Board of Directors

Cynthia T. Kennedy, Esq.
President, ATNI

Jennifer Cleary
Treasurer, ATNI

Steven Harrison
Author

John Odom, MD
Orthopedic Surgeon

Wendell Wallach
Business Consultant

Advisory Council

Joe Braidish

Executive Director, ATNI

Margaret Cleary

Rehabilitation Nurse

Dorje Dolma
Surgery Recipient

Tsering Dolma
Surgery Recipient

Rick Doty
Certified Public Accountant

Michael Friedenberg
Real Estate Broker

Eric Jamrich, MD

Orthopedic Surgeon

Jill Kamon, MD
Pediatrician

Jon Krakauer
Author

David Spiegel, MD
Pediatric Orthopedic Surgeon

Fred Taylor

Business Consultant

Contact ATNI

Post Office Box 7111
Boulder, Colorado 80306
U.S.A.

+1 720.565.8777 (voice)
+1 303.447.1511 (facsimile)

info@alltogether.org

www.alltogether.org

Drolma Continues to Heal and Thrive

Drolma Lhamo, a bright and beautiful eight- year-old Tibetan girl and the fifth child brought to the United States for life-saving surgeries, has now been in our country for about 10 months. This has been a busy yet wonderfully productive time for everyone.

So much has happened for Drolma. Earlier this year, she underwent two very successful surgeries at Shriners Hospital in Los Angeles from which she emerged a full two inches taller. A post surgical check-up in April went very well, and she’ll likely return to LA in mid-July for another check-up and consultation on further surgery to correct a difference in leg length. Her dedication to her schoolwork never wavered however, and she recently completed the third grade at Mountain View Elementary School in Longmont, Colorado. On top of all this, Drolma enrolled this March in a Tibetan school that meets weekly in Boulder. The children study Tibetan culture, practice language and writing skills, and perform traditional Tibetan songs and dances.

Drolma’s host family in Longmont, Stephanie and Lewis Geyer and family, who have provided so much loving care to Drolma, celebrated in April the arrival of their third daughter, Grace Evelyn (see photo below of Drolma with Grace). Drolma’s support family in Windsor, Colorado, Jeannie and Doug Kreykes and family (who were hosts to a previous ATNI sponsored child), have offered critical assistance every step of the way.

Everyone at All Together Now International acknowledges the courage and healing capacity Drolma has demonstrated, as well as the compassion and selflessness shown by her host and support families. You have taught us much, and for that we are sincerely grateful.

ATNI’s Vision

All Together Now International …

is a leading developer of innovative programs and visionary alliances that promote international peace by creating greater economic, educational, and health care opportunities for disadvantaged people in some of the world’s poorest regions.

ATNI’s Mission

Our mission is to advance in underdeveloped countries unique programs that foster self-sufficiency, personal responsibility, and community building while addressing people’s most basic human needs. Our core program involves the design and replication of health delivery system prototypes for the prevention and treatment of spinal diseases in children.

We promote other innovative, locally sustainable programs that …

► provide housing and education to destitute or orphaned children.

► deliver requisite health services to impoverished women, promoting their health and enabling them to provide greater care and support to their families.

► create economic self-sufficiency for impoverished women through learn to earn programs that give them the necessary knowledge and skills to manage their own small businesses.

v HIGHLIGHTS IN THIS ISSUE

· Update on Drolma Lhamo

· Our Vision and Mission Statements

· News & Announcements

· Creative Ways to Donate

· Financial Information You Can Use

This issue: Planned Giving

· Project Updates

· Special Feature

This Issue: Why Support the People of Nepal?

News, Announcements, and Activities

NEW ATNI WEBSITE. Since our last newsletter, ATNI has launched a brand new website. Please go to www.alltogether.org and take a look at what we’ve done. And, feel free to contact us with your comments and feedback. We owe many thanks to Tracy Reiner who volunteered her time and talent to help us redo the site. Tracy has two businesses that we invite you to support – Tracy Reiner Designs (www.tracyreinerdesigns.com), a marketing communications and graphic design firm, and That’s Perfect (www.that’s-perfect.com), a personal shopping service.

ATNI IS HARD AT WORK ON AN AGGRESSIVE GRANT-WRITING CAMPAIGN. During the past four months, All Together Now International has submitted 44 grant proposals, and we’ve gotten some encouraging responses from a few grant makers. We have focused our funding requests on a project labeled Straight Spines – Health Children, which highlights the work we’ve done with the Hospital and Rehabilitation Centre for Disabled Children (HRDC) in Nepal, and the work with life-saving surgeries here in the US.

Among others, targets for our grant proposal campaign have been: former donor foundations (including the Johnson Family Foundation, Garth Brooks’ Teammmates for Kids Foundation, and Jon Krakauer’s Everest ’96 Memorial Fund), foundations supporting Colorado organizations, medical company foundations, foundations focused specifically on spinal disorders, foundations supporting children’s health and well-being, and foundations focused specifically on orthopedic care. This activity will continue, and we hope to get more sophisticated in our foundation profiling and targeting. Further, we are beefing up our web presence through the popular search engines so that we more readily come to the attention of grant-making researchers.

ATNI CONTINUES TO NETWORK WITH AREA NONPROFITS TO EXPLORE POSSIBLE SYNERGIES. Since October of last year, ATNI has conducted meetings with several Boulder and Colorado Front Range based nonprofits to identify ways that we can deepen and accelerate each other’s impact by working together more collaboratively. To date, we have met with organizations like the Nepal Community Development Foundation, Friends of Nepal, the International Mountain Explorers Connection, the Tibetan Village Project (sanctioned by the Dalai Lama), Mohammad Aslamy’s Afghanistan Orphanage Project, and the Village Earth Consortium on Sustainable Development (part of Colorado State University’s International Institute on Sustainable Development). These conversations are ongoing, and we look forward to bringing you news of further developments.

ATNI RECEIVES A GENEROUS GIFT OF REAL ESTATE SALE PROCEEDS. Advisory council member, Michael Friedenberg, helped to arrange the sale of four Austin, Texas based town homes, which had been generously donated to ATNI by a good friend of the organization. ATNI received the net proceeds from the four transactions, and our benefactor got a well-deserved tax break.

Creative Ways to Donate to ATNI

ATNI BENEFITS FROM DEAL WITH MATRIX REAL ESTATE, LLC. Boulder based Matrix Real Estate, LLC has agreed to donate 50% of their commission at closing to All Together Now International when the buyer or seller anywhere in the US has been referred to them by ATNI. Contact Chris Condrey for a free, no obligation consultation - phone 303.447.1500 or email ccondrey@matrixre.com.

Matrix Real Estate's personalized approach ensures buyers and sellers of getting the best price for their real estate transactions, and this half-commission donation plan means that many others benefit, too. Buyers and sellers reap the rewards of outstanding deals while making a difference in the lives of disadvantaged people in some of the world's poorest regions. All Together Now International encourages all of its supporters to call Matrix when buying or selling a home and mention ATNI for this special half-commission donation.

SHOP AND GIVE THROUGH iGIVE.COM: Visit www.iGive.com when you shop online, and a portion of each purchase from your favorite merchants will be donated to ATNI. The iGive.com shopping mall houses nearly 500 online sites, including such popular merchants as Amazon, Barnes & Noble, Lands’ End, Eddie Bauer, Gap, Ann Taylor, Neiman Marcus, Dell, Circuit City, Brookstone, Harry and David, Hallmark, PETsMART, 1‑800‑FLOWERS, Spiegel, and many more. It’s easy. Here’s how it works … Visit the iGive.com site and join for free, registering ATNI as your favorite cause. Then, each time you make a purchase from one of the iGive.com merchants, a portion of that purchase will be given to ATNI. And, for each initial purchase made within 45 days of joining, iGive.com will give ATNI an extra $5.00.

Financial News You Can Use

Planned Giving

Planned giving can have a truly transformative effect on ATNI by ensuring our long-term financial health. And, the vast majority of planned gifts are not complex or technical at all – they are really quite simple. While we understand that it is a deeply personal decision, we encourage all interested donors to consider leaving ATNI some of their assets after they no longer need them.

Bequests, through wills and living trusts, remain the basic planned giving vehicle. The American Association of Fund-Raising Counsel recently estimated that more than $18 billion a year is given to qualified charities through bequests. Planned gifts can come also in the form of a beneficiary designation on an IRA or a life insurance policy. Both of these gift types are easy to understand and very easy for donors to arrange. They are also revocable, so donors do not have to worry about tying up assets that may be needed later on in life. Further, there are some very creative ways to address people’s common concern that every dollar given to a charity is a dollar taken away from their heirs. A qualified estate-planning attorney can demonstrate ways that your heirs receive 100%, while your charity still gets a sizeable gift.

Project Updates

HRDC – Spinal Surgical Center for Children

An Interview with Medical-in-Charge, Dr. Ravi Thapaliya

One of our volunteers, Diane Sisk, recently conducted this interview with HRDC’s rehabilitation specialist, Dr. Ravi Thapaliya, just before he left for Australia for a year of additional medical training. Ravi is expected to rejoin the HRDC team when he returns from his year of study.

Note: Questions and answers have been edited for easier reading, and to allow this interview to fit within our format.

DS I read that approximately 23% of the Nepalese disabled population suffers from physical disabilities and that 30% of these physical disabilities are preventable. Can you estimate what percent of these physical disabilities are related to spine disease/conditions? What are the major causes of spine disease in Nepal?

RT Yes, a large portion of disability is preventable in Nepal. Unfortunately, there has not been any study as to what percentage of such disability is attributed to spine disorders. Anecdotally, our experience [with] our spine program tells us that there is a significant percentage of children with spine problems. As much as 10-15% of the physical disability could be due to some form of spine problems. [A] majority of the spine problems are secondary to spine tuberculosis. However, we have noticed [through our] screening … that a significant percentage of Nepalese children have [a] congenital structural abnormality of [the] spine (congenital scoliosis and kyphosis). In adults and adolescents, trauma, disc prolapse and degenerating diseases are also major spine problems.

DS The spine program at HRDC has an impressive community based outreach program that includes 50 mobile screening camps to identify and refer children to the spine program. Also, you’ve established screening programs in 10 schools. Can one assume that these activities contribute to the prevention of advanced spine disease in Nepal? …What interventions are used to treat early stage spine diseases and conditions, and how does this compare to interventions used to treat advanced spinal disease?

RT I am so pleased to tell you that the community based outreach program, [which] mainly focuses on screening and preventing spine problems in childhood, has shown that many spine disorders can be detected early in the stage [and are] amenable to [a] lesser degree of intervention. We have detected several congenital scoliosis [conditions] for which a surgical correction without instrumentation was possible. Many of the spine disorders that we came across, if not detected in time, would surely pose a problem later in life [that] would not be amenable to any form of corrective surgery or other methods of treatment. Similarly, a spine disorder when detected early, may be treated with physiotherapy and exercises only, whereas if presented late, would require surgery. We have examples [of] several children with advanced spine problems [who] required [referral] to … western countries … This [is] … an extremely

expensive affair. A community outreach program … [detects] spine problems early enough so that they can be treated optimally by the existing resource[s] at HRDC … The community outreach program is therefore extremely satisfying and is one of our community programs with [the] best outcomes. It is a screening as well as preventive program – causing prevention at different levels of disease stages.

DS How often do you see serious spine disease/conditions at your clinic? What happens if spine disease goes untreated? Are there any studies or estimates about what percent of the Nepalese population has untreated spine disease and/or the number of deaths caused by untreated spine disease?

RT Unfortunately, we see children with very severe and very advanced spine disease every now and then. As appropriate service is not accessible to [the] majority of the Nepalese population, this will continue to happen for a good long time. Spine disease, when it is progressive (and a majority of the spine diseases are progressive) will result in significant change in posture, altered biomechanics, stunted growth, and internal organ abnormality, [and] respiratory problems. Many such disorders are not compatible with life beyond [a] certain age (like second decade or third decade). If it is [an infectious] disease, then there may be rapid deterioration of general health. In every way, there will be [a] severe compromise in quality of life as well as longevity. Unfortunately, we do not have statistics on mortality and morbidity related to spine disorders in Nepal. To my knowledge, no such epidemiological study has been carried out or published.

`Updates From Other ATNI Supported Projects`

Nepal Children’s Home

This is an organization established in 1989 to provide education, health care, and a residential facility to the orphaned, abandoned, or underprivileged children in Nepal. It is a nonprofit social welfare organization registered with the Nepal government, Ministry of Home, District Office, Kathmandu. Children’s Home has three facilities: Girl’s Home, Transit Home, and a boy’s home in Mahendranagar. With ATNI’s support these three homes are now providing support to 166 children, up from slightly more than 100 as of our last report. Additionally, the following results have been achieved with ATNI’s support and direction:

● Educating Children in Nepal Scholarship Program Started

Children’s Home was able to start in the Far Western Development Region of Nepal a new program called Educating Children in Nepal. They were able to conduct an examination and make a selection of 174 children for the scholarship. They have begun looking for sponsors for these children and, so far, have been able to find about 80 sponsors for the selected children.

● Kitchen and Dining Construction Completed

In 2003, they completed the construction of a kitchen and dining room for the boy’s home in Mahendranagar. The home now has the capacity to feed 100 children at one sitting.

● School Bus

They have purchased a large school bus with a capacity for about 50 children. This bus has been used to pick up the children who are part of the Educating Children in Nepal program.

● Land Purchased for Girl’s Orphanage

The Children’s Home continues to expand and improve its facilities, notably by purchasing land in the Kathmandu Valley in order to construct a permanent girl’s orphanage, which would allow the Home to take in more needy girls. The land has been purchased through the Khokana Village Development Committee.

ROKPA International – Nepal Project

Through ATNI’s support this service group is able to regularly feed more than 800 people per day through an outdoor kitchen. In addition, this group runs an emergency medical clinic, a newly opened clothes depot, and provides foster care and some education to more than 60 children. Also, through a special partnership with Shanti Sewa Griha, a leprosy clinic we support, these children’s mothers take part in workshops to learn useful skills such as sewing, in order to improve living situations at home.

Kala Raksha

This India based project is designed to help women achieve self-sufficiency by developing their artistic and craft skills, and by teaching them to manage small businesses and make intelligent decisions about using the income they generate.

Kala Raksha is now working to find a long-term solution to the sustainability of art and craft. Two problems operate simultaneously for artisans: the first is how to earn a fair living in an industrialized economy by doing handwork, and the second is how to nurture the creative spirit of traditional art in the face of commercialization. Kala Raksha is beginning to answer this dilemma with its most recent projects, the Learning for Earning basic education program, and Kala Raksha Vidyalaya, the Design School for Artisans. Learning for Earning is a customized educational program in which artisans teach one another very useful topics such as basic business skills, personal accounting, and time management. The training has also introduced the teaching artisans to computer-aided design. A far more ambitious project, Kala Raksha Vidayalaya, is envisioned as a self-sustaining school for design, where education will be fee based.

Shanti Sewa Griha

Established in 1992, this is a home and hospice, a workplace, and a medical clinic for people with leprosy and for the very destitute. Shanti trains its clients (their word for those they serve) in weaving, knitting, and other art forms, which enables them to sustain themselves. During the years of ATNI’s support, the Shanti center has grown from 13 clients to a current population of 823, including 175 children. Programs at Shanti have been expanded significantly, and now include:

● a disabled children’s center

● a kindergarten

● a malnutrition center

● a women’s workshop

● an organic vegetable garden and a tree project aimed at reforestation and fruit production

● a mobile health camp, established in 2003, which has already provided examinations and infectious disease screenings to more than 200 people

● several income-generating activities, including, seasonal markets, a showroom for the sale of Shanti craft products, a poultry farm, and an apiary

Shanti has been working for 10 years in rented premises, and now wants to build its own center, which will include a hospital. They have acquired 2260 square meters of land, and are working hard to raise funds for construction of the facilities.

Why Give to the People of Nepal?

Even in tough times, in the midst of an uncertain economy and high unemployment rates, America remains rich in resources and has much to offer Nepal, one of the poorest countries in the world.

We can offer a healthier life…

v In the US, life expectancy at the time of birth is 77.

v 7 out of 1,000 babies born die every year in the US.

v In Nepal, life expectancy at the time of birth is 59.

v 70 out of 1,000 babies born die every year in Nepal.

Diarrhea, pneumonia and measles are the primary causes of infant mortality. Malnutrition, early marriage and child bearing, poor housing conditions, inadequate access to safe drinking water, and insufficient sanitary facilities contribute to the nation's poor health standard.

We can offer education…

v According to MSNepal.org, more than half of Nepal’s population cannot read or write. Further, literacy rates among male and female populations remain grossly disproportionate: Nepal’s adult female literacy is less than 25% as compared to 55% for males.

We can offer financial support …

v US unemployment is currently estimated at around 6% while 12.5% of Americans live below the US poverty line.

v Nepal’s current unemployment rate is estimated at 47% with 42% of the people living below the country’s poverty line.

According to the Danish Association for International Co-operation, Nepal has a per capita income of US $ 210 (equivalent to US $ 1,186 in terms of international purchasing power parity).

What does this mean in US dollars?

For US $ 1170, the Hospital and Rehabilitation Center for Disabled Children (HRDC) screened six schools (2,215 children) in its community outreach program to identify spine disease in Nepalese children. Early detection can prevent deformities, breathing problems, and death.

SOME PICTURES FROM THE ATNI

PHOTO GALLERY

A room within the living quarters at the Children’s Home in Nepal.

The Shanti Sewa Griha leprosy clinic.

Here are some of the children from the Children’s Home in their school uniforms.

Dr. Banskota (far right) and others celebrating the third anniversary of the Hospital and Rehabilitation Centre for Disabled Children, during the year 2000.