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Considerable progress has been made in the area of cardiac surgery and the cardiologic treatment of heart disease over the years in Nepal, but there are still key access and affordability issues for patients to obtain much needed care. Since the establishment of two major cardiac surgery centers, the Shahid Gangalal National Heart (SGNHC) and the Manmohan Cardiothoracic Vascular Heart and Transplant Center (MCVTC), both under the guidance of Dr. Bhagawan Koirala; a Nepali surgeon who received adult cardiac surgery training in the United States , pediatric surgery training in Canada and an active board member of the Jayanti Memorial Trust; with a combination of his work and the work of other Nepali surgeons, many of whom he trained, the volume of cardiac operations is now close to 3000. But, there still continues to be a lack of access, availability and affordability of care in a country of 26.6 million people with a high incidence of rheumatic heart disease. This is where the Trust steps in to render aid to the indigent populous, whether it is in the form of medicine, devices or disposables etc.