The celebrated Sherpas of Himalayan mountaineering, who lived in the rugged high-altitude environment of the Everest area of Nepal, lacked Western style medical services and so iconic New Zealander, Sir Edmund Hillary, 'hero' of Everest, built them a small hospital in 1966. He administered Khunde Hospital through the Himalayan Trust, but with substantial support, since the late-1970s, from the Sir Edmund Hillary Foundation in Canada. Overseas medical volunteers assisted by local staff provided a range of outpatient and inpatient, curative and preventive services. The history of Khunde Hospital, therefore, provides a case study for the introduction of modern medicine, as Sherpas referred to Western or biomedicine, and for the implementation of an overseas aid project. In my analysis I have moved away from a binary, oppositional examination of a cross-cultural encounter and have situated Khunde Hospital in a conceptual device of 'worlds'. I argue that the hospital existed and operated simultaneously within multiple separate yet interconnected worlds, but do not privilege one discourse over another. These worlds work beyond culture, encompassing institutions, political structures and knowledge communities and were physical, social and intellectual spaces within which there were rules and norms of behaviour that structured action. In order to explore the histories of Khunde Hospital I set it within four distinct but overlapping worlds: that of Sir Edmund Hillary, the Sherpa, Western medicine and international aid. These are worlds that I have identified as being important for the questions I am looking at. My central discussion is the ongoing encounter between Sherpa beliefs and practices about sickness and modern medicine, particularly looking at the individual patient�s use and non-use of the hospital and how staff there responded. The response was neither a one-way diffusion of Western medical practice, nor a collision between the spirit-suffused system of the Sherpa and scientific biomedicine. People used the hospital for some things but not others, based on their perception as to whether the hospital was the effective, appropriate option to take. Over the years, the hospital and community became used to each other in a relationship that was in practice a coexistence of difference. Each acknowledged and could incorporate aspects of the other�s beliefs and practices when dealing with a person�s sickness, but remained separate. Using the conceptual device of worlds, however, suggests the need for this example of the introduction and spread of Western medicine to be grounded in a consideration of Hillary�s particular form of aid, the shifting discourse of international medical aid between the 1960s and the 1990s and the unique world of the Sherpa of Khumbu. All of these worlds influenced the provision of health care at and from Khunde Hospital in different ways, sometimes separately but often simultaneously, and at some times and for some issues more than others. People, place and relationships often had as much influence as - and sometimes more than - the medicine. If the key to understanding Khunde Hospital is the relationship between Sherpas and Hillary and the respect that began in a partnership on the mountains in the 1950s, then the multiple worlds of Khunde Hospital underscore the complexities of implementing Sherpa requests to build a hospital in their rugged home near the world�s highest mountain.

The celebrated Sherpas of Himalayan mountaineering, who lived in the rugged high-altitude environment of the Everest area of Nepal, lacked Western style medical services and so iconic New Zealander, Sir Edmund Hillary, 'hero' of Everest, built them a small hospital in 1966. He administered Khunde Hospital through the Himalayan Trust, but with substantial support, since the late-1970s, from the Sir Edmund Hillary Foundation in Canada. Overseas medical volunteers assisted by local staff provided a range of outpatient and inpatient, curative and preventive services. The history of Khunde Hospital, therefore, provides a case study for the introduction of modern medicine, as Sherpas referred to Western or biomedicine, and for the implementation of an overseas aid project. In my analysis I have moved away from a binary, oppositional examination of a cross-cultural encounter and have situated Khunde Hospital in a conceptual device of 'worlds'. I argue that the hospital existed and operated simultaneously within multiple separate yet interconnected worlds, but do not privilege one discourse over another. These worlds work beyond culture, encompassing institutions, political structures and knowledge communities and were physical, social and intellectual spaces within which there were rules and norms of behaviour that structured action. In order to explore the histories of Khunde Hospital I set it within four distinct but overlapping worlds: that of Sir Edmund Hillary, the Sherpa, Western medicine and international aid. These are worlds that I have identified as being important for the questions I am looking at. My central discussion is the ongoing encounter between Sherpa beliefs and practices about sickness and modern medicine, particularly looking at the individual patient�s use and non-use of the hospital and how staff there responded. The response was neither a one-way diffusion of Western medical practice, nor a collision between the spirit-suffused system of the Sherpa and scientific biomedicine. People used the hospital for some things but not others, based on their perception as to whether the hospital was the effective, appropriate option to take. Over the years, the hospital and community became used to each other in a relationship that was in practice a coexistence of difference. Each acknowledged and could incorporate aspects of the other�s beliefs and practices when dealing with a person�s sickness, but remained separate. Using the conceptual device of worlds, however, suggests the need for this example of the introduction and spread of Western medicine to be grounded in a consideration of Hillary�s particular form of aid, the shifting discourse of international medical aid between the 1960s and the 1990s and the unique world of the Sherpa of Khumbu. All of these worlds influenced the provision of health care at and from Khunde Hospital in different ways, sometimes separately but often simultaneously, and at some times and for some issues more than others. People, place and relationships often had as much influence as - and sometimes more than - the medicine. If the key to understanding Khunde Hospital is the relationship between Sherpas and Hillary and the respect that began in a partnership on the mountains in the 1950s, then the multiple worlds of Khunde Hospital underscore the complexities of implementing Sherpa requests to build a hospital in their rugged home near the world�s highest mountain.