<figure><img width="800" height="600" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221114101124/63720a059c7e80680e0b5579jpeg.jpg" alt=""/><figcaption>Photo: NEURO HOSPITAL</figcaption></figure>* A 32-year-old female patient was suddenly unable to move one side of her body. She was rushed to Upendra Devkota Memorial National Institute of Neurological and Allied Sciences (Neuro Hospital) where doctors used a new non-invasive treatment to remove a clot that was obstructing the artery supplying blood to her brain. The patient’s mobility was immediately restored and she walked out of the hospital.* A man in his mid-fifties arrived at Neuro hospital five hours after suffering a stroke. He underwent the 15-minute procedure after which he could move all of his limbs freely.The strokes could have been fatal for both patients if they had not been rushed to hospital, and if the new state-of-the-art mechanical thrombectomy procedure was not available.The prevalence of strokes in Nepal has increased 40% in the past decade, and more and more younger people are suffering the condition that could paralyse or kill them. Strokes are the third leading cause of premature deaths in Nepal, and ranks first for disabilities. A person somewhere in Nepal suffers a stroke every 20 seconds. Doctors say a changing lifestyle and <a href="https://www.nepalitimes.com/banner/nepalis-binge-on-junk-foods-the-west-rejected/">dietary habits</a>, including heavier drinking and smoking has led to an increase in <a href="https://www.nepalitimes.com/latest/why-do-so-many-nepalis-have-high-blood-pressure/">hypertension</a>, <a href="https://archive.nepalitimes.com/article/nation/diabetes-in-south-asia,3018">diabetes</a>, high cholesterol — all precursors to strokes. <figure><img width="1201" height="660" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221114101124/63720a089c7e80680e0b557ajpeg.jpg" alt=""><figcaption> </figcaption></figure>Recent studies have also reported that people infected with Covid-19 have an elevated risk of ischemic stroke, adding to the burden of disease. Other risk factors include aging, congenital heart diseases, hormonal changes and pregnancy. Women are comparatively more prone to suffering strokes.Ischemic strokes account for 85% of all cases, where an artery supplying blood to the brain is blocked damaging it. Haemorrhagic stroke, on the other hand, occurs when blood from a ruptured artery collects in the brain.“A stroke is a medical emergency, especially ischemic stroke which can lead to permanent disabilities and even death if it is not treated immediately,” says Subash Phuyal, Nepal’s first interventional neuro-radiologist at the Neuro Hospital in Bansbari.In fact, speed is of the essence to save the life or prevent life-long paralysis of a patient. But patients in Nepal often are not aware of symptoms and get to hospitals too late, where the right treatment may not be available. <figure><img width="4032" height="3024" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221114101124/63720a0b9c7e80680e0b557bjpeg.jpg" alt=""><figcaption> </figcaption></figure>Unlike a heart attack, stroke patients do not feel any pain, making it difficult to identify it. Which is why doctors have come up with the acronym BE FAST (Balance, Eyes, Face drooping, Arm weakness, Slurred speech, and Time) to identify signs of stroke in time.Patients usually experience a sudden problem with their sense of balance, have blurred vision, double vision or loss of sight in one or both eyes. There could be facial drooping, weakness or paralysis on one side of the body, and slurred speech.If a patient gets to hospital within four hours of a stroke, they are immediately given a medicine to dissolve the blood clot obstructing the artery, restoring blood flow to the brain. This treatment is effective in only 10% of patients. Read also: <a href="https://www.nepalitimes.com/banner/new-treatment-offers-hope-for-nepals-leprosy-patients/">New treatment offers hope for Nepal’s leprosy patients</a>, Sonia AwaleHowever, with mechanical thrombectomy, 90% of patients who get to hospital in time can be cured. A small incision is made in the thigh and catheters inserted using an imaging machine in the cath lab. The catheter travels along the major arteries until it retrieves the clot to allow the blood to flow again.In the case of haemorrhagic stroke, surgery to clip the blood vessel is now replaced with a method called endovascular coiling in which the catheter inserts platinum coils to block the aneurysm.This non-invasive mechanical thrombectomy was first devised in 2015, and it was already available at the Neuro Hospital in Kathmandu four years later. Its biplane cath lab has been treating up to 25 patients a month.The hospital’s founder <a href="https://www.nepalitimes.com/here-now/upendra-devkotas-lives/">Upendra </a>Devkota (see box) was determined to introduce the newly-developed endovascular treatment technology in Nepal, but did not live to see it save lives. He died of cancer in 2018. His wife Madhu Devkota completed the dream, and set up an interdisciplinary team for stroke patients. Neuro Hospital is also building a rehabilitation centre for recovering patients who often need physiotherapy.But despite having the most advanced stroke treatment in Nepal, most people are not aware of the danger signs of a stroke. They also do not know that such non-surgical treatment is available in Kathmandu. It is also not widely known that such care is available in the country, and up to half the stroke patients at Neuro Hospital are brought too late for treatment.Nepal’s topography adds to the problem of getting patients to hospital in time. Madhu Devkota suggests the government could provide an air ambulance facility, as it does for complicated maternity cases.Says Subhash Phuyal: “People must know that strokes are preventable, and that advanced treatment is available right here in Nepal. But the most important thing is to get the patient to hospital as quickly as possible.”  <img width="630" height="882" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221114101124/63720a0f9c7e80680e0b557cjpeg.jpg" alt="">Visionary doctorA young and talented doctor at Bir Hospital, Upendra Devkota, was sent on a scholarship to the Glasgow Neuroscience Institute in 1983 to train in neurosurgery. Under the guidance of the renowned Professor Graham Teasdale, Devkota proved himself among the best neurosurgeons in the world and had a bright career ahead of him in the UK.But the Gurkha-native left all that behind to return to Nepal in 1989 to set up the country’s first Neurological Trauma Unit at Bir Hospital. He worked day and night, while also training young neurosurgeons with limited resources.Devkota briefly served as the Health Minister under King Gyanendra in 2005, and a year later started setting up the National Institute of Neurological and Allied Sciences.“Many tried to dissuade us, but despite challenges we were determined to set up an institution dedicated to preventing paralysis and disabilities in Nepal,” says Madhu Devkota. “My husband had foreseen the need for an advanced neurological centre in Nepal. So we thought, if not us, who would? So, we ran with it.”Read also: <a href="https://www.nepalitimes.com/latest/why-do-so-many-nepalis-have-high-blood-pressure/">Why do so many Nepalis have high blood pressure?</a> Sonia Awale

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New cure for stroke, but prevention is key

<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221114101120/637208bb9c7e80680e0b5502jpeg.jpg" alt="" width="1487" height="1122"/>'Beauty lies in the eyes of the beholder.' In spite of this or because of it, the global beauty industry at $511 billion is one of the fastest-growing businesses and is expected to reach over $716 billion by 2025.Changing standards about what is supposed to 'look good’, and often unrealistic beauty goals dictated by influencers and celebrities on social media like Instagram and TikTok have only accelerated the trend. It is no surprise Nepal is also fast catching up.Which is why, despite the pandemic, beauty clinics and skin treatment centres in Kathmandu have seen an increased demand for nose reconstruction/rhinoplasty, double eyelid surgery/blepharoplasty, dimple creation, hair removal, breast reduction, brow lift, lip fillers, and scar removal.Read also: <a href="https://www.nepalitimes.com/banner/nepals-far-sighted-eye-care/">Nepal's far-sighted eye care</a>, Sonia Awale"The most common cosmetic surgery is blepharoplasty, where double eyelid folds are created for monolids or for dermatochalasis where upper eyelid skin sag due to aging," says surgeon Sarina Rajbhandari, who was surprised to find a lot of people coming for rhinoplasty in Nepal when she first started the practice.After learning about the prevalence of rhinoplasty, Rajbhandari decided to pursue further facial plastic surgery while continuing to practice ENT. She completed her Master's in Otolaryngology and worked at Kirtipur Cleft &amp; Burn Center.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221114101120/637208be9c7e80680e0b5503jpeg.jpg" alt="" width="1200" height="1600"><figcaption> </figcaption></figure>Facial reconstruction was a relatively new field filled with challenges in Nepal's medical scene, but the young doctor saw potential, eventually leading her on the path to becoming Nepal's first female facial plastic surgeon.Rajbhandari did her fellowship from Tri-Service General Hospital in Taiwan in 2019 under Chuan Hsiang Kao, who trained at the University of California in San Diego.She also worked under Kwon Taek Keun at AONE Clinic in South Korea, which is the new capital for facial plastic surgery in the world. She also underwent a month-long facial plastic training at Chulalongkorn University in Bangkok.Even as people opt to go under the knife to change or improve their look, the procedure is riddled with common myths, the biggest being the cost factor."The general public tends to think that only the rich can afford plastic surgery. That is not true," says Rajbhandari, adding that it is the question of want vs. need. "There is no set price for a type of surgery because everyone is different, but it is much more affordable to get the quality procedures done in Nepal than abroad."It is also important to distinguish between reconstructive and cosmetic surgeries. Facial plastic surgery has two categories. First is reconstruction, which includes trauma cases, burns, scar revision, and surgeries for congenital birth defects. The second is cosmetic, where you can change your appearance because you want to reinvent yourself.Another common misconception about facial plastic surgery is that it lasts forever, gives unrealistic results, and the recovery process is swift.A scar can be minimised but cannot be eliminated. The skin is constantly aging, so if you choose to have a facelift now, it may last just 10-15 years. It is not a one-and-done procedure. It is essential you have realistic expectations, explains Rajbhandari.It is recommended to meet with medical professionals a few times to discuss options and possibilities rather than rushing for any cosmetic treatment. It is essential that patients and clients make an informed decision before moving forward because they are essentially altering their appearance.Rajbhandari has performed an astonishing number of 'revision' surgeries after their procedures were botched. She also suggests meeting with different surgeons to see who you feel most comfortable with."People value marketing on social media over qualifications of the doctor, so it is important to check their credentials before trusting your face with one," she says. Rajbhandari herself does not perform immediate surgery, preferring to first discuss what the procedure entails, the risks, and how to take care of things afterward.<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221114101120/637208c19c7e80680e0b5504jpeg.jpg" alt="" width="1500" height="2250">She adds: "We are dealing with people's appearance that affects their self-esteem and mental health. We make sure they understand what they are doing before they go under the knife."Given the importance society places on women's beauty and the cosmetic products that primarily target them, one may think only women come for plastic surgery. A significant portion of Rajbhandari's patients is male.Despite her experience and qualifications, Rajbhandari still faces the challenges of being a young female doctor in Nepal. A lot of people still prefer to go to a male doctor for surgery. "I have had consultations with patients and clients who meet with me to talk but choose to go to a male doctor for the actual surgery," she reveals.Rajbhandari has also been judged on her own appearance. She has been called vain for putting on makeup but also called out for not making an effort despite being a facial plastic surgeon. She does not let the opinion of others affect her work, however.Read also: <a href="https://archive.nepalitimes.com/news.php?id=14071#.YgD3I-5Bz0s">Nepal's real heroines</a>, Naresh Newar"But having a supportive work environment, coworkers, and a good team makes a difference in both your professional and personal life," adds the surgeon who divides her time between Grande Hospital and Healthy Choice Clinic in Kathmandu.The Omicron surge is already subsiding in Nepal and the region, but Rajbhandari's work schedule was not much different even during the peak of the pandemic. She typically works 7-8 hours a day, but there have also been days where she worked from 6AM to 9PM and performed surgeries even on Saturdays. A supportive family is her backbone.Having said that, doctors themselves need to be healthy. She prioritises her physical and mental being. Her diet is healthy, and she eats on time. She walks regularly and religiously follows her skincare routine before bed.Sarina Rajbhandari's best recommendation as a doctor: "Invest time in yourself."Read more: <a href="https://www.nepalitimes.com/opinion/childless-by-choice/">Childless by choice</a>, Anjana Rajbhandary<a href="https://www.nepalitimes.com/review/50-outstanding-women-of-nepal/">50 outstanding women of Nepal</a>, Pratibha Tuladhar

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Going under the scalpel in Nepal

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110161148/636d1db19c7e80680e0af3d0jpeg.jpg" alt="" width="767" height="575"/><figcaption>Security personnel and relatives of the deceased attend a mourning at the premise of infectious disease hospital in Pokhara. Photos: BARSHA KAFLE</figcaption></figure>A 79-year-old woman lay on the emergency bed, diagnosed with pneumonia due to Covid-19. Even as she was gasping for breath she had a smile on her face, handing over an invitation card to the attending doctor who was also her relative.Her grandson’s wedding was four days later. Family members from across the world had flown into Pokhara for the ceremony. She died of severe acute respiratory distress syndrome with multiple organ failure a day before the wedding, and it had to be cancelled.As her physician, I had sleepless nights when her condition worsened. We <a href="https://www.nepalitimes.com/here-now/nepal-health-workers-battle-covid-19-but-also-stigma/" target="_blank" rel="noopener noreferrer">health-care workers are also human beings</a>. When we lose near and dear ones it takes a toll on our physical and mental health, we grieve when our patients die. We may hide our emotions but we suffer all the same.The woman was just one of many relatives I have lost during this pandemic. As I grieved with family members gathered at the hospital, we were once again reminded of the Buddhist teachings about impermanence. Yet none of us is ever ready.“But it must be easier for you to face death as a doctor,” one of the mourners said to me. No, it is just as difficult. If not more, because as a physician I had the added responsibility of saving her life.Army men dressed in PPE from head to toe had arrived to take her body for safe disposal. Relatives from across the world who had come to celebrate a wedding ended up attending a funeral.The Gandaki Province government established Nepal’s first provincial infectious disease hospital in July 2020. Since then, it has managed nearly 1,300 Covid-19 cases at a cost of Rs500 million.Tha Gandaki Province government established Nepal's first provincial infectious disease hospital in July 2020. Since then, it has managed nearly 1, 300 Covid-19 cases saving Rs500 million out of pocket expenditure of common people.We have lost 52 people to the coronavirus in the same period. The Covid-19 mortality rate in this provincial hospital is 4.1%, relatively high compared to the total number of people who were hospitalised.The global death rate now stands at 1.97% with a total of 5,318,277 fatalities. This figure is exceptionally high given it has only been two years. Even then, this figure does not include <a href="https://www.nepalitimes.com/banner/the-real-cost-of-nepals-second-wave/" target="_blank" rel="noopener noreferrer">the social, mental and economic consequences</a> to family and friends of the deceased.But each Covid death is also a lesson for us to learn from. Most of these deaths could have been prevented if only Nepal had a robust primary health care system, and if preventive measures were more strictly enforced.With the <a href="https://www.nepalitimes.com/here-now/omicron-may-not-be-as-risky-but-take-care/" target="_blank" rel="noopener noreferrer">rise of new variants like Omicron</a>, it is also advisable to up our vaccination drive and we should also start administering boosters to vulnerable populations given our stock of doses and those that are on the pipeline.A man in his late thirties was isolating at home in Pokhara after getting infected. He just had a common cold but I requested him to undergo hospital-based isolation as he was symptomatic. But just a few days after getting admitted, his symptoms worsened and his condition deteriorated. He was then transferred to another hospital, and died soon after.This was not a case that should have been fatal. Even after 12 years of clinical experience, some of the Covid-19 outcomes I have encountered in the past year have been unexpected and shocking. It must have been devastating for the young man’s family and friends.Earier this year, when a 86-year-old mukhiya from Mustang died at our hospital of Covid complications, hundreds of Thakalis travelled to Pokhara to show their respect to the deceased despite the coronavirus surge at the time. Young or old, the virus was indiscriminate.In November 2020, I myself had to self-isolate with an upper respiratory infection due to a coronavirus infection. I thought I would not survive the excruciating body ache, sleepless nights and high anxiety level. During those horrific 10 days at <a href="https://www.nepalitimes.com/here-now/at-the-covid-19-frontlines-in-rural-nepal/" target="_blank" rel="noopener noreferrer">Bayalpata Hospital in Achham</a> I was battling an infection that I was treating my patients for.An elderly couple had been admitted to our hospital with Covid, both of them had severe symptoms. The husband died within a few hours of admission, but his wife was not aware of his passing until she became critically ill herself, and the family decided to tell her the truth. She passed away a week after her spouse. Medical staff usually have seen it all, but so moved with sorrow they mourned too.Holistic <a href="https://www.nepalitimes.com/banner/this-is-how-to-upgrade-nepals-rural-health/" target="_blank" rel="noopener noreferrer">health care</a> is the central core of modern medicine. But the caregivers can provide only acute biomedical care to alleviate the suffering of Covid patients. Their psycho-social wellbeing and that of their family members are often ignored. And we have not even begun to think about the mental health and trauma of the frontline workers.Over 800,000 Nepalis have been infected with the coronavirus and 12,852 have died of the disease. It is time we study this data, in particular the common causes of Covid-19 deaths in Nepal. Is it heart attack, blockage of vessels in the lungs, multiple organ failure or acute respiratory distress syndrome?We must reshape our health policies based on these facts and evidence. We must ensure adequate preparation with ICU beds, oxygen supply, <a href="https://www.nepalitimes.com/latest/donated-ventilators-gather-dust-in-nepal/" target="_blank" rel="noopener noreferrer">ventilators</a> and other equipment that were in short supply earlier this year.Only then can we design a robust and customised care system to protect our population from future surges.Bikash Gauchan is the Executive Director of the Infectious and Communicable Disease Hospital in Gandaki Province.

Diary of a Covid frontline worker in Nepal

<figure><img width="760" height="486" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110914114/636ba5ae9c7e80680e0736dajpeg.jpg" alt=""/><figcaption>Govinda KC, Nepal’s crusading surgeon and health activist, plastering a patient's ankle at the Mugu District Hospital on Sunday. He saw 177 patients for free in five days before travelling on to Jumla on foot. Photos: ACHYUTRAJ BHANDARI</figcaption></figure>Health reform <a href="https://www.nepalitimes.com/banner/risking-his-life-to-save-lives/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/banner/risking-his-life-to-save-lives/&amp;source=gmail&amp;ust=1597224179931000&amp;usg=AFQjCNFQK2JWnimNdv8w4s23TLpC78KGKQ">activist Govinda KC</a>, who has been on 17 hunger strikes to pressure the government to make medical care more affordable, has been holding free clinics for patients in hospitals and COVID-19 isolation wards in western Nepal ever since the pandemic started.KC arrived in Gamgadi on 5 August after walking two days from Jumla, and immediately started free consultations with patients, performing emergency operations at the Mugu District Hospital. He has seen 177 patients since then, and performed three operations.<a href="https://archive.nepalitimes.com/regular-columns/One-To-Many/Truth-be-told%20,749" data-saferedirecturl="https://www.google.com/url?q=https://archive.nepalitimes.com/regular-columns/One-To-Many/Truth-be-told%2520,749&amp;source=gmail&amp;ust=1597224179931000&amp;usg=AFQjCNFtSQBKZtB-vcam4Nsz2wAtqOnl4A">KC is himself an orthopaedic surgeon</a>, and has made it his life’s mission to make medical care free and accessible to the Nepalis who need it the most. His hunger strikes were protests against <a href="http://archive.nepalitimes.com/blogs/kundadixit/page/5/" data-saferedirecturl="https://www.google.com/url?q=http://archive.nepalitimes.com/blogs/kundadixit/page/5/&amp;source=gmail&amp;ust=1597224179931000&amp;usg=AFQjCNHY_jV_4K2jz-1PFUWl9VPIgc1DvA">government interference in the health sector</a>, and <a href="http://archive.nepalitimes.com/article/editorial/Kleptocracy-kills,3161" data-saferedirecturl="https://www.google.com/url?q=http://archive.nepalitimes.com/article/editorial/Kleptocracy-kills,3161&amp;source=gmail&amp;ust=1597224179931000&amp;usg=AFQjCNH9lmHQky6NGRYp5QvehHAAxtSGGQ">collusion between politicians and tycoons</a> involved in medical education that was driving up costs.  As word spread that KC had arrived at the Mugu District Hospital last week, patients from surrounding villages started pouring into Gamgadi to have relatives examined. He has also been training resident surgeons on surgical procedures.“For us, he is god,” said 17-year-old Gagan Bham from Rara, whom KC operated on for a fracture in his ankle. <img width="1050" height="635" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110914114/636ba5b09c7e80680e0736dbjpeg.jpg" alt="">Also from Rara is 10-year-old Reshma Bham who had broken her hand while grazing livestock last year. KC operated on her, and straightened out her arm which is now plastered and in a sling.“We lived up in the mountains and did not have the money get her treated. We were afraid our daughter would be disabled for life, Dr KC was sent here by god,” said Reshma’s mother Danta, who added that she had heard about KC’s arrival by chance on the radio.After working without a break for 12 hours a day, on Monday KC returned on foot to Jumla.  KC has been on a tour of remote northwestern Nepal, where health care is neither accessible not affordable for a majority of people. The need for medical attention has gone up since quarantine centres and isolation wards have been set up for COVID-19 patients in the region, most of whom are returnees from India.KC has not been welcomed everywhere. Last month, a government health post in Rimi of Dolpo district refused to let the crusading doctor see patients there, saying he did not have government permission.  KC nevertheless saw some patients before travelling on to Bajura.One of KC’s hunger strikes was in Jumla two years ago where he demanded that medical colleges should be opened in every province in Nepal, and he wanted the Karnali Institute of Health Sciences to be the centre for Karnali Province. He broke his hunger strike after government assurances in 2018. But seeing no progress has been made to fulfil that demand, last month in Jumla he threatened to go on another hunger strike.

Govinda KC treats patients in remote Nepal

Devprakash Tripathi in Ghatana ra Bichar, 29 JanuaryNCP Co-chair Pushpa Kamal Dahal recently expressed strong support for the sovereignty of Venezuela’s elected communist government, and denounced foreign intervention, particularly that of the United States. This is ironic because his own political trajectory has depended on foreign intervention and support. As a rebel, Dahal sought shelter abroad while perpetrating violence in his home country. His signing of national agreements while in foreign land was already an open invitation for interference. Even when he was in power, Dahal pursued the agendas of foreign powers to support his own power.Historically, Dahal has shown no respect for Nepal’s sovereignty. He was involved in demolishing statues of Prithvi Narayan Shah, was irreverent of poet Bhanubhakta Acharya and other figures regarded as Nepal’s national heroes. Yet, Dahal is in effusive admiration of Marx, Lenin, Stalin and Mao who in no way contributed to Nepal’s development. Dahal’s statements are hypocritical, and inconsistent with his own past.There is speculation that Dahal issued the statement to regain China’s diminishing trust in him after his India visit. This was evident in the way the Chinese snubbed him on a recent trip to China. This latest statement calling for international support of Venezuela’s communist government may be intended to convince China that his communist stance is still intact.

A conflicting stance

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108101144/636a252e9c7e80680e0439b4jpeg.jpg" alt="" width="1000" height="507"/><figcaption>Photo: YOYOKHABAR</figcaption></figure>Nagarik, 31 JanuaryDoctors across the country have taken to the streets to protest the government’s inaction on Govinda KC’s demands and his deteriorating health. The House of Representatives passed the Medical Education bill on 25 January, amidst opposition, without addressing KC’s demands of reforms in medical education. Doctors, united under the leadership of Nepal Medical Association, have begun a relay hunger strike to pressurise the government.KC is on his 16th fast-unto-death at the TU Teaching Hospital at Maharajganj. His health is said to be critical after not eating for more than three weeks and he has difficulty breathing due to chest pains. Decreasing white blood cell count has put his life at grave danger. The amount of oxygen, glucose, and potassium in KC’s body has also decreased, he has trouble sleeping and is vulnerable to infections. KC needs to be treated in an Intensive Care Unit (ICU) but has refused to go to there.KC has been fasting since 10 January, asking the government to implement the agreement made with him after his 15th fast. But after the government prepared the Medical Education bill in contradiction of the agreement, KC began his current fast. The government claims that the bill fulfills KC’s demands.Nepal Medical Association says that doctors in major cities like Biratnagar, Dharan, Janakpur, Chitwan, Birgunj, Butwal, Pokhara, Nepalganj, Dhangadi and others have carried out protests in support of KC, and medical professionals working in Primary Health Care Centers have joined them.On Wednesday, former Chief Justice Sushila Karki visited KC and expressed her solidarity with his movement. “Not fulfilling Dr. KC’s demands would be a loss to the entire nation, and his victory is the victory of 30 million Nepalis,” she said as she asked the government to fulfill his demands.

Doctors solidarity with Govinda KC

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221107121140/6368ef229c7e80680e035962jpeg.jpg" alt="" width="1500" height="997"/><figcaption>Dr Bhampa Rai with his wife Urmila Rai on Thursday. Photo: Gopal Gartaula</figcaption></figure>In the early 1990s, Bhutan's royal regime <a href="http://archive.nepalitimes.com/regular-columns/On-the-way-up/Nepal-lhotshampa-rohingya,1046" target="_blank" rel="noopener">forced out nearly 75,000 of its Nepali-speaking Lhotshampa people</a>, and with the help of the Indian authorities dumped them in Nepal’s Jhapa district.The refugees were housed in seven camps in Jhapa and Morang districts and spent the next two decades there until they were <a href="https://www.nepalitimes.com/banner/live-together-work-together/" target="_blank" rel="noopener">repatriated to third countries</a> after Bhutan refused to take them back.Bhutan evicted one-sixth of its population, and this is regarded as the largest expulsion in recent history of a people by any country in terms of the size of the original population.Bhampa Rai's family formed part of that massive refugee population. However, unlike other refugees, he was not hounded out of Bhutan. He joined the exodus because he could not bear the pain inflicted upon his people by the Bhutanese government.Rai was the royal family physician in Thimphu, and the Bhutan government asked him not to leave. But he refused to stay back, saying he was needed more by the refugees in the camps than by the royal family.After spending a few months in West Bengal, Bhutanese refugees were chased away by India as well. They first lived in makeshift camps along the Mechi River where they battled with hunger, wildlife attacks and disease outbreaks. Rai did all he could to save ailing refugees, providing free treatment and medicines for them.Later, when they were shifted to the seven camps supported by the UN High Commission for Refugees (UNHCR), Rai set up a clinic in Damak and continued to provide free health care not just for Bhutanese refugees but also for poor Nepalis. He turned down all lucrative job offers, dedicating his life to the people his country had made stateless.Most of the refugees for whom Rai sacrificed his life have now been <a href="http://archive.nepalitimes.com/article/Nepali-Times-Buzz/resettled-former-Bhutanese-refugee-hold-on-to-their-roots,3043" target="_blank" rel="noopener">resettled down in the United States</a>, Europe and Australia. Some 6,000 older refugees remain, <a href="http://archive.nepalitimes.com/article/Nepali-Times-Buzz/camps-for-Bhutanese-refugees-are-emptying-but-some-want-to-return-home,2748" target="_blank" rel="noopener">hoping some day to be allowed back to their homeland</a>. The <a href="http://archive.nepalitimes.com/article/nation/Bhutanese-refugees-resettlement-program-ending-in-2018,4121" target="_blank" rel="noopener">UNHCR is closing down its last remaining camp</a>.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221107121140/6368ef259c7e80680e035963jpeg.jpg" alt="" width="1500" height="1100"><figcaption> </figcaption></figure>But Rai, now 68, is penniless and battling cancer. His wife Urmila Rai's kidneys have failed, and she needs dialysis twice a week. They are destitute and abandoned.In 2004, Rai told this reporter he would not opt for third-country resettlement, and he has remained true to his word. His dying wish is to be able to return to Bhutan, but Thimphu has turned down repeated requests from the UN.On Tuesday, members of civil society held a function in Kathmandu to raise money for the treatment of the Rai couple. He sent a message to the meeting that he was more concerned about repatriation of the remaining refugees rather than his own life.Prakash Angdembe, a filmmaker, says the central character of his award-winning movie Desh Khojdai Jada (In Search of a Nation) was inspired by the life of Bhampa Rai."I have never met a more self-less and iron-willed person than him,” Angdembe said. “It is heart-breaking to see such a great soul in misery."Rai never asked for anything for himself, but sent a letter to the Nepal government, requesting for free dialysis for his wife — a facility that poor Nepalis can get. However, she is not Nepali, and is not entitled to free treatment.Prime Minister K P Oli is from the same town in Jhapa where the Rais served their compatriots and Nepalis for nearly three decades.Says journalist Devendra Bhattarai who is also from Jhapa: "PM Oli knows who Bhampa Rai is and what he has done, I wonder why he is not coming forward to help the couple.”Ironically, Prime Minister Oli has himself had a kidney transplant and needs constant medical attention.Donors who want to contribute to the Rai couple can contact editors@nepalitimes.comRead also: <a href="http://archive.nepalitimes.com/article/nation/Bhutanese-refugees-resettlement-program-ending-in-2018,4121" target="_blank" rel="noopener">The end of the road for Bhutan's refugee</a>s, Jenna Kunze<a href="http://archive.nepalitimes.com/regular-columns/On-the-way-up/Nepal-lhotshampa-rohingya,1046" target="_blank" rel="noopener">Lhotshampa, Rohingya</a>, Kanak Mani Dixit<a href="http://archive.nepalitimes.com/article/Nepali-Times-Buzz/camps-for-Bhutanese-refugees-are-emptying-but-some-want-to-return-home,2748" target="_blank" rel="noopener">The 100,000th refugee</a>, Gopal Gartaula

No one to care for doctor who cared for everyone

Nepal’s only international aviation gateway, at Kathmandu airport, will cut night-time operation hours to allow construction of taxiways, and airlines have been told to curtail flights. This is expected to lead to more than normal chaos during the height of peak autumn and spring tourist seasons at an airport that is congested even at the best of times. The airport will close from 10PM to 8AM from 8 November-31 March 2025. The taxiways will now connect to the thresholds at both ends of the runway, making the airport more efficient in handling higher frequencies of landings and takeoffs. The parallel taxiway extension will allow international flights to land every 4 minutes instead of the current every 7 minutes. At present planes have to wait to land until a plane taking off backtracks along the runway.&nbsp; Kathmandu is Nepal’s only airport with international operations, and it has only one runway that is only one way in from the south over the mountains. With the taxiway improvement, the airport will be able to handle 42 aircraft landings and takeoffs per hour — double the current capacity.&nbsp; The Civil Aviation Authority of Nepal (CAAN) has been trying to entice international airlines to also start flying to and from the other two international airports at Pokhara and Bhairawa (Lumbini) by slashing landing and handling charges. But so far only Nepal Airlines operates a weekly flight to Bhairawa from Kuala Lumpur.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241018161016_046569e53d1d66cd445cc66c697c0ef724810aec9f54bdf827481e3cd6b80c32.jpg" data-media-id="editor_0" data-image-id="20241018161016_046569e53d1d66cd445cc66c697c0ef724810aec9f54bdf827481e3cd6b80c32" data-rendition-name="original" width="2356" height="1134" loading="lazy" alt="Kathmandu airport expansion"> <figcaption>Kathmandu Airport Expansion plan with extension of taxiways to the thresholds of runways 02 and 20 that will limit airport operations from 8 November 2024 - 31 March 2025. Areas in blue are existing structures, including the international terminal which in future will be the domestic airport, and the new international terminal near the north end of the runway,</figcaption> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241018121028_6e17cc2ee87c1b02d78cb54905825b7aa15299b7a00f5eddb01a59579ab85c1a.jpg" data-media-id="editor_1" data-image-id="20241018121028_6e17cc2ee87c1b02d78cb54905825b7aa15299b7a00f5eddb01a59579ab85c1a" data-rendition-name="original" width="1353" height="1328" loading="lazy" alt="Kathmandu airport NT"> </figure>  CAAN has reportedly told international airlines to cut their flight frequency to Kathmandu citing the shorter operation hours and has told budget airlines to shift some of their flights to Pokhara or Bhairawa, or face cuts. Many airlines currently operate regular flights to and from Kathmandu between 10PM and 8AM: Air Arabia to Sharjah, Fly Dubai to Dubai, Jazeera Airways to Kuwait, Cathay Pacific to Hong Kong, Singapore Airlines, several Nepal Airlines flights, and one of four daily flights by Qatar Airways to Doha. Jazeera Airways, FlyDubai, and Thai AirAsia have applied and got permission from CAAN to begin regular flights to Bhairawa’s Gautam Buddha International Airport. Starting 9 November, FlyDubai will start making a stopover in Bhairawa before flying on to Kathmandu. Immigration, customs and security are all fully functional in Bhairawa. In Kathmandu, the next phase of the airport upgrade includes converting the current international terminal for domestic operations, the construction of a new international terminal where the domestic departure area is now, as well as moving the hangars and the Nepal Army Air Wing to the eastern side of the runway. The apron area will also double its parking space for widebody jets. This is part of a Airport Capacity Enhancement Project that was initially funded through a $80 million loan from the Asian Development Bank (ADB), and the entire masterplan is expected to cost $800 million. This project is the latest upgrade to Nepal’s only international airport since it saw its first flight in 1949. The current international and domestic terminals are too small to handle the current annual traffic volume of 8.5 million passengers a year that is growing at 20% a year.

Kathmandu airport to cut flight hours

As Kathmandu becomes more congested and polluted, and with remote online work becoming the norm, many professional Nepalis are planning to retire in Pokhara, or move there.&nbsp; With its stunning mountain panorama, balmy winters and proximity to a profusion of wilderness areas, builders are responding to this demand with new townhouses, housing development and apartments. One such block of flats is the 10-storey <a href="https://sungavaapartment.com/">Sungava Apartment</a> located at Phulbari above the Seti River, near the point where it flows into and under Pokhara. The imposing structure near Manipal Hospital is almost complete, and on a recent visit the site was strewn with huge boulders unearthed while digging the foundation.&nbsp; The Seti brought down these boulders during a gigantic flood that geologists estimate happened 800 years ago when a chunk of Annapurna IV broke off and ploughed into the glacier below. Today, Sungava (means ‘orchid’) sits safely on a high terrace, 100m above the blue-green Seti and commands a view of Dhaulagiri, Annapurna South, Machapuchre, Annapurna III and IV.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2024102411104_5f8fc736c86ea3c08d7bef43bb727081d3cc1a2caa55ae2b441717e6044de7e9.jpg" data-media-id="editor_1" data-image-id="2024102411104_5f8fc736c86ea3c08d7bef43bb727081d3cc1a2caa55ae2b441717e6044de7e9" data-rendition-name="original" width="2016" height="1512" loading="lazy" alt="High living below the Himalaya NT"> </figure>  The soil here is conglomerate that has solidified like concrete, and the boulders were extracted by heavy earthmovers. It is intriguing to think that these metamorphic rocks as big as cars, rounded by glacial grinding, were once a part of a much higher Annapurna IV. Even for those with little interest in geology, Sungava is an ideal place to contemplate the tectonic forces that pushed these peaks into the sky to be sculpted into delicate shapes by wind, snow, earthquake and avalanche over millions of years. The view of the Himalayan panorama from Sungava’s many balconies are breathtaking when not obscured by clouds, or the haze that drifts in from across the southern border. On most days, just watching the towering pyramid of Machapuchre (Tamu name: कतासुँ क्लिको) play hide and seek with the clouds is mesmerising. There are rocks aplenty at Phulbari, and it is probably the flowers that grew along the flat terraces e that gave the place its flowery name. The boulders will hopefully be turned into a rock garden while landscaping. An nearby restaurant complex is making the best use of the stones in its design, using flat rocks as outdoor benches and tables. Sungava was designed by the husband-wife architect team of Deepak Sherchan and Jyoti Joshi of <a href="https://thedarkmermaidamarbshrestha.blogspot.com/2013/12/creative-builders-collaborative-cbc.html">Creative Builders Collaborative (CBC)</a>, which also built Heritage Plaza, Indreni Apartment and numerous other projects in Nepal. Sadbhavana retains CBC’s trademark Newari-style masonry and here it borrows from the orange brickwork of the old town of Pokhara, integrating it with modern design elements. A few of those heritage houses are still standing in Ganesh Tole and Ram Krishna Tole in Pokhara’s old quarter.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2024102411108_5eb64a4885961b6d30781cefeb1e8a313da313ac5227c7a66b60f0c7d48d6fab.jpg" data-media-id="editor_3" data-image-id="2024102411108_5eb64a4885961b6d30781cefeb1e8a313da313ac5227c7a66b60f0c7d48d6fab" data-rendition-name="original" width="1362" height="595" loading="lazy" alt="High living below the Himalaya NT"> </figure>  About 400m from the apartment past a bend on the river, and down below three tiers of terraces in the canyon is a suspension bridge. Below it, the Seti is still swollen with post-monsoon flow as it tumbles away in a hurry to head down south.&nbsp; Back at the apartment, it is quiet, far away from the hubbub of Lakeside a 15 minute drive away, and in the lap of greenery. There are 52 units at Sungava and it already has a close-knit prospective community of professionals, including doctors, publishers, engineers, and businesspeople from the renewable energy and IT sectors.&nbsp; Some residents say they opted for a second home in Pokhara to make it a ‘base camp’ to explore the Annapurnas with its many hiking trails made newly accessible with new roads. With the NRN citizenship law, overseas Nepalis can now also buy the flats. &nbsp; The floor plans include options for north and south-facing 3-bedroom apartments with verandas, and the facility has underground parking has EV charging, heated pool, sauna and gym. There are still some unsold apartments with panoramic views of the mountains and one can imagine oneself at the kitchen with its huge window, humming a ditty while preparing breakfast: “खाना पकाउँ हिमाल हेरेर...”

High living below the Himalaya

When the United Nations held its Summit of the Future at its headquarters in New York in September, many world leaders, including Nepal’s Prime Minister K P Oli, highlighted the effect of climate breakdown in increasing the frequency and intensity of natural disasters. What did not get as much attention was the long term impact of the climate crisis on food production. In fact, heat stress, weather extremes and the consequences on rain-fed agriculture is already being felt worldwide, undermining the chances of the <a href="https://unstats.un.org/sdgs/">UN’s Sustainable Development Goals (SDGs)</a> being met by 2030.&nbsp; The SDG’s 17 targets commit countries like Nepal to reduce poverty and inequality, end malnutrition, protect the natural environment, and ensure that citizens all enjoy health, justice and prosperity without leaving anyone behind.&nbsp; However, besides the impact of climate breakdown on agricultural production, in Nepal the area under cultivation is impacted by urban expansion, falling productivity and the need for expensive inputs like fertiliser and pesticides.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241019041052_626413c5baf4dae407ac9579231b41daeb51510aa636b75aeb7489d94cca6a62.jpg" data-media-id="editor_1" data-image-id="20241019041052_626413c5baf4dae407ac9579231b41daeb51510aa636b75aeb7489d94cca6a62" data-rendition-name="original" width="999" height="1500" loading="lazy" alt="urban agriculture in Kathmandu"> <figcaption>Kathmandu's urban sprawl is eating into its fertile cultivable lands. Photo: TAYLOR MASON</figcaption> </figure>  Now, a new study led by Nepali researcher Prajal Pradhan at the University of Groningen in The Netherlands looks at how urban agriculture may offer a solution to falling food production and meeting SDG targets. The researchers evaluated 1,450 publications exploring the contributions of urban agriculture with both positive and negative effects, and published their findings in the journal Cells Report Sustainability. Urban agriculture can help achieve 17 SDGs, positively influencing 81 targets. However, it could also undermine 51 goals.&nbsp; Read also: <a href="https://nepalitimes.com/here-now/the-vanishing-land">The vanishing land</a>, Taylor Mason “Urban agriculture offers immense potential for sustainable development, but realising this potential depends crucially on adopting practices that minimise its adverse effects while maximising its benefits,” Pradhan explains. Urban agriculture can substantially enhance urban food security, provide employment to the urban poor, serve as ground water recharge in built-up areas, and preserve open spaces that can serve as safe havens during disasters like earthquakes. However, it also presents problems like the potential health risks from contamination and the need for expensive inputs. &nbsp; “Urban agriculture plays a definitive role in advancing the SDGs, but achieving this requires tailored, context-specific solutions that address the unique challenges of different regions,” says Yuanchao Hu of Wuhan University in China and who is a researcher at the Potsdam Institute for Climate Impact Research. “But it needs equitable access and rigorous management of environmental risks.”&nbsp; Rapid urbanisation is eating into Nepal’s most fertile agricultural land, which means farming in remaining open spaces inside cities can be a viable alternative, especially as food prices rise.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241019041052_7b7c9413086226fbdc630d45acf772cfa1ced77a8970b9056ec5ec7e5226fdf8.jpg" data-media-id="editor_3" data-image-id="20241019041052_7b7c9413086226fbdc630d45acf772cfa1ced77a8970b9056ec5ec7e5226fdf8" data-rendition-name="original" width="1500" height="999" loading="lazy" alt="urban agriculture in Kathmandu"> <figcaption>A vegetable patch in between new houses in Thimi. Photo: TAYLOR MASON</figcaption> </figure>  “The conversion of Nepal’s most fertile land into cities is a severe problem,” Pradhan told Nepali Times. “Crop cultivation, horticulture, agroforestry, beekeeping, livestock rearing, or aquaculture can all be farming activities within and around cities.”&nbsp; The study makes recommendations for sustainable practices that build on the positive aspects of urban agriculture while mitigating the downsides, thereby promoting more resilient cities in future. Research shows that urban agriculture has been helping many countries attain SDG targets by enhancing food security and biodiversity while helping education and preservation of open spaces.&nbsp; Indeed, many farmers from the hinterland who have settled in Kathmandu Valley or other urban areas of the country have been practicing urban agriculture, leasing neighbourhood patches or cultivating roof gardens both out of necessity because of inflation and falling income to grow their own food, and also as a fulfilling hobby. Saurav Dhakal, a sustainability advocate with Story Cycle and now research fellow at the Asian Institute of Technology in Thailand, says there are socio-economic and environmental benefits of urban agriculture. “It provides benefits to all urban dwellers, regardless of their income status,” says Dhakal, “families get fresh food, and there are many other benefits like water retention, heat regulation and biodiversity. These are all public goods, so special government incentives may be needed.” It is not unusual to see vegetable patches and even paddy fields within inner city Kathmandu where an older generation of farmers are using available fertile land and <a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/rooftop-gardens-kathmandu,1415">roof gardens to produce fresh, nutritious food </a>to reduce their dependence on food items that have to be bought after being trucked in from large distances.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2024101905100_1291ce98dbbb8caed8702ac4b1d469b3e13016d7ecaaf3bfd5f91c974d3c0c77.jpg" data-media-id="editor_5" data-image-id="2024101905100_1291ce98dbbb8caed8702ac4b1d469b3e13016d7ecaaf3bfd5f91c974d3c0c77" data-rendition-name="original" width="1500" height="999" loading="lazy" alt="urban agriculture in Kathmandu"> <figcaption>An older generation of farmers are using any available fertile land to continue farming but it is getting more and more difficult. Photo: TAYLOR MASON </figcaption> </figure>  Nepal’s urban population grew rapidly from only 3.6% in 1991 to 25% today. There is large outmigration from the mountains to peri-urban areas of the Tarai, to Kathmandu Valley and Pokhara, with many young men then moving abroad for work. Kathmandu Valley’s population has swelled to nearly 3 million, and is growing at 6.5% a year. Dilip Shrestha, 71, used to work for Nepal Food Corporation, so he knew firsthand about inflation, shortages and vegetables with pesticide residue. So, when he designed his new house in Kathmandu, he built a spacious roof where he grows cucumber, ginger, garlic, coriander, onions, tomatoes, chili, beans, okra, pumpkin and lettuce. His family eats healthier, and he has reduced dependence on the market.&nbsp; The co-author of the Cell Reports Sustainability journal article, Daya Raj Subedi who is a PhD candidate at Beijing Forestry University, says urban agriculture also promotes inclusion and psycho-social wellbeing.&nbsp; He says, “A crucial finding of the study is the identification of opportunities and challenges associated with urban agriculture, it can promote sustainable transformation of society.” In Banepa, 55-year-old Bijaya Manandhar in her lifetime has watched the fertile farms of her neighbourhood that used to supply vegetables to Kathmandu, now completely built up with no open space left. The pandemic lockdown prompted her to turn to the family’s <a href="https://nepalitimes.com/banner/rooftop-agriculture-on-the-roof-of-the-world">ancestral livelihood by growing food</a> not on terrace farms, but on the roof terrace. Manandhar is now a part of <a href="https://nepalitimes.com/banner/rooftop-agriculture-on-the-roof-of-the-world%5C%5C">कौसी खेती र करेसाबारी क्रान्ती</a> (Rooftop Farming and Garden Revolution) which has an online membership of 52,000, and awards annual prizes to women who excel in urban agriculture.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241019041052_7257f5def8f823f35a799fa6f6825e153f2ffa406ac11325d4fe74049b79e96d.jpg" data-media-id="editor_8" data-image-id="20241019041052_7257f5def8f823f35a799fa6f6825e153f2ffa406ac11325d4fe74049b79e96d" data-rendition-name="original" width="1600" height="736" loading="lazy" alt="urban agriculture in Kathmandu"> <figcaption>Rooftop farming is gaining popularity as a form of urban agriculture. </figcaption> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241019041052_beff1a4494ce896dd8fd383ee1f518e5448bcf7ea8bb138255391c7bcb9769ed.jpg" data-media-id="editor_9" data-image-id="20241019041052_beff1a4494ce896dd8fd383ee1f518e5448bcf7ea8bb138255391c7bcb9769ed" data-rendition-name="original" width="4000" height="3000" loading="lazy" alt="urban agriculture in Kathmandu"> </figure>  Pradhan says the challenge now is to upscale such examples of successful urban agricultural practices so they support Neal’s efforts to meet SDG targets. He adds, “Crop cultivation around cities can be protected by land use plans and regulations. Promoting community-based agriculture, including rooftop gardens, requires community engagement and public-private partnerships across the food value chain.”&nbsp; Such support would accelerate the popularity of existing rooftop farming and community gardens in Kathmandu Valley, or kitchen garden initiatives in Pokhara, and building on traditional farming practices that are preserved and integrated into urban settings like in Bhaktapur and Banepa. In Lalitpur, the Women Entrepreneurship Facilitation Center promotes urban farming enhancing both sustainability and empowerment.&nbsp; Another co-author of the report, Yuanchao Hu from China says followup research of the team will aim to identify good practices in local urban agriculture practices. He adds, “There are examples of urban agriculture that optimise sustainability, ensuring that it remains a viable solution for cities globally while countries try to meet SDG targets.” Prajal Pradhan, Daya Raj Subedi, Kshitij Dahal, Yuanchao Hu, Prakriti Gurung, Sijal Pokharel, Sagar Kafle, Biplav Khatri, Sudeeksha Basyal, Monika Gurung, and Aruna Joshi. Urban Agriculture matters for sustainable development. Cell Reports Sustainability, 1:100217, 2024. [DOI: 10.1016/j.crsus.2024.100217] Prajal Pradhan (<a href="mailto:p.pradhan@rug.nl">p.pradhan@rug.nl</a>) This article is brought to you by <a href="https://nepalitimes.com/" target="_blank">Nepali Times</a>, in collaboration with <a href="https://inpsjapan.com/en/" target="_blank">INPS Japan</a> and <a href="https://sgi-peace.org/" target="_blank">Soka Gakkai International</a>, in consultative status with UN ECOSOC.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20240630110640_30c3782f9c09219bf1c249b51483a3cfb7a53a06d117d2aebd23ca7080d12758.jpg" data-media-id="editor_14" data-image-id="20240630110640_30c3782f9c09219bf1c249b51483a3cfb7a53a06d117d2aebd23ca7080d12758" data-rendition-name="original" width="680" height="103" loading="lazy" alt="SDG logo"> </figure>

Back to the land in the cities

The 700-year-old Lakshmi Narasingha temple in Bhaktapur houses a rare half-lion and half-human incarnation of Lord Vishnu carrying the Goddess Lakshmi. The temple was destroyed in the 1934 mega earthquake that killed 10,000 people and destroyed many monuments in Kathmandu Valley. It was rebuilt by a German project in the 1980s, but as a single-storey structure instead of its original two-tier pagoda design.&nbsp; With new findings from in-depth research, Bhaktapur municipality began re-restoring the temple in 2021, preserving its original architecture.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241017131016_2fae38cce543ad7b1f6de632feb3e212e08ed1acedd747830e949d7b8e878f18.jpg" data-media-id="editor_0" data-image-id="20241017131016_2fae38cce543ad7b1f6de632feb3e212e08ed1acedd747830e949d7b8e878f18" data-rendition-name="original" width="2048" height="1365" loading="lazy" alt="In with the old in Nepal NT"> </figure>  “Our temples and heritage sites hold deep meaning. It is disheartening to witness how often they lose their original elements, whether by design or accident,” explains Kumar Chawal of the Consumer Committee of Bhaktapur. “There is a need to preserve our architecture and protect its historical value for future generations. Otherwise, we risk losing a vital part of our identity.” The Laksmi Narsingha restoration is similar to the Bhai Dega temple in Patan Darbar Square which also collapsed in 1934, but was rebuilt with a Moghul-style dome by the Rana government at the time. Only two months before the 2015 earthquake, heritage conservationists had started to rebuild Bhai Dega as the original three-tier based on early photographs. But priorities shifted when four other temples in the square were brought down by the 7.8M earthquake on 25 April 2015.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241017131016_697ea707d9ad163be5de5f2efbf5b70d3cab771adcc22f0fae6bf937c6cb0130.jpg" data-media-id="editor_1" data-image-id="20241017131016_697ea707d9ad163be5de5f2efbf5b70d3cab771adcc22f0fae6bf937c6cb0130" data-rendition-name="original" width="2048" height="1365" loading="lazy" alt="In with the old in Nepal NT"> </figure>  This showed how damage to monuments in Kathmandu Valley spanned from one earthquake to the next. Bhai Dega restoration remains half-complete to this day because money for its restoration ran out.&nbsp; Whereas Bhai Dega restoration was done by the Kathmandu Valley Preservation Trust with grants from western embassies and international foundations, in Bhaktapur it is the municipality itself that allocated the Rs30.7 million needed to restore the Lakshmi Narasingha temple. The expected date of completion is early 2025. The municipality and local communities are focusing on two main aspects: preserving the past and promoting localisation. The restoration team has designed a blueprint for the temple by using historical photographs and insights from older generations.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241017131016_182882fdc393c99e70d1d0490319e415229563666c4934e3a582426ebf00ca30.jpg" data-media-id="editor_2" data-image-id="20241017131016_182882fdc393c99e70d1d0490319e415229563666c4934e3a582426ebf00ca30" data-rendition-name="original" width="1200" height="560" loading="lazy" alt="In with the old in Nepal NT"> </figure>  “At first, the Lakshmi Narasingha temple had only one entrance, but during the demolition process, we uncovered the foundations of four doors. Now, we are restoring all of them. This is an example of how our ancient structures have changed over time, often without our knowledge,” says Chawal. “Constructing temples is not like building houses. They carry historical and spiritual values, which is why they hold a special place in our hearts,” he adds. By replicating ancient design elements and rebuilding the temple as accurately as possible to its original form, the team has stayed true to Bhaktapur’s soul. But the restoration also revived ancient techniques that were in danger of being forgotten, generating employment for woodcarvers, masons, and contractors. The community of Bhaktapur’s Gahiti neighbourhood near the famous Nyatapola Temple has also set aside specific days for locals to volunteer in the reconstruction work. This has encouraged young people to take pride in ownership of their heritage. Families have also supported the effort by donating funds for bells, the temple pinnacle, and other structural features to the temple.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241017131016_db850ec0c084cdbe54f65bee92dad2ad8122d20fd60ec87ec086fbb9d2f72bd6.jpg" data-media-id="editor_3" data-image-id="20241017131016_db850ec0c084cdbe54f65bee92dad2ad8122d20fd60ec87ec086fbb9d2f72bd6" data-rendition-name="original" width="2048" height="1365" loading="lazy" alt="In with the old in Nepal NT"> </figure>  “I feel at peace knowing I have contributed my sweat to restoring this temple,” said one volunteer. “It is our duty to preserve our temples and heritage. The Nyatapola area will look magical once this temple is completed.” Community mobilisation is a long-standing tradition in Bhaktapur. In the past, locals have actively participated in the restoration of other temples in the city, such as Bhairav and Nyatapola fostering a strong sense of ownership. This collective engagement has not only been crucial in preserving the city's historical monuments but also in strengthening the bond between local communities and their heritage, says officials at the municipality. While securing funding is essential, and the municipality showed it values heritage conservation, the Lakshmi Narasingha restoration is proof that active involvement and sense of responsibility of the local community is as important, if not more. Local involvement also means that the monuments will be cared for into the future, When locals take ownership of these efforts, the restored monuments are not only protected in the present but are also cared for in the future.