Karnali is one of the least developed provinces in Nepal. It is located on the edge of the Himalaya, bordering with Tibet in the north. A total of 36.5% of the population live below the poverty line (UNDP 2018). Back to Life is working in Mugu District, which is amongst the poorest and most remote areas in the world.

In Mugu, approximately 55,000 people live in small communities that are scattered in a mountainous area of 3,500 km². Despite recent progress in the construction of roads, most of these communities are still cut-off from modern civilization and can only be reached by tackling long strenuous mountain tracks. The communication network is very limited and the use of technology very low to none.

Families lack basic supplies, such as clothing, safe drinking water, and electricity. Many of them are even struggling to bring enough food on the table to feed their children. Due to the extreme high-altitude climate and scarcity of arable land, the local food production stays far behind what could be considered a healthy diet. In fact, many children and adults suffer from malnutrition, which significantly reduces productivity, as well as cognitive and physical development. 

Importantly, medical care is one of the worst in the world: one single hospital in Gamgadhi is responsible for more than 55,000 people. Yet, often neither medicine nor doctors are available, so that even curable diseases can lead to death for the patients. The precarious health status in the area is further impacted by very poor hygiene and sanitation, which is linked to many preventable and even fatal diseases. An illiteracy rate of almost 50 percent indicates the extremely low level of education in Mugu.

Many families struggle deeply and survive on a day-by-day basis, often with no hope for change. Their possessions are sparse and the few things they have are usually tattered or broken. Most people live with only one set of clothing, which they wear all year round, and no shoes - even though during winter it gets bitterly cold and the villages become covered in snow.

The tools people use to work on their family plots are mostly hand-made, like most things in Mugu. As such, also construction works are still done through manual labour only. Materials are either transported by people carrying heavy loads or with the help of donkeys. There are hardly any machines available in these remote mountains.

Families live with an open fireplace in their homes, which they use as a source of heat and light, and, of course, for cooking. Women and children collect the firewood for hours every day and carry it back to their homes. At night, the family sleeps on the ground around the fireplace. Most homes have just one room and are built right next or above the cow shed. The flat roof is used for agriculture and serves as working and storage space as well.

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