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 initial leader of the Board, while Ernest Oliver held the first administrative role. The Flemings initiated medical services in Kathmandu in January 1954, and the Friedericks started their work in Tansen six months later; however, their activities expanded to encompass multiple areas, including education and hydropower development. The UMN's objectives have been clearly defined through five-yearly agreements with the Government of Nepal.