https://youtu.be/rWChxjpei0AAn increasing number of Nepali workers in the Persian Gulf and Malaysia are dying of heat stress, and experts warn that the fatality rate could go up as the <a href="https://www.nepalitimes.com/editorial/act-globally-think-locally/" target="_blank" rel="noopener">global average temperature</a> rises in coming decades.<a href="https://www.karger.com/Article/Pdf/500853" target="_blank" rel="noopener">A recent study</a> published in the journal <a href="https://www.karger.com/Article/Abstract/500853" target="_blank" rel="noopener">Cardiology</a> presents a strong correlation between average monthly afternoon heat levels and mortality among Nepali workers in Qatar. Of the total fatalities due to cardiovascular disease (CVD) among Nepalis, 58% occurred during the summer months and 22% in winter, mostly caused by heat stress. This is much higher than the global average of 15% of total deaths in the 25-35 age group being due to CVD.Read also: <a href="https://www.nepalitimes.com/?p=30850&amp;preview=true" target="_blank" rel="noopener">His last journey home to Nepal</a>, Shankar Dahal‘There was a strong correlation between average monthly afternoon heat levels and cardiovascular disease mortality. It is likely that a large proportion of these CVD deaths during hot months were due to serious heat stroke,’ the report states.Nepali climate expert Ngamindra Dahal agrees: “<a href="https://nepalitimes.atavist.com/nepalis-killed-in-the-line-of-duty" target="_blank" rel="noopener">Deaths of Nepali migrant workers</a> in the Gulf due to excessive heat is not new, but the climate crisis has made working conditions outdoors hotter and more humid.”Read also: <a href="https://www.nepalitimes.com/?p=30810&amp;preview=true" target="_blank" rel="noopener">LABOUR PAINS</a>, Editorial<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108131156/636a52419c7e80680e0522e4jpeg.jpg" alt="" width="1400" height="778"/><figcaption>HEAT AND STRESS: Bishnu KC’s brother-in-law Keshar Khatri in his home village of Okharkot in Piuthan district preparing the cremation by the Jhimruk recently. KC died of heat stroke while working in Qatar. Pic: SHANKAR DAHAL</figcaption></figure>A <a href="https://www.nature.com/articles/nclimate2833" target="_blank" rel="noopener">study of high-resolution climate models</a> published in the journal Nature Climate Change projected that much of the Gulf region will be uninhabitable before the end of the century. The Persian Gulf is the fastest warming sea on the planet due to its shallowness, a process that is increasing humidity, making the mugginess worse.Ironically, the part of the world that is exporting most fossil-fuel energy will now feel the brunt of the greenhouse warming caused by carbon emissions.Climate simulations show that by 2090 average ‘wet bulb temperature’ – a combination of temperature and humidity – in cities like Dubai and Doha will exceed the threshold of human adaptability of 35°C, the temperature beyond which the human body is unable to survive more six hours at 70% humidity.A recent <a href="https://insideclimatenews.org/news/23072019/military-heat-death-illness-climate-change-risk-security-global-warming-benning-bragg-chaffee" target="_blank" rel="noopener">investigative report</a> by Inside Climate News and NBC News showed that at least 17 US soldiers have died of heat exposure during exercises at US military bases since 2008.Many Nepali migrant workers in the Gulf are exposed to similar conditions since they work in construction, which requires them to be outdoors all day. Many of them are not properly briefed about the dangers of dehydration, and at the end of the work day return to chilly air-conditioned rooms.Read also: <a href="http://archive.nepalitimes.com/article/nation/disproportionate-number-of-deaths-of-Nepali-workers-in-Malaysia,2812" target="_blank" rel="noopener">Dying to work in Malaysia,</a> Sonia AwaleBishnu KC from Okharkot village in Piuthan went to work in the Gulf 10 months ago. He often told his sister back home how difficult it was to work on the high scaffolding in the heat. KC came home in a coffin recently, just another of the 7,000 Nepalis who have died working overseas in the past 10 years. Others return with kidney problems, and need dialysis or transplants.Says Dahal: “This problem is going to get worse. Pre-departure orientation for workers should emphasise how to cope with heat stress, and the importance of keeping hydrated.”<h2>Dignity in life and death</h2><figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108131156/636a52459c7e80680e0522e5jpeg.jpg" alt="" width="1400" height="990"><figcaption> </figcaption></figure>Appalled by the sloppy <a href="https://nepalitimes.atavist.com/home-they-bring-the-workers-dead" target="_blank" rel="noopener">treatment of dead overseas workers</a>, Nepali activists petitioned the Supreme Court two years ago to demand autopsies to determine cause of death, and to provide a more dignified return home at Kathmandu airport.The NGOs, <a href="https://pourakhi.org.np/home/" target="_blank" rel="noopener">Pourakhi Nepal</a> and Law and Policy Forum for Social Justice, filed the public interest litigation writ demanding the right of migrant workers to a post-mortem and more respectful handover of bodies in a separate section at the airport. They won the case, but implementing agencies have been slow to act.“We are heavily <a href="https://www.nepalitimes.com/editorial/remit-for-remittances/" target="_blank" rel="noopener">dependent on remittance</a> from <a href="https://www.nepalitimes.com/banner/paying-an-arm-and-a-leg/">migrant workers</a> but where is our respect for the individuals who make it happen?” asks Manju Gurung of Pourakhi Nepal. “We do not care for their working conditions, we mistreat them and we do not even respect them after they have died. The cause of death goes uninvestigated and their bodies are unmanaged.”Activists claim that doctors in the destination countries are aware of the actual causes of the majority of these fatalities, but are often bribed by employers to pass them off as ‘natural deaths’.In addition, many workplaces do not meet even the most basic standards of safety and minimum working conditions, they say, which often leads to occupational hazards that can result in death. If the real cause of death is revealed, employers are liable to pay hefty compensation and hence to try and cover up the true causes. Most deaths are described as ‘heart failure’, ‘natural’, or ‘cardio-vascular disease’.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108131156/636a52489c7e80680e0522e6jpeg.jpg" alt="" width="1250" height="417"><figcaption> </figcaption></figure>Rising average temperatures in the Gulf region due to climate change have also increased the incidence of heat stress among those who have to work outdoors. Experts say many of the deaths of Nepali workers are due to heart failure cause by heat and overwork.Apart from the daily average 2-3 migrant workers who arrive at Kathmandu airport in coffins, many others remain in morgues in the Gulf and Malaysia. Some are workers who ran away from their first employers after being dissatisfied with their pay and working conditions. Under the kafala system, they lacked passports and became undocumented workers. Without legal documents to verify their identity, the bodies have not made it back home. No one has an exact figure of such cases.Lately, the Foreign Employment Board has updated its mandatory pre-departure orientation for migrant workers, making them more country-specific and relevant. They now include information on legal issues, working conditions and pay, cultural sensitivities and heat stress and the need to keep hydrated.Gurung blames a lack of political will for the continued apathy, because it is ordinary citizens who are affected.  She adds: “It is the poorest who suffer, so it is not a <a href="https://www.nepalitimes.com/editorial/bargaining-power/" target="_blank" rel="noopener">priority for the government</a> and our embassies in destination countries. Workers should be cared for, even after death.”

Sonia Awale

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The heat is killing us

https://youtu.be/rWChxjpei0AKeshar Khatri was pacing up and down the arrival area of Kathmandu airport one recent morning, frequently glancing up at the Arrivals monitor. It had been more than two hours since the Doha flight landed, yet there was no sign of his brother-in-law, Bishnu KC.Finally, he saw them – three grim-faced men pushing two baggage trolleys with a red box. Ten months after leaving his home village of Okharkot of Piuthan, Bishnu KC was coming home in a coffin. A few minutes later, another coffin arrived containing the body of a Nepali who had died in Saudi Arabia.Other happy returning workers rolled heavy, cellophane-wrapped suitcases as they emerged from the arrival concourse where relatives who had been waiting waved at them from behind the glass partition. There were happy reunions in the parking lot. They barely noticed the two coffins being strapped to nearby pickups.Read also:<a href="https://www.nepalitimes.com/?p=30810&amp;preview=true" target="_blank" rel="noopener">LABOUR PAINS</a>, Editorial<a href="https://www.nepalitimes.com/?p=30809&amp;preview=true" target="_blank" rel="noopener">The heat is killing us</a>, Sonia Awale<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108131156/636a528c9c7e80680e052300jpeg.jpg" alt="" width="1400" height="780"/><figcaption>SUDDEN DEATH: The coffin of Bishnu KC is wheeled out of Kathmandu Airport by his room mate Ram Bilas Yadav. All Photos: SHANKAR DAHAL</figcaption></figure><figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108131156/636a528f9c7e80680e052301jpeg.jpg" alt="" width="1400" height="787"><figcaption> </figcaption></figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108131156/636a52929c7e80680e052302jpeg.jpg" alt="" width="1400" height="1066"><figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108131156/636a52959c7e80680e052303jpeg.jpg" alt="" width="1400" height="788"><figcaption> </figcaption></figure><figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108131156/636a52989c7e80680e052304jpeg.jpg" alt="" width="1400" height="782"><figcaption> </figcaption></figure>Bishnu KC was now a statistic: just one of 670 Nepali workers overseas who died in the last 12 months, and 6,921 in the past decade, among them <a href="http://archive.nepalitimes.com/article/nation/death-of-nepali-migrant-workers-in-qatar,1592" target="_blank" rel="noopener">1,367 in Qatar alone</a>. At the nearby Departure area, other Nepalis were lining up at the special gate for overseas workers to check in for flights. At least 900 are still leaving every day, yet this number is down due to a freeze on Malaysia work permits.Ram Bilas Yadav, KC’s roommate in Qatar, accompanied the coffin and handed Khatri a bag with his brother-in-law’s belongings, including his remaining salary of 4,052 Qatari Riyal ($1,113). The certificate in Bishnu KC’s name from the public health department of Qatar stated the cause of death: ‘Died in sleep of natural cause. Heart failure.’ There was <a href="https://archive.nepalitimes.com/article/headline/Sudden-death,2797" target="_blank" rel="noopener">no post-mortem report</a>.The pickup then left on the 450km journey to Okharkot. Driver Rabin Shrestha, from Ramechhap, works as a hearse driver for the Foreign Employment Promotion Board. He exits the Valley at Thankot, driving at top speed. He says he has to return to Kathmandu to collect another coffin the next day. (See box.)<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108131156/636a529b9c7e80680e052305jpeg.jpg" alt="" width="640" height="654"><figcaption> </figcaption></figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108131156/636a529e9c7e80680e052306jpeg.jpg" alt="" width="640" height="905">Occupants of the pickup reach Bhalubang off the East-West Highway past midnight, and decide to catch some sleep in their seats. They have timed their arrival in Okharkot in the morning so KC’s family can immediately perform funeral rites. Although tired after the long ride, no one can sleep. Khatri thinks of Bishnu, who was 27 and had only his mother at home. His brother lives elsewhere, and his sisters are married, one of them to Khatri.“He was promised work in Global Link Food Service in Doha, but ended up working on a high rise construction site in 50-degree heat,” Khatri recalled. “He used to write home to his sister that he was finding the work very difficult.”There was a big crowd of relatives and neighbours when the pickup reached the village the next morning, accompanied by loud wailing as the coffin was taken out. Bishnu’s mother whispered ‘mero babu’ when she saw her son’s lifeless face, and fainted. Relatives draped the body in yellow, sprinkled vermilion and carried it to the banks of the Jhimruk for the cremation.This is the second body to be returned home to Okharkot from overseas, while Piuthan district recorded five fatalities of migrant workers last year. There is no record of the number of Nepalis working in India, although the estimates vary between 2.5 and 3.5 million. If a person from Piuthan dies in India there is no official record, and the bodies are usually not brought home.Although research on <a href="http://archive.nepalitimes.com/article/nation/disproportionate-number-of-deaths-of-Nepali-workers-in-Malaysia,2812" target="_blank" rel="noopener">Sudden Death Syndrome</a> is sparse and autopsies are rarely performed on dead workers, the causes are thought to <a href="https://nepalitimes.atavist.com/home-they-bring-the-workers-dead" target="_blank" rel="noopener">be hard work in hot and humid conditions</a>, excessively air-conditioned living quarters at night, worry about low pay, stress because of cheating by middlemen, and homesickness. Rising temperatures due to the climate emergency are also making working conditions harsher in the Gulf (see adjoining article).Although the Nepal government offers the family of every worker who dies abroad Rs700,000, the ones whose deaths are categorised as ‘natural’ are not eligible. In the past decade, the government has paid out Rs1.67 billion to the families of <a href="http://archive.nepalitimes.com/article/nation/nepali-migrants-too-young-to-die,2811" target="_blank" rel="noopener">dead workers</a>.Here on the banks of the Jhimruk, the cremation is done. Khatri finally looks through the content of his brother-in-law’s handbag. There is his passport, some letters and the death certificate that says his death was ‘natural’. “It is going to be most difficult for Bishnu’s mother,” he says. “He was the only one taking care of her.”<h2>Delivering death</h2><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108131156/636a52a19c7e80680e052307jpeg.jpg" alt="" width="1400" height="782">Rabin Shrestha’s job as a <a style="background-color: #ffffff; letter-spacing: 0.01em;" href="https://nepalitimes.atavist.com/home-they-bring-the-workers-dead" target="_blank" rel="noopener">hearse driver</a> is year-round. The reason he drove so fast from Kathmandu to Piuthan with the coffin of Bishnu KC in the back of his pickup was because he had to return to Kathmandu airport to collect another body of a dead worker the next day. Shrestha says he alone delivers 12 coffins every month all over Nepal.The task has taken Shrestha to 69 of Nepal’s 77 districts. “I have really seen the whole of Nepal on this job,” he said on the long drive to Piuthan recently. “Rain, landslides, bandhs; I have to get the bodies of the workers home one last time.”Shrestha and his colleagues mostly do the Kathmandu-Central Tarai route. That is because the highest number of fatalities of Nepali workers overseas is among those who come from the six districts of the central and eastern Tarai. Last year alone, Morang registered 35 deaths, Sarlahi 35, Dhanusha 33, Siraha 29, Mahottari 27 and Dang had 21.At the Foreign Employment Board in Kathmandu, an overworked civil servant says he is waiting for a transfer from his depressing job. He said: “My job is to keep track of which coffins are arriving on which flights, and make sure there is a hearse to receive them and take them to their home districts. It is like working in a funeral home.”

His last journey home to Nepal

<figure><img width="1400" height="1050" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108131156/636a524a9c7e80680e0522e7jpeg.jpg" alt=""/><figcaption>Pic: SHANKAR DAHAL</figcaption></figure>Nepal’s politicians are prone to hyperbole, and every decade or so they have a habit of declaring that no Nepali will have to go abroad to work. A more realistic goal would be to make migration as safe as possible, eliminate exploitation and abuse by fellow Nepalis and unscrupulous employers in destination countries, and upgrade migrants’ skills so they earn more. Migrant workers need to be treated with respect at the departure and arrival desks at the airport, as befitting their vital role in propping up this country’s economy.Read also: <a style="background-color: #ffffff; font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/?p=30850&amp;preview=true" target="_blank" rel="noopener">His last journey home to Nepal</a>, Shankar DahalOnly after we do that, and start generating infrastructure and manufacturing-driven employment through investment-friendly policies back home, can we start boasting that Nepalis don’t have to leave the country anymore to find work. Alas, we don’t see signs of that happening any time soon.   We are stuck with labour migration for the foreseeable future, and we have to make the best of it. There are signs that under Labour Minister Gokarna Bista, economic diplomacy has moved into high gear. Nepal has been playing a leading role on migration matters in South Asia, starting with the declaration at the 2015 SAARC Summit in Kathmandu of Article 21, which enjoins regional countries to collaborate for the welfare of migrant labour in destination countries.Read also: <a href="https://www.nepalitimes.com/?p=30809&amp;preview=true" target="_blank" rel="noopener">The heat is killing us</a>, Sonia AwaleThe SAARC Plan of Action on Labour Migration was adopted in May 2016, and a ministerial declaration of the ‘Colombo Process’ was made in November of that year. South Asian countries also started working together under the umbrella of the ‘Abu Dhabi Dialogue among the Asian Labour Sending and Receiving Countries’. Nepali diplomats and activists have also been active in the Global Compact on Migration, adopted last year, which seeks to ensure ‘safe, orderly and regular migration’.Read also: <a href="https://nepalitimes.atavist.com/home-they-bring-the-workers-dead" target="_blank" rel="noopener">Home they bring the workers dead</a>, Upasana KhadkaExperts at a recent roundtable organised in Kathmandu by SARTUC (South Asian Regional Trade Union Council) and the Hri Institute, and attended by advocacy and labour policy gurus, reaffirmed the natural weakness of sending countries because of competition and lack of political will to coordinate. Destination countries therefore shop for the cheapest labour, for example playing off Bangladeshis against Nepalis.To a greater or lesser degree, all South Asian labour exporting countries face the same problems of exploitation by middlemen, cheating by employers – as in the recent case of 44 Nepali women tricked into sewing jobs in China, and others rescued from a night club in Mombasa.  Although Nepali workers seem to be disproportionately affected by Sudden Death Syndrome because of heat stress, all South Asian workers have higher fatality rates for young men in that age group.Despite the hardships, Nepalis have a good reputation for hard work. Perhaps because of this, they are assigned to dangerous work on high-rise scaffoldings. Increasingly, Nepalis are also moving into the service sector and managerial positions, taking over from Filipinos.Yet, the challenges for countries heavily dependent on migrant labour, like Nepal, are growing. They include trafficking of women, and men, as in recent cases in Kenya and Libya. Tensions are brewing between Qatar and the UAE/Saudis, as well as the Saudi-Iranian conflict, an ‘Emeritisation’ happening in the UAE, and East and West African labour are displacing traditional Nepali jobs in construction and security in the Gulf. (The Kenyans come across as smarter, better-dressed and with English competence.) All these events serve to remind us that dependence on remittances is fragile, and we must have a Plan B.The idea of developing skills for Nepalis before they go overseas has been limited to rhetoric, despite tens of millions of dollars spent by donors and the government.Read also: <a href="https://www.nepalitimes.com/latest/nepal-malaysia-labour-pact/" target="_blank" rel="noopener">Nepal-Malaysia Labour pact</a>, Ramu SapkotaMedia coverage of issues related to overseas migrant labour tends to obscure the millions of Nepalis, the poorest among the migrants, who go to India. Exact figures are lacking, with Indian diplomats pointing at a high figure of 7 million. But during the Eminent Persons’ Group negotiations a more realistic 3 million figure was presented. The Pew Research Institute has placed Nepal as the seventh largest country sending remittances to India, thanks to migrant workers from Bihar, West Bengal and Odisha.In this issue, we examine Sudden Death Syndrome, and how the climate crisis will make heat stress a matter of life or death for Nepali workers in the Gulf (page 14-15). Sudden death is classified as ‘natural’ and not ‘workplace related’, preventing workers’ families from collecting insurance. The Nepal government must insist on autopsies of dead workers to pinpoint cause of death, or perform them on bodies when they arrive in Kathmandu. The coffins are also not handled with respect when they arrive via the regular baggage channel at Kathmandu Airport.Read also: <a href="https://www.nepalitimes.com/banner/kleptocrats-of-kathmandu-and-kualalampur/" target="_blank" rel="noopener">Kleptocrats of Kathmandu and Kuala Lumpur</a>, Ramu Sapkota  and Alyaa AlhadjriThe group Paurakhi has won a writ petition at the Supreme Court ordering the government to create special facilities at the airport for arriving coffins. But there has been no move to implement this.The Foreign employment Board has now upgraded its curriculum on pre-departure training to make it more relevant and country-specific. That is a welcome step to making migration safer. Let us also make it more worthwhile. 10 Year Ago This WeekIn Nepali Times 10 years ago (issue #462 of 31 July - August 6) we are reminded that there is nothing new about the annual emergency Nepal faces during the monsoon. The only difference is that it is getting worse. Excerpt from the page 1 report:‘When it rains it pours. As if the political crisis wasn’t bad enough, Nepal is going through a multi-layered economic and development emergency.But roaming the corridors of power in Singha Darbar, you wouldn’t know it. There is a cholera epidemic in western Nepal, the winter drought that destroyed the wheat crops was followed by a delayed monsoon that decimated maize and rice.This is bound to make inflation of essential food commodities even worse. It is already running between 20 and 50%, defying all economic theories, and despite the open border with India where inflation is single digit.’<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108131156/636a524e9c7e80680e0522e8jpeg.jpg" alt="" width="800" height="1225">

LABOUR PAINS

https://www.youtube.com/watch?v=ezfdhBKEtsEGrowing up in Chitwan, Radha Paudel’s father used to tell her stories of faraway Jumla: how it took weeks to walk there, the cold snowy winters, the Tila River on the banks of which were the world’s highest paddy fields. She was fascinated.Paudel became a nurse and, as luck would have it, was posted to Jumla with a safe motherhood program. The maternal mortality rate in the Karnali at the time was at sub-Saharan levels. The strict patriarchy made it an epicentre for neglected reproductive health problems among women.Read also:<a href="https://www.nepalitimes.com/?p=21465&amp;preview=true" target="_blank" rel="noopener">Nepal’s superwomen beat superstition</a>, Aruna Upreti<a style="background-color: #ffffff; font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/?p=21434&amp;preview=true" target="_blank" rel="noopener">That time of the month</a>, EditorialNepal’s armed conflict with the Maoists was at its peak, and Jumla suffered several rebel raids. Paudel witnessed the fierce one in Jumla in 2002 in which hundreds, including the CDO, DSP and civilians were killed. She survived by hiding under a bed all night as gunfire and bombs were going off outside.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108101148/636a269e9c7e80680e043a26jpeg.jpg" alt="" width="1400" height="933"/><figcaption>CODE RED: Nurse turned writer turned activist Radha Paudel discusses dignified mentruation at her work place in Kathmandu this week. Photo: BIKRAM RAI</figcaption></figure>“It was terrifying, I fainted. Then I asked myself what drove them to take up the gun. I found the answer: the class, caste and gender discrimination in the region,” Paudel recalls.She wrote a book, Khalangama Hamala (The Attack on Khalanga) that described not just the night of the <a href="http://archive.nepalitimes.com/news.php?id=4589#.XGFoddIza70" target="_blank" rel="noopener">battle</a> but the harsh condition of life for the people of Jumla. The book was awarded the <a href="https://archive.nepalitimes.com/article/review/Nurse-book-wins-Madan-Prize,1670" target="_blank" rel="noopener">Madan Puraskar</a> in 2013 and brought the plight of the <a href="http://archive.nepalitimes.com/news.php?id=3046#.XGFpl9Iza70" target="_blank" rel="noopener">Karnali</a> to national attention.After a career as nurse and writer, Paudel is now a full-time activist trying to address practices like menstruation restriction on women, which symbolise entrenched gender inequality not just in Jumla, but all over Nepal.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108101148/636a26a19c7e80680e043a27jpeg.jpg" alt="" width="1422" height="888"><figcaption> </figcaption></figure>Paudel is back with a second book Pavitra Ragat (Pure Blood), and like her first one this book also deals with blood-letting — only this time it is about the discrimination and taboos women have to face during their periods.The story began in Paudel’s own childhood, and she writes about how her mother and sisters were made to stay away from the kitchen and temples during menstruation. She had seen girls who menstruated for the first time isolated for three weeks, so when it was her turn Radha ran away from home to her sister’s place.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108101148/636a26a49c7e80680e043a28jpeg.jpg" alt="" width="1400" height="1050"><figcaption> </figcaption></figure>The book is searing in its honesty, and the practical difficulties Nepali women face during <a href="http://archive.nepalitimes.com/article/Nepali-Times-Buzz/That-time-of-the-month,3098" target="_blank" rel="noopener">adolescence</a>: not finding enough rags to soak up the blood, always worrying if the blood is leaking through clothes, and asking classmates in school if her skirt is stained, not drinking water so that she didn’t have to go to toilet and risk losing her rag…As a nurse, Paudel conducted research on <a href="https://www.nepalitimes.com/review/bloody-period/" target="_blank" rel="noopener">menstrual practices</a> and found that many rural women in Nepal did not even know about panties and pads, they bled freely all day, and in many households women took turns to use the same rags. The book is graphic, and not for the faint-hearted reader as it describes the monthly reality for <a href="http://archive.nepalitimes.com/article/nation/why-is-female-sexuality-still-a-taboo-in-Nepal,2908" target="_blank" rel="noopener">many Nepali women</a>.When Paudel got her first job, she proudly bought herself proper panties and new, clean cloth to use during menstruation. But, she realised the situation had not changed for many of her fellow-women in Jumla.Read also: <a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/removing-menstrual-shame,4148" target="_blank" rel="noopener">Removing menstrual shame</a>, Clara Hare-Grogg<a href="http://archive.nepalitimes.com/article/nation/women-speaking-out-against-chaupadi,3518" target="_blank" rel="noopener">Periods of banishment</a>, Subeksha PoudelToday, Poudel is not just spreading awareness but manufacturing <a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/pad-power-nepal,4147" target="_blank" rel="noopener">biodegradable sanitary pads</a> at a factory in Chitwan, and training young women about how to use these washable pads that do not leak.Paudel explains why it is important de-glamourise modern sanitary napkins: they are made of synthetic materials and take up to 1,000 years to degrade. Much of the plastic waste dumped by the trails in Nepal are made of discarded sanitary pads.Besides making an environmental statement, Paudel also wants to promote dignified menstruation and remove the taboo surrounding menstrual ostracisation, the practice of chhaupadi in which women in western Nepal are banished to the cow shed once a month.“Menstrual isolation is a human right violation, it isolates women by barring them from kitchens, water sources, temples, schools, and homes,” says Paudel. “This means women are treated like second class citizens, or not even human.”<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108101148/636a26a89c7e80680e043a29jpeg.jpg" alt="" width="500" height="753">Paudel is determined to also change the image of Karnali as being a backward, illiterate and primitive region. For instance, Nepal’s 2018 Criminal Code prohibits the practice of <a href="http://archive.nepalitimes.com/article/nation/period-of-banishment,3529" target="_blank" rel="noopener">banishing</a> women to chhaupadi huts during menstruation or childbirth, but does not address more general menstrual restrictions practiced all over Nepal. Limiting the crime of isolating women to <a href="https://archive.nepalitimes.com/regular-columns/GUEST-COLUMN/blood-sisters-menstruation,839" target="_blank" rel="noopener">chhaupadi</a> unfairly points the finger at only western Nepal.Women dying of suffocation or snake bites in menstrual sheds make headlines, but not the everyday humiliation women everywhere are subjected to. Paudel says the ceremonial demolition of chhaupadi huts is misdirected. “Even if you replace the huts with a 5-star hotel, that is still discrimination,” she says.<a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/removing-menstrual-shame,4148" target="_blank" rel="noopener">Menstrual shaming</a> exists all over the world, not just in Nepal. Just this month, Unicode approved a droplet of blood as an emoji to symbolise menstruation. Plan International lobbied for the emoji because its poll found that nearly half the girls and women in the UK between 14-21 were embarrassed about their periods.Across the world, women use code words when they refer to their periods, and Nepal is no different. Paudel lists some of them: chhui, chhau, nachhune, para sarne, all describing the isolation and stigma women face.Radha Paudel now wants to go beyond physical aspects of menstrual ostracisation to psycho-social and religious beliefs that make many women themselves firm believers in the taboos. Part of the reason she wrote the book is to demystify menstruation so that students, families, men and women can <a href="http://archive.nepalitimes.com/article/nation/Girl-talk-period,2377">talk about it openly</a>.Read also:<a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/pad-power-nepal,4147" target="_blank" rel="noopener">Pad Power</a>, Ziyu Lin<a href="https://www.nepalitimes.com/uncategorized/stereotyping-women-as-victims/" target="_blank" rel="noopener">Stereotyping women as victims</a>, Radha Adhikari and Jeevan Sharma

Communicating to remove menstrual taboo

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108101148/636a26849c7e80680e043a1djpeg.jpg" alt="" width="1400" height="902"/><figcaption>DEFYING TRADITION: This cow shed in Kailali used for menstural banishment. It has now been turned into a store room for rice husk.</figcaption></figure>Media reports of the practice of chhaupadi are full of harrowing tales of suffering, and women dying of cold or suffocation during their monthly exile to the cowshed.A recent trip across eight districts in Nepal’s Far West revealed a critical mass of women who are defying the practice and overcoming the superstitions that perpetuate it. Each of the women have a different reason for shunning the shed, but together they are breaking an entrenched taboo that has come to epitomise gender discrimination in Nepal.Read also:<a style="background-color: #ffffff; font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/banner/communicating-to-remove-menstrual-taboo/" target="_blank" rel="noopener noreferrer">Communicating to remote menstrual taboo</a>, Sewa Bhattarai<a style="background-color: #ffffff; font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/?p=21434&amp;preview=true" target="_blank" rel="noopener noreferrer">That time of the month</a>, EditorialIn Achham, a 23-year old girl bravely decided to stay at home, even though her mother goes to the shed. On occasions when they menstruate together, the daughter cooks food inside and takes it out for her mother. She says indignantly, “The municipality says there must be a toilet at home, but no one ever discusses that women must not be forced to live in cowsheds.”Nirmala BK, 30, is also from Achham and is an example of how a mother’s courage can help eliminate practices like chhaupadi. Since she was not allowed to cook during her periods, Nirmala’s children would walk through town carrying flour, and beg people to cook roti for them. After seeing how miserable they were, the mother resolved to stay home and cook during menstruation.Some women have supportive husbands who empowered them to break the taboo. In Bajhang one woman said her husband pressured her mother-in-law to be allowed to stay indoor during her periods. “My mother-in-law still tries to find out whether I am menstruating or not, but I just tell her a white lie that I took a medicine to stop the bleeding,” she added.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108101148/636a26889c7e80680e043a1ejpeg.jpg" alt="" width="1400" height="1057"><figcaption> </figcaption></figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108101148/636a268a9c7e80680e043a1fjpeg.jpg" alt="" width="800" height="1044">Ramaroshni Giri stays at home during menstruation for safety reasons, but has gone one step further to break the taboo about milking livestock during her periods. “If I don’t do it, the cows will not give milk, and besides, none of the cows have died,” Giri says.A teenage girl in Achham kept her monthly cycle a secret because her mother threatened to kick her out of the house if she stayed indoors.One day, coming home from school the girl was shocked to see that her younger siblings had gone hungry all day because their mother was in the shed. She flew into a rage against her mother: “Does our religion say the children have to go hungry?” After that outburst, the mother now stays home and cooks even during her periods.There is superstition that the shaman will shiver if a menstruating woman touches him. So, 35-year-old Gangadevi Bista from Doti decided to test that. Feigning an illness, Bista showed her hand to a dhami during her periods, but not a shiver from him. She made sure the whole village found out about it.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108101148/636a268d9c7e80680e043a20jpeg.jpg" alt="" width="1400" height="1149"><figcaption> </figcaption></figure><figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108101148/636a26909c7e80680e043a21jpeg.jpg" alt="" width="1400" height="778"><figcaption> </figcaption></figure>A restaurant owner in Achham has abandoned chhaupadi , saying her business would collapse if she banished herself to a shed every month. “The elders, dhami and jhankri have all eaten the food I cooked even during my periods, none of them fell sick,” she says.A Dalit woman almost lost her baby son while she was in the shed in winter. She fell asleep with her eight-month-old in the shed and they were both nearly killed by a fire. She has not gone back to the shed after that.Many equate chhaupadi with poverty, but it is a product of a deep-seated patriarchy. In spite of positive changes, the practice continues and the pain of many women proves that raising awareness alone is not enough. Chhaupadi has already been criminalised by law, and needs to be strictly enforced.Read also: <a href="http://archive.nepalitimes.com/article/nation/nation-holding-up-half-the-district,489" target="_blank" rel="noopener noreferrer">Holding up half the district</a>, Kunda Dixit<h2>Vending machine for pads</h2><figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108101148/636a26939c7e80680e043a22jpeg.jpg" alt="" width="1250" height="831"><figcaption> </figcaption></figure>Students at the Gyanodaya High School in Kathmandu do not have to worry about getting their periods while in class, forgetting to bring sanitary pads, or even skipping school for a few days every month. The school has installed a vending machine for its 1,300 female students and 75 female staff which will provide a napkin after dropping a Rs 1 coin, but the users have to pay Rs 5 to the school for the added cost.The students in Grade 6 or 7 who get their periods for the first time, often while in school, are the ones who are going to benefit the most from the vending machine, the first sanitary pad vending machine in Nepal, and Gyanodaya has established itself as a menstruation-friendly school.The school, whose students achieve one of the highest pass rates in SEE exams in the country, expects the girl students to do much better in class now that they don't have to worry about their periods so much."We used to face hassles when we would forget to bring pads, and it was troublesome to borrow from classmates, we used to have to leave school and go home," now we don't have to worry about it anymore," says Ganga Sapkota, a student.Principal Natikaji Maharjan, who also teaches science at the schoool, says the curriculum places a priority on studying reproductive health so as to remove the taboos and superstition surrounding menstruation.He says this is a pilot project, and the school hopes to set aside a budget for free distribution of the pads from next year. “It will help in spreading awareness about mestruation as being a natural biological process,” he says.From the Nepali PressShanti Tamang in Setopati.com, 14 Feburary<a style="background-color: #ffffff; font-size: 15px; letter-spacing: 0.01em;" href="https://setopati.com/social/175077?fbclid=IwAR0wvMka4BR4PCNJVDc8vJn3GdI3e_4hKTzJW-Eqa_TsJYx6LH3LVjYNn1E" target="_blank" rel="noopener noreferrer">Full story</a> in Nepali here.

Nepal’s superwomen beat superstition

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108101148/636a26669c7e80680e043a12jpeg.jpg" alt="" width="800" height="1099"/><figcaption>Illustration: DIWAKAR CHETTRI</figcaption></figure>The practice of chhaupadi in which women in western Nepal are banished to cow sheds during their periods grabs a lot of media attention within Nepal and internationally, eclipsing the much more widespread and entrenched menstrual restrictions in the rest of Nepal.As cruel and inhumane as chhaupadi is, journalistic coverage as usual tends to be event-focused, headlining only deaths due to suffocation, snakebites or exposure. There is little context to explain that the practice is now much less widespread as literacy improves, and after it was outlawed.As public health specialist Aruna Uprety <a href="https://www.nepalitimes.com/here-now/nepals-superwomen-beat-superstition/" target="_blank" rel="noopener">reports from Accham in this issue</a>, young women and mothers across western Nepal are now defying this superstition. But that is not ‘newsy’ enough for the international media.To be sure, it is a travesty that young women are still dying because they are forced to fend for themselves in the flimsy huts, where some fall prey to the cold, infections, wild animals, or rapists. Chhaupadi is cruel and an egregious violation of the human rights of women, perpetuated by conservative societal norms.Read also: <a style="background-color: #ffffff; font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/?p=21465&amp;preview=true" target="_blank" rel="noopener">Nepal’s superwomen beat superstition</a>, Aruna Upreti<a href="https://www.nepalitimes.com/?p=21456&amp;preview=true" target="_blank" rel="noopener">Communicating to remove menstrual taboo</a>, Sewa BhattaraiBut while women in western Nepal are cast out to spend four days every month in sheds, in other parts of Nepal they are confined to isolation in separate rooms. They are not allowed to cook or eat in the kitchen, cannot touch taps, and are supposed to keep off places of worship. These are not poor and illiterate women in rural Nepal, but college graduates, upper and middle class urban women in Kathmandu, and even the Nepali diaspora.Many women believe the superstition about menstrual ostracisation and willingly follow the practice, thinking crops will wither, livestock will die, cows will not give milk, or that their fathers and brothers will die if they ‘pollute’ them during their periods. Festivals like Rishi Panchami reinforce these beliefs, where women apologise for all the ‘sins’ they many have committed, even unintentionally, during menstruation.Women are also excluded from festivals and auspicious occasions, forced to find distant water sources for washing, and left out of schools and work. More damaging is the emotional toll: women feel humiliated and dehumanised as they grow up feeling powerless from a young age.Writer and menstruation activist <a href="https://www.nepalitimes.com/banner/communicating-to-remove-menstrual-taboo/" target="_blank" rel="noopener">Radha Paudel in her new book</a> released this week, Apavitra Ragat (Impure Blood), argues that all menstrual restrictions are human rights violations, not just chhaupadi. She says the demolition of chhaupadi huts and the distribution of sanitary pads, while being important interventions, do not address the continuing isolation of women during their periods, and their feelings of inferiority that it perpetuates.Read also:<a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/removing-menstrual-shame,4148" target="_blank" rel="noopener">Removing menstrual shame</a>, Clara Hare-Grogg<a href="http://archive.nepalitimes.com/article/nation/women-speaking-out-against-chaupadi,3518" target="_blank" rel="noopener">Periods of banishment</a>, Subeksha PoudelPaudel suggests that the focus should be shifted to a more holistic advocacy where all members of society accept that menstruation is not impure. For that, communication and education are key, and the campaigns must include men, as well as school teachers, health workers, faith healers and community leaders.Positive stories also need more coverage because not everything about menstruation is regressive in Nepal. Over the years, increasing numbers of women have started questioning this tradition, and have proactively and collectively broken the taboo. Education has brought about dramatic change, spreading knowledge among students and their parents about the biological reasons for menstrual blood.The accounts of women who suffer in cow sheds are tragic, but much more compelling are the brave stories of those that have countered the practice in Nepal’s most conservative communities. They prove that reform is possible, and can be brought about by the combined strength of many ordinary women fighting for justice and rights for themselves and their children. They show that courageous progressive women exist in the same places where the taboo is strongest, and where those extreme cases of deaths and despair are reported.Ultimately, dignified menstruation for women all over Nepal should focus not just on hygiene and safety through sanitary pads and alternatives to chhaupadi huts, but on making sure that women are not shamed by menstruation and are free to participate in any activity, whether or not it is ‘that time of month’.Read also: <a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/pad-power-nepal,4147" target="_blank" rel="noopener">Pad Power</a>, Ziyu Lin<a href="https://www.nepalitimes.com/uncategorized/stereotyping-women-as-victims/" target="_blank" rel="noopener">Stereotyping women as victims</a>, Radha Adhikari and Jeevan Sharma<h2>10 years ago this week</h2>Ten years ago this week, the<a href="http://archive.nepalitimes.com/news.php?id=15656#.XGZRbFUzaUk" target="_blank" rel="noopener"> Ass’ Backside Column</a> in edition <a href="http://archive.nepalitimes.com/issue/438" target="_blank" rel="noopener">#4</a>38 of Nepali Times of 13-19 February 2008 was titled “Go back to sleep’. It was a spoof on the elected Maoist government honouring the PLA anniversary. Excerpt:Go back to sleep, we’ll wake you up when things start getting really exciting around here. As things stand now, nothing is really happening. Politicians are all up to their ears in party affairs, and no one has any time for the country. The southern plains and the eastern hills have been locked down now for weeks, but PM PKD has all the time in the world to helicopter over to Panchthar to attend his army’s anniversary. Defence Minister Cloudy was off in western Nepal attending a Tharu council. This whole week, the Baddie brass has been busy getting organised for the three-day gala war anniversary in Nawalparasi. All the UML members of the cabinet, including the Hydro Minister, will be out of action for another week because of the party convention in Butwal. And next week Nepal’s Other Army will be celebrating its own Army Day on Shivaratri.<a href="http://archive.nepalitimes.com/issue/438"><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108101148/636a26699c7e80680e043a13jpeg.jpg" alt="" width="511" height="814"></a>

That time of the month

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

New year revolutions

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

What is invisible is more dangerous

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

dignity