<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108131148/636a50529c7e80680e04fd53jpeg.jpg" alt="" width="1400" height="933"/><figcaption>TIMELY ADVICE: After providing implants at a remote health post in Baitadi recently, visiting service providers Madhavi Bhatta and Ashmita Bohora warn sisters Hasa and Harina Sarki (seated, left) of possible side effects. Pics: ROJITA ADHIKARI</figcaption></figure>Two nurses visiting distant Maharudra Health Post in Baitadi had packed up, said goodbye to staff and started down the road when two local women waved down their jeep. “We want to have an implant,” they said.The nurses told the women they would be back next week, but they insisted: “We have walked three hours, leaving our breastfed babies to get our implants.” The nurses relented, the jeep turned around and returned to the health post.Read Also: <a href="https://www.nepalitimes.com/here-now/migrating-males-and-population-decline/" target="_blank" rel="noopener">Migrating males and population decline</a>, Om Astha RaiThe local women were lucky. Only half of health facilities in Nepal provide all five major contraceptives as part of their regular services. Implants and long acting reversible contraceptives (LARC) are not easily available, mainly due to lack of trained staff. Filling that gap are visiting service providers at remote health posts like this one in Baitadi.Only 43% of all married women of reproductive age in Nepal have access to modern contraceptives, according to the Demographic Health Survey (DHS) 2016 report. Although it was only 26% in 1996, there is still a huge unmet need for family planning.Nepal’s population clock will touch 30 million next month, but the country’s falling fertility rate means that population will stop growing in three decades after it reaches 37 million. A Nepali woman on average had 6 babies in the 1960s, now she has 2, which is below the population replacement level.The two women who stopped the nurses were Hasa Sarki, 23, and her sister Harina, 20 (pictured, right). Hasa already has four children, and Harina has two. The sisters live in the same house in Lakhulla village, about three hours walk from the health post.“When we heard the implant nurses were here, we took off, leaving our food and shouting to my husband to take care of the baby,” said Harina.Read also: <a href="https://www.nepalitimes.com/banner/lets-talk-about-it/" target="_blank" rel="noopener">Let’s talk about it</a>, Duksangh Sherpa<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108131148/636a50559c7e80680e04fd54jpeg.jpg" alt="" width="1400" height="933"><figcaption> </figcaption></figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108131148/636a50589c7e80680e04fd55jpeg.jpg" alt="" width="1400" height="933">The sisters are Dalits from a community of subsistence farmers. Hasa was married at 15 and already has three daughters and a son. The land does not provide food for the family, so Hasa’s husband goes to India six months a year.“My husband and I decided to have five years’ pregnancy prevention as we can’t afford to have any more children. I am so happy that after today I will be safe for five years,” added Hasa.One of the nurses, Binda Saud, says the number of women requesting contraceptives even in these remote areas is growing, but the one medic trained in inserting implants was transferred and there is no one to do it in the health post. Which is why the government has mobilised 63 visiting service providers (VSP) in 14 districts across Nepal to promote implants and IUCDs, with support from the UN Population Fund and British agency DFID.Read also: <a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/globe-rallies-to-aid-nepals-women,3841" target="_blank" rel="noopener">Cutting the lifeline</a>, Kate RyanLack of personnel trained in implants is just one barrier in remote villages, where many people still believe that birth control is against god’s wishes. As a result, <a href="http://archive.nepalitimes.com/article/from-nepali-press/baby-factory-bajura-nepal,4018" target="_blank" rel="noopener">women give birth annually</a> and many are anaemic, malnourished, and some die.“One of the worst cases I have faced is that of a woman who had seven children who told me she wanted five years’ protection, but when I started the process of putting an implant into her arm she started shaking and saying god will not forgive her; she changed her mind,” recalled the other auxiliary nursing midwife, Madhavi Bhatta.There are families in these remote mountains where mothers and their daughters-in-law give birth together. Laxmi BK, 37, and her daughter-in-law Puja BK, 19, gave birth within months of each other. Laxmi was married when she was 14, and now has 8 children, including the youngest who is 18 months. Puja got married when she was 16, and gave birth to her first child a year ago.<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108131148/636a505c9c7e80680e04fd56jpeg.jpg" alt="" width="1296" height="544">“I don’t know much about contraception, I used an injection once but it led to bleeding and I thought I would die, so I decided never to use it again,” Laxmi said.The VSP approach was piloted by the government in Ramechhap district in 2015, and after positive results was expanded  in 2018.“It is a cost-effective way to substantially increase the uptake of five modern family planning methods in areas of low use and high unmet demand for contraception,” explained Amit Dhungel of UNFPA Nepal.The government is also encouraged by the success of the initiative, especially for delivery of family planning. “VSPs travel to remote areas which are difficult for the government to reach,” said Kabita Aryal at the Department of Health in Kathmandu. “That fills the gap in health facilities and health workers.”Getting the right contraception in the right place at the right time can change a Nepali woman’s life. That hope could be seen in the smiles on the faces of Hasa and Harina Sarki last month as they hurried home to their families with their new implants.<h2>Happier now</h2><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108131148/636a505e9c7e80680e04fd57jpeg.jpg" alt="" width="1400" height="933">Kalawati Chand, 31, from Khaligad village in Baitadi, (above) received an implant at a VSP camp two years ago, and says it is a big relief not to be worried about getting pregnant.“I already had two abortions, and I used to get pregnant every year, which means I was not able to focus on my children and even the farm. This had led to discord in the family,” Kalawati said. “But now I have more time for my children, husband and to go to the fields. We are happier now.”Setu Mahata, 26, (below) was waiting at Udayadev Health Post in Baitadi, a 1.5 hour walk from her home recently. The mother of two had been taking pills, but she heard that a VSP was coming and wanted to get a 5-year protective implant.“It is really convenient that the nurse comes here, otherwise I would have to spend two days going to another health post, and that would be expensive,” she said.Read also: <a href="http://archive.nepalitimes.com/article/Nepali-Times-Buzz/child-marriage-in-Nepal,3863" target="_blank" rel="noopener">Far too young,</a> Sonia Awale<h2>ISPs</h2><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108131148/636a50619c7e80680e04fd58jpeg.jpg" alt="" width="1400" height="933">Call them ISPs, (implant service providers) these nurses are at the frontlines of reducing Nepal’s birth rate. The visiting service providers are female staff nurses or auxiliary nursing midwives (ANMs) trained to use long-acting reversible contraceptives (LARCs) and provide family planning services, especially in hard to reach areas and for minority groups. They also coach and support existing health workers to deliver quality, comprehensive family planning services.“I have been working as a VSP since the start and I have travelled to all 69 health facilities of Baitadi district. We have provided more than 2,100 IUCDs and implants in this district alone,” says ANM Madhavi Bhatta.Travelling in one of Nepal’s remotest and most rugged districts is not easy. Bhatta sometimes has to walk nine hours a day to reach health posts. What motivates her is the smile she sees on the faces of the women once they get their implants.“I can see the happiness, relief and satisfaction on their faces. It makes me forget all the hardship of getting to them,” says Bhatta.

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Implant service providers take contraception to Nepal's poor

Nepal’s fertility rate is going down even though contraceptive use has not increased<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221104141140/636517189c7e80680e02c252jpeg.jpg" alt="" width="1400" height="933"/><figcaption>THE RIGHT SHOT: Health worker Januka Dhakal injects Depo-Provera on a woman at Rayale Health Post of Kavre district on Tuesday. With their husbands away, fewer women now want to use contraceptives. Sonia Awale</figcaption></figure>Sita Yonjan, 21, has a two-year-old daughter, and recently stopped using <a href="http://archive.nepalitimes.com/article/from-nepali-press/Ftnp-the-curse-of-the-contraceptive,493">contraceptives</a> even though she is not planning to have another child. She says she doesn’t need her birth control implant anymore because her husband went away to work in Qatar two months ago.Yonjan visited a health post in Rayale village of Kavre to remove the birth control implant that she had inserted last year. The tiny device prevents births for five years, and does not need to be removed even when users abstain from intercourse. But many Nepali men want their wives to stop using contraceptives when they leave for overseas work."My husband thinks I could sleep with anyone if I use contraceptives in his absence," Yonjan frankly admits.An estimated four million Nepali men of reproductive age <a href="http://archive.nepalitimes.com/article/nation/The-cycle-of-migration,3230">work abroad</a>, and their wives back home generally see no need for contraceptive implants, preferring to use short-term methods like condoms, pills and injectables when their husbands come home on leave. Like Yonjan, those using IUDs and implants remove them as soon as their husbands go away again.https://www.youtube.com/watch?v=8lXkqrDtUOUDemographers say this explains the riddle about why Nepal's fertility rate has been going down despite contraceptive prevalence rate remaining low.When Nepal conducted its first-ever nationwide health survey in 1996, only 26% women were using modern contraceptives. Within ten years, it had nearly doubled to 44%, but has leveled off since. The contraceptive prevalence rate actually declined to 43% in 2016, when the last National Demographic Health Survey (NDHS) was conducted. Even so, the fertility rate that measures the average number of children per couple has been going down -- from 4.6 in 1996 to 3.1 in 2006 and 2.3 in 2016 (see graphs, overleaf).Demographers were initially puzzled by the drop in the fertility rate despite contraceptive use rate flatlining. But an analysis in 2013 suggested a correlation between male outmigration and contraceptive use. Another analysis is now underway, which will probably confirm the impact out-migration of men may be having on contraceptive use and fertility rate."If we consider only women who are married and living with husbands, we find a high contraceptive prevalence rate," explains Sharad Pathak, a demographer at the government’s Family Health Division. "This rate is low only because lots of women generally do not need contraceptives when their husbands are away."<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221104141140/6365171c9c7e80680e02c253jpeg.jpg" alt="" width="900" height="826">However, experts warn that Nepal’s declining fertility rate may not mean that population growth will reach replacement level -- one in every four married women still have an unmet need for family planning. A third of young married women aged 15-19 do not use contraceptives, making them more vulnerable to unintended pregnancies and unsafe abortion.Kristine Blokhus at the UN Population Fund (UNFPA) says Nepali women are aware of the benefits of having fewer babies, but face barriers in accessing contraceptives: "Health facilities often run out of contraceptive stocks, and there are not enough trained health workers to provide long-term contraceptives like implants and IUD."A 2016 UNFPA assessment showed most health posts provide only condoms, pills and injectables because of the lack of trained staff. Only one third of the facilities provide all five types of modern contraceptives including implants and IUDS. In most villages, women have to choose between oral pills or Depo-Provera, which they cannot use if there are side effects. Male or female sterilisation is available occasionally, and most women complain their husbands do not want to use condoms.With rising female literacy, the number of women opting for traditional family planning like withdrawal and the rhythm method instead of modern contraceptives is also going up. In 1996, only 3% of married women used such natural methods, now it is 10%. However, the NDHS 2016 showed that 62% women using the rhythm method to avoid pregnancy did not have an accurate knowledge about the ovulation cycle.Nepal’s target is to increase its contraceptive prevalence rate to 52% by 2020, but it may not meet that goal because of male migration, the preference for natural methods, and family planning programs being scaled back due to a drop in U.S. funding after the <a href="http://archive.nepalitimes.com/article/Nepali-Times-Buzz/globe-rallies-to-aid-nepals-women,3841">gag rule under President Trump</a>. The United States has traditionally been the main supporter of family planning projects in Nepal, through organisations like Marie Stopes International that provide abortion services.Beth Schlachter, Director of Family Planning 2020, who recently visited Kathmandu to take stock of Nepal's progress, says: "The US gag rule might affect Nepal's family planning programs if organisations delivering safe abortion services here do not find other resources to supply contraceptives."Since Nepal is poised to become an 'aging' <a href="http://archive.nepalitimes.com/article/Nepali-Times-Buzz/need-to-prepare-for-ageing-society,3624">society by 2030 and an 'aged one' by 2050</a>, there is an even greater need to scale up family planning. For the country to reduce its dependency ratio and <a href="http://archive.nepalitimes.com/article/editorial/editorial-reaping-demographic-dividend,3621">reap the demographic dividend</a>, many more women must have easier access to a much wider range of contraceptives.The mix mattersWhen Nepal launched its first population control campaign in the late 1960s, its population was only 13 million, it was growing at 3% per year because the fertility rate was nearly 6 children per couple. The only contraceptive choice women had then was to get their partners to use condoms. Most men did not like using them, and women did not have any control over reproductive health. The pill could have given women freedom to limit or space births, but they were scared of its side effects.Later, injectables like Depo-Provera and IUDs were introduced and today the government provides five types of contraceptives for free, and conducts health camps offering permanent family planning methods like male as well female sterilisation. But many other contraceptives like emergency pills and female condoms are available only in private clinics, and most rural women cannot use them even if they want to.<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221104141140/6365171e9c7e80680e02c254jpeg.jpg" alt="" width="900" height="609">Beth Schlachter, Director of Family Planning 2020, says Nepal needs to provide a much wider mix of contraceptives in order to protect women from unintended pregnancies, unsafe abortions and maternal deaths: "What a 15-year-old girl needs might be different from what a 24-year-old mother of two children needs," she says. "If we try to address all of them with just one or two methods, we will not be very successful."Marie Stopes International is preparing a pilot program to test the acceptability of a new type of Depo-Provera called Sayana Press which can be injected at home and would suit women who do not like to visit health posts every three months for their Depo-Provera.Read also:<a href="http://archive.nepalitimes.com/article/Nepali-Times-Buzz/globe-rallies-to-aid-nepals-women,3841">Cutting the lifeline</a>,  Kate Ryan<a href="http://archive.nepalitimes.com/article/editorial/editorial-reaping-demographic-dividend,3621">Reaping the demographic dividend</a>, Editorial

Migrating males and population decline

The winter air pollution season started early this year with emissions, Diwali firecrackers and crop residue burning making the air unbreathable across north India. Much of the pollution was transboundary, with prevailing winds carrying the suspended particulates from Pakistan, across India to Nepal and beyond. All this pollution and domestic emissions killed 41,300 in Nepal in 2023, and 85% of all deaths were because of noncommunicable diseases such as heart and lung disease, lung cancer, diabetes, and dementia, according to the State of Global Air (SoGA) 2025 report released Thursday. With the onset of winter, Kathmandu Valley’s own emissions are trapped in a surface inversion layer and as in previous years will have some of the worst air quality in the world.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251023131016_7c42a4e8b0dce01dfeeaaf89dbb10dbfa036b41163f3ebada88c7ce17dbded49.png" data-media-id="editor_0" data-image-id="20251023131016_7c42a4e8b0dce01dfeeaaf89dbb10dbfa036b41163f3ebada88c7ce17dbded49" data-rendition-name="original" width="921" height="850" loading="lazy" alt="Air pollution killing season starts early NT"> </figure>  The SoGa report says air pollution has now become the leading risk factor for deaths in Nepal, ahead of tobacco and high blood pressure. Interestingly, while the health impacts due to environmental risk factors such as unsafe water and sanitation have reduced significantly since 2000, the opposite is true for ambient PM2.5 (particles smaller than 2.5 microns). Globally, 7.9 million deaths were attributable to air pollution– about 1 in 8 deaths – in 2023. Of this total, 4.9 million deaths were attributable to PM2.5 exposure, 2.8 million were from household air pollution, and 470,000 were from ozone. Similarly, dementia attributable to air pollution resulted in 626,000 deaths and 40 million healthy years of life lost. And 95% of air pollution attributable deaths in adults over the age of 60 are due to noncommunicable diseases. The burden of noncommunicable diseases in relation to air pollution is rising worldwide and in Nepal. The SoGA report shows that nearly nine of ten global air pollution deaths are from chronic ailments, and half of all respiratory disease deaths are attributable to air pollution.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251023131020_8577f464b4a73007de5dd018b8ac91dae3a9c732dbb81a44b6aa5a0ced7df3df.png" data-media-id="editor_1" data-image-id="20251023131020_8577f464b4a73007de5dd018b8ac91dae3a9c732dbb81a44b6aa5a0ced7df3df" data-rendition-name="original" width="1080" height="1080" loading="lazy" alt="Air pollution killing season starts early NT"> </figure>  In Nepal, air pollution is responsible for three out of four COPD deaths, one out of three heart deaths and one out of five diabetes deaths. More than one third of lower respiratory infection deaths were due to air pollution. “The data presented in the State of Global Air report highlight the significant impacts of poor air quality on the health and well-being of billions of people around the world, especially those living in Asia and Africa,” says Pallavi Pant of the Boston-based Health Effects Institute (HEI) that released the report in collaboration with the Institute for Health Metrics and Evaluation and the NCD Alliance. She adds: “Growing momentum on air quality management across those hard-hit locations, including expansion of air quality monitoring, adoption of air quality regulations, and sector-specific interventions are yielding improvements for those most impacted.” Low- and middle-income countries stand to gain most by reducing air pollution, with particularly strong impacts on children, older populations, and people with pre-existing health conditions. Indeed, of the 41,300 air pollution deaths in 2023 in Nepal, 31,600 were in adults over the age of 60 years and 3,500 in children below five years. Death rate for air pollution in Nepal, which is 178 per 100,000, is more than 10 times higher than high-income countries, which is at 17 per 100,000.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251023131020_604e852aed4ffde0dc7d1df72fcd3e73d904136dfb1bb2407e53b7445f3ef72c.png" data-media-id="editor_2" data-image-id="20251023131020_604e852aed4ffde0dc7d1df72fcd3e73d904136dfb1bb2407e53b7445f3ef72c" data-rendition-name="original" width="1078" height="423" loading="lazy" alt="Air pollution killing season starts early NT"> </figure>  “Win-win solutions for air pollution and NCDs exist, with added benefits for climate, physical activity, nutrition, and many other global development priorities,” says Alison Cox, Policy and Advocacy Director at the Geneva-based NCD Alliance. “These policies are effective and deliver a strong return on investment - for the sake of our people and the planet we need to implement them faster.” Fine particle pollution (ambient PM2.5) is the largest driver of air pollution’s burden of disease worldwide as kit attributed to 4.9 million deaths and 124 million healthy years of life lost in 2023. Vehicles, power plants, factories, and homes, as well as agricultural and industrial activities, waste burning and wildfires are some of the biggest sources of pollutants. South Asia is among the regions of the world with the highest exposures to ambient PM2.5 , while more than 36% of people around the world live in areas where PM2.5 levels do not meet even the least stringent interim target. As per the report, 78% of Nepal’s 30 million population lives in areas where annual PM2.5 exposure exceeds the least stringent WHO Air Quality Interim Target of 35 µg/m3. Meanwhile, exposure to household air pollution due to the use of solid fuels for cooking remains an important driver for the disease burden in the country. “Ongoing efforts to meet global development goals are not achievable without directly addressing air pollution,” says Maria Neira, Commissioner of Our Common Air. “Countries and cities must focus their efforts toward reducing air pollution emissions, including household air pollution, which has particularly severe impacts on young children and older people across Asia and Africa.”

Air pollution killing season starts early

This year, the <a href="https://nepalitimes.com/opinion/quo-vadis-un-80-9vthn7mg">United Nations is marking its 80th anniversary</a> and it is being celebrated with special events across the world to commemorate its establishment on 24 October 1945. It has also been 75 years since the first UN adviser, the Swiss geologist Toni Hagen, was sent to Nepal to explore development opportunities. In 1950, there were no roads and Hagen walked on foot across the length and breadth of Nepal’s mountains, valleys and plains. This year also marks the 60th anniversary of the United Nations Development Program (UNDP) in Nepal, and much of Hagen’s work laid the basis for the UN’s involvement in education, health, and connectivity in Nepal’s future development. Despite frequent changes in government and political system, Nepal has made remarkable progress. The poverty rate has gone down by half in the past 30 years to 20.27% of the population. Much of it has to do with remittances from Nepalis working overseas, but it is also a result of the Nepal government’s investment in education, health care and social welfare.&nbsp; There have been special initiatives like the Prime Minister’s Employment Program that have provided jobs to nearly 800,000 people in the country’s 743 municipalities — especially in those areas with lower Human Development Index (HDI) like the far-west and the Tarai.&nbsp; This year’s HDI report by UNDP shows that Nepal’s score had risen to 0.622, whereas it was only 0.404 in 1990. In the past 33 years, the average lifespan of Nepalis has risen by 15.6 years to 70.4 years, whereas it was only 54.8 in 1990. However, the country’s HDI ranking is still 145 among the world’s 193 countries. “Yes, there has been significant improvement in living standards in the past 60 years, road connectivity has improved, the maternal mortality rate has gone down dramatically, almost everyone has phones, there are schools,” says Saru Joshi of the thinktank Nepal Policy Institute. But, she adds: “It is still difficult to get citizenship papers, especially in the name of the mother, and this has excluded many women from banking services, inheritance. After all our progress in physical infrastructure, Nepal now needs to prioritise inclusive social development.”&nbsp; Some of this is also happening. Eighteen years ago, Nabaraj Subedi, 49, of a village in Baglung decided not to join his peers &nbsp;fleeing the Maoist conflict to find work overseas. He invested Rs500,000 to buy a diesel generator and start a small furniture business.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251024071044_eeef308e19a73de507a425b2c6afc47269884549cf4c8fac07ca9a4898c8e031.jpg" data-media-id="editor_1" data-image-id="20251024071044_eeef308e19a73de507a425b2c6afc47269884549cf4c8fac07ca9a4898c8e031" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="Nawaraj Subedi"> <figcaption>Nawaraj Subedi, 49, proprietor of Tarakhola Furniture Factory. </figcaption> </figure>  Today, with the installation of the 380 kilowatt small hydroelectric plant, he does not need to depend on his unreliable generator to power his equipment anymore. There is now a road connecting his village, and Subedi has generated local jobs, opened a sales branch in the city, and gets orders from as far away as Pokhara and Chitwan. “My costs have gone down drastically because of the electricity, and sales have gone up because of the road connecting my furniture to markets. My business has expanded,” Subedi says. Back in 1960 in a report he prepared for the Nepal government on behalf of the United Nations, Toni Hagen had emphasised just this: investing in electricity generation and connectivity to uplift the remote rural areas of Nepal.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251024081024_188ab121dc3cf2816ee71a72cb3687493eda37ab99ecc04802d647c8c9b4cd2d.jpg" data-media-id="editor_2" data-image-id="20251024081024_188ab121dc3cf2816ee71a72cb3687493eda37ab99ecc04802d647c8c9b4cd2d" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="Tarakhola Furniture Factory"> <figcaption>Subedi's staff at the Tarakhola Furniture Factory.</figcaption> </figure>  Subedi’s furniture factory gets its electricity from the nearby Tarakhola Hydropower, a company set up eight years ago with financial and technical support from UNDP’s Renewable Energy for Rural Livelihood (RERL) project. &nbsp; “The project completely transformed living standards in this village,” says municipality chair Dhan Bahadur BK. “It has helped create jobs locally, there is now money to invest in education and healthcare. Households can pay their electricity fees electronically through smart billing.”&nbsp; After working with the government on rural electrification, UNDP is focussed on using that power for local employment creation. A women’s group, for example, has bought an electric-powered potato processing machine that can produce chips.&nbsp; “We are 12 of us mothers, daughters, daughters-in-law who process, package and market the potato that we grow ourselves, and it has raised our income,” says Sukmaya Roka, 57, who chairs the group.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251024071044_70b22418699178bcdd0abb0aa308796980ecd29634bcda6ff113a7624e709751.jpg" data-media-id="editor_3" data-image-id="20251024071044_70b22418699178bcdd0abb0aa308796980ecd29634bcda6ff113a7624e709751" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="Sukamaya Roka"> <figcaption>Sukamaya Roka, 57, chair of Sipa Aalu Chips Utpadan Samuha from Tarakhola Rural Municipality, Baglung. </figcaption> </figure>  Today, 6.1 million households in Nepal (92.2% of total) have electricity in their homes, up from 17.9% 30 years ago. Access to electricity has not just brought lights to homes, but improved everything from productivity, quality of education, healthcare and phone connectivity.&nbsp; “To see what electricity and roads can do, just look at our municipality,” says chair Dhan Bahadur BK, “citizens have become more self-reliant, more aware of the outside world.”&nbsp; NETTLES INTO CASH&nbsp; Just a little bit of training, resource backup and local empowerment can uplift the living standards of Nepalis. The progress made in harvesting abundantly-available allo (nettles) and turning it into household products is an example. When a landslide swept away his home and farm in a flood 40 years ago, Buddhi Purja of Parbat became destitute. But he took part in a government training program supported by UNDP and Australia to harvest the wild nettles that grew on mountain slopes and turn the fabric into bags.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251024071048_56c440c478dffbc13911369b6f4133baf658cc3667773cdb44b7c40e006463ce.jpg" data-media-id="editor_4" data-image-id="20251024071048_56c440c478dffbc13911369b6f4133baf658cc3667773cdb44b7c40e006463ce" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="Rhitu Saugat Handicraft"> <figcaption>A worker at Rhitu Saugat Handicraft making a bag out of nettles.</figcaption> </figure>  “After the landslide, we had to go hungry if we did not get a day job,” Purja recalls, “but after this training we have found that we can turn nettles into cash.” His allo bags are now hanging in tourist shops in Pokhara Lakeside and Thamel.&nbsp; The idea that nettles can be processed into useful fabric has not spread across the country, and new ecologically conscious consumers in Europe and elsewhere now import Made in Nepal nettle products.&nbsp; Purja started out with an investment of Rs500,000, and had a Rs20 million business that employed 25 workers. The Covid crisis in 2020 affected the sales, but Purja has recovered from it, sent his daughter off to study abroad, and is thinking of diversifying his product range.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251024071044_ab6d15abcbb9a643e12a384f4bc488b7e210a8c95303fbe1b2f77716d26eede9.jpg" data-media-id="editor_5" data-image-id="20251024071044_ab6d15abcbb9a643e12a384f4bc488b7e210a8c95303fbe1b2f77716d26eede9" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="Buddi Purja"> <figcaption>Buddi Purja, proprietor of Rhitu Saugat Handicraft in Pokhara.</figcaption> </figure>  While UNDP’s project has made successful businessmen out of people like Purja, nationwide it has created 187,000 jobs in rural medium-scale industries. Much of what has worked in Nepal has been at the community level with decentralised projects like these that use the entrepreneurship of people like Buddhi Purja, Navaraj Subedi, and Sukmaya Roka. It is tantalising to imagine how much more progress Nepal would have made if their work could be replicated nationside and upscaled to the state-level.

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Public anxiety about immigration has become a powerful political currency across many liberal democracies. In Australia, as elsewhere, legitimate concerns about housing and economic fairness can be, and increasingly are exploited by anti-democratic actors who frame migration not as a policy issue but as a cultural threat.&nbsp;
When these narratives move from online spaces to public rallies, they do more than divide opinion; they erode the social trust and pluralism on which democracy depends. Understanding how populist and far-right movements weaponise migration debates is crucial to recognising the early challenging signs of liberal democracy.
Immigration has become one of the most politically charged issues in Australia, not only because of the numbers but because of its entanglement with cost-of-living pressures, housing shortages, and rent spikes.&nbsp;
The latest Household, Income and Labour Dynamics in Australia (HILDA) <a href="https://www.unimelb.edu.au/newsroom/news/2025/september/how-we-live-latest-hilda-data-gives-insight-into-a-changing-australia">data</a> shows rising household financial stress as Australian households spending more on rent and income tax. These changes likely reflect a mix of economic and policy factors but create a lot of room for people to hold inaccurate and occasionally contradictory attitudes on these issues.&nbsp;
While net overseas migration has started to decline from its post-pandemic peak, public concern remains high, amplified by populist rhetoric. Some surveys have <a href="https://www.theguardian.com/australia-news/2025/feb/04/australians-want-less-migration-but-oppose-cutting-international-student-numbers-study-finds">revealed</a> a nuanced picture: most Australians want lower migration overall but oppose cutting international student numbers, and support targeted skilled migration to address workforce gaps.&nbsp;
As former Home Affairs Minister Clare O’Neil <a href="https://minister.homeaffairs.gov.au/ClareONeil/Pages/how-australia-broke-its-migration-system.aspx">argued</a> in 2023, Australia’s migration system is “broken and un-strategic”, not delivering for business, for migrants, or for the larger population. This is a situation that frustrates both sides of the debate and makes immigration an easy political flashpoint.
The recent <a href="https://marchforaustralia.org/">March for Australia</a> rallies turned these anxieties into street-level mobilisation. Tens of thousands <a href="https://www.bbc.com/news/articles/czjmre371l1o">protested</a> at what they called ‘mass immigration’, while far-right groups seized the opportunity to inject xenophobic slogans and calls for ‘remigration’ into the public space. These demonstrations were not only about visa caps or housing and jobs; they became performances of who is entitled to belong.&nbsp;
When immigration is framed not as a policy question but as a cultural test of Australianness, it risks shrinking the demos, the very community that democracy is meant to represent.
What made the March for Australia so striking was not only its size but its composition. Recent investigative reporting <a href="https://www.theage.com.au/politics/victoria/don-t-mention-hitler-and-you-re-sweet-the-great-march-for-australia-deception-20250909-p5mtlc.html">revealed</a> that neo-Nazi groups were not merely present at the March for Australia rallies but played a role in covertly organising them. They amplified messaging online, coordinated attendance, and sought to mask their involvement to broaden appeal.&nbsp;
This highlights that democratic erosion is rarely spontaneous; it requires actors who deliberately exploit social grievances, mistrust, and polarisation to mobilise anger for their anti-democratic ends. The banners reading ‘<a href="https://www.theguardian.com/commentisfree/2025/sep/01/how-do-i-feel-safe-after-march-for-australia-anti-immigration-protest-ntwnfb">Stop Immigration</a>’ revealed that public hostility towards migrants, <a href="https://www.afr.com/politics/federal/pressure-mounts-for-price-to-apologise-to-indian-australians-20250908-p5mt7x">particularly</a> from the Indo-Pacific, is growing.
For many migrants, these displays are more than conceptual debates about white national identity. They are experienced emotionally. Writing shortly after the rallies, Melbourne-based writer Jafrin Kabir <a href="https://www.theguardian.com/commentisfree/2025/sep/01/how-do-i-feel-safe-after-march-for-australia-anti-immigration-protest-ntwnfb">reflected</a> that she had never felt so foreign on Australian soil. She pays taxes and inflated rents, contributes skills in the national interest, cheers for the Tillies and calls Melbourne “home”, yet suddenly felt unsafe because of the origin and colour of her skin.&nbsp;
Similarly, Chinese national interviewed by media outlet <a href="https://www.scmp.com/news/china/diplomacy/article/3325127/i-feel-insecure-chinese-nationals-australia-blindsided-anti-immigration-marches">reported</a> cancelling weekend plans and feeling “blindsided” by the scale of the marches.
Scapegoating migrants especially in times of economic stress is an age-old phenomenon and is not just limited to Australia. Across the democratic world, from the United States to the UK and parts of Europe, hostility toward migrants and minorities has become a route for anti-democratic forces. Populist actors often <a href="https://www.theguardian.com/australia-news/2025/mar/27/peter-dutton-keeps-blaming-migration-for-the-housing-crisis-but-can-it-really-be-that-simple">use</a> cultural anxiety and demographic change to justify illiberal and undemocratic measures, claiming to restore order while actually dismantling checks and balances.
By analysing democratic decay, scholars like Lydia Khalil at the Lowy Institute, <a href="https://interactives.lowyinstitute.org/features/democratic-erosion/">argue</a> that democracies rarely break down at once. Instead, they incrementally weaken through vicious cycles: declining trust in institutions, entrenched division based on hate, the normalisation of political violence, and the bit by bit removal of norms and guardrails.&nbsp;
Though some of the conditions are present in Australia to be exploited by anti-democratic actors, for example, almost two-thirds of Australians believe their leaders intentionally mislead them, according to the <a href="https://www.edelman.com/au/trust/2025/trust-barometer">2025 Edelman Trust Barometer</a>, &nbsp;but their presence is not determinative.
Australia’s democratic guardrails remain strong: independent courts, transparent elections run by the AEC, and a free press continue to hold power to account. Federalism and active civil society further diffuse power and create space for contestation.&nbsp;
But if public trust continues to erode and social divisions deepen, these safeguards will come under strain. Early recognition and action are crucial to ensure that today’s street-level hostilities do not translate into institutional regression.
Preventing such outcome requires a socially embedded understanding of migration, an understanding that goes beyond simplistic optimistic and pessimistic views. Policy makers should go beyond Push-Pull models, functionalist and neoclassical and historical-structural theories.&nbsp;
Consulting the work done by <a href="https://www.guilford.com/books/The-Age-of-Migration/Haas-Castles-Miller/9781462542895#:~:text=International%20Population%20Movements%20in%20the%20Modern%20World,-Hein%20de%20Haas">Hein de Haas</a> et-el, migration should be conceptualised as an intrinsic part of broader processes of development, social transformation and globalisation rather than a 'problem to be solved'. We need more nuanced views that have an eye for the complexity of migration processes and the diversity of its causes and impacts.
Sohail Akhtar is a Melbourne- based researcher focusing on governance, public policy, and migration. He contributes to Lowy Institute Sydney.
This article was issued by the Toda Peace Institute and is being republished from <a href="https://toda.org/global-outlook/2025/is-street-level-hostility-a-challenge-to-liberal-democracy-reflections-from-australia.html">the original</a> with their permission.

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