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According to UN statistics (the UNDP Human Development Index, report/ratio 2004) 42% of the Nepalese population (26 million inhabitants) live below the poverty line (US$ 1 a day) and 86% live with less than US$ 2 a day. The annual income per capita is US$ 240 in 2005 (in Western Europe and North American, the average is one hundred time greater).

The most backward districts of the mid-west and far-west have annual incomes per capita of US$ 100, this less than half the national figure. In certain parts of Nepal, especially in the mountainous areas, life expectancy is 42 years on average, with an illiteracy rate of 63%. The national average is 59 years with a illiteracy rate of 49%. During the Nepal Development Forum in February 2002, international donors allocated an annual assistance of US$ 500 millions for 2 years. Despite everything this country is still the poorest of Asia.

A) Economy

Nepal is among the poorest and least developed countries in the world with 42% of its population living below the poverty line. Agriculture (rice, wheat, maize, tea, jute) is the mainstay of the economy, providing a livelihood for over 80% of the population and accounting for 40% of GDP. Industrial activity mainly involves the processing of agricultural produce including jute, sugarcane, tobacco, and grain. Textile and carpet production, accounting for about 80% of foreign exchange earnings in recent years, contracted in 2001-02 due to the overall slowdown in the world economy and pressures by Maoist insurgents on factory owners and workers. Security concerns in the wake of the Maoist conflict and the September 11, 2001 terrorist attacks in the US have led to a decrease in tourism, another key source of foreign exchange. Since 1991, the government has been moving forward with economic reforms, e.g., reducing business licenses and registration requirements to simplify investment procedures, reducing subsidies, privatising state industries, and laying off civil servants. Nepal has considerable scope for exploiting its potential in hydropower and tourism, areas of recent foreign investment interest. Prospects for foreign trade or investment in other sectors will remain poor, however, because of the small size of the economy, its technological backwardness, its remoteness, its landlocked geographic location, and its susceptibility to natural disaster. The international community's role of funding more than 60% of Nepal's development budget and more than 28% of total budgetary expenditures will likely continue as a major ingredient of growth.

B) Social and sanitary data

The cast system is still present in the country and a strong discrimination towards women is still to be seen. It is indeed one of the rare countries in the world where the life expectancy of women is inferior to men (WHO figures: 57,9 as opposed to 58,6). This difference is partly due to a high mortality rate while giving birth and a strong discrimination towards women in their access to the health system. This mortality is one of the highest in the world with 575 deaths per 100,000, which is equivalent to 120 times the French rate. Moreover, the literacy rate of these women does not exceed 14% according to the CIA worldfactbook 2000.

Mostly rural, the different populations generally live in poor life and shelter conditions. Only 20% of the houses in Nepal have sanitary facilities and thus the water supplies are often contaminated by used water, increasing the number of people affected by gastro-intestinal illnesses.

The public spending for health issues per inhabitant is US$ 5 per year, with US$ 2 for medicine. In average, there are 5 doctors and 30 hospital beds for 100,000 people. In the hill district, the number of doctors does not exceed 1 or 2 per 200,000 inhabitants.
16% to 25% of child mortality is due to diarrhoea and dehydration (in the gastro-intestinal affectations, we can add parasitism, gastritis...) and respiratory affectations are the cause of 30% to 40% of child mortality: acute respiratory infections (ARI: acute respiratory insufficiency, such as bronchitis, pneumonia, tuberculosis). Child mortality represents 73/1000.

In Nepal, 400,000 to 800,000 traditional healers can be found (approx. 1 for 6 families), who heal more than half of the total population. This traditional medical system has been officially recognized by the World Health Organization as an efficient way to treat a lot of chronic illnesses such as respiratory and digestive infections, anaemia and depression. The healer use traditional plants that have been identified by pharmaceutical laboratories as effective medicine.

This project is not meant to question the efficiency of both western and traditional medicine, but to identify their benefits and their respective limits.

Concerning more specifically the area where we work:

Teraï is a frontier strip of land with India which constitutes the end of the Gangetic plain before the beginning of the "hills", mountains which can reach 3,000 meters. About half of the Nepalese population lives on this fertile territory that is the valley of Kathmandu. This area has maintened both its agriculture and its trade with India, and can be regarded as not being one of the priority zones to establish a development programme, but this is not the case. The region is confronted with multiple local problems such as very strong demographic growth, deforestation and overexploitation of the land, and a social system strongly exacerbated by the discriminatory caste system. On top of which there are the national problems of a Maoist guerrilla war and a total deficiency of the quasi non-existent and under financed authorities. All thees problems have dramatic effects on the medical and educational system.