Nepal's extreme physio-geography, uneven distribution of houses and villages, differences in rural, urban living systems promotes the water crisis.  Water is usually available in rural river valleys, but particularly the livelihood of villages sitting on the upper parts of the hills are highly affected by scarce water availability.

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 Nepal is a landlocked country with an extremely challenging landscape.  Many people must make long, dangerous journeys to reach water sources.  In the rural lowlands and the mountains, the distance to water sources is great and water supplies are often polluted with naturally occurring arsenic.  Open defecation also spreads diseases across living environments.