MediLoop™: Continuous Care in Nepal's Khumbu Region
What Is the MediLoop™? Continuous Remote Care in Nepal's Khumbu
The MediLoop™ is a permanent clinical circuit that brings free primary care to eight villages in Nepal's Upper Khumbu region. It runs on two 100-day cycles each year, so patients always know when the doctor is coming back. Snow Leopard International Medicine (SLIM) built it to replace the one-off health camp.
Medically reviewed by Dr. Ujjwal Shah, MD (Internal Medicine), Medical Director, SLIM Nepal.
SLIM is a medical charity for people. It has no connection to the wildlife organizations that share part of its name.
What is the MediLoop™, in one picture?
The MediLoop™ is Snow Leopard International Medicine's care model: a permanent clinical circuit based at Pangboche (3,985 m) in the Everest region. Dr. Shah and the SLIM team work two geographical wings, the West Loop and the East Loop, completing two 100-day clinical cycles every year.
SLIM describes it as an "infinity loop." The point is not a single visit but a rhythm that repeats, so a diagnosis in one cycle can be followed up in the next.
Everything a patient receives is free. That means walk-in access, a professional primary diagnosis on the ground, essential over-the-counter medications chosen after assessment, scheduled follow-up, and referral support when a condition needs a hospital.
Quick answer: one base (Pangboche), two wings (West and East), two 100-day cycles a year, eight villages, and a scheduled return every time.
Key Takeaways
- The MediLoop™ is a permanent clinical circuit across eight villages in Nepal's Upper Khumbu, run from Pangboche at 3,985 m.
- It runs two clinical cycles a year, across a West Loop and an East Loop.
- Each cycle is 110 days: 5 days of mobilization + 100 days on the mountain + 5 days of demobilization. Two cycles = 220 days in the high-altitude Khumbu.
- Each cycle has five phases: Launch, Outreach, Deep Clinic, The Return, and Referral and Reset.
- After 220 mountain days and two weeks' holiday, about 130 days a year remain for free urban clinics in Kathmandu, Lumbini and Pokhara, plus health camps, planning, training, and fundraising.
- SLIM states that 100% of donations support the Loop. Gifts are not currently US tax-deductible.
How does the MediLoop™ care model work?
Each cycle is 110 days: 5 days of mobilization, 100 clinical days on the mountain, and 5 days of demobilization. The 100 clinical days move through five phases — Launch (days 1–5), Outreach (6–45), Deep Clinic (46–74), The Return (75–94), and Referral and Reset (95–100) — taking the team from staging supplies, to first contact, to intensive care, to follow-up, to referrals.
Each 100-day clinical cycle is bracketed by a mobilization and a demobilization increment, so the full cycle runs 110 days:
- 5 days mobilization (front end): from Kathmandu into the mountains — Dr. Ujjwal Shah coordinates getting prescription drugs and medical supplies shipped from Kathmandu to Lukla (the gateway to the Himalayas), organizes porters to carry the supplies up, and hikes Lukla → Pangboche.
- 100 days to do the loop: the clinical cycle on the mountain.
- 5 days demobilization (back end): secure the base-station clinic at Pangboche, then fly back to Kathmandu.
110 days per cycle × 2 cycles (one pre-monsoon season, one post-monsoon season) = 220 days; plus 15 days (two weeks' holiday) = 235; and 365 − 235 = 130 days remaining in the year for urban healthcare initiatives — free clinics and healthcare outreach in Kathmandu, Lumbini and Pokhara.
The theme line: 220 days of mountain-based, high-altitude rural free health intervention + 130 days of urban healthcare outreach + 2 weeks' holiday = the year.
Here is what each clinical phase does, using SLIM's own description of the cycle:
- Launch (days 1–5): staging at the Pangboche base, sorting supplies, calibrating equipment.
- Outreach (days 6–45): village visits, primary diagnoses, and immediate treatment.
- Deep Clinic (days 46–74): intensive care days and management of chronic conditions.
- The Return (days 75–94): follow-up visits and prescription adjustments.
- Referral and Reset (days 95–100): referrals to city hospitals and the handover to the next loop.
The sequence is the evidence that this is a system, not a camp. A patient seen during Outreach is not discharged into silence. The same team comes back during The Return to see whether the treatment worked.
What happens for the other 130 days?
Two 110-day cycles make 220 days in the mountains. After two weeks of holiday (365 − 220 − 15), about 130 days remain in the year. The five-day mobilization and five-day demobilization on each of the two cycles are already counted inside those 220 mountain days.
Mobilization means organizing the drug shipment and medical supplies, arranging transport and porters, and hiking up to Pangboche. Demobilization means closing the base, securing and storing equipment, and traveling back. The remaining 130 days go to free urban clinics and healthcare outreach in Kathmandu, Lumbini and Pokhara, which SLIM keeps distinct from its rural mountain program, and to high-altitude health camps with Nepal's Rotary Clubs, alongside planning, training, and the grants and donations that keep the Loop moving. It is unglamorous. It is also why the clinic can open on schedule at 3,985 m.
Where does the MediLoop™ operate?
The circuit serves eight villages on or near the Everest Base Camp trail from its Pangboche base: Tengboche, Deboche, Phortse, Nauche, Khunde, Khumjung, Thame, and Thamo. The Pangboche base station sits at 3,985 m and anchors both the West and East Loops. See the MediLoop™ page for a visualization of where the villages sit and how the loop works.
Many of these names will be familiar to anyone who has trekked to Everest Base Camp. For the people who live there, they are home, and the nearest hospital is a long way down the trail.
The route matters because walking is how everything arrives. Medicine, equipment, and the team itself move on foot or by porter over mountain trails. A fixed circuit lets SLIM plan that logistics burden once per cycle rather than improvising each time.
SLIM has not published a per-village visit schedule, so the exact dates for any given village are best confirmed with the team through the SLIM contact page.
Stone houses and terraced slopes typical of the Khumbu villages on the circuit.
What a MediLoop™ clinic provides
The MediLoop™ provides free walk-in primary care: a professional diagnosis on the ground, essential over-the-counter medications based on assessment, scheduled follow-up visits, and logistics and paperwork support for patients who need advanced treatment at hospitals in Kathmandu.
Four things define a visit:
- Walk-in access. Any resident can come. There is no appointment gate.
- Primary diagnosis. A physician assesses the problem rather than guessing from a symptom list.
- Essential medications. Over-the-counter treatments matched to the assessment.
- A follow-up plan. Patients are part of a scheduled plan, not a one-time number.
This is primary care, not emergency rescue. Anyone on the trail with worsening symptoms, or with signs of high-altitude pulmonary or cerebral edema such as breathlessness at rest, confusion, or loss of coordination, should descend and seek urgent help. This article is general information and no substitute for medical care.
How the MediLoop™ differs from a one-off health camp
A one-off camp arrives, treats whoever is waiting, and leaves. The MediLoop™ returns on a fixed schedule, so patients get follow-up, prescription adjustments, and referrals. Continuity is the product.
Three practical differences follow from that design.
- Predictability. Residents know when to expect the doctor's return for check-ups and prescription refills.
- Follow-up. The Return phase exists specifically to review earlier cases and adjust treatment.
- Referral. Phase five turns unresolved cases into referrals with logistics and paperwork support, instead of a shrug and a leaflet.
What this means for you: if you are judging a medical charity, ask when the team comes back, not how many people were seen on day one.
Why do continuous 100-day cycles matter for remote healthcare?
Chronic and recurring conditions need repeat contact. When a clinician returns on a known schedule, patients can trust that treatment will be checked, prescriptions adjusted, and referrals handled, which one-time visits cannot offer in places where the next doctor may be days away.
Trust is slow to build. A village that has seen visiting groups come and go has good reason to hesitate before relying on the next one. A team that shows up in the same place, at the same point in every cycle, earns that reliance over repeated visits.
Follow-up is the clinical half of the same argument. A prescription that needs adjusting in six weeks is only useful if someone is there in six weeks. The 100-day cycle builds that timing into the design.
The model also travels. A repeatable cycle with a fixed base, a fixed sequence, and a planned off-season is something other remote regions could study.
Before the ask, one picture of what you would be supporting: two cycles a year, each moving through the same five phases.
The cycle in order: mobilization → launch → outreach → deep clinic → return → referral and reset → demobilization.
The five phases of a single 100-day MediLoop™ cycle (not including the five-day preparation before the cycle, which we refer to as the mobilization increment, nor the five-day post-cycle winding down, which we refer to as the demobilization portion of the operation):
Supporting the MediLoop™
You can support the MediLoop™ by donating, ideally as a recurring monthly gift, or by inquiring about volunteering with the team. SLIM states that 100% of donations go to the Loop: logistics, referral transport for registered patients, local team salaries, and essential supplies — SLIM Nepal is not a rescue or helicopter-dispatch service. All administrative expenses are absorbed by the Canadian parent organization, Snow Leopard International Medicine Ltd. (Canada).
If the model makes sense to you, the Get Involved page lists every way to help, including donating, volunteering, and a supplies list. To give directly and Support our Mission, use the online donation form.
A note on taxes. Gifts to SLIM are not currently US tax-deductible. CRA tax receipts are available through our partner, The Veritas Foundation (theveritasfoundation.com).
Learn how to get involved with the MediLoop™
For the team's own description of the model, see the MediLoop™ page and the About page.
FAQ
Is Snow Leopard International Medicine related to the Snow Leopard Trust?
No. Snow Leopard International Medicine is a medical charity that provides free primary care to people in Nepal's Upper Khumbu and in Kathmandu. It is a separate organization from wildlife conservation groups, and its work involves no animals.
Who runs the MediLoop™?
Dr. Ujjwal Shah, MD (Internal Medicine) is the cofounder and Medical Director of SLIM Nepal, and he leads all clinical work with his team. Roderick McLean is the founder and Chairman of Snow Leopard International Medicine Ltd. (which we refer to as SLIM Canada), and is as well the cofounder of SLIM Nepal along with Ujjwal. Ujjwal has total autonomy for all Nepal-based operations. Our accounting functions are carried out in Canada by Ms. Eishita Alam, MBA, QAA — who serves in the capacity as the Group's Comptroller and CFO. SLIM Canada has been pre-funded so we will have sufficient funds on hand to underwrite all expenses to operate SLIM Nepal for a period of 7 years. All monies are held in an interest-bearing account in Toronto, Ontario, Canada, with a federally registered foundation — The Veritas Foundation — theveritasfoundation.com.
How long is a MediLoop™ cycle?
Each cycle is 100 clinical days plus 5 days at the front and 5 days at the back end — what we call mobilization and demobilization — so 110 days per cycle. Two cycles a year make 220 days, and adding two weeks' holiday for Dr. Shah brings it to 235. That is 220 days in the mountains doing rural healthcare, two weeks' holiday, and the remaining 130 days spent in urban environments — Kathmandu, Lumbini and Pokhara — carrying out urban healthcare initiatives, providing free medical assistance and pharmaceuticals.
What happens if a patient needs a hospital?
Patients who need advanced care are referred to hospitals in Kathmandu. SLIM provides the logistics and paperwork support for that referral, and the Referral and Reset phase at the end of each cycle is built around it.