Last month, Finance Minister Bishnu Paudel and Pokhara Mayor Dhanraj Acharya were burned when hydrogen-filled balloons exploded at the launch of <a href="https://nepalitimes.com/news/pokhara-s-tourism-woes">Pokhara Visit Year 2025</a>. Both were flown to Kathmandu for treatment. In 2023, Nepali Congress Member of Parliament (MP) Chandra Bhandari was severely burned in a kitchen fire. He was taken to India for treatment. His Rs5.6 million medevac and treatment bill was paid by the government. It took the<a href="https://archive.nepalitimes.com/article/nation/burning-in-the-aftermath,3757"> burn injuries </a>of <a href="https://nepalitimes.com/here-now/what-nepal-s-vip-prisoners-do-in-jail">high-profile figures </a>in Nepal to finally spark action on an issue that affects mainly the country’s poorest. “We call this the burns paradox,” says Kiran Nakarmi at the Nepal Cleft and Burn Centre at Kirtipur Hospital, where the Pokhara patients received care. “Treatment is costly and <a href="https://archive.nepalitimes.com/news.php?id=19400">most victims are poor</a>."&nbsp; About 60,000 people suffer <a href="https://nepalitimes.com/here-now/removing-scars?fbclid=IwAR2MiX-ZhGNSsqUwgDYfvLWE3a7ZeLaHncz66MMKLQGtSSraTjr9cF5mIWo">burn injuries</a> in Nepal each year and 2,200 of them die. The demand for care in Kirtipur is growing.&nbsp; In 2014, it treated 90 <a href="https://archive.nepalitimes.com/article/nation/A-burning-desire-to-help,881">burn patients</a> and this more than doubled to 194 in 2015, reached 373 in 2016, and peaked at 790 in 2023. Last year the Centre treated 753 patients, and in January alone this year it was 111. Ninety-two percent of cases come from outside Kathmandu from 75 districts,” says Nakarmi. “When we started it was 42%.”&nbsp; Ideally, burns treatment should be decentralised so that local levels have primary <a href="https://nepalitimes.com/news/altruistic-healthcare-models-in-nepal">burn care centres</a> no more than two hours away, where patients can get initial treatment like cooling and dressing of wounds, and fluid replacement. Read also: <a href="https://nepalitimes.com/here-now/removing-scars?fbclid=IwAR3YJaMAa7AekbmwWYy3UlNnJkDj8XZk8qRxcagXd7Sl0M4m4SzolGs_0ow">Removing Scars</a>, Yugeshwor Koirala If necessary, they could be transferred to regional centres to handle surgery for minor burns. The government has already designated six such facilities across the country, and Nakarmi says the Centre could train their staff. He clicks forward on a slide to show a female patient brought in two months ago with her buttocks and thighs burned. “The wound was deep, it was not going to heal on its own. She needed some kind of graft.” If surgeons at a regional facility were properly trained, they could have done the graft. Instead, the patient waited for one month before coming to Kirtipur.&nbsp; Nakarmi is looking for funding for a 70-bed national burn care centre at Kirtipur Hospital, where patients can be isolated from the risk of infection that comes with sharing space in general wards. Another MP, Bindabasini Kansakar, is herself a<a href="https://nepalitimes.com/here-now/nepal-s-acid-attack-survivors-find-a-saviour"> survivor of an acid attack </a>by a spurned suitor in 2013. She registered a Bill in Parliament last year that includes specialised burn units in all <a href="https://nepalitimes.com/editorial/devolution-for-development">government hospitals </a>with 100+ beds, and in some private hospitals and medical colleges in Kathmandu. She is also calling on the government to create a fund to give immediate <a href="https://nepalitimes.com/news/justice-delayed-justice-denied-byrx8a1c">financial support to victims </a>and their families, discounts for women and children, especially from poorer communities, as well as training for health staff, twice yearly awareness programmes at local levels, and strong penalties to deter acid attacks and intentional burn injuries. Parliament’s delay in passing the Bill is ‘deeply frustrating, especially given my personal experience,’ Kansakar wrote to us.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250314110312_8d1a63b9d63d2ee0c116ffa1bc46e9a3aa5e63e7cdeeceb5a67fd7e772fbe957.jpg" data-media-id="editor_11" data-image-id="20250314110312_8d1a63b9d63d2ee0c116ffa1bc46e9a3aa5e63e7cdeeceb5a67fd7e772fbe957" data-rendition-name="original" width="1446" height="717" loading="lazy" alt="burn incidents in Nepal"> <figcaption>Member of Parliament Bindabasini Kansakar before an acid attack by a spurred suitor in 2013 (left), after, and now. </figcaption> </figure>  ‘I know first-hand the physical, emotional, and financial struggles<a href="https://archive.nepalitimes.com/news.php?id=18771"> burn victims </a>endure. Delays mean more victims are left without proper care, financial support, or legal protection,’ she added. ‘If burns affected wealthier or more influential communities, the response might have been swifter. This inequality is precisely why the Bill is so crucial — to ensure<a href="https://nepalitimes.com/news/justice-delayed-justice-denied-byrx8a1c"> justice and support for all victims</a>, regardless of their social standing.’ Burn incidents are the second most common injury in rural Nepal, according to the World Health Organization, and researcher Kamal Phuyal says that making just a handful of simple adjustments to everyday life could prevent most major burns. Before <a href="https://nepalitimes.com/news/ways-nepal-can-rebound-from-covid-19-2966ixvu">Covid-19</a>, he ran a research project in three municipalities in the mountains, hills and Tarai. After six months gathering data, the team told locals to make changes in their communities to prevent burns. For the next two and a half years, Phuyal worked with health staff, female community <a href="https://nepalitimes.com/news/enlisting-female-health-volunteers-to-fight-covid-19-b4qlgy1e">health volunteers</a> and other locals. In that time, the number of major burns in the three districts dropped from 21 to zero for two years running. The most effective change was to stop people from cooking on the ground. “If you can put the <a href="https://nepalitimes.com/here-now/what-s-cooking-in-nepal-besides-politics">cooking stoves</a> just three feet (1m) off the ground, 50% of burns can be eliminated,” explains Phuyal.&nbsp; Nakarmi says that 70% of patients at Kirtipur Hospital, too, got burn injuries in the kitchen. “It should be the safest place to be, but it is the most unsafe,” she adds. Phuyal says<a href="https://nepalitimes.com/here-now/deputies-drive-development-in-rural-nepal"> local representatives</a> were convinced by his findings and, especially in Makwanpur, eager to make changes. He expected them to adopt a policy to approve construction of a house only if the plans included putting the cooking space 1m off the ground, to reduce burn incidents, Phuyal explained at a training session at Sushma Koirala Memorial Hospital (SKMH) last October. But <a href="https://nepalitimes.com/news/nepal-s-uneven-covid-19-deaths">Covid-19</a> hit, the project ended, the officials were replaced after elections, and the work lost momentum. Today, no <a href="https://nepalitimes.com/banner/local-government-by-the-people-for-the-people-of-the-people">local government</a> seems to have moved forward on <a href="https://archive.nepalitimes.com/news.php?id=18770">burn prevention</a>. During the training session at SKMH, the hospital’s deputy director, Rojina Shilpakar, described some of the burn cases at the facility in recent months. In Dailekh district, two boys were severely burned while collecting fodder. “The parents all thought that they would die so they didn’t take them for medical help. But after two weeks they survived and the story was posted on <a href="https://nepalitimes.com/news/the-social-media-contagion">social media</a>.” The hospital reached out and arranged for both boys to be brought to Kathmandu, one to Kirtipur Hospital and the other to SKMH, with burns on 40% of his body. “He was emaciated, just flesh and bones, covered in <a href="https://nepalitimes.com/banner/medicine-goes-back-to-its-roots?fbclid=IwAR31DMkL6vtx8KFvX3KG79Jf6omKN8H8VZ0Dr9G-1UWtIBlFHNphMJi8mrY">herbal medicine </a>that looked like mud,” recalls Shilpakar. If he had been brought for treatment quickly, he could have recovered sooner, she adds. But he was <a href="https://nepalitimes.com/banner/nearly-half-of-nepali-children-still-malnourished">malnourished,</a> and contractures had developed where one part of the body sticks to another, preventing movement. “We couldn’t take him to the operating room right away because of his malnourished condition. He had to gain some weight, increase his haemoglobin levels. Even skin grafts were not taken properly, so it affected the <a href="https://nepalitimes.com/banner/the-art-of-healing">healing,</a>” explains Shilpakar. <a href="https://nepalitimes.com/editorial/pandemic-of-poverty">Poverty</a> prevents many families from<a href="https://nepalitimes.com/here-now/it-s-an-emergency-nepal-needs-to-improve-trauma-care"> seeking care</a>, although both facilities will not turn away burn cases for <a href="https://nepalitimes.com/news/poor-cash-rich-nepal">lack of money</a>. SKMH paid the bills for the Dailekh boys' treatment, including an eight-month hospital stay. Now seven, the youngster has already had a follow-up surgery and is likely to need more operations as he grows. Smaller <a href="https://nepalitimes.com/news/healthcare-moving-from-hospitals-to-homes">hospitals</a> outside Kathmandu often do not not accept severe burn cases, and instead send them immediately to a larger facility. “If the patient dies within a few hours, they will be blamed, So they just try to push them away,” adds Shilpakar. SKMH has been <a href="https://archive.nepalitimes.com/news.php?id=16801">training health workers</a> from across the country to treat burns since 2012. This includes countering the prevalent belief at the time that burn victims should not be given fluids. Patients would reach the centre <a href="https://nepalitimes.com/multimedia/dirty-dangerous-difficult-and-dehydrating">dehydrated</a>, and then go into acute <a href="https://nepalitimes.com/opinion/comment/saving-kidneys-to-save-nepal">kidney failure</a>. Some with a high percentage of burns die. Those cases have decreased in the last few years because <a href="https://nepalitimes.com/opinion/comment/nepal-health-workers-at-risk-of-workplace-hazards">health workers </a>have been trained, including to give fluids to patients. The treatment at the Cleft and Burn Centre has become much more effective since it opened in 2014. Says Nakarmi: “Back then we could not save anyone who had 40% burns or greater. Now we can save half of victims with 40% burns, and if someone has 60% burns, they have a 15% chance of survival. We aim to save half of patients with 60% burns.” The centre developed a six-day training for health staff on burns care for workers from facilities country-wide, but funding was provided by <a href="https://nepalitimes.com/news/how-usaid-cut-affects-nepal">USAID</a> and has been cut. There is no replacement in sight. Recent increase in government support for burns treatment seems to have been sparked by the case of MP Bhandari. In October, the government announced free treatment for patients from the<a href="https://nepalitimes.com/here-now/why-nepal-s-poverty-rate-is-stuck"> poorest families</a>.&nbsp; “But there is a little catch,” says Nakarmi. “The treatment of destitute burn victims, are supposed to be covered right? But everyone else also wants to get support. A lot of Nepali people are not destitute, but they are poor. We just try to cover their costs as much as possible.”

Marty Logan

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A burning problem that needs solutions

Pritam Kunwar was born with a cleft lip and palate in Pokhara, but his family could not afford treatment for his condition. His face was disfigured, his speech was unintelligible, and the food he ate would often get into his nasal cavity.&nbsp; Finally, at 15 he received cleft surgery, but without post-operative therapy his speech was still impaired. Then one day, at age 26, his life changed. He used to make a living rowing boats at Phewa Lake, where a foreigner hopped on for a ride. He turned out to be a plastic surgeon volunteering in Nepal who referred him to Fishtail Hospital. That is where he met Shankar Man Rai. Kunwar underwent a second surgery, and received speech therapy. Today, he holds a Taekwondo black belt, and runs an academy by Pokhara’s Lakeside, training young women in self-defence. “Before my second surgery, the students at my martial arts academy did not understand a word I said, but after I could speak properly they learnt faster,” recalls Kunwar.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20230804080844_7e557a7682a0bc504237ed5cf9b1b6082ecf346ee34a541c43ae00d25377a2d2.jpg" data-media-id="editor_0" data-image-id="20230804080844_7e557a7682a0bc504237ed5cf9b1b6082ecf346ee34a541c43ae00d25377a2d2" data-rendition-name="original" width="7238" height="2400" loading="lazy" alt="Removing scars 2"> <figcaption>Pritam Kunwar was born with a cleft lip and palate in Pokhara. After two surgeries and speech therapy, he now runs a Taekwondo academy training women in self defence.(Photo: Jana Ašenbrennerová)</figcaption> </figure>  On average, one out of every 500 live births in Nepal is a case of cleft lip or palate, birth deformities in which the lip or palate fail to fuse. Incidence in Nepal is higher than in most parts of the world for reasons which are unclear, but may have to do with a combination of genetic and environmental factors.&nbsp; However, the numbers afflicted are going down due to awareness and treatment at the <a href="https://nepalcleftandburncenter.org/">Nepal Cleft and Burn Center</a> at Kirtipur overlooking Kathmandu.&nbsp; “Before the 1980s, cleft and burn treatment through plastic surgery was unheard of in the country,” explains Shankar Man Rai, who is now a plastic surgeon and director of the Kirtipur centre. “International volunteer teams carried out the procedures, while Nepali doctors remained under-equipped.” Since then, Rai’s team has seen that scenario change. Improved awareness of the condition means parents bring their children for treatment to the 30-bed Centre almost as soon as they are born.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20230804080844_56ba408f9cd1b497374609fc6002f6a5412b99432d4aff498f8f8fca81445e6d.jpg" data-media-id="editor_2" data-image-id="20230804080844_56ba408f9cd1b497374609fc6002f6a5412b99432d4aff498f8f8fca81445e6d" data-rendition-name="original" width="3600" height="2400" loading="lazy" alt="Removing scars"> <figcaption>Shankar Man Rai(Photo: Jana Ašenbrennerová)</figcaption> </figure>  Nepali paediatric and general surgeons were trained by the international teams, and for over 25 years Rai’s team has been treating thousands of burn and cleft patients free of cost. The facility is funded by two non-profits, ReSurge International and Smile Train. The facility at Kirtipur was inaugurated in 2014, but the <a href="https://nepalcleftandburncenter.org/">Cleft and Burn Center </a>was initiated in 2002 by American textile retailer Jim Webber after meeting Rai in Nepal. Webber ran the Tibet Rug company, and organised financial support from other rug importers from Nepal to help fund the project.&nbsp; Since then, the Center has been Nepal’s first and leading teaching hospital specialising in deformity-correction surgery. Today, it is being run by Kirtipur Municipality and the non-profit <a href="https://www.phectnepal.org/">Public Health Concern Trust Nepal (phect-NEPAL)</a>, providing free treatment not just to patients at the centre but through camps in remote parts of the country.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20230804080844_a5ba78663011d44d14e8c3f4d8dccbf4eb23c07d9d5dd7770187c4788023878b.jpg" data-media-id="editor_5" data-image-id="20230804080844_a5ba78663011d44d14e8c3f4d8dccbf4eb23c07d9d5dd7770187c4788023878b" data-rendition-name="original" width="2048" height="1365" loading="lazy" alt="Removing scars"> <figcaption>Photo: PHECT NEPAL</figcaption> </figure>  Kiran Nakarmi is the head of the Department of Burns, Plastic and Reconstructive Surgery at Kirtipur Hospital who worked with Rai to set up the centre. He says a cleft lip is easily recognised in infants, and can now even be diagnosed via ultrasound before birth. “Timely treatment is important because it yields better speech outcomes,” Nakarmi explains. “Our focus is on comprehensive care. Surgery alone is not enough, it needs follow-up with speech and occupational therapy and counseling.”  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20230804080848_ee0057f9cd2d17d2834babd2164720028ef66b3d41fec3199246d7e21b2d4d91.jpg" data-media-id="editor_6" data-image-id="20230804080848_ee0057f9cd2d17d2834babd2164720028ef66b3d41fec3199246d7e21b2d4d91" data-rendition-name="original" width="3600" height="2400" loading="lazy" alt="Remioving scars 6"> <figcaption>Kiran Nakarmi looks at a patient.(Photo: Jana Ašenbrennerová)</figcaption> </figure>  The Kirtipur center’s camps have reached many rural parts of Nepal, impacting more than 20,000 cleft patients. Initially, speech therapists used to go to the camps but now has trained nurses like Kabita Bhattarai Gurung to carry out the same task.&nbsp; The outreach camps provide free food, lodging, orthodontic treatment, parental counseling, and speech therapy to patients, a model which Rai says can be replicated globally.&nbsp; The caseload for cleft palates has fallen sharply and the Kiritpur center which used to carry out up to 1,200 cleft operations a year till a decade ago now performs half that.&nbsp; <h2>Burning need</h2>  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20230804080844_9a3c5a83db7f5f9ef918acbe1093472f7c9c2c6e9266078038b34420e00208bf.jpg" data-media-id="editor_7" data-image-id="20230804080844_9a3c5a83db7f5f9ef918acbe1093472f7c9c2c6e9266078038b34420e00208bf" data-rendition-name="original" width="3600" height="2400" loading="lazy" alt="Removing scars"> </figure>  But with the decline in cleft cases, there has been a growing need to treat burn patients at Kirtipur.&nbsp; Bhesh, 14, was playing in his home in western Nepal when he heard his mother shriek from the kitchen. She was cooking when the open fire spread and engulfed the house.&nbsp; Read Also: <a href="https://archive.nepalitimes.com/article/nation/burning-in-the-aftermath,3757">Burning in the aftermath,</a> Sahina Shrestha Four days later, both Bhesh and his mother arrived at Nepal Cleft and Burn Center. The long ride had been excruciating, and with burns over 30% of her body, his mother died shortly after. Bhesh went through several surgeries and skin grafts. Over a third of the patients admitted to the Centre are children, and half are women.&nbsp; “We think that the home is the safest place, but that is where most burn injuries occur,” says Rai. “The proportion of children with burns at the Center shot up to over 40% during the pandemic. At home they were more at risk.” Rural women are exposed to open fires, and children suffer because they are largely unsupervised in high-hazard settings. Disfigured burn patients have to deal with social stigma because they are seen as a sign of bad luck.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20230804080848_0f27d63b1f3a521c61cdb69bc45799d40ba1bea94c60d094cab9e6b5d7279035.jpg" data-media-id="editor_9" data-image-id="20230804080848_0f27d63b1f3a521c61cdb69bc45799d40ba1bea94c60d094cab9e6b5d7279035" data-rendition-name="original" width="3600" height="2400" loading="lazy" alt="Removing scars"> </figure>  The Center also treats burn violence usually perpetrated against women in the homes of in-laws, and this adds to the count of the 110 people who die of burns each year in Nepal. “Burns survivors in Nepal need more support,” says<a href="https://archive.nepalitimes.com/news.php?id=18771"> Wendy Marston, co-founder and advisor of Burns Violence Survivors (BVS) Nepal</a>. “Small acts of kindness from all of us, such as the spreading of education, and charitable giving, can go far in helping these survivors and patients.” BVS Nepal works with underserved patients in over 12 hospitals, providing funds for their treatment, therapy, and setting up businesses for survivors. Its prevention approach is shared by the Burn and Cleft Center which also holds burn awareness camps for community health workers and local people. “For household burns, awareness is surely the first step towards prevention,” Rai says. “But we can’t simply tell people what to do if they don’t have the means to act.” A WHO study shows that burns are the second most common injury in rural Nepal, accounting for 5% of disabilities in the country,&nbsp; Read Also: <a href="https://www.nepalitimes.com/here-now/tsering-sumjok-is-all-right">Tsering Sumjok is all right</a>, Sahina Shrestha “When we first started treating burns, we began with disabilities caused by post-burn contractures,” explains Nakarmi. “If the wound is in a place such as a joint, this causes the patient to lose mobility.”&nbsp; The Kirtipur team prioritises comprehensive care for burn contractures. But unlike with cleft palates, they failed to see any decline in the caseload even after years of effort. Rai says this is because burn survivors are not getting the treatment needed. Surgeons hope that using flaps and grafts they can reduce the occurrence of contractures. Nepal’s difficult geography keeps patients like Bhesh from quickly receiving care. Burn survivors from all over the country are referred to the few specialised centres in Kathmandu, but there is usually a long waiting list and it takes weeks before a doctor can see them.&nbsp; The Kirtipur Center has largely succeeded in minimising waits by enabling surgeons to go to patients instead of the other way around. This means patients at the Center receive the surgery they need within days of being admitted.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20230804080852_34cfa9c4509717fa9b1fb8ff4184effa8d3e8d199b834ffae5ca43c117dd6611.jpg" data-media-id="editor_12" data-image-id="20230804080852_34cfa9c4509717fa9b1fb8ff4184effa8d3e8d199b834ffae5ca43c117dd6611" data-rendition-name="original" width="3600" height="2400" loading="lazy" alt="Removing scar"> </figure>  But there are challenges. “Your treatment is not possible here,” were the words that Nepali Congress leader Chandra Bhandari heard at the Nepal Burn and Cleft Center where he was rushed there after suffering severe burn wounds in a gas cylinder explosion in February. Bhandari was eventually medevaced to Mumbai where he was successfully treated.&nbsp; “It is unfair that any Nepali should have to go abroad for burn treatment,” Bhandari told Nepali Times. “Our surgeons are the best in the world, yet they have had to rely solely on individual and community effort. The government urgently needs to support the surgeons, and I pledge to do what I can.”&nbsp; There are only 30-40 reconstructive plastic surgeons in the country, eight of them at Kirtipur, which offers a residency program for reconstructive plastic surgery affiliated with the National Academy of Medical Sciences program at Bir Hospital, whose curriculum was developed by Rai.&nbsp; While cosmetic plastic surgery is a booming profession in Nepal, the niche dedicated to burns treatment has not got the attention it deserves. Kirtipur Hospital, for instance, only has seven ICU beds, The country’s only skin bank at the Center has got only 31 donations in the nine years since it was set up.&nbsp; Read Also: <a href="https://archive.nepalitimes.com/article/nation/A-burning-desire-to-help,881">A burning desire to help</a>, Kunda Dixit With little government support, the Center mostly runs on international help for free treatment to about 600 patients a year. But even as its focus shifts from clefts to burns, international assistance is skewed in favour of cleft palates.&nbsp; “We get more donations than we need for clefts,” Rai reveals. “Burns are where we need greater investment, but because they are more expensive and complex, and have higher odds of ending in mortality, there is less interest from donors.” Not only is the government not providing needed help, its bureaucracy puts up obstacles every step of the way. Kirtipur Municipality received a donation of Rs2,900,000 for urgent burn treatment supplies. But red tape has delayed delivery. The Center now has an ambitious plan to establish a sustainable fund for free burns treatment by encouraging donations from well-to-do local Nepalis and the diaspora. The goal is not to have to turn to international donors for money. The Nepal Cleft and Burn Center will soon open a branch in Itahari of Sunsari district with the same level of care as Kirtipur.&nbsp; Says Nakarmi: “We don’t need big, lavish burn hospitals all over the country. We need a lot more primary burn centers where rural patients can receive immediate care, and then be referred to the larger centers if need be.” Nepal has seen major improvements in burn and cleft palate surgeries in recent years thanks to doctors like Rai and Nakarmi. Says Rai: “I am sure we will see a day when no patient seeking treatment in Nepal has to live with scars, both figuratively, and literally.”&nbsp;

Removing Scars

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022111410110/637203b79c7e80680e0b2821jpeg.jpg" alt="" width="960" height="695"/><figcaption>Tsering Sumjok Gurung with German plastic surgeon André Borsche (left) and Peter Hinze (right). Borsche had treated her childhood injury at the Sushma Koirala Memorial Hospital in Kathmandu. All photos courtesy: PETER HINZE</figcaption></figure>Last November, in the waiting room of a hospital in Bad Kreuznach in Germany, Tsering Sumjok Gurung caught glimpse of a familiar face.The tall man with graying hair and moustache was wearing a white coat over a yellow jumper. He was none other than plastic surgeon André Borsche who had treated her horrific childhood burn injury at the <a href="https://www.skmt.org.np">Sushma Koirala Memorial</a> Hospital in Kathmandu ten years previously.“It was an emotional reunion for both of us,” Tsering, now 23, remembers. “He was very friendly and wanted to see how my injuries had healed.”Tsering was 18 months old that summer when her family made the annual migration up to high pasture to graze their yaks. One day, while her mother was tending the livestock, Tsering fell off her crib right into the fireplace. She was badly burnt on her back, and right arm.Read also: <a href="https://archive.nepalitimes.com/article/nation/A-burning-desire-to-help,881">A burning desire to help</a>, Kunda Dixit<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022111410110/637203ba9c7e80680e0b2822jpeg.jpg" alt="" width="308" height="462">There were no doctors in her village of Bhijer, so she was treated for the next four years by the local <a href="https://archive.nepalitimes.com/article/nation/I-am-an-amchi,3349" target="_blank" rel="noopener noreferrer">amchi healer</a>. This kept her alive, but the skin on her right arm was fused with the torso. All her childhood, Tsering was carried around in a doko bamboo basket.“Burns are common in <a href="https://www.nepalitimes.com/banner/dazzling-dolpo/" target="_blank" rel="noopener noreferrer">Dolpo</a> because home life revolves around the kitchen fire,” says Tsering. “I was lucky.”Despite being painful to move around, Tsering started going to school in Bhijer and excelled in studies. In Grade 2, a group of wealthy American and Swiss trekkers visited the school that they had supported. They noticed Tsering, examined her injuries, and helped bring her to Kathmandu for school and treatment. Over the years, the two families have also funded a hospital and a cheese factory in the village.Tsering used to watch her classmates in Kathmandu run and play, or dance in school programs, but could not participate because of her injury. She was eventually admitted to the Sushma Koirala Hospital, which is supported by INTERPLAST-Germany, where André Borsche and his team performed five major operations with reconstructive surgery. Every week, she had to make a painful bus ride from her dorm in Boudha to the hospital in Sankhu for physiotherapy and follow-ups.She missed many classes, but she made up for it by reading books which inspired her to become a doctor, so she could serve her community in Dolpo. Not able to afford higher education, in 2017 she started working as a hostel warden at a school in Chobar.That is when she met German journalist Peter Hinze who was researching his first book on <a href="https://www.amazon.com/The-Great-Himalaya-Trail/dp/3957281377" target="_blank" rel="noopener noreferrer" data-saferedirecturl="https://www.google.com/url?q=https://www.amazon.com/The-Great-Himalaya-Trail/dp/3957281377&amp;source=gmail&amp;ust=1641892465582000&amp;usg=AOvVaw3DjWYFudXKEdEQ0H4UlQmW">The Great Himalayan Trail, </a>and Tsering later travelled with him to Upper Dolpo to make a film with herself as the lead character.Tsering was back in Bhijer for the first time in ten years, and her family and neighbours were surprised how much she had grown and changed. Her injuries were not visible anymore, and no one could believe that a little girl who had such terrible injuries would be so transformed.Read also: <a href="http://archive.nepalitimes.com/news.php?id=18771#.Ydv72C8w3u0">Lending a hand</a>, Nepali Times“I met the right people who helped me get treatment otherwise my life would have been different,” Tsering says. “Even now, there are many children in my neighbouring villages who are not as fortunate.”The film project was cancelled because of the pandemic, but Hinze converted the research into the book 100000 Schritte zum Glück about Dolpo, and invited Tsering to Germany for the unveiling in November. The book made it to number 4 on Amazon's best seller list in Germany.<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022111410110/637203bd9c7e80680e0b2823jpeg.jpg" alt="" width="169" height="242">And he had a surprise in store – a meeting with the surgeon who had treated her in Kathmandu all those years ago. It was an emotional and joyful reunion.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022111410110/637203bf9c7e80680e0b2824jpeg.jpg" alt="" width="960" height="641"><figcaption> </figcaption></figure>“This was one of the best days in my 26-year career, when I could see the wonderful result of our charity work,” said André Borsche.Tsering was equally happy: “I made it from my family stone hut in Bhijer to the hospital in Germany to meet the surgeon who changed my life.”Read also: <a href="https://www.nepalitimes.com/here-now/nepals-acid-attack-survivors-find-a-saviour/">Nepal’s acid attack survivors find a saviour</a>, Sabina Devkota<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022111410110/637203c19c7e80680e0b2825jpeg.jpg" alt="" width="750" height="1000">In the hospital, Borsche examined her burn scars and was satisfied with how well her back had healed. He suggested one more operation, but Tsering refused any more treatment.“I am over medical procedures for now,” Tsering told Nepali Times on her return from Germany. “After all those surgeries, I am put off by the sight of blood. I don’t want to think about the pain afterwards. For now I think I am ok.”These days, when Tsering is not busy with her full-time work at the Chobar school, she helps Hinze with Project Dolpo, a private initiative to help those who need assistance in her home district. She gets frequent calls from families in Dolpo who are in distress.Says Hinze: “I think this is a motivating story about a girl who never gave up, and who trusted herself. It shows how when help gets to the right people, the underprivileged and the almost forgotten, it can make a big difference to their lives.”This past week in Kathmandu, Tsering has been busy taking a seven-year-old boy from Dolpo who was also badly burnt with boiling water, and was brought to Kathmandu for treatment. Tsering has been taking the patient to the burns hospital in Kirtipur for medical attention.“It happened to me, and now to this boy. These accidents occur so frequently and Upper Dolpo just does not have the facilities to treat burn injuries,” says Tsering.For now, she wants to complete her education and ultimately return to Dolpo: “I feel it is my responsibility to give back to my community. The only way my village is going to develop is when young people like me get educated, and head back to help others like us. There is so much to do.”Read also: <a href="https://www.nepalitimes.com/here-now/the-prolonged-trauma-of-acid-attack-survivors/">The prolonged trauma of acid attack survivors</a>, Laxmi Basnet

Sahina Shrestha

Tsering Sumjok is all right

‘One early morning, we heard the ambassador’s wife cry out, “Ram, Ram, Ram!” A disaster has befallen Nepal!” She had heard on the radio that a fire had consumed Singha Durbar." This is not about the arson attack on 9 September 2025, but the one on 8 July, 1973. It started in the South Wing of the then single-largest building in all of Nepal. It took two days to bring the blaze under control, requiring the use of explosives to demolish one wing to protect the imposing western facade. As Bhekh Bahadur Thapa recalls in the English translation of his memoir A Life in Public Service: Nepal from Autocracy to Democracy, he was then on leave from the Nepal government serving with the IDRC in Ottawa.&nbsp; He had already served as Nepal’s Finance Secretary at age 25, went on to be Finance Minister and Governor of Nepal Rastra Bank. He was already younger than some of the GenZ ministers in Nepal’s present RSP government. Thapa, now 89, was at the launch of the book in February which was attended by former diplomats and bureaucrats. After speeches by panelists, there was a question from the audience about how Thapa had managed to be the diplomat he was, managing Nepal’s international relations on the world stage.&nbsp; Writer and journalist Akhilesh Upadhyay, who was moderating the panel, responded by going into the section of the book where we see Thapa as an ambassador to the US, playing tennis with White House officials, cultivating a network of contacts to project the identity and welfare of Nepal, and making it possible for a state visit by King Birendra to Ronald Reagan’s America. The book is full of anecdotes that suggest Thapa was a clever and strategic diplomat, always calm and unruffled, easily making friends in high places with his maturity and engaging sense of humour. Thapa’s memoir is heavy on details about Nepal’s administrative history during the years he was active in public service, serving as minister and ambassador under three kings: Mahendra, Birendra and Gyanendra, and alongside five prime ministers.&nbsp; Aside from an insider look on how certain treaties, development deals and research projects in Nepal came into fruition, Thapa goes into great detail about his personal and professional relationships with the kings, ministers, ambassadors, foreign leaders and politicians.&nbsp; As a reader, one is struck by the level of detail around the events that unfolded in Nepal over the years during Thapa’s tenure. Was Thapa recording a journal over the years of the events and the conversations that transpired, or were they committed to his phenomenal memory? Either way, the reader gets a glimpse of Nepal’s recent history from the early days of the Panchayat, through the People’s Movement and the democracy period, the Maoist insurgency, Royal Palace massacre of 2001, and Gyanendra’s coup of 2005.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2026041204048_125dc8ae300a1e33124f394abe724d42727f83e067b0201d2008b58d60c459a4.jpg" data-media-id="editor_0" data-image-id="2026041204048_125dc8ae300a1e33124f394abe724d42727f83e067b0201d2008b58d60c459a4" data-rendition-name="original" width="1584" height="1000" loading="lazy" alt="How to win friends and influence nations NT"> </figure>  Not enough is said about the political parties of the time whose presence led to the way Nepal’s multiparty democracy came to be shaped. The book keeps its focus on the administration and the key figures around it, mostly those in the Panchayat era. Towards the second half of the book, we do start to hear about political parties, but not in great depth. Another figure whose presence in the book is conspicuously less prominent is that of his wife, Rita Thapa — the person who seems to have rescued him every time financial quandary or family care became a challenge. Yet, we do not see her as a full person. Perhaps because of the personal tragedies in his life, the children are also barely mentioned.&nbsp; The book is therefore less personal and more technical. Throughout, we learn about Thapa’s thinking as he navigated the world of diplomacy to win him the trust of those who mattered. There are tips here for a new generation of Nepali officials and diplomats about how much commitment and focus is needed to be good at one’s job and serve the national interest. This book adds to tomes that have been written on Nepal’s fragile relationship with India. ‘India has always wished for Nepal to remain dependent on it,’ writes Thapa, who served as Nepal’s ambassador to India and later in the Eminent Persons Group &nbsp;on Indo-Nepal relations that has been allowed to languish. The book has several insights into the Indo-Nepal trysts with diplomacy and agency.&nbsp; China’s role is also recorded, viewed through conversations during a visit to Beijing, but all that was before Nepal’s neighbour to the north emerged as a world economic and military power. The book also has such sudden instances of quirkiness and humour. For instance, we see a young Thapa in America explaining to a government official why he would like to return to Nepal instead of settling down in the US. “Because, Nepal is beautiful,” he said. The text is immaculate and does not read much like a translation, credit for which clearly goes to the team that put the edition together: translator Prawin Adhikari, &nbsp;Anagha Neelakanthan and Bhekh Thapa’s daughter, Manjushree. As Nepal enters a new era of governance and diplomacy, A Life in Public Service: Nepal from Autocracy to Democracy should be essential reading for students of political science, economics and foreign affairs who can gain a fresh perspective on the country’s trajectory.&nbsp; There are dozens of forgotten state secrets recorded in the book, but the reader must also remember this is a story told from one person’s perspective and there may be others.&nbsp; So, what really made Thapa the diplomat he was? I met him in 2004 at the Kantipur TV studio when he was serving as king Gyanendra’s foreign minister. He was there for a studio interview, and I was just done with my English newscast.&nbsp; He surprised me at the door: “Pratibha! I’ve been reading your articles in The Kathmandu Post. You must keep writing.” I thanked him, glad to have been noticed for my work by a stranger. That was perhaps one of the things that set Thapa apart — he excelled at staying close to those in power, while also noticing those who were not.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260412040412_213e706136a038ec9f5e2b8c6d7f7c1e9ceed9479e22fe2884872ad7bd20955f.jpg" data-media-id="editor_1" data-image-id="20260412040412_213e706136a038ec9f5e2b8c6d7f7c1e9ceed9479e22fe2884872ad7bd20955f" data-rendition-name="original" width="1136" height="702" loading="lazy" alt="Book details"> </figure>

How to win friends and influence nations

This is the 91st 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 have still not come to terms with the reality that my daughter Ruby Thakur is now the Deputy Speaker of Nepal’s Parliament. Sometimes, when I am walking, the thought hits me, and I cannot believe it.&nbsp; Things changed for my daughter in a very short time. I had dreamt that the best my daughter could achieve was a good engineering job. Fate had bigger plans for her. She is no longer just my daughter, she is the nation’s daughter. Nepal’s daughter.&nbsp; My children’s education was always my foremost priority. That is the main reason I went overseas for employment. I realised the value of education while working in Saudi Arabia. In my office, colleagues with good education earn $8,000 per month working on computers. Those with low education toil outdoors in the heat for much lower wages. A good education or skills can change everything. I am in Nepal on vacation and will soon return to my job. Ruby is all set now. But I still have to take care of my other children's education. As the eldest son, I myself never got a chance to prioritise my own education. I dropped out in Grade 7 because I had to take care of my ageing parents and younger siblings. I have done all kinds of jobs. I worked in a landlord’s field for a share of the harvest. Even now my wife and I farm for the land owner and have to give away half of what we grow.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260413120444_051b61e01a5189af538aa1e011acd3e2b38d5f42825116b2afd325d93d0c519b.jpg" data-media-id="editor_0" data-image-id="20260413120444_051b61e01a5189af538aa1e011acd3e2b38d5f42825116b2afd325d93d0c519b" data-rendition-name="original" width="4032" height="2268" loading="lazy" alt="DD"> <figcaption>Sogarath Thakur during a break in Nepal with wife tending to his farm.</figcaption> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260413120448_8a1c3ac3fd559026bc6f981cc8dc82cb8ad09a3a4f55fb9f6f7fd5f49c3d5571.jpg" data-media-id="editor_1" data-image-id="20260413120448_8a1c3ac3fd559026bc6f981cc8dc82cb8ad09a3a4f55fb9f6f7fd5f49c3d5571" data-rendition-name="original" width="4032" height="2268" loading="lazy" alt="DD"> </figure>  Then I worked as a barber, my family’s line of occupation. I went door to door cutting people’s hair and later worked in a relative’s saloon. Hairstyles were simple back then, and I got to keep half the fee. I also worked in a brick factory where I was paid weekly. &nbsp; I married when I was 16, and my wife was a year younger. As my family and responsibilities grew, I had to migrate leaving behind my three children including Ruby who was just three months old.&nbsp; I went to Qatar where I continued working as a barber. It was a large saloon and the standards for cleanliness and professionalism were higher. I had to hand over 70% of my daily earnings to the employer. I had to rely on my colleague to translate what the customer wanted. But I slowly became fluent in Arabic. I used to jot down words in Nepali and Arabic and memorise them. In Qatar, customers even came at night for haircuts, and people stayed up late. I would work till 3AM.&nbsp; Communicating with my family was one-way. I would go to Bismillah and ask someone to type out questions to my family about their whereabouts, how the harvest was that season. I would offer very little information about my life in Qatar because it was not easy. What was the point of getting them all worried? What could they do? I never received a letter in return, so throughout my time in Qatar, I never knew how my family was faring. When I appeared in the village after five years without any advance notice, it was a bittersweet reunion, and I had no gifts. I still remember how unfamiliar my village felt when I came home after so many years. I had to ask for directions. When I came home, Ruby was already in school. I had left her in my wife’s arms five years prior. I missed her growing up, and did not even see her pictures. My wife had to introduce her to me as her father. But it took just 15 minutes for her to warm up to me.&nbsp; The Arabic skills I had picked up in Qatar came in handy when I remigrated two years later to Saudi Arabia. I worked as a labourer in the desert heat, but once my company found out I spoke Arabic, I was hired for an indoor job as an office boy. The struggle in Qatar had paid off. I worked in an air conditioned office serving tea or coffee, doing bank runs or getting documents signed and photocopied. I have worked in the same company for the past 20 years, sending money home.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260413120448_f083fa873a6d77b19c8b0bdde623415c643a151fb550c57ff4e52b3c2431355f.jpg" data-media-id="editor_2" data-image-id="20260413120448_f083fa873a6d77b19c8b0bdde623415c643a151fb550c57ff4e52b3c2431355f" data-rendition-name="original" width="5712" height="3213" loading="lazy" alt="DD"> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260413120452_5ccd9a01ee05ce26b71381725108215d0f0d3806508b0cb482aabcfea09bbaef.jpg" data-media-id="editor_3" data-image-id="20260413120452_5ccd9a01ee05ce26b71381725108215d0f0d3806508b0cb482aabcfea09bbaef" data-rendition-name="original" width="4032" height="3024" loading="lazy" alt="DD"> </figure>  My wife is not just my children’s guardian, but also mine throughout the two decades I was away. I trust her with all my earnings, and she manages our household finances well. She makes sure that the children’s school fees and other expenses are paid on time. These days, with video calls, things have become much easier for me to stay in touch with home.&nbsp; When Ruby told me she wanted to do an engineering diploma, I was happy. Later, her friends inspired her to join politics so she started getting involved with Shram Sanskriti Party. I first found out she got the proportional representation nomination through social media while on my work duty in Saudi Arabia. I was so excited, but even more so when she was elected Deputy Speaker. I was back home in Dhanusha on my vacation at the time.&nbsp; We are overjoyed and waiting for her to come back to the village for a visit when she gets a chance so we can celebrate properly with everyone. I plan to go back to Saudi Arabia as originally planned, I have a good job and will work for maybe five more years. Ruby has taken 75% of the load off my back. She can help take care of her siblings.&nbsp; I sleep at 8PM every day and wake up at 5AM to exercise before my day in Saudi Arabia begins – I have stuck to the same routine for the last two decades and it has worked well for me and my health. I have a good rapport with my boss who is an Egyptian. My requests to resign have often been met with counter-offers to stay on. My honesty and hard work have won me the company's trust. I will go back and resume working as I have, despite my daughter’s huge achievements. I am still a farmer’s son, a simple man who has to fulfil his family responsibilities. My colleagues in Saudi Arabia are aware that Ruby is Deputy Speaker in Nepal’s Parliament, they are all happy for me and have congratulated me. This time, when I go back, I have promised them that I will throw a bakhri party to celebrate my daughter’s achievement.

The nation’s daughter

Nepalis are insured but not covered

At 6 feet and one inch, Hira Bahadur Ghalan was exceptionally tall for a Nepali. In 1936, when people came to his Tamang village near Tistung looking for porters, they recruited him on the spot. This was no ordinary job, Hira Bahadur would lead gangs of 30 or more porters to carry cars bought by Rana rulers from Bhimphedi to Kathmandu.&nbsp; Those were the days when the only motorable roads in Nepal were in Kathmandu, but the capital was not connected to anywhere else by road. So, before cars could carry people, people had to carry cars. More Nepalis had carried cars than ridden in one. The porters were paid Rs5 for the job, and sometimes the Rana owners gave Hira Bahadur a Rs25 baksheesh. One of the cars his community helped carry was a 1939 Daimler Benz gifted by Adolf Hitler to King Tribhuvan to woo Nepal away from the British. The rusted dusty vehicle is now in the Narayanhiti Palace Museum.&nbsp; Hira Bahadur hauled cars for 25 years until his knees gave way, he died at age 90 eight years ago — the last surviving car porters of Nepal from Chitlang Valley.&nbsp; Hira Bahadur Ghalan had three sons and three daughters, one of them is Maila Kaji Lama, who at age 68, is a chauffeur in Kathmandu. His son, Manjil Lama is a pilot with Summit Air, flying to remote Himalayan airstrips. Three generations of one family worked in professions that followed a century of transportation history in Nepal. &nbsp; After the <a href="https://nepalitimes.com/multimedia/the-long-and-winding-road-to-india">Tribhuvan Rajpath was finished in 1957</a> and the ropeway upgraded, Hira Bahadur was out of a job. He tilled the family farm, watching trucks and buses headed to and from Kathmandu on the hairpins.&nbsp; As a child, Maila Kaji was fascinated by cars and wished one day to be able to drive one. After he failed Grade 8, he came to Kathmandu in 1975 and got a Rs20/month job at a petrol station in Maiti Devi. “I watched King Birendra’s coronation and was impressed by the glamour of Kathmandu, and decided to stay here,” Maila Kaji says.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2026041816040_a1a41e47dec8500727702f700e43af625f059043cbcd283f13b247344b3a20aa.png" data-media-id="editor_1" data-image-id="2026041816040_a1a41e47dec8500727702f700e43af625f059043cbcd283f13b247344b3a20aa" data-rendition-name="original" width="1974" height="1608" loading="lazy" alt="car carriers"> <figcaption>Maila Kaji</figcaption> </figure>  Former minister Ramesh Nath Pandey used to bring his Volkswagen Beetle to the station, and Maila Kaji started taking care of his car. Later, he drove a Russian Jeep for former minister and geographer Harka Gurung. Along the way, he fell in love with the daughter of a Brahmin colleague, and married her. “My father back in Tistung did not approve of our inter-ethnic marriage, and not speak to me for five years,” Maila Kaji recalls. Manjil Lama grew up in Kathmandu, and did well in science in school. He had wanted to go the US to become a pilot like his friends, but was denied a visa.&nbsp; “The visa officer told him I did not earn enough,” says Maila Kaji, “so I sold some property and sent Manjil to flying school in the Philippines.”  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2026041816040_e9091162840baa6d182de2d7cc6f09e43ec9cfd9a9b6e71e7e7b14bc72da3537.png" data-media-id="editor_2" data-image-id="2026041816040_e9091162840baa6d182de2d7cc6f09e43ec9cfd9a9b6e71e7e7b14bc72da3537" data-rendition-name="original" width="1434" height="1754" loading="lazy" alt="car carriers"> <figcaption>Manjil Lama</figcaption> </figure>  After returning to Nepal, Manjil Lama now flies Let 410s of Summit Air to difficult air strips like Lukla and Simkot, and has logged over 2,000 hours. He has to go to the Czech Republic regularly for simulator training. Says Maila Kaji Lama: “My father worked hard carrying cars to raise us, I started from scratch to become a driver to support my family, and my son is now a pilot with experience in flying in the world’s toughest terrain.” &nbsp; Watch <a href="https://www.youtube.com/watch?v=lvT3iTi8yw4" target="_blank">video clip from S Dillon Ripley here</a>.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260419020448_40f8b1bdaace08106ca5c24819b6e7a34fb2109a9a3ec5c6ac179b3309e686ed.png" data-media-id="editor_4" data-image-id="20260419020448_40f8b1bdaace08106ca5c24819b6e7a34fb2109a9a3ec5c6ac179b3309e686ed" data-rendition-name="original" width="900" height="1582" loading="lazy" alt="car carriers"> </figure>