Khadaga Bahadur Giri, 50, from Dolakha, suffered an injury on the right leg, requiring surgery. But he could not go to Kathmandu for financial reasons, a representative example of people living in rural Nepal.

Under-resourced and poorly managed health systems in countries like Nepal pose challenges in achieving universal health coverage. One big challenge is the lack of specialist doctors and nurses in a rural setting. An innovative strategy to overcome this would be to promote General Practitioners (GPs) through training to help them to provide the comprehensive care needed by our patients there.

GPs provide whole-person care, working in partnerships with patients, nurses, allied health professionals and specialist colleagues. A GP knows the limitations of his skills and experience and understands when and where to enlist the most appropriate help, support and advice from colleagues.

They have broad skills and knowledge base that allows them to synthesise the treatment plan for the whole person. Given the changing demography of our patients and their need for holistic care, more generalist care in the specialities is needed. A critical role is emerging for GPs to work with specialists in our hospitals to provide high-quality and sustainable patient care.

In Nepal, there are several organisations that are working to promote GPs and their skills. One of them is Nyaya Health Nepal, which works in Achham and Dolakha districts. But the healthcare system lacks so many things. One of them is orthopaedics services. These services are being provided in both districts through the training and guidance of orthopaedic surgeons. To promote such services in countries like Nepal, an INGO, SIGN Fracture Care International, has been providing surgical equipment to local organisations like Nyaya Health Nepal. Giri underwent the operation that he needed at Charikot, performed by an orthopaedic surgeon and GPs, for free.  Continuous training of GPs to impart more advanced skills is required to transform the way healthcare has been delivered to the poor and marginalised people. The ultimate aim should be to improve and transform the healthcare system in rural Nepal.

General Practitioners with limited surgical training can play a significant role in providing surgical services in rural Nepal. With additional training, these GPs can be critical in serving rural areas of Nepal.