ASHA's Journey

They both entered the University of Tokyo Medical Research Institute's Public Health Medical Program at the same time. Shakya, with around 10 years of experience as a physician, and Nin, who had just graduated from university, bonded at a welcome party. Their connection strengthened when they discovered that Nin's university thesis was about Nepal.

The day after Shakya and Nin met, a devastating earthquake struck Shakya's home country, Nepal. Prompted by a call from Nin, who had seen the news, they decided to contribute to Nepal's relief efforts by planning a mobile medical clinic.

In collaboration with an international NGO active in the region, they conducted mobile medical clinics in a village near the epicenter of the earthquake in Nepal. During the visit, Shakya, who hadn't visited the village in four years, saw a long line of people waiting for medical consultations. The clinics took place at two locations over a period of four days, serving more than 500 patients. This revealed not only the scarcity of medical resources in Nepal but also the lack of proper recording, storage, and utilization of patient information in the healthcare system.

The idea of properly managing medical information to enable the provision of appropriate healthcare services emerges. The team applies to the University of Tokyo's "Global Creative Leader (GCL) Program," a joint project involving medical and information engineering, and secures funding.

The initial version of ASHA's original medical equipment management software, "ASHA fusion," is completed and introduced during a medical outreach in Chitwan, southern Nepal. We got positive feedback from local NGO doctors involved in the outreach, suggesting its use in healthcare institutions. Subsequently, the target audience is shifted to healthcare facilities.

Following the activities in Chitwan, not only mobile clinics but also the healthcare institution-focused "ASHA fusion v2.0" is completed. It is introduced at Trishuli Clinic, located approximately 2 hours from Kathmandu, and the demonstration begins.

"ASHA Fusion v2.0" has been introduced and its implementation has begun at a simple clinic operated by Dhulikhel Hospital, located in the suburb of Nepal.

The updated version of "ASHA fusion" is introduced and undergoes validation at the Manmohan Memorial Community Hospital, a central hospital located approximately two hours from Kathmandu in the Pharping region.

In anticipation of the graduation of all founding members from graduate school and the loss of the project's status within the university, the decision was made to obtain legal recognition as a Non-Profit Organization (NPO) for the purpose of sustaining long-term activities.

As a centerpiece of the "Rajpur Project," ASHA begins employing community health staff, known as "Community Health Workers," in areas with poor access to healthcare facilities in Nepal. These local health workers provide services that traditional unpaid volunteers cannot fully cover and offer regular care needed by patients. Anticipating future care utilizing mobile applications, the local partner initiates activities in advance.

The development of a dedicated app for Community Health Workers, "ASHAConnect," begins. The decision is made to create the app from scratch, incorporating features such as collecting digital data, tracking changes over time, and ensuring the accurate identification of high-risk patients.

Due to the impact of infectious diseases, in-person meetings become completely impossible in Japan. The opportunity for face-to-face communication significantly decreases compared to the graduate school days, making operation and daily communication challenging. The situation is further exacerbated as Nepal also enforces strict border closures, leading to the cancellation of all planned travels.

While celebrating the 5th anniversary since its establishment, we faced challenges with the life stage changes of core members and the impact of the COVID-19 pandemic, leading to business stagnation. The possibility of dissolution was considered, but with Shakya's decisive words, "Let's continue," the decision shifted to persist. Simultaneously, a sense of urgency prompted outreach to members from Nin's alma mater and current university students, steering towards revitalizing the organization's activities.

Having approached only the healthcare providers so far, we notice that there is a phenomenon where, due to the influence of traditional medicine and superstitions, people do not always seek Western medical care even when it is necessary. Considering this, we decide to add an different approach towards residents. Targeting middle school students who are assumed to have flexible thinking and can understand concepts of a certain difficulty, health education is being implemented.

ASHA won the Grand Prize at the "Vision Hacker Awards 2021 for SDG 3," an award that aims to discover and nurture the next generation of leaders in the field of international health and global health.

After COVID-19 pandemic subsided, we decided to held an event named "ASHA Design" aimed at strengthening the organization by gathering in person, sharing atmosphare, and collectively contemplating the future. It is planned to be conducted regularly in the future.

ASHA obtained certification as a designated Non-Profit Organization (NPO) that allows donors to receive tax deductions for their contributions.

A comprehensive collaboration agreement was signed to promote digital health in Nepal and collaborate on the "Likhu Project" in the Likhu Tamakoshi village.

Initiating the first project in the "Hill region," ASHA collaborated with the local NGO GU Foundation, led by Ganesh Lama, a supporter since ASHA's inception. This expansion aimed to incorporate some of the activities previously carried out in Rajpur into a new area.

Not only gathering information to understand local needs but also recognizing the necessity of addressing healthcare improvement at the community level, ASHA establishes contact with Bishal Belbase, MD, the representative of the local NGO Karma Health, through an introduction from a former ASHA board member. They share a common vision of creating a "locally driven, sustainable, and needs-based healthcare system using digital technology," leading to mutual understanding. Initiating the "Rajpur Project," ASHA begins working on a healthcare delivery model for the entire Rajpur region alongside its support activities for healthcare institutions.

The decision has been made to expand a portion of the initiatives undertaken in Rajpur to the neighboring village of Gadhawa. This expansion is initiated as a collaborative project with the KDDI Foundation.

Leveraging the experiences and initiatives undertaken in Nepal, a new project starts in Akita in collaboration with Akita International University (AIU), which is the alma mater of ASHA members including Nin. The project involves university students actively monitoring the health of elderly individuals in the community.