Until a few months ago, the quarter of a million people living in Accham, Nepal, were served by a single doctor.

But over the last two years, a group of Yale medical students founded the Nyaya Clinic in Sanfebagar — a village in the Accham district in the remote region of Far Western Nepal — bringing basic health care to rural Nepalis.

Over the next few months, the clinic will phase in new modes of treatment, including a telemedicine center, while its organizers here at the University continue to raise funds.

The clinic will be staffed by a doctor and a team of professionals — including nurse-midwives, mid-level health practitioners and community health workers — with varied levels of training. All staff members will be local Nepalis.

In 2006, Nyaya president Jason Andrews ’02 MED ’07 traveled to Nepal to perform medical work and create a documentary about the HIV epidemic in the far western regions. Upon arrival, he was struck by the lack of healthcare infrastructure, co-founder Duncan Maru MED ’09 EPH ’09 said.

When he returned home, Andrews contacted Maru and Sanjay Basu MED ’09 EPH ’09, and the three began the intial planning to found Nyaya Health. In the beginning, Maru said, they focused primarily on addressing the problem of HIV and raised funds on that platform.

But Maru said they changed course after concluding that HIV/STD clinics often provided education and testing but no treatment. The clinics employ trained professionals, he said, who, if working as primary healthcare providers, could see a far greater number of patients.

“We had really been trained with the mantra that HIV [and TB] are the biggest problems, but they are symptoms of a much larger problem in terms of the system and the way people have to live,” Basu said.

Maru said HIV could not be addressed without first tending to the general health infrastructure in the area. The group eventually chose to focus on maternal and child care.

The group hoped to partner with the government of Nepal, but Maru said the collaboration proved to be difficult.

“It was a huge bureaucratic hurdle to get the agreement with the ministry of health in Nepal signed,” Chris Belknap ’08, a member of Nyaya said. “We ended up not taking any money at first just to get it signed.”

Basu said they also faced some opposition from local HIV and STD clinics, who he said had an implicit agreement with each other not to bring attention to the lack of concrete services provided, he said.

“Everybody’s very welcoming, but underneath there are bombed out buildings, NGOs that have come and gone, and the complete failure of the government to provide any sort of basic infrastructure,” he said.

The group faced skepticism from locals and had to convince the Nepalis that they were, in fact, there to help and were different from their peer organizations, Belknap said.

What sets their clinic apart, he said, is the increased support and funds Nyaya receives from numerous organizations, including Google Grants.

Nyaya Health is also raising funds through University programs. The group is one of two beneficiaries of iDance, a fundraising dance marathon that serves as the culmination of Global Health Week 2008, Patrick McCarthy ’09, chair of Global Health Week, said.

Robert Nelb ’08, founder of the Public Health Coalition, said people were initially skeptical of Nyaya Health’s venture.

“People are always critical at the beginning but there is such a sustained interest in global health on campus,” Nelb said. “It’s a great model of how Yale students and Yale faculty come together and make a sustained difference halfway across the world.”

Nelb is a columnist for the News.

Belknap and Bibhav Acharya MED ’11, executive vice president of the group, will discuss the Nyaya Health clinic in the Calhoun College Fellows Lounge this Friday.