It was only five years ago that neologisms like ‘self-quarantine’, ‘comorbidity’, ‘contact tracing’, ‘omicron’ entered the Nepali lexicon.
PCR, CCMC, PPE, WFH and other acronyms were thrown about, and we became intimate with vaccine names: AstraZeneca, Pfizer, Moderna, Sinovac. We ‘social distanced’ or ‘sheltered-in-place’ as we tried to ‘flatten the curve’.&nbsp;
After the second Covid-19 case was identified in a female Nepali student returning from Paris, the country went into <a href="https://nepalitimes.com/banner/nepal-goes-into-lockdown-for-a-week">lockdown on 24 March 2020</a>. A day later, India followed suit, halting the movement of over 1.3 billion people.&nbsp;
Tens of millions of <a href="https://nepalitimes.com/here-now/a-long-way-to-europe">migrant workers</a> walked hundreds of kilometers, including Nepalis. Many died along the way.
Social ostracisation and <a href="https://nepalitimes.com/banner/nepals-muslims-face-stigma-after-covid-19-tests">stigmatisation</a> based on rumours fanned by <a href="https://nepalitimes.com/news/the-social-media-contagion">social media</a> was rife. <a href="https://nepalitimes.com/here-now/nepal-health-workers-battle-covid-19-but-also-stigma">Nepali workers</a> who made it to the border were quarantined. Some jumped into the raging <a href="https://nepalitimes.com/news/lockdown-limbo-in-no-mans-land">Mahakali River</a> to get to their families and drowned.&nbsp;
Two million <a href="https://nepalitimes.com/here-now/in-the-minds-of-nepal-s-migrant-workers">Nepali migrant workers</a> in the Gulf and <a href="https://nepalitimes.com/opinion/labour-mobility/crossborder-virus-and-nepali-migrant-workers">Malaysia</a> were stranded, as there were not enough flights to repatriate them. Nepalis abroad sent money home as people lost their jobs, others collected money to ship <a href="https://nepalitimes.com/here-now/nepal-s-frontline-workers-brave-it-out">ventilators, masks and personal protective equipment (PPE)</a> to Nepal. &nbsp;&nbsp;
“Covid might be over but we are still unprepared for rescue and repatriation on that scale, considering that many Nepali workers are in conflict zones of the Middle East,” warns Upasana Khadka of the non-profit Migration Lab. “The pandemic also highlighted the need for <a href="https://nepalitimes.com/news/nepal-plans-to-reintegrate-returning-workers">migrant reintegration</a>, transnational mechanisms to claim wages of returnees, but most importantly it brought home the role of low-paying, unskilled migrant workers in propping up <a href="https://nepalitimes.com/news/nepal-prepares-for-economic-fallout-of-pandemic">Nepal’s economy.</a>”
Read also: <a href="https://nepalitimes.com/news/poor-cash-rich-nepal">Poor cash-rich Nepal</a>, Sonia Awale&nbsp;
The lockdown was initially announced for a week, but lasted four months till mid-July 2020. Within a month Nepal went back into lockdown again for four weeks before it was eased, and there was another two-month lockdown in April 2021. The time that should have been used for a mass vaccination was squandered in shutting people in their homes. This newspaper stopped its print edition for a year.&nbsp;
Without lockdowns many more <a href="https://nepalitimes.com/here-now/protecting-nepal-s-elderly-from-covid-19-c6e60vp6">elderly Nepalis</a> and those with pre-existing ailments would have died. During the deadly Delta second wave, even children became sick. But the <a href="https://nepalitimes.com/news/lockdown-likely-to-be-extended">prolonged lockdowns</a> hit the poorest and neediest Nepalis hardest.
Research scientist Sameer Dixit at the Center for Molecular Dynamics Nepal remembers getting into an argument with security personnel as he bicycled in the morning during lockdown.&nbsp;
“They would ask me to mask up but I would tell them it wasn’t required because the air was so clean for the first time,” he recalls.
Indeed, the air was so clean that people could see the snowy mountains from <a href="https://nepalitimes.com/here-now/the-tarai-s-shrinking-forests">the Tarai </a>and <a href="https://nepalitimes.com/news/mt-everest-pvt-ltd">Mt Everest</a> was visible from Chobhar. The lockdown offered proof that <a href="https://nepalitimes.com/news/double-whammy-air-pollution-and-covid-19-zevz0864">Kathmandu’s notorious air pollution</a> could indeed be cleaned up by <a href="https://nepalitimes.com/banner/blueprint-for-a-net-zero-nepal">reducing emissions</a>.
“In many ways, we had actually forgotten about the need for cleaner, better air, <a href="https://nepalitimes.com/here-now/coronavirus-shutdown-gives-nepal-s-nature-a-respite">Covid served as a reminder,</a>” says urban planner Bhushan Tuladhar. “In fact, air pollution made <a href="https://nepalitimes.com/news/nepal-has-no-health-minister-as-covid-19-cases-rise-again">Covid cases</a> worse. But as soon as the pandemic ended, we were back to breathing dirty air. Last week Kathmandu ranked among the most polluted cities in the world.”
A 2019 study put <a href="https://nepalitimes.com/here-now/bad-air-and-polluted-politics">air pollution</a> fatalities at 41,000 per year in Nepal, several times more than total reported Covid deaths, 11,959. Better air quality would increase the life span of Nepalis by nearly five years.
Unfortunately, there is no vaccine to combat <a href="https://nepalitimes.com/here-now/air-pollution-is-more-dangerous-than-smoking">air pollution</a>. And with the <a href="https://nepalitimes.com/opinion/life-time/to-vax-or-not-to-vax">anti-vaxxers</a> in the <a href="https://nepalitimes.com/editorial/trump-s-second-coming">Trump administration</a>, there are already cuts in critical vaccine research to fight the next pandemic. This coincides with a bird flu outbreak and measles deaths in the United States.&nbsp;
“The single biggest <a href="https://nepalitimes.com/news/life-lesson-from-the-pandemic">lesson of the pandemic</a> was the <a href="https://nepalitimes.com/latest/vaccines-are-the-only-solution">importance of vaccines</a>,” says Dixit, adding that the US withdrawal from WHO will lead to serious gaps in preparing for the next pandemic.
Read also: <a href="https://nepalitimes.com/here-now/still-learning-lessons-from-covid">Still learning lessons from COVID</a>, Sonia Awale&nbsp;
Buddha Basnyat of the Oxford University Clinical Research Unit (OUCRU) says US pullout from <a href="https://nepalitimes.com/opinion/global-solidarity-needs-intensive-care-in-pandemic-battle">global health</a> is a huge setback that could compromise disease surveillance and diagnosis: “The pace at which the Covid vaccines were developed was nothing short of a miracle, but we are vulnerable to both emerging and pre-existing diseases.” &nbsp;
<a href="https://nepalitimes.com/news/how-usaid-cut-affects-nepal">US withdrawal </a>has left the field wide open for China and India to now lead the way. According to AidData headquartered in Virginia, China provided over $4.6 billion in Covid-19 aid from 2020 to 2022, surpassing the United States and Germany which contributed $4.05 billion and $3.64 billion respectively.
China donated more than 239 million doses of Covid vaccines to its Asian neighbours. India supplied 301 million vaccine vials to 99 countries and two UN entities, 15 million doses as donation to more than 50 nations including Nepal. The US donated nearly three times more, but that may not happen next time.
Read also: <a href="https://nepalitimes.com/banner/why-is-there-vaccine-hesitancy-in-nepal">Why is there vaccine hesitancy in Nepal?</a> Sonia Awale
“With <a href="https://nepalitimes.com/news/the-great-game-2nd-half">America backing out</a>, China and to a lesser degree India, will fill that role, and it is not necessarily a bad thing for us. As neighbours we are closer to them and it would be advantageous to us,” says Sher Bahadur Pun, virologist at the infectious diseases hospital in Teku. He adds: “But capacitating our health sector to manufacture <a href="https://nepalitimes.com/editorial/vacillating-on-vaccines">vaccines</a> at home would be the best way to prepare for future pandemics and health emergencies.”

Sonia Awale

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One in every three Nepalis carries the <a href="https://nepalitimes.com/editorial/tb-or-not-tb">tuberculosis</a> bacillus. There may be no active symptoms, but they can at any point progree into a full blown infection. TB kills up to 47 Nepalis daily. If so many people died every day in road traffic accidents, it would make headlines every day. But they do not because tuberculosis afflicts the poorest people in the poorest parts of Nepal.&nbsp; The annual 17,000 fatalities from <a href="https://nepalitimes.com/banner/for-nepal-a-game-changer-in-tb-control">tuberculosis in Nepal</a> are preventable with cost-effective treatment. A new pilot study in Chitwan and Piuthan in the past two years showed that 1,160 (out of 1,173 household contacts) completed the Tuberculin Skin Test (Mantoux Test) of whom 542 (45%) were positive. After doing a chest x-ray, 509 met the eligibility criteria for TB preventive therapy. 500 (97%) gave consent to the treatment.&nbsp; Researchers were pleasantly surprised. As in other countries in the region, they were expecting very few to agree to take preventive therapy medicines because they did not have TB symptoms, so a 95% agreeing to the treatment was exceptionally high. “People in Chitwan and Piuthan who participated in the study were not sick, they were just carrying the TB bacteria, but they agreed to take the preventive drugs because they have all known of relatives who had died of TB,” explains Buddha Basnyat, a physician who advised the Birat Nepal Medical Trust (BNMT) that conducted the research.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20240325030340_43b4bc93b22c3964ee021a9dc9df40f9da783917b2ebfbe798a03a82276421a7.jpg" data-media-id="editor_2" data-image-id="20240325030340_43b4bc93b22c3964ee021a9dc9df40f9da783917b2ebfbe798a03a82276421a7" data-rendition-name="original" width="1500" height="1125" loading="lazy" alt="Tuberculosis preventive therapy in Nepal"> <figcaption>Health care volunteers during an outreach screening program in Dhanusha as part of active case-finding for tuberculosis in local communities.</figcaption> </figure>  BNMT is now extending the study to Nawalparasi and Rupandehi with the National Tuberculosis Control Centre. Latent TB is more prevalent in the Tarai districts because of their higher population density. With Nepal suffering such an <a href="https://nepalitimes.com/here-now/nepal-tb-cases-grossly-underestimated">enormous disease burden from tuberculosis</a>, one would have thought World TB Day on Sunday 25 March would have got more attention. But it was overshadowed by Holi celebrations. It would have been interesting to see how many in the crowds attending the concert at Darbar Marg would test positive. Scientists worry that the World Health Organisation’s END TB strategy of reducing global tuberculosis incidence by 90% and deaths by 95% in the next ten years is too ambitious unless latent tuberculosis cases are also treated.&nbsp; What makes this failure all the more tragic is that tuberculosis is a completely preventable and treatable infection. Every $1 invested in TB gives a $39 return, yet there is little investment and advocacy to combat this biblical illness. South Asia accounts for some 40% of all TB cases and 38% of all TB deaths — most of them occurring in the thickly-populated states across the Nepal border in India. The region also has a high burden of multi-drug resistant TB, one-third of global cases. In the past, Directly Observed Therapy Short Course (DOTS) drug therapy in which patients were administered medicines at health posts was considered a cure-all for tuberculosis. <a href="https://archive.nepalitimes.com/news.php?id=294">Nepal had a high success rate for DOTS</a>, but there were loopholes in the program: latent cases remained hidden and only the cases that came to the health system were treated. DOTS also added to the pre-existing stigma so that patients travelling to the health posts would be identified as having tuberculosis. In one instance, a patient in Bardia chose to take a dangerous tiger-infested jungle route to reach the health post. &nbsp; Meanwhile, BNMT had been setting up a strong community network of health volunteers, and was <a href="https://nepalitimes.com/banner/nepal-tests-and-treats-tb-with-a-flying-pharmacy">tracking active TB cases</a>. Unlike DOTS, it involved meeting family and friends of patients, allowing more case detection and treatment. Even so, they were not looking for latent infections.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20240325030340_39b79cbd0799bee83a8ae67fd8016d9c75b539d89679e5a4328a7b8540bbca01.jpg" data-media-id="editor_6" data-image-id="20240325030340_39b79cbd0799bee83a8ae67fd8016d9c75b539d89679e5a4328a7b8540bbca01" data-rendition-name="original" width="1687" height="1125" loading="lazy" alt="Tuberculosis preventive therapy in Nepal"> <figcaption>Female Community Health Volunteers (FCHVs) have played a significant role in active case finding.</figcaption> </figure>  Latent cases can progress to active tuberculosis especially when a patient's immune system is weak because of malnutrition, illnesses like HIV, or age. In fact, half of TB worldwide can be attributed to undernourishment. Latent TB can be confirmed in two simple steps: a Mantoux test with an above 10 score and a clear chest x-ray. If positive, the patient is given the 3HP preventive therapy — a once-weekly treatment with isoniazid-rifapentine for 12 weeks. This treatment can prevent reinfection for as long as six years, and is not to be confused with the one for active cases which requires daily treatment for six months. “On an individual level, you can still get reinfected if you are living in a house with active cases. But if you treat the community at large with preventive therapy, you drive down the prevalence of TB and in turn, people won't get reinfected,” explains Maxine Caws of BNMT. She adds: “If we can use preventive therapy to push down the reservoirs of infection then we extend the amount of time people are protected as is the case in Europe for example where people don't get TB anymore because they are not exposed to the bacteria at all. We have to eradicate that reservoir.” The traditional BCG vaccine given within 28 days of birth is effective against childhood tuberculous meningitis and miliary disease, but does not prevent TB in adults. Efforts are underway to develop a new effective vaccine but there are many challenges.&nbsp; TB vaccine development is difficult because exposure to the tuberculosis bacillus does not seem to induce sufficient protective immunity. A new viable vaccine could take a decade, but in that time 13 million more people would die.&nbsp; “We cannot wait and do nothing until a new effective vaccine is developed. Preventive therapy is a vaccine until we have one,” adds Basnyat. Indeed, the 3HP preventive therapy after diagnosis costs only $5 per regimen. So, Nepal’s strategy should be a simultaneous focus on 3HP preventive therapy and case finding.&nbsp; The problem has been a lack of priority for preventive therapy at national and international levels because it does not involve costly research and interventions, and the patients are poor. Explains Caws: “On paper, we have very strong policies but the commitment in terms of funding from the governments has not materialised, essentially because it is not affecting the rich unlike with Covid when we threw everything at it to have a vaccine developed in a year.” TB’s main problem, <a href="https://nepalitimes.com/opinion/comment/pandemic-eclipses-nepals-tb-epidemic">unlike Covid</a> and HIV/AIDS is that it is a disease of the poor.&nbsp;

Ending TB is possible, and cost-effective

<img width="828" height="501" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110111120/636cd1179c7e80680e08f894jpeg.jpg" alt="Air pollution in Kathmandu"/>Winter inversion, vehicular emission, wildfires, and cross-border industrial pollution have combined to give Kathmandu Valley the worst air quality among cities in the world this week, adding to the risk of respiratory complications for Covid-19 patients.On Monday night, the Air Quality Index (AQI) in parts of Kathmandu crossed 500, according to measurements at the <a href="https://www.nepalitimes.com/" target="_blank" rel="noopener noreferrer">US Embassy measuring station</a> at Phora Darbar. It remained at above 500 from 10PM till 5AM, falling to 480 at 7AM on Tuesday. <figure><img width="2156" height="1000" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110111120/636cd1199c7e80680e08f895jpeg.jpg" alt="NASA Worldview image of Nepal wildfires"><figcaption>A NASA Worldview satellite image of Nepal on 3 January showing the spread of smoke from wildfires in Kaski, Lamjung, and Dhading. Combined with vehicle and crossborder pollution,Kathmandu's AQI count hovered at 500 for the second straight day.</figcaption></figure> The Department of Environment’s own measuring station in parts of Kathmandu showed the AQI staying above 400 all day on Monday. Other global AQI measurement sites like <a href="https://support.iqair.com/en/" target="_blank" rel="noopener noreferrer">IQAir</a> put Kathmandu’s pollution level at 487 – the highest among cities in the region. <img width="746" height="512" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110111120/636cd11c9c7e80680e08f896jpeg.jpg" alt="AQI Kathmandu">New Delhi’s AQI levels, which have been consistently high all winter because of crop residue burning as well as vehicular and industrial pollution, got a respite on Monday because of rainfall. At a time when Kathmandu’s <a href="https://waqi.info/#/c/26.725/78.758/6.2z" target="_blank" rel="noopener noreferrer">AQI was hitting record highs on Tuesday morning</a> with 438, the New Delhi suburb of Noida recorded less than 151 (<a href="https://aqicn.org/map/#@g/24.4264/86.8579/5z">AQI World map, below).</a> <figure><img width="2234" height="1346" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110111120/636cd11e9c7e80680e08f897jpeg.jpg" alt="New Delhi and Kathmandu AQI levels"><figcaption>AQI levels in north India and Nepal on 5 January at 8AM showing Kathmandu's much higher pollution levels compared to New Delhi.</figcaption></figure>AQI is a composite measurement of the concentration of particulate matter below 10 and 2.5 microns, carbon monoxide, sulphur and nitrogen dioxide and ground ozone. AQI level between 0-50 is ‘Good’, 51-100 is ‘Moderate’, 101-150 is ‘Unhealthy for Sensitive Groups’, 151-200 is ‘Unhealthy’, 201-300 is 'Very Unhealthy', and anything above 301 is regarded as 'Hazardous'. Kathmandu's AQI has remained at the Maroon 'Hazardous' level for two days in a row. The US Environment Protection Agency (EPA) has also colour coded various AQI levels at Green, Yellow, Orange, Red, Purple, and Maroon. The World Health Organisation (WHO)’s guidelines state that AQI should be below 35, and the concentration of particles below 2.5 microns should be below 25 μg/m³over a 24 hour period. This means Kathmandu's pollution has been 15 times higher than the WHO standard. <img width="2172" height="760" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110111120/636cd1219c7e80680e08f898jpeg.jpg" alt="AQI measurement guide">In Nepal, a Cabinet decision last year adopted the Department of Environment’s guidelines for air pollution to declare a health emergency if AQI exceeded 300 – meaning the government can ban open burning, close factories, and take measures to reduce vehicles on the roads. The government, which has been engulfed in a crisis within the ruling party after Prime Minister K P Oli dissolved the Lower House and called for snap polls in April-May, seems to be too distracted to pay attention to the converging crises of Covid-19 and air pollution. <img width="1202" height="1064" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110111120/636cd1249c7e80680e08f899jpeg.jpg" alt="Bhushan Tuladhar tweet">“This is a grave threat to public health, the government should have declared an emergency and taken urgent measures to curb pollution,” says environmental expert Bhushan Tuladhar. (left)The air pollution emergency in Kathmandu puts the elderly, those with asthma and other respiratory ailments at high risk, and would be especially dangerous to those with Covid-19.  <img width="756" height="1286" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110111120/636cd1279c7e80680e08f89ajpeg.jpg" alt="AQI Ratnapark"><img width="660" height="1346" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110111120/636cd1299c7e80680e08f89bjpeg.jpg" alt="AQI rank by city">Poor air quality in Kathmandu and inside rural homes due to smoky kitchen fires kill far more people across South Asia than SARS-CoV-2. However, the record-breaking pollution this winter will add to the risk of the coronavirus.  Even before Covid-19, the World Health Organisation (WHO) had warned that poor <a href="https://www.nepalitimes.com/banner/nepal-lockdown-proves-air-quality-can-be-improved/" target="_blank" rel="noopener noreferrer">air quality</a> in northern India and the Tarai was already the <a href="http://archive.nepalitimes.com/article/Nepali-Times-Buzz/air-pollution-decreases-life-span,3999" target="_blank" rel="noopener noreferrer">reducing average lifespan</a> of tens of millions of people by 3.7 years.“Long-term exposure to air pollution can cause many of the health conditions associated with increased vulnerability to Covid-19, such as diabetes and chronic heart and lung diseases,” said the <a href="https://www.stateofglobalair.org/sites/default/files/documents/2020-10/soga-2020-report.pdf" target="_blank" rel="noopener noreferrer">State of Global Air 2020</a> released last October.  <figure><img width="1920" height="1080" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110111120/636cd12b9c7e80680e08f89cjpeg.jpg" alt="Patan School Lalitpur clock tower"><figcaption>The clock is ticking for Kathmandu to act on reducing the health hazards of air pollution.</figcaption></figure>The <a href="https://www.nepalitimes.com/latest/double-whammy-air-pollution-and-covid-19/" target="_blank" rel="noopener noreferrer">report</a> says that 100% of the population in India lives in areas where PM2.5 levels are higher than the WHO Air Quality Guideline. Nepal is not far behind with 98% of its people living in such areas. More than 65% of all deaths due to chronic obstructive pulmonary disorder (COPD) in 2019 were linked to air pollution in Nepal.Says Pallavi Pant, air quality scientist at the Health Effects Institute: “Exposures to air pollution have been shown to affect the human body’s immune defence, making an individual more susceptible to respiratory infections such as pneumonia.”

Kathmandu air pollution hits record high

<figure><img width="1400" height="933" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109171152/636bdb6b9c7e80680e0802c3jpeg.jpg" alt=""/><figcaption>Photo: MONIKA DEUPALA</figcaption></figure>In the past eight months of this year, 791 people have died in Nepal from Covid-19. In the whole of 2019, <a href="https://www.nepalitimes.com/here-now/air-pollution-is-more-dangerous-than-smoking/" target="_blank" rel="noopener noreferrer">air pollution</a> directly killed 42,100 people in the country.Poor air quality in cities and inside homes due to smoky kitchen fires kill far more people across South Asia than SARS-CoV-2. But now, researchers say, there is a looming danger that as winter approaches, deterioration of air quality and Covid-19 will emerge as a double whammy.Even before the pandemic, the World Health Organisation (WHO) was already warning that poor <a href="https://www.nepalitimes.com/banner/nepal-lockdown-proves-air-quality-can-be-improved/" target="_blank" rel="noopener noreferrer">air quality</a> in the Indo-Gangetic plains that includes a part of the Tarai in Nepal was already the <a href="http://archive.nepalitimes.com/article/Nepali-Times-Buzz/air-pollution-decreases-life-span,3999" target="_blank" rel="noopener noreferrer">reducing average lifespan</a> of tens of millions of people by 3.7 years. <figure><img width="1876" height="1018" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109171152/636bdb6e9c7e80680e0802c4jpeg.jpg" alt=""><figcaption> </figcaption></figure>“Long-term exposure to air pollution can cause many of the health conditions associated with increased vulnerability to Covid-19, such as diabetes and chronic heart and lung diseases,” says the <a href="https://www.stateofglobalair.org/sites/default/files/documents/2020-10/soga-2020-report.pdf" target="_blank" rel="noopener noreferrer">State of Global Air 2020</a> released on Wednesday. The report shows that air pollution is among the biggest risk factors for all major mortality in the region, surpassed only by high blood pressure, tobacco use, and poor diet. <figure><img width="1500" height="861" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109171152/636bdb719c7e80680e0802c5jpeg.jpg" alt=""><figcaption> </figcaption></figure><figure><img width="640" height="820" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109171152/636bdb759c7e80680e0802c6jpeg.jpg" alt=""><figcaption> </figcaption></figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109171152/636bdb789c7e80680e0802c7jpeg.jpg" alt="" width="1500" height="1442"><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109171152/636bdb7b9c7e80680e0802c8jpeg.jpg" alt="" width="1500" height="993">Air pollution accounted for 6.7 million deaths globally, 2.1 million in South Asia, and nearly 42,100 deaths in Nepal in 2019 alone. Nepal ranks among the top 10 countries with the highest PM2.5 concentrations (harmful particles less than 2.5 microns suspended in the air).  Bangladesh, India and Pakistan also made the cut.The report says that 100% of the population in India lives in areas where PM2.5 levels are higher than the WHO Air Quality Guideline. Nepal is not far behind with 98% of its people living in such areas. The report, a collaboration between the Boston-based Health Effects Institute and the Institute for Health Metrics and Evaluation comes as the Covid-19 pandemic has claimed more than 116,000 lives in India and 765 in Nepal. Pollution and SARS-Cov-2 both affect the respiratory tract and lead to pneumonia. In fact, patients with pre-existing heart and lung disease are at high risk of coronavirus infection.On Wednesday, there were a total of 44,476 active cases after an additional 5,743 positives with Kathmandu Valley alone reporting 3,107 of them. With 2,996 discharged in the last 24 hours, the recovery rate now stands at 68.7%. There are a total of 269 patients in ICU and 87 on ventilator support. Bagmati province accounts for the most of them, 152 in ICU and 59 on ventilator.  <figure><img width="1492" height="639" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109171152/636bdb7e9c7e80680e0802c9jpeg.jpg" alt=""><figcaption> </figcaption></figure>More than 65% of all deaths due to chronic obstructive pulmonary disorder (COPD) in 2019 were linked to air pollution in Nepal. In India, it was 60%, and over 30% of the deaths due to ischemic heart disease in 2019 were linked to air pollution in both countries.These figures will only increase with the upcoming winter months which is also the flu season. India is already struggling with over 7.6 million Covid-19 cases. Nepal’s capital Kathmandu has run out of hospital beds including ICUs, oxygen, ventilators, and there is a shortage of other medical supplies. Although the full links between air pollution and Covid-19 are not yet known, there is clear evidence connecting air pollution and increased heart and lung disease. There is growing concern that air pollution exposures, especially in the most polluted regions of South Asia, could exacerbate the effects of Covid-19 significantly.“Exposures to air pollution have been shown to affect the human body’s immune defence making an individual more susceptible to respiratory infections such as pneumonia,” says Pallavi Pant, air quality scientist at the Health Effects Institute. “Air pollution exposures are linked with a range of diseases including chronic heart and lung diseases – all of which contribute to poorer outcomes in patients infected with the virus.”  <figure><img width="1500" height="441" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109171152/636bdb819c7e80680e0802cajpeg.jpg" alt=""><figcaption> </figcaption></figure><figure><img width="1491" height="616" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109171152/636bdb839c7e80680e0802cbjpeg.jpg" alt=""><figcaption> </figcaption></figure>Researchers say it is likely that people living in areas with high air pollution will experience more adverse outcomes from Covid-19. The report also found that air pollution is a leading risk factor to health both in Nepal and India followed by smoking and high blood pressure. Even though there is now greater awareness in Nepal and in South Asia about the impact of poor air quality, <a href="https://www.nepalitimes.com/editorial/beat-air-pollution/" target="_blank" rel="noopener noreferrer">not even steps have been taken</a> at the nation state level. There is also no <a href="https://www.nepalitimes.com/opinion/one-atmosphere/" target="_blank" rel="noopener noreferrer">cross-border collaboration in controlling air quality</a> especially as the annual season for crops residue burning is sending plumes of pollution across South Asia.“Although there have been actions and air quality improvements in some countries, including Nepal, there has been little or no sustained progress over the last decade in the most polluted countries of South Asia and Africa,” says the report.In the first-ever comprehensive analysis of air pollution’s global impact on newborns, the report finds that outdoor and household particulate matter pollution contributed to the deaths of nearly 500,000 infants in their first month of life. Nearly two-thirds (64%) of the infant deaths are linked to use of household burning of solid fuels, hitting hardest in South Asia and Sub-Saharan Africa.In Nepal, 22% of all neonatal mortality is linked to air pollution, most of which is attributed to indoor pollution from kitchen fires. This is much higher than the figure in India where 46% of all neonatal deaths due to air pollution is attributed to household air pollution.

Double whammy: air pollution and Covid-19

It was amazing to see the <a href="https://www.livescience.com/coronavirus-changes-pollution-over-china.html" data-saferedirecturl="https://www.google.com/url?q=https://www.livescience.com/coronavirus-changes-pollution-over-china.html&amp;source=gmail&amp;ust=1585383076968000&amp;usg=AFQjCNGy6JG88eR8u4HltgNkCfaY_NGX_w">dramatic before-and-after satellite images</a> of pollution reduction after coronavirus lockdowns in China, and how quickly the air could be cleaned up and improve health.But to sustain that, individuals, countries and economies must consciously reduce consumerism, realign our means of production, and rethink economic ‘growth’.For Nepal it is a chance to recalibrate the economy and steer it towards more self-reliance, and preparedness for future disasters of this nature.From my frequent stays throughout Nepal since the 1970s I have encountered many projects that attempted, altruistically, to abet local and women’s development by the introduction of multifarious craft and agricultural production designed for non-local markets.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110911110/636b7a259c7e80680e064742jpeg.jpg" alt="" width="1284" height="916"/><figcaption>Photo: LIVESCIENCE.COM</figcaption></figure><figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110911110/636b7a289c7e80680e064743jpeg.jpg" alt="" width="1554" height="1196"><figcaption>Photo: LIVESCIENCE.COM</figcaption></figure>Products included fruits and vegetables for the palates of the expatriate families in major centres, and simple or imaginative crafts for the ever-growing tourist industry back then.Gradually, in the process of increased sophistication and quality improvement, particular products required the input of not only whatever was locally available, but some enhancing component like a special fertiliser for certain vegetables, or unique components for handicrafts.Then there was the essential aspect of getting whatever was produced to suitable markets, usually in the capital or some tourist region. I recall enquiring with the implementers of such projects in remoter areas about how they obtained their ‘enhancements’ for production. And how did they get their products to market? The answer involved some type of transportation.But when roads became predictably impassable during the monsoon, travel in either direction became impossible or transport costs considerably increased. When labour strikes, political strife, demographic shifts affected the ability to sell products, locally developed production stalled and, in many cases, collapsed.E F Schumacher of the ‘Small is Beautiful’ fame understood this. A Gandhian economist, he promoted local production but from local resources, in order to remain independent from intermediate variables, such as the need for outside components and long distance transport, that was outside anyone’s control.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110911110/636b7a2a9c7e80680e064744jpeg.jpg" alt="" width="2052" height="1368"><figcaption>Unusually quiet New Road during the lockdown. Photo: BIKRAM RAI</figcaption></figure>Self-reliance, perhaps not everywhere or always, makes sense. I am not suggesting that we eliminate import/export globally. But when critical societal crises arise, as now with COVID-19, it has not taken long to realise that countries and economies reliant on importing food, materials and components from overseas can quickly become incapacitated.The answer is not to eliminate extraterritorial interaction, but try to support, improve and promote local production and marketing within reasonable limits, along with a reduction in excessive consumerism.Tourism is a unique case. It survives on the ease of travel for visitors from outside who come to the country and spend their money. For this reason, while self-reliance is still relevant, there are other critical considerations that have to be taken into account to mitigate and decrease health and safety problems.Notably, these include the travel routes and their maintenance, leadership and guidance with continuously refreshed skills and knowledge, as well as accommodation and food services that can practice and maintain industry-standard hygiene and sanitation. These components require improved training and monitoring.If promoting large increases of tourist volume through campaigns like Visit Nepal 2020, hosting facilities, and transport services must be prepared to act immediately on critical directives – distancing of guests -- in the event of some infectious outbreak like the one we are experiencing now.It may be a good idea for the government to plan for strategically located facilities in case of predictable health issues like infections, and not just for rare outbreaks like coronavirus. Just as there are certain services that are in place only seasonally in particular regions, so extra health and safety assistance can be deployed to supplement unavailable or inadequate services. This could be a ‘pay for service’ self-sustaining operation.Despite the sound recommendations after last year’s Everest traffic jam, there has yet to be a concerted effort to bring all essential agencies of government and private companies to collaboratively work out enhanced management of critical climbing areas and over-tourism generally. Non-action on this may also contribute to the less frequent, but disastrous, health emergencies like COVID-19.Iván G Somlai is Director of <a href="http://ethnobureaucratica.weebly.com/" data-saferedirecturl="https://www.google.com/url?q=http://ethnobureaucratica.weebly.com/&amp;source=gmail&amp;ust=1585383076968000&amp;usg=AFQjCNHTHo0O5N_Al30Kf3KYNlnyIy3B9Q">EthnoBureaucratica</a> based in Canada, and was a former consultant with Nepal’s Ministries of Health, Industry, and Tourism.<a href="http://ethnobureaucratica.weebly.com/" data-saferedirecturl="https://www.google.com/url?q=http://ethnobureaucratica.weebly.com/&amp;source=gmail&amp;ust=1585383076968000&amp;usg=AFQjCNHTHo0O5N_Al30Kf3KYNlnyIy3B9Q">http://ethnobureaucratica.weebly.com</a>Ivan.Somlai@INSEAD.edu<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110911110/636b7a2e9c7e80680e064745jpeg.jpg" alt="" width="152" height="165">

Pandemic is a chance to rethink development

Architecture can be a powerful agent of change, shaping not just spaces but the way people live, connect, and experience the world.&nbsp; For Nepal, which is <a href="https://nepalitimes.com/banner/natures-fragile-gift-to-nepal">gifted by nature</a> and rich in <a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/ambassador-fund-cultural-preservation-nepal,2092">cultural heritage</a>, &nbsp;reviving rural architecture with modern amenities could hold the key to more <a href="https://nepalitimes.com/here-now/what-sustainable-tourism-means-in-practice">sustainable tourism </a>that benefits local people more. “<a href="https://nepalitimes.com/banner/bayalpata-hospital-in-nepal-wins-global-design-award">Design and architecture</a> are amazing tools to create a unique experience for visitors,” says Spanish architect Tomeu Esteva of Esteva i Esteva Architecture Studio. “Difficult destinations have beautiful hotels with design and comfort.” Esteva was in Kathmandu with his colleagues at an event organised by the Spanish Honorary Consulate at Dwarika’s Hotel last week to showcase buildings which Nepali architects can adapt with local material and design inputs.&nbsp; Rural architecture holds a unique significance: it is more than a shelter and must reflect <a href="https://nepalitimes.com/here-now/inking-an-idenity">local identity, culture</a> and <a href="https://nepalitimes.com/here-now/saving-humla-from-heritage-loss">heritage</a>. An area’s natural and cultural harmony can be upset by <a href="https://nepalitimes.com/here-now/protecting-protected-areas-from-infrastructure?fbclid=IwAR1wK0MDFlFST_2EYb3f54LS4-fPt6rYfLG1DJ1JaQsU3w8-ezyXIxGOqzk">poorly planned development</a>, speakers at the event said, but the environment can be improved and revitalised by well-integrated structures.&nbsp; Another Spanish architect, Belen Moneo, has designed hotels at elevations of 3,700m in her home country Spain that supply natural spring water spas. “<a href="https://nepalitimes.com/banner/lost-in-reconstruction">Creativity in construction</a> must be encouraged. Rural architecture always shows possibilities of what we can do better,” Moneo explains, adding that designs must enhance <a href="https://nepalitimes.com/opinion/the-healing-power-of-nature">the beauty of nature</a> and give a natural feel at a time when steel, glass and cement dominate <a href="https://nepalitimes.com/here-now/rebuilding-kathmandu-after-the-1934-quake">urban design</a>.&nbsp; This is why the <a href="https://nepalitimes.com/here-now/weaving-nature-into-craft">use of natural products</a> such as bamboo, local timber, straw and rammed earth are in demand from customers who want a fresh eco-friendly look encouraged in construction of rural architectural structures. The demand for boutique hotels has increased world over, with &nbsp;more and more tourists favouring aesthetics, experience and comfort over price. While creativity is an important part of <a href="https://nepalitimes.com/here-now/architecture-for-mountains">construction and architecture</a>, incentives to build and use <a href="https://archive.nepalitimes.com/article/nation/Building,370">rural construction materials</a> still remain minimal, and Moneo emphasises the significance of design and execution.&nbsp; Esteva helped design the Vana Retreat in Dehradun that kept the natural environment in focus, with the structure giving an elaborate aesthetic experience to visitors. Another example is Hotel Las Mercedes in the Dominican Republic which was designed and constructed by Moneo and the company she co-founded Moneo Brock, respecting and revaluing the traditional architecture of the area. Hotels providing such experience could attract tourists and revenue. The Spanish ambassador to Nepal Juan Antonio March Pujol said, “The role of architecture and architects in developing tourism is crucial, not only in urban areas but rural settings as well.”&nbsp; The concept of rural boutique hotels gained traction in Spain during the 1990s, particularly in regions like Majorca with economic and environmental sustainability as the main focus. In Nepal <a href="https://nepalitimes.com/opinion/12-full-opinion/guiding-nepal-s-tourism-industry">the tourism industry</a> directly employs about 1 million people, and makes up about 8% of the country’s GDP. In Nepal, the stone homes of <a href="https://nepalitimes.com/news/reviving-himalayan-vulture-and-culture">Mustang and Manang</a>, bamboo and mud structures of <a href="https://nepalitimes.com/here-now/the-tarai-s-shrinking-forests">the Tarai</a>, and the Kathmandu Valley’s terra cotta tile skylines, graceful temples, and tranquil bahal courtyards are all examples of <a href="https://nepalitimes.com/here-now/nepal-s-traditional-seismic-resistant-designs">Nepal’s traditional architecture</a>.&nbsp; Nepali architect Sarosh Pradhan has been working for the past eight years on the Brakka Village project in Manang Valley north of <a href="https://nepalitimes.com/banner/municipalities-want-to-manage-annapurna">the Annapurnas</a>. Other examples of this kind of rural architecture for high-end tourism are the Shinta Mani Hotel in Mustang and Khumbu Lodge below <a href="https://nepalitimes.com/news/mt-everest-pvt-ltd">Mt Everest</a>. Says Pradhan, “There are places in Nepal that radiate purity and embrace simplicity. Creating projects in such settings require deep reflection and thoughtful planning.”  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250421030444_a07a23f6b60fa89c0f35b9dc1aaf19937da4881e6bfb2e1858f3c27dff91729f.jpg" data-media-id="editor_19" data-image-id="20250421030444_a07a23f6b60fa89c0f35b9dc1aaf19937da4881e6bfb2e1858f3c27dff91729f" data-rendition-name="original" width="4608" height="2184" loading="lazy" alt="A new architecture for Nepal's tourism"> </figure>  Rural architecture is not easy, and sometimes more expensive. Inflation, energy efficiency, <a href="https://nepalitimes.com/here-now/those-who-stay">the climate crisis</a>, and <a href="https://nepalitimes.com/banner/cost-of-living-in-a-big-city">increased costs of living</a> pose obstacles to sustainable rural architecture. Read also: <a href="https://nepalitimes.com/here-now/forgotten-international-starchitects-in-nepal">Forgotten international starchitects in Nepal</a>, Anne Feenstra and Varun S Bapu Esteva says faith and trust between client and architect is necessary for any project to be successful. He adds that architects must practice being humble, the process of designing always involves learning and not imposing their ideas on clients. Nepal is uniquely positioned for the growth of <a href="https://nepalitimes.com/banner/hiking-up-the-benefits-of-tourism">rural tourism</a> because of its stunning countryside as well as its internationally renowned traditions in holistic wellness. Creating infrastructure that is small, thoughtfully planned and that respects both tradition and contemporary hospitality standards is crucial. “Projects in Nepal can be made cost effective by using materials from houses that have been brought down,” says Esteva. “Pilot projects involving <a href="https://nepalitimes.com/banner/local-government-by-the-people-for-the-people-of-the-people">local people </a>and simple designing also helps the process.” <a href="https://nepalitimes.com/banner/vacant-homes-become-homestays-in-nepal">The growth of homestays in Nepal</a> is a step in the right direction, but they are still a bit too rustic for the international traveller who also wants comfort and is willing to pay extra for it. Upgrading the facilities in homestays and ensuring that the <a href="https://nepalitimes.com/here-now/an-archive-of-nepali-heritage">architectural heritage</a> of the locality is preserved using locally sourced building material could allow owners to charge more. Says Sangita Shrestha of Dwarika’s Hotel, “Our effort is to build upon rural architecture by empowering local communities and using what is available locally. We can fine tune and encourage indigenous design and training.” The vision goes beyond just boosting the economy, it is about building a future where tourism helps villages grow in a healthy and lasting way. Instead of using up resources, it gives back to the land and the people. It supports local communities by<a href="https://nepalitimes.com/opinion/staying-in-nepal-to-create-jobs"> creating jobs</a>, improving infrastructure, and protecting natural beauty. When done right, tourism can be a tool for <a href="https://nepalitimes.com/editorial/progress-and-or-preservation">preserving culture and nature</a>, not harming them. Architects must therefore see their work as more than just designing buildings, they also need to care deeply about people and places, especially in rural areas that can benefit the most.&nbsp; With global interest in sustainable and off-the-beaten-path travel increasing, Nepal stands at the cusp of a <a href="https://nepalitimes.com/news/missing-out-on-nepal-s-tourism-potential">tourism transformation</a> that values community-driven, eco-conscious hospitality. A mix of modern ideas and traditional knowledge could transform rural tourism in Nepal. Says Shrestha, “Young architects should spend time with <a href="https://nepalitimes.com/latest/the-unsung-heroes-of-conservation">local and indigenous communities</a>, listen to their stories, and learn from their <a href="https://nepalitimes.com/banner/life-and-livelihood-in-remote-nepal">ways of living</a>. These communities have deep knowledge about the land, materials, and climate. If this wisdom is used in new designs, it can help create tourism spaces that truly benefit everyone.” &nbsp;

A new architecture for Nepal's tourism

Extract from an addendum to Nepal's Two Wars, Chapter 2 in the updated edition of Essays on Nepal: Past and Present by Sam Cowan, a retired British Army general with a long association with the Gurkhas. The book was first published in 2018, and republished earlier this month by FinePrint exclusively on Amazon. The addendum details a one-to-one conversation the author had in the <a href="https://archive.nepalitimes.com/news.php?id=8884">Royal Palace </a>with the <a href="https://archive.nepalitimes.com/news.php?id=8371">King Gyanendra</a> in November 2002 just after he had taken his initial steps on the road that ultimately led to <a href="https://archive.nepalitimes.com/news.php?id=14681">the abolition of the monarchy</a> in Nepal in 2008. In the early evening of September 16, 2002, in my role as Colonel Commandant of the Brigade of Gurkhas, I had my second and last official audience with King Gyanendra to give him an update on the Brigade’s activities over the previous 12 months. I had some 6 or 7 such audiences with <a href="https://nepalitimes.com/here-now/preserving-king-birendra-s-family-home">King Birendra</a>.&nbsp; These were official affairs with the British ambassador of the day present, along with key <a href="https://archive.nepalitimes.com/news.php?id=12233">palace officials</a> and a representative from Nepal's Foreign Ministry. The two monarchs were very different in character and temperament, but both treated me with the utmost civility and made the audiences as relaxed and easy for me as possible.&nbsp; It is, however, worth recording that when the official business had been covered, King Birendra, with a twinkle in his eye, often ended by asking, “Now General, what’s the gossip in London?” The second audience with <a href="https://archive.nepalitimes.com/news.php?id=8026">King Gyanendra </a>was my last official act in uniform. We came back to Kathmandu in the first week of November (after treks) to stay for a few nights with our Defence Attaché before heading back to the UK. Waiting for me was a message from the Palace saying that King Gyanendra would like to meet me informally: <a href="https://archive.nepalitimes.com/news.php?id=6933">no uniform</a> and no ambassador.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250421080420_f9046f9882d4481781d14f2b64f18c7fbbea62562e1d74e3465de6d01fb43750.jpg" data-media-id="editor_7" data-image-id="20250421080420_f9046f9882d4481781d14f2b64f18c7fbbea62562e1d74e3465de6d01fb43750" data-rendition-name="original" width="1750" height="2406" loading="lazy" alt="Gyanendra crowned page 1"> <figcaption>Nepali Times Special Edition of 6-14 June 2001 with enthronement of Gyanendra. </figcaption> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250421080424_21333d6ae21828eb47fe3f849438d215fe2804460d47bb2896ef4aee4e895ad2.jpg" data-media-id="editor_8" data-image-id="20250421080424_21333d6ae21828eb47fe3f849438d215fe2804460d47bb2896ef4aee4e895ad2" data-rendition-name="original" width="1500" height="1857" loading="lazy" alt="Royal massacre"> <figcaption>Nepali Times 22-29 June 2001 covering the royal massacre after which Gyanendra became king. </figcaption> </figure>  Although I had no idea what the purpose of the meeting might be, events in Kathmandu since I last saw the king put me on edge. On October 4, 2002, Gyanendra had dismissed Prime Minister Sher Bahadur Deuba, allegedly for failing to hold <a href="https://nepalitimes.com/news/what-goes-on-in-nepal-s-elections">elections</a>. He had put in place a new prime minister and a cabinet personally selected by him. When I heard the news on my travels, the people I met were generally supportive of the king’s actions. There was a general view that something had to be done, the country was going nowhere, and the king deserved his chance, not least to solve<a href="https://nepalitimes.com/latest/14-years-after-conflict-no-closure-in-nepal"> the Maoist </a>problem. Back in Kathmandu, views were not so sanguine. The chosen prime minister, Lokendra Bahadur Chand, was a relic from <a href="https://nepalitimes.com/here-now/mob-movement-and-mayhem">the Panchayat period</a> whose party had failed to win a single seat in the last elections held in 1999. Some of the chosen cabinet ministers had, to put it mildly, dubious reputations, and others had no record of proven competence in any field. There was a fear that the king’s real motive in dismissing <a href="https://nepalitimes.com/editorial/deubas-denouement">Deuba</a> was to start to reverse the democratic gains made since 1990. I informed <a href="https://nepalitimes.com/news/nepal-britain-mark-centenary-of-1923-treaty">the British ambassador</a> about the invitation. He was strongly against accepting it, which was probably the clinching reason for my decision to do the polite thing and accept it. On the evening of November 7, 2002, I presented myself at the royal palace, alone and in civilian attire.&nbsp; As in the past, the Military Secretary, Major General Vivek Shah, met and escorted me into the presence of the monarch. This time, however, he was politely asked to leave the room and shut the door behind him. King Gyanendra greeted me warmly and invited me to sit down.&nbsp; Read also:<a href="https://nepalitimes.com/news/the-ghost-of-monarchy-returns-to-haunt-nepal"> The ghost of monarchy returns to haunt Nepal</a>, Shristi Karki  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250421080424_e382af945d0ad2a04ae41fabe5393f793dd10f54cb1220f111c7c9e7423eb558.jpg" data-media-id="editor_15" data-image-id="20250421080424_e382af945d0ad2a04ae41fabe5393f793dd10f54cb1220f111c7c9e7423eb558" data-rendition-name="original" width="1000" height="993" loading="lazy" alt="Gyanendra coup"> <figcaption>Nepali Times 4-10 February 2005 after king Gyanendra's coup imposed media censorship. anendra became king. </figcaption> </figure>  I had wondered, and to be truthful, had worried, not just about the purpose of the meeting, but about how the conversation might start and develop. I reduced my resolve to two points: be polite but speak candidly. The latter resolve was quickly put to the test with the king’s opening words: “Sam, [in previous meetings it had been ‘General’, you walk the highways and byways of this land more than most, tell me what the common man is thinking?” &nbsp;“Your Majesty, I have no idea what they are thinking, but they are waiting.” “Waiting?” “Yes, Your Majesty, they are waiting to see whether what you did some weeks ago in appointing your own prime minister and cabinet ministers is going to make any difference to their lives or whether it is just going to be more Kathmandu hot air.” “Everything is going to be difficult and is going to take time, a lot of time.” “Your Majesty, time is the one thing you don’t have. You must act quickly and decisively to take advantage of the opportunity you have created. Everyone knows that you have appointed these new ministers. Why don’t you get them in here one by one and tell them that they have three months to deliver a programme in their area of responsibility that is going to make a difference to people’s lives? Most will fail to do so. Sack them! It will be a powerful signal of your strong intent to deliver real change.” I can express the opening of our conversation in this way because just about every word is still etched in my mind. The king’s response to my last quoted words was to challenge me to give an example of something that could be delivered quickly. I can give a verbatim record of what I said in response to this unexpected challenge: “Health posts, Your Majesty, there is no shortage of them throughout the country as building them has been one of the sources of local corruption, but very few have any medicine to issue at present or have skilled people to assess and meet medical needs. Your Majesty, children are dying for lack of a few pills. Given the right priority, over a period, say of six months, every health post could be fully stocked with medicine and manned with trained people. This is something I could help to lead for you as I know it would have strong international backing. At last, people would know that you mean business.” As I warmed to the theme, I could see no sign of the king having any enthusiasm for the idea, and I quickly disengaged as it dawned on me, as it had clearly dawned on the king, that the reason for the deficiencies in health posts was to prevent any Maoist combatant from gaining access to any <a href="https://nepalitimes.com/opinion/tech-away/nepal-s-health-tech-industry-is-here-to-stay">medical support</a>, and if this meant people suffering, so be it. The subject of the Maoist insurgency inevitably came up, and I took the opportunity to elaborate on what is written in the final four paragraphs of the article above. I advised King Gyanendra that, self-evidently, since there were three parties in the conflict—him, the Maoists, and the political parties—it was imperative that he form an alliance with one of them, preferably the political parties; otherwise, he would find himself isolated, as the other two parties would inevitably, at some stage, form their own alliance. However, it quickly became apparent that the king’s mind was on a totally different track. On the Maoists, he told me that he had channels open to them, but he was scathing about the political party leaders. He made it clear that they would be waiting for a very long time before he gave any power back to them, and that is a polite way of expressing the actual words he used, but “crawling through the door” is a phrase which has stuck in my mind.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250421080424_5403455ff6168f0d202a96cb53edea69136d74d59b989cfcc7cc4a1d57672cb5.jpg" data-media-id="editor_17" data-image-id="20250421080424_5403455ff6168f0d202a96cb53edea69136d74d59b989cfcc7cc4a1d57672cb5" data-rendition-name="original" width="2000" height="1317" loading="lazy" alt="fall of monarchy"> <figcaption>Nepali Times 28 April-3 May 2005 with cover image by Ajay Joshi of jubilant protesters after street demonstrations sidelined king Gyanendra, paving the way for a ceasfire and restoration of democracy. </figcaption> </figure>  As the conversation developed, it became ever clearer that King Gyanendra had decided to go in alone, relying on the misleading assurances he was constantly receiving from <a href="https://archive.nepalitimes.com/news.php?id=14954">the army</a>, and no doubt his close advisers, that the Maoists could and would be quickly defeated militarily, and taken out of the equation. This would obviate the need for him to do any deal with the political parties.&nbsp; Thus, the way would be clear for him to establish a version of his father’s Panchayat system, under a constitution that would be granted to the people by him, their sovereign, as his father and brother had done in 1962 and 1990. As in those constitutions, ultimate power would have remained in the sovereign’s hands. This proposed direction of travel was very clear from what the king said to me. In sum, King Gyanendra was motivated by a desire to emulate his immediate predecessors by granting his people a constitution that would restore his father’s Panchayat system in a modern form and give him a central role in decision-making. What was particularly dispiriting was that beyond this single objective he had no plan worthy of the name, nor demonstrably did he have the people with the skills to implement an appropriate plan even if one had existed. Crucially and depressingly, there was little or no indication from the king that he realised that such a course of action could put Nepal’s monarchy into serious jeopardy, as indeed proved to be the case. <h2>King Twice</h2>  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250420110436_315d519fe3d68d2406ebe1480fed54720fbf21b8907a4da5cde751fdc623d445.jpg" data-media-id="editor_19" data-image-id="20250420110436_315d519fe3d68d2406ebe1480fed54720fbf21b8907a4da5cde751fdc623d445" data-rendition-name="original" width="1302" height="632" loading="lazy" alt="“Tell me what the common man is thinking!”"> </figure>  <a href="https://archive.nepalitimes.com/news.php?id=8371">Gyanendra Bir Bikram Shah has been king twice</a>. In 1950 he was enthroned briefly as a child king (left, above) by the Rana Prime Minister Mohan Shumsher when his grandfather, King Tribhuvan, fled to exile in India. In 2001 he was crowned king again after the massacre in the royal palace in which his brother King Birendra and nine other members of his family were killed by Crown Prince Dipendra.&nbsp; During his second reign, Gyanendra gradually asserted power by sacking Prime Minister Sher Bahadur Deuba in 2002, and then taking full control after the 1 February 2005 coup. He was sidelined after the ceasefire in April 2006, and became a commoner after the Constituent Assembly finally <a href="https://archive.nepalitimes.com/article/from-nepali-press/Ftnp-abolishing,624">abolished the monarchy in 2008</a>. In the past year, Gyanendra has tried to exploit public dissatisfaction with the political parties to restore the monarchy.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250421080432_26ef4a4b0e3cee9fdc6794446702efe16550d293904b4f6dd46fe35d4d10c788.jpg" data-media-id="editor_22" data-image-id="20250421080432_26ef4a4b0e3cee9fdc6794446702efe16550d293904b4f6dd46fe35d4d10c788" data-rendition-name="original" width="1136" height="702" loading="lazy" alt="Essays on Nepal by Sam Cowen"> </figure>

“Tell me what the common man is thinking!”

“It's Kathmandu.” Just as the family was sitting down for one of its extended lunches, that jubilant cry was from François Driard’s grandfather announcing the next posting for his diplomat parents.&nbsp; Driard (pictured) was 18 in the summer of 1996,<a href="https://nepalitimes.com/opinion/suburban-tales/chasing-a-nomad"> a bit of a hippie</a> already, and his life was about to change forever with the magical word “<a href="https://nepalitimes.com/banner/time-capsule-of-kathmandu">Kathmandu</a>”. “I was awed with that information from my grandfather, nothing else mattered … In France <a href="https://nepalitimes.com/here-now/tales-of-courage-and-suffering-cx95f89e">in the 1990s</a>, Kathmandu had a mythical aura,” Driard recalls. He came to Kathmandu for Christmas that year to visit his stepfather, the French Ambassador Michel Lummaux. It was to be the first of many visits during school holidays, before he decided to permanently settle down in Nepal. “Kathmandu, and Nepal, were very different then, it was magical, I liked the nature, the people, civilisation, temples, trees,” says Driard, who explored the country sitting on the top of buses. “Visitors talk about the crazy <a href="https://nepalitimes.com/banner/cost-of-living-in-a-big-city">urbanisation</a>, traffic jams today, and all that is true. But Kathmandu has not <a href="https://nepalitimes.com/here-now/loss-of-soul-and-soil">lost its soul</a>.” After his stepfather’s tenure in Nepal ended, Driard worked as a business reporter for international publications but decided he did not want to be anyone’s employee anymore. In 2007 he landed in Kathmandu with €20,000 in savings to invest.&nbsp; He knew a few crucial things about himself: he liked food and nature, which is very much tied up with his upbringing--full of lively conversations during lunch and dinner at the family table between <a href="https://nepalitimes.com/here-now/nepals-yak-cheese-is-on-world-map">abundant cheese, wine and cigars</a>. So he decided it would be cheese, and registered Himalayan French Cheese and went to the French Alps for a month to learn how to make Tomme de Savoie. “<a href="https://nepalitimes.com/banner/the-story-of-langtang-cheese">Cheese making is such an ancient craft </a>and so I thought I won’t need much money or studying which I hated and indeed, if you have a tamako bhado and fire you are set,” explains Driard. But Nepal’s temperature and humidity were not ideal, even at higher altitudes. The first customers for his cheese were the Hyatt Regency and Nina and Hager. But he needed to create a market for cheese in a country which only knew hard churpi in the north and soft paneer in the south. He started selling his cheeses at the Summit Hotel weekend market, expanding to his own 1905 Farmer’s Market which later moved to Le Sherpa in Maharajganj, where it is now, and also a market at Labim Mall in Pulchok. He had cow dairies in Nuwakot and Dhulikhel, and finally a yak cheese unit at 3,379m in Ramechhap. It was the yak blue cheese from here that went on to win a Gold Medal in France, putting Nepal’s French cheese on the world map. “People come and try our cheese at the market, they ask questions. There is a lot of education to be done about cheese,” adds Driard, who also has three cheese shops in the Valley. Driard now makes 25 types of cheese. The products are being noticed and every year he has French students coming to Nepal to learn the art of yak cheese making. “In France, one family or company makes one kind of cheese for generations. In that I’m very unique as a cheese artisan,” he says. “The students come in to learn but I tell them to also teach us something too, add another cheese to my collection.” Read also: <a href="https://nepalitimes.com/here-now/langtang-after-10-years">Langtang after 10 years</a>, Sonia Awale Being a foodie, Driard is now also dabbling in meat with his own charcuterie at Meatini with bacon, ham, sausage and pâtés. All of this is now served at his Emilio’s Pizza, a leafy hideaway in Lazimpat. His South Side in Moksh is probably the smallest wine bar in the world. “I call the process sublime,” says Driard of his ventures, which have grown organically. “You need the same temperature and humidity of 12°C and 80% for cheese, meat and wine.” Emilio’s speciality is the eight-cheese pizza (which has eight types of cheeses), and a pizza with bhutan topping (not the country but fried intestines and organs Nepali-style). He has opened a small branch at Courtyard in Pokhara.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250426070456_bacae302c040dc18eeecdeafda72ddf06a6d2cec138ea9be7e45fe94cdf8b5b3.jpg" data-media-id="editor_8" data-image-id="20250426070456_bacae302c040dc18eeecdeafda72ddf06a6d2cec138ea9be7e45fe94cdf8b5b3" data-rendition-name="original" width="1500" height="1125" loading="lazy" alt="8 cheese pizza"> <figcaption>Eight-cheese pizza</figcaption> </figure>  With two artisanal cheese units, two farmers’ markets, a <a href="https://nepalitimes.com/here-now/the-meat-of-the-story">meat processing unit</a>, a bakery, and wine bar he now envisions a vineyard so he can add Nepali wine to his repertoire. Another future plan is to start up an agri-tourism business where customers can drink, eat and work in peace. In the past 20 years in Nepal, Driard has not always succeeded in his ventures but this hasn’t curbed his enthusiasm. He is learning as he goes, and like an old wine, Nepal is growing on him. Its slowness suits his French art de vivre with eating slowly outdoors, having conversation, importing less.&nbsp; “I have proven that with even a little money you can do a lot of things in Nepal,” adds Driard. “In the West, they easily invest half a million euros on a cheese factory, I invested 10 times less.”&nbsp;

Fromage, vin et charcuterie Népalais

He had just sat down for lunch after tending the garden at his house in Lagan Tole on 25 April 2015 when the ground began to shake violently. &nbsp; Gautam Nepal, 56 at the time, realised it was an earthquake. He panicked at the thought of his neighbours' multi-storied buildings toppling on top of his modest one-storey house. He rushed out as the high-rises swayed and groaned. “We were used to earthquakes, moderate ones are a regular occurrence in Kathmandu, but I had never felt fear like I felt on that day,” recalls Gautam. “My house proved strong, it did not collapse.”  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250419040440_82a74881218223df70e30eb1759cd3a7c9edbb7728acef83c3f8b397d6e6dfe9.jpg" data-media-id="editor_0" data-image-id="20250419040440_82a74881218223df70e30eb1759cd3a7c9edbb7728acef83c3f8b397d6e6dfe9" data-rendition-name="original" width="1737" height="1000" loading="lazy" alt="Loss of soul and soil NT"> <figcaption>LAGAN TOLE'S TOLL: Lagan Tole photographed by tour guide Neil S Rawlins during his travel to Kathmandu in February 1970.</figcaption> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250419040448_90914720a75b7d31a12bc27f0c0af9484a5e5efc7dd797dc6bcd190fc28ecdcb.jpg" data-media-id="editor_1" data-image-id="20250419040448_90914720a75b7d31a12bc27f0c0af9484a5e5efc7dd797dc6bcd190fc28ecdcb" data-rendition-name="original" width="1500" height="1004" loading="lazy" alt="Loss of soul and soil NT"> <figcaption>Lagan Tole photographed by Neils Gutschow in 1992.</figcaption> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250419040440_9a4dd35b070949949bfe275eff8216dd29f88f74a30b063dc614845226f68f03.jpg" data-media-id="editor_2" data-image-id="20250419040440_9a4dd35b070949949bfe275eff8216dd29f88f74a30b063dc614845226f68f03" data-rendition-name="original" width="1501" height="1000" loading="lazy" alt="Loss of soul and soil NT"> <figcaption>Lagan Tole in 2025.</figcaption> </figure>  Other residents of Lagan who also live in traditional low rise houses had the same fear. Tara Nepali, then 48, was doing the washing that Saturday.&nbsp; She recalls, “When my house began to shake, I could only think about the bigger buildings falling on top of me. I was sure my house would collapse, but to my surprise, it survived, and so did we.”  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250419040440_2b4b1ec427d9aec5980021b97b25ca3164d5f79337f113ba02b1d802f71b7cad.jpg" data-media-id="editor_3" data-image-id="20250419040440_2b4b1ec427d9aec5980021b97b25ca3164d5f79337f113ba02b1d802f71b7cad" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="Loss of soul and soil NT"> <figcaption>Gautam Nepali in front of his one-storey Lagan home, where he had been having lunch just before the earthquake struck 10 years ago.</figcaption> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250419040436_6f8a7057bbd269214712076e13117b665165e03a0351db0e3666aee05e91f63c.jpg" data-media-id="editor_4" data-image-id="20250419040436_6f8a7057bbd269214712076e13117b665165e03a0351db0e3666aee05e91f63c" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="Loss of soul and soil NT"> <figcaption>Tara Nepali in front of her house in Lagan. She was doing the washing during the earthquake in 2015.</figcaption> </figure>  But Buddha Khadgi, 68, was not so lucky. His was one of the few houses in the neighbourhood to be reduced to rubble. His lifelong collection of photographic prints were buried, and so were the traditional Newari musical instruments passed down through generations of his family that he used to give music lessons.&nbsp; “I lost the things that connected me to my roots and my heritage. That was infinitely more heartbreaking than the fact that my house was gone,” says Khadgi, now living in a new cement structure.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250419040436_58f4a8ee4eb740536c69096a4d8c0cd2007fdbcc4ef56551ff460d2ef0ef6f2b.jpg" data-media-id="editor_5" data-image-id="20250419040436_58f4a8ee4eb740536c69096a4d8c0cd2007fdbcc4ef56551ff460d2ef0ef6f2b" data-rendition-name="original" width="2496" height="1671" loading="lazy" alt="Loss of soul and soil NT"> <figcaption>Lagan's Maka Galli some decades ago. Photo: SHREE RAM NEPALI</figcaption> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250419040440_6b2bacaf0a1e93b441aff8093b343836d6de0b44d7b29f9b758209845f675bff.jpg" data-media-id="editor_6" data-image-id="20250419040440_6b2bacaf0a1e93b441aff8093b343836d6de0b44d7b29f9b758209845f675bff" data-rendition-name="original" width="1000" height="1500" loading="lazy" alt="Loss of soul and soil NT"> <figcaption>Lagan's Maka Galli in 2025. The neighbourhood's old Newari houses have been replaced by concrete structures, although the falcha has been rebuilt in traditional style.</figcaption> </figure>  Lagan Tole in Kathmandu's historic heart emerged relatively unscathed from the earthquake in large part because, like in nearby Asan, the buildings are densely packed and lean on each other. But in the years after the earthquake, urban pressure and fear of future quakes have made families tear down their traditional houses with sloping tile roofs and replace them with concrete structures.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250419040440_25983e79dc88388cb370b16f7f631e4c276cfc997ffa1f9ce3701e40c876b355.jpg" data-media-id="editor_7" data-image-id="20250419040440_25983e79dc88388cb370b16f7f631e4c276cfc997ffa1f9ce3701e40c876b355" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="Loss of soul and soil NT"> <figcaption>Glimpses of present-day Lagan.</figcaption> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250419040440_9a6a88df8815352a452895c43840a898d4b6c080b79562383306c0cfe8bcd952.jpg" data-media-id="editor_8" data-image-id="20250419040440_9a6a88df8815352a452895c43840a898d4b6c080b79562383306c0cfe8bcd952" data-rendition-name="original" width="1000" height="1500" loading="lazy" alt="Loss of soul and soil NT"> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250419040440_a348b974bd3a5e76d0bf9b309f98813556d43dd6c361856c67e79c03d4283e69.jpg" data-media-id="editor_9" data-image-id="20250419040440_a348b974bd3a5e76d0bf9b309f98813556d43dd6c361856c67e79c03d4283e69" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="Loss of soul and soil NT"> </figure>  Lagan’s longtime residents, especially the elderly whose families have lived here for generations, say that the neighbourhood with its characterless new tall cement boxes is no longer familiar to them. “We used to say that our houses are not supposed to be taller than temples, the houses of our gods,” says Gautam. “Now, the houses here dwarf the temples and even the chariot of Seto Machindranath.”  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250419040440_88d18ce580abaf9e62fd807403f2e3c9a5bd8972d3b32bdacb97d8991c7fec35.jpg" data-media-id="editor_10" data-image-id="20250419040440_88d18ce580abaf9e62fd807403f2e3c9a5bd8972d3b32bdacb97d8991c7fec35" data-rendition-name="original" width="1041" height="1441" loading="lazy" alt="Loss of soul and soil NT"> <figcaption>The Seto Machindranath procession at Lagan on 10 April 1998, during which the chariot caught fire. Photo: SOCIAL MEDIA</figcaption> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250419040440_c403f91f9a48c14eaaeed2d38a2cb97714416765730b6d12f29487f9b0f47e83.jpg" data-media-id="editor_11" data-image-id="20250419040440_c403f91f9a48c14eaaeed2d38a2cb97714416765730b6d12f29487f9b0f47e83" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="Loss of soul and soil NT"> <figcaption>The Seto Machindranath procession at Lagan earlier this month.</figcaption> </figure>  &nbsp;The old baha courtyards, falcha resting places, and open spaces where Lagan’s residents used to grow vegetables and gather as a community are nearly all gone. And the taller the houses get, residents say they feel less anchored to the soil. Lagan has also lost its soul -- the community spirit is eroding as elderly neighbours rarely venture down to meet each other in the evenings. &nbsp; “This no longer feels like the tole I grew up in,” says a resident. “We are beginning to lose the relationships we had with each other as a community, and with it, the spirit of Lagan.”&nbsp;