Author: Rachel Neufeld, Nurse Practitioner, Canuck Place Children’s Hospice, Vancouver, Canada
In April 2026, I travelled to Nepal to learn how palliative care is developing across the country. This took me to various cities across Nepal, where I met physicians, nurses, hospital leaders, and community teams dedicated to improving care for patients with serious illness.
My visit revealed a country with strong leaders, motivated teams, and a wealth of good ideas. What is needed now is stronger communication, collaboration and shared learning across the sites.
Kanti Children’s Hospital – Kathmandu
Kanti is preparing to launch a new home‑visit program for PPC through the TWCC Catalyst Lab. I joined ward rounds with the team, and I joined the first home visit of the project. The visit went well, and the team identified areas to improve, and build on as they proceed with this pilot project.
Patan Academy of Health Sciences – Lalitpur
At Patan Hospital, Dr. Rateena Sreshta is working to bring palliative care into the pediatric ward. She hopes to train senior pediatric nurses to become PPC champions and I led a session on “Introduction to PPC” for the pediatric nursing staff. Plans are underway to start a PPC outpatient clinic and eventually create dedicated PPC beds.
Dr. Rajkumar continues to lead and support the palliative training program for community support workers with the aim of reaching every district in the area with PPC embedded within this course. The hospital has a well run adult palliative unit linked with Hospice Nepal, a free standing hospice with a new building currently under construction.
Bhaktapur Cancer Hospital – Bhaktapur
Led by Dr. Bishnu Shresthe and Sister Radhika Makaju, there is a 10 bed palliative unit and they consult throughout the hospital. The unit provides active symptom management and end-of -life care. The majority of patients are adults, though the team collaborates with the pediatric unit as needed. The team also conducts weekly home visits and hopes to expand telemedicine through their busy outpatient department.
BPKIHS – Dhara
Dr. Soniya Dulal is leading a new palliative care project for community care, supported by TWCC. She manages oncology patients both as in- patient and outpatient clinic, runs home visits, and is building a multidisciplinary team. I taught nursing students and nursing professors about palliative care; communication, symptom management and research. Although PPC is included in the curriculum, it is not actively being practiced at this hospital. Dr. Soniya is available to support the continuation of pediatric oncology care that is initiated at tertiary hospitals and will support families who choose end-of-life care for their child within their home community.
BPKMCH – Bharatpur
In Bharatpur, Dr. Krishna Sagar Sharma is integrating PPC directly into the pediatric oncology ward (24 beds), including dedicated beds for end of life care. He is building a multidisciplinary team including a dietician and family support worker. There are also 6 designated pediatric beds at the hospice house. A community home palliative care team provides visits once a week, operating from the hospice and a new hospice ward is currently under construction. I was able to meet hospital directors to continue to advocate for the growth and expansion of palliative care here and in the community.
Green Pastures Hospital – Pokhara
Dr. Amritha Shrestha provides palliative care and developmental pediatric services. They run camps for children with neurodevelopmental conditions and offer day‑care activities. She and Senior nurse Mahima, are keen to be a part of a pediatric palliative care network in Nepal and help build training capacity for nurses in palliative care across Nepal.
Lalgadh Hospital – Lalgadh
Lalgadh cares for many patients with leprosy and other chronic conditions. They already have a strong multidisciplinary team, and could further benefit from a structured palliative approach to pain and symptom management (PSM). I taught a session on leprosy pain assessment and management and encouraged the use of standardized pain assessment tools. Sister Manju hopes to establish a PSM outpatient clinic and recognizes the need for a dedicated coordinator to integrate the different services.
A Country Ready to Work Together
Across Nepal, I met many skilled and dedicated providers who, if connected more intentionally, could support each other and form a collective to train others and strengthen palliative care across the country.
The new Rix Faculty includes leaders from centres across Nepal, and is a promising way to build these connections. The group convened for their inaugural meeting together during my visit. Members are interested in sharing clinical experience, developing training programs for palliative care in Nepal, supporting research and learning from each other’s strengths.
Nepal has the talent and motivation to grow palliative care training and leadership. With continued partnership and stronger national networks, the country is well‑positioned to build a more connected and sustainable palliative care system for both children and adults.
