<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

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Nepal election live results

It took the September GenZ firestorm and public anger against non-performing actors for a 35-year-old structural engineer and rapper Balendra (Balen) Shah to oust Nepal’s four-time prime minister and former revolutionary.
The UML’s KP Oli has been trounced by 50,000 votes in his home turf, an area where he has won many elections in his 55-year political career. It is the same story across Nepal, where established politicians are being rejected by voters.
A 'Balen Wave' has swept the country, dyeing it in the RSP’s Blue party colour. But the UML and NC particularly did this to themselves.&nbsp;
An apology and a retirement after the September protests would have saved Oli some dignity, and given the rebranded UML a tiny bit of hope and perhaps a few more electoral wins.&nbsp;
Maybe he could have been remembered fondly as the funny old guy who made one last fatal political error, but now he will be defined by this defeat. Maintaining control and legitimacy in his own party will be hard too.&nbsp;
Contrary to his past combativeness and blaming nefarious foreign conspiracies, Oli gracefully conceded on Saturday, congratulating 'Balen Babu' &nbsp;and wishing him 'a successful five years'.
Balendra Shah and his RSP knew what they were doing. As of Sunday, it has won 118 and leads in 7 other constituencies, a lot of them with similarly wide margins of victory. RSP candidates have even beaten well regarded candidates like Gagan Thapa of the NC and Kulman Ghising of Ujyalo Nepal.&nbsp;

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Many including this paper questioned the RSP's strategy of choosing popular candidates over competence. But the point of an election is to win it, and there was a short campaign window to put it all together and the RSP pulled it off most successfully.&nbsp;
To be sure, the party should not get too much credit. Its manifesto was broad and bland, and no different than the other older parties.&nbsp;
A big part of the RSP ballots, maybe even most of it, were people voting against the old parties rather than for it. Many seemed to feel that this was coming, and perhaps even hoped for it.
There is also a sense of lingering cynicism. Nepal has had several revolutions and many new political starts and things always seem to end up in the same corrupt hopelessness. There is every possibility that the new RSP government will also go the same way.&nbsp;
The RSP is much bigger than Balendra Shah, although it was his popularity that made this victory possible. Its victory brings with it a sense of hope as all new things do.&nbsp;
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Not all party members who were elected are going to be as accountable or have integrity. Many of them have a chequered past, saw an opportunity in joining the RSP and took the risk.&nbsp;
What changed things were the events of September. Politicians saw firsthand that 'Power to the People' is not some abstract idea. Get too loose to it, forget that you are ruling and not serving, and you get booted out.&nbsp;
The interim Sushila Karki government deserve credit for delivering on its biggest mandate of holding the election in such a short time frame. The expectation at large was that the polls would be delayed or even scuttled.
In fact, a two-thirds RSP majority is a great opportunity to rethink the country’s political culture and institutionalise change. The point of the government in a democracy is to serve the people. Appointing non-political, competent people worked, at least in the short tenure of the interim government.&nbsp;
Adding layers of bureaucracy and committees and party politics along federal, provincial and local levels heaped resistance to the simple goal of making lives easier for the Nepali.&nbsp;
Nepal is getting a reboot, and the next few months will show whether the country is on the right track with its new generation government.

Balen takes Jhapa and Nepal

“Let's have another cup of tea,” <a href="https://nepalitimes.com/here-now/ujwal-thapa-s-light-shines-on-n0tfurod">Ujwal Thapa</a> of the alternative Bibeksheel Nepali party told the young activist Pukar Bam ten years ago. The two had 12 cups of tea that day, discussing ways to get Nepal out of its political deadend. Thapa contested the Constituent Assembly election in 2013 as an independent from Kathmandu, and formed Bibeksheel Nepali to galvanise youth impatient for change, fielding candidates in the first federal election in 2017. Ujwal Thapa was a political guru who was way ahead of his time, and his protégés were among the RSP’s winning candidates in last week’s election. Pukar Bam was a core member of Bibeksheel Nepali until its dissolution, and won the Kathmandu-4 seat this time. Other former Bibeksheel members who won the election from the RSP in Kathmandu include Ranju Neupane from Kathmandu-1, Sasmit Pokharel from Kathmandu-5, and Biraj Bhakta Shrestha in Kathmandu-8. As votes were counted and the results from Kathmandu began to come in, the candidates paid fulsome tribute to Ujwal Thapa’s mentorship and in inspiring idealistic youth to become a part of an alternative political force. Today, as RSP members of Parliament, they are no longer an alternative, but a part of Nepal’s new mainstream politics. Thapa returned to Nepal after finishing his undergraduate computer science degree in the US at the peak of the Maoist insurgency. His foray into politics began when he traveled to Nepal’s western mountains to train communities in mediation. After the war, he started a computer design company for young entrepreneurs entering the workforce. But he became frustrated with the inability of the second Constituent Assembly to promulgate the Constitution, and the power struggle between political parties played out in the streets that led to frequent shutdowns paralysing the country.  <figure><img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260313120348_d18647d53a3b2927328067c35b2e3e6eecf9aefe13f23384e73a2c17211cd9cb.jpg" data-media-id="editor_1" data-image-id="20260313120348_d18647d53a3b2927328067c35b2e3e6eecf9aefe13f23384e73a2c17211cd9cb" data-rendition-name="original" width="823" height="682" loading="lazy" alt="The RSP's activist DNA"><figcaption>Thapa with Pukar Bam, who was elected to Parliament last week from Kathmandu-4. Photo: PUKAR BAM / FACEBOOK</figcaption></figure>  PROTEST TO POLITICS Ujwal Thapa had had enough, and rallied people from across walks of life, leading peaceful, silent demonstrations proclaiming 'नेपाल खुल्ला छ' against prolonged, violent strikes. Citizens fed up with the main political parties organised to defy the shutdowns. Thapa’s activism and vision for a new Nepal drew disenchanted and previously apathetic youth into politics and to join the Bibeksheel Sajha Party in 2013. Thapa was the pioneer of alternative politics in Nepal, and was leading a youth force long before the GenZ became synonymous with Nepal’s September Storm. He mentored and guided social activists who are today influential youth leaders engaged in non-traditional politics. “Ujwal Thapa, with his entrepreneurial spirit, wanted to address people’s pain-points, and believed that activism was the starting point to alternative politics,” explains <a href="https://nepalitimes.com/opinion/nepal-loses-rare-purpose-driven-leader">Ashutosh Tiwari</a>, former member of Bibeksheel Sajha party. “He sought to build confidence, motivate, and build a community for young people, which drew a lot of people into Bibeksheel.” He adds: “ And while people might say that Bibeksheel never got big, that was never its point. Its function was to be an early talent incubator, which is what it did as evident by the result of this election.” Thapa died in 2021 of complications related to Covid-19, and Bibeksheel had two mergers with Rabindra Mishra’s Sajha Party before being permanently dissolved in 2021. But many of its idealistic members joined Rabi Lamichhane’s RSP, formed just four months before the 2022 federal election. Such was the groundswell of support for change that the RSP became the fourth-largest in Parliament. In 2017, Ranju Neupane (then Ranju Darshana) was the youngest mayoral candidate for Kathmandu at age 21, and contested the federal election in 2022. Pukar Bam himself lost the 2022 election in Kathmandu-1 as an independent.  <figure><img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260313120348_6302a9b534f57191d9a2cb2c31b31449873c6cc27d375344a248dd90847921dd.jpg" data-media-id="editor_3" data-image-id="20260313120348_6302a9b534f57191d9a2cb2c31b31449873c6cc27d375344a248dd90847921dd" data-rendition-name="original" width="1729" height="1365" loading="lazy" alt="The RSP's activist DNA"><figcaption>Photo: SOCIAL MEDIA</figcaption></figure>  Sashmit Pokharel also ran an unsuccessful campaign as an independent candidate in Kathmandu during the 2022 provincial election. Later, he was a member of the City Planning Commission under Balendra Shah when he was elected mayor of Kathmandu in 2022. Last week, the RSP swept the election with a supermajority of 182 seats in Parliament. Voters placed their trust in the party and its leaders to steer Nepal in a new direction after the youth unrest in September. In many ways, Nepal’s youth have decided, just as Ujwal Thapa once did, that enough is enough with corruption, malgovernance, nepotism and dynastic politics. In the <a href="https://nepalitimes.com/review/the-man-who-shook-our-minds">documentary</a> about his life, Dimag Ghochne Manche, released earlier this year, some RSP nominees who previously worked with and were mentored by Thapa spoke of the impact he had on their lives, career, and activism. Among them is Biraj Bhakta Shrestha, former minister of Youth and Sports who is now a second time RSP parliamentarian. “I tell everybody that if it hadn’t been for Ujwal Dai, I would not have gotten into politics,” he says in the film. It would be unfair to attribute all the success of the hard-fought campaigns entirely to Ujwal Thapa’s protégés and former coworkers. But his ethos and vision for Nepal was what inspired them, and will in the coming years be reflected in national politics through the young idealists he mentored. Says Ashutosh Tiwari: “There are many Bibeksheels outside of RSP in constant and open communication with their old friends who have been elected. They will be keeping the lawmakers in check so that they do no stray too far from the values that they grew up with.”

RSP’s activist DNA

This is the 88th episode of Diaspora Diaries, a Nepali Times series in collaboration with Migration Lab providing a platform to share experiences of living, working and studying abroad. Chandra Gurung, Sierra Leone Six of us came to Nepal from Sierra Leone to vote for घण्टी of the RSP. But the six votes were wasted because of the crisis in the Gulf and delayed flights. We arrived the day after the election.&nbsp; The morning we were supposed to fly out, we found out our flight was cancelled, so we had to postpone by four days to figure out an alternate route. Luckily, we did not get stranded in the Gulf like many others. Even though I missed the election, I now look forward to spending time with my family especially to help my children with their studies as their exams are approaching. I am happy because it looks like we will get the outcome we desired and came to Nepal for. Stability is Nepal's most urgent need. If the government is stable and works for five years, they might be able to build change.&nbsp; Fighting corruption, quality education and job creation should be the priority for the new government. We had already advised our families to give the new party a chance. Despite being a new party, the RSP has been able to win the hearts of people. Well-educated people with professional backgrounds have joined the party even though they might not have experience in politics. I first left Nepal in 2008, I am still abroad, and I do not know when I will return. I need to save. I want to see this new government create the conditions to bring us back. In these 18 years, I have not felt like returning. My goal is to make sure I can provide good opportunities to my children. I miss home, going overseas is only to make a living.&nbsp; Suraj Bhandari, Korea I had timed my vacation to vote for Nepal. In our discussions back in Korea, the GenZ protest made those of us overseas want to vote for and bring change. Whichever party it was, we wanted a new one. I had also told my family that if I was unable to arrange my vacation around the election, they should consider voting for new candidates.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260307020344_ebd90331e37dd1c6d37c4d1e35fe58eefcbf1923894cf397aafb7a81b887d63f.jpg" data-media-id="editor_0" data-image-id="20260307020344_ebd90331e37dd1c6d37c4d1e35fe58eefcbf1923894cf397aafb7a81b887d63f" data-rendition-name="original" width="1600" height="900" loading="lazy" alt="Nepali migrants in Korea"> </figure>  We have seen what the old parties have done for the country, they had their chance which they wasted.&nbsp; Leaving Nepal feels different because this time, I am leaving with the hope that Nepal will soon be worth returning to. What I realised after migrating is that when you are away, you have even more love for your country. We overseas youth know the pain of being away and wanted to vote for change.&nbsp; If you earn one lakh abroad, you are willing to work for half that amount back home so you can be with your family. Next time when I come back to Nepal, I want to be able to come for good and not just on vacation. I leave with hope. I hope to return to start my business in Nepal.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260307020344_e835553553e201610afabafa73827a8b7e56d05a6b86c14721f3080d3d5a730f.jpg" data-media-id="editor_1" data-image-id="20260307020344_e835553553e201610afabafa73827a8b7e56d05a6b86c14721f3080d3d5a730f" data-rendition-name="original" width="1600" height="900" loading="lazy" alt="Korea migrant worker"> </figure>  Investing here in a small business is very risky and I hope that changes. I think we have done our part, now it is up to the new government to do its part. They have five years to deliver and if they don’t, we will again have to look for change. I hope history won't repeat itself. When the Maoists came to power, they had brought a similar sense of hope and people believed them and voted. They started off well initially but failed to deliver. I hope that won't happen with घण्टी. Rajendra Kunjeda, Belgium Those of us overseas have attachments back home. But because of the Gulf crisis I was not able to make it on time for the election.&nbsp; When I talk to colleagues in Belgium, the broad consensus among us Nepalis was that we should give the new party a chance. The expectation from the new government is that we need a way out of the rut the country is in. That is what the election was about.&nbsp; When you live in a developed country, you also hope the same for your country. Transformation takes time, but I hope for the best. Not all the old guard was bad, and not all the new guard will be good either. But the new government has to take the country towards development. The expectation is not for overnight change.&nbsp; I was lucky to get a scholarship to study in Europe and have now started working. My degree in agricultural science is relevant for Nepal and the world – you need food to live.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260307020344_1b419bdc71ea6b2b307d5cace49112f976757949b64323fea282986e11231b55.jpg" data-media-id="editor_2" data-image-id="20260307020344_1b419bdc71ea6b2b307d5cace49112f976757949b64323fea282986e11231b55" data-rendition-name="original" width="1600" height="900" loading="lazy" alt="Nepalis in Denmark"> </figure>  I felt bad about not making it on time for the election because I was so excited. Not everyone can return, but what the diaspora wants is evident from social media posts and conversations. I did not influence my parents back home because it is their right to vote for whoever they wanted.&nbsp; During the GenZ movement, the deaths of the students were devastating, but it has also made it clear that the nation is desperate for change. It was an outcome of trying to suppress the change that youth desired.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260307020348_3fa02333f99ff131e84e31c2e990aa40fc1797913b5e6625a18f86d40649ddfa.jpg" data-media-id="editor_3" data-image-id="20260307020348_3fa02333f99ff131e84e31c2e990aa40fc1797913b5e6625a18f86d40649ddfa" data-rendition-name="original" width="1200" height="1600" loading="lazy" alt="Gen Z movement"> </figure>  In Nepal, I have worked with returnees who came back during Covid-19 to see how their skills can be productively utilised in Nepal. There is a lot of potential there which the government needs to prioritise.&nbsp; I have not decided whether to stay overseas or return to Nepal. If day-to-day life and bureaucracy were easier, it would be better. When I am assured that I can sustain myself and get a sense of satisfaction in Nepal, I will consider returning. I need to feel confident in Nepal, feel ढुक्क that if I work hard both I and the country will benefit. This requires a collaborative approach. The Blue sweep means we are on the right path. Sudip Khanal, Denmark I was coming from Denmark to vote. My wife and I left on 28 February but we were stuck for eight days in Istanbul. I was coming to vote for change. I am happy to see that Blue is winning. Even though I did not get to vote, I am glad the country is getting the change it needed.&nbsp; I first went to Denmark in 2022, starting as a student and after graduation I am working. The Nepal embassy in Copenhagen has made things easier to deal with immigration stuff but for a wider population across the world especially the Gulf I also wish the embassies did more.&nbsp; This time our government was not proactive in supporting Nepalis stranded overseas due to the Gulf crisis. Our main wish is that the new government creates new opportunities at home. Education, healthcare and jobs should be the biggest priorities.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260307020344_a774a87b087d49498900728988049634956e8286a61923d9a8cd0de2fafa49ea.jpg" data-media-id="editor_4" data-image-id="20260307020344_a774a87b087d49498900728988049634956e8286a61923d9a8cd0de2fafa49ea" data-rendition-name="original" width="1600" height="900" loading="lazy" alt="Belgoum Nepali migrant"> </figure>  If I could earn up to Rs80,000 back home I would return. I studied business in Denmark but I don’t yet have the guts to return. I am worried about whether there will be a return on investment here and there are no jobs to fall back to. Abroad, I can work for someone else even if I cannot start my own business. I hope change will now come. But this will not happen quickly. All of us back in Denmark supported change. We wanted to come as a group but many students faced constraints like exams or classes. I had no holidays but after the GenZ protests I did not want to waste my vote. Unfortunately, I was not able to return in time but I convinced my parents to give घण्टी a chance for the RSP. Let’s see how things go. ANONYMOUS, Dubai I lived in Dubai for five and a half years, returned to Nepal for a year, and then remigrated two years ago. It was convenient that my holidays and the election coincided.&nbsp; The new government should provide proper job opportunities back home. There are 4-5 people in a house, you need at least Rs50,000 to live comfortably in Nepal. When someone is sick, where can we go?&nbsp; Companies abroad are not always good about leave. You are promised something here, and get another job abroad. Embassies do not always listen to us, like the Philippine embassy.&nbsp; People get tired and give up.&nbsp; I am updating election results on my phone but I am more worried about my flight which is likely to be cancelled because of the situation in the Gulf. The airline just says ‘it is not cancelled till now’, but they do not tell you when you can fly.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260307020348_399b70503f4e25a35e21574985d0d188285b457c38534ae6d95b35e4546b5683.jpg" data-media-id="editor_5" data-image-id="20260307020348_399b70503f4e25a35e21574985d0d188285b457c38534ae6d95b35e4546b5683" data-rendition-name="original" width="1600" height="900" loading="lazy" alt="Nepali migrants"> </figure>  I paid Rs5,000 to come here from Dhanusa just to be told there are no flights. It is simple things like this that need improvement. We have watched politicians for many years and they kept youth unemployed. How can you love any government that has killed kids?&nbsp; The new ones say they will do something, lets see. Foreign labour migration has helped me. I cannot earn even Rs10,000 a month in my village. How will I support my children? If I go, I can send them money. My family is happy. I work hard for them. If my दुख्ख keeps 4-5 people in my family सुख्ख it is all right, isn’t it?

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