Charles Yau - A new direction for Project DOVE in Nepal's villages

Charles Yau: A new direction for Project DOVE in Nepal’s remote villages
By Tan Ruilin, Writer

Charles Yau (right), with community leaders who facilitated Project DOVE’s collaborative work in Dang. // Credit: Project DOVE Nepal, Duke-NUS

In the verdant, rolling hills of western Nepal’s Dang district, an alarming health trend among elderly women sparked the curiosity of a team of medical students. Despite never smoking, many women presented symptoms synonymous with chronic smokers—troubling breathing issues, persistent coughs, and chest tightness.

While few—if any—of these women smoked, they did have something in common: they spent hours in their enclosed kitchens preparing meals for their families, toiling at open charcoal stoves, burning dried firewood taken from the surrounding lush hills.

This mystery, uncovered during a community project led by Charles Yau (Duke-NUS MD student, Class of 2026) and his team, unfolded a startling revelation about the hazards of traditional indoor cooking practices.

This observation led to an unexpected connection: the women were developing the chain-smoking associated condition known as chronic obstructive pulmonary disease (COPD) in their later years because of prolonged exposure to smoke of a different kind.

As the Project DOVE student team visited the households of Dang to observe the way the villagers lived, they realised that the commonplace practice of indoor cooking was exposing the women to years of household air pollution through smoke from the open fires.

A woman cooks indoors at an open-fire stove in rural Nepal. // Credit: Project DOVE Nepal, Duke-NUS

“Journeying with someone through the end of their life is a privilege. It really puts your life into perspective—all your issues seem so small by comparison.”
Charles Yau

Explained Yau, co-director of the student-led overseas medical mission Project DOVE, on its first year of visiting Nepal in 2024: “There are multiple layers to the issue. Culturally, it’s because women are expected to be homemakers; geographically, there is no piped gas available as the village is situated in the middle of a nature reserve—and as the weather is generally erratic, ranging from cold seasons to monsoon downpours, people do not cook outside.”

“When we asked why they cooked this way, the women replied that their families had been doing it that way for generations. In this way, you can see how some upstream habits and lifestyles really create downstream consequences,” added Yau, who co-led the project with second-year medical student Sheriff Quek.

A queue forming outside the medical camp that Project DOVE ran in a village in Dang. // Credit: Project DOVE Nepal, Duke-NUS

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Yau describes himself as passionate about service and innovation. For him, the concept of caring for patients through empathetic connection began early. He spent his formative years in hospitals, watching his father diagnose, treat and comfort patients in his clinic. Through shadowing his father, Yau watched his father build relationships with patients, witnessing firsthand the significance of providing services to patients at their most vulnerable, and what that service could do for them. This observation never left him, and in many ways, would go on to shape much of what Yau would accomplish in his life.

Then Yau’s father passed away when he was 16, leaving him to take up odd jobs to support his family. Whether or not he had had plans to go to medical school, they had to be put on hold. Supporting his family with an immediate income took precedence, putting medical school on the back-burner. In his first year of university studying business, he attended a talk where the guest speaker likened management consultants to “doctors for businesses”.

“I was younger then, but that line really stuck with me,” said Yau. “I really threw myself into it because of that analogy.”

Yau working long hours and late nights as a management consultant. // Credit: Courtesy of Charles Yau

Yau would go on to become a management consultant in the fintech industry and even set up a global pro-bono consulting service at the Hong Kong University of Science and Technology, a service that eventually expanded to the University of Southern California in the US, and Indonesia.

When asked about his previous time in the consulting world, Yau explained, “I really enjoyed my time as a consultant. Part of it stems from working on difficult and interesting problems, the other part is being of genuine help to people in need.”

Clearly, Yau has a knack for the service-oriented, but what does he, in turn, get from solving others’ problems? “I think there’s tremendous value in learning vicariously through others’ experiences. Coming at problems from a different angle really puts your own problems into perspective. Learning how to solve your own problems from helping others, you start to kind of see that it all falls back to certain fundamentals.”

This back-to-basics approach seems to inform Yau’s attitude towards helping others—a drive to equip them with the skills they need to succeed and thrive, as well as ameliorate suffering.

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Unsurprisingly, returning to fundamentals was something that also shaped Project DOVE’s research endeavours in Nepal. Together with their partner non-governmental organisation, Peace Child Ministry, they first set about assessing the community’s health needs.

Duke-NUS students and volunteers from Peace Child Ministries conducting a medical camp in Dang, Nepal. // Credit: Project DOVE Nepal, Duke-NUS

Finding the cause of the widespread incidence of COPD was just one of the ways in which they hoped to help improve people’s lives.

On this visit to Nepal, the first in a series of a five-year-long plan, the team conducted a preliminary needs assessment. To investigate healthcare in Dang at different levels, they visited three villages with varying socioeconomic status to witness firsthand their way of life, in aspects as varied as culture, daily practices and hygiene standards.

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“As the trip went on, we saw brick houses give way to clay huts, no paved roads, no running water, and so on,” described Yau.

They also conducted a medical camp where villagers received free medical care, allowing the students to understand the health issues present within the population.

Despite leveraging the prior experience of their partner Peace Child Ministry, they did not expect the overwhelming response from the villages:

“We had budgeted for 200 cases per day, which already was quite a lot—but we had more than 300 cases on the first day. We had to turn people away. We almost ran out of medication on that first showing, and we had flown three days’ worth of medication there from Kathmandu.”

Yau’s team had to adapt to the supply crunch, buying more medication from the shops in the area.

A storage shed in Dang, used to house tools and animals. // Credit: Project DOVE Nepal, Duke-NUS

It was apparent that the lack of health education was one of several fundamental factors in keeping the population of Dang underserved. Having observed gaps in hygiene, eye and ear issues, and children’s and women’s health, Yau said Project DOVE’s next steps are to focus on education.

“Teaching them basic first aid has become a priority in preventing many complications from simple injuries. Project DOVE Nepal is looking at ways to trial health education modules in rural communities where Peace Child Ministry already sends their School-in-a-Thumbdrive initiative—a way to supply educational material to even more remote areas of western Nepal.”

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The inception of Project DOVE Nepal itself arose from a unique situation. Duke-NUS students had been going on medical missions to the region under the Project DOVE umbrella since 2010. Now, in 2024, Project DOVE, for the first time, embarked on more than one trip in a year, with teams going to Nepal as well as Sri Lanka.

In May 2023, when Yau was first introduced to a local doctor and the founder of the non-governmental organisation Peace Child Ministry, Dr Michael Ong, the seeds for a long-term, multi-year collaboration were sown. Peace Child Ministry works extensively with the local villagers and elders in western Nepal. With this access to key members of the local community, Project DOVE Nepal found an exceptional opportunity to work with an underserved population.

Dr Michael Ong treating one of the villagers of Dang at the medical camp. // Credit: Project DOVE Nepal, Duke-NUS

Said Yau, “Dr Ong saw the importance of students obtaining practical experience with underserved communities, and in exchange for providing manpower and logistics to the people on the ground, the students partnered with an organisation for an experience that they wouldn’t have had otherwise. We began this five-year partnership, embarking on a journey with the locals to increase public health literacy.” Education, after all, is the crux of global health and raising health standards in such communities.

With this opportunity, Yau and his team worked on the necessary approvals to start this new offshoot of Project DOVE, as well as draw up the accompanying risk assessments and mitigation plans. However, getting everything in place—introductions, planning documentation and logistical preparations—turned out to be a race against time.

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It was a chance introduction that helped bring the project over the line. Yau was put in touch with two existing global health directors—Dr Courtney Davis, co-lead of Education for the SingHealth Duke-NUS Global Health Institute, and Dr Gayathri Devi D/O Nadarajan, a clinical assistant professor with the SingHealth Duke-NUS Emergency Medicine Academic Clinical Programme.

“I went to this meeting with them and brought Dr Ong along while honestly not expecting much—but at least I could show them he was a real person and that this was the real deal.”

Shortly after that meeting, Yau received the greenlight for Project DOVE Nepal. With the trip less than six months away, the newly approved Project DOVE Nepal team had a sprint finish to get everything ready for their trip in April.

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Between managing the maelstrom of large-scale projects and giving his time to others, Yau is no stranger to mechanics of organising and participating in volunteer activities. His efforts began, naturally, in medicine, starting with volunteering at a public hospital in Hong Kong around 2010.

There, his interest was piqued by a moment in the intensive care unit, where he noticed a doctor and nurse spending a significant amount of time sitting with a patient, comforting them. Curious, he asked his clinical mentor what they were doing, and it turned out to be palliative medicine.

“At the time, palliative medicine wasn’t as well known. I felt drawn to it because it really spoke to the core of medicine: always comforting, even at the end. I was especially drawn to it as an underrepresented field, and of course, through my own experience with death.”

A decade later, to ensure his interest in palliative care and medicine wasn’t merely fleeting, Yau returned to volunteering. Now, he spends his leisure time working with the Assisi Hospice and the No One Dies Alone programme, where he sits with patients who have no family or friends in their final moments.

Yau with a team of volunteers and hospice workers during one of his stints at the Assisi Hospice. // Credit: Charles Yau

With gentle feeling, Yau describes his time with the hospice patients: “All you have to do is hold them. When people are at the end of life, the last senses to go are hearing and the sense of touch.

“There was one patient who only spoke Hokkien, and I only speak Mandarin. We were both using broken Hokkien and Mandarin to converse. After a few months, he realised he had never actually learnt my name, so he passed me a paper napkin, asking me to write it in Chinese characters. After I did so, he wrote his own name down, turned to me, and said, ‘You remember me.’ At the end of the day, you’re there to comfort them and be their friend. That’s what matters most.”

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It’s clear that whether it’s journeying with a single patient or conceptualising a five-year global health undertaking, Yau takes a ‘Clinicians Plus’ approach that threads dedication through both meticulous detail, and a view towards innovating the future, combining practical care with boundless compassion.

Under an unfettered sky, Yau walks along a dirt path in one of the Dang villages with a member of the community. // Credit: Project DOVE Nepal

Yau’s personal life, or what little there is of it—being a student in the thick of med school—consists of exercising. But don’t be fooled—his working out is not merely aesthetic.

Yau quipped, “I’m forced to—I have two slipped discs, and my doctor told me that I need to maintain muscle mass, or suffer debilitating sciatic pain!”

On the more extraverted side of things, Yau also dabbles in voice acting, and frequently hosts Duke-NUS events. On the least extraverted side, however, he maintains zero social media presence—other than his LinkedIn—perhaps almost the most unbelievable of his feats, given how pervasive digital media is.

Most of Yau’s motivations, as well as his ability to put problems in perspective, are illustrated by how he describes his hospice volunteering:

“Being with someone and journeying with them through the end of their life is a privilege. It really puts your life into perspective—all your issues seem so small by comparison. It’s my honour to learn and journey with them.”

As the sun sets over the hills of Dang, the journey for Charles Yau and Project DOVE is just beginning. With each household visit, each community interaction, they inch closer to transforming lives through health education and sustainable practices.

It’s a testament to the power of medical advocacy in bridging the gap between tradition and modern health standards, ensuring that each breath taken in these villages is a cleaner, safer one.