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Nepal: the pain of stroke treatment
  1. Bikram Prasad Gajurel1
  1. Neurology, Maharajgunj Medical Campus, Tribhuvan University, Institute of Medicine, Kathmandu, Nepal
  1. Correspondence to Bikram Prasad Gajurel, Department of Neurology, Maharajgunj Medical Campus, Tribhuvan University, Institute of Medicine, Kathmandu, Nepal; bikram_gajurel{at}

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Nepal, a small country in the southern part of Asia (figures 1 and 2), is well known over the world for its magnificent natural beauty. Roughly about half the size of the United Kingdom (about 150 000 square kilometres), its rich geography ranges from the hot and humid tropics of the Southern Terai plains (figure 3) adjoining Northern India, to the high mountain range in the north adjoining Tibet, China. Perhaps Nepal’s best-known natural landmark is Mount Everest, the world’s tallest mountain at 8848 m (figure 4). Nepal is also the birthplace of Gautama Buddha, the founding father of the modern Buddhist philosophy (figure 5).

Figure 1

National flag of Nepal.

Figure 2

Map of Nepal (source: survey department of Nepal).

Figure 3

The plain Terai region of Nepal (courtesy Dr Arun Sedain).

Figure 4

Mount Everest (courtesy Dr Yogesh Subedi).

Figure 5

Lumbini, the birthplace of Gautama Buddha.

Despite its rich natural resources (figures 6–9) and several hundred years of cultural heritage, hidden among its majestic glories lies the poignant reality of challenges of providing good medical care in one of the least developed countries of the world. As in any other third-world country grappling with the processes of westernisation, stroke is common in Nepal and appears to increase every year. But Nepal has almost none of the skilled manpower and well-equipped facilities needed to deal with this common problem. For a total population of over 30 million, there are fewer than 20 trained neurologists and only a single stroke neurologist—almost all of them concentrated in the capital city of Kathmandu, with its population of …

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  • Contributors The author is solely responsible for the design, draft, revision and final approval of the work. The author agrees to be accountable for all aspects of the work.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Map disclaimer The depiction of boundaries on the map(s) in this article does not imply the expression of any opinion whatsoever on the part of BMJ (or any member of its group) concerning the legal status of any country, territory, jurisdiction or area or of its authorities. The map(s) are provided without any warranty of any kind, either express or implied.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Commissioned. Externally peer reviewed by Colin Mumford, Edinburgh, UK and David Simpson, Edinburgh, UK.

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