<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

Architecture can be a powerful agent of change, shaping not just spaces but the way people live, connect, and experience the world.&nbsp; For Nepal, which is <a href="https://nepalitimes.com/banner/natures-fragile-gift-to-nepal">gifted by nature</a> and rich in <a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/ambassador-fund-cultural-preservation-nepal,2092">cultural heritage</a>, &nbsp;reviving rural architecture with modern amenities could hold the key to more <a href="https://nepalitimes.com/here-now/what-sustainable-tourism-means-in-practice">sustainable tourism </a>that benefits local people more. “<a href="https://nepalitimes.com/banner/bayalpata-hospital-in-nepal-wins-global-design-award">Design and architecture</a> are amazing tools to create a unique experience for visitors,” says Spanish architect Tomeu Esteva of Esteva i Esteva Architecture Studio. “Difficult destinations have beautiful hotels with design and comfort.” Esteva was in Kathmandu with his colleagues at an event organised by the Spanish Honorary Consulate at Dwarika’s Hotel last week to showcase buildings which Nepali architects can adapt with local material and design inputs.&nbsp; Rural architecture holds a unique significance: it is more than a shelter and must reflect <a href="https://nepalitimes.com/here-now/inking-an-idenity">local identity, culture</a> and <a href="https://nepalitimes.com/here-now/saving-humla-from-heritage-loss">heritage</a>. An area’s natural and cultural harmony can be upset by <a href="https://nepalitimes.com/here-now/protecting-protected-areas-from-infrastructure?fbclid=IwAR1wK0MDFlFST_2EYb3f54LS4-fPt6rYfLG1DJ1JaQsU3w8-ezyXIxGOqzk">poorly planned development</a>, speakers at the event said, but the environment can be improved and revitalised by well-integrated structures.&nbsp; Another Spanish architect, Belen Moneo, has designed hotels at elevations of 3,700m in her home country Spain that supply natural spring water spas. “<a href="https://nepalitimes.com/banner/lost-in-reconstruction">Creativity in construction</a> must be encouraged. Rural architecture always shows possibilities of what we can do better,” Moneo explains, adding that designs must enhance <a href="https://nepalitimes.com/opinion/the-healing-power-of-nature">the beauty of nature</a> and give a natural feel at a time when steel, glass and cement dominate <a href="https://nepalitimes.com/here-now/rebuilding-kathmandu-after-the-1934-quake">urban design</a>.&nbsp; This is why the <a href="https://nepalitimes.com/here-now/weaving-nature-into-craft">use of natural products</a> such as bamboo, local timber, straw and rammed earth are in demand from customers who want a fresh eco-friendly look encouraged in construction of rural architectural structures. The demand for boutique hotels has increased world over, with &nbsp;more and more tourists favouring aesthetics, experience and comfort over price. While creativity is an important part of <a href="https://nepalitimes.com/here-now/architecture-for-mountains">construction and architecture</a>, incentives to build and use <a href="https://archive.nepalitimes.com/article/nation/Building,370">rural construction materials</a> still remain minimal, and Moneo emphasises the significance of design and execution.&nbsp; Esteva helped design the Vana Retreat in Dehradun that kept the natural environment in focus, with the structure giving an elaborate aesthetic experience to visitors. Another example is Hotel Las Mercedes in the Dominican Republic which was designed and constructed by Moneo and the company she co-founded Moneo Brock, respecting and revaluing the traditional architecture of the area. Hotels providing such experience could attract tourists and revenue. The Spanish ambassador to Nepal Juan Antonio March Pujol said, “The role of architecture and architects in developing tourism is crucial, not only in urban areas but rural settings as well.”&nbsp; The concept of rural boutique hotels gained traction in Spain during the 1990s, particularly in regions like Majorca with economic and environmental sustainability as the main focus. In Nepal <a href="https://nepalitimes.com/opinion/12-full-opinion/guiding-nepal-s-tourism-industry">the tourism industry</a> directly employs about 1 million people, and makes up about 8% of the country’s GDP. In Nepal, the stone homes of <a href="https://nepalitimes.com/news/reviving-himalayan-vulture-and-culture">Mustang and Manang</a>, bamboo and mud structures of <a href="https://nepalitimes.com/here-now/the-tarai-s-shrinking-forests">the Tarai</a>, and the Kathmandu Valley’s terra cotta tile skylines, graceful temples, and tranquil bahal courtyards are all examples of <a href="https://nepalitimes.com/here-now/nepal-s-traditional-seismic-resistant-designs">Nepal’s traditional architecture</a>.&nbsp; Nepali architect Sarosh Pradhan has been working for the past eight years on the Brakka Village project in Manang Valley north of <a href="https://nepalitimes.com/banner/municipalities-want-to-manage-annapurna">the Annapurnas</a>. Other examples of this kind of rural architecture for high-end tourism are the Shinta Mani Hotel in Mustang and Khumbu Lodge below <a href="https://nepalitimes.com/news/mt-everest-pvt-ltd">Mt Everest</a>. Says Pradhan, “There are places in Nepal that radiate purity and embrace simplicity. Creating projects in such settings require deep reflection and thoughtful planning.”  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250421030444_a07a23f6b60fa89c0f35b9dc1aaf19937da4881e6bfb2e1858f3c27dff91729f.jpg" data-media-id="editor_19" data-image-id="20250421030444_a07a23f6b60fa89c0f35b9dc1aaf19937da4881e6bfb2e1858f3c27dff91729f" data-rendition-name="original" width="4608" height="2184" loading="lazy" alt="A new architecture for Nepal's tourism"> </figure>  Rural architecture is not easy, and sometimes more expensive. Inflation, energy efficiency, <a href="https://nepalitimes.com/here-now/those-who-stay">the climate crisis</a>, and <a href="https://nepalitimes.com/banner/cost-of-living-in-a-big-city">increased costs of living</a> pose obstacles to sustainable rural architecture. Read also: <a href="https://nepalitimes.com/here-now/forgotten-international-starchitects-in-nepal">Forgotten international starchitects in Nepal</a>, Anne Feenstra and Varun S Bapu Esteva says faith and trust between client and architect is necessary for any project to be successful. He adds that architects must practice being humble, the process of designing always involves learning and not imposing their ideas on clients. Nepal is uniquely positioned for the growth of <a href="https://nepalitimes.com/banner/hiking-up-the-benefits-of-tourism">rural tourism</a> because of its stunning countryside as well as its internationally renowned traditions in holistic wellness. Creating infrastructure that is small, thoughtfully planned and that respects both tradition and contemporary hospitality standards is crucial. “Projects in Nepal can be made cost effective by using materials from houses that have been brought down,” says Esteva. “Pilot projects involving <a href="https://nepalitimes.com/banner/local-government-by-the-people-for-the-people-of-the-people">local people </a>and simple designing also helps the process.” <a href="https://nepalitimes.com/banner/vacant-homes-become-homestays-in-nepal">The growth of homestays in Nepal</a> is a step in the right direction, but they are still a bit too rustic for the international traveller who also wants comfort and is willing to pay extra for it. Upgrading the facilities in homestays and ensuring that the <a href="https://nepalitimes.com/here-now/an-archive-of-nepali-heritage">architectural heritage</a> of the locality is preserved using locally sourced building material could allow owners to charge more. Says Sangita Shrestha of Dwarika’s Hotel, “Our effort is to build upon rural architecture by empowering local communities and using what is available locally. We can fine tune and encourage indigenous design and training.” The vision goes beyond just boosting the economy, it is about building a future where tourism helps villages grow in a healthy and lasting way. Instead of using up resources, it gives back to the land and the people. It supports local communities by<a href="https://nepalitimes.com/opinion/staying-in-nepal-to-create-jobs"> creating jobs</a>, improving infrastructure, and protecting natural beauty. When done right, tourism can be a tool for <a href="https://nepalitimes.com/editorial/progress-and-or-preservation">preserving culture and nature</a>, not harming them. Architects must therefore see their work as more than just designing buildings, they also need to care deeply about people and places, especially in rural areas that can benefit the most.&nbsp; With global interest in sustainable and off-the-beaten-path travel increasing, Nepal stands at the cusp of a <a href="https://nepalitimes.com/news/missing-out-on-nepal-s-tourism-potential">tourism transformation</a> that values community-driven, eco-conscious hospitality. A mix of modern ideas and traditional knowledge could transform rural tourism in Nepal. Says Shrestha, “Young architects should spend time with <a href="https://nepalitimes.com/latest/the-unsung-heroes-of-conservation">local and indigenous communities</a>, listen to their stories, and learn from their <a href="https://nepalitimes.com/banner/life-and-livelihood-in-remote-nepal">ways of living</a>. These communities have deep knowledge about the land, materials, and climate. If this wisdom is used in new designs, it can help create tourism spaces that truly benefit everyone.” &nbsp;

A new architecture for Nepal's tourism

Extract from an addendum to Nepal's Two Wars, Chapter 2 in the updated edition of Essays on Nepal: Past and Present by Sam Cowan, a retired British Army general with a long association with the Gurkhas. The book was first published in 2018, and republished earlier this month by FinePrint exclusively on Amazon. The addendum details a one-to-one conversation the author had in the <a href="https://archive.nepalitimes.com/news.php?id=8884">Royal Palace </a>with the <a href="https://archive.nepalitimes.com/news.php?id=8371">King Gyanendra</a> in November 2002 just after he had taken his initial steps on the road that ultimately led to <a href="https://archive.nepalitimes.com/news.php?id=14681">the abolition of the monarchy</a> in Nepal in 2008. In the early evening of September 16, 2002, in my role as Colonel Commandant of the Brigade of Gurkhas, I had my second and last official audience with King Gyanendra to give him an update on the Brigade’s activities over the previous 12 months. I had some 6 or 7 such audiences with <a href="https://nepalitimes.com/here-now/preserving-king-birendra-s-family-home">King Birendra</a>.&nbsp; These were official affairs with the British ambassador of the day present, along with key <a href="https://archive.nepalitimes.com/news.php?id=12233">palace officials</a> and a representative from Nepal's Foreign Ministry. The two monarchs were very different in character and temperament, but both treated me with the utmost civility and made the audiences as relaxed and easy for me as possible.&nbsp; It is, however, worth recording that when the official business had been covered, King Birendra, with a twinkle in his eye, often ended by asking, “Now General, what’s the gossip in London?” The second audience with <a href="https://archive.nepalitimes.com/news.php?id=8026">King Gyanendra </a>was my last official act in uniform. We came back to Kathmandu in the first week of November (after treks) to stay for a few nights with our Defence Attaché before heading back to the UK. Waiting for me was a message from the Palace saying that King Gyanendra would like to meet me informally: <a href="https://archive.nepalitimes.com/news.php?id=6933">no uniform</a> and no ambassador.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250421080420_f9046f9882d4481781d14f2b64f18c7fbbea62562e1d74e3465de6d01fb43750.jpg" data-media-id="editor_7" data-image-id="20250421080420_f9046f9882d4481781d14f2b64f18c7fbbea62562e1d74e3465de6d01fb43750" data-rendition-name="original" width="1750" height="2406" loading="lazy" alt="Gyanendra crowned page 1"> <figcaption>Nepali Times Special Edition of 6-14 June 2001 with enthronement of Gyanendra. </figcaption> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250421080424_21333d6ae21828eb47fe3f849438d215fe2804460d47bb2896ef4aee4e895ad2.jpg" data-media-id="editor_8" data-image-id="20250421080424_21333d6ae21828eb47fe3f849438d215fe2804460d47bb2896ef4aee4e895ad2" data-rendition-name="original" width="1500" height="1857" loading="lazy" alt="Royal massacre"> <figcaption>Nepali Times 22-29 June 2001 covering the royal massacre after which Gyanendra became king. </figcaption> </figure>  Although I had no idea what the purpose of the meeting might be, events in Kathmandu since I last saw the king put me on edge. On October 4, 2002, Gyanendra had dismissed Prime Minister Sher Bahadur Deuba, allegedly for failing to hold <a href="https://nepalitimes.com/news/what-goes-on-in-nepal-s-elections">elections</a>. He had put in place a new prime minister and a cabinet personally selected by him. When I heard the news on my travels, the people I met were generally supportive of the king’s actions. There was a general view that something had to be done, the country was going nowhere, and the king deserved his chance, not least to solve<a href="https://nepalitimes.com/latest/14-years-after-conflict-no-closure-in-nepal"> the Maoist </a>problem. Back in Kathmandu, views were not so sanguine. The chosen prime minister, Lokendra Bahadur Chand, was a relic from <a href="https://nepalitimes.com/here-now/mob-movement-and-mayhem">the Panchayat period</a> whose party had failed to win a single seat in the last elections held in 1999. Some of the chosen cabinet ministers had, to put it mildly, dubious reputations, and others had no record of proven competence in any field. There was a fear that the king’s real motive in dismissing <a href="https://nepalitimes.com/editorial/deubas-denouement">Deuba</a> was to start to reverse the democratic gains made since 1990. I informed <a href="https://nepalitimes.com/news/nepal-britain-mark-centenary-of-1923-treaty">the British ambassador</a> about the invitation. He was strongly against accepting it, which was probably the clinching reason for my decision to do the polite thing and accept it. On the evening of November 7, 2002, I presented myself at the royal palace, alone and in civilian attire.&nbsp; As in the past, the Military Secretary, Major General Vivek Shah, met and escorted me into the presence of the monarch. This time, however, he was politely asked to leave the room and shut the door behind him. King Gyanendra greeted me warmly and invited me to sit down.&nbsp; Read also:<a href="https://nepalitimes.com/news/the-ghost-of-monarchy-returns-to-haunt-nepal"> The ghost of monarchy returns to haunt Nepal</a>, Shristi Karki  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250421080424_e382af945d0ad2a04ae41fabe5393f793dd10f54cb1220f111c7c9e7423eb558.jpg" data-media-id="editor_15" data-image-id="20250421080424_e382af945d0ad2a04ae41fabe5393f793dd10f54cb1220f111c7c9e7423eb558" data-rendition-name="original" width="1000" height="993" loading="lazy" alt="Gyanendra coup"> <figcaption>Nepali Times 4-10 February 2005 after king Gyanendra's coup imposed media censorship. anendra became king. </figcaption> </figure>  I had wondered, and to be truthful, had worried, not just about the purpose of the meeting, but about how the conversation might start and develop. I reduced my resolve to two points: be polite but speak candidly. The latter resolve was quickly put to the test with the king’s opening words: “Sam, [in previous meetings it had been ‘General’, you walk the highways and byways of this land more than most, tell me what the common man is thinking?” &nbsp;“Your Majesty, I have no idea what they are thinking, but they are waiting.” “Waiting?” “Yes, Your Majesty, they are waiting to see whether what you did some weeks ago in appointing your own prime minister and cabinet ministers is going to make any difference to their lives or whether it is just going to be more Kathmandu hot air.” “Everything is going to be difficult and is going to take time, a lot of time.” “Your Majesty, time is the one thing you don’t have. You must act quickly and decisively to take advantage of the opportunity you have created. Everyone knows that you have appointed these new ministers. Why don’t you get them in here one by one and tell them that they have three months to deliver a programme in their area of responsibility that is going to make a difference to people’s lives? Most will fail to do so. Sack them! It will be a powerful signal of your strong intent to deliver real change.” I can express the opening of our conversation in this way because just about every word is still etched in my mind. The king’s response to my last quoted words was to challenge me to give an example of something that could be delivered quickly. I can give a verbatim record of what I said in response to this unexpected challenge: “Health posts, Your Majesty, there is no shortage of them throughout the country as building them has been one of the sources of local corruption, but very few have any medicine to issue at present or have skilled people to assess and meet medical needs. Your Majesty, children are dying for lack of a few pills. Given the right priority, over a period, say of six months, every health post could be fully stocked with medicine and manned with trained people. This is something I could help to lead for you as I know it would have strong international backing. At last, people would know that you mean business.” As I warmed to the theme, I could see no sign of the king having any enthusiasm for the idea, and I quickly disengaged as it dawned on me, as it had clearly dawned on the king, that the reason for the deficiencies in health posts was to prevent any Maoist combatant from gaining access to any <a href="https://nepalitimes.com/opinion/tech-away/nepal-s-health-tech-industry-is-here-to-stay">medical support</a>, and if this meant people suffering, so be it. The subject of the Maoist insurgency inevitably came up, and I took the opportunity to elaborate on what is written in the final four paragraphs of the article above. I advised King Gyanendra that, self-evidently, since there were three parties in the conflict—him, the Maoists, and the political parties—it was imperative that he form an alliance with one of them, preferably the political parties; otherwise, he would find himself isolated, as the other two parties would inevitably, at some stage, form their own alliance. However, it quickly became apparent that the king’s mind was on a totally different track. On the Maoists, he told me that he had channels open to them, but he was scathing about the political party leaders. He made it clear that they would be waiting for a very long time before he gave any power back to them, and that is a polite way of expressing the actual words he used, but “crawling through the door” is a phrase which has stuck in my mind.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250421080424_5403455ff6168f0d202a96cb53edea69136d74d59b989cfcc7cc4a1d57672cb5.jpg" data-media-id="editor_17" data-image-id="20250421080424_5403455ff6168f0d202a96cb53edea69136d74d59b989cfcc7cc4a1d57672cb5" data-rendition-name="original" width="2000" height="1317" loading="lazy" alt="fall of monarchy"> <figcaption>Nepali Times 28 April-3 May 2005 with cover image by Ajay Joshi of jubilant protesters after street demonstrations sidelined king Gyanendra, paving the way for a ceasfire and restoration of democracy. </figcaption> </figure>  As the conversation developed, it became ever clearer that King Gyanendra had decided to go in alone, relying on the misleading assurances he was constantly receiving from <a href="https://archive.nepalitimes.com/news.php?id=14954">the army</a>, and no doubt his close advisers, that the Maoists could and would be quickly defeated militarily, and taken out of the equation. This would obviate the need for him to do any deal with the political parties.&nbsp; Thus, the way would be clear for him to establish a version of his father’s Panchayat system, under a constitution that would be granted to the people by him, their sovereign, as his father and brother had done in 1962 and 1990. As in those constitutions, ultimate power would have remained in the sovereign’s hands. This proposed direction of travel was very clear from what the king said to me. In sum, King Gyanendra was motivated by a desire to emulate his immediate predecessors by granting his people a constitution that would restore his father’s Panchayat system in a modern form and give him a central role in decision-making. What was particularly dispiriting was that beyond this single objective he had no plan worthy of the name, nor demonstrably did he have the people with the skills to implement an appropriate plan even if one had existed. Crucially and depressingly, there was little or no indication from the king that he realised that such a course of action could put Nepal’s monarchy into serious jeopardy, as indeed proved to be the case. <h2>King Twice</h2>  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250420110436_315d519fe3d68d2406ebe1480fed54720fbf21b8907a4da5cde751fdc623d445.jpg" data-media-id="editor_19" data-image-id="20250420110436_315d519fe3d68d2406ebe1480fed54720fbf21b8907a4da5cde751fdc623d445" data-rendition-name="original" width="1302" height="632" loading="lazy" alt="“Tell me what the common man is thinking!”"> </figure>  <a href="https://archive.nepalitimes.com/news.php?id=8371">Gyanendra Bir Bikram Shah has been king twice</a>. In 1950 he was enthroned briefly as a child king (left, above) by the Rana Prime Minister Mohan Shumsher when his grandfather, King Tribhuvan, fled to exile in India. In 2001 he was crowned king again after the massacre in the royal palace in which his brother King Birendra and nine other members of his family were killed by Crown Prince Dipendra.&nbsp; During his second reign, Gyanendra gradually asserted power by sacking Prime Minister Sher Bahadur Deuba in 2002, and then taking full control after the 1 February 2005 coup. He was sidelined after the ceasefire in April 2006, and became a commoner after the Constituent Assembly finally <a href="https://archive.nepalitimes.com/article/from-nepali-press/Ftnp-abolishing,624">abolished the monarchy in 2008</a>. In the past year, Gyanendra has tried to exploit public dissatisfaction with the political parties to restore the monarchy.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250421080432_26ef4a4b0e3cee9fdc6794446702efe16550d293904b4f6dd46fe35d4d10c788.jpg" data-media-id="editor_22" data-image-id="20250421080432_26ef4a4b0e3cee9fdc6794446702efe16550d293904b4f6dd46fe35d4d10c788" data-rendition-name="original" width="1136" height="702" loading="lazy" alt="Essays on Nepal by Sam Cowen"> </figure>

“Tell me what the common man is thinking!”

“It's Kathmandu.” Just as the family was sitting down for one of its extended lunches, that jubilant cry was from François Driard’s grandfather announcing the next posting for his diplomat parents.&nbsp; Driard (pictured) was 18 in the summer of 1996,<a href="https://nepalitimes.com/opinion/suburban-tales/chasing-a-nomad"> a bit of a hippie</a> already, and his life was about to change forever with the magical word “<a href="https://nepalitimes.com/banner/time-capsule-of-kathmandu">Kathmandu</a>”. “I was awed with that information from my grandfather, nothing else mattered … In France <a href="https://nepalitimes.com/here-now/tales-of-courage-and-suffering-cx95f89e">in the 1990s</a>, Kathmandu had a mythical aura,” Driard recalls. He came to Kathmandu for Christmas that year to visit his stepfather, the French Ambassador Michel Lummaux. It was to be the first of many visits during school holidays, before he decided to permanently settle down in Nepal. “Kathmandu, and Nepal, were very different then, it was magical, I liked the nature, the people, civilisation, temples, trees,” says Driard, who explored the country sitting on the top of buses. “Visitors talk about the crazy <a href="https://nepalitimes.com/banner/cost-of-living-in-a-big-city">urbanisation</a>, traffic jams today, and all that is true. But Kathmandu has not <a href="https://nepalitimes.com/here-now/loss-of-soul-and-soil">lost its soul</a>.” After his stepfather’s tenure in Nepal ended, Driard worked as a business reporter for international publications but decided he did not want to be anyone’s employee anymore. In 2007 he landed in Kathmandu with €20,000 in savings to invest.&nbsp; He knew a few crucial things about himself: he liked food and nature, which is very much tied up with his upbringing--full of lively conversations during lunch and dinner at the family table between <a href="https://nepalitimes.com/here-now/nepals-yak-cheese-is-on-world-map">abundant cheese, wine and cigars</a>. So he decided it would be cheese, and registered Himalayan French Cheese and went to the French Alps for a month to learn how to make Tomme de Savoie. “<a href="https://nepalitimes.com/banner/the-story-of-langtang-cheese">Cheese making is such an ancient craft </a>and so I thought I won’t need much money or studying which I hated and indeed, if you have a tamako bhado and fire you are set,” explains Driard. But Nepal’s temperature and humidity were not ideal, even at higher altitudes. The first customers for his cheese were the Hyatt Regency and Nina and Hager. But he needed to create a market for cheese in a country which only knew hard churpi in the north and soft paneer in the south. He started selling his cheeses at the Summit Hotel weekend market, expanding to his own 1905 Farmer’s Market which later moved to Le Sherpa in Maharajganj, where it is now, and also a market at Labim Mall in Pulchok. He had cow dairies in Nuwakot and Dhulikhel, and finally a yak cheese unit at 3,379m in Ramechhap. It was the yak blue cheese from here that went on to win a Gold Medal in France, putting Nepal’s French cheese on the world map. “People come and try our cheese at the market, they ask questions. There is a lot of education to be done about cheese,” adds Driard, who also has three cheese shops in the Valley. Driard now makes 25 types of cheese. The products are being noticed and every year he has French students coming to Nepal to learn the art of yak cheese making. “In France, one family or company makes one kind of cheese for generations. In that I’m very unique as a cheese artisan,” he says. “The students come in to learn but I tell them to also teach us something too, add another cheese to my collection.” Read also: <a href="https://nepalitimes.com/here-now/langtang-after-10-years">Langtang after 10 years</a>, Sonia Awale Being a foodie, Driard is now also dabbling in meat with his own charcuterie at Meatini with bacon, ham, sausage and pâtés. All of this is now served at his Emilio’s Pizza, a leafy hideaway in Lazimpat. His South Side in Moksh is probably the smallest wine bar in the world. “I call the process sublime,” says Driard of his ventures, which have grown organically. “You need the same temperature and humidity of 12°C and 80% for cheese, meat and wine.” Emilio’s speciality is the eight-cheese pizza (which has eight types of cheeses), and a pizza with bhutan topping (not the country but fried intestines and organs Nepali-style). He has opened a small branch at Courtyard in Pokhara.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250426070456_bacae302c040dc18eeecdeafda72ddf06a6d2cec138ea9be7e45fe94cdf8b5b3.jpg" data-media-id="editor_8" data-image-id="20250426070456_bacae302c040dc18eeecdeafda72ddf06a6d2cec138ea9be7e45fe94cdf8b5b3" data-rendition-name="original" width="1500" height="1125" loading="lazy" alt="8 cheese pizza"> <figcaption>Eight-cheese pizza</figcaption> </figure>  With two artisanal cheese units, two farmers’ markets, a <a href="https://nepalitimes.com/here-now/the-meat-of-the-story">meat processing unit</a>, a bakery, and wine bar he now envisions a vineyard so he can add Nepali wine to his repertoire. Another future plan is to start up an agri-tourism business where customers can drink, eat and work in peace. In the past 20 years in Nepal, Driard has not always succeeded in his ventures but this hasn’t curbed his enthusiasm. He is learning as he goes, and like an old wine, Nepal is growing on him. Its slowness suits his French art de vivre with eating slowly outdoors, having conversation, importing less.&nbsp; “I have proven that with even a little money you can do a lot of things in Nepal,” adds Driard. “In the West, they easily invest half a million euros on a cheese factory, I invested 10 times less.”&nbsp;

Fromage, vin et charcuterie Népalais

Bhuthan भुठान starts with Bishnu Bahadur KC played by <a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/dhuwa-smoke-telefilm,2671">Hari Bansha Acharya</a> on a call, requesting to speak to the visa officer. By this point, he had <a href="https://nepalitimes.com/here-now/nepal-should-now-allow-visa-on-arrival">applied for a visa </a>to Bhutan 10 times, but was denied each time. KC was a <a href="https://nepalitimes.com/here-now/nepal-s-women-excel-in-sports-in-2024-z9ramyct">national football player </a>in Bhutan in 1988 before he and other Nepali-speaking Lhotsampa people were forced out of the country in the 1990s as part of the Druk regime’s ‘One Nation One People’ campaign. Over 100,000 Bhutanese Nepalis were forced out, driven across India and dumped in Nepal where they lived in seven<a href="https://nepalitimes.com/here-now/elderly-left-in-bhutan-refugee-camp"> refugee camps</a> supervised by the United Nations and other charities until they were resettled in the United States, Australia, New Zealand and some European countries starting in 2007. In the fictional movie with the satirical English title The World’s Happiest Man, KC has resettled in the state of Ohio in the US but wishes to visit his home country once before he dies. Between flashbacks, we learn KC has died without having fulfilled his wish. &nbsp; The drama then focuses on KC’s two families from two marriages as they debate whether to cremate him as per <a href="https://archive.nepalitimes.com/article/from-nepali-press/muslim-hindu,2996">Hindu rites </a>or give him a Christian burial. A mediator played by Hollywood actor Bruce Dern urges them to take a firm decision before it is too long.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250430140420_b398a08091b866da2b0b8f6c1e6e26781609749aba896bfd2c68a10a519295c3.jpg" data-media-id="editor_5" data-image-id="20250430140420_b398a08091b866da2b0b8f6c1e6e26781609749aba896bfd2c68a10a519295c3" data-rendition-name="original" width="945" height="945" loading="lazy" alt="Bhutan, the movie"> </figure>  There are drawn out scenes of KC being baptised and when he is confronted by his first wife from Darjeeling played by Anuradha Majumdar, he says he changed his religion in the hope that he will be <a href="https://nepalitimes.com/opinion/comment/bhutan-s-refugees-between-hope-and-despair">allowed back in Bhutan</a>.&nbsp; We find out KC has a second wife, a Christian Nepali played by Puja Chand. Dayahang Rai as the younger son doesn’t have much screen time to flex his acting chops. &nbsp; Acharya competently portrays a man that is equal parts haunted by the memories of and longing for his home country. KC’s pain and loss is acute when he is teaching football to Gungun but between mid-scene, he freezes, perhaps lost in memories of being in Bhutan’s national team. &nbsp; In another scene, KC recalls his mother singing a lullaby in Dzongkha. He also has a box filled with medals, photographs and a football which he deflates with a knife in a powerful depiction of his <a href="https://nepalitimes.com/here-now/searching-for-a-homeland-away-from-home?fb_comment_id=1506516030025634">complicated emotions about his homeland</a>. KC keeps checking his mailbox in the hopes that his <a href="https://archive.nepalitimes.com/news.php?id=4977">visa application</a> has been accepted. He says in Nepali: “If a tree that has already struck roots in one place is shifted to another, it will not survive.”  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250430140420_4a9c27410326489576c04dedf40016bda3825e8f9663317f54fbfec4cbda6d34.jpg" data-media-id="editor_9" data-image-id="20250430140420_4a9c27410326489576c04dedf40016bda3825e8f9663317f54fbfec4cbda6d34" data-rendition-name="original" width="1422" height="2048" loading="lazy" alt="Bhutan, the movie"> </figure>  Dern’s character says that the <a href="https://nepalitimes.com/opinion/comment/nepal-s-transitional-justice-and-the-west-s-recalibration">western world</a> has become “lonely in pursuit of happiness”, another reference to Bhutan’s obsession with its Gross National Happiness index. Scenes shift quickly throughout making the story difficult to follow at times. The use of symbolism is a trite overdone. Nonetheless, भुठान is a nuanced depiction of raw pain and agony of losing one’s homeland. But one cannot help but leave the theatre feeling deflated. KC dies without having visited <a href="https://nepalitimes.com/here-now/small-bhutan-dreams-big">Bhutan</a>, but perhaps he does in his afterlife. It is up to the audience to create its own ending to this sad story of exile. भुठान Mad Monkey Films, 2025 Directed by Binod Paudel 102 minutes In cinemas in Nepal