“Like a Yam Between Two Stones”: Remembering Healthcare at War in Nepal (1996–2006)


The Nepal civil war (1996-2006) opposed a rural Maoist insurrection and a succession of monarchical regimes and governments. Despite a shift in perception of the conflict post 9/11, the conflict remained largely internal to Nepal with limited international involvement. Over that same period, health indicators in most domains recorded significant improvements including in the areas most affected by the conflict. Building on human rights datasets of violent incidents and systematic oral history in three regions affected to varying degrees by the conflict, this article argues that the health care facilities were instrumentalized by both sides of the conflict as one element of their political and military strategy, while medical practitioners had to juggle the demands of insurgents and security forces. Through 80 interviews conducted in 2020-2021 in situ, this article engages with the apparent paradox of a conflict which did not have detrimental effects on health care overall despite its violence. It then considers how the war, violence and mental health consequences of a decade of terror are now recalled and made sense of some fifteen years after the end of the war. With the former insurgents now running the new republic, grassroots militants remember the war in sometimes nostalgic ways when it comes to their centrality in the Maoist objectives and vision. The healthcare provisions arising from the war sometimes do not match some of the wartime resources deployed by insurgents and counterinsurgents keen to demonstrate their commitment to health provisions as a common good that needed to be made more accessible. Finally, this article reflects on the absence of the concept of attacks on healthcare in contemporary analyses, at a time when the concept was gathering support internationally. In this sense this article charters a paradox of violence and resourcing of health care as well as a pre-paradigm shift analysis of a seemingly outmoded political insurgency.

This content is restricted to site members. If you are an existing user, please login. New users may click here to subscribe.

Existing Users Log In

About Bertrand Taithe

Bertrand Taithe is Professor of Cultural History at the University of Manchester and a founder member of the Humanitarian and Conflict Response Institute. He works on the history of humanitarian aid and of its representations. His most recent articles and books include L'Humanitaire s'exhibe—The Humanitarian Exhibition (Geneva, Georg, 2022) and "The Politics of Catholic Humanitarian Aid: Missionaries and American relief in Algeria 1942–1947," French History (2023). He is a co-investigator of the Researching the Impact of Attacks on Healthcare and Colonial and Transnational Intimacies projects, and Principal Investigator of the Wellcome Discovery Award "Developing Humanitarian Medicine: from Alma Ata to Bio-Tech, a history of norms, knowledge production and care (1978–2020)." For further details and the full list of publications see: https://research.manchester.ac.uk/en/persons/bertrand.taithe

About Bhimsen Devkota

Bhimsen Devkota is a professor of Health Education at Tribhuvan University of Nepal. He obtained his PhD in Public Health from the University of Aberdeen, UK. He is involved in various research works in Nepal, including South Asia. He is well-versed in researching and publishing on education, global health, health service research, and conflict and politics. He has published several articles on Nepal's conflict with a particular focus on health services.

About Louis Lillywhite

Louis Lillywhite is a Senior Consulting Fellow at the Royal Institute of International Affairs (Chatham House). Previously the Surgeon-General of the UK Armed Forces, he now works in global health. He was a member of the post 2016 Ebola WHO Committee, which reviewed the International Health Regulations and developed the Global Health Track (now Human Security) at the Munich Security Conference. He has written on health service provision by Non-State Armed Groups, the impact of weapons on civilian deaths in the Syrian conflict, attacks on healthcare and civilian-military relations; and, for WHO, has been researching the role of the military in pandemic preparedness.