Bishop Pickett was the founding President of the Board and Ernest Oliver the first Executive Secretary. The Flemings had already commenced medical work in Kathmandu in January 1954, and the Friedericks began medical work in Tansen in June 1954, but the work quickly expanded and diversified into other areas, such as education and development of hydropower. The activities of the UMN have been clearly defined in five-yearly agreements with the Government of Nepal.
Bishop Pickett was the inaugural President of the Board, while Ernest Oliver served as the first Executive Secretary. The Flemings had initiated medical services in Kathmandu in January 1954, and the Friedericks started medical work in Tansen in June 1954; however, their efforts expanded rapidly to encompass other sectors such as education and hydropower development. The UMN's objectives have been clearly outlined in five-yearly accords with the Government of Nepal.