The 14th <a href="https://www.apthc2024.org/">Asia-Pacific Travel Health Conference</a> is set to take place in Kathmandu from 18-21 September, bringing together 200 delegates from 27 countries to explore advances in <a href="https://archive.nepalitimes.com/news.php?id=19282">travel medicine</a> which have relevance for Nepal’s own tourism industry.
The biannual conference is the first in four years after its 13th iteration in New Zealand in 2020 was cancelled due to the Covid-19 pandemic. Previous conferences have been held in Bangkok and in Kathmandu in 2016.
Lessons for the travel industry from the <a href="https://nepalitimes.com/news/nepal-covid-19-impact-worse-than-official-figures">Covid-19 pandemic</a> will be prominent in the agenda of the conference in which experts from the <a href="https://www.istm.org/">International Society of Travel Medicine</a> will also be taking part. Nearly 60 of the 200 participants are from Nepal.
"The careful practice of travel medicine can be an important sentinel for diseases,” says <a href="https://nepalitimes.com/opinion/more-porters-sick-on-everest-trail">Buddha Basnyat, MD</a>, Chair of the Oxford University Clinical Research Unit-Nepal, who is part of the Nepali delegation.
The 3-day event will kick off with a day-long Pre-Conference Seminar on Adventure and Wilderness Travel, as well as separate sessions on mental health strategies and military medicine before the main events next week.
“Travel medicine is very relevant to Nepal because it has always been a desirable tourism destination,” says Pratibha Pandey, MD, of <a href="https://ciwechospital.com/">CIWEC Hospital and Travel Medicine Center</a>, which is a partner to the <a href="https://www.apths.org/">Asia-Pacific Travel Health Society</a>.
She adds: “Outbreaks of diseases like <a href="https://nepalitimes.com/banner/mosquitoes-move-up-mountains-as-the-earth-warms">dengue</a>, issues of <a href="https://nepalitimes.com/news/fatalism-and-fatalities">road and aviation safety</a>, and economic hardships have had an impact on the number of travellers coming to Nepal, which will be reflected at the conference.”
Read also: <a href="https://nepalitimes.com/news/poor-safety-to-hit-nepal-tourism">Poor safety to hit Nepal tourism</a>, Sonia Awale 
Each day of the conference will include three plenary panels, followed by parallel symposia, communication sessions, and interactive workshops. The conference will highlight special groups, including the elderly, pregnant, and otherwise immuno-compromised travellers. 
An ‘ABC’ workshop which will provide participants with the basics of setting up a clinic and explain pre-travel consultations. Other sessions include discussion about vaccines, including a plenary on the changing immunisation landscape, newer vaccine technologies, as well as a seminar on the <a href="https://www.reuters.com/business/healthcare-pharmaceuticals/japans-takeda-partners-with-indias-biological-e-boost-dengue-vaccine-production-2024-02-27/">Japanese Qdenga vaccine</a> against dengue that has not yet been licensed for use in Nepal.
Travel medicine is not just important for tourists coming to Nepal, but also for Nepalis since non-endemic infections like <a href="https://www.nature.com/articles/d41586-024-02912-6#:~:text=Mpox%20is%20caused%20by%20variants,materials%20contaminated%20with%20the%20virus.">Mpox and other diseases</a> can be brought here by visiting carriers.
“We were diagnosing dengue and typhus fever in travellers to Kathmandu who came via Rajasthan or Bangkok in the 1990s, long before these diseases became well-established in the local population,” explains Buddha Basnet, who is delivering a lecture on the <a href="https://nepalitimes.com/banner/a-shot-in-the-arm-for-vaccines-in-nepal">Typhoid Conjugate vaccine</a> and its roll-out in Nepal in one of the symposia.
The conference will also discuss airlift and emergency evacuation and a workshop on the role of the military in disaster and outbreak relief operations — both especially relevant to trekking and mountaineering in Nepal. <a href="https://nepalitimes.com/news/climate-breakdown-linked-to-thame-flood">Climate breakdown</a> has increased the need for better preparedness and rescue.
 Read also: <a href="https://nepalitimes.com/here-now/kathmandu-loses-its-open-spaces">Kathmandu loses its open spaces</a>, Tom Robertson and Nilima Thapa Shrestha
Other sessions include a plenary on sustainable travel in the age of no-jet set and <a href="https://www.nytimes.com/2023/02/06/travel/travel-climate-no-fly-pledge.html">climate guilt</a>, as 4% of greenhouse emissions are from air travel. Workshops will also look into other infectious diseases and the use of AI and Large Language Models like ChatGPT on travel medicine.
Because travel medicine specialises in diseases and health conditions that are acquired during international travel, it involves pre-travel, during travel, and post-travel consultations. Apart from the relevance of travel medicine to provide medical care to visitors to Nepal, there is also the opportunity to advance pre-travel and post-travel medicine for Nepalis.
Says CIWEC’s Prativa Pandey: “Heartbreaking as it is, migrant workers and students are leaving in droves, and many migrants are <a href="https://nepalitimes.com/opinion/comment/saving-kidneys-to-save-nepal">coming back with kidney failure</a>, about which there is very little data or research, so there is an urgent need to address those areas as well in Nepal.”
Read also: <a href="https://nepalitimes.com/news/brain-gain-into-brain-drain">Brain gain into brain drain</a>, Sonia Awale
Some of the participants include the ‘father of travel medicine’ Robert Steffan from Switzerland, Tomas Jelinek of the Berlin Centre for Travel and Tropical Medicine, editor of the Journal of Travel Medicine Annelies Wilder Smith, David Shlim who was Medical Director of CIWEC in Kathmandu 1983-1998, and <a href="https://www.ox.ac.uk/news-and-events/find-an-expert/professor-david-warrell">Sir David Warrell</a> a world expert on snake bite, rabies and infectious disease.

Shristi Karki

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Medicine on the move

<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109101156/636b796c9c7e80680e064700jpeg.jpg" alt="" width="335" height="490"/>Nepal has had three months of lead time to study the <a href="https://www.nepalitimes.com/latest/wait-and-watch/" target="_blank" rel="noopener">coronavirus pandemic</a> and behaviours that have been associated with flattening the curve of the COVID-19 infection. Every cultural circumstance has the potential to contribute a different solution, and we should attempt to link our own common practices with the pandemic to come up with <a href="https://www.nepalitimes.com/latest/all-nepal-flights-cancelled-22-31-march/" target="_blank" rel="noopener">novel ways of dealing</a> with it.One such behaviour could the Nepali habit of blowing the nose hard (seee-seee!) and the deep, loud, clearing the throat (haak-thoo!).The <a href="https://www.nepalitimes.com/opinion/global-thinking-and-local-action-on-coronavirus/" target="_blank" rel="noopener">COVID-19</a> spreads through droplets transmitted though the air from sneezing and coughing. If two people have not maintained social distancing, virus particles from an infected person may land on an uninfected companion and enter the latter’s body through her eyes, nose, or mouth. The particles then travel to the back of the nasal passages and to the mucus membrane at the back of the throat.The spiked protein of the <a href="https://www.nepalitimes.com/editorial/this-is-a-test/" target="_blank" rel="noopener">coronavirus</a> particles hook on to cell membranes at the back of the throat, and it is here that the virus’s genetic material enters the cells of the human body, resulting in infection. The symptoms of dry cough and sore throat start with this. The genetic material of the virus then uses the cells as the virus’s carriers and multipliers and starts to move down the bronchial tubes towards the lungs, where it does the most damage.If <a href="https://www.nepalitimes.com/opinion/what-is-novel-about-the-novel-coronavirus/" target="_blank" rel="noopener">coronavirus</a> particles travel to the back of the nasal passage and the back of the throat to infect the individual in question, could it be that the loud Nepali habit of blowing the nose hard and clearing the throat can contribute to reducing the numbers of infected?If this is indeed the case, all that blowing and spitting must be done in an appropriate place. Doing it in public and where others are present risks spreading the virus even more widely.Given that the coronavirus resides at the back of the nose and throat before making its way to the lungs, could it be that our first line of defense – if we should get the virus – would be to wash our faces, including our eyes, and to blow our noses and clear our throats?We should <a href="https://www.nepalitimes.com/banner/covid-19-revives-nepals-wash-drive/" target="_blank" rel="noopener">wash our hands several times a day</a>  as we have been instructed. Our hands can transfer the virus from one place to another. They can infect us if they bring the virus in contact with our own eyes, nose, or mouth, and if we are infected, they can pass the virus on by bringing the virus into contact with things that others will touch.But if the virus has in fact already found its way on to our bodies, then we will want to get it off of our bodies, and perhaps washing our faces and ejecting it from our noses and mouths – as so many Nepalis do – is the way.Once again, it is critical that we never spit or blow our noses in public places. Avoiding this restricts the spread not only of coronavirus but of major killers that have been around for much longer, such as <a href="https://www.nepalitimes.com/banner/tb/" target="_blank" rel="noopener">TB</a>  If we must blow our noses or clear our throats in public, we should blow our noses into a handkerchief which we later wash, and we must swallow our saliva. If swallowed, the virus particles would be killed by the juices in the digestive tract.Perhaps, in addition to frequent hand-washing, we should wash our faces, blow our noses and cough out several times a day as part of an anti-coronavirus regimen.Shanta Basnet has a PhD in public health from Columbia University.

Keeping nose and throat clean

Climber, expedition leader and later a supplier of bottled oxygen to Himalayan mountaineers, Henry Barclay Todd died on 3 November 2025 in his favourite place on earth, Kathmandu.&nbsp;
Todd was larger than life, a metaphor often used, yet it could not be more fitting. Standing nearly 2m tall, and possessing an unshakeable will, he lived life on a grand scale, both in body and spirit.&nbsp;
Todd was a pillar in the Himalayan climbing community, supporting many mountaineers across Nepal and Pakistan, making it possible for them to fulfil the dream of standing on the world’s highest peaks. He believed deeply in the strength, skill, and potential of the Sherpa people, and offered them opportunities that might otherwise have remained out of reach.&nbsp;
“Thank you, Henry. Your trust changed my life. Rest in peace, my leader, my teacher, my friend,” said Dorjee Gyelzen Sherpa in his tribute.
Born in 1945 to Royal Air Force officer Henry Todd and May Todd of the Women’s Royal Air Force, Henry spent his early years in Singapore. He led a lively childhood with his two brothers, far removed from the mountains that would later define his path.&nbsp;
A gifted swimmer like his father, Henry never pursued the sport professionally. Instead, after returning to Dundee as a teenager and attending seven different schools, he set off for London, where he began working for an insurance company before finding his true calling in adventure.
Henry Todd first came to Nepal in the mid-1980s and made his first attempt on Ama Dablam in 1987, an expedition that marked the beginning of an extraordinary and colourful climbing career. <a href="https://www.himalayandatabase.com/" target="_blank">The Himalayan Database</a> lists 61 expeditions that he led in Nepal alone — there were more in the Karakoram, Argentina and the Alps.&nbsp;
But Todd would joyfully say that a few hard Scottish ascents held a more personal meaning to him than even the greatest Himalayan summits.
Over the decades, he crossed paths with many legendary climbers like Anatoli Boukreev, Jerzy Kukuczka, Doug Scott and Chris Bonington as well as celebrities including members of Pink Floyd and Nobel Prize laureates whom he befriended.&nbsp;
He had a gift to never name-drop, but would simply mention that he had had lunch with Minnie Driver (niece of his long-time friend Andra) or that he had bought his first car from Donald Sutherland. For Todd, these were not bragging rights, they were simply part of the colourful tapestry of his life.
Todd’s life was filled with extraordinary experiences from surviving plane crashes, avalanches and earthquakes to quietly solving countless problems, which was one of his favourite past-times. His hands, famously large and steady, were always ready to help whether in the chaos of the mountains or the calm of a base camp.&nbsp;
With his sharp sense of humour and the beloved exclamation “Whoopie!”,he could bring lightness even to the toughest moments. He never tired of taking on challenges or helping when someone was in need, and he enriched so many people’s lives with his endless stories.
His legacy is immense. He helped build the human backbone of Himalayan climbing, enabling generations of climbers to test themselves in the world’s highest places. With his passing, an era of bold, spirited Himalayan guiding has come to a close.
Todd survived by a loving family, many close friends and a global community of climbers and Sherpas who will never forget him and his endless tales.&nbsp;
His family said in a statement: ‘Henry’s strength, warmth and unyielding belief in others will live on far above the clouds. He was indestructible in our eyes and in our hearts, he always will be.’
There will be a memorial service at Pashupati Temple in Kathmandu on 8 November 2025 around lunchtime.

Henry Barclay Todd, 80

The autumn mountaineering season is not over yet, and already there have been 12 fatalities on Himalayan peaks in Nepal.
Of the 1,450 climbing permits issued, 436 were for Mt Ama Dablam (6,812m), 374 for Mt Manaslu (8,163m) and 186 for Himlung Himal (7,126m). There were deaths on all three mountains.
The death of two French climbers on Ama Dablam happened before unseasonal blizzards hit the mountains. But Cyclone Montha from the Bay of Bengal brought on high winds and up to 1m of snow in the peak trekking and mountaineering season.
This increased avalanche conditions, and made helicopter evacuation of stranded and injured climbers difficult. Lower down the mountains, more than 1,000 trekkers from Nepal and around the world were stuck in the Annapurnas, Manaslu circuit and the Khumbu.
However, there have also been allegations that it was not just the weather that delayed rescues. Multiple levels of bureaucracy and the need for flight permits to restricted areas like Manang and Manaslu critically delayed evacuation flights.
Italian climbers Farronato Stefano and Caputo Alessandro were found dead in their tent at Panbari Himal Camp I (6,887m) in the Manaslu area. They had been trapped by heavy snowfall since 28 October, and their bodies were found on 4 November by a team from the expedition organisers, Sherpa Alpine Trekking Service. The team was made up of high level mountain guides and expedition leader Valter Perlino.
The team had been climbing to Camp 3 but decided to descend to base camp because of thrombosis in Perlino’s left foot. The two climbers who would eventually get trapped decided to break at Camp I, a decision that would prove fatal after the projected six-day snowfall arrived two days early.
“They were sleeping in a tent and were buried under 2.5 metres of compacted snow. It happened during the night between Thursday and Friday. While they were sleeping, absurd,” said Perlino.
A deadly incident took place the morning of 3 November, when five foreigners and two Nepalis died in an avalanche on Yalung Ri at 5,630m in the Rolwaling. They were part of a larger group of 15 that were acclimatising for an attempt on the nearby Dolma Khang (6,332m).
Local authorities in Gauri Shankar Conservation Area say calls were immediately made to helicopter companies as well as various ministries in Kathmandu that have to issue permits to fly to the region bordering China.
But the permits for rescue flights to Rolwaling Valley were delayed by eight hours. Rescue flights in these areas require permission from the Ministry of Tourism, the Ministry of Defence, the Home Ministry, and the Civil Aviation Authority of Nepal (CAAN).
Experts say this should be exempted in times of emergency when time is of the essence. CAAN spokesperson Pratap Babu Tiwari claimed to not know of the avalanche on Yalung Ri and deflected questions to the permission department.&nbsp;
There was a similar tragedy on Himlung Himal in Manang as well. Australian Chin-Tark Chan, 49, was climbing with 8K Expeditions and fell ill on 27 October at about 6,800m, developing snow blindness and loss of mobility. The guides immediately called the US insurance company Global Rescue for authorisation of a longline rescue.
Global Rescue refused, saying a rescue at that height would violate Nepal’s aviation rules and put the pilot at unacceptable risk. They asked the guides to transport Chan to Camp 3 at 6,400m to a permitted altitude. Seeing it was a life-or-death situation for its client, 8K called in an aerial rescue anyway, but the helicopter could not land due to bad weather. Chan died slightly below Camp 3 on 29 October.
Global Rescue said in a statement that it was ready to send in a helicopter after Chan had been transported to Camp 3, but several hours were lost for that attempt, and the weather did not get better in the next few days.
To underscore just how dangerous helicopter rescues in the Himalaya can be in bad weather, a chopper from Altitude Air skidded off the helipad at Lobuche below Mt Everest while trying to rescue trekkers in whiteout conditions.&nbsp;
CAAN announced a ban on flights during blizzards or dense fog. While rescue missions are often heroic and courageous, they should not be foolhardy if conditions are unsafe and the risk to pilots and rescuers too high. This autumn was a lesson for future expeditions and for the Nepal government.&nbsp;
The Italian duo on Panbari were caught out by snow that arrived two days ahead of schedule, but the group on Yalung Ri should have postponed their ascent after multiple warnings from the Department of Hydrology and Meteorology to avoid high altitudes.

Deadly autumn in Himalayan climbing

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.”

disease-transmission

Medicine on the move

Keeping nose and throat clean

Henry Barclay Todd, 80

Deadly autumn in Himalayan climbing

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

Nepal haemorrhaging nurses