The Nalta Rural Hospital

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The Nalta Rural Hospital

• By
• Jon Bagby
• The American Nalta Foundation

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Overview

• History of the Nalta Hospital
• Challenges
• The Future...

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A Very Brief History

• Dr. George Bagby, working through Orthopedics
  Overseas meets Dr. Ruhal Haque.
• Dr. Haque, the Administrator of the
  Government-run RIHD Hospital in Dhaka,
  Bangaladesh offers to donate land in Nalta if Dr.
  Bagby builds the hospital.

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Nalta Factoids

• Nalta District is located on the western frontier
  of Bangaladesh.
• Comprised mainly of rural residents 1
  million strong.
• Thirty miles from the Indian border.
• Most Importantly Lacking in a trauma center or
  M.D., level patient care.

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1997-2000

• After the successful introduction of the Bagby
  and Kuestlic (BAK) bone basket (for spinal
  fusions) into the U.S. Market, Dr. Bagby gifts
  250,000 to begin construction.
• Construction is completed in January 2000.

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Nalta Hospital
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Current Facility

• 29 Bed facility including 4 cribs
• 24 Hour emergency services
• Operating theatre
• Outpatient clinic
• Pharmacy, pathology, and radiology
• Prosthetic Fabrication Center
• Ambulance and Minibus

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Current Staff

• 1 General Practitioner
• 1 Anesthesiologist
• 1 Cardiologist
• 2 Orthopedic Surgeons
• 1 OB/Gyn

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Challenges

• Oversite of construction from the opposite side
  of the planet.
• Communication
• Technical
• Cultural
• Community perception

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Oversite

• Funds were dispersed monthly based on reports
  from Dr. Haque.
• Changes in the building design (50 ft pilings)
  resulted in cost over runs.
• This in turn resulted in a scaling back of the
  original floor plan to approximately 10,000 ft2.

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Communication

• Technical - lack of consistent communication via
  phone - remedied by the purchase of a satellite
  phone.
• Cultural - Cultural differences as well as
  expectations continuously challenge both parties
  remedied by patience and ongoing partnership.

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Community Perception

• Ambivalence
• Bred in part by folk practitioners who felt
  threatened by the new facility.
• Due to the hospitals desire to collect fees for
  services where ever appropriate.
• Due to a lack of stable medical staff during the
  early part stages of operation.

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Long-term Goal

• To provide all people in need regardless of their
  ability to pay.
• Current Reality
• 10 free service currently provided
• 90 of services rendered generate revenues for
  the hospital

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Future

• Hospital is currently running a monthly shortfall
  of between 1,000 and 3,000.
• These shortfalls have historically been made up
  by Dr. Bagby personally.
• The formation of a non-profit 501 (c) 3
  corporation (American Nalta Foundation) seeks to
  bring in donations to fund future shortfalls
  (goal Sept 2002).

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Major Needs

• Develop a fund raising program.
• Medical and non-medical equipment.
• Establish a communication system.
• Housing for physicians and staff, as well as
  visiting medical teams.

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American Nalta Foundation

• Attention George Bagby
• 105 W. 8th Avenue, Suite 438
• Spokane, WA 99204-2318