<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022111410118/637205999c7e80680e0b28c6jpeg.jpg" alt="" width="1920" height="1080"/><figcaption>When the only ambulance in Diprung Chuichumma could not attend to all the emergencies, Chair Bhupendra Rai himself drove the infected to health centres.</figcaption></figure>KhotangLast year, as Nepal plunged headlong into <a href="https://www.nepalitimes.com/banner/the-real-cost-of-nepals-second-wave/" target="_blank" rel="noopener noreferrer">the second wave</a> of Covid-19, cities around the country including Kathmandu Valley announced lockdowns, and people of Diprung Chuichumma Rural Municipality of Khotang streamed back home.The people were home, but they also brought the virus with them. The only ambulance in the municipality could not attend to all the emergencies, so Chair Bhupendra Rai donned a PPE and started driving the infected to the health centre in his own car. Sometimes, he would go door-to-door carrying patients on his back to the car.The municipality set up a 25-bed isolation centre, ramped up awareness campaigns, and carried out antigen tests. Vice-chair Sapana Rai was equally involved. Those who couldn’t be treated inside the municipality were taken to hospitals in Kathmandu and  Biratnagar.“We entered politics for the people. So, when they were suffering, we couldn’t just sit back and relax, we had to be hands-on in serving them and taking the lead from the front,” Bhupendra Rai told us on the phone from Khotang as he waits for word on <a href="https://www.nepalitimes.com/banner/dance-of-democracy/" target="_blank" rel="noopener noreferrer">the date for local elections slated for April</a>.This <a href="https://www.nepalitimes.com/latest/nepals-local-governments-lead-from-the-front/" target="_blank" rel="noopener noreferrer">local government team was proof</a> that elected grassroots politicians understand the need of their area, are more accountable, and are willing to serve their constituents.The Omicron surge is spreading, but this time there are not as many cases of Covid-19 in the village. But the Rais are not taking any chances. The municipality has increased the number of antigen tests and encouraged the infected to isolate at home.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022111410118/6372059c9c7e80680e0b28c7jpeg.jpg" alt="" width="2048" height="1152"><figcaption> </figcaption></figure>Kathmandu may have a shortage of cetamol painkillers, but there is plenty stockpiled here to meet villagers’ needs. And the municipality has deployed health volunteers to accelerate the vaccination drive.“Whoever could walk to the centre are all vaccinated, now we need to reach those who cannot come on their own,” says Rai.As schools nationwide remained closed during the lockdown, the municipality deployed more than 200 teachers with masks on who went house-to-house tutoring students. It also bought produce from local farmers who could not take it to market due to the lockdown and distributed to needy families. This ensured food security as well as income for the local farmers.When Bhupendra Rai was elected in 2017, there were not enough roads in his rural municipality. Every monsoon, the constituency would be locked in as the Sunkosi and Sapsi river flooded. Today, a motorable bridge connects this remote village to the rest of the country. Every household has electricity and access to drinking water.“All this would not have been possible without the local elections and local representatives in place, it forced us to perform,” says Rai.Tehrathum<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022111410118/6372059f9c7e80680e0b28c8jpeg.jpg" alt="" width="2048" height="1149"><figcaption> </figcaption></figure>To the east in Laligurans Municpality, Tehrathum Mayor Arjun Mabuhang also worked on connectivity as soon as he got elected five years ago. Having seen <a href="https://www.nepalitimes.com/uncategorized/elected-contractors/">rampant corruption in road contracts</a>, Mabuhang got the municipality to buy its own excavators to build roads with the help of locals, cancelling out middlemen.“Now all the wards have roads and there is ownership amongst the people because they themselves were involved in building them,” says Mabuhang.He also introduced a program to upgrade agriculture by supporting dairy farmers and offering grants for vegetable and fruit farming, poultry, and pig farms. The roads helped get the produce to market.Says the mayor: “Because I am from here and I myself have seen the ground reality and know what the people here need, I work in the areas that benefit the people most. We did what we could with the budget we were given, but we need to work more on improving schools.”Sindhupalchok<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022111410118/637205a39c7e80680e0b28c9jpeg.jpg" alt="" width="960" height="720"><figcaption> </figcaption></figure>In Sindhupalchok’s Jugal Rural Municipality, Deputy Chair Srijana Tamang has been single-mindedly working on improving education. As a child, she remembers walking for hours from home to school and back. In winter night fell quickly on her way home, and during the monsoon she would be covered from head to toe in leeches.When she was elected five years ago, one of the first things Tamang and Chair Hom Narayan Shrestha worked on was to appoint new teachers and upgrade school buildings, some of them destroyed in the earthquake.Having worked as a social worker in the past, Tamang recognised the priority areas for her rural municipality, and her background and familiarity with the people helped her not only gain an edge during the elections but prepared her to deal with the problems of her community.“When I was elected, I really wanted to prioritise roads and education, but <a href="https://www.nepalitimes.com/latest/rural-nepal-fights-back-covid-19/" target="_blank" rel="noopener noreferrer">the pandemic meant we had to address more urgent issues</a>,” adds Tamang, who offered RT PCR testing and monitored the spread of the disease, turning a local school into an isolation centre. With Omicron, Tamang believes the people are more aware, and better prepared.“The pandemic was the first big challenge for me as a local representative,” says Tamang. “But knowing that we are working for our people and our families, there is always a greater sense of responsibility.”In 2020, while Tamang was away on official business, a <a href="https://www.nepalitimes.com/here-now/deadly-monsoon-in-nepal-turns-deadlier/" target="_blank" rel="noopener noreferrer">massive landslide at Lidi</a> killed 39. She travelled overnight to help with the rescue and relief effort and got support to rehabilitate those made homeless. She got geologists to prepare a disaster risk map of her municipality to prevent future disasters, and prepare for them.Jhapa<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022111410118/637205a69c7e80680e0b28cajpeg.jpg" alt="" width="2048" height="1536"><figcaption> </figcaption></figure>Jhapa’s, Kamal Rural Municipality has the distinction of being among <a href="https://www.himalkhabar.com/news/125595?fbclid=IwAR1g00nElAMlIzStd-FiN7M-f6PZ1H3KQXE6V0f8Y4ztDNxclOSJ9KWQPZs" target="_blank" rel="noopener noreferrer">four of the 753 municipalities around the country ranked cleanest</a> in budget disbursement by the Office of Auditor General. It is a well-deserved recognition for Chair Menuka Kafle for whom tackling leakage and corruption was a priority.For any project with a budget over Rs5 million, the municipality went through a strict tender process. It also stopped giving out advances for projects and kept track of expenditure.“For the others to follow the rules, we had to lead by example, so we made sure that we were meticulous about accounting,” says Kafle.Over the last five years, the rural municipality has constructed more than 70km of roads, upgraded bridges, and ensured that all wards have electricity. Kafle distributed carts to women fruit and vegetable vendors and launched income generation activities for women.“When women are economically independent, they don’t have to depend on others and can make their own decisions,” says Kafle.The municipality offered cash incentives to encourage pregnant women to visit health centres for regular check-ups and registration of new-borns. When Kafle first got elected, many people in the community <a href="https://www.nepalitimes.com/latest/is-democracy-too-expensive-for-nepal/">did not believe that a woman could run the office</a>.During important meetings people would ignore her and seek out the male Deputy Chair. These days Kafle is in high demand.<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022111410118/637205a99c7e80680e0b28cbjpeg.jpg" alt="" width="1080" height="486">Says Kafle: “We women who are in power have to work hard to build trust in the community and do everything within our power so that women who come after us don’t face so much difficulty.”

Sahina Shrestha

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All politics is local

<figure><img width="1920" height="1080" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109121140/636b922f9c7e80680e06f133jpeg.jpg" alt=""/><figcaption>Photos: DIPRUNG CHUICHUMMA RURAL MUNICIPALITY</figcaption></figure>Sabitra Devkota of Diprung Chuichumma rural municipality in Khotang had been isolating at home for four days after testing positive for Covid-19 in late May when she fell unconscious. There was no one to take her to hospital. Devkota’s relatives informed Diprung Chuichumma rural municipality Chair Bhupendra Rai about her situation. Rai immediately drove to Devkota’s house and took her to hospital himself.Devkota is one of many Covid-positive residents of this village in Khotang district of eastern Nepal whom Chairperson Rai has helped this month. With the vice-chair Sapana Rai, the two leaders have been actively on the frontlines as the deadly second Covid wave that has battered the country’s urban hubs <a href="https://www.nepalitimes.com/latest/in-nepal-virus-climbs-from-plains-to-mountains/" target="_blank" rel="noopener noreferrer">sweeps across rural Nepal</a>.Out of 300 Covid-19 PCR tests done in the village, 93 came back positive last month. And as cases began to rise, the only ambulance operating within the municipality was unable to attend to the increased number of calls. So Bhupendra Rai donned a PPE and turned his official vehicle into an ambulance. He now drives Covid-infected patients to hospital himself, spending more time on the road than he does at his desk.Inaccessibility to roads in some areas of the municipality means that Rai’s vehicle sometimes cannot reach near enough for people to walk to. When that happens, Rai goes into their homes and carries them out to his vehicle himself.  <img width="1920" height="1080" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109121140/636b92329c7e80680e06f134jpeg.jpg" alt=""><img width="800" height="450" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109121140/636b92359c7e80680e06f135jpeg.jpg" alt="">He has to be hands-on, he explains, in order to reduce the risk of the infected person’s family members being exposed to the virus.“I wear a PPE and masks at all times, so the chances of me contracting the virus are relatively less than when relatives come in contact with infected people while helping them,” says Rai.Vice-chair Sapana Rai has been equally involved in the efforts, working with Bhupendra Rai to provide aid to Covid-positive residents, take people to get antigen tests at the temporary Covid hospital, and arrange for isolation facilities depending on the severity of individual Covid cases.<a href="https://www.nepalitimes.com/latest/a-little-help-goes-a-long-way-in-home-isolation/">A little help goes a long way in home isolation</a>, Nepali Times <figure><img width="1920" height="1080" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109121140/636b92379c7e80680e06f136jpeg.jpg" alt=""><figcaption> </figcaption></figure>The municipality has set up a 25-bed isolation centre with supplemental oxygen. “Asymptomatic individuals are told to isolate at home,” explains Bhupendra Rai, “while those who show serious symptoms are kept in this isolation facility.” The two village leaders have also been coordinating to send critically ill Covid-19 patients for treatment to Kathmandu, Dhulikhel or Charikot.Testing has also been ramped up across each tole to manage the spread of the virus before the situation gets out of hand. In fact, as health workers go <a href="https://www.nepalitimes.com/latest/rural-nepal-fights-back-covid-19/" target="_blank" rel="noopener noreferrer">door-to-door</a> conducting antigen tests, Rai is usually right alongside them. “I have been accompanying health workers to keep the morale up,” he says.<a href="https://www.nepalitimes.com/here-now/at-the-covid-19-frontlines-in-rural-nepal/">At the Covid-19 frontlines in rural Nepal</a>, Priti Thapa<iframe src="https://www.facebook.com/plugins/video.php?height=420&amp;href=https%3A%2F%2Fwww.facebook.com%2Fito.diprungmun%2Fvideos%2F868380697356377%2F&amp;show_text=false&amp;width=560&amp;t=0" width="560" height="420" style="border:none;overflow:hidden" scrolling="no" frameborder="0" allowfullscreen="true" allow="autoplay; clipboard-write; encrypted-media; picture-in-picture; web-share"></iframe>So far, 14 patients in the municipality have recovered from the disease during the second wave. Khotang is among the few districts in Nepal not under prohibitory orders. As such, the local government has advised Diprung Chuichumma residents to stay home unless strictly necessary to go outside. Additionally, they have tightened security measures, putting out an order that requires anyone entering the municipality from outside to have a negative test report.The local government has also been actively pushing out campaigns on Covid prevention. “We have been providing support to Covid-positive individuals while simultaneously running awareness programmes across the municipality,” says vice-chair Sapana Rai.Meanwhile, constant exposure to the virus has meant that Bhupendra Rai has not come in close contact with his own family in a month. Rai is diligent about showering and disinfecting when he gets home from work every day. He stays and takes his meals in a separate room, and doesn’t venture into the kitchen or to where his family gathers. Rai believes in leading from the front. “Now is not the time for us to give out orders to others while we stay in a bubble of safety,” he says. “We were elected to serve the people. If we unite now to fight this virus, there will be brighter days ahead.”Read also: <a href="https://www.nepalitimes.com/banner/nepals-doctors-are-like-soldiers-fighting-a-war/">Nepal’s doctors are like soldiers fighting a war</a>, Donatella Lorch

Nepal’s local governments lead from the front

It was pure drama: the political transition in Madhes unfolded by the dawn’s early light. At around 4AM on Monday, Province Head Sumitra Subedi Bhandari quietly departed Janakpur saying she was headed to Kathmandu for health reasons.&nbsp;
Outgoing Chief Minister Jitendra Sonal, whose coalition had begun to unravel, even saw her off, asking supporters to clear the road for her motorcade.
But an hour later, instead of continuing on to the capital, Bhandari stopped in Bardibas on the East-West Highway. There, as the sun started rising over the misty plains, she administered the oath of office to Saroj Kumar Yadav of the CPN-UML, invoking Article 168(3) of the Constitution.&nbsp;
Bhandari is also a member of the CPN-UML. The provision she invoked is typically used only after coalitions fail under Article 168(2), and the timing and location of the swearing-in have since drawn scrutiny.
Bhandari was subsequently relieved of her duties, and former National Planning Commission member Surendra Labh Karna was sworn in as the new Madhes province head on Tuesday.
Sonal had formed his government barely a month ago, with the backing of 56 provincial lawmakers but it became evident he would not secure the 54 votes needed to survive a confidence motion.&nbsp;
Several lawmakers in his coalition publicly signalled they would abstain. Still, the seven-party alliance that opposed Yadav’s appointment argues that the Province Head, who is the highest constitutional rank in the provincial structure, acted prematurely and under pressure from central UML party command.&nbsp;
A coalition of seven parties, including the Nepali Congress (NC), had been urging the Province Head to invite them to form a new government under Article 168(2). At the same time, the UML, which had been holding demonstrations outside the Province Head’s office in Janakpur, was calling for the formation of a minority government under Article 168(3).
The alliance of the seven parties that included the NC and Maoist Centre took to the streets. By mid-morning, protests had escalated outside Madhes Bhawan with cadre vandalising both the Chief Minister’s office and the Province Head’s office.
This was the third government in Madhes to fall since the 2022 provincial elections, and it follows a similar pattern. The previous Chief Minister Satish Kumar Singh of the Janamat Party, resigned before a scheduled confidence vote after losing the support of his own party and others including NC and LSP.&nbsp;
His resignation unfolded amid nationwide GenZ protests against corruption, demanding accountability and reform. The recurring instability points to a structural tension in Nepal’s federalism.&nbsp;
Provincial politics remain closely tied to alliances shaped in Kathmandu. The withdrawal of support by parties like the NC and Maoist Centre in provinces often reflects national-level calculations rather than provincial priorities.
As a result, the Provincial Assembly is repeatedly consumed by survival of the coalition instead of governance. Development work stalls. Budget execution slows. Public frustration grows. In a province that was at the forefront of the movement for federalism to counter what is seen as neglect, apathy and discrimination by Kathmandu, the sense that the system may not delivering on its promise is becoming increasingly pronounced.
If federalism is to be strengthened, provincial governments must be able to function with a degree of autonomy that currently exists more in principle than in practice. Otherwise, the perception that federalism is costly, unstable, and ineffective will continue to expand, providing fertile ground for anti-federal sentiment that is already gaining traction.
Earlier examples such as the NC General Secretary Bishwo Prakash Sharma in January calling for a new government in Madhes led by his party demonstrates how the central party leadership deliberately intervenes in provincial affairs. His remarks came during campaigns for bi-elections in Madhes when former CM Singh had been in office for six months only.&nbsp;
Likewise, in early June 2024, the federal coalition in Kathmandu shifted from a Maoist Centre and NC to form a new alliance between the NC &nbsp;and the UML. Within a day, coalition negotiations in Madhes changed to mirror this.
UML leaders publicly stated: “The issues at the federal and provincial levels will be resolved together.” This indicated that the realignment in Madhes followed national party decisions rather than provincial deliberation.
The events that unfolded in Madhes are a reminder that federalism in Nepal is still in transition, and that its success depends on political actors honouring the constitutional framework.

Chronic instability in the Madhes

You do not have to be a climate expert or atmospheric pandit to claim that Nepal is not pulling its weight on the grand narratives of the Anthropocene. As a heavily populated ‘country-on-an-incline’ from the Tarai to the Himalaya, Nepal is a thermometer of global warming.&nbsp; Its people are human witnesses to environmental and climate breakdown, but remain mute observers to the unfolding crises. Nepal should be leading the pack at the COP30 climate conference in Belém, backed by science and lived experience. But it is doubtful that two of the most crucial climate-related subjects central to the culture, economies and human wellbeing in the Himalaya and South Asia will be discussed at the summit that started this week in Brazil.&nbsp; The first topic that should be raised at COP is Black Carbon or the South Asian Brown Cloud, made up of tiny suspended particles in the air. This is not just a transboundary health hazard, there is now enough science to make the case that Himalayan snowmelt is accelerated significantly by the albedo effect that makes ice melt faster because of reduced reflectivity. But Kathmandu has not been able to make governments near and far listen. In 2014, I wrote a short piece published in Outlook magazine explaining why India’s Prime Minister Modi looking northward from a SAARC Summit retreat in Dhulikhel was unable to see the Jugal Himal range barely 30km away. His view was obscured by the pollution layer arriving from as far away as Lahore with substantial contribution from the Delhi region. That summit itself was an opportunity for Nepal to inform the Indian and Pakistani prime ministers that much of the haze, smog, dust and soot that settles on our slopes was generated in Sindh, Punjab, Punjab, Haryana, Western UP and Delhi NCR, carried by prevailing westerly winds up to the Himalaya. The forest fires within Nepal as well as Kathmandu Valley’s pollution contribute to the haze, but the shroud that suffocates the region through autumn, winter and spring is mostly transnational. Last year, these anthropogenic fine aerosols actually curled over the Bay of Bengal and invaded the airspace of Sri Lanka and Maldives.&nbsp; Even as the soot particles accelerate glacial melt and impact everything from infrastructure to public health, the most visible effect is on tourism. Nepal’s economic future is based on tourism, and much of this relies on being able to see the snow mountains. Why should travellers go to Pokhara if they cannot see the Annapurnas?&nbsp; Hoteliers in Nagarkot have started a campaign: ‘Visit Nagarkot 2025: More than Sunrise and Sunset’. While clever, the slogan is a response to the acclaimed Himalayan vista from Everest to the Annapurnas from the hill station, now obscured by the brown curtain of haze for most of the year. As the bellwether country of South Asia when it comes to the climate crisis, Nepal must build diplomatic confidence to reach out to the governments of Pakistan and India even in their present state of antagonism. Kathmandu must launch ‘haze diplomacy’ for its own sake and for the region.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251113001132_16c9941da7b31c1d4683c06dc0f8a572803240701270606848851f915140329c.jpg" data-media-id="editor_0" data-image-id="20251113001132_16c9941da7b31c1d4683c06dc0f8a572803240701270606848851f915140329c" data-rendition-name="original" width="1005" height="695" loading="lazy" alt="permafrost"> </figure>  IMPERMANENT FROST&nbsp; Permafrost is understood mostly as a phenomenon of the Arctic, Antarctica, Siberia and Alaska. Mountains elsewhere did not figure, though it was natural for the ground to freeze all year round at high altitudes.&nbsp; In the Himalaya, besides the snowfields and glaciers, frozen moisture binds rocks and stabilises slopes. But global warming is melting the permafrost that used to cement mountain flanks, including boulders, sand and scree slopes. Some of the debris (गेग्रान) did tumble down, but much of it remained entombed on high, thanks to permafrost. Pokhara Valley and the Seti River reaching all the way up to the base of the Annapurnas, is the best place to observe this dance of geology between gravity and the mountain range. Rubble from the collapse about <a href="https://nepalitimes.com/here-now/remembering-the-seti-disaster">700 years ago of paleo-Annapurna IV </a>created the sediment field on which Pokhara is situated today. However, much of the debris from the crumbled mountain is still lodged up on and around Annapurna IV, but the binding is loosening with the warming earth. A <a href="https://www.icimod.org/event/analysing-permafrost-in-the-hindu-kush-himalaya-using-open-access-tools/">2024 report by the International Centre for Integrated Mountain Development (ICIMOD)</a> indicates that global warming is thawing the permafrost across High Asia. Among the unintended consequences of climate breakdown is that mountains and moraines are collapsing, with <a href="https://www.icimod.org/press-release/everest-region-a-hotspot-of-cryosphere-linked-hazards-icimods-new-study-on-nepals-2024-thame-flood-confirms/">cascading impact</a> that includes glacial lake outburst floods, reduced groundwater recharge as well as winter flow in the Ganga, Indus and Brahmaputra. No one has calculated the total volume of rubble locked in by permafrost across the Himalaya. Despite the increased risk, there is accelerated construction of highways, hydropower projects, housing and tourism infrastructure across the Himalaya. While the COP conferences discuss rising oceans and receding glaciers (without doing much about it), Himalayan permafrost has been melting unremarked. In their path-breaking September 2024 <a href="https://nepalitimes.com/multimedia/the-not-so-permanent-frost">article in Nepali Times</a>, Wilfried Haeberli and Alton C Byers argued that the extreme events of the past few years that led to mountain and moraine collapses, unleashing destructive debris flows downstream, were the result of melting permafrost. Haeberli and Byers suggest that the avalanches and floods including those of <a href="https://archive.nepalitimes.com/article/nation/Anatom-of-a-Himalayan-tsunami,1330">Seti (2012)</a>, <a href="https://www.icimod.org/article/understanding-the-chamoli-flood-cause-process-impacts-and-context-of-rapid-infrastructure-development/">Chamoli (2021)</a>, Birendra Tal (2023), <a href="https://www.sciencedirect.com/science/article/pii/S2772883825000251">Sikkim (2023)</a>, <a href="https://nepalitimes.com/news/climate-breakdown-linked-to-thame-flood">Thame (2024)</a>, <a href="https://himat.org/publication/byers-rockfall-induced-2019/">Barun (2017)</a> and <a href="https://nepalitimes.com/banner/drones-to-the-rescue-in-melamchi">Melamchi (2021)</a> were the result of the thawing of frozen ground. They say that the collapse of the lateral moraine on the <a href="https://nepalitimes.com/news/sikkim-flood-is-warning-to-nepal">South Lhonak glacial lake</a> in Sikkim on 4 October 2023 that swept away more than 100 people, destroyed the $1 billion Chungthang Dam as well as houses, roads and farms far downstream, was also caused by cloudburst on a lateral moraine that had lost its permafrost adhesive. There will be permafrost sceptics, as there have been climate change deniers. But it is time to wake up to the reality that the Himalayan peaks are no longer the immutable sentinels as regarded by humanity since prehistoric times.&nbsp; Modern society has pumped so much greenhouse gas into the atmosphere that now even the mountains are giving up. And we have not even begun to think about the bacteria and viruses locked away in the permafrost up the slope.&nbsp; Loss of permafrost adds to the cumulative impact of climate breakdown, including extreme weather events, drought and cloudbursts, heat waves in the plains affecting lives and livelihoods, creating mass migration, social unrest, and upending politics and geopolitics. The government and polity of Nepal have a duty to themselves and the larger humanity to wake up to the climate breakdown. The Sagarmatha Sambaad conclave organised by the Government in May failed to emerge as a pulpit for global warming and associated ills. Our political class, bureaucracy and academia should make up for lost opportunities to rise to the occasion and take the lead.&nbsp; Kanak Mani Dixit is writer, commentator and founding editor of Himal Southasian.

Climate of tragedy and apathy

This is the 73rd episode of Diaspora Diaries, a Nepali Times series in collaboration with Migration Lab providing a platform to share experiences of living, working and studying abroad. I don’t remember playing with dolls as a little girl. There is not much to remember from my childhood.&nbsp; My responsibilities began at a very young age, as I had two younger brothers to take care of. I was born in Sarlahi, but we moved around quite a bit as my father was in the government and got transferred frequently.&nbsp; From Rasuwa to Dang, from Nepalgunj to Kathmandu. I struggled to adjust in Kathmandu because I joined Grade 9 in the middle of the term. The education was different and fellow students also did not support me initially. But over time, I adjusted and made friends. I did not dream of becoming a nurse. It was by accident. I wanted to pursue medicine, but failed the entrance exam by a few marks. I did not want to lose a year, so decided to take up microbiology instead.&nbsp; I got married after my undergraduate, and my husband encouraged me to take up something more technical like nursing or engineering instead of Masters in Microbiology. As my quantitative background was weak, I chose nursing. I felt like I was born to be a nurse. Juggling my married life and studies was difficult. My teachers would often ask me why I am falling behind. It was not easy, but I managed and took up a full-time job as a nurse. There are challenges being a nurse in Nepal. You are overworked, underpaid, there is lack of appreciation. Superiors can be overbearing. These problems persist. But the bright spot is that you get to serve fellow Nepalis, and be close to your family.&nbsp; Just like I had no intention initially of becoming a nurse, I had no intention of migrating overseas. But life had different plans for me. After my baby boy was born, I noticed that something was off. Even at nine months he had not started crawling or sitting. As a nurse I knew something was wrong, and I took him for check-ups. He tested negative for down syndrome, but he had a heart defect.&nbsp; The cardiologist recommended that I take him to India where he was diagnosed with Williams Syndrome, a rare genetic condition that affects 1 in 10,000 people. It delayed his development. I looked for therapy. It was either not effective, or too expensive. Some schools also refused to admit him, and it drove me to tears.&nbsp; My family members overseas in the UK, US told me to emigrate as there were better facilities for differently abled children. So I decided to apply to the UK. Luckily just then there were calls for candidates under the Nepal-UK government-to-government pilot scheme for 100 nurses. Only 40 met the criteria, and I was one of them.&nbsp; I still remember the day I received the news on the day of my puja. There were people around me, and they told me that it was the result of my fasting and devotion on that auspicious day. Perhaps it was. Life was taking a new turn, and I was happy. I made it to the UK in February 2024 without paying a single paisa to any broker. The G2G scheme was unique as we were treated with dignity and valued for our skills: they covered costs for the ticket and visa, reimbursed us for exams we had taken and costs involved in the preparation and testing of the Objective Structured Clinical Examination were also covered.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251106071148_dc5a0d0ea3024b34a4f2735754f8eb67a650bc7f61b98c75d589676c65b02a0c.jpg" data-media-id="editor_0" data-image-id="20251106071148_dc5a0d0ea3024b34a4f2735754f8eb67a650bc7f61b98c75d589676c65b02a0c" data-rendition-name="original" width="1200" height="1600" loading="lazy" alt="Nurses NT"> </figure>  It was of course difficult to leave my son behind. But I was doing it for his future. I had the option of taking him from the start, but it was a new place and I wanted to be well-settled and knowledgeable about the options available for him before bringing him along. As I packed, he would ask me to take him with me in my suitcase. It did not seem like he was affected by my departure, and it was only later that his teachers said that he would express his feelings more openly at school. He just did not know how to tell me he missed me, and he would tell teachers he was worried I had forgotten him if we did not speak for a day.&nbsp; He missed me, and that realisation made me emotional. But I had to carry on. Life in the UK was difficult in the beginning. Even so, I wanted to prove to myself that I could do it. Fortunately I had cooperative staff who patiently answered my questions. I think I would have been irritated if I were in their place. But they did not seem to mind, and their support and guidance made it easy for me to adjust to the new work environment. APPRECIATION I still struggle to understand the accent of my English patients, and have ask the matron for help. They compliment me on my English, but I can speak better than I understand. The good thing about working in the UK is that you are appreciated for your work, which can be motivating. Sometimes, after a long day’s work you get a message from your supervisor acknowledging your work with a thank you. That’s enough to erase your tiredness.&nbsp; So far I have received 32 WOW nominations which are acknowledgements from patients for a job well done. It can be motivating, especially in the beginning. The main difference between the Alpana who first left Kathmandu for the UK and the Alpana now is that I am a much more confident person. What makes a good nurse? Skills, knowledge and qualifications are of course a given. But mostly, you need humanity. A smiling face. The way you communicate. Your empathy. These attributes can already solve many problems that patients are facing. This is my second time back home in the last 20 months. And this time, I have arranged for my son’s visa. I will go back after Tihar with my son and husband.&nbsp; I am happy, but also a little nervous about what awaits us. What kind of school will I put him in? Will it really be different from schools here? Will his needs be addressed? Will it be like here, or will he be able to adjust?&nbsp; But I am determined to make it work. Success for me would be if he adjusted well and there is a change in his condition. He still cannot recognise alphabets and read words like kids in his age group. Hopefully he will get learning support in the UK. He also has a knack for music, and this is common among individuals with Williams Syndrome. His ears perk up when he hears music, and he takes part in musical events at school. He still does not recognise letters &nbsp;but he uses voice commands to search for guitar videos on YouTube. I will enrol him in music classes, and help him develop this gift. For now, I worry how he will behave on his long flight. He has a short attention span and gets restless. He is also very social and will want to speak with everyone around him, and might irritate fellow passengers.&nbsp; I have already started trying to make him understand that he will need to behave on the flight. He nods in agreement. Let’s see how it goes. &nbsp;

“I felt like I was born to be a nurse”

A month after September’s GenZ movement in Nepal, nurses working in private hospitals took to the streets demanding better work conditions, and salaries equal to what government nurses are paid.&nbsp;
The strike started at Pokhara’s Manipal Teaching Hospital before spreading nationwide, and nurses working at government hospitals joined in.&nbsp;
Nurses at private hospitals are forced to work for far less than Nepal’s minimum monthly wage of Rs19,550 — without overtime, breaks, and other benefits and under physically and mentally taxing conditions. This is driving many qualified nurses to emigrate.
For newly-appointed Health Minister Sudha Sharma Gautam in the interim government, the strike became her first order of business. She met representatives of the Nursing Association of Nepal (NAN), the protesting nurses, and others from the health sector.&nbsp;
An agreement was reached under which private hospitals and medical colleges will pay nurses a minimum monthly salary of Rs34,730. &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
“It is a shame that nurses have been working under such exploitative conditions all this time” says Radha Adhikari, at the School of Health and Life Sciences of the University of the West of Scotland. “The agreement is basic, and there is a long way to go to improve their working conditions. But it is a start.”
NAN chair Chandrakala Sharma has said the ministry’s task force to look into working conditions will also look into facilities for nurses in government hospitals.&nbsp;
“We are committed to solidifying the wage agreement by amending relevant laws within this month,” Sharma said in a video posted by NAN on Facebook. “Our movement is not over, we are still protesting and &nbsp;following up with the Ministry.”
NAN issued an ultimatum to the government to implement the agreements within 48 hours. That deadline has now lapsed and the nurses are back on strike. Many of those protesting now accuse NAN of betraying them.
Jyoti Ranabhat of the Nurses Struggle Committee was present in the meeting, but refused to sign the agreement. “It did not address what we were demanding, we will now go it alone into Plan B,” she tells Nepali Times.&nbsp;
Previous grievances of the nurses did result in similar agreements, but private hospitals failed to comply with government’s past directives — most recently the minimum salary and benefit determined by the state in December 2024.&nbsp;
The Nepal Nursing Council says there are 126,580 registered nurses, specialists, midwives, and Auxiliary Nurse Midwife (ANM) professionals in Nepal. Yet, nursing positions at hospitals remain vacant.&nbsp;
The reason for understaffing is a mass emigration of medical professionals, including nurses. Nursing student enrollment is also declining and there is disinterest in a profession that does not afford health workers quality of life, respect, or dignity.
“Our fight is not with the private sector, it is by definition profit-oriented, our grievance is with the state,” says Ranabhat. “The government is responsible to provide us dignity, respect, and fair pay.”&nbsp;
GREENER PASTURES
Poor pay and working conditions are driving doctors and nurses abroad in large numbers in recent years. Many have simply quit the profession, leading to a shortfall in medical professionals. 

The shortage of nurses is a global phenomenon, and countries like the US, UK and Australia have compensated for their own shortage by offering jobs from countries like the Philippines, India and Nepal.&nbsp;
Nepal Nursing Council data shows that outmigration of nurses rose sharply after 2002, and an estimated &nbsp;20,000-45,000 nurses have left since.
“The state’s denial, derision, and disregard of nurses has caused resentment and disillusionment in the community, driving nurses out,” says Ranabhat. “Ultimately, Nepalis will pay the price when there are no nurses left here.”
Many Nepali nurses who have gone abroad are happy with the respect and quality of life in their jobs abroad. But many others face exploitative recruiters in Nepal and employers abroad. Nursing consultancies have mushroomed as nursing colleges struggle to meet demand.&nbsp;
Adhikari herself worked at United Mission Hospital Tansen before moving to the UK 30 years ago, and remembers that working conditions then were much better for nurses.&nbsp;
“Nepal’s health sector has gone downhill since privatisation,” she states. “Medical colleges are only concerned with supplying doctors and nurses internationally, because that is what makes money.”
But once Nepal’s nurses are abroad, there is no guarantee that they will have jobs in the nursing sector. Many find themselves working outside their field of expertise, in hospitality or sales.&nbsp;
“Nepal has become a production hub for nurses, and Nepali nurses have become products for export,” adds Ranabhat. &nbsp;“People might think this will add to remittances, but no one is thinking about what will happen to Nepal’s health sector.”&nbsp;
For many, nursing has become a way out of Nepal rather than a vocation. In 2022, the government signed an agreement with the UK to send Nepali nurses to work there at zero cost, with benefits and protection equal to UK nurses.&nbsp;
The pilot phase was expected to recruit 100 nurses, and applications opened in July 2023, with 45 nurses said to be selected by Britain’s NHF representatives by the end of 2023. Forty-one of them obtained labour permits.&nbsp;
They may be treated well, but the reality of working in the international health sector is not as straightforward.
Radha Adhikari told us from Scotland: “Market saturation, exploitation, discrimination based on race, gender, and foreignness prevent nurses from finding the right, respectful jobs even here. Ultimately, migration cannot be sustainable for Nepal’s nurses.”

diprung-chuichumma-rural-municipality

All politics is local

Nepal’s local governments lead from the front

Chronic instability in the Madhes

Climate of tragedy and apathy

“I felt like I was born to be a nurse”

Nepal haemorrhaging nurses