In the physiotherapy ward at Katmandu's Bir Hospital, a middle-aged woman lay in bed, her back strapped to a big mechanical device. Rukmini Roka, 56, who suffers from chronic backache, struggled to stretch her legs as required by the special therapy machine.

"Sabai thik chha? Bistarai garnuhos (Is everything alright? Please do it slowly)," Yumi Ito, the young lady dressed in white standing by Roka's bedside, said in fluent Nepali as she helped her stretch her legs back and forth.

Visibly thankful for Ito's support, Roka responded gently in Nepali, her mother tongue and the lingua franca of this multiethnic but impoverished Himalayan nation encircled by China and India. "That's better and easier, but it still hurts."