<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

In 2003, the death by police firing of a student protesting a rise in fuel prices pushed Nepal’s student activists to join the प्रतिगमन विरोधी आन्दोलन (Movement Against Regression), which political parties had begun after king Gyanendra’s sacking an elected government a year before. The students’ participation elevated the movement and prompted more Nepalis to join in, leading to the People’s Movement that first sidelined the monarchy and then abolished it in 2008.&nbsp; That took five years to happen. But 12 years later, this month, a youth-led protest forced the prime minister to resign within 30 hours.&nbsp; Police massacred GenZ activists, many of them students, outside Parliament on 8 September. This intensified public anger, leading to targeted attacks, looting, and burning of the homes of political leaders, private businesses, and public buildings.&nbsp; Amid the smouldering ruins of state institutions, young Nepalis chose a new prime minister to lead an interim government and deliver a fresh mandate. All of this happened in five days.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250910140912_019d62de4b62a366299a27d1276e931a7dadefcc674441e7fb3acd503970efaf.jpg" data-media-id="editor_0" data-image-id="20250910140912_019d62de4b62a366299a27d1276e931a7dadefcc674441e7fb3acd503970efaf" data-rendition-name="original" width="8000" height="5760" loading="lazy" alt="Nepal in ashes"> <figcaption>Parliament building up in flames during the GenZ protest on 9 September. Photo: KAMAL PRASAI</figcaption> </figure>  Students have been central to Nepal’s democratic and political process since the mid 20th century. In her 2018 book Making New Nepal, researcher Amanda Thérèse Snellinger traces the history of student activism and politics against a background of &nbsp;Nepal’s socio-political history and party politics.&nbsp; Snellinger examines the interplay of ideology and identity, explores how student activists fit into a political landscape continually occupied by the traditional elite, and details how student leaders have established themselves through relationships with influential actors on local, national, regional, and transnational levels. The Rana regime’s repression caused students to be politically aware. In 1947, students held the first organised protest against the Rana autocracy demanding educational reforms. The breadth of student activism expanded during the Panchayat era after king Mahendra banned political parties, which drove mainstream politicians and parties underground. &nbsp;Student activists then became proxies for multiparty democracy because they were still able to organise.&nbsp; Student politics was institutionalised, and unions emerged as vanguard sister organisations of political parties. Student activism, more so than mainstream political parties, played key roles during &nbsp;both major movements in 1990 and the 2000s, as they mobilised the citizenry to join the democratic process.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250924130940_f94cf97fb7ed98b90b48736e1aa8a76466f50337dffc36ec78e9cd5e6927deea.jpg" data-media-id="editor_1" data-image-id="20250924130940_f94cf97fb7ed98b90b48736e1aa8a76466f50337dffc36ec78e9cd5e6927deea" data-rendition-name="original" width="1952" height="2928" loading="lazy" alt="1990 people's movement Nepal"> <figcaption>The iconic image of the 1990 People's Movement agaist the autocratic Panchyat regime of the king. Photo: MIN RATNA BAJRACHARYA</figcaption> </figure>  Through extensive ethnographic research between 2003 and 2015, Snellinger investigates the political coming of age of student activists during the final years of the armed insurgency and their role in and beyond the movement that ultimately abolished the monarchy. Her research revolves around the political journeys of five student activists: Akash and Rishi from the Nepali Congress (NC) student wing Nepal Student Union (NSU), Salini from the UML’s All Nepal National Free Students’ Union (ANNFSU-Akhil), Gyanu from ANNISU-Revolutionary of the Maoists, and Lagan, who began his political journey from Nepal Majdoor Kisan Party’s student wing Nepal Krantikari Bidyarthi Sangathan. The ‘movement against regression’ in 2003 served as the entry point &nbsp;for activists into national party politics. Indeed, it was their &nbsp;participation in the movement that elevated the profile of the main subjects of Snellinger’s research. In the years that followed, the paths of the five activists diverged. Some made it into mainstream politics, even becoming lawmakers. In doing so, they have had to trade idealism for pragmatism, and their attempts realise their previous vision for Nepal’s democracy have been overshadowed by their political opportunism and position. And even decades after they began their journey as student activists, the generation that the book focuses on are still considered &nbsp;‘youth’ leaders. Snellinger quotes a former student leader who joined mainstream politics as saying: “I am still a youth because &nbsp;my aspirations remain unfulfilled.”  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250924130944_7cca095d79fb5ce45cf92c61b77d72c31c5e0931aa744c73e264b6f91efdd29b.jpg" data-media-id="editor_2" data-image-id="20250924130944_7cca095d79fb5ce45cf92c61b77d72c31c5e0931aa744c73e264b6f91efdd29b" data-rendition-name="original" width="1500" height="1004" loading="lazy" alt="2006 People's Movement of Nepal"> <figcaption>A student protester wearing a paper crown and ridiculing Gyanendra with an impersonation, a day after king stepped down and left his palace. Photo: AJAY JOSHI / A PEOPLE WAR</figcaption> </figure>  Meanwhile, the refusal of Nepal’s octogenarian leaders to retire (even after The upheaval this month) has created a surplus of younger adults waiting in the wings, making the word ‘youth’ relative in Nepal’s political trajectory. Other subjects of Snellinger's research have retreated from student and mainstream activism, either in disappointment over their mother party’s retreat from some of their more radical positions, or to &nbsp;continue their work at the community level through education and journalism. One of them has leveraged her political connections to further women-led initiatives after unsuccessful election bids. Nearing the end of her research in 2015, Snellinger observes the disappointment of Madhesi communities whose movement to demand more inclusive provisions of the draft Constitution had gone in vain, even after 45 lives were lost.&nbsp; As the Constitution was promulgated in 2015, TVs were switched off in the Tarai, and there were sighs of resignation. In Kathmandu, Snelllinger noted that the student leaders that entered mainstream politics protesting for inclusive democracy had little empathy for the struggles and similar demands of groups in the Madhes. Despite the students’ role in ending the monarchy, Nepal’s political status quo has remained. The institutions and people that replaced the &nbsp;monarchy have allowed one set of Kathmandu elites to be replaced with another.&nbsp; The socio-political benefits promised during the movement two &nbsp;decades ago have remained tightly controlled by leaders who refuse to give up their hold on power. The political system was overhauled, but without concrete reform. It was only a matter of time before public frustration would boil over. Indeed, Snellinger concludes her book by predicting the inevitability of future movements in Nepal.&nbsp; She writes: ‘Leaders emerge through the andolan … a new generation will emerge shaped by Nepal’s accumulated socio-political heritage, which they will mediate to shape a liveable present and future for themselves in their country, perhaps by continuing the movement.’&nbsp; And that is exactly what happened on 8-9 September. Students marched in the streets demanding an end to corruption and impunity, but this time not as proxies of political parties.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250908120948_8a9acceede487651487c2f15b65e40f900ee6cd390bbf98394eade6b95d05b28.jpg" data-media-id="editor_3" data-image-id="20250908120948_8a9acceede487651487c2f15b65e40f900ee6cd390bbf98394eade6b95d05b28" data-rendition-name="original" width="1600" height="1200" loading="lazy" alt="Gen Z protest"> <figcaption>A student during the GenZ protest against acorruption on 8 September. Photo: SUDIKSHA TULADHAR</figcaption> </figure>  Their desire for socio-political reform was apolitical at a time in Nepal’s history when the nation’s student organisations have weakened and lost credibility, mirroring the erosion of trust in their parent parties. Along with party-based student unions, the Free Student Union (FSU)— the umbrella body all student unions—has lost its reputation due to corruption and embezzlement. That is not to say there are no similarities in movements past and present. Whether political or apolitical, protests have been overshadowed by a lack of unity within the groups that spearhead movements. They have led to destruction of public and private institutions.&nbsp; Leaders of youth and student movements have also had to bear the brunt of the frustration of the people they represent when there is no delivery on their demands. The academics of students have suffered because of frequent lockouts of university and college administration. Youth andolan, whether political or apolitical, has been a rite of passage into Nepali democratic politics — dissensus is an integral part of political regeneration. It remains to be see how the fall &nbsp;from grace of political parties after the GenZ movement will affect their affiliated student unions. As elections approach, student unions and youth collectives will find their own footing in Nepal’s &nbsp;newly emerging socio-political landscape. The youth who took to the streets are asking for a complete overhaul for political parties. Establishmentarian leaders still have not seen the writing on the wall.&nbsp; NextGen leaders in their parties have been waiting for years for their turn &nbsp;to break through the glass ceiling. These established political actors will not go down without a fight in the run-up to March elections.&nbsp; Amanda Thérèse Snellinger perhaps needs a post-script or even a sequel to her book to see how a new generation of leaders, forged by their student activism, will compete in Nepal's new political arena.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250923190928_98d53dd49d56c92950bc34642eaee51dea458fd64312d945a358ad70e5e994bb.jpg" data-media-id="editor_4" data-image-id="20250923190928_98d53dd49d56c92950bc34642eaee51dea458fd64312d945a358ad70e5e994bb" data-rendition-name="original" width="1136" height="702" loading="lazy" alt="Making new Nepal book details NT"> </figure>

Nepal’s historic youth dissensus

What does a journalist do when young protesters are shot in front of her? Does she do her job and stay neutral? Can you stay neutral?&nbsp; As protests engulfed Kathmandu, Nepal's journalists found themselves reporting a story that was personal. While doing their job, some of them were even targeted by mobs.&nbsp; Dart Asia Pacific Fellow <a href="https://www.linkedin.com/in/arunkarki/" target="_blank">Arun Karki</a> visited their newsrooms and spoke with his colleagues on their experience of reporting the GenZ protests that erupted on 8 September. These are the first-hand accounts of journalists who witnessed the turmoil in the city they call home. Sunita Karki was at a workshop in a hotel on 8 September. She saw the first waves of protests through hotel windows. Curfew alerts flooded her phone, a vehicle belonging to a human rights group sat burning across the road, young boys were taking their wounded friends on motorbikes to the Everest Hospital, and police were beating a teenager with hands raised up.&nbsp; “I cried a lot,” she said, but the tears were not out of fear -- they were because she felt guilt. “I couldn’t write the news. We were witnessing these scenes from a five-star hotel.” By evening, the death toll had reached 19. On 9 September at about 3:35 p.m. &nbsp;her outlet, the Annapurna Post's office in Tinkune, Kathmandu, was set on fire. Staff had to leave the building as parts of the newsroom burnt down.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250924040948_e1cc49c9e4fcc4bd4cd3c0163c782fc4e9956bf633cff7b53a63cf8e2dd74cff.jpg" data-media-id="editor_1" data-image-id="20250924040948_e1cc49c9e4fcc4bd4cd3c0163c782fc4e9956bf633cff7b53a63cf8e2dd74cff" data-rendition-name="original" width="1333" height="1000" loading="lazy" alt="Dart Centre Asia Pacific"> </figure>  When she knew her office was burning, she anxiously told her husband that she would resign from the job: "If we have to hide our identification cards in every protest, what kind of journalist am I?" she asked herself. She filed a story the next day, but her emotions kept bouncing between that of a journalist’s duty and shock. She said that in moments like this, it’s hard to feel truly neutral. After watching the police beat people, she felt a strong urge to step in, not just stand back and report. The first real calm came later, when people came to the street and lit small candles together. “This was a sort of victory procession. I felt some relief after brutal days,” she said. <a href="https://www.linkedin.com/in/angaddhakal/" target="_blank">Angad Dhakal</a> a photojournalist who works at Kantipur National Daily, was standing outside his office building when protesters stormed in and set parts of it on fire. He had already been informed that protesters were planning to torch his office building and &nbsp;rushed to his office hoping to save his hard drives containing ten years of photography work. He failed. He raised his camera and "forcefully" pressed the shutter - more to document the scene than out of "professional enthusiasm or duty".&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250924040948_ebafaacb85c4ea045c41f2c63f1eff06fee9a4ddb5fbf419724e1a5d533781fa.jpg" data-media-id="editor_3" data-image-id="20250924040948_ebafaacb85c4ea045c41f2c63f1eff06fee9a4ddb5fbf419724e1a5d533781fa" data-rendition-name="original" width="1333" height="1000" loading="lazy" alt="It is hard to feel neutral NT"> <figcaption>Photo: GAURAV POKHAREL</figcaption> </figure>  “My office was burning. What should I photograph?” he recalled. A few moments later, a protester noticed the “PHOTO” label on his yellow Press jacket. Dhakal deflected it by saying he was an early career freelancer and YouTuber. So that protesters wouldn't find out, he went to one corner and took his jacket off. When it comes to covering street protests, &nbsp;Angad usually stands near the police because it feels safer. But on 8 September, fire and gunshots made even that area unsafe. A rubber bullet hit his friend Dipendra Dhungana that badly injured him.&nbsp; He thought, “Where do we go now? If we stay here, we’ll be hit.” After witnessing two days of protests, violence, and killings, and seeing his own office burning, he couldn't sleep for days. The same afternoon that government buildings burned and Kantipur was attacked, a message in a protest Discord forum talked openly of 'attacking Kantipur'.&nbsp; Rumours spread to other outlets. Outside OnlineKhabar's office, where <a href="https://www.linkedin.com/article/edit/7376157229248528384/?author=urn%3Ali%3Afsd_company%3A79132377#" target="_blank">Gaurav Pokharel</a> works, the newsroom manager saw “very suspicious people were walking around”. They lowered blinds, avoided windows, locked the front gate and dispersed staff to other places across the city. The outlet was threatened and effectively locked down, but not torched. Pokharel hid his press ID. “ I never showed the ID card. Sometimes I had to enter the crowd shouting slogans, just to blend in among the protesters,” he said. He watched people fall under gunfire, he helped pull one surrounded journalist out of a hostile crowd.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250924040948_3b335eee57280373cb51f460534ca4476df23f89c787ba9e4a66d116a537b1a3.jpg" data-media-id="editor_5" data-image-id="20250924040948_3b335eee57280373cb51f460534ca4476df23f89c787ba9e4a66d116a537b1a3" data-rendition-name="original" width="1333" height="1000" loading="lazy" alt="It is hard to feel neutral NT"> <figcaption>Photo: GAURAV POKHAREL</figcaption> </figure>  As a freelancer, Gaurav also contributed articles for international outlets. Later, while transcribing an interview of a young protest organiser, he wrote to his editor at an international outlet : “This was very hard to write. I cried many times while doing it.” He had been working at a stretch for days battling bouts of exhaustion and low blood pressure.&nbsp; Protesters vandalised and set fire within the Singha Darbar complex housing Nepal Television and Radio Nepal. They tried to disrupt public broadcasting.&nbsp; Surendra Paudyal began the day with his press ID hanging on his neck, thinking it would let him move freely. But when he reached Singha Darbar around 3:30PM, the situation felt dangerous.&nbsp; He put the ID in his pocket. When asked what mattered most, he answered without pause: life comes first. In that moment, he felt real fear and a strong duty to protect his team.&nbsp; His focus narrowed to basic things: stay calm, find exits, get everyone out safely. Later, they were able to keep the 8 pm news on air through a regional link. He felt mixed emotions and a sense of relief that the broadcast continued, but also sadness and anger that their own studio had come under attack. Reprinted with permission from the Dart Centre Asia Pacific, a regional hub that provides trauma-informed support and advice to journalists.

"It is hard to feel neutral"

Among the songs GenZ protesters were chanting at the Mandala on 8 September was Amrit Gurung’s folk-rock rendition of the Panchayat-era patriotic song, <a href="https://www.youtube.com/watch?v=0iXnL31W93c">रातो र चन्द्र-सुर्जे जङ्गी निशान हाम्रो</a>. But amidst waving double pennants that day in Kathmandu were strands of Gopal Yonjan singing <a href="https://www.youtube.com/watch?v=N7D8P-g3Uw4" target="_blank">बनेको छ पहराले</a> and <a href="https://www.youtube.com/watch?v=57SlGf4m7R4" target="_blank">देशले रगत मागे</a>. The irony is that the message of Nepali nationalism the musician was trying to convey 50 years ago with his lyrics carries a new resolute relevance in today's context: I am a son of Nepal who will never kowtow to anyone.&nbsp; You can behead me, but I will never bend the knee. &nbsp; I can withstand fire, but will not stand injustice.&nbsp; If the nation demands blood, I will sacrifice myself. My mother will not weep, for she is the daughter of a Nepali. This was pure patriotic poetry that only someone like Gopal Yonjan could write. They are inter-generational and immortal — speaking as much for the GenZ today, as it was for the early days of nation-building when they were recorded in vinyl and broadcast over Radio Nepal.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025092210094_4d5f65bf3ba2d2823e3da8aff6a77f2b9aa4eff4b1e1b6a8eeed8c0bcb58e47b.jpg" data-media-id="editor_3" data-image-id="2025092210094_4d5f65bf3ba2d2823e3da8aff6a77f2b9aa4eff4b1e1b6a8eeed8c0bcb58e47b" data-rendition-name="original" width="2000" height="1600" loading="lazy" alt="Gopal Yonjan NT 1"> <figcaption>Gopal Yonjan was an adept flautist from a young age in Darjeeling.</figcaption> </figure>  Those two songs together have over 20 million views on the Music Nepal YouTube channel, and many of the comments have been posted after the 9 September massacre and the raging conflagration at the epicentre of the Nepali state&nbsp; They attest to the emotional depth of Nepali nationhood and love of motherland in every citizen of every generation no matter how dreadful the circumstances — and especially when the future looks fragile and uncertain.&nbsp; The release of Gopal Yonjan: The Man &amp; His Music by his wife Renchin could not have come at a more momentous time in Nepal’s history to celebrate this iconic legend of modern Nepali music. Yonjan would have been 82 today, and as a poet, lyricist, singer innovated and improvised using Nepal’s folk traditions to infuse modern arrangements, meld melody with harmony, and lend them words that made the songs eternal.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025092308098_76c4e4df756de0c1bea9858e1da0bcb6acb8145f27963e1679f5509a6ac2f078.jpg" data-media-id="editor_4" data-image-id="2025092308098_76c4e4df756de0c1bea9858e1da0bcb6acb8145f27963e1679f5509a6ac2f078" data-rendition-name="original" width="2712" height="3900" loading="lazy" alt="Gopal Yonjan Narayan Gopal"> <figcaption>Narayan Gopal with Gopal Yonjan, the ‘Gopal Duet’ at Swayambhu circa 1963.</figcaption> </figure>  HOMECOMING Renchin Yonjan brings us an intimate family album of historic photographs of Gopal growing up in school in Darjeeling, his arrival in Kathmandu and the decision to make Nepal his home. She quotes Gopal: ‘I was deeply moved by the very glimpse of Nepal. I was enchanted by the greenery of Kathmandu, the gentle nature of the people, their pure thoughts, and their hospitality … how wonderful it would be to spend my live in such a beautiful and serene place.’ It was a kind of homecoming for Gopal Yonjan, the land his ancestors left to migrate to British India. In Kathmandu he found kindred spirits and musicians as passionate about their craft as himself: Narayan Gopal, Nagendra Thapa, Ratna Shumsher Thapa, Shiva Shanker, Pushpa Nepali  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250922100920_99a97f6cd76c130d5df91a38ac236906bcb21ba6fc2d2d693ba51e0a97c045d4.jpg" data-media-id="editor_5" data-image-id="20250922100920_99a97f6cd76c130d5df91a38ac236906bcb21ba6fc2d2d693ba51e0a97c045d4" data-rendition-name="original" width="1500" height="1071" loading="lazy" alt="Gopal Yonjan"> <figcaption>Gopal Yonjan arriving at Kathmandu airport in 1963 and greeted by Nepali singers Pushpa Nepali, Dilmaya Khati, Shiv Shanker Shrestha, among others. </figcaption> </figure>  Gopal Yonjan and Narayan Gopal hit it off right away, complementing and inspiring each other with their shared love for meaningful music. They came to be known as the ‘Gopal Duet’, and Yonjan wrote in Nepali in his diary on 21 April 1963 about their first meeting: ‘I was immediately struck by his talent and presence. There was something in both his artistry and demeanour that drew me in. It didn’t take long for us to draw close.’ Towards the end of his life, Gopal Yonjan drifted away from themes of patriotism and unity to celebrate music in its purest form in his Gopalaya Studio in Kathmandu. It became art for art’s sake.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250922100912_f9aeec8d96049c580a4b63789664e1ae80971d3be3c7809acfe51b84e3e31cd1.jpg" data-media-id="editor_6" data-image-id="20250922100912_f9aeec8d96049c580a4b63789664e1ae80971d3be3c7809acfe51b84e3e31cd1" data-rendition-name="original" width="2000" height="1304" loading="lazy" alt="Gopal Yonjan"> <figcaption>Gopal Yonjan at his Gopalaya Studio in Kathmandu in 1992.</figcaption> </figure>  The words of his song <a href="https://www.youtube.com/watch?v=D8ZHg3wkvzw" target="_blank">मेरो गीत मेरै प्रतिविम्ब होइन</a> immortalised by Narayan Gopal has lines that give goosebumps to anyone who listens to them: मेरो गित भन्ने अधिकार छैन, गित को पो म हूँ मेरो गित होइन (I have no right to call this my song. This song does not belong to me. I belong to this song.) &nbsp; In Nepal, Gopal Yonjan also found a more complicated story. There were grand historical narratives of nationalism, bravery and glory, but there was an undercurrent of fear and control. Renchin writes in the chapter, Tell Me Where My Country Lies: ‘[Gopal saw] national pride slowly erode in the face of social exclusion, political silence, and economic disenfranchisement.’  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250922100912_57578ebebc7e405cf6ad3080611366893bee30cfc071567e6509038da866b2f2.jpg" data-media-id="editor_8" data-image-id="20250922100912_57578ebebc7e405cf6ad3080611366893bee30cfc071567e6509038da866b2f2" data-rendition-name="original" width="1500" height="1043" loading="lazy" alt="Gopal Yonjan"> <figcaption>Renchin and Gopal Yonjan in their garden in Kathmandu in the late 1980s.</figcaption> </figure>  Gopal Yonjan’s song <a href="https://www.youtube.com/watch?v=Zru8yWSuRCI" target="_blank">भनिदे नेपाली दाइ मेरो देश कहाँ पर्यो</a> is ‘as much an elegy as a manifesto’ with searing lines like ‘Where is the river that ran red with Nepali blood? Where is the battlefield where our defenders wiped their khukri?’ Gopal Yonjan sings this song himself, reminding Nepalis of the sacrifices made to forge this nation, and for us not to squander them.&nbsp; In his song <a href="https://www.youtube.com/watch?v=_pVKpsK6Wy8" target="_blank">लाहुरे</a>, Yonjan celebrates Nepal’s illustrious history written in blood both to keep the nation free and then spilling it to defend other countries. Today, the same song takes on added meaning of Nepali lahure shedding not blood but sweat and tears as they toil abroad to send money to families back home. It evokes the pain of separation, and an anger at an uncaring state that drives them to leave. Gopal Yonjan died aged 53 in 1997 in a New Delhi hospital, leaving a legacy that still defines the Nepali nation in ageless musical compositions. The US-based <a href="https://www.gopalaya.org/" target="_blank">Gopayala</a> and the Gopal Yonjan Foundation have worked to remaster some of the tapes and recordings that are in safekeeping at Cornell University’s Carl A Koch Library.&nbsp; Renchin Yonjan has collected some of that valuable documentation in her book, Gopal Yonjan: The Man &amp; His Music. Her concluding paragraph sounds prescient because of what Nepal has just been through: ‘Gopal’s patriotic compositions remain timeless not because they repeat old slogans, but because they ask new questions, and demand that we answer not with our voices, but with our lives.’  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025092210090_3d0b5ecad2313b09e83e0de91bf510004f1ff836d7e66f0543ccd49432bb6386.jpg" data-media-id="editor_12" data-image-id="2025092210090_3d0b5ecad2313b09e83e0de91bf510004f1ff836d7e66f0543ccd49432bb6386" data-rendition-name="original" width="1136" height="518" loading="lazy" alt="Gopal Yonjan"> </figure>

Gopal Yonjan’s immortal songs

Harry Jackson was on an epic adventure ‘from Thailand to the UK on 2 wheels’ when he ran into the ultimate sidequest. Having just visited Zangla in Ladakh, Jackson had only landed in Kathmandu when he found himself in the middle of GenZ protests earlier this month. ‘<a href="https://www.youtube.com/watch?v=Slq6zWu9o9w">Arriving in Nepal - Chaos, Protest &amp; Curfews</a>’ is the title of his first video (<a href="https://www.youtube.com/@wehatethecold/videos">wehatethecold on YouTube</a>) about the protest. He shoots police as they shoot at protesters outside Parliament. Jackson is riding a Honda CT125, a retro lightweight motorbike with off-road capabilities. Strapped to the bike is his sparse luggage, flute, and a faded Union Jack. People are rioting on the streets and there is a heavy armed police presence as he makes his way to his hostel in Thamel. His vlog the day after on 9 September has 29 million views. In ‘<a href="https://www.youtube.com/watch?v=IyxSqeFrlp0">The side of Nepal the media won’t show you</a>’, Jackson rides his bike straight at the crowd just past the Parliament building into Old Baneswar.&nbsp; He parks it and walks among the protestors, documenting it all: from the police firing capsules of tear gas into the crowd to the burning Parliament building as well as the jubilant, victorious crowd in the premises as they destroy police vehicles and dance. “I’m shocked at the scenes I’ve witnessed here today. I have truly witnessed history on a stupid trip from Thailand to England on a f***ing moped!” exclaims Jackson as he leaves the scene for the day, heading back to his hostel to edit the footage. The hostel is in direct contrast to the raucous scenes of the protest, as tourists and Nepalis sit and lounge at tables. ‘KUIRE VLOGGER’ Nepalis quickly called him the ‘kuire vlogger’, and attribute his skin colour to his popularity. Objectively, the videos are well made. Jackson goes full gonzo journalist, putting himself right in the heart of the action, talking directly to the people, all while narrating the events as they unfold. Despite being cut together in an entertaining way, the footage retains a raw, unpolished quality that outdoes what most professional journalists with a heavy duty camera crew could do. At a time when legacy media has been seen to be pushing biased narratives, Jackson wants to see for himself what happened, and make up his own mind.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250925120956_f7141e06c72655502fc4b2e56120d084b0f5ae111078d66df4fd0415adf8d376.jpg" data-media-id="editor_3" data-image-id="20250925120956_f7141e06c72655502fc4b2e56120d084b0f5ae111078d66df4fd0415adf8d376" data-rendition-name="original" width="2880" height="1604" loading="lazy" alt="WehateTheCold"> </figure>  This kind of video journalism takes a lot of skill and a certain personality. Many people, almost everybody, had their phones out at the protests, but only a handful were like Jackson. He interviewed people firsthand, edited the clips and uploaded them the same day. Jackson continued his vlogging over the next few days as the curfew was first put in place and then lifted. He explores the city as the Valley rebounds. By this time, Nepalis recognise him everywhere he goes. Jackson had achieved moderate fame as a 23-year old DJ in Birmingham, but what he has done in Nepal is something else. Almost everyone he talks to has already seen his vlog, and they are all eager to interact. He has been on multiple podcasts in Nepal too, and most videos online on the protests reference his vlogs. Before his Nepal blogs, Jackson had a modest 16k subcribers on YouTube, but after Nepal figure is now almost 700k, gaining over 100k each through 11-13 September. Most of them are Nepali viewers. “I’m just a regular dude who just did what he wanted to do,” says Jackson on a podcast. “I wanted to go on an adventure, learn about history, and learn languages. And I wanted to film it, document it, and have a wicked film for my life to show future generations.” &nbsp;

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