International Activity Report 2004
Nepal

International staff: 10
National Staff: 24

Assisting civilians trapped by conflict

In Nepal, chronic political instability has made it difficult for patients to receive care in a weakened health care system already hindered by poverty and insufficient medical personnel and supplies. For years, government and insurgent groups have vied for control of this mountainous kingdom, creating a bloody civil conflict in which all forces target civilians. In August 2003, the most recent ceasefire in Nepal was broken, further diminishing MSF's ability to bring aid to the Nepalese people. MSF works in the Rukum district of midwestern Nepal, where living conditions are precarious because the national army occupies the district capital and Maoists hold the surrounding rural areas. Most of the approximately 200,000 people who live in the mountainous region are indigenous farmers. Since February 2003, MSF has run the district hospital in Rukum, carrying out approximately 900 inpatient and outpatient consultations each month. MSF has rehabilitated some hospital wards, the laboratory and the waste area. MSF staff members also treat 70 people with tuberculosis in the hospital. In 2004, MSF conducted mobile clinics in Maoist-controlled terri tories where access to health care is almost nonexistent.

MSF facilitates airlifts to Nepalganj in southern Nepal for patients needing surgery, in an effort to make urgently needed care more accessible. Although this assistance helps the critically injured, most Nepalese must walk for days to reach the nearest heath post.

In March 2004, MSF ended its activities in Jumla, a district in Karnali zone, located in mid-western Nepal. The organization had begun to rehabilitate health posts in Jumla as part of a general health project, but pressure from both sides of the conflict made the work impossible. MSF was forced to withdraw from the district after local authorities asked MSF to suspend its activities in January 2004.

MSF has worked in Nepal since 2002.