In the early 1960’s, a Ghurka soldier extended an invitation to a physician in the British Army to start a medical project in the Okhaldhunga district. From its humble beginnings as a small remote clinic, it has grown into a small community hospital with 45 inpatient beds and an active Public Health Unit. Nestled in a remote region of the foothills of the Himalayas due south from Mount Everest, the hospital is the only facility in Okhaldhunga district and additionally serves people in four surrounding districts, accounting for a population of more than 250,000 people. In comparison to other areas of Nepal, Okhaldhunga district is severely impoverished. A recent study by the community health team, found that less than 3% of all people in this district have any extra resources left after meeting the basic needs of feeding their family. This is also is an acute care general hospital. In 1951, the Nepalese monarch ended the century-old system of rule by hereditary premiers and instituted a cabinet system of government. Reforms in 1990 established a multiparty democracy within the framework of a constitutional monarchy. An insurgency led by Maoist extremists broke out in 1996. The ensuing ten-year civil war between insurgents and government forces witnessed the dissolution of the cabinet and parliament and assumption of absolute power by the king. Several weeks of mass protests in April 2006 were followed by several months of peace negotiations between the Maoists and government officials, and culminated in a November 2006 peace accord and the promulgation of an interim constitution. Following a nation-wide election in April 2008, the newly formed Constituent Assembly declared Nepal a federal democratic republic and abolished the monarchy at its first meeting the following month. The Constituent Assembly elected the country's first president in July.