Orange, yellow and brown. Sama Bajracharya fills the canvas with colours, her forehead creased in concentration and a smile playing at her lips. Sama is 47 and has <a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/A-for-autism,270">autism</a>, a neurological and developmental disorder that affects how people interact with others, communicate, learn, and behave. It took years for Sama’s parents to come in terms with and understand her challenges.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20240416110452_d76000000456e391ebecd6304ca0352da0df367a097a24fba40845620bd0167e.jpg" data-media-id="editor_1" data-image-id="20240416110452_d76000000456e391ebecd6304ca0352da0df367a097a24fba40845620bd0167e" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="Autism awarness with art"> <figcaption>A colourful painting by Sama Bajracharya.</figcaption> </figure>  It was not until a teacher identified her difficulties – an inability to follow lessons, recognise letters and play with other students. She often withdrew and remained isolated. Her parents took her to a doctor who diagnosed her with autism. Because not much was known about the condition at the time, her parents held onto the hope that she would be cured. For 18 years, her mother Ratna Shova Bajracharya took her to traditional healers, dya majus and ayurvedic hospitals. “I did everything that I could, I just wanted to see her live like everyone else happy,” says Ratna Shova.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20240416110456_3783e96dfaeb643383995c2bb37ef189a55c704889ea55ef769842526f132a3f.jpg" data-media-id="editor_2" data-image-id="20240416110456_3783e96dfaeb643383995c2bb37ef189a55c704889ea55ef769842526f132a3f" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="Autism awarness with art"> <figcaption>Sama with her mother Ratna Shova.</figcaption> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20240416110456_a9006224a4e882de540cfc8ad3f9bb298c2b4fb66eaa8f2b48e4b83f68630126.jpg" data-media-id="editor_3" data-image-id="20240416110456_a9006224a4e882de540cfc8ad3f9bb298c2b4fb66eaa8f2b48e4b83f68630126" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="Autism awarness with art"> <figcaption>Sama with her sister Nima walking towards a bus station.</figcaption> </figure>  Upon learning there was no cure from a specialist, Ratna had to adjust their lives to accommodate Sama’s needs. This was not easy as sometimes Sama would exhibit aggressive behaviour including self-harm, throwing objects, breaking mirrors and threatening to jump off the window. A turning point came in 2005 when Sama met Sarita Dangol during an art event for people with autism. A senior artist, Sarita started mentoring Sama in arts and crafts. Art became a form of therapy for Sama, promoting mental and physical stability. Read also: <a href="https://nepalitimes.com/multimedia/the-art-of-healing">The art of healing</a>, Sewa Bhattarai Seeing the impact arts had on her, Sarita along with Sunila Bajracharya co-founded Mikha - The Creative Begins in 2022 to help empower other individuals like Sama by providing them a platform to explore and grow through art.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20240416110456_da249677323f0b78b936809ea68be00dd17f6530c1f8028723d318c71faafb8e.jpg" data-media-id="editor_5" data-image-id="20240416110456_da249677323f0b78b936809ea68be00dd17f6530c1f8028723d318c71faafb8e" data-rendition-name="original" width="1500" height="1015" loading="lazy" alt="Autism awarness with art"> <figcaption>Sama likes knitting.</figcaption> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20240416110456_1dc69dfe3b36b094726ca5ee1fd63f5754a623d4ab8efc8d52e6b5b86a1945f9.jpg" data-media-id="editor_6" data-image-id="20240416110456_1dc69dfe3b36b094726ca5ee1fd63f5754a623d4ab8efc8d52e6b5b86a1945f9" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="Autism awarness with art"> <figcaption>Sama hugs her knitting mentor after her art classes.</figcaption> </figure>  Mikha has become a source of joy for Sama, she excitedly attends classes with her classmates Sabha and Ritu both of whom have been diagnosed with down syndrome. In 2023, Sama participated in the International Disability Dance and Art Festival in Delhi and showcased her artistic and dancing talents, instilling a sense of confidence in her.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20240416110456_8c1556b05170bbe7cbb2f2a1959e26fe3ccfb294c3a86f4fc9b84ba225ccbffb.jpg" data-media-id="editor_7" data-image-id="20240416110456_8c1556b05170bbe7cbb2f2a1959e26fe3ccfb294c3a86f4fc9b84ba225ccbffb" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="Autism awarness with art"> <figcaption>Sama with her friends Sabha and Ritu during their art class.</figcaption> </figure>  Read also: <a href="https://nepalitimes.com/here-now/the-mental-scars-of-violence">The mental scars of violence</a>, Sewa Bhattarai According to the 2021 Census, there are 4,886 individuals with autism in Nepal, out of 647,744 people surveyed. This is 0.8% of the sample population. In 2019, the Autism Care Nepal Society (ACNS estimated) that some 300,000 children were living with autism in Nepal. There has been a <a href="https://nepalitimes.com/here-now/why-are-autism-cases-rising-in-nepal">worrying increase in autism among younger Nepalis</a>, partly due to increased awareness and diagnosis of the condition. Management and support systems, however, are sorely lacking.&nbsp;

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Autism awareness with art

In 2014, when Surendra Bajracharya was conducting an autism screening camp in Doti, he came across the most unusual case he had seen till then and since. A 46-year-old man had been carried by his brother in a doko basket on his back all the way from his home in the village. The patient had spent his childhood tied up on a leash due to his impulsive behaviour, unusual mood reaction and fits. He had never learnt to move on his own. “He could not speak or walk. We first thought he had cerebral palsy,” recalls Bajracharya. “But after examining him we felt his symptoms matched those of people with autism.” Read also: <a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/A-for-autism,270">A for autism</a>, Sulaiman Daud and Cindrey Liu The patient and his brother were orphaned at a young age, and it was the brother who was his guardian and nurse all his life. There was no other support system in the family or community.&nbsp; As the office head of Autism Care Nepal Society (ACNS), Surendra Bajracharya has seen everything from a parent dying by suicide due to being overwhelmed by his autistic child to children being caged in attics and enduring social ostracisation because of their condition. But of late, there has been growing awareness in Nepal about autism. In the last decade, ACNS has seen a steady rise in the total diagnoses from just 11 in 2008 to over 300 in 2022. This does not necessarily mean an increase in incidence, but is a good indicator of greater awareness and concern about autism among parents and the public. Read also: <a href="https://archive.nepalitimes.com/news.php?id=18281">A care in time</a>, Paavan Mathema  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20230818080852_9e5862b5c4f2ce7e8e1c4936c3b119c6f3b33d1d4860105f4225922c57a61c10.jpg" data-media-id="editor_2" data-image-id="20230818080852_9e5862b5c4f2ce7e8e1c4936c3b119c6f3b33d1d4860105f4225922c57a61c10" data-rendition-name="original" width="812" height="464" loading="lazy" alt="Autism increasing"> <figcaption>Total number of cases of autism diagnosed in Nepal from 2008 - 2022.</figcaption> </figure>  However, the increase in cases of autism has also been linked to unhealthy dietary practices, especially junk food by the mother during pregnancy. <a href="https://www.nepalitimes.com/news/the-other-pandemic-mental-health">Following the Covid-19 pandemic</a>, doctors are also reporting an unusually high number of children with what they call ‘virtual autism’. Excessive screen time before two years of age, they believe, is associated with a decrease in cognitive and language development. “We have enough reason to believe that virtual screen time is the primary catalyst for this drastic rise in cases,” states Bajracharya. “They grew up confined in their homes, overexposed to screens and away from social interactions during the pandemic.” According to the World Health Organisation (WHO) estimates, 1 in every 100 children globally has autism. Nepal's 2021 Census reported 4,886 individuals with autism out of 647,744 people surveyed, which is 0.8% of the sample population. “Although recognising autism as a disability in the National Census was a first for Nepal, the actual prevalence of autism spectrum disorders is higher than reported,” adds Bajracharya. “And it is likely that increasing screen time will further worsen the problem in children.” In 2019, <a href="https://autismnepal.org/">the ACNS</a> estimated that there were some 300,000 children living with autism in Nepal. More credible data is crucial for Nepal to base its interventions and policies on autism care.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20230818120828_2c3654d64356af0197ef8753a96da89e57e8d8255a0f5cdc68eda8e9a988c12d.jpg" data-media-id="editor_5" data-image-id="20230818120828_2c3654d64356af0197ef8753a96da89e57e8d8255a0f5cdc68eda8e9a988c12d" data-rendition-name="original" width="924" height="594" loading="lazy" alt="Autism in Nepal"> </figure>  At the Centre for Autism in Kathmandu, parents are increasingly aware of the special needs of their children, but lack adequate service and support. “There is no incentive for autism caregivers in Nepal,” says Manju Shrestha, an autism specialist at the centre. When Shrestha joined the centre two years ago, there were 32 children enrolled. In two years, that number has almost tripled to 92, with many mildly autistic children progressing into mainstream schools after substantial improvement. “Most parents approach us with concern about their toddler’s delayed speech,” explains Shrestha. Among other symptoms, delayed language development, hyperactivity, restricted behaviour, repeating words and phrases over and over, or playing with the same toys the same way every time are the most common signs that parents have started correctly identifying on their own. But despite such strides in public awareness due to the Internet and social media, the government has been slow to act. The Disability Act 2074 has classified <a href="https://archive.nepalitimes.com/news.php?id=18502">disability</a> into four categories on the basis of severity: namely profound (A), severe (B), moderate (C) and mild (D). Individuals in each group get assigned a different coloured identity card with which they can access different levels of care and privileges. But with autism, children often do not get assigned the correct card. “Although an autistic child may need the same level of care as someone with leprosy, they are only assigned category B, while those with physical disabilities are assigned group A,” explains Shrestha. Such misplaced categorisation means the child’s family receives a lower allowance which falls short of helping them afford necessary therapy.&nbsp; “The problem lies in the difference between autism and other physical disabilities,” argues Shrestha. “To most people children with autism may look completely normal. They may even utter a few words, occasionally respond, and seem just like any other child. But the psychological and emotional care they need is significantly different.” Autism Care Nepal Society and <a href="https://centreforautism.com.np/">Centre for Autism</a> are two of only a handful of special needs schools that understand this difference. They employ autism-friendly teaching and learning methods tailored to the needs of each individual child, helping them progress at their own pace.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20230818080856_22f33d80714b875edde5a4092593e2bb4efefe50b1165c84260c926763a72341.jpg" data-media-id="editor_8" data-image-id="20230818080856_22f33d80714b875edde5a4092593e2bb4efefe50b1165c84260c926763a72341" data-rendition-name="original" width="1536" height="1024" loading="lazy" alt="Autism care"> <figcaption>Surendra Bajracharya lecturing volunteers in an autism awareness workshop.</figcaption> </figure>  On a national level, the availability of such institutions, therapists and specialists is inadequate. To bridge this gap between the rising cases and insufficient specialists, ACNS has been running a diploma in special education in autism spectrum disorder. ACNS also conducts several awareness and training projects across Nepal, including a parent-child training project that has seen widespread success in 44 districts across all seven provinces. Plans are underway to set up a new National Centre for Autism in Lalitpur to provide education, training and other services to individuals and families affected by autism. ACNS hopes to work with the Ministry of Education, Ministry of Health and Ministry of Women, Children and Social Welfare to diversify and decentralise autism care. While much of the ignorance and taboos associated with autism are dissipating with increased knowledge and awareness, the condition remains a public health concern in Nepal. The cases are going up and those afflicted are increasingly younger.&nbsp; Experts say the government has to abandon its one-size-fits-all approach in dealing with autism spectrum disorders. For a health issue as wide-ranging and variable as this, care must also be provided to meet diverse needs. Says Manju Shrestha: “Recognising the abilities, talents and sparks within each child with autism demands drastic shifts in our present state of healthcare and education. This change is long overdue.” As for Surendra Bajracharya, the middle aged man he met in Doti nine years ago is still etched in his mind, and it inspires him to do more. He says, “The innocence in his eyes … it is tragic that people have to suffer so much from an affliction when care can be made available.”&nbsp;

Why are autism cases rising in Nepal?

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109101120/636b70d49c7e80680e06009bjpeg.jpg" alt="" width="1500" height="803"/><figcaption>Photo : UNICEF</figcaption></figure>Last month, the prestigious <a href="https://www.nejm.org/" target="_blank" rel="noopener">New England Journal of Medicine</a> published a study of the <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa1905047" target="_blank" rel="noopener">successful trial of a new typhoid vaccine</a> that could prevent thedeaths of many children around the world. The vaccine research was conducted at Patan Hospital by a Nepali researcher.The randomised control trial of the typhoid conjugate vaccine (TCV) was conducted among more than 20,000 participants in Lalitpur district, and the efficacy of the new vaccine was found to be 81.6% -- a major improvement on previous vaccines. (See box below).The positive news from Nepal came as various parts of the world, including the US, Europe, Samoa and Africa, struggled to cope with the biggest measles outbreak in decades. Most of the cases have now been associated with people forgoing recommended preventive shots because of fears of side-effects fanned by social media.Fear of vaccination started ever since a paper in 1998 in the medical journal <a href="https://www.thelancet.com/" target="_blank" rel="noopener">The Lancet</a> cited a link between autism and the <a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/maurice-hilleman-the-vaccine-man,1852" target="_blank" rel="noopener">measles, mumps, rubella (MMR) vaccine</a>. The research was later found to be fraudulent and retracted, but the anti-vaccine movement gained traction again in the past year after the rumours resurfaced on the Internet resulting in families rejecting early childhood immunisation against diseases like polio, rubella and measles.“The good news is that unlike in the rest of the world, people in Nepal demand vaccines. If we miss to vaccinate a child for any reason, parents come knocking, asking for the shots,” says Jhalak Gautam of the Family Welfare Division at Teku.Sameer Mani Dixit of The Centre for Molecular Dynamics Nepal concurs. “Entire communities actively participate in vaccination programs and are well aware of the benefits. Every mother in Nepal knows the immunisation schedule by heart.”The Centre for Molecular Dynamics Nepal has just completed a study on why the country has been so successful with its immunisation program, and the results will be published later this month. This study and similar studies underway in Senegal and Zambia are being conducted with  funding from the Bill and Melinda Gates Foundation, in an effort to analyse the success of vaccination programs in developing nations.Nepal’s national immunisation program started in 1988 and now vaccinates some 620,000 children under 15 months of age every year against 11 infectious diseases such as <a href="https://www.nepalitimes.com/banner/tb/">tuberculosis</a>, <a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/Bouncing-back-higher-wheelchair-basketball,3802" target="_blank" rel="noopener">polio</a>, pneumonia and measles.The last case of <a href="https://www.nepalitimes.com/banner/polio-hunt/" target="_blank" rel="noopener">polio</a> was detected in Rautahat district in 2010, and Nepal was declared polio free four years later. The country also eliminated maternal and neonatal tetanus in 2005. Similarly, Japanese encephalitis, diphtheria, pertussis and pneumonia have all been controlled, and there are regular vaccinations against congenital rubella syndrome and hepatitis B.Despite the high immunisation rate, thousands of Nepali children continue to die due to easily preventable and treatable communicable diseases <a href="https://archive.nepalitimes.com/news.php?id=16988#.XiBL7_4zaUk" target="_blank" rel="noopener">like diarrhoea</a> and according to Nepal Demographic Health Survey 2016, one in a hundred Nepali children have still not been vaccinated against any infectious diseases.Read also: <a href="https://www.nepalitimes.com/here-now/nepal-is-a-microcosm-of-all-of-the-changes-in-world-health/" target="_blank" rel="noopener">"Nepal is a microcosm of all the change in world health"</a>Immunisation coverage data from last year also shows a worryingly high dropout rate. While 93% of newborns received BCG jabs, the first in the national immunisation schedule, the coverage dropped to 73% by the time children received the last vaccine, an immunisation against measles and rubella, recommended at the age of 15 months.Several cases of <a href="http://archive.nepalitimes.com/news.php?id=186#.XiBGW_4zaUk" target="_blank" rel="noopener">measles</a> have been detected in Kapilvastu, Dang, Makwanpur, Sarlahi and Manang districts recently, and Nepal has not been able to meet its previously set target to eliminate measles and rubella by 2019. The new goal is to eliminate the diseases by 2023.“Dropout rate is a challenge, we have not been able to reach the remotest corners of the country, and children miss their shots because of migration,” says Jhalak Gautam. “We now have a strategy to identify missed pockets and deliver shots at home if required.”The Immunisation Section of the Ministry of Health is now gearing up for a nation-wide measles-rubella vaccination campaign aimed at those who might have missed routine shots. Three million children between the ages 9 months to 5 years are expected to participate in two phases of the campaign later this year.Polio drops will also be administered at the same time to 1.5 million children under five in 19 Tarai districts. The Immunisation Section is also introducing a new vaccine against rotavirus this June to reduce the prevalence of childhood diarrhoea.The new challenge to vaccination comes from an unlikely quarter: federalism. There is confusion about where the vaccines are sourced and who should pay for them. There is concern about the quality of vaccines, many of which need a cold chain with refrigeration to the point of delivery.Warns Patan Hospital physician Buddha Basnyat: “Nepal’s immunisation program is a model of success, but we cannot afford to be complacent.We have to introduce newer and more effective vaccines while also prioritising hygiene and <a href="https://www.nepalitimes.com/banner/toilet-trained/" target="_blank" rel="noopener">sanitation</a> simultaneously.”<h2>Successful trial of new typhoid vaccine</h2><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109101120/636b70d79c7e80680e06009cjpeg.jpg" alt="" width="1500" height="1000">Over 20,000 children between 9 months and 16 years of age in Lalitpur district participated in the <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa1905047" target="_blank" rel="noopener">first large-scale randomised controlled trial</a> of a new vaccine against <a href="http://archive.nepalitimes.com/news.php?id=17306#.XiBGav4zaUk" target="_blank" rel="noopener">typhoid</a>, a disease that affects millions across South Asia.Half of them received the vaccine and the other half received control shots. The efficacy of Typhoid Conjugate Vaccine (TCV) was found to be 81.6%, and the results were published last month in the prestigious New England Journal of Medicine.Prior to this, a small-scale TCV trial was conducted in Britain, and the World Health Organisation (WHO) has since strongly recommend the use of the vaccine for countries and regions where the water and food-borne infection is most common. "Pakistan has been able to control typhoid with this vaccine and <a href="https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(19)30320-1/fulltext" target="_blank" rel="noopener">Vietnam</a> has eliminated it," says lead author of the paper, Mila Shakya, "Administration of this new, effective vaccine by our government will help control the most common bacterial disease in Nepal and South Asia."<a href="http://archive.nepalitimes.com/news.php?id=12158#.XiBGbP4zaUk" target="_blank" rel="noopener">Typhoid</a> is a contagious infection caused by the bacteria Salmonella typhi, which is found in contaminated food and water and which causes fever, diarrhoea and vomiting. It can easily be prevented with awareness, safe drinking water and frequent hand-washing.The vaccine is useful because it is a prophylactic in places where preventive measures are taking time to implement. There are some 21 million typhoid cases and 161,000 typhoid-related deaths annually worldwide. South Asia has been often dubbed as the hub of typhoid and there are some 500 cases per 100,000 population in the region.“This study is Nepal taking a lead in preventing typhoid, after never having really prioritised it. It might not kill as many people as other diseases do, but it still affects thousands of school-going children,” says physician Buddha Basnyat at Patan Hospital.TCV is <a href="http://archive.nepalitimes.com/news.php?id=18178#.XiBGdP4zaUk" target="_blank" rel="noopener">not the first typhoid vaccine to be developed</a>. Currently there is an injectable unconjugated polysaccharide vaccine for persons aged two years and above, and an oral capsule for those over six years of age. But they do not work well on young children and they provide protection only for a few years. TCV on the other hand can be given to children below 2 years and the immunisation lasts up to five years.“A single dose of the new vaccine is safe, immunogenic, and effective, and the deployment of the vaccine will reduce the burden of <a href="https://www.nepalitimes.com/opinion/so-far-so-good/infectious-enthusiasm-for-travel/" target="_blank" rel="noopener">typhoid</a> in high-risk populations,” stated the interim analysis. “This new evidence of efficacy is especially timely with the recent spread of extensively drug resistant typhoid fever, which threatens child health in affected regions.”Pakistan, which has been struggling against an outbreak of drug resistant typhoid fever since 2016 is already using TCV with positive results and its Sindh province will become the first region in the world to include TCV in routine childhood immunisations.<a href="https://www.gavi.org/" target="_blank" rel="noopener">Gavi, the Vaccine Alliance</a>, which has earmarked $85 million to fund the introduction of the vaccine in the world’s poorest countries, is supporting the program. Nepal is also eligible for funding from the alliance.Says Basnyat: “We should take action before we are also hit, like Pakistan, by the drug-resistant typhoid. What are we waiting for, when Gavi is ready to fund the vaccination program for free and its benefits are so clear. This is a case of vaccine under-utilisation.”Sonia Awale

Sonia Awale

A shot in the arm for vaccines in Nepal

Nepal has shut down dozens of social media platforms in a move that is widely seen as an effort to tax the revenue they generate in the country, and to control content critical of government. The sites were blocked as of midnight on Thursday, 4 September and affects all Meta products including WhatsApp and Messenger, Threads, and others. Although YouTube, Google and X are also on the government’s list, they were still working as of Friday midday.&nbsp; The government says it took the action after repeated warnings to the platforms to open offices in Nepal, a Cabinet decision last month setting a deadline, as well as a 17 August Supreme Court ruling also requiring them to register and pay requisite taxes. However, the Bill cited in the ban, ‘The Operation, Use, and Regulation of Social Media in Nepal’ has not yet been passed by Parliament. Some social media platforms which were already paying taxes in Nepal even though they are not officially registered, have also been blocked. The move is the latest in <a href="https://nepalitimes.com/news/big-beautiful-bills" target="_blank">a slew of draft legislations</a> designed to undermine Nepal’s open society. A Bill amending the Print and Publications Act would allow district bureaucrats to shut down media. Another draft Bill would allow political appointees to head a new Media Council with the power to revoke the licenses of journalists.&nbsp; A counter-intelligence Bill would let just about anyone in government to arbitrarily tap phones, read emails and trail citizens. On Wednesday the government announced new immigration requirements that would allow it to track the movement of all foreigners in the country. Yet another draft Bill has been set to Parliament to dissolve the <a href="https://archive.nepalitimes.com/news.php?id=10675" target="_blank">Social Welfare Council (SWC)</a> and move registration and monitoring of non-governmental organisations, nonprofits and charities to the Ministry of Social Welfare. Seen in this light, the blockage of social media platforms this week is seen as the latest government attempt to constrict freedom of press. Nepal is one of the few remaining open societies in Asia, and now appears to be drifting towards authoritarianism. The government’s sudden shutdown of social media has been greeted with howls of protest on platforms that still remain open, like Viber and TikTok, as well as in Nepal’s mainstream press. Even senior members of the ruling UML-NC coalition have sharply criticised the move, asking if the government is trying to “turn Nepal into North Korea”.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025090508098_a2ab330e403e8418a7006cd5e915607382628dd6984524332bf7b99c74743656.jpg" data-media-id="editor_2" data-image-id="2025090508098_a2ab330e403e8418a7006cd5e915607382628dd6984524332bf7b99c74743656" data-rendition-name="original" width="4280" height="5187" loading="lazy" alt="social media ban in Nepal"> </figure>  The Regional Director of the New York-based Committee to Protect Journalists (CPJ) Beh Lih Yi said in a statement: ‘Nepal’s sweeping ban on social media sets a dangerous precedent for press freedom. Blocking online news platforms vital to journalists will undermine reporting and the public’s right to information. The government must immediately rescind this order and restore access to social media platforms, which are essential tools for exercising press freedom.’ Besides undermining press freedom, blocking social media platforms will also hurt commerce and the economy since so many small and medium business trade through Instagram, Facebook and other platforms. Nepal’s vibrant social media has also been a boost or citizens to assert identity, build solidarity against injustice and play an adversarial role when the mainstream media does not do it. Social media platforms have also become the tenuous link for Nepali families scattered across the world to keep in touch with each other — its importance growing with the increasing size of the diaspora. The government wants social media platforms to register, pay taxes and remove posts on their sites that ‘undermine the national interest and Nepal’s territorial integrity, disturb social and religious harmony’.&nbsp; In response, rights activists have said while there is need for the government to regulate extreme content and hate speech, officials appear to be more intent on clamping down on free speech and trying to force platforms to share the revenue. On Friday, the government had allowed WhatsApp back online, but there were reports that it had instructed the Nepal Telecommunication Authority (NTA) to instruct mobile and internet service providers to block by Friday night all platforms, including Facebook, Instagram, Messenger, WhatsApp, X (Twitter), YouTube, LinkedIn, Reddit, Threads, Snapchat, Pinterest, Signal, Clubhouse, Rumble.&nbsp; Platforms that have registered and are allowed include TikTok, Viber, Nimbuzz, Popo Live, WeTalk, Global Diary and the Nepali portal Hamro Patro. TikTok was banned last year for ‘disturbing social harmony’ and it was lifted after the platform registered its office in Nepal. But even while it was banned, many users simply switched to VPN. Telegram was also banned for ‘financial crimes’ and it has since also been allowed back. NTA officials confirmed that some Asia-Pacific regional offices of platforms, including Meta had been in touch overnight inquiring about the registration process.&nbsp; Nepal is not alone in regulating social media. China bans most Western platforms, Russia and Turkey regulate their and require platforms to locate their data servers in the country. Gulf countries allow social media but keep a tight control on dissent.&nbsp; Experts have said even the government will not dare close down YouTube since so many Nepali individuals and companies make money with posts on that platform, and closing it would also impact on Google and Gmail. Facebook had also just launched a monetisation scheme for videos and reels, and Nepalis uploading content would lose revenue.&nbsp; Blocking the platforms has already hit content creators, influencers and cut small businesses from reaching customers. A survey of social media use in Nepal by Sharecast Initiative showed that 94% of those with smart phones used YouTube, followed by Facebook (92%) while TikTok was in the 50-60% range. X and Instagram were in the single digits. A YouTube ban will also hurt the mainstream media since up to 20% of the revenue of Nepal’s main tv channels came through YouTube. Some 11.1 million Nepalis watch YouTube content every day, the survey showed. ‘For global giants like Meta or Google, Nepal is a small market, and they may not even flinch — but for millions of Nepalis, these platforms are central to daily life, livelihoods, and connections across the world,’ wrote AI consultant Naresh Newar in a LinkedIn post. Some experts said the government’s sweeping ban on social media networks was untenable and the government would be forced to rollback sooner or later. Said editor Shiva Gaunle: “The platforms had given citizens a voice and broken the monopoly of the government, legislators, the courts and journalists over public opinion. This is an effort to reassert that monopoly, but Nepal can never be turned into a North Korea.”

Protest grows against Nepal’s social media ban

Unlike many countries, there is not much incentive in Nepal for the private sector to fund charities and non-profits. Donations and grants are not tax-deductible.
Yet there are corporate entities that have Corporate Social Responsibility (CSR) in their portfolio of activities through foundations that they have set up. Some do it loudly to gain public relations mileage, while others are quiet about their <a href="https://nepalitimes.com/opinion/comment/norway-supports-himalayan-climate-research?mdrv=www.nepalitimes.com&amp;=1">generous support</a>.
The CSR outlay of factories and manufacturing companies is regulated by Industrial Enterprise Act (IEA), while the Nepal Rastra Bank oversees grants banks and financial institutions contribute and requires them to set aside 1% of their net profit for CSR activities.
The guideline requires banks and financial institutions to donate to activities covering education, health, environment and financial literacy, among others. Recently, the Supreme Court directed the government to formulate a Bill in the parliament to standardise and regulate the private sector’s CSR activities.
“We receive guidelines from Nepal Rastra Bank and follow them,” says Pranisha Shrestha who heads the CSR Department at NMB Bank. “We have got a notice about updates on those guidelines, and we will adapt accordingly.”
<a href="https://nepalitimes.com/news/greening-nepal-s-tourism">Environmental sustainability </a>is one of the important components of CSR for Nepali companies, and there have been many initiatives aimed at urban renewal. One of the most visible is of the telecommunication company Ncell, which is among Nepal’s largest taxpayers.
Five years ago, Ncell adopted a 6km stretch of the Ring Road from Ekantakuna to Koteswor-Kalanki, planting 12,000 saplings. They have now grown into<a href="https://nepalitimes.com/opinion/seeing-the-forest-and-trees-in-nepal"> a thick forest</a> along the embankment of the road.
Not only is the lush greenery in an overbuilt part of Lalitpur soothing to the eye, it also helps in reducing temperature within <a href="https://nepalitimes.com/news/in-the-heat-of-the-moment-5xcycyot">the urban heat bubble</a>, and also contributes to reducing air pollution and traffic noise.
“We started a pilot project along 600m of the Ekantakuna section of the Ring Road during the pandemic,” recalls Bishakha Lakshmi Khadka, Director of Corporate Communications and Sustainability at Ncell. “It went really well, and after that we extended the<a href="https://nepalitimes.com/here-now/saving-cities-with-trees"> tree planting</a> and upkeep to Kalanki.”
Sustainability also means making younger Nepalis aware of <a href="https://nepalitimes.com/banner/natures-fragile-gift-to-nepal">the value of nature </a>and environmental sustainability, which is why Ncell has also undertaken a Green School initiative in and around Kathmandu Valley. Besides its One-Tree-One-Youth and 1 Million Trees campaigns, the initiative also aims at behavior change about littering with its waste hackathon in schools.
“The young students can be catalysts with a multiplier effect beyond their schools to society at large, and it has inter-generational impact into the future,” explains Khadka.
Indeed, while <a href="https://nepalitimes.com/banner/tree-mendous">Nepal has doubled its forest cover </a>in the past 30 years to 46% of the country’s area, urban centres like Kathmandu do not have much open spaces and greenery left. And that is where companies like Ncell, Jawalakhel Group of Industries, and others have focused on CSRs.
NMB Bank also runs financial literacy programs for youth where they can learn more about social media safeguards, digital payment systems, with a focus on safety and security. Such training not only helps build skills for the future but also protects young Nepalis from online crime.
“<a href="https://nepalitimes.com/opinion/protecting-children-from-anti-social-media">Threats to young minds through social media</a> use are growing as platforms feed algorithm-driven content,” says Shrestha. “We felt media and digital literacy are important in all seven provinces not just to protect young people, but also give them the confidence to use digital financial systems.”
The bank has a special focus on women in leadership programs, and provides scholarships provided in schools across Nepal on environment and sustainability in higher education. Health is another sector where private companies have worked with donating medical equipment, sponsoring health camps and conducting blood donation drives.
CSR or PR?
Other companies heavily involved in CSR include NIMB Bank which contributes to heritage conservation and education, Buddha Air helps farmers in Morang to increase productivity, VOITH with its motto ‘Little things We Do’ provides scholarships to students and has gifted &nbsp;vehicles to hospitals and nature conservation groups, Dwarika’s Hotel promotes organic farming and zero waste initiatives, heritage conservation and helps revive traditional handicrafts.
Although some CSR activities have been criticised for masquerading as PR and for greenwashing, many Nepali companies are actually contributing to improve the situation for individuals in need and underserved communities.
It also brings a sense of accountability to the corporate sector so they look beyond shareholder profit with greater involvement in the public good. In Nepal, where government delivery mechanisms are not up to speed in the social sector and environmental sustainability, CSR is a vehicle for public-private partnerships.
Collaboration with the government is an important aspect of these initiatives since that allows localised campaigns to be scaled up by showing what is possible. For example, the three Metropolitan Cities of the Valley and other private companies are trying to emulate what Ncell has achieved on the Ring Road.
“The Ring Road plantation project has been massively successful,” says Khadka “We were recognised by the Lalitpur Metropolitan City and the Forestry Department for adding greenery to what would have been just an asphalt strip.”

Corporates responsible to society

<a href="https://www.youtube.com/watch?v=x2fZXyjsE28" target="_blank">Yog Narendra Malla</a> became king at age 18, and ruled Patan from 1684-1705 — his reign marked by a cultural and architectural renaissance of the city state. He put up a statue of himself in the palace square with a little bronze bird sitting on the guardian serpent above his head. It is said he told his subjects that he would look after their welfare till the day the bird flew off. During<a href="https://nepalitimes.com/here-now/lessons-not-learned-from-2015-o2etq6zu"> the 2015 earthquake</a>, the pedestal collapsed and the statue was damaged. The bird was lost, only to be located in a pile of debris and reinstated when the <a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/piece-by-piece-patan-darbar-square-reconstruction,3782" target="_blank">statue was consecrated</a> two years later. <div class="embed-block"><iframe width="560" height="315" src="https://www.youtube.com/embed/x2fZXyjsE28?si=jYfIb4p6zCLXYQ1T" title="YouTube video player" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share" referrerpolicy="strict-origin-when-cross-origin" allowfullscreen></iframe></div> History remembers Yog Narendra Malla as a wise king, but like most<a href="https://nepalitimes.com/here-now/preserving-king-birendra-s-family-home"> royalty of the day</a>, he had a weakness for women. He is supposed to have consorted with 30 queens and numerous concubines. At least 33 of them self-immolated themselves on the king's funeral pyre when he died, adhering to the prevailing <a href="https://archive.nepalitimes.com/article/review/Jhola,947">practice of sati</a>. When Yog Narendra Malla’s favourite queen found out that he was carrying on with yet another woman, she got the local community of the Kwelachhi neighbourhood to stage a shadow sex play to quite literally expose his unfaithfulness. Actors enacted the explicit exploits of the king and his mistress, a bright butter lamp projecting the moving shadows of their lovemaking on a thin white drape to entertain those gathered in the square below. The queen made sure that the show was designed to face the home of the king’s paramour to shame them both. She also paid for a group to chant a bhajan with lyrics that ridiculed the king’s extramarital affair. The Jhyalcha Guthi community trust that the queen set up three-and-half century ago is still active to this day, and performs the annual shadow play in the same building in Kwelachhi the day before <a href="https://nepalitimes.com/banner/the-legend-behind-the-myth-of-indra-jatra">Indra Jatra </a>every year. This year’s show is on Friday evening, 5 September. The opening lines of the chants that accompany the play are the same words approved by the queen all those years ago: “Raja Yog Narendra ya aparadh…” (King Yog Narendra’s crime…) The community leader of the Kwelachhi neighbourhood, 62-year-old Baburaja Awale, explains the importance of the event: “This Jhyalcha is our<a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/saving-the-intangible,3303"> intangible heritage</a> and oral history. We do not have a written format, it has been passed down from generation to generation. Every word of the bhajan is the story of King Yog Narendra Malla.”  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250904070952_249e85b32cbd99bb8515151557e0ec1a65d44a34ef1aacabaaeb469622d12664.jpg" data-media-id="editor_8" data-image-id="20250904070952_249e85b32cbd99bb8515151557e0ec1a65d44a34ef1aacabaaeb469622d12664" data-rendition-name="original" width="1750" height="1167" loading="lazy" alt="Sex and the city of Patan"> <figcaption>The statue of Yog Narendra Malla being reinstated after it toppled in the 2015 earthquake. Photo: GOPEN RAI/ NEPALI TIMES ARCHIVE</figcaption> </figure>  Jhyalcha Pyankha, as the ceremony is called, starts with a puja for the Bhimsen — the god of wealth and prosperity, a popular <a href="https://nepalitimes.com/here-now/the-homecoming-of-nepal-s-gods">deity in Patan</a> who has a temple dedicated just to him in the palace square. This is immediately followed by a bhajan of Bhairab performed with <a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/Buzz-house,670">traditional Newa musical instruments</a>. Community members serve snacks consisting of samay baji beaten rice, water buffalo chunks, soybean, green veggies, lentils, ginger, garlic and aila liquor. “In the first act of the shadow play, the man initiates the lovemaking, and in the third it is the woman,” says Laxmi Lal Awale, also a member of the trust that organises the show. The shadow action is all uncensored, but interspersed with <a href="https://nepalitimes.com/review/between-the-sacred-and-everyday">scenes of everyday life</a>: the woman is spinning a thread, the king is going about his royal chores, and the two sit down to share sanacha fermented pickle that is popular this time of year. <div class="embed-block"><iframe width="560" height="315" src="https://www.youtube.com/embed/qZ3twuG1wNQ?si=yRfkoC3A-X9cIl8r" title="YouTube video player" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share" referrerpolicy="strict-origin-when-cross-origin" allowfullscreen></iframe></div> “Back then, there was no tv, films or YouTube, and yet we managed to stage the shadow play using our own resourcefulness,” says Baburaja Awale. “It is important to continue the tradition.” The challenge now is to ensure that the<a href="https://nepalitimes.com/opinion/the-reign-of-the-god-of-rain"> younger generation takes over</a>, learning the lyrics of the ancient bhajan. The dafa khala group that performs all over Patan during festivals and religious events is now training teenagers to play the musical instruments and act in the shadow play. The Jhyalcha was staged even after the 2015 earthquake when the falcha where the bhajan is performed collapsed and they made-do in a tin shed. The structure was later rebuilt with a grant from the group, Photo Circle. Lalitpur Metropolitan City sets aside a budget of Rs50,000 to organise the Jhyalcha Pyankha every year, but this is not enough and is supplemented by individual donations. The performers including musicians and actors are all volunteers, and take part in it because it is their community duty. The erotic shadow play was way ahead of its time, not just in its graphic content but the use of contemporary local technology as well as improvisation and pure imagination. Says Laxmi Lal: “Whatever its origin in the legend of King Yog Narendra Malla and his queen, Jhyalcha also served as a medium of <a href="https://nepalitimes.com/here-now/lets-talk-about-it">sex education</a>. In the past, women were discouraged from watching the shadow play, but today everyone is welcome, we all watch it together.” Jhyalcha Pyankha Kwelachhi, Chyasal, Patan 7PM onwards Friday, 5 September

Sex and the city of Patan

The world’s largest corporations now rival most governments – not only in terms of revenue and assets, but also in their ability to shape political outcomes. Their power is reinforced by the immense personal fortunes of billionaires, which enable them to wield disproportionate influence over <a href="https://nepalitimes.com/news/big-beautiful-bills">public policies, laws, and regulations</a>.
Crucially, extreme concentrations of wealth and power could not have developed without the active support of policymakers, whether tacit or explicit. Consequently, being an oligarch is inherently precarious.
Crony capitalism may grant enormous advantages, but it also carries built-in risks. Chief among them is <a href="https://nepalitimes.com/editorial/slapping-democracy">political change</a>: new leadership, whether elected or imposed, may not extend the same protections or privileges to elites favored by the previous government.
That danger is especially acute in authoritarian or personality-driven regimes, where leaders’ whims often override institutional checks. The <a href="https://edition.cnn.com/business/timeline-elon-musk-trump-x-dg">on-again, off-again bromance</a> between US President Donald Trump and Elon Musk is an obvious example.
As <a href="https://nepalitimes.com/news/the-geopolitics-of-nepal-s-politics">geopolitical tensions</a> escalate, however, oligarchs are no longer contending solely with domestic challenges. Increasingly caught in global power struggles, they have become convenient targets for hostile foreign powers seeking to pressure or undermine the leaders they support.
The <a href="https://www.aljazeera.com/news/2023/4/12/us-and-uk-announce-new-sanctions-targeting-russian-ultra-wealthy">sanctions</a> imposed by the United States and the European Union on oligarchs linked to Russian President Vladimir Putin following the 2022 invasion of Ukraine are a case in point. While these measures have done little to change the course of the war, they have profoundly disrupted the lives and businesses of those affected.
Indian billionaires Gautam Adani and Mukesh Ambani have also found themselves in America’s crosshairs. Both have profited enormously from their ties to Prime Minister Narendra Modi – a fellow Gujarati – with their fortunes growing in tandem with his political ascent. This has made them useful bargaining chips in the ongoing trade negotiations between the US and India.
Read also: <a href="https://nepalitimes.com/news/nepal-and-the-us-india-tariff-tiff">Nepal and the US-India tariff tiff</a>, Sudiksha Tuladhar
To be sure, Ambani’s Reliance Group had already mastered the art of leveraging political influence to advance its business interests well before Modi rose to power. But Ambani’s alliance with Modi has pushed Reliance’s dominance to new heights. Adani’s rise, by contrast, is <a href="https://thewire.in/political-economy/why-gautam-adani-is-a-factor-in-india-us-ties">inextricably tied to Modi</a>, dating back to the latter’s tenure as chief minister of Gujarat.
Both oligarchs, particularly Adani, have relied on their proximity to Modi to expand their business empires, benefiting from regulatory reforms tailored to their interests and <a href="https://www.cnbctv18.com/aviation/adani-winning-bids-for-six-airports-former-head-of-privatisation-panel-explains-key-policy-changes-15898141.htm">acquiring state assets</a> through lucrative privatization deals, often without a public tender. They have also moved into new sectors by <a href="https://www.freepressjournal.in/business/full-timeline-of-how-gvk-and-adanis-changing-fortunes-sealed-mumbai-airports-fate">purchasing successful firms</a> targeted by Modi’s administration, effectively neutralizing potential competitors.
Moreover, Ambani and Adani have enjoyed privileged access to publicly owned banks, receiving favourable loan terms that allowed them to <a href="https://www.thehindu.com/news/national/companies-bought-over-by-the-adani-group-got-haircut-of-96-to-42-on-loans-from-public-sector-banks-congress/article68606029.ece">restructure</a> their debts with minimal scrutiny. Their political connections, evidenced by frequent appearances alongside Modi during his international trips, have helped them secure <a href="https://www.newsclick.in/%E2%80%98Beneficiaries%E2%80%99-Modi%E2%80%99s-Globetrotting-Adani-Ambani">major contracts abroad</a>.
These political alliances have translated into lenient regulatory treatment. In Adani’s case, allegations that he has engaged in stock manipulation through opaque shell companies in offshore tax havens – exposed by US-based <a href="https://www.reuters.com/world/india/adani-vs-hindenburg-research-what-you-need-know-2024-01-03/">short-seller Hindenburg Research</a> – were met with a muted response. Regulatory bodies like the Securities and Exchange Board of India declined to pursue a serious investigation.
Officially, Ambani has come under scrutiny for profiting from the <a href="https://www.nytimes.com/2025/08/09/business/india-russian-oil-ambani.html">resale of Russian oil</a>, effectively circumventing US sanctions, while Adani is being investigated for <a href="https://www.bbc.com/news/articles/c748y8e4093o">alleged bribery</a>. But Trump’s actions appear to be a calculated attempt to pressure Modi through his inner circle. Adding insult to injury, they come from a US president whom Modi has long described as a “<a href="https://www.nytimes.com/2025/07/31/world/asia/modi-trump-india-tariffs.html">true friend</a>”.
Modi has claimed that his sole concern is protecting Indian farmers – a statement that would surely come as a surprise to the farmer protest movement, which his government has long vilified and suppressed.
Trump, for his part, insists that his priority is securing a better deal for American producers and workers. In reality, many of his key demands are aimed at advancing the interests of US-based multinationals and those of <a href="https://economictimes.indiatimes.com/industry/services/property-/-cstruction/trump-calls-indias-economy-dead-but-trump-towers-earn-thousands-of-crores-from-gurgaon-mumbai-pune-and-other-cities/articleshow/123164276.cms">his own companies</a>.
But given Trump’s track record, it’s hard to imagine that personal grievances did not play a role. Relations between the two leaders have noticeably cooled since Modi <a href="https://economictimes.indiatimes.com/news/defence/narendra-modi-trump-phone-call-pm-modi-makes-it-clear-to-trump-us-played-no-role-in-india-pakistan-ceasefire-no-talks-on-india-us-trade-deal/articleshow/121922239.cms">refused to endorse</a> Trump’s dubious claim that he helped broker the recent India-Pakistan cease-fire – a narrative Trump had hoped would strengthen his bid for a Nobel Peace Prize. Modi’s refusal to play along effectively derailed that effort.
Trump and Modi are both shrewd and self-interested enough to recognise each other’s true priorities. By attacking Modi’s tycoons, Trump may have found the most effective pressure point to extract significant concessions from the Indian government.
If Modi yields, it won’t just be a costly political blunder but also a tragedy with far-reaching consequences for India and the world economy. © Project Syndicate
Jayati Ghosh, Professor of Economics at the University of Massachusetts Amherst, is a member of the Club of Rome’s Transformational Economics Commission.&nbsp;