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A total of 5504 patients were treated at the Friendship Clinic during this one year period with further additional laboratory tests carried out. This figure is similar to previous years’ numbers- 2010/2011: 6795 and 2011/2012: 6201 (including lab tests), however it has and is, continuing to decrease. This slow reduction in clients is a likely reflection of the on-going improvements in the standard of living and levels of education in the local population. The Safe Drinking Water and Sanitation Project is a continuing development which gives people access to safe drinking water and is providing education to improve their knowledge about how to ensure safe water consumption. Additionally, the health education delivered by the clinic staff provides information about other health-related issues, such as smoking cessation, improving personal hygiene and first aid, of which much of the local population have a poor understanding.
 
These efforts therefore have reduced the rates of many water borne diseases and conditions which are directly related to poor lifestyle choices thus reducing the need for clinic visits. As education and development improves at the community level so too does the care provided by the Nepalese government who now offer 36 medications free of charge from local health posts. This has led to individuals being able to treat themselves for the less serious illnesses which are encountered and allows the clinic more time to deal with the severe and critical cases.
 
Other interesting changes in the community have also been reflected in the clinic’s client base; around 300,000 people in Nepal each year quit subsidence farming for more modern working roles and many more people travel which has resulted in nearly every household having one relation living in a city or abroad. “..an estimated 1,300 Nepalese citizens go abroad for work every single day” (CNN). This has created improvements in the general economic status of the local people and levels of education, leading to changes in patients’ expectations of health care and therefore the clinic’s service. In the past, patients were largely concerned with symptom control, but now, due to a better level of awareness they more often expect diagnosis and proactive treatment and ultimately resolution of illness. Because of this, many are travelling to the local cities to seek specialist care rather than visiting local medical clinics. Developing our services is therefore very important; the acquisition of an x-ray machine and other medical equipment are hoped for in the very near future as we continue to improve our facilities in order to meet our patients’ needs. We have also seen changes in the types of diseases that are prevalent, as ailments related to sanitation and hygiene are reducing, western diseases such as heart disease, depression and diabetes are becoming more commonly recognised which is bringing new challenges to our health workers.
 
All vaccination programs recommended by the World Health Organisation are now being funded by the government and provided to the community free of charge through the local health post, therefore making it unnecessary for us to offer these services however we still offer a tetanus vaccination service for those patients who require boosters.
 
This total number (5504), does not include the people assisted by the many subprojects of Clinic Nepal, this number is a pure reflection of the quantity of patients seen in the clinic’s general practice. The details of the health camps and the clinic’s other outreach projects including their figures are listed in the sections below.

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