<figure><img width="1165" height="600" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109141116/636ba8469c7e80680e0737cejpeg.jpg" alt=""/><figcaption>All photos: HEALTHY SMILES</figcaption></figure>Health care facilities are in much demand during the Covid-19 pandemic, but one branch of medicine that is not seeing any patients is dentistry. The patient cannot wear a mask, it is impossible for the dental surgeon to maintain physical distance during treatment, and patients, dentists and their nurses all face extended exposure to virus-carrying aerosols.The World Health Organization (WHO) has advised patients to delay visiting their dentists during the pandemic, and the Nepal Ministry of Health has told dental surgeries to close during the lockdown period.However, dentists interviewed for this overview told Nepali Times if there is one field of medicine that is most prepared to stop the spread of infections, and who were already following strict protocols, it is oral care.“Long before Covid-19 dental clinics already had strict protocols to prevent the spread of airborne infections, so if any doctors already had  preventive measures in place it would be dentists,” says dental surgeon Sushil Koirala of the <a href="http://www.punyaarjanfoundation.org.np/main/" data-saferedirecturl="https://www.google.com/url?q=http://www.punyaarjanfoundation.org.np/main/&amp;source=gmail&amp;ust=1598755551072000&amp;usg=AFQjCNG60e9232rmC_ehPE51HjcNhCR4iw">Punyaarjan Foundation.</a>Koirala says most dentists in the region were already following the WHO protocol from the SARS epidemic in 2003, and even before that dental clinic staff in Nepal have been taking precautions against tuberculosis, seasonal influenza, and other airborne pathogens.<a href="https://www.nepalitimes.com/here-now/protecting-those-who-protect-us-from-the-epidemic/">Protecting those who protect us from the epidemic</a>, Ramu SapkotaFor the first four months of lockdown after March, the government ordered all dental clinics closed, and had allowed oral care departments in two hospitals to remain open for dental emergencies. However, they soon closed after staff tested positive for the novel coronavirus. From March to mid-July most dentists spoke to their patients on the phone about symptoms, and depending on the case, the patients were given advice, prescribed painkillers or antibiotics.Over 90% of the cases were gum infections or tooth decay due to excessive snacking during the lockdown. Most could be treated with analgesics and mouthwash. “With the more serious cases, we practiced a crude form of telemedicine where we asked the patient to take a live video of their oral cavities so we could advise on a course of action,” Koirala says. “Some of my patients learnt to take really good selfies.”Even when the restrictions were partially lifted on 21 July, clinics were still largely empty because the patients were too scared to visit, and the staff stayed away. Dental clinics then followed their standard protocols, adding new guidelines on pre-appointment interviews, disinfection of surgery after every patient, personal protective equipment, and procedures like limiting the number of patients and minimising contact.<a href="https://www.nepalitimes.com/latest/tb-patients-in-limbo-due-to-covid-19/">TB patients in limbo due to COVID-19</a>, Devika Agarwal <img width="1138" height="600" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109141116/636ba8499c7e80680e0737cfjpeg.jpg" alt="">Some innovative clinics like Healthy Smiles in Kathmandu developed their own protocols a based on guidelines issued by the US Centre for Disease Control (CDC) and have <a href="https://youtu.be/MV048n6EuPE" data-saferedirecturl="https://www.google.com/url?q=https://youtu.be/MV048n6EuPE&amp;source=gmail&amp;ust=1598755551072000&amp;usg=AFQjCNEeNub-ibeeEVrwxo8E6Oz-ul--QQ">made videos</a> to illustrate the process to patients.“As this is a droplet infection with aerosol transmission, our attempt is to minimise it with online screening of limited patients, social distance and masks, well ventilated rooms with negative pressure along with high vacuum dental suctions and a floor level exhaust at floor level,” explains dental surgeon Neil Pande of Healthy Smiles.After every patient, the entire outer wear is changed by all to ensure no cross contamination between patients. The donning and doffing of PPE is carried out in a strict sequence and disinfected before cleaning. All the surfaces are decontaminated with 70% alcohol three times, once immediately after and other twice after, with an interval of one hour. Healthy Smiles actually got Nepali engineers to design and build its new ventilation system that sucks air out of the surgery and passes it through HEPA filters to decontaminate it.<a href="https://www.nepalitimes.com/latest/govinda-kc-treats-patients-in-remote-nepal/">Govinda KC treats patients in remote Nepal</a>, Achyutraj Bhandari“We believe infection control to be one of the main pillars of the healthcare system, and it is even more important during this pandemic,” Pande says. “It has completely changed the face of dentistry.”Elsewhere in developed countries, many dentists have defied the WHO’s recommendations saying they are already used to taking necessary precautions to prevent infections. In fact, they argue that patients may suffer other health complications if they cannot see their doctors in time, and that oral infections can worsen the outcome of patients with Covid-19.  In Singapore, where a very strict testing and tracing regimen is in place, dental clinics have remained open and the flow of patients is at 80% of pre-pandemic level. In Australia, except in the state of Victoria, most dentists are seeing patients.In Nepal, Punyaarjan Foundation has <a href="http://www.punyaarjanfoundation.org.np/main/" data-saferedirecturl="https://www.google.com/url?q=http://www.punyaarjanfoundation.org.np/main/&amp;source=gmail&amp;ust=1598755551072000&amp;usg=AFQjCNG60e9232rmC_ehPE51HjcNhCR4iw">published a booklet</a> and posters in Nepali that allow individuals and families to self-evaluate their own risk levels with various activities. Says Sushil Koirala: “Dentists are taught to be extra-cautious about infections, and with this publicity material we want to share that knowledge with the Nepali public -- that the only way to fight infectious disease transmission is through individual responsibility and discipline.Read also: <a href="https://www.nepalitimes.com/here-now/kidney-patients-dying-due-to-covid-19-lockdown/">Kidney patients dying due to COVID-19 lockdown</a>, S Dhiren

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Need to see a dentist during the pandemic?

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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New treatment offers hope for Nepal’s leprosy patients

Nepal showed inconsistent performance at the T20 World Cup 2026 in Mumbai with flashes of brilliance, but ultimately snatched defeat from the jaws of victory. The <a href="https://nepalitimes.com/news/rhinos-hit-the-ground-running">near-win against England</a>, a test cricket team by an associate country, in the opening game showed promise and suggested that Nepal’s cricket was on the cusp of glory. The Nepal Premier League and a flawless performance in the qualifiers had raised hopes that perhaps the Rhinos could progress out of the group stage. However, subsequent losses against newcomers Italy and the West Indies were harsh reality checks about the true state of the game: there is a lot of catching up to do in the present, and structural changes to put in place to win big in the future. Head Coach Stuart Law summed it all up quite harshly: “To go from that high to then go to an extreme low four days later, that’s not showing mental toughness.” He was worried about the distraction of social media and lack of focus among players: “When you’re in cricket, do your cricket. It’s a difficult one for me because I’m a social media dinosaur, I don’t understand it. You don’t have to keep showing your face if we’re winning games.” Finally a late-night win against Scotland on Tuesday redeemed some of Nepal’s pride. A strong opening partnership, yet another rugged Dipendra Singh Airee innings and Sompal Kami’s vindictive 3 for 25 helped Nepal beat Scotland in their last group game at the T20 World Cup.  <figure><img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260218010220_6ca369f6aefc8b653c2572467f050e96b029c96b71fed5fb4213898c7d469325.jpg" data-media-id="editor_1" data-image-id="20260218010220_6ca369f6aefc8b653c2572467f050e96b029c96b71fed5fb4213898c7d469325" data-rendition-name="original" width="1366" height="2048" loading="lazy" alt="T20 World Cup Nepal"></figure>  There was nothing riding on the game but honour, it means at least that Nepal do not crash out on zero. The game ebbed and flowed. Scotland started well and looked set to score 200 before collapsing in the end at 170. The Nepal batting effort also started out well, but in the middle overs after some wickets had fallen, it looked like the team was whimpering out again. Boundaries dried up, the run rate creeped up to almost 13, before Airee and Jha woke up and took charge and got to 171 with a few balls to spare. The dhaka topi crowd in the stands loved it. A big part of the reason Nepal’s performance was so much better against England than in the other games was the mentality going in. Against England, Nepal were clear underdogs and could play freely. Even a nasty defeat would have been forgiven. Against newcomers Italy, these roles were flipped. Fans and perhaps the players underestimated Italy, a nation much better known for its football culture. But it had put together a smart, experienced team made up of Italian cricketers with South African, Australian, English, Indian, Pakistani and Sri Lankan heritage. And Nepal may have won a series against West Indies last year, but against the full strength Caribbean squad they were easily beaten.  <figure><img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260218010220_dc27adaa2102b493f940a97f9572769e695c2c1c41c8558fc4c23657cc1c3261.jpg" data-media-id="editor_2" data-image-id="20260218010220_dc27adaa2102b493f940a97f9572769e695c2c1c41c8558fc4c23657cc1c3261" data-rendition-name="original" width="2048" height="1366" loading="lazy" alt="T20 World Cup Nepal"></figure>  Another key difference is that Nepal was batting second against England. Against Italy and the West Indies, having to set a target rather than chase it, there was miserable batting failure. The front of the order — openers Kushal Bhurtel and Aasif Sheikh, captain Rohit Poudel — did not pace themselves well. They started much too slow, not able to take advantage of the first six powerplay overs. Airee’s 58 and Sompal Kami’s 26 off 11 against the West Indies were the only innings of any note. The middle order of Bam, Jha, Aarif Sheikh was not much better. Nepal really struggled with the ball too in that game, taking the one wicket against the West Indies and none against Italy. Of course, it is a huge ask of your bowling attack to defend anything below 150 in the modern T20 game. There were questionable tactical choices. Early wickets are essential when defending a low score. But key wicket taker Sandeep Lamichhane was not brought on until the middle overs, when the opponents had made too many runs to feel any fear. So they took him on and he had a really poor tournament, going for a lot of runs.  <figure><img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260218010220_b0301b854ddf235e1bcb84e8ed58060a68c8f3f13d3bb5a7596e1f51184e0d03.jpg" data-media-id="editor_3" data-image-id="20260218010220_b0301b854ddf235e1bcb84e8ed58060a68c8f3f13d3bb5a7596e1f51184e0d03" data-rendition-name="original" width="1366" height="2048" loading="lazy" alt="T20 World Cup Nepal"></figure>  To captain Poudel’s credit, he acknowledged the bad showing against Italy: “It was not a 123 all-out wicket. We are professionals and not turning up for the game was disappointing.” Coach Law thinks that Nepal is going to get to the next step. If the team is ambitious, and hopes to compete at the elite level, then it cannot celebrate a loss against England. If it wants to win consistently, it has to shed the ‘Cardiac Kids’ nickname. It is better to win than to be fun to watch but lose. The T20 game is so brisk and so it is often won in the margins. Good catching and fielding can create momentum and save a team the 5, 10 runs that win the game. Nepal were uncharacteristically poor in the field against Italy and West Indies, often fumbling and leaking boundaries. Airee didn’t get any of his usual run-outs either. Nepal lost cheap wickets through run-outs and stumpings. All these unforced errors right through the match add up on the scoreboard.  <figure><img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260218010220_1630c283f277631dfbddd3d7f29b930b124bde97c8f6a411cc2e1d089e452f45.jpg" data-media-id="editor_4" data-image-id="20260218010220_1630c283f277631dfbddd3d7f29b930b124bde97c8f6a411cc2e1d089e452f45" data-rendition-name="original" width="1366" height="2048" loading="lazy" alt="T20 World Cup Nepal"></figure>  SKILL SET Mentality is important but sport performance ultimately comes down to skill. There looked to be a large gap, and perhaps one of the reasons is because the Nepal team is so full of all-rounders. Airee’s two-way performance is undeniable, but Bhurtel, Paudel and Karan KC do plenty of both too and they do not do it super well very often. If the team wants to get consistent, it must have consistent performers with the bat and ball. That calls for some of these players to focus completely on one skill over the other. You do not see openers bowling so much in the top teams as Bhurtel does. The main reason for this skill gap, and one of the hardest parts about being an associate nation, is how little cricket the members of the team play compared to the test nations. Said Stuart Law: “The longer format is where you learn how to play the game. The shorter formats are where you have your fun. We need some sort of multi-day games.”  <figure><img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260218010220_652ef3ba6fceab394a94c18cabd322dca8ba4a1266557660064339de9169c91d.jpg" data-media-id="editor_5" data-image-id="20260218010220_652ef3ba6fceab394a94c18cabd322dca8ba4a1266557660064339de9169c91d" data-rendition-name="original" width="2048" height="1366" loading="lazy" alt="T20 World Cup Nepal"></figure>  The contrast in experience showed during the Italy game. Most of the members of the Italy team were well into their thirties, had played a high volume of domestic cricket and were more self-assured. So, while the young Nepali team were more athletic, they seemed to lack the skill and experience to know what to do when things were going wrong. The Italians seemed to go about their game with a lot more self assurance. In the long run, this means setting up grassroot structures, getting kids into formal training when young, and setting up a longer format domestic league. In the short term, CAAN could organise frequent series with other associate nations, and individual athletes could go play long form club cricket abroad. Surely some team in the world has to have a spot for a player like Airee, for example. It has been Airee’s tournament. Scores of 44 v England, 58 v West Indies, and now a match-winning 50 against Scotland that gives the travelling Nepali support something to cheer for. The tournament could have been a lot more, but it is wholesome to end on a win.

Nepal goes in and out of T20

Chronic winter drought and decades of unmanaged forest biomass have turned wildfires into a systemic risk for Nepal. We need to re-learn to convert fire fuel in forests into fertilizer for crops.&nbsp; On 11 January, a huge forest fire spread rapidly from China into the forests of Sindhupalchok, 40km northeast of Kathmandu. The newly-opened Tatopani border checkpoint was closed. Smoke from the fire spread across central Nepal, blocking the sun.&nbsp; The fire burnt itself out within a few days, but the border stayed closed for longer. Such wildfires were once rare in mid-winter, and traditionally peaked between March and May as temperatures rose ahead of pre-monsoon showers. What is unsettling is not just the early onset of the fires, but also their scale. This shift is not accidental, the pattern has been unfolding over years due to winter drought, weakening post-monsoon moisture, and the accumulation of dry forest biomass as Nepal’s forest area doubled in the past 30 years.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2026022009024_5f4a84bb389f9b56f4fa47d4f694adcd464eb13b192d184af0f1eb20efdfeebf.jpg" data-media-id="editor_0" data-image-id="2026022009024_5f4a84bb389f9b56f4fa47d4f694adcd464eb13b192d184af0f1eb20efdfeebf" data-rendition-name="original" width="2000" height="1055" loading="lazy" alt="Wildfire season NT"> <figcaption>A NASA FIRMS image of Nepal with red dots signifying fires in February 2025.</figcaption> </figure>  Together, these factors have made forests tinder dry in spring, just waiting for a spark. Nepal has experienced winter drought in eight of the past ten years (this winter was an exception). Winter rain and snow at higher elevations play a decisive role in maintaining surface moisture, recharging shallow aquifers, and keeping forest floors damp enough to resist ignition. When winter rains fail, forests dry out months earlier than usual. Satellite-based assessments show a steep decline in surface moisture across the middle mountains of Nepal, particularly in areas with dense forest cover but limited undergrowth management. Springs that once flowed year-round are now seasonal.&nbsp; More than half of the springs in the mid-hills have either dried up or show significantly reduced discharge, a trend closely linked to declining soil moisture and disrupted recharge zones. Dry soil does not just threaten water security — it helps the vegetation ignite. FUEL WITHOUT FUNCTION For decades, Nepal’s forests have been accumulating dry leaf litter, fallen branches, shrubs, and deadwood. Historically, this biomass was not considered waste because rural households regularly collected leaf litter for livestock bedding, which was later composted and returned to farms as fertilizer.&nbsp; Forest floors were therefore relatively clean while the mulch fertilized farms. That relationship has steadily eroded due to outmigration, changes in livestock systems, restrictions on access to community forests, and the growing availability of chemical fertilisers.&nbsp; Community forests across the country today are thick with dry twigs, branches and leaves — a highly combustible carpet. When prolonged drought dries this biomass, even a small spark from a herder’s intentional fire, a cigarette, or lightning strike can trigger massive fires.&nbsp; Under such conditions, the question is no longer whether fires will occur, but how intense and widespread they will be. Forest fires are often framed as an environmental issue concerning trees and wildlife. In reality, their impact extends far beyond forest boundaries.&nbsp; Smoke travels faster and further than flames. Fine particulate matter, especially harmful PM2.5, spreads across countries. In recent fire seasons, air quality monitors in Kathmandu have recorded air quality levels several times higher than WHO guidelines. The smoke adds to Kathmandu’s own pollution and lingers for days.&nbsp; Flights are cancelled or delayed in cities like Pokhara, and poor visibility blocks mountain views affecting tourism. Health facilities report spikes in respiratory complaints, particularly among children and the elderly. Just as wildfires have multi-sectoral causes, the impact of forest fires go beyond forests. One critical dimension remains largely invisible: the soil. The fires cause silent damage beneath the ash, and the emergency does not end when the flames subside. Beneath the surface, soil suffers long-term damage. Organic matter burns away, beneficial microorganisms die. The soil structure weakens, reducing the land’s ability to absorb and retain water. The scorched earth is more prone to erosion, increasing the risk of floods and landslides once the rains return.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2026022009028_cc54ff056b2cac8b789cfd4d11afef9eaf943368e47b99aabd57c7b63b776cf2.jpg" data-media-id="editor_1" data-image-id="2026022009028_cc54ff056b2cac8b789cfd4d11afef9eaf943368e47b99aabd57c7b63b776cf2" data-rendition-name="original" width="1717" height="2143" loading="lazy" alt="Wildfire season NT"> <figcaption>Wildfire risk map based on the validated Random Forest model (a) Overall reclassified wildfire risk map of Nepal, (b) District level wildfire risk, and (c) Municipality wildfire risk map.</figcaption> </figure>  In many of Nepal’s agricultural areas, soil organic matter levels are already below 2% -- lower than what is needed for resilient and productive farming. Repeated fires push these levels even lower, undermining soil fertility and forcing farmers to rely more heavily on chemical fertilisers, unleashing a vicious cycle of higher costs and food insecurity.&nbsp; Climate breakdown is often cited as the primary culprit, and rightly so. Rising temperatures and erratic rainfall have intensified fire risk. But fires in Nepal are increasingly the result of human intervention.&nbsp; The response of all three levels of government remains too little, and too reactive. Each year, resources are mobilised to extinguish fires once they have already spread. Far less attention is paid to managing the fuel load within forest undergrowth that makes such fires inevitable.&nbsp; Meanwhile, forestry and agriculture policies are not coordinated, missing opportunities to address shared challenges. Forest fires are not natural disasters, but predictable outcomes of governance choices. National plans and climate pledges set an ambitious target of raising soil organic matter to 4%. The science behind this goal is solid. Higher organic matter improves water retention, stabilises yields, reduces fertiliser dependence, and enhances long-term food security. What remains unclear is the pathway.&nbsp; Where will the organic inputs come from? How will they be processed and applied safely at scale? Without practical answers, the 4% target risks remaining aspirational rather than achievable. Forest undergrowth can be turned into fuel and fertiliser. Biochar is produced by heating organic biomass in a low-oxygen environment, converting it into a stable form of carbon that can be added to soil.&nbsp; When properly produced and applied, it improves soil structure, enhances water and nutrient retention, supports microbial activity, and locks carbon into the ground for decades. In Nepal biochar addresses two interconnected problems: reducing the accumulation of combustible biomass in forests, lowering fire risk, while simultaneously rebuilding depleted soils. In doing so, it restores the broken link between forest management and agriculture.&nbsp; Done well, biochar is not merely an environmental intervention. It is an economic one, with potential to create local employment, reduce farmers’ input costs, and support climate-smart agriculture. But biochar propagation depends on improved governance. If promoted as isolated pilots or short-term projects, it will fail. What is needed is institutional clarity: standards for production and safety, quality control mechanisms, farmer extension services, and coordination across local, provincial, and federal levels.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2026022009028_e6e2218f38fae5b1fe81d9f99078fe01f58d04b4b3b2c41447f017c3f838a1d4.jpg" data-media-id="editor_2" data-image-id="2026022009028_e6e2218f38fae5b1fe81d9f99078fe01f58d04b4b3b2c41447f017c3f838a1d4" data-rendition-name="original" width="1536" height="2048" loading="lazy" alt="Wildfire season NT"> <figcaption>Freshly prepared biochar under control tempature (350-600°C).</figcaption> </figure>  Community forest user groups could manage biomass collection. Local governments then support safe, decentralised production units. Agricultural extension services guide farmers on application, linked to soil testing and monitoring. Such an approach would reduce fire risk, improve soil health, and generate rural livelihoods.&nbsp; Poorly produced biochar or contaminated feedstock can harm soils and human health. Without training, standards, and oversight, good intentions can backfire. Nepal needs to move beyond fire-fighting to fire prevention and confront the structural causes that make them a growing risk. It is not just a technical choice – it is one that demands political will from newly-elected leaders after March. &nbsp;&nbsp; Ngamindra Dahal is a hydrometeorologist with the Nepal Water Conservation Foundation specialising on climate and water management issues.&nbsp;

RED ALERT: Get ready for the wildfire season

Early on Monday morning, a bus from Pokhara to Kathmandu plunged off the highway in Dhading killing 19 passengers. Two weeks ago, another bus fell into the Tama Kosi in Manthali, killing 12. A few days before that a bus crash in Baitadi killed 13 people.&nbsp; In just the month before Nepal's election, more than 50 people have been killed in road traffic accidents. Most of these cannot be called 'accidents'. They are a direct result of poorly maintained highways and lack of enforcement of traffic discipline. Political parties in Nepal have rolled out their election manifestos, and voters are once again presented with a flood of promises. Page after page, these documents list megawatts and microcredit, highways and airports, jobs and investment. In these manifestos, growth is quantified, projects itemised, revenue forecast — and there are even threats to beat up contractors who do not finish their jobs. But when everything is declared a priority the stale promises are empty. The voter is left confused as to where the party’s loyalties really lie. Will any of these plans and pledges actually ever materialise and help Nepalis live longer, safer, healthier lives? The main job of any accountable government is to protect its citizens, not so much from foreign enemies but from domestic mismanagement. And this means the most basic test the new government should be made to pass is whether it can ensure basic well-being and protection for all its people. The problems of safety, health, and survival remain unresolved for most Nepalis, and are quietly eroding their lives. In the past year alone, the country’s <a href="https://nepalitimes.com/news/roadkill">roads and highways claimed more than 2,300</a> lives. An estimated 41,000 Nepalis die each year directly because of <a href="https://nepalitimes.com/here-now/what-is-invisible-is-more-dangerous">air pollution</a>, and their <a href="https://nepalitimes.com/news/air-pollution-killing-season-starts-early">lifespans are lessened by 3.4 years</a>.&nbsp; <a href="https://nepalitimes.com/editorial/poor-health">Non-communicable diseases</a> now account for well over half of total deaths in the country. And even where survival has improved, deprivation remains. Chronic malnutrition continues to haunt communities in <a href="https://nepalitimes.com/here-now/mass-migration-from-muktikot">Nepal’s western mountains</a> despite progress in maternal and child health.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260223130240_4f4ef83a31c3c4ae36ecdffb33a355e2fa3de9e98244b840a895af2d95c35ac0.jpg" data-media-id="editor_5" data-image-id="20260223130240_4f4ef83a31c3c4ae36ecdffb33a355e2fa3de9e98244b840a895af2d95c35ac0" data-rendition-name="original" width="1024" height="683" loading="lazy" alt="A life-first manifesto for Nepal NT"> </figure>  These are the lived realities of most Nepalis, and it is here that development can deliver its most immediate returns. A rising GDP, in and of itself, does not make roads safer, clean polluted air, or provide enough nutrition to children. Such outcomes demand intentional, granular policies that confront the specific, everyday problems shaping people’s lives.&nbsp; Macroeconomic growth, trade and investment are important, but these alone cannot guarantee improvements health and safety. The word ‘growth’, after all, is also synonymous with malignancy. Economic progress and human protection are correlated only when governance deliberately links them. Impact on life is the unit in which ordinary Nepalis calculate progress. What is needed, then, is a governing philosophy measurable in these same terms: a ‘life-first’ standard where every policy, budget, and reform can be understood and judged by its impact on protecting and extending human life. Such a ‘life-first’ approach would scrutinise three aspects of every policy. First, whether the policy prevents loss of life. A death is termed preventable if better, more coordinated response systems and regulations could have avoided it (vaccines, drugs, road safety, clean drinking water). A newly built six-lane highway <a href="https://nepalitimes.com/here-now/highway-accidents-are-no-accident-in-nepal">can be a death trap</a> due to poor design or lax enforcement of safety rules. If neonatal deaths continue in a district despite hospitals being present, or if malnutrition claims lives in predominantly agricultural regions, they too are failures. Preventable deaths also cluster where accountability is less direct. Just last year, <a href="https://nepalitimes.com/news/suicides-a-pandemic-within-a-pandemic">Nepal recorded 6,866 suicides</a>, with nearly 20 lives lost every day, yet these deaths fail to prompt any serious examination of governance. The same holds for fatalities linked to domestic or communal violence, alcohol and substance misuse, or ‘natural’ disasters, which register as ‘tragedies without remedy’ rather than as outcomes policy can influence. But when avoidable loss of life recurs at scale, isolated incidents become patterns, and patterns reveal systemic neglect. Saving lives, however, is only the first step, and what matters just as much is the quality of years lived. Nepal’s life expectancy now stands at 71 years, yet many citizens spend years in avoidable disability, untreated chronic illness, or mental distress. A life- first government must ask not only whether people live, but whether they thrive. Are citizens able to pursue education, work, and family life without fear of preventable harm? Do communities have access to clean air and water, nutritious food, and basic healthcare? Can a teenager anywhere in Nepal imagine a future not foreclosed by premature marriage, or untreated depression?  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260223130240_157d72b80b82a07699b6bffbb30036b86f0f767a5674cc3db3d5c20343442940.jpg" data-media-id="editor_8" data-image-id="20260223130240_157d72b80b82a07699b6bffbb30036b86f0f767a5674cc3db3d5c20343442940" data-rendition-name="original" width="2529" height="1427" loading="lazy" alt="A life-first manifesto for Nepal NT"> </figure>  Thriving requires policies that prevent suffering and promote well-being in addition to ensuring survival.&nbsp; Finally, governance must consider graceful aging. Elderly Nepalis should not be left to navigate disease, poverty, or isolation alone. Social systems, healthcare, and community support must enable their continued participation and dignified well-being. Adopting this three-layered standard would gradually reorient how success of any new government is defined. Transportation would be judged by fatalities reduced on the roads. Electricity generation would be measured by whether households can switch from firewood dependence to smoke-free electric stoves.&nbsp; Increase in annual rice harvest must translate into better nutrition, reducing the prevalence of chronic diseases like diabetes. Accountability must follow problems rather than stop at Singha Darbar. Only then will politicians and bureaucrats eventually recognise that their work converges on the same human endpoint. Critics will argue that economies are complex, trade-offs are inevitable, and that governance cannot be reduced to a single metric.But, as Acemoglu and Robinson show in their book <a href="https://ia801506.us.archive.org/27/items/WhyNationsFailTheOriginsODaronAcemoglu/Why-Nations-Fail_-The-Origins-o-Daron-Acemoglu.pdf">Why Nations Fail</a>, the key difference between prosperity and poverty lies in inclusive institutions that empower citizens and create broad incentives for well-being.&nbsp; Extractive institutions concentrate power and wealth in the hands of a few while keeping the majority trapped in neglect. Nepal’s governance has remained a striking example of extraction. If lawmakers in the new Parliament continue to resist changes that would save and improve the lives of ordinary citizens, the same systemic rot will persist for generations to come. A life-first mentality can cut through this inertia by clarifying the moral centre of governance and reminding policymakers that behind every policy failure lies human cost. <a href="https://nepalitimes.com/here-now/epicentre-of-hunger">Every mother in Bajura</a> with a child going hungry at night, every farmer in the Madhes unable to afford medical care, and every family that has lost <a href="https://nepalitimes.com/opinion/comment/saving-kidneys-to-save-nepal">a migrant son to kidney failure</a> understands the true <a href="https://nepalitimes.com/multimedia/dirty-dangerous-difficult-and-dehydrating">value of a life saved</a>. Life is the one metric that transcends ideology, ethnicity, and region. Centering governance on this single, focused metric, can shift an election from a contest of rhetoric to a contest of evidence. Which party ensured access to safe water and basic healthcare? Which made work at home and abroad safer and less exploitative. Which measurably extended healthy years of life for ordinary citizens? Health is wealth. By improving the healthy lifespan of citizens economic prosperity would follow naturally. A ‘life-first’ governance model would therefore compel Nepal to address the underlying structural failures across all sectors, rather than merely alleviating their symptoms. The GenZ protest that toppled the government last September was, at its core, a demand for accountability and a rejection of politics as usual. But as the country edges closer to the polls, that clarity has started to dissipate. Parties are now echoing the language of reform, but the public discourse remains dominated by promises that feel disconnected from Nepal’s most immediate and basic priorities. Every preventable death, every hungry child, and every neglected elder becomes a direct failure of governance and a moral debt the state must answer for. It is how we can make sure we keep the next government in check. The writers are Nepali GenZ students of biomedical engineering at the Hong Kong Polytechnic University.

Nepal’s life or death election

Party flags and banners wave from electric poles, houses and e-rickshaws are festooned with posters. Madhes Province is in the grip of election fever, and in a tour through four of its districts, there is the sense that any efforts by mainstream political parties at reforms have come too little too late. Among the banners, the sky blue of the<a href="https://nepalitimes.com/news/new-vs-new-in-nepal"> RSP is more prominent </a>here this time, and the rallying cry across the country for new and improved leadership is echoed on the ground. “For the people around here, whatever these old leaders are saying has become just noise,” says a lassi shop operator in Janakpur, waving a dismissive hand at flags with the NC’s tree symbol across the street. In Janakpur, UML nominee Raghubir Mahaseth was barred from canvassing door-to-door. Campaign posters of the mainstream parties have been torn from walls and replaced with RSP posters.&nbsp; In Inarwari village of Rautahat in the Madhes heartland, local elected officials whose parties have been merged into the Nepali Communist Party hope to retain enough supporters this election. But not many residents say they would vote for its candidate. &nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2026022005024_a793e3a19cbd536fde50708c4a41b8b0d39a4716c6973feddad889097b655641.jpg" data-media-id="editor_1" data-image-id="2026022005024_a793e3a19cbd536fde50708c4a41b8b0d39a4716c6973feddad889097b655641" data-rendition-name="original" width="1600" height="1200" loading="lazy" alt="Battleground Tarai NT"> <figcaption>Photos: SHRISTI KARKI</figcaption> </figure>  A first-time voter in Sarlahi’s Haripur is home on a semester break from medical school in Kathmandu, and is waiting excitedly for 5 March. “You can’t really say out loud whom you’re voting for around here,” he says, as he mimes ringing a bell. “It is time for someone new to be in-charge." In the highway town of Bardibas, an elderly teashop owner says that all she hears are calls for घण्टी, the RSP’s bell symbol. “After all, bells are rung in the house of gods,” she says. “It seems like the right choice.” The RSP wave sweeping the nation after the GenZ movement is seen in Madhes, and the PR ballots might reflect that, notes political analyst Tula Narayan Shah.&nbsp; “But the socio-cultural networks, organisational setup, and legacy of democratic movement of traditional parties might still give them a fighting chance on the first past the post ballot,” he says. &nbsp;“The door-to-door campaign style of candidates has always been more prominent in Madhes than elsewhere.”&nbsp; Villages like Dhankaul in Sarlahi-4 where <a href="https://nepalitimes.com/news/grand-split-in-nepal-s-grand-old-party">Gagan Thapa</a> of the Nepali Congress (NC) is running against incumbent Amresh Singh, is an NC stronghold. Singh won the election here twice before in 2013 and 2017 when he was an NC leader, and still had goodwill among NC voters when he ran and won as an independent during the 2022 election. “I voted for him twice before when he was in the NC, but he did not do anything for this or other villages. Once he is elected, he has not set foot here,” says Rajiv Yadav, a voter in Dhanakul. “The RSP will get more votes here than last time, but Gagan is sure to win. This village will vote for him.”  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2026022005024_26691bb5a37edf705cc197a632d0bf032f984079a838d31bcd943bc0b9c97ff3.jpg" data-media-id="editor_3" data-image-id="2026022005024_26691bb5a37edf705cc197a632d0bf032f984079a838d31bcd943bc0b9c97ff3" data-rendition-name="original" width="1600" height="1200" loading="lazy" alt="Battleground Tarai NT"> </figure>  Madhes is in the spotlight this election because two prime ministerial candidates have focused their attention in the region. Balen Shah began his campaign in Janakpur (main picture, left) in January as a ‘Son of Madhes’, and Gagan Thapa chose Sarlahi-4 as his constituency over Kathmandu-4, from where he has been elected since 2013.&nbsp; The Madhes has always been the battleground for Nepal’s electoral politics, and candidates from here, like Krishna Prasad Bhattarai from Parsa, Pushpa Kamal Dahal from Siraha, Jhala Nath Khanal from Sarlahi, and Madhav Kumar Nepal from Rautahat, have all been prime ministers. Despite electing politicians to high office in Kathmandu, districts of Madhes have consistently ranked low in development and service delivery indicators, especially in basic healthcare and education. Socio-economic inequalities stemming from a lack of opportunities has also meant that Madhes districts have the highest rate of out-migration in the country.&nbsp; What is different this time is that the people of the province have a Madhesi prime ministerial candidate who will represent them in national politics, and the main competition ultimately will be between the NC and RSP prime ministerial candidates. Interestingly, voters seem to be looking beyond Madhes-based parties who have historically campaigned on identity and federalism.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2026022005024_1b5c1134fb02ded72a12221200918df584b0cd003139bb2be44951efe9a65bf1.jpg" data-media-id="editor_4" data-image-id="2026022005024_1b5c1134fb02ded72a12221200918df584b0cd003139bb2be44951efe9a65bf1" data-rendition-name="original" width="1600" height="1200" loading="lazy" alt="Battleground Tarai NT"> </figure>  “Leaders of Madhes parties have glorified their struggle for votes but failed to perform on good governance at local and provincial levels,” explains Tula Narayan Shah. “Now, Balen has become a PM candidate as a face of the region, and as someone who will deliver based on his work as Kathmandu mayor.” If the RSP wins, it will be governing in the absence of provincial leadership that would play a crucial mediatory role between Kathmandu and local units. On Wednesday, RSP’s Madhes province chair Mamta Sharma resigned from the party and joined the NC. There is also some underlying tension between RSP cadre loyal to Balen Shah and Rabi Lamichhane. “It is not prudent to predict who will win the election and whether parties will deliver on promises,” says Tula Narayan Shah. “But win or lose, there is little basis at this time to believe that the RSP will be committed to making the federal system and provinces more functional.” Voters here in the heart of the federalism movement, however, are willing to give the RSP the benefit of the doubt. &nbsp;Resident Brahma Dev in Janakpur told us: &nbsp;“The RSP, like parties that came before them, deserve a chance to prove their leadership in the next five years. If they do not deliver, we can always vote them out next time.”&nbsp; On Wednesday, NC leaders unveiled the party’s 10-point election manifesto at a large rally in Janakpur (main picture, right). Gagan Thapa began by addressing a cheering crowd in Maithili, and said the NC was reformed, adding:&nbsp; “The GenZ did not reject us, they told us to change our ways.” Also on Wednesday 800km away at the other end of the country in Dhangadi, Balen Shah, in a speech that lasted just three minutes, he said: “Don’t vote for us, give us work to do.”&nbsp;