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;

original

674x448

610x380

500x500

400x266

400x240

400x203

301x200

1250x600

1084x550

Why are autism cases rising in Nepal?

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022111413114/63722eef9c7e80680e0c24ebjpeg.jpg" alt="" width="768" height="1024"/><figcaption>Bhavana with her young son. Photo: RITA ALE MAGAR</figcaption></figure>It was a night that Rita Ale Magar says she will never forget. Bhavana, 17, from remote Dumre Dara village walked 2.5 hours to reach a birthing centre of Udaypur.The underage mother was already 16 days overdue, her blood pressure was alarmingly high and she was going through prolonged labour. She was having difficulty pushing out the baby and was in severe pain.This was the most complicated case the centre had received, and the nurses were understandably nervous. But Nurse Rita had to lead the team and take the decision to try to save both the mother and her baby who were at high risk.“This was the moment when I had to use all the knowledge that I was taught by my mentors,” recalls Rita, who is a beneficiary of the Simulation-Based Mentorship Program (SBMP) of the group, One Heart Worldwide.After nearly two hours, the baby was born but that was only the beginning of the ordeal. The baby was not breathing and had no heart rate or muscle tone.“All of us thought the baby was dead, but we had to try our hardest to save him. I had less than a minute to give my best,” adds Rita, still shaken as she narrates her experience.It was at that point she remembered the ‘Golden Minute’ session she had learned about at the mentorship program -- the time needed for newborn resuscitation of babies born with asphyxia and deprived of oxygen.Nurse Rita quickly cut off the umbilical cord, put the baby on the resuscitation table and gave him electric suction which allowed it to start breathing. But the baby still looked pale, and was having difficulty crying.At the same time, the mother’s condition was worsening, she was bleeding profusely. The nurse sought help from a paramedic team to ventilate the baby with an Ambu bag while she tended to the mother.The baby's condition started to improve, but since there was no neonatal intensive care unit at the birthing centre, Rita referred the baby to a hospital in Biratnagar. The baby boy has since recovered and is now healthy.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022111413114/63722ef19c7e80680e0c24ecjpeg.jpg" alt="" width="389" height="515"><figcaption>Nurse Rita Ale Magar used the ‘Golden Minute’ to save a newborn who was suffering from severe complications. Photo: ONE HEART WORLDWIDE</figcaption></figure>“I was panicking but I benefited from my mentorship, and I will always be grateful to the clinical team from One Heart Worldwide who had trained me,” she adds.One would think that health professionals would not want to work in villages with minimal resources, but the opposite is true for Rita for whom being stationed in the far-off government birthing centre has been a challenge, but fulfilling when she can save lives like this recent case.Nurse Rita has delivered over 200 babies in the last three years. The birthing centre was initially under-equipped and she was the only Skilled Birth Attendants. This is where the One Heart came in to provide hands-on simulation exercises to nurses to get them ready for real-life birthing complications.Two nurses who received that simulated training were instrumental in saving the underage mother and her baby. They also counseled family members.Read also: <a href="https://www.nepalitimes.com/here-now/who-will-save-nepals-poor-new-mothers/">Who will save Nepal’s poor new mothers?</a> Rojita AdhikariThe patient, Bhavana did not know about the risks associated with pregnancies and was adamant about giving birth at home because she herself was born at home. Additionally, she had not seen anyone going to the birthing centre for delivery.Even after she was long past her due date Baavana was still not convinced about institutional delivery. It was only when she realised she was putting herself and her baby at risk did she relent.“Ultimately, she made the right decision but it was almost too late. Luckily, she survived. Saving her was so rewarding also because this could set an example to other villagers,” adds the nurse.But it is not easy for the villagers to get to the birthing centre due to the rugged terrain which further discourages them from accessing institutional delivery. There is no proper transport or ambulance service either. Most people have to walk over four hours to get to the centre which is especially inconvenient for pregnant women and girls.Says Rita Ale Magar: “But no matter how hard the journey, it is worth the effort because us nurses are here at the birthing centre to help mothers like Bhavana and their newborns.”Read more: <a href="https://www.nepalitimes.com/banner/no-conceivable-reason-for-unwanted-pregnancies/">No conceivable reason for unwanted pregnancies</a>, Rojita Adhikari

Balancing life and death in Nepal

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109111144/636b84729c7e80680e067796jpeg.jpg" alt="" width="1500" height="1125"/><figcaption>Rita Khatri, 21, is the only skilled birth attendant in her village of Phediguth of Okhaldhunga district, where she has helped to promote institutional birthing despite the challenges posed by the pandemic. All photos: NARESH NEWAR</figcaption></figure>Unlike many of her nursing colleagues who yearn to go abroad or find a job in a city hospital, Rita Khatri returned to her home village in Okhaldhunga after completing her training as a skilled birth attendant in Kathmandu.It was not easy for the 21-year-old to be taken seriously by her own community in Phediguth village of Champadevi Municpality, she had to earn their trust and respect one safe delivery at a time.But just as families in surrounding villages came to depend on her for vital <a href="https://www.nepalitimes.com/latest/3-nepali-mothers-still-die-daily-at-childbirth/" target="_blank" rel="noopener noreferrer">prenatal care and safe deliveries</a>, the Covid-19 pandemic hit. Now, on top of all the other health challenges in rural Nepal, there is the additional danger of being infected with this contagious new strain of the coronavirus that has spread across the country.Because of its remoteness and lack of connectivity, the pandemic has not affected this scenic district of eastern Nepal as seriously as other parts of the country. Still, there are 90 active Covid-19 cases in the district and a dozen people on average test positive every day.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109111144/636b84769c7e80680e067797jpeg.jpg" alt="" width="1500" height="1125"><figcaption> </figcaption></figure>Being a trained midwife, Rita Khatri’s main worry is that restrictions on travel and fears about the <a href="https://www.nepalitimes.com/here-now/birth-and-death-during-a-pandemic/" target="_blank" rel="noopener noreferrer">virus will affect maternal and neonatal health services</a> as most villagers are afraid to visit her birthing centre for check-ups and deliveries.“I am scared that the pandemic will set back all the work we have done here to reduce home deliveries and to improve maternal and infant survival,” Khatri says. “We had finally managed to convince families to opt for institutional birthing, but that might now change.”Staff at the centre are also worried about their safety, since this <a href="https://www.nepalitimes.com/editorial/this-is-war/" target="_blank" rel="noopener noreferrer">second wave is much more deadly</a> than the one in 2020. Last year, Khatri had helped mothers even when most government health posts had shut down in the districts, many staff were afraid to come to work, and if they did were afraid to even touch their patients.But Khatri kept the birthing centre open, and carried out 32 deliveries in 2020, some of them complicated ones where the <a href="https://www.nepalitimes.com/here-now/birth-and-death-during-a-pandemic/" target="_blank" rel="noopener noreferrer">mothers’ life would have been in danger</a> if they had given birth at home.“Closing down would have meant risking the lives of many mothers,” says Khatri, who has been trying to convince as many families as possible who are under her care that it was safe to visit the birthing centre.https://www.youtube.com/watch?v=ESmZURVRyN4It is much more difficult this year to convince both mothers and staff. Still, Khatri says, “I am also apprehensive about being infected, but I am the only SBA around here, and I want to ensure as many <a href="https://www.nepalitimes.com/banner/infant-deaths-up-during-nepal-lockdown/" target="_blank" rel="noopener noreferrer">institutional deliveries</a> as possible and save mothers and their babies from risking home births.”Khatri says that for her, nursing is not just a job. It is an occupation through which she wished to serve her community where there is no doctor for miles around. There is a steely determination in her thin voice as she says, “I will keep my doors open no matter how bad the pandemic is, this is what I was trained to do.”The community has a new esteem for Rita Khatri because of the dedication and hard work she displayed last year, and villagers are glad that they have her to go to for <a href="https://www.nepalitimes.com/opinion/newborn-deaths-and-a-vision-for-a-post-pandemic-nepal/" target="_blank" rel="noopener noreferrer">safe motherhood</a>.It has not been easy for Khatri to earn this trust. When she first returned home to Okhaldhunga to join Phediguth Health Post, villagers heard that a new ‘doctor’ had arrived. But when they came to visit, they were visibly disappointed that it was just a girl they knew from the village.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109111144/636b847a9c7e80680e067798jpeg.jpg" alt="" width="1500" height="1125"><figcaption> </figcaption></figure>But within a few months, Khatri proved herself through her profesionalism and ability to handle the most complicated maternity cases at the birthing centre which was upgraded with help from the non-profit, <a href="https://www.nepalitimes.com/banner/what-can-be-more-fulfilling-than-saving-lives/" target="_blank" rel="noopener noreferrer">One Heart Worldwide</a> (OHW).Not every delivery goes right, there are some which need specialist treatment or caesarian sections, others suffer post-partum haemorrhage and some mothers are already in a critical condition because they are brought to the centre too late. When the mother or child cannot be saved, Khatri has sometimes been slapped, kicked and verbally abused by angry relatives.“I could understand their frustration, but I did not let anything demoralise me,” says Khatri. “I was trying to the best of my ability to save their lives.”Today, everyone respectfully calls Khatri ‘Sister’, and some even call her ‘Doctor’. Many also have apologised for mistreating her in the past, and come bearing gifts to show their gratitude. “I refuse to take them because I am just doing my duty,” Khatri tells us.Champadevi Health Post has upgraded its maternity room, but there are many others across Nepal that are struggling with <a href="https://www.nepalitimes.com/banner/this-is-how-to-upgrade-nepals-rural-health/" target="_blank" rel="noopener noreferrer">proper buildings, equipment and staff</a>. The biggest challenge is the lack of nurses trained as skilled birth attendants.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109111144/636b847d9c7e80680e067799jpeg.jpg" alt="" width="1500" height="1125"><figcaption> </figcaption></figure>When Rita Khatri joined the Phediguth Health Post, its birthing centre did not have proper equipment, not even a maternity bed for deliveries. Most deliveries happened late at night without electricity, and mothers were in prolonged labour sometimes lasting 16 hours. Some of Khatri’s patients preferred lying on the floor to give birth because they found the table that served as a maternity bed so uncomfortable.Without electricity, staff had to stumble in the dark during deliveries, and it was difficult to keep the maternity room warm without heaters. Khatri tried unsuccessfully with the local government to get power supply, but it was One Heart Worldwide that installed solar-powered lights. Little by little, the facility was improved to be the clean and bright birth centre it is today.Khatri is modest about her accomplishment: “This is the least I could do for my birthplace, so giving birth is safe."To donate to Phediguth Health Post: Account name: Phediguth Health PostRastriya Banijya Bank, OkhaldhungaAccount number 207000290101

Saving Nepali mothers on Mother’s Day

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110111152/636cd8879c7e80680e092e49jpeg.jpg" alt="" width="1500" height="1125"/><figcaption>Phediguth village in Okhaldhunga where poor roads make access to health facilities difficult for complicated maternity cases. All photos: NARESH NEWAR</figcaption></figure>Stories of birthing are not the kind of conversation that children in Nepal usually have with their mothers. Surya Bhatta’s career path, however, took a new turn when his mother shared her own story of how she survived a near-death complication when she was giving birth to his elder sister.His mother was married at 11, and had her first baby at 16. Access to health services in their home village in Dhading was limited at the time, and she suffered from severe postpartum complications.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110111152/636cd88b9c7e80680e092e4ajpeg.jpg" alt="" width="640" height="364"><figcaption> </figcaption></figure>“Luckily, my mother survived but we all know many Nepali mothers still face similar risks due to poor maternal health,” says Bhatta, now executive director of One Heart Worldwide (OHW), a US-based organisation working in Nepal.At 34 Bhatta is proud to be playing a role to save the lives of mothers like his mother. Although the country has made vast improvements in reducing the maternal mortality rate from 539 per 100,000 live births 25 years ago to 240 today, it is still unacceptably high.An estimated 2,000 new <a href="https://www.nepalitimes.com/here-now/who-will-save-nepals-poor-new-mothers/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/here-now/who-will-save-nepals-poor-new-mothers/&amp;source=gmail&amp;ust=1615874753197000&amp;usg=AFQjCNEu5wCZ54G1e7vKzay3LB7DTXI7mA">mothers still die</a> in Nepal every year —  most of them because health posts are not properly equipped and staffed. The maternal mortality rate also went up in 2020 because the lockdown and pandemic prevented many mothers from getting to hospitals or birthing centres.Bhatta and his colleagues have been working to improve maternal neonatal health care, and with a 70-strong team is setting up birthing centres and hospitals in Nepal’s most remote districts to upgrade care for mothers and babies.<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110111152/636cd88e9c7e80680e092e4bjpeg.jpg" alt="" width="200" height="191">Starting from five villages of Baglung in 2010, One Heart has expanded to 21 districts and helped renovate and equip more than 500 birthing centres in 164 municipalities where road access is still limited. The centres work with local municipalities on a cost-sharing public-private-partnership formula.https://www.youtube.com/watch?v=tVA--CRk3nMMany government health posts in rural municipality wards are under-resourced and often struggle to even buy standard maternity delivery beds and lifesaving equipment. There is inadequate <a href="https://www.nepalitimes.com/banner/federalism-leaves-nepals-medical-sector-ailing/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/banner/federalism-leaves-nepals-medical-sector-ailing/&amp;source=gmail&amp;ust=1615874753197000&amp;usg=AFQjCNEX5KH1MBkZwv3gDbQd0uKEItLdXg">infrastructure</a> for pre-natal, delivery and post-natal care, and a chronic shortage of trained midwives in rural areas.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110111152/636cd88f9c7e80680e092e4cjpeg.jpg" alt="" width="1500" height="1710"><figcaption> </figcaption></figure>Nurses are not trained to handle complicated cases during and after delivery, and as frontline maternity workers face the wrath of local communities when mothers and babies die.Bhatta and his team have zeroed in on training nurses at health posts to become skilled birth attendants, an intervention that directly saves lives. One Heart’s trained nurses and renovated birthing centres now care for more than 72,000 pregnant women across Nepal annually.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110111152/636cd8929c7e80680e092e4djpeg.jpg" alt="" width="1500" height="1125"><figcaption> </figcaption></figure>“Even during the pandemic rural municipalities were able to find resources to share half the cost of construction to renovate the birthing centres,” says Bhatta who works in partnership with local governments and community groups.Bhatta sets program priorities after consultation with local elected representatives, tries to raise money locally, and then tops it up by competing globally for international grants. He says, “We can’t make our people always dependant on international aid. We need to be innovative by taking risks with new ideas.”<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110111152/636cd8959c7e80680e092e4ejpeg.jpg" alt="" width="1500" height="1125"><figcaption> </figcaption></figure>The partnership approach for upgrading birthing centres through cost-sharing is innovative, and one that encourages local ownership, clearly outlining outcomes. It went ahead because local governments under Nepal’s new federal structure were willing to start implementation immediately.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110111152/636cd8989c7e80680e092e4fjpeg.jpg" alt="" width="1500" height="1125"><figcaption> </figcaption></figure>“Entrepreneurship is needed in the social sector not for profit making, but for creating quality service that can go up to scale,” explains Bhatta. “Social entrepreneurship is all about evidence-based work that guide organisations to reduce risks and help improve through sustainable local health systems. There are challenges in Nepal, but there are so many opportunities to overcome them through partnerships like this.”<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110111152/636cd89b9c7e80680e092e50jpeg.jpg" alt="" width="1500" height="964"><figcaption> </figcaption></figure>Bhatta makes a case for Nepalis to return home after higher education overseas, just as he himself did after graduating from Dartmouth in the United States, fulfilling the promise he had made to his mother that he would make a difference for as many Nepali mothers like her as possible.He says, “I am proud of the team we have built, I feel we are making a difference especially for rural communities. What can be more fulfilling than helping save lives?

“What can be more fulfilling than saving lives?”

<figure><img width="1500" height="1000" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022111011114/636cccdf9c7e80680e08bc46jpeg.jpg" alt=""/><figcaption>Photo: WFP NEPAL</figcaption></figure>The Government of Japan is to provide assistance worth $3.47 million to the <a href="https://www.nepalitimes.com/banner/grow-nourish-sustain-together-world-food-day/" target="_blank" rel="noopener noreferrer">United Nations World Food Programme</a> (WFP) Nepal, to support families worst-hit by the loss of income because of the Covid pandemic. The Mother and Child Health and Nutrition Programme will fund projects in five districts of Provinces 1 and 2.
The support is in the long line of the Japanese government’s continued assistance to Nepal to improve the health and nutrition of young mothers and children. Outgoing Japanese Ambassador to Nepal Saigo Masamichi and WFP Nepal Country Representative Susan Jane Pearce signed the grant agreement. 
“This partnership between the Japanese Government, the Government of Nepal, and WFP has the potential to improve the health and nutrition of 19,000 <a href="https://www.nepalitimes.com/latest/the-lost-covid-generation/" target="_blank" rel="noopener noreferrer">children</a> aged 6 to 23 months and 49,700 pregnant and breastfeeding mothers through specialised nutritious food. Community Food Banks equipped with food storage facilities will be set up targeting 25,000 households,” said Masamichi during the signing event.
Jhapa, Morang, Sunsari, Saptari and Siraha districts, prone to annual flash floods and landslides made worse by the climate crisis, are the core project areas. The assistance will also help populations whose livelihood was disrupted by the Covid-19 lockdowns and the economic collapse, mainly in rural locations where agriculture is the primary source of income for families.
A series of surveys by UNICEF Nepal and Sharecast Initiative last year concluded that <a href="https://www.nepalitimes.com/editorial/pandemic-of-poverty/" target="_blank" rel="noopener noreferrer">42% of households in Nepal have no income</a> as an impact of the pandemic. The study also showed that another 19% families have a monthly income of less than NRs10,000.
A separate study by the Ministry of Agriculture showed that nearly <a href="https://www.nepalitimes.com/latest/nepalis-eating-less-due-to-lockdown-hardships/" target="_blank" rel="noopener noreferrer">a quarter of families in Nepal are eating less</a>, and 6% had run out of food following the coronavirus crisis. Province 2 is among the most vulnerable of the districts suffering the impact.
The grant will further boost the ability of 2,500 government officials and health specialists to support health and nutrition services during pregnancy and childbirth, monitor child growth, and provide nutrition counselling at 100 municipal health facilities.
Says Susan Jane Pearce of WFP Nepal: “Covid-19 has had severe impacts. By supporting the production and consumption of locally available and traditionally consumed nutritious food and through shock-responsive community food banks, we hope that this project will increase dietary diversity among the poor and food insecure households and build community resilience to climatic shocks.”

Japan to assist Nepali mothers and children

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110915118/636bb4569c7e80680e07bb98jpeg.jpg" alt="" width="640" height="427"/><figcaption>Photo: OM ASTHA RAI/NEPALI TIMES ARCHIVE</figcaption></figure>The world recorded an all-time low under-five deaths in 2019, but the COVID-19 pandemic has resulted in major disruptions to health services that threaten to undo decades of hard-won progress and put millions of additional lives at stake.There were 5.2 million children who died of preventable causes last year, compared to 12.5 million in 1990. But UNICEF, the World Health Organisation (WHO) and World Bank say the pandemic may force the mortality rate up again.“The global community has come too far towards eliminating preventable child deaths to allow the Covid-19 pandemic to stop us in our tracks,” says HenriettaFore, UNICEF Executive Director. “When children are denied access to health services because the system is overrun, and when women are afraid to give birth at the hospital for fear of infection, they, too, may become casualties of COVID-19.”Indeed, although SARS-CoV-2 seems to <a href="https://www.nepalitimes.com/latest/why-are-younger-people-in-poor-countries-dying-of-covid-19/" target="_blank" rel="noopener noreferrer">spare the younger population</a>, disruptions in medical care and in the supply chain for essential medicines is leading to a spike in non-coronavirus fatalities among children.For instance, the under-5 child mortality rate in Nepal had declined substantially from 271 deaths per 1,000 live births in 1969 to 31 in 2019 -- a dramatic 78% reduction from 1990 levels.Health services to prevent or treat causes of child death such as preterm, low birth weight, complications during birth, neonatal sepsis, pneumonia, diarrhoea and malaria, as well as vaccination, have played a large role in this progress.But following Covid-19 lockdown, Nepal saw a <a href="https://www.nepalitimes.com/banner/children-are-collateral-damage-in-nepal-lockdown/" target="_blank" rel="noopener noreferrer">30% increase in the number of under-fives who have died</a> in the March-April-June this year compared to the same period last year – mainly due lack of transport to take sick children to hospital, or reluctance to seek medical attention because of the fear of the virus.A rapid assessment conducted by UNFPA in coordination with Family Welfare Division during the initial phase of the lockdown period in Nepal also reported more than 60% decline in antenatal visits and 35% <a href="https://www.nepalitimes.com/banner/infant-deaths-up-during-nepal-lockdown/" target="_blank" rel="noopener noreferrer">decrease in institutional delivery as compared to before the restriction</a>.A UNICEF survey conducted over the past few months across 77 countries found that almost 68% of countries reported disruption in health checks for children and immunisation services, 63% in antenatal checkups and 59% in post-natal care.A recent WHO survey in 105 countries revealed that 52% of countries were experiencing disruptions in health services for sick children and 51% in services for management of malnutrition.“The fact that today more children live to see their first birthday than any time in history is a true mark of what can be achieved when the world puts health and well-being at the centre of our response,” says Tedros Adhanom Ghebreyesus, WHO Director-General. “Now, we must not let the COVID-19 pandemic turn back remarkable progress for our children and future generations.”Based on the responses from countries that participated in the surveys, the most commonly cited reasons for health service disruptions included parents avoiding health centres for fear of infection, transport restrictions, suspension or closure of services and facilities, fewer healthcare workers due to diversions or fear of infection due to shortages in personal protective equipment, and greater financial difficulties.Back in May, initial modelling by Johns Hopkins University also showed that <a href="https://www.nepalitimes.com/latest/pre-existing-diseases-may-kill-more-children/" target="_blank" rel="noopener noreferrer">6,000 additional children worldwide could die per day</a> due to disruptions due to COVID-19.To be sure, <a href="https://www.nepalitimes.com/opinion/newborn-deaths-and-a-vision-for-a-post-pandemic-nepal/" target="_blank" rel="noopener noreferrer">newborns</a> across the world were at highest risk of death even before Covid-19 pandemic. In 2019, a newborn baby died every 13 seconds. Moreover, 47% of all under-five deaths occurred in the neonatal period, up from 40% in 1990. Severe disruptions in essential health services due to Covid-19 have only added to the challenge.Says John Wilmoth, Director of the Population Division of the UN Department of Economic and Social Affairs, “While this report highlights the negative effects of the Covid-19 pandemic, it also draws attention to the need to redress the vast inequities in a child’s prospects for survival and good health.”

Covid-19 to reverse child survival gains

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110914114/636ba5fc9c7e80680e0736f8jpeg.jpg" alt="" width="1500" height="1000"/><figcaption>Photo: RSS</figcaption></figure>A report published online in the journal <a href="https://www.thelancet.com/action/showPdf?pii=S2214-109X%2820%2930345-4" data-saferedirecturl="https://www.google.com/url?q=https://www.thelancet.com/action/showPdf?pii%3DS2214-109X%252820%252930345-4&amp;source=gmail&amp;ust=1597502712571000&amp;usg=AFQjCNHILFhzVJvsa3-jDtOse6F5jqCotw">The Lancet Global Health</a> this week revealed that the COVID-19 pandemic has caused 50% fewer women in Nepal than usual to give birth in hospitals, resulting in higher risks for premature births, stillborn deliveries and newborn deaths.The study, conducted in nine hospitals across Nepal found that the stillbirth rate at hospitals and birthing centres increased from 14 per 1,000 before the lockdown to 21, and the neonatal mortality increased from 13 per 1,000 livebirths to 40.‘An urgent need exists to protect access to high quality intrapartum care and prevent excess deaths for the most vulnerable health system users during this pandemic period,’ the report noted.While the study focused on the indirect impacts of the pandemic on maternal and neonatal health service delivery, and did not attempt to calculate deaths resulting from these impacts, it warned: ‘During the COVID-19 pandemic, women and their babies (both in utero and neonates) are susceptible and at risk due to gaps in care that can result in adverse birth outcomes, including mortality.’It continued: ‘The decrease in the number of institutional births and increase in adverse outcomes are especially concerning because of Nepal’s fragile health system, and raisequestions on policies regarding strict lockdowns in low-income and middle-income countries.’In fact, <a href="https://www.nepalitimes.com/banner/children-are-collateral-damage-in-nepal-lockdown/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/banner/children-are-collateral-damage-in-nepal-lockdown/&amp;source=gmail&amp;ust=1597502712571000&amp;usg=AFQjCNF8MuMWip3DU9TRCsEF_50a5L1Atg">Nepali Times had reported</a> earlier this year that ‘many more children have died during the four months of lockdown compared to the same period last year because of lack of access to health care due to the restriction on mobility, interrupted vaccination campaigns and the lack of medicines.’‘Initial government figures also show that a total of 204 children under 5 have died across the country during the lockdown between 14 March-14 June. This number was at a much lower 151 during the same period last year,’ our report said.According to Lubna Baqi, Nepal Country Representative for the UN Population Fund (UNFPA): “The finding of (this week’s) study are deeply troubling. A drop in institutional deliveries by 52.4% has significant implications on health outcome as noted in the study. A further drop in institutional deliveries will have a devasting impact on maternal and newborn health.”An online rapid assessment by UNFPA in April found a similar decline, about one-half, in deliveries in health institutions. In June, Ministry of Health Spokesperson Mahendra Shrestha said fewer than 45% of women were giving birth in facilities, down from 75% before the Coronavirus pandemic.The Lancet study, based on monitoring in nine hospitals in Nepal, found decreases in:-       Institutional births (by roughly 50%)-       Foetal heart rate monitoring during labour-       Breastfeeding within one hour of birth-       Women being accompanied during delivery.The authors speculate that ‘the increase in preterm birth could also be associated with the distress of COVID-19-related social restrictions, considering psychosocial stress during pregnancy .’They add: ‘The increased proportion of admitted women having complications during admission, including preterm birth, during the COVID-19 lockdown period, might suggest that women at high risk of complications are disproportionately attending health facilities or that the number of complicated cases has increased due to delays and other challenges of the lockdown.’Those challenges are unfortunately already familiar in Nepal: lack of transportation to health facilities, a shortage of personal protective equipment (PPE), lack of gloves and other equipment for managing childbirth, and poor readiness of health facilities, etc.The Lancet study did report witnessing some improved practices, such as more skin-to-skin contact between mothers and newborns and better hand-washing. It suggests a ‘need to continue communication with policy makers and programme coordinators to address such inequalities and coverage gaps so that additional deaths can be averted’.In an interview earlier this year Baqi noted, “It’s good to have the ministry of health at the federal level saying, ‘Of course essential services must continue’ but there’s a big gap in implementation.”On Friday she added via email: ‘While current attention is on preventing and treating COVID-19 cases, it is likely that maternal and newborn mortality has increased across the country due to poor utilisation of services on the one hand and lack of preparedness on the other hand.’Baqi also pointed to shortages of trained personnel — including skilled birth attendants — essential life-saving drugs and PPEs. “The above concerns have received inadequate attention, among competing priorities, and limited financial resources have been mobilised to bridge the gaps in reproductive, maternal, child and adolescent health,” she said.The Lancet Global Health paper concludes: ‘Pandemic lockdowns threaten lives and jeopardise progress that has been made in the past two decades in Nepal, potentially derailing on-track efforts to achieve the Sustainable Development Goals by 2030, especially for maternal and neonatal survival.’

Infant deaths up during Nepal lockdown

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110914114/636ba5539c7e80680e0736bbjpeg.jpg" alt="" width="1232" height="691"/><figcaption></figcaption></figure>A survey of Nepal’s children during the lockdown has confirmed what experts had feared – that there has been an adverse impact on education and nutrition for a majority of them.More than half the families polled reported a loss of jobs or earnings, and this resulted in one-third of the households facing shortages of food, medicines and other necessities.This has impacted children within those households most directly, according to the first of a monthly tracking poll conducted nationwide by <a href="https://www.unicef.org/nepal/sites/unicef.org.nepal/files/2020-08/UNICEF%20Child%20and%20Family%20Tracker%20Survey.pdf" data-saferedirecturl="https://www.google.com/url?q=https://www.unicef.org/nepal/sites/unicef.org.nepal/files/2020-08/UNICEF%2520Child%2520and%2520Family%2520Tracker%2520Survey.pdf&amp;source=gmail&amp;ust=1597041203631000&amp;usg=AFQjCNGo2GmsIcJifQwp6zpDl4nROHaGhw">UNICEF Nepal</a> and <a href="https://www.sharecast.org.np/" data-saferedirecturl="https://www.google.com/url?q=https://www.sharecast.org.np/&amp;source=gmail&amp;ust=1597041203631000&amp;usg=AFQjCNEKj_ojDQ7aoqzexOM0-k93e6VWwg">Sharecast Initiative</a> at the end of May.Because more than two months have passed since the poll was taken, the situation for Nepal’s children is likely to be even more precarious. Some 7,500 households with at least one child was covered in the survey – more than 70% of them engaged in agriculture and a quarter with salaried jobs.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110914114/636ba5569c7e80680e0736bcjpeg.jpg" alt="" width="1220" height="691"><figcaption></figcaption></figure>Province 2 reported the highest rates (77%) of job and earnings losses, and those whose incomes were most affected by the COVID-19 lockdown lived in sub-metropolitan cities. People living in big cities and in Gandaki Province were less affected by the lockdown.This is sure to mean that the pandemic and the lockdown is widening already skewed income disparities within Nepal. Those earning less than Rs20,000 a month were the ones whose livelihoods have been most adversely impacted by the impact of the pandemic on the economy.Households facing the brunt of this income loss reported shortages of food, medicines, fuel and other essentials. Since the survey was conducted in May, many households were already low on food, and there were supply chain disruptions. <a href="https://www.nepalitimes.com/editorial/high-risk-remittance/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/editorial/high-risk-remittance/&amp;source=gmail&amp;ust=1597041203631000&amp;usg=AFQjCNExiQa1A5as__NPWZT6xxO45hciig">Remittances from Nepali abroad fell by half</a> in April, compared to the same month last year.“The survey was done in the early stages of the lockdown, so we expect the impact to be greater now,” says Madhu Acharya of Sharecast Initiative that conducted the survey.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110914114/636ba5589c7e80680e0736bdjpeg.jpg" alt="" width="1261" height="607"><figcaption></figcaption></figure>Although 64% of those surveyed said they were not suffering any shortages, rural respondents in Sudurpaschim and Province 2 reported the most food shortages. The shortages were manifested in families not being able to afford meat, eggs, dairy products, and some vegetables. This is expected to increase malnutrition among Nepali children under five, <a href="https://www.nepalitimes.com/banner/nearly-half-of-nepali-children-still-malnourished/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/banner/nearly-half-of-nepali-children-still-malnourished/&amp;source=gmail&amp;ust=1597041203631000&amp;usg=AFQjCNG5yDD3eoaiEaLZ7WwB4QofCnI1Jg">43% of whom were already malnourished.</a>More than half the children in Karnali Province are stunted because of insufficient nutrition. Many of the most vulnerable children who were getting in school meals have not been able to go to school for the past five months and have been <a href="https://www.nepalitimes.com/latest/nepals-out-of-school-children-get-food-at-home/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/latest/nepals-out-of-school-children-get-food-at-home/&amp;source=gmail&amp;ust=1597041203631000&amp;usg=AFQjCNG5tSrVm9ytGDAOD5UQYEULWR1SOA">missing out on supplemental nutrition</a>.One in every five household polled in the survey in May said their children were getting a reduced variety and smaller portions in fewer meals. Understandably, the reduction in food intake was highest in households with lowest incomes – one-third of them said their children were getting less food.Some 18% of mothers said they were breastfeeding more to compensate for reduced food intake of their small children, with the numbers much higher (32-34%) in Sudurpaschim and Karnali Provinces.Some 16% of breasting mothers of children under two from the poorest families reported that they were eating less, even though 90% of Nepali mothers said they were breastfeeding their children.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110914114/636ba55b9c7e80680e0736bejpeg.jpg" alt="" width="1238" height="652"><figcaption></figcaption></figure>UNICEF says that although some of these changes could be related to existing pre-monsoon shortages, it warns that the response of households to reduce food intake in children is worrying.The survey shows that in May most families had been coping by digging into their savings (better off families), or by borrowing money from friends and relatives (poorer households).Preliminery government statistics show that there has been <a href="https://www.nepalitimes.com/banner/children-are-collateral-damage-in-nepal-lockdown/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/banner/children-are-collateral-damage-in-nepal-lockdown/&amp;source=gmail&amp;ust=1597041203631000&amp;usg=AFQjCNG9CTMVDT2NWEjU0J5AJwHpS9VRuw">a 30% increase in the number of under-fives who have died</a> in the March-April-June this year compared to the same three months last year – mainly due lack of transport to take sick children to hospital, or reluctance to seek medical attention because of the fear of the virus.The survey found that although 83% of pregnant women had access to ante-natal care, the figure was much lower for Province 2 (74%). Disaggregating that data by ethnicity, it was found that only half the Tarai Brahmin mothers polled had health checkups during their pregnancy in May. Surprisingly, the figure for Tarai Dalits was a much higher 77%.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110914114/636ba55e9c7e80680e0736bfjpeg.jpg" alt="" width="1233" height="680"><figcaption></figcaption></figure>Perhaps the most serious impact of the lockdown has been on education. Even in May, 95% of households said their children had stopped going to school, and 52% were not even studying at home. O<a href="https://www.nepalitimes.com/here-now/digital-divide-exposes-class-divide-in-nepal-schools/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/here-now/digital-divide-exposes-class-divide-in-nepal-schools/&amp;source=gmail&amp;ust=1597041203631000&amp;usg=AFQjCNEUD9JnlY3pwhqxNosy9-vm1futCQ">nly 29% had access to distance learning</a>, but that only half were using it.That means only about 12% of Nepali children are taking classes online, or through radio/tv. Even here, the disparity is stark: while up to a third of children in higher income households were using distance learning tools, only 5% in poorer families were doing so.“The continued loss of access to education in low income families might have irreversible negative effects on the country’s economy and adversely affect the potential of the country to ensure equitable and sustainable development,” UNICEF concludes.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110914114/636ba5619c7e80680e0736c0jpeg.jpg" alt="" width="1259" height="706"><figcaption></figcaption></figure>The more positive aspect of the survey results is that there is high level of awareness about the way in which COVID-19 is transmitted, and most families appeared to be taking the necessary precautions.More than 93% knew how the coronavirus spread, what preventive measures to take and most said they were washing hands frequently with soap, staying at home, and wearing masks when outside. This means preventive measures against SARS-CoV-2 could also <a href="https://www.nepalitimes.com/opinion/prevention-while-searching-for-a-cure/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/opinion/prevention-while-searching-for-a-cure/&amp;source=gmail&amp;ust=1597041203631000&amp;usg=AFQjCNEl2beu0G5Dd2ZkbXxsSXNNMYqUjg">protect Nepalis from other prevalent infections</a> like diarrhea, typhoid, tuberculosis and other respiratory diseases.The household members told enumerators they got most of their information about the disease from radio (82%), from family and friends (72%), mobile ring tone (38%) and ward officials.More results of the UNICEF-Sharecast report <a href="https://www.unicef.org/nepal/sites/unicef.org.nepal/files/2020-08/UNICEF%20Child%20and%20Family%20Tracker%20Survey.pdf" data-saferedirecturl="https://www.google.com/url?q=https://www.unicef.org/nepal/sites/unicef.org.nepal/files/2020-08/UNICEF%2520Child%2520and%2520Family%2520Tracker%2520Survey.pdf&amp;source=gmail&amp;ust=1597041203631000&amp;usg=AFQjCNGo2GmsIcJifQwp6zpDl4nROHaGhw">here.</a>

COVID-19 impact on food and school in Nepali children

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109141136/636badaf9c7e80680e077fabjpeg.jpg" alt="" width="1400" height="933"/><figcaption>Photo: GOPEN RAI</figcaption></figure>On Friday, it will be four months since Nepal closed the country down to prevent the spread of  SARS-CoV-2, the virus strain that causes COVID-19. Of the 40 who have died of the infection in Nepal, two are children below 5.But many more children have died during the four months of lockdown compared to the same period last year because of lack of access to health care due to the restriction on mobility, interrupted vaccination campaigns and the lack of medicines.However, the coronavirus grabs all the headlines. Mortality due to non-COVID-19 causes does not make the news – even though it is clear that a lockdown enforced to control one disease has caused far more deaths from other prevalent diseases, and threatens to undermine Nepal’s progress in infant and child survival over the past four decades.“The COVID-19 crisis and lockdown have pushed many families into poverty, many have lost their sources of income, l<a href="https://www.nepalitimes.com/latest/eu-unicef-support-child-nutrition-during-lockdown/" target="_blank" rel="noopener noreferrer">eading to malnourishment among children</a>,” says Jhalak Gautam of the Child Health Division at the Health Ministry. “Increased malnutrition means children are more susceptible not only to COVID-19 but to many other infectious diseases such as measles and diphtheria.”Under-5 child mortality rate in Nepal had declined substantially from 271 deaths per 1,000 live births in 1969 to 32 in 2018. Government figures show that since 17 July 2018-16 July 2019, a total of 1,357 children under 5 died of various infectious diseases all over the country. Preliminary figures for the same period 2019-2020 is 1,263 – even though only 78% of the data has been collected.Initial government figures also show that a total of 204 children under 5 have died across the country during the lockdown between 14 March-14 June. This number was at a much lower 151 during the same period last year.This data clearly show that the total child death numbers collected by Female Health Care Volunteers is higher this year — meaning they died at home. The number of those who have died at hospital in the same three months this year is lower than last year probably because parents are not taking children to hospital when they are sick during the lockdown.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109141140/636badb39c7e80680e077facjpeg.jpg" alt="" width="1714" height="1210"><figcaption> </figcaption></figure>An expert at the Health Information Management System says when all the data for this year comes in, it is bound to be much higher than last year. This means the lockdown has pushed Nepal back in meeting its health targets under the United Nations’ SDGs (Sustainable Development Goals).Under the SDG target, Nepal is supposed to bring child mortality down further to 25 deaths per 1,000 live births by 2030. Persistent childhood malnutrition is a major reason for infant and child mortality remaining high despite dramatic progress in the 1990s. <a href="https://www.nepalitimes.com/banner/nearly-half-of-nepali-children-still-malnourished/" target="_blank" rel="noopener noreferrer">Figures for stunting, wasting and anaemia in Nepal have plateaued in the last decade</a>  Now, the lockdown has added to the challenge.Says Elke Wisch, UNICEF Representative to Nepal: “Progress made on children’s nutrition in the last decade is at risk of being reversed as rising numbers of children are facing malnutrition due to loss of household income and resulting food insecurity. The social and economic loss for Nepal resulting from the deterioration in children’s nutrition status will be felt long after the COVID 19 crisis is over.”The lockdown has also disrupted <a href="https://www.nepalitimes.com/banner/a-shot-in-the-arm-for-vaccines-in-nepal/" target="_blank" rel="noopener noreferrer">vaccination campaigns</a> across the country, leading to <a href="https://www.nepalitimes.com/here-now/meanwhile-a-measles-outbreak-in-nepal/" target="_blank" rel="noopener noreferrer">measles outbreaks in Dhading and Gorkha</a> in April. Although regular immunisation services have now been restored in health facilities in all 77 districts, parents have been unable to take their children for shots because of restrictions on transportation and also because of the fear of COVID-19 transmission in health posts.In fact, the WHO and UNICEF earlier this week stated that preliminary data for the first four months of 2020 points to a <a href="https://www.who.int/news-room/detail/15-07-2020-who-and-unicef-warn-of-a-decline-in-vaccinations-during-covid-19" target="_blank" rel="noopener noreferrer">substantial drop in the number of children completing three doses of the vaccine</a> against diphtheria, tetanus and pertussis (DTP3), first time in 28 years. Moreover, at least 30 measles vaccination campaigns were or are at risk of being cancelled, which could result in further outbreaks in 2020 and beyond.“Vaccines are one of the most powerful tools in the history of public health, and more children are now being immunised than ever before,” said Tedros Adhanom Ghebreyesus, WHO Director-General. “But the pandemic has put those gains at risk. The avoidable suffering and death caused by children missing out on routine immunizations could be far greater than COVID-19 itself.”With schools closed for the past four months, children in many schools are also not getting their lunches. Domestic violence has also seen a spike during the lockdown, with many of the victims children. There is also evidence of a <a href="https://www.nepalitimes.com/latest/child-marriages-up-during-nepal-lockdown/" target="_blank" rel="noopener noreferrer">rise in child marriage</a>  anxiety, stress and <a href="https://www.nepalitimes.com/here-now/post-pandemic-mental-health-epidemic/" target="_blank" rel="noopener noreferrer">mental disorder</a>Nepal appears to be on track to proving correct the grim prediction in May by the Johns Hopkins Bloomberg School of Public Health that 1.2 million children worldwide could die from pre-existing diseases like malaria, pneumonia or diarrhoea in the next six months due to the disruption to health services and food supplies due to the lockdown. That makes <a href="https://www.nepalitimes.com/latest/pre-existing-diseases-may-kill-more-children/" target="_blank" rel="noopener noreferrer">6,000 fatalities a day</a> – a whopping 45% rise in child mortality.“Under a worst-case scenario, the global number of children dying before their fifth birthdays could increase for the first time in decades,” UNICEF Executive Director Henrietta Fore warned. “We must not let mothers and children become collateral damage in the fight against the virus. And we must not let decades of progress on reducing preventable child and maternal deaths be lost.”<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109141140/636badb69c7e80680e077fadjpeg.jpg" alt="" width="3600" height="2400"><figcaption> </figcaption></figure>Another aspect of the pandemic that Nepal has to be careful about is that while worldwide data show that children are relatively safe from contracting SARC CoV-2 which has mainly affected people above 70 years, in Nepal children also seem vulnerable.Health Ministry data show that the rate of infection among children below 5 is 2.2% and increasing – much higher than the global average. The infection rate among young children was at just 1% a month and a half ago.Many of the infected children belong to families who returned from India in the past three months, but children have also been infected by people who flouted lockdown rules and safety measures. This is why Far-west Province has the highest coronavirus infection rate among children at 5%.Nepal has also seen a <a href="https://www.nepalitimes.com/latest/why-are-younger-people-in-poor-countries-dying-of-covid-19/" target="_blank" rel="noopener noreferrer">disproportionate number of COVID-19 infections and mortality among a younger population</a>  Experts say this is mainly due to young returnee migrant workers from India, Malaysia and the Gulf, who make for the majority of the coronavirus cases in the country. Moreover, testing across the country so far has focused on returnees.“Unlike elsewhere, in Nepal people with co-morbidity have a higher risk of dying regardless of the age group, and this is worrying,” says epidemiologist Sher Bahadur Pun of the Health Ministry. “But we must widen our testing to come to a concrete conclusion about this. So, <a href="https://www.nepalitimes.com/opinion/prevention-while-searching-for-a-cure/" target="_blank" rel="noopener noreferrer">until we have a vaccine</a> we must wear masks, maintain physical distance and follow hand hygiene. This includes children.”

Sonia Awale

Children are collateral damage in Nepal lockdown

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109141132/636bac049c7e80680e077f0djpeg.jpg" alt="" width="1152" height="532"/><figcaption>A mother in Kalikot District measures arm of her child using a MUAC tape after receiving a short orientation on family MUAC NT</figcaption></figure>The European Union and UNICEF are collaborating to prevent malnutrition in Nepali children due to the socio-economic impact of the COVID-19 crisis and have contributed €250,000 to monitor child health.COVID-19 crisis and the lockdown in its fourth month has pushed thousands of Nepali families into deeper poverty, leading to increased <a href="https://www.nepalitimes.com/banner/junk-food-is-making-nepali-children-shorter/" target="_blank" rel="noopener noreferrer">malnourishment among children</a>. Moreover, with Female Community Health Volunteers (FCHVs) unable to make regular visits during the lockdown, families’ access to health services has been reduced further.After taking great strides in reducing malnutrition that saw stunting decline from 57% in 1990s to 36%, figures for stunting, wasting and anaemia in Nepal <a href="https://www.nepalitimes.com/banner/nearly-half-of-nepali-children-still-malnourished/" target="_blank" rel="noopener noreferrer">have plateaued in the last decade</a>.Even before the lockdown, one in three children in Nepal were still malnourished. According to the 2016 Demographic and Health Survey, wasting (low weight for age) among Nepali children under 5 still hovers at 10% — a mere 1% decrease from 8 years ago.The UN’s Sustainable Development Goals require Nepal to reduce wasting to less than 5% by 2030. Stunting needs to be well below 15% in 10 years to meet the global target, it is about 36% now."Across Nepal, the COVID 19 crisis is putting children’s lives and their futures in jeopardy. Progress made on children's nutrition  in the last decade is at risk of being reversed as rising numbers of  children are facing malnutrition due to loss of household income and resulting food insecurity", said Elke Wisch, UNICEF Representative to Nepal. "The social and economic loss for Nepal resulting from the deterioration in children’s nutrition status will be felt long after the COVID 19 crisis is over."The €250,000 will support the 'Family MUAC' intervention under which MUAC (Mid-Upper Arm Circumference) tapes will distributed to 308 local governments across 30 districts in Nepal. The tapes enable parents and caregivers to monitor the health of their children themselves.The existing Multi-Sector Nutrition Plan volunteer in all local governments will facilitate the intervention and the partnership will also provide essential supplies such as ready-to-use therapeutic food.'Family MUAC' allows for the early detection and referral of children with acute malnutrition to the nearest health centre and subsequently to nutrition rehabilitation centres, all the while reducing the exposure of FCHVs and the community to the virus.“During the last 10 years, the EU has supported Nepal to combat malnutrition, with tangible results. However, the COVID-19 crisis is making this battle more difficult.” said Veronica Cody, EU Ambassador to Nepal. "Through increasing its financial support, the EU wants to send a strong signal to Nepal: the EU is and will be by your side to leave malnutrition behind."Since 2016, the European Union and UNICEF have been supporting Nepal to scale up its Multi-Sector Nutrition Plan across the 30 districts that have a high prevalence of maternal and child malnutrition. The key nutrition-specific interventions have included treating malnourished children, protecting, promoting and supporting <a href="https://www.nepalitimes.com/banner/back-to-the-nipple-in-nepal/" target="_blank" rel="noopener noreferrer">breastfeeding</a> and providing Vitamin-A and other micronutrients.The nutrition-sensitive interventions have included promoting hand washing, management of kitchen gardens, and ending early marriage, as well as supporting the related policies. This latest contribution will be shortly followed by a renewed EU support of €23.35 million, which will reinforce the implementation of the nutrition plan until the end of 2022.

EU, UNICEF support child nutrition during lockdown

One smoggy winter morning in February 2019, Ekta regretted coming to her sculpture class. It was the first day of her period, and the 19-year-old wished she was home, curled up in bed with a hot water bag to soothe her cramps.
Her class was at Kalapremi Ceramic Studio, a dark room on the ground floor of a house in Maharajganj, and Ekta’s teacher was the artist Gopal Das Shrestha ‘Kalapremi’, a noted sculptor.
Two other students were already there, using all their muscle strength to knead the sculpting clay. Ekta, now 24, recalls how Kalapremi asked her if she was feeling all right. She avoided him, as she did not want everyone to know she was menstruating.
Kalapremi repeatedly asked Ekta what was wrong. She finally muttered that she was having her period, after which he grabbed her hand and led her to a partitioned corner of the studio and sat her on a chair. Before she could stop him, he slid his hand under her dress, and started massaging her abdomen.
“I was horrified,” Ekta recalls. “I told him to stop, but he didn’t listen, asking me not to be shy, saying he knew how to relieve my pain. He stopped only after I protested furiously.”&nbsp;
The art tutor then said, “You’re like my daughter. I’m doing it out of love to make you feel better, but you’re so stubborn.”&nbsp;
“Instead of saying sorry he acted like I was the one having crazy thoughts,” remembers Ekta, adding that from April 2016 to August 2020 beginning the time she was 16, the artist sexually abused and harassed her on several occasions. &nbsp;
Now, Ekta and the artist’s other former students are finally sharing their experiences and some are pressing legal charges against him, hoping that others do not have to endure what they did.&nbsp;
Award-winning artist and teacher Gopal Das Shrestha ‘Kalapremi’ (the name means ‘Art Lover’) is known for his ceramic art, sculpture, and contemporary pottery. He was <a href="https://nepalitimes.com/review/the-house-of-kalapremi">profiled in Nepali Times after a collaborative exhibition</a>, ‘Where the Wild Things Are’ at the Siddhartha Art Gallery three years ago.&nbsp;
His pieces, titled Gaalis, featured sculpted female figures with the heads of dogs, sheep, and donkeys (pictured) to depict derogatory terms for women. Some critics said the collection was a satire on feminists.
Kalapremi started his artistic and teaching career in 1983 and over the years taught at Bhanubhakta School, Kathmandu University School of Arts, Lalitkala Campus and at his private Kalapremi Ceramic Studio. He has also lectured at Jeonju University in South Korea and recently at Tabor Academy in the United States.
Seven of Kalapremi’s former students were interviewed for this story. Five female students said he touched them inappropriately in his studio or at Kathmandu University. Two male students said they witnessed him abuse and harass the women. In all cases, the students struggled to recognise the abuse when it occurred, and the lack of reporting systems left them to cope on their own for years.&nbsp;
Earlier this year, students shared a social media post hinting at Kalapremi’s history of abusive behaviour following which more students of the artist reached out sharing similar experiences. Some students spoke of abuse that happened as long as 20 years ago.
Kalapremi, 60, has denied the allegations. He told Nepali Times: “Some years ago, there was a movement encouraging people to hug and kiss. I used to do it purely out of friendship and love. But after seeing posts on social media last year calling out my behaviour, I realised my actions may have hurt some people. I understand now that I should have been more mindful.”
He added: “I am also an auxiliary health worker, so I know the exact points to massage to relieve menstrual pain. It’s not just menstruation, I take anyone who is ill to the hospital.”
Sexual abuse is much more rampant than reported given how difficult it is to prove it in court. The law defines sexual abuse as occuring when someone touches another’s private parts, coerces them into touching theirs, uses vulgar language, shows degrading images, or behaves indecently towards them without consent.&nbsp;
Ekta and her fellow students are consulting lawyer Suneeta Regmi Pokhrel, who says they know that even if the court decides in their favour, it is difficult to survive after speaking up, and influential men defend themselves saying they are being framed.&nbsp;
“They are in a lot of pain and weep when recalling how he abused them,” Regmi Pokhrel told us. “They are angry and have filed a case against him, but they are also terrified. They know he is a powerful man and they have seen how our society treats women who speak up against abusers. Unless people speak up, perpetrators will be emboldened.”
Art and academia in Nepal simply reflect the power imbalances in society where people with intersecting identities experience worse forms of abuse. Theatre actors Raj Kumar Pudasaini, Rajan Khatiwada, and Sunil Pokhrel were called out during the #MeToo movement in the Nepali theatre scene in 2019. Even after the allegations Pokhrel went on to receive national awards, while others continued to work without repercussions.
“If you speak up against abusers, you gradually get sidelined from projects,” explained a theatre artist who wished anonymity fearing professional setbacks. “The theatre scene in Nepal is quite small, you just have to make peace with the perpetrators and work with them if you want to sustain yourself.”&nbsp;
In academia there is a history of faculty members sexually harassing students and getting away with it. After Tribhuvan University (TU) lecturer Krishna Bhattachan was accused of harassing women students, the university said it would follow Nepal’s sexual harassment law and set up a reporting mechanism. But nothing happened to the professor, who had already retired. Instead, he counter-accused the students of 'attacking the indigenous people’s movement with baseless allegations' as <a href="https://kathmandupost.com/letters/2019/01/29/bhattachan-responds">he told the Kathmandu Post in 2019</a>. He continues to be featured as a prominent speaker including at TU.
Other faculty members previously accused of sexual harassment include Jagadish Murti Koirala from TU, Bishnu Prasad Acharya from Ratna Rajya Campus, and Bodha Raj Tripathee from Lalitpur Madhyamik Vidhyalaya. A woman staff member from TU also filed a sexual abuse complaint against Dambar Chemjong from TU.
Prominent figures like <a href="https://nepalitimes.com/news/the-rise-and-fall-of-nims-purja">mountaineer Nims Purja</a> have been <a href="https://www.nytimes.com/2024/05/31/sports/mountaineering-sexual-harassment-abuse-nims-purja.html">accused of sexual assault</a>, and cricketer Sandeep Lamichhane, actor <a href="https://nepalitimes.com/news/celebrity-rape-case-spotlights-nepal-laws">Paul Shah</a>, and former speaker of Parliament <a href="https://nepalitimes.com/news/mahara-arrested">Krishna Bahadur Mahara</a> have been accused of rape, but society-at-large has let off the alleged perpetrators amdist a larger debate about justice for survivors and punishment of perpetrators.&nbsp;
‘Gaushala-26’ is the court name given to the 18-year-old who accused Sandeep Lamichhane, former captain of Nepal’s national cricket team and skipper of Biratnagar Kings in the <a href="https://nepalitimes.com/here-now/here-comes-the-nepal-premier-league">ongoing Nepal Premier League</a>, of rape. She left the country citing society questioning her character affecting her mental health while Lamichhane got an outpouring of support. In May, the Patan High Court overturned a prior verdict that found Lamichhane guilty of rape and had sentenced him to eight years in prison. During the 23-month legal battle to pursue justice, Gaushala-26 faced threats of gang rape and acid attacks.&nbsp;
Exhausted by the struggle, Gaushala-26 sought to “move to a new world” where she could live free without hiding her identity.
Actress Samragyee Rajya Laxmi Shah in an Instagram video now deleted detailed the harassment she faced from a filmmaker during a movie shoot. She did not name any name but veteran actor Bhuwan KC filed a defamation case against Rana, but the court ruled that the charge lacked sufficient evidence.&nbsp;
Former Kathmandu mayor <a href="https://nepalitimes.com/opinion/theytoo">Keshav Sthapit also mocked the #MeToo movement</a>, calling accusations against him by journalists Rashmila Prajapati and Ujjwala Maharjan “a rape of men’s rights”.
Serial Abuse
Back at the Kalapremi Ceramics studio, another former student, 24-year-old Rajiv, says he felt the need to speak out after seeing his female classmates being abused.&nbsp;
“He frequently kissed them on their cheeks,” he told Nepali Times. “Whenever they walked into the studio he flailed his arms like a child asking for a hug. They awkwardly hugged him from the side, but he pulled them closer, held their chin, and kissed their cheeks.”&nbsp;
Rajiv says he also saw Kalapremi pull the women’s bra straps, touch their breasts, and slap their buttocks. The young students would freeze, not knowing how to react, and if they protested, he would say it was “normal in art”. Rajiv, 19 at the time like his classmates, remembers thinking perhaps the well-respected artist was right after all.
Another student, Luna, who took lessons at Kalapremi’s studio from 2020 to 2022 did try to confront the tutor after he made an obscene proposal to her. She recalls: “One day when the other students had left the studio and it was just the two of us, he told me that God had given him special artistic talent and he could transfer those powers to me. But to do that both of us will have to be naked, inside a dark room, and have sex.”
Luna, who was 18 then, was livid and told him she did not want any of his powers, but she says he laughed at her as if he was joking. She did not tell her family about the incident because she thought no one would believe her.&nbsp;
“They were all in awe of this famous artist and felt I should be grateful that to be learning sculpting from him,” she says. “I was scared to be alone with him in case he talked about sex again. My coping mechanism was to be rude so he wouldn’t try to come close to me.”
Seeing how some classmates were standing up to Kalapremi, Ekta too tried to push back against his advances, but she said he found ways to coerce her. Since Ekta, Rajiv, and Luna could not afford Kalapremi’s Rs30,000 monthly fee for lessons, he had offered them all a stipend to assist him in the studio.
“He had spondylosis and took me to his therapy sessions to learn massage techniques, then he often made me and other students massage him,” says Ekta. Whenever she refused, he would feign pain to make her feel sorry for him. “He would insist that I put my hands under his shirt so that I could massage him better,” she adds.
The art tutor often tried to “seduce sympathy” from Ekta by sharing how he had never been loved as a child and was “sexually frustrated” as an adult.&nbsp;
“At 7PM, he would pour himself Signature whiskey and immediately go off again about how he was sex-starved. I didn’t know how to respond. It took me time to realise alcohol was just an excuse to talk about sex,” Ekta says.
If convicted, Kalapremi could face financial penalty and/or a prison sentence of up to three years according to Section 224 of National Penal (Code) Act 2017.&nbsp;
Data suggests that victims of child sexual abuse on average take nearly 24 years to tell someone about their trauma, and some may never disclose it at all.&nbsp;
“In our culture, children are rarely taught about boundaries. They often react, show anger when adults pinch their cheeks. But adults insist they did it out of love, and force the children to accept it,” says Sita Lama, a psychotherapist at Manka Kura. “And even when someone touches them inappropriately they struggle to identify and verbalise it.”
When perpetrators claim to be “acting out of love”, Lama says survivors are likely to perceive it as something safe, rather than recognising it as abuse.&nbsp;
“It may take years for them to realise they were abused,” she explains. "And even when they become aware, the power imbalance with the abuser and the associated shame often prevents survivors from speaking up."
Other former students from the School of Art at Kathmandu University have also come forward years later, saying Kalapremi sexually abused them. As young adults, they felt his behaviour was off but were uncertain if it was inappropriate, illegal, or they did not know how to respond. After having understood that it was indeed abuse, they say they are speaking out now to protect others.&nbsp;
Amina Singh, a visiting faculty member at Kathmandu University, says there is no clause against sexual abuse in contracts of teachers, and there is no formal grievance handling mechanism for the students.&nbsp;
“So the only way students can to deal with sexual abuse is approach someone they trust,” she says.
Eight other former art students of Lalit Kala Campus and Srijana College of Fine Arts of Tribhuvan University and other private art studios in Kathmandu say they were also sexually abused by their art teachers. Three faculty members interviewed from these institutions said they saw the abuse, but felt it was futile to report it given how powerful the teachers were.
In the absence of a formal system, some longtime women artists warned each other about “problematic” artists. They shared &nbsp;a “heads-up” to be more cautious when collaborating with them, and avoided responding to their calls and texts after work hours.
To ensure art institutions are safe for all, galleries, museums, artist studios, and smaller art spaces need to develop policies on sexual harassment. This would include a code of conduct or studio policies that hold the leadership accountable and outline the principles of professional ethics.&nbsp;
Students and employees should inquire about accountability mechanisms for raising concerns, both formally and informally, advocates say.
Three years after Ekta left the ceramics studio, she learnt that Kalapremi had harassed many other women. Still trying to get a footing in the art industry, she attended a workshop in Kathmandu where women artists discussed ways to stay safe in the art sector.&nbsp;
Since it was a close-knit group Ekta opened up about how she felt violated and realised she was not alone, he had been abusing underprivileged students for years, and this was common knowledge among artists in Nepal.
Ekta says that even after she quit, Kalapremi continued sending her text messages like ‘I am thinking of you’, ‘Why have you stopped speaking with me’, or ‘I am waiting for your call’.&nbsp;
But what really forced her to act was when Ekta found out that he was sending similar texts to her younger sister.&nbsp;
“I’ve had enough,” she told us. “He abused me all these years but I won’t let him abuse my sister.” &nbsp;
Ekta, Rajiv and Luna are not the real names of the students.&nbsp;

‘Art Lover’ accused of sexual abuse

It was 8:15 in the evening of 25 March 1968 when everyone in the village of Batulechaur near Pokhara heard a deafening sound like thunder as a bright flashing object hurtled down to land in a field.&nbsp; That field belonged to Kul Timilsina, and the next morning he retrieved a sheet of metal about 2m by 1m and carried it home with the help of a few others, thinking it would be useful for his buffalo shed.&nbsp; Before he died at age 83 three years ago, Timilsina had told photo archivist Sunil Ulak that the black metal sheet was not rectangular and had rounded corners. There are a few witnesses still alive who have a clear recollection of the object that fell from the sky that night.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2024120707128_75cc85aac56b9cc4a77366471f058d7b3eb6868776811b0923845c2d0a61f014.jpg" data-media-id="editor_0" data-image-id="2024120707128_75cc85aac56b9cc4a77366471f058d7b3eb6868776811b0923845c2d0a61f014" data-rendition-name="original" width="1170" height="601" loading="lazy" alt="UFO over Pokhara"> <figcaption>The field in Batulechaur belonging to Kul Timilsina where fragments of a flying object fell from the sky in 1968.</figcaption> </figure>  One of them is Timilsina’s wife Gyanu, who was 22 at the time. She had been at home, and remembers hearing the big bang and the sky becoming very bright. “We saw the thing in the field in the morning,” she told us. “It looked like a lid, a covering of some sort. The way it was stuck in the ground, it must have fallen from the sky. We thought we could use it to dry clothes on, and took it home.”&nbsp; Another witness is Kul Narayan Paudel. “I was only eight then. We ran to the field to see what had fallen. It was a four-sided metal sheet. The elders took it away, and I don't know what happened to it.” &nbsp; Ram Bahadur Baniya, a teacher at the local school, says he had heard the sheet had been brought to the school, and later handed over to the Zonal Commissioner at the time, Nanda Prasad Malla. “But that is all hearsay,” he says.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2024120707128_0bf207a12063fb8155b3c8d9a00a94887b126380c9e0627527c84cf5e1101f54.jpg" data-media-id="editor_1" data-image-id="2024120707128_0bf207a12063fb8155b3c8d9a00a94887b126380c9e0627527c84cf5e1101f54" data-rendition-name="original" width="1170" height="610" loading="lazy" alt="UFO over Pokhara"> <figcaption>Gyanu Timilsina, wife of Kul Timilsina.</figcaption> </figure>  There are two versions of what happened to Kul Timilsina’s metal sheet. One is that an American Peace Corp Volunteer teaching at the nearby Bindyabasini School took it, and another is that it was handed over to the government. Recently declassified Central Intelligence Agency (CIA) and US State Department documents from the time say that the US Embassy in Kathmandu tracked down the object two years later and had it shipped back to the US. A telegram from the Department of State and Department of Defense tagged as ‘MOON DUST / Space Fragments’ dated 1 March 1972 stated: ‘1. Restored space fragment will be on board Embassy support flight 115 arriving Kathmandu on or about March 10. Fragment is packed in shipping crate (cargo no. 72-33365) marked in care of DAO.&nbsp; 2. State and Defense representatives examined fragments prior to shipment finding restoration acceptable.’  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241207071212_929d903ee06d41baa4f6040e981cd7c7d7bd75cc9c37c9b617d307fc8538d2df.png" data-media-id="editor_2" data-image-id="20241207071212_929d903ee06d41baa4f6040e981cd7c7d7bd75cc9c37c9b617d307fc8538d2df" data-rendition-name="original" width="856" height="568" loading="lazy" alt="UFO over Pokhara"> <figcaption>Declassified CIA documents about the investigation into the object sighted in Pokhara. </figcaption> </figure>  The documents show that the US government, military and intelligence agencies investigated this incident thoroughly when it occurred, and have continued to revisit it ever since, as recently as five years ago. What is even more intriguing is that the object that fell in Pokhara was not the only unidentified space object that fell to earth that year. There were similar sightings of objects falling from the sky in Ladakh, Sikkim and Bhutan between 19 February and 25 March 1968.&nbsp; These mysteries were the subject of a CIA investigation in 1968 titled ‘<a href="https://www.cia.gov/readingroom/docs/CIA-RDP81R00560R000100070007-8.pdf">Sighting of Unidentified Flying Objects in Ladakh, Nepal, Sikkim and Bhutan</a>’, and the report is part of the recent online declassification of 800,000 top-secret documents from the period.&nbsp; &nbsp;Although unidentified flying objects (UFOs) have a connotation now of being alien craft, it could be pieces of satellite, missile, rocket or even aircraft. The CIA report documents six sightings in 1968 and quotes local sources as describing all of them having similar characteristics: bright blue or red streaks in the sky accompanied by loud sounds like lightning and thunder and objects falling to the ground. Aside from the metallic object that was found in Batlechaur, there were other items also found nearby in Tallakot, Tureypasal, Armalakot and Maidan. Whatever the object was, it seems to have disintegrated even before it hit the ground.&nbsp; The CIA report records the first sighting on 19 February 1968 in various parts of Sikkim and Olangchung Gola and Ghunsa in eastern Nepal. The light was said to be ‘long and thin’ and giving out ‘green and red light’. &nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241207071212_c3c825027d966a2aedc846970390eebe063957503c7eacc8e01e0517843f9bbb.png" data-media-id="editor_4" data-image-id="20241207071212_c3c825027d966a2aedc846970390eebe063957503c7eacc8e01e0517843f9bbb" data-rendition-name="original" width="892" height="596" loading="lazy" alt="UFO over Pokhara "> </figure>  Two days later on 21 February, a soundless blue object was seen traveling fast across the sky above Thimphu in Bhutan. Then on 4 March there were multiple daytime sightings or white streaks in the sky at Chang La Pass, Fukche and Koyul in Ladakh. There were more sightings in Ladakh on the very day fragments fell near Pokhara on 25 March 1968.&nbsp; After the sightings in Pokhara, rumours started flying in Kathmandu that these were aliens trying to land on Earth, it could be Russian or Chinese spy planes or satellites, and some even say it as a sign from heaven that the end of the world was near. This was at the height of the Cold War. The Russians and Americans were testing their thermonuclear devices as well as intercontinental ballistic missile delivery systems. The Washington-Beijing rapprochement had not yet happened, and China was making quick progress testing atomic bombs. Within two years after its first atomic test, in 1966 China exploded its first hydrogen bomb at the Lop Nur site in Xinjiang, 3,000km to the north from Nepal. After neary six decades, what is still intriguing is that all the sightings within a few months of each other in 1968 were along the Himalayan arc bordering Tibet: from Bhutan, Sikkim Nepal, to Ladakh. The US military intelligence seems to have concluded that this was not a coincidence and there were frequent research trips to the site in Pokhara by American officials in the months after the incident. With the help of the Royal Nepal Army, the region north of Pokhara was thoroughly searched.&nbsp; A confidential memo dated 25 June 1968 by Jerry C Trippy to a ‘Mr Farley’ mentions that the US Air Force’s Foreign Technology Division had decided that the debris could be important because it may be related to a Chinese missile test or a Soviet ‘Vehicle Venik’ rocket.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241207071216_feb5425692dc36b20187de4e4fcc2ce9fd12b6d9e1b8724398e50bcdbf9032fe.jpg" data-media-id="editor_5" data-image-id="20241207071216_feb5425692dc36b20187de4e4fcc2ce9fd12b6d9e1b8724398e50bcdbf9032fe" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="UFO over Pokhara"> </figure>  On 28 August 1968 the US Embassy in Kathmandu sent a letter to Washington DC saying that the object could be of Soviet origin, possibly from when the rocket carrying the ‘Kosmos 208’ satellite re-entered the atmosphere. But why were the fragments falling to earth several weeks apart, and in the same region? No one knows where the metal sheet that Kul Timilsina recovered is now. It was definitely packed in a crate and taken to the US, and although it is rumoured that it was returned that is not very likely. Archivist Sunil Ulak heard from the Timilsina family that CIA officials had returned to the site five years ago. &nbsp; Interest in UFOs peaked in the US in the 1950s, with the Cold War space race and tests of atomic weapons and delivery rockets. CIA and scientists were being sent to investigate sightings, both publicly and privately. Could the Pokhara fragments as well as the sightings in Ladakh and Bhutan actually be alien craft falling to earth? The renewal in interest in space travel in large part due to Elon Musk’s SpaceX, UFOs and sightings are again subjects of public interest.&nbsp; Even 57 years later, even if there was definitive proof about whether the Batlechaur fragment was from a Chinese missile or a soviet rocket, it has not been made public in documents declassified so far. We may never know.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241207071216_b6938795f40731e7657fd6dcbb3cf460a326186a15eb11d4f832f602201ff598.jpg" data-media-id="editor_6" data-image-id="20241207071216_b6938795f40731e7657fd6dcbb3cf460a326186a15eb11d4f832f602201ff598" data-rendition-name="original" width="642" height="320" loading="lazy" alt="UFO over Pokhara"> </figure>  Sunil Ulak speculates if the debris actually came from an American aircraft, perhaps on an intel mission upon China. “Which could explain why they were so thorough in collecting the fragments in Pokhara,” he says. But that still does not explain the multiple sightings weeks apart in 1968.&nbsp; Indeed, US military aircraft were at that time flying frequent night-time missions from air force bases in India to supply weapons to Khampa guerrilla camps in Nepal located north of Pokhara in Mustang. It could very well be that the Chinese shot down one such aircraft. The other sightings could have been contrails of US spy planes, or Chinese anti-aircraft missiles.&nbsp; There were quite a few developments regarding UFOs in 2024. In a US congressional hearing in July, former intelligence officer David Grusch claimed that the government had long been involved in a program to investigate and retrieve non-human craft crashes, and then try to reverse engineer them. However Grusch did not show any evidence.&nbsp; The UAP Disclosure Act of 2024 was signed into law by Joe Biden in December 2023. It plans to oversee the public disclosure of UFO information. However, there is a clause in it that prevents disclosure if it would cause threats to military defense, intelligence operations or foreign relations.&nbsp; It is unlikely that the declassified documents about sightings in the Himalayan will cause any real surprise about definite evidence of alien life even if it was found. It seems humanity will continue, at least for now, to wonder about curious lights in the sky and whether there is anybody out there.&nbsp;

UFO over Pokhara

When Rastriya Swatantra Party (RSP) president Rabi Lamichhane was arrested in October on charges of defrauding depositors of cooperatives, the party’s vice president Swarnim Wagle gifted him Fareed Zakaria’s book, Age of Revolutions.
Since then, Lamichhane has been shunted around from Kathmandu to Pokhara to Chitwan and back to Pokhara to attend police investigations and court proceedings. He was being flown to Birganj via Kathmandu on Buddha Air on Monday. There is another pending case in Janakpur.
Human rights groups and civil society have criticised the government for hounding Lamichhane with inhumane treatment that borders on physical torture. The two parties in the coalition, Nepali Congress (NC) and the UML, see Lamichhane’s RSP as a potentially formidable challenge to their power.
Even if the fraud charges against Lamichhane are true, the Nepali public is increasingly looking at the government’s actions through the police and courts as political vendetta.
Despite all the travelling, sometimes by plane and often by road at night, Lamichhane appears to be in high spirits, waving to supporters who often gather if they know he is going to be driven around. A social media video shows him giving high fives to fellow passengers on a recent flight to Pokhara.&nbsp;
In the past weeks, streets in Pokhara have erupted with parallel protests by Lamichhane’s supporters as well as depositors of cooperatives who lost their savings to the scam.&nbsp;
Although family visits are allowed, prison officials in Pokhara told Nepali Times that not many people visit Lamichhane these days. He added, “When he does get visitors, he asks them to bring him books.”
Lamichhane is currently Nepal’s most high-profile public figure in custody, and highlights the stark difference between how influential prisoners are treated compared to ordinary inmates.
There are six prison cells at Kaski District Police Office’s two-story detention centre, three on each floor. And while authorities pack prisoners into already overcrowded cells, Lamichhane has an entire room on the second floor to himself.&nbsp;
He has also been allowed to call his family every few days. Other prisoners are not permitted phone calls except for emergencies.
Meanwhile, Lamichhane’s former business partner Chhabilal Joshi, an ex-Deputy Inspector General of Police with whom he established his Gorkha Media Network, is in custody under the same charges in the prison cell next to him.
Lamichhane is accused of siphoning off depositors' money to the tv network in which he was part-owner and anchor. &nbsp;
Both Lamichhane and Joshi are able to buy food from the police canteen instead of being served the regular meal like other prisoners. Joshi has also given his statement to authorities in Rupandehi and Kathmandu for his alleged role in the scam. Lamichhane is yet to be presented in Kathmandu for questioning.
While he was in custody at the Kathmandu District Police Complex, Joshi expressed his desire to sleep in a police officer’s office, reportedly assuring authorities that he would not run away and he was entitled to certain facilities as a former officer of the law.
“He seemed to be under the impression that he is still a police officer,” says a source at the Kathmandu District Police. “We made it clear to him that as someone accused of a crime, he was not entitled to special treatment.”
Former ministers Balkrishna Khand and Top Bahadur Rayamajhi, and ex-home secretary Tek Narayan Pandey, who were arrested in connection with the fake refugee scam last year, were similarly housed in the offices of law enforcement officials instead of prison cells. Khand has since been released after six months in jail.
While there is no legal provision to keep high-ranking officials in separate detention centres when they are arrested, authorities granting them special facilities is not uncommon. Law enforcement officials say VIP detainees expect preferential treatment while in police custody.
Among those is former Kosi Province minister Lila Ballav Adhikari, who was arrested from Biratnagar on 10 November over his alleged involvement in human trafficking and brought to Kathmandu. Adhikari had flown to Japan without government approval with three individuals on 29 October to attend a cultural conference, but had been sent back to Nepal from Narita.&nbsp;
His three companions were arrested at Kathmandu airport upon their arrival, but Adhikari was able to exit unscathed from the VIP lounge. Adhikari had resigned as the Kosi Province Minister for Internal Affairs and Law when it became public that his companions had been taken into custody, and was himself arrested shortly after. He has since been cleared by the courts.
Throughout his detention, Adhikari was kept separately from other inmates. Senior Superintendent of Police (SSP) Basant Rajouri, head of the Bhadrakali complex, says that while there is no separate detention area for VIPs, some detainees are kept separately depending on the nature of their crime.
However, sources say that arrangements were made for retired judges and others to visit Adhikari frequently worked at the office of a Deputy Superintendent of Police (DSP) during his time in custody.&nbsp;
“He used to constantly pester the authorities to let him sit outside in the sun, and to be able to use the police officer’s shower area,” added an officer.
Adhikari was released on 25 November after the government prosecutor’s office decided not to charge him in a move that was seen to expose the government’s double standards.
Over at Kathmandu’s Dilli Bazar Prison, former Kist Bank CEO Kamal Gyawali emerges from his prison cell into the courtyard of the prison’s ‘Ka (क)’ block every morning with a thick book in his hands, ready to give his daily sermon.
With his long beard, Gyawali, who is serving a prison sentence for banking fraud, looks the part of a religious guru as he implores his rapt listeners to “walk the right path, abandon bad thoughts and turn to scripture and spirituality”.&nbsp;
Afterward, the attendees gather to discuss politics and current affairs. Inmates at his daily sermons at the prison include other high-profile detainees, including former MP Ichchha Raj Tamang, who is in jail for money laundering and cooperatives fraud, former joint secretary Chudamani Sharma, who was convicted of corruption, as well as NC leader Chandra Bahadur Lama and Krishna Bahadur Upreti of the UML both of whom are on trial for embezzling billions of rupees.
Victims of the cooperatives scam that former lawmaker Tamang was involved in have made trips to the prison and requested visits, but he has refused to meet with any of them.
“Tamang often complains that the state has prevented him from returning the money to the victims by locking him up,” says a police officer at the Dili Bazar jail.
“All you hear every day from the VIP prisoners is that they have been framed,” adds the officer. “No one admits that they were involved in misdeeds.”
But while most high-profile prisoners complain about prison conditions, one exception is former provincial lawmaker Deepak Manange, who is serving a sentence at Dilli Bazar Jail for attempted murder.
“He is the happiest prisoner here,” says a warden. “Unlike the others, he doesn’t claim to have been framed, in fact he doesn’t seem to care that he is in prison.”
Manange is detained in the ‘Kha (ख)’ block of the prison complex, which he renovated at his own expense. The block previously housed female prisoners, but Manange used his influence to transfer them elsewhere. He faces no shortage of visitors, who range from political leaders to people from the underworld.
Along with Manange, other well-known prisoners in this block include Nepal Telecom Managing Director Sunil Poudel, and former executive director of the Surakshan Printing Centre Bikal Poudel, who are serving time for corruption.
Former prisoners at Dilli Bazar prison include ex-ministers Khum Bahadur Khadka and Shyam Sundar Gupta, NC leader Ganesh Lama, Maoist MP Balkrishna Dhungel, Nagarik Unmukti Party leader Resham Chaudhary, as well as former IGs Ramesh Chand Thakuri, Om Bikram Rana, and Hem Bahadur Gurung.
Section 54 of Nepal’s Prison Act assigns each prison’s internal administration the
responsibility of governing its prisoners, which means the more favourable the jail management is, the more comfortable it is for prisoners.
Dilli Bazar prison has been the prison of choice for many high-ranking prisoners, especially those convicted of white collar crimes, due to its more accommodating administrators. The prison, which has the capacity to house 700 inmates, is also less crowded than other jails.
Anuj Bhattarai, spokesperson of the Department of Prison Management, says that there is no legal classification in Nepal for felons to be assigned prisons based on the nature of their crimes.
“That Dilli Bazar Jail has a higher number of prisoners convicted of crimes like corruption is most likely a coincidence,” says Bhattarai. “There is no provision for influential people to be able to choose where they will be incarcerated.”&nbsp;
Translated by Shristi Karki from the Nepali original published in himalkhabar.com

What Nepal’s VIP prisoners do in jail

As soon as she milks her cow, 52-year-old Punam B K is off, pedaling her bicycle furiously along the highway with a blue milk can in the front basket.&nbsp; By the time she arrives at the Jaya Shiva Ganesh Dairy Producers Cooperative in Gopalganj village, others are already there, their bicycles parked on the roadside. The farmers are all holding on to their blue milk cans, and are chatting away.&nbsp; “We keep what is needed for the family, and sell whatever remains here at the cooperative,” says B K, as the volume, fat and non-fat solid content of her milk is measured. It is then poured into a bigger vat to be mixed with milk from other farmers. B K collects her receipt with the value of her milk, and prepares to head home. The farmers are reimbursed on a quarterly basis.&nbsp; Read also: <a href="https://nepalitimes.com/multimedia/a-family-that-works-together-stays-together">A family that works together stays together</a>, Sahina Shrestha “Everyone around here has at least a cow or buffalo to provide milk for the family, the cowdung is used for fertiliser, and we can bring whatever is left over to the cooperative,” says B K who, like the others, brings her milk by bicycle twice a day, once in the morning and again in the evening.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241210081232_0df32c0f6a572aef83eca02dc7a86f75ea5dbc88dc6c2390d42a44ab3cc93395.jpg" data-media-id="editor_1" data-image-id="20241210081232_0df32c0f6a572aef83eca02dc7a86f75ea5dbc88dc6c2390d42a44ab3cc93395" data-rendition-name="original" width="1700" height="1275" loading="lazy" alt="dairy farmers in Chitwan"> </figure>  All this may seem like nothing special, just an ordinary farmer selling her milk. But it has to be seen in the context of dairy farmers overcoming subsistence and increasing household income. Nearly 200,000 dairy farmers from over 1,200 cooperatives have not been paid by the government-run DDC for their milk for a year or more.&nbsp; The DDC has fixed a quota for buying milk from cooperatives that limits production even during the peak winter months. Farmers in Chitwan are so fed up, they have staged demonstrations in Kathmandu and even poured milk on the East-West Highway in protest.&nbsp; Punam B K’s milk ends up in Bhawani Dairy, a milk processing plant in Chitwan that buys milk from various cooperatives in the district. It was established six years ago by three entrepreneur cousins Devrath Baral, Drishya Baral and Subash Paudel and is now being supported by the Commercial Agriculture for Smallholders and Agribusiness (CASA) project.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241210081232_4e3c65390b9c5345f807b10cbb8c36b006ef6d3cb972e07b5067f4b2db2be32e.jpg" data-media-id="editor_2" data-image-id="20241210081232_4e3c65390b9c5345f807b10cbb8c36b006ef6d3cb972e07b5067f4b2db2be32e" data-rendition-name="original" width="1500" height="1102" loading="lazy" alt="dairy farmers in Chitwan"> </figure>  This UK-funded project implemented by Swisscontact in Nepal has been supporting agro-businesses in 23 countries in Asia and Africa. They focus on improving the capacity of private dairy and vegetable farmers to find markets and build a sustainable supply chain for their produce. It helps dairies like the one in Chitwan with branding and marketing, as well to track business through a Dairy Management System (DMS) digital database.&nbsp; Bhawani Dairy also got support to conduct orientation for cooperative farmers to learn about new ways to boost productivity with breeding, cowshed management and hygiene maintenance. Many commercial farmers in Chitwan, some with up to 60 cows and buffaloes, have benefited.&nbsp; B K says she only has six cows, so not everything she hears at the orientation about increasing cowshed area is applicable. “We are just happy our milk is not wasted, and we can earn some cash from the surplus,” she says.&nbsp; Bhawani Dairy’s clientele is based entirely in Chitwan and in towns along the East-West Highway. But building on its success here, the company is looking to expand nationwide and target the Kathmandu market. Being a perishable product, the <a href="https://nepalitimes.com/opinion/so-far-so-good/nepal-s-milk-heartland-rebounds">diary business is challenging</a>. Businesses also need investment and technical support to diversify into value-added milk products like cheese, yoghurt, ice cream or powdered milk.&nbsp; “For now, the best thing we as a dairy business can do for farmers is to buy their milk at a decent price and pay them in time,” says Drishya Baral of Bhawani Dairy.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241210081232_6c06efb5674dbcd8679015af543bfda87030755383a13c9269e272af28e85953.jpg" data-media-id="editor_4" data-image-id="20241210081232_6c06efb5674dbcd8679015af543bfda87030755383a13c9269e272af28e85953" data-rendition-name="original" width="1700" height="1275" loading="lazy" alt="dairy farmers in Chitwan"> </figure>  Another agro-industry supported by CASA since 2018 is Himalayan Supervores, a venture that sources farm produce to supply vegetables and other foods to restaurants and hotels in the city, and even export Halal-certified produce to Gulf countries.&nbsp; CASA helped with cold chain management system to keep vegetable produce fresh so that the products earn trust about quality in the national and international market. Himalayan Supervores is already exporting to UAE and Qatar, and is targeting other Gulf countries next. “The guidance provided by the international expert was invaluable, we could not have bought that knowledge even with money,” says Nelson Shrestha of Himalayan Supervores. “It was not about fancy hardware, but how to minimise wastage, increase productivity, save time and money.”&nbsp; Though Himalayan Supervores collects vegetables from vegetable cooperatives, it indirectly works with a network of thousands of cooperative farmers. Its catchment area therefore is enormous, and it has enhanced their knowledge about organic farming methods, bio-pesticides, and the right way to handle and package vegetables. CASA’s most recent tie-up is with Pokhara-based Poshilo Foods, which specialises in increasing the shelf-life of local nutritional food items. During the Covid lockdown <a href="https://www.instagram.com/p3bparajuli/">Prithwi Kallyan Parajuli</a> saw an opportunity to supply nutritional foods that stayed longer, and set up Poshilo.&nbsp; It took traditional satu flour made from dry-roasted pulse, added more nutrients, and packaged it. Four flavours of satu with nutrient values differentiated for various age groups now line the shelves of supermarket chains like KK Mart, Saleways. Poshilo is now exploring the export market in India.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241210081232_a8dbea8c8d45ac4eff6c37fb47da7ff461989c662ba86d207a008381101acdcf.jpg" data-media-id="editor_6" data-image-id="20241210081232_a8dbea8c8d45ac4eff6c37fb47da7ff461989c662ba86d207a008381101acdcf" data-rendition-name="original" width="1700" height="1275" loading="lazy" alt="dairy farmers in Chitwan"> </figure>  In the five years of helping Nepali agribusinesses, CASA has already teamed up with 35 established companies. Parajuli heaps fulsome praise on the catalytic support and guidance he got early on, not just for product design, but to explore market viability, branding and marketing.&nbsp; He has participated in government-led programs before, but says those are one-off and focus only on technical solutions and do not pay much attention to the important back-end work with management and sales.&nbsp; Says Devrath Baral of Bhawani Dairy in Chitwan: “We would probably have eventually got to where we are now, but it would have taken years longer without CASA. And now we can share our experience with other agribusinesses in Nepal.”

child-health