Challenges and Opportunities in Healthcare and Development
Nepal
Nepal is a landlocked country with a population of approximately 30.9 million people (2023), ranking 146th out of 193 countries on the Human Development Index (HDI). Political instability and economic hardship continue to impact the everyday lives of many Nepalis, limiting access to essential services such as healthcare, transportation and adequate nutrition.
One of the most pressing issues is the lack of accessible healthcare, especially in rural areas. Many people are forced to travel long distances on poor roads to reach even the most basic medical services. In remote villages, life-saving procedures like Caesarean sections are often unavailable, leading to preventable maternal deaths. Children frequently live with undiagnosed conditions such as congenital heart defects, only receiving care when symptoms become life-threatening.
Access to clean water and sanitation is another major challenge. As of 2022, only 16.1% of the population had access to safely managed drinking water and just over 50% had adequate sanitation services. Malnutrition also affects a significant portion of the population: 18.3% of children under five are undernourished and about 5.7% of the general population suffers from chronic undernutrition.
Poverty continues to affect large segments of society, with 20.3% of the population living below the national poverty line. The healthcare system is under considerable strain, with only 1.2 doctors per 1,000 people. For comparison, Germany has 4.5 physicians per 1,000 inhabitants.
Despite these challenges, Nepal has made progress. Life expectancy has risen from 56.1 years in 2000 to 70.4 years in 2023. The country also has a quite young population, with 28.7% under the age of 15 and only 6.4% over 65. This demographic trend underscores the urgent need for investments in education, training and job creation to harness the country’s potential.
Amid these structural challenges, the people of Nepal continue to show resilience. They are known for their kindness, honesty and work ethic – qualities that offer a strong foundation for sustainable development and meaningful partnerships.
Quelle: BMZ - Federal Ministry for Economic Cooperation and Development
Health facts at a glance
> Number of doctors: 87 per 100,000 inhabitants
> Number of cildren who die before their fifth birthday: 26,5 per 1,000 live births
> Maternal mortality during pregnancy or at birth: 142 per 100,000 live births
> Population: 29,69 Milllionen
> Average life expectancy: 70,35 Jahre
> Number of people younger than 15: 28,71%
Nepal in pictures
Reaching the Unreachable
Health Engagement in Jumla, Nepal
Jumla is one of Nepal’s 77 districts and part of Karnali Province since the country’s 2015 constitutional restructuring. Known for its breathtaking landscape and resilience, Jumla is home to the highest-altitude rice cultivation in Nepal, with fields reaching elevations between 2,400 and 3,050 meters above sea level.
Karnali is the largest of Nepal’s seven provinces, covering 27,984 square kilometers - nearly 19% of the country’s total area - yet it remains one of the most remote and underserved. As of the 2021 census, the province has a population of approximately 1.69 million people. Due to the terrain and poor transportation infrastructure, many people in Jumla struggle to access even basic medical services.
Common medical procedures like Caesarean sections or cardiac screenings are often unavailable. Many children suffer from undiagnosed congenital or rheumatic heart disease, and only seek care when they are already in a critical stage - often too late for effective treatment. The country’s capital, Kathmandu, is the only center for cardiac surgery, located 800 km away. Reaching it requires two flights, and unfortunately, regular air service from Jumla is unreliable.
In response to these challenges, our local partner has initiated school health programs focused on early cardiac screening and general health checks, primarily in government schools. By identifying serious conditions early and coordinating treatment, he and his team are working to prevent unnecessary deaths from treatable causes.
The path is not easy. Difficult geography, low literacy rates and economic hardship all contribute to the population’s hesitation to seek care. Many fear the costs of healthcare or simply don’t know it is available. But even small efforts can change lives.
"As a healthcare professional working in this region, I have witnessed firsthand the barriers and daily struggles these families face. These experiences have deeply motivated me to serve. Supporting these communities not only brings hope and healing to them -it gives my work its true purpose."
A Case Story Told by Our Local Partner
Ramita’s Journey from Mugu to Recovery
In the remote district of Jumla, access to healthcare remains a daily struggle for many. One such story is that of Ramita B.K., a five-year-old girl from Khatyad Ward 7 in neighboring Mugu district.
Ramita arrived at the outpatient department of Karnali Academy of Health Sciences (KAHS) unable to sit or walk for the past 7 days. After medical evaluation, our team made a provisional diagnosis of Guillain-Barré Syndrome (GBS) - a condition requiring urgent treatment with a medicine called IVIG (Intravenous Immunoglobulin). Unfortunately, neither the medication nor the necessary diagnostic imaging like MRI were available locally. The cost of treatment, around Rs. 70,000, was beyond the reach of her family and a transfer to a hospital in Kathmandu was financially and logistically impossible.
Ramita at the day of admission,
unable to sit or walk.
As healthcare workers deeply rooted in our community, we could not remain passive. I reached out to as many people as I could, sharing her case and asking for help. Luckily, a kind woman from Kathmandu, now living in Texas, responded immediately and generously offered to cover the cost of the medication.
Getting the medicine to Jumla became the next challenge. After a delayed flight and logistical hurdles, the medicine arrived just in time - stored safely along the way thanks to people who stepped in without hesitation. We began Ramita’s treatment the same day. It was the first case of Gullian-Barre syndrome that we wanted to treat in a rural setting, so we were also worried and a little anxious at the time, but we had no other options. Within a week, she was able to walk again, and happily greeted me Namaste whenever I visited ward.
She stayed with us for 15 days. Her care, including accommodation and food, was covered through our hospital’s social service unit. After discharge, I followed up three months later - her father told me she now walks to school on her own.
After the 4th day of IVIG treatment, Ramita can walk on her own.
This experience reminded me how difficult life can be for families in Karnali and Mugu. I wondered why the government health service could not reach the target population. There must be a funding opportunity for medicines and treatment of rare diseases that could also save their lives. But it also showed what is possible when people act out of compassion and solidarity. One person’s help, combined with local commitment, changed a child’s life.
Ramita's story reminds me that we can achieve so much when we work together. It inspires me to keep fighting for better access to healthcare in remote areas. Even small acts of kindness can create a glimmer of hope. And sometimes that's all it takes to save a life. I am very thankful to the person who helped the child. Ramita's smile now motivates us to stand up for those in need. It inspires us to continue working towards a future where no one faces such struggles alone and to pass on the help of people with a good heart directly to those who need it.
Ramita's story also reminds us at mates4health why we support dedicated local health professionals - those who deeply understand their communities, act with compassion, seek practical solutions and tirelessly advocate for those in need.
We thank Dr. Kamal for sharing Ramitas story with us.
Our local partner
Dr. Kamal Prasad Thani, MBBS, MD Pediatrics
Based at Karnali Academy of Health Sciences (KAHS) in Jumla, Nepal, our local partner has been serving the region since 2013, committed to improving access to healthcare in one of the country’s most remote areas.
“I want to work as a local partner for mates4health to help bring positive change to underserved communities and support people in leading healthier lives.”
Be the change that you wish to see in this world.
Mahatma Gandhi
mates4health e.V. is a non-profit organisation (VR 210361). All Rights Reserved.
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