<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109141136/636badaf9c7e80680e077fabjpeg.jpg" alt="" width="1400" height="933"/><figcaption>Photo: GOPEN RAI</figcaption></figure>On Friday, it will be four months since Nepal closed the country down to prevent the spread of  SARS-CoV-2, the virus strain that causes COVID-19. Of the 40 who have died of the infection in Nepal, two are children below 5.But many more children have died during the four months of lockdown compared to the same period last year because of lack of access to health care due to the restriction on mobility, interrupted vaccination campaigns and the lack of medicines.However, the coronavirus grabs all the headlines. Mortality due to non-COVID-19 causes does not make the news – even though it is clear that a lockdown enforced to control one disease has caused far more deaths from other prevalent diseases, and threatens to undermine Nepal’s progress in infant and child survival over the past four decades.“The COVID-19 crisis and lockdown have pushed many families into poverty, many have lost their sources of income, l<a href="https://www.nepalitimes.com/latest/eu-unicef-support-child-nutrition-during-lockdown/" target="_blank" rel="noopener noreferrer">eading to malnourishment among children</a>,” says Jhalak Gautam of the Child Health Division at the Health Ministry. “Increased malnutrition means children are more susceptible not only to COVID-19 but to many other infectious diseases such as measles and diphtheria.”Under-5 child mortality rate in Nepal had declined substantially from 271 deaths per 1,000 live births in 1969 to 32 in 2018. Government figures show that since 17 July 2018-16 July 2019, a total of 1,357 children under 5 died of various infectious diseases all over the country. Preliminary figures for the same period 2019-2020 is 1,263 – even though only 78% of the data has been collected.Initial government figures also show that a total of 204 children under 5 have died across the country during the lockdown between 14 March-14 June. This number was at a much lower 151 during the same period last year.This data clearly show that the total child death numbers collected by Female Health Care Volunteers is higher this year — meaning they died at home. The number of those who have died at hospital in the same three months this year is lower than last year probably because parents are not taking children to hospital when they are sick during the lockdown.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109141140/636badb39c7e80680e077facjpeg.jpg" alt="" width="1714" height="1210"><figcaption> </figcaption></figure>An expert at the Health Information Management System says when all the data for this year comes in, it is bound to be much higher than last year. This means the lockdown has pushed Nepal back in meeting its health targets under the United Nations’ SDGs (Sustainable Development Goals).Under the SDG target, Nepal is supposed to bring child mortality down further to 25 deaths per 1,000 live births by 2030. Persistent childhood malnutrition is a major reason for infant and child mortality remaining high despite dramatic progress in the 1990s. <a href="https://www.nepalitimes.com/banner/nearly-half-of-nepali-children-still-malnourished/" target="_blank" rel="noopener noreferrer">Figures for stunting, wasting and anaemia in Nepal have plateaued in the last decade</a>  Now, the lockdown has added to the challenge.Says Elke Wisch, UNICEF Representative to Nepal: “Progress made on children’s nutrition in the last decade is at risk of being reversed as rising numbers of children are facing malnutrition due to loss of household income and resulting food insecurity. The social and economic loss for Nepal resulting from the deterioration in children’s nutrition status will be felt long after the COVID 19 crisis is over.”The lockdown has also disrupted <a href="https://www.nepalitimes.com/banner/a-shot-in-the-arm-for-vaccines-in-nepal/" target="_blank" rel="noopener noreferrer">vaccination campaigns</a> across the country, leading to <a href="https://www.nepalitimes.com/here-now/meanwhile-a-measles-outbreak-in-nepal/" target="_blank" rel="noopener noreferrer">measles outbreaks in Dhading and Gorkha</a> in April. Although regular immunisation services have now been restored in health facilities in all 77 districts, parents have been unable to take their children for shots because of restrictions on transportation and also because of the fear of COVID-19 transmission in health posts.In fact, the WHO and UNICEF earlier this week stated that preliminary data for the first four months of 2020 points to a <a href="https://www.who.int/news-room/detail/15-07-2020-who-and-unicef-warn-of-a-decline-in-vaccinations-during-covid-19" target="_blank" rel="noopener noreferrer">substantial drop in the number of children completing three doses of the vaccine</a> against diphtheria, tetanus and pertussis (DTP3), first time in 28 years. Moreover, at least 30 measles vaccination campaigns were or are at risk of being cancelled, which could result in further outbreaks in 2020 and beyond.“Vaccines are one of the most powerful tools in the history of public health, and more children are now being immunised than ever before,” said Tedros Adhanom Ghebreyesus, WHO Director-General. “But the pandemic has put those gains at risk. The avoidable suffering and death caused by children missing out on routine immunizations could be far greater than COVID-19 itself.”With schools closed for the past four months, children in many schools are also not getting their lunches. Domestic violence has also seen a spike during the lockdown, with many of the victims children. There is also evidence of a <a href="https://www.nepalitimes.com/latest/child-marriages-up-during-nepal-lockdown/" target="_blank" rel="noopener noreferrer">rise in child marriage</a>  anxiety, stress and <a href="https://www.nepalitimes.com/here-now/post-pandemic-mental-health-epidemic/" target="_blank" rel="noopener noreferrer">mental disorder</a>Nepal appears to be on track to proving correct the grim prediction in May by the Johns Hopkins Bloomberg School of Public Health that 1.2 million children worldwide could die from pre-existing diseases like malaria, pneumonia or diarrhoea in the next six months due to the disruption to health services and food supplies due to the lockdown. That makes <a href="https://www.nepalitimes.com/latest/pre-existing-diseases-may-kill-more-children/" target="_blank" rel="noopener noreferrer">6,000 fatalities a day</a> – a whopping 45% rise in child mortality.“Under a worst-case scenario, the global number of children dying before their fifth birthdays could increase for the first time in decades,” UNICEF Executive Director Henrietta Fore warned. “We must not let mothers and children become collateral damage in the fight against the virus. And we must not let decades of progress on reducing preventable child and maternal deaths be lost.”<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109141140/636badb69c7e80680e077fadjpeg.jpg" alt="" width="3600" height="2400"><figcaption> </figcaption></figure>Another aspect of the pandemic that Nepal has to be careful about is that while worldwide data show that children are relatively safe from contracting SARC CoV-2 which has mainly affected people above 70 years, in Nepal children also seem vulnerable.Health Ministry data show that the rate of infection among children below 5 is 2.2% and increasing – much higher than the global average. The infection rate among young children was at just 1% a month and a half ago.Many of the infected children belong to families who returned from India in the past three months, but children have also been infected by people who flouted lockdown rules and safety measures. This is why Far-west Province has the highest coronavirus infection rate among children at 5%.Nepal has also seen a <a href="https://www.nepalitimes.com/latest/why-are-younger-people-in-poor-countries-dying-of-covid-19/" target="_blank" rel="noopener noreferrer">disproportionate number of COVID-19 infections and mortality among a younger population</a>  Experts say this is mainly due to young returnee migrant workers from India, Malaysia and the Gulf, who make for the majority of the coronavirus cases in the country. Moreover, testing across the country so far has focused on returnees.“Unlike elsewhere, in Nepal people with co-morbidity have a higher risk of dying regardless of the age group, and this is worrying,” says epidemiologist Sher Bahadur Pun of the Health Ministry. “But we must widen our testing to come to a concrete conclusion about this. So, <a href="https://www.nepalitimes.com/opinion/prevention-while-searching-for-a-cure/" target="_blank" rel="noopener noreferrer">until we have a vaccine</a> we must wear masks, maintain physical distance and follow hand hygiene. This includes children.”

Sonia Awale

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Children are collateral damage in Nepal lockdown

<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108121156/636a44879c7e80680e04d336jpeg.jpg" alt="" width="1200" height="800"/>Nepal has made significant progress in raising primary school enrolment, with more than 95% of boys and girls now attending school from Grades 1 through 5. More than half of adolescent girls in rural areas are now in secondary schools; 15 years ago it was less than 30%.Despite this achievement, poverty, family pressure and gender-unfriendly schools mean that the <a href="http://archive.nepalitimes.com/news.php?id=19596#.XOUa4yAza70">dropout rate</a> for girl students is still high. As a result, adolescent girls from rural areas get caught in a trans-generational cycle of poverty inherited from their mothers, and are more likely to pass it on to their own children.In response, VSO Nepal, in partnership with Aasaman Nepal, the British Council, Global Action and Mercy Corps, is helping girls in districts like Parsa -- where female literacy is low -- through a program called Sisters for Sisters’ Education. Older girls are recruited to mentor younger ones, increase their enrolment and prevent dropouts.<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108121156/636a448a9c7e80680e04d337jpeg.jpg" alt="" width="1200" height="800">The older girls are volunteers from the community, who act like Big Sisters to get Little Sisters into school and guide them through adolescence. Big Sisters provide not only academic support but also encouragement and taboo-busting information on sexual and reproductive health to the younger ones.More than one-third (36%) of Nepali women over 15 <a href="https://tradingeconomics.com/nepal/literacy-rate-youth-female-percent-of-females-ages-15-24-wb-data.html">have had no education</a>. This rate increases with age, and more than 91% of women ages 60-64 cannot read or write.Sisters for Sisters not only gets Big Sisters to mentor Little Sisters through school and act as positive role models, it works with younger girls, their families and schools to ensure they remain within the formal education system.Although <a href="https://www.nepalitimes.com/banner/child-marriage-in-nepal-eloped-at-13-mother-by-17/">child marriage is illegal</a>, girls living in rural areas get pulled out of school to be married as early as 13. As girls enter adolescence, this and other pressures increase, resulting in a rising dropout rate: 6% drop out of primary school while 8% percent drop out of secondary school.<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108121156/636a448d9c7e80680e04d338jpeg.jpg" alt="" width="1200" height="800">By leaving school, adolescent girls in rural areas fail to acquire a <a href="http://archive.nepalitimes.com/article/editorial/not-just-half-the-sky,1178">lifetime capacity for critical thinking and problem solving</a> that can only be learned via secondary education, which goes beyond basic literacy and numeracy skills.As Little Sisters age, VSO supports them to enrol in higher education, which enhances the girls’ confidence and self-esteem, enabling them to take control of their own sexual and reproductive health and rights, and develop life skills.So far, peer learning support funded by the UK’s Department for International Development (DFID) has helped 8,115 girls in Nepal in 50 schools in Dhading, Lamjung, Surkhet and Parsa.Priyanka Budathoki is with VSO Nepal.<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108121156/636a44909c7e80680e04d339jpeg.jpg" alt="" width="1200" height="800">_______________________________________________________________________“Never look back” Sunti Devi is 34 and her daughter is 12, the age she was when she got married. Aged 16 with two babies in her arms and a small bag, Sunti was forced to leave her husband’s home. She does not want her daughter, or other daughters in Nepal, to go through what she did and now mentors female students in her community. Sunti’s story:<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108121156/636a44939c7e80680e04d33ajpeg.jpg" alt="" width="217" height="193">“I was in Grade 7 when my parents fixed my marriage with someone in a faraway village. I became a mother at 13, and my in-laws taunted me for giving birth to a daughter. A year later I gave birth to a baby boy and hoped to be accepted back to my husband’s house. I returned only to find that he had married someone else.I completed Grade 10 and began teaching in a primary school, renting a room to raise my children as a single mother. I started working in Sisters for Sisters’ Education and have never looked back. I am living in the same community where my husband lives with his second wife, but that does not affect me anymore. I am determined not to let my students be forced into marriage at an early age. As an Auntie Champion I train the girls in life skills, mentor them and increase their confidence.”_______________________________________________________________________“I am proud of my sisters”Apsana Khatun, 19, from Province 2, is a Big Sister community volunteer who mentors four girls (Little Sisters) in a community school. When her relatives wanted her married Apsana’s mother resisted. Her story:<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108121156/636a44949c7e80680e04d33bjpeg.jpg" alt="" width="816" height="544">“I am a Muslim. The girls in my community cannot go out on their own, and have to wear veils. My relatives wanted me married off, but my mother allowed me to go to school. Many other girls are not so lucky. After completing Grade 10, I became a Big Sister community volunteer in Sisters for Sisters’ Education in my village.I am responsible for four Little Sisters, whom I mentor with academic guidance and emotional support. At first their parents were not happy with me. But I persisted, and got two of them who had dropped out back in school. Now, the parents treat me like family. I feel so proud when the girls in my school say they want to be teachers, doctors and nurses. My mother never went to school; I want every mother in Nepal to be educated."

Sisterhood of students

Child marriage in Nepal: eloped at 13, mother by 17

<img width="1400" height="661" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221107161120/636922e39c7e80680e03a152jpeg.jpg" alt=""/>Shrinkhala Khatiwada is on a whirlwind tour: to the remote village of Bharta in Makwanpur (pictured) where she is building a health post, on to London for a fundraising dinner, and stopping over in Kathmandu en route to China.Nepali Times caught up with her to find out what Miss Nepal 2018 has been up to since her coronation in April.The reason Khatiwada is into post-earthquake reconstruction is because she is also an award-winning architecture student. She wants to complete a health post in the Chepang village of Bharta before the Miss World pageant in November as her entry for the subtitle ‘Beauty with a Purpose’.“I have always been passionate about architecture, and the earthquake opened up a huge need for architects. While we rebuild, we have to take care to preserve our traditional architecture and make sure the cities are well planned,” says Khatiwada.Read also: <a href="http://archive.nepalitimes.com/news.php?id=9224#.W6zDhnszbIU" target="_blank" rel="noopener">The Palung story</a>, Gaurab Raj Upadhyaya<a href="http://archive.nepalitimes.com/article/nation/Chepang-living-edge,3136" target="_blank" rel="noopener">Living on the edge</a>, Riwaj Rai in Makwanpur She expands on the concept of healing by design: how a well ventilated hospital room makes a patient feels better. The Makwanpur health post is a learning experience, as she finds out the nitty-gritty of transforming this concept into reality. She had initially hoped to finish construction for Dasain, but the cost has doubled because the site is so remote that it is expensive to transport construction materials there. <figure><img width="1400" height="932" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221107161120/636922e79c7e80680e03a153jpeg.jpg" alt=""><figcaption> </figcaption></figure>So, she is busy with fundraising dinners and approaching corporates, while the costs keep going up. Now, she is helping build a road to the village which had none. The village is now accessible, but the monsoon has delayed work. The foundation for building has finally being laid, and Khatiwada hopes to complete it soon and hold a health camp before the Miss World pageant.Read also: <a href="https://www.nepalitimes.com/from-the-nepali-press/stuck-in-grade-5/" target="_blank" rel="noopener">Stuck in Grade 5</a>, Binita Dahal<a href="http://archive.nepalitimes.com/news.php?id=9489#.W6zD8HszbIU" target="_blank" rel="noopener">Chepangi schools</a>, Mallika Aryal<a href="http://archive.nepalitimes.com/article/from-nepali-press/First-Chepang-nurse,3143" target="_blank" rel="noopener">First Chepang nurse</a>, Sajana Baral“A health post is for treatment, but prevention of diseases is just as important,” explains Khatiwada, who herself spoke to villagers about basic hygiene like hand washing, showering, and building latrines. The village has a high level of malnutrition among children, complications from early marriages and rampant superstition.At present, villagers have to walk for two hours to reach the nearest health post, and Khatiwada knows there are many villages which are as much in need as this one. “This is just the beginning of my work in philanthropy and architecture. Eventually I want to use my fame to build more of what Nepal needs, whether it is health posts in remote areas, or schools and homes in disaster zones,” she adds.Read also: <a href="https://nepalitimes.atavist.com/reconstruction-in-ruins" target="_blank" rel="noopener">Reconstruction in ruins</a>, Om Astha Rai and Sahina Shrestha<a href="https://www.nepalitimes.com/here-now/building-homes-on-a-deadline/" target="_blank" rel="noopener">Building homes on a deadline</a>, Om Astha raiAfter her year as Miss Nepal ends, Khatiwada plans to focus on philanthropic architecture through her One Home Foundation. This is actually what attracted her to Miss Nepal, to use the celebrityhood for a good cause, not necessarily its glamour.“This is a platform where you get famous overnight, and then it is up to you how you use that fame,” she explains. “I want to use it to become a change maker. In fact, the whole reason I am excited about participating in the Miss World pageant is so I can make global contacts to help me continue my work in architecture.”Nepal has never won the Miss World title, though Ishani Shrestha bagged the Beauty with a Purpose title in 2013. This year, all eyes are on the competent and confident Shrinkhala Khatiwada, and Nepal will be cheering her on.Read also: <a href="http://archive.nepalitimes.com/blogs/thebrief/2017/06/12/charismatic-nikita/" target="_blank" rel="noopener">Charismatic Nikita</a>, Sabita Shrestha<a href="http://archive.nepalitimes.com/news.php?id=12450#.W6zFbHszbIU" target="_blank" rel="noopener">Mud, glorious mud</a>, Nripal Adhikary

Miss Nepal's mission

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221107141112/6369045e9c7e80680e037d1djpeg.jpg" alt="" width="3000" height="2000"/><figcaption>(Left to right) Soniya Kumary Sada eloped when 16 after her Grade 10 exam, but her husband is away at work in India and she is prevented from studying by her in-laws. Sudesh Rishidev from the Musar community was married at 18, at a time when he had no idea what a husband’s responsibilities were. Navin Rishidev is Sudesh’s friend and was married when he was 18 and his wife was 14 because his parents wanted someone to help with the cooking.</figcaption></figure>Given Nepal’s poor record in enforcement and implementation, it is a given that here, passing laws are not enough. This is glaringly evident in the average age of marriage, which is stuck at 18 despite law raising the minimum marriage age to 20.Data shows that <a href="http://archive.nepalitimes.com/article/Nepali-Times-Buzz/ending-child-marriage-in-Nepal,3864" target="_blank" rel="noopener">37% of girls in Nepal marry before the age of 18</a>, and 10% are still married by the age of 15. This is the third highest rate of child marriage in South Asia after Bangladesh and India. Despite the rise in female literacy child marriage has not gone down significantly. This is taken as a proof that education is slow to reform deep-rooted patriarchy.<a href="http://archive.nepalitimes.com/article/Nepali-Times-Buzz/child-marriage-in-Nepal,3863" target="_blank" rel="noopener">Child marriage</a> is highest in districts with low female literacy and the Tarai districts have a particularly high rate. Experts say that even if marriage age can be deferred to 16 for boys and girls in the Tarai, it will be an achievement. This has thrown the government’s target to eradicate child marriage by 2030 in doubt.At a Girl Summit for the youth of Province 1 and 2 here last month, local government officials, lawmakers all made the right noises, expressing commitment to meet the <a href="https://archive.nepalitimes.com/article/nation/on-air-radio-ro-deter-child-marriage,4185" target="_blank" rel="noopener">zero child marriage goal by educating, empowering and employing girls</a>. They heard from adults who were married when they were children, and were informed of pressures in male-dominated society from family and the influence of the Internet in encouraging early relationships lately. The Summit's motto was: ‘Educate Girls To Save Girls’.Sudesh Rishidev from a Musar community in Rangeli of Morang was 18 when he was married and did not know a husband’s responsibilities. “I knew I had to look after my family, but did not know how,” recalls Rishidev, now a 26-year-old anti-child marriage campaigner.Navin Rishidev is Sudesh’s friend and is now 28, but he was married when he was 18 and his wife was 14. His parents had five other children, and wanted him married only so they could have a daughter-in-law to help with the household chores. Today Navin is a well-known Maitihili singer and uses his musical talent to raise awareness against child marriages.Soniya Kumari Sada from Chandranagar eloped with Indrajit Sada when she was 16, just after her Grade 10 exam. However, with her husband working in India, her in-laws refused to let her study and banished her back to her parent’s home. She is now worried about her future.Pooja Shah, 18, from Janakpur had to take care of her mother and three siblings after her father died. Relenting to pressure from her mother to get married, she wedded 21-year-old Sarkar Shah, but says: “I did this for my mother, who was facing financial pressure to raise the family.” She is sad about dropping out of school, but understands why her mother forced her to do it.Rani Mahato is now 37 and an active member of a political party, but was married when she was 11. “I was not even aware that I had been married,” recalls Mahato, who is now district vice-chair of her party. She is glad the average age of marriage has climbed to 17, even though it is still low.Ajay Kumar Rishidev, from Morang is now 23 and in Grade 12. He is under pressure from family to get married but has evolved a clever strategy to deal with it: he brings his friends to talk to his parents, or he disappears from his home when he hears that prospective bride families are visiting.This has helped him to stay single till now, an he is involved in performing street dramas to show the Musar communities reasons on why child marriage deprives women of opportunities in life.Saroj K Patel, ward Chair of Jeetu Simra Sub Municipality in Province 2, is with the Rastriya Janata Party, but says the campaign against child marriage crosses party lines. But he adds that banning registration of marriage below 20 is depriving many young married women of their rights.<a href="https://www.nepalitimes.com/here-now/mr-province-2/" target="_blank" rel="noopener">Chief Minister of Province 2 Lal Babu Raut</a> is convinced that increasing female literacy is the first order of business to fight patriarchy and caste system that lie at the high rate of child marriages in the Tarai. He is trying to amend the relevant clauses in the Civil Laws, and impose a 50% quota in the provincial police.Raut seems to know what he is talking about when he says: “Women are less corrupt than men, so if they are educated and employed, they will also benefit along with their families and the community.”namrata1964@yahoo.comRead also:<a href="http://archive.nepalitimes.com/article/Nepali-Times-Buzz/child-marriage-in-Nepal,3863" target="_blank" rel="noopener">Far too young</a>, Sonia Awale<a href="https://archive.nepalitimes.com/article/nation/on-air-radio-ro-deter-child-marriage,4185" target="_blank" rel="noopener">On air to deter child marriage</a>, Shipra Jha<a href="http://archive.nepalitimes.com/article/Nepali-Times-Buzz/ending-child-marriage-in-Nepal,3864" target="_blank" rel="noopener">Not just a social problem, but an economic one</a>, Elizabeth Hanna Satow

Can Nepal end child marriage by 2030?

On Tuesday, leader of the monarchist RPP once again gathered on Kathmandu’s streets to deliver fiery speeches, but this time there was no arson and looting and no need for riot police to fire live rounds or tear gas.
RPP leaders demanded the release of their members including vice-president Rabindra Mishra and MP Dhawal Shamsher Rana were arrested during the violent <a href="https://nepalitimes.com/news/republicans-and-royalists-on-nepal-s-streets">28 March protests at Tinkune </a>which left two dead. 
They denounced the current leadership of the main parties, demanding the <a href="https://nepalitimes.com/editorial/nepal-party-reincarnating-hindu-monarchy">restitution of Nepal as a Hindu kingdom</a>. They also said the government was responsible for the fatalities on 28 March because it provoked its rally with a tear gas attack even before it started.
It has now been revealed that the police fired at least 100 live rounds from high powered assault rifles at the crowd. Twenty-one of the 120 injured received bullet wounds, and most of them were bystanders and people trying to reach home. 
Tuesday protest on the Ring Road in Balkhu was much more subdued, and comparatively fewer RPP supporters showed up. The arson and vandalism in the previous protest appears to have cost some support for <a href="https://nepalitimes.com/news/the-ghost-of-monarchy-returns-to-haunt-nepal">former king Gyanendra </a>especially for the anointment of medical tycoon and bank defaulter <a href="https://nepalitimes.com/news/street-politics">Durga Prasai </a>as ‘commander’ of the Tinkune rally.
Some monarchists acknowledge Gyanendra’s mistakes when was king 2001-2008, but say he has had a lot of time to reflect on his shortcomings and seems more disciplined and committed. His supporters have tried to build on nostalgia among some Nepalis for<a href="https://nepalitimes.com/news/why-invest-in-nepal"> domestic stability </a>and international respect that <a href="https://nepalitimes.com/here-now/if-birendra-was-alive-nepal-could-still-be-a-monarchy">the monarchy</a> commanded. 
“Nepalis were promised better service delivery, opportunities for the underserved, as well as better, more honest use of state resources, but the <a href="https://archive.nepalitimes.com/news.php?id=16992">people in leadership </a>have not been able to deliver on their commitments,” says RPP leader Prakash Chandra Lohani. “The gap between their rhetoric and reality has widened, the people feel betrayed, and the respect Nepali people had previously had for them has changed to revulsion.” 
Indeed, many commentators have warned the three main parties and their <a href="https://nepalitimes.com/editorial/politics-as-usual">serial prime ministers</a> who have ruled Nepal for much of the past 30 years should address rising public anger with them, and see the writing on the wall.
‘<a href="https://nepalitimes.com/news/nepal-government-changes-again">The UML, NC and Maoists</a> must introspect about their conduct,” warns Gunaraj Luitel, editor of Nagarik, in an op-ed this week. ‘These leaders for life may save themselves from simmering public anger, but they will not be able to save the system. The monarchist wave can only be dispelled when citizens are assured of <a href="https://nepalitimes.com/here-now/nepal-s-local-election-gives-power-back-to-people">better governance</a> through <a href="https://nepalitimes.com/latest/real-world-training-for-youth-leaders">younger leaders</a>, and reforms.’ 
Rifts between radical royals who are gunning for a return to <a href="https://nepalitimes.com/here-now/mob-movement-and-mayhem">Panchayat-style absolutism </a>and moderate monarchists who favour a constitutional king have also weakened the movement somewhat. The split between the RPP and RPP-Nepal cost the royalists numbers in Parliament in 2022, and both parties denounced the violence last month, albeit shifting the blame on the government.
The irony is that the same royalists who want to scrap the republican Constitution had formed electoral alliances with the UML during the 2022 elections. RPP-Nepal chair Kamal Thapa contested the 2022 election with the UML. Thapa has not taken part in the last two rallies, saying he will only be a part of a movement under a national flag, and not a RPP party banner.
For his part, the RPP’s Rajendra Lingden is said to be hesitant to censure some of his party’s more radical royalists for fear of fissure within his ranks, despite his aversion to Durga Prasai’s role. 
Analysts have questioned why <a href="https://nepalitimes.com/news/old-is-still-gold-in-nepali-politics">supporters of the monarchy </a>have decided to reestablish an institution that would not ultimately have executive decision-making power. There are doubts about whether authoritarian-minded Gyanendra will be satisfied being a <a href="https://archive.nepalitimes.com/news.php?id=13957">ceremonial king</a>. 
Read also: <a href="https://nepalitimes.com/news/nepal-s-deja-vu-on-black-friday">Nepal’s déjà vu on Black Friday</a>, Sonia Awale
"The Nepali people will not accept <a href="https://nepalitimes.com/here-now/forgotten-woman-who-sheltered-communist-activists">an absolute monarchy </a>at this point of time, and both the public as well as <a href="https://archive.nepalitimes.com/news.php?id=8371">king Gyanendra</a> are fully aware that there is no other possibility beyond a constitutional monarchy," asserts the RPP’s Lohani. “The traditional monarchy’s institutional capacity might have been enough to meet the needs of feudal Nepal, but an absolute monarchy is impossible both in concept and practice in the context of <a href="https://archive.nepalitimes.com/regular-columns/Economic-Class/waiting-for-an-industrial-revolution,784">modern day Nepal</a>.”

New year revolutions

Besides multiple <a href="https://nepalitimes.com/news/republicans-and-royalists-on-nepal-s-streets">street demonstrations </a>that gridlocked Kathmandu’s traffic for the past weeks, public discourse in Nepal has also been dominated by dangerously <a href="https://nepalitimes.com/here-now/air-pollution-is-more-dangerous-than-smoking">high air pollution levels</a>. Caused mostly by hundreds of <a href="https://nepalitimes.com/news/wildfire-season-starts-early-in-nepal">forest fires </a>raging across the country, the smoke contains suspended soot particles that harms <a href="https://nepalitimes.com/opinion/playing-with-poison">human health</a>. Thursday’s rain have cleared the air somewhat, and many people will soon forget how bad the air quality was. But the time to address the roots of next summer’s fire season is now.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250411060440_d1a119716a9031aadfdd611d299348d436842d376a03e664b8d773957a237524.jpg" data-media-id="editor_4" data-image-id="20250411060440_d1a119716a9031aadfdd611d299348d436842d376a03e664b8d773957a237524" data-rendition-name="original" width="502" height="540" loading="lazy" alt="Wildfires"> <figcaption>EXTINGUISHED: Forest fires raging all over Nepal in the week after 3 March (above) reduced air quality, creating a public health hazard in Kathmandu and across the country. Each red dot is a fire detected by infrared sensors on the NASA Fire Information for Resource Management System (FIRMS) satellite. But the rain on Thursday doused most of the fires (below) with more rain forecast over the weekend.</figcaption> </figure>  The reason everyone was talking about air pollution was because the<a href="https://nepalitimes.com/banner/nepal-is-going-up-in-smoke"> smoke from wildfires</a> was visible. But much more toxic are the invisible and odourless <a href="https://nepalitimes.com/news/nepal-doubles-its-carbon-footprint">gases from vehicular and industrial emissions </a>which have always been there. The theme of World Health Day on 7 April this week was ‘Healthy Beginnings, Hopeful Futures’ dedicated to <a href="https://nepalitimes.com/opinion/comment/saving-more-mothers-and-babies">preventing maternal and newborn deaths</a>. It is estimated that in Nepal, 30% of neonatal mortality can be blamed on air pollution. But that is only part of the story. Harmful as fine particulate matter is to human health, carbon monoxide, nitrogen dioxide, ground-level ozone and other gases in vehicular emissions are more hazardous to health. While the concentration of suspended particulate matter tinier than 1.5 microns (PM2.5) is closely monitored, these toxic gases are invisible, not measured much, and the public is not aware about the dangers they pose. Surface ozone is produced by the interaction of various gases found when <a href="https://nepalitimes.com/news/fossil-fuels-poison-air">burning fossil fuels</a>. Besides being poisonous, ground level ozone contributes up to 0.23°C to <a href="https://nepalitimes.com/here-now/nepal-s-mountains-are-melting">global warming</a> because it is also a greenhouse gas. A new policy brief by the Clean Air Fund titled The Case for Action on Tropospheric Ozone blames surface ozone for a half a million premature deaths every year, 54.8% of which are in South Asia. Ozone also stunts plant growth and reduces crop yields by 26% globally, and 11% loss in <a href="https://nepalitimes.com/news/economic-benefits-of-saving-the-ecology">forest productivity</a>, the report adds.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250411060456_aa02a923f8b27544ae54d0220162678f5bbb5eeb8fc3c466173c22c49b3e9a85.jpg" data-media-id="editor_11" data-image-id="20250411060456_aa02a923f8b27544ae54d0220162678f5bbb5eeb8fc3c466173c22c49b3e9a85" data-rendition-name="original" width="998" height="724" loading="lazy" alt="Gas Chambers"> </figure>  Read also: <a href="https://nepalitimes.com/here-now/bad-air-and-polluted-politics">Bad air and polluted politics</a>, Sonia Awale Ground-level ozone is not emitted directly into the air like other gases, but is formed when oxides of nitrogen (NOx), carbon monoxide (CO) and volatile organic compounds (VOCs) released from automobile tailpipes or industry smokestacks react chemically with each other in the presence of sunlight. The main source of carbon monoxide in Kathmandu Valley are its 1.2 million two-wheelers. “Usually the concentration of carbon monoxide is 200-500 parts per billion (ppb), this has increased up to 3,000 in Kathmandu. Meanwhile, ground-level ozone has gone from 70-80 ppb to 150 ppb,” says Ravi Sahu, regional air quality specialist with the Kathmandu-based International Centre for Integrated Mountain Development (ICIMOD).&nbsp; Sahu says <a href="https://nepalitimes.com/news/no-smoke-without-fire-p7vb9dcj">rampant forest fires of the past weeks</a> have also added to carbon monoxide and ozone in the air, not just the fine particles that make up the visible smoke. He adds, “There isn’t much awareness about <a href="https://nepalitimes.com/banner/poisoning-the-air-we-breathe">ground-level ozone and carbon monoxide</a>, we need to urgently look into it.” A distinction must be made between good and bad ozone. Stratospheric ozone protects living beings from harmful ultraviolet (UV) radiation from the sun.&nbsp; Tropospheric ozone can again be separated into two types: ozone in the free atmosphere which is a greenhouse gas much more potent than carbon dioxide, and ground-level ozone which has adverse impacts on health and agriculture. ‘Cutting tropospheric ozone presents a unique challenge as it requires smart and fast action across multiple greenhouse gases and air pollutants, as well as multiple economic sectors,’ notes the Clean Air Fund's policy briefing. ‘It is a growing and neglected problem that needs an integrated approach on both a local and global level to tackle climate change and air pollution together.’ Dying young There was a time when Nepal made it to international news bulletins only if there were fatalities on Mt Everest. Now, Kathmandu’s bad air frequently makes headlines all over the world. This past week, the concentration of PM2.5 that harms human health was up to 40 times the WHO recommended guideline — adding to the poisonous gases already present from vehicle emissions. The Department of Environment says 40% of the pollution in the past weeks was from wildfires sparked by nearly 6 months without substantial rain over central Nepal. Most of the rest is from vehicular and industrial emissions from Kathmandu itself and across the southern border. NASA’s Fire Information and Resource Management System (FIRMS) which issues daily maps of fires, showed hundreds of blazes raging across Nepal on Wednesday, mainly in Chitwan, Parsa and along the East-West Highway.&nbsp; “If we look at the figures for the last few years, it is clear that wildfires have become the biggest source of air pollution, they are seasonal but have overtaken vehicular emissions,” says urban planner and environmentalist Bhushan Tuladhar. “Forest fires, stubble burning, and open burning of garbage are the bigger problems now. Nepal, India, Bangladesh, and Pakistan are at risk every year, we shouldn’t further delay in finding solutions,” warned air quality expert Bhupendra Das during an event on air pollution organised on 7 March by the Nepal Forum of Environmental Journalists (NEFEJ).&nbsp; Indeed, studies have shown that in winter 60% of the air pollution over Kathmandu is transboundary from the south, and in November it is compounded by smoke from crop residue burning by farmers in India and Pakistan blown in by prevailing winds. Forest fires are a regular pre-monsoon occurrence in Nepal, often intentionally set by farmers and herders to stimulate new grass growth for livestock. Winter rains have failed for eight of the past ten years, and this means the fires often spread out of control. The other reason for the increase in wildfires is the doubling of forest fires to 46% of the country’s area in the past 25 years. But this has happened simultaneously with outmigration, with some mountain districts losing 30% of their population between 2011-2021. With less pressure on forests for fodder and firewood, the undergrowth of community forests is loaded with dry fuel just waiting for a spark. The bowl-shaped topography of Kathmandu, Pokhara and other valleys further concentrates pollutants as they are trapped by surrounding mountains. But a year with a high number of wildfires is usually followed by a year or two with fewer incidents. For example: there were 6,537 fires in 2021 but the following year the number was down to 1,528. There were 5,216 fires last year, this year the number has already reached 1,800, and the trend is likely to be broken. Heavy rains forecast for the coming days are expected to douse some of the fires and clean up the air. But the damage has been done: Kathmandu residents of all age groups this week crowded clinics and hospitals with burning eyes, itchy throats, difficulty breathing, headaches, and dizziness. But in the longer term, soot particles that are tiny enough to jump the blood-air divide in lung capillaries do not just cause Chronic Obstructive Pulmonary Disease (COPD), asthma, but also cancers, heart attacks, strokes, birth defects and other chronic diseases. The latest Air Quality Life Index (AQLI) report by the University of Chicago shows that the annual concentration of PM2.5 in Kathmandu’s air rose from 17.87µg/m3 in 1998 to 31.33µg/m3 in 2022. Air pollution has got worse by 75% in Kathmandu in 25 years. During this time, air pollution has reduced the average life expectancy of Kathmandu’s residents by 3.5 years. According to the Health Effects Institute in Boston, dirty air is among the biggest public health concerns in Nepal killing over 42,100 a year. The adverse impact of high levels of air pollution is not limited to public health, it is seriously affecting tourism. Operators in Pokhara this week said that there were many negative online posts by visitors unable to see the famous panorama of Machapuchre and the Annapurnas even from Sarangkot. Aviation is also affected, as planes have to circle sometimes for hours burning a lot of fuel because of runway visibility being below minima at Kathmandu airport. The higher fuel cost is just passed down to customers, making air tickets in and out of Kathmandu some of the highest in the world. Kathmandu, with a population of four million, has not implemented a concrete policy to curb toxic air despite having formulated various action plans and repeated commitments by the government to protect the environment and control air pollution. The Department of Environment’s 2017 Air Quality Management Action Plan for Kathmandu put forward a policy to reduce air pollution caused by vehicles which was approved by the Cabinet, but has yet to be put to practice. The action included the immediate implementation of the Euro 5 emission standard to reduce pollution emitted by vehicles. However, Nepal has not even been able to implement Euro 4 standards so far. India, meanwhile, has already moved forward with the implementation of the Euro 6 standards. Says Ravi Sahu: “Air pollution in Nepal is not just about air pollution, it has ties to tourism, aviation, the economy so we must be prepared for annual conditions like forest fires, and this requires urgent interdisciplinary collaboration.” &nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250411050452_821d09e283d8a590f1369bfb71b9b7fc6d950726e0651ea86c6488d04deb1742.jpg" data-media-id="editor_15" data-image-id="20250411050452_821d09e283d8a590f1369bfb71b9b7fc6d950726e0651ea86c6488d04deb1742" data-rendition-name="original" width="839" height="784" loading="lazy" alt="Silent Killers"> </figure>  &nbsp;

What is invisible is more dangerous

82 in २०८२

Here in the mountains of far-western Nepal, the biggest threat to life and limb is gravity. Women collecting fodder fall from trees, boys grazing goats fall off cliffs, heavily loaded tractors plunge from dirt roads carved out of steep slopes. There is nothing to be done about those who die on the spot. But for the severely wounded there is only one hospital: Bayalpata. And it is there that <a href="https://www.youtube.com/watch?v=CJzWlnYd0ZM&amp;t=8s" target="_blank">orthopaedic surgeon Mandeep Pathak</a> is the last hope for many wounded people. Pathak, 42, is too modest to tell us how many lives he has saved over the past 10 years he has worked at Bayalpata. But hospital records show he has performed more than 4,000 operations in the past decade, many of them so patients did not suffer permanent physical disabilities. Pathak also did 800 major life-saving surgeries in that time. “I treat patients with injuries, but I wish I could also treat poverty,” Pathak says, emerging from Bayalpata’s surgical theatre one recent afternoon. <div class="embed-block"><iframe width="700" height="415" src="https://www.youtube.com/embed/CJzWlnYd0ZM?si=s_rkbU4YDaw87gqH" title="YouTube video player" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share" referrerpolicy="strict-origin-when-cross-origin" allowfullscreen></iframe></div> Sudurpaschim Province in Nepal’s far-west is far away from everything: from Kathmandu, from adequate medical care, from food security, and far from the reach of government services. It has suffered state neglect for centuries, its men mainly migrating to India for seasonal work to families who depend on subsistence agriculture. Pathak remembers the searing sadness he felt when a patient once told him, “Doctor, I sold the last of my rice to pay to come here, please give me a medicine that I can take on an empty stomach.” Pathak was born in Kathmandu, and after getting his MBBS from Kathmandu University, he got an MD from The Philippines. At a time when many Nepali doctors and staff nurses were emigrating, Pathak did not just return to Kathmandu but decided to go to one of the remotest districts in Nepal to serve those most in need. The hospital was established in 2009 in the village of Bayalpata, and has been managed by the non-profit <a href="https://www.nyayahealthnepal.org/" target="_blank">Nyaya Health Nepal (NHN)</a> as a public-private partnership treating 100,000 patients a year for no fees at all. NHN is now preparing to hand over the running of the hospital to the Sudurpaschim provincial government so its <a href="https://nepalitimes.com/banner/this-is-how-to-upgrade-nepals-rural-health" target="_blank">model of hospital management</a> can be replicated.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250414130456_b59dabd4604a24426a55fe91c0e5866b5029858bdb4c4028c331557aeb5408ae.jpg" data-media-id="editor_4" data-image-id="20250414130456_b59dabd4604a24426a55fe91c0e5866b5029858bdb4c4028c331557aeb5408ae" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="Bayalpata hospital"> <figcaption>Bayalpata hospital in Achham.</figcaption> </figure>  People from not just Achham but surrounding districts, and from as far away as Humla, bring patients to Bayalpata, sometimes walking for days. Some with complicated pregnancies are brought in stretchers, young children with broken arms walk into the emergency, and sometimes there are mass casualties when a tractor or bus falls off a road. And Pathak is always there with his team performing triage, and doing orthopaedic surgeries that would be difficult even in Kathmandu. Recently, his team did a hip replacement at <a href="https://nepalitimes.com/banner/state-of-the-art-rural-hospital" target="_blank">Bayalpata Hospital</a>. Mild mannered, modest, soft-spoken, hard-working, professional are the words families of patients who have been treated at <a href="https://nepalitimes.com/here-now/nepal-s-rural-lifeline" target="_blank">Bayalpata Hospital </a>use to describe Mandeep Pathak. But the surgeon is too busy to let all this get to this head.&nbsp; Asked why he does not emigrate like his peers or get a lucrative position at a private hospital in Kathmandu, Pathak answers simply, without a trace of self-importance, “I do not think I could get the satisfaction or sense of fulfilment anywhere else.” When travelling to attend medical congresses overseas or visit family in Kathmandu, Bayalpata has other doctors to take care of patients, but many wait patiently till Pathak returns for their consultation or surgery.&nbsp; When he returns from seminars abroad after learning the latest skills, Pathak’s suitcases are not full of clothes or presents, but titanium bone implants, external fixation rods, or intramedullary nails to be used in <a href="https://nepalitimes.com/news/altruistic-healthcare-models-in-nepal" target="_blank">surgeries at Bayalpata</a>.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025041414040_5356278472c1eb2b9e4af1d593d6234cc8dc5e5161a8c614197c01abefadbd80.jpg" data-media-id="editor_8" data-image-id="2025041414040_5356278472c1eb2b9e4af1d593d6234cc8dc5e5161a8c614197c01abefadbd80" data-rendition-name="original" width="2048" height="1368" loading="lazy" alt="surgery"> </figure>  Before Bayalpata Hospital was established, most people suffering broken bones had to travel down to Dhangadi or Nepalganj for treatment. No more. Although Pathak’s specialisation is orthopaedic oncology, he is mostly treating fractures and rejoining broken bones.&nbsp; Now as Bayalpata’s Hospital Director, Pathak also has administrative and fundraising duties. He has to take the 10-hour ride down to Dhangadi often to meet various Sudurpaschim ministries to release the hospital’s budget — that is sometimes more difficult than the most complicated surgery. Recently, he had to cancel an appointment with the Chief Minister to rush back to Bayalpata because there was a patient who needed emergency surgery. “I told myself, let me save this patient first, then I will try to save the hospital,” he recalls.&nbsp; Once, when he had to be away for a month on emergency surgery training in the US, the family of a 90-year-old woman who had dislocated her hip after falling from a staircase was waiting for him to return. Her son told Pathak: “Doctor, either put her out of her suffering, or cure her.” Pathak told him it was too dangerous to operate at her age, but the son said his mother was in so much pain it was worth the risk. The operation was touch-and-go, but it was successful. The woman who had been brought in on a stretcher, walked out of the hospital three days after the operation.&nbsp; A few months later, a 27-year-old woman was brought into the ER bleeding profusely from an arm mangled by a thresher machine. Even in that state, she was breastfeeding her baby. Pathak welled up seeing this display of selfless motherhood, as he wheeled her into surgery. She needed three operations, but now has full use of her hand. <div class="embed-block"><iframe width="700" height="415" src="https://www.youtube.com/embed/xJdxLD0hBqo?si=mOpM2R_DsYL88Lfg" title="YouTube video player" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share" referrerpolicy="strict-origin-when-cross-origin" allowfullscreen></iframe></div> It is the sense of achievement from such recovery that keeps Mandeep Pathak here in this isolated village in the middle of nowhere. Bayalpata Hospital has not just saved lives, it also saves families from poverty because they do not have to take sick relatives to expensive city hospitals.&nbsp; In January, a woman was brought to Bayalpata with both hands broken. She said she had taken a fall, but Pathak did not believe her. When alone in the surgery, she finally admitted that her husband had beaten her.&nbsp; It was her husband who had brought her to hospital for treatment, but she refused to file a police report. Pathak quietly put both her arms in casts, thinking about the poverty, patriarchy and injustice in society that he is unable to treat.

early-marriage