Challenges facing a new prehospital care service in the developing world: the Nepali Ambulance Service (NAS)

Introduction Prehospital trauma systems have been shown to significantly reduce mortality in resource limited areas[1]. Nepal has an annual per-capita health expenditure of $30[2]. In 2012, the first professionally trained, non profit Nepali Ambulance Service (NAS) began operations with five ambulances. It is a non-profit initiative in Kathmandu valley aiming to deliver rapid ambulance transport and medical care for all patients. This case study aims to document the challenges experienced by the directors and technicians responsible for implementing this novel service, with a view to sharing their experiences with organisations developing prehospital care systems in similar regions.