Michael Griesbaum is right to question whether health in Mugu is as far behind that in Kathmandu (Letters, #183) as I asserted in 'Diagnosing Nepal' (#182). Since there is no registry of vital events in Nepal, life expectancy statistics are estimates at best. The numbers were taken from the recent census and reported in District Drug Use and Health Profile 2002 published by INRUD. Infant mortality is also considered highest in Mugu, so these data are consistent. Griesbaum might take solace from knowing that the gap in the USA is over 40 years (as reported in 'US Patterns of Mortality by County and Race: 1965-1994' published by the Harvard School of Public Health). Shame on us all, everywhere.

Stephen Bezruchka,
University of Washington