Even as a high schooler in Kathmandu, my overriding reason to pursue a career in medicine was to serve the needy and poor. It was my good fortune that I was able to complete graduate medical education on a scholarship in India and move on to the US to complete a surgical residency program in Orthopaedic Surgery. Landing in New York with $50 in my pocket and being very poorly informed about living in such a vast city was nothing short of an adventure! The challenges were enormous but my determination to move on and succeed was strong. The training experience was unique and brutal – it rubbed into my being the meaning of perseverance and hard work. I was lucky to complete my residency in the subject of my choice.

Halfway around the world my parents lived in a village in their traditional farm – a simple life very close to nature. An occasional letter would arrive from them with suggestions about giving work in Nepal a try. This thought did keep creeping into the back of my mind.

As I neared the completion of my training, I came to understand the complexities of advancing one’s career in the US. There would be no looking back to return to Nepal for a go at work there if I didn’t do it now! My wife and our little son Anil returned to Nepal 10 months ahead of me, so that on completion of my residency I could prepare for my examinations. Thus, I was not present when our second child, Dr. Bibek, was born. I saw him only eight months after his birth when I returned to Nepal. Once back, I did not know what to expect professionally. My intention was to be useful and give it my best try or return back to the US.

Soon after returning, I realized that I had made a grave mistake by not continuing to pursue a career in the US – at least this was my initial feeling. There were no jobs to walk into, no platforms for work. The hospitals that existed were primitive and very poorly equipped. Amidst such depressing facts, I started work as a volunteer surgeon at a Mission Hospital literally working out of a box of basic supplies. I also had to simultaneously deliver anesthesia and assist other surgeons. I switched many gears, I lived in poverty – I was unable to deliver any comforts to my family. I walked or rode an old bicycle to work, and I feared at times that I had failed.

As the months went by, the obstacles that I was facing on a daily basis unfolded into many heart-wrenching stories which started to affect me. Children having to leave home to work, children suffering from deformities, diseases, and injuries because no treatment was available, or it was unaffordable. These early experiences haunted me in the daytime and in sleep, and motivated me to do more. I volunteered as a hand surgeon at a Leprosy hospital one day a week; another day I volunteered at a hospital 20 km outside Kathmandu in Banepa. I also worked at a home for physically handicapped children run by a Jesuit missionary priest. I was appalled as well as overwhelmed by the total inadequacy of services available. Here was an opportunity to be a real changemaker and help the needy. These experiences completely changed my attitude and I made a determination that I would make every effort to create better platforms for care in whatever way I could.

My confidence grew as I became more familiar with the prevailing pathologies – I also started to improvise and quickly realized how so much could be done for so little, despite very primitive conditions in the facilities where I was working. I was sold – the idea of going back to the US disappeared from my mind completely.

Opportunities did come, along with hard work. HRDC was born in 1985 and I took on the challenge of running it with very limited resources. I practically lived in the hospital day and night for several years. I was able to realize the importance of developing manpower for sustainability of the work. Partnerships developed and strengthened; residency training was begun. Thirty-five years on HRDC has blossomed into a unique facility unlike anywhere else in the world, providing the best comprehensive care to the neediest children.

As a little boy, I have very fond memories of playing with disabled children at HRDC while my father went about his unending work on Saturdays. I was too young to understand what he was doing, much less why, but I remember him as being busy, happy and fulfilled. As I grew older, these Saturday outings made me want to follow in his footsteps. Our home was one simple room and my mom had to sometimes sell her wedding jewelry to make ends meet while my dad was busy volunteering his services for poor disabled kids. Even when he had to sleep on the hospital stretcher after an incredibly busy day, I never, ever saw the desire nor the happiness and fulfillment decrease.

After finishing his Orthopedic training in the US, he left opportunities for a lucrative career and a secure future for his family to return to Nepal. There was seemingly nothing to come back to, but this giant of a man decided not only to return, but to make it his life’s mission to work for the most vulnerable children. Three and a half decades and a lot of “sweat and blood” later, HRDC is today a world-renowned institution that provides state-of-the-art care to Nepal’s most disadvantaged children.

As I become more involved with this work, I am in awe of what my dad has accomplished. In HRDC, he has created a model of care delivery that could be replicated in many similar resource-poor areas of the world. He has shown how much “one man with a mission” can accomplish and this has been my inspiration to return to Nepal after my training abroad. As a kid, I remember my father as being the kindest and humblest of men, something that hasn’t changed a bit in spite of his tremendous achievements. At his core, he remains the same guardian angel for Nepal’s most disadvantaged children. Emerson said that “an institution is an extended shadow of one man” and my father’s HRDC exemplifies this.

What inspires me to follow in my father’s footsteps? The enormous impact that HRDC’s work has on the lives of the children it treats and their families. The compassionate, family-like atmosphere that is so palpable. To be honest, for me it’s like coming home every time I come to HRDC. The feeling of kindness and belonging is indescribable. Witnessing a child who walks for the first time in his or her life is a privilege.

In the next twenty years HRDC will hold firm to its culture of accountability and transparency – something my father ingrained from day one. We’re already working to refine all of our systems so we can optimize every resource. Our motto has always been that we can do so much with so little. We’re digitizing patient information, installing an organic farm at HRDC for food production, speaking to the government to help us set up a biogas plant that will generate energy for cooking, and more.

And, our biggest resource is our staff – from our community-based rehabilitation workers spread throughout the country, to our satellite clinics to the hospital itself. Many have been with us for decades and 28 current staff are previous patients. We support everyone to work to their fullest capacity, and we will continually identify future leaders and train them. As my father has shown, leaders don’t create followers – leaders create more leaders. We look forward to sharing HRDC’s model of care in a low-resource country and hope it will serve as a blueprint for excellence and collaboration to benefit children all over the world.