Situated north of India along the Himalaya Mountains, Nepal often conjures up images of mystical temples and majestic mountain peaks. But Nepal is one of the poorest and least developed countries in the world. About the size of Arkansas, less than 25% of the land is arable. More than a third of the country’s estimated 30 million inhabitants live in poverty. Nepal ranks 145th out of 179 countries according to the Human Development Index, used by the United Nations Development Program. The adult literacy rate is 54%. Nepal has a high infant mortality rate, and a life expectancy of 58 years. The predominant religion is Hinduism, practiced by 86% of the population. Buddhism comes second at 8%.
Even though democratic systems were established in the 1960’s, the royal family regained its lost political power and—contrary to the wish of common people—dismissed the government cabinet, banned political parties, and eventually dismissed parliament. A thirty-year, single-party autocratic 'panchyat system' prevailed until a strong pro-democracy movement emerged again in the 1990s. In 1996 a "Maoist" armed insurgency erupted and lasted until 2006.
The people’s movement that took place in early 2007 successfully dethroned King Gyanendra and Nepal was declared a secular republic state. In mid-2007 a Comprehensive Peace Accord (CPA) was signed between the rebellion and the government. An election for the constituent assembly was held in May 2008 to draft a new constitution for the country. However, this mission has faced unprecedented hurdles due to the lack of inter-party cooperation and competition for power. The failure to make inter-party political consensus, especially between major 3 parties, has led to a longer period of transition, uncertainty, and fragile governance.
Hemophilia in Nepal
An estimated 3 thousand people live with hemophilia in Nepal, but only 339 have been identified and registered so far. Most are poor and do not have access to education, health, or employment.
Factor concentrates, the mainstay of treatment, is expensive and beyond the reach of most Nepalese. The government does not purchase factor and has not as yet responded to campaigns aimed at changing this policy. Patients therefore depend on cryoprecipitate or donated factor.
Nepal Hemophilia Society (NHS) was formed by a volunteer group of patients with bleeding disorders and parents in 1992. It aims to provide comprehensive care to person with haemophilia (PWH) and to unite them into a community motivated for self-help and mutual support.