On Top of the World

Dr. Lani Ackerman was born with faith and a heart for healing.

From a very early age, Ackerman, a professor at the University of Houston’s Tilman J. Fertitta Family College of Medicine, says she was destined for a life of serving Christ by helping others and building bridges between some of the world’s most underserved communities and the world of medicine.

“From the time I was a child, I knew that part of my calling in medicine would be serving in places where people had little or no access to care,” she says. “But as my career progressed, I also discovered a deep passion for teaching — that became my gift.”

Ackerman’s medical journey has taken her around the world — Alaska, China and the Amazon jungle, just to name a few.

But nothing could compare to the complex tapestry of challenges and opportunities she would find at the top of the world — Nepal — where she has spent more than three decades quietly making a difference in the lives of millions of people.

“I saw a real need there for not only for providing care, but for educating physicians, medical students and the patients themselves,” she says.

Health Care in the Highest Place on Earth

Nepal, a stunningly beautiful country of more than 30 million people nestled between China and India in southern Asia, is home to the Himalayas — the highest mountain range on Earth — and the mother of all mountains, Mount Everest. Adventure seekers from around the world flock there to hike, climb and trek its rugged terrain.

But Nepal’s geography is both blessing and burden.

The ruggedness that makes it so alluring to outsiders isolates nearly three-quarters of its own citizens — while the capital, Kathmandu, and other major cities are relatively well-connected, people in remote, high-altitude communities face serious infrastructure, transportation and connectivity issues, creating barriers to some of life’s most basic needs, like education and health care.

“Access to health care is poor in rural areas, even with all the progress the country has made,” she says. “Some villages still take two weeks to reach.”

Since 2010, life expectancy in Nepal has increased and the government is working towards universal health care coverage for everyone. But it still faces constraints on resources, workforce shortages and quality of care concerns. Despite decreases in deaths from many infectious diseases, the rates for tuberculosis are still high, chronic lung and heart disease remain the leading causes of death and there is increased disability from trauma and motor vehicle accidents. Overall, Nepal ranks in the bottom half of the Global Health Security Index.

Making a Difference

Ackerman first arrived in the Himalayas in 1990, along with her husband, and initially practiced medicine, trained health workers and developed medical education programs for two years in Bhutan, Nepal’s neighboring country. A few years later, they moved to Nepal with their three (and later four) children where they lived and worked in rural areas.

Within a few years, she and her Nepali colleagues founded a medical school to address the severe shortage of doctors and other health care workers and expanded the small community hospital and outreach clinics in areas of maternal and child health — a critical need as Nepal then had one of the highest maternal mortality rates in the world.

Despite the danger from a growing civil war — Ackerman says she and her family were almost killed on several occasions — she launched grassroots programs, including an orphanage, a literacy and non-formal education program, a veterinary program and organic farm training, through what became a large non-governmental organization.  Everything was built around one philosophy: equipping and empowering locals to develop their own communities.

“I don’t take credit for anything,” she says. “Our role was to give the people already there what they needed to succeed and to work behind the scenes to support their leadership.”

After the massacre of the royal family and continued worsening of the war, combined with the need to expand funding for the NGO and allow their children to reconnect with the American culture, they turned the leadership of the NGO over to the Nepali colleagues they had trained, and returned to the U.S. 

But their work in Nepal has never ended.

To this day, Ackerman stays closely connected to Nepal — she holds regular Zoom calls with their NGO leadership and publishes research with doctors, mentors faculty and returns each year to teach and collaborate. On a recent trip a few months ago, she taught at one of the most remote and highest altitude medical schools in the world: the Karnali Academy of Health Sciences.

“The journey there is exhausting and challenging…” she says. “The roads are barely passable, and during monsoon season, they’re often completely shut down.”

Nepal is making progress. Today, there are excellent medical schools, strong medical residency programs and improved public health infrastructure. But the country is facing another issue: brain drain. Many well-trained Nepali doctors are leaving for better opportunities abroad.

“Political and economic instability continue to push them out,” Ackerman says. “That’s why it’s critical we support them locally — through sustainable partnerships, not short-term missions.”

Looking to the Future

At UH, Ackerman leads the Fertitta College of Medicine’s global health efforts with that same collaborative vision. In April, the college signed its first memorandum of understanding with a Nepali medical school, paving the way for joint research, remote faculty development and, eventually, student exchanges.

“Global health experiences make better doctors,” Ackerman says. “Students come back more humble, more resourceful, more compassionate. They remember why they chose medicine.”

Even those who never leave Houston stand to gain.

“This is a truly global city. You’re going to care for patients with different languages, cultures and expectations,” she says. “Working abroad helps you navigate those differences with sensitivity and respect.”

Ackerman speaks from deep experience. She’s seen polio, diphtheria and infections most American doctors only know from textbooks. She’s delivered babies in conditions few can imagine. And she’s stood in awe of her Nepali colleagues who continue their work against all odds.

“Nepal is a rough place to be a physician,” she says. “But it’s full of people with incredible resilience and heart.”

And more than thirty years after she first set foot in Nepal, Dr. Lani Ackerman’s mission remains the same: to empower, to educate, and to serve — wherever the need is greatest.

“Nepal is not my country,” she said. “But it’s my second home.”