No one at Chautara hospital who lived through that night of terror exactly a year ago can still speak about it without a trembling voice.

A Maoist force estimated at 1,000 used the hospital to attack an army base guarding an adjacent telecom tower. The first shots were fired just after 9PM on the night of 23 April 2006, a day before King Gyanendra restored parliament after three weeks of nationwide protests.

The Maoists tried to break into the army base using the hospital's corridor. But this was directly in the line of fire of a sandbagged bunker with an army machine gun post. The noise was deafening, bombs were going off and bullets were ricocheting off hospital equipment.

The Maoists evacuated patients from the wards, but a father who was looking after his sick son was killed when a bomb demolished their room and both were buried in the debris.

"There were bodies everywhere, the Maoists were using the maternity clinic as their armoury and had set up a triage down the hall," recalls Nanda Lal Sikarmi, who was in charge of the hospital. Like everyone else in Chautara that night, the doctor hid under his bed wide-awake and terrified till dawn.

The fighting subsided a bit at about 1.30 AM when a helicopter circled overhead, but resumed soon after. At the army base, Lieutenant Bhan Bahadur Airi had trained his men to conserve ammunition and they took turns firing as others reloaded ammo clips.

"After the helicopter flew back and they started running low on ammunition, the boys were really scared," Airi recalls, "they wanted to use rocket propelled grenades to fire at the hospital but I couldn't allow it because of the fear of civilian casualties."

Given the intensity and duration of the firefight, it is surprising that only three patients in the hospital and one soldier were killed. Six Maoist bodies were found the next morning but eye-witnesses saw dozens of dead guerrillas being taken away down the mountain.

The next morning the hospital looked like the war zone that it was. More than 500 improvised explosives littered the wards. The operation theatre, maternity ward, and main corridors were destroyed. There was blood all over the floor where the Maoists treated their wounded comrades.

"I just wish we never have to see such violence again," Sikarmi told us last week showing us his bullet-ridden blood pressure gauge. The doctor is determined to push through with an ambitious reconstruction and expansion of the hospital. The Rs 80 million project will turn this into a full-fledged district hospital with an OPD block, a TB section, paediatric department, and a fully-equipped maternity ward.

Even without the conflict and despite its proximity to the capital, Sindhupalchok has maternal and child mortality rates higher than the national average. Nearly 90 percent of all deliveries are still carried out at home, and this week the OPD was full of children with stomach and chest infections.

The army says it had been trying to get the telecom tower moved because of the proximity to the hospital and its vulnerability to attack. Doctors at the hospital had been unsuccessfully trying to get the army to move its observation post from its roof and human rights groups had been critical of the military using the hospital as a sentry point.

The Maoist motive may have been to stage a strategic victory over a district headquarter at a time when a people power uprising was reaching a climax in Kathmandu. For local Maoists it was revenge for the army's helicopter raid in Thokarpa the previous month in which Maoist commander Agni Sapkota narrowly escaped being killed. Thokarpa itself was supposed to be a Maoist victory commemoration for the killing of 13 soldiers in an ambush in Kabhre a few weeks previously.

Chautara got a lot of publicity with the arrival of international media the next morning from Kathmandu but the battle was soon overshadowed by the dramatic events in Kathmandu the next day and the king's restoration of parliament.
As Sikarmi showed us the ruins of his hospital, he said: "This is a symbol of the waste of war, but we were lucky this was the last battle before peace was restored. Now we can rebuild."