The past year has been another very busy one for the Ladakh Heart Foundation (LHF). We have been continuing and extending our activities over Ladakh, trying to prevent and cure all forms of heart disease, while also concerning ourselves with the general health of the local population, which explain the creation, this year, of the Ladakh Institute of Prevention (LIP), dedicated to environmental, occupation, life style related and high altitude diseases. The activities of this newly born institute, with Lama Chogyal as its executive director, are presented in a separated newsletter. Our efforts (Ladakh Heart Foundation) can be broken down into five main areas: Primary preventative medicine, including primary prevention of acute rheumatic fever, as in the past years. Lectures and seminars were the main means of communication to impart health education. Village clinics in out-lying regions. The maintenance of a register of all patients in the region, and the continued monitoring of their conditions. Surgery and diagnostic clinics. Contributing, in a humble way, to the health care facilities provided by the government by initiating innovative projects, but always with the final objective of creating an environment conducive to make those projects acceptable to the government and the population, which also applies to LIP activities. In context of the last point, we are delighted to highlight that two of our initiatives are now well accepted both by the government as well as the population. The first one consists in the local government (L.A.H.D.C.) agreeing to bear the expenses incurred on the cardiothoracic surgery (P.D.A. and Mitral Valvotomy) being conducted by Professor Sanpath Kumar, Cardiovascular Surgeon, in the local government owned hospital (S.N.M. Hospital). The initiative and the expenses involved were initially the responsibility of LHF and the Venerable Lama Lobsang, Hon'ble member of Sheduled Tribe Government of India. Secondly, our primary prevention program against acute rheumatic fever, involving Benzathine Penicillin prophylaxis in children of age 5 to 15 suffering from streptococcal throat infection, is now well accepted by the patients and the medical profession in Ladakh. LHF initiated this program and still bears the expenses. The good outcome of this preventive program has resulted in acceptance by all parties concerned. We look forward to hand it over permanently to the government in near future. In the meantime, LHF is also proud to announce that the construction of the new hospital has progressed considerably over the last year, as well as the guesthouse attached to it. What follows is a little more detail on the advances that have been made and we include some photos, as well.