Green Pastures Hospital is a specialist leprosy hospital in Pokhara, Nepal. As part of its service it offers a range of appliances aimed to assist in the rehabilitation of patients. This paper outlines the different orthoses and prostheses made at the Orthopaedic Appliances Centre in the hospital, their various indications and some of the benefits and problems associated with their use. Specific reference is made to the requirements related to local conditions and customs. The terrain, communications, facilities and materials available in Nepal make the work of the few rehabilitation engineers in the country somewhat different from that of those in the West. Some of these differences are described, drawing out contrasts in technical requirements of appliances and in organizational structures in the field of rehabilitation in the UK and Nepal.