Tranexamic acid (TXA) is a game-changer drug in the treatment of post-partum haemorrhage (PPH), the main cause of death in women immediately after giving birth.Unsurprisingly, 99 % of these deaths occur in under-developed countries like Nepal because many patients cannot afford treatment. The good news is that TXA is inexpensive, and is widely available in South Asia.<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109101136/636b75419c7e80680e0623ddjpeg.jpg" alt="" width="800" height="479"/>Most doctors, especially those who work in emergency room settings, have certainly heard about this drug and probably use it often. The drug’s scope is clearly not limited to PPH: it is very often used in trauma victims to stem bleeding.Read also: <a href="https://www.nepalitimes.com/?p=41024&amp;preview_nonce=ec84b2062a&amp;preview=true" target="_blank" rel="noopener">No conceivable reason for unwanted pregnancies</a> <a href="https://www.nepalitimes.com/here-now/who-will-save-nepals-poor-new-mothers/">Who will save Nepal’s poor pregnant women … a government plan, or God?</a>, Rojita AdhikariHowever, many doctors, <a href="https://www.figo.org/news/save-mothers-stop-PPH" target="_blank" rel="noopener">including those in obstetrics and gynecology</a>, may not know why exactly this well-known and often-used drug has recently shot to prominence in the treatment  of  PPH.It all had to do with the <a href="https://www.lshtm.ac.uk/newsevents/news/2017/every-minute-counts-when-using-lifesaving-drug-treat-bleeding" target="_blank" rel="noopener">WOMAN study</a>. In order to avoid unnecessary bias regarding drug recommendations, Western medicine is generally based on randomised, double-blind, placebo-controlled trials called RCT (randomised controlled trials).These rigorous methods are applied so that the final results will have as little to do with chance as possible. (In fact this year’s Nobel Prize in economy went to a couple, Banerjee and Duflo,who used the RCT method to arrive at their conclusions on alleviating global poverty.)For the <a href="https://sinaiem.org/txa-in-the-hemorrhaging-postpartum-patient/" target="_blank" rel="noopener">TXA study,</a> the investigators recruited women aged 16 years and older with a clinical diagnosis of <a href="https://www.medpagetoday.com/meetingcoverage/smfm/70933" target="_blank" rel="noopener">post-partum hemorrhage after vaginal birth or caesarian section</a> from 193 hospitals in 21 countries, including BPKIHS and Birat Hospital in Dharan and Nepal Medical College in Kathmandu.Read also: <a href="https://www.nepalitimes.com/here-now/nepal-far-from-hitting-contraceptive-target/" target="_blank" rel="noopener">Nepal far from hitting contraceptive target</a>, Sewa BhattaraiBetween March, 2010 and April 2016, 20,060 women were randomly assigned by the international panel of study investigators to receive either 1 gram of intravenous TXA or a matching  placebo (a look-alike sugar pill) in addition to the usual care that included other drugs.The results were ground-breaking. When given within three hours after the onset of PPH, one in three maternal deaths were prevented with TXA. The study was published in the medical journal Lancet in May 2017. The World Health Organization (WHO) took note.<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109101136/636b75439c7e80680e0623dejpeg.jpg" alt="" width="1000" height="562">In fact the WHO had already recommended the use of TXA in PPH back in 2012, but the recommendation at that time was to use TXA almost as a last resort after the uterotonics failed to control the bleeding. Uterotonics are drugs like oxytocin and prostaglandins that are commonly used to contract the uterus to stop haemorrhage. TXA does not work by tightening the uterus but by inhibiting the breakdown of blood clots (fibrin and fibrinogen), a completely different mechanism of action.Read also: <a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/globe-rallies-to-aid-nepals-women,3841" target="_blank" rel="noopener">Cutting the lifeline</a>, Kate RyanIn  2017, based on the WOMAN trial (the World Maternal Antifibrionlytic acronym is in keeping with TXA’s mechanism  of action), the WHO put out new recommendations prioritising the use of TXA in the treatment of PPH: to use it as soon as possible with the uterotonics and not to wait and watch.This updated recommendation may not be known to many health care professionals on the frontline of post-partum haemmorhage treatment in Nepal. The use of TXA for a patient with PPH will only succeed if there is the political will to push it. Otherwise this tremendous advancement in medical care will be relegated to the dustbin.Fortunately, the Nepal government may soon be endorsing  new guidelines for the prompt use of TXA, especially in remote health facilities, to further reduce Nepal’s maternal mortality rate.Read also: <a href="http://archive.nepalitimes.com/article/nation/people-politics-placentas-child-delivery-complications,3922" target="_blank" rel="noopener">People, Politics, and Placentas</a>, Bikash GauchanThe prompt use of TXA can also decrease the financially- devastating helicopter rescues that poor Nepali families in far-away districts have to resort to to save the lives of relatives suffering from PPH. Most cannot afford to hire helicopters and bleed to death.In most cases, TXA has to be given intravenously, and since many Nepali births (and deaths) take place at home, this approach may not be feasible. Who is going to put in the intravenous line even if the drug is available and cheap?Amazingly, the tablet form of the drug is already easily available in Nepal, but more research is needed to find out if giving the drug orally will achieve the same result. If TXA  tablets stop post-birth bleeding as injections do, that would be very welcome news for Nepali mothers-to-be.Buddha Basnyat, MD, is a physician at the Patan Academy of Health Sciences and writes on health issues for Nepali Times.

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Miracle drug to reduce maternal deaths

In 2003, the death by police firing of a student protesting a rise in fuel prices pushed Nepal’s student activists to join the प्रतिगमन विरोधी आन्दोलन (Movement Against Regression), which political parties had begun after king Gyanendra’s sacking an elected government a year before. The students’ participation elevated the movement and prompted more Nepalis to join in, leading to the People’s Movement that first sidelined the monarchy and then abolished it in 2008.&nbsp; That took five years to happen. But 12 years later, this month, a youth-led protest forced the prime minister to resign within 30 hours.&nbsp; Police massacred GenZ activists, many of them students, outside Parliament on 8 September. This intensified public anger, leading to targeted attacks, looting, and burning of the homes of political leaders, private businesses, and public buildings.&nbsp; Amid the smouldering ruins of state institutions, young Nepalis chose a new prime minister to lead an interim government and deliver a fresh mandate. All of this happened in five days.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250910140912_019d62de4b62a366299a27d1276e931a7dadefcc674441e7fb3acd503970efaf.jpg" data-media-id="editor_0" data-image-id="20250910140912_019d62de4b62a366299a27d1276e931a7dadefcc674441e7fb3acd503970efaf" data-rendition-name="original" width="8000" height="5760" loading="lazy" alt="Nepal in ashes"> <figcaption>Parliament building up in flames during the GenZ protest on 9 September. Photo: KAMAL PRASAI</figcaption> </figure>  Students have been central to Nepal’s democratic and political process since the mid 20th century. In her 2018 book Making New Nepal, researcher Amanda Thérèse Snellinger traces the history of student activism and politics against a background of &nbsp;Nepal’s socio-political history and party politics.&nbsp; Snellinger examines the interplay of ideology and identity, explores how student activists fit into a political landscape continually occupied by the traditional elite, and details how student leaders have established themselves through relationships with influential actors on local, national, regional, and transnational levels. The Rana regime’s repression caused students to be politically aware. In 1947, students held the first organised protest against the Rana autocracy demanding educational reforms. The breadth of student activism expanded during the Panchayat era after king Mahendra banned political parties, which drove mainstream politicians and parties underground. &nbsp;Student activists then became proxies for multiparty democracy because they were still able to organise.&nbsp; Student politics was institutionalised, and unions emerged as vanguard sister organisations of political parties. Student activism, more so than mainstream political parties, played key roles during &nbsp;both major movements in 1990 and the 2000s, as they mobilised the citizenry to join the democratic process.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250924130940_f94cf97fb7ed98b90b48736e1aa8a76466f50337dffc36ec78e9cd5e6927deea.jpg" data-media-id="editor_1" data-image-id="20250924130940_f94cf97fb7ed98b90b48736e1aa8a76466f50337dffc36ec78e9cd5e6927deea" data-rendition-name="original" width="1952" height="2928" loading="lazy" alt="1990 people's movement Nepal"> <figcaption>The iconic image of the 1990 People's Movement agaist the autocratic Panchyat regime of the king. Photo: MIN RATNA BAJRACHARYA</figcaption> </figure>  Through extensive ethnographic research between 2003 and 2015, Snellinger investigates the political coming of age of student activists during the final years of the armed insurgency and their role in and beyond the movement that ultimately abolished the monarchy. Her research revolves around the political journeys of five student activists: Akash and Rishi from the Nepali Congress (NC) student wing Nepal Student Union (NSU), Salini from the UML’s All Nepal National Free Students’ Union (ANNFSU-Akhil), Gyanu from ANNISU-Revolutionary of the Maoists, and Lagan, who began his political journey from Nepal Majdoor Kisan Party’s student wing Nepal Krantikari Bidyarthi Sangathan. The ‘movement against regression’ in 2003 served as the entry point &nbsp;for activists into national party politics. Indeed, it was their &nbsp;participation in the movement that elevated the profile of the main subjects of Snellinger’s research. In the years that followed, the paths of the five activists diverged. Some made it into mainstream politics, even becoming lawmakers. In doing so, they have had to trade idealism for pragmatism, and their attempts realise their previous vision for Nepal’s democracy have been overshadowed by their political opportunism and position. And even decades after they began their journey as student activists, the generation that the book focuses on are still considered &nbsp;‘youth’ leaders. Snellinger quotes a former student leader who joined mainstream politics as saying: “I am still a youth because &nbsp;my aspirations remain unfulfilled.”  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250924130944_7cca095d79fb5ce45cf92c61b77d72c31c5e0931aa744c73e264b6f91efdd29b.jpg" data-media-id="editor_2" data-image-id="20250924130944_7cca095d79fb5ce45cf92c61b77d72c31c5e0931aa744c73e264b6f91efdd29b" data-rendition-name="original" width="1500" height="1004" loading="lazy" alt="2006 People's Movement of Nepal"> <figcaption>A student protester wearing a paper crown and ridiculing Gyanendra with an impersonation, a day after king stepped down and left his palace. Photo: AJAY JOSHI / A PEOPLE WAR</figcaption> </figure>  Meanwhile, the refusal of Nepal’s octogenarian leaders to retire (even after The upheaval this month) has created a surplus of younger adults waiting in the wings, making the word ‘youth’ relative in Nepal’s political trajectory. Other subjects of Snellinger's research have retreated from student and mainstream activism, either in disappointment over their mother party’s retreat from some of their more radical positions, or to &nbsp;continue their work at the community level through education and journalism. One of them has leveraged her political connections to further women-led initiatives after unsuccessful election bids. Nearing the end of her research in 2015, Snellinger observes the disappointment of Madhesi communities whose movement to demand more inclusive provisions of the draft Constitution had gone in vain, even after 45 lives were lost.&nbsp; As the Constitution was promulgated in 2015, TVs were switched off in the Tarai, and there were sighs of resignation. In Kathmandu, Snelllinger noted that the student leaders that entered mainstream politics protesting for inclusive democracy had little empathy for the struggles and similar demands of groups in the Madhes. Despite the students’ role in ending the monarchy, Nepal’s political status quo has remained. The institutions and people that replaced the &nbsp;monarchy have allowed one set of Kathmandu elites to be replaced with another.&nbsp; The socio-political benefits promised during the movement two &nbsp;decades ago have remained tightly controlled by leaders who refuse to give up their hold on power. The political system was overhauled, but without concrete reform. It was only a matter of time before public frustration would boil over. Indeed, Snellinger concludes her book by predicting the inevitability of future movements in Nepal.&nbsp; She writes: ‘Leaders emerge through the andolan … a new generation will emerge shaped by Nepal’s accumulated socio-political heritage, which they will mediate to shape a liveable present and future for themselves in their country, perhaps by continuing the movement.’&nbsp; And that is exactly what happened on 8-9 September. Students marched in the streets demanding an end to corruption and impunity, but this time not as proxies of political parties.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250908120948_8a9acceede487651487c2f15b65e40f900ee6cd390bbf98394eade6b95d05b28.jpg" data-media-id="editor_3" data-image-id="20250908120948_8a9acceede487651487c2f15b65e40f900ee6cd390bbf98394eade6b95d05b28" data-rendition-name="original" width="1600" height="1200" loading="lazy" alt="Gen Z protest"> <figcaption>A student during the GenZ protest against acorruption on 8 September. Photo: SUDIKSHA TULADHAR</figcaption> </figure>  Their desire for socio-political reform was apolitical at a time in Nepal’s history when the nation’s student organisations have weakened and lost credibility, mirroring the erosion of trust in their parent parties. Along with party-based student unions, the Free Student Union (FSU)— the umbrella body all student unions—has lost its reputation due to corruption and embezzlement. That is not to say there are no similarities in movements past and present. Whether political or apolitical, protests have been overshadowed by a lack of unity within the groups that spearhead movements. They have led to destruction of public and private institutions.&nbsp; Leaders of youth and student movements have also had to bear the brunt of the frustration of the people they represent when there is no delivery on their demands. The academics of students have suffered because of frequent lockouts of university and college administration. Youth andolan, whether political or apolitical, has been a rite of passage into Nepali democratic politics — dissensus is an integral part of political regeneration. It remains to be see how the fall &nbsp;from grace of political parties after the GenZ movement will affect their affiliated student unions. As elections approach, student unions and youth collectives will find their own footing in Nepal’s &nbsp;newly emerging socio-political landscape. The youth who took to the streets are asking for a complete overhaul for political parties. Establishmentarian leaders still have not seen the writing on the wall.&nbsp; NextGen leaders in their parties have been waiting for years for their turn &nbsp;to break through the glass ceiling. These established political actors will not go down without a fight in the run-up to March elections.&nbsp; Amanda Thérèse Snellinger perhaps needs a post-script or even a sequel to her book to see how a new generation of leaders, forged by their student activism, will compete in Nepal's new political arena.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250923190928_98d53dd49d56c92950bc34642eaee51dea458fd64312d945a358ad70e5e994bb.jpg" data-media-id="editor_4" data-image-id="20250923190928_98d53dd49d56c92950bc34642eaee51dea458fd64312d945a358ad70e5e994bb" data-rendition-name="original" width="1136" height="702" loading="lazy" alt="Making new Nepal book details NT"> </figure>

Nepal’s historic youth dissensus

What does a journalist do when young protesters are shot in front of her? Does she do her job and stay neutral? Can you stay neutral?&nbsp; As protests engulfed Kathmandu, Nepal's journalists found themselves reporting a story that was personal. While doing their job, some of them were even targeted by mobs.&nbsp; Dart Asia Pacific Fellow <a href="https://www.linkedin.com/in/arunkarki/" target="_blank">Arun Karki</a> visited their newsrooms and spoke with his colleagues on their experience of reporting the GenZ protests that erupted on 8 September. These are the first-hand accounts of journalists who witnessed the turmoil in the city they call home. Sunita Karki was at a workshop in a hotel on 8 September. She saw the first waves of protests through hotel windows. Curfew alerts flooded her phone, a vehicle belonging to a human rights group sat burning across the road, young boys were taking their wounded friends on motorbikes to the Everest Hospital, and police were beating a teenager with hands raised up.&nbsp; “I cried a lot,” she said, but the tears were not out of fear -- they were because she felt guilt. “I couldn’t write the news. We were witnessing these scenes from a five-star hotel.” By evening, the death toll had reached 19. On 9 September at about 3:35 p.m. &nbsp;her outlet, the Annapurna Post's office in Tinkune, Kathmandu, was set on fire. Staff had to leave the building as parts of the newsroom burnt down.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250924040948_e1cc49c9e4fcc4bd4cd3c0163c782fc4e9956bf633cff7b53a63cf8e2dd74cff.jpg" data-media-id="editor_1" data-image-id="20250924040948_e1cc49c9e4fcc4bd4cd3c0163c782fc4e9956bf633cff7b53a63cf8e2dd74cff" data-rendition-name="original" width="1333" height="1000" loading="lazy" alt="Dart Centre Asia Pacific"> </figure>  When she knew her office was burning, she anxiously told her husband that she would resign from the job: "If we have to hide our identification cards in every protest, what kind of journalist am I?" she asked herself. She filed a story the next day, but her emotions kept bouncing between that of a journalist’s duty and shock. She said that in moments like this, it’s hard to feel truly neutral. After watching the police beat people, she felt a strong urge to step in, not just stand back and report. The first real calm came later, when people came to the street and lit small candles together. “This was a sort of victory procession. I felt some relief after brutal days,” she said. <a href="https://www.linkedin.com/in/angaddhakal/" target="_blank">Angad Dhakal</a> a photojournalist who works at Kantipur National Daily, was standing outside his office building when protesters stormed in and set parts of it on fire. He had already been informed that protesters were planning to torch his office building and &nbsp;rushed to his office hoping to save his hard drives containing ten years of photography work. He failed. He raised his camera and "forcefully" pressed the shutter - more to document the scene than out of "professional enthusiasm or duty".&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250924040948_ebafaacb85c4ea045c41f2c63f1eff06fee9a4ddb5fbf419724e1a5d533781fa.jpg" data-media-id="editor_3" data-image-id="20250924040948_ebafaacb85c4ea045c41f2c63f1eff06fee9a4ddb5fbf419724e1a5d533781fa" data-rendition-name="original" width="1333" height="1000" loading="lazy" alt="It is hard to feel neutral NT"> <figcaption>Photo: GAURAV POKHAREL</figcaption> </figure>  “My office was burning. What should I photograph?” he recalled. A few moments later, a protester noticed the “PHOTO” label on his yellow Press jacket. Dhakal deflected it by saying he was an early career freelancer and YouTuber. So that protesters wouldn't find out, he went to one corner and took his jacket off. When it comes to covering street protests, &nbsp;Angad usually stands near the police because it feels safer. But on 8 September, fire and gunshots made even that area unsafe. A rubber bullet hit his friend Dipendra Dhungana that badly injured him.&nbsp; He thought, “Where do we go now? If we stay here, we’ll be hit.” After witnessing two days of protests, violence, and killings, and seeing his own office burning, he couldn't sleep for days. The same afternoon that government buildings burned and Kantipur was attacked, a message in a protest Discord forum talked openly of 'attacking Kantipur'.&nbsp; Rumours spread to other outlets. Outside OnlineKhabar's office, where <a href="https://www.linkedin.com/article/edit/7376157229248528384/?author=urn%3Ali%3Afsd_company%3A79132377#" target="_blank">Gaurav Pokharel</a> works, the newsroom manager saw “very suspicious people were walking around”. They lowered blinds, avoided windows, locked the front gate and dispersed staff to other places across the city. The outlet was threatened and effectively locked down, but not torched. Pokharel hid his press ID. “ I never showed the ID card. Sometimes I had to enter the crowd shouting slogans, just to blend in among the protesters,” he said. He watched people fall under gunfire, he helped pull one surrounded journalist out of a hostile crowd.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250924040948_3b335eee57280373cb51f460534ca4476df23f89c787ba9e4a66d116a537b1a3.jpg" data-media-id="editor_5" data-image-id="20250924040948_3b335eee57280373cb51f460534ca4476df23f89c787ba9e4a66d116a537b1a3" data-rendition-name="original" width="1333" height="1000" loading="lazy" alt="It is hard to feel neutral NT"> <figcaption>Photo: GAURAV POKHAREL</figcaption> </figure>  As a freelancer, Gaurav also contributed articles for international outlets. Later, while transcribing an interview of a young protest organiser, he wrote to his editor at an international outlet : “This was very hard to write. I cried many times while doing it.” He had been working at a stretch for days battling bouts of exhaustion and low blood pressure.&nbsp; Protesters vandalised and set fire within the Singha Darbar complex housing Nepal Television and Radio Nepal. They tried to disrupt public broadcasting.&nbsp; Surendra Paudyal began the day with his press ID hanging on his neck, thinking it would let him move freely. But when he reached Singha Darbar around 3:30PM, the situation felt dangerous.&nbsp; He put the ID in his pocket. When asked what mattered most, he answered without pause: life comes first. In that moment, he felt real fear and a strong duty to protect his team.&nbsp; His focus narrowed to basic things: stay calm, find exits, get everyone out safely. Later, they were able to keep the 8 pm news on air through a regional link. He felt mixed emotions and a sense of relief that the broadcast continued, but also sadness and anger that their own studio had come under attack. Reprinted with permission from the Dart Centre Asia Pacific, a regional hub that provides trauma-informed support and advice to journalists.

"It is hard to feel neutral"

Harry Jackson was on an epic adventure ‘from Thailand to the UK on 2 wheels’ when he ran into the ultimate sidequest. Having just visited Zangla in Ladakh, Jackson had only landed in Kathmandu when he found himself in the middle of GenZ protests earlier this month. ‘<a href="https://www.youtube.com/watch?v=Slq6zWu9o9w">Arriving in Nepal - Chaos, Protest &amp; Curfews</a>’ is the title of his first video (<a href="https://www.youtube.com/@wehatethecold/videos">wehatethecold on YouTube</a>) about the protest. He shoots police as they shoot at protesters outside Parliament. Jackson is riding a Honda CT125, a retro lightweight motorbike with off-road capabilities. Strapped to the bike is his sparse luggage, flute, and a faded Union Jack. People are rioting on the streets and there is a heavy armed police presence as he makes his way to his hostel in Thamel. His vlog the day after on 9 September has 29 million views. In ‘<a href="https://www.youtube.com/watch?v=IyxSqeFrlp0">The side of Nepal the media won’t show you</a>’, Jackson rides his bike straight at the crowd just past the Parliament building into Old Baneswar.&nbsp; He parks it and walks among the protestors, documenting it all: from the police firing capsules of tear gas into the crowd to the burning Parliament building as well as the jubilant, victorious crowd in the premises as they destroy police vehicles and dance. “I’m shocked at the scenes I’ve witnessed here today. I have truly witnessed history on a stupid trip from Thailand to England on a f***ing moped!” exclaims Jackson as he leaves the scene for the day, heading back to his hostel to edit the footage. The hostel is in direct contrast to the raucous scenes of the protest, as tourists and Nepalis sit and lounge at tables. ‘KUIRE VLOGGER’ Nepalis quickly called him the ‘kuire vlogger’, and attribute his skin colour to his popularity. Objectively, the videos are well made. Jackson goes full gonzo journalist, putting himself right in the heart of the action, talking directly to the people, all while narrating the events as they unfold. Despite being cut together in an entertaining way, the footage retains a raw, unpolished quality that outdoes what most professional journalists with a heavy duty camera crew could do. At a time when legacy media has been seen to be pushing biased narratives, Jackson wants to see for himself what happened, and make up his own mind.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250925120956_f7141e06c72655502fc4b2e56120d084b0f5ae111078d66df4fd0415adf8d376.jpg" data-media-id="editor_3" data-image-id="20250925120956_f7141e06c72655502fc4b2e56120d084b0f5ae111078d66df4fd0415adf8d376" data-rendition-name="original" width="2880" height="1604" loading="lazy" alt="WehateTheCold"> </figure>  This kind of video journalism takes a lot of skill and a certain personality. Many people, almost everybody, had their phones out at the protests, but only a handful were like Jackson. He interviewed people firsthand, edited the clips and uploaded them the same day. Jackson continued his vlogging over the next few days as the curfew was first put in place and then lifted. He explores the city as the Valley rebounds. By this time, Nepalis recognise him everywhere he goes. Jackson had achieved moderate fame as a 23-year old DJ in Birmingham, but what he has done in Nepal is something else. Almost everyone he talks to has already seen his vlog, and they are all eager to interact. He has been on multiple podcasts in Nepal too, and most videos online on the protests reference his vlogs. Before his Nepal blogs, Jackson had a modest 16k subcribers on YouTube, but after Nepal figure is now almost 700k, gaining over 100k each through 11-13 September. Most of them are Nepali viewers. “I’m just a regular dude who just did what he wanted to do,” says Jackson on a podcast. “I wanted to go on an adventure, learn about history, and learn languages. And I wanted to film it, document it, and have a wicked film for my life to show future generations.” &nbsp;

The accidental journalist

Although instability is endemic to South and Southeast Asia, it is becoming increasingly dangerous both for India’s neighbors and India itself. This was reflected most recently in the violent unrest in Nepal. But that crisis is hardly an isolated case. In Bangladesh, directly to India’s east, the same tensions that led to the overthrow of the government in 2024 remain unresolved. And to the southeast, Thailand is reeling from the court-ordered removal of its prime minister and a series of recent border clashes with Cambodia. 
According to the Armed Conflict Location &amp; Event Data project, Myanmar’s civil war has claimed at least <a href="https://acleddata.com/report/war-sky-how-drone-warfare-shaping-conflict-myanmar" target="_blank">80,000 lives</a>, both civilians and combatants, since 2021, following the military coup that ended Aung San Suu Kyi’s democratic government. To India’s west, a perpetually volatile Pakistan wrestles with the zombies of its history: Islamist extremist groups and poor economic and governmental performance. 
To the south, Sri Lanka may have settled down following the ouster of its president three years ago, but its economy shows few signs of mounting a sustained recovery. And to the north, China’s quest for regional hegemony is another source of instability. 
For India, these crises are not distant concerns. Refugee flows from Bangladesh are causing social unease and disruptions in India’s eastern states; the never-ending threat of cross-border terror from Pakistan nearly incited a war in Kashmir this summer; and now, Nepal’s volatile politics have given China another opportunity for meddling. Since this arc of fragility is too large to ignore, the question for India’s leadership is how to absorb and minimize the shockwaves, and how to steady the region.
One can start with Nepal, which has struggled to live by the ambitious constitution that was forged to end a long Maoist rebellion two decades ago. Nepali state institutions remain fragile and contested, and hopes of stability have been repeatedly dashed by factionalism, corruption, and political leaders’ inability to consolidate a system that everyone can trust. The recent spasm of shockingly brutal violence is a symptom of these deeper fault lines. 
India cannot be indifferent to such instability. Our long, open border with Nepal makes us vulnerable to refugee flows and cross-border crime, and our deep cultural, ethnic, religious, and economic ties mean that the government in Kathmandu will always look over its shoulder at the government in New Delhi. Moreover, China’s increasing influence in Nepal’s domestic politics has, as a matter of necessity, made the country a major strategic concern for India. 
In Bangladesh, the interim government that has ruled since <a href="https://www.project-syndicate.org/columnist/sheikh-hasina">Sheikh Hasina</a>’s ouster is failing in its efforts to restore law and order or safeguard human rights. The economy, a bright spot for decades, is under pressure from domestic political jitters and US President Donald Trump’s punishing tariffs. The febrile political environment has left the country’s minorities feeling increasingly insecure. The stakes for India are high, because its own efforts to manage the border, migration, and counterterrorism depend on the regime in Dhaka maintaining order. 
At first glance, Thailand’s turmoil and the border clashes with Cambodia may seem less urgent. But India, under its Act East policy, has been pursuing deeper economic and strategic ties with the Association of Southeast Asian Nations’ ten member states and their 600 million-plus people. Any instability within that bloc will complicate this outreach. 
Moreover, Thailand has long served as a bridge between South and Southeast Asia. If its institutions falter, or if disputes with Cambodia escalate despite Malaysian Prime Minister <a href="https://www.project-syndicate.org/columnist/anwar-ibrahim">Anwar Ibrahim</a>’s best efforts to broker a resolution, India’s vision of a connected, secure Indo-Pacific corridor could become untenable. 
To describe Pakistan as chronically troubled may sound dismissive, but it is an unfortunate truth. The country’s civilian authorities have been consistently undermined, as when <a href="https://www.project-syndicate.org/columnist/imran-khan-1">Imran Khan</a>’s elected government was ousted in 2022 at the military’s behest. Extremist groups thrive when politics becomes a blood sport, and Pakistan’s fragile economy only exacerbates this dynamic. 
From India’s perspective, Pakistan’s troubles are more than a domestic issue, because they regularly threaten to spill across the Line of Control in Kashmir, fueling terrorism, destroying any prospect for regional peace, and even introducing the specter of a nuclear catastrophe. This continuous instability chains India to the sub-continental chessboard, even when it wants to look outward. The Pakistan-China axis further complicates the status quo, which is unlikely to change in the foreseeable future. 
All these stories point to a larger worrying trend: democracy in India’s neighborhood is in retreat. Constitutions are being rewritten, and courts politicized. Sensing weakness, too many army generals see themselves as free to intervene, including by jailing or exiling political leaders.
For India – the world’s largest democracy – responding to this trend demands a more assertive regional strategy. Of course, for most of South Asia, barring Pakistan, India is the first responder when crises hit. But during periods when India’s neighbors do not think they need its help, they tend to shrug off its security concerns. 
And as if India’s neighborhood were not dangerous enough, the wider world adds its own layers of uncertainty. Trump’s policy toward the region has been arbitrary in the extreme, leading smaller states to hedge their bets. In Japan and South Korea, debates are underway about the wisdom of acquiring nuclear weapons, now that China is flexing its muscles and the US security umbrella has been called into question. 
Although India has stood its ground in the face of the storm, the regional and Trump-induced volatility is making it harder to maintain the country’s treasured strategic autonomy. The task now is no longer to deepen ties with America, but to maintain the strategic, technological, and economic core of the partnership while building resistance against sudden shifts in US policy. 
India is not seeking dominance in South Asia. Its goal is to build an inclusive, rules-based, and connected region – and thus transform a history of recurring crises into a future of enduring stability. © <a href="https://www.project-syndicate.org/">Project Syndicate</a>
Nirupama Rao is a former foreign secretary of India and former Indian ambassador to China and the United States.

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