<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221114101120/637208bb9c7e80680e0b5502jpeg.jpg" alt="" width="1487" height="1122"/>'Beauty lies in the eyes of the beholder.' In spite of this or because of it, the global beauty industry at $511 billion is one of the fastest-growing businesses and is expected to reach over $716 billion by 2025.Changing standards about what is supposed to 'look good’, and often unrealistic beauty goals dictated by influencers and celebrities on social media like Instagram and TikTok have only accelerated the trend. It is no surprise Nepal is also fast catching up.Which is why, despite the pandemic, beauty clinics and skin treatment centres in Kathmandu have seen an increased demand for nose reconstruction/rhinoplasty, double eyelid surgery/blepharoplasty, dimple creation, hair removal, breast reduction, brow lift, lip fillers, and scar removal.Read also: <a href="https://www.nepalitimes.com/banner/nepals-far-sighted-eye-care/">Nepal's far-sighted eye care</a>, Sonia Awale"The most common cosmetic surgery is blepharoplasty, where double eyelid folds are created for monolids or for dermatochalasis where upper eyelid skin sag due to aging," says surgeon Sarina Rajbhandari, who was surprised to find a lot of people coming for rhinoplasty in Nepal when she first started the practice.After learning about the prevalence of rhinoplasty, Rajbhandari decided to pursue further facial plastic surgery while continuing to practice ENT. She completed her Master's in Otolaryngology and worked at Kirtipur Cleft &amp; Burn Center.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221114101120/637208be9c7e80680e0b5503jpeg.jpg" alt="" width="1200" height="1600"><figcaption> </figcaption></figure>Facial reconstruction was a relatively new field filled with challenges in Nepal's medical scene, but the young doctor saw potential, eventually leading her on the path to becoming Nepal's first female facial plastic surgeon.Rajbhandari did her fellowship from Tri-Service General Hospital in Taiwan in 2019 under Chuan Hsiang Kao, who trained at the University of California in San Diego.She also worked under Kwon Taek Keun at AONE Clinic in South Korea, which is the new capital for facial plastic surgery in the world. She also underwent a month-long facial plastic training at Chulalongkorn University in Bangkok.Even as people opt to go under the knife to change or improve their look, the procedure is riddled with common myths, the biggest being the cost factor."The general public tends to think that only the rich can afford plastic surgery. That is not true," says Rajbhandari, adding that it is the question of want vs. need. "There is no set price for a type of surgery because everyone is different, but it is much more affordable to get the quality procedures done in Nepal than abroad."It is also important to distinguish between reconstructive and cosmetic surgeries. Facial plastic surgery has two categories. First is reconstruction, which includes trauma cases, burns, scar revision, and surgeries for congenital birth defects. The second is cosmetic, where you can change your appearance because you want to reinvent yourself.Another common misconception about facial plastic surgery is that it lasts forever, gives unrealistic results, and the recovery process is swift.A scar can be minimised but cannot be eliminated. The skin is constantly aging, so if you choose to have a facelift now, it may last just 10-15 years. It is not a one-and-done procedure. It is essential you have realistic expectations, explains Rajbhandari.It is recommended to meet with medical professionals a few times to discuss options and possibilities rather than rushing for any cosmetic treatment. It is essential that patients and clients make an informed decision before moving forward because they are essentially altering their appearance.Rajbhandari has performed an astonishing number of 'revision' surgeries after their procedures were botched. She also suggests meeting with different surgeons to see who you feel most comfortable with."People value marketing on social media over qualifications of the doctor, so it is important to check their credentials before trusting your face with one," she says. Rajbhandari herself does not perform immediate surgery, preferring to first discuss what the procedure entails, the risks, and how to take care of things afterward.<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221114101120/637208c19c7e80680e0b5504jpeg.jpg" alt="" width="1500" height="2250">She adds: "We are dealing with people's appearance that affects their self-esteem and mental health. We make sure they understand what they are doing before they go under the knife."Given the importance society places on women's beauty and the cosmetic products that primarily target them, one may think only women come for plastic surgery. A significant portion of Rajbhandari's patients is male.Despite her experience and qualifications, Rajbhandari still faces the challenges of being a young female doctor in Nepal. A lot of people still prefer to go to a male doctor for surgery. "I have had consultations with patients and clients who meet with me to talk but choose to go to a male doctor for the actual surgery," she reveals.Rajbhandari has also been judged on her own appearance. She has been called vain for putting on makeup but also called out for not making an effort despite being a facial plastic surgeon. She does not let the opinion of others affect her work, however.Read also: <a href="https://archive.nepalitimes.com/news.php?id=14071#.YgD3I-5Bz0s">Nepal's real heroines</a>, Naresh Newar"But having a supportive work environment, coworkers, and a good team makes a difference in both your professional and personal life," adds the surgeon who divides her time between Grande Hospital and Healthy Choice Clinic in Kathmandu.The Omicron surge is already subsiding in Nepal and the region, but Rajbhandari's work schedule was not much different even during the peak of the pandemic. She typically works 7-8 hours a day, but there have also been days where she worked from 6AM to 9PM and performed surgeries even on Saturdays. A supportive family is her backbone.Having said that, doctors themselves need to be healthy. She prioritises her physical and mental being. Her diet is healthy, and she eats on time. She walks regularly and religiously follows her skincare routine before bed.Sarina Rajbhandari's best recommendation as a doctor: "Invest time in yourself."Read more: <a href="https://www.nepalitimes.com/opinion/childless-by-choice/">Childless by choice</a>, Anjana Rajbhandary<a href="https://www.nepalitimes.com/review/50-outstanding-women-of-nepal/">50 outstanding women of Nepal</a>, Pratibha Tuladhar

Anjana Rajbhandary

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Going under the scalpel in Nepal

<figure></figure> <img width="4000" height="3000" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109181148/636be83b9c7e80680e087847jpeg.jpg" alt=""/><figcaption>Consultation: Dermatologist Sunita Yadav of the Skin Arts Aesthetics.</figcaption> Growing up was not easy for Sahara Sharma. Acne and pimples marred her self-confidence as a teenager. She obediently followed all the beauty tips that came her way, but flawless skin would have to wait as she evolved from a teenager into a woman. Now in her 30s, Sahara no longer has pimple issues, but she often spends her time at skin clinics for other treatments — hair removal, lash extension and even consultation for pigmentations. The growth of high-tech skin clinics in Kathmandu, has become a boon for many like her.“If I was exposed to such trends in my teenage days, I would have looked different. I can opt for better treatments now,” says Sahara. <a href="https://www.nepalitimes.com/banner/mobile-nepal-is-hooked-on-youtube/">With 61.5% of Nepalis having access to smartphones</a>, the exposure to international beauty trends is wider than ever. Following in the footsteps of celebrities on social media and using Snapchat filters that allow for unrealistic beauty goals, there is more room for validation of vanity.   <figure></figure> <img width="1000" height="1000" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109181148/636be83e9c7e80680e087848jpeg.jpg" alt=""><figcaption>Before and after images: Tummy tuck: This procedure removes excess fat to make the abdomen muscles tighter.</figcaption> Despite the economic impact of the pandemic, it has been a busy time for skin clinics in Nepal offering botox, rhinoplasty, blepharoplasty, hair removal, dimple creation, breast reduction, lift brow, lipo suction, lip fillers, vaginoplasty and double eyelid surgery.Rupak Ghimire’s Darbar Marg-based, <a href="http://www.aavaranskin.com/">Aavaran Skin and Hair Clinic</a> is swamped with clients waiting for their turn for consultations. Dermatologist and hair transplant expert, Ghimire sees more than 30 clients a month for follicular grafts alone. Initially, people dismissed hair transplants as bizarre and his attempts to promote the procedure failed miserably. Four years later, Ghimire has a new story, “Clients during their first consultations usually come looking dejected and sceptical about side-effects but by the end of months of sessions, they turn into new people, and not just physically.”  <figure></figure> <img width="640" height="657" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109181148/636be8419c7e80680e087849jpeg.jpg" alt=""><figcaption>Before and after images: Scar treatment: This procedure removes scars caused by pigmentation.</figcaption> While discourse rages on body shaming and the relevance of cosmetic surgeries, there are those who continue spending money on beautification. “Beauty lies in the eyes of the beholder. Our job is to make clients look natural and that is an art in itself. Making changes in your physical appearance is a personal choice,” explains Swopnil Sharma of the <a href="https://skinartsnepal.com/">Skin Arts Aesthetics</a> in New Baneswar who says people mainly ask about botox treatment, hair removal, and Asian eyelid surgery. However, following a new medical law, skin clinics can now only offer botox treatment for frown and wrinkle liftment. The treatment is only allowed on the upper part of the face, as use of such treatment in the lower part can damage a person’s face and the nervous system.  “It’s a risk. We have to lay everything transparent on the table prior to providing treatment to our clients and that’s the best way to go forward with such high-skilled technique,” says Swopnil. There are other caveats to beautification. It comes with a price tag, and patience. These services are not inexpensive and the beautification does not work at the wave of a magical wand. Some treatments may take months of sessions and others years.The most common beauty trends in Nepal even during the pandemic are hair removal, acne treatment, hair transplants and tummy tucking. The price range per session depends on the nature of treatment, and could begin from Rs2,000 and range up to Rs100,000.   What pleasantly surprises beauty experts is that Nepal has a market for such cosmetic trends. They say it encourages them to dedicate themselves to introduce sound and safe treatments to potential clients. And the Covid-19 fears are not keeping them away, in fact business is booming.Ghimire initially tried to warn clients about visits, given the pandemic and the financial uncertainties. He also tried to convince them to hold off treatments such as botox, but more clients queued-up at his clinic, instead.Swopnil’s marketing strategy via<a href="https://www.tiktok.com/@skinartsnepal" target="_blank" rel="noopener noreferrer"> TikTok</a> has attracted more clients. “Since everyone is at home, we share videos on the treatments and procedures done in our clinic and via TikTok. People have been booking time for appointments, which has turned out to be a success for us,” she says. <figure></figure> <img width="891" height="910" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109181148/636be8449c7e80680e08784ajpeg.jpg" alt=""><figcaption>Eyelid surgery: This procedure removes excess skin from upper eyelids to remove droopy appearance.</figcaption> At <a href="https://www.facebook.com/meroskincare/">Mero Skin Care</a> in Lazimpat, services are different from those available at other clinics. Pramila Rai helps ensure women can flutter their eyelids with more coquetry with a lash lift and extensions, and raises their brows through microblading. “The pressure of looking good has become so great. The number of clients always peaks during wedding seasons,” says Rai. South Korea has the world's highest number of cosmetic surgeries done every year. An ardent fan of South Korean beauty and entertainment trends, Shristi Shakya says watching the hit K-drama series <a href="https://www.imdb.com/title/tt8912344/" target="_blank" rel="noopener noreferrer">My ID is Gangnam Beauty </a>about a girl who performs plastic surgery to remain relevant in her society has opened her eyes to the pros and cons of going under the knife. However, Shakya admits that if given the opportunity, she would love to tweak a thing or two. “Maybe, a little bit of eyelid surgery would do no harm,” she says. Makeup artist, Ashlesha Rana did a few sessions of laser hair removal treatment but had to stop due to Covid-19. She plans to complete the sessions once normalcy has returned. “Frankly, I don’t like to experiment much. It is very important to do your research before you decide on trying any of these trends and more important to know where to stop,” she admits. “The idea of beauty is always shifting.”

Beauty clinics do brisk business despite Covid

<figure></figure> <img width="4000" height="3000" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109191116/636bef324b0ad905ca02ef90jpeg.jpg" alt=""/><figcaption>Consultation: Dermatologist Sunita Yadav of the Skin Arts Aesthetics.</figcaption> Growing up was not easy for Sahara Sharma. Acne and pimples marred her self-confidence as a teenager. She obediently followed all the beauty tips that came her way, but flawless skin would have to wait as she evolved from a teenager into a woman. Now in her 30s, Sahara no longer has pimple issues, but she often spends her time at skin clinics for other treatments — hair removal, lash extension and even consultation for pigmentations. The growth of high-tech skin clinics in Kathmandu, has become a boon for many like her.“If I was exposed to such trends in my teenage days, I would have looked different. I can opt for better treatments now,” says Sahara. <a href="https://www.nepalitimes.com/banner/mobile-nepal-is-hooked-on-youtube/">With 61.5% of Nepalis having access to smartphones</a>, the exposure to international beauty trends is wider than ever. Following in the footsteps of celebrities on social media and using Snapchat filters that allow for unrealistic beauty goals, there is more room for validation of vanity.   <figure></figure> <img width="1000" height="1000" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109191116/636bef364b0ad905ca02ef91jpeg.jpg" alt=""><figcaption>Before and after images: Tummy tuck: This procedure removes excess fat to make the abdomen muscles tighter.</figcaption> Despite the economic impact of the pandemic, it has been a busy time for skin clinics in Nepal offering botox, rhinoplasty, blepharoplasty, hair removal, dimple creation, breast reduction, lift brow, lipo suction, lip fillers, vaginoplasty and double eyelid surgery.Rupak Ghimire’s Darbar Marg-based, <a href="http://www.aavaranskin.com/">Aavaran Skin and Hair Clinic</a> is swamped with clients waiting for their turn for consultations. Dermatologist and hair transplant expert, Ghimire sees more than 30 clients a month for follicular grafts alone. Initially, people dismissed hair transplants as bizarre and his attempts to promote the procedure failed miserably. Four years later, Ghimire has a new story, “Clients during their first consultations usually come looking dejected and sceptical about side-effects but by the end of months of sessions, they turn into new people, and not just physically.”  <figure></figure> <img width="640" height="657" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109191116/636bef384b0ad905ca02ef92jpeg.jpg" alt=""><figcaption>Before and after images: Scar treatment: This procedure removes scars caused by pigmentation.</figcaption> While discourse rages on body shaming and the relevance of cosmetic surgeries, there are those who continue spending money on beautification. “Beauty lies in the eyes of the beholder. Our job is to make clients look natural and that is an art in itself. Making changes in your physical appearance is a personal choice,” explains Swopnil Sharma of the <a href="https://skinartsnepal.com/">Skin Arts Aesthetics</a> in New Baneswar who says people mainly ask about botox treatment, hair removal, and Asian eyelid surgery. However, following a new medical law, skin clinics can now only offer botox treatment for frown and wrinkle liftment. The treatment is only allowed on the upper part of the face, as use of such treatment in the lower part can damage a person’s face and the nervous system.  “It’s a risk. We have to lay everything transparent on the table prior to providing treatment to our clients and that’s the best way to go forward with such high-skilled technique,” says Swopnil. There are other caveats to beautification. It comes with a price tag, and patience. These services are not inexpensive and the beautification does not work at the wave of a magical wand. Some treatments may take months of sessions and others years.The most common beauty trends in Nepal even during the pandemic are hair removal, acne treatment, hair transplants and tummy tucking. The price range per session depends on the nature of treatment, and could begin from Rs2,000 and range up to Rs100,000.   What pleasantly surprises beauty experts is that Nepal has a market for such cosmetic trends. They say it encourages them to dedicate themselves to introduce sound and safe treatments to potential clients. And the Covid-19 fears are not keeping them away, in fact business is booming.Ghimire initially tried to warn clients about visits, given the pandemic and the financial uncertainties. He also tried to convince them to hold off treatments such as botox, but more clients queued-up at his clinic, instead.Swopnil’s marketing strategy via<a href="https://www.tiktok.com/@skinartsnepal" target="_blank" rel="noopener noreferrer"> TikTok</a> has attracted more clients. “Since everyone is at home, we share videos on the treatments and procedures done in our clinic and via TikTok. People have been booking time for appointments, which has turned out to be a success for us,” she says. <figure></figure> <img width="891" height="910" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109191116/636bef3b4b0ad905ca02ef93jpeg.jpg" alt=""><figcaption>Eyelid surgery: This procedure removes excess skin from upper eyelids to remove droopy appearance.</figcaption> At <a href="https://www.facebook.com/meroskincare/">Mero Skin Care</a> in Lazimpat, services are different from those available at other clinics. Pramila Rai helps ensure women can flutter their eyelids with more coquetry with a lash lift and extensions, and raises their brows through microblading. “The pressure of looking good has become so great. The number of clients always peaks during wedding seasons,” says Rai. South Korea has the world's highest number of cosmetic surgeries done every year. An ardent fan of South Korean beauty and entertainment trends, Shristi Shakya says watching the hit K-drama series <a href="https://www.imdb.com/title/tt8912344/" target="_blank" rel="noopener noreferrer">My ID is Gangnam Beauty </a>about a girl who performs plastic surgery to remain relevant in her society has opened her eyes to the pros and cons of going under the knife. However, Shakya admits that if given the opportunity, she would love to tweak a thing or two. “Maybe, a little bit of eyelid surgery would do no harm,” she says. Makeup artist, Ashlesha Rana did a few sessions of laser hair removal treatment but had to stop due to Covid-19. She plans to complete the sessions once normalcy has returned. “Frankly, I don’t like to experiment much. It is very important to do your research before you decide on trying any of these trends and more important to know where to stop,” she admits. “The idea of beauty is always shifting.”

https://www.youtube.com/watch?v=kJLBI7sim0M&amp;feature=youtu.beA revolutionary treatment for open wounds has dramatically reduced the healing period of <a href="http://archive.nepalitimes.com/news.php?id=711#.XSckw-szaUk" target="_blank" rel="noopener">leprosy patients in Nepal</a>, saving them money and prolonged pain. The new procedure has huge implications internationally, as it reduces the medical cost for treating patients with chronic open wounds.The technique, called Leukocyte Platelet Rich Fibrin (LPRF), was <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6089057/" target="_blank" rel="noopener">devised for dental surgery</a> by Nelson Pinto of Chile and has proven to accelerate the healing of tissue. Now, it is also being used to treat hard-to-heal skin lesions of <a href="https://archive.nepalitimes.com/article/nation/diabetes-in-south-asia,3018" target="_blank" rel="noopener">diabetes</a> and leprosy patients.“LPRF has shown miraculous results in the treatment of chronic wounds in Nepal,” says dental surgeon Sushil Koirala who is pushing the new treatment in government hospitals. “It does not need special equipment, is cheap and, so simple even paramedics and nurses can perform it.”<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108131140/636a4f009c7e80680e04fce5jpeg.jpg" alt="" width="1400" height="1050"/><figcaption>SECOND CHANCE: Surgeon Indra Bahadur Napit guides a paramedic during a session of LPRF on a patient with leprosy at Anandaban Hospital. Pic: KUNDA DIXIT</figcaption></figure>There are three specialised leprosy hospitals in Nepal: Ananadaban in Lele, Green Pastures in Pokhara, and Lalgadh in Dhanusa. Anandaban Leprosy Hospital 16 km south of Kathmandu has been trying out LPRF on patients with excellent results.Leprosy is a biblical disease in which bacteria called Mycobacterium leprae damages the patient’s nerves and causes the fingers, toes and limbs to go numb, leading to further injuries. Leprosy is treated with antibiotics, but some patients suffer antigen reaction and need long-term rehabilitation.One of the patients at Anandaban is Phelit Sahi, who was ostracised by her community in Jumla because she had leprosy and had been living in a cave for 25 years. Reporters who had gone to cover a local event in a helicopter found out about her, and flew her to Kathmandu for treatment.Every week, doctors draw 80cc of blood from her and place it in a special centrifuge for 12 minutes. The clear plasma separates from the red corpuscles and is compressed to form a high-density fibrin clot which is applied to her wound.“She is among more than 100 patients that we have treated with LPRF, and we have gained enough experience in this technique to lead the way for the world,” says surgeon Indra Bahadur Napit at Anandaban, who presented his results at WHO in Geneva.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108131140/636a4f039c7e80680e04fce6jpeg.jpg" alt="" width="1400" height="933"><figcaption> </figcaption></figure>Raju Lama was 27 when he was diagnosed with leprosy, but because of late diagnosis, his fingers and toes were deformed, and he had to abandon his job. Doctors recommended amputating his right leg, but became the first patient to get LPRF treatment. He is happy with his “ragat upachar” (blood treatment) and says after several LPRF procedures his wounds are healing much faster.Ram Kumari Sah and her husband from Janakpur have been living with leprosy for decades. She does not feel pain in her hands and legs and often hurts herself. Her lesions become infected and never healed. This week, she was waiting for her turn at the LPRF ward in Anandaban.The hospital’s LPRF pilot study has shown that 97% of the cases healed completely within seven weeks. The results are so encouraging that news of this revolutionary treatment has spread through word of mouth. A dozen patients, currently at Anandaban were referred by hospitals in India. A team of Nepali doctors is also training doctors in Burma, Bangladesh and Nigeria.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108131140/636a4f069c7e80680e04fce7jpeg.jpg" alt="" width="1400" height="1003"><figcaption> </figcaption></figure>The new treatment is expected to add to Nepal’s success in reducing the prevalence of leprosy from 21 cases per 10,000 in the 1980s to less than 1 today. Nepal was officially declared leprosy-free in 2010 when the prevalence rate came down to 0.79%.However, in recent years, the prevalence rate is creeping up again, and was 0.94% in 2018. More than 3,000 new patients are diagnosed with leprosy every year, with most of the cases found in Province 2. Experts say this could be a result of active case finding and may not mean that the prevalence is increasing.Leprosy is curable with multidrug therapy but many do not get treatment on time. The incubation period is five years on average and symptoms may occur within a year, but can also take as long as 30 years to become visible, making the disease difficult to diagnose, and the delay leads to nerve damage and deformities. Leprosy is transmitted through the air during close and frequent contact with untreated cases.“Leprosy can afflict anyone but there is a correlation between the disease and poverty,” explains dermatologist Mahesh Shah. “If one’s immune system is strong, the bugs do not do any damage. But poor hygiene and nutrition increases susceptibiltity. Neglected people from neglected countries suffer from leprosy the most.”<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108131140/636a4f0a9c7e80680e04fce8jpeg.jpg" alt="" width="1400" height="1169"><figcaption> </figcaption></figure>Up to 40% of patients undergoing multidrug treatment develop a reaction, and need long-term hospitalisation. Since the patients are poor, most private hospitals are not interested in treating them. At Anandaban, treatment is free as it is supported by government grants and charities.Since 1% of cases suffer from relapse in Nepal, active door-to-door case finding is important to meet the WHO target of zero leprosy transmission by 2030.Even more daunting is to counter societal stigma and ostracisation of leprosy patients. Family members regard the disease as punishment from the gods, and even some medical interns and nurses refuse to touch patients despite patients being on antibiotics and unable to spread the disease. Nepal’s laws still allow husbands to divorce their wives if they have leprosy.“It is a complicated disease made even more so by stigma and ignorance,” says Napit, “but with LPRF, we now have a powerful weapon in our arsenal. A vaccine would be the final solution, but no one cares about leprosy. All the funding goes for diseases like HIV.”   <h2>Miraculous healing</h2>When Nelson Pinto’s favourite horse broke its leg, he had two options: either put it down or amputate its leg. The Chilean dentist decided on a third option.He drew some blood from the horse, spun it in a centrifuge to separate the autologous fibrin matrix which is rich in platelets, and applied the plasma to the horse’s wound. After a few weeks, the horse was cantering again.Pinto knew about the technique because Leukocyte Platelet Rich Fibrin (LPRF) was developed for dental implant treatment. The surgeon was so convinced that the new process would be useful in treating chronic open wounds that he embarked on a global crusade to spread its use.Pinto convinced fellow-dentist from Nepal, Sushil Koirala, whom he met at an international conference, to adopt the technique. Since then, Koirala has been trying to convince the government and private hospitals to adopt the procedure, but without much success. However, Anandaban Leprosy Hospital in Lalitpur has seen phenomenal improvements in the healing time of lesions among its patients. (See adjoining report above)LPRF is now used to treat diabetic wounds, lesions caused by leprosy, localised <a href="http://archive.nepalitimes.com/article/nation/burning-in-the-aftermath,3757" target="_blank" rel="noopener">burns</a> and surgical wounds, and with this, healing time is often cut in half. It is also being used in cosmetic surgery to remove wrinkles and rejuvenate the skin. The reason why it is so effective, Pinto explained during a trip to Nepal last month, is because it is completely natural and autologous, which means a patient is not receiving any foreign tissues or chemicals.And the treatment is cheap. A similar treatment used in Europe, which involves a kit manufactured by a multinational pharmaceutical company, costs $3,000 per patient. LPRF costs only $30. But it seems as though private hospitals are not interested in this treatment as patients heal so quickly. Many doctors are also not enthusiastic because LPRF can be administered by a paramedic or a nurse.Says Sushil Koirala: “The reason they don’t like it is because there is no money in it. LPRF only uses the patient’s blood and there are no chemicals or equipment involved for multinational companies to make money out of.”Koirala’s Punyaarjan Foundation has donated centrifuge machines to a few hospitals in Nepal including the Sushma Koirala Memorial in Sankhu, Anandaban Leprosy Hospital, Bir Hospital in Kathmandu and to three hospitals in Burma with varying degrees of acceptance.The Bible relates how Jesus Christ miraculously and instantaneously cured ten lepers at the gates of Jerusalem. LPRF may not cure leprosy lesions as quickly, but the procedure is nearly as miraculous.<h2>Life after leprosy</h2><figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108131140/636a4f0d9c7e80680e04fce9jpeg.jpg" alt="" width="1400" height="1050"><figcaption> </figcaption></figure>Kumar Tamang, 47, is putting the final touches on his painting of an elephant with a bejewelled crown and a howdah. He dips his paintbrush on a palate and paints the border bright red. His fingers are numb and deformed by leprosy, yet he has been painting for 25 years. His love for Mithila art is on full display on the walls, pillars and ceiling of Shanti Sewa Griha, a leprosy clinic set up by the German charity, Leprahilfe, in 1992.Nearby, in a dark corner, is 50-year-old Nathuni Barai from Nawalparasi, who also has deformed fingers which he uses deftly to draw intricate patterns on a letter pad. Both Tamang and Barai are former patients at <a href="http://archive.nepalitimes.com/news.php?id=15213#.XSckyeszaUk" target="_blank" rel="noopener">Shanti Sewa Griha,</a> making a livelihood from products that Leprahilfe buys from fundraising. Their families live nearby, and their children attend a school set up by the charity.Now, nearly three decades after the clinic was set up, Shanti Sewa Griha runs a school and orphanage in Budhanilkantha, an organic farm in Sundarijal and a rehabilitation centre near Pashupati.As the number of patients grew, they were trained in painting, tailoring, quilt making, carpentry and jewellery making as a form of livelihood. Bags, uniforms, paintings, stationery and decorative items are sold as souvenirs to raise money for the upkeep of the shelters and to pay former patients.“This is a form of operational therapy which tries to break the vicious circle this disease has formed,” said Marianne Grosspietsch, one of the founders of Leprahilfe. “Our goal is to create hope in Nepal.”In 1974, Grosspietsch adopted a young boy named Puskar Limbu who had leprosy like the rest of his family. She took the boy to her home in Germany, treated his leprosy and sent him to school. Limbu went on to pursue a successful career in graphic design in Germany and is a grandfather himself today.Children of former leprosy patients have also gone on to become nurses and doctors.Kalpana Pariyar (pictured above) was 14 when she was diagnosed with leprosy before there was serious nerve damage to her fingers. She grew up in the shelter and married fellow-patient Krishna Majhi, whom she took care of until he died eight years ago. She now has a college going daughter and an eight-year-old son.“I have spent my entire life here. This is my home, this is where I made my life and found peace,” says Pariyar, looking up from her sewing machine on which she was weaving dhaka fabric.Sonia Awale

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