Doctor who does not just treat symptoms

Orthopedic surgeon Anil Shrestha’s journey to medicine was laid down well before he was born. His father, noted industrialist Juddha Bahadur Shrestha, had aspired to become a doctor but was turned away from a medical school in India. 

"It became his mission that one of us, his sons, nephews, or nieces, would don that white coat," recalls Shrestha. That dream fell upon him, the youngest son, and he enrolled at Calcutta Medical College. 

Freshly graduated he returned to Nepal, where he hoped for a comfortable post at a hospital in Kathmandu. Instead, he was assigned to Jumla, a district which was even remoter and underserved than it is now. But that journey 40 years ago would prove transformative. 

"It was an eye-opener. I had no idea what rural Nepal was really like. When I reached Jumla, I asked myself why do we become doctors? It is because we have to make a difference," he recalls. 

The moment that would forever shape his approach to medicine happened at a government-run medical camp. An injured man had travelled from a remote village all the way to Kathmandu for surgery, selling his land to pay for it. He needed to remove his implants but faced a grim reality of having to sell more of his land to afford the procedure. 

"I thought to myself that we treat the x-rays, but we don’t treat the patients,"  Shrestha told us in an interview.  "What good is a perfectly functioning hand if this man could no longer have a land to plough?"

The encounter made the physician realise that healthcare in Nepal should look beyond symptoms and  diagnoses, and consider the socio-economic realities of patients. He made it his mission to provide care that didn’t just fix bodies but addressed the underlying factors affecting people’s lives. 

He co-founded the Nepal Orthopaedic Hospital in 1998 to provide high-quality surgery at affordable prices. But when he arrived at the site near Gokarna, it was anything but promising. 

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Photo courtesy: NEPAL ORTHOPAEDIC HOSPITAL

"It was just two blocks of a one-story building," he recalls. "They said: Here’s the hospital. Run it. But buildings don’t make hospitals. You need doctors, you need equipment, you need patients." 

With a bold plan and support of friends and international donors, Shrestha started with 15 beds, providing care to anyone in need, regardless of their ability to pay. Initially, 93% of their operating expenses were covered by international donors but in less than 10 years, it had reversed the figures so that most of the cost was covered by internal resources.

The hospital is self-sufficient today and does not turn away any patient that cannot afford the cost. Over the past 25 years, it has given more than $1 million in charity care. 

But Shrestha’s job was far from over. Realising the chronic lack of proper spinal care in Nepal, he got involved with the Spinal Injury Rehabilitation Center in Sanga in 2001, offering holistic treatment to paraplegic and quadriplegic patients. It was a leap of faith-started with a few friends, a handful of nurses, and no specialised doctors. 

"We just knew the need. People, especially women were falling off trees and cliffs, injuring their backs," Shrestha says, “They needed rehabilitation and physiotherapy, and we thought, why wait? You start small, and if you’re doing well, others will help you." 

Shrestha had long believed that healthcare in Nepal needed to reach the farthest corner, and after working with Nick Simons Institute (NSI) he realised that partnering with government hospitals can better strengthen the overall health system. Shrestha’s journey took another turn when he was asked to join the board of OneHeart Worldwide, whose mission, to reduce maternal and neonatal mortality in Nepal’s most underserved areas, deeply resonated with him. 

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A caretaker with a patient at the Spinal Injury Rehabilitation Center.

Shrestha’s approach to leadership is as grounded as his approach to medicine, it was never about control but rather always about enabler-ship. He explains: "Humility is key, and treating staff equally fosters a sense of unity and trust that is essential in difficult times.” 

He recalls a time at the Orthopaedic Hospital when funds were so tight that salaries could not be paid. The trust was so great that staff worked without pay for three months. 

Shrestha has a vision to open centres for spinal rehabilitation across all seven provinces of Nepal to provide specialised care – since the number of spinally injured patients rises dramatically because of highway accidents.

He wants a health system where each district's hospital is properly equipped and functional, thereby discouraging referral of critical patients to Kathmandu over long and bumpy roads.  

His message to the next generation of Nepali doctors and social entrepreneurs: "You don't have to wait until everything is perfect to get started. All you need is an idea, and if you see a need, jump into it. Start small and you will always have people to help if you’re passionate and clear about your goals." 

Shrestha avoids the limelight, and had to be convinced to agree to this profile interview. He says, "When you build an institution, don’t think it’s yours. It belongs to everyone who helped along the way."

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