The Beginning of the Movement

The Beginning of the Movement

The Scripture verse "Love your neighbour, as you love yourself" and common slogan "Prevention is better than Cure" inspired  Ramesh Khadka, a young dental hygienist working in Patan Hospital, Dental Department. His experiences in interacting with dental patients from the rural areas, instilled in him a burning desire to reach out and help rural communities where health care services were inaccessible. Starting in 1993, carrying medicine and other equipment in a backpack, Ramesh started visiting VDCs in Godavari-Lalitpur, Balkot-Bhaktapur, Ranipauwa-Nuwakot, SabruBesi-Rasua, Kathmandu-Pharping and Nanglebhare on foot to provide basic oral health care services. The "one man mobile clinic" travelled for long distances over foothills and mountainous areas. During these early ventures, the focus was on oral health care including extraction and dental treatment, health education, brushing technique etc. The poor and needy came for treatment. There were no-charges for treatment. People suffering from oral cancer, advanced dental abscesses and gum diseases came for treatment. Most of these cases could easily have been prevented by maintaining oral hygiene and preventive care. These experiences made a deep impression and convinced Ramesh about the importance of prevention and early intervention.

These experiences gave impetus to the idea of forming an NGO that was to reach out to the remote areas to provide health care.

These experiences gave impetus to the idea of forming an NGO that was to reach out to the remote areas to provide health care services.  On 15^th January 1994, an NGO was registered under the name Share and Care in Medico, Nepal (SCM/N) as the first Christian non-profit organization to respond to the health care needs of vulnerable people and communities in rural areas. In the same year, Share and Care Nepal took over the Pharping Clinic which was a UMN project and continued the provision of medical services to the surrounding poor communities.

In 1995 learning from the experiences of Jamkhed, India, the entire program was reviewed and revamped. The organization’s working approach shifted from ‘charity and welfare’ to ‘community based development’.  From then on, Share and Care has been involved in reaching out to the poor and vulnerable, empowering and transforming communities.

Forming an NGO

Ramesh shared these experiences with friends, colleagues and relatives. The idea of forming an NGO and reaching out to the remote areas to provide health care services took birth. However, the lack of experience in forming and managing an NGO loomed large and hindered further progress. He sought the missionaries from Patan hospital, doctors, church elders and other well wishers for advice and support and a meeting was arranged. Dr. Kaarlo Saumela, Head of Dental Department, Patan offered his home and a good meal for this initial meeting. This meeting marked the beginning of Share and Care. 

The Beginning of Share and Care

After a lot of discussion, the name of "Share and Care in Medico" was chosen. Share and Care represented the idea of "sharing whatever you have and caring with whatever you can". Since health care services were the basis of the work, "in Medico" was added.

On 15th January 1994, Ramesh Khadka with support from well wishers and friends registered Share and Care in Medico. It became the first Christian non- profit organization to respond to the health care needs of vulnerable people and communities in rural areas.

A plate of beaten rice

The work began in a small way, visiting the villages, conducting dental camps, awareness programs and interacting with people.

The people expressed their thankfulness in different ways. Some offered food and others offered their homes to rest. In one instance, an elderly woman who was given treatment for a dental problem, became overwhelmed. In her desire to repay Ramesh for his services she invited him fervently to come to her home. Her one room mud house was dark and mouldy. The woman was full of excitement at the arrival of the special guest. She reached for the highest wooden shelf in the hut where items of value were stored. Extracting a worn out plastic packet she proceeded to fill a plate with beaten rice. This rice, she explained had been kept for a special occasion. She had one son who worked away from home and she had been saving this special treat to give him on his return.

However, Ramesh reminded her of her son and she wanted to share the beaten rice with him. Ramesh was touched by her desire to share this special possession. He ate the stale rice in silent reverence.

The Pharping Clinic

In early 1994, Ramesh resigned from his job in Patan Hospital and joined full time in Share and Care. In September 1994, he took the opportunity to participate in a training program at the Comprehensive Rural Health Project (CRHP), Jamkhed India. The three month program included visits to the existing projects, interaction with the village health workers and opportunities to observe the functioning of a model primary health care and development project which became known all over the world.

Ramesh was deeply impressed with the confidence and knowledge of the village health workers at CRHP, Jamkhed. He started visualizing how a similar process could be initiated in the villages of Pharping. His ideas of providing charitable services and welfare work disappeared and he began exploring the concepts of partnering with the community for sustainable development. He was convinced that the charitable clinic at Pharping should be transformed into a community based health and development centre. At Jamkhed he developed an action plan for starting a community based health and development program in Pharping.

Bursting with enthusiasm and new ideas, Ramesh returned to Nepal in December 1994 to share the new action plan with the Board of Share and Care.

However the shift from the welfare approach to community based approach was difficult to accept and implement and it took more than one year for the Board to be convinced about the relevance and usefulness of this significant step.

From Welfare to Community Development

Meanwhile the United Mission to Nepal (UMN) had established a clinic in Pharping in the year 1966 which provided basic health care services. Sick people from Makwanpur and Lalitpur districts visited the clinic which was managed by one nurse. Over a period of more than 25 years, the services provided by the clinic reached out to many. At this infant stage, Share and Care in Medico Nepal on the invitation of the United Mission to Nepal took over the Pharping clinic on June 22, 1994.

Basic health care services, health education and mobile clinics were conducted from Pharping clinic. The staff of Share and Care included one trained ANM - Purna Maya and Ramesh Khadka.

Early Struggles

The reception was mixed and it was difficult to convince the Board and funding partners about the effectiveness of the community based development approach. The community in Pharping were accustomed to play the role of receivers of services. They were reluctant to participate in the process of development in which they were to become ‘key agents of change’ in their communities.

In one of the first community organized by Share and Care, community representatives who were invited to join, avoided coming to the meeting. In further meetings, one or two of the members came to participate out of curiosity. Over a period of time, the community members started taking much interest and enjoyed the idea of participating in the meetings and sharing their views and ideas. Soon the situation changed. Community members started enquiring about the date of the next meeting and expressed their deep interest in participating in the meetings and becoming part of the process of community development. The ‘receivers’ had started to see themselves as ‘key players’.

The Move on Ministry, Singapore which was providing financial support to the Pharping clinic had reservations about supporting the new project. During this difficult period, Dr. Dick Harding (UMN) came forward to help Share and Care to make contact with the Presbyterian Church of USA and Dr. Mabelle Arole, CRHP Jamkhed offered financial support and advice.

The First Project

In 1995, through Dr. Mabelle Arole, Share and Care made contact with funding partners who supported the project. Yona Sithling a young student joined Share and Care as a volunteer.

Two village health workers from CRHP, Jamkhed came to Pharping to share their experiences and sensitize the women in Pharping on their role in development. In 1996, with five field staff the community based health and development project started in two VDCs - Sheshnarayan and Dakshinkali. The project was based on the integrated primary health care approach. 

No Looking Back

In 1998 the project expanded to other surrounding VDCs. Other staff joined Share and Care. In the year 2001 and 2002, the integrated community based health and development project grew to embrace neighbouring VDC's and two new VDC's in North Eastern Part of Kathmandu District.

In 1998, Share and Care celebrated its 10th Anniversary with the theme "Joy of the Journey". It was a time to reflect on the past struggles and achievements and celebrate together with the community members and other friends of Share and Care.

Over a period of 13 years, the Pharping clinic which grew into a primary health care centre has now been transformed to "A School for Community" which provides learning opportunities for women and youth through non traditional ways. It offers a degree course recognized by the Tribhuvan University and also has a community resource centre, community library and computer literacy program.

Working towards sustainability was one of the priorities of Share and Care. In order to carry forward the work, two community based NGOs – Women Empowered Society for Development (WESD) and A School for Community (ASC) movement were initiated and equipped through various capacity building programs. With the help of Share and Care the NGOs were registered and started taking the responsibility of managing the project activities independently. Share and Care then withdrew active presence in the project area but continued to provide encouragement to the NGOs which have been expanding and growing on their own reaching out to the surrounding communities.

In 2002, Share and Care ventured to a new project area in Jarsinpauwa, 20 km from Kathmandu. Partnerships with the government, churches and church based organizations, funding partners were established and strengthened.

The scripture verse which inspired one person had taken root in the hearts of many others and stimulated the beginnings of a movement which grew gradually to reach out to many with the message of hope.