<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108151120/636a664f9c7e80680e059974jpeg.jpg" alt="" width="1200" height="793"/>Around the world, in rich countries and poor, financing healthcare is one of the biggest challenges. In poor countries, it becomes a life-or-death issue.Over 40% of global healthcare expenses are still covered by patients and their families, and more than half the world’s population lacks access to essential health services. Medical bills push 100 million people into extreme poverty every year.Nepal has taken remarkable strides in healthcare in past decades despite internal conflict and instability, but <a href="https://archive.nepalitimes.com/article/nation/national-health-insurance-not-as-easy,4028" target="_blank" rel="noopener">medical care is still unaffordable</a> or inaccessible to most. More than half the healthcare expenditure of Nepalis is still covered out of pocket. Nearly a third of families spend over 10% of their annual income on medical care.Read also: <a style="background-color: #ffffff; font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/banner/this-is-how-to-upgrade-nepals-rural-health/" target="_blank" rel="noopener">This is how to upgrade Nepal's rural health</a>, Sewa Bhattarai <a style="background-color: #ffffff; font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/banner/state-of-the-art-rural-hospital/" target="_blank" rel="noopener">State of the art rural hospital</a>, Marty LoganThursday, 12 December, is Universal Health Coverage Day, an important date to remind ourselves of the next steps we need to take to achieve healthcare for all. The 2015 constitution of Nepal declares basic and emergency healthcare as fundamental rights of citizens, putting the responsibility of financing such care on the state. Following federalism, municipal governments have got the responsibility to manage basic and essential care. A national health insurance bill has been passed and is being implemented.The state guarantees quality healthcare without financial burden on citizens, for which the insurees pay Rs3,500 per year for a family of five, and receive care worth Rs100,000. This is expected to reduce the burden of out of pocket and catastrophic expenses, while the government covers the premium for citizens under the poverty line.Read also: <a href="https://archive.nepalitimes.com/article/nation/national-health-insurance-not-as-easy,4028" target="_blank" rel="noopener">A national health insurance scheme is not as easy as it looks</a>, Sonia Awale<a style="background-color: #ffffff; font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/editorial/poor-health/" target="_blank" rel="noopener">Poor health</a>, EditorialThere is also a provision for free essential drugs and free treatment for patients with cardiovascular disease, cancer, spinal injuries, renal ailments and sickle cell anaemia, through the Disadvantaged Citizens Medical Treatment Fund.None of these initiatives is being implemented fully yet, but with federalism Nepal has a chance to build an accountable and sustainable healthcare system. The country therefore needs to focus on the following areas to manage health financing to meet the targets of the Sustainable Development Goals:<ul><li>Increase public sector healthcare investment to at least 7% of annual national budget. This should also be targeted towards reducing external aid.</li> 	<li>Empower people for self-care and make treatment more strategic and efficient as the burden shifts from communicable to non-communicable diseases.</li> 	<li>Focus on primary health care and improve services at the first point of care with comprehensive, accessible and community based care.</li> 	<li>Coordinate multisectoral policy action involving education, agriculture and social behaviour.</li> 	<li>Launch a priority national campaign to spread insurance coverage. Enrollment can be top-down starting with all government officials and then the public at large.</li></ul>A mixed financing model using tax-based funds through the treasury, and premium-based funds through health insurance can work for public, private, community, and other hospitals that run under the state-non-state partnership. An example of state- non-partnership is Bayalpata Hospital in Achham district, managed through a public-private partnership between the ministry of health and population and the non-profit Nyaya Health Nepal, where insurance reimbursement covered over 60% of the hospital’s operating costs.The hospital provides healthcare with no user fees. The care is extended from hospital to communities using a network of community health workers. How can care delivery with no user fee sustain? Can Nepal afford to provide such care to its entire population?It is possible. The country should effectively implement the national health insurance program, and strategically invest tax based funding. In the mixed financing model, for a ‘district level hospital, insurance can cover 60% of healthcare operating costs, and tax-based funding can take care of the rest. But to ensure effectiveness, the tax-based investment will need to be unrestricted and tied to audited performance indicators. The cost of care should also incorporate the extension of hospital-based services into communities in the catchment area.Bayalpata Hospital serves both as a primary care facility and also as a referral hospital. In this case, the tax-based contribution can be split into the three government tiers, with the federal government providing support for infrastructure, and provincial and local governments covering the cost of basic healthcare, and referral care not covered by the insurance.Insurance reimbursement then covers the cost of insurance-covered care, the local government allocates funds required for basic and emergency healthcare, and the provincial government pays for managing the cost of referrals beyond insurance coverage.<a style="background-color: #ffffff; font-size: 15px; letter-spacing: 0.01em;" href="https://archive.nepalitimes.com/article/nation/Nation-Crowdfund-globally-act-locally,490" target="_blank" rel="noopener">Bayalpata Hospital</a> provides basic and referral care, and its tax-based contribution can be split into the three government tiers, with the federal government providing support for basic infrastructure and provincial and local governments covering the cost of basic and referral care not covered by the insurance.Insurance reimbursement then covers the cost of insurance-covered care, the local government allocates funds required for basic and emergency healthcare, and the provincial government pays for managing the cost of referrals beyond insurance coverage.The proposed model has a 60:25:15 ratio to pay for health care, with 60% from insurance and provincial and local governments paying 25% and 15% of the cost. When the benefit package increases to cover the cost of healthcare without capitation, the share of health insurance coverage percentage will increase significantly, thereby reducing the tax-based direct public sector investment.S P Kalaunee is Executive Director of Nyaya Health Nepal, which manages Bayalpata and other public hospitals in partnership with the ministry of health and population.

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Is free health care possible in Nepal?

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221104141144/6365179b9c7e80680e02c286jpeg.jpg" alt="" width="1400" height="905"/><figcaption>IN GOOD HANDS: Community Health Worker Bhajan Kunwar checks patient Namsara Tamrakar at her home in Chandika village of Achham. Pics: Marty Logan and Srawan Shrestha</figcaption></figure>Rounding a steep curve on the road to the district capital of Mangalsen a startling set of modular structures comes into view. The modern buildings look out of place in this scenic, but underserved, region of western Nepal.The construction is part of a $4 million expansion of <a href="http://archive.nepalitimes.com/news.php?id=17650#.WreWXNRua70">Bayalpata Hospital</a>, a unique medical facility that is a model for public-private partnership to improve medical care in Nepal’s remote interior.Inside the ward, orthopaedic surgeon Mandeep Pathak is examining an elderly man with a swollen knee. Clearly visible on an x-ray monitor is a short pin inserted by a general practitioner a few weeks ago, after the patient fell and broke his kneecap.https://www.youtube.com/watch?v=SuWvlDGasEAIn the same room with the surgeon today is Community Medical Assistant (CMA) Khagendra Pant, who is wrapping plaster around the arm of a small boy. Thanks to training at the hospital, Pant was able to diagnose the boy’s injury as a clean fracture that did not require an operation.Such training means Bayalpata now has to refer just 10-20% of orthopaedic cases to hospitals in Dhangadi and Nepalganj, compared to nearly 70% two years ago.“I am proud to say that all the basic trauma care can now be done by general practitioners. Plus they can diagnose cases and decide which need to be referred to outside centres,” says Pathak.Training is integral to Bayalpata’s mission, says Director of Medical Education <a href="http://archive.nepalitimes.com/regular-columns/GUEST-COLUMN/Saving-one-mother-at-a-time,816">Bikash Gauchan</a>: his hospital has continuing medical education for clinicians, and on the job training for future nurses and other staff. General practitioners from various centres learn rural surgery at Bayalpata while mid-level staff come to improve their clinical knowledge.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221104141144/6365179e9c7e80680e02c287jpeg.jpg" alt="" width="1400" height="650"><figcaption> </figcaption></figure>For some <a href="http://archive.nepalitimes.com/article/nation/aim-for-fewer-patients-in-achham-possible-hospital,2022">patients who travel many days</a> to reach Bayalpata, access to basic surgery here means avoiding an expensive trip to the city. People whose limbs were fractured as long as three years ago delayed treatment until surgery was available at the hospital because they couldn’t afford the trip to a city hospital.Treatment at Bayalpata and at another hospital in Dolakha run by the non-profit Possible, is <a href="http://archive.nepalitimes.com/article/nation/Nation-free-for-all-healthcare,491#.UbrA4ueLA1s">free</a>. The group believes healthcare is a fundamental human right protected by Nepal’s Constitution, and should have no cost at point of delivery.Possible is funded by donations and Nepal government grants, which will grow as its hospitals attain clinical targets, such as the percentage of women who give birth in a facility with a trained clinician. Operating expenses last year were $4.8 million, of which 9% came from the government.Arrivals are registered in the hospital’s Electronic Health Record (EHR), which puts patients’ information at the fingertips of clinicians throughout the hospital, and eliminates bulky paper records.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221104141144/636517a19c7e80680e02c288jpeg.jpg" alt="" width="1400" height="823"><figcaption> </figcaption></figure>One patient already on the EHR is Namsara Tamrakar. Sitting cross-legged on a raised, wooden platform outside her home in Chandika village (left), the elderly woman shows visiting hospital staff that she knows how to use her inhaler, but it is empty.Three years ago, a doctor at Bayalpata diagnosed her with chronic obstructive pulmonary disease and prescribed medicine via inhaler. Now Community Health Worker Bhajan Kunwar (see box, left) visits regularly to follow up. Like others, Tamrakar’s house has a small blue metal tag on an outside wall with a unique household ID. The houses are also geo-tagged.Kunwar’s visit is guided by CommCare, a software developed by Dimagi and customised by Possible that includes counselling information and checklists for each patient. Plans are to integrate CommCare with the EHR so that field followups are immediately reflected in the hospital’s system. Eventually, Bayalpata’s EHR will be linked to a national data system.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221104141144/636517a49c7e80680e02c289jpeg.jpg" alt="" width="1400" height="1024"><figcaption> </figcaption></figure>Kunwar takes Tamrakar’s blood pressure: 120 by 80. The woman is happy to hear the news and to see Kunwar again: “She comes, does a check-up, and tells me what sickness I have, and if it is getting better or worse. She insists I go to Bayalpata for a follow-up.”The hospital's <a href="http://archive.nepalitimes.com/article/nation/Nation-Crowdfund-globally-act-locally,490">community health program</a> focuses on maternal and child health as well as non-communicable diseases such as hypertension, diabetes and respiratory ailments. Possible employs 56 community health workers looking after more than 80,000 people in Achham and Dolakha. It is planning to more than quadruple that number next year.Bayalpata Hospital started in 2009, when the group <a href="http://archive.nepalitimes.com/article/nation/Crowding-it-out,1003">Nyaya Health</a> (now Possible) took over an abandoned government facility. Then it had five beds and treated up to 12,000 patients a year. Last year, Possible saw 86,000 patients at Bayalpata: the goal is to treat 150,000 people annually after the new wards, emergency room, administration building, a dormitory and remaining small houses for on-call staff are added.“Our integrated, hospital-to-home approach will be a model for Nepal, and beyond,” explains Gauchan, “and we will be proving that in a resource-limited setting, health care expansion, providing universal health coverage to people is possible.”But is the Bayalpata model really replicable? Skeptics say that two hospitals could have been built for the cost of the new buildings, which feature rammed earth technology, solar energy and rainwater collection, and that only substantial donor support made the expansion possible.Gauchan admits that the initial investment may seem high but says it will be more cost-effective in the long run.He adds: “The existing infrastructure for rural health care is way less than the minimum needed to address the emerging burden of non-communicable diseases and road accidents as well as infectious diseases. That is why we are investing in a very robust infrastructure.”<h2>Community spirit</h2>In 2011, Bhajan Kunwar (pictured above) was living an “Ok” life with her husband Purna and children in Bhageswor village of Achham when her sister-in-law Shavitra asked for a favour.Shavitra had been hearing rumours that her husband, who was working in India, was having an affair or had even remarried. Would Purna take her to India to find out? Purna agreed, and brother and sister set off with a friend. En route, Purna received a phone call from Shavitra’s husband warning them not to come, or there would be trouble.They continued anyway, and after crossing the border got on a train. That night, a group of men, perhaps including police, boarded the train and took Purna away. He later called Shavitra’s husband to say he had been kidnapped and would be killed unless help came quickly.Police found Purna’s body the next morning, on the roadside in Ahmednagar, east of Mumbai. It looked like he had been run over, but Bhajan believes he was murdered.Widowed at 25 and with two small children, Bhajan spent the mourning period worrying about how she would afford to send the children to school, and if her mother-in-law and community would accept her becoming the breadwinner for her husband’s four younger brothers and sisters and their families. (Her father-in-law had died earlier).That month, Bayalpata Hospital had a vacancy for a community health worker for the area. Bhajan was hired and six years later, still visits on foot the more than 700 households in her catchment area, checking that patients are taking their medicines, and much more (see main article).“This hospital made me strong,” she tells us. "Before I didn’t know anyone in my village and I didn’t know so many things.” Now with a college certificate, Bhajan advises young women to get educated before they get married. “I tell them ‘if I can do it, you can do it too’. I believe in myself and don’t care what others say about me. If you are true and honest, no harm will come to you.”Bhajan says she will never forget her husband. “But I have to live for my children, and control my mind and my heart. If I am strong, they can have a regular life. The hospital is now my husband, I cannot imagine leaving it.”Marty Logan in Achham<h2>Operating remotely</h2>When nine-year-old Samir Tamang was bitten by a dog on his way to school in Rayale village of Kavre last week, he had to take a two-and-a-half hour long bus ride to Kathmandu with his grandfather Suk Bahadur Tamang, for a rabies vaccination at Teku Hospital.Samir missed school and his grandfather, who works as a driver in Kathmandu, had to ask for leave from his employers.“We are relatively close to the capital, but imagine what it must be like for people living in remote parts of Nepal where there are no roads,” says Suk Bahadur.Indeed, despite the spread of basic health care in Nepal, emergency treatment and procedures like mending broken bones or caesarean sections are not yet available in rural areas. This means families have to sell property or borrow from moneylenders to be able to afford treatment in the cities. Studies have shown that many Nepali families are driven to poverty if relatives are referred to private hospitals.Unmet surgical needs in remote districts remain a major public health issue in Nepal, according to a recent study in 39 remote area hospitals commissioned by the Nick Simons Institute (NSI).One day this week, an informal survey of patients at the government-run Bir and Teaching Hospitals in Kathmandu showed that a majority of the patients were from remote districts, some as far away as Piuthan and Jajarkot.The NSI study shows that except for caesarean sections in Dolakha, Lamjung and Panchthar, very few government hospitals elsewhere were able to do simple operations of the abdominal cavity, or even mend broken bones.Nepal’s surgery rate falls well below the Lancet Commission target of 5,000 operations per 100,000 population. If the goal is to have a surgical facility within two-hour travel distance for patients, at present only a third of the population can reach an orthopaedic surgeon, and only 22% have access to abdominal surgery.However, the survey reaffirms that the presence of a medical general practitioner (MDGPs who can perform caesarean sections and other relatively simple surgical procedures) can change this. District hospitals with resident MDGPs can eliminate the need for patients to make expensive and extended trips to the cities for treatment.The minimum personnel at a district hospital should include an MDGP, obstretrics doctor, anaesthesia assistant, staff nurse and biomedical technician. However, Nepal’s density of hospitals with such staffing is very low (0.4-3.1 per 100,000) as against the Lancet Commission target of 20 per 100,000 population.“In the long run we need specialists but placing three of them in each district hospital will take a long time. For the next 5-10 years, MDGPs will be the answer to solve surgical problems throughout the country,” explains Anil Shrestha, NSI’s Executive Director.The study recommends an MDGP-led generalist surgical team with proper staff, drugs and equipment to upgrade emergency surgical care in all district hospitals.Adds Shrestha: “The government has to strengthen strategically located district hospitals and make them functional to take care of surgical needs throughout the year. It is entirely possible to do.”Sonia Awale in KavreRead also:<a href="https://www.nepalitimes.com/editorial/poor-health/">Poor health</a>, Editorial <a href="http://archive.nepalitimes.com/news.php?id=17650#.Wrydky5ubIV">Resurrection Accham</a>,  Paavan Mathema<a href="http://archive.nepalitimes.com/article/nation/aim-for-fewer-patients-in-achham-possible-hospital,2022">Boy walked eight days to treat broken arm</a>,  Tsering Dolker Gurung<a href="http://archive.nepalitimes.com/article/nation/Nation-free-for-all-healthcare,491#.UbrA4ueLA1s">Free-for-all health</a>,  Duncan Maru and Roshan Bista

Marty Logan

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State of the art rural hospital

Home Minister Sudan Gurung resigned on Wednesday following increasing coverage of and criticism over his investment in companies linked to controversial Nepali business figures Sulav Agrawal and Deepak Bhatta, who are currently under investigation for money laundering.
‘I am resigning from the position of Home Minister effective today to ensure impartial investigation into matters associated with me, and to make sure that there is no conflict of interest,’ Gurung wrote, saying that morality and public trust mattered more to him than office.
Gurung ended his message to the nation in English as he invoked the security forces, writing: &nbsp;‘For my country and For the respect of our security forces and For the youths of Nepal.’
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Gurung has become the second member to depart the Cabinet, serving for less than a month, despite the Nepali electorate’s hopes that Nepal would finally get a stable government after the RSP’s sweeping victory in the March elections.&nbsp;
Prime Minister Balendra Shah had sought clarification from Gurung on Wednesday after new details emerged about his shares in two micro-insurance companies, Star Micro Insurance and Liberty Micro Life, which are said to have been issued their licence by the Nepal Insurance Authority at the behest of Bhatta and Agrawal.
Gurung denied financial misconduct, saying that his investment in the two companies was included in his asset disclosure and insisting the misunderstanding is because of how the shares have been categorised.&nbsp;
Leaders within the RSP had called for an internal investigation into Gurung as they sought to maintain the party’s platform of clean governance and transparency. As such, Gurung’s position had become increasingly untenable, especially since former Labour Minister was sacked without being given an opportunity for clarification over a disciplinary breach involving his wife’s appointment to the Health Insurance Board.&nbsp;
On social media, Sah on Tuesday seemed to express dissatisfaction over the PM’s request for Gurung’s clarification.&nbsp;
Judging by the comments under Gurung’s resignation post, a significant part of the Nepali public seems to be firmly on Gurung’s side, blaming the mass media and what they call mouthpieces of old parties for driving him out of the Cabinet.&nbsp;
This is a reflection of his meteoric rise and the continued support he has maintained since he stepped into the spotlight as the leader of Nepal’s youth movement in the aftermath of the September protest.&nbsp;
Gurung has made headlines constantly ever since he burst onto the national stage, which includes questions over the degree of his and his organisation Hami Nepal’s involvement in the September 9 unrest, calls to divulge details behind Hami Nepal’s finances, and not paying five years of rent for an illegal lakefront property in Pokhara.&nbsp;
There have also been unsubstantiated claims, despite Gurung’s denial, about his ‘ties’ to the Free Tibet movement, which has made the Chinese— as well as Nepalis— wary.&nbsp;
As Home Minister, Gurung cultivated an image of a tough but approachabe leader, overseeing a series of high-profile arrests of previous political leadership and business figures even as he posted photos of sleeping in a sofa in his office, and engaged with the public on the streets and on social media.&nbsp;
As it stands, the Home Ministry was a bone of contention between Shah and RSP Chair Rabi Lamichhane before it was awarded to Gurung, who is a close ally of PM Shah. Analysts had noted that with Gurung in charge, the Home Ministry would be a hook for Shah if Lamichhane, with his share of controversies, stepped out of line.&nbsp;
Following Gurung’s resignation, the Prime Minister’s secretariat has said that the PM would take charge of the portfolio for the time being. But it will be interesting to see if and how fresh negotiations for the Ministry unfold within RSP.&nbsp;
And with his supporter base largely intact, it remains to be seen how much of an impact this setback will have on Sudan Gurung’s political aspirations.&nbsp;

Home Minister Sudan Gurung resigns

Sudan Gurung is dancing. It is 2009. He has an emo fringe falling over one eye and is spinning on a polished floor. His dance shows dedication — moves that take years of bruised elbows to land. The clip is 16 years old, and had been sitting in the dead archives of YouTube and old Facebook pages, watched by almost nobody. This month <a href="https://www.tiktok.com/@4gr4j/video/7621892206902725909">it has 1.9 million views</a>. Gurung became Home Minister on 27 March and resigned on Wednesday, barely a month into office. His<a href="https://www.tiktok.com/@aayvik/video/7626069452177542408"> pre-political life had been put back into circulation</a> at industrial speed -- the b-boying, the DJ sets, and the YouTube video of him dancing in a music clip.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2026042202040_71df4d531423e7c941abde95fb8106346c70ab0afb71bbeb520cc570f14ba178.jpg" data-media-id="editor_2" data-image-id="2026042202040_71df4d531423e7c941abde95fb8106346c70ab0afb71bbeb520cc570f14ba178" data-rendition-name="original" width="2300" height="1000" loading="lazy" alt="When aura meets audit"> </figure>  The youth of Nepal, well-versed in snappy TikTok edits and aura compilations, turned the archive into a meme economy almost overnight. TikTok remixed the footage to trap beats. The comments settled on a nickname that crossed into everyday speech within days: 'Homie Minister'. <div class="embed-block"><blockquote class="tiktok-embed" cite="https://www.tiktok.com/@yalexthwreal/video/7622325255792512276" data-video-id="7622325255792512276" style="max-width: 605px;min-width: 325px;" > <section> <a target="_blank" title="@yalexthwreal" href="https://www.tiktok.com/@yalexthwreal?refer=embed">@yalexthwreal</a> <a title="sudangurung" target="_blank" href="https://www.tiktok.com/tag/sudangurung?refer=embed">#sudangurung</a> new home minister of Nepal😎 <a title="fyppppppppppppppppppppppp" target="_blank" href="https://www.tiktok.com/tag/fyppppppppppppppppppppppp?refer=embed">#fyppppppppppppppppppppppp</a> <a title="sudangrg" target="_blank" href="https://www.tiktok.com/tag/sudangrg?refer=embed">#sudangrg</a> <a title="home" target="_blank" href="https://www.tiktok.com/tag/home?refer=embed">#home</a> <a title="minister" target="_blank" href="https://www.tiktok.com/tag/minister?refer=embed">#minister</a> <a target="_blank" title="♬ original sound - •⪨н є α я т ❤н α ¢ к є я ⪩• - Music Universe 🎧" href="https://www.tiktok.com/music/original-sound-•⪨н-є-α-я-т-❤н-α-¢-к-є-я-⪩•-7308733170064231170?refer=embed">♬ original sound - •⪨н є α я т ❤н α ¢ к є я ⪩• - Music Universe 🎧</a> </section> </blockquote> <script async src="https://www.tiktok.com/embed.js"></script></div> As Home Minister, Gurung was in charge of the Nepal Police, Armed Police Force, Department of Immigration, and the country's internal security apparatus. Calling him 'homie' collapsed the distance between that office and the Discord server where the movement that brought him into power had organised itself. What is harder to explain is why the nostalgic clips did the narrative work for Gurung's political standing right up until the moment the paperwork did not. A teenager on a dance floor in a Thamel club, filmed before smartphones had decent cameras, was functioning as political currency for a powerful home minister, while a share registry was quietly filling the other column. The footage was not an argument. Gurung was not doing anything in it that related to home affairs. He was just dancing. The comments compared him to <a href="https://www.tiktok.com/@4gr4j/video/7621892206902725909">Korean film heroes</a>. A separate <a href="https://www.tiktok.com/@tandavyt7/video/7622151050128018708">48,000-like edit</a> was captioned 'Our New Home Minister Aura'. The replies were full of people saying they got chills listening to him speak. Even after his resignation, most comments on his Facebook page were supportive, saying he had been punished for pursuing truth and justice.&nbsp; Political legitimacy in Nepal has been built out of many things over the last 70 years, but it has never been built out of this. The question was always: what happens when the job starts demanding things his style, boldness, and swag cannot provide. Political aura in Nepal used to be a slow harvest, now it isn't. B P Koirala spent eight years in prison under the Panchayat. He wrote fiction at Sundari Jal. The writing survived, the prison sentences survived, and that experience became the template for what a serious Nepali politician looked like: someone the state had tried to break and failed. Legitimacy was accumulated by having their lives taken away, and refusing to bend the knee. The old mechanics of legitimacy produced politicians who could be audited. The record was made of words, dates, votes, and years behind bars. A voter who wanted to know what a leader stood for read his writings. A journalist digging for inconsistency could find it. The system was slow, often corrupt, and frequently boring. But boring was part of the job description. A minister was supposed to be slightly dull — evidence that the person was doing the unglamorous work of reading files and sitting through committee meetings. Today, boring is a disqualification. The attention economy rewards velocity and visual charge, and a politician who cannot generate either does not exist in the feed, and that means does not exist at all. The legacy parties are still issuing press statements criticising the new guard in the grammar of paper trails and procedural failure. But the audience has stopped reading, users scroll for their next viral bite. Sudan Gurung, unlike the old parties, understood exactly which grammar the feed rewarded. On his first evening as Home Minister, he posted a photo of himself sleeping on a sofa inside the ministry. Caption: creation cannot be greater than the creator, government is not above the people. The image travelled further in 12 hours than any ministerial press release has ever done.&nbsp; A minister napping on a sofa, phone-shot, zero production, read by the public as evidence of a minister who had skipped the motorcade and got straight to work. Gurung used Facebook to announce the names of former ministers and businessmen he intended to arrest. The feed was used to pre-announce state security action.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260422010456_2fa1918e1dd031d01f38b4001ee306d9414073cec0b795fa43a75cb5a8deb8c7.png" data-media-id="editor_6" data-image-id="20260422010456_2fa1918e1dd031d01f38b4001ee306d9414073cec0b795fa43a75cb5a8deb8c7" data-rendition-name="original" width="926" height="868" loading="lazy" alt="When aura meets audit"> </figure>  INFLUENTIAL INFLUENCER This is not how the Ministry of Home Affairs has ever operated. It is how a YouTuber releases a series. Sudan Gurung was a political content creator. As home minister, he was an influential influencer kinetically doing something in the visual medium. Much like Prime Minister Balendra Shah's sunglasses, Gurung's aura, authenticity and swag were a brand asset, instantly recognisable at thumbnail size. Balen's rap career supplies a pre-political archive that authenticates him the same way Gurung's DJ sets and b-boying clips authenticated him. The aesthetic is doing the work a manifesto used to do. The work is authenticity, and the strategy is auramaxxing. The emo fringe predates the ministry. The DJ sets predate Hami Nepal. The b-boying predates the earthquake, the NGO, the September uprising, the interim cabinet, all of it. Whatever Gurung is now, he was already that person before the office existed. This was the real spectacle of the Homie Minister: authenticity. Nepal's youth have grown up watching heavily-polished, talking-point ministers speak in a language aimed at nobody in particular. But that grainy archival clip of the Home Minister from 2009 was honest.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260422010456_5d6dff3a09e8b7e77dc60c3aa567c9e02b6bd5f90f94e20737ec05cc9a09023b.jpg" data-media-id="editor_7" data-image-id="20260422010456_5d6dff3a09e8b7e77dc60c3aa567c9e02b6bd5f90f94e20737ec05cc9a09023b" data-rendition-name="original" width="1800" height="1000" loading="lazy" alt="When aura meets audit NT"> </figure>  The effect transcended GenZ. <a href="https://www.tiktok.com/@ektapokharel/video/7623242573481561365">A TikTok trend</a> captioned NOT ONLY OUR HOME MINISTER, WE ARE ALSO FROM THAT ERA <a href="https://www.tiktok.com/@sonykhadka/video/7624106790266948872">has millennials posting their own</a> archive photos from the same period, aligning themselves with Gurung's pre-political aesthetic. The aura did <a href="https://www.tiktok.com/@_thakuri/video/7623397397556645141">cross-generational work</a>. It was a shared legibility, spanning at least 15 years of Nepali youth culture, with the Home Minister standing at its centre.&nbsp; The traditional politician's entire adult life is a performance of identity. Every photograph is lit for the media, every statement is vetted. The persona is the product, and the product has been in development for 30 years. This makes the old guard legible but suspect in the attention economy. A generation raised on authenticity-as-currency reads the decades of careful performance as evidence of something to hide. The polish is the problem. The nostalgic Sudan Gurung party clips inverted this. The polish was absent. The footage could not be performance aimed at the viewer, because the viewer did not exist in 2009 and neither did the political stakes. The clip was therefore read as real, in a way a press conference can never be. It was just a kid dancing, and he happened to grow up to be the Home Minister. But Sudan Gurung's job was never to go viral. The Ministry of Home Affairs requires the person running it to file a complete asset declaration and to avoid holding financial interests in crony entities.&nbsp; None of that work is content. A correctly filed asset declaration does not get remixed into a trap beat. A functioning immigration database is not a TikTok. The paperwork that constitutes actual governance is structurally boring in exactly the way the old parties are structurally boring, and for the same reason. It is the slow, procedural, checkable apparatus that the old system was built to produce and that the new system has not yet learned to replace. And it is painstaking follow-the-money paper trail investigative journalists in the legacy media who uncovered the evidence. You cannot auramaxx your way out of a share registry. You cannot post your way past a conflict-of-interest statute. No amount of fire outfits and wild DJ transitions does anything for you when a journalist pulls the initial shareholder list of Star Micro Insurance and finds your name at number 49, with Rs2.5 million in shares alongside investors linked to Deepak Bhatta and Sulav Agrawal — two men currently at the centre of a Rs 3.7 billion money laundering investigation. <a href="https://www.tiktok.com/@blox.drop/video/7622173520981658900">Auramaxxing was engineered</a> for the mechanics of reaching office. It is the reason Sudan Gurung became Home Minister and Gagan Thapa did not. The question that had not yet been tested, until this week, was whether the same weapon works when the terrain changes. The terrain does change when you assume power. This week, the answer arrived. TWO CLOCKS Two clocks had been running, and they did not sync. The first clock was built for auramaxxing. A clip posted at eight in the morning peaked by noon. A sofa photo was remixed before the minister had left the building. The feedback loop is fast and legible, and a politician playing this clock gets real-time data on what to post next. The old guard never learned to read it, which is a large part of why they lost the election. The second clock was the one the ministry actually runs on. It measures in quarters, court calendars, and the slow grind of investigation files moving between offices. A share registry takes weeks to pull. A money-laundering case moves at the speed of the prosecutor's office, which is to say, it often does not appear to move at all, until one morning it does. The legacy mass media is fed leaks, and the second clock does not care whether the minister is currently trending. The two clocks collided this week, and the second clock got there first. Faster than anyone expected. The first clock put Gurung in the Home Ministry in weeks. The second clock put him out of it in less than a month. On Sunday evening, Diyopost and Janaastha published documents showing Gurung as a founding shareholder in Star Micro Insurance and Liberty Micro Life — companies licensed by the Nepal Insurance Authority in 2022 following what reporting identified as political lobbying by Bhatta and Agrawal. A photograph also surfaced of Hami Nepal, the NGO Gurung chairs, honouring Bhatta as a donor on 21 December 2021. Gurung's first response was auramaxxed. A Monday Facebook post distinguishing ‘rumours’ from ‘facts’, insisting the shares were disclosed within his broader Rs20 million securities portfolio, promising to cooperate with any investigation. "Allegations and truth are not the same thing," he wrote. "Decisions should be based on evidence, not sentiment." It was a coherent clip, but it did not stop the clock. By Wednesday, Prime Minister Balendra Shah had sought written clarification. Leaders within the RSP itself were calling for his resignation. The opposition Nepali Congress had framed the question as one of democratic transparency.&nbsp; Gurung resigned, posting his decision to Facebook as he did everything else. Ethics, he wrote, hold more weight than any position. There is no power greater than public trust. He ended in English, invoking ‘my country … the respect of our security forces … the youths of Nepal’. Even the exit was content. And this is the asymmetry the office exposed. A politician whose legitimacy is built on fast 30 second videos is structurally exposed to a process that runs slower than the news cycle, because the archive of aesthetic proof was not engineered to answer documentary evidence.&nbsp; It was engineered to displace the demand for documentary evidence in the first place. When that demand returns, as it always does once a politician takes office, the digital archive keeps performing, but the documents keep getting uncovered. And the two tracks do not communicate. The old guard knew this clock because they had no other clock to know. What they lost in charisma they gained in durability: a politician built over 20 years of parliamentary record is harder to dislodge with a single document because they have already survived thousands of documents. The new guard has not been stress-tested against its own paper trail. Sudan Gurung has now been tested, and the test is over, and the template has been written in his exit rather than his survival.&nbsp; A politician can enter office on the strength of a dance clip, and the same class of evidence — share registries, company filings, founding-shareholder lists at number 49 — that would have ended the career of a politician in a previous era of Nepali politics has ended his. The second clock got there. The feed did not save him. Or not entirely. Because the resignation itself is now in the feed. The Facebook post. The 46 brothers and sisters. The epic sign-off. Within hours of stepping down, Gurung had already re-enrolled his exit into the same register that put him in office. The clip of the Home Minister dancing in 2009 is still in circulation. The sofa photo still reads as sincerity. The investigation into the micro-insurance shares will move at the speed of Nepal's prosecutor's office, which is to say, at a speed the feed has long since outrun. The movement that installed Gurung in the name of ending elite capture has had its answer about whether its own hero is subject to the same audit it demanded of everyone else. He walked — or was walked — before the audit ran its course. The resignation was framed as moral choice rather than forced exit, and the framing is already winning. Whether that framing holds is the next test. Auramaxxing, it turns out, is a weapon that works in one direction only: it got him the job, and when the documents arrived, it did not save him. But it may yet save the person. These are not the same thing. If the technique is wounded, it is not yet dead. The next Nepali politician with a pre-political archive and a phone is watching how Gurung exits, not just how he entered. And the answer is: you exit the same way you entered: on Facebook. In your own voice. Before anyone else writes the caption. Whether he comes back is the thing to watch. Whether the technique does is already decided. &nbsp; &nbsp;

When Aura meets Audit

Just three weeks in, Prime Minister Balendra Shah has already shed two ministers, and is having to contend with the economic fallout of the West Asia war plus the global order that it has upended.&nbsp;
The new dispensation in Nepal has aroused interest in New Delhi, Beijing as well as Washington. The ouster of Home Minister Sudan Gurung, whose first act in office was to arrest former prime minister K P Oli, has foreign policy wonks scratching their heads.
The US sent Assistant Secretary of State for South and Central Asian Affairs Samir Paul Kapur on a special mission to figure out what is happening in Kathmandu. In town at the same time was Cao Jing, Deputy Director General of the Asian Affairs Department of China’s Ministry of Foreign Affairs. And Prime Minister Shah is preparing for an official visit to India.
For the Americans, it is mostly about containing China and looking after the welfare of Tibetan refugees, while pushing its own MCC Compact and State Partnership Program (SSP). Beijing is mindful of the post-Dalai Lama era, and does not want instability in Nepal to encourage free-Tibet activities. India lately seems more wary of American activity in what it considers its backyard.
The Chinese appear relieved to see Sudan Gurung go. Only last week, Ambassador Zhang Maoming met Gurung during which he raised the issue of Tibetan and Taiwanese activities in Nepal, seeking firm commitment that Kathmandu would not harbour activities hostile to Beijing.
“Geographically we are close to Tibet and not to the Mainland, so China remains suspicious of us, especially after the TOB and free-Tibet components that emerged from the GenZ protests,” says geopolitical analyst Indra Adhikari.
Kapur, for his part, met RSP Chair Rabi Lamichhane, Finance Minister Swarnim Wagle and Foreign Minister Shishir Khanal. Although investment and infrastructure was on the agenda, the main issue seems to have been about Tibetan refugees. In nearly parallel meetings with ministers, Cao Jing warned Nepal not to be too cosy with the Americans.
For Indian academic and Nepal watcher Sukh Deo Muni, all this harks back to American activity in Nepal during the height of the Cold War. He tweeted: ‘US senior diplomat Paul Kapur's statement in Kathmandu must be understood carefully in New Delhi. He said the US does not want China or any other country to dominate Nepal.’&nbsp;
‘Any other country’ could be a pointed reference to India, and what this means is that Nepal may now have to navigate even more carefully a tri-polar world order reshaped by the West Asia war.&nbsp;
Nepali journalist based in New Delhi Akanshya Shah agrees that the United States may not be seeing Nepal through the Indian lens anymore, while New Delhi does not want heightened US activity in what it considers its sphere of influence. All this is further complicated by recent frostiness in Washington-New Delhi ties.
“New Delhi doesn’t have that familiarity factor it used to with old leadership in Nepal, but it is curious about what the young Balen Shah will do and what kind of relation he will pursue with India,” she adds. “Certain decisions of the Balen government such as ending VIP culture and delivering passport at homes have hugely resonated with the Indian people, he has in some ways become a role model among the youth in India as well.”
India has invited Prime Minister Shah for an official state visit, which will be his first foreign trip as per tradition. Shah graduated in structural engineering from a college in Bengaluru, and knows India well. Shah has injected religious elements into his public exposure as prime minister and this could help project Nepal’s ‘soft power’ in dealing with India.
But he has also been a nationalist on the Limpiyadhura map dispute, and there are other thorny issues like air connectivity, river projects and power exports that need to be ironed out.&nbsp;
Sukh Deo Muni warns that the old Indian diplomatic approach based on religio-cultural stakeholders in Kathmandu may not work anymore. He wrote: ‘India's Modi government must prepare itself well to deal with new Nepalese leadership and their empowered support base, which is self-confident, highly nationalist, aspirant and impatient.’
The RSP’s 22-page National Commitment document said Nepal should abandon its historical ‘buffer state’ identity to serve as a ‘vibrant bridge’ between regional and global powers. Much of this debate is theoretical, and there is much navel-gazing that distracts from regional realpolitik.&nbsp;
“Whether we are a buffer state or a vibrant bridge, in today’s heightened geopolitical scenario we have to have good relations with good neighbours,” explains Akanshya Shah. “What is of paramount importance is that our ties are based on the aspirations of the young generation, so that they are engaged.”
Indra Adhikari goes as far as to say that the concepts of “buffer state” and “vibrant bridge” have both failed and Nepal is neither. “We have had zero roles in mediating or de-escalating the tensions between India and China to call ourselves a buffer state. As a vibrant bridge, we cannot facilitate trade of the two countries. The new government should have researched and consulted more before proposing the same outdated and failed foreign policy concepts.”&nbsp;
What will be much more important for Prime Minister Shah is to continue Nepal’s traditional policy of ‘equidistance’ and convince his interlocutors that it is not an anti-Indian stance.&nbsp;
“At a time when there is increased interest of big powers in Nepal, we need to do a bit of our own homework for the systemic reforms we want,” says Akanshya Shah. “As for India, we first need to clearly define what we want on connectivity, energy and culture. But most importantly, we have to capitalise on the goodwill of India which we haven’t been able to in the past.”
Adds Indra Adhikari: “When it comes to fundamental aspects of foreign policy that ensures and enhances the well being of our citizens, national parties should all have one unified voice that doesn’t change when the government does. Only then the future generations can own it.”

Love thy neighbours (and America)

Prime Minister Balendra Shah sought written clarification from Home Minister Sudan Gurung following news of his investment in two companies linked to controversial Nepali business figures Sulav Agrawal and Deepak Bhatt, who are currently at the centre of a Rs3.7 billion money laundering investigation.
Home Minister Gurung's secretariat said that it has responded to the PM and submitted a written explanation. This comes after Home Minister Sudan Gurung issued a public clarification about the new developments regarding his investments on Monday.&nbsp;
Gurung is listed as a founding shareholder of two micro-insurance companies Star Micro Insurance and Liberty Micro Life, having acquired shares amounting to Rs2.5 million. The two companies are said to have been issued their licence by the Nepal Insurance Authority at the behest of Bhatt and Agrawal. Family members and close aides of both Bhatt and Agrawal have stakes in the two companies.&nbsp;
Bhatt, chairman of Infinity Holdings, is a power broker accused of using his political connections to secure and manipulate public procurement contracts, influence policy changes ass well as leadership appointments to regulatory institutions including the Securities Board of Nepal and Nepal Insurance Authority.&nbsp;
Meanwhile, Shanker Group vice-chair Sulav Agrawal was also arrested earlier this month as part of a broader money laundering probe as well as an investigation into the group’s finances. Agrawal was previously arrested during the Covid-19 pandemic after he was found selling &nbsp;67 infrared thermometers from a vehicle with diplomatic credentials. At the time, Bhatt is said to have used his connections to facilitate Agrawal’s release.&nbsp;
Critics have raised concerns the lack of detailed disclosures on Gurung’s part about investments tied to the very figures that his Home Ministry is in charge of investigating. There are also questions as to the source of his investment, which Gurung said in his clarification were raised through loans.
In his clarification, Gurung denied concealing his investments, saying that his shares in the two companies are part of in his over Rs20 million portfolio included in his asset disclosure and insisting the misunderstanding is because of how the shares have been categorised. &nbsp;
On his name and portfolio being associated with controversial figures, he responded, ‘There are hundreds to thousands of shareholders in a company. Buying shares does not constitute a partnership with anyone.’&nbsp;
He continued: ‘If that is the basis, then everyone with investments in those companies must be held accountable, which is not fair. Investments in the companies include those from media houses and banks. Are they all guilty?’
Leaders within the RSP have called for internal investigation into Sudan Gurung, to maintain the party’s platform of clean governance and transparency.&nbsp;
This comes after the sacking of Labour Minister Dipak Sah earlier this month after the RSP found him to be in breach of the party code of conduct following the reappointment of his wife to the Health insurance board. Sah was not given the opportunity for clarification prior to his departure.&nbsp;
Critics have said that the party is reverting to the patronage-driven politics of previous leadership following the appointment of figures close to RSP leadership in various key positions.
Many influential business owners elected to the House with direct stakes in the business, finance, tourism, and infrastructure sectors sit in Parliamentary Committees that would directly benefit their interests. &nbsp;
On Monday, RSP appointed Bhupdev Shah, who previously was a part of Balen Shah’s secretariat during his tenure as Kathmandu Mayor, as the party’s general secretary. Some have questioned the party’s decision to appoint Shah without going through an election process in its upcoming general convention.&nbsp;
Shah’s appointment comes as there is increased public attention over members of the Prime Minister’s inner circle being appointed to key advisory positions as well as to head governance reform committees.

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Love thy neighbours (and America)

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