Healthcare & Hospital

Nepal has two healthcare systems running in parallel. Public hospitals are inexpensive and overwhelmed; private hospitals are fast, well-equipped and still cheap by international standards. Most residents use both - public for serious surgery and specialist departments, private for anything they want seen this week. Knowing which to walk into is the difference between a morning and three days.

Public and private

Government hospitals carry the specialist depth. Bir Hospital in Kathmandu is the country's oldest, Tribhuvan University Teaching Hospital in Maharajgunj handles complex cases, and Patan Hospital has a long-standing reputation across the river. They are cheap, sometimes nearly free, and busy in a way that is hard to overstate. Queues start early and departments work on a first-come basis.

Private hospitals - Grande, Norvic, Mediciti, B&B and others - run on appointments, have shorter waits and English-speaking staff, and charge accordingly. For a foreign resident or a middle-income Nepali family, private outpatient care costs a fraction of what the same consultation costs in Europe or North America.

	Public	Private
Outpatient consultation	Very low, often under 500 NPR	800 – 2,500 NPR
Waiting time	Hours, same-day queue	Usually same or next day by appointment
Specialist depth	Strongest for complex cases	Good, varies by hospital
English spoken	Variable	Generally yes
Payment	Upfront, cash common	Upfront, cards usually accepted

The hospital directory lists the main institutions with addresses and departments.

How a visit actually goes

The pattern is consistent across both systems and catches people out the first time. You register first at a counter, pay a small registration fee, and receive a file or card. That file is yours to carry - hospitals do not generally hold your records for you, and bringing it back saves repeating tests.

Diagnostics are usually a separate counter and a separate payment. Pharmacy is a third. You will move between windows more than you expect, and each step wants its own receipt.

Keep every piece of paper. If you intend to claim on insurance, the receipts and the doctor's notes are the claim.

Pharmacies and medicines

Pharmacies are everywhere, open late, and staffed by people who are genuinely helpful. Many medicines that require a prescription elsewhere are available over the counter here, and generics - largely from India - are inexpensive.

Two cautions. Bring a photograph of the packaging of anything you take regularly, because brand names differ and the active ingredient is what you need to match. And for anything long-term or serious, get a local doctor's prescription rather than self-managing from a counter conversation.

Insurance

Nepal operates a government health insurance scheme that Nepali citizens can enrol in, and private insurers offer policies alongside it. Employer cover is increasingly common in formal-sector jobs - see jobs and career.

The thing to understand regardless of policy: most hospitals expect payment at the time of treatment and leave you to claim it back. Direct billing arrangements exist but are the exception, not the rule. Budget for being out of pocket first.

If you are not a Nepali citizen, cover works differently and travel or expatriate policies have their own rules about where you can be treated. Healthcare for foreigners and insurance cover that properly.

Emergencies

The national ambulance number is 102, and private hospitals run their own ambulance lines that are often faster in the valley. In practice, for anything urgent in Kathmandu, a taxi or a private ambulance to the nearest capable hospital is frequently quicker than waiting.

Blood is worth knowing about in advance. Nepal operates largely on a replacement system - when a patient needs blood, the family is asked to arrange donors. If you have no family network here, say so early so the hospital can work with the blood bank.

Emergency has the full list of numbers and what to do first.

Altitude and travel medicine

Altitude illness is a genuine clinical issue in Nepal, not a trekking footnote, and a small number of clinics specialise in it. CIWEC in Kathmandu has decades of experience with travel medicine, altitude and the infections visitors actually get. If you are heading above 3,000 metres, a consultation beforehand is cheap and sensible.

Routine travellers' complaints - stomach infections, respiratory problems in winter air - are common and well understood by any local doctor.

Where this goes wrong

• Walking into a public hospital at 11am expecting to be seen. Registration queues start early and close.
• Losing the file. It is your medical record. Without it, tests are repeated at your cost.
• Assuming insurance will be billed directly. Almost always you pay, then claim.
• Treating a pharmacy as a diagnosis. Excellent for refills, not a substitute for a consultation on anything persistent.

Where to go next

For a serious condition, start with the hospital directory and pick on department rather than reputation. If you are new to the country, life in Nepal covers the winter air quality that drives a lot of first-year respiratory complaints.

Choosing where to go, by situation

The system rewards matching the facility to the problem, and the mismatch is what costs money and time.

A pharmacy for a minor complaint. Pharmacists are knowledgeable and will advise, and it is faster and cheaper than a consultation.

A local clinic or a polyclinic for ordinary illness, a wound, a test.

A private hospital for anything needing imaging, admission or a specialist, and for speed. This is what most foreign residents and insurers use.

A teaching or government hospital for complex and specialist care, where the expertise is concentrated and the queues are longest.

An emergency department for a genuine emergency, going directly rather than waiting for an ambulance if you can move safely.

Ask what a consultation and any test will cost before agreeing to it. Prices vary between facilities for the same procedure, and asking is normal.