The corridor between Simara and Birganj is Nepal’s prominent industrial area. Proximity to the Indian border, and location astride the main highway to Kathmandu also makes it an important trade route. However, these very attributes also bring out many problems, including health risk. Pollution of the waterways by factories is one hazard, the toxic effluents leaching into the soil contaminating groundwater.&nbsp; The other less visible but insidious health hazard on both sides of the border is from <a href="https://archive.nepalitimes.com/article/nation/impact-of-lead-on-intellectual-development%20,3820" target="_blank">lead poisoning</a>. Neither in India nor in Nepal is there much awareness in government or the public about the long term impact of lead in the environment. &nbsp; The solution to this problem should also be crossborder, but like with every other transboundary issue there is very little discussion between the two governments about it. International Lead Prevention Week (21-26 October) is as good a time as any to look into the issue. <a href="https://www.thelancet.com/journals/lanplh/article/PIIS2542-5196(23)00166-3/fulltext#:~:text=The%20global%20cost%20of%20lead,income%20losses%20from%20IQ%20loss." target="_blank">Worldwide, lead exposure risk</a> has reduced after leaded gasoline phase-out because it was discovered that lead in the environment caused a reduction of IQ and cardiovascular disease in people. In Nepal, however, research by the group <a href="http://cephed.org.np/" target="_blank">CEPHED (Center for Public Health and Environmental Development)</a> in Kathmandu has shown that lead is still present in paint, lead chromate used in colour dyes specially during Tihar, and in cooking utensils. Nepal is already at the bottom in terms of average intelligence of the population, according to the <a href="https://worldpopulationreview.com/country-rankings/average-iq-by-country" target="_blank">World Population Review.</a>&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241025161024_45dd6cad017d1c1387d238213bb2cbfcadae2e0b17bedb839c44ca47bfd8655f.jpg" data-media-id="editor_4" data-image-id="20241025161024_45dd6cad017d1c1387d238213bb2cbfcadae2e0b17bedb839c44ca47bfd8655f" data-rendition-name="original" width="1674" height="1360" loading="lazy" alt="lead poisoning in Nepal"> </figure>  Another <a href="https://a70774f5.streaklinks.com/CK_WIdlTE-cobDnhCwv4l9MA/https%3A%2F%2Fwww.nature.com%2Farticles%2Fs41598-024-59519-0" target="_blank">Rapid Market Survey</a> by the group Pure Earth that analysed hundreds of household items in Nepal found that 14 types of ceramic, aluminium or plastic kitchen ware had levels of lead above safe limits. Recycled aluminium cookware that leach lead is said to be the best-known of the three sources. Here in the Tarai, there is evidence that lead content in the <a href="https://journal.com.ph/lead-loaded-eyeliner-tested-in-malaysia-also-sold-in-the-philippines/" target="_blank">kajal traditional eye-liners </a>used daily by women is high enough to be a health hazard. The frightening thing is that despite the known risk, there have been no studies in the borderlands between India and Nepal about the lead content in the bloodstream of the population, especially of women and children. There are some extrapolated global statistics that suggest one third of urban Nepalis have blood lead levels that are higher than the safe threshold. Even Amarnath Thakur of the Mangalam Diagnostic Centre in Birganj says there are no reliable figures on lead contamination. There was a paper published in the Journal of Pathology of Nepal in 2016 that said the blood lead level among school-going children was ‘alarmingly high’. “There has not been enough definitive research, but the condition is probably not very good, especially among children,” says paediatrician Sailash Thakur, who thinks it is largely because of the proximity of the industrial corridor. In Kathmandu, two out of every three children could grow into adults with <a href="https://archive.nepalitimes.com/article/nation/impact-of-lead-on-intellectual-development%20,3820" target="_blank">limited mental and intellectual capacity</a> because of high blood lead content. “Imagine what this will do to our country,” said paediatrician Imran Ansari at Patan Hospital told <a href="https://archive.nepalitimes.com/article/nation/impact-of-lead-on-intellectual-development%20,3820" target="_blank">Nepali Times in 2018</a>. A 2013 survey of school children in Kathmandu Valley calculated that every extra 10 µg/dl concentration of lead in the blood resulted in <a href="https://archive.nepalitimes.com/article/nation/jiom.com.np/index.php/jiomjournal/article/download/744/686" target="_blank">a drop in IQ of 2.35 points</a>.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241025161024_ad9df4419d7a7e9adcc77393dca9aab8680bb514797e66f940efcafbb8acc75a.jpg" data-media-id="editor_10" data-image-id="20241025161024_ad9df4419d7a7e9adcc77393dca9aab8680bb514797e66f940efcafbb8acc75a" data-rendition-name="original" width="1700" height="1118" loading="lazy" alt="lead poisoning in Nepal"> </figure>  Here in Birganj, children and pregnant women are exposed to high lead content, but there is little awareness, no strategy to tackle it, and no action on the part of local, provincial or federal governments. Awareness is especially necessary just before festivals like Diwali, Chhath, or Holi when spices, vermilion and other colour powders are used with <a href="https://nepalitimes.com/news/toxic-tihar" target="_blank">high lead chromate content</a>, as well as heavy metals like cadmium and strontium that are highly toxic. The paint industry uses lead to make the products shinier, to reduce rust and to make paint dry faster. Even though the companies say that they voluntarily no longer use lead, there is little monitoring whether they do or not. One research in the Tarai found groundwater contaminated with lead and arsenic, but municipalities here have never heard of either. It has been ten years since the Ministry of Forests and Environment issued a gazette notice fixing the maximum lead concentration in paint to 90 ppm (parts per million). But that regulation seems to exist only on paper, and the government has abandoned its primary responsibility of safeguarding the health of people. Lead poisoning is not like other types of toxic ingestion, children and adults can be exposed to it through the ambient air and once it enters the bloodstream the lead then affects the brain and other organs over the long term. Children have been found to be especially vulnerable. Lead poisoning can even expose the foetus if the mother is exposed to it, and the damage it does is much more serious than what it would do to an adult. There are many sources of contamination: carelessly disposed lead acid batteries, inverter batteries, e-waste, leaded paint, water coming out of older leader pipes. But the general public is mostly unaware of these risks.&nbsp; Lead poisoning is a hidden danger, and if the federal government does not care, it should be the Madhes Province that does by spreading public awareness, monitoring sources of lead, and providing safe alternatives. &nbsp;Cooperation with local governments across the open porous border in India would also be essential.

Chandra Kishore

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The silent danger of lead

Humla is in the remote northwestern corner of Nepal. And in a remote corner within Humla district is Limi Valley. Culturally, linguistically and even geologically, this is the Tibetan Plateau, and Limi’s 2,000 inhabitants are facing the threat of cultural erosion and outmigration of its young people. Now, however, local schools are trying to change that by ensuring quality education not only so that local children do not have to go to faraway boarding schools, but also to attract students from other parts of Humla. The Aatmiya Shree Sunkhani Basic School in the village of Halji has Tibetan language classes and tries to instil pride in students about their local culture. It has also invested in better dormitories and other facilities so the school does not have to close in the winter months because of the extreme cold there at 3,700m elevation. Following the construction, the school hopes to revamp the quality of instruction, and change the focus of curriculum to address the challenges of heritage loss and outmigration. Limi Valley is the location of the 1,100-year-old Rinchenling Monastery and represents the cultural soul of Upper Humla. It has enormous potential for pilgrim tourism because of the proximity to the sacred Lake Mansarovar and Mt Kailash across the border in China. Limi has three villages: Til, Halji, and Zhang, and they each had a school till five years ago but they closed down because of lack of students. The valley is only accessible by crossing the 5,000m Nyalu Pass, and its extreme remoteness translates into isolation, lack of jobs and opportunities. Most young people have migrated to Kathmandu, or to Purang across the border in China. What is left in Limi are the elderly, and children separated from parents. “Only grandmothers are left in the community,” says Anjila Thapa of Aatmiya. Humla’s children are growing up in Kathmandu or abroad and losing touch with their culture. Aatmiya is a Nepal-based sister organisation of CITTA, a non-profit seeking to bring healthcare, education, and economic development to the most remote and underserved communities in Nepal and India. It was founded by American artist Michael Daube, whose love for anthropology and Buddhism led him to work in the region. CITTA runs a Women’s Economic Development Centre, hospitals, and schools in Jaisalmer and Odisha in India, and also manages a hospital in Sindhuli. Aatmiya (which means ‘intimate’ in Nepali) was started in 2011 as a public-private partnership under which there are government teachers as well as those supported by the project. Earlier, schooling was not much more than “kids teaching kids”, says Daube, and government teachers were unwilling to travel to such remote parts of Humla and were mostly absent.  <figure><img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20240616020616_4b1ba2f6d9f351d4d4e1b50607e1df85a2221444b0bae2b0eb5d1fcd7e865d75.jpg" data-media-id="editor_0" data-image-id="20240616020616_4b1ba2f6d9f351d4d4e1b50607e1df85a2221444b0bae2b0eb5d1fcd7e865d75" data-rendition-name="original" width="1600" height="1200" loading="lazy" alt="Limi Humla school"></figure>  Their unfamiliarity with the local language and culture also meant that schools were actually the reason for cultural erosion. Now, with its Community Centre housing for teachers and a free hostel for students, parents can feel more confident in their children’s education and accommodation year-round while keeping them in Limi. “Earlier, people in surrounding areas used to say Limi was poor and backward,” says Ward Chair Paljor Tamang. “Now, people say that if the school provides teachers and opportunities, children will come from other parts of Humla to study up here.”  <figure><img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20240616020616_23d9bf409f31a8d3ed559aa3ff2b11d0b8f7b315904242d1c9f20880503e3cb0.jpg" data-media-id="editor_1" data-image-id="20240616020616_23d9bf409f31a8d3ed559aa3ff2b11d0b8f7b315904242d1c9f20880503e3cb0" data-rendition-name="original" width="1600" height="1066" loading="lazy" alt="Limi Humla school"></figure>  The school, centrally located in Dalji, is set to be inaugurated in September, with the construction of the site's main building nearly complete (pictured above). Even so, the push factors driving young people away may be too strong to halt outmigration. “Construction and hardware won’t bring students back,” admits Anjila Thapa, who wants to start additional teacher training before classes begin. The school is adding Tibetan language teachers, and Aatmiya also plans to introduce fellowships focusing on extracurricular activities and a holistic education. CITTA Country Director Sanjeev KC says the school’s success will not just be measured in maintaining student numbers, but increasing them by attracting those from the community currently studying in faraway Kathmandu. “Within the next five years, we hope to have 70 or 80 students,” says KC. “We identified the gaps in education and worked with the community to understand their needs. That is why we pooled our resources for a centrally located school.” There is now a need for a high school till SEE level, and the goal is to make its present Grade 7 the first graduating class. Daube wants Aatmiya to be more than just a school, but an effort to preserve the culture and local economy. The organisation recently began working with local women to produce and internationally market shuktu, traditional woollen blankets. When the Limi Valley School opens in September, it aims to prove that modern education and cultural preservation can go hand-in-hand. “Of those who have left Limi, many still own land and farms here”, says Tamang. “With adequate facilities and opportunities, we may see them return”.

Saving Humla from heritage loss

This piece is not about Tapasi Pannu’s Bollywood movie, Thappad. But the echo of that slap from childhood still echoes in my ear.&nbsp;
It was the first and only time my father ever laid a hand on me. It could happen again, since Nepali parents have a tendency to believe that no matter how old you are, you are always a child. They can hit you even in your 30s.&nbsp;
My father, a retired high school principal, seldom raised his voice at us while we were growing up. His silence and stern gaze were nevertheless frightening to us youngsters, and struck fear in our hearts.&nbsp;
As children, we never dared speak to him directly. Our mother acted as an intermediary, even in trivial matters like buying a ball-point pen for Rs4.
Read also: <a href="https://nepalitimes.com/news/why-do-so-many-nepali-students-underperform">Why do so many Nepali students underperform?</a>, Anita Shrestha
This was the 1990s, and we all excelled in studies. We were disciplined children who never uttered a curse word. We respect our elders. We were the epitome of well-behaved children.
So imagine our shock when I was subjected to physical punishment from my father for the first time. And it all had to do with my use, or misuse, of the English language.
We started learning English in Grade 4. I had topped not only my &nbsp;class, but the entire school. I could recite what was on any page in my text book. I had a photographic memory.&nbsp;
I excelled not only in academics, but also in General Knowledge. I could rattle off all the countries of South Asia and their capitals and heads of state.&nbsp;
My sister and I were the only two students in our class who had mastered the multiplication table up to 20. One day, our primary school principal announced that only students who knew the table up to 20 could go home, while the rest had to stay back and keep learning until they did. My sister and I found ourselves waiting until evening for our classmates to catch up.
Read also: <a href="https://nepalitimes.com/banner/after-quantity-nepals-education-needs-quality">After quantity, Nepal's education need quality</a>, Prakriti Kandel
I was 9, and also starting to learn to spell simple English words. I took immense pride in my progress because my grandfather did as well. However, it wasn't enough for my father.
That day, I was doing my English homework, while my father and his colleagues were engrossed in a political conversation. One of his colleagues suddenly asked, "Which grade are you in?"
"Fourth," I replied proudly.
He continued, "What is your roll number?" (Ah, the roll number, a prestigious measure of talent in those times.)
"One," I answered confidently.
He then asked me to recite the multiplication tables for 7, 9, 13, 17, and 19. Which I did, and I noticed my father’s eyes gleaming with pride.
My father’s other friend was also interested and asked me what I was writing.&nbsp;
When I responded “English”, he asked me to write out the lowercase alphabet — widely regarded as the more challenging aspect of English writing. I guess he was trying to confirm if I truly deserved the Roll Number 1 position.&nbsp;
To everyone's surprise, I swiftly wrote out the lower case alphabets from a-z. Satisfied, he was about to return to the political conversation when my father abruptly asked me, "Can you spell 'dog' for Uncle?"
“I can,” I said. “D-O-G,”
"And how about 'god'?" my father pressed on. I spelled god, and everyone was impressed.
Then my father asked me to spell ‘bag’. In those days, children attending <a href="https://nepalitimes.com/editorial/ministry-of-education-gets-an-f">government schools</a> in <a href="https://nepalitimes.com/here-now/the-marginalised-on-the-margins">rural Madhes</a> had to carry our books cradled in our left hands. Sometimes, they held the books tightly against their chest with both hands, like parents carrying a child.&nbsp;
School bags were fancy and rare. Only private school students had bags. You could be sure a student carrying a school bag, wearing shoes and a tie would be attending a private school.&nbsp;
I had never carried a school bag, and did not know how to spell it. I looked up at the ceiling and squirmed, and my father’s eyes widened. The lines on his forehead showed disappointment.&nbsp;
It must have been less than a minute, but it felt like an eternity. The more time I took, the more they saw me as unworthy of having Roll Number 1. To escape my predicament, I blurted out: “B-O-G."&nbsp;
That was it. My father rose from his stool and slapped me on my face. No one stopped him. His colleagues tried to console me by urging me to study harder.&nbsp;
Read also: <a href="https://nepalitimes.com/here-now/learning-rubbish-memorising-gibberish">Learning rubbish, memorising gibberish</a>, Yugottam Koirala and Yugeshwor Koirala
I was in shock. I had never imagined that my father would ever hit me. The slap did not just hurt me physically, but left a deep emotional scar. I fell ill with a fever that evening, and everyone knew the reason.
No one said a word to my father. My grandfather consoled me, but said that I needed to study even more diligently. As if I had not been studying diligently before.&nbsp;
I have hated the English language ever since. I never dedicated myself to learning English properly in class. And I hated English even more after we had Thoo (ठू) Sir. But that is a story for some other time.

Anbika Giri

The Thappad

Flipping through the pages of the government textbook for Grade 7 Nepali, one comes across this baffling paragraph which would be funny if it were not so serious:&nbsp; An elderly couple live in a village. They bear a son in their old age whom they name Balram. When Balram grows up to be a young man, the couple decide to get him married. The wedding is a grand affair. Balram’s wife is exceptionally beautiful and his parents are ecstatic about having found such a beautiful buhari. However, the sasura, curious about her intellect and disposition, decides to test her. So he calls her in and asks her, ‘Buhari, can you tell me how much you think we spent on your wedding?’ Read also: <a href="https://nepalitimes.com/here-now/learning-rubbish-memorising-gibberish">Learning rubbish, memoring gibberish</a>, Yugottam Koirala and Yugeshwor Koirala Red flags go up all over that paragraph that serves as the story's exposition. But wait, things get even more interesting:&nbsp; &nbsp;The buhari replies, ‘I think you must have spent only about 2-3 manas of rice grains’. Offended by these words, the sasura retorts as he fumes with anger, ‘Your wedding cost me a fortune, and you’re saying 2-3 manas of rice grains is all that was spent? You make it seem like I incurred no expenses’. In what sounds like a line lifted right off of a hammy Indian daily soap, the sasura then goes on to say, ‘I don’t even want to look at your face anymore. Go back to your parents’ house right away! There is no place in my home for a buhari like you’.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20230925090916_76578a0ecf3c35d2bdeff79022ed048c5bcfeed57a9cfd4b618c5d33c62f2783.jpg" data-media-id="editor_1" data-image-id="20230925090916_76578a0ecf3c35d2bdeff79022ed048c5bcfeed57a9cfd4b618c5d33c62f2783" data-rendition-name="original" width="1311" height="463" loading="lazy" alt="Nepali textbooks"> <figcaption>The story in the government textbook for Grade 7 Nepali.</figcaption> </figure>  Although aghast at her father-in-law’s response, the buhari does not utter a word. The dad-in-law, on the other hand, is determined to send her off to her parents’ house. The two then embark on a journey to the buhari’s parental home. As the plot thickens, it is revealed that the buhari has a special ability, thanks to which she can communicate with animals. Along the way, the sasura-buhari hear a wolf howling. The sasura does not think much of it, but the buhari knows exactly what the wolf is ‘saying’. The wolf's words translated are too bizarre to ideate. It says, ‘There is a corpse buried right here. If someone were to dig it up, I could feed on it. There’s a diamond ring on one of its fingers. I’d give the ring to whoever digs up the corpse for me’. Upon hearing this, the buhari thinks to herself, ‘If only I could lay my hands on that ring. My sasura will never believe me if I tell him about this. Oh, what a fix I am in!’ Soon, the sasura-buhari decide to make a pit stop under the shade of a banyan tree, and the sasura dozes off as he rests. The buhari then sneaks off to the spot where the wolf had been howling and starts to dig. Unsurprisingly, she unearths the corpse, presents it to the wolf, and takes the diamond ring on the body's finger. Not only are readers confounded by the sheer absurdity of the plot of this 'story', but it must be hard for young Grade 7 readers (or even their teachers) to shake off the macabre mental image it projects in the mind. Aside from a blatant disregard for the concept of dignified treatment of the dead, this story actually presents grave robbing as a perfectly acceptable thing to do.&nbsp; This is not all. The buhari then goes on to dig up some more valuables after a crow tips her off. The sasura is delighted to have come upon so much wealth because of the buhari. Subsequently, she also hands the diamond ring to the sasura and tells him all about how she found it. As you may have guessed, the sasura is now in awe of the buhari and regrets ever having doubted her. Having had a change of heart, he decides not to take the buhari back to her parental home. &nbsp; The story drags on as the sasura continues to ask the buhari random questions to test her wit till he is convinced of her ‘intelligence’ and ends with the sasura ‘entrusting’ the buhari with all his household responsibilities as he is finally impressed with her. What is a student to learn from the protagonist’s attitude towards his daughter-in-law? Will the story leave a child assuming it appropriate for a man to ask his daughter-in-law how much he must have spent on her wedding? Will a child be able to question why such an enquiry on the part of the father-in-law is even relevant? Will a seventh grader who reads the story consider it a man’s prerogative to ‘send his daughter-in-law off’ to her parents the minute he feels offended? What is a girl child to make of the portrayal of the buhari in the story? Are they to think that there is nothing wrong with assuming that a man is entitled to ‘test’ whether his daughter-in-law is good enough for the household?  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20230925090920_7a8bef87e71b1ce652247b916eaa4d0e1addfb882b53dcbfad2bf39c5693805c.jpg" data-media-id="editor_2" data-image-id="20230925090920_7a8bef87e71b1ce652247b916eaa4d0e1addfb882b53dcbfad2bf39c5693805c" data-rendition-name="original" width="1000" height="500" loading="lazy" alt="Nepali textbooks"> <figcaption>Government textbook for Grade 7 Nepali.</figcaption> </figure>  Is it only after she proves her ‘worth’ that a woman is acceptable to her marital family, even if that means digging up graves to bring in wealth? Oh, by the way, where was the woman’s husband while all of this transpired? Even if the author who wrote this story thought it would be an appropriate example to teach children they should not be too quick to judge a person, didn’t a single person who reviewed this story to decide whether it should be part of the school curriculum find the details in the story in the slightest bit objectionable?&nbsp; It is worth noting here that the line-up of authors and reviewers featured in the preface of the textbook in question is predominantly male and all from the dominant ethnic group. Perhaps objections were raised to the content of the book, but they were overruled? Either way, this and many other examples warrant a closer assessment of the government’s school curriculum development system, particularly the process of reviewing and screening content to ensure it is conducive to children’s overall social and emotional development in addition to helping enhance creative and analytical skills. It is crucial for those who design Nepal's school curricula to be mindful that the content of textbooks can solidify gender and social stereotypes in young minds and shape how people perceive and interact in society. If we are to envisage a future free of gender bias and social inequality for Nepal, school textbooks may be a good place to start. &nbsp;&nbsp; Sudeshna Thapa is a human rights lawyer and researcher. thapa.sudeshna@gmail.com

The Exceptional Buhari

In her small, shared rented room in Sitapaila, Kathmandu 22-year-old Nisha Chauhan gets ready for her class at Padma Kanya Campus. She wants to be a counsellor and a social worker because she herself was abandoned at age 5 on the streets and rescued. Attempts to trace her parents failed, and she spent the next 13 years in a care home.
She has vague memories of her biological parents but considers the care home her family.
“The shelter had around 50 to 60 children and we were looked after by our house parents and caretakers,” Nisha remembers. “The environment was favorable and while growing up, I had many friends.” &nbsp;
At 18, Nisha was required to leave the care home because she was now an adult, and it has been a difficult adjustment.
She relocated to a small rented room which she shares with a friend. The care home where she was staying provided her Rs 5,000 a month, which was barely enough to cover her monthly expenses. &nbsp;
“It is a huge change to go from always having people around you to suddenly being on your own,” Nisha explains. “And you have to pay the bills, find a job, and juggle studies.”
Nisha now works as an intern at Department of Social Work at Padma Kanya Campus. However, since the internship does not pay her anything, she still has to rely on the limited amount that she gets from the care home.&nbsp;
For many young people in care, reaching adulthood and leaving shelters is a source of anxiety. They often struggle with their identity, face stigma and carry trauma from their past.
Young people leaving care are one of the most vulnerable groups in society. <a href="https://www.udayancare.org/research-and-publication/research-studies-and-papers" target="_blank">A 2019 research study</a> in India shows that when care leavers step into the adult world without adequate education, vocational skills, financial support or a social safety net, they often are often trapped by poverty, homelessness, mental health problems and exploitation. Many end up on the streets.
The<a href="https://lawcommission.gov.np/en/wp-content/uploads/2021/01/Constitution-of-Nepal.pdf" target="_blank"> Constitution of Nepal</a>, guarantees that the state is the ultimate guardian of children, responsible for their necessary protection and fulfilment of their rights.<a href="https://www.lawcommission.gov.np/en/wp-content/uploads/2019/07/The-Act-Relating-to-Children-2075-2018.pdf" target="_blank">The Act relating to Children 2018</a> also states that children who are deprived of parental care or are on the verge of losing parental care should be placed at alternative care system. However, there is no clear policy for the aftercare support of young people. &nbsp;&nbsp;
“Shortcomings on the part of the government and poor data gathering have negatively impacted care leavers in Nepal,” says Ganga B Gurung, National Director of SOS Children’s Villages Nepal.&nbsp;
According to the National Child Rights Council,<a href="https://risingnepaldaily.com/news/24044" target="_blank"> in the fiscal year 2021/2022,</a>there were more than 10,000 children in 417 alternative care homes. However, there is little information on what happens to them when they leave the shelters after 18. &nbsp;
“The present system doesn’t recognise their vulnerability and need for extended support,” adds Gurung. “As a result, they are excluded from policies related to social protection and reservation.”&nbsp;
Care leavers often fail to get documents such as citizenship, national identity cards, and birth registration.
General Secretary of Child Care Home Network Nepal, Rabin Nepali says that obtaining citizenship is a challenging process for many care leavers in alternative care system whose parents are unknown despite the progressive constitution provision.
The Constitution of Nepal stipulates that the young people who have a legal custodian, foster parents or orphanage have to vouch for their parentless status are eligible to obtain citizenship.&nbsp;
But Nepali says that the authorities are often prejudiced and torment care leavers with needless harassment.&nbsp;
“It is difficult for care leavers to easily get legal documents such as citizenships unless they are accompanied by care home staff who can convince the official,” he adds.&nbsp;
Rita grew up at SOS Children’s Villages Nepal and took along her care home mother to the district office for her citizenship. Each SOS village house have 5 to 8 children in the ‘family’ and are raised by ‘mothers’ and ‘aunts’.&nbsp;
District officials refused to accept Rita’s citizenship application, saying her surname did not match the SOS mother’s. “Although we tried to explain to them the constitutional provision, they wouldn’t listen to us,” says Rita, who finally got her citizenship after a lawyer accompanied her to the office.&nbsp;
Nisha also took eight months to get her birth certificate and citizenship card, while most others get theirs in a day or two.&nbsp;
Nisha wants to study abroad, but the idea of getting her passport makes her anxious because she doesn't want to deal with government officials.
“There must be many young people from care homes who have faced mental trauma as I did during the process of acquiring legal documents, and it is unfair to us,” she says.
To ensure support for other young people leaving care, care leavers across the country have formed Baikalpik Herchaha Yuwa Samaj Nepal (बैकल्पिक &nbsp;&nbsp;हेरचाह &nbsp;युवा समाज नेपाल), a peer-support network where young people feel they are not alone with challenges.
“The objective is to form a network so care leavers like us have a platform to bring reform,” says Binayak Manandhar, president of the organization. “Young people leaving care frequently feel isolated, lonely and lack the safety net of someone to talk to and advise them in a crisis.”
Says Nisha, “After care policies are crucial for our well-being and we need extra support for financial aid, jobs, and legal documents. Our inclusion at local, national, and global levels in policy and practice discussions is necessary. I don’t think we are asking for more than what we deserve.”
Some names have been changed.
Elisha Shrestha is a communication manager at SOS Children's Villages Nepal.

Better care of care leavers

Marty Logan

Growing appetite for school lunches

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022111410114/637204f29c7e80680e0b288djpeg.jpg" alt="" width="1500" height="1000"/><figcaption>Photos: UNICEF NEPAL</figcaption></figure>Despite periods of political and economic instability, Nepal achieved dramatic progress in maternal and child health in the early 2000s becoming an international model.It took great strides in reducing childhood malnutrition, in particular, reducing stunting from 57% in 1996 to 33% in 2016. Maternal and Infant mortality rates also similarly declined, only for much of these successes <a href="https://www.nepalitimes.com/banner/nearly-half-of-nepali-children-still-malnourished/" target="_blank" rel="noopener noreferrer">to stall in the recent years</a>. And this trend has been made worse by the Covid-19 pandemic, states a new UNICEF report.Titled “<a href="https://onlinelibrary.wiley.com/toc/17408709/2022/18/S1" data-saferedirecturl="https://www.google.com/url?q=https://onlinelibrary.wiley.com/toc/17408709/2022/18/S1&amp;source=gmail&amp;ust=1642768390008000&amp;usg=AOvVaw2Qo1HoClES2POc3Qyp2i-7">Nutrition in Nepal: Three decades of progress for children and women</a>”, the report brings together a set of nine original articles that examine the drivers of success and identify where greater policy and programmatic action is needed to achieve the Sustainable Development Goal (SDG) nutrition targets.“Optimal maternal and child nutrition is the basis for developing a resilient society,” says EU Ambassador to Nepal, H.E. Nona Deprez. “The decline in the number of malnourished children, improvements in health facilities and services, and the multisectoral approach used in Nepal over the past three decades are a testament to the Government of Nepal’s commitment to reducing all forms of malnutrition.”A <a href="https://onlinelibrary.wiley.com/toc/17408709/2022/18/S1" data-saferedirecturl="https://www.google.com/url?q=https://onlinelibrary.wiley.com/toc/17408709/2022/18/S1&amp;source=gmail&amp;ust=1642768390008000&amp;usg=AOvVaw2Qo1HoClES2POc3Qyp2i-7">special supplement of the Maternal and Child Nutrition Journal</a> published on Thursday lists some of Nepal’s biggest nutritional achievements. Between 1996-2016, the early initiation of breastfeeding saw an increase from 18% to 56%, and complementary feeding increased from 54% to 77%.During the same period, women taking sufficient iron and folic acid supplements during their pregnancy rose from 6% to 71%. This was combined with earlier and more frequent antenatal care visits.Consistent administering of Vitamin A has saved the lives of an estimated 45,000 Nepali children under the age of five, between 2002 and 2015. Similarly, households using adequately iodised salt doubled from 35% to 77% from 1998 to 2016.Much of this progress can be credited to improvements in household wealth, parental education, and <a href="https://www.nepalitimes.com/banner/toilet-trained/" target="_blank" rel="noopener noreferrer">sanitation</a>. But equally important was increased coverage of health and nutrition services undertaken by successive governments.Nepal Government utilised ground-breaking research to test interventions and overcome challenges, it is also committed to enforcing mandatory legislation such as salt iodisation, writes the journal supplement.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022111410114/637204f69c7e80680e0b288ejpeg.jpg" alt="" width="1500" height="1001"><figcaption></figcaption></figure>Mobilisation of <a href="https://www.nepalitimes.com/latest/enlisting-female-health-volunteers-to-fight-covid-19/" target="_blank" rel="noopener noreferrer">Female Community Health Volunteers</a> (FCHVs) across Nepal villages and towns have improved the health of mother and children, so has an investment in sectoral programs including education and sanitation.But there are now new challenges to achieving national and global targets on nutrition, which also threatens to undermine past gains.“The learning from the past 25 years that are incorporated in the supplement will inform and contribute to future improvements. However, we must act now, given the impact that the pandemic has had on the nutritional health of mothers and their children,” says Elke Wisch, UNICEF Representative to Nepal.During the pandemic, most households experienced job losses or reduced income. With the <a href="https://www.nepalitimes.com/here-now/3rd-wave-in-2-years/" target="_blank" rel="noopener noreferrer">Omicron-led third wave</a> spreading across Nepal, the pandemic’s ensuing socioeconomic crisis is long from over.This means reduced dietary intake among children and mothers. School closures will deprive many children of getting one decent meal a day. All this will add to <a href="https://www.nepalitimes.com/banner/nepals-epidemic-of-hunger/" target="_blank" rel="noopener noreferrer">childhood malnutrition</a> which continues to be a major cause of death and retarded mental and physical development among younger populationsAs such, UNICEF has recommended the government to improve the general public’s access to nutritious, safe, affordable, and sustainable diets. It also suggests integrating essential nutrition services into the existing service delivery platforms like family planning, antenatal, delivery and post-natal care and well-child and sick-child care and continuing to mobilise FCHVs to reach more women and children.To disseminate factual information, advice and counselling on infant and young child feeding, <a href="https://www.nepalitimes.com/here-now/3rd-covid-wave-infects-nepals-frontliners/" target="_blank" rel="noopener noreferrer">healthcare workers</a> can also use multiple communication channels such as radio, TV or social media.But perhaps equally if not more important is strengthening local levels so that they can plan, implement and monitor nutrition programs and services, and maintain Nepal's commitment to generating data, information, and evidence to assess progress and inform decisions.

Covid undermines Nepal's mother-child gains

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221114091156/637203229c7e80680e0b27f0jpeg.jpg" alt="" width="1944" height="1098"/><figcaption></figcaption></figure>In the heart of Edinburgh near the Church of St John the Evangelist is <a href="https://www.oneworldshop.co.uk/" data-saferedirecturl="https://www.google.com/url?q=https://www.oneworldshop.co.uk/&amp;source=gmail&amp;ust=1641433168882000&amp;usg=AOvVaw2DlDyvp0funtWsI3daY8Bf">One World Shop</a>, a modest-looking store that sells goods from all over the world.Among the products are ‘<a href="https://www.nepalitimes.com/banner/made-in-nepal/" target="_blank" rel="noopener noreferrer">Made in Nepal</a>’ sweaters, mufflers, felted slippers, and beanies which are flying off the shelves this winter. There are also Nepali handicraft items, lokta paper products, herbal bath soaps and <a href="https://www.nepalitimes.com/banner/clothed-in-cannabis/" target="_blank" rel="noopener noreferrer">hemp products</a> for sale.But the items are not as much for profit as they are for the international promotion of fair trade handmade goods made by women in poorer communities to improve their livelihood with added income. The store, a fair trade organisation set up in 1983, sources most of its Nepali products from the Association for Craft Producers and Get Paper Industry in Kathmandu."Our goal is to empower women and alleviate poverty through diversification of livelihood options," explains Rachel Farey, business manager of the One World Shop which also sponsors Nepali women to be trained at institutes in the UK. “We buy goods only when we confirm that they were made by women in need, or if they are somehow involved in manufacturing.”Farey comes from a family with a long-standing connection with Nepal. Her uncle was former Gurkha officer <a href="http://archive.nepalitimes.com/news.php?id=9296#.YdRS8C8RqLd" data-saferedirecturl="https://www.google.com/url?q=http://archive.nepalitimes.com/news.php?id%3D9296%23.YdRS8C8RqLd&amp;source=gmail&amp;ust=1641433168882000&amp;usg=AOvVaw2zTu5ZxUmpVaWi0pbRP35h">Mike Cheney</a>, a pioneer figure in <a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/trekking-in-Nepal-turns-50,2658" target="_blank" rel="noopener noreferrer">Nepal’s trekking</a> and mountaineering scene during the 1970s, who set up Sherpa Cooperative to ensure that porters had proper working conditions.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221114091156/637203259c7e80680e0b27f1jpeg.jpg" alt="" width="640" height="971"><figcaption>Mike Cheney</figcaption></figure>Cheney had served in the British Army from 1946 to 1957 in the Royal Armoured Corps and the 10th Gurkha Rifles. After retiring from active service, he became a tea-estate manager in Darjeeling, and came to Kathmandu in 1965 for the first time and continued working in a tea estate in Ilam.He then turned to Nepal’s fledgling trekking industry, and in 1966 joined forces with <a href="https://www.nepalitimes.com/opinion/hiking-with-jimmy/" target="_blank" rel="noopener noreferrer">Jimmy Roberts</a> who had set up <a href="https://www.nepalitimes.com/here-now/the-himalayan-odyssey/" target="_blank" rel="noopener noreferrer">Mountain Travel Nepal</a>, the first registered trekking company in the world. In his later years, Cheney concentrated his efforts on promoting the country as a household name in the climbing and mountaineering industry.“Mike Cheney showed Nepal the way ahead, connecting the country to the rest of the world at a time when it was not easy to market a new destination, while at the same time making sure that porters got a good deal,” says tourism entrepreneur Karma Sherpa Lama in Kathmandu.Cheney was vocal about <a href="http://archive.nepalitimes.com/news.php?id=4747#.YdT8di2B2b8" target="_blank" rel="noopener noreferrer">low-paid porters</a> carrying heavy leads during mountaineering and trekking expeditions and worked to raise living standards by setting an example with his Sherpa Cooperative. He made sure that porters were paid higher wages, had proper gear for high altitudes, and were taken care of if they fell sick.Cheney’s other major contribution was in scouting new trekking routes across Nepal, away from already <a href="https://www.nepalitimes.com/here-now/managing-everests-waste-problem/" target="_blank" rel="noopener noreferrer">crowded Everest</a> and Annapurna areas, and improving the trails. Cheney was also a correspondent for several alpine journals and mountaineering magazines in Europe and the United States.Cheney was an active member of the Himalayan Rescue Association with its clinic in Pheriche, and the Trekking Agents’ Association of Nepal. He was the Local Hon Secretary of the Bombay-based Himalayan Club, a fellow of the Royal Geographical Society and a member of the Alpine Club.Now, his niece Farey is following in his footsteps and is committed to helping Nepali women and children through her store One World Shop in Edinburgh which sells a wide range of handmade crafts, jewelry, textiles, interior furnishings, furniture, toys, clothing, ceramics, handmade paper products, cards, books and foods.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221114091156/637203289c7e80680e0b27f2jpeg.jpg" alt="" width="1700" height="802"><figcaption></figcaption></figure>“Our mission is to reduce poverty by sourcing and selling fair trade goods from all around the world,” says Farey. “It is not just the individual artisans who make the goods that benefit from our work, but also their families and the communities in which they live.”Like her uncle, Farey is also a passionate trekker herself and has visited Nepal often. She says that in a way she is carrying on Mike Cheney’s mission: to uplift Nepali families by removing middlemen and guaranteeing them a just income.For Farey ‘fair trade’ is not just a concept, she is actually practicing it in her business through One World Shop which sources and sells sustainably produced products from around the world by ensuring a decent price which is ploughed back into their communities.During the pandemic, One World Shop was selling its products online even though supplies from Nepal were disrupted because of flight cancellations.

Edinburgh store comes full circle to Nepal

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110161152/636d1e8b9c7e80680e0af416jpeg.jpg" alt="" width="960" height="640"/><figcaption>Photo: SAGLO SAMAJ/HIMALMEDIA</figcaption></figure>The Covid-19 worsened the disparities in young children’s development and learning in Nepal. One out of five Nepali children between the ages of 2-4 years are not developing on track amidst the pandemic with noted impact on their health, <a href="https://www.nepalitimes.com/latest/covid-19-cancels-regions-gains-in-education/">learning</a> and psychological well-being, a new UNICEF study has revealed.The Early Childhood Development Index (ECDI) survey conducted in August among 2,853 households via phone conversation showed that children from lower income families, living in rural areas, with caregivers with no or low levels of education, and not attending early childhood education (ECE) programs were at higher risk.Even among children who attended ECE, those who attended government ECE were at higher risk of being developmentally off track compared to those who attended private programs.Early stimulation activities like <a href="https://www.nepalitimes.com/here-now/the-power-of-reading-aloud/">reading books</a>, telling stories, singing songs, going outside, naming objects, counting, or drawing things were found instrumental for young children’s development and learning. However, the data revealed an alarming plunge in parental engagement compared to pre-pandemic conditions.As the country opened up with the decline in Covid cases in August 2021 and parents pursued livelihood options, only 31% of children received early stimulation at home by family members compared to 73% in 2019.A follow up survey in October found that mothers’ engagement improved over the time after she got over the initial hectic schedule right of the pandemic. The same can’t be said for the fathers, whose parental engagement remained low at 6%, maintaining a social norm of men’s reduced role in raising children.This is just the latest in the series of impacts that young children have been subjected to following the pandemic. Early in the coronavirus crisis, repeated lockdowns and travel restrictions meant that parents were unable to take their children for routine immunisation, also resulting in an outbreak of measles in the Dhading district. Similarly, the dramatic <a href="https://www.nepalitimes.com/banner/children-are-collateral-damage-in-nepal-lockdown/">decline in institutional delivery</a> led to increased infant mortality.Reduced family income due to job losses during the pandemic also added to the problem of childhood malnutrition in Nepal. School closures also deprived many children of getting <a href="https://www.nepalitimes.com/latest/nepals-out-of-school-children-get-food-at-home/">one decent meal a day</a> while they also missed their lessons with over 80% of government school children not having attended classes – online or otherwise in the past two years.Among children in the age group 2-4 years, half of those surveyed were found to have been enrolled in <a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/Prepping-for-preschool,253">pre-primary level</a> but 34% of them didn’t participate in learning through alternative learning modalities at all, most of the children only accessed home tuition. While low-tech solutions like educational radio and TV and tele-teaching were almost unused, high-tech solutions like online classes were used almost exclusively among children who attended private ECE.Underused low-tech solutions and unequal access to high-tech solutions might have further contributed to the developmental gap observed between children who attended private ECE and other children and is the proof of the <a href="https://www.nepalitimes.com/here-now/digital-divide-exposes-class-divide-in-nepal-schools/">growing digital divide</a> between private and public institutions.Following the survey results, UNICEF has recommended remedial learning to target children at a higher risk. The government and aid agencies should also develop a system to support teachers and parents to understand their children and figure out their learning levels through user-friendly assessments.In many ways, Covid-19 was a learning lesson for future disasters and being forced to adapt to online educational tools has helped teachers, students and parents prepare for school closures. But the alternative methods of learning remain largely underused, mostly in lack of infrastructure. School across Nepal <a href="https://www.nepalitimes.com/here-now/lessons-not-learned-from-the-pandemic/">has to be trained and well-equipped</a> with Internet facilities and electronic devices.Having said that, parenting education, in particular, involvement of fathers and learning at home is of utmost importance and should be communicated as much in the communities.

Covid derails child development in Nepal

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110161132/636d19729c7e80680e0ac81djpeg.jpg" alt="" width="800" height="533"/><figcaption>The art festival was inagurated by noted Nepali actor Rajesh Hamal (second from right). Also pictured, general manager of Turkish Airlines Abdullah Tuncer Kececi (first from left). Photos: MONA</figcaption></figure>More than 1,500 children in Nepal are diagnosed every year with some form of cancer. Many of them are treatable, but because of the lack of timely diagnosis and proper treatment, many young lives are tragically lost.Help from them has come from an unexpected quarter: Nepali artists who have been representing the country’s social issues on canvas, sculpture or digital art.Earlier this month, 33 of Nepal’s most prominent artists from all genres took part in a live painting performance at <a href="https://www.nepalitimes.com/banner/nepals-first-private-art-museum/" target="_blank" rel="noopener noreferrer">the Museum of Nepali Art</a> in the Kathmandu Guest House premises in Thamel. Part of the proceeds generated from the sale went to the oncology ward of the Kanti Children’s Hospital.Less than 30% of Nepali children have their cancers diagnosed on time, but many of even those are unable to afford expensive treatment.The art festival was inaugurated by noted Nepali actor Rajesh Hamal, who kick-started the event by painting his own contemporary piece ‘No smoking’ under the guidance of noted artists Kiran Manandhar and Lok Chitrakar.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110161132/636d19759c7e80680e0ac81ejpeg.jpg" alt="" width="800" height="533"><figcaption>Renowned contemporary artist Kiran Manandhar with participating artist Sangee Shrestha.</figcaption></figure>As the artists warmed up to the performance, it was evident that they were producing a diverse body of art with differing techniques. It ranged from traditional pauba and <a href="https://www.nepalitimes.com/banner/vibrant-mithila-art-thrives-in-nepal/" target="_blank" rel="noopener noreferrer">Mithila art</a> to abstracts embodying cubism and conceptual art forms.But they were all sharing the space and participating in an exercise that aimed to help underprivileged children with hope. Access to diagnosis and treatment is literally a matter of life or death for many young patients.The art festival coincided with the inauguration of the Kathmandu Guest House (KGH) by renowned <a href="https://www.nepalitimes.com/banner/nepals-far-sighted-eye-care/" target="_blank" rel="noopener noreferrer">ophthalmologist Sanduk Ruit</a> with founder/director of the Museum of Nepali Art (MoNA) <a href="https://www.nepalitimes.com/opinion/i-m-a-g-i-n-a-t-i-o-n-by-uttam-nepali/" target="_blank" rel="noopener noreferrer">Rajan Sakya</a>.“We are committed to conducting similar events annually to promote art for a cause so that it serves those in need,” Sakya said.Following the main event on 7 October, the paintings were exhibited at MoNA in the presence of Bishnu Rath Giri, head of the oncology unit at Kanti Children’s Hospital.Lately, <a href="https://www.nepalitimes.com/banner/nepali-art-going-places/" target="_blank" rel="noopener noreferrer">Nepali art has been getting the recognition</a> it deserves with many of them being exhibited at famous museums, art galleries and private collections worldwide. These pieces fetch hundreds of thousands of dollars in the international art market, and yet it is rare for contemporary Nepali art to shine at home.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110161132/636d19779c7e80680e0ac81fjpeg.jpg" alt="" width="800" height="533"><figcaption></figcaption></figure><figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110161132/636d197c9c7e80680e0ac820jpeg.jpg" alt="" width="800" height="533"><figcaption></figcaption></figure>MoNA aims to be a crucible for Nepali art, so that the gallery is an ‘art hub’ in Kathmandu’s bustling Thamel neighbourhood. Such art hubs are common in developed countries including France, Italy, China, and Japan.Established in 2020, MoNA is Nepal’s first museum dedicated to preserving and promoting <a href="https://www.nepalitimes.com/opinion/jeevan-rajopadhyays-untitled/" target="_blank" rel="noopener noreferrer">Nepali art</a>, especially those of living artists. And this is the first time that a live art festival has been held to support a cause.“This event is the start of the crucial process of bridging this social and intellectual gap between artists and the general public,” says Sakya. “One need not be an art historian or critique to recognise creativity and beauty, and artists do not differentiate between ethnicities. Art is tangible culture and a living expression of us Nepalis.”Sworup Kant AdhikariPaintings can be viewed online <a href="https://www.mona.com.np/art/art-fest-2021">here</a>.

Art for a cause

Architecture can be a powerful agent of change, shaping not just spaces but the way people live, connect, and experience the world.&nbsp; For Nepal, which is <a href="https://nepalitimes.com/banner/natures-fragile-gift-to-nepal">gifted by nature</a> and rich in <a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/ambassador-fund-cultural-preservation-nepal,2092">cultural heritage</a>, &nbsp;reviving rural architecture with modern amenities could hold the key to more <a href="https://nepalitimes.com/here-now/what-sustainable-tourism-means-in-practice">sustainable tourism </a>that benefits local people more. “<a href="https://nepalitimes.com/banner/bayalpata-hospital-in-nepal-wins-global-design-award">Design and architecture</a> are amazing tools to create a unique experience for visitors,” says Spanish architect Tomeu Esteva of Esteva i Esteva Architecture Studio. “Difficult destinations have beautiful hotels with design and comfort.” Esteva was in Kathmandu with his colleagues at an event organised by the Spanish Honorary Consulate at Dwarika’s Hotel last week to showcase buildings which Nepali architects can adapt with local material and design inputs.&nbsp; Rural architecture holds a unique significance: it is more than a shelter and must reflect <a href="https://nepalitimes.com/here-now/inking-an-idenity">local identity, culture</a> and <a href="https://nepalitimes.com/here-now/saving-humla-from-heritage-loss">heritage</a>. An area’s natural and cultural harmony can be upset by <a href="https://nepalitimes.com/here-now/protecting-protected-areas-from-infrastructure?fbclid=IwAR1wK0MDFlFST_2EYb3f54LS4-fPt6rYfLG1DJ1JaQsU3w8-ezyXIxGOqzk">poorly planned development</a>, speakers at the event said, but the environment can be improved and revitalised by well-integrated structures.&nbsp; Another Spanish architect, Belen Moneo, has designed hotels at elevations of 3,700m in her home country Spain that supply natural spring water spas. “<a href="https://nepalitimes.com/banner/lost-in-reconstruction">Creativity in construction</a> must be encouraged. Rural architecture always shows possibilities of what we can do better,” Moneo explains, adding that designs must enhance <a href="https://nepalitimes.com/opinion/the-healing-power-of-nature">the beauty of nature</a> and give a natural feel at a time when steel, glass and cement dominate <a href="https://nepalitimes.com/here-now/rebuilding-kathmandu-after-the-1934-quake">urban design</a>.&nbsp; This is why the <a href="https://nepalitimes.com/here-now/weaving-nature-into-craft">use of natural products</a> such as bamboo, local timber, straw and rammed earth are in demand from customers who want a fresh eco-friendly look encouraged in construction of rural architectural structures. The demand for boutique hotels has increased world over, with &nbsp;more and more tourists favouring aesthetics, experience and comfort over price. While creativity is an important part of <a href="https://nepalitimes.com/here-now/architecture-for-mountains">construction and architecture</a>, incentives to build and use <a href="https://archive.nepalitimes.com/article/nation/Building,370">rural construction materials</a> still remain minimal, and Moneo emphasises the significance of design and execution.&nbsp; Esteva helped design the Vana Retreat in Dehradun that kept the natural environment in focus, with the structure giving an elaborate aesthetic experience to visitors. Another example is Hotel Las Mercedes in the Dominican Republic which was designed and constructed by Moneo and the company she co-founded Moneo Brock, respecting and revaluing the traditional architecture of the area. Hotels providing such experience could attract tourists and revenue. The Spanish ambassador to Nepal Juan Antonio March Pujol said, “The role of architecture and architects in developing tourism is crucial, not only in urban areas but rural settings as well.”&nbsp; The concept of rural boutique hotels gained traction in Spain during the 1990s, particularly in regions like Majorca with economic and environmental sustainability as the main focus. In Nepal <a href="https://nepalitimes.com/opinion/12-full-opinion/guiding-nepal-s-tourism-industry">the tourism industry</a> directly employs about 1 million people, and makes up about 8% of the country’s GDP. In Nepal, the stone homes of <a href="https://nepalitimes.com/news/reviving-himalayan-vulture-and-culture">Mustang and Manang</a>, bamboo and mud structures of <a href="https://nepalitimes.com/here-now/the-tarai-s-shrinking-forests">the Tarai</a>, and the Kathmandu Valley’s terra cotta tile skylines, graceful temples, and tranquil bahal courtyards are all examples of <a href="https://nepalitimes.com/here-now/nepal-s-traditional-seismic-resistant-designs">Nepal’s traditional architecture</a>.&nbsp; Nepali architect Sarosh Pradhan has been working for the past eight years on the Brakka Village project in Manang Valley north of <a href="https://nepalitimes.com/banner/municipalities-want-to-manage-annapurna">the Annapurnas</a>. Other examples of this kind of rural architecture for high-end tourism are the Shinta Mani Hotel in Mustang and Khumbu Lodge below <a href="https://nepalitimes.com/news/mt-everest-pvt-ltd">Mt Everest</a>. Says Pradhan, “There are places in Nepal that radiate purity and embrace simplicity. Creating projects in such settings require deep reflection and thoughtful planning.”  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250421030444_a07a23f6b60fa89c0f35b9dc1aaf19937da4881e6bfb2e1858f3c27dff91729f.jpg" data-media-id="editor_19" data-image-id="20250421030444_a07a23f6b60fa89c0f35b9dc1aaf19937da4881e6bfb2e1858f3c27dff91729f" data-rendition-name="original" width="4608" height="2184" loading="lazy" alt="A new architecture for Nepal's tourism"> </figure>  Rural architecture is not easy, and sometimes more expensive. Inflation, energy efficiency, <a href="https://nepalitimes.com/here-now/those-who-stay">the climate crisis</a>, and <a href="https://nepalitimes.com/banner/cost-of-living-in-a-big-city">increased costs of living</a> pose obstacles to sustainable rural architecture. Read also: <a href="https://nepalitimes.com/here-now/forgotten-international-starchitects-in-nepal">Forgotten international starchitects in Nepal</a>, Anne Feenstra and Varun S Bapu Esteva says faith and trust between client and architect is necessary for any project to be successful. He adds that architects must practice being humble, the process of designing always involves learning and not imposing their ideas on clients. Nepal is uniquely positioned for the growth of <a href="https://nepalitimes.com/banner/hiking-up-the-benefits-of-tourism">rural tourism</a> because of its stunning countryside as well as its internationally renowned traditions in holistic wellness. Creating infrastructure that is small, thoughtfully planned and that respects both tradition and contemporary hospitality standards is crucial. “Projects in Nepal can be made cost effective by using materials from houses that have been brought down,” says Esteva. “Pilot projects involving <a href="https://nepalitimes.com/banner/local-government-by-the-people-for-the-people-of-the-people">local people </a>and simple designing also helps the process.” <a href="https://nepalitimes.com/banner/vacant-homes-become-homestays-in-nepal">The growth of homestays in Nepal</a> is a step in the right direction, but they are still a bit too rustic for the international traveller who also wants comfort and is willing to pay extra for it. Upgrading the facilities in homestays and ensuring that the <a href="https://nepalitimes.com/here-now/an-archive-of-nepali-heritage">architectural heritage</a> of the locality is preserved using locally sourced building material could allow owners to charge more. Says Sangita Shrestha of Dwarika’s Hotel, “Our effort is to build upon rural architecture by empowering local communities and using what is available locally. We can fine tune and encourage indigenous design and training.” The vision goes beyond just boosting the economy, it is about building a future where tourism helps villages grow in a healthy and lasting way. Instead of using up resources, it gives back to the land and the people. It supports local communities by<a href="https://nepalitimes.com/opinion/staying-in-nepal-to-create-jobs"> creating jobs</a>, improving infrastructure, and protecting natural beauty. When done right, tourism can be a tool for <a href="https://nepalitimes.com/editorial/progress-and-or-preservation">preserving culture and nature</a>, not harming them. Architects must therefore see their work as more than just designing buildings, they also need to care deeply about people and places, especially in rural areas that can benefit the most.&nbsp; With global interest in sustainable and off-the-beaten-path travel increasing, Nepal stands at the cusp of a <a href="https://nepalitimes.com/news/missing-out-on-nepal-s-tourism-potential">tourism transformation</a> that values community-driven, eco-conscious hospitality. A mix of modern ideas and traditional knowledge could transform rural tourism in Nepal. Says Shrestha, “Young architects should spend time with <a href="https://nepalitimes.com/latest/the-unsung-heroes-of-conservation">local and indigenous communities</a>, listen to their stories, and learn from their <a href="https://nepalitimes.com/banner/life-and-livelihood-in-remote-nepal">ways of living</a>. These communities have deep knowledge about the land, materials, and climate. If this wisdom is used in new designs, it can help create tourism spaces that truly benefit everyone.” &nbsp;

A new architecture for Nepal's tourism

On Tuesday, leader of the monarchist RPP once again gathered on Kathmandu’s streets to deliver fiery speeches, but this time there was no arson and looting and no need for riot police to fire live rounds or tear gas.
RPP leaders demanded the release of their members including vice-president Rabindra Mishra and MP Dhawal Shamsher Rana were arrested during the violent <a href="https://nepalitimes.com/news/republicans-and-royalists-on-nepal-s-streets">28 March protests at Tinkune </a>which left two dead. 
They denounced the current leadership of the main parties, demanding the <a href="https://nepalitimes.com/editorial/nepal-party-reincarnating-hindu-monarchy">restitution of Nepal as a Hindu kingdom</a>. They also said the government was responsible for the fatalities on 28 March because it provoked its rally with a tear gas attack even before it started.
It has now been revealed that the police fired at least 100 live rounds from high powered assault rifles at the crowd. Twenty-one of the 120 injured received bullet wounds, and most of them were bystanders and people trying to reach home. 
Tuesday protest on the Ring Road in Balkhu was much more subdued, and comparatively fewer RPP supporters showed up. The arson and vandalism in the previous protest appears to have cost some support for <a href="https://nepalitimes.com/news/the-ghost-of-monarchy-returns-to-haunt-nepal">former king Gyanendra </a>especially for the anointment of medical tycoon and bank defaulter <a href="https://nepalitimes.com/news/street-politics">Durga Prasai </a>as ‘commander’ of the Tinkune rally.
Some monarchists acknowledge Gyanendra’s mistakes when was king 2001-2008, but say he has had a lot of time to reflect on his shortcomings and seems more disciplined and committed. His supporters have tried to build on nostalgia among some Nepalis for<a href="https://nepalitimes.com/news/why-invest-in-nepal"> domestic stability </a>and international respect that <a href="https://nepalitimes.com/here-now/if-birendra-was-alive-nepal-could-still-be-a-monarchy">the monarchy</a> commanded. 
“Nepalis were promised better service delivery, opportunities for the underserved, as well as better, more honest use of state resources, but the <a href="https://archive.nepalitimes.com/news.php?id=16992">people in leadership </a>have not been able to deliver on their commitments,” says RPP leader Prakash Chandra Lohani. “The gap between their rhetoric and reality has widened, the people feel betrayed, and the respect Nepali people had previously had for them has changed to revulsion.” 
Indeed, many commentators have warned the three main parties and their <a href="https://nepalitimes.com/editorial/politics-as-usual">serial prime ministers</a> who have ruled Nepal for much of the past 30 years should address rising public anger with them, and see the writing on the wall.
‘<a href="https://nepalitimes.com/news/nepal-government-changes-again">The UML, NC and Maoists</a> must introspect about their conduct,” warns Gunaraj Luitel, editor of Nagarik, in an op-ed this week. ‘These leaders for life may save themselves from simmering public anger, but they will not be able to save the system. The monarchist wave can only be dispelled when citizens are assured of <a href="https://nepalitimes.com/here-now/nepal-s-local-election-gives-power-back-to-people">better governance</a> through <a href="https://nepalitimes.com/latest/real-world-training-for-youth-leaders">younger leaders</a>, and reforms.’ 
Rifts between radical royals who are gunning for a return to <a href="https://nepalitimes.com/here-now/mob-movement-and-mayhem">Panchayat-style absolutism </a>and moderate monarchists who favour a constitutional king have also weakened the movement somewhat. The split between the RPP and RPP-Nepal cost the royalists numbers in Parliament in 2022, and both parties denounced the violence last month, albeit shifting the blame on the government.
The irony is that the same royalists who want to scrap the republican Constitution had formed electoral alliances with the UML during the 2022 elections. RPP-Nepal chair Kamal Thapa contested the 2022 election with the UML. Thapa has not taken part in the last two rallies, saying he will only be a part of a movement under a national flag, and not a RPP party banner.
For his part, the RPP’s Rajendra Lingden is said to be hesitant to censure some of his party’s more radical royalists for fear of fissure within his ranks, despite his aversion to Durga Prasai’s role. 
Analysts have questioned why <a href="https://nepalitimes.com/news/old-is-still-gold-in-nepali-politics">supporters of the monarchy </a>have decided to reestablish an institution that would not ultimately have executive decision-making power. There are doubts about whether authoritarian-minded Gyanendra will be satisfied being a <a href="https://archive.nepalitimes.com/news.php?id=13957">ceremonial king</a>. 
Read also: <a href="https://nepalitimes.com/news/nepal-s-deja-vu-on-black-friday">Nepal’s déjà vu on Black Friday</a>, Sonia Awale
"The Nepali people will not accept <a href="https://nepalitimes.com/here-now/forgotten-woman-who-sheltered-communist-activists">an absolute monarchy </a>at this point of time, and both the public as well as <a href="https://archive.nepalitimes.com/news.php?id=8371">king Gyanendra</a> are fully aware that there is no other possibility beyond a constitutional monarchy," asserts the RPP’s Lohani. “The traditional monarchy’s institutional capacity might have been enough to meet the needs of feudal Nepal, but an absolute monarchy is impossible both in concept and practice in the context of <a href="https://archive.nepalitimes.com/regular-columns/Economic-Class/waiting-for-an-industrial-revolution,784">modern day Nepal</a>.”

New year revolutions

Besides multiple <a href="https://nepalitimes.com/news/republicans-and-royalists-on-nepal-s-streets">street demonstrations </a>that gridlocked Kathmandu’s traffic for the past weeks, public discourse in Nepal has also been dominated by dangerously <a href="https://nepalitimes.com/here-now/air-pollution-is-more-dangerous-than-smoking">high air pollution levels</a>. Caused mostly by hundreds of <a href="https://nepalitimes.com/news/wildfire-season-starts-early-in-nepal">forest fires </a>raging across the country, the smoke contains suspended soot particles that harms <a href="https://nepalitimes.com/opinion/playing-with-poison">human health</a>. Thursday’s rain have cleared the air somewhat, and many people will soon forget how bad the air quality was. But the time to address the roots of next summer’s fire season is now.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250411060440_d1a119716a9031aadfdd611d299348d436842d376a03e664b8d773957a237524.jpg" data-media-id="editor_4" data-image-id="20250411060440_d1a119716a9031aadfdd611d299348d436842d376a03e664b8d773957a237524" data-rendition-name="original" width="502" height="540" loading="lazy" alt="Wildfires"> <figcaption>EXTINGUISHED: Forest fires raging all over Nepal in the week after 3 March (above) reduced air quality, creating a public health hazard in Kathmandu and across the country. Each red dot is a fire detected by infrared sensors on the NASA Fire Information for Resource Management System (FIRMS) satellite. But the rain on Thursday doused most of the fires (below) with more rain forecast over the weekend.</figcaption> </figure>  The reason everyone was talking about air pollution was because the<a href="https://nepalitimes.com/banner/nepal-is-going-up-in-smoke"> smoke from wildfires</a> was visible. But much more toxic are the invisible and odourless <a href="https://nepalitimes.com/news/nepal-doubles-its-carbon-footprint">gases from vehicular and industrial emissions </a>which have always been there. The theme of World Health Day on 7 April this week was ‘Healthy Beginnings, Hopeful Futures’ dedicated to <a href="https://nepalitimes.com/opinion/comment/saving-more-mothers-and-babies">preventing maternal and newborn deaths</a>. It is estimated that in Nepal, 30% of neonatal mortality can be blamed on air pollution. But that is only part of the story. Harmful as fine particulate matter is to human health, carbon monoxide, nitrogen dioxide, ground-level ozone and other gases in vehicular emissions are more hazardous to health. While the concentration of suspended particulate matter tinier than 1.5 microns (PM2.5) is closely monitored, these toxic gases are invisible, not measured much, and the public is not aware about the dangers they pose. Surface ozone is produced by the interaction of various gases found when <a href="https://nepalitimes.com/news/fossil-fuels-poison-air">burning fossil fuels</a>. Besides being poisonous, ground level ozone contributes up to 0.23°C to <a href="https://nepalitimes.com/here-now/nepal-s-mountains-are-melting">global warming</a> because it is also a greenhouse gas. A new policy brief by the Clean Air Fund titled The Case for Action on Tropospheric Ozone blames surface ozone for a half a million premature deaths every year, 54.8% of which are in South Asia. Ozone also stunts plant growth and reduces crop yields by 26% globally, and 11% loss in <a href="https://nepalitimes.com/news/economic-benefits-of-saving-the-ecology">forest productivity</a>, the report adds.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250411060456_aa02a923f8b27544ae54d0220162678f5bbb5eeb8fc3c466173c22c49b3e9a85.jpg" data-media-id="editor_11" data-image-id="20250411060456_aa02a923f8b27544ae54d0220162678f5bbb5eeb8fc3c466173c22c49b3e9a85" data-rendition-name="original" width="998" height="724" loading="lazy" alt="Gas Chambers"> </figure>  Read also: <a href="https://nepalitimes.com/here-now/bad-air-and-polluted-politics">Bad air and polluted politics</a>, Sonia Awale Ground-level ozone is not emitted directly into the air like other gases, but is formed when oxides of nitrogen (NOx), carbon monoxide (CO) and volatile organic compounds (VOCs) released from automobile tailpipes or industry smokestacks react chemically with each other in the presence of sunlight. The main source of carbon monoxide in Kathmandu Valley are its 1.2 million two-wheelers. “Usually the concentration of carbon monoxide is 200-500 parts per billion (ppb), this has increased up to 3,000 in Kathmandu. Meanwhile, ground-level ozone has gone from 70-80 ppb to 150 ppb,” says Ravi Sahu, regional air quality specialist with the Kathmandu-based International Centre for Integrated Mountain Development (ICIMOD).&nbsp; Sahu says <a href="https://nepalitimes.com/news/no-smoke-without-fire-p7vb9dcj">rampant forest fires of the past weeks</a> have also added to carbon monoxide and ozone in the air, not just the fine particles that make up the visible smoke. He adds, “There isn’t much awareness about <a href="https://nepalitimes.com/banner/poisoning-the-air-we-breathe">ground-level ozone and carbon monoxide</a>, we need to urgently look into it.” A distinction must be made between good and bad ozone. Stratospheric ozone protects living beings from harmful ultraviolet (UV) radiation from the sun.&nbsp; Tropospheric ozone can again be separated into two types: ozone in the free atmosphere which is a greenhouse gas much more potent than carbon dioxide, and ground-level ozone which has adverse impacts on health and agriculture. ‘Cutting tropospheric ozone presents a unique challenge as it requires smart and fast action across multiple greenhouse gases and air pollutants, as well as multiple economic sectors,’ notes the Clean Air Fund's policy briefing. ‘It is a growing and neglected problem that needs an integrated approach on both a local and global level to tackle climate change and air pollution together.’ Dying young There was a time when Nepal made it to international news bulletins only if there were fatalities on Mt Everest. Now, Kathmandu’s bad air frequently makes headlines all over the world. This past week, the concentration of PM2.5 that harms human health was up to 40 times the WHO recommended guideline — adding to the poisonous gases already present from vehicle emissions. The Department of Environment says 40% of the pollution in the past weeks was from wildfires sparked by nearly 6 months without substantial rain over central Nepal. Most of the rest is from vehicular and industrial emissions from Kathmandu itself and across the southern border. NASA’s Fire Information and Resource Management System (FIRMS) which issues daily maps of fires, showed hundreds of blazes raging across Nepal on Wednesday, mainly in Chitwan, Parsa and along the East-West Highway.&nbsp; “If we look at the figures for the last few years, it is clear that wildfires have become the biggest source of air pollution, they are seasonal but have overtaken vehicular emissions,” says urban planner and environmentalist Bhushan Tuladhar. “Forest fires, stubble burning, and open burning of garbage are the bigger problems now. Nepal, India, Bangladesh, and Pakistan are at risk every year, we shouldn’t further delay in finding solutions,” warned air quality expert Bhupendra Das during an event on air pollution organised on 7 March by the Nepal Forum of Environmental Journalists (NEFEJ).&nbsp; Indeed, studies have shown that in winter 60% of the air pollution over Kathmandu is transboundary from the south, and in November it is compounded by smoke from crop residue burning by farmers in India and Pakistan blown in by prevailing winds. Forest fires are a regular pre-monsoon occurrence in Nepal, often intentionally set by farmers and herders to stimulate new grass growth for livestock. Winter rains have failed for eight of the past ten years, and this means the fires often spread out of control. The other reason for the increase in wildfires is the doubling of forest fires to 46% of the country’s area in the past 25 years. But this has happened simultaneously with outmigration, with some mountain districts losing 30% of their population between 2011-2021. With less pressure on forests for fodder and firewood, the undergrowth of community forests is loaded with dry fuel just waiting for a spark. The bowl-shaped topography of Kathmandu, Pokhara and other valleys further concentrates pollutants as they are trapped by surrounding mountains. But a year with a high number of wildfires is usually followed by a year or two with fewer incidents. For example: there were 6,537 fires in 2021 but the following year the number was down to 1,528. There were 5,216 fires last year, this year the number has already reached 1,800, and the trend is likely to be broken. Heavy rains forecast for the coming days are expected to douse some of the fires and clean up the air. But the damage has been done: Kathmandu residents of all age groups this week crowded clinics and hospitals with burning eyes, itchy throats, difficulty breathing, headaches, and dizziness. But in the longer term, soot particles that are tiny enough to jump the blood-air divide in lung capillaries do not just cause Chronic Obstructive Pulmonary Disease (COPD), asthma, but also cancers, heart attacks, strokes, birth defects and other chronic diseases. The latest Air Quality Life Index (AQLI) report by the University of Chicago shows that the annual concentration of PM2.5 in Kathmandu’s air rose from 17.87µg/m3 in 1998 to 31.33µg/m3 in 2022. Air pollution has got worse by 75% in Kathmandu in 25 years. During this time, air pollution has reduced the average life expectancy of Kathmandu’s residents by 3.5 years. According to the Health Effects Institute in Boston, dirty air is among the biggest public health concerns in Nepal killing over 42,100 a year. The adverse impact of high levels of air pollution is not limited to public health, it is seriously affecting tourism. Operators in Pokhara this week said that there were many negative online posts by visitors unable to see the famous panorama of Machapuchre and the Annapurnas even from Sarangkot. Aviation is also affected, as planes have to circle sometimes for hours burning a lot of fuel because of runway visibility being below minima at Kathmandu airport. The higher fuel cost is just passed down to customers, making air tickets in and out of Kathmandu some of the highest in the world. Kathmandu, with a population of four million, has not implemented a concrete policy to curb toxic air despite having formulated various action plans and repeated commitments by the government to protect the environment and control air pollution. The Department of Environment’s 2017 Air Quality Management Action Plan for Kathmandu put forward a policy to reduce air pollution caused by vehicles which was approved by the Cabinet, but has yet to be put to practice. The action included the immediate implementation of the Euro 5 emission standard to reduce pollution emitted by vehicles. However, Nepal has not even been able to implement Euro 4 standards so far. India, meanwhile, has already moved forward with the implementation of the Euro 6 standards. Says Ravi Sahu: “Air pollution in Nepal is not just about air pollution, it has ties to tourism, aviation, the economy so we must be prepared for annual conditions like forest fires, and this requires urgent interdisciplinary collaboration.” &nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250411050452_821d09e283d8a590f1369bfb71b9b7fc6d950726e0651ea86c6488d04deb1742.jpg" data-media-id="editor_15" data-image-id="20250411050452_821d09e283d8a590f1369bfb71b9b7fc6d950726e0651ea86c6488d04deb1742" data-rendition-name="original" width="839" height="784" loading="lazy" alt="Silent Killers"> </figure>  &nbsp;

What is invisible is more dangerous

Here in the mountains of far-western Nepal, the biggest threat to life and limb is gravity. Women collecting fodder fall from trees, boys grazing goats fall off cliffs, heavily loaded tractors plunge from dirt roads carved out of steep slopes. There is nothing to be done about those who die on the spot. But for the severely wounded there is only one hospital: Bayalpata. And it is there that <a href="https://www.youtube.com/watch?v=CJzWlnYd0ZM&amp;t=8s" target="_blank">orthopaedic surgeon Mandeep Pathak</a> is the last hope for many wounded people. Pathak, 42, is too modest to tell us how many lives he has saved over the past 10 years he has worked at Bayalpata. But hospital records show he has performed more than 4,000 operations in the past decade, many of them so patients did not suffer permanent physical disabilities. Pathak also did 800 major life-saving surgeries in that time. “I treat patients with injuries, but I wish I could also treat poverty,” Pathak says, emerging from Bayalpata’s surgical theatre one recent afternoon. <div class="embed-block"><iframe width="700" height="415" src="https://www.youtube.com/embed/CJzWlnYd0ZM?si=s_rkbU4YDaw87gqH" title="YouTube video player" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share" referrerpolicy="strict-origin-when-cross-origin" allowfullscreen></iframe></div> Sudurpaschim Province in Nepal’s far-west is far away from everything: from Kathmandu, from adequate medical care, from food security, and far from the reach of government services. It has suffered state neglect for centuries, its men mainly migrating to India for seasonal work to families who depend on subsistence agriculture. Pathak remembers the searing sadness he felt when a patient once told him, “Doctor, I sold the last of my rice to pay to come here, please give me a medicine that I can take on an empty stomach.” Pathak was born in Kathmandu, and after getting his MBBS from Kathmandu University, he got an MD from The Philippines. At a time when many Nepali doctors and staff nurses were emigrating, Pathak did not just return to Kathmandu but decided to go to one of the remotest districts in Nepal to serve those most in need. The hospital was established in 2009 in the village of Bayalpata, and has been managed by the non-profit <a href="https://www.nyayahealthnepal.org/" target="_blank">Nyaya Health Nepal (NHN)</a> as a public-private partnership treating 100,000 patients a year for no fees at all. NHN is now preparing to hand over the running of the hospital to the Sudurpaschim provincial government so its <a href="https://nepalitimes.com/banner/this-is-how-to-upgrade-nepals-rural-health" target="_blank">model of hospital management</a> can be replicated.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250414130456_b59dabd4604a24426a55fe91c0e5866b5029858bdb4c4028c331557aeb5408ae.jpg" data-media-id="editor_4" data-image-id="20250414130456_b59dabd4604a24426a55fe91c0e5866b5029858bdb4c4028c331557aeb5408ae" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="Bayalpata hospital"> <figcaption>Bayalpata hospital in Achham.</figcaption> </figure>  People from not just Achham but surrounding districts, and from as far away as Humla, bring patients to Bayalpata, sometimes walking for days. Some with complicated pregnancies are brought in stretchers, young children with broken arms walk into the emergency, and sometimes there are mass casualties when a tractor or bus falls off a road. And Pathak is always there with his team performing triage, and doing orthopaedic surgeries that would be difficult even in Kathmandu. Recently, his team did a hip replacement at <a href="https://nepalitimes.com/banner/state-of-the-art-rural-hospital" target="_blank">Bayalpata Hospital</a>. Mild mannered, modest, soft-spoken, hard-working, professional are the words families of patients who have been treated at <a href="https://nepalitimes.com/here-now/nepal-s-rural-lifeline" target="_blank">Bayalpata Hospital </a>use to describe Mandeep Pathak. But the surgeon is too busy to let all this get to this head.&nbsp; Asked why he does not emigrate like his peers or get a lucrative position at a private hospital in Kathmandu, Pathak answers simply, without a trace of self-importance, “I do not think I could get the satisfaction or sense of fulfilment anywhere else.” When travelling to attend medical congresses overseas or visit family in Kathmandu, Bayalpata has other doctors to take care of patients, but many wait patiently till Pathak returns for their consultation or surgery.&nbsp; When he returns from seminars abroad after learning the latest skills, Pathak’s suitcases are not full of clothes or presents, but titanium bone implants, external fixation rods, or intramedullary nails to be used in <a href="https://nepalitimes.com/news/altruistic-healthcare-models-in-nepal" target="_blank">surgeries at Bayalpata</a>.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025041414040_5356278472c1eb2b9e4af1d593d6234cc8dc5e5161a8c614197c01abefadbd80.jpg" data-media-id="editor_8" data-image-id="2025041414040_5356278472c1eb2b9e4af1d593d6234cc8dc5e5161a8c614197c01abefadbd80" data-rendition-name="original" width="2048" height="1368" loading="lazy" alt="surgery"> </figure>  Before Bayalpata Hospital was established, most people suffering broken bones had to travel down to Dhangadi or Nepalganj for treatment. No more. Although Pathak’s specialisation is orthopaedic oncology, he is mostly treating fractures and rejoining broken bones.&nbsp; Now as Bayalpata’s Hospital Director, Pathak also has administrative and fundraising duties. He has to take the 10-hour ride down to Dhangadi often to meet various Sudurpaschim ministries to release the hospital’s budget — that is sometimes more difficult than the most complicated surgery. Recently, he had to cancel an appointment with the Chief Minister to rush back to Bayalpata because there was a patient who needed emergency surgery. “I told myself, let me save this patient first, then I will try to save the hospital,” he recalls.&nbsp; Once, when he had to be away for a month on emergency surgery training in the US, the family of a 90-year-old woman who had dislocated her hip after falling from a staircase was waiting for him to return. Her son told Pathak: “Doctor, either put her out of her suffering, or cure her.” Pathak told him it was too dangerous to operate at her age, but the son said his mother was in so much pain it was worth the risk. The operation was touch-and-go, but it was successful. The woman who had been brought in on a stretcher, walked out of the hospital three days after the operation.&nbsp; A few months later, a 27-year-old woman was brought into the ER bleeding profusely from an arm mangled by a thresher machine. Even in that state, she was breastfeeding her baby. Pathak welled up seeing this display of selfless motherhood, as he wheeled her into surgery. She needed three operations, but now has full use of her hand. <div class="embed-block"><iframe width="700" height="415" src="https://www.youtube.com/embed/xJdxLD0hBqo?si=mOpM2R_DsYL88Lfg" title="YouTube video player" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share" referrerpolicy="strict-origin-when-cross-origin" allowfullscreen></iframe></div> It is the sense of achievement from such recovery that keeps Mandeep Pathak here in this isolated village in the middle of nowhere. Bayalpata Hospital has not just saved lives, it also saves families from poverty because they do not have to take sick relatives to expensive city hospitals.&nbsp; In January, a woman was brought to Bayalpata with both hands broken. She said she had taken a fall, but Pathak did not believe her. When alone in the surgery, she finally admitted that her husband had beaten her.&nbsp; It was her husband who had brought her to hospital for treatment, but she refused to file a police report. Pathak quietly put both her arms in casts, thinking about the poverty, patriarchy and injustice in society that he is unable to treat.

children