The mountains have always called to the soul of Nepal. Their peaks pierce the skies like ancient prayers, silent yet profound. For most, a trek through the Manaslu Circuit is a dance with nature's raw magnificence-a pursuit of solitude, spiritual awakening, or physical challenge. But for a small team of health workers who set out on a nine-day journey from Chaitra 16 to 24, 2081 (March 28 – April 5, 2025), the trail became something else entirely.
It became a mission of care, a pilgrimage of healing.
The Call to Serve
Twelve of us answered the call to serve and explore. At the heart of our journey was the quiet yet resolute leadership of Mr. Krishna Dhakal who himself is a former Public Health Officer, Government of Nepal not only led the group but took on the immense responsibility of planning and coordination. From the very first day of conception - back in Kartik, five months prior - he dedicated himself to shaping the itinerary, managing team logistics, and ensuring seamless arrangements for lodging and fooding at every stop along the trail. Our group included senior physicians, orthopedic surgeons, medical officers, and selfless volunteers. Among them was Dr. Gun Raj Lohoni, a Former Additional Secretary, Ministry of Health, Government of Nepal and veteran MDGP; my colleague Dr. Shankar Sigdel, an orthopedic surgeon like myself; Dr. Amor Lohoni, a young and driven medical officer; and myself, walking not as an administrator or surgeon, but as a son of the mountains. We were nutured and guided by a dedicated group of health workers, Rotarians from Rotary Club of Gorkha, and social workers who played an instrumental role in community engagement and logistical coordination. These included: Krishna Prasad Dhakal, Kiran Shrestha, Amrit Bogati, Som Bahadur Koirala, Kamal Pokharel, Subash Malla, Hariman Basnet and Badri Gartaula.
Our sincere gratitude also goes to Mr. Parichit Adhikari, a well-known social worker and businessman from Arkhet Bazaar, whose invaluable support helped us connect effectively with Upper Gorkha's remote communities. His coordination and network smoothed many difficult paths-both literal and logistical.
Together, our shared goal was simple yet profound: to deliver essential healthcare services and assess the health infrastructure of remote Himalayan villages - bringing medical attention to areas where it is often difficult to access.
Our backpacks held more than clothes and gear-they were filled with essential medicines, instruments, and hopes. Ahead of us lay narrow trails, high passes, frozen rivers-and people waiting quietly for care, perhaps not even knowing we were coming.
First Steps and First Touch
The journey began with a heartening visit to Dharche Basic Hospital, where Dr. Sherman Gurung and team welcomed us with the warmth of an old friend.
The hospital, modest but organized, radiated possibility. There is something moving about walking into a rural hospital and finding it alive-not just in function, but in spirit.
Later that day, we reached Jagat, where the Community Health Unit awaited. We set up a spontaneous health camp, and within hours, 25 villagers, most of them elderly, arrived with ailments worn like old scars. Acid reflux, breathlessness, aching knees, persistent coughs-simple things made complex by the absence of regular medical care.
At Sirdibas, word had already spread. People arrived in the evening, in slippers and woolen caps, seeking a doctor not in a white coat, but with a torch in hand and compassion in his eyes.
Beyond the Trail - Into Their Lives
Every village we passed through-Philim, Gaap, Namrung, Lho, Shyalla-added a new layer to our understanding of mountain life. We weren't just walking; we were witnessing, learning, and healing.
In Shyalla, we paused for more than just rest. The altitude here demands reverence. It also demands knowledge. Our team held an awareness session by Dr. Gun Raj Lohoni about Acute Mountain Sickness -how to recognize it, respond to it, and not underestimate it. This was not just for trekkers, but for porters, guides, and villagers, whose livelihoods depend on endurance at unforgiving heights.
At every stop, the faces we saw bore the same truths: lack of equipped health posts, dependency on traditional healers, and long-lost follow-ups due to roads that never arrived. People weren't just sick; they were disconnected from the very systems meant to heal them.
Samagaun: The Village That Waited
Somewhere beneath the mighty gaze of Manaslu, lies Samagaun-a village whose beauty defies words and whose people carry generations of wisdom in their eyes. Health Assistant Kamana Koirala had informed the villagers in advance, and when we arrived, we were greeted not with ceremony, but with trust.
More than 30 patients came that day. They came with faith-faith that the doctors who walked days to reach them had not done so in vain. We treated APD, chest infections, chronic pain, fatigue, and more. For every diagnosis, there was also a conversation, a moment of education, a seed of empowerment planted in a language that went beyond prescriptions.
Dharmashala to Bhimtang: When the Night Became a Clinic
The higher we climbed, the thinner the air-and the more acute the needs. At Dharmashala, perched at nearly 4500 meters, the cold was biting, and so were the symptoms of altitude sickness. That night, we treated porters and guides who had fallen ill. It wasn't dramatic medicine-it was kindness, vigilance, and timely care that got them back on their feet.
The next day, after crossing the awe-inspiring Larke La Pass (5106m)-a place where the heavens seem close enough to touch-we descended into Bhimtang, Manang. Just as we were settling in for a warm meal, the local mothers' group came to us in the dark, seeking help. Tired though we were, our team responded. We treated eight women that night, offering comfort and care beneath the stars, far from any hospital.
What We Learned in Silence
Our trek was not just a journey across geography-it was a passage through Nepal's rural health landscape. What we saw demands reflection:
Despite being a highly rural area, there was notable availability of basic medicines-thanks to the support of the Provincial Health Office, local rural municipalities, and various NGOs and INGOs. However, the health posts still lacked proper equipment and adequately trained human resources. Despite the presence of physical infrastructure, this gap in technical capacity continues to limit effective service delivery.
Most of the patients we encountered were elderly, burdened with chronic conditions such as acid peptic disorders and respiratory illnesses. Sadly, there is little to no long-term care available for them.
Modern medicine is largely absent-not because people prefer traditional healing, but because it is their only option. The reliance on age-old remedies stems more from necessity than from belief.
Transportation remains a formidable barrier. Many patients who should be under regular follow-up at the Province Hospital in Gorkha are unable to make the trip due to financial constraints and logistical challenges.
During our observations, it also became clear that there is a significant lack of institutional deliveries in the region. This gap is driven both by the challenging landscape and deep-rooted cultural practices. As a result, many women continue to give birth at home, without skilled birth attendants, increasing the risks to both mother and child. Promoting institutional deliveries through nearby birthing centers-with strong community awareness and the support of local governments and municipalities-can make a crucial difference. Such efforts will not only save lives but also contribute meaningfully to Nepal's national goal of reducing the maternal mortality rate (MMR).
And yet, amid these hardships, nature offers its own remedies. The people of Upper Gorkha enjoy fresh and healthy food, drink pure water sourced directly from the mountains, and engage in regular physical labor in the crisp mountain air. This combination has granted them a natural resilience that urban dwellers may have long forgotten.
Ruila Naka: A Border Beckons
Our visit to Ruila Naka, the Nepal-China border point, was surreal. There, where the prayer flags flutter in cold silence, lies a geopolitical boundary often forgotten. But to stand there is to be reminded that Nepal's mountains are not just topography-they are guardians of identity, culture, and sovereignty.
This border is more than a place-it is a must-visit for those seeking to understand Nepal's edges, not just on the map, but in meaning.
A Trek Becomes a Testament
By the time we descended through Tilche, Goa, and Dharapani, we were changed. We had crossed rivers and mountains, but more importantly, we had crossed into the lives of strangers and left behind healing.
This wasn't just a trek.
It was a journey of purpose. A reminder that a stethoscope in a backpack and a kind word on a mountain path can matter just as much as a surgery in a city hospital.
Let Us Walk With Purpose
To fellow doctors, adventurers, and youth of Nepal:
Travel. Explore. Serve.
There is magic in our mountains - not just in their beauty but in their people. Let's make internal tourism a movement. Let's turn our holidays into missions, and our treks into tales of transformation. Health is not just a hospital-based service; it is an outreach of humanity, especially where the road ends, and trails begin.
To every reader of this story, I say: Let us rediscover Nepal not only with our eyes, but with our hearts and hands.
Walk the trails not just for photos, but for connection. Pack a little medicine, offer a little service. You don't need to be a doctor to listen, to help, or to uplift.
There is healing in walking. And there is hope in walking with purpose.
So, the next time the mountains call-answer not just as a traveler, but as a giver.
Because sometimes, the most meaningful journeys are not the ones that change us, but the ones where we change something for someone else.
Khanal is an orthopedic surgeon and Medical Superintendent at Province Hospital Gorkha
