<figure><img width="957" height="638" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109141132/636bacb09c7e80680e077f49jpeg.jpg" alt=""/><figcaption>Photo: BIKRAM RAI</figcaption></figure>Nepal has been spared the worst of the COVID-19 pandemic so far, and Kathmandu Valley has been among the least affected areas of the country. But there has been a worrying increase in the capital since the lockdown was partially eased two weeks ago.
The detection of 23 new cases on Wednesday has brought the tally to 288, with 190 in Kathmandu, 53 in Bhaktapur and 45 in Lalitpur districts. From Thursday, three wards of Lalitpur’s Mahalaxmi Municipality have been put under strict lockdown after nine people were tested positive in those localities this week.
Public health officer Tek Raj Ojha said the nine were all returnees from abroad, patients at hospitals, and two were health workers themselves. They have been kept in isolation, and all are asymptomatic.<a href="https://www.nepalitimes.com/editorial/open-and-shut-case/" target="_blank" style="background-color: rgb(255, 255, 255); font-size: 15px; letter-spacing: 0.01em;" rel="noopener noreferrer">Open and shut case</a>, Editorial
“Until we can conduct mass testing and find out where they were infected, we cannot say that there is community transmission,” Ojha says. Forty others who had been in contact have been traced and are being tested.
The three wards of the municipality are back in lockdown with all shops closed, although provision stores and pharmacies are allowed to open from 7-9AM.
The daily bombardment of total new cases does sound alarming. However, Nepal’s PCR test rate per capita is one of the highest in South Asia, the fatality rate of 0.2% is one of the lowest, hospitalisation and ICU admissions are normal. Nepal’s positivity rate is at 6% for PCRs, little lower than India at 7%.
The Ministry of Health and its agencies keep track of the trends, but make blunders. For example, on two days last week several labs showed 100% positive cases among those in PCR tests. The daily tallies are transmitted by labs at 1PM to the National Public Health Laboratory, then to the Epidemiology and Disease Control Department, which then passes them on to the Health Emergency Operation Centre at the Ministry of Health, which then announces them at a daily press briefing. None of the agencies detected the anomaly.
After it created a stir on social media, the government finally admitted that there had been an “error in the submission” of the figures by the labs which had bundled all positive cases without giving the total samples tested.
Teaching Hospital’s Niranjan Shah says he had tested 249 samples on 1 July of which 114 were positive. “But the Ministry published the table with only the positive figures without the total numbers tested,” he said.
Faced with the growing numbers in Kathmandu, the government is now increasing surveillance testing in crowded areas to confirm if there is community transmission. Although not all the results have come in, so far they show that the virus is not spreading in this way yet.
However, public health experts warn that Nepal should look at worrying trends in India. The country recorded its highest ever daily new cases with 26,000 positives on Wednesday – two weeks after the government loosened its lockdown. This brings India’s total caseload to 770,000 with 21,000 fatalities.
More worryingly, the daily cases are now rising in states bordering Nepal. West Bengal now has 807 deaths from COVID-19, and Uttar Pradesh also has 800 and counting.
And even though these numbers are small compared to India’s total population size, experts say it shows how quickly COVID-19 can spread in crowded cities where citizens do not comply with precautions.

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We are being tested

<figure><img width="944" height="629" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109141132/636bac979c7e80680e077f3fjpeg.jpg" alt=""/><figcaption>Photo: BIKRAM RAI</figcaption></figure>Nearing the 15th week of the lockdown is a decisive milestone to take stock of how Nepal is positioned vis-a-vis the coronavirus pandemic. The epicentres have been shifting across the world, with some  countries like the United States “knee-deep in the first wave”, as the country’s top infectious diseases expert Anthony Fauci described it this week.Brazil’s President Jair Bolsanaro, who refused to let his country deal seriously with the pandemic even as it became the country with the second highest death toll, himself tested positive this week. In India, the virus has spiked in the country’s metros with record daily cases just after Prime Minister Narendra Modi started relaxing the lockdown last month. However bad it may seem at the moment, Nepal is not doing too badly. Its PCR test rate in one of the highest in South Asia, the fatality rate is low, hospitalisation and ICU admissions are not above normal.Public health experts say the positivity rate is going down and the total case load is plateauing.Physicians, however, are <a href="https://www.nepalitimes.com/latest/nepal-must-hope-for-the-best-prepare-for-the-worst/" target="_blank" rel="noopener noreferrer" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/latest/nepal-must-hope-for-the-best-prepare-for-the-worst/&amp;source=gmail&amp;ust=1594345240798000&amp;usg=AFQjCNG5s5Q09s8YZEwIMzgB8hkaLowz8A">not as optimistic</a>. They have always pooh-poohed the idea that Nepalis have greater immunity because of our diet, or exposure to germs. The reason the case load is low, they say, is because there still have not been enough tests. And they warn that Nepalis are predisposed to diabetes and cardio-vascular diseases, and the prevalence of tuberculosis puts the whole <a href="https://www.nepalitimes.com/latest/has-nepals-lockdown-just-postponed-covid-19/" target="_blank" rel="noopener noreferrer" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/latest/has-nepals-lockdown-just-postponed-covid-19/&amp;source=gmail&amp;ust=1594345240798000&amp;usg=AFQjCNGk5i1ADaO6W1djlf5Cpl8KZNtXcg">population at high risk</a>. The virus could just be waiting to strike. But one thing both agree on is that full re-opening is not advisable even after the ‘eased’ lockdown is over on 22 July, and a full scale public awareness campaign should be launched about wearing masks in public and physical separation. The government seems to be listening — on Tuesday it announced fines and punishment for those caught without masks in public.The dilemma for governments everywhere has been to <a href="https://www.nepalitimes.com/editorial/unlockdown/" target="_blank" rel="noopener noreferrer" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/editorial/unlockdown/&amp;source=gmail&amp;ust=1594345240798000&amp;usg=AFQjCNF94-ZoT361ymnOA93B03DBXJ2KpQ">balance lives and livelihoods.</a> Countries that have lifted lockdowns too early have paid for it with a resurgence, those which maintained strict lockdowns without widespread testing have squandered the sacrifice made by their citizens. As <a href="https://www.nepalitimes.com/editorial/fear-goes-viral/" target="_blank" rel="noopener noreferrer" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/editorial/fear-goes-viral/&amp;source=gmail&amp;ust=1594345240798000&amp;usg=AFQjCNErFR90JDaKUN2cmB2YggR1H4hScw">fear of hunger</a> overcomes the fear of the virus, some leaders opened up dreading public anarchy and loss of political control. The countries that have done well to quell the virus are the ones where politicians and technocrats have taken the advice of scientists, weighed the pros and cons, communicated clearly with their citizens, and eased restrictions in a carefully calibrated manner. In Nepal, the government of Prime Minister K P Oil has been so busy with political fire-fighting that his administration has bungled the response. In a quintessentially Nepali way, the government has muddled along with no real plan. Worse, it has allowed greedy politicians, bureaucrats and crony businessmen to profit from the pandemic.From the very start, it got the <a href="https://www.nepalitimes.com/banner/why-rapid-tests-are-doing-more-harm-than-good/" target="_blank" rel="noopener noreferrer" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/banner/why-rapid-tests-are-doing-more-harm-than-good/&amp;source=gmail&amp;ust=1594345240798000&amp;usg=AFQjCNFyDXMLz8REixy0tj5-XZLKliyqvQ">wrong testing kits</a>. It was not prepared for the influx of returnees from India, it delayed overseas repatriation flights causing misery to tens of thousands of Nepalis stuck abroad. Even when it got the right PCR kits, <a href="https://www.nepalitimes.com/latest/why-nepal-lags-in-covid-19-testing/" target="_blank" rel="noopener noreferrer" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/latest/why-nepal-lags-in-covid-19-testing/&amp;source=gmail&amp;ust=1594345240798000&amp;usg=AFQjCNHhPu9wciVS3_HAb9H3bLowkX30tQ">they were not compatible</a> with the machines already here. Valuable time was lost, and at one point there were <a href="https://www.nepalitimes.com/latest/far-western-province-stops-covid-19-tests/" target="_blank" rel="noopener noreferrer" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/latest/far-western-province-stops-covid-19-tests/&amp;source=gmail&amp;ust=1594345240798000&amp;usg=AFQjCNH-i3ZuUAEDHdF9iBWbYVVUp1JIQw">35,000 swab samples</a> piled up at testing centres. Even then, it refused to allow private labs to conduct tests. It did not want to listen to specialists who offered a cheap solution — get cartridges for the 1<a href="https://www.nepalitimes.com/here-now/a-covid-19-game-changer-for-nepal/" target="_blank" rel="noopener noreferrer" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/here-now/a-covid-19-game-changer-for-nepal/&amp;source=gmail&amp;ust=1594345240798000&amp;usg=AFQjCNEexVq7uxXb_6etxRFUtHqopM-Iiw">00 GeneXpert PCR machines</a> that are already there for TB surveillance.And the latest scandal this week is that the Ministry of Health has been trying to cover-up its incompetence in the counting process which resulted in some government labs in Patan and Dhangadi showing 100% positivity rate on 1 July and 3 July. It did not even notice the error in its own daily tabulation, and when it did, tried to sweep it under the carpet.As we go to press on Thursday evening, the total number of confirmed cases have risen to 16,531, with about 8,700 in isolation and 24,000 in quarantine centres. There have been 35 fatalities so far, mostly dying of co-morbidity. Most cases are asymptomatic, and there has been no marked increase in hospitalisation. The good news is that <a href="https://www.nepalitimes.com/here-now/nepal-quarantines-hotspots-for-disease/" target="_blank" rel="noopener noreferrer" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/here-now/nepal-quarantines-hotspots-for-disease/&amp;source=gmail&amp;ust=1594345240798000&amp;usg=AFQjCNFPbBpVFNMT4Ahbi4qs_J03QjgNhQ">quarantine centres are emptying</a> as the number of returnees from India goes down. The bad news is that the number of positive cases in Kathmandu is going up. Surveillance testing of focus groups and in crowded parts of the Valley may show community transmission.If that is the case, there is only one way out: test-isolate-trace-treat.

Open and shut case

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109121120/636b8d7f9c7e80680e06b350jpeg.jpg" alt="" width="640" height="427"/><figcaption>Photos: BIKRAM RAI</figcaption></figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109121120/636b8d849c7e80680e06b351jpeg.jpg" alt="" width="640" height="427"><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109121120/636b8d879c7e80680e06b352jpeg.jpg" alt="" width="640" height="427">One week into my US tour, Europe was being ravaged by COVID-19, and America had belatedly begun to come out of denial about the pandemic. President Trump announced a ban on non-Americans flying to the United States. Europeans already there were scrambling to get out.Our nine-member group from the Philippines, Vietnam, Cambodia, Uzbekistan, Sri Lanka, India and Pakistan had been briefed at the Environment Protection Agency in Washington DC, and had arrived in New Orleans to meet activists who worked on relief after Hurricane Katrina. There were reports of an outbreak in California where we were headed next.<a href="https://www.nepalitimes.com/latest/nepal-lockdown-to-be-extended/" target="_blank" rel="noopener noreferrer">Nepal lockdown to be extended</a><a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/banner/how-nepal-should-plan-to-exit-lockdown/" target="_blank" rel="noopener noreferrer">How Nepal should plan to exit lockdown</a>, Ramesh KumarAfraid we might be stranded by flight bans, the organisers decided to send us home. Soon, I was on a 24-hour journey from New Orleans to Kathmandu, via London and Doha. Along the way the airline lost my checked-in luggage in Heathrow, and I have given up hope of ever getting it back.Since landing in Kathmandu in mid-March in one of the last regular flights, I have been in self-quarantine. As a health and environment reporter at Nepali Times, I have been covering the pandemic from home, connecting to our virtual newsroom on Zoom.I did not have any symptoms during that time, but because we have elderly family members, I maintained a strict isolation, obsessively sanitising everything I touch, wearing a mask even when I have locked myself in my room.<a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/here-now/nepal-vs-covid-19/" target="_blank" rel="noopener noreferrer">Nepal Vs COVID-19</a>, Rastraraj Bhandari<a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/opinion/prevention-while-searching-for-a-cure/" target="_blank" rel="noopener noreferrer">Prevention while searching for cure</a>, Buddha BasnyatWhen we got a call on Monday from the Municipality to come for testing, I was relieved because it meant that the government’s contact tracing system was working. Local governments were tracking down everyone in Lalitpur who had come back from abroad in the past month.I was never scared for myself, but for others in the family since the virus is so infectious. I extensively researched Rapid Diagnostic Test (RDT), Polymerase Chain Reaction (PCR) and what they entailed.That Tuesday morning I took a few steps out of my house for the first time in a month. Everything still looked and smelled the same, except the streets were deserted. We decided to walk to the Lagankhel testing centre, and on the way I had to tie my shoelace twice. Each time, I hand sanitised myself after I was done. I had turned into a certified germophobe.We avoided the main roads, and it was hot – Kathmandu had gone from winter to summer in the month I spent in self-isolation indoors. Buildings on the road to Lagankhel advertising ‘Study in Australia’ and ‘Learn Korean Language’ looked deserted, except for a few people peeking out of the windows.<a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/banner/why-rapid-tests-are-doing-more-harm-than-good/" target="_blank" rel="noopener noreferrer">Why rapid tests are doing more harm than good</a>, Ramu Sapkota<a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/latest/nepal-must-hope-for-the-best-prepare-for-the-worst/" target="_blank" rel="noopener noreferrer">Nepal must hope for the best, prepare for the worst</a>, Buddha BasnyatIronically, the tent for mass testing was placed right beside the temple where the idol of Machhindranath is bathed in milk before it is placed in the chariot for its annual festival. If it was not for the lockdown, just about now they would be preparing the temple for the jatra.Police were outside the tent telling people queuing up for tests to maintain a safe distance. The media was present in force in reflective green vests taking photos and videos of the returnees being tested, giving me a taste of what it feels like to be on the other side.All of us in the queue wore masks. Some even sported surgical gloves and sunglasses. Few wore jackets and hoodies. The person behind me was busy making calls to get his relative to also come for the test.Under the tent, there were puddles from the morning rain and flies were buzzing around nearby. They were all reminders that we already had a problem of unsanitary conditions spreading disease before this new infection came around.<a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/here-now/post-pandemic-mental-health-epidemic/" target="_blank" rel="noopener noreferrer">Post-pandemic mental health epidemic</a>, Sonia Awale<a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/opinion/shape-up-the-lockdown/" target="_blank" rel="noopener noreferrer">Shape up the lockdown</a>, Marty LoganIt was my turn next. I was given sanitiser to apply on my hands. Two medical officers in PPEs asked my name, age, address, country I returned from and when I had flown in. Interestingly, a municipality official at the desk already knew my particulars and replied before I could. She was the person who had called my house that morning.We had been reporting on how despite the lockdown, Nepal was lagging behind in testing, but I was impressed with the coordination and the thoroughness of how it was being done. Local governments from the ward to municipality were being proactive in house-to-house contact tracing for new arrivals and symptoms. Someone was doing their homework, and that was reassuring.A lab technician drew a drop of blood from my finger, and gave me a cotton ball with disinfectant. That was it. Small kits with blood droplets were neatly arranged in multiple rows and columns, mine was placed next to them. So, this was a RDT, and not a PCR which would mean collecting an oral and nasopharyngeal swab sample.The test result came later that day – all of us in Lagankhel had tested negative. My blood did not have antibodies, which meant I had not been exposed to the virus.At home, I am still not taking any chances. I will continue to self-isolate amidst a nationwide lockdown. As for my parents, this is the first time they are happy that I failed a test.https://www.youtube.com/watch?v=LXCENWJLuKk&amp;t=6sSonia Awale is Associate Editor at Nepali Times, is a student of public health, and covers environment and healthcare issues.

Sonia Awale

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How COVID-19 puts us to the test

<figure><img width="1059" height="604" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109121116/636b8cd29c7e80680e06b319jpeg.jpg" alt=""/><figcaption>Shekhar Golchha, Pashupati Murarka and Sudhir Mittal of Shree Airlines handing over PCR kits donated by Singapore's Temasek Foundation to Dipendra Taman Singh from the Ministry of Health on Friday after they were flown from Singapore to Kathmandu on special Shree Airlines flights. </figcaption></figure>Singapore’s <a href="https://www.temasekfoundation.org.sg" target="_blank" rel="noopener">Temasek Foundation</a> has provided 10,000 PCR test kits to Nepal for <a href="https://www.nepalitimes.com/latest/nepal-extends-covid-19-testing-but-no-new-cases/" target="_blank" rel="noopener">detecting COVID-19 cases</a> which will be deployed to frontline health workers to test patients all across the country.Called ‘Fortitude Kit 2.0’ the kits are designed by Singapore’s Agency for Science, Technology and Research (A*START) to detect the SARS-CoV-2 virus. The all-in-one 1-step RT-PCR kits come with all materials required for the reaction, which includes primer probes mix, enzyme mix, the positive control, negative control and internal control template. “In these difficult times, Temasek Foundation stands in solidarity with our friends from Nepal,” said Benedict Cheong, CEO of Temasek Foundation International. “We hope these test kits will be helpful to hospitals and medical professionals who are bravely managing the <a href="https://www.nepalitimes.com/latest/nepal-must-hope-for-the-best-prepare-for-the-worst/" target="_blank" rel="noopener">COVID-19 situation in Nepal</a>.”<a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/banner/why-rapid-tests-are-doing-more-harm-than-good/" target="_blank" rel="noopener">Why rapid tests are doing more harm than good</a>, Ramu SapkotaThe kits were flown from Singapore to Kathmandu on a special Shree Airlines CRJ 700 flight on Friday organised by Shekhar Golchha, Pashupati Murarka and Sudhir Mittal of Shree Airlines, and handed over to the Ministry of Health for distribution to hospitals across Nepal. Vijayendra Baral at Singapore General Hospital, and in Kathmandu Ranjit Acharya and Neil Pande facilitated the process. <img width="1116" height="1280" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109121116/636b8cd59c7e80680e06b31ajpeg.jpg" alt="">Temasek Foundation had also helped Nepal strengthen public schools after <a href="https://www.nepalitimes.com/here-now/epicentre-of-two-disasters-in-west-nepal/" target="_blank" rel="noopener">the 2015 earthquake</a> and in post-disaster recovery management jointly with <a href="https://www.singhealth.com.sg" target="_blank" rel="noopener">SingHealth</a> and Ministry of Health in Nepal. The project built systems and capacity in the area of disaster healthcare training and management for the pre-hospital and in-hospital environments so as to improve preparations for future disasters. The project trained 432 specialist medical trainers and hospital leaders, 206 nurses and 38 physiotherapists in hospitals and venues across  Kathmandu, Biratnagar and Nepalganj and culminated in a mass disaster simulation droll in Kosi Zonal Hospital in November 2019. <a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/latest/nepal-to-test-covid-19-test-kits-from-china/" target="_blank" rel="noopener">Nepal to test COVID-19 test kits from China</a>, Ramu SapkotaA 30-member team identified by the Ministry Of Health Nepal as potential future master trainers were also travelled to Singapore in April 2019 for a 5-day training in disaster management.SingHealth has also signed an agreement with TU Teaching Hospital in Kathmandu to collaborate in Paediatrics and neonatology, liver transplants, orthopedics amongst other subspecialties. Friends of SingHealth also provided pediatric anaesthesia equipment for children having eye surgery at Tilganga Institute of Opthalmology.SingHealth is the largest healthcare cluster in Singapore with a network of acute hospitals, national speciality centres, community hospitals and polyclinics offering over 40 clinical specialities.

10,000 COVID-19 test kits to Nepal from Singapore

<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109121112/636b8bca9c7e80680e06b2c1jpeg.jpg" alt="" width="480" height="854"/><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109121112/636b8bcc9c7e80680e06b2c2jpeg.jpg" alt="" width="480" height="854">Doctors in Jumla collects swab of a patient on 7 April. Photos: DHIRAJ GURUNGOn 13 April, the nose and throat swab of a woman in Kailali district tested positive for the COVID-19. The 65-year-old who was in quarantine had previously tested negative in a Rapid Diagnostic Test (RDT) and sent home.But only three days later, a <a href="https://www.nepalitimes.com/latest/nepal-extends-covid-19-testing-but-no-new-cases/" target="_blank" rel="noopener">Polymerase Chain Reaction (PCR) report</a> confirmed that she was infected with novel coronavirus, upon which she was taken to Seti Provincial Hospital for isolation. She is one of the eight people who had their swab and blood samples collected for both RDT and PCR, but officials didn’t wait for the PCR report.“She should not have been sent home without waiting for the PCR report confirmation. It was a grave mistake because she could have spread the virus after coming out of quarantine,” says Sameer Dixit, researcher at the Centre for Molecular Dynamics in Kathmandu.In fact the RDT can show false negatives in people for up to a week after infection because their bodies have not produced sufficient anti-bodies to be detected. In fact, public health officials say Nepal should have gone directly for PCR like Korea and other countries instead of RDTs.As of 16 April, 15,800 people have been tested for COVID-19, using both RDT and PCR. But a lack of distinction in the specificity of the two test methods in the public consciousness has led to unnecessary panic and stigmatisation of people and entire communities.<a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/latest/nepal-must-hope-for-the-best-prepare-for-the-worst/" target="_blank" rel="noopener">Nepal must hope for the best, prepare for the worst</a>, Buddha Basnyat and Sanjeev adhikari<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109121112/636b8bce9c7e80680e06b2c3jpeg.jpg" alt="" width="640" height="427"><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109121112/636b8bcf9c7e80680e06b2c4jpeg.jpg" alt="" width="640" height="427">Health workers in Lalitpur conduct rapid diagnostic tests on 14 April for people who have come from abroad recently. Photos: BIKRAM RAIThe rapid diagnostic test can only monitor if an individual has developed antibodies to fight against the COVID-19, and can be detected only a week after infection and for at least six months after. The test cannot identify the virus itself and therefore cannot verify if the person has an active infection.When the virus enters a human body, the body’s natural immune system is activated and secretes a protein to kill the virus called antibody. There are two types of antibodies: Immunoglobulin G (IgG) and Immunoglobulin M (IgM). It takes at least six days for IgM and 15 days for IgG to develop after a virus enters the body.RDT kits being used to test COVID-19 can detect both types of antibodies, which is why rapid tests conducted in the early stage of infection will give a negative result even if the individual is actually infected. The case in point is the patient from Kailali who took a RDT before it could have detected the virus. The real-time PCR however was able to detect the coronavirus in her swab sample.“Tests conducted without proper scientific knowledge and guidelines will do more harm than good,” stresses lab specialist Umesh Prasad Gupta.<a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/here-now/ke-garne-attitude-kills-people/" target="_blank" rel="noopener">Ke garne attitude kills people</a>, Laxmi BasnetNepal has not yet developed a protocol to guide healthcare workers conducting mass testing for COVID-19, and the government’s decision to use RDT for mass testing actually contradicts the WHO recommendation and the Indian Council of Medical Research (ICMR) guidelines.Those protocols require RDT to be conducted only for individuals who have undergone 14 days of quarantine, healthcare workers, or for people placed in isolation in hospitals. And even if the result turns out to be negative, a retest with PCR is mandatory. High risk patients are to be placed under quarantine until the PCR confirmation.On the other hand, if a suspected individual tests negative in PCR, he/she should still be placed in quarantine and undergo RDT after 10 days. Only if the second test is negative, is the person to be released.The WHO has also recommended countries to use the real-time PCR for the COVID-19 testing because RDT is only 86% sensitive, and cannot detect new infections.However in Nepal, the Office of the Prime Minister and Cabinet on 4 April directed the health ministry to retest all people whose blood samples tested positive on RDT. The Health Ministry also decided to retest 20% of all negative RDT with PCR, when in fact PCR should have been the basis of further investigation.On 1 April, the Ministry of Health instructed that 75,000 RDT kits imported from China by a private contractor <a href="https://www.nepalitimes.com/latest/nepal-to-test-covid-19-test-kits-from-china/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/latest/nepal-to-test-covid-19-test-kits-from-china/&amp;source=gmail&amp;ust=1587217332074000&amp;usg=AFQjCNG1Z_W10XJJ0rgDFUS-jmgFusJQxw">not be used because of doubts about their reliability.</a> The importer, Omni Business Corporate Internaitonal (OBCI) was also accused to inflating the cost of the kits and using its connections to the Prime Minister Oli to do the deal on 25 March.The Department of Health also announced on 2 April that it had cancelled the contract with Omni and confiscated its Rs50 million deposit. However, it looks like Omni is still in business and the Department said 30,000 of the rapid diagnostic kits that Omni brought are the ones being used all over the country to test people who have come from abroad recently.

Why rapid tests are doing more harm than good

Many of us former Nepal Peace Corps volunteers (PCVs) would agree that our time in Nepal changed in significant but very different ways our perspectives on life if not the future paths we chose to follow. Of no one was this truer than Dorothy Mierow. Dorothy was born in 1920, in Colorado Springs. Her father Charles C Mierow was a classics scholar and Latin professor, who served for ten years as president of Colorado College.&nbsp; Dorothy developed an interest in animals as a child, graduated with a BA degree in natural history from Carlton College in 1942, a Master’s in biology from the University of Pittsburgh, and another Master’s in geography from the University of Minnesota.&nbsp; As a young woman, Dorothy traveled with her father throughout Europe, including a visit to ancient Greek ruins, and took a Magellan Tour by cruise ship around the world in 1958.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025071901074_0bad133ab22aada319e74bbad95d563e191371db291c08f373839fbd15440262.jpg" data-media-id="editor_0" data-image-id="2025071901074_0bad133ab22aada319e74bbad95d563e191371db291c08f373839fbd15440262" data-rendition-name="original" width="903" height="1178" loading="lazy" alt="How the Peace Corps changed a volunteer's life"> <figcaption>HOME AWAY FROM HOME: Dorothy Mierow as a college student in her native Colorado.</figcaption> </figure>  She was a college teacher during much of the 1940s, also teaching at a girls’ school in Hawaii. Then back to her native Colorado in 1953, where she became a curator and later director of the Colorado College Natural History Museum. She taught geography classes, and in her free time, Dorothy climbed 22 of Colorado’s 14,000-foot peaks. Traveling in India in 1960, Dorothy decided to spend two weeks in Nepal. In late 1961, she filled out an application to join the Peace Corps and specified that she wanted to go to Nepal, ‘because I admired the people so much when my father and I were there on our trip’.&nbsp; Dorothy reached Kathmandu in September 1962 as the first group of American Peace Corps volunteers in Nepal. She stood out from the others: one of the few women in that group, surely the oldest at age 41, a world traveler, and a woman who already had established a professional career.&nbsp; One doubts if Dorothy had had a husband and children whether she would ever have gone to work and spend much of the rest of her life in Nepal.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025071901078_68e84ade1ffb0f6c83c7f8fa5c1e7315b5f6c543217f96cde012e4d86f171515.jpg" data-media-id="editor_1" data-image-id="2025071901078_68e84ade1ffb0f6c83c7f8fa5c1e7315b5f6c543217f96cde012e4d86f171515" data-rendition-name="original" width="1259" height="910" loading="lazy" alt="How th Peace Corps changed a volunteer's life NT"> <figcaption>Pokhara Bazar in 1962.</figcaption> </figure>  The Peace Corps assigned Dorothy to teach geography at Tri-Chandra College. After the school closed in the winter due to lack of heating, USAID and the College of Education asked Dorothy to help train general science teachers.&nbsp; She taught for two months and became involved in a textbook-writing project, commenting: ‘I would like the children to know something about public health, conservation (the trees are going fast and so is the soil), and learn the names of some of their common birds, trees, and flowers. They are more impressed with electricity, airplanes, and cell structure.’ When a new college opened in Pokhara in 1963, Dorothy was transferred there and lived with a Nepali family. The college boasted 30 students and no permanent buildings.&nbsp; In October 1963, Dorothy wrote: ‘Pokhara is a town of almost 5,000 people … We are in a fertile valley surrounded by foothills … There is a small Mission Hospital … a Leper Hospital and Tibetan Refugee Camp started by the Red Cross and now run by the Swiss. With winter approaching, more Tibetans are appearing in town, often with pack horses or donkeys. Some have been carrying large boxes of powdered milk,donated (by USAID) to the camp from the airport … There is no electricity, and the transportation problems make many items scarce and expensive. I am really a sort of a museum. The landlord brings all kinds of people in to see how I live and count my shoes and dresses. They express amazement at my books, pictures, tin oven, Nepali dolls from Kathmandu, screened food shelves and curtained closet.’ The standard term for Peace Corps volunteers was two years, but Dorothy extended her term and was still at Prithvi Narayan College at the end of 1965, when she wrote that she had 20 Geography students in the first-year class and 6 in the second year preparing for the IA Examination. The college enrollment was 125 students, and the foundation for a new science building was being excavated.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025071901074_c6a80e5e0db0c705b2f8733c6d30dc0386fe3abbd2238ea9d947b7d746f94a29.jpg" data-media-id="editor_2" data-image-id="2025071901074_c6a80e5e0db0c705b2f8733c6d30dc0386fe3abbd2238ea9d947b7d746f94a29" data-rendition-name="original" width="902" height="605" loading="lazy" alt="How the Peace Corps changed a volunteer's life"> <figcaption>Mierow and friends at Phewa Lake.</figcaption> </figure>  Dorothy noted that she ate one meal a day at the (Shining Mission) Hospital but otherwise lived on dal-bhat, momo, and potato curry at local shops. However, she had developed a new passion: to build what she initially called the Pokhara Museum of the Himalaya. In commendable Peace Corps fashion, Dorothy always worked with Nepalis and respected the culture. ‘The greatest joy and satisfaction I have had has been from the building of a Museum-Library in memory of my parents … It has been possible to feel like a wealthy benefactor with the money saved by father for the family’s education and now available for the education of others… (Father) would have loved to be in on the founding of a new college and be able to plan a library. Several hundred of the books to be in the museum-library came from his collection and were carefully selected to be of use for students in Nepal…’&nbsp; ‘The museum part is to satisfy my own inclinations and was thought of when I found how little diversion there was for the people of Pokhara… It is part of the University requirements for the college that it should have a geography and biology museum. The museum building is small but adequate.&nbsp; I have tried to design it in harmony with Nepalese architecture and decorate it with some of the art of the best artists or woodcarvers… Posts holding up the porch roof are carved by Cottage Industries to represent different peoples of Nepal in typical costumes. The door was carved by a local wood carver and has typical birds of Nepal around it. Inside are 10 roof-support carvings designed by the retired Director of the National Museum in Kathmandu, Mr. C.M. Maskey.&nbsp; They were carved by the best wood carvers in Patan very skilfully. The building has three rooms: the library, the exhibition room, and a smaller workroom which can be used by our newly formed Woman’s Club as well as other groups or classes.’  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025071901074_03d3359c65389d30a0134e9a4862778994121e7e833b7d28b18e06e36fc76ff8.jpg" data-media-id="editor_3" data-image-id="2025071901074_03d3359c65389d30a0134e9a4862778994121e7e833b7d28b18e06e36fc76ff8" data-rendition-name="original" width="629" height="599" loading="lazy" alt="How the Peace Corps changed a volunteer's life"> <figcaption>Mierow with local women in Pokhara in 1969.</figcaption> </figure>  Dorothy promoted her project to influential Nepalis connected with organisations whose support she solicited: The Department of Archaeology, the Department of Agriculture, the Godavari Botanical Gardens; Tribhuvan University’s Science and Education Department, Nature Conservation Society.&nbsp; The museum was opened officially in early 1967. The Annapurna Natural History Museum, the building Dorothy designed and had constructed, is still open and features some exhibits which she created many years ago.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025071901074_54326a8a0685e980e782378076de2f5cd02d2426e9b0d94eed972d3dbe83af26.jpg" data-media-id="editor_4" data-image-id="2025071901074_54326a8a0685e980e782378076de2f5cd02d2426e9b0d94eed972d3dbe83af26" data-rendition-name="original" width="1333" height="1000" loading="lazy" alt="How the Peace Corps changed a volunteer's life"> <figcaption>The Annapurna Natural History Museum.</figcaption> </figure>  Dorothy returned to America in 1967, but she longed for Nepal. In the spring of 1969, she again tried to enroll as a Peace Corps volunteer but was told that as she had spent more than four years, she would not be eligible for another assignment. Undeterred, she persuaded the college in Pokhara to invite her to return as a teacher.&nbsp; UNICEF and the Forestry Department sponsored Dorothy to prepare charts on trees, birds, animals and flowers in colour for distribution to the schools of Nepal. Dorothy, back in the Peace Corps, returned to Pokhara and the Museum in 1972. She formed a friendship with her former geography student from Sikles, Chandra Prasad Gurung, and in 1974, she brought Chandra to America, where he enrolled in Colorado College and studied cultural anthropology.&nbsp; Chandra subsequently earned his PhD in geography from the University of Hawaii and returned to Pokhara to become director of the Annapurna Conservation Area Project. Gurung actively promoted ecotourism, landscape conservation, and biodiversity conservation in Nepal. His life was cut short along with those of 23 other Nepalis and foreigners who perished in a helicopter crash near Taplejung in September 2006.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025071901074_322d3c3ac6f1b08ffa07c44a19998b937a7db9eb43527f7539cf6481e1546314.jpg" data-media-id="editor_5" data-image-id="2025071901074_322d3c3ac6f1b08ffa07c44a19998b937a7db9eb43527f7539cf6481e1546314" data-rendition-name="original" width="2500" height="1000" loading="lazy" alt="How the Peace Corps changed a volunteer's life"> <figcaption>Mierow's four books on Nepal and its biodiversity. </figcaption> </figure>  Dorothy worked with several well-known Nepalis to publish her paintings and photos in beautifully illustrated books. She and Hemanta Mishra of the National Parks and Wildlife Service wrote Wild Animals of Nepal (Ratna Pustak Bhandar, 1976). More than 400 photos Dorothy took on treks to the Everest region, Gosaikunda, Muktinath, Jumla and Rara Lake, as well as travels in the Tarai, appeared in Himalayan Flowers and Trees (Sahayogi Prakashan, 1978).&nbsp; The botanist Tirtha Bahadur Shrestha identified the species. Dorothy and Kesar Lall published This Beautiful Nepal (Sahayogi Press, 1981). Birds of the Central Himalayas (1988) contained Dorothy’s paintings of 250 species of birds found along the areas of the Kali Gandaki River, Pokhara, Chitwan and the central Tarai. Dorothy summed up her life and work in Nepal in Thirty Years in Pokhara (Pilgrims Book House, 1997). Dorothy returned to Pokhara and her adopted Gurung family several times during the 1980s and 1990s to celebrate festivals and meet old friends. Her final years were spent at her mountain cottage in Green Mountain Falls north of Colorado Springs. She died at the age of 79 in August, 2000. Nepal gave new meaning and purpose to Dorothy Mierow’s life. Daniel W Edwards was a Peace Corps volunteer in 1966 and is the author of several books on Nepal. The author thanks Special Collections, Tutt Library, Colorado College.

How the Peace Corps changed a volunteer’s life

· On the night of 15 May, two glacial lakes burst in Tharka in Humla and the debris flow washed away homes and bridges.&nbsp; · Last week, a slurry surge on the Kali Gandaki in Upper Mustang caused at least Rs15 million in damage, and was traced to a melting glacier. · Dozens are feared dead after <a href="https://nepalitimes.com/news/rasuwa-flood-likely-a-glof">an expanding glacial lake in Tibet overflowed</a>, sweeping down into Nepal and damaging four hydropower plants generating 230MW, nearly 8% of the country’s total grid supply.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250718060748_45225dc707c1e9c2968ca8dbf6e564e01e4eb6e2ff254fb8eb940cf62cdd910b.jpg" data-media-id="editor_1" data-image-id="20250718060748_45225dc707c1e9c2968ca8dbf6e564e01e4eb6e2ff254fb8eb940cf62cdd910b" data-rendition-name="original" width="2667" height="1500" loading="lazy" alt="Rasuwa flood"> <figcaption>Miteri friendship bridge connecting Nepal and China was swept away in the Rasuwa flood. Photo: PRAKASH CHANDRA TIMILSENA / NPL</figcaption> </figure>  And those are just in the past month. Climate scientists say Himalayan glacial lake outbursts are becoming more frequent and destructive, and a warning for Nepal not to put all its eggs in the hydropower basket.&nbsp; <a href="https://nepalitimes.com/editorial/when-it-rains-it-pours-ksqprbu3">Record precipitation last September</a> unleashed floods that killed 200 people, and temporarily slashed Nepal’s total generation capacity of 3,000MW by nearly half. The <a href="https://nepalitimes.com/banner/nepal-valley-suffers-quadruple-disaster">Melamchi flood of 2021</a> caused by <a href="https://nepalitimes.com/multimedia/the-not-so-permanent-frost">permafrost melting</a> on a glacier upstream nearly destroyed a $800 million water supply scheme, Nepal’s largest infrastructure project which four years later still has not resumed full operation. The <a href="https://nepalitimes.com/news/sikkim-flood-is-warning-to-nepal">glacial lake overflow in Sikkim</a> caused by record rainfall in September 2023 that destroyed the $1.2 billion Chungthung Dam and caused catastrophic damage to infrastructure on the Teesta River. This was a warning to the cascade of hydropower plants on the Arun and Marsyangdi river basins.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250718060736_6f61797a6be308321e3bae26e55d2f64cba4b9e5eb262adacb9e92fb5f3c6152.jpg" data-media-id="editor_6" data-image-id="20250718060736_6f61797a6be308321e3bae26e55d2f64cba4b9e5eb262adacb9e92fb5f3c6152" data-rendition-name="original" width="919" height="549" loading="lazy" alt="hydro disasters and hydropower plants"> </figure>  Nepal has set a target of generating an additional 28,500MW by 2035 -- out of the feasible 48,000MW -- but how viable is an energy strategy that is exposed to heightened risk due to climate breakdown? &nbsp; “As extreme weather events increase, we must design and build infrastructures respecting river flow and topography,” says former Energy Secretary Dwarika Nath Dhungel. “We must make the best use of our water resources, but not by letting excavators loose everywhere mining riverbeds and building haphazardly where we shouldn’t.”&nbsp; Although no project can be disaster-proof, <a href="https://nepalitimes.com/banner/climate-smarter-himalayan-infrastructure">climate smart design</a> can minimise damage from flash floods and landslides. Recent disasters have driven up insurance premiums for energy projects in Nepal, and smaller ones cannot even afford them. The 456MW Upper Tamakosi hydroelectric project which is still not fully functional after the September floods has claimed insurance worth Rs1.8 billion. The alternative to high risk high investment hydropower projects is <a href="https://nepalitimes.com/here-now/what-s-cooking-in-nepal-besides-politics">energy diversification</a> to other renewables such as solar, wind or biogas. Nepal gets annual sunlight of 300 days with 6-7 hours on average to total 50,000 terawatt-hours (TWh) per year.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250718060744_4acd452b4117180ca9bb5d3be839ff46dfd5464e4d507f5ad3704cef6253bc48.jpg" data-media-id="editor_9" data-image-id="20250718060744_4acd452b4117180ca9bb5d3be839ff46dfd5464e4d507f5ad3704cef6253bc48" data-rendition-name="original" width="1080" height="720" loading="lazy" alt="solar power"> <figcaption>Farmers in Tarai using solar powered water pump. Photo: GHAMPOWER</figcaption> </figure>  The Solar and Wind Energy Resource Assessment (SWERA) calculates that Nepal could source 3,000MW from wind energy alone, considering 10% of the area with more than 300W/m2 wind power density. <a href="https://nepalitimes.com/opinion/people-power/decentralising-power-in-nepal">Solar energy</a> stations are cheaper and quicker to build, and would be an ideal alternative to reliance on hydropower.&nbsp; “There has been some investment in solar power, especially from the state sector,” says water expert Madhukar Upadhyay. “But there is an issue of land acquisition since the arrays need a lot of space. It is comparatively easier to get a permit to put up a hydropower plant on a river.” As for biogas, there is simply no incentive to build on past success with household level plants to <a href="https://nepalitimes.com/here-now/more-bullshit">promote industrial-scale production</a>. Scaling up biogas by integrating it with urban biodegradable waste would still be a viable alternative to LPG.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250718060744_715d44afd5eb4ba8dafa209b0ad0f19400665797b5f078f5636821e600f96684.jpg" data-media-id="editor_12" data-image-id="20250718060744_715d44afd5eb4ba8dafa209b0ad0f19400665797b5f078f5636821e600f96684" data-rendition-name="original" width="1419" height="954" loading="lazy" alt="windmill"> <figcaption>A wind mill in Hapsikot in Nawalpur. Photo: WINPOWER NEPAL</figcaption> </figure>  Nepal’s public sphere is buzzing with excitement over the discovery of potentially 430 billion cubic metres of methane gas beneath Dailekh district that, if properly harnessed, would meet the country’s energy demand for the next 50 years. Even though a feasibility study is awaited, politicians from the prime minister down see this as a petro bonanza that will make Nepal rich. But drilling, storage and distribution of CNG in the country’s current kleptocratic state make that unlikely. If Nepal was to get rich solely on its hydro-energy potential, it could have done so in the past 50 years. Says Dhungel: “This is not exactly a new discovery, but it is premature to celebrate until its extraction is proven to be cost effective. And let us hope it does not get <a href="https://nepalitimes.com/news/balance-of-power">tangled in geopolitics</a>, since China is involved in the prospecting and drilling, which could make India uneasy.”&nbsp; The country suffers from the Dutch Disease curse even before its resource is fully exploited. And the same cronyism, corruption and rent-seeking structure cannot deliver the riches we expect from Dailekh’s methane discovery. Now, <a href="https://nepalitimes.com/here-now/right-climate-for-nepal-s-energy-transition">with hydropower in jeopardy</a>, Nepal’s planners will have to evolve a new strategy for energy security into the future. But first, governance needs to be cleaned up with long-term strategic planning that takes climate risk into account. For example, do we need to mine fossil gas when there are renewable options? Will Dailekh take Nepal away from its climate commitments? Says Madhukar Upadhyay: “Nepal has always been resource rich and management poor. And the larger the resource, the bigger our management incapacity. It is a societal malaise.”&nbsp;

Nepal’s Resource Curse

चौतारा rest stops have long been an integral part of scenic touristic town of <a href="https://nepalitimes.com/news/pokhara-six-decades-ago">Pokhara </a>but are now rarely seen as the city bursts at the seams. They say inhabitants of Pokhara saw a plane before they saw cars. Indeed, the grass airfield was built in the 1950s, while the Kathmandu highway 20 years later. Before roads, people walked to get around, pausing to rest or even nap under the shade of banyan-pipal trees. <a href="https://nepalitimes.com/here-now/pokhara-s-desperation-and-hope">Pokhara airport’</a>s ‘terminal’ in those days was a shady chautara where passengers waited for their flights. The chautara bore silent witness to daily life, whether it was travellers seeking a brief respite from the summer heat or villagers gathering for a chat in the mornings and evenings. But with the roads came vehicles, and then houses started filling up spaces, even farmlands. Pokhara began transforming from a serene village to a <a href="https://nepalitimes.com/news/pokhara-comes-alive-at-night">bustling city</a>.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250719010724_d101fa482441ce67afdf5bc4e4547b334e7662c1cf0a20e9d31a0e8dff66f04b.jpg" data-media-id="editor_3" data-image-id="20250719010724_d101fa482441ce67afdf5bc4e4547b334e7662c1cf0a20e9d31a0e8dff66f04b" data-rendition-name="original" width="2147" height="1581" loading="lazy" alt="Trees of life and living NT"> <figcaption>Photo: DURGA RANA MAGAR</figcaption> </figure>  The banyan-pipal trees were chopped down to make way for wider intersections and buildings. The once-iconic rest stops that carried Pokhara’s identity had all but vanished. “Building chautara was once considered a religious duty, which is why so many of them were constructed across Pokhara,” says archivist Sunil Ulak. <a href="https://archive.nepalitimes.com/news.php?id=10927">Ekai Kawaguchi</a>, a Japanese Buddhist monk, who visited Nepal 120 years ago en route to Tibet, documented <a href="https://nepalitimes.com/banner/no-visitors-in-pokhara-to-admire-view">the landscape of Pokhara</a> and its surroundings. In his book, Three Years in Tibet, he reflects on the natural beauty of the town and its shady trees. A chautara used to be surrounded by ponds, where shepherds would bring their cattle to drink from while they took a nap under the shade. The gentle rustling of leaves in the cool breeze lent a soothing melody as did the chirping of birds, while the insects took refuge in the branches and leaves. Read also: <a href="https://nepalitimes.com/here-now/pokhara-800-years-ago">Pokhara 800 years ago</a>, Kunda Dixit This ‘nature’s breeze’, as botanist Kalyan Panta puts it, is now history due to <a href="https://nepalitimes.com/banner/cost-of-living-in-a-big-city">haphazard urbanisation</a>. “When the wind strikes against one leaf, it creates a domino effect and other leaves start waving as well,” he explains. There were 632 chautara in the city until 1977, and by 2000 the number had fallen to 278. But in some wards the number of trees fell from 55 in 1984 to only five now.&nbsp; The gradual loss of these resting places has meant habitat <a href="https://nepalitimes.com/banner/between-existence-and-extinction-in-nepal">destruction of birds and insects</a>, it has also damaged the environment and natural beauty of the city.&nbsp; Researcher Jagannath Adhikari’s study showed that infrastructure projects ignored the environment, and concluded that that urbanisation in Pokhara was unsustainable.&nbsp; The destruction continues to this day. Recently, old chaurata in wards 6, 13 and 14 were cleared to make way for a sacrificial ritual. In fact, ward 6 got a permit from the local government to clear its remaining trees.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250719010724_cee1d4faf8376e7ba18b9c7012ea4215b7c3fbf7e0983b0c97005df5567d6de0.jpg" data-media-id="editor_9" data-image-id="20250719010724_cee1d4faf8376e7ba18b9c7012ea4215b7c3fbf7e0983b0c97005df5567d6de0" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="Trees of life and living NT"> <figcaption>Photo: DURGA RANA MAGAR</figcaption> </figure>  But in wards 13 and 14, the Human Service Foundation cut down some 33 trees for which it is in a dispute with the metropolitan city as there is no unclear jurisdiction regarding who gives the permit. The Kaski Division Forest Office is currently investigating the matter. Elsewhere in ward 19, the ward office had launched ‘मेरो रूख, म काट्छु’ campaign due to an alleged chaos caused by monkeys in the area. The decision was rescinded after an all-around opposition.&nbsp; To be sure, there are policies in place to protect trees such as the Gandaki Province Forestry Act, 2080, and the Regulations, 2081. The province government also introduced an act in 2019 per which no tree, including pipal, silk cotton and other <a href="https://nepalitimes.com/opinion/suburban-tales/trees-trees?%2F">trees of natural and historical importance</a> shall be damaged, eroded or removed. But the local government, responsible for implementing the Act, is doing the opposite. “If this rapid rate of tree felling continues, neither trees nor chautara will survive for the future generation,” conservationist Ram Bahadur Poudel tells us, adding that old trees are being cleared under the pretext of pruning branches. Interestingly, Ulak notes that Pokhara-8 was called सिमलचौर in the past because there were so many majestic silk cotton trees, but there are very few left, if any, and hence altering the identity of a place. With modernisation, people have questioned the significance of chautara in this day and age. But they still have relevance. Urban centres in Pokhara and Kathmandu are much hotter than the outskirts because of the <a href="https://nepalitimes.com/news/in-the-heat-of-the-moment-5xcycyot">urban heat island effect</a>. Says archivist Ulak: “While their original purpose was to provide rest, today they continue to play a crucial role in regulating temperature, beautifying the city, and preserving our environment.”

Trees of life and living

Nepalis are living longer than ever. By 2028, the country is set to join the ranks of other <a href="https://nepalitimes.com/news/nepals-demographic-window-is-closing">ageing societies</a> around the world, and by 2054, 1 out of every 7 people in Nepal will be over 65. Life expectancy at birth has risen dramatically from just 55 in 1990 to 71 today, &nbsp;thanks to improvements in public health and access. But as more people live longer, the country must also prepare for a parallel rise in age-related illnesses and the complex social and medical needs that come with an <a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/need-to-prepare-for-ageing-society,3624">ageing population</a>. Extended families have always acted as a safety net for <a href="https://nepalitimes.com/news/home-sweet-home-for-older-nepalis">the elderly</a>, with children and grandchildren shouldering most caregiving duties. But with more than 1,600 <a href="https://nepalitimes.com/banner/migration-not-a-wish-but-necessity-for-nepalis">Nepalis migrating </a>every day, older parents are left behind with no one to care for them. <a href="https://nepalitimes.com/editorial/the-new-equaliser">Remittances</a> from migrating youth, which account for nearly a third of Nepal’s GDP, have kept the economy afloat. But money sent home cannot make up for the chronic departure of kin and caregivers, who are often the first to catch the signs and symptoms of disease in elders. In rural areas where over 85% of Nepal’s elderly live, the absence of this daily vigilance means early signs of illness often go unnoticed until they become debilitating. As a result, chronic conditions like hypertension, diabetes, and depression are left unmanaged.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250720130748_213f2c65f2638872e9ac0550a7ac251e4960c3726dc5c76215962a23ba71dff1.jpg" data-media-id="editor_5" data-image-id="20250720130748_213f2c65f2638872e9ac0550a7ac251e4960c3726dc5c76215962a23ba71dff1" data-rendition-name="original" width="1064" height="701" loading="lazy" alt="Smart ageing is Nepal’s next frontier"> </figure>  Geriatric medicine is largely absent from medical curricula and there is no national plan in place to manage cognitive decline, memory loss and confusion. These are often mistaken for signs of normal ageing, instead of <a href="https://archive.nepalitimes.com/article/nation/dementia-brings-new-problem-that-families-have-little%20knowledge-of,2151">dementia</a>, delaying care until it is too late. The same pattern plays out with strokes, osteoarthritis, and vision problems — conditions that could be managed early but are instead allowed to spiral into <a href="https://nepalitimes.com/opinion/comment/changing-disability-to-this-ability-h68f6sq2">disability</a>. Nepal is not ready for an older future. It needs a strategy for ‘smart ageing’ where the focus is not adding years to life, but enhancing years lived through the intelligent application of policy, infrastructure, and crucially, <a href="https://nepalitimes.com/opinion/comment/tech-and-transition-in-nepal">technology</a>. Many models of smart ageing, however, are sculpted around modern societies where independent living in later life is the norm. Furthermore, eroding traditional family care and an underdeveloped formal care system means there is a large gap that can’t simply be filled by copy-pasting from foreign models. Nepal must shape its own version of smart ageing. The <a href="https://nepalitimes.com/news/healthcare-moving-from-hospitals-to-homes?%2F">tech boom</a> has led to homegrown digital healthcare apps such as Hamro Doctor, Cura Health, Jeevee and Health Yaad Ayo which offer teleconsultations, online appointments, and at-home test bookings. As <a href="https://nepalitimes.com/review/nepal-s-new-digital-landscape">smartphones and internet access</a> extend to the most rural fringes of the Nepali countryside, geography is no longer a barrier to the use of these digital tools. What limits their use is the lack of digital proficiency among the older generation. Others find the idea of turning to a device instead of a familiar, reassuring face unfathomable. That is why <a href="https://nepalitimes.com/opinion/addressing-nepals-digital-divide?ref=blog.togglecorp.com">digital literacy</a> efforts must be paired with guided human support to build trust alongside technical skill. Such a model of community-led digital mediation is already gaining traction elsewhere. In the UK, ‘digital health ambassadors’—often young people or even schoolchildren—are trained to co-design and advocate for online platforms that resonate with peers who might otherwise feel excluded from automated health services. A Nepali version could engage cohorts of nursing students, tech-savvy youngsters and returnee migrants to assist elders in navigating digital health platforms and troubleshooting problems, and most of all, normalising the idea of health apps being a reliable recourse.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250720130748_fcb94ab76e76b5574189757e88d76fccad4e115e78dd9eae92a3bd4c882c3431.png" data-media-id="editor_12" data-image-id="20250720130748_fcb94ab76e76b5574189757e88d76fccad4e115e78dd9eae92a3bd4c882c3431" data-rendition-name="original" width="2246" height="1590" loading="lazy" alt="Smart ageing is Nepal’s next frontier"> </figure>  Nepal’s own network of Female Community Health Volunteers (FCHVs), whose credibility is rooted in long-standing relationships across rural communities, could be similarly upskilled, their roles in <a href="https://nepalitimes.com/here-now/target-2030-for-maternal-and-newborn-health">maternal and child health </a>expanded and repurposed to also include geriatric tech support. However, there is a limit to how much older adults can adapt to new technologies. So, Nepal should simultaneously invest in passive technologies—tools that monitor and act for the elderly, instead of demanding active use. That is where wearables and in-home smart health devices collectively known as 'gerontechnology' come in. Picture an 82-year-old in far-flung Rolpa, away from the facilities of an urban hospital. Installed in her home are low-cost motion sensors that monitor prolonged inactivity or signs of a fall, instantly triggering alerts to the nearest health post when necessary. On her wrist, a wearable bracelet continuously tracks her sleep, vital signs, oxygen saturation, and glucose levels. This data is encrypted and synced to a digital dashboard accessible by health staff at the local post. If the system flags an acute risk—such as a potential stroke or hypoglycemia—a nearby health worker is dispatched immediately to her home. If her readings over time indicate a trend toward a <a href="https://nepalitimes.com/news/why-do-so-many-nepalis-have-high-blood-pressure">chronic condition</a> like diabetes, community health volunteers step in. They help schedule a virtual consultation with an endocrinologist in Butwal. Based on the advice received, she gets a prescription and picks up her medication from the local community pharmacy, along with a smart dispenser to ensure she sticks to her treatment plan without missing doses. This is not as far-fetched as it may sound. Many of the individual devices forming this connected medical system called an Internet of Medical Things (IoMT) already exist in Nepal as imported commercial products. What is missing is a stronger framework for <a href="https://nepalitimes.com/business/public-health-partnership">public-private collaboration</a>: one where health tech companies continue developing locally adapted tools, and the government actively integrates these innovations into public health delivery. <a href="https://nepalitimes.com/opinion/people-power/nepal-as-an-ai-power-bank">Nepal’s tech ecosystem</a> is maturing, but policymaking must evolve in tandem, especially when it affects an older generation largely resistant to change. The backlash against the recent mandate requiring National Identity Cards for accessing social security benefits revealed the pitfalls of imposing top-down reforms without adequate preparation or support for seniors. For Nepalis to age well, community caregivers, doctors, innovators, and above all, the state, must step in where families have stepped away. The goal is not to replicate traditional care, but to build a coordinated system of support that connects everyone through technology. The future is older for Nepal, let us be wiser too. The writers are pursuing their undergraduate studies in biomedical engineering at the Hong Kong Polytechnic University.