Everyone in Nepal should beware of <a href="https://nepalitimes.com/here-now/kathmandu-s-street-smart-dogs">dogs in the streets</a>, which are the most likely source of rabies infection. Rabid dogs are not always aggressive. They can be partly paralysed and drooling saliva.&nbsp; A bite, scratch or even licking an open wound by an unknown dog or any sick-looking mammal should be taken seriously. The best treatment following a dog bite is to wash the wound immediately with soap or detergent and then go to a hospital or clinic straight away for advice.&nbsp; <a href="https://nepalitimes.com/news/microchipping-nepal-s-dogs">It is urgent to begin treatment </a>if it is prescribed. A course of rabies vaccine is 3 or 4 doses, and an injection of rabies immune serum into the wound may be given if the risk is severe. Treatment is free in Nepal’s government hospitals and clinics, but the immune serum is expensive and only available at major hospitals.&nbsp; Private clinics may provide treatment but at a cost. If this preventive treatment is delayed or is incomplete the risk of <a href="https://nepalitimes.com/banner/dog-bites-man-is-still-news-in-nepal">rabies infection</a> remains. Treatment is most urgent if the bites are on the head, neck or hands. Over 100 people die from rabies in Nepal every year, according to Hemant Ojha, head of zoonotic at Epidemiology and Diseases Control Division, and there are nearly 3 million dogs, many of them strays. More than 132,000 people were bitten by dogs and<a href="https://nepalitimes.com/here-now/nepal-s-wild-dogs-also-need-to-be-saved">wild animals</a> last year, and 40% of them were children. This year alone, there have been about a dozen reported deaths already, and the government is trying to address the shortage of vaccines in hospitals around the country. However, pre-exposure vaccine before being bitten by a rabid animal is 100% effective. Although rabies infection is 100% fatal once the illness has started, the vaccine can be 100% protective if given before contact with a rabid animal. No one has ever died of rabies who has had a course of pre-exposure vaccine and later, if bitten by a possibly rabid animal, had a booster vaccination. Rabies immune serum is not needed.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250904090956_ae6ebacd7cf39fe56639b8a460ffa531815748bd6ce7dec5f5e654340b53ced9.jpg" data-media-id="editor_4" data-image-id="20250904090956_ae6ebacd7cf39fe56639b8a460ffa531815748bd6ce7dec5f5e654340b53ced9" data-rendition-name="original" width="1000" height="1000" loading="lazy" alt="Do you worry about dying of rabies? NT"> </figure>  For pre-exposure vaccination, only a small amount of vaccine is needed and 0.1 ml can be injected into the surface of the skin. One vial of vaccine can be shared between a family or other group of people which reduces the cost.&nbsp; A separate syringe and needle must be used for each person. However, they must all go to the clinic together because an opened vial must be discarded at the end of the day. A vial of vaccine costs approximately NPR 650–700 at pharmacies, private clinic charges vary. If bitten by an animal later in life, only booster vaccine is needed but rabies immune serum is not needed. Only mammals can be infected by rabies, including dogs, cats, cattle, sheep, buffalo and wild mammals including bats. In humans many cases are not reported but a study in India showed that 12,700 people die of rabies every year. 40% of the deaths are in children under the age of 15 years. Bites or even a scratch, usually from a rabid dog or cat, can result in an agonising death a few months later. The virus in the animal’s saliva is inoculated through the skin, and travels in nerves up to the brain. The rabies virus multiplies resulting in inflammation of the brain. Read also: <a href="https://nepalitimes.com/news/the-return-of-communicable-diseases">The return of communicable diseases</a>, Sonia Awale The diagnosis of rabies encephalitis depends on recognising the typical symptoms in people who have been in contact with a possibly rabid mammal in the previous weeks or months. The most characteristic symptoms are jerky muscle contractions, like quick gasps for air when trying to drink water, also fear of water, going on to fits, confusion and anxiety. The infection progresses to unconsciousness, and breathing, heart or nervous system complications might follow. When the facilities exist, the possibility of giving <a href="https://nepalitimes.com/opinion/global-solidarity-needs-intensive-care-in-pandemic-battle">intensive care </a>to prolong life may arise, but although a very few patients, who have had incomplete vaccination, may survive a few weeks or months, they will be left with severe disability, unable to feed themselves, walk or talk. Rabies infection can sometimes be a paralysing illness like polio, without spasms. When the muscles of breathing become paralysed, the patient dies. Tests on the patients’ skin or saliva can confirm the diagnosis, but this is not likely to be possible locally. After death a tiny sample of brain tissue can be tested. In<a href="https://nepalitimes.com/banner/bhaktapurs-dog-catchers"> a disease as agonising and terrifying as rabies</a>, relieving distressing symptoms is the primary concern. Because there is no treatment which will kill the virus in the brain, the only option is to give active compassionate care, to reduce suffering. Palliative therapy must reduce thirst and dehydration, fever, anxiety, fear, restlessness, agitation, seizures and pain. The patient should be nursed in quiet darkened rooms, because bright lights and loud noises might provoke spasms. Fluids, sedatives and anticonvulsants help to keep the patient comfortable. Death usually occurs within a week or so. In an ideal world, everyone in Nepal could have peace of mind by having a complete course of vaccine. Children are at greatest risk as they are less aware of rabies and may not report contact with a possibly rabid animal. &nbsp; Mary Warrell was with the Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford.

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Do you worry about dying of rabies?

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109151116/636bb65c9c7e80680e07bc59jpeg.jpg" alt="" width="2048" height="1365"/><figcaption>Photo: MONIKA DEUPALA</figcaption></figure>Last year this time, the Infectious and Tropical Disease Hospital in Teku would be filled with patients suffering from mosquito or dog bites. But for the past week, entire families are sleeping in the open overnight at the hospital gate waiting for their turn to get Covid-19 PCR tests in the morning.The novel coronavirus has overshadowed many prevalent diseases and their treatment in Nepal, and one of the deadliest among them is <a href="http://archive.nepalitimes.com/news.php?id=19652#.X3E9tS2B0b0" target="_blank" rel="noopener noreferrer">rabies</a>.Last month, on a day that saw six Covid-19 fatalities nationwide, at least three people died of rabies in Dolakha district after a dog bit 10 people. The three, aged 32, 14 and 8, died despite receiving anti-rabies vaccines.Their families filed police complaints against a local clinic for using faulty vaccine, but ward chair Raj Kusum Lama later said the three died because they did not go for the full treatment of three injections.In Kathmandu, the Teku hospital is the only one which administers free anti-rabies vaccines. It used to get as many as 150 dog bite cases a day, but the number dwindled to only about 30 daily cases in the past months – even though there is anecdotal evidence of hungry street dogs getting more aggressive during the lockdown.Surya Ghimire was recently walking from his home in Dhapakhel to a school in Patan where he is a security guard, when he was suddenly attacked by a <a href="http://archive.nepalitimes.com/article/Nepali-Times-Buzz/woof-of-fresh-air-for-street-dogs-in-kathmandu,4132" target="_blank" rel="noopener noreferrer">canine pack</a>."There were no cars on Sat Dobato, and the dogs ruled the intersection. It was so dangerous, I started carrying a stick to protect myself,” he recalled. “The dogs were chasing people on motorcycles. They never did this before.”<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109151116/636bb65f9c7e80680e07bc5ajpeg.jpg" alt="" width="3264" height="2448"><figcaption>Photo: BASU PARAJULI/THE KAT CENTRE</figcaption></figure>The lockdown also meant that without transport, people could not travel to health facilities to access the vaccine on time. Even after travel restrictions were lifted, many dog bite victims are afraid to visit Teku because it is also where Covid-19 patients are tested and treated.“Rabies is a under-diagnosed and under-rated in Nepal,” explained Buddha Basnyat of Patan Academy of Health Sciences. “Rabies doesn’t take any prisoners, it kills. Good thing we have a set of highly effective preventive measures.”A post-exposure prophylaxis, commonly known as anti-rabies vaccine, must be administered immediately after a dog bite, even if the dog may not be rabid. No one wants to take the chance. The vaccine takes about a week for the body to develop antibodies to fight the virus.While completely preventable, <a href="http://archive.nepalitimes.com/news.php?id=17455#.X3E9tS2B0b0" target="_blank" rel="noopener noreferrer">rabies</a> is a disease with the highest documented case-fatality rate -- close to 100%. Globally, it is responsible for 59,000 deaths every year, and 40% of all human rabies deaths are of children under 15.While rabies occurs in more than 150 countries, it is endemic in South Asia and Africa. India alone accounts for 40% of all annual rabies deaths in the world.Nepal has an average of 125 cases a year, but experts say most of the cases in remote rural areas go unreported. In fact, given the uncontrolled and growing population of stray dogs in urban areas, rabies and its preventive measures deserve more attention.“Teku hospital is synonymous with dog bite treatment, but the anti-rabies vaccine should be made available across the country and not just in few government hospitals,” says Prativa Pandey of CIWEC Travel Medicine Centre in Kathmandu. “Widespread access to the vaccine also means cutting down on travel cost for patients seeking treatment.”<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109151116/636bb6629c7e80680e07bc5bjpeg.jpg" alt="" width="640" height="530"><figcaption>Photo: KAT CENTRE</figcaption></figure>Indeed, if all major hospitals, health facilities and clinics had a stock of vaccines, many more lives would have been saved during the lockdown. Free anti-rabies vaccines are available only in Teku and limited district hospitals. Private hospitals stock the vaccine, but there is a hefty charge. Even then, most facilities are not equipped with immunoglobulin, which together with post-exposure prophylaxis is considered a complete treatment against rabies.An immunoglobulin shot is crucial in severe bite wounds, but both equine and human immunoglobulin can be found only in a select few clinics.“South India has made much progress in equine serum and we should invest on making it more widely available in Nepal,” says Basnyat. “It’s much cheaper than human immunoglobulin and doesn’t need a lot of maintenance, and the side effects are reduced.”Knowledge about immediate and thorough bite wound washing with soap and water is also crucial, and can save lives. But prevention by <a href="http://archive.nepalitimes.com/news.php?id=17934#.X3E9xS2B0b0" target="_blank" rel="noopener noreferrer">controlling the street dog population</a> and canine vaccination are equally important. Although bats and monkeys also carry the rabies virus, dog bites make up 99% of all transmission in Nepal.Animal welfare organisations such as Kathmandu Animal Treatment (KAT) Centre and Sneha’s Care have been immunising community dogs in the Valley. Along with individual initiatives, they have also been busy <a href="https://www.nepalitimes.com/banner/singha-darbar-dogs-go-hungry-in-lockdown/" target="_blank" rel="noopener noreferrer">feeding and caring for stray animals during the lockdown</a> so they are not as aggressive.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109151116/636bb6649c7e80680e07bc5cjpeg.jpg" alt="" width="1500" height="1000"><figcaption>Photo: MONIKA DEUPALA</figcaption></figure>On Monday, 28 September, the Global Alliance for Rabies Control is marking the 14th World Rabies Day with the slogan ‘End Rabies: Collaborate, Vaccinate’. Nepal and other endemic countries should renew their commitment to end rabies by prioritising and <a href="https://www.nepalitimes.com/banner/bhaktapurs-dog-catchers/" target="_blank" rel="noopener noreferrer">investing on preventive measures</a> and meet the World Health Organisation (WHO) target of bringing down human deaths from dog-mediated rabies to zero by 2030.Elsewhere in the world, pre-exposure vaccines are readily available and most travellers to Nepal use one so that even in case of a dog bite, they can survive with only one booster dose of the anti-rabies vaccine.Says Prativa Pandey: “Ideally, immunisation against rabies like we have for polio is recommended for this part of the world even though it is expensive. Even so, we must make the vaccine available and invest on preventive measures to save lives.”

Dog bites man is still news in Nepal

Climber, expedition leader and later a supplier of bottled oxygen to Himalayan mountaineers, Henry Barclay Todd died on 3 November 2025 in his favourite place on earth, Kathmandu.&nbsp;
Todd was larger than life, a metaphor often used, yet it could not be more fitting. Standing nearly 2m tall, and possessing an unshakeable will, he lived life on a grand scale, both in body and spirit.&nbsp;
Todd was a pillar in the Himalayan climbing community, supporting many mountaineers across Nepal and Pakistan, making it possible for them to fulfil the dream of standing on the world’s highest peaks. He believed deeply in the strength, skill, and potential of the Sherpa people, and offered them opportunities that might otherwise have remained out of reach.&nbsp;
“Thank you, Henry. Your trust changed my life. Rest in peace, my leader, my teacher, my friend,” said Dorjee Gyelzen Sherpa in his tribute.
Born in 1945 to Royal Air Force officer Henry Todd and May Todd of the Women’s Royal Air Force, Henry spent his early years in Singapore. He led a lively childhood with his two brothers, far removed from the mountains that would later define his path.&nbsp;
A gifted swimmer like his father, Henry never pursued the sport professionally. Instead, after returning to Dundee as a teenager and attending seven different schools, he set off for London, where he began working for an insurance company before finding his true calling in adventure.
Henry Todd first came to Nepal in the mid-1980s and made his first attempt on Ama Dablam in 1987, an expedition that marked the beginning of an extraordinary and colourful climbing career. <a href="https://www.himalayandatabase.com/" target="_blank">The Himalayan Database</a> lists 61 expeditions that he led in Nepal alone — there were more in the Karakoram, Argentina and the Alps.&nbsp;
But Todd would joyfully say that a few hard Scottish ascents held a more personal meaning to him than even the greatest Himalayan summits.
Over the decades, he crossed paths with many legendary climbers like Anatoli Boukreev, Jerzy Kukuczka, Doug Scott and Chris Bonington as well as celebrities including members of Pink Floyd and Nobel Prize laureates whom he befriended.&nbsp;
He had a gift to never name-drop, but would simply mention that he had had lunch with Minnie Driver (niece of his long-time friend Andra) or that he had bought his first car from Donald Sutherland. For Todd, these were not bragging rights, they were simply part of the colourful tapestry of his life.
Todd’s life was filled with extraordinary experiences from surviving plane crashes, avalanches and earthquakes to quietly solving countless problems, which was one of his favourite past-times. His hands, famously large and steady, were always ready to help whether in the chaos of the mountains or the calm of a base camp.&nbsp;
With his sharp sense of humour and the beloved exclamation “Whoopie!”,he could bring lightness even to the toughest moments. He never tired of taking on challenges or helping when someone was in need, and he enriched so many people’s lives with his endless stories.
His legacy is immense. He helped build the human backbone of Himalayan climbing, enabling generations of climbers to test themselves in the world’s highest places. With his passing, an era of bold, spirited Himalayan guiding has come to a close.
Todd survived by a loving family, many close friends and a global community of climbers and Sherpas who will never forget him and his endless tales.&nbsp;
His family said in a statement: ‘Henry’s strength, warmth and unyielding belief in others will live on far above the clouds. He was indestructible in our eyes and in our hearts, he always will be.’
There will be a memorial service at Pashupati Temple in Kathmandu on 8 November 2025 around lunchtime.

Henry Barclay Todd, 80

The autumn mountaineering season is not over yet, and already there have been 12 fatalities on Himalayan peaks in Nepal.
Of the 1,450 climbing permits issued, 436 were for Mt Ama Dablam (6,812m), 374 for Mt Manaslu (8,163m) and 186 for Himlung Himal (7,126m). There were deaths on all three mountains.
The death of two French climbers on Ama Dablam happened before unseasonal blizzards hit the mountains. But Cyclone Montha from the Bay of Bengal brought on high winds and up to 1m of snow in the peak trekking and mountaineering season.
This increased avalanche conditions, and made helicopter evacuation of stranded and injured climbers difficult. Lower down the mountains, more than 1,000 trekkers from Nepal and around the world were stuck in the Annapurnas, Manaslu circuit and the Khumbu.
However, there have also been allegations that it was not just the weather that delayed rescues. Multiple levels of bureaucracy and the need for flight permits to restricted areas like Manang and Manaslu critically delayed evacuation flights.
Italian climbers Farronato Stefano and Caputo Alessandro were found dead in their tent at Panbari Himal Camp I (6,887m) in the Manaslu area. They had been trapped by heavy snowfall since 28 October, and their bodies were found on 4 November by a team from the expedition organisers, Sherpa Alpine Trekking Service. The team was made up of high level mountain guides and expedition leader Valter Perlino.
The team had been climbing to Camp 3 but decided to descend to base camp because of thrombosis in Perlino’s left foot. The two climbers who would eventually get trapped decided to break at Camp I, a decision that would prove fatal after the projected six-day snowfall arrived two days early.
“They were sleeping in a tent and were buried under 2.5 metres of compacted snow. It happened during the night between Thursday and Friday. While they were sleeping, absurd,” said Perlino.
A deadly incident took place the morning of 3 November, when five foreigners and two Nepalis died in an avalanche on Yalung Ri at 5,630m in the Rolwaling. They were part of a larger group of 15 that were acclimatising for an attempt on the nearby Dolma Khang (6,332m).
Local authorities in Gauri Shankar Conservation Area say calls were immediately made to helicopter companies as well as various ministries in Kathmandu that have to issue permits to fly to the region bordering China.
But the permits for rescue flights to Rolwaling Valley were delayed by eight hours. Rescue flights in these areas require permission from the Ministry of Tourism, the Ministry of Defence, the Home Ministry, and the Civil Aviation Authority of Nepal (CAAN).
Experts say this should be exempted in times of emergency when time is of the essence. CAAN spokesperson Pratap Babu Tiwari claimed to not know of the avalanche on Yalung Ri and deflected questions to the permission department.&nbsp;
There was a similar tragedy on Himlung Himal in Manang as well. Australian Chin-Tark Chan, 49, was climbing with 8K Expeditions and fell ill on 27 October at about 6,800m, developing snow blindness and loss of mobility. The guides immediately called the US insurance company Global Rescue for authorisation of a longline rescue.
Global Rescue refused, saying a rescue at that height would violate Nepal’s aviation rules and put the pilot at unacceptable risk. They asked the guides to transport Chan to Camp 3 at 6,400m to a permitted altitude. Seeing it was a life-or-death situation for its client, 8K called in an aerial rescue anyway, but the helicopter could not land due to bad weather. Chan died slightly below Camp 3 on 29 October.
Global Rescue said in a statement that it was ready to send in a helicopter after Chan had been transported to Camp 3, but several hours were lost for that attempt, and the weather did not get better in the next few days.
To underscore just how dangerous helicopter rescues in the Himalaya can be in bad weather, a chopper from Altitude Air skidded off the helipad at Lobuche below Mt Everest while trying to rescue trekkers in whiteout conditions.&nbsp;
CAAN announced a ban on flights during blizzards or dense fog. While rescue missions are often heroic and courageous, they should not be foolhardy if conditions are unsafe and the risk to pilots and rescuers too high. This autumn was a lesson for future expeditions and for the Nepal government.&nbsp;
The Italian duo on Panbari were caught out by snow that arrived two days ahead of schedule, but the group on Yalung Ri should have postponed their ascent after multiple warnings from the Department of Hydrology and Meteorology to avoid high altitudes.

Deadly autumn in Himalayan climbing

This is the 73rd episode of Diaspora Diaries, a Nepali Times series in collaboration with Migration Lab providing a platform to share experiences of living, working and studying abroad. I don’t remember playing with dolls as a little girl. There is not much to remember from my childhood.&nbsp; My responsibilities began at a very young age, as I had two younger brothers to take care of. I was born in Sarlahi, but we moved around quite a bit as my father was in the government and got transferred frequently.&nbsp; From Rasuwa to Dang, from Nepalgunj to Kathmandu. I struggled to adjust in Kathmandu because I joined Grade 9 in the middle of the term. The education was different and fellow students also did not support me initially. But over time, I adjusted and made friends. I did not dream of becoming a nurse. It was by accident. I wanted to pursue medicine, but failed the entrance exam by a few marks. I did not want to lose a year, so decided to take up microbiology instead.&nbsp; I got married after my undergraduate, and my husband encouraged me to take up something more technical like nursing or engineering instead of Masters in Microbiology. As my quantitative background was weak, I chose nursing. I felt like I was born to be a nurse. Juggling my married life and studies was difficult. My teachers would often ask me why I am falling behind. It was not easy, but I managed and took up a full-time job as a nurse. There are challenges being a nurse in Nepal. You are overworked, underpaid, there is lack of appreciation. Superiors can be overbearing. These problems persist. But the bright spot is that you get to serve fellow Nepalis, and be close to your family.&nbsp; Just like I had no intention initially of becoming a nurse, I had no intention of migrating overseas. But life had different plans for me. After my baby boy was born, I noticed that something was off. Even at nine months he had not started crawling or sitting. As a nurse I knew something was wrong, and I took him for check-ups. He tested negative for down syndrome, but he had a heart defect.&nbsp; The cardiologist recommended that I take him to India where he was diagnosed with Williams Syndrome, a rare genetic condition that affects 1 in 10,000 people. It delayed his development. I looked for therapy. It was either not effective, or too expensive. Some schools also refused to admit him, and it drove me to tears.&nbsp; My family members overseas in the UK, US told me to emigrate as there were better facilities for differently abled children. So I decided to apply to the UK. Luckily just then there were calls for candidates under the Nepal-UK government-to-government pilot scheme for 100 nurses. Only 40 met the criteria, and I was one of them.&nbsp; I still remember the day I received the news on the day of my puja. There were people around me, and they told me that it was the result of my fasting and devotion on that auspicious day. Perhaps it was. Life was taking a new turn, and I was happy. I made it to the UK in February 2024 without paying a single paisa to any broker. The G2G scheme was unique as we were treated with dignity and valued for our skills: they covered costs for the ticket and visa, reimbursed us for exams we had taken and costs involved in the preparation and testing of the Objective Structured Clinical Examination were also covered.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251106071148_dc5a0d0ea3024b34a4f2735754f8eb67a650bc7f61b98c75d589676c65b02a0c.jpg" data-media-id="editor_0" data-image-id="20251106071148_dc5a0d0ea3024b34a4f2735754f8eb67a650bc7f61b98c75d589676c65b02a0c" data-rendition-name="original" width="1200" height="1600" loading="lazy" alt="Nurses NT"> </figure>  It was of course difficult to leave my son behind. But I was doing it for his future. I had the option of taking him from the start, but it was a new place and I wanted to be well-settled and knowledgeable about the options available for him before bringing him along. As I packed, he would ask me to take him with me in my suitcase. It did not seem like he was affected by my departure, and it was only later that his teachers said that he would express his feelings more openly at school. He just did not know how to tell me he missed me, and he would tell teachers he was worried I had forgotten him if we did not speak for a day.&nbsp; He missed me, and that realisation made me emotional. But I had to carry on. Life in the UK was difficult in the beginning. Even so, I wanted to prove to myself that I could do it. Fortunately I had cooperative staff who patiently answered my questions. I think I would have been irritated if I were in their place. But they did not seem to mind, and their support and guidance made it easy for me to adjust to the new work environment. APPRECIATION I still struggle to understand the accent of my English patients, and have ask the matron for help. They compliment me on my English, but I can speak better than I understand. The good thing about working in the UK is that you are appreciated for your work, which can be motivating. Sometimes, after a long day’s work you get a message from your supervisor acknowledging your work with a thank you. That’s enough to erase your tiredness.&nbsp; So far I have received 32 WOW nominations which are acknowledgements from patients for a job well done. It can be motivating, especially in the beginning. The main difference between the Alpana who first left Kathmandu for the UK and the Alpana now is that I am a much more confident person. What makes a good nurse? Skills, knowledge and qualifications are of course a given. But mostly, you need humanity. A smiling face. The way you communicate. Your empathy. These attributes can already solve many problems that patients are facing. This is my second time back home in the last 20 months. And this time, I have arranged for my son’s visa. I will go back after Tihar with my son and husband.&nbsp; I am happy, but also a little nervous about what awaits us. What kind of school will I put him in? Will it really be different from schools here? Will his needs be addressed? Will it be like here, or will he be able to adjust?&nbsp; But I am determined to make it work. Success for me would be if he adjusted well and there is a change in his condition. He still cannot recognise alphabets and read words like kids in his age group. Hopefully he will get learning support in the UK. He also has a knack for music, and this is common among individuals with Williams Syndrome. His ears perk up when he hears music, and he takes part in musical events at school. He still does not recognise letters &nbsp;but he uses voice commands to search for guitar videos on YouTube. I will enrol him in music classes, and help him develop this gift. For now, I worry how he will behave on his long flight. He has a short attention span and gets restless. He is also very social and will want to speak with everyone around him, and might irritate fellow passengers.&nbsp; I have already started trying to make him understand that he will need to behave on the flight. He nods in agreement. Let’s see how it goes. &nbsp;

“I felt like I was born to be a nurse”

It was pure drama: the political transition in Madhes unfolded by the dawn’s early light. At around 4AM on Monday, Province Head Sumitra Subedi Bhandari quietly departed Janakpur saying she was headed to Kathmandu for health reasons.&nbsp;
Outgoing Chief Minister Jitendra Sonal, whose coalition had begun to unravel, even saw her off, asking supporters to clear the road for her motorcade.
But an hour later, instead of continuing on to the capital, Bhandari stopped in Bardibas on the East-West Highway. There, as the sun started rising over the misty plains, she administered the oath of office to Saroj Kumar Yadav of the CPN-UML, invoking Article 168(3) of the Constitution.&nbsp;
Bhandari is also a member of the CPN-UML. The provision she invoked is typically used only after coalitions fail under Article 168(2), and the timing and location of the swearing-in have since drawn scrutiny.
Bhandari was subsequently relieved of her duties, and former National Planning Commission member Surendra Labh Karna was sworn in as the new Madhes province head on Tuesday.
Sonal had formed his government barely a month ago, with the backing of 56 provincial lawmakers but it became evident he would not secure the 54 votes needed to survive a confidence motion.&nbsp;
Several lawmakers in his coalition publicly signalled they would abstain. Still, the seven-party alliance that opposed Yadav’s appointment argues that the Province Head, who is the highest constitutional rank in the provincial structure, acted prematurely and under pressure from central UML party command.&nbsp;
A coalition of seven parties, including the Nepali Congress (NC), had been urging the Province Head to invite them to form a new government under Article 168(2). At the same time, the UML, which had been holding demonstrations outside the Province Head’s office in Janakpur, was calling for the formation of a minority government under Article 168(3).
The alliance of the seven parties that included the NC and Maoist Centre took to the streets. By mid-morning, protests had escalated outside Madhes Bhawan with cadre vandalising both the Chief Minister’s office and the Province Head’s office.
This was the third government in Madhes to fall since the 2022 provincial elections, and it follows a similar pattern. The previous Chief Minister Satish Kumar Singh of the Janamat Party, resigned before a scheduled confidence vote after losing the support of his own party and others including NC and LSP.&nbsp;
His resignation unfolded amid nationwide GenZ protests against corruption, demanding accountability and reform. The recurring instability points to a structural tension in Nepal’s federalism.&nbsp;
Provincial politics remain closely tied to alliances shaped in Kathmandu. The withdrawal of support by parties like the NC and Maoist Centre in provinces often reflects national-level calculations rather than provincial priorities.
As a result, the Provincial Assembly is repeatedly consumed by survival of the coalition instead of governance. Development work stalls. Budget execution slows. Public frustration grows. In a province that was at the forefront of the movement for federalism to counter what is seen as neglect, apathy and discrimination by Kathmandu, the sense that the system may not delivering on its promise is becoming increasingly pronounced.
If federalism is to be strengthened, provincial governments must be able to function with a degree of autonomy that currently exists more in principle than in practice. Otherwise, the perception that federalism is costly, unstable, and ineffective will continue to expand, providing fertile ground for anti-federal sentiment that is already gaining traction.
Earlier examples such as the NC General Secretary Bishwo Prakash Sharma in January calling for a new government in Madhes led by his party demonstrates how the central party leadership deliberately intervenes in provincial affairs. His remarks came during campaigns for bi-elections in Madhes when former CM Singh had been in office for six months only.&nbsp;
Likewise, in early June 2024, the federal coalition in Kathmandu shifted from a Maoist Centre and NC to form a new alliance between the NC &nbsp;and the UML. Within a day, coalition negotiations in Madhes changed to mirror this.
UML leaders publicly stated: “The issues at the federal and provincial levels will be resolved together.” This indicated that the realignment in Madhes followed national party decisions rather than provincial deliberation.
The events that unfolded in Madhes are a reminder that federalism in Nepal is still in transition, and that its success depends on political actors honouring the constitutional framework.

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