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).

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 …