<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109181148/636be7f69c7e80680e087831jpeg.jpg" alt="" width="1500" height="1125"/><figcaption>Photos: BNMT</figcaption></figure>Drone therapy for tuberculosis diagnosis in Nepal’s remote and hard to reach mountains has won at the <a href="https://tiaca.org/tiaca-press-release/pelican-biothermal-and-nepal-flying-labs-win-2020-tiaca-air-cargo-sustainability-awards/" target="_blank" rel="noopener noreferrer">2020 International Air Cargo Association (TIACA)</a> Sustainability Awards and will receive $10,000 in prize money as a start-up category winner.The winning project, <a href="https://www.nepalitimes.com/banner/nepal-tests-and-treats-tb-with-a-flying-pharmacy/" target="_blank" rel="noopener noreferrer">Drone Optimised Therapy System</a> (DrOTS) by Nepal Flying Labs links rural health posts with high-end diagnostic tool via drones to improve the accessibility of tuberculosis diagnostic tests.“In a year marked by a global pandemic which disrupted our industry, problem solving and forward-thinking companies like Nepal Flying Labs bring hope that air cargo can come out of this crisis stronger and more resilient,” says Céline Hourcade of TIACA, which celebrates and encourages outstanding industry initiatives driving sustainability in air cargo.Under DrOTS, drones fly from a central district hospital to health posts in the mountains to collect sputum samples and deliver both diagnoses and treatment to patients living in up-country villages. The samples are tested using a <a href="https://www.nepalitimes.com/banner/for-nepal-a-game-changer-in-tb-control/" target="_blank" rel="noopener noreferrer">high-end GenExpert kit</a>.If they are positive, patients are given DOTS (directly observed treatment short course) treatment using smart pill boxes, which keep electronic records of whether or not patients have taken the antibiotics regularly.The highly competitive award evaluated humanitarian projects based on three aspects of sustainability -- economic social and environmental -- as well as innovation and practicality of the applied solution. The winners were announced online on 10 December.The project had also won the prestigious industry award from the <a href="https://www.auvsi.org/industry-news/winners-2020-xcellence-awards" target="_blank" rel="noopener noreferrer">Association for Unmanned Aerial Vehicles</a> – the AUVSI XCELLENCE Award 2020 in Humanitarian and Public Safety category in October.The goal of this project is to assist Nepal’s Ministry of Health in generating data on <a href="https://www.nepalitimes.com/banner/tb/" target="_blank" rel="noopener noreferrer">tuberculosis</a> and support it in its efforts to reduce the prevalence of the infection. This perfectly curable medieval disease is the biggest infectious killer in the world today, more than HIV or malaria.https://www.youtube.com/watch?v=Xf4OpwoblRc&amp;feature=emb_logoWhile Nepal is a role model in the community-based DOTS treatment, which ensures index patients are taking their medicines, this alone will not suffice in the battle against TB, since a patient would often have already infected others in the household and workplace. Which is why active case finding and early treatment is the key.The first comprehensive national TB prevalence survey 2018-19 in Nepal showed that the burden of TB in Nepal is much higher than previously estimated. There are now known to be 245 TB cases per 100,000 people – which means there are 69,000 new cases each year. Some 6,000 people in Nepal die every year because of the infection while every other Nepali is a carrier of TB.“Tragically over 35,000 cases of TB are not due to difficulties reaching the basic health services. To accelerate progress towards the end of TB in Nepal we must increase efforts to reach remote and disadvantaged populations with high quality TB services,” says Maxine Caws, epidemiologist with BNMT. “The drone project project represents one such approach to solve this problem, and also has the potential to address many other health challenges facing rural populations of Nepal.”The DrOTS test flight was conducted successfully in Piuthan district in western Nepal last year. Since then, over 106 flights have been carried out, collecting and delivering more than 742 sputum samples, with a result of 26 positive cases from eight remote health facilities. The technology has also been used for TB control in Zimbabwe and Papua New Guinea.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109181148/636be7fa9c7e80680e087832jpeg.jpg" alt="" width="1500" height="1125"><figcaption>Locals wait for drone to arrive.</figcaption></figure><figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109181148/636be7fe9c7e80680e087833jpeg.jpg" alt="" width="1500" height="1125"><figcaption>Using the drone interface.</figcaption></figure>The drones weigh 9kg when empty and can carry another 7kg in a cargo hold designed to protect against biohazards; they can be airborne for 30 minutes. The craft flies at speeds of up to 1km per minute, and is controlled by a pilot at the take-off point who coordinates with a health worker at the destination.The DrOTS project is a multidisciplinary consortium of Birat Nepal Medical Trust (BNMT Nepal), DroNepal, Nepal Flying Labs, Liverpool School of Tropical Medicine, UK and WeRobotics, Switzerland working in partnership with the Nick Simons Institute, National Tuberculosis Centre, and Stony Brook University, USA.Says Biplav Pageni of Nepal Flying Labs: “We hope to scale our drone cargo technology to other rural locations and establish networks of medical cargo drones to help more people in the coming days. Drones are said to be the future of air cargo but I believe they are the present and we are using it to save lives in Nepal.”

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Nepal anti-TB drone project awarded

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109191116/636beef44b0ad905ca02ef7ajpeg.jpg" alt="" width="1500" height="1125"/><figcaption>Photos: BNMT</figcaption></figure>Drone therapy for tuberculosis diagnosis in Nepal’s remote and hard to reach mountains has won at the <a href="https://tiaca.org/tiaca-press-release/pelican-biothermal-and-nepal-flying-labs-win-2020-tiaca-air-cargo-sustainability-awards/" target="_blank" rel="noopener noreferrer">2020 International Air Cargo Association (TIACA)</a> Sustainability Awards and will receive $10,000 in prize money as a start-up category winner.The winning project, <a href="https://www.nepalitimes.com/banner/nepal-tests-and-treats-tb-with-a-flying-pharmacy/" target="_blank" rel="noopener noreferrer">Drone Optimised Therapy System</a> (DrOTS) by Nepal Flying Labs links rural health posts with high-end diagnostic tool via drones to improve the accessibility of tuberculosis diagnostic tests.“In a year marked by a global pandemic which disrupted our industry, problem solving and forward-thinking companies like Nepal Flying Labs bring hope that air cargo can come out of this crisis stronger and more resilient,” says Céline Hourcade of TIACA, which celebrates and encourages outstanding industry initiatives driving sustainability in air cargo.Under DrOTS, drones fly from a central district hospital to health posts in the mountains to collect sputum samples and deliver both diagnoses and treatment to patients living in up-country villages. The samples are tested using a <a href="https://www.nepalitimes.com/banner/for-nepal-a-game-changer-in-tb-control/" target="_blank" rel="noopener noreferrer">high-end GenExpert kit</a>.If they are positive, patients are given DOTS (directly observed treatment short course) treatment using smart pill boxes, which keep electronic records of whether or not patients have taken the antibiotics regularly.The highly competitive award evaluated humanitarian projects based on three aspects of sustainability -- economic social and environmental -- as well as innovation and practicality of the applied solution. The winners were announced online on 10 December.The project had also won the prestigious industry award from the <a href="https://www.auvsi.org/industry-news/winners-2020-xcellence-awards" target="_blank" rel="noopener noreferrer">Association for Unmanned Aerial Vehicles</a> – the AUVSI XCELLENCE Award 2020 in Humanitarian and Public Safety category in October.The goal of this project is to assist Nepal’s Ministry of Health in generating data on <a href="https://www.nepalitimes.com/banner/tb/" target="_blank" rel="noopener noreferrer">tuberculosis</a> and support it in its efforts to reduce the prevalence of the infection. This perfectly curable medieval disease is the biggest infectious killer in the world today, more than HIV or malaria.https://www.youtube.com/watch?v=Xf4OpwoblRc&amp;feature=emb_logoWhile Nepal is a role model in the community-based DOTS treatment, which ensures index patients are taking their medicines, this alone will not suffice in the battle against TB, since a patient would often have already infected others in the household and workplace. Which is why active case finding and early treatment is the key.The first comprehensive national TB prevalence survey 2018-19 in Nepal showed that the burden of TB in Nepal is much higher than previously estimated. There are now known to be 245 TB cases per 100,000 people – which means there are 69,000 new cases each year. Some 6,000 people in Nepal die every year because of the infection while every other Nepali is a carrier of TB.“Tragically over 35,000 cases of TB are not due to difficulties reaching the basic health services. To accelerate progress towards the end of TB in Nepal we must increase efforts to reach remote and disadvantaged populations with high quality TB services,” says Maxine Caws, epidemiologist with BNMT. “The drone project project represents one such approach to solve this problem, and also has the potential to address many other health challenges facing rural populations of Nepal.”The DrOTS test flight was conducted successfully in Piuthan district in western Nepal last year. Since then, over 106 flights have been carried out, collecting and delivering more than 742 sputum samples, with a result of 26 positive cases from eight remote health facilities. The technology has also been used for TB control in Zimbabwe and Papua New Guinea.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109191116/636beef84b0ad905ca02ef7bjpeg.jpg" alt="" width="1500" height="1125"><figcaption>Locals wait for drone to arrive.</figcaption></figure><figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109191116/636beefb4b0ad905ca02ef7cjpeg.jpg" alt="" width="1500" height="1125"><figcaption>Using the drone interface.</figcaption></figure>The drones weigh 9kg when empty and can carry another 7kg in a cargo hold designed to protect against biohazards; they can be airborne for 30 minutes. The craft flies at speeds of up to 1km per minute, and is controlled by a pilot at the take-off point who coordinates with a health worker at the destination.The DrOTS project is a multidisciplinary consortium of Birat Nepal Medical Trust (BNMT Nepal), DroNepal, Nepal Flying Labs, Liverpool School of Tropical Medicine, UK and WeRobotics, Switzerland working in partnership with the Nick Simons Institute, National Tuberculosis Centre, and Stony Brook University, USA.Says Biplav Pageni of Nepal Flying Labs: “We hope to scale our drone cargo technology to other rural locations and establish networks of medical cargo drones to help more people in the coming days. Drones are said to be the future of air cargo but I believe they are the present and we are using it to save lives in Nepal.”

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109141132/636babf89c7e80680e077f08jpeg.jpg" alt="" width="1400" height="933"/><figcaption>Photo: NEPALI TIMES ARCHIVE</figcaption></figure>COVID-19 has made headlines every day over the past two months, but tuberculosis (TB) patients across South Asia have their treatment interrupted due to the lockdown.South Asia is a vast hub for TB. India alone had 2.7 million new cases and 440,000 deaths due to TB in 2018 — the highest in the world. Every year, tuberculosis kills at least 6,000 people in Nepal and every other person is a carrier of the microbe.The WHO has set <a href="https://www.who.int/tb/End_TB_brochure.pdf?ua=1" data-saferedirecturl="https://www.google.com/url?q=https://www.who.int/tb/End_TB_brochure.pdf?ua%3D1&amp;source=gmail&amp;ust=1593695520550000&amp;usg=AFQjCNHVd_kVz8K7Q1LZxUa_CWkwSdG7Vg">global targets</a> to reduce new cases of TB by 90% and deaths by 95% between 2015 and 2035. However, the fight against TB faces a setback of an estimated 5-8 years globally, due to COVID-19.The COVID-19 crisis has uncovered gaps in the present healthcare system in the Subcontinent. There is now a shortage of functioning sputum testing centres as well as DOT (Directly Observed Treatment Short-course) centres. Healthcare workers are also wary of going on-ground and carrying out tests and diagnoses.Migrant workers with TB, who are travelling away from their workplaces, are at risk of treatment interruption, which may lead to <a href="https://en.wikipedia.org/wiki/Multi-drug-resistant_tuberculosis#:~:text=Infectious%20disease,drugs)%2C%20isoniazid%20and%20rifampin." data-saferedirecturl="https://www.google.com/url?q=https://en.wikipedia.org/wiki/Multi-drug-resistant_tuberculosis%23:~:text%3DInfectious%2520disease,drugs)%252C%2520isoniazid%2520and%2520rifampin.&amp;source=gmail&amp;ust=1593695520550000&amp;usg=AFQjCNEkqQ32ZjQluu9UU_sZ8EeTipApXQ">multi-drug-resistant (MDR) TB</a>. Additionally, due to the stigma attached with the symptoms of COVID-19, people are now afraid to get tested for TB, which has symptoms similar to those of COVID-19.This can exacerbate the problem, as undiagnosed patients can infect many more. Those with lung injuries due to TB may be <a href="https://www.thetruthabouttb.org/coronavirus/" data-saferedirecturl="https://www.google.com/url?q=https://www.thetruthabouttb.org/coronavirus/&amp;source=gmail&amp;ust=1593695520550000&amp;usg=AFQjCNHh8d8TmjVl40wPRPytgXeQDPsiww">prone to more severe outcomes</a> if infected with COVID-19.“In India, health-seeking behaviour has completely changed after COVID-19. People think twice before seeking a doctor,” says Khasim Sayyed of TB Alert India. “We are expecting a very high number of patients across all DOT centres and outpatient departments once the lockdown is lifted, because the patients are afraid to get diagnosed right now.”A combination of strategies will be required to restore normal TB services, with the objective to reduce the accumulated pool of undetected TB patients. Here are some other steps that can be taken to strengthen both diagnosis and treatment:Diagnosis<ul><li>Governments should collaborate with non-profits and use technology to ramp-up active case-finding and contact tracing.</li> 	<li>Community health workers should conduct door-to-door sample collection.</li> 	<li>Health system should ensure diagnostic services for TB. Currently, most labs are being used for COVID-19 testing only.</li> 	<li><a href="https://www.nepalitimes.com/here-now/a-covid-19-game-changer-for-nepal/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/here-now/a-covid-19-game-changer-for-nepal/&amp;source=gmail&amp;ust=1593695520550000&amp;usg=AFQjCNEqv3e5bpooFbMQx594hHcms3j7uA">GeneXpert</a> test should be enabled for MDR TB cases as they are quicker and can identify if a person has resistance to the drug.</li></ul>Treatment<ul><li>Healthcare workers and non-profits should facilitate tele-counselling to sensitise family members about the possible side effects and severe symptoms of TB.</li> 	<li>The government, in collaboration with non-profits, should run a helpline so that TB patients can better manage severe symptoms or side effects.</li> 	<li>Health practitioners should leverage digital tools to diagnose patients and prescribe first-line treatment.</li></ul>Additionally, institutions must also work to safeguard healthcare workers from tuberculosis, as well as COVID-19, during any intervention. And as more private practitioners turn to digital facilities for diagnosis and consulting, there is a need to design solutions for marginalised communities.The projected numbers for TB highlight the urgency for a better intervention strategy. While the COVID-19 pandemic deserves attention and intervention, the response to it should not come at the cost of another disease. (IPS)Devika Agarwal has worked with TB Alert India, Ministry of Health and Family Welfare, Government of Delhi, and the non-profit Aaroogya. This story was <a href="https://idronline.org/managing-an-epidemic-within-a-pandemic/" data-saferedirecturl="https://www.google.com/url?q=https://idronline.org/managing-an-epidemic-within-a-pandemic/&amp;source=gmail&amp;ust=1593695520550000&amp;usg=AFQjCNGlN78X8O31tWoB2VkPn1rFIadjaA">originally published</a> by India Development Review (IDR) and has been reprinted under an arrangement with Inter Press Service (IPS).

TB patients in limbo due to COVID-19

https://www.youtube.com/watch?v=Xf4OpwoblRc&amp;feature=youtu.beProblem: Some 70% of Nepalis are carriers of the tuberculosis bacillus and many of them have full-blown versions of the disease. Although diagnosis and treatment is available, the sick cannot travel to hospitals. How to test the sputum of patients, and deliver antibiotics in remote and road-less parts of Nepal?Solution: By drones.Nepal has been acclaimed for its directly observed treatment short course (DOTS) for treating tuberculosis, which demands a combination of antibiotics that are administered under supervision. However, TB is difficult to diagnose and treat in remote parts of this country.That is why the Britain Nepal Medical Trust (BNMT) is taking a big leap in treating TB with a pilot project in a remote part of Piuthan district in the mountains of central Nepal. Read also: <a href="https://www.nepalitimes.com/banner/tb/" target="_blank" rel="noopener">TB</a>, Sonia Awale<a href="https://www.nepalitimes.com/editorial/tb-or-not-tb/" target="_blank" rel="noopener">TB or not TB</a>, EditorialThe Trust has cleverly recycled the <a href="http://archive.nepalitimes.com/news.php?id=294#.XPkeWBYzaUk" target="_blank" rel="noopener">DOTS</a> acronym to DrOTS, this time to mean Drone Optimised Therapy System, and is running test flights in the district to collect sputum samples and deliver both diagnoses and treatment to patients living in up-country villages.The drone flies to health posts in the mountains, and returns sputum samples to the district hospital in Swargadwari Municipality and the public health centre (PHC) in Piuthan Municipality. The samples are tested using a <a href="http://archive.nepalitimes.com/news.php?id=17747#.XPkeaxYzaUk" target="_blank" rel="noopener">GenExpert kit</a>. If they are positive, patients are given DOTS treatment using smart pill boxes, which keep electronic records of whether or not patients have taken the antibiotics.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110813110/636a44c69c7e80680e04d34djpeg.jpg" alt="" width="1500" height="1125"/><figcaption>Photo: RAMU SAPKOTA</figcaption></figure>“We are using the drones experimentally to ensure that we can reach the hidden cases of tuberculosis, since every untreated patient is a potential carrier of the disease and can spread it,” explains Shraddha Acharya, BNMT coordinator in Piuthan.During the pilot phase, drones will be used only to collect sputum samples from remote settlements. If the tests are successful, the Trust hopes to use the unmanned craft to also deliver medicine.Thanks to the initiative, health personnel will no longer need to walk for days to deliver sputum samples from health centres in the villages to the district hospital and PHC for testing, and then return with medicines for those who test positive. The current system results in delays in getting medicines to patients, and also lack of supervision administering the antibiotics.Read also:<a href="https://www.nepalitimes.com/banner/for-nepal-a-game-changer-in-tb-control/" target="_blank" rel="noopener">For Nepal, a game-changer in TB control</a>, Buddha Basnyat and Maxine CawsCommunity Health Worker Sita GC (pictured above) says the drones are god-sent because they can deliver samples in 25 minutes, where earlier it took 2-3 days. “Logistics was a huge problem because of unreliable transport; now it is easy to diagnose and treat quickly,” she adds.<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110813110/636a44ca9c7e80680e04d34ejpeg.jpg" alt="" width="640" height="427">Maxine Caws (pictured above) of BNMT, an epidemiologist with the Liverpool School of Tropical Medicine, says the drones are being tested in Piuthan because it is the mountain district in Nepal with the highest TB prevalence. Last year, the district treated 379 patients for tuberculosis, but 335 new cases were detected in the same period.The remote-controlled craft are handled by drone specialist Nepal Flying Lab. “We found this to be an exciting project because the drones are ideal for bridging distances to remote areas and the sputum samples and medicines are not too heavy,” says the lab’s Uttam Pudasaini, who adds this is the first time such deliveries are being tested in Asia.The drones weigh 9kg when empty and can carry another 7kg in a cargo hold designed to protect against biohazards; they can be airborne for 30 minutes. The craft flies at speeds of up to 1km per minute, and is controlled by a pilot at the takeoff point who coordinates with a health worker at the destination. In future, the project plans to train health workers to fly the drones themselves.<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110813110/636a44cd9c7e80680e04d34fjpeg.jpg" alt="" width="640" height="427"><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110813110/636a44d19c7e80680e04d350jpeg.jpg" alt="" width="640" height="427"><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110813110/636a44d49c7e80680e04d351jpeg.jpg" alt="" width="640" height="359">The technology has been used for TB control in Zimbabwe and Papua New Guinea. In Nepal, the pilot project is funded by the Nick Simons Institute till December. “Further extension will be determined by whether it is successful and cost-effective,” says Caws.Sita GC says so far up to 35 positive cases of TB have been detected from sputum samples in Piuthan this month. However, many people refuse to give samples, and others do not follow instructions on taking antibiotics.The ministry of health is also involved in the drone trials. Spokesperson Mahendra Shrestha says that if the tests are successful the government will take over the program and try to replicate it for TB control in other remote areas.“If this project is successful, Piuthan and Nepal will be famous worldwide. But the biggest challenge is to first make the tests work,” says Shrestha.<h2>TB or not TB</h2><figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110813110/636a44d79c7e80680e04d352jpeg.jpg" alt="" width="1500" height="1000"><figcaption> </figcaption></figure>There are 10 million new cases of tuberculosis every year, and the medieval disease still takes the lives of 1.5 million people annually worldwide.South Asia accounts for 40% of the global TB burden, with over 4 million cases as well as 40% of total fatalities, a third of them patients who succumbed after they failed to respond to treatment. But worsening air pollution, smoking and alcoholism are big risk factors for TB infection in the region.Some 11 Nepalis die every day from the highly contagious infection.There are 40,000 new cases of TB here every year, and Nepal also has a very high rate of latent TB infection. Despite antibiotics, it is often difficult to reach patients in underserved parts of the country and Nepal’s harsh terrain makes it hard to access diagnosis and treatment on time. Experts say there is huge under-reporting of cases.Nepal is a role model in the community-based DOTS (directly observed treatment short course), with its supervised administration of antibiotics to patients. Yet, experts say much more aggressive <a href="https://www.nepalitimes.com/banner/for-nepal-a-game-changer-in-tb-control/" target="_blank" rel="noopener">case detection and an early treatment system</a> should be in place if the country is to meet the UN target of reducing TB mortality by 95% and cutting new cases by 90%, by 2035.This means developing techniques to reach the poorest in the remotest parts of the country, and also requires increases in Nepal’s TB control budget and prioritising the infection otherwise known as the ‘poor man’s disease’.<a href="https://archive.nepalitimes.com/page/resistance-to-live-saving-drugs-threatens-to-set-back-progress-in-nepal" target="_blank" rel="noopener">MDR (multi-drug resistant) TB</a> is also spreading, as patients develop resistance to commonly used drugs for treatment. The last survey in Nepal showed that among previously treated cases, anti-microbial resistance was found in 15.8% of cases, against the world average of 18%.Nepal also has the added challenge of an open border with India and migrant workers continue to bring infections home, while many patients from India come to this country for treatment.The UN General Assembly held its first-ever, high-level meeting on tuberculosis last year to draw attention and generate investment for TB research, treatment and diagnosis. The SAARC TB Centre located in Kathmandu focuses on prevention and control of tuberculosis and TB/HIV co-infection. Research is also needed for non-resistant drugs with shorter regimen.Sonia Awale

Nepal tests and treats TB with a flying pharmacy

Recent outrage in Sikkim over an Indian Army expedition climbing <a href="https://nepalitimes.com/here-now/saving-kangchenjunga">Kangchenjunga</a>, the world’s third-highest peak, has spiked attention to the need to balance mountaineering jobs with indigenous reverence for sacred landmarks. Kangchenjunga (8,586m) is not a peak as much as it is a mountain range with 16 peaks above 7,000m on the border between India and Nepal -- the word itself means ‘five treasures of the snows’ in Tibetan. Some of the highest prominences like Kangchenjunga West and Kangbachen are in Nepal, while the Main, Central and South Peaks are on the border. Climbing the peak from the Indian side has been banned since 2001 because the indigenous Lepcha community there regard the mountain as the abode of Dzoe-nga, the patron deity of Sikkim, which was an independent Himalayan Kingdom until it was annexed by India in 1975.&nbsp; Buddhists in Sikkim say their saint, Padmasambhava, recognised the mountain as a protective spirit. The state has declared the base of the mountain Kangchenjunga National Park, which covers an area one-third of Sikkim. ‘The act of scaling this sacred peak is not only a matter of serious concern but also a violation of both the prevailing legal provisions and the deeply held religious beliefs of the people of Sikkim,’ read a letter from Chief Minister Prem Singh Tamang (Golay) to Amit Shah, India’s Minister of Home Affairs and Cooperation.&nbsp; Tamang continued: ‘We further request Your Honour to take up the issue with the Government of Nepal to ensure that no future expeditions are permitted on the sacred mountain, in deference to the deeply held beliefs and cultural values of the people of Sikkim.’ Kangchenjunga was climbed for the first time exactly 70 years ago by a British team who told King Tashi Namgyal, the Choegyal of Sikkim, that they would not set foot on the summit. Since then, there have been about 532 successful climbs of the peaks and 52 have died while trying.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250628060616_5c268e08cf49f36b79ef9b31933fc2d9bf9a6f65414e7ca06dd028bf04e7ccc1.png" data-media-id="editor_1" data-image-id="20250628060616_5c268e08cf49f36b79ef9b31933fc2d9bf9a6f65414e7ca06dd028bf04e7ccc1" data-rendition-name="original" width="1782" height="1178" loading="lazy" alt="Kangchenjunga: too sacred to climb NT"> <figcaption>Indigenous communities in Sikkim held purification ceremonies following the Indian expedition to Kangchenjunga. Photo: THE VOICE OF SIKKIM / FACEBOOK</figcaption> </figure>  <a href="https://nepalitimes.com/here-now/peak-climbing-season-2025-s4abrxny">This spring climbing season</a> alone, there were 70 climbing permits for foreigners issued for Kangchenjunga by the Nepal government, and made it to the top while one French climber died.&nbsp; One of the expeditions this year was an Indian Army team led by Col Ranveer Jamwal, who has summited the highest peaks on all seven continents, and Mt Everest thrice. Jamwal’s team was on the final leg of a ‘<a href="https://economictimes.indiatimes.com/news/india/nimas-summits-mt-kangchenjunga-concludes-historic-har-shikhar-tiranga-mission-successfully/articleshow/121341315.cms?from=mdr">Har Shikhar Tiranga</a>’ (The Tricolour on Every Peak) mission to plant the Indian flag at the highest points of each of India’s 28 states. Kanchenjunga was the last peak they had left, and the hardest, but the expedition put five climbers on the summit. What seems to have incensed the Sikkimese is that while it has banned climbing the mountain from its side, it was an Indian military expedition that went to Nepal to climb the mountain. After news broke of the climb in May, the Sikkim Indigenous Lepcha Tribal Association asked people to observe purification ceremonies in temples across the state. Mayalmit Lepcha of the association acknowledged that the Sikkim government was also partly at fault: “I don’t think such an expedition could have gone forward without the state government being informed, so it could have done something to intervene. It shows weakness. What’s done is done, all we can do is carry out these sanctification ceremonies.”&nbsp; In 2000, one year before Sikkim’s ban, the state allowed an Austrian team to attempt Kanchenjunga’s northeast face for a fee of $20,000, on agreement that they would stop 10m before the summit. Despite this, there was outrage over the expedition on the grounds that it violated Indian laws regarding the defiling of religious sites and Sikkim’s rights to maintain its culture after merging with India. The Indian Army expedition was also seen to have circumvented Sikkim’s law and violated religious sensibilities by going through Nepal. While the team may have thought they were respecting Sikkim’s beliefs by finding a way to complete the mission, the people of Sikkim saw it as defilement.&nbsp; The somber mood of the Sikkim people at the ritual contrasts sharply with Jamwal’s sense of accomplishment. “Without a doubt, the most difficult summit of my life,” he told reporters after the climb. “It tested every ounce of our will.”&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250628060616_ccfe079c78dab788d19fe2080ee8a5d5dcb11de4157316f6d94e5964da097157.jpg" data-media-id="editor_4" data-image-id="20250628060616_ccfe079c78dab788d19fe2080ee8a5d5dcb11de4157316f6d94e5964da097157" data-rendition-name="original" width="787" height="377" loading="lazy" alt="Kangchenjunga: too sacred to climb NT"> <figcaption>Prayer flags along the Sikkim-Kangchenjunga trekking route. Photo: TREKKINGININDIA.COM</figcaption> </figure>  The <a href="https://nepalitimes.com/news/the-rise-and-fall-of-nims-purja">controversial Nepali-British mountaineer Nirmal Purja</a> was also on Kangchenjunga this spring the mountain, on a mission to summit all 14 8,000m peaks for a third time. He echoed Jamwal about the tough conditions: “The conditions above camp were extremely tough, with deep snow and challenging terrain—more crevasses than usual.” Nepal’s government has not said anything publicly, but it is unlikely that it will ban climbing on Kangchenjunga, since it is becoming popular with expeditions because of its technical challenges, and overcrowding on Mt Everest. Nepal does have bans in place for some of its mountains out of respect for local beliefs. <a href="https://nepalitimes.com/banner/to-open-machapuchre-for-mountaineering-or-not">Mt Machapuchre</a> (6,990m) the imposing pyramid that looms over Pokhara, for example, is seen as an icon of purity by the Gurung people and a symbol of Vishnu by the Hindu communities who live at its base. A strict climbing ban has been in place since 1957, when a British expedition led by Col Jimmy Roberts stopped 45m short of the summit – either because the last bit was too difficult or out of deference to local sentiments.&nbsp; Khumbila that stands above Namche Bazar is only 5,761m high, but like Kanchenjunga is considered the protector deity of the Sherpa people. Gauri Shankar on the Nepal-China border, called Chomo Tseringma by the local community, was off-limits between 1965 and 1979 due to its association with Lord Shiva and Gauri, his consort. Although expeditions are now allowed, there are not too many takers. In Tibet, climbing Mount Kailash is prohibited by the Chinese government because it revered by the Hindus, Buddhists and followers of the Bon faith. Even Mt Everest is regarded as sacred, and its Sherpa name is Chomolungma, Goddess Mother of the Earth.&nbsp; Economically, climbs on Kanchenjunga bring in decent revenue. This climbing season, the 41 permits, at $1,800 each, brought in $73,800. This is somewhat comparable to Makalu, Lhotse, and Annapurna I, but these numbers are dwarfed by the $4 million in <a href="https://nepalitimes.com/news/the-everest-industry">Everest permits</a>. Revenue from Kanchenjunga climbing permits is something Nepal could potentially forgo if necessary, but the expeditions also provide jobs to hundreds of high altitude guides, porters, base camp support staff and other logistical costs.&nbsp; As the third highest mountain in the world and the tallest in India, there will always be significant motivation to climb it from the Nepal side, especially as climbers are drawn by the technical climbing at high altitude.

Kangchenjunga: too sacred to climb?

The debate about who is less accountable to the public: politicians or bureaucrats is as old as Nepal’s democracy itself.
Some blame politicians for being beholden to the businessmen who finance their electoral campaigns, and are forced to return the favour with contracts and kickbacks when in power.&nbsp;
Others say it is civil servants who are neither civil nor servants, and know the inner workings of the system to exploit loopholes – they then teach ministers, MPs, mayors, or ward chairs which juicy projects can be squeezed. And everyone gets their share.
In reality, it is probably not a case of either, or. Both have their hands deep in the honey pot. Corruption is now such a given that yet another exposé in the mainstream press, like the latest visit-visa scam, does not raise eyebrows anymore.
We may have to edit Lord Acton’s famous quote to say that in Nepal we do not even need absolute power to corrupt absolutely. The ruling cartel has divvied up the spoils, so that no one ever faces charges. The three parties all know about the skeletons rattling in each other’s closets, and they cancel each other out.
Politicians and bureaucrats get all the blame for taking bribes, but what of the givers of bribes? In this crony capitalism, businesses invariably need political patrons in an elaborate <a href="https://nepalitimes.com/here-now/nepals-only-growth-industry-private-sector-corruption" target="_blank">national network of give-and-take</a>.
<a href="https://nepalitimes.com/here-now/nepals-only-growth-industry-private-sector-corruption" target="_blank">Politicians and businesses work hand-in-glove</a> so that conflict of interest in contracts, insider trading, cartelling, and non-performing assets of banks become the norm. Our survey after the 2017 local election showed that out of the 753 newly-elected local government chairs, <a href="https://nepalitimes.com/news/elected-contractors" target="_blank">nearly 300 were contractors</a> involved in sand-mining, quarrying, or transportation syndicates.
Nepal’s tycoons have discovered that instead of donating to election war chests of politicians, it is a much surer return on investment to spend the money to <a href="https://nepalitimes.com/news/the-business-of-politics-in-nepal" target="_blank">become legislators and politicians themselves</a>.
In democracies, there are checks and balances to control corruption when it becomes endemic. The Nepal Police and Central Bureau of Investigation (CBI) are supposed to do the detective work without political interference. The courts are required to be independent in dispensing justice and punishing crooks.
But the less said about the judiciary the better. A writ petition in the Supreme Court last week accused our sister magazine <a href="https://www.himalkhabar.com/" target="_blank">HimalKhabar</a> of contempt of court for two stories: one about how high courts have been overturning a majority of verdicts of district courts in cases of rape, and another about the Biratnagar High Court clearing a self-proclaimed holy man, Krishna Bahadur Giri, of rape despite police presenting physical evidence.
The doctrine of the separation of powers stipulates that it is when the other three pillars in a democracy are compromised that the role of the free press becomes even more vital. The world over, as soon as populist autocrats are elected to the executive, their first order of business is to co-opt the legislature and the judiciary. Then they buy off, intimidate, or neutralise the media with Strategic Lawsuits Against Public Participation (SLAPP).
Nepal’s officialdom seems to be taking midnight Zoom lessons from other despots on how to gag the media. Last month, popular talk show host Dil Bhushan Pathak was served an arrest warrant by the Kathmandu District Court for <a href="https://www.youtube.com/watch?v=-CntsnTrtG8" target="_blank">a YouTube explainer</a> about the alleged involvement of the son of Foreign Minister Arzu Deuba Rana in a reported purchase of Kathmandu’s Hilton Hotel.
The Lalitpur District Court ruled that Pathak could not be arrested without fair trial, but this week the Kathmandu District Court filed another case against the journalist based on a complaint by the Cyber Bureau, and put him on a fugitive list.&nbsp;
Without going into the veracity of Pathak’s explainer, it is deeply problematic that the Electronic Transaction Act has been invoked – proof that politicians are getting the courts and investigating agencies to make an example of a high profile journalist.&nbsp;
The intention is to silence media investigations into the fake refugee scandal in which the main partner in the ruling coalition is implicated, and in which one of its former home ministers was jailed last year.
The Kathmandu High Court has been mysteriously active in targeting journalists these days. <a href="https://bizmandu.com/" target="_blank">Bizmandu</a> and <a href="https://nepalkhabar.com/" target="_blank">Nepalkhabar</a> were served a notice last month <a href="https://nepalitimes.com/news/no-freedom-after-expression-y4inku06" target="_blank">to withdraw a story they did</a> on the Chair of the <a href="https://www.sebon.gov.np/" target="_blank">Security and Exchange Board of Nepal (SEBON</a>) Santosh Narayan Shrestha allegedly demanding kickbacks from hydropower investors.&nbsp;
Incredibly, the court even asked the two portals not to report on the subject anymore – a ruling so absurd that the Patan High Court overturned it a week later.&nbsp;
The allegations against Shrestha were made in a public meeting of the <a href="https://www.ippan.org.np/members/3060/bungal-hydro-ltd" target="_blank">Independent Power Producers Association of Nepal (IPPAN)</a>, and MPs demanded a <a href="https://myrepublica.nagariknetwork.com/news/parliament-demands-probe-into-sebon-chairman-over-alleged-commission-demand-40-32.html" target="_blank">Parliament inquiry</a> into the regulator. <a href="https://www.himalkhabar.com/144523/santosh-narayan-shrestha" target="_blank">HimalKhabar</a> reported this week that while Shrestha was reportedly demanding commissions from private investors for IPOs, he cleared primary share sales in Bajhang’s 10.75MW <a href="https://www.ippan.org.np/members/3060/bungal-hydro-ltd" target="_blank">Bungal Hydro</a> in which his family members have investments, company records show.
And then just on Monday, bureaucrats hoodwinked MPs by deleting references in a bill requiring a two-year ‘cooling off’ period under which retiring civil servants could be barred from holding constitutional positions for two years.
The contest for who is more corrupt: bureauacrats, politicians, or the private sector is on.
Kunda Dixit

SLAPPing Democracy

In 2023, northern India suffered record-breaking heat. In 2024, it broke its own record. In 2025, the Indo-Gangetic plains and the Nepal Tarai suffered a prolonged pre-monsoon heat wave and humidity, forcing closure of schools and workplaces. This week, <a href="https://www.dw.com/en/europe-heat-wave-intensifies-as-fresh-warnings-issued/live-73108302">southern Europe is suffering the worst heat wave</a> since temperature records began. Football matches, tennis tournaments have been affected, and tourist sites have been closed off. Qatar has ordered a midday work curfew for Nepali and other migrant workers are the maximum temperature this week touched 45°C.&nbsp; Kathmandu Valley experienced its highest temperature in 25 years in May 2024 at 35.3°C. This year, the maximum temperature exceeded 30°C on many days — heat that till a decade ago would be considered unusual. Rains in early June also meant that towns in the mountains sweltered under high heat plus humidity.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250703090748_6975cfc2ad573f3a09ca301a299a9e92a420da7f1c5c90b8e4d061a2053dcd3e.jpg" data-media-id="editor_1" data-image-id="20250703090748_6975cfc2ad573f3a09ca301a299a9e92a420da7f1c5c90b8e4d061a2053dcd3e" data-rendition-name="original" width="1935" height="801" loading="lazy" alt="maximum average temperature in Kathmandu"> <figcaption>Source: DHM</figcaption> </figure>  Measuring just temperature does not give a true picture of how hot it is. When humidity is factored in, the heat index this summer has been much higher in northern India and Nepal. Also, the hotter the air temperature the higher the concentration of water vapour in it. “We feel it is getting hotter, and our statistics back that up,” says Shanti Kandel at the Department of Hydrology and Meteorology, which issued two heat wave warnings this year, compared to 11 last year. “We need more research to analyse how humidity is make this situation worse.” <a href="https://economictimes.indiatimes.com/news/india/india-faces-alarming-30-rise-in-moist-heat-stress-over-40-years-affecting-wide-swath-of-country-imd-study/articleshow/109376863.cms?from=mdr">A recent analysis</a> by the Indian Meteorological Department has found that heat stress in that country has increased by nearly 30% over the past 40 years. Similarly, India’s Council on Energy, Environment and Water (CEEW) noted that cities like Delhi, Chandigarh, Jaipur, and Lucknow have experienced a 6-9% rise in relative humidity in the last decade.&nbsp; It also states that <a href="https://www.reuters.com/sustainability/climate-energy/majority-indian-districts-face-high-heatwave-risk-study-shows-2025-05-20/#:~:text=%22About%2057%20per%20cent%20of,usual%20number%20of%20heatwave%20days.">60% of Indian districts</a>, home to three-quarters of the country’s 1.3 billion people face a high to very high risk from extreme heat, with rising night-time temperatures and humidity. The heat index is also called ‘<a href="https://nepalitimes.com/here-now/north-indian-heat-wave-hits-nepal">wet-bulb temperature</a>’ and is a measure of how hot the human body feels when humidity levels are also high — usually much hotter than the recorded temperature. For example, a wet-bulb temperature of 35°C is considered the maximum limit of heat and humidity that humans can handle, beyond which the body cannot cool by perspiration, leading to death. One indicator of increasing humidity is a rise in average minimum temperature, and Nepal recorded the highest figure since 1981 last year, with a peak of 15.8°C. Higher minimum temperature denotes warmer nights, which in turn is an indication of heat stress caused by increasing humidity, which in turn is a result of global warming. Aside from higher average temperatures worldwide this year, what makes heat and humidity more unbearable is that cities are always hotter than their surroundings. This is due to the <a href="https://nepalitimes.com/opinion/comment/preparing-for-kathmandu-s-heat-waves">urban heat island (UHI) effect</a> – for example the temperature inside Kathmandu’s Ring Road can be hotter by <a href="https://www.epa.gov/heatislands/what-are-heat-islands">up to 4°C during the daytime and by 1 to 3°C in the evening</a> compared to the outskirts. “Climate change is one reason for rising temperature, but there are other factors like increased heat in urban spaces due to concrete buildings and infrastructure, emissions from vehicles, industries, and home appliances,” explains urban planner Bhushan Tuladhar. He adds: “Much of this comes down to how we have developed our cities, not just our roads and buildings but also our water system, waste management, culture and customs as well as economy.” There is a feedback loop at work: as it gets hotter, more energy is used for fans, coolers, and air-conditioners which in turn add to the urban heat bubble. The way to reduce the UHI effect is to have more parks, tree-lined streets and water bodies to cool cities down.&nbsp; <a href="https://www.sciencedirect.com/science/article/abs/pii/S2212095525002093">A recent study published in the journal Urban Climate</a> by Nepali researchers at the University of Massachusetts, Tribhuvan University, University of Groningen, etc showed that even within Kathmandu, urban forests cooled neighbourhoods by as much as 1.2°C while ponds reduced the temperature by up to 0.85°C compared to nearby houses.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250703090748_e4de75dbdfb5fcfdeb0935eda364dc16b5dca8857ba335ab0f4586ebdc5093a9.jpg" data-media-id="editor_8" data-image-id="20250703090748_e4de75dbdfb5fcfdeb0935eda364dc16b5dca8857ba335ab0f4586ebdc5093a9" data-rendition-name="original" width="2580" height="1038" loading="lazy" alt="urban heat island in Kathmandu"> <figcaption>Source: URBAN CLIMATE et al.</figcaption> </figure>  ‘Our results demonstrate that blue-green spaces provide significant cooling benefits across the Kathmandu Valley, with distinct patterns by type, size, design, and urban context,’ concluded the paper, whose lead author is Saurav Bhattarai at Jackson State University in the United States. The old towns in Kathmandu Valley with traditional brick and tile architecture, ponds and trees managed hot summers better. Compact houses around a courtyard gave people just the right amount of sunlight, and use of clay mortar and bricks insulated houses in winter while cooling them in summer. There were open spaces, fertile land along the floodplains for farming, and brick pavements that allowed for seepage. “Our cities were planned taking nature into account,” says Sangeeta Singh, a professor of urban planning at the Institute of Engineering. “Kathmandu Valley is now built up, but we can still reintegrate blue-blue spaces into town planning with vertical gardening, urban forestry, using local material and harvesting rainwater.”&nbsp; Kathmandu’s municipalities have by-laws controlling building design and structure, but strict enforcement of land use and zoning are missing. Extreme heat disproportionately affects the urban poor who may not have access to fans or air-conditioners, exacerbating poverty.&nbsp; Cities in the plains have it even worse. As heat and humidity rise simultaneously, it could <a href="https://nepalitimes.com/banner/garmi-se-behal-chalo-nepal">reverse the current mass migration</a> of people from the mountains to the Tarai, where 53% of Nepal’s population lives. <a href="https://thedocs.worldbank.org/en/doc/92fbbbc6180238e18e7b239fad83e38a-0280032024/original/12-DHNT-Temperature-poverty-inequality-September-2024.pdf">A World Bank study</a> put the cost of a 1°C rise in temperature at 17.1% increase in poverty globally. Estimates put the total number of urban poor in developing countries exposed to the worst heat extremes at 26 million presently, this number is bound to grow to 215 million by mid-century, an over eight-fold increase. Meanwhile, 489,000 health-related deaths occur each year, 45% of them in Asia alone. “Heat has to be seen from a class perspective,” says Singh. “Those with money can afford gadgets and appliances to keep their homes and offices cool, but not day labourers or poor families living in cramped housing with poor ventilation.” Climate breakdown is going to widen the class divide in cities, as <a href="https://nepalitimes.com/banner/unthinkable-in-the-current-climate">summers become unliveable</a>. Says Singh: “We need policy intervention to address this class injustice. Our building by-laws and new town development must urgently integrate climate and energy efficiency elements.”

In the heat of the moment

The monsoon this year arrived on time, and brought life-giving rain — irrigating paddy terraces, recharging groundwater, reviving springs, and increasing electricity generation.
But Nepal has to deal with either too much water or too little. On a clear April day before the monsoon, the hills of Sindhuli district were parched, and there were wildfires burning out of control. There had been no rain for the past six months.
And that has been the perennial crisis for Nepal’s farmers: that 85% of the rainfall occurs during just four months of the monsoon with little rain for the other eight months.&nbsp;
The water crisis is related to the powerful changes sweeping the mid-hill region of Nepal. With better roads, higher incomes and more exposure, many residents now aspire to have the kind of water supply seen in urban homes. They want hot or cold water at the turn of a tap, showers and flush tank toilets.&nbsp;
To meet this rising demand, many local and provincial governments are investing in large water supply projects often by lifting water from rivers hundreds of metres down the mountain. But these new systems may not be sustainable in the long run.
Many villages in Sindhuli are switching from local springs to piped systems, and even in rural homes, overhead tanks are becoming common.
But this new convenience comes with big challenges. Lifting water from rivers far below requires long pipes, electric pumps, and constant maintenance. These systems are costly, and the streams themselves often shrink to a trickle in the dry months. Big water-lifting schemes look impressive, but there is doubt if they can meet growing water demand.
A much more sustainable solution would be what some communities are doing: restoring old ponds or build new recharge systems. But those villages are exceptions, in most places traditional ponds and wallows are being filled up to be turned into sports fields, or make way for buildings.
Where there are new ponds, they are sometimes in the wrong places or without proper design. Roads and drains are not engineered properly and have increased landslides and erosion. Water management in hilly areas is not just about building things, it is about building in the right way, in the right place.
Traditional water systems were based on nature. They were not perfect, but they used the land wisely. Ponds used to hold rainwater and slowly refill springs which supported families, farms, and forests.&nbsp;
Not everything worked well in the past, but we can learn from traditional water management practices. Across Nepal, some rural municipalities have launched campaigns to store monsoon runoff — either in tanks, ponds or by recharging the aquifers.
But not all efforts have been successful. Some ponds are built without any hydrological study. Some are rushed to meet deadlines rather than real needs.&nbsp;
Now, the Muhan initiative hopes to revive springs to make households more resilient and help farmings. With the financial support of the Australian Centre for International Agricultural Research, research is being done to understand how springs work and how they are affected by changes in rainfall, land use, and development.&nbsp;
Instead of just building pipes and tanks, the project maps the entire springshed so we can understand the root cause of water shortage. In Sindhuli, the problem is not the amount of rain, but the loss of natural systems that store it and the social systems that manage water.&nbsp;
Nepal’s towns and villages now face a major challenge: how to manage water all year round as demand rises with people’s living standards. Depending only on river-lift systems is not a sustainable solution.&nbsp;
We need a mix of approaches that help store water from the rainy season to make it available for the rest of the year, whether by directly harvesting rainwater, restoring ponds, managing springsheds, or smart management of demand.
Rural Nepal is also seeing dramatic depopulation. Much of the outmigration can be stemmed if there is easier water supply for agriculture and household use. Across the mid hills, villages are emptying because springs are going dry. Government policy needs to catch up with the reality on the ground, and support solutions that work for people and nature. Every water supply plan should include recharge structures. Every road or building project should consider water flow and erosion. Local governments need more than budgets: they need training, tools, and data.
Ngamindra Dahal is with the Nepal Water Conservation Foundation, Kathmandu. Hemant Ojha collaborated in this piece and is associated with the Australian National University.

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Nepal anti-TB drone project awarded

Nepal anti-TB drone project awarded

TB patients in limbo due to COVID-19

Nepal tests and treats TB with a flying pharmacy

Kangchenjunga: too sacred to climb?

SLAPPing Democracy

In the heat of the moment

Water for Life