A ventilator ‘bank’ where hospitals can rent critical care machines for Covid-19 patients has given Nepal's cash-strapped healthcare system a much-needed lifeline.

The Himalayan nation, like its South Asian neighbours, experienced a spike in infections in April and May with hospitals overwhelmed and medical supplies running low.

As the infectious disease started to spread across the impoverished nation a year ago, Nepal only had 840 ventilators for a population of nearly 30 million, according to government data.

Most of the ventilators -- needed to help severely ill Covid-19 patients breathe -- were in the capital Kathmandu, leaving regional and rural hospitals vulnerable.

While daily infections have since declined from a peak of more than 9,000 cases in mid-May, authorities say hospitals remain under pressure.

But Nepal Ventilator Services, a non-profit that has bought 85 of the machines through donations since the start of the pandemic last year, has helped to meet the surge in demand.

‘Nepal is chronically, insufficiently equipped with machines like ventilators,’ the group's co-founder, 42-year-old doctor Bishal Dhakal, told AFP.

‘It does not have even required numbers, which is about 2,000 to 3,000 machines for a 30-million population of Nepal.’

The heart surgeon turned general practitioner reached out to donors for funding in April last year and money poured in, allowing the organisation to buy 20 ventilators to rent out to hospitals at cost.

Bhim Hospital in the country's south, which had one ventilator, loaned two from Dhakal's group in August for three months.

‘Our patients needed ventilators but we did not have enough budget to immediately buy any,’ the government hospital's medical superintendent, Shakuntala Gupta, told AFP.

‘The bureaucratic process for an approval is also long.’

- 'Rescued us' –

Since then, the ventilators have been used for nearly 1,500 patients across the country.

Hospitals are charged 3,000 rupees ($25) per day to cover maintenance and transportation costs.

Karuna Hospital in Kathmandu, which has been renting eight ventilators since April this year, said the ‘bank’ was life-saving.

‘At the peak, almost every patient who was admitted in the ICU required ventilator support,’ the private hospital's chief executive, Ram Kumar Shrestha, told AFP.

‘If the ventilator 'bank' did not exist, the death rate would perhaps be beyond our imagination, not just here but in many places of Nepal.’

Laxmi Rokaya, 29, was struggling to breathe a week after she was infected in May.

Her brother, Kunsang Magar, was unable to find a spare ventilator in Kathmandu until they reached Karuna.

‘They (Nepal Ventilator Services) rescued us. I don't know if we would have found a ventilator without them,’ Magar told AFP, adding that Rokaya was placed on a ventilator for two days and released from hospital just over a week later.

Dhakal said all the organisation's 85 ventilators were loaned out during the peak.

The country has reported nearly 630,000 infections and over 8,900 deaths so far. Even as the second wave wanes, officials are concerned the third is around the corner.

Dhakal is working on increasing his ventilator stock and is training more people to operate the specialised equipment.

‘Hospitals can come to us for critical equipment that they might not need long-term,’ he added.

‘We (want)... to make sure the public has access to healthcare when in need.’