<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022112916110/63861ea79c7e80680e0ccddajpeg.jpg" alt="" width="799" height="536"/><figcaption></figcaption></figure>There have been few days without rain this April and May in Kathmandu. That means more disease for Kathmandu. Not COVID-19, but the virus we used to talk about -- last year's scary unknown disease, dengue.The year 2019 saw Nepal's worst ever outbreak of dengue, with 15,000 people infected, many times the previous high. Dengue was particularly bad in the Kathmandu Valley. At least six people died.The medical journal The Lancet has warned that Kathmandu could see a dengue ‘explosion’ because it has become ‘an ideal breeding ground’ for the mosquito that carries dengue -- the notorious Aedes aegypti. Already in 2020, four cases have been reported in Kathmandu, and four in Lalitpur.<a href="https://www.nepalitimes.com/banner/big-story-of-small-pox-in-nepal/" target="_blank" rel="noopener noreferrer">Big story of smallpox in Nepal</a>, Tom Robertson<a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/banner/viruses-past-present-and-future/" target="_blank" rel="noopener noreferrer">Viruses past, present and future</a>, Tom RobertsonDengue spiked in 2019 with outbreaks around the developing world. In recent years, Delhi, Dhaka, Ho Chi Minh City, Senegal and Singapore have faced bad outbreaks. A dengue outbreak in Delhi in 2015 inundated hospitals and clinics across the city.Dengue likes warm humid conditions. Before corona, dengue was the world's fastest growing dangerous virus, increasing four-fold in just over a decade. Two of every five people around the world, nearly 3 billion people, live in dengue risk areas where it is a leading cause of illness. Each year approximately 100 million people contract the disease, and over 20,000 die.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022112916110/63861eaa9c7e80680e0ccddbjpeg.jpg" alt="" width="961" height="540"><figcaption> </figcaption></figure>Like malaria, dengue is actually several different diseases that we give a single name. There are four dengue viruses: Dengue 1, 2, 3, and 4. A person can catch each one, and get sick as many as four times.A first infection generally brings only mild flu symptoms, if any at all. But a second infection can cause ‘severe dengue’ with plasma leakage, bleeding, and shock. This can kill. No treatment exists for dengue, but generally symptoms can be managed.<a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/here-now/climate-health-emergency/" target="_blank" rel="noopener noreferrer">Climate health emergency</a>, Sonia Awale<a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/banner/mosquitoes-move-up-mountains-as-the-earth-warms/" target="_blank" rel="noopener noreferrer">Mosquitoes move up mountains as the earth warms</a>, Sonia AwaleDengue's main mosquito host, Aedes aegypti, is no ordinary mosquito. In a species known for death and deviousness, it has few rivals. Not many mosquitoes have so successfully defied human efforts at control, including in recent decades.Long before dengue, Aedes aegypti carried a far deadlier disease: yellow fever. During the 16th and 17th, slave ships brought yellow fever carrying A. aegypti from Africa to the Americas, devastating indigenous populations and reshaping the region's balance of power. In the early twentieth century, the A. aegypti -- yellow fever combination almost blocked the construction of the Panama Canal.Most wildlife avoid humans. Not A. aegypti. It loves us, particularly the ecological disorder we often create. The more humans, the more disturbed ecosystems, the more A. aegypti. Cities, especially disorganised cities, create ideal habitat: lots of standing water for breeding and lots of humans for feeding.Dengue's other mosquito carrier is A. albopictus.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022112916110/63861eac9c7e80680e0ccddcjpeg.jpg" alt="" width="640" height="463"><figcaption> </figcaption></figure><figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022112916110/63861eaf9c7e80680e0ccdddjpeg.jpg" alt="" width="640" height="635"><figcaption> </figcaption></figure>The Lancet points to dengue's major causes: climate change, relentless and haphazard urbanisation, brisk trade and transit from dengue-infested areas, and poor health infrastructure. As Kathmandu grows and gets more connected to other parts of Asia, dengue spreads.Climate change has been overrated as a cause. Warming temperatures can extend the range of Aedes carriers but other causes deserve more attention. ‘Last summer’s explosion of dengue in Kathmandu Valley was <a href="https://www.nepalitimes.com/banner/mosquitoes-move-up-mountains-as-the-earth-warms/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/banner/mosquitoes-move-up-mountains-as-the-earth-warms/&amp;source=gmail&amp;ust=1590920172779000&amp;usg=AFQjCNHqCreNEFDji4GDyS_wUW1JkpUOGA">blamed on climate change</a>,’ the Nepali Times recently noted, ‘but it was actually a perfect storm of crowded and squalid living conditions, poor drainage, greater mobility of people, and a particularly wet monsoon.’The real problem is disorganised urbanisation. The A. aegypti carrier thrives in small collections of clean water in flower pots, old car and truck tyres, uncovered water containers, and even puddles. It bites people early morning and at dusk.<a href="https://www.nepalitimes.com/here-now/nepal-is-a-microcosm-of-all-of-the-changes-in-world-health/" target="_blank" rel="noopener noreferrer">"Nepal is a microcosm of all of the changes in world health"</a><a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/here-now/ke-garne-attitude-kills-people/" target="_blank" rel="noopener noreferrer">K garne attitude kills people</a>, Laxmi BasnetNepal, like much of the developing world, has witnessed dramatic and disorderly urban growth in recent years, much in the lowlands along highways. ‘Nepal's Tarai," Mukesh Pokhrel recently wrote also in this newspaper, "is turning into one endless elongated metropolis.’Kathmandu itself grew four-fold between 1980 and 2010, and is one of the fastest growing cities in one of the world's fastest urbanising regions.'<a href="https://www.nepalitimes.com/banner/mosquitoes-move-up-mountains-as-the-earth-warms/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/banner/mosquitoes-move-up-mountains-as-the-earth-warms/&amp;source=gmail&amp;ust=1590920172779000&amp;usg=AFQjCNHqCreNEFDji4GDyS_wUW1JkpUOGA">Cities like Kathmandu are perfect breeding grounds</a> for the Aedes mosquito,' says Jeremy Farrar of the Wellcome Trust in an interview with this paper. 'Kathmandu’s climate is changing, the city is growing exponentially in a haphazard way and the mosquito loves highly dense populations of people.'<a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/banner/east-west-city/" target="_blank" rel="noopener noreferrer">East-West City</a>, Mukesh Pokhrel<a href="http://archive.nepalitimes.com/news.php?id=19301#.XtI_7y2B3-Y" target="_blank" rel="noopener noreferrer">Dengue fever</a>, Buddha BasnyatThe Lancet highlights what might happen in a dengue explosion in Kathmandu. ‘A tug-of-war might occur between the worried well and the truly sick,’ it says. ‘Hospitals might be overwhelmed and many needy patients with other diseases could be turned away.’Doctors inexperienced with the disease pose a particular worry. They could misunderstand its dynamics and cause unnecessary deaths by over-treating with unneeded antibiotics, transfusions, and excessive intravenous fluids. This has happened elsewhere.The dengue-carrying Aedes aegypti mosquito is difficult to control. Brazil eradicated it twice, in the 1950s and in the 1970s, and twice it returned. Several factors explain why: a lack of sustained careful epidemiological surveillance, insecticide resistance, the high costs of materials and wages, insufficient community participation and coordination with the health sector, and, crucially, the spread of haphazard urban development. Narrow control programs inevitably run into trouble.The World Health Organisation (WHO) stresses both micro and macro efforts to fight dengue. Individual families can put tight lids on water containers. They can eliminate breeding spots such as empty cans, bottles, and tires. It also says community engagement and building country capacity for environmental management and disease surveillance is important.“Locally adapted vector control measures such as household water storage management and, more importantly, engaging individuals and communities to manage their immediate environment are essential to controlling the spread of the disease,” says Raman Velayudhan, head of WHO’s Vector and Ecology Management Unit.School-based awareness programs, The Lancet authors noted, can help block dengue's spread. ‘Students are good learners and can be taught to effectively use repellents and mosquito nets and get rid of water collections near their homes and schools; students will then spread this information to their parents.’ Several countries have implemented successful school programs.Historian Frank Snowden sums it up: "Dengue takes full advantage of societal neglect and the absence or cessation of vector control programs."Tom Robertson, Ph D, is an environmental historian who writes about the history of malaria in Nepal. And just wrote a <a href="https://www.nepalitimes.com/banner/big-story-of-small-pox-in-nepal/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/banner/big-story-of-small-pox-in-nepal/&amp;source=gmail&amp;ust=1590920172779000&amp;usg=AFQjCNFk193f6QnfjiWqivawrVZt2FPA4A">five-part series on smallpox</a> for Nepali Times as part of his History of Disease column.

Tom Robertson

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History of Disease

The dangers of the dengue virus

Although smallpox is now ‘unfamiliar to the world today’ historian Elizabeth Fenn has written that it was ‘a misery commonplace in years gone by.’For centuries, the smallpox virus and the gruesome death and destruction it caused upended people's lives around the world and in Nepal. In this History of Disease series in Nepali Times in the past month I have recounted how smallpox traveled and killed in Europe and America, became a terrible test for survival for children in South Asia, and  struck down both royals and regular citizens in Nepal in the 19th century.We have seen how people devised inoculation and vaccination to fight the disease, and how vaccines and strong surveillance helped eradicate the disease around the world and in Nepal in the 1970s, but only 'by the slimmest of margins'.Several things about the history of the disease deserve special emphasis. As much as any influential king or prime minister, we sometimes forget that smallpox and other diseases shaped the course of human events.Part I: <a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/banner/big-story-of-small-pox-in-nepal/" target="_blank" rel="noopener noreferrer">Big story of smallpox in Nepal</a>Part II: <a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/opinion/the-smallpox-virus-in-british-india/" target="_blank" rel="noopener noreferrer">The smallpox virus in British India</a>Part III: <a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/opinion/smallpox-politics-and-power-in-kathmandu/" target="_blank" rel="noopener noreferrer">Smallpox, politics and power in Kathmandu</a>Part IV: <a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/opinion/how-nepal-eradicated-the-smallpox-virus/" target="_blank" rel="noopener noreferrer">How Nepal eradicated the smallpox virus</a><figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022112916110/63861ea39c7e80680e0ccdd9jpeg.jpg" alt="" width="1500" height="1001"/><figcaption>Photo: MANISH PAUDEL</figcaption></figure>Viruses such as measles, influenza, hepatitis, polio, rabies, and HIV – as well as non-viral diseases such as cholera, TB, syphilis, and malaria – remade not just individual lives, but also physical, economic, and political landscapes.The fury of smallpox reminds us of the inescapable power of nature. Despite all our efforts, humans are part of nature, and life is fragile.We are living beings made up of cells and nutrients, subject to the rules of geography and biology, death and disease. This reality held true in the past, and holds true today, as much as we hope otherwise. Smallpox may have been chased away, but COVID-19 stands at the doorstep.Each disease has its own characteristics, its own biological personality, its own way of spreading through society and attacking human bodies. <a href="https://www.nepalitimes.com/here-now/the-mosquito-that-changed-nepals-history/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/here-now/the-mosquito-that-changed-nepals-history/&amp;source=gmail&amp;ust=1590041413347000&amp;usg=AFQjCNEvpoGS7wd8yELy9-vJ0LG1oby5kw">Malaria moved via mosquitoes</a> which liked warm weather, <a href="https://www.nepalitimes.com/latest/kathmandu-in-the-time-of-cholera/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/latest/kathmandu-in-the-time-of-cholera/&amp;source=gmail&amp;ust=1590041413347000&amp;usg=AFQjCNGDo4ZWCamW139FFTuqWLpgRZuSoQ">cholera through germs in water</a>, and syphilis through sex. Due to these differences, each disease left its own unique imprint on history.<a href="https://www.nepalitimes.com/banner/big-story-of-small-pox-in-nepal/" target="_blank" rel="noopener noreferrer" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/banner/big-story-of-small-pox-in-nepal/&amp;source=gmail&amp;ust=1590041413347000&amp;usg=AFQjCNF3MVYYqp8ZY4QHWix_z0-R_ABxUA">Big story of small pox in Nepal</a>, Tom RobertsonSmallpox spread through the air, moved easily from person to person, caused searing pain, and, if it did not kill, left behind disfigured, broken human bodies. In Nepal, if it had struck older people, not children, or if it had not left its victim's faces scarred and their eyes damaged, it might have brought less terror.On the other hand, if it had had a reservoir in animals (as many viruses do) it would have been much harder to eliminate, and we might still be facing its burning fevers and excruciating rashes today. Small pox’s particular biology shaped history in a particular way.Nature is not just a passive stage on which we humans act out our dramas as we wish. Instead, it is an actor in every drama, sometimes in the background, sometimes centerstage, but often coming and going at its own will, not ours.<a href="https://www.nepalitimes.com/opinion/the-smallpox-virus-in-british-india/">The smallpox virus in Nepal</a>, Tom RobertsonLooking back, if we recount the stories just of kings and queens and their political chess matches, we overlook some of history's main drivers and its most important stories. In fact, if we overlook disease history we will not understand the stories of kings and queens as well as we think. Can we really tell the history of Rana Bahadur, Girvana, Bimsen Thapa, and Bir Shumshere -- much less the stories of ordinary people around the country -- without understanding the central role of disease?Looking forward, we would do well not to forget nature's power to completely take over the course of events. Smallpox also reminds us that, even though humans share the same biology, diseases often affect some subsets of society more than others, particularly those with less money and power. In other words, biological forces may be universal but they play out in social landscapes as complex and uneven as Nepal's dadakada.In the Americas, smallpox even more than guns, gave Europeans a huge advantage over the indigenous people who had never encountered the disease before, and thus lacked immunity. <a href="https://www.nepalitimes.com/opinion/the-smallpox-virus-in-british-india/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/opinion/the-smallpox-virus-in-british-india/&amp;source=gmail&amp;ust=1590041413347000&amp;usg=AFQjCNHRE-p56xptgt9wTBUUjoc05RxNwA">In colonial India, smallpox and ideas about how to treat it divided the British from Indians</a> more than it brought them together.<a href="https://www.nepalitimes.com/banner/big-story-of-small-pox-in-nepal/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/banner/big-story-of-small-pox-in-nepal/&amp;source=gmail&amp;ust=1590041413347000&amp;usg=AFQjCNF3MVYYqp8ZY4QHWix_z0-R_ABxUA">In Nepal, smallpox preyed upon both rich and poor</a>, powerful and powerless alike. But as the 19th century Newar song 'Sitalamaaju Mye' reminds us, it divided Gorkha conquerors and Newar families. <a href="https://www.nepalitimes.com/opinion/smallpox-politics-and-power-in-kathmandu/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/opinion/smallpox-politics-and-power-in-kathmandu/&amp;source=gmail&amp;ust=1590041413347000&amp;usg=AFQjCNFFHANLUtlK0myrUwhb4qdFGZg4Pg">Smallpox shaped power struggles between Bhimsen Thapa and his political rivals</a>, and later, in the effort at eradication, altered relations between government health workers and individuals from impoverished ethnic minorities.<a href="https://www.nepalitimes.com/opinion/smallpox-politics-and-power-in-kathmandu/">Smallpox, politics and power in Kathmandu</a>, Tom Robertson No doubt, smallpox also shaped gender relations in ways we need more historical research on. Just as differences between diseases mattered in the course of history, so, too, did social differences.<a href="https://www.nepalitimes.com/opinion/how-nepal-eradicated-the-smallpox-virus/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/opinion/how-nepal-eradicated-the-smallpox-virus/&amp;source=gmail&amp;ust=1590041413347000&amp;usg=AFQjCNGC0hhwCb-vpWbsy8-oT_gcbRcM6Q">Nepal's successful effort to eradicate smallpox in the 1960s and 1970s</a> seems particularly relevant to us today. Nepal's last case in 1975 shows what it took to banish a complex disease in challenging circumstances: sustained governmental focus and coordination, adequate long-term funding, scientific knowledge, talented and dedicated staff, careful record keeping, program flexibility and adaptation to local culture and conditions, and dogged surveillance.Yet even at this moment of seeming human control, nature's power was on display. Smallpox eradication happened only with help from nature. Compared to malaria and polio, smallpox was relatively easy to control. It was so intense that it was easy to spot, and that intensity also made it difficult for contagious victims to move around infecting others. Smallpox did not strike a person twice. And unlike other viruses, it proved very susceptible to a vaccine. This history suggests some of the special challenges that COVID-19 poses.Here, too, social difference mattered. Nepal's eradication campaign shows the enormous challenge of protecting individual rights in moments of public health crisis. In Nepal and other South Asian countries, government personnel sometimes used violence to force citizens to get vaccinated. Some health workers grew so convinced of their righteousness -- the 'purity of purpose' in one man's self-description -- that they felt comfortable steamrolling the wishes of others, often people from socially marginalised groups with little say in society to begin with.<a style="background-color: #ffffff; font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/opinion/how-nepal-eradicated-the-smallpox-virus/" target="_blank" rel="noopener noreferrer">How Nepal eradicated the smallpox virus</a>, Tom RobertsonSuch coercion probably could have been avoided through more nimble policies, more extensive training, and better public education. Problems often sprouted, the historian David Arnold noted, when doctors and other health workers didn't understand how ordinary people saw the world and quickly dismissed their concerns as backward or superstitious -- when, as he put it, the medical system had grown ‘culturally and politically distant from the lives of its subjects’.In the end, the history of smallpox shows the fragility of life, but also the power of human perseverance. Smallpox struck down one of every three it infected. It stole beautiful children from their mothers and fathers. It stole sight from survivors. In some places, it wiped out entire families and laid waste to whole villages. It was deadly, ruthless, and horrific. It sometimes brought out the worst in human nature.But it also often spurred great ingenuity, compassion, togetherness, and resilience. In the face of disease, humans have found surprising ways to support each other, learn from the past, endure the suffering of the present, and find hope again in the future.This is the fifth article in the <a href="https://www.nepalitimes.com/opinion/big-story-of-small-pox-in-nepal/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/opinion/big-story-of-small-pox-in-nepal/&amp;source=gmail&amp;ust=1590041413347000&amp;usg=AFQjCNHAaHCW0Y2UQjeFfh0UQoUPVtsqbA">series </a>History of Disease. The next column will deal with danger of dengue in Nepal. <a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/how-chitwan-was-opened,4159" data-saferedirecturl="https://www.google.com/url?q=https://archive.nepalitimes.com/article/Nepali-Times-Buzz/how-chitwan-was-opened,4159&amp;source=gmail&amp;ust=1590041413347000&amp;usg=AFQjCNEcTfdhSI0N9Tqo_qgoyZnrHCccug">Tom Robertson</a>, PhD, is researching the environmental history of Kathmandu Valley.Read other articles on smallpox in Tom Robertson’s History of Disease series in <a href="https://www.nepalitimes.com/opinion/how-nepal-eradicated-the-smallpox-virus/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/opinion/how-nepal-eradicated-the-smallpox-virus/&amp;source=gmail&amp;ust=1590041413347000&amp;usg=AFQjCNGC0hhwCb-vpWbsy8-oT_gcbRcM6Q">Nepali Times</a>.

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Viruses past, present and future

In 1966, the <a href="https://www.who.int/news-room/detail/13-12-2019-who-commemorates-the-40th-anniversary-of-smallpox-eradication" target="_blank" rel="noopener noreferrer">World Health Organization (WHO)</a> launched a worldwide campaign to eradicate smallpox. The aim was ‘zeropox’ -- not just control of the disease, but its complete elimination.After an aggressive campaign run by Nepal's autocratic government, the country saw its last case ever in 1975. The program should be celebrated. But what should also not be forgotten is that it sometimes resorted to heavy handed methods. Balancing public safety and individual rights was not easy.Historically, smallpox had been one of the world's biggest and most terrifying killers. <a href="https://www.nepalitimes.com/opinion/the-smallpox-virus-in-british-india/" target="_blank" rel="noopener noreferrer">In South Asia, the disease attacked young adults and children</a>, those born since the previous epidemic, leaving many disfigured or blind. In Nepal in the 19th  century, smallpox left few communities unscathed, and <a href="https://www.nepalitimes.com/opinion/smallpox-politics-and-power-in-kathmandu/" target="_blank" rel="noopener noreferrer">even killed a king</a>.In 1966, smallpox still plagued 31 countries, annually infecting 10-15 million people and killing 2 million. Two areas caused the most concern: the horn of Africa and South Asia, including Nepal.Part I: <a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/banner/big-story-of-small-pox-in-nepal/" target="_blank" rel="noopener noreferrer">Big story of smallpox in Nepal</a>Part II: <a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/opinion/the-smallpox-virus-in-british-india/" target="_blank" rel="noopener noreferrer">The smallpox virus in British India</a>Part III: <a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/opinion/smallpox-politics-and-power-in-kathmandu/" target="_blank" rel="noopener noreferrer">Smallpox, politics and power in Kathmandu</a>Part V: <a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/banner/viruses-past-present-and-future/" target="_blank" rel="noopener noreferrer">Viruses past, present and future</a>		
							<figure><img width="1282" height="1386" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022112916110/63861ea09c7e80680e0ccdd8jpeg.jpg" alt=""/><figcaption>Smallpox vaccination statue outside the World Health Organization headquarter entrance in Geneva.</figcaption></figure>Nepal, a WHO official wrote in the early 1960s, ‘must be considered as one of the areas most highly endemic for smallpox in South East Asia’. In 1958, a wave of smallpox hit Kathmandu. A 1965 survey revealed that <a href="https://www.nepalitimes.com/opinion/big-story-of-small-pox-in-nepal/" target="_blank" rel="noopener noreferrer">16% of the Valley's total population had struggled with the virus at some point in their lives</a>. Those were the ones the disease hadn't killed.Each year a few imported cases appeared in the western hills. Don Messerschmidt describes a late 1963 outbreak along the hulakibato in Lamjung, but the main problem areas were the Kathmandu Valley and the Tarai, particularly the eastern plains because of heavy cross-border movement.<a href="https://www.who.int/features/2010/smallpox/en/" target="_blank" rel="noopener noreferrer">WHO and the Nepal government launched a pilot program</a> in 1962 in Kathmandu Valley using new freeze dried vaccine, an improved version of the one Edward Jenner had devised in the 1790s, but got disappointing results.After two and a half years, only 30% of Valley residents were protected. WHO blamed ‘administrative problems and the religious and mundane objections of some sections of the population to vaccination’.In 1966, the program expanded countrywide, with new commitment and revised procedures, including better record keeping to prevent double counting. In 1971 the program started month-long mass vaccination campaigns. Each year for four straight years, several thousand temporary staff vaccinated 6 million Nepalis. Between 1967 and 1975, 39 million Nepalis got vaccinated or re-vaccinated.Another new strategy proved a game changer: aggressive surveillance and containment. Previously, officials had prioritised vaccinations. They had not traced and mapped infections, and thus did not know how many people had the virus and where. In 1971, a WHO official later wrote, ‘vigorous surveillance became the rule’.Surveillance meant routine house-to-house searches. Instead of waiting for cases to be reported, program workers went looking for them. Containment meant vaccinating and revaccinating the entire population near a newly discovered case. This was erring on the safe side by casting a broad net. The program also intensified tracing, detecting infection origins in a remarkable 95% of cases.The aggressive surveillance and containment methods delivered results. ‘It appeared that transmission had been interrupted,’ a WHO official noted later. Nepal had devised ‘a new and surprisingly effective tactic’.But then came a setback: ‘a tidal wave’ of new cases with nearly 2,000 new infections in 240 separate outbreaks. Three of every four of these cases were imports from Uttar Pradesh and Bihar in India where smallpox proved particularly recalcitrant. Of Nepal's 12 million population at the time, 90% lived within 100km of these Indian states.The program responded with more vaccination campaigns, surveillance, and containment, making steady progress. To address outbreaks in Morang the Nepal smallpox program in 1975 initiated a ‘watchdog’ system, a tactic recently devised in India. Staff were posted at the houses of infected people to ensure that they did not leave and that no unvaccinated person entered. Cash rewards were given to citizens and staff reporting new cases.In April 1975, Nepal saw its last case. A disease that had plagued Nepalis for centuries was gone. Looking back, WHO officials saw the surveillance and containment program as the key.‘The shift in strategy in 1971, laying great emphasis on surveillance-containment, was largely responsible for the success of the Smallpox Eradication Programme in Nepal,’ wrote the program's director in a 1977 wrap up report. ‘It is possible that transmission would have been interrupted earlier if the watchguard system had been adopted during 1974.’In many ways Nepal's eradication of smallpox was a heroic victory. The global smallpox program's director applauded Nepal's ‘remarkable accomplishments’. This narrative is not inaccurate but it is not the whole story.To begin with, smallpox eradication owed a great deal to biology. Compared to other diseases, smallpox was simply easier to eradicate. It was easy to see and diagnose (no asymptomatic infections) and did not re-infect people once gone. The disease's painful symptoms prevented movement, slowing transmission. Moreover, the vaccine was easy to administer and extremely effective. There was no virus reservoir among animals re-injecting the disease into human society again and again.Diseases like malaria and polio had far more natural advantages, and have proven much harder to eradicate globally.‘Without the particular characteristics of smallpox and the smallpox vaccine,’ historian Randall Packard has observed, ‘the disease would have been much more difficult to conquer, and the campaign would, in all likelihood, have failed. As it was, it only succeeded by the thinnest of margins.’One particular challenge was how to handle Nepalis who resisted vaccination. In the eastern Tarai, many people, particularly indigenous groups, held what a WHO report described as 'religious objections to vaccination’.WHO said this area became 'the scene of many problems of containment’. In Kathmandu, some Newar groups used to 'strongly object' to vaccination. In Kailali, some Tharus 'resisted vaccination for religious reasons'.Historian Susan Heydon notes that program workers often unjustifiably dismissed the concerns of Nepalis who resisted vaccination. Those who hesitated, she notes, were blamed as superstitious, derided as ‘backward and uneducated’.Instead, she faults the WHO program itself for not doing enough to educate the general population about the benefits of vaccination. She also notes that the program often administered vaccinations during hours next to impossible for ordinary working people.Eradication program workers also occasionally used unnecessary coercion. Coerced vaccinations were not common worldwide or in South Asia. But as historian Packard notes, there was a ‘tendency for aid workers to view themselves as somehow empowered to do whatever it takes to fulfill their mission, and to disregard local customs and laws’. In India and Bangladesh, historian Paul Greenough discovered that 'heavy-handed methods were sometimes relied upon'. On one occasion in Bihar in 1975, for example, health officials accompanied by police arrived at a tribal person's house by jeep at midnight, broke down the door, held down family members, and forcibly vaccinated them. Mandatory vaccinations and re-vaccinations as part of broad containment efforts sometimes sparked 'chaos' in villages.'Encounters with government vaccinators,' Greenough observes, were 'never about immunisation alone.' Religious, caste, and gender dynamics shaped interactions, as did ill will from previous health campaigns.One American health worker in India later recalled how a sense of unbridled self-righteousness led him to mistreat people. 'One of the rules was that everybody gets vaccinated. I was awful in my conviction of purity of purpose -- in breaking down doors and vaccinating crying women, etc.' To a large degree, the ends seemed to justify the means.Official reports, Greenough writes, often dismissed resistance and underreported coercion. He wishes there had been much more training for healthworkers and broader,more careful education for the public.In Nepal, one foreign smallpox fieldworker described how health workers sometimes had to search for Nepalis hiding from them in fear:‘... a good natured room to room search of houses with flashlights, accompanied by the village leader, would detect adults and children hiding under beds, in chests, large wicker baskets, and even in large clay storage vessels. However, the search was done as a game of hide and seek, with laughter after people were found and vaccinated, such as in one particular case where lifting the cover of a large wicker basket revealed two children hiding inside.’This may have been seemed like a game to health workers, but probably not to those Nepali men, women, and children with unknown government strangers searching for them. They seemed terrified.In the name of containing smallpox, a global health problem and an old scourge in Nepal, in the late 1960s and 1970s Nepal's government had tremendous authority to monitor and search Nepal's population. Maintaining public safety certainly justifies strong action, but the unnecessary infringement of individual rights and liberties must also be avoided as well.  This is the third in a <a href="https://www.nepalitimes.com/opinion/big-story-of-small-pox-in-nepal/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/opinion/big-story-of-small-pox-in-nepal/&amp;source=gmail&amp;ust=1588753218027000&amp;usg=AFQjCNEp4BFSGiWvId09CsLCgnF31j8F-w">series of articles</a> about the history of disease in Nepal. The fifth installment will look at what Nepal can learn from past epidemics in dealing with this one.  <a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/how-chitwan-was-opened,4159" data-saferedirecturl="https://www.google.com/url?q=https://archive.nepalitimes.com/article/Nepali-Times-Buzz/how-chitwan-was-opened,4159&amp;source=gmail&amp;ust=1588753218027000&amp;usg=AFQjCNGtSUyejPwwFFhYdaZjZohWFJUIQw">Tom Robertson</a>, PhD, is researching the environmental history of Kathmandu Valley.

How Nepal eradicated the smallpox virus

<figure><img width="1138" height="822" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022112916110/63861e9a9c7e80680e0ccdd6jpeg.jpg" alt=""/><figcaption>A woman in Kathmandu carrying her child infected by small pox in 1964. Photo: WHO</figcaption></figure>The smallpox virus plagued Nepali communities throughout the 19th and early 20th centuries. As historian Susan Heydon has written about in a recent essay called ‘Death of the King’, smallpox destroyed families rich and poor alike, with tremendous personal and political consequences. In the late 1790s, <a href="https://www.nepalitimes.com/opinion/big-story-of-small-pox-in-nepal/">smallpox erupted in Kathmandu Valley</a>. Little is known about the outbreak, but at the time the Valley's cities were still recovering from Prithvi Narayan Shah's conquest three decades earlier. Kathmandu's population lived and worked on streets that one British visitor described as ‘excessively narrow, and nearly as filthy as those of Benares'.In 1799, King Rana Bahadur's favorite wife, Kantivati, came down with smallpox, igniting a series of events that reshaped court politics. Seeing his wife gravely ill, Rana Bahadur dedicated himself to prayers for her, and even abdicated the throne in favour of his two-year old son, Girvana. His efforts were to no avail: Kantivati succumbed to the disease. Rana Bahadur, distraught and furious, desecrates and destroys the temple of Hariti Ma (known to Hindus as Sitala) at Swayambhu.Rana Bahadur also orders children with the disease removed outside the Valley, all the way across the Tama Kosi in the East or the Marsyandi in the West. Because of the Valley's demographics, these were Newar children. A traditional Newar song recounts what happens. Called 'Sitalamaaju Mye', the song is addressed to 'Mother Sitala,' the smallpox goddess. Part I: <a href="https://www.nepalitimes.com/banner/big-story-of-small-pox-in-nepal/" target="_blank" rel="noopener noreferrer">Big story of smallpox in Nepal</a>Part II: <a href="https://www.nepalitimes.com/opinion/the-smallpox-virus-in-british-india/" target="_blank" rel="noopener noreferrer">The smallpox virus in British India</a>Part IV: <a href="https://www.nepalitimes.com/opinion/how-nepal-eradicated-the-smallpox-virus/" target="_blank" rel="noopener noreferrer">How Nepal eradicated the smallpox virus</a>Part V: <a href="https://www.nepalitimes.com/banner/viruses-past-present-and-future/" target="_blank" rel="noopener noreferrer">Viruses past, present and future</a>'Oh Mother Sitala,' the first line goes, 'behold the piteous state of your people! The children were driven out of the country, surrounded by soldiers.' The song describes the stages of the disease, which touched most Nepali families at one point or another, through its appeal to three different deities. ‘We pray to Mother Kachala, who brings forth the smallpox blisters, to Mother Sitala, who fills them with water, and to Mother Bachala, who carries off the afflicted.’Parents faced heartbreaking difficulties. 'They led them away, carrying one child on the back, one child under the arm and dragging along a third child.' After a week, the families reach the Tama Kosi. There, a child dies. Unable to say goodbye the proper way, the devastated parents throw the body into the river. One of the legacies of these distant events, the 'Sitalamaaju Mye' song appears to use the tragic expulsion of families to symbolise the mistreatment and dukha Newars faced since the takeover of the Valley by the Shah regime in the 1770s. Observers this month have noted that the song speaks to the hardships faced by many Nepali migrant laborers, displaced from their worksites by Covid-19, trying to return to village homes.Rana Bahadur ends up in exile in India, and takes along with him a young Bhimsen Thapa. He returns to power in 1804, but is killed in 1806, opening the door for Thapa to seize power and go on to become one of the most important rulers in Nepal's early history.Smallpox struck again in 1816, and again shapes the power struggles in Nepal's tumultuous Darbar. Bhimsen Thapa still held power, but King Girvana, now 21, was a clear threat.The disease appeared first in the west of the country but found its way to Kathmandu by July. As historian Vikram Hasrat has documented, ‘Smallpox became so virulent in the country that hundreds and thousands of men, women and children, old and young, were swept away. The rivers, tanks, and canals were crowded with dead and dying; and in the streets a man had scarcely room to walk and the dogs dragged away the neglected and putrefied corpses and vultures died with surfeit of human flesh.’Fear gripped the palace. King Girvana had not contracted the disease as a child. He also had young children. Officials requested vaccinations from the British, who had been trying to spread the new practice in India for over a decade.As historian Heydon has documented, the <a href="https://www.nepalitimes.com/opinion/the-smallpox-virus-in-british-india/">British sensed possible political advantage</a>: ‘It would not only be an act of humanity to introduce the Vaccination,’ the British resident Edward Gardner wrote his superiors in India on July 17, ‘but be a desirable object, perhaps to have the Raja and the Officers of the Court inoculated by us.’The British organised vaccinations around the Valley, beginning in Banepa. It is hard to say how many people actually got vaccinated. But one thing we do know: the king was not among them.  <figure><img width="1376" height="980" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022112916110/63861e9d9c7e80680e0ccdd7jpeg.jpg" alt=""><figcaption> </figcaption></figure>The exact reasons why are lost to history, but not the consequences. In late October, both of the king's children showed fever and then rash. One perished on 2 November. Gardner passed along news of the king's family to Calcutta: ‘His youngest son a child under two years of age I am sorry to add died this morning of that distemper and his eldest &amp; only remaining male child has also taken the disease.’ Two weeks later, on 18 November, Gardner learned that 'the Raja had unfortunately taken the smallpox'. He died two days later. The resident reported the event: ‘Alarming symptoms it seems made their appearances during the night which continuing unabated, the Raja was according to the usual custom in this country conveyed early in the morning to the temple at Pusputhnath, where he breathed his last about 11 o’clock am. As was Hindu custom, preparations were underway quickly for his funeral.’ Girvana's senior queen, Siddhi Rajya Laxmi, threw herself on her husband's funeral pyre, as tradition demanded.Gardner regretted the missed chance to prevent the king's death. ‘Many opportunities have unaccountably been neglected for him receiving the vaccination.’ It's hard to know why. There was, however, as historian <a href="https://www.nepalitimes.com/review/the-rest-is-history-for-john-whelpton/">John Whelpton</a> notes, 'speculation about foul play'. The young prince Rajendra recovered and was placed under the regency of <a href="https://www.nepalitimes.com/banner/turning-a-shrine-into-a-temple-of-learning/">Tripura Sundari, a longtime ally of Bhimsen Thapa</a>. Girvana's death and Tripura Sundari's installation as the young king's regent helped <a href="http://archive.nepalitimes.com/blogs/kundadixit/2014/01/05/the-pashmina-war/">Bhimsen Thapa</a> retain his grip on power, a grip he would not yield for another two decades.  Over the next century and a half, as Heydon shows, smallpox showed itself routinely in Nepal. Every spring communities would make prayers to ward off the disease. <a href="https://www.nepalitimes.com/latest/kathmandu-in-the-time-of-cholera/">But periodically epidemics raged</a>. One observer in east Nepal in 1885, for instance, noted that a wave of smallpox had ‘carried off a large number of the inhabitants of Khumbu’.<a href="https://www.nepalitimes.com/here-now/nepal-is-a-microcosm-of-all-of-the-changes-in-world-health/">“Nepal is a microcosm of all of the changes in world health”,</a> Nepali TimesVaccination use was sporadic, and government efforts weak. At mid-century, the Kathmandu-based <a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/pencilling-in-kathmandu-rajman-singh-chitrakar,3379">British doctor Henry Oldfield</a> noted that Jang Bahadur Rana held ‘great faith’ in vaccination and had his children and other royal children inoculated, but did little else. In the 1920s, British journalist <a href="http://archive.nepalitimes.com/news.php?id=3351#.XqwdhS8w0Wo">Perceval Landon</a> noted, 'Vaccination is not compulsory but it is free to those who choose to avail themselves.' Several reasons explain why Nepalis did not use vaccination. Some people, particularly some Newars and Tarai groups, disliked the vaccine. But a far greater problem was that the Rana governments did little to make it widely available or to promote it. They never set up a health system to promote sound practices across Nepal. In contrast, in India by the early 20th century, the British campaign to spread vaccination had found its legs. Millions of ordinary Indians in Madras and other parts of the country started getting vaccines. In 1947 alone, the year the British left India, 21.3 million Indians received vaccinations or re-vaccinations.Nepalis who studied or traveled in India and those who served in the British Army noticed how little health service the Rana regime provided their countrymen. Smallpox was one of many diseases and ailments that modern medicine could help with. The Ranas' lack of concern about the people's health and welfare helped fuel the growing movement to drive them from power. After the 1951 revolution, successive Nepal governments tried to set up a modern health care system in the towns and villages. They implemented disease control programs, including <a href="https://www.nepalitimes.com/here-now/the-mosquito-that-changed-nepals-history/">a nationwide malaria eradication effort</a>, launched in 1959 with the help of the US and the WHO. A smallpox campaign for the Kathmandu Valley was launched in 1961 and became a nationwide eradication program in 1966.  After tormenting Nepalis for centuries and sometimes shaping their politics, smallpox was finally eradicated from Nepal in 1975. It is a tremendous success story -- a story of strong bureaucratic organisation, impressive scientific work, and tenacious implementation. But it is also a story of occasional heavy handedness by a government given unprecedented powers in the effort to maintain public health. This is the third in a <a href="https://www.nepalitimes.com/opinion/big-story-of-small-pox-in-nepal/">series of articles</a> about the history of disease in Nepal. The fourth installment will explore the eradication campaign in the 1960s against smallpox. <a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/how-chitwan-was-opened,4159">Tom Robertson</a>, PhD, is researching the environmental history of Kathmandu Valley.

Smallpox, politics and power in Kathmandu

<figure><img width="1016" height="1280" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109121124/636b8dd59c7e80680e06b36djpeg.jpg" alt=""/><figcaption>Irish-born painter Thomas Hickey's painting in 1806 of three queens of Mysore where the royal woman on the right is pulling up her sari to spread awareness about small-pox vaccination. Photo: PRIVATE COLLECTION</figcaption></figure>The first record of smallpox in South Asia was in the 7th century, although the virus was probably widespread on the Subcontinent a millennia before that. In late 19th century India, for which we have the first reliable statistics, smallpox struck down more than 100,000 people a year, more in epidemic years. In some parts of north India, few escaped it. In Nepal, smallpox generally hit in the spring. ‘Transmission reached a peak during April and May,’ a 1977 WHO report notes, ‘and thereafter fell off rapidly as the monsoon increased relative humidity and hampered population movement.’Smallpox generally attacked children, and older people who hadn't already contracted the disease. ‘Since smallpox erupted epidemically roughly every five to seven years in most parts of India,’ historian of medicine David Arnold explains, ‘its principal victims were children born since the previous epidemic.’Smallpox was ‘the inevitable bridge which every child has to cross before entering into life,’ noted Sir Sayyid Ahmad Khan in India in 1879. ‘Recovery from the disease is considered second birth.’Part I: <a href="https://www.nepalitimes.com/banner/big-story-of-small-pox-in-nepal/" target="_blank" rel="noopener noreferrer">Big story of smallpox in Nepal</a>Part III: <a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/opinion/smallpox-politics-and-power-in-kathmandu/" target="_blank" rel="noopener noreferrer">Smallpox, politics and power in Kathmandu</a>Part IV: <a href="https://www.nepalitimes.com/opinion/how-nepal-eradicated-the-smallpox-virus/" target="_blank" rel="noopener noreferrer">How Nepal eradicated the smallpox virus</a>Part V: <a href="https://www.nepalitimes.com/banner/viruses-past-present-and-future/" target="_blank" rel="noopener noreferrer">Viruses past, present and future</a>‘It has become quite a saying among the agricultural and even wealthier classes,’ a British planter in the 1860s noted, ‘never to count children as permanent members of the family until they have been attacked with and recovered from smallpox.’Symptoms did not show during the virus's two-week incubation period. Those infected felt fine, and some even travelled, taking the disease with them, although they were not yet contagious.But after two weeks, the first of smallpox's horrific symptoms hit: intense fever, often with splitting headaches, body aches, and vomiting. Children often broke into convulsions. After a couple days, the patient might feel better for a day or two, and even rejoin normal life. But by this point contagious, they risked passing along the infection. Then came a red rash, at first on the tongue but soon all over the body, even on the palms of the hands and the soles of the feet, causing tremendous pain.By the fifth day, fluid started accumulating in the now bigger and bluish pockmarks. Fever deepened. Eyelids, lips, and nose grew swollen. The afflicted person had trouble swallowing. They might fall into delirium. Lesions could form on the eyes. The patient could be hard to recognise. A dreadful smell was common, as were secondary infections. <figure><img width="930" height="758" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109121124/636b8dd79c7e80680e06b36ejpeg.jpg" alt=""><figcaption> </figcaption></figure>At two weeks, scabs formed. They ‘encrust most of the body’, historian Fenn writes. The pain was awful, ‘any movement excruciating.’ The itching could be unbearable. Death, if it was to visit, normally arrived by this point. The disease also tore apart the lungs, heart, and liver. Smallpox consumed its human hosts ‘as a fire consumes its fuel, leaving spent bodies, dead or immune, behind,’ writes Fenn. In Nepal, as in much of north India, people thought of smallpox in religious terms, as a visitation by the goddess Sitala, ‘the cool one’. This understanding of disease came with its own remedy: ‘Smallpox was conceptualised,’ historian Arnold writes, ‘not as a disease but rather as a form of divine possession, and the burning fever and pustules that marked her entry into the body demanded ritual rather than therapeutic responses.’  Sufferers showed respect and honour to Sitala with the proper prayers and offerings. 'Oh Mother Sitala,' 19th century Newaris used to sing, 'do not afflict us! Deliver the people, we beg you a thousand times!'In addition to prayers to Sitala, some South Asians, including Nepalis, used inoculation to head off the disease. They intentionally give their children mild cases of smallpox, hoping that death would not result. Once recovered, the patient would have life-long immunity. Inoculation carried risks and did not work as well as the vaccine developed from cowpox by Edward Jenner in the 1790s, especially after it was improved during the mid 19th century. But inoculation did save many people from death. Otherwise, smallpox killed one in three of those who got it.As early as 1802, and for much of the nineteenth century, the British tried to introduce Jenner's vaccine into its Indian colony. But they ran into lots of obstacles, many of their own creation, so it took until the early 20th before vaccinations became common.What happened? For starters, until the 1850s, the British vaccine was not as effective as they thought, especially in India's heat. Vaccination required person to person contact. Vaccination also cost more than the British wanted to pay, so they did not build the necessary health and education infrastructure. In addition, cultural gaps surrounding the belief in Sitala, which the British tried to crush instead of to accommodate, also interfered. Many resisted vaccination. ‘To some Hindus,' Arnold explains, 'recourse to any form of prophylaxis or treatment was impious, likely to provoke the goddess and further imperil the child in whose body she currently resided.’ Ultimately, he emphasises, the big problem was that the British administration and medical system in India was‘culturally and politically distant from the lives of its subjects’. But by the early 20th, the British had improved the vaccine and its delivery, done a better job of explaining its benefits, and begun to meet with more success. In the decade after 1935, for instance, each year roughly 4.3 million people in Madras alone, almost 10% of the population, received vaccinations.Just as in India, the smallpox virus periodically ravaged Nepal, causing tremendous suffering, killing many, and leaving behind scarring and blindness. It affected all levels of society, even Nepal's royal family on several occasions in the 19th century.  This is the second in a <a href="https://www.nepalitimes.com/opinion/big-story-of-small-pox-in-nepal/" target="_blank" rel="noopener noreferrer">series of articles</a> about the history of disease in Nepal. Forthcoming columns will explore the role of smallpox in Kathmandu’s power struggles in the 19th century, and its eradication campaign in the 1960s. Tom Robertson, PhD, is researching the environmental history of Kathmandu Valley.

The smallpox virus in British India

When we think of Nepal's history, mostly political events jump to mind: the expansion of the Gorkhali state, Jang Bahadur's takeover, or the 'People's War’. We rarely think about disease. But diseases have shaped the course of history in the Himalaya in many unexpected and important ways. Perhaps no disease did so more than malaria, which plagued low hill valleys and especially Tarai forests for centuries. Its near complete eradication in the 1960s has altered the lives of almost every Nepali in one way or another. Viruses somewhat similar to the coronavirus have also touched the lives of countless Nepalis, and shaped larger events. Measles, influenza, hepatitis, <a style="letter-spacing: 0.01em;" href="https://www.nepalitimes.com/banner/polio-hunt/" target="_blank" rel="noopener noreferrer">polio</a>, and rabies have killed or maimed thousands. In 1918, the <a style="letter-spacing: 0.01em;" href="https://www.nepalitimes.com/opinion/remembering-a-pandemic-100-years-ago/" target="_blank" rel="noopener noreferrer">Spanish Influenza</a> cut down 12-18 million Indians, and probably tens of thousands of Nepalis. In some districts in north India, 1 in 10 died. Near Agra, 1 in 7 died. More recently, 50,000 Nepalis now live with HIV, many others have been lost to this virus which first appeared three decades ago.Part II: <a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/opinion/the-smallpox-virus-in-british-india/" target="_blank" rel="noopener noreferrer">The smallpox virus in British India</a>Part III: <a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/opinion/smallpox-politics-and-power-in-kathmandu/" target="_blank" rel="noopener noreferrer">Smallpox, politics and power in Kathmandu</a>Part IV: <a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/opinion/how-nepal-eradicated-the-smallpox-virus/" target="_blank" rel="noopener noreferrer">How Nepal eradicated the smallpox virus</a>Part V: <a href="https://www.nepalitimes.com/banner/viruses-past-present-and-future/" target="_blank" rel="noopener noreferrer">Viruses past, present and future</a> <figure><img width="2048" height="1393" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109121120/636b8d9e9c7e80680e06b359jpeg.jpg" alt=""/><figcaption>Health worker administering a small pox vaccine on a person in Sanischare of Jhapa. Photo: BETH PRENTICE AND BOB FRANK</figcaption></figure>Before COVID-19, perhaps the most feared virus in Nepali history was smallpox. Until its eradication in the mid 1970s, smallpox (biphar in Nepali, chechak in Hindi) regularly terrorised Nepali towns and villages. It struck mostly children, causing excruciating pain, killing many, and leaving survivors permanently disfigured. Every year saw new cases, but every five or ten years, a broader epidemic would tear through communities, particularly dense settlements such as Kathmandu and avenues of trade and communication, such as Nepal's postal routes. A large outbreak hit Kathmandu in 1958, and a pockmark survey in 1965 showed that 16% of the Valley's population had contracted smallpox at some time in their lives. And they were the survivors -- the virus killed roughly one of every three it afflicted.Unlike diseases like cholera that hit the poor in greater numbers, smallpox was an equal opportunity killer. It struck down both raja and raiti. Several times it invaded Nepal's royal palace.The last case of smallpox in Nepal appeared in 1975. The disease, historian <a href="https://www.colorado.edu/history/elizabeth-fenn" target="_blank" rel="noopener noreferrer">Elizabeth Fenn</a> has written, is ‘a misery commonplace in years gone by but unfamiliar to the world today'. <a href="https://www.nepalitimes.com/latest/kathmandu-in-the-time-of-cholera/">Kathmandu in the time of Cholera</a>, Tom RobertsonViruses like smallpox and COVID-19 originate in animals before spreading to humans. Coronavirus developed in bats, but no one knows where smallpox came from. Today, experts believe that as many as 100 million types of viruses exist in animals worldwide, waiting to jump to humans under the right conditions. Once in the human body, viruses become tiny engines of infection of simple but deadly design, little bits of genetic coding packaged in a protein that hijack the body's cells, transforming them into ‘virus producing factories', as historian of medicine Frank Swowden has put it. The virus then reproduces exponentially, killing its host cells and, unless checked, overwhelming the body's defenses.  All diseases have different characteristics and personalities. Their origins, methods of transmission, symptoms, and social impact vary widely. Smallpox spread easily. It moved not by bite of flea or mosquito but from human to human contact, normally through droplets coughed or sneezed into the air. Because the disease caused open sores in a patient's mouth and throat, a single sneeze or cough could launch thousands of infected particles into the air. The virus could also spread through beds and items of clothing. If you lived in a house with a relative suffering from smallpox, and if you had never had the disease before, you had a 50-50 chance of getting it. There was no cure.<a href="https://www.nepalitimes.com/here-now/the-mosquito-that-changed-nepals-history/">The insect that changed Nepal's history</a>, Tom Robertson <figure><img width="2300" height="2728" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109121120/636b8da19c7e80680e06b35ajpeg.jpg" alt=""><figcaption> </figcaption></figure>Smallpox was horrific. Perhaps only bubonic plague and cholera sparked more terror. It left survivors badly pockmarked and often blind. Historically, smallpox caused three-quarters of all blindness in India. Smallpox, an Indian observer noted in 1879, ‘touches the keenest of human susceptibilities; for there are thousands in this country who, though spared by it from death, still have traces of its violence in the deep marks on the face or the loss of an eye’.Around the world, the smallpox virus wrought havoc and dramatic social change. In Europe, it ripped through the dense, disorganised cities and towns of the 17th and 18th  centuries. Half of Europe's population carried scars from the disease. Smallpox afflicted rich and poor alike. It killed England's Queen Mary and Prince William, ending the house of Stuart.In the Americas, smallpox spurred even more devastation and turmoil. Because indigenous groups had no previous exposure and therefore no immunity, they died in much higher rates than Europeans. Whole communities were wiped out. <a href="https://www.nepalitimes.com/here-now/nepal-is-a-microcosm-of-all-of-the-changes-in-world-health/">“Nepal is a microcosm of all of the changes in world health”,</a> Nepali Times  <figure><img width="1278" height="716" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109121120/636b8da59c7e80680e06b35bjpeg.jpg" alt=""><figcaption> </figcaption></figure>The massive waves of death cleared the way for European settlement and spurred the import of slaves from Africa, many of whom had immunities from childhood. Smallpox acted as an ‘unwitting instrument of empire,’ according to Fenn.In its tragic wake, smallpox also prompted important public health innovations. In many parts of Asia, including India and Nepal, people for centuries used variolation -- inoculation using live virus -- to block the disease. A string infected from a mild case of the disease would be rubbed under the skin, thus actually giving the person the disease. Some would perish, but most survived, thereby gaining immunity from future outbreaks.A less risky and more broadly effective vaccine was developed in Britain in the 1790s. A country doctor named Edward Jenner, noticing that milkmaids never contracted smallpox, discovered that intentionally giving humans cowpox -- a virus related to smallpox -- could create immunity to the disease without inoculation's painful symptoms and risk of death. Jenner predicted that vaccines like his could one day eradicate smallpox from the planet. ‘The annihilation of the smallpox, the most dreadful scourge of the human species,' he wrote in 1801, 'must be the final result of this practice.’That prophecy became reality in the 1970s -- but only after a century of misguided British efforts in colonial India, and only after a complicated and controversial global eradication campaign in the 1960s and 1970s that only succeeded, as one historian of medicine put it, ‘by the thinnest of margins’. Coronavirus differs from smallpox in important ways. Nonetheless, revisiting smallpox's history in the Himalaya can help us better understand the interconnected social, medical, and political landscapes in which we live. This is the first in a <a href="https://www.nepalitimes.com/opinion/big-story-of-small-pox-in-nepal/" target="_blank" rel="noopener noreferrer">series of articles</a> about the history of disease in Nepal. Forthcoming columns will explore British attempts to spread vaccination in India and the role of smallpox in Kathmandu’s power struggles in the 19th century, and its eradication campaign in the 1960s. <a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/how-chitwan-was-opened,4159" target="_blank" rel="noopener noreferrer">Tom Robertson</a>, PhD, is researching the environmental history of Kathmandu Valley.

Big story of small pox in Nepal

Nepal’s former king Gyanendra was greeted by flag-waving supporters as he arrived at Kathmandu Airport on Sunday afternoon from Pokhara after attending pro-monarchy rallies in various parts of the country. Gyanendra and his family were escorted from the airport by supporters to his residence at Nirmal Niwas, where his family has been living since 2008 when the Constituent Assembly abolished the monarchy. The 2015 Constitution then turned Nepal into a federal democratic republic. The deposed monarch had been on a two-month long tour of religious sites and local communities across western Nepal, ending in a two-week stay in Pokhara. After staying out of controversy, Gyanendra made a statement on Nepal’s Democracy Day last month in which he said he was willing to play a role in “saving the country”. There has been a surge of pro-monarchy posts and videos on social media, where the country’s previous kings have been glorified as being nationalists who were respected by the international community.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250309120340_07b324fee8d082ed3f8566544e24d45fcd600bbb122374fc39c7a94ce3d044f2.jpg" data-media-id="editor_0" data-image-id="20250309120340_07b324fee8d082ed3f8566544e24d45fcd600bbb122374fc39c7a94ce3d044f2" data-rendition-name="original" width="1914" height="1276" loading="lazy" alt="The ghost of monarchy returns to haunt Nepal NT"> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250309120340_769f688f3a5eb3602f4c24c350ba1caa6965a171c079d783e28db0f746b810d0.jpg" data-media-id="editor_1" data-image-id="20250309120340_769f688f3a5eb3602f4c24c350ba1caa6965a171c079d783e28db0f746b810d0" data-rendition-name="original" width="2000" height="1333" loading="lazy" alt="The ghost of monarchy returns to haunt Nepal NT"> </figure>  Nepal’s monarchists, which include Gyanendra’s backers, several pro-monarchist parties and other anti-government figures, think <a href="https://nepalitimes.com/editorial/new-year-same-difference">public disillusionment </a>with the country’s ageing and ineffective leaders and institutions is at breaking point.&nbsp; There is also disappointment with elected leaders and technocrats from new parties like the Rastriya Swatantra Party (RSP), with its <a href="https://nepalitimes.com/news/rabi-s-detention-churns-nepali-politics">leader Rabi Lamichhane under investigation</a> for his alleged involvement in a scandal involving diverting funds from cooperatives. One of the staunchest backers of Gyanendra’s comeback as king is former BBC journalist Rabindra Mishra, who has been active on social media platforms posting videos and text extolling the monarchy. He has referenced recent street uprisings in Sri Lanka, Bangladesh, and Syria, cautioning Nepal’s mainstream leaders not to dismiss support for the monarchy. ‘Support for a return to monarchy is increasing even though the mainstream parties may dismiss it,’ wrote Mishra. ‘Like the leaders of Sri Lanka and Bangladesh, they should not try to suppress the voices on the streets.’  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250309120340_d8758f6b7474c9f3aea3661ccd60955d8553971cb0d799039bbfd232aa1a0691.jpg" data-media-id="editor_4" data-image-id="20250309120340_d8758f6b7474c9f3aea3661ccd60955d8553971cb0d799039bbfd232aa1a0691" data-rendition-name="original" width="1890" height="1260" loading="lazy" alt="The ghost of monarchy returns to haunt Nepal NT"> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250309120340_63613759744c0fac33ff3eabc298079c3e525063882f4b3760954bbc0833b5cd.jpg" data-media-id="editor_5" data-image-id="20250309120340_63613759744c0fac33ff3eabc298079c3e525063882f4b3760954bbc0833b5cd" data-rendition-name="original" width="2000" height="1333" loading="lazy" alt="The ghost of monarchy returns to haunt Nepal NT"> </figure>  But for all their bluster, Nepal’s mainstream politicians who have rotated leadership of the country between themselves, seem worried about the crowds on the streets in support of the monarchy. The TikTok ban last year, which the government said was to ‘maintain social harmony’ was put into effect to prevent pro-monarchy groups from organising on the platform. The ban on TikTok has now been lifted, and supporters of the monarchy have mobilised platforms to fan nostalgia of the golden age of royalty, and to brand former kings Mahendra and Birendra as <a href="https://nepalitimes.com/review/a-past-foretold">nationalists who upheld Nepal’s sovereignty during the Cold War</a> and commanded respect worldwide. Archival video clips of Mahendra being received by President Eisenhower in 1960 and <a href="https://nepalitimes.com/here-now/if-birendra-was-alive-nepal-could-still-be-a-monarchy">Birendra </a>by President Reagan in 1983 have been liked by thousands. Comments contrast this to the incompetence and poor standing of Nepal’s current prime ministers.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250309120340_7dab05f5703e17a82da73277f0b39bf178c1005e0758aa50077ffe1a037f4af6.jpg" data-media-id="editor_8" data-image-id="20250309120340_7dab05f5703e17a82da73277f0b39bf178c1005e0758aa50077ffe1a037f4af6" data-rendition-name="original" width="1810" height="1206" loading="lazy" alt="The ghost of monarchy returns to haunt Nepal NT"> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250309120340_1ab38cdccfd076babd78579fa345520a7b2fa9c838322226a259540c8c290437.jpg" data-media-id="editor_9" data-image-id="20250309120340_1ab38cdccfd076babd78579fa345520a7b2fa9c838322226a259540c8c290437" data-rendition-name="original" width="1812" height="1206" loading="lazy" alt="The ghost of monarchy returns to haunt Nepal NT"> </figure>  While most of the people present at the demonstration included the older demographic, younger people have especially used social media to express their support for the monarchy. Young Nepalis, disillusioned with leaders who have been prime minister multiple times since the mid-1990s, are attracted to the idea of reinstating the monarchy as a form of anti-incumbent protest, but also because they have little to no memory of living under an authoritarian absolute monarchy. ‘Those who say the monarchy is paramount today are the ones who did not live through it in the past, and are dissatisfied with the current state of affairs,’ wrote Guna Raj Luitel, Chief Editor of Nagarik Daily, in an op-ed in the newspaper on Sunday.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250309120340_720d0059207b9918def39e983d9b5c114b6afb4e7ac0ed1dadd2cba2f20f9aa6.jpg" data-media-id="editor_10" data-image-id="20250309120340_720d0059207b9918def39e983d9b5c114b6afb4e7ac0ed1dadd2cba2f20f9aa6" data-rendition-name="original" width="2000" height="1333" loading="lazy" alt="The ghost of monarchy returns to haunt Nepal NT"> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250309120340_bfe50ebd413d1b177ebd02df5f837038d8a04c9d343afe39be1ebcde36db893a.jpg" data-media-id="editor_11" data-image-id="20250309120340_bfe50ebd413d1b177ebd02df5f837038d8a04c9d343afe39be1ebcde36db893a" data-rendition-name="original" width="2000" height="1333" loading="lazy" alt="The ghost of monarchy returns to haunt Nepal NT"> </figure>  He added: ‘For those of us who have spent parts of our lives under the rule of the king… we have not yet forgotten those days, when the institution was unable to do any useful work, a disheartening period characterised by Nepalis being unable to speak freely.’ Commentators have especially been pointing to Gyanendra’s military coup in 2005 when he dissolved parliament, and tried to take the country back to the time of absolute monarchy, just like his father Mahendra did in 1960. Gyanendra became king after his brother and most of his family were killed in the royal palace massacre in 2001. Many Nepalis still seem to believe that Gyanendra was responsible, and some of this is reflected in comments on monarchist social media posts. As the monarchist rallies spread, Prime Minister K P Oli said last week that if Gyanendra really wanted power, he should form a political party and run in the next elections in 2027. Other leaders have urged the former king to honour the 2008 Constitutional Assembly decision to abolish the monarchy, as well as Nepal’s 2015 Constitution.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250309120340_978ef979c7774312ac00d3192803d974ea57ec45d704f89663b301f4f0cc9704.jpg" data-media-id="editor_12" data-image-id="20250309120340_978ef979c7774312ac00d3192803d974ea57ec45d704f89663b301f4f0cc9704" data-rendition-name="original" width="1832" height="1221" loading="lazy" alt="The ghost of monarchy returns to haunt Nepal NT"> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250309120340_d11276de0161d258f135e8fba4d3eb37d0a9e579b06a4819c6609b4ecdbbe51e.jpg" data-media-id="editor_13" data-image-id="20250309120340_d11276de0161d258f135e8fba4d3eb37d0a9e579b06a4819c6609b4ecdbbe51e" data-rendition-name="original" width="2000" height="1333" loading="lazy" alt="The ghost of monarchy returns to haunt Nepal NT"> </figure>  &nbsp;In response, royalist leaders including Kamal Thapa, Rajendra Lingden, and Rabindra Mishra have responded that the monarchy is above the electoral system, calling for the reinstatement of a constitutional monarchy in which Gyanendra would be a figurehead. “There is no question of the king contesting an election, that is our job,” said RPP-Nepal chair Kamal Thapa in a tv interview. “The monarchy is a custodian of the nation, it is an institution above electoral politics.” However, there does seem to be a disagreement between hardline royalists who want a return to absolute monarchy in which Gyanendra would actually hold executive powers, and those who favour a ceremonial one. Gyanendra recently visited Bhutan, where he was given a royal welcome, and has made several trips to India where there is some support for reinstating Nepal as the world’s only Hindu kingdom.

The ghost of monarchy returns to haunt Nepal

Kathmandu was once a lake inhabited by <a href="https://nepalitimes.com/news/snakes-on-plains">serpents</a>, until Manjushree visiting from present-day China saw a fluorescent lotus in the water. To reach it, the sage used his flaming sword to cut a gorge <a href="https://nepalitimes.com/from-the-nepali-press/dry-port-at-chobhar-faces-resistance">at Chobhar</a>, draining the lake and turning it into a fertile valley. The Manjushree Trail Race (MTR) is inspired by this legend. There are five categories along a near-circular route around the rim of <a href="https://nepalitimes.com/banner/bringing-silicon-valley-to-kathmandu-valley">Kathmandu Valley</a>: 10k, 30k, 50k, 100k, and one that is 100 miles that is 157.7km (map, right). The 100 miles category starts at 8AM on 14 March, and runners have 52 hours until noon on 16 March to complete it. Arjun Kulung Rai’s 26:52:56 is the current record, set in 2024. “<a href="https://archive.nepalitimes.com/news.php?id=17327">The Manjushree legend</a> and the perfect loop make the race very meaningful, and I wanted to do it,” says participant Dong Sheng from the northern Chinese city of Harbin who started running in 2016 with 5k until he accomplished a 100 miler in 2022. “<a href="https://archive.nepalitimes.com/article/nation/first-edition-ultra-trail-kathmandu,1050">Running </a>is spiritual, as you are always trying to overcome what you could previously do.” Sheng is one of 131 international runners who have signed up for the Manjushree race, where there are a total of 502 participants this year, 94 of them women. The first edition of the race only had 7 runners total. Read also: <a href="https://nepalitimes.com/here-now/nepali-trail-running-champions">Nepali trail running champions</a>, Preeti Khattri “A reason this race is popular is because it is a good mix of rural and accessible,” says Jimmy Oostrom, a Dutch runner. “Often, 100-milers are way out of the way. Here, the start is only a short drive after landing in Kathmandu.”&nbsp; The 100 mile and 50km are now qualifier races for the Asia Trail Masters, an international series of trail races based in Hong Kong. Last year, a Nepali team competed and won in the Asia Trail Master Championship series in Borneo. The 100-mile category starts and finishes at Single Tree on Nagarjun, other distances have different start and end points. On the winning team was Rashila Tamang, who is part of Trailmandu that implements logistics for the race, such as recruiting and training volunteers, and marking the route. “Nepal has great <a href="https://archive.nepalitimes.com/news.php?id=9938">geography</a> for <a href="https://nepalitimes.com/here-now/mira-rai-racing-to-help-other-runners">trail running</a>, but it is still very hard to make it your career,” says Tamang.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025031219034_98b83aa3d42c7d5e8a2ef2f80dc03512374413e31eb55441234cd075bea7e113.jpg" data-media-id="editor_8" data-image-id="2025031219034_98b83aa3d42c7d5e8a2ef2f80dc03512374413e31eb55441234cd075bea7e113" data-rendition-name="original" width="1244" height="598" loading="lazy" alt="Manjushree Trail map "> </figure>  The MTR has a guidebook detailing the categories, route, checkpoints, rules and what is available at each stop.&nbsp; “If we say we’re going to start at 8, we’re going to start at 8,” says Narayan Acharya, the man behind naming the race ‘Manjushree’. “People tried to sign up after the deadline, we had to tell them no.” Acharya who builds <a href="https://nepalitimes.com/banner/foundations-for-sustainable-buildings-in-nepal">traditional rammed earth houses</a> through his company Sustainable Future Nepal, has been long involved with promoting trail running in Nepal, and hailing from Jumla himself, mentored <a href="https://nepalitimes.com/here-now/run-sunmaya-run">Sunmaya Budha</a> also from Jumla, now a trail running star in and outside Nepal. Read also: <a href="https://nepalitimes.com/here-now/sunmaya-budha-stays-in-the-running">Sunmaya Budha stays in the running</a>, Vishad Raj Onta&nbsp; The organisers are sponsoring up to 50 runners from <a href="https://nepalitimes.com/banner/portrait-of-a-photographer-in-rural-nepal">rural Nepal</a> who may not afford the Rs6,000 entry fee to participate. “It is hard to get sponsors to give us money because Nepal is still a pretty small market,” says Oostrom, currently on crutches due to an ACL injury. “We also have to take the necessary precautions to make sure we can quickly help a runner in trouble.” The logistics of an ultra trail race are more complicated than a <a href="https://archive.nepalitimes.com/news.php?id=1223">marathon</a>. Marking and maintaining the trail requires careful work, especially as signs often get lost. The <a href="https://nepalitimes.com/multimedia/the-steadfastness-of-a-long-distance-runner">long distances </a>also require runners to run through the night.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025031219030_19111e03939541b8980007437c89966dc7a8fd6246b8407440694503bf7890a3.jpg" data-media-id="editor_15" data-image-id="2025031219030_19111e03939541b8980007437c89966dc7a8fd6246b8407440694503bf7890a3" data-rendition-name="original" width="2250" height="1501" loading="lazy" alt="Manjushree Trail "> </figure>  A <a href="https://nepalitimes.com/business/buddha-air-gets-state-of-the-art-flight-tracking-system">live tracking system </a>would ensure a runner’s safety as well as prevent cheating, but for now organisers are relying on vigilant volunteers and fellow runners to find runners needing help. There are strict rules for the race, and breaking them can result in significant time penalties or even disqualification. Get food or drink assistance outside of the checkpoints and you get a penalty of 15 minutes. Miss any pieces of mandatory gear and an hour is added to your time. Take some sort of shortcut or cheat using a vehicle, and you are disqualified. There are dangers like cliffs <a href="https://archive.nepalitimes.com/page/cantilever-trail-nepal">along the trail</a>, lightning on exposed ridges, <a href="https://nepalitimes.com/banner/disasters-in-nepal-come-in-waves">landslides caused by earthquakes</a>, <a href="https://nepalitimes.com/banner/trekking-to-save-nepals-snow-leopards">leopards</a>, and hornet swarms. Ultra running takes a massive toll on the body. The brain may shut off certain areas to be able to keep going, so volunteers watch runners carefully.&nbsp; “After mile 50, your body starts digesting itself,” says Oostrom.&nbsp; Alongside Acharya and Oostrom, the organising crew is made up of race director Ashish Mishra, and Jeevan Lama and Rashila Tamang from Trailmandu. “We can execute this race well because we are all passionate runners ourselves,” says Acharya. The team has taken measures to make the race safe and comfortable for female participants. ‘Run freely, speak openly, and wear what makes you feel comfortable in our races,’ says the guidebook. Prize money is the same for male and female winners, across categories.&nbsp; Lately, Nepal has been steadily building itself as a destination for<a href="https://nepalitimes.com/banner/taking-the-high-line"> adventure sports </a>such as <a href="https://nepalitimes.com/here-now/nepal-pushes-mountain-bike-tourism">mountain biking</a> and trail running. And with the Manjushree race, enthusiasts have hopes to set the standard for other trail races in the country. Sheng has been part of big races in China. “The better the economy, and more money people have, the more they can get involved in such pursuits,” he says. “But I have to say, for the scale of this race, everything has been done very professionally.”&nbsp;

Around Kathmandu in 100 miles

Throughout human history, civilisations have been named after the rivers along which they flourished: Indus Valley, Nile, Tigris-Euphrates. Many of these cultures later collapsed, partly because they could not manage their water needs properly. Three recent books about Himalayan rivers look at their history and geography, and how they nourished civilisations downstream. The rivers gave birth to the world’s major religions, their waters and the mountains from which they sprang were revered. Mythology and geology converge in High Asia. Mt Kailash is holy to the Hindu, Jain, Buddhist and Bon faiths as the centre of the world and the abode of the gods. Indeed, from its vicinity emerge Asia’s great rivers: the Indus and Sutlej, Ganga and the Yarlung Tsangpo (Brahmaputra) and Karnali (Mapcha Tsangpo).&nbsp; Legend has it that Kathmandu Valley was once a primordial lake drained by Manjushree who cut a mountain with his flaming sword. There is scientific evidence that the paleo lake was indeed emptied in stages starting 40,000 years ago after a tsunami unleashed by a major earthquake epicentred in Langtang. The Bon faith describes the Tibetan Plateau being pushed up from a roiling primeval sea, confirming current evidence about the orogenesis of the Himalaya. In local lore, supernatural lha (animal deities) and lu (serpents, naga) moved from sea to land, just as the theory of evolution explains the emergence of early amphibians and land creatures. In <a href="https://www.routledge.com/Rivers-of-the-Asian-Highlands-From-Deep-Time-to-the-Climate-Crisis/Gamble-Tan-Xu-Beavis-Maurer-Pittock-Powers-Wasson/p/book/9781032490595?srsltid=AfmBOopjkpgcN1_7t1jTI_Z1_27yRthBTbdHA15OWcE9Ge3S409jhUX3">Rivers of the Asian Highlands: From Deep Time to the Climate Crisis</a>, Himalayan historian <a href="https://scholars.latrobe.edu.au/rgamble">Ruth Gamble</a> and co-authors begin by tracing the genesis of the Himalaya, citing evidence that the Tibetan Plateau pre-dated the collision of the Indian and Eurasian plates 50 million years ago. Asia’s main rivers co-emerged with the mountains, their waters cutting canyons through rocks as they were uplifted. The gigantic pileup acted as a moisture trap for the proto-monsoon, the rain and ice sculpting peaks as they rose. But so strong were tectonic forces that the uplift outpaced erosion on the Tibetan Plateau. These dynamic processes are still at work, but in many places across High Asia there is a new factor at play: modern infrastructure (like haphazard road-building in Nepal) is increasing erosion faster than the uplift rate.&nbsp; ‘This is an example of human action overcoming tectonics,’ write the authors in Rivers of the Asian Highlands, in which the chapters look at Himalayan rivers from a planetary scale, their socio-cultural histories, to present-day engineering to regulate them. An ongoing dam-building spree and anthropogenic climate breakdown combine to bring about the most rapid change the Himalaya and their rivers have seen for millions of years. One example is the Medog Hydropower Station being built on the Yarlung Tsangpo at a bend on the Brahmaputra before it enters India. The river drops 2,000m within a 50km stretch, the gradient allowing it to generate 60,000MW — the biggest single hydroelectric plant in the world. Gamble and the authors of Rivers of the Asian Highlands highlight the Gravitational Potential Energy (GPE) of the Himalaya that allows falling water to be converted into electricity. But GPE also unleashes landslides, rockfalls, avalanches, Glacial Lake Outburst Floods (GLOFs) and Landslide Lake Outburst Floods (LLOFs), the risks posed by them magnified by climate change and seismicity. <blockquote>The Asian Highlands’ abundance of Gravitational Potential Energy (GPE) can support the region’s energy transition, but it needs to be produced in much less hazardous and less environmentally and socially impactful ways. The best means of doing this is through off-river, pumped-storage hydropower stations that back up solar and wind energy generators. Smaller projects such as this would also involve less risky tunneling and displacement.</blockquote> Rivers of the Asian Highlands: From Deep Time to the Climate Crisis by Ruth Gamble, et al. There is geological evidence that megafloods on Himalayan rivers are more responsible than mass wasting in weathering down the mountains. One big LLOF, for example, could ‘move 1,000 times more sediment than would otherwise be transported over millions of years’. Permafrost melting in the Tibetan Plateau and inside moraines caused recent back-to-back GLOFs in Chamoli in the Indian Himalaya, Melamchi in Nepal, and the South Lhonak in Sikkim — all deadly disasters that together destroyed billions of dollars worth of infrastructure downstream. Rivers of the Asian Highlands travels from deep time to the present climate crisis, taking readers through neatly divided chapters titled Mountain Rivers, Climatic Rivers, Frozen Rivers, Living Rivers, Human Rivers, Territorializing Rivers, Agricultural and Pastoral Rivers, even NGOs and Rivers.&nbsp; Although the book’s title is about the ‘Asian highlands’, it <a href="https://www.himalmag.com/comment/eastern-himalaya-cradle-ethnogenesis">focuses mainly on the Dri Chu (Yangtse)</a> and Yarlung Tso (Brahmaputra). Readers looking for references to Nepal’s rivers will be disappointed, although there is quite a bit about Bhutan. This is surprising because 70% of the annual flow in the Ganga is from tributaries in Nepal, some of them rivers like Karnali, Arun or Bhote Kosi that traverse the Tibetan rimlands. As demand for water and energy grows in the large and increasingly affluent population of north India, and climate breakdown melts Himalayan glaciers, storing monsoon runoff on reservoirs in Nepal is going to be the geopolitical issue of the next decades.&nbsp; The chapter on NGOs and Rivers also fails to cite the work of Nepal’s civil society groups like the Alliance for Energy that built international solidarity in 1995 against the Arun III project on a river that starts in Tibet and flows into Nepal. Ultimately, the World Bank pulled out of the project and the Nepal government invested in smaller decentralised plants. Today, a cascade of power plants are being built by Indian companies on the Arun which do not seem to have taken into account the <a href="https://www.science.org/doi/10.1126/science.ads2659">2023 Sikkim GLOF</a> that swept away the $1 billion dollar Teesta III and destroyed other infrastructure. The World Bank itself is back with the Upper Arun project located directly below expanding glacial lakes in Tibet.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250222020256_f2b33e60e6b386308bdf59b58b59e116e90e2e4466a06200faf76fd851f53505.jpg" data-media-id="editor_4" data-image-id="20250222020256_f2b33e60e6b386308bdf59b58b59e116e90e2e4466a06200faf76fd851f53505" data-rendition-name="original" width="5712" height="3213" loading="lazy" alt="Teesta"> <figcaption>The Super Trisuli project in Nepal has ruined the most scenic and ecologically sensitive part of the river to generate just 100MW of power. Photo: KUNDA DIXIT</figcaption> </figure>  Despite geographical gaps, Rivers of the Asian Highlands reads like an encyclopedia of Himalayan rivers. The authors look at them not in isolation but as interconnected systems which need a multidisciplinary approach to study the geological, religio-cultural, infrastructure, climate and ecosystem services aspects of catchments.&nbsp; Mt Kailash (Kang Rinpoche) is a case in point. It is fascinating to think that it was part of a mountain range even before the collision of the continents that formed the Himalaya, and was probably buried in ice 3km thick till 15,000 years ago during the Last Glacial Maximum.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025022203020_23c02ec4671f5c3c561fa6b450c1f209720a25794e067b9bb5db0f4649b1b6dc.jpg" data-media-id="editor_5" data-image-id="2025022203020_23c02ec4671f5c3c561fa6b450c1f209720a25794e067b9bb5db0f4649b1b6dc" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="Mt Kailash"> <figcaption>Mt Kailash. Photo: NABIN BARAL</figcaption> </figure>  Lake Mansarovar and Mt Kailash are also the subject of the new Nepali language book छालबाटो (Road by the Waves) by environmental journalist <a href="https://nepalitimes.com/news/nepal-and-china-to-study-trans-himalayan-railway">Ramesh Bhushal</a> in which he walked, rafted and drove from the source of the Karnali in Tibet, right through 500km of western Nepal, and on to India <a href="https://nepalitimes.com/banner/dancing-with-the-river">where the river meets the Ganga</a>. In his entourage is activist, <a href="https://archive.nepalitimes.com/regular-columns/Comment/rivers-fighting-back,993">Megh Ale</a>, who is on a campaign to stop dams and infrastructure on <a href="https://nepalitimes.com/banner/dams-and-dreams-a-journey-down-the-karnali">Nepal’s longest and only free-flowing river</a>. The book profiles his lonely upstream struggle to conserve the country’s rivers. “We worship rivers, but we don’t love them,” laments Ale. Bhushal’s book is as much about the landscape of this transboundary river as it is about the people he meets along the way, and their relationship with <a href="https://nepalitimes.com/banner/climate-denial-in-the-himalaya">a river that most regard as a curse </a>keeping them poor because they believe it flows out of Rakshas Tal (Lagngar Tso) in Tibet, regarded as a lake of demons, unlike the sacred Mansarovar nearby. The expedition is out to prove that the <a href="https://nepalitimes.com/banner/a-karnali-portrait">Karnali River</a> actually starts in the mountains 50km southwest of the Mansarovar (Mapamyu Tso) at the <a href="https://www.youtube.com/watch?v=jQ9Za5QDkvY">Peacock Falls (Mapchu Khambap)</a>. The Indus is called Sengge (Lion), Sutlej is Langchen (elephant) and the Brahmaputra is Tamchok (horse), all starting within 60km of Mansarovar but flowing out in different directions. <blockquote>“I have visited hundreds of rivers around the world, but for some reason I have never seen a river as beautiful as the Karnali. One day I would like to visit its source.”</blockquote> River conservation activist Megh Ale quoted in छालबाटो by Ramesh Bhusal. But all this reverence for the mountains and rivers may not be enough to save the region from the impact of climate breakdown. Heat stress in the Subcontinent will coincide with a shortage of water in the coming decades.&nbsp; <a href="https://www.nytimes.com/2018/12/01/opinion/himalayas-mountains-dams.html">Sunil Amrith</a> in his 2019 book, <a href="https://nepalitimes.com/here-now/the-monsoon-and-nature-s-arithmetic">Unruly Waters: How Mountain Rivers and Monsoons Have Shaped South Asia’s History</a> takes a broader look at how geotectonics, geopolitics, colonialism and nationalism have determined the relations between human beings and rivers. The Himalayan water cycle starts from monsoon moisture that precipitates with orographic uplift along the mountains, atmospheric rivers unleash cloudbursts, ground water emerges from springs that join up to flow down to rivers and the ocean. The Third Pole is the biggest repository of fresh water stored as ice after the polar regions. But it is a hotspot both because of the climate crisis and geopolitical tensions, which impacts on river basin cooperation, early warning data sharing, and ultimately in mitigation of greenhouse gas emission and planning for new risks faced by infrastructure. After independence, India adopted the colonial extraction model for rivers. Inaugurating the Bhakra-Nangal Dam in 1953, Jawaharlal Nehru called it “a temple of &nbsp;modern India … worthy of worship’. Gamble also alludes to this in her book about the European attitude about rivers as a resource to be ‘enclosed, extracted, scrutinised, commodified’. <a href="https://dialogue.earth/en/water/review-unrully-waters/" target="_blank">Amrith</a> profiles the work of Sir Arthur Cotton who was building canals linking rivers in British India at about the same time his contemporaries like botanist <a href="https://nepalitimes.com/here-now/republic-of-nepal-s-animal-kingdom" target="_blank">Joseph Dalton-Hooker </a>were exploring the <a href="https://nepalitimes.com/here-now/saving-kangchenjunga" target="_blank">Teesta and other rivers</a> in the Himalaya to catalogue new plant species. India's current National River Linking Project that would join 37 rivers with 9,000km of canals builds on Cotton’s early work. <blockquote>If there is one consistent lesson in Unruly Waters, it is that water management never has been, and can never be, a purely technical or a scientific question; neither can it be addressed on a purely national scale … the battle continues to understand the monsoons and mountain rivers that shape Asia.</blockquote> Unruly Waters: How Mountain Rivers and Monsoons Have Shaped South Asia’s History by Sunil Amrith And in Nepal, hydropower has become the holy grail as the government unveiled an Energy Development Roadmap to generate 28,500MW by 2035 at a cumulative cost of nearly $50billion. This means no river in Nepal will be left free-flowing. The Trisuli along the Prithvi Highway is being dammed for only 100MW of power, destroying the most scenic part of a river that has rapids famous internationally for white water rafters. Even before it was completed, the dam site suffered Rs200 million in damage in last September’s flood.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025022203020_d9610a11bccb593d32bf4d214479caa17dfbdd6cdfe5e8c38fdcb8eb752fc0ec.jpg" data-media-id="editor_18" data-image-id="2025022203020_d9610a11bccb593d32bf4d214479caa17dfbdd6cdfe5e8c38fdcb8eb752fc0ec" data-rendition-name="original" width="4032" height="2268" loading="lazy" alt="Trisuli"> <figcaption>Boulders and sediment 80m deep were brought down by the Teesta after a GLOF destroyed the $1 billion Teesta III plant in Sikkim in 2023. Photo: KUNDA DIXIT</figcaption> </figure>  In Sikkim, there is strong <a href="https://india.mongabay.com/2025/02/political-stir-follows-expert-panels-approval-to-rebuild-teesta-dam-in-sikkim/">local opposition to rebuild Teesta III</a> but investors are looking at the huge economic windfall from the river as it drops from 5,000m below Kangchenjunga to 300m within 80km — one of the highest Gravitational Potential Energy of any river in the world. Besides Nepal and Bhutan, the ‘watersheds’ of the Himalaya are turning into ‘powersheds’ as India and China compete for hydro-hegemony. India is said to be planning to dam the Brahmaputra to offset the disruption caused by China’s Medog Dam upstream (see map, below).&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025022203024_37c60bd2a45a32cd23928c900615b6c7045b2e0265050c4761c3749361181999.png" data-media-id="editor_20" data-image-id="2025022203024_37c60bd2a45a32cd23928c900615b6c7045b2e0265050c4761c3749361181999" data-rendition-name="original" width="1918" height="668" loading="lazy" alt="Himalayan rivers map"> </figure>  The thread running through all three books is the need to recognise the ecosystem services that the inhabitants of High Asia provide by protecting our rivers. Not all rivers need to be monetised, conserving rivers and the cultures they retain protects a nation’s natural wealth into the future as the humans of High Asia try to survive climate breakdown. The highlands will be under even more pressure in the coming decades as people in the plains migrate en masse to higher latitudes or higher altitudes to escape deadly heat and ocean expansion.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025022203028_524a74bf65111db3826bfd246576329c45cd4bd0a48b15024b6a520582bbf05a.jpg" data-media-id="editor_21" data-image-id="2025022203028_524a74bf65111db3826bfd246576329c45cd4bd0a48b15024b6a520582bbf05a" data-rendition-name="original" width="1136" height="702" loading="lazy" alt="River of Asian Highlands cover"> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025022203028_20c17a9b92b11c8bb33df5f2fc2781498464288533c310ccd61e1245e709d99c.jpg" data-media-id="editor_22" data-image-id="2025022203028_20c17a9b92b11c8bb33df5f2fc2781498464288533c310ccd61e1245e709d99c" data-rendition-name="original" width="1136" height="702" loading="lazy" alt="Unruly waters cover"> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250222030212_649cc2ba02e806da2b128fccaf5de2e5c830e10646ba0b43d56da39f65a70f9f.jpg" data-media-id="editor_23" data-image-id="20250222030212_649cc2ba02e806da2b128fccaf5de2e5c830e10646ba0b43d56da39f65a70f9f" data-rendition-name="original" width="1136" height="702" loading="lazy" alt="Chaalbato cover"> </figure>

Saving what is left of Himalayan rivers

Frustrated with revolving door <a href="https://nepalitimes.com/news/the-geopolitics-of-nepal-s-politics">politics</a> with the same <a href="https://nepalitimes.com/editorial/tried-tested-and-failed">tired, tested and failed </a>leaders, Nepal’s cybersphere is harking back to the good old days when we had strongmen rulers like <a href="https://nepalitimes.com/multimedia/jung-bahadur-s-destitute-descendants">Jang Bahadur Rana </a>or <a href="https://nepalitimes.com/news/king-mahendra-didn-t-pay-hunting-bill-in-us">King Mahendra</a>. The<a href="https://nepalitimes.com/here-now/inside-story-of-nepal-s-rana-dynasty"> century-long Rana oligarchy</a> ended 74 years ago this week, and the Shah kings airbrushed <a href="https://nepalitimes.com/here-now/the-insect-that-changed-nepal-s-history">Nepal’s history</a> to downplay their achievements and glorify their own dynasty. After <a href="https://nepalitimes.com/here-now/if-birendra-was-alive-nepal-could-still-be-a-monarchy">the monarchy</a> was abolished in 2008, <a href="https://nepalitimes.com/review/the-role-of-rituals-in-royalty">the Shah kings</a> were similarly vilified. But Nepali society is mature enough to realise that the truth is not all black and white. Jang Bahadur may have usurped power in a ruthless coup, but he was a geopolitical strategist way ahead of his time. Whatever you may say about King Mahendra’s efforts in quashing <a href="https://nepalitimes.com/news/is-democracy-too-expensive-for-nepal">democracy</a> and pushing a unitary state, he defended <a href="https://nepalitimes.com/opinion/guest-editorial/nepal-should-recognise-palestinian-sovereignty">Nepal’s sovereignty</a> and projected its international image right through the sensitive Cold War period. Jang Bahadur in England is a new Nepali language book by journalist Gajendra Budhathoki about the visit in 1850 by Nepal’s prime minister to England and France, the first by a South Asian potentate. He met Queen Victoria and by all accounts was able to establish Nepal’s presence on the world stage. Historians have long mulled why a devout Hindu like Jang Bahadur would want to break the taboo and cross the Black Waters. Budhathoki recounts the incident upon his arrival at Southampton on 2 May 1850, when British customs officials tried to check the belongings of the Nepali entourage. Furious, Jang Bahadur threatened to sail right back to France if they opened any of the bags. Jang had three main reasons for his trip. Essentially he was on a spy mission to assess <a href="https://nepalitimes.com/here-now/a-forgotten-gurkha-rebellion-e8z403ab">British military</a> might to decide if it was worthwhile for Nepal to try to militarily take back territory ceded to British India in the Sugauli Treaty of 1816. So, Jang asked his perplexed hosts to show him cannon factories, artillery and naval yards. He even visited Woolwich Arsenal (now the Royal Arsenal) not once, but three times.&nbsp; Read also: <a href="https://nepalitimes.com/here-now/looking-back-at-the-1923-nepal-britain-treaty">Looking back at the 1923 Nepal-Britain Treaty</a>, Santa Gaha Magar Suitably impressed, Jang decided to be Britain’s BFF, and even rode down to Lucknow with 3,200 Nepali troops to rescue the British from the Sepoy Mutiny of 1857. As a reward, the British gave back the Tarai districts of Banke, Bardia, Kailali, and Kanchanpur (Naya Muluk). This close relationship continued with Jang’s descendants right till the time the British left India in 1947. Jang Bahadur was also fed up with the Governor General Lord Dalhousie in Calcutta who tended to bully Nepal, and wanted to build direct contacts with his bosses in London. The British told him Dalhousie was their man in India, and Jang should deal with him. <a href="https://nepalitimes.com/banner/the-way-we-were">Jang’s visit to France</a> does not get as much attention in the book, but he was also trying to gauge France’s strength and to see if its military was more powerful than Britain’s. At that time, France was Britain’s main rival and was trying to make inroads in India. At the Louvre, Jang Bahadur was drawn to exhibits reflecting French military prowess. Later, when he met Louis Napoleon III, he asked if he could see a parade of 900,000 troops to assess France’s military might.&nbsp; Read also: <a href="https://nepalitimes.com/review/nepal-france-ties-in-photos">Nepal-France ties in photos</a>, Reeti KC Freshly returned from <a href="https://nepalitimes.com/here-now/a-long-way-to-europe">Europe</a>, an emboldened Jang Bahadur Rana led Nepal in a war against Tibet in 1855 which ended with the Treaty of Thapathali a year later. This was the third time Nepal and Tibet had fought, the first time being soon after <a href="https://archive.nepalitimes.com/regular-columns/guest-editorial/Prithvi-Narayan-Shah-a-visionary-leader,1102">Prithvi Narayan Shah</a> in 1788.&nbsp; The Qing Dynasty came to the rescue of Tibet, and while both sides claimed victory, the Sino-Nepalese War ended essentially as a stalemate with the Treaty of Betrawati.&nbsp; All of this is detailed in Axel Michaels’ book, Nepal: A History from the Earliest Times to the Present which is a recent English translation of his German Kultur und Geschichte Nepals published in 2018.&nbsp; Michaels is a Professor of Classical Indology and Religious Studies at Heidelberg University, and writes that Nepal mattered little to China. Proof of this is that while both Nepal and Tibet agreed to accept the suzerainty of the Qing emperor following the war, Nepal managed to retain its autonomy but Beijing asserted its control over <a href="https://nepalitimes.com/business/himalaya-to-lhasa">Lhasa</a>. And despite a clause in the treaty which stated, ‘if a foreign power attacks Nepal, China shall support Nepal’, China never did so during the1814–16 war with the East India Company.&nbsp; This practice has continued to this day. Aside from token petroleum shipments, Beijing did not help out Nepal during the Indian Blockade of 2015. Even though Nepali leaders have tried to play India off against China, the two do not find Nepal important enough to fight over and prefer to leave it as a buffer state between them.&nbsp; In that sense, Britain also did not press home its victory after 1816 and left Nepal alone. The malarial jungles to the south, rugged Himalayan terrain and the lack of marketable products (except soldiers) may have persuaded the traders at the East Indian Company that it was not worth the effort. There is a lesson from history here for Nepal: the country must look out for itself, and this requires deft diplomacy to understand what our giant neighbours really want and leverage it for our gain. This may require strategies like the ones made by Jang Bahadur and King Mahendra after all. Michaels is not a fan of either the Rana or the Shah dynasties. He says that although the Rana era is characterised as ‘a century of tyranny’, the description holds true for the Shah period as well.&nbsp; Michaels does not mince his words about Gurkha recruitment into the British and Indian Armies (another legacy of the Sugauli Treaty). He calls the mercenaries ‘cheap labour’ and Pushpa Kamal Dahal ‘represents a continuation of the King-Brahmin alliance’. In fact, he goes at length to discuss how the Khas-Arya used ‘Hindu state’ to homogenise a country that couldn’t have been more diverse. But democracy has not served Nepal well either. Corruption, impunity and lack of transparency are rife. And so, Michaels asks if Nepal is a failed state. No it is not, but it is a fragile state. He leaves us with these parting words: ‘If Nepal succeeds in continuing down this road, preserving its ethnic and cultural diversity, leaving the ethnic populations with a certain degree of autonomy, while at the same time integrating them into political decision-making processes, and if it manages the reforms needed for land-ownership, labour, education, infrastructure, then the country can become a model for unity in diversity, even in the age of leveling globalisation.’&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250222070248_a32db0a1e39c4a3a5158af81bbcf927aeb96524bcbc6b41086a223685642b367.jpg" data-media-id="editor_17" data-image-id="20250222070248_a32db0a1e39c4a3a5158af81bbcf927aeb96524bcbc6b41086a223685642b367" data-rendition-name="original" width="1136" height="702" loading="lazy" alt="Jang Bahadur in England "> </figure>  &nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250222070252_e2fa5309f10d36f963243c24ea06d7d354d3dfaf24c7ef283d70369fbeabd02e.jpg" data-media-id="editor_18" data-image-id="20250222070252_e2fa5309f10d36f963243c24ea06d7d354d3dfaf24c7ef283d70369fbeabd02e" data-rendition-name="original" width="1136" height="702" loading="lazy" alt="Nepal Book"> </figure>  &nbsp;