<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221114121112/637222e29c7e80680e0c031ejpeg.jpg" alt="" width="1086" height="724"/><figcaption>Charikot Hospital. Photo: NYAYA HEALTH NEPAL</figcaption></figure>Nepal’s medical industrial complex has modernised healthcare in the country, but it has also pushed treatment out of reach of most citizens.Collusion between politicians and medical magnates has made it so expensive to become a doctor that it has set off a chain reaction to make hospital treatment unaffordable.Meanwhile, government hospitals are <a href="https://www.nepalitimes.com/here-now/at-the-covid-19-frontlines-in-rural-nepal/">under-funded, under-staffed and under-motivated</a>. Most medical personnel in district hospitals and health posts moonlight in private clinics, and patient treatment is substandard.Desperate families have to sell property, jewelry and other assets <a href="https://www.nepalitimes.com/banner/in-a-healthy-state/">to afford private treatment</a>, pushing even some middle-class families below the poverty line.Read more: <a href="https://www.nepalitimes.com/banner/in-a-healthy-state/">In a healthy state</a>, Nepali TimesBut there are notable examples of government hospitals that are running well because of various models of partnership with non-profits, foundations and charities. They prove that affordable high quality healthcare is possible, and those hospitals need not be so expensive to run.There is <a href="https://archive.nepalitimes.com/news.php?id=18362#.YrQjS-xByrc">Dhulikhel Hospital</a> which has a tiny registration fee, treatment is low cost, an insurance scheme pays for most treatment, and patients are charged according to their capacity to pay. Despite being a government hospital, Dhulikhel has upheld a consistently high standard of care and treatment.United Mission to Nepal has run a hospital in Tansen for over 60 years, a community hospital in Okhaldhunga, and was till recently managing Patan Hospital, providing high quality care at low cost to patients.Other public-private partnership institutions that could be models to be replicated across Nepal include:<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221114121112/637222e59c7e80680e0c031fjpeg.jpg" alt="" width="1500" height="1000"><figcaption> </figcaption></figure><h3>Bayalpata Hospital</h3>After <a href="https://www.nepalitimes.com/opinion/is-free-health-care-possible-in-nepal/">Bayalpata Hospital</a> was established in Achham 20 years ago, for many years it did not have a single doctor. Treatment was so poor that even emergency cases had to be taken on a grueling 12 hour drive down to Dhangadi.In those days HIV tagged along with the migrant workers returning from India, and there was a full-blown AIDS and TB epidemic in Achham and other district in Far Western Nepal. The mortality rate, already very high among women and children, soared.In 2009, Nepali and American medical students inspired by the community health model of <a href="https://www.nepalitimes.com/latest/paul-farmer-on-my-mind/">Paul Farmer</a> set up Nyaya Health Nepal (formerly Possible) taking over  Bayalpata under a public-private partnership with the government.Since then, Bayalpata Hospital has upgraded its facilities (left) and <a href="https://www.nepalitimes.com/banner/state-of-the-art-rural-hospital/">treated nearly 1.5 million patients for free</a>, some of them for complicated caesarian and orthopedic surgeries.Read also: <a href="https://www.nepalitimes.com/opinion/is-free-health-care-possible-in-nepal/">Is free health care possible in Nepal?</a> S P KalauneeUp to 100,000 patients from Achham and surrounding districts come to Bayalpata because they get free treatment there, and many families have saved themselves from sinking into poverty.Bayalpata also runs a network of community health centres with an Electronic Health Record (EHR) system that digitally keeps track of all patients in the catchment area. The presence of just this one hospital has improved the health parameters of surrounding districts, bringing down the maternal and child mortality rates. Achham once had the highest maternal mortality rate in Nepal, today institutional deliveries make up 90% of total deliveries, and very few women die at childbirth.“We have a simple objective: to show that providing free and high quality treatment to the most underserved area of the country is possible at a very low cost,” explains Srijana Devkota of Nyaya Health Nepal.Once <a href="https://archive.nepalitimes.com/article/nation/Nation-Crowdfund-globally-act-locally,490">fully funded by international foundations</a> to run hospitals in Bayalpata and Charikot, NHN now provides free medical treatment in Achham for just Rs200 million a year, of which half now comes from the Sudurpaschim Province and local municipality.+977 - 4100517<a href="https://www.nyayahealthnepal.org/">https://www.nyayahealthnepal.org/</a><figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221114121112/637222e89c7e80680e0c0320jpeg.jpg" alt="" width="750" height="401"><figcaption> </figcaption></figure><h3>Spinal Injury Rehabilitation Centre</h3>The <a href="https://www.facebook.com/SpinalNepal/">Spinal Injury Rehabilitation Centre</a> (SIRC) in Banepa is a public-private partnership  providing treatment and rehabilitation to people with spinal injuries. It was started by journalist and civil rights activist Kanak Mani Dixit after his miraculous survival and recovery in a trekking accident in 2000 along the Annapurna Circuit that damaged his spinal cord.SIRC now <a href="https://www.nepalitimes.com/here-now/injured-use-internet-to-reach-physiotherapists/">helps rehabilitate up to 100 spinally injured patients</a> a year, and the numbers are going up every year due to injuries sustained in highway accidents and falls from trees and cliffs. The facility was located in Banepa because of its proximity to highways and nearby trauma centres. The hospital has also been providing community treatment and tele-rehabilitation services for follow-ups.Read also: <a href="https://www.nepalitimes.com/editorial/poor-health-makes-nepalis-poorer/">POOR HEALTH MAKES NEPALIS POORER</a>, EditorialThe hospital has medical officers, urologists, physiotherapists, occupational therapists, nursing care, prosthetics, orthotics, psychologists and consultants. Those who cannot afford to pay are still treated for free, others are charged the same rate as Bir Hospital.“Because patients often have to stay for more than five months, it may be difficult for them to afford the cost, so we charge them according to their capacity to pay,” says SIRC’s Raju Dhakal.SIRC’s annual running cost is Rs50 million, of which most comes from grants by non-profits and other fund-raising activities. The government also chips in with a budget for the physical construction and equipment as well as occasional allocations to cover budget shortfalls.infosirc@wlink.com.np, spinalnepal@gmail.com<a href="https://www.sirc.org.np/">https://www.sirc.org.np/</a><h3>Charikot Primary Health Centre</h3>The 2015 earthquake damaged <a href="https://www.nepalitimes.com/latest/unique-hospital-handover-in-dolakha/">Charikot Primary Health Centre</a> along with 98% of the medical facilities in Dolakha district. But the disaster was a blessing in disguise for the Charikot centre. It was rebuilt and upgraded to a full-scale 50-bed hospital and managed first by Médecins Sans Frontières and then by the non-profit Nyaya Health Nepal (NHN). Residents of Dolakha did not have to make expensive journeys to Kathmandu because medical treatment was available for free at Charikot.Read also: <a href="https://www.nepalitimes.com/opinion/dangers-of-privatising-health-insurance-in-nepal/">Dangers of privatising health insurance in Nepal</a>, Gaj B Gurung and Sushil KoiralaIn 2020, NHN handed over management of the hospital to Bagmati Province and Bhimeshwor Municipality which now run the facility with low cost treatment for up to 300 patients a day. The Charikot experiment has been hailed as a model for successful transfer by a private non-profit to the local government, and it has been running well despite the presence of two private hospitals in Charikot.“It has been a seamless handover from Nyaya Health to the government, and the level of care and treatment is the same,” says chief physician Binod Dangal. “We perform caesarean sections, orthopedics, telemedicine, free check-ups for the elderly, children and pregnant women, mental health counselling, and chronic illness monitoring.”+977 49 421125<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221114121112/637222ea9c7e80680e0c0321jpeg.jpg" alt="" width="1080" height="608"><figcaption> </figcaption></figure><h3>Sagarmatha Chaudhary Eye Hospital</h3>For the past 30 years, the <a href="http://archive.nepalitimes.com/news.php?id=10071#.YrQlROxByrc">Sagarmatha Chaudhary Eye Hospital</a> in Lahan of Siraha district has been providing the cheapest cataract surgery in the world for just Rs1,200 per operation.Thirty years ago when the hospital started, it had only 12 beds. It now treats 470,000 people every year with patients coming in from as far away as southern India and Bangladesh, and they pay the same amount as Nepalis. Just in the last three years, the eye hospital has treated 321,000 foreign nationals.“It is possible to provide the services at an affordable cost because we are a non-profit, and have an economy of scale,” explains Abhishek Roshan of Sagarmatha Chaudhary Eye Hospital.Read also: <a href="https://archive.nepalitimes.com/article/editorial/health-tip-editorial,4032">Health tip</a>, EditorialThe hospital has <a href="http://archive.nepalitimes.com/news.php?id=10071#.YrQlROxByrc">also set up 15 eye care centres throughout the district, and takes treatment directly to the people</a> so they do not have to make the journey to Lahan. It has a separate department for paediatric services, care for newborn babies with vision problems. In 2021 alone, it performed 1,170 eye surgeries on children.Apart from providing treatment of retina, cornea, glaucoma, oculoplasty, the hospital also serves as an international research centre, collaborating with institutions like The London School of Hygiene and Tropical Medicine.The hospital subsidises its eye treatment for patients with revenue from its agribusiness ventures. A part of the hospital’s land is dedicated to fish farming, and an orchard for litchi and mangoes, as well as a bamboo grove.“Income from those ventures help us keep the cost of treatment down,” says Roshan. The hospital is also supported by Christian Blind Mission (CBM), the European Commission and Arvis.+977-33- 560080https://www.erec-p.org/sagarmathaRead more: <a href="https://archive.nepalitimes.com/article/nation/national-health-insurance-not-as-easy,4028">A national health insurance scheme is not as easy as it looks</a>, Sonia Awale

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Taking wealth out of health

<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022111412118/6372219c9c7e80680e0c02c6jpeg.jpg" alt="" width="1000" height="662"/>This year’s health budget kept the contribution to health insurance of the previous year's allocation of Rs7.5 billion. However, the plan to hand over the institutional management of health insurance programs to the private sector through the Ministry of Finance defeats the fundamental goal of the health security.This is not entirely surprising, of course, because the Health Ministry had passed a <a href="https://archive.nepalitimes.com/article/nation/national-health-insurance-not-as-easy,4028">narrow and poorly thought model of health security</a> for Nepal, and there were already concerns that it would eventually be handed over to the private sector and traded as a commodity.A private company can contribute to a health insurance program. But can they really contribute to national public health security, understand equity, expand <a href="https://www.nepalitimes.com/editorial/poor-health-makes-nepalis-poorer/">access to the poorest and the most marginalised</a> population, and negotiate with the government providers for quality services? Are they fundamentally designed to serve the poor?Read also: <a href="https://archive.nepalitimes.com/article/nation/national-health-insurance-not-as-easy,4028">National health insurance not as easy</a>, Sonia AwaleThe private sector has a role in contributing to achieving Universal Health Coverage by mainly serving the affluent. The poor neither can afford private health insurance nor access expensive private hospitals. Even if they are admitted to hospitals, they have to bear <a href="https://www.nepalitimes.com/opinion/is-free-health-care-possible-in-nepal/">catastrophic expenses</a> pushing them into the vicious cycle of poverty.The private insurance companies only pool the resource, they do not share the risk for those who cannot afford to pay the premium. It will be naïve to assume that such companies could be easily maneuvered to deliver services as a fair-price approach. There are around 20 registered private health insurance companies and 366 private hospitals in Nepal, and some are <a href="https://www.nepalitimes.com/latest/nepal-tries-to-ensure-covid-19-insurance/">selling health insurance at exorbitant premiums</a> many times higher than the current premium cap.There are six national health security indexes: prevent, detect, response, health, norms, and risk. During the pandemic, insurance companies got richer by <a href="https://www.nepalitimes.com/latest/nepal-tries-to-ensure-covid-19-insurance/">selling fake insurance schemes</a> while the hospital profits bulged through expensive Covid treatment. Very few hospitals treated Covid patients with a humanitarian approach. None of their technical advancements helped effectively prevent, detect, and respond to the pandemic.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022111412118/6372219f9c7e80680e0c02c7jpeg.jpg" alt="" width="1641" height="1000"><figcaption> </figcaption></figure>The current health insurance program has identified the elderly, completely disabled, leprosy, Multi-Drug Resistant TB patients, people living with HIV, and ultra-poor as target populations to waive their premium. Though not adequate, this is an equity approach.But none of these target populations are <a href="https://archive.nepalitimes.com/article/nation/national-health-insurance-not-as-easy,4028">eligible for private health insurance</a>, or they will have to pay a much higher premium. It will be unwise to assume that these companies will change overnight and be equitable. They are powerful enough to influence government policy and have the power to bend them to suit their commercial interests.Read also: <a href="https://www.nepalitimes.com/editorial/poor-health-makes-nepalis-poorer/">Poor health makes Nepalis poorer</a>, EditorialInstead, the government should <a href="https://archive.nepalitimes.com/article/editorial/health-tip-editorial,4032">strengthen the Health Insurance Board</a> and explore ways to integrate health security with the broader social security scheme. In the short term, there are urgent but straightforward reforms like recruiting adequate and skilled human resources, strengthening the organisational systems, revising the design of service purchase strategy and equity, and gradually, having effective providers/purchasers split for better implementation.Ultimately, the program will benefit by forming a broader and more robust social security structure, co-incidentally introduced at the same time by the government. It would be able to absorb costs by pooling tax-based health care contributions and merging subsidies given to the treatment of cancer, renal failure, and other chorionic diseases under one integrated umbrella.But the current government does not appear serious about <a href="https://www.nepalitimes.com/opinion/health-insurance-must-be-an-election-agenda/">reforming health insurance</a>, and simply does not understand the fundamental principles of health security. Health insurance is not just limited to providing health care, but is a part of broader health security.Read also:  <a href="https://archive.nepalitimes.com/article/editorial/health-tip-editorial,4032">Health tip</a>, EditorialThe idea that health security can be strengthened by passing the buck to the private sector amounts to abandoning the constitutional commitment to provide health care, not as a service but as a citizen's fundamental right. The Nepal government is a signatory to achieving the health targets of the Sustainable Development Goals.As argued by Nepali Congress leader Gagan Thapa, who is one of the pioneers who <a href="https://archive.nepalitimes.com/article/editorial/health-tip-editorial,4032">pushed health insurance</a> in Nepal, they contribute to strengthening the health system, strive for healthy populations, cushion the poor and provide them access to health services. It is a vehicle for mobilising adequate health resources, enhancing health security, and ultimately achieving Universal Health Coverage.These goals cannot be met by trading the people's health as mere commodities.Gaj Gurung has a PhD in public health from Chulalongkorn University and Sushil Koirala is a public health expert. Both are based in Bangkok.Read more: <a href="https://www.nepalitimes.com/opinion/is-free-health-care-possible-in-nepal/">Is free health care possible in Nepal?</a> S P Kalaunee

Dangers of privatising health insurance in Nepal

In 2013, while writing <a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/Flu,294">a weekly health column</a> in this paper, I explored the potential for <a href="https://www.cdc.gov/coronavirus/mers/index.html" target="_blank" rel="noopener">MERS </a>(Middle Eastern Respiratory Syndrome) to spread among Nepalis working with camels in the Gulf states. Despite all the dire predictions of how that coronavirus could be brought back to Nepal and spread in the population, it is still a mystery why there was no MERS outbreak here. Viruses do have their own predilections.This time, although <a href="https://www.nepalitimes.com/banner/why-nepal-must-watch-about-coronavirus-but-not-panic/" target="_blank" rel="noopener">Nepal officially has had only one person diagnosed</a> with the novel coronavirus (COVID-19) who later recovered, it is utterly foolhardy to think that we may escape this pandemic. In Italy, there were only four cases in 20 February, but three days later it soared to 400 cases. That virulence is what is new about this novel coronavirus.Even if Nepal does not have a surge of cases now, there is every likelihood that we will have to deal with an outbreak next winter. In addition how COVID-19 will interact with a summer dengue outbreak like last year in Kathmandu is anyone’s guess. It is important to be prepared with preventive aspects.Read also: <a href="https://www.nepalitimes.com/editorial/this-is-a-test/" target="_blank" rel="noopener">This is a test</a>, Editorial<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109101152/636b79239c7e80680e0646e5jpeg.jpg" alt="" width="960" height="640"/><figcaption>An Army personnel demonstrates how to wear protective gear while treating possible COVID-19 patients in Nepal. All Photos: BIKRAM RAI</figcaption></figure>Masks for the general public are more for self-assurance than anything else. People who are coughing and have symptoms should wear masks. But widespread use of masks for the general public may only deplete the limited supply of masks where they are actually needed in hospitals. The most important prevention is <a href="https://www.nepalitimes.com/banner/covid-19-revives-nepals-wash-drive/" target="_blank" rel="noopener">washing hands </a>properly with soap and water 5 to 6 times per day and avoid touching the face. Keeping a reasonable distance from one another is also important. The elderly need to be especially careful.One of the most crucially helpful decisions that the Chinese government took in December 2019 after the novel coronavirus struck Wuhan was to rapidly share the molecular structure of the virus (its genomic sequence) with the world. This made it possible for drug manufacturing companies like <a href="https://www.modernatx.com/" target="_blank" rel="noopener">Moderna</a>, a biotechnology company based in the US, to start working on a vaccine.Read also: <a href="https://www.nepalitimes.com/banner/a-shot-in-the-arm-for-vaccines-in-nepal/" target="_blank" rel="noopener">A shot in the arm for vaccines in Nepal</a>, Sonia AwaleThe first human trial against COVID-19 will start later on this month. This is incredibly fast because in earlier times, it would take at least six years before a vaccine was developed. Although an effective vaccine is the best defence against COVID-19, what can be done for prevention in Nepal here and now is more important.First, the good news. It is now well known that about 80% of COVID-19 victims will have mild symptoms not requiring hospital admission. Of the rest, 15% will be severe and 5% may be critical, possibly requiring ventilators in an intensive care unit. Even if only 0.5% of patients from South Asia’s population of 1.8 billion require ventilators, it is easy to imagine the tragic scale of this potential  emergency.The Wuhan data from Chinese doctors also revealed that it was the elderly (mostly male) that took the brunt of the disease and that children were not symptomatic, even though they may be infected by the virus. The findings also showed that about 1% of the patients who suffer from  COVID-19 die.This is the stark difference between COVID-19 and other causes of influenza where the death rate is only 0.1%. That is, COVID-19 kills ten times more people, and they are mostly above 60 years old. Although 1% may sound small, actual numbers will be numbing when large populations are infected.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109101152/636b79249c7e80680e0646e6jpeg.jpg" alt="" width="3600" height="2400"><figcaption> </figcaption></figure>Besides vaccines, there are also drug studies going on to fight COVID-19. One such medicine is called <a href="https://www.kaletra.com/" target="_blank" rel="noopener">Kaletra</a>, commonly used for HIV patients. Many other drug trials (including the antimalarial drug cholroquin) are going on.The incubation period (the time from infection to symptoms) was also studied in Wuhan and forms the basis of the quarantine period of 14 days. The average incubation period is five days but may be up to 12 days. To be on the safe side a two-week quarantine is recommended, after which it is unlikely that the symptoms will manifest.Unlike some western countries, China, Singapore, Taiwan, and South Korea practiced widespread contact tracing to control the disease. If someone was diagnosed with COVID-19, the health professionals took a detailed history of  who their contacts (including family and friends) were, and followed up to see if they developed symptoms. Contact tracing helped stem the spread of the disease in these countries.Buddha Basnyat is a clinical researcher at Patan Academy of Health Sciences and a <a href="https://www.nepalitimes.com/opinion/what-is-novel-about-the-novel-coronavirus/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/opinion/what-is-novel-about-the-novel-coronavirus/&amp;source=gmail&amp;ust=1585631034431000&amp;usg=AFQjCNE0aoyspsOeHIBjtexE2rB8xE3KOw">frequent health columnist</a> for Nepali Times.

Buddha Basnyat

What is novel about the novel coronavirus?

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109101152/636b79289c7e80680e0646e7jpeg.jpg" alt="" width="960" height="640"/><figcaption>A quarantine zone at Nepal Army's headquarters in Tundikhel. Photo: BIKRAM RAI</figcaption></figure>By now the novel coronavirus pandemic has affected every corner of the globe. If it has not brought disease, it has at least brought the <a style="background-color: #ffffff; font-size: 16px; letter-spacing: 0.15px;" href="https://www.nepalitimes.com/editorial/fear-goes-viral/" target="_blank" rel="noopener">fear of infection</a>. Cities, and indeed entire countries, are in lockdown. Fortress Europe has raised its walls higher. Airlines are grounded. Nepal has banned trunk international routes from Friday night. Even countries with excellent public health facilities and emergency preparedness plans are overwhelmed.Nepal is now <a href="https://www.nepalitimes.com/opinion/global-thinking-and-local-action-on-coronavirus/" target="_blank" rel="noopener">so closely intertwined with globalisation</a> through migration, tourism and trade that its <a href="https://www.nepalitimes.com/here-now/nepals-economy-already-weak-takes-direct-hit/" target="_blank" rel="noopener">already-fragile economy has been badly hit</a> even before a full-blown health emergency hits. Ironically, less-developed countries seem to have a built-in resilience that comes from being crisis-prone -- since they are lower down in the economic ladder, they have a shorter distance to fall.Read also: <a href="https://www.nepalitimes.com/editorial/poor-health-makes-nepalis-poorer/" target="_blank" rel="noopener">Poor health makes Nepalis poorer</a>, EditorialDespite Nepal’s surprisingly <a href="https://www.nepalitimes.com/banner/born-in-nepal/" target="_blank" rel="noopener">dramatic improvements in mother-child survival </a>over the past two decades, <a href="https://www.nepalitimes.com/editorial/poor-health/" target="_blank" rel="noopener">the public health system here is in crisis</a>. State-of-the-art modern hospitals in the city, while reducing the need for Nepalis to go abroad for treatment, are out of reach of a majority of the population. Government health facilities are more affordable, but for the most part medical care there is not up to mark.Nepalis are still afflicted by easily preventable water-borne diseases like <a href="https://archive.nepalitimes.com/news.php?id=16988#.XnMUhagzbSF" target="_blank" rel="noopener">typhoid and diarrhoea</a>, vector-borne infections like malaria, encephalitis or dengue, and illnesses like <a href="https://www.nepalitimes.com/banner/nepal-tb-cases-grossly-underestimated/" target="_blank" rel="noopener">tuberculosis </a>and acute respiratory infections that spread through breathing. Great inroads have been made in reducing the impact of communicable diseases in the past decades through awareness programs, vaccinations and safer drinking water, but children in <a href="https://www.nepalitimes.com/banner/this-is-how-to-upgrade-nepals-rural-health/" target="_blank" rel="noopener">remoter parts of Nepal</a> are still dying of simple infections.Read also: <a href="https://www.nepalitimes.com/banner/a-shot-in-the-arm-for-vaccines-in-nepal/" target="_blank" rel="noopener">A shot in the arm for vaccines in Nepal</a>, Sonia AwaleOn top of this, urbanising Nepal now also has the added burden of <a href="https://www.nepalitimes.com/editorial/poor-health/" target="_blank" rel="noopener">non-communicable afflictions</a> like diabetes, cardio-vascular ailments and renal disease. As families move from the districts to the cities, changes in diet and more sedentary habits have given rise to an epidemic of lifestyle-related diseases. This is compounded by genetic susceptibility among South Asians for diabetes and heart disease.For example, a study by the BPKIHS in Dharan showed that while the national average for <a href="https://archive.nepalitimes.com/article/nation/diabetes-in-south-asia,3018" target="_blank" rel="noopener">Type 2 diabetes </a>prevalence is 8.1% of the population, the incidence in Dharan was 14%, while it was only 1% in Taplejung. The prime minister’s own second kidney transplant this month showed that <a href="https://archive.nepalitimes.com/article/editorial/health-tip-editorial,4032" target="_blank" rel="noopener">ignoring risk factors and not diagnosing non-communicable diseases</a> can lead to a huge health burden for families and the state. A small percentage of Nepalis have health insurance, so many middle income families fall below the poverty line due to medical expenses. Many Nepali migrant workers have been forced to seek jobs abroad to pay back debts incurred during hospitalisation of family members.Last summer’s explosion of dengue in Kathmandu Valley was <a href="https://www.nepalitimes.com/banner/mosquitoes-move-up-mountains-as-the-earth-warms/" target="_blank" rel="noopener">blamed on climate change</a>. But it was actually a perfect storm of crowded and squalid living conditions, poor drainage, greater mobility of people, and a particularly wet monsoon. None of these factors have been addressed, so we are staring at a recurrence of dengue this year even while we cope with <a href="https://www.nepalitimes.com/banner/why-nepal-must-watch-about-coronavirus-but-not-panic/" target="_blank" rel="noopener">a possible COVID-19 outbreak</a>.Public health has not been a national priority for successive governments in Nepal. Even if it has, it is only in paper and has not really been translated into <a href="https://www.nepalitimes.com/opinion/is-free-health-care-possible-in-nepal/" target="_blank" rel="noopener">accessible and affordable healthcare</a> for the general public. Governance failure has contributed to this state of affairs, but there is also the virus of corruption that has afflicted the entire government healthcare system. A politico-business nexus has also infected <a href="http://archive.nepalitimes.com/news.php?id=19560" target="_blank" rel="noopener">medical education</a>, putting it out of reach of deserving poorer students.Read also: <a href="https://www.nepalitimes.com/editorial/when-panic-goes-viral/" target="_blank" rel="noopener">When panic goes viral</a>, EditorialInto this mix, we now have the coronavirus scare. Officially, Nepal has just one case in which the patient recovered and has been discharged. The government has tested about 500 people, and all have been negative. Experts have confirmed that the tests are credible, and proper protocols are in place. But not enough tests have been done to determine if there are more people out there with the virus.At $75 per test, the kits are expensive. This is where international help would be needed, and if the case rate rises the country will also need help with containment and mitigation. Nepal has been lucky so far that there is no indication of community transmission yet. But our luck could turn any day.

This is a test

The daily 10-hour curfew at Tribhuvan International Airport from 8 November that will last five months has affected tourism during Nepal’s peak season, with some hotels and trekking agencies here reporting cancellations into spring next year. The reduced hours at Nepal’s main aviation gateway till 31 March means that a third of all flights have been cut. This has also caused ticket prices to surge by up to eight times of normal fares. For example a Kathmandu-Delhi ticket that used to cost Rs12,000 is now listed at Rs50,000, and even then seats are not available.&nbsp; “Especially if they are here to trek, change in flight dates can cause tourists to miss their connections,” says Jagan Timilsina, who runs a trail running and outdoor education business. &nbsp; Pokhara is feeling the brunt as hotels report last-minute cancellations for November because of flight disorders. Some hoteliers also say although there have been some cancelled trips, most itineraries have been rescheduled.&nbsp; Hari Prasad Sharma Gaire of the local chapter of the Hotel Association of Nepal says the Kathmandu airport closure should have been timed for the off-season. He told us: “Starting construction during the peak tourist season was a mistake and will cause the tourism industry to lose a lot of business. The upgrade could have been spread out over a longer time but closed for fewer hours at night so that disruption was minimal.”&nbsp; Nearly a third of the 1.2 million tourists who visit Nepal annually come to Pokhara, which is also the gateway to Mustang, the Annapurna treks and pilgrimage tourism to Muktinath. Located by scenic lakes with a range of adventure sports like hot air ballooning, paragliding, canyoning, bungee and ziplines, Pokhara is also popular among diaspora Nepalis. “Besides its own attractions, Pokhara is really the hub for central Nepal, and we have been trying to get visitors to extend their stay here,” says Timilsina, who started out as a trekking porter and rose up the ranks to be an expedition guide and entrepreneur. &nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2024111603114_0e071ce63ea9b0a9a7ee76f8c3cea0ff08c6767c41dd09f6bc4413d2db067a60.jpg" data-media-id="editor_0" data-image-id="2024111603114_0e071ce63ea9b0a9a7ee76f8c3cea0ff08c6767c41dd09f6bc4413d2db067a60" data-rendition-name="original" width="3500" height="2333" loading="lazy" alt="Pokhara's tourism woes NT"> <figcaption>Tourist arrivals in Pokhara have slumped since the disruptions at Kathmandu airport due to upgrading work. Photo: KRISHNA MANI BARAL/NEPALI TIMES ARCHIVE</figcaption> </figure>  Even without the Kathmandu airport closure affecting tourist arrivals, Pokhara was already suffering from a decline due to many factors like the poor state of the Prithvi Highway, the shortage of luxury accommodation for high-end tourists, and the reluctance of international airlines to start direct flights to Pokhara despite an expensive new airport that was inaugurated two years ago.&nbsp; “There was a lot of initial excitement on the construction of the international airport,” says Timilsina, “but it hasn’t delivered as expected due to politics. People have invested in nearby businesses, and have faced losses.” India has blocked direct flights from its cities to Pokhara because the facility was built by a Chinese company. Although tourists and pilgrims from India hit record levels this year, the poor state of the highways and the Indian bus accident on the highway to Kathmandu in July that killed 27 pilgrims from Maharashtra state dampened arrival figures. Gaire says, “While tourist arrivals to Pokhara are now approaching pre-Covid levels, we haven’t seen the improvement we were expecting. We need a better marketing strategy. What are our embassies abroad doing?”&nbsp; Indeed, Pokhara used to be a favourite destination for Chinese tourists. There was a boom in arrivals from China before Covid, especially after a popular Chinese tv serial was shot on location here. But arrivals from China have not really recovered since the pandemic because of the economic slowdown there. Promoting Pokhara airport to handle direct flights from Chengdu or Kunming could revive Chinese arrivals.&nbsp; Nepal’s Civil Aviation Authority (CAAN) has used the Kathmandu airport closure as an excuse to arm-twist international airlines to start flying to Bhairawa, which has barely been in operation for two years since it was inaugurated. So far, Fly Dubai, Thai AirAsia, Jazeera and Qatar are flying to Bhairawa, but most use it as a hop before flying on to Kathmandu, which does not reduce congestion at Kathmandu.&nbsp; An ideal situation could have been to get Pokhara to run to full capacity while Kathmandu is partially out of action. Pokhara entrepreneurs are puzzled why the CAAN and the national government have not taken more interest in promoting Pokhara as an alternative to reduce the congestion in Kathmandu. Nepal’s football team that was flying to Dushanbe this week couldn’t get tickets via Delhi, and took a domestic flight to Bhadrapur, crossed over to Bagdogra and flew on to Delhi to catch their flight to Tajikistan.

Pokhara’s tourism woes

An excerpt of a conversation between an anthropologist and linguist Mark Turin, PhD and Lava Deo Awasthi, PhD, the first Chairperson of the Language Commission of Nepal. Nepali Times: What is the role of Nepal’s Language Commission and when was it formed? Lava Deo Awasthi: The Constitution of Nepal (2015) created a Language Commission (LC) with the following four core mandates: (a) to develop eligibility criteria for gaining status as an official language and offer recommendations to the Government of Nepal about the official language(s) in each province; (b) to offer recommendations to the Government about measures to be taken for the conservation, promotion, and development of languages; (c) to suggest possible ways of using mother tongues in education by assessing their stage of development; and, (d) to conduct studies, carry out research and perform monitoring functions about the response to the constitutional provisions for the federalisation of languages in Nepal. The Commission was founded in 2016 and I was appointed as the Chairperson of the Commission in September of the same year by the Cabinet of Ministers. What in your own professional and educational background helped to prepare you for the role? I have worked with the Government of Nepal for about 30 years, alongside holding teaching appointments at universities in Nepal. Prior to assuming the role of the Chairperson of the Commission, I served as permanent Secretary to the Government of Nepal and worked as the Chief Administrator of the Central Development Region. I was appointed as Director General of the Department of Education and completed my assignments as Joint Secretary at the Planning, Monitoring and Educational Administration Divisions of the Ministry of Education.&nbsp; In addition, I have taught courses as a visiting professor at Tribhuvan University and Kathmandu University for more than three decades. Later, I also started supervising MPhil and PhD students at the Far Western University in Mahendranagar, Kanchanpur. My PhD project from the Danish University of Education was dedicated to making sense of Nepal’s social construct and commitment to multilingualism, exploring the persistence of monolingual school practices in the face of constitutional promises and state commitments to multilingualism. I conducted a survey of Nepal’s languages and carried out a qualitative study of the Tharu language in the district of Bardia. I analysed language policy statements and explored classroom pedagogies in schools. I documented how teachers showed a tendency to resist change and maintain the status quo because they were not consulted when new educational language policies were introduced. Teachers also exhibited a deeply-held adherence to the Gurukul education system which appears to have been harnessed as a way to resist newer pedagogical ideologies imported from the West. Recognising how engrained these rich traditions of knowledge transmission are, I wanted to know how students’ engagement in the learning process appeared to have dwindled, creating a gap between children’s home languages and the language(s) of the school. Whilst statutory provisions for education in the mother tongue were oriented towards promotion, classroom pedagogies remained resolutely monolingual and exclusionary. The result was that multilingual education policies that had been introduced in Nepal did not result in meaningful changes in classroom practices. My research was also a reflection of childhood traumas I had experienced at the earliest stage of formal education. My home language, Baitadeli, has a strong oral tradition and no written literature. English is my fifth language in terms of exposure and competence, and my home district of Baitadi is well-known for its loyalty to the local language. I had to drop out of school after completing my sixth grade. Staying at home, I received much attention from my family and had much greater exposure to my native language, culture and environment. My overall impression is that dropping out of school had a surprisingly positive impact on my life. The opportunity offered a surprising dividend for me as I gained mastery in my mother tongue and received extensive exposure to folk literature and Indigenous knowledge and survival skills, cultivating my interest in language, culture, literature and local cosmologies.&nbsp; Now that I reflect on it, I appreciate how language has always played a key role in my life. I grew up in a multilingual environment: brought up with Baitadeli, Hindi, Sanskrit, Nepali and English. Language played a major part in my decision to leave school and my later success is closely linked to my competence in several languages. It was rewarding to be at home with my family as I deepened my understanding of native language and culture, which in turn helped me to harness and refine my art of living. Languages matter so much to me because they are both software and hardware. Later, when I was in secondary school, I realised that my command of my home language contributed significantly to enhancing my Nepali and English. I used my mother tongue as a form of linguistic capital to strengthen my competence in both English and Nepali.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2024111811110_5400ba54792bf9e4854e1c1effde8bf09804e99647f23513700b450cc49adc4a.jpg" data-media-id="editor_0" data-image-id="2024111811110_5400ba54792bf9e4854e1c1effde8bf09804e99647f23513700b450cc49adc4a" data-rendition-name="original" width="1000" height="1500" loading="lazy" alt="Dr Lava Deo Awasthi"> </figure>  In your term as the Commission’s first Chairperson, what were your strategic goals and objectives? My first strategic goal was to create an environment conducive to implementing the provisions of the Constitution of Nepal in relation to language. My priority was to prepare a detailed action plan for my six-year tenure in consultation with language stakeholders, including language experts, professionals, activists, Indigenous community members and representatives of relevant national and local-level institutions. The Commission formed a body of high-level advisors to ensure that the Chairperson’s work was well-informed and credible. The advisors to the committee had highly visible professional and social reputations in Nepal and had much experience in the field of language conservation, promotion, research and development. Another strategy we adopted was to establish close institutional linkages with federal, provincial, and local level governments for collecting opinions and disseminating information widely.&nbsp; What critical issues did you have to consider while discharging your duty? When Nepal’s new Constitution was drafted, a number of concerns could not be adequately addressed. These related to the conservation of languages, the recognition of official languages at the provincial level, and the use of mother tongues at federal, provincial, and local levels. These unresolved issues and matters pertaining to the federalizsation of Nepal’s languages were passed on to the Language Commission to address and resolve.&nbsp; Regarding the recommendations for official languages, a five-year timeline had been set by the Constitution. With great effort, we succeeded in having all provinces agree to recognise their official languages as per the recommendations of the Commission.&nbsp; What were your greatest achievements during your term? One of the greatest achievements was that we succeeded in setting a language agenda at all levels. Nepal’s language communities and other stakeholders expressed the view that this was the first time their languages were recognised and their voices heard by the state. People participated in debates and discussed issues relating to language that in all likelihood had never before happened in their lifetimes, at least not in ways that were supported by the state. We encouraged people to speak in their own language(s) and provided translators during plenary sessions and group discussions. Another major achievement was developing criteria for the status planning of languages at federal, provincial, and local levels, and to recommend 11 province-level official languages, in addition to the Nepali language. Similarly, a notable achievement was recognising Indigenous languages spoken by smaller communities, all of whom faced ongoing marginalisation and high levels of endangerment. The Commission identified 9 new languages that had not been reported in the 2011 census, and provided a framework for recognising official languages within a municipality. The commission emphasised the need for documentation and digitisation of languages for developing corpora and archives at national and sub-national levels.&nbsp; Languages of historical importance as well as classical languages were given recognition for their protection, growth, and development. Recommendations were made for the conservation, promotion and development of Nepal’s marginalised languages that are threatened by majority languages and for those languages that hold particular power at local and global levels. Recommendations were also made for how best to safeguard Nepal’s languages from the ever-growing spread of English and other powerful, globalising languages.&nbsp; A further important aspect of the Commission’s work was to emphasise mother tongue medium instruction in schools across the nation. Recognising the role of language in children’s cognitive, socio-emotional and academic development, the Commission suggested strategies for linking schools with ward-level language clusters for use in the classroom. The importance of nurturing and respecting a child’s first language was reiterated in the Commission’s recommendations for children’s learning and all-round development. By the end of my term, a remarkable change could be observed in terms of building trust within and across Nepal’s diverse language communities. A network of language groups and stakeholders across the country proved to be a powerful way of bringing all language communities under one roof for a collective review of and response to the process of federalising language policy. The many language stakeholders across Nepal appreciated the opportunity to work within a coordinated framework, and—feeling empowered by this—seemed genuinely enthusiastic about the initiatives taken by the Commission.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2024111811114_b45297fdd2fedf17bdb6313e495a1062c0d87f1a19fa5349f871f220b75f93ab.jpg" data-media-id="editor_1" data-image-id="2024111811114_b45297fdd2fedf17bdb6313e495a1062c0d87f1a19fa5349f871f220b75f93ab" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="Dr Lava Deo Awasthi NT"> </figure>  What were the most significant challenges for you as Chairperson? One of the major challenges was winning people’s trust in advocating for the mission of the Language Commission. I faced considerable resistance as I sought to emphasise the use of native languages in families and communities. While the Commission advocated for multilingualism and promoted linguistic diversity, the prevailing policy circles and central level institutions had been deeply influenced by a one-language discourse and ideology of Nepali only. The spread of English also poses a huge threat to Nepal’s languages. However, people in power do not seem to see this as a problem. They tend to abandon their own languages in preference for English. The way that Nepal’s municipalities are increasingly introducing English as a medium of instruction at the earliest stage of a child’s school-based education has proven to be detrimental to their cognitive development, socio-emotional wellbeing and academic success. Most of Nepal’s elites have been heavily influenced by the spread of English and remain unaware about its impact on their home languages as well as on the inter-generational transmission of Indigenous languages in the country. I wish that we could have produced more compelling evidence to show the consequences of making poor policy choices for our children’s education. Demystification calls for a collective response. To make change happen across this entire, complex and federalising country was daunting work and left like a race against time. I feel that I could have done more to offer concrete examples in favour of using the mother tongue as a medium of children’s education at the earliest stages of a child’s education. What do you see the Language Commission achieving in the next 5-10 years? The Language Commission will have to ensure that all of its key recommendations are implemented at all levels of government. In 10 years’ time, all seven of Nepal’s provinces will have their official languages in place. These languages will also be recognised as languages of federal business, alongside Nepali. I anticipate that all official languages in the federal and provincial systems will have a national portal for inter-language corpora using machine translation to fulfil their federal, provincial and local level language functions, and that all languages spoken in Nepal will be represented through a digital database in the national archive. The Office of Statistics will monitor the status of Nepal’s languages over time. By the end of the next decade, each municipality in the country will have recognised one or two official languages at the local level, based on speech populations. Other local languages will have received community-level legal recognition and official status to fulfil their functional roles. Languages that are highly endangered or at risk will be entitled to receive state grants for enhancing local level capabilities to encourage families and young learners to speak the language. Incentive schemes will be introduced in municipalities that promote language within the family and at home. Inter-generational transmission of languages will have received welcome and timely attention across Nepal. It is my hope that all schools—public and private—will have introduced mother tongue medium instruction at the earliest stage of school education, at least up to class five. Nepali, English and other national as well as classical and foreign languages will be taught as subjects. The existing policy of English medium education at the early stage of education will be abolished. The Government of Nepal will be held accountable if the number of speakers of any language decreases or if local communities face language loss and greater endangerment. Under the aegis of the Language Commission, a Centre for Language Research and Innovation will be created with world-class facilities for language documentation and archiving in collaboration with Tribhuvan University’s Central Department of Linguistics and other relevant institutions. Harnessing the vastness of Nepal’s linguistic diversity, the Language Commission will morph into a centre of excellence for national and international communities to engage in collaborative language research, to share experiences and document best practices at in service of global linguistic diversity and Nepal’s many Indigenous languages.

Languages are both software and hardware

Nearly 750,000 Nepalis went abroad for employment in the past year, and more than 100,000 left on student visas. Most of them were young Nepali men and women, and the number has been increasing every year. As with other sections of society, Nepal’s security agencies also face a recruitment crisis. Nepal Police opened recruitment for 64 inspectors in September, and received 2,239 applications, compared to 2,718 candidates last year. Police also invited candidates for 256 assistant sub-inspectors this year for which it received 17,756 applications – down from 19,932 last year. It is the same story in the Nepal Army, the number of applicants for the post of Officer Cadet (Second Lieutenant) went down from 6,144 for 400 open seats in 2019 to 4,390 in 2020. Meanwhile, applicants in the paramilitary Armed Police Force went down from 857 applications for 75 posts in 2021 to 536 applicants for 99 posts last year. While the number of applicants appears higher than the demand, the data shows a significant decrease in applications for vacancies in Nepal’s law enforcement agencies. Security personnel are recruited on the basis of rank and age in Nepal, and the age cutoff for entry into Nepal’s security agencies is typically 25 years. Sociologist and migration expert Ganesh Gurung says that the demographic of young, physically fit Nepalis emigrating abroad in search of better opportunities has impacted recruitment into law enforcement and the military here at home. “The returns from working in Nepal’s police and army are minimal, whereas overseas job opportunities are more attractive,” Gurung says. “The work may be physically demanding abroad, but the pay is a lot higher.”  <figure><img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241116041148_a7e477e0ee2f56acf16c2559fdb24d8f0377f7bc1f9e56138bc40108fc4fa33f.jpg" data-media-id="editor_0" data-image-id="20241116041148_a7e477e0ee2f56acf16c2559fdb24d8f0377f7bc1f9e56138bc40108fc4fa33f" data-rendition-name="original" width="800" height="534" loading="lazy" alt="Nepal Police"><figcaption>Nepal Police</figcaption></figure>  Nepal Police spokesperson DIG Dan Bahadur Karki agrees that the physical and mental demands of a law enforcement job is incomparable to the income that security personnel earn. “A young Nepali who works in Dubai earns enough to build a home in the village within four years, while a Nepali with the same qualifications and physical ability in a security agency here barely makes enough to survive,” says Karki. “Obviously the youth prefer foreign employment.” Security agencies are now worried about the quality of inducted manpower. “There is a difference in work ethic between an applicant chosen from a competitive pool of 50 candidates versus one chosen from a pool of three candidates,” explains Gurung. “Unmotivated employees hamper the overall performance of the state apparatus.” Nepal Army spokesperson Brigadier General Gaurab Kumar KC says recruitment has not been hampered by outmigration: “We have still been getting more than three times the applicants than there are open posts, so we are not yet worried.” Even so, the passing rates of aspirants have gone down for security forces after the Public Service Commission began examinations for military recruitment in 2015. In fact, the Nepal Army complained about the Commission’s involvement in recruitment. Still, the number of vacant military posts tends to exceed the number of passing candidates. Nepal Army’s KC says that the military will not compromise on intake criteria even if there are fewer passing applicants. “Unqualified persons will not be admitted even if there are less-than-required passing candidates. We will re-advertise if that is the case.” But Nepal’s security forces now also have to worry about retention of existing personnel. About 900 Nepal Army, 600 Nepal Police, and 300 Armed police personnel resign every year before the completion of their tenure.  <figure><img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241116041148_b8cd62f70eea3aac7d3d3778615a5b70b1e20550c9bd76321f051f9c766fd2a9.jpg" data-media-id="editor_1" data-image-id="20241116041148_b8cd62f70eea3aac7d3d3778615a5b70b1e20550c9bd76321f051f9c766fd2a9" data-rendition-name="original" width="750" height="378" loading="lazy" alt="Armed police forces"><figcaption>Armed Police Force</figcaption></figure>  In 2020, Home Minister Ram Bahadur Thapa recalled almost 1,000 police personnel who had been deployed for the security of VIPs after long-standing criticism that security forces were being misused to cater to political and bureaucratic leadership. However, security personnel have continued to be assigned to high-ranking officials as glorified housekeepers. In December 2022, Rabi Lamichhane’s Home Ministry had instructed its offices to recall unauthorised security personnel assigned to high-ranking officials, following which 500 officers from Nepal Police and Armed Police Force were withdrawn from their details. But the Nepal Army does not have to follow such rules, and the practice of army personnel serving high-ranking active-duty and retired military personnel remains. Conditions here are dire enough that many active duty officers in Nepal’s military and police forces have chosen to leave their jobs to serve in the Russian Army to fight in the Ukraine war. The hierarchical culture and chain of command of politics, bureaucracy, law enforcement and military has also meant that abuse and mistreatment of subordinates is rife in Nepal’s security forces. “Feudalism is alive and well within our security institutions,” says Gurung. “When soldiers and security forces who swore to protect and serve the nation are made to be at the beck and call of politicians and bureaucrats, it is easy to understand why they are disillusioned with their jobs and why they choose to quit and find jobs abroad.”

Job insecurity in security forces

Earlier this month, Nepal received Rs1.6 billion from the World Bank as part of its <a href="https://nepalitimes.com/news/will-nepal-ever-be-paid-for-saving-trees">Forest Carbon Partnership Facility (FCPF)</a>, rewarding the country for increasing its carbon sink capacity. Nepal is the first in South Asia to benefit from this facility, and it is specifically to recompense the country for increasing forest cover in 13 Tarai districts between 2018-2024. “We are also trying to get another Rs13 billion from the facility while also preparing for free market-based carbon trading in the international market,” says Nabaraj Pudasaini of the REDD (Reducing Emissions from Deforestation and Forest Degradation in Developing Countries) Implementation Centre. Big emitters of greenhouse gases are under pressure to reduce their carbon emissions, and many have signed agreements to do so by investing in decarbonisation projects in developing countries. Countries that emit more than a specified amount of carbon would be able to buy emission rights from countries that emit less. Nepal is internationally known for its community forestry program which has been largely credited for <a href="https://nepalitimes.com/banner/tree-mendous">increasing tree cover to over 45%</a> in less than three decades. But this achievement had not been adequately recognised or rewarded internationally before. Forests, especially in the tropics, absorb and store large amounts of carbon while releasing oxygen in a process known as photosynthesis. <a href="https://www.fao.org/forest-resources-assessment/en/">Preventing deforestation</a> and increasing canopy cover is considered a much more achievable goal than reducing emission in the scale necessary to limit global average temperature to 1.5°C above pre-industrial levels. COP11 in Montreal in 2005 first proposed reducing carbon emissions by improving forest quality by halting degradation. By 2015, a new mechanism of financial assistance was created to help less developed countries with sustainable management of forests <a href="https://www.un-redd.org/">(called REDD+)</a>. Under this new mechanism, countries receive aid based on their efforts to prevent forest degradation and increase carbon sink, and in 2021 the World Bank was entrusted with implementing it. Nepal’s FCPF receipt this month was calculated on the basis of 2.4 million tons of carbon stored at a rate of $5 per ton. In the second phase, Nepal will receive more than Rs4 billion within the next year for storing an additional 7 million tons of carbon. Eighty per cent of this amount obtained from carbon trading needs to be spent on local beneficiaries and indigenous communities.&nbsp; But carbon trading is not easy, Nepal needs to prove that protected forests will not be destroyed in future.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241121091132_c8a381c9a95aa86fec558951650d97bb87914741f01766982ba2b086af001f16.jpg" data-media-id="editor_4" data-image-id="20241121091132_c8a381c9a95aa86fec558951650d97bb87914741f01766982ba2b086af001f16" data-rendition-name="original" width="1500" height="999" loading="lazy" alt="Greenbacks for greenery NT "> <figcaption>Photo: KUNDA DIXIT</figcaption> </figure>  Explains carbon trading expert Yugan Manandhar. “Forests should be handed over to the community and shown that they are managed sustainably. Proving this will be particularly challenging; forest encroachment and degradation is rife in the Tarai.” <a href="https://nepalitimes.com/multimedia/nepal-is-going-up-in-smoke">Deliberate forest fires</a> have also added to the challenge because they increase carbon emissions and reduce the sink capacity of forests. The basis for the amount that Nepal received was set five years ago by calculating the carbon reserves of forests in the 13 Tarai districts. In the meantime, sustainable forest management, tree plantation, forest destruction and erosion control were prioritised to increase carbon reserves in those forests. Nepal is signing another carbon trading agreement during the ongoing Baku climate conference. The <a href="https://www.leafcoalition.org/">Lowering Emissions by Accelerating Forest finance (LEAF Coalition) </a>proposes to sell the carbon stored in the forests of Bagmati, Gandaki and Lumbini provinces. For this, Nepal signed the letter of intent three years ago at COP26 in Glasgow. The target is to store 70 million tons of carbon in 32 million hectares of forest in the three provinces per which Nepal will receive Rs13 billion in four years at $10 per ton with provisions to increase the rate if various conditions are met. However, the agreement in itself doesn’t guarantee the amount. According to the targets set by Nepal, forest degradation should be stopped and carbon reserves increased by protecting tree cover. Preparations are also underway for clean air carbon trade because it has offset fossil fuel use by introducing 30,000 electric vehicles. Nepal has been selected for the first round to receive $40 million within one and a half years through the Clean Air System of the World Bank. Given that most of Nepal’s energy mix is from biomass, replacing them with electric stoves can significantly improve health by reducing indoor pollution as well as strengthen the country’s capacity for carbon trade. “Nepal's goal now is to sell carbon in the free market where carbon credits are bought and sold based on supply and demand in an open and transparent manner,” adds Pudasaini of the REDD Implementation Centre. “Nepal can now set its own price and bargain with interested buyer countries and organisations.” Lately, India has been discussing setting up a carbon market. Nepal has exported Rs12.72 billion worth of electricity to India so far this fiscal year, which can be traded under Nepal’s carbon market. “Carbon trading can create significant economic benefits for Nepal, which will help reinvest in development and environmental protection projects,” says Manandhar. “But we must prioritise sustainable management of forests, cutting older trees and allowing regrowth as well as promoting electric stoves and electric vehicles.”

affordable-health-care