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Half a century ago, sickle-cell genes made the indigenous Tharu people robust against falciparum malaria. But their present-day descendants are paying a health penalty.

Nepal generalSubesh raj kayasthaPratima chaudharyChhatra karkiPhanindra prasad baralRajan pandeyChhatra karki pratima chaudharyRajan pandePrabhuram chaudharySickle cell anaemia society nepalDisease control divisionMinistry of healthDepartment of health servicesMental health sectionGeruwa rural municipalityBheri hospital