programme. BNMT serves as lead organisation on a consortia project, funded by the European Union, to foster the health and livelihoods of conflict affected people.

BNMT moves forward with strengthening the Nepali voice in governance by voting that the organization’s chief executive become a trustee ex officio. BNMT kicks-off its 40th anniversary with Dr. Gillian Holdsworth’s NobleTrans-Himalayan Trek in which she and fellow intrepids walk the full length of Nepal-more than 1000 kilometres-between September and November.