*Bhola Bishwakarma

With no land or property of his own, Bhola depended on daily wage labor to feed his family. As his children grew, so did his worries. Providing food, clothing, and education felt like an impossible task. Like many others from his community, Bhola made the painful decision to migrate to India in search of work. Before leaving, he gave away his ox, chickens, and even his loyal dog to a neighbor. When the dog tried to follow him, Bhola’s heart broke but he had no choice. In Mumbai, India life was harsh. He worked long hours for six years, fell ill, and was left without savings or support. Exhausted and defeated, he returned to Nepal with his family.

What awaited him at home was heartbreaking. His house was damaged, there was little food, and hope felt distant. Yet one sight moved him deeply his dog, weak but faithful, still guarding the house. That moment reminded Bhola that he still had something worth rebuilding.

Around this time, Bhola learned about INF Nepal’s work supporting the poorest families. He joined the Kala Shilla Self-Help Group, where he received entrepreneurship and skill-development training through a partnership between INF Nepal and Narharinath Municipality. During his time in India, Bhola had observed bakery businesses and dreamed of starting one in his own village. Recognizing his determination, the group selected him for specialized bakery training.

After completing one month of intensive training, Bhola received financial support NPR 65,000 from the group’s revolving fund and an additional NPR 50,000 loan from a local cooperative. With this support, he purchased essential bakery equipment and started his own business.

Today, Bhola’s bakery earns NPR 2,500–3,000 per day, with a net profit of NPR 1,000–1,500. This steady income allows him to send his children to school, meet household needs, and live with dignity. More importantly, he no longer needs to leave his family and the community behind in search of work.Bhola now encourages other villagers not to migrate unnecessarily. He believes opportunities exist at home if people are given the right skills and support. His success has inspired others; 14 new entrepreneurs have since emerged in the community.

“I learned that we don’t always need to go abroad to survive,” Bhola says. “If we work together and use what we learn, we can build our future in our own village.” Through Bhola’s journey, INF Nepal’s approach combining skills training, financial access, and community support demonstrates how sustainable livelihoods can transform not only individual lives, but entire communities.

*Name changed for anonymity

Her eldest daughter, now 26, has a severe physical disability and requires constant care. Sumi’s sons were still children when their father passed away. With no income, no livestock, and no savings, Sumi struggled daily to feed her family. They lived in a makeshift shed, spending half the year in a remote cattle shelter high in the hills, where rain leaked through the roof and nights were cold. Without support, Sumi’s daughter endured isolation. There were times when Sumi had to tie her daughter outside while fetching water; walking over an hour to the river returning to find her hungry, soiled, or injured. Despite these hardships, her daughter’s intelligence and potential shone through, waiting for an opportunity to be realized.

In 2024, INF Nepal arrived in Sumi’s village with a resilience and disability inclusion project. The initiative revived the inactive community forest user group and formed a new self-help group (SHG), prioritizing households affected by disability and food insecurity. Sumi and her daughter were selected as members.

INF encouraged direct participation of persons with disabilities in community meetings. To enable her daughter’s involvement, the group decided to hold a meeting at Sumi’s home. That day changed everything. When her daughter realized the group had come to listen to her, she first cried—but then smiled. For Sumi, it was the first time in 20 years she had seen her daughter’s smile, and it gave her a renewed sense of strength and purpose.

Following the visit, Sumi was proposed for an income-generating initiative. She chose goat farming a livelihood she could manage while caring for her daughter. With a revolving fund of NPR 15,000, Sumi bought two hybrid goats. Within a month, one goat gave birth to twins, increasing her herd to four. She also received ten fruit saplings as additional support.This small beginning transformed her life. Sumi now plans to grow her herd, sell goats, replace her leaking thatch roof with corrugated iron sheets, and buy new clothes for her daughter. More importantly, she has regained her dignity and her family’s place in the community.

Today, Sumi’s daughter participates actively in community activities, and their SHG continues to support vulnerable households like theirs. Sumi reflects, “INF Nepal didn’t just support a livelihood. They restored our dignity, resilience, and hope. We are no longer just surviving we are living with purpose.”

This story shows how targeted, and inclusive interventions can transform lives providing not just material support, but also emotional strength, social inclusion, and a sustainable path toward independence.

*Name changed for anonymity

*Babita Budha is 22 years old and lives in Sipa village, Ward No. 7 of Soru Rural Municipality, Mugu. Like many young women in remote Karnali, her life once seemed limited by geography, poverty, and deeply rooted social norms.

Babita completed her higher secondary education (+2) in her own village. Yet, despite her education, opportunities were almost non-existent. There were no local jobs, and as a young woman, she faced constant discouragement. “Our society believed that women were only meant for household work,” she recalls. Women were rarely included in meetings, decision-making spaces, or community committees.

At just 19, Babita was married. Poverty and lack of awareness pushed her parents toward early marriage, seeing it as a way to reduce their financial burden rather than invest further in their daughter’s education. “Only later did I truly understand why so many girls are married early,” Babita reflects. “Now, I feel a responsibility to raise awareness so other girls do not face the same fate.”

When Babita was still in Grade 10, INF Nepal launched its project in her village. Her mother became a member of a Self-Help Group (SHG), and Babita occasionally accompanied her to meetings. Listening quietly from the side, Babita was deeply inspired by discussions on social change, women’s rights, and collective strength.

After her marriage, Babita moved to her husband’s family home. A year later, she gathered the courage to ask her mother-in-law if she could take over the SHG membership. With her support, Babita officially became a member of Karnali SHG at the age of 20 the youngest in the group.

With regular facilitation from INF project staff, Babita began learning leadership, meeting facilitation, and decision-making skills. Over time, her confidence grew. Today, she can independently facilitate SHG meetings without external support.

Women Leading Financial Change

In 2022, members from multiple SHGs came together to form a women-led cooperative to ensure long-term financial sustainability and income generation. They made a bold decision: the cooperative would be exclusively for women.

During the second general assembly, Babita was elected as a member of the cooperative’s leadership team. She now carries dual responsibilities—strengthening the cooperative and continuing her work with the SHG to raise awareness on social and economic issues.

Today, Hamro Milijuli Cooperative stands as a powerful example of women’s collective strength with the Total fund of NPR 3,617,798 with 407 women as shareholders and providing loans to 81 women just last fiscal year. These loans have enabled women to start and grow small businesses such as poultry farming, goat rearing, tailoring, grocery shops, furniture making, and other income-generating activities.

Through her journey, Babita has learned a powerful truth: financial independence is the foundation of women’s empowerment. “When women have access to money and control over financial decisions, they can educate their daughters, delay early marriage, and break cycles of poverty,” she says.

Her dream is to expand cooperative-led income generation, including agriculture-based enterprises, so more women can achieve financial security while staying in their communities.

“I would not be who I am today if INF Nepal had not started this project in our village,” Babita says with gratitude. “INF didn’t just support us they taught us sustainability, leadership, and belief in ourselves.” Today, Babita Budha is no longer a silent observer. She is a leader, an advocate, and a role model for young women across her community a proof that when women are trusted, trained, and supported, they can transform not only their own lives but the future of an entire generation.

*Name changed for anonymity

For the past eleven years, INF Nepal has been making a significant and lasting contribution to improving the quality of life of rural and remote communities in the north-eastern part of Rolpa through its WASH (Water, Sanitation and Hygiene) Project. During this period, INF Nepal has supported the construction of more than 40 small-scale drinking water schemes and the rehabilitation of several old and deteriorated systems. Through these efforts, safe drinking water access has been ensured for more than 2,000 households, directly contributing to the Government of Nepal’s strategic “One House–One Tap” policy and its effective implementation at the grassroots level.

The WASH Project follows a community-centered and sustainability-focused approach. INF Nepal has supported the development of durable “one house–one tap” drinking water systems, improvement of sanitation facilities, and promotion of positive hygiene behaviors. Beyond household water supply, the project has also promoted the collection and reuse of wastewater generated from taps. This water is reused for kitchen gardens and irrigation, helping communities adapt to increasing drought and water scarcity caused by climate change, while also strengthening household food security and nutrition.

The project has had a transformative impact on women, children, persons with disabilities, and elderly people. The burden, risk, and time associated with carrying water from distant and unsafe sources have been drastically reduced. As a result, community members now have more time for education, income-generating activities, household care, and social participation. Improved access to water and sanitation has led to better hygiene practices, reduced illness, enhanced dignity, and a cleaner living environment.

A key beauty of the WASH Project lies in the strong ownership and labor contribution of the community. From planning to construction, communities have actively participated through free labor, use of local materials, and land contribution. User committees were formed to lead decision-making, manage construction, and oversee operation and maintenance. Cost-sharing with local government further strengthened accountability and partnership, ensuring the schemes are not only built but sustained.

In this continuation of the effort, on Mangsir 20, the Dharakharka One House–One Tap Drinking Water Scheme constructed in Sunilsmriti Rural Municipality Ward No. 8 was jointly inaugurated and officially handed over to the community by Mr. Lekhnath K.C., Director of Community Development Department, INF Nepal, and Mr. Maniram Budhathoki, Chairperson of Sunilsmriti Rural Municipality. The scheme was implemented in line with the national One House–One Tap strategy and consists of two sub-schemes:

1. Khadare Khola Drinking Water Sub-Scheme:

This scheme provides safe drinking water directly to the courtyards of 20 households, benefiting 107 people (60 males and 47 females).

2. Goganpani Khola Drinking Water Sub-Scheme:

This scheme provides safe drinking water to 25 households, benefiting 124 people (60 males and 64 females).

Together, the two sub-schemes serve a total of 45 households and one school, benefiting 297 people. In all 45 households, wastewater from taps is systematically collected and reused for irrigation, ensuring maximum utilization of water resources and contributing to greener homesteads and improved food production.

The total cost of the drinking water scheme, including the main system, wastewater collection ponds, and dish-drying racks, amounted to NPR 6,101,390. Of this, INF Nepal contributed NPR 2,344,010, Sunilsmriti Rural Municipality contributed NPR 300,000, and the local community contributed NPR 3,516,880 through labor contribution, local materials, and land support. This shared investment reflects strong partnership, local ownership, and collective responsibility.

To ensure long-term sustainability, a Repair and Maintenance Fund has been established for the scheme and deposited in the user committee’s account. Water meters have been installed at all household taps, and users contribute fees based on water consumption, which are added to the maintenance fund. Additionally, users have received repair and maintenance training along with essential tools, enabling them to manage minor repairs locally and reduce dependency on external support.

Through its WASH Project, INF Nepal has gone beyond infrastructure development. It has fostered dignity, resilience, community solidarity, and hope—transforming water from a daily struggle into a shared asset that supports health, livelihoods, climate adaptation, and a better future for rural communities in Rolpa.

Before joining a Self-Help Group (SHG), Anju had little knowledge of commercial vegetable farming. Her family depended mainly on unstable daily wages, making it difficult to afford even the basic necessities like food, clothing, and education for her children. She had never heard about off-season vegetable farming or how farming could be turned into a profitable business.

That all began to change when Anju became a member of a Self-Help Group formed by INF Nepal under a project launched in 2023. The project aimed to improve food security, build climate resilience, and strengthen community cooperation in Pachaljharana Rural Municipality. In Bayalagothi, one of the five SHGs was created, comprising poor and marginalized families, people with disabilities, and single women. Anju not only joined but quickly became an active leader, later taking on the role of group facilitator.

Through the project, Anju and other group members received various types of support — seeds, training in commercial and off-season farming, Integrated Pest Management (IPM), organic fertilizer management, goat rearing, and essential infrastructure like irrigation ponds and drinking water supply systems. Anju was selected by her group to run a model farm and received materials such as a plastic house, drip irrigation set, vegetable seeds, plastic drums, sprayers, and traps.

With the training and resources provided, Anju began growing vegetables like cauliflower, cabbage, radish, cucumber, tomato, chili, garlic, onion, beans, pumpkin, and potatoes. She adopted improved agricultural techniques including nursery management, drip irrigation, organic fertilizer use, mulching, intercropping, and planting disease-resistant varieties.

Since Kartik 2081 (November 2024), Anju has earned approximately NPR 35,000 by selling vegetables. The income has allowed her to invest in her children’s education and improve her family’s nutrition. At present, cucumbers flourish in her plastic house while other vegetables thrive in the open fields.

Reflecting on her journey, Anju shares with pride,
“Joining the self-help group changed my life. With the training and support from the project, I now earn between NPR 30,000 to 40,000 every three months. Even with a small piece of land, it’s possible to earn a good income with low investment.”

Anju’s story is a powerful example of how targeted support and community-driven initiatives can transform lives, bringing hope and resilience to families who once lived in constant uncertainty.

Note: The name in this story has been changed.

Picture : Rubi during Counselling Session

*Ruby Rai, a permanent resident of Bhojpur, is married and has a teenage son.

Just a day before her life-changing accident, Ruby traveled to her mother’s home in Sankhuwasabha, a district that takes a full day of road travel to reach from Bhojpur. On the morning of the accident, Ruby, her mother, and her sister-in-law were in the kitchen preparing tea when a massive boulder struck their house. Tragically, the impact killed her mother and sister-in-law instantly. Ruby herself sustained severe injuries to her legs and ribs, leaving her immobile.

It took an hour for the villagers to organize a rescue, and Ruby was carried for three hours on foot to reach a helicopter that transported her to the Armed Police Force (APF) Hospital in Kathmandu. There, she received treatment for her broken ribs and legs over the course of two and a half months. Despite the extensive medical care, Ruby’s Left leg had to be amputated. A doctor at APF Hospital referred Ruby to Green Pastures Hospital (GPH) for artificial limbs. When she arrived at GPH, her physical and psychological condition was dire. The trauma of losing her loved ones and her mobility had left her unable even to grieve properly.

Through several sessions of psychosocial counseling at GPH, Ruby gradually began to rediscover hope and a renewed love for life. She came to understand that artificial limbs could help her regain independence in daily activities and improve her mobility.

Through the GPH medical charity, Ruby received prosthetic legs, which restored her mobility, and several sessions of psychosocial counseling that helped her process her grief and rebuild her confidence.

Ruby expressed her heartfelt gratitude for the transformation in her life, finding strength to move forward.

Nimuka Lepcha, a counselor in Social Service Department at GPH, shares: “We welcome patients and their families, providing individualized counseling that addresses both emotional and psychological needs. Many arrive in distress—grieving, hopeless, and some even suicidal. Our support focuses on nurturing their emotional and social well-being, helping them find strength and hope. Our role is to walk alongside them, offering a space where they can express their pain, process their emotions, and find the strength to rebuild their lives.

One such patient was Ruby. When she arrived, she was not only physically weakened but also deeply traumatized by her loss. Through counseling, we helped her navigate her grief, regain confidence, and embrace the possibilities ahead. Seeing her stand and walk again—not just physically but also emotionally—is a reminder of the resilience that lies within each person when given the right support and care.”

The Social Service Department at GPH plays a pivotal role in addressing the psychosocial needs of patients, particularly those facing challenges related to leprosy, disability, spinal cord injury and other chronic illnesses. By providing counseling, support, and advocacy, the department contributes to improving patients’ overall well-being and quality of life. The department’s efforts in building hope and resilience among patients align with INF’s mission of serving the poor and disadvantaged. While the SSD does not offer highly specialized clinical treatments, the department excels in providing empathetic and personalized support to patients. The focus on active listening and understanding patients’ unique needs differentiates the SSD’s services. The department manages to provide counseling over 100 sessions and charity assistance to 100 individuals per month.

Picture: Rubi with her prosthesis

*Name changed for anonymity

Story Collected by: Nimuka Lepcha

Pic: Hasiram’s Newly Constructed House

His family lived in an old house that had been severely damaged by the earthquake, forcing them to shift to temporary shelter. Amidst the struggle, Hasiram was fortunate to receive some support in the form of maize from the community, which helped them get through the toughest times. In recognition of the need for safer homes in the community, the Ward Disaster Management Committee selected Hasiram’s house based on a set of selection criteria. Soon after, the construction of a model house for his family began. As part of the process, a 7-day mason training was organized, where participants, including Hasiram, learned about building codes and construction norms. They were also involved in supporting the construction work.

Mr. Badri Panta, a local leader, shared, “We, as a ward team, along with technical experts from INF Jajarkot and the local community, have worked together to complete this model house. By completing this project, we gained more understanding of how to construct other homes. With the government’s approval of the detail damage assessment, we are now moving forward with plans to build safer houses. We’ve collaborated closely with the INF Nepal team, and with their external support, we were able to build a safer home for Hasiram’s family. We are proud of our efforts, and we’ll continue to work with all partners to support other vulnerable families in our community.”

Mr. Surendra Rawat, the ward’s technical person, was involved from the very beginning of the project and played an instrumental role in coordinating the construction of the model house. “We followed government building codes meticulously throughout the process,” Mr. Rawat said. “By using Interlock CSEB bricks, we successfully completed the model house and included toilet facilities. This experience has not only provided a safer home for Hasiram’s family but has also allowed us to develop skills among local laborers. After completing the mason training and building this house, we now have a solid foundation to build other houses in our municipality.”

Pic1: Hasiram Kami with his wife Rita BK in his new constructed house. / Pic2: Hasiram’s damaged house and it’s residue after the Jajarkot Earthquake.

Despite the many challenges they face, the ward’s team remains committed to helping vulnerable families. “We have many more families in need,” Mr. Rawat continued. “Our ward has a disaster risk management plan, and we are working to implement all activities related to DRM, WASH, and livelihoods. Coordinating with various supporting partners is crucial for us to restore the lives of families affected by the Jajarkot earthquake.”
INF Nepal, in collaboration with INF UK and PWS&D, has been implementing the Jajarkot earthquake recovery project in Nalagad Municipality, Ward No. 4, since August 2024. Their combined efforts have made a lasting impact, bringing hope and a safer future to families like Hasiram’s.

Best Western Plus Hotel, Kathmandu and Virtual Conference Online

Session – 18th February – Day 1

1. Welcome and Conference Inauguration

Presenter: Ms Mahima Battarai (MC), Dr Arun Budha (Medical Services Director, GPH), Mr Krishna Adhikari (ED, INF Nepal), Prof Rajesh Gongal (VC, PAHS)

2. History of Palliative Care in INF Nepal and the Development of the Sunita Project

Presenter: Dr Ruth Powys (Retired Palliative Care Services Head, GPH)

3. Palliative Care Needs in Rural Nepal: Exploratory Mixed Methods Survey

Presenter: Sunita Project Research Team

4. Sunita Project – Training Programs and Evaluation: What Did We Learn?

Presenter: Sunita Project Research Team

5. Working Together for Palliative Care: A Rural Health Team’s Experience

Presenter: Dr Dum Kumari and Team from Rainas Municipality

6. Research Partnership with Global Health Academy

Presenter: Dr Dave Fearon (GHA, University of Edinburgh)

7. Essential Medicines for Palliative Care

Presenter: Dr Daniel Munday (Consultant Advisor, Sunita Project)

Launch of the Palliative Care Formulary : Mr Krishna Adhikari, Prof Bishnu Paudel, Prof Rajesh Gongal

Session – 19th February – Day 2

1. Opening Ceremony Day Two

Presenter: Dr Arun Budha, Dr Cathy Ratcliff (CEO EMMS), Mr Rob Fenn (British Ambassador)

2. Keynote Lecture One: “10 years’ Experience of Developing Community Palliative Care”

Presenter: Professor Rajesh Gongal (VC Patan Academy of Health Sciences and Hospice Nepal)

3. Overview of Sunita Project and the Way Forward

Presenter: Dr Amrita Shrestha (Palliative Care Services Lead, GPH)

4. “Sunita’s Story” a Contributor-led Video of Rural Palliative Care – Chair’s Remarks

Presenter: Mr Krishna Adhikari

5. Keynote Lecture Two: Global Health and Palliative Care

Presenter: Professor Liz Grant (Director, Global Health Academy, University of Edinburgh, UK)

6. WHO – Global Initiatives

Presenter: Dr Megan Doherty (Consultant, WHO, Geneva)

7. Palliative Care in Kerala: The Pallium India Experience

Presenter: Ms Smriti Rana (Head of Strategic Programmes and Partnerships, Pallium India)

8. Palliative Care and Mental Health in the Community

Presenter: Dr Chitra Venkateswaran (Consultant Psychiatrist and Director, Mehac Foundation, Kerala)

9. Rural Palliative Care in Ethiopia

Presenter: Dr Nuhamin Gebre (King’s College, London)

10. Poverty Reducing Palliative Care – Malawi

Presenter: Dr Maya Jane Bates (GHA, University of Edinburgh)

11. NAPCare Response

Presenter: Professor Bishnu Paudel (President of NAPCare)

12. Palliative Care at the Gurkha Welfare Trust

Presenter: Dr Satish Gurung (Deputy Medical Director, GWT)

13. The Difference Palliative Care Makes in a Rural Hospital

Presenter: Dr Rajib Neupane (UMN Hospital Tansen)

14. Fellowship in Palliative Care: Report of the First Completed Rotation

Presenter: Dr Raj Kumar Gajmer (Assistant Professor, PAHS)

15. Children’s Palliative Care

Presenter: Dr Amrita Shrestha, Ms Sarah Riggsbee (Rehabilitation Lead, GPH)

16. Vacuum Dressing Research

Presenter: Dr Suraj Maharjan (Plastic Surgeon), Dr Arjan Knulst (Biomedical Engineer, GPH)

17. PhD – NCD Research in Nepal

Presenter: Ms Namuna Shrestha (University of Huddersfield, UK)

18. MSc Dissertation – Moral Distress in Healthcare Workers

Presenter: Ms Manju BK (Palliative Care Specialist Nurse, Lalgadh Hospital)

19. Closing Ceremony with Message from Chief Guest

Presenter: The Honourable Minister of Health and Population, Mr Pradip Paudel

20. “Sunita’s Story” a Contributor-led Video of Rural Palliative Care

INF Nepal Hosted International Conference on Palliative Care in Rural Nepal: “Leave No One Behind”

Kathmandu, February 18-19, 2025

INF Nepal successfully hosted the International Conference on Palliative Care for All in Rural Nepal: “Leave No One Behind.” The hybrid conference took place at Best Western Plus (Hotel Ryne), Pingalasthan, Kathmandu, on February 18-19, 2025, featuring fully integrated face-to-face and virtual sessions.

This conference aimed to explore the development of primary palliative care in rural Nepal and celebrate the achievements of the Sunita Project—a UK Aid Match-funded initiative delivered by INF Nepal in partnership with EMMS International, a Scottish health development charity. This two-day conference brought together key stakeholders, healthcare professionals, policymakers, and international experts to discuss and promote equitable access to palliative care services in Nepal’s rural areas.  The conference highlighted the key outcomes and lessons learned from the Sunita Project (2022-2025), which played a crucial role in developing a sustainable model for primary palliative care in rural Nepal.

Over the two days, the conference witnessed firsthand impact of Sunita Project and and similar initiatives, demonstrating how holistic, community-driven care can support individuals and families facing life-limiting illnesses in some of Nepal’s most remote and resource-limited areas. As the conference continued, we had the opportunity to learn and hear from esteemed speakers and experts from South Asia, Africa, and beyond, who shared/presented insights, innovative solutions, and real-world experiences in advancing palliative care. These discussions aimed to deepen understanding and inspire collective action toward strengthening palliative care services within Nepal’s healthcare system.

Key Highlights from Day One 18^th February, 2025:
The conference opened with a warm welcome address by Dr Arun Kumar Budha, Medical Services Director of INF Nepal Green Pastures Hospital. In his speech, he extended his gratitude to distinguished guests, international delegates, and participants, emphasizing the importance of palliative care in ensuring dignified and compassionate healthcare for individuals facing life-limiting illnesses. He highlighted INF Nepal’s commitment to strengthening primary palliative care services in rural Nepal and expressed optimism that this conference would foster collaborations, knowledge exchange, and actionable strategies to improve healthcare accessibility. Some of the other key highlights is listed below:

Opening Ceremony: The event was inaugurated digitally by Professor Dr. Rajesh Nath Gongal, Vice-Chancellor of Patan Academy of Health Sciences, alongside Krishna Adhikari, Executive Director of INF Nepal.

• Dr. Ruth Powys, former Palliative Care Services Lead at INF Nepal Green Pastures Hospital, presented the history of palliative care in INF Nepal and the development of the Sunita Project, which has been instrumental in creating a sustainable model for palliative care in rural settings.
• The Sunita Project research team shared insights from an exploratory mixed-method survey on palliative care needs in Nepal, providing valuable data for improving future services. Similarly, Dr Daniel Munday and the Project team presented on the training programs and evaluation conducted under the initiative, emphasizing capacity-building for healthcare providers.
• Dr Dum Kumari Pun and her team from Rainas Municipality showcased a successful rural health team experience in integrating palliative care into local healthcare services.
•  Dr Dave Fearon from the Global Health Academy, University of Edinburgh, delivered a session on global approaches to palliative care and their applicability in Nepal.
• A major milestone of the day was the launch of the Palliative Care Formulary of this essential resource for healthcare providers, designed to enhance palliative care services. Professor Dr. Bishnu Dutta Paudel, President of the Nepalese Association of Palliative Care, also addressed the gathering.

The day concluded with reflections and discussions chaired by Dr Amrita Shrestha, Palliative Care Service Lead at INF Nepal Green Pastures Hospital. Throughout the event, Mahima Bhattarai expertly moderated the sessions, ensuring smooth transitions and meaningful discussions. Krishna Adhikari, Executive Director of INF Nepal, served as the conference chair, overseeing the proceedings and reinforcing the organization’s commitment to expanding palliative care access across Nepal.

Key Highlights of Day Two, 19^th February 2025:
The second day of the International Conference on Palliative Care for All in Rural Nepal built upon the discussions from Day One, diving deeper into scientific research, international perspectives, and collaborative efforts to enhance palliative care in Nepal. With a focus on community-driven models and global health initiatives, Day Two brought together experts, policymakers, and healthcare professionals to discuss sustainable solutions for palliative care in low-resource settings. The day also featured research presentations on community palliative care in Nepal, experiences from frontline health workers, and case studies from international partners in India, Bangladesh, Ethiopia, and Malawi.

The morning session was graced by His Excellency Rob Fenn, UK Ambassador to Nepal, whose presence underscored the importance of international partnerships in strengthening palliative care services. The day began with a warm welcome, from Dr Arun Kumar Budha setting the stage for discussions on community-based palliative care and its transformative impact on rural healthcare. Followed by speech from Dr Cathy Ratcliff, CEO, EMMS International Dr. Ratcliff emphasized EMMS International’s commitment to palliative care in Nepal, sharing insights on partnership-driven approaches that have helped improve end-of-life care in remote areas. The UK Ambassador HE Rob Fenn, reaffirmed the British government’s support for initiatives like the Sunita Project and highlighted the critical role of collaboration in ensuring quality palliative care services for marginalized communities.

Keynote Lectures & Research Presentations:

• Keynote Lecture 1: “10 Years’ Experience of Developing Community Palliative Care” Prof. Dr. Rajesh Nath Gongal, Vice-Chancellor, Patan Academy of Health Sciences (PAHS) Prof. Dr. Gongal shared insights from the Makwanpur model, a pioneering initiative that has successfully integrated palliative care into Nepal’s primary healthcare system.
• Premiere of “Sunita’s Story”, a powerful contributor-led video showcasing the real-life impact of the Sunita Project, narrated through personal experiences of patients, caregivers, and frontline health workers.
• Overview of the Sunita Project & Future Roadmap, Dr Amrita Shrestha, Palliative Care Services Lead, INF Nepal, Green Pastures Hospital (GPH)
  Dr. Shrestha outlined the achievements, challenges, and future directions of the Sunita Project, emphasizing the need for policy integration and capacity-building efforts.

International & National Contributions:

• Keynote Lecture 2: “Global Health and Palliative Care”
  Liz Grant, Professor of Global Health, University of Edinburgh, UK
  Prof. Grant discussed palliative care as a global health priority, highlighting models from low-income countries that can inform Nepal’s approach.
• Perspectives from Global Experts & Organizations
• WHO Global Initiatives in Palliative Care – Megan Doherty, Consultant, WHO Geneva
• Palliative Care in Kerala: The Pallium India Experience – Smriti Rana, Head of Strategic Programs & Partnerships, Pallium India
• Palliative Care & Mental Health in the Community – Chitra Venkateswaran, Founder/Director, Mehac Foundation, Kerala
• Rural Palliative Care in Ethiopia – Nuhamin Gebre, King’s College London, UK
• Poverty-Reducing Palliative Care in Malawi – Maya Jane Bates, Global Health Academy, University of Edinburgh

• Prof. Dr. Bishnu Dutta Paudel, President, Nepalese Association of Palliative Care presented NAPCare’s role in shaping Nepal’s national palliative care framework, calling for greater policy support and funding.
• Dr Satish Gurung, from The Gurkha Welfare Trust shared lessons from palliative care initiatives for Gurkha veterans, focusing on community-based support for aging populations.
• Dr. Rajib Neupane, from United Mission Hospital, Tansen highlighted the challenges and successes of implementing palliative care in a rural hospital setting.
• Dr. Raj Kumar Gajmer, from Patan Academy of Health Sciences shared his personal reflections on Nepal’s first fellowship in palliative care, marking a significant step toward specialized training for healthcare professionals.

Palliative Care & Research

• “Lily Ko Baigancha”: A Children’s Palliative Care Initiative Amrita Shrestha & Sarah Riggsbee, INF Nepal GPH lead a heartfelt session on pediatric palliative care, addressing the unique challenges of caring for terminally ill children. Similarly, Dr Suraj Maharjan, Consultant Plastic Surgeon presented on behalf of Dr Arjan Knulst, Biomedical Engineer, INF Nepal GPH about the
  breakthrough about the Vacuum dressing in wound care management with implications for palliative care patients requiring long-term dressing solutions.
• Namuna Shrestha, former Sunita Project Research Officer shared her PhD Research, University of Huddersfield, UK learnings. A comprehensive study on NCDs specially the Type two Diabetes and their connection to palliative care needs in Nepal. Similarly, Manju BK, from Lalgadh Hospital (Former Palliative Care Clinical Lead) presented her finding and learnings from the MSc Dissertation: “Moral Distress in Healthcare Workers“ An insightful presentation on the emotional and ethical challenges faced by healthcare workers in palliative care settings.

Closing Remarks & Vote of Thanks

• As a concluding remark Dr Bishnu Dutta Paudel reiterated the need for continued efforts in research, training, and advocacy to strengthen palliative care services across Nepal. Krishna Bahadur Adhikari, Executive Director, INF Nepal & Chair of the Conference expressed deep gratitude to all participants, speakers, and partners for their engagement and contributions, reaffirming INF Nepal’s commitment to improving palliative care accessibility in rural Nepal.

Palliative care is a vital yet often overlooked component of healthcare, especially in remote and rural areas. This conference aimed at advocating for accessible and quality palliative care for all, ensuring that no one is left behind. By bringing together leading experts and policymakers, the event will pave the way for sustainable palliative care solutions in Nepal.

The conference embodies INF Nepal’s ongoing commitment to improving the quality of life for disadvantaged and marginalized communities in Nepal through innovative health and development initiatives. INF Nepal invites healthcare professionals, policymakers, researchers, and the public to participate in this vital event to learn, collaborate, and help ensure palliative care reaches even the most remote corners of Nepal.

About the Sunita Project: The Sunita Project, led by the Palliative Care and Chronic Disease (PCCD) unit at Green Pastures Hospital in Pokhara, has been pivotal in developing a sustainable model of primary palliative care in rural Nepal. Over the past three years, the project has trained health workers and Female Community Health Volunteers (FCHVs), raised community awareness through schools and health-related groups, and fostered a strong evidence base through a comprehensive research program in partnership with the Global Health Academy at the University of Edinburgh.

The Sunita Project is set to conclude on 31st March 2025. Emerging outcomes from the project will be shared at the conference. In addition to presentations from the project team, the conference will feature insights from partner organizations delivering palliative care across rural Nepal. International guests from South Asia and Africa will also contribute, offering perspectives from their own contexts to enrich the global conversation on palliative care.