In 2023, the National Disaster Risk Reduction and Management Authority (NDRRMA) conducted a Structural Integrity Assessment of 29,000 public buildings in 145 municipalities across Nepal. Only 9.4% of them were found to be safe.&nbsp; The study deployed remote sensing as well as engineers on the ground to assess the risk, and showed that more than half needed major strengthening, while 12.5% could be retrofitted. Another 12% would need immediate demolition, and 5% of the public buildings were sited in poor soil (below).&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250419030456_bc5ba9d543d872871d015cb2129406c690a84583efc72fb795ae682a9ca6ae63.jpg" data-media-id="editor_0" data-image-id="20250419030456_bc5ba9d543d872871d015cb2129406c690a84583efc72fb795ae682a9ca6ae63" data-rendition-name="original" width="517" height="511" loading="lazy" alt="public buildings and earthquakes"> <figcaption>Data: NDRRMA</figcaption> </figure>  After the 2015 earthquake, NDRRMA assessed 18,000 school buildings in the affected areas where over a million students were enrolled. More than half the buildings were found to be structurally vulnerable, while 30% of the schools with 184,000 students had been damaged. None of the classrooms retrofitted for seismic resistance collapsed. The surveys prove that Nepal <a href="https://nepalitimes.com/here-now/lessons-not-learned-from-2015-o2etq6zu">could have seen a catastrophic loss of children's lives</a> had the 2015 disaster occurred on a weekday when classrooms would be full.&nbsp; National Society for Earthquake Technology (NSET-Nepal) also surveyed hospitals, water supply and telecommunication in the early 2000s to see how Nepal would fare in an 8M+ earthquake. Even then, the data showed that over half of such infrastructure would be destroyed. Increased population density and multi-storey structures since then means the death and destruction could be much greater. The <a href="https://bipad.gov.np/uploads/publication_pdf/Nepal_Disaster_Report_Final_2024.pdf">studies</a> also point to a critical lack of structural integrity of public buildings, emergency preparedness and response systems. They underscore Nepal’s limited capacity for search and rescue, a dysfunctional emergency operations centre, and poorly constructed houses and public buildings. Ten years after the earthquake, most of these public buildings have been rebuilt or retrofitted, and there is general understanding that schools and hospitals at the very least need to be stronger.&nbsp; But much of this awareness and subsequent action is limited to the 14 districts affected by the 2015 disaster. The rest of the country, especially western Nepal <a href="https://nepalitimes.com/editorial/mind-the-gap">where a mega-quake is long overdue</a>, is woefully unprepared. Globally, Nepal ranks 11th in the list of countries vulnerable to seismic hazard. Added to this is risk from climate breakdown.&nbsp; Nepal is disaster-prone, and preparedness is the first line of defense. Schools, hospitals and other public buildings need special priority not only because of the chance of mass casualties, but also because they can be shelters after a disaster strikes and hospitals need to be intact to treat the wounded.&nbsp; Nearly 8,000 schools and 30,000 <a href="https://archive.nepalitimes.com/article/nation/earthquake-an-opportunity-to-rebuilt-education-system-not-just-fallen-schools,2336">classrooms were damaged or destroyed in the 2015 earthquake</a>. Another 1,000 government buildings were destroyed and over 3,000 were partially damaged, 1,211 hospitals and primary health posts collapsed.&nbsp; If it was not a Saturday, total fatalities would have been much higher than the official toll of 8,962. Apart from infrastructure, emergency preparedness includes stockpiling essential supplies for effective first response. In schools, this means immediate rescue and evacuation of children, and getting them safely to their families.&nbsp; Disaster preparedness education is in school curricula, but should also include safety instructions depending on the type of building and conduct regular emergency evacuation drills.&nbsp; Hospitals, doctors, nurses and paramedics will themselves be affected in a disaster, but must also treat and care for the overwhelming numbers after a quake. Health facilities must have functioning back-up power, and pre-positioned water, drugs, equipment.&nbsp; <a href="https://nepalitimes.com/news/trump-shock-wave-hits-nepal">The suspension of USAID</a> has had a direct impact on ongoing rebuilding and retrofitting activities across Nepal.&nbsp; One of the projects halted is for building 500 temporary learning centres in Jajarkot and Rukum where some 150,000 children were out of school after the 6.4M quake in November 2023.&nbsp; ---  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250419030456_3e0b8bc3c11aa56ca2295665d4d7f93cab6247d9fec41d5a617ff52002070622.jpg" data-media-id="editor_6" data-image-id="20250419030456_3e0b8bc3c11aa56ca2295665d4d7f93cab6247d9fec41d5a617ff52002070622" data-rendition-name="original" width="2500" height="1667" loading="lazy" alt="school buildings and earthquakes"> <figcaption>LESSONS NOT LEARNT: Nava Adhasha Secondary School at Kathmandu Darbar Square was severely damaged in the 2015 earthquake but classes are being held in it. Photo: SUMAN NEPALI</figcaption> </figure>  Ten years after the 2015 earthquake, it is accepted that Nepal’s reconstruction efforts have been largely successful and relatively quick compared to disasters of similar scale in India, Pakistan, Iran and Haiti. Nepal was lucky that many things helped reduce the loss of life on 25 April 2015. The magnitude was less than 8 Richter, the duration and frequency of shaking meant that most concrete buildings did not collapse. And the earthquake struck during daytime on a weekend which meant children were out of school.&nbsp; “If it were a working day, at least 10,000 children would have died, and another 7,000 government officers which would include security personnel, critical to rescue and relief,” says <a href="https://nepalitimes.com/opinion/a-disaster-resilient-nepal-is-possible">Anil Pokhrel</a>, who till recently headed the National Disaster Risk Reduction and Management Authority (NDRRMA).&nbsp; In Nepal in 2015, nearly 8,000 schools and 30,000 <a href="https://nepalitimes.com/here-now/quake-was-a-learning-experience-for-nepal-s-schools">classrooms were damaged or destroyed</a>. Some 1,000 government buildings were destroyed, over 3,000 were partially damaged. As many as 1,211 health facilities, including hospitals, primary health care centres, and health posts, were destroyed or damaged.&nbsp; The safety of public buildings is important not just because they involve a larger number of people, their continued functionality is even more crucial after a disaster. While schools serve as temporary shelters, hospitals become a battleground to save as many people as possible with limited resources, including doctors and nurses. “The safety of public buildings during earthquakes is of utmost importance which is why their design and construction standards are much higher and stringent than those of regular residential structures,” says Surya Narayan Shrestha of the National Society for Earthquake Technology (NSET) – Nepal. He adds: “But emergency preparedness and safety behaviour are as important. Students should be rescued and evacuated from schools, while hospitals should be equipped to handle an increased influx of people as well as provide uninterrupted services.”  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025041904040_a1dd53b921ef75de2ccdf8b513d9fc959ea73c8267d50b9b57013412e07379b5.jpg" data-media-id="editor_9" data-image-id="2025041904040_a1dd53b921ef75de2ccdf8b513d9fc959ea73c8267d50b9b57013412e07379b5" data-rendition-name="original" width="2500" height="1667" loading="lazy" alt="hospitals and earthquakes"> <figcaption>EMERGENCY CARE: Hospitals need to be prepared to manage existing patients and an increased influx of people while providing uninterrupted service in the aftermath of an earthquake. Photo: SONIA AWALE</figcaption> </figure>  <a href="https://www.nset.org.np/nset2012/index.php/event/eventdetail/eventid-595#:~:text=HOPE%20course%20deliberates%20about%20the,disaster%20and%20mass%20casualty%20incidents.">Hospital Preparedness for Emergency (HOPE)</a> is a four-day course developed by the United States Agency for International Development (USAID) for effective management of disaster and public health emergencies at the health facility level. Experts say the training, which was first implemented in 2004, was crucial in allowing doctors and nurses in Kathmandu hospitals like Bir and Teaching, to provide immediate and uninterrupted service in the aftermath of the earthquake. Such preparedness should be extended in other parts of the country, especially to health workers and facilities, including stockpiling essential supplies. However, similar support from <a href="https://nepalitimes.com/news/how-usaid-cut-affects-nepal">USAID has now been terminated</a>. Sangeeta Singh is a professor of urban planning at the Institute of Engineering, and was in Khokana for an assessment when the 7.3M aftershock hit on 12 May 2015. She ran out of a narrow alley directly into an open square. She recalls how, despite suffering much damage, traditional structures provided enough time for locals to escape, leading to fewer casualties. Community-designated open spaces, alternative routes and supplies of essential items also helped. “We must allow local units of government in emergency response, implement building codes, and while we are at it, why not allocate some of the budget money to retrofitting instead of only building roads?” says Singh. “Ten years later, Nepalis have all but forgotten 2015, individuals and institutions flout building codes and the monitoring mechanism is not effective.” In the past ten years, municipalities have been trying to enforce building codes more strictly in the 14 districts affected in 2015. But the same is not true for the rest of the country, especially the far west which hasn’t seen a major quake in over 500 years, and has <a href="https://nepalitimes.com/banner/past-disasters-foretold">accumulated enough stress to cause an 8M+ megaquake</a>. The level of unpreparedness was proven by how disastrous even the moderate 6.4M Jajarkot earthquake was in 2023, killing 153 people and injuring at least 375. Over 62,000 houses were destroyed or damaged, as well as 750 school buildings. Earthquake-resistant designs must be promoted and deployed across the country, especially for schools built with heavy construction materials like stone and round slippery boulders. Bamboo, hollow concrete blocks and rammed earth technologies are better, and concrete buildings must be reinforced so they do not become death traps. For a country as prone to multi-hazards, the government should implement proper land use with zoning. A recent example is Nepal Mediciti Hospital which was inundated in last September’s floods, disrupting medical care. The hospital was built on a floodplain. As a former lakebed with soft topsoil and shallow groundwater table, particularly in the central and southern floodplain areas, Kathmandu Valley is <a href="https://nepalitimes.com/news/the-rise-of-high-rises">prone to liquefaction</a> and excessive shaking during an earthquake.&nbsp; <a href="http://conference.ioe.edu.np/publications/ioegc2016/IOEGC-2016-03.pdf">One 2016 study</a> said that 33% of the total area of Kathmandu Valley lies in a very high risk zone for liquefaction. <a href="https://dpnet.org.np/public/uploads/files/geohazards-02-00009%202021-12-16%2007-17-20.pdf">Another study</a> published in the journal GeoHazards in 2021 said that 60% of the hospitals, 64% of colleges, 54% of the schools and 42% of the road network in Kathmandu are in high liquefaction risk zones if there was a magnitude 8 earthquake. Furthermore, 78% of Kathmandu airport's area is similarly vulnerable. The study recommends relocation of these facilities as well as other critical services, or at the very least, retrofitting. ‘The development of all these facilities should be carried out considering appropriate land use guided by the liquefaction risks to mitigate potential loss and proper functioning after earthquakes,’ it states. Explains Sangeeta Singh: “In addition to structural safety and emergency preparedness, a policy to guide proper land use is the need of the hour, especially for urban centres. We must assess multi-hazard vulnerability, and conduct a safety audit for existing public buildings, our lack of preparedness is astounding.” Former NDRRMA chief Anil Pokhrel adds that asset registry and an inventory of the safety status of public buildings are urgent must-dos. It is also needed in case of insurance payouts. Such a system could also help Nepal to quantify climate damage and, in turn, claim reparations. “In many ways, we are better prepared after 10 years of the 2015 earthquake, we have much experience in rebuilding but we are nowhere close to where we need to be,” admits Pokhrel. “The risk is growing rapidly, our preparedness hasn’t kept pace.”&nbsp;

Sonia Awale

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Structural problems

Nepal’s major hospitals are not prepared for emergency response and care in an event of another earthquake or pandemic, according to a recent new study published in the International Journal of Emergency Medicine. The paper lists a serious lack of preparedness at emergency units of hospitals, and compares the capacity of private, government, and teaching hospitals in Kathmandu.
The study was the first of its kind conducted in Nepal and its investigators aimed to build on the Emergency Care Systems Assessment (ECSA) conducted by Nepal’s Health ministry the WHO in 2019. The ECSA report had identified 39 key items to improve emergency care in the country. <a href="http://archive.nepalitimes.com/news.php?id=17851#.ZA7O-3ZBy3A" target="_blank">Another survey in 2011</a> had shown that only two of the hospitals in Kathmandu Valley at the time had earthquake resistant buildings.
&nbsp;The cross-sectional pilot study looked into seven tertiary hospitals in the Valley out of which three are academic, two are governmental, and two are private institutions. Included in the study are TU Teaching Hospital, Patan Hospital, Dhulikhel Hospital, Bir Hospital, the National Trauma Centre, Grande Hospital and HAMS Hospital.&nbsp;
Researchers used a cross-sectional mixed-method study to gather data on facility characteristics, human resources, clinical services, and signal functions of seven major tertiary-level health facilities in the Kathmandu Valley.&nbsp;
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<a href="https://www.nepalitimes.com/banner/taking-wealth-out-of-health">Taking wealth out of health</a>
<a href="https://www.nepalitimes.com/banner/in-a-healthy-state/">In a healthy state</a>
Investigators identified three respondents from each of the seven institutions who are directly involved with the emergency department in a clinical care or administrative leadership role. Respondents included physicians, nurses, hospital administrators, and general hospital staff.
Emergency response—which is at the forefront of natural disasters and pandemics—during two major disaster events in the country, the 2015 Gorkha earthquake and the Covid19 Delta wave in 2021, showed that Nepal’s emergency response and care was subpar, write the authors.
“This study was designed and conducted so that we recognise our weaknesses, and start slowly improving them,” said Olita Shilpakar, an emergency physician at TUTH, and one of the authors.
The study concluded that while all the facilities surveyed had general availability of round-the-clock emergency services, there were significant gaps as well as differences in infrastructure, diagnostic, consultant, and human resource availability.
“The WHO estimates nearly 40% of lives can be saved with appropriate emergency care,” said Ramu Kharel, an assistant professor of emergency medicine at Brown University in the USA who led the study. “Improving emergency care is one of the most efficient public health interventions. Our study identified many opportunities for us to improve emergency care at hospital levels.”
Government hospitals were characterised by a lack of a designated triage area, as well as the unavailability of Obstetrics/Gynecology (Ob-Gyn), orthopaedics, paediatrics, or psychiatry consulting services.
Academic hospitals had limited isolation rooms or infectious diseases and were found to not have adequate access to toilet facilities. There was limited availability of social work services and security personnel.&nbsp;
In private hospitals, protocols for time targets in triage, triage for children below five years of age, trauma care, and burn care among other services were found to be missing. Safety protocols for managing hazardous exposures were not there, and there was a lack of protection for staff and patients from violence.&nbsp;
While government hospitals that typically care for low-income populations reported better availability of ancillary services and social care services, private hospitals not supririsngly scored the highest in access to and availability of health infrastructure.
Meanwhile, academic facilities were found to have more written protocols given their increased likelihood for research and teaching compared to governmental and private facilities. However, academic institutions were found to have the highest rating with greater availability of consulting services.
Common barriers across all institutions included a lack of training in key emergency procedures, written protocols, point-of-care testing, and ancillary patient services.&nbsp;
Read also: <a href="https://www.nepalitimes.com/opinion/is-free-health-care-possible-in-nepal/">Is free health care possible in Nepal?</a> S P Kalaunee
Researchers have recommendations regarding the triage system and time metrics, training and education, written protocols for emergency care, and health infrastructure in order for the health facilities included in the study to improve emergency care. Investigators also highlighted a need for specific training, and cross-collaboration between the institutions to strengthen Nepal’s emergency services.
“The findings of this study will allow us to find areas of collaboration between institutions as well. For example, some hospitals have better protocols, others have better triage systems,” said Kamal Thapa, one of the study investigators and an emergency consultant at Grande Hospital. “We need to work together to improve emergency care. Ultimately, our concern is <a href="https://www.nepalitimes.com/editorial/poor-health-makes-nepalis-poorer">good patient care.</a>”
Emergency medicine is a new field globally, and especially so for Nepal but evidence from other countries has shown that even simple interventions— like having a good triage system in hospitals— have a significant impact in saving lives.
Said Kharel: “The next step for these hospitals is to use the findings as a guide to take steps towards addressing gaps identified in this report. Furthermore, we need to conduct larger research around the country to look at gaps in emergency care in rural area facilities.”
Read also: <a href="https://archive.nepalitimes.com/article/editorial/health-tip-editorial,4032">Health tip</a>, Editorial

Emergencies in Nepal's Emergency Rooms

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109101132/636b73eb9c7e80680e062365jpeg.jpg" alt="" width="1500" height="911"/><figcaption>Photo: NATIONAL TRAUMA CENTRE</figcaption></figure>Speeding along a narrow winding mountain road in Dhading, a heavily intoxicated truck driver lost control of the <a href="https://www.nepalitimes.com/banner/nepals-deadly-roads-take-their-toll/" target="_blank" rel="noopener">vehicle</a> and it overturned, killing seven and severely injuring 34 passengers hitching a ride.This was a mass trauma incident that required immediate attention, but <a href="http://nationaltraumacenter.gov.np/" target="_blank" rel="noopener">Nepal’s only trauma care centre</a> was located in Kathmandu, 90km away via bumpy roads jammed with traffic.Read also: <a href="https://www.nepalitimes.com/?p=40249&amp;preview_nonce=aefd82ecbe&amp;preview=true" target="_blank" rel="noopener">injured use Internet to reach physiotherapists in Nepal</a>, Sonia AwaleMost passengers from the truck accident were taken to nearby hospitals in Dhading, but the 21 most critical patients were airlifted or driven in ambulances to the National Trauma Centre in Kathmandu.“It had already taken a while to bring the patients to the Trauma Centre, so we had to act quickly once they were here,’’ recalls Pramod Yadav, acting medical superintendent at the facility.The standard protocol for trauma care is the triage system -- determining the priority of treatment based on the severity of injury. Doctors at the National Trauma Centre quickly designated yellow, green and red codes to patients to ensure that those in critical condition were taken care of first, and fast.Read also: <a href="https://archive.nepalitimes.com/article/nation/accident-prone-Mugling-Narayangadi-highway,3828" target="_blank" rel="noopener">Unblocking an artery</a>, Sanjeev SharmaOn-call doctors were contacted and began assessing the patient’s injuries. But without a functioning MRI and a faulty CT machine, some had to be sent to private clinics and later returned to the hospital.This is a recurring event for patients seeking immediate care at the government-run Trauma Centre where patients in critical condition have to be moved about from one facility to another for tests.“We cannot afford an MRI machine, it is very expensive to repair our CT machines, we have limited trolley beds and only 11 ICU beds when we need more than 50,” says Yadav. “We are requesting the government for Rs420 million to become a real trauma centre, especially since we are the only one in the country.”There were 60,000 severe trauma injuries in Nepal in the last year, a 3,000 increase from the previous year, and a whopping 27,000 over the year before that. Like with all government-run medical centres, the Trauma Centre lacks resources, is under-staffed, and is incapable of handling this exponential increase.“In the last two, three years, falls, physical assault, <a href="https://www.nepalitimes.com/banner/nepals-deadly-roads-take-their-toll/" target="_blank" rel="noopener">road traffic accidents</a>, sports injuries and <a href="https://archive.nepalitimes.com/article/nation/burning-in-the-aftermath,3757" target="_blank" rel="noopener">burns</a> have been the leading causes of trauma,” lists  Siddhartha Dhungana, the Medical Record Officer at the National Trauma Centre. “Head injuries and multi-organ failures have been the highest causes of death in these cases.”Most hospitals in Nepal, like the National Trauma Centre, follow the World Health Organisation’s trauma protocol. During a trauma case, medical personnel are contacted as soon as possible, patients are screened, their needs are identified and necessary care is given.Although the government has not developed a standard care protocol for trauma like it has for cancer patients, private hospitals have implemented and refined their own systems based on WHO guidelines.<a href="http://archive.nepalitimes.com/article/nation/politics-behind-epidemic-of-hospital-vandalism,3578" target="_blank" rel="noopener">Om Hospital</a>’s Continuing Medical Education Program is at the forefront of teaching trauma care to new doctors and providing courses on improved techniques to existing doctors.“We make sure that the ABCs of trauma care are followed strictly and that blood is readily available be it from our blood bank or staff-chain blood donors,” says Binod Adhikari of Om, which handles dozens of cases every day and has systems in place to coordinate between doctors, nurses and critical care anesthesiologists to provide emergency care to patients.<h2>Ambulance chasers</h2><figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109101132/636b73ee9c7e80680e062366jpeg.jpg" alt="" width="1500" height="1125"><figcaption> </figcaption></figure>Most of Nepal's ambulances are just jeeps with stretchers, with no life-support systems or medical attendants. It was only in 2011 that Nepal’s first emergency medical service was established. Supported by the Patan Academy of Health Sciences and the Stanford University School of Medicine, Nepal Ambulance Service (NAS) has since trained more than 100 emergency medical technicians (EMTs) and ambulance drivers and operates the <a href="http://archive.nepalitimes.com/news.php?id=18888#.XjvhpTIzaUk" target="_blank" rel="noopener">'Dial 102' service</a>. NAS operates mainly in Kathmandu Valley, Pokhara, Chitwan, Butwal and Bhairawa.“Before this, only few private hospitals had ambulances and they were used mainly for patient transfer rather than pre-hospital care,” says Hari Khadka, a paramedic at <a href="https://www.grandehospital.com/" target="_blank" rel="noopener">Grande International Hospital</a> and a member of the first EMT batch of NAS. “Ten years ago, there was simply no concept of pre-hospital care or paramedics in Nepal.”Now, many hospitals have their own EMS systems with mostly Type 3 ambulances that have first aid kits and basic medical supplies. <a href="https://www.nrcs.org/" target="_blank" rel="noopener">Nepal Red Cross Society</a> (NRCS) operates 283 ambulances nationwide. Although not every ambulance carries a paramedic, every driver has received first aid training.“We have five Type 2 ambulances and a paramedic in each vehicle,” says Bipul Neupane of NRCS. “We send these ambulances to patients who need basic life support systems.”But for patients needing critical care in remote areas, there is no recourse but expensive helicopter medical evacuation.Like Type 1 ambulances, some of these helicopters can have doctors, ventilators, advanced life support, and EMTs.“EMS has helped save many lives in Nepal but it isn’t always the best option considering the geography of Nepal and the condition of the roads,” says Sanjaya Karki, Head of the Emergency Department at <a href="https://www.nepalmediciti.com/" target="_blank" rel="noopener">Nepal Mediciti Hospital</a>. “Helicopter Emergency Medical Services ensure that we can get to critical patients as quickly as possible and provide the best pre-hospital care.”

It’s an emergency: Nepal needs to improve trauma care

Nepali Congress (NC) President Gagan Thapa's candidacy in Sarlahi-4 has thrust this Madhes constituency into rare national focus. If Thapa wins and the NC emerges as the largest party, Sarlahi-4 will send Nepal's next prime minister to Parliament. But if he does not, Nepal’s grand old party will face the next years in the opposition to fight another day. There is a troubling paradox in Sarlahi-4 where the district bordering the Indian state of Bihar has been a battleground for national politicians with fierce electoral competition, all while remaining one of the region's most underserved and underdeveloped constituencies.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260305140344_069cbbc11e971a851b444866dee57f760c0cc611ed40bdf96c627e343e3c0485.png" data-media-id="editor_0" data-image-id="20260305140344_069cbbc11e971a851b444866dee57f760c0cc611ed40bdf96c627e343e3c0485" data-rendition-name="original" width="1802" height="1276" loading="lazy" alt="Sarlahi-4 voting"> <figcaption>Photo: MADHES PAHARA MEDIA</figcaption> </figure>  Ever since Mahant Thakur split from NC in 2008 to form the Tarai Madhes Loktantrik Party, the district has seen rotating political alliances and fragmented votes. Yet, despite 18 years of candidates promising change irrigation schemes remain incomplete, market access for farmers has not improved, unemployment is high.&nbsp; On election day, voters here marked their ballots with fingers stained by dye from the Holi festival the day before. The road leading to Barathawa Bazar was deserted for the most part, except for some youth riding in motorcycles. This is where the high-profile contest between Gagan Thapa and RSP nominee Amresh Singh is being staged. Among the other aspirants is 27-year-old UML candidate Amnish Yadav, the son of former MP Shiv Pujan Yadav. The Yadavs are a political family with considerable caste influence in the constituency. In 2022 Yadav’s daughter Madhumala Yadav received over 14,000 votes here, ranking third overall. Yadav was voted MP from the Maoist party, but defected to the UML this time. His other son is the chair of Sarlahi’s Ramnagar Rural Municipality. Sarhali-4 has 121,012 voters, and the Yadav is banking on the 27,000-strong Yadav vote bank. Sarlahi-4 voter Avishek Sah told us he wanted his vote to go to a young nominee and not someone who has been MP thrice already, like Amresh Singh. &nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260305140344_527c5c2f9aa6a6c7e3bbdfbfe79fdafb0a0b56a62427e9ced86b924c6c563b10.jpg" data-media-id="editor_1" data-image-id="20260305140344_527c5c2f9aa6a6c7e3bbdfbfe79fdafb0a0b56a62427e9ced86b924c6c563b10" data-rendition-name="original" width="1200" height="1600" loading="lazy" alt="Sarlahi-4 voting"> <figcaption>Photo: AYUSHA CHALISE</figcaption> </figure>  To make local loyalties even more complicated, Amnish Yadav’s uncle, Harinder Yadav is an active NC member and walked side by side with Gagan Thapa during his door-to-door campaigns.&nbsp; The NC is betting on Thapa getting over 60% of the total votes. Amresh Singh’s tally could be limited to 10,000 votes — that too because of the nationwide RSP wave, and the popularity of its prime ministerial hopeful Balendra (Balen) Shah. “Amresh Singh lost his appeal when he played victim after he was denied a ticket by the NC in 2022,” Harinder Yadav says. Voters we spoke to here agreed with this assessment that Singh did not do much for the district once he got elected in the past, and being a part of the RSP seems to be his biggest asset. “The only reason I voted for Amresh Singh is because Balen is in RSP,” local voter Mahendra Gupta from Barathawa. &nbsp;“This is his last chance to return the people’s trust.”&nbsp; Gupta is aware of the institutional presence of the NC here. The party received the most votes in 2022 local elections, adding that the candidacy of someone as high-profile as Thapa is a positive sign for Sarlahi-4.&nbsp; Other voters like Ruby Gupta are rooting for both the NC and the RSP. “I will vote for Gagan and for Balen,” she says, adding that her FPTP vote will go to Thapa while her PR ballot would be for the RSP. RSP supporters are confident that their candidate will win big because even though many voters may not have openly voiced their support they still voted for the party and candidate. The Balen Wave was not limited to RSP voters, but also to UML candidate Yadav, who said in a gathering that he will be “the voters Balen” if they elect him. He touted his party’s track record in government, and largely campaigned on administrative efficiency, infrastructural expansion, and local service delivery. Amresh Singh ran on the RSP’s anti-establishment brand, promising to fight corruption, challenge traditional party politics, improve basic services such as education, health, jobs, and infrastructure, while pushing for stronger representation and development for Madhes.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260305140344_982df01801fa7d3532ca0555ecb8a0756e3223be3d93650e08ca82a312dc2ebd.jpg" data-media-id="editor_2" data-image-id="20260305140344_982df01801fa7d3532ca0555ecb8a0756e3223be3d93650e08ca82a312dc2ebd" data-rendition-name="original" width="1600" height="1200" loading="lazy" alt="Sarlahi-4 voting"> <figcaption>Photo:AYUSHA CHALISE</figcaption> </figure>  Singh’s rivalry with his NC competitor goes beyond the ballot— he allegedly blames Thapa for being denied the NC ticket in 2022, which led him to win the election from Sarlahi-4 as an independent. &nbsp; For his part, Gagan Thapa focused on a more pragmatic development agenda that includes upgrading roads and irrigation, improving schools and hospitals, supporting farmers, and creating employment opportunities with improved governance at the centre. He also promised to build an engineering college in the constituency.&nbsp; Thapa also promoted his own anti-establishment image within the NC, repeatedly reminding voters on the campaign trail that he represents the aspirations of the youth.&nbsp; On Thursday, as voting progressed, there were violent disruptions in two centres where voting was briefly halted. But Sarlahi district police spokesperson Saroj Rai told Nepali Times that there were no major problems. Police in collaboration with the Nepal Army sent the ballot papers to the district’s counting stations, where the votes are expected to be tallied through the night and the winner announced Friday morning.

Sarlahi-4 nervously watches ballot count

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Nepal election live results

As this report is uploaded, the latest results in Nepal’s election show that the Rastriya Swatantra Party (RSP) is headed for an even bigger sweep than most had predicted.
The RSP was leading by large margins in 49 of 165 constituencies, &nbsp;with the UML, NC and NCP trailing far behind. Prominent political figures from the old parties like K P Oli, Minwndra Prasad Rijal, Ishwar Pokhrel, Bishnu Prasad Poudel, Bimalendra Nidhi all seem headed for defeat.
It does look like the RSP’s bell election symbol is ringing right across Nepal — from cities to the remotest districts in the mountains and plains. The party’s blue colour is sweeping the land.
The Nepali people seem to have sent a clear message that they were throughly dissatisfied with the chronic failure of the three main parties to work in the national interest to create jobs and deliver development. It was also an expression of lingering outrage over the the 8 September massacre outside Parliament. &nbsp;
It now looks almost certain that Balendra Shah will get to be Nepal’s next, and youngest, prime minister. Hopefully he will be leading a cabinet of competent and honest technocrats. It remains to seen how the power equation between Shah and the RSP’s leader, Rabi Lamichhane will play out.
Lamichhane is out of jail on bail for fraud cases which he has called political vendetta by the previous regime. Both he and Shah are charismatic and ambitious. Their working relationship will determine Nepal's political stability and whether it can avoid the political cronyism of the past.
This election was not just about casting votes. It was about standing up to principles and a value system, and respecting the hopes and aspirations of Nepal’s youth. It to push for transparent government and against impunity — including for the gunning down of young Nepalis in cold blood.
<div class="embed-block"><iframe src="https://election-geo-dashboard.pages.dev/" width="100%" height="600" frameborder="0"> </iframe>Live election results as winners of candidates are announced.</div>
CAN DO MAN
Shah got mixed reviews as mayor. He was impulsive and ad hoc, but most people inKathmandu and beyond liked his can-do attitude and unconventional style which stood in sharp contract to the legacy leaders. Over his three year mayorship he showed more maturity and planning capacity.&nbsp;
But he always ran headlong into opposition from the federal government over his urban planning and other initiatives to make Kathmandu more liveable. Coming from a civil and structural engineering background, he was involved in building low-cost housing after the 2015 earthquake.
But his public persona is more tied to his irreverent rap lyrics that stood up for the marginalised underprivileged in society, while exposing the high-handedness and apathy of the state. But this also exposed contradictions because he also used his own municipal guards to beat and chase away street vendors and squatters.
But there is no doubt that a combination of the sharp messaging in his rap videos amplified by the algorithms of social media ignited Nepal’s youth to rise up. It was more about optics and emotion than policy and strategy.
He studied Kathmandu district for five years, visiting experts in every field before announcing his independent candidacy for mayor in 2022. Many like me in his own constitunecy did not know who he was and where he came from.
He is a year younger than my architect son, and I saw in him a reflection of my own son’s commitment to serving the nation. I voted for him to be mayor despite his sometimes erratic behaviour, which could be attributed to his youth.
The best sign of his strategic planning, which unsettled septuagenarian and octogenarian politicians, is the he did not grab the first easy option of becoming prime minister in September when GenZ activists offered him the post.&nbsp;
Joining RSP was a masterstroke, as was his challenge to Oli in Jhapa to project national branding. He needed a party platform and Lamichhane needed a popular prime ministerial persona since he himself could not hold the post.
Shah has shown the capacity to take risks when he believes the value justifies the action for the country. Now, he will have to show more strategic thinking on a national scale, as well as understand the delicate geopolitics of Nepal.&nbsp;
He must rise above the kind of crude social media posts that earned him followers on X, but did nothing to erase his erratic and impulsive image.&nbsp;
Some assume that behind his trademark RayBan shades is a closet dictator, and his past remarks about Hitler are still up on social media. He has in the past shown impatience with criticism, unleashing supporters on social media to troll detractors.&nbsp;
Even so, the public seems willing to place their hope on an educated young man with integrity and a proven record for planning at the helm. By tomorrow it will be clear whether the hope Nepalis have held has been fulfilled, and the coming years will show if the RSP will lead Nepalis to a better future.
The voters seem to have shown the door even to the NC despite the fact that under Gagan Thapa, the party had turned a new leaf. A strong government under Prime Minister Balendra Shah heading a carefully selected cabinet and a strong opposition of the NC, UML and other parties for check and balance may be just what we need for a stable Nepal.&nbsp;
Nepalis have collectively always shown maturity in elections. This time they have given a resounding endorsement for integrity and for good governance.

Bells ring all over Nepal

After Thursday’s election, Nepalis are in a wait-and-watch mode. The Election Commission says counting ballot papers will be expedited this time, and the results for the First-Past-The-Post (FPTP) will start being declared within days. In 2022, it took three weeks for the final results to be tallied.&nbsp;
But winning an election is only half the challenge for the parties, forming a government under parliamentary politics is like a complicated mathematical equation.&nbsp;
In 2022, the Nepali Congress (NC) emerged as the biggest party, winning 89 seats. But the UML with 78 seats and the Maoists with 32 formed a minority government. In fact, Sher Bahadur Deuba did not become PM then despite leading the biggest party in Parliament.
This time, there is an unmistakeable Rastriya Swatantra Party (RSP) wave led by its prime ministerial candidate, Balendra Shah. Besides his own popularity, Shah represents change which most Nepalis are clamouring for after decades of corrupt and feckless coalitions that did not deliver.&nbsp;
The past months of campaigning has seen massive youth engagement on social media through memes, AI clips, and viral images. Digital content that appeals to emotion rather than policy debate between candidates shape electoral outcomes in Nepal and elsewhere. &nbsp;
Shah represents GenZ aspirations, and was their candidate for prime minister. It was only when he declined that Sushila Karki was nominated. None of the political parties in the recent past -- new, old, or revolutionary — have won enough seats to go it alone.&nbsp;
The most recent majority government was formed by the short-lived Communist Party of Nepal after the UML-Maoist merger in 2022. But that rare two-thirds majority collapsed after a power struggle between K P Oli and Pushpa Kamal Dahal. The only party to have won a majority was the NC in the 1991 and 1999 elections. But it is near impossible for it to repeat this success now, even with Gagan Thapa's rebranding of the party.&nbsp;
We have compiled these possible scenarios for election outcome in order of likelihood:
RSP gets a majority
RSP hits the magic 138 to form a government entirely on its own. Balendra Shah wins Jhapa-5, and becomes the new prime minister at 35, the youngest ever to hold the office in Nepal. But danger lurks: there could be a personality clash between Shah and Lamichhane who are both equally ambitious. History could repeat itself.&nbsp;
RSP wins but does not get a majority
RSP is likely to sweep the most votes, but what if it does not secure enough seats for a majority? It would need a coalition partner and Nepali Communist Party (NCP) under Pushpa Kamal Dahal could fit the bill, but only if it has the numbers. The RSP is not likely to team up with the UML or NC.
The NCP is relatively untainted by the 8 September events, and also has former UML defectors like Madhav Kumar Nepal and Bhim Rawal who could bag their rural vote banks. After all, there are no permanent foes in politics. If the royalist RPP and Tarai-based Janata Samajwadi have enough seats, those could be options for the RSP. &nbsp;
NC is second
The NC under the new leadership of Gagan Thapa could become the second biggest force and form a government with RSP in a power-sharing deal with Shah. This would be the most stable scenario since the RSP and NC have competent and idealistic young technocrats. Thapa himself embodies a strong combination of both old and new politics to navigate the system for more efficient government. But then Thapa and the RSP's Rabi Lamichhane do not get along.
NC and NCP form a majority
If the NC becomes the largest party but not by a big margin, it could join up with the NCP and Ujyalo. Teaming up with the UML would likely face backlash with the party and outside. If Gagan Thapa becomes prime minister he will face internal pressure from both Deuba loyalists. Same old story.
Minority coalition of NC, UML and NCP
RSP becomes the first party but does not get a majority, paving the way for the three legacy parties to cobble together a minority government. While this is possible in Nepal’s parliamentary system, such a scenario is likely to lead to more instability and dissatisfaction among young Nepalis demanding change, and even trigger street unrest. &nbsp;