The 14th <a href="https://www.apthc2024.org/">Asia-Pacific Travel Health Conference</a> is set to take place in Kathmandu from 18-21 September, bringing together 200 delegates from 27 countries to explore advances in <a href="https://archive.nepalitimes.com/news.php?id=19282">travel medicine</a> which have relevance for Nepal’s own tourism industry.
The biannual conference is the first in four years after its 13th iteration in New Zealand in 2020 was cancelled due to the Covid-19 pandemic. Previous conferences have been held in Bangkok and in Kathmandu in 2016.
Lessons for the travel industry from the <a href="https://nepalitimes.com/news/nepal-covid-19-impact-worse-than-official-figures">Covid-19 pandemic</a> will be prominent in the agenda of the conference in which experts from the <a href="https://www.istm.org/">International Society of Travel Medicine</a> will also be taking part. Nearly 60 of the 200 participants are from Nepal.
"The careful practice of travel medicine can be an important sentinel for diseases,” says <a href="https://nepalitimes.com/opinion/more-porters-sick-on-everest-trail">Buddha Basnyat, MD</a>, Chair of the Oxford University Clinical Research Unit-Nepal, who is part of the Nepali delegation.
The 3-day event will kick off with a day-long Pre-Conference Seminar on Adventure and Wilderness Travel, as well as separate sessions on mental health strategies and military medicine before the main events next week.
“Travel medicine is very relevant to Nepal because it has always been a desirable tourism destination,” says Pratibha Pandey, MD, of <a href="https://ciwechospital.com/">CIWEC Hospital and Travel Medicine Center</a>, which is a partner to the <a href="https://www.apths.org/">Asia-Pacific Travel Health Society</a>.
She adds: “Outbreaks of diseases like <a href="https://nepalitimes.com/banner/mosquitoes-move-up-mountains-as-the-earth-warms">dengue</a>, issues of <a href="https://nepalitimes.com/news/fatalism-and-fatalities">road and aviation safety</a>, and economic hardships have had an impact on the number of travellers coming to Nepal, which will be reflected at the conference.”
Read also: <a href="https://nepalitimes.com/news/poor-safety-to-hit-nepal-tourism">Poor safety to hit Nepal tourism</a>, Sonia Awale 
Each day of the conference will include three plenary panels, followed by parallel symposia, communication sessions, and interactive workshops. The conference will highlight special groups, including the elderly, pregnant, and otherwise immuno-compromised travellers. 
An ‘ABC’ workshop which will provide participants with the basics of setting up a clinic and explain pre-travel consultations. Other sessions include discussion about vaccines, including a plenary on the changing immunisation landscape, newer vaccine technologies, as well as a seminar on the <a href="https://www.reuters.com/business/healthcare-pharmaceuticals/japans-takeda-partners-with-indias-biological-e-boost-dengue-vaccine-production-2024-02-27/">Japanese Qdenga vaccine</a> against dengue that has not yet been licensed for use in Nepal.
Travel medicine is not just important for tourists coming to Nepal, but also for Nepalis since non-endemic infections like <a href="https://www.nature.com/articles/d41586-024-02912-6#:~:text=Mpox%20is%20caused%20by%20variants,materials%20contaminated%20with%20the%20virus.">Mpox and other diseases</a> can be brought here by visiting carriers.
“We were diagnosing dengue and typhus fever in travellers to Kathmandu who came via Rajasthan or Bangkok in the 1990s, long before these diseases became well-established in the local population,” explains Buddha Basnet, who is delivering a lecture on the <a href="https://nepalitimes.com/banner/a-shot-in-the-arm-for-vaccines-in-nepal">Typhoid Conjugate vaccine</a> and its roll-out in Nepal in one of the symposia.
The conference will also discuss airlift and emergency evacuation and a workshop on the role of the military in disaster and outbreak relief operations — both especially relevant to trekking and mountaineering in Nepal. <a href="https://nepalitimes.com/news/climate-breakdown-linked-to-thame-flood">Climate breakdown</a> has increased the need for better preparedness and rescue.
 Read also: <a href="https://nepalitimes.com/here-now/kathmandu-loses-its-open-spaces">Kathmandu loses its open spaces</a>, Tom Robertson and Nilima Thapa Shrestha
Other sessions include a plenary on sustainable travel in the age of no-jet set and <a href="https://www.nytimes.com/2023/02/06/travel/travel-climate-no-fly-pledge.html">climate guilt</a>, as 4% of greenhouse emissions are from air travel. Workshops will also look into other infectious diseases and the use of AI and Large Language Models like ChatGPT on travel medicine.
Because travel medicine specialises in diseases and health conditions that are acquired during international travel, it involves pre-travel, during travel, and post-travel consultations. Apart from the relevance of travel medicine to provide medical care to visitors to Nepal, there is also the opportunity to advance pre-travel and post-travel medicine for Nepalis.
Says CIWEC’s Prativa Pandey: “Heartbreaking as it is, migrant workers and students are leaving in droves, and many migrants are <a href="https://nepalitimes.com/opinion/comment/saving-kidneys-to-save-nepal">coming back with kidney failure</a>, about which there is very little data or research, so there is an urgent need to address those areas as well in Nepal.”
Read also: <a href="https://nepalitimes.com/news/brain-gain-into-brain-drain">Brain gain into brain drain</a>, Sonia Awale
Some of the participants include the ‘father of travel medicine’ Robert Steffan from Switzerland, Tomas Jelinek of the Berlin Centre for Travel and Tropical Medicine, editor of the Journal of Travel Medicine Annelies Wilder Smith, David Shlim who was Medical Director of CIWEC in Kathmandu 1983-1998, and <a href="https://www.ox.ac.uk/news-and-events/find-an-expert/professor-david-warrell">Sir David Warrell</a> a world expert on snake bite, rabies and infectious disease.

Shristi Karki

original

674x448

610x380

500x500

400x266

400x240

400x203

301x200

1250x600

1084x550

thumbnail

viewImage

Medicine on the move

<figure><img width="1500" height="844" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110111120/636cd12e9c7e80680e08f89djpeg.jpg" alt=""/><figcaption>Uma Kumari Sah with her grandmother.</figcaption></figure>It started with persistent skin <a href="https://archive.nepalitimes.com/article/nation/what-are-you-allergic-to,4151" target="_blank" rel="noopener noreferrer">allergy</a> for 15-year-old Uma Kumari Sah. She got a checkup at a leprosy hospital in Dhanusa, and later in India. Doctors detected a growth in her lungs. The very next day she flew to Kathmandu where she was given six cycles of chemotherapy, twice a week.Sah is from Hariban municipality of Sarlahi district where 30 people have died in the past three years, seven others are undergoing treatment for various types of <a href="https://archive.nepalitimes.com/article/nation/think-pink-breast%20cancer-diagnosis-treatment,3877" target="_blank" rel="noopener noreferrer">cancer</a>.  The three neighbourhoods of the village have a population of 1,500. Extrapolating this figure nationwide would mean a death toll from cancer of a staggering 650,000 people all over Nepal in three years.Hariban village is at the lap of the <a href="https://archive.nepalitimes.com/page/crushing-tale-of-Chure" target="_blank" rel="noopener noreferrer">Chure Range</a> adjoining the Tarai. There is well water, and the fertile fields are perfect for vegetables which are taken to Kathmandu to be sold. But what brings the farmers prosperity could also be one of the reasons for the epidemic of cancer here.Farmers are using herbicides and insecticides, some of them <a href="https://www.nepalitimes.com/from-the-nepali-press/banned-pesticides-are-widely-used-in-nepal/" target="_blank" rel="noopener noreferrer">banned in Nepal</a>. The water table is receding due to over-extraction and what comes out of the pumps is arsenic-laced. <figure><img width="1500" height="844" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110111120/636cd1319c7e80680e08f89ejpeg.jpg" alt=""><figcaption>Chapini Khola with refuse strewn along the waterway.</figcaption></figure>Cancer used to be so rare in Nepal that there is no word for it in the Nepali language. But Hariban could be a microcosm of the cancer sweeping the country. Cancer is now the <a href="http://nhrc.gov.np/wp-content/uploads/2019/04/Progress-Interim-_cancer.pdf" target="_blank" rel="noopener noreferrer">fifth leading cause of death</a> in Nepal, with lung, <a href="https://www.nepalitimes.com/opinion/moving-forward-to-live-pink/" target="_blank" rel="noopener noreferrer">breast</a>, cervix, stomach and colorectal cancers being the most common. Approximately 28,000 new carcinoma cases are diagnosed every year in Nepal with mortality at 20,000, both at an increasing rate as per the Global Cancer Observatory estimates. But many more cases go undiagnosed due to lack of resources and insufficient screening. The ongoing <a href="https://www.nepalitimes.com/latest/living-with-cancer-during-the-coronavirus/" target="_blank" rel="noopener noreferrer">Covid-19 pandemic has added to the crisis</a>. There were five times more funerals at the Pashupati cremation site in December 2020 compared the previous year. While some could be people who died from the coronavirus, many others are thought to be patients with cancer or other chronic disease who could not get timely treatment.    Lockdowns and restrictions as well as fear of contracting SARS-CoV-2 had <a href="https://www.nepalitimes.com/here-now/kidney-patients-dying-due-to-covid-19-lockdown/" target="_blank" rel="noopener noreferrer">affected patients of many chronic illnesses</a> such as cancer due to reduced treatment and screening facilities. This in turn has likely resulted in more fatalities, say health experts. Back in Hariban, Sah is now doing well after treatment. She says: “I’m lucky because my family could afford the treatment. I now plan to study science, be a nurse and care for patients like me. I want to help the poor and provide them treatment without cost.” Rafi Miya also lives in the neighbourhood and can barely survive on income from farm. Now, in addition to poverty, the family is burdened with cost of cancer treatment for himself and his son. Miya was diagnosed with throat cancer after a biopsy in Bharatpur Cancer Hospital. “They operated on me and took the growth out, but my voice is hoarse now. We cannot get the medication here, and it is expensive.” His son Lipla Miya’s cancer has affected his bowel and bladder functions. His treatment has already cost Rs200,000.   Phekini Devi Mahato Sundi also lives nearby, and started getting skin rashes, and suspects the <a href="http://archive.nepalitimes.com/regular-columns/Testimony/lets-talk-about-boobs/breast-cancer-awareness,989" target="_blank" rel="noopener noreferrer">lump in her breast is cancer</a>. She cannot even afford to travel to get a checkup. Her husband Sinai has asthma, and is despondent that he does not have the money for her treatment. https://www.youtube.com/watch?v=qF5VYI-JVLI&amp;feature=youtu.be“We have no money, without it there is no treatment. Doctors only treat those with money,” he says, pointing to his damaged spectacles, which he cannot afford to replace.   At Hariban’s Namuna Community Hospital, physician Anil Kumar Chaudhari conforms that there has been a steep rise in malignancies, and patients are referred to hospitals in Kathmandu or Bharatpur.“There is a steady stream of cancer patients from the surrounding villages, most have skin, liver, lungs and throat cancer,” says Chaudhary. “Those who can afford it go to India.”The Nepal government provides Rs100,000 for cancer patients who cannot afford treatment, but this is negligible compared to the total bill. Most patients here seek treatment when the cancer is at an advanced stage, so they end up losing all their money as well as their lives.Another neighbor, Jaggilal Sah suffered minor illnesses for a few years, but when he got sick during the pandemic, the doctors diagnosed him with third stage brain tumour. Surya Bahadur Sangtang’s father was also diagnosed with last stage cancer and died within few months.Says Sangtang: “He was admitted to hospital for 2-3 months, we lost all our money, and we also lost our father.”The dramatic rise in cancer made Harban’s local government investigate possible contributing factors. Many residents depend on <a href="https://archive.nepalitimes.com/article/nation/heavy-pesticide-use-and-low-consumer-awareness-affecting-public-health,1394" target="_blank" rel="noopener noreferrer">commercial vegetable farming</a>, and there is <a href="https://archive.nepalitimes.com/article/nation/pesticide-laced-vegetables-continue-to-poison,1555" target="_blank" rel="noopener noreferrer">rampant pesticide spraying</a>.  With the <a href="http://archive.nepalitimes.com/article/Nation/water-table-of-kathmandu-valley-falling-fast-recharge-to-replenish,4100" target="_blank" rel="noopener noreferrer">depletion of groundwater</a>, villagers have turned to shallow tubewells increasing the risk of arsenic contamination. A sample survey from community tubewells here showed the amount of arsenic at 0.63mg/l , several times higher than the safe limit of 0.05mg/l. <figure><img width="1500" height="844" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110111120/636cd1359c7e80680e08f89fjpeg.jpg" alt=""><figcaption>A garbage-filled well.</figcaption></figure><figure><img width="1500" height="844" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110111120/636cd1389c7e80680e08f8a0jpeg.jpg" alt=""><figcaption>Drinking water that is not fit to drink because of pollutants.</figcaption></figure>Near the village is the Indushankar Sugar Mill that buys sugarcane from local farmers and turns it into sugar and alcohol, letting out toxic effluent into surrounding waterways. There are also 125 brick kilns in Sarlahi district, 16 of them in Hariban alone. <a href="https://archive.nepalitimes.com/article/nation/black-carbon-easier-to-control-than-carbon-dioxide-to-reduce-global-warming%20,2079" target="_blank" rel="noopener noreferrer">Soot particles from</a> the stacks can also be carcinogenic.Says a local Dhanbahadur Ghising: “Farmers use pesticides elsewhere too, but why aren’t other villages also getting cancer? This probably means it has something to do with polluted water and arsenic here.” <figure><img width="1500" height="844" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110111120/636cd13c9c7e80680e08f8a1jpeg.jpg" alt=""><figcaption>Smoke stack of a brick kiln in Hariban.</figcaption></figure>Hariban Municipality has been forced to act. It is installing deep tubewells from up to 30m so that there is less chance of arsenic contamination of drinking water. The Indushankar Sugar Mill also dug a deep well and installed three tanks to store drinking water for villagers.Progress on the alternative sources of water is slow, and it will take time to have an impact. In the meantime, young and old in Hariban face daily exposure to whatever is causing the cancer epidemic here. This Sarlahi village also has lessons for other parts of Nepal, which may also be exposed to the same risk factors. Based on Episode 2 of <a href="https://www.facebook.com/saglosamaj" target="_blank" rel="noopener noreferrer">Saglo Samaj</a>, a tv magazine program produced by Himalmedia which is broadcast every Monday, at 8:30 pm on Dish Home Channel 130.<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110111124/636cd1409c7e80680e08f8a2jpeg.jpg" alt="" width="1447" height="815">

Nepal’s other pandemic: cancer

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110914118/636ba6a99c7e80680e073737jpeg.jpg" alt="" width="1365" height="2048"/><figcaption>Photo: BIKRAM RAI</figcaption></figure>When Lalbahadur Shah of Birganj died last week, none of his relatives showed up for his funeral even though he tested negative for Covid-19. With no family, friends and neighbours attending, the Muslim community members took it upon themselves to perform his final rites as per the Hindu faith.Shah had hypertension and diabetes, although he had tested positive for <a href="https://www.nepalitimes.com/latest/dont-take-covid-19-lightly/" target="_blank" rel="noopener noreferrer">SARS-CoV-2</a>, he had recovered from the infection. He succumbed to other health complications.Across Nepal, people infected with the virus, even those who have recovered, have been <a href="https://www.nepalitimes.com/here-now/covid-19-sharpens-caste-discrimination-in-nepal/" target="_blank" rel="noopener noreferrer">shunned by neighbours and society</a>. Migrant returnees and their families have been singled out and humiliated. Doctors and health workers have been harassed by landlords.This is nothing new in Nepal. Tuberculosis and leprosy patients have been traditionally shunned. And the stigma associated with Covid-19 is very reminiscent of <a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/stigma-ostracisation-for-HIV-patients-remain-in-western-nepal,1724" target="_blank" rel="noopener noreferrer">how people with HIV/AIDS used to be treated in Nepal</a> in the past, and may have lessons for dealing with SARS-CoV-2, since the virus (like HIV) is here to stay.“Physical distancing doesn’t mean discrimination and we should make people understand this,” says public health expert Aruna Uprety. “There is widespread panic about Covid-19 and this is turning people against those infected with it, exactly like it was with HIV/AIDS. This in turn is adding to the mental stress of the patients, undermining their recovery.”Says Anjana Rajbhandary, a counsellor and columnist: "Social stigma is attached to lack of knowledge and when people know less, they feel the need to blame someone else because they are afraid of the unknown. Fear and anxiety about death and disease can lead to gossip, which results in stereotyping and discrimination."Constant focus in the mass media on new infections and <a href="https://www.nepalitimes.com/latest/nepal-covid-19-deaths-cross-100/" target="_blank" rel="noopener noreferrer">fatalities</a> over those who have recovered has reinforced the misconception that Covid-19 is highly lethal, adding to the fear about it.On Tuesday, Nepal reported a total of 1,016 new cases, its highest daily rise with 205 in Kathmandu Valley alone, forcing the local governments in Kathmandu, Lalitpur and Bhaktapur <a href="https://www.nepalitimes.com/banner/kathmandu-valley-back-to-lockdown/" target="_blank" rel="noopener noreferrer">to reimpose lockdown for a week</a> starting Wednesday midnight. So far, 17,580 people have recovered while 114 have passed away.The number of new infections was down to 671 on Wednesday, 151 of them in Kathmandu Valley.The similarities between HIV/AIDS and Covid-19 goes beyond <a href="https://archive.nepalitimes.com/news.php?id=19019" target="_blank" rel="noopener noreferrer">stigma</a>. Just like HIV/AIDS  spread like wildfire in western Nepal among families with husbands working in India, most of the Covid-19 cases were imported from India and spread among the poorest sections of Nepal’s most underserved region. And just like with HIV, Covid-19 is felling people with compromised immune systems.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110914118/636ba6ad9c7e80680e073738jpeg.jpg" alt="" width="300" height="400"><figcaption> </figcaption></figure><figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110914118/636ba6ae9c7e80680e073739jpeg.jpg" alt="" width="300" height="400"><figcaption> </figcaption></figure>Long-time HIV/AIDS activist Rajiv Kafle also sees parallels between the current Covid-19 crisis and the HIV epidemic of the 1990s in <a href="https://archive.nepalitimes.com/article/nation/ending-AIDS-in-Nepal,2707" target="_blank" rel="noopener noreferrer">turning public awareness into behavioural change for prevention</a>  Both diseases are caused by viral infections and attack the immune-compromised – only the method of transmission is different. While HIV is spread through unprotected sex, sharing needles or blood transfusions, SARS-CoV-2 spreads human-to-human through aerosol particles.“As with HIV, I see a lot of denial about coronavirus. Back in the day, peer-pressure led people to partake in highly risky behaviour like sharing syringes. Peer-pressure today can be seen in the form of people pulling down their masks in presence of friends,” says Kafle.Mass media was a crucial tool in the battle against HIV/AIDS in the days before social media. In particular, tv serials and docudramas featuring popular faces like comedian duo Madan Krishna Shrestha and Hari Bansa Acharya were highly effective in creating awareness about preventive measures such as safe sex and clean needles as well as in lessening the stigma for some 50,000 people living with HIV in Nepal.Nearly 30 years later, Shrestha and Acharya are once more doing skits for public service announcements via social media and tv to <a href="https://www.nepalitimes.com/editorial/lockdown-may-be-over-but-pandemic-is-not/" target="_blank" rel="noopener noreferrer">spread awareness about Covid-19 preventive measures</a>. The message is similar: while it was condoms and safe needles for HIV/AIDs, it is masks and distancing for Covid-19.“If we were able to change peoples’ behaviour in something as sensitive as sex, then we should be able to do it much more effectively for Covid-19,” says Rita Thapa of Nepal Public Health Foundation, who was formerly with the WHO. “We still have time to work together with local authorities, civil society and the government to run mass awareness campaign that reaches down to the grassroots.”Since this August, the government has started providing free TLD (once-a-day generic fixed-dose combination of tenofovir disoproxil fumarate, lamivudine, and dolutegravir), new antiretroviral drug considered the best regimen in the world for 17,000 people living with HIV in Nepal. Activists like Kafle credit this milestone to treatment literacy, community mobilisation and continued activism.“Only a similar kind of dedication will guarantee accountability and transparency in terms of testing and treating coronavirus in Nepal when the vaccine and therapies aren’t available,” he adds.Aruna Uprety recalls a recent field visit to Makwanpur district where she found Chepang nomads living without toilets or clean drinking water, who were not <a href="https://www.nepalitimes.com/opinion/prevention-while-searching-for-a-cure/" target="_blank" rel="noopener noreferrer">wearing masks</a> and maintaining distance.“It is now pretty clear we will have to learn to live with Covid-19 just as we did with HIV. What would help is strengthening our immune system to fight against the infection, be it by applying traditional medicinal or by eating nutritious indigenous food,” says Uprety. “But to prevent infection for now our first line of defence are masks, distancing and hand-washing.”

Sonia Awale

Learning from HIV to fight Covid-19 in Nepal

Although smallpox is now ‘unfamiliar to the world today’ historian Elizabeth Fenn has written that it was ‘a misery commonplace in years gone by.’For centuries, the smallpox virus and the gruesome death and destruction it caused upended people's lives around the world and in Nepal. In this History of Disease series in Nepali Times in the past month I have recounted how smallpox traveled and killed in Europe and America, became a terrible test for survival for children in South Asia, and  struck down both royals and regular citizens in Nepal in the 19th century.We have seen how people devised inoculation and vaccination to fight the disease, and how vaccines and strong surveillance helped eradicate the disease around the world and in Nepal in the 1970s, but only 'by the slimmest of margins'.Several things about the history of the disease deserve special emphasis. As much as any influential king or prime minister, we sometimes forget that smallpox and other diseases shaped the course of human events.Part I: <a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/banner/big-story-of-small-pox-in-nepal/" target="_blank" rel="noopener noreferrer">Big story of smallpox in Nepal</a>Part II: <a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/opinion/the-smallpox-virus-in-british-india/" target="_blank" rel="noopener noreferrer">The smallpox virus in British India</a>Part III: <a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/opinion/smallpox-politics-and-power-in-kathmandu/" target="_blank" rel="noopener noreferrer">Smallpox, politics and power in Kathmandu</a>Part IV: <a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/opinion/how-nepal-eradicated-the-smallpox-virus/" target="_blank" rel="noopener noreferrer">How Nepal eradicated the smallpox virus</a><figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022112916110/63861ea39c7e80680e0ccdd9jpeg.jpg" alt="" width="1500" height="1001"/><figcaption>Photo: MANISH PAUDEL</figcaption></figure>Viruses such as measles, influenza, hepatitis, polio, rabies, and HIV – as well as non-viral diseases such as cholera, TB, syphilis, and malaria – remade not just individual lives, but also physical, economic, and political landscapes.The fury of smallpox reminds us of the inescapable power of nature. Despite all our efforts, humans are part of nature, and life is fragile.We are living beings made up of cells and nutrients, subject to the rules of geography and biology, death and disease. This reality held true in the past, and holds true today, as much as we hope otherwise. Smallpox may have been chased away, but COVID-19 stands at the doorstep.Each disease has its own characteristics, its own biological personality, its own way of spreading through society and attacking human bodies. <a href="https://www.nepalitimes.com/here-now/the-mosquito-that-changed-nepals-history/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/here-now/the-mosquito-that-changed-nepals-history/&amp;source=gmail&amp;ust=1590041413347000&amp;usg=AFQjCNEvpoGS7wd8yELy9-vJ0LG1oby5kw">Malaria moved via mosquitoes</a> which liked warm weather, <a href="https://www.nepalitimes.com/latest/kathmandu-in-the-time-of-cholera/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/latest/kathmandu-in-the-time-of-cholera/&amp;source=gmail&amp;ust=1590041413347000&amp;usg=AFQjCNGDo4ZWCamW139FFTuqWLpgRZuSoQ">cholera through germs in water</a>, and syphilis through sex. Due to these differences, each disease left its own unique imprint on history.<a href="https://www.nepalitimes.com/banner/big-story-of-small-pox-in-nepal/" target="_blank" rel="noopener noreferrer" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/banner/big-story-of-small-pox-in-nepal/&amp;source=gmail&amp;ust=1590041413347000&amp;usg=AFQjCNF3MVYYqp8ZY4QHWix_z0-R_ABxUA">Big story of small pox in Nepal</a>, Tom RobertsonSmallpox spread through the air, moved easily from person to person, caused searing pain, and, if it did not kill, left behind disfigured, broken human bodies. In Nepal, if it had struck older people, not children, or if it had not left its victim's faces scarred and their eyes damaged, it might have brought less terror.On the other hand, if it had had a reservoir in animals (as many viruses do) it would have been much harder to eliminate, and we might still be facing its burning fevers and excruciating rashes today. Small pox’s particular biology shaped history in a particular way.Nature is not just a passive stage on which we humans act out our dramas as we wish. Instead, it is an actor in every drama, sometimes in the background, sometimes centerstage, but often coming and going at its own will, not ours.<a href="https://www.nepalitimes.com/opinion/the-smallpox-virus-in-british-india/">The smallpox virus in Nepal</a>, Tom RobertsonLooking back, if we recount the stories just of kings and queens and their political chess matches, we overlook some of history's main drivers and its most important stories. In fact, if we overlook disease history we will not understand the stories of kings and queens as well as we think. Can we really tell the history of Rana Bahadur, Girvana, Bimsen Thapa, and Bir Shumshere -- much less the stories of ordinary people around the country -- without understanding the central role of disease?Looking forward, we would do well not to forget nature's power to completely take over the course of events. Smallpox also reminds us that, even though humans share the same biology, diseases often affect some subsets of society more than others, particularly those with less money and power. In other words, biological forces may be universal but they play out in social landscapes as complex and uneven as Nepal's dadakada.In the Americas, smallpox even more than guns, gave Europeans a huge advantage over the indigenous people who had never encountered the disease before, and thus lacked immunity. <a href="https://www.nepalitimes.com/opinion/the-smallpox-virus-in-british-india/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/opinion/the-smallpox-virus-in-british-india/&amp;source=gmail&amp;ust=1590041413347000&amp;usg=AFQjCNHRE-p56xptgt9wTBUUjoc05RxNwA">In colonial India, smallpox and ideas about how to treat it divided the British from Indians</a> more than it brought them together.<a href="https://www.nepalitimes.com/banner/big-story-of-small-pox-in-nepal/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/banner/big-story-of-small-pox-in-nepal/&amp;source=gmail&amp;ust=1590041413347000&amp;usg=AFQjCNF3MVYYqp8ZY4QHWix_z0-R_ABxUA">In Nepal, smallpox preyed upon both rich and poor</a>, powerful and powerless alike. But as the 19th century Newar song 'Sitalamaaju Mye' reminds us, it divided Gorkha conquerors and Newar families. <a href="https://www.nepalitimes.com/opinion/smallpox-politics-and-power-in-kathmandu/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/opinion/smallpox-politics-and-power-in-kathmandu/&amp;source=gmail&amp;ust=1590041413347000&amp;usg=AFQjCNFFHANLUtlK0myrUwhb4qdFGZg4Pg">Smallpox shaped power struggles between Bhimsen Thapa and his political rivals</a>, and later, in the effort at eradication, altered relations between government health workers and individuals from impoverished ethnic minorities.<a href="https://www.nepalitimes.com/opinion/smallpox-politics-and-power-in-kathmandu/">Smallpox, politics and power in Kathmandu</a>, Tom Robertson No doubt, smallpox also shaped gender relations in ways we need more historical research on. Just as differences between diseases mattered in the course of history, so, too, did social differences.<a href="https://www.nepalitimes.com/opinion/how-nepal-eradicated-the-smallpox-virus/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/opinion/how-nepal-eradicated-the-smallpox-virus/&amp;source=gmail&amp;ust=1590041413347000&amp;usg=AFQjCNGC0hhwCb-vpWbsy8-oT_gcbRcM6Q">Nepal's successful effort to eradicate smallpox in the 1960s and 1970s</a> seems particularly relevant to us today. Nepal's last case in 1975 shows what it took to banish a complex disease in challenging circumstances: sustained governmental focus and coordination, adequate long-term funding, scientific knowledge, talented and dedicated staff, careful record keeping, program flexibility and adaptation to local culture and conditions, and dogged surveillance.Yet even at this moment of seeming human control, nature's power was on display. Smallpox eradication happened only with help from nature. Compared to malaria and polio, smallpox was relatively easy to control. It was so intense that it was easy to spot, and that intensity also made it difficult for contagious victims to move around infecting others. Smallpox did not strike a person twice. And unlike other viruses, it proved very susceptible to a vaccine. This history suggests some of the special challenges that COVID-19 poses.Here, too, social difference mattered. Nepal's eradication campaign shows the enormous challenge of protecting individual rights in moments of public health crisis. In Nepal and other South Asian countries, government personnel sometimes used violence to force citizens to get vaccinated. Some health workers grew so convinced of their righteousness -- the 'purity of purpose' in one man's self-description -- that they felt comfortable steamrolling the wishes of others, often people from socially marginalised groups with little say in society to begin with.<a style="background-color: #ffffff; font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/opinion/how-nepal-eradicated-the-smallpox-virus/" target="_blank" rel="noopener noreferrer">How Nepal eradicated the smallpox virus</a>, Tom RobertsonSuch coercion probably could have been avoided through more nimble policies, more extensive training, and better public education. Problems often sprouted, the historian David Arnold noted, when doctors and other health workers didn't understand how ordinary people saw the world and quickly dismissed their concerns as backward or superstitious -- when, as he put it, the medical system had grown ‘culturally and politically distant from the lives of its subjects’.In the end, the history of smallpox shows the fragility of life, but also the power of human perseverance. Smallpox struck down one of every three it infected. It stole beautiful children from their mothers and fathers. It stole sight from survivors. In some places, it wiped out entire families and laid waste to whole villages. It was deadly, ruthless, and horrific. It sometimes brought out the worst in human nature.But it also often spurred great ingenuity, compassion, togetherness, and resilience. In the face of disease, humans have found surprising ways to support each other, learn from the past, endure the suffering of the present, and find hope again in the future.This is the fifth article in the <a href="https://www.nepalitimes.com/opinion/big-story-of-small-pox-in-nepal/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/opinion/big-story-of-small-pox-in-nepal/&amp;source=gmail&amp;ust=1590041413347000&amp;usg=AFQjCNHAaHCW0Y2UQjeFfh0UQoUPVtsqbA">series </a>History of Disease. The next column will deal with danger of dengue in Nepal. <a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/how-chitwan-was-opened,4159" data-saferedirecturl="https://www.google.com/url?q=https://archive.nepalitimes.com/article/Nepali-Times-Buzz/how-chitwan-was-opened,4159&amp;source=gmail&amp;ust=1590041413347000&amp;usg=AFQjCNEcTfdhSI0N9Tqo_qgoyZnrHCccug">Tom Robertson</a>, PhD, is researching the environmental history of Kathmandu Valley.Read other articles on smallpox in Tom Robertson’s History of Disease series in <a href="https://www.nepalitimes.com/opinion/how-nepal-eradicated-the-smallpox-virus/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/opinion/how-nepal-eradicated-the-smallpox-virus/&amp;source=gmail&amp;ust=1590041413347000&amp;usg=AFQjCNGC0hhwCb-vpWbsy8-oT_gcbRcM6Q">Nepali Times</a>.

Tom Robertson

Viruses past, present and future

Epidemics are nothing new in Nepal. In fact, the country’s history is littered with references to frequent outbreaks of cholera, influenza, measles and other disease that killed thousands at a time Nepal.Yet, despite knowledge about prevention or the availability of vaccines, Nepalis still continue to die in large numbers. An outbreak of diarrhoea killed 200 people, mostly children, in Jajarkot in 2009. Last year’s unprecedented eruption of <a href="https://tropmedhealth.biomedcentral.com/articles/10.1186/s41182-020-0194-1" data-saferedirecturl="https://www.google.com/url?q=https://tropmedhealth.biomedcentral.com/articles/10.1186/s41182-020-0194-1&amp;source=gmail&amp;ust=1586755561427000&amp;usg=AFQjCNF2kQRkqfQlK6HcTgAWijq2RpcGaQ">dengue in Kathmandu</a> infected 15,000 and <a href="https://www.nepalitimes.com/banner/mosquitoes-move-up-mountains-as-the-earth-warms/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/banner/mosquitoes-move-up-mountains-as-the-earth-warms/&amp;source=gmail&amp;ust=1586755561427000&amp;usg=AFQjCNEBf6yExopyyX2QWQrwe2mffPJ09w">killed at least a dozen people</a>.So, for Nepal the only difference between the coronavirus pandemic and previous disease outbreaks is that it is global in scope, and it has wrecked the economy. The government has been more proactive this time, compared to previous epidemics in taking strict measures to prevent the spread, like the <a href="https://www.nepalitimes.com/latest/nepal-covid-19-lockdown-extended-till-7-april/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/latest/nepal-covid-19-lockdown-extended-till-7-april/&amp;source=gmail&amp;ust=1586755561428000&amp;usg=AFQjCNHcPke1rqEHuZS0-wb1tig9mHFzYw">lockdown</a> which has now lasted nearly three weeks.Even so, experts say Nepal’s response was unnecessarily delayed. Nepal was one of the first countries outside China to report a case of COVID-19 when a Nepali student who had returned from Wuhan tested positive for the virus on 24 January. He later recovered, and right new cases have been detected since, but it was only in the second week of April that the government finally began mass testing in western Nepal and Tarai districts, where there have been returning migrant workers from India.<a href="https://www.nepalitimes.com/opinion/remembering-a-pandemic-100-years-ago/">Remembering a pandemic 100 years ago</a>, Buddha Basnyat<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109121112/636b8b679c7e80680e06b298jpeg.jpg" alt="" width="4096" height="2730"/><figcaption>A doctor based in Sukraraj Tropical and Infectious Disease Hospital explains on COVID-19. Photo: BIKRAM RAI</figcaption></figure>The mosquito-borne haemmorhagic fever is already being reported in all seven provinces. Cases have been arriving in hospitals which are already on high alert of COVID-19. A double epidemic would mean medical facilities will be overwhelmed.“We are not new to epidemics. Thousands of children continue to die of easily preventable diarrhoea every year and there will be another dengue outbreak this summer, but where is the preparedness?” asks Gangalal Tuladhar, a disaster expert and politburo member of the ruling Nepal Communist Party. “It is a primary duty of a responsible government to prepare for any disaster or an epidemic before it strikes.”<a href="https://www.nepalitimes.com/here-now/nepal-is-a-microcosm-of-all-of-the-changes-in-world-health/">“Nepal is a microcosm of all of the changes in world health”</a>, Nepali TimesIt is ironic that a senior member of a ruling political party that commands a near two-thirds majority in Parliament is the one complaining about the government being lax. To be sure, the government has been strict in enforcing the lockdown, and Prime Minister Oli hinted during a conference call with provincial chief ministers on Saturday that the lockdown may need to be extended because the virus was spreading in India.Also, local government have been crediting with taking effective prevention measures, including house-to-house surveillance and monitoring of high-risk individuals. Swab collection and mass testing of high risk groups has started in earnest.<a href="https://www.nepalitimes.com/here-now/confusion-persists-about-lockdown-rules/">Confusion persists about lockdown rules</a>, Alisha Sijapati<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109121112/636b8b6b9c7e80680e06b299jpeg.jpg" alt="" width="640" height="427"><figcaption> </figcaption></figure>Still, Nepal’s lack of preparedness to fight public health emergencies has been similar to the apathy shown about enforcing building codes and having a rescue and relief strategy in place for future mega-earthquakes.It took the devastating 2015 earthquake to finally push the policymakers to develop the Disaster Risk and Management Act in 2017 – more than five years after it was languishing in the legislature. Unlike the Natural Calamity Act 1982 that is centred on the relief, the new Act listed 22 kinds of disasters in Nepal and it focuses on preparedness. Epidemics however have been categorised under ‘non-disaster’ in the new Act.<a href="https://www.nepalitimes.com/banner/rebuilding-five-years-after-2015-quake/">Rebuilding five years after 2015 quake</a>, Alisha SijapatiEpidemics has been lumped together with famine, fire, pest or micro-bacterial attack, industrial accident, toxic gas hazard, chemical radiation leakage, gas explosion, toxic food intake, environmental pollution, deforestation, physical infrastructure damage and accidents during disaster relief.“Placing snakebites and outbreaks together itself shows that we haven’t really understood what an epidemic means. There is a huge difference in how we have to deal with them,” says Baburam Marasini, former head of the Epidemiology and Disease Control Division.The emergence of COVID-19 on top of the reoccurrence of pre-existing diseases mean countries need health institutions with medical staff equipped to deal with epidemics, research wing to undertake new studies on emerging diseases, and a strong system that can take immediate steps to control spread of a contagion.<a href="https://www.nepalitimes.com/banner/rebuilding-five-years-after-2015-quake/">The climate connection to Covid-19</a>, Rastraraj Bhandari“We need to make laws taking infectious diseases into account, strengthen local infrastructure as well as increase capacity of the health sector,” Marasini says.  “We have to turn COVID-19 into an opportunity to build a new health structure and strengthen existing laws.”Chronic lack of coordination and turf battles between the Department of Health Services, National Public Health Laboratory, Epidemiology and Disease Control Division, Epidemiology and Epidemic Management Section, Teku Hospital and Animal Disease Investigation and Control Division have added to the problem.Says public health expert Madhav Chaulagain: “We are unprepared not just for new emerging epidemics but for the pre-existing diseases and seasonal disasters too.”<a href="https://www.nepalitimes.com/here-now/in-nepals-weather-erratic-is-the-new-normal/">In Nepal’s weather, erratic is the new normal</a>, Olivia Molden and Tyler McMahonClose to three years after Nepal adopted a decentralised federal structure, provincial governments have to fly COVID-19 samples to Kathmandu in lack of regional laboratories and hospitals specialising in infectious diseases.The root of the problem is a culture not primed for prevention, but for cure. Also a ‘ke garne’ fatalistic attitude that tends to leave solving a known problem until after the disaster hits.“We think about building modern hospitals to cure people. What developing countries like us should really be focusing on is prevention and preparedness,” says Gangalal Tuladhar. “We are lucky we still have time to prepare for COVID-19. It is time to work on prevention.”Read also:<a href="https://www.nepalitimes.com/latest/cash-flow-crisis-for-migrants-and-families/">Cash flow crisis for migrants and families</a>, Upasana Khadka<a href="https://www.nepalitimes.com/opinion/what-is-novel-about-the-novel-coronavirus/">What is novel about the novel coronavirus?</a>, Buddha Basnyat

Ke garne attitude kills people

<img width="782" height="512" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110912118/636b8aae9c7e80680e06b254jpeg.jpg" alt=""/>Nepali Times spoke to Barun Mathema, professor of epidemiology at the Mailman School of Public Health at Columbia University in New York about how the COVID-19 pandemic will affect prisons. He was recently on the <a href="https://www.facebook.com/cnn/videos/vb.5550296508/226123838751517/?type=2&amp;theater" data-saferedirecturl="https://www.google.com/url?q=https://www.facebook.com/cnn/videos/vb.5550296508/226123838751517/?type%3D2%26theater&amp;source=gmail&amp;ust=1586343755174000&amp;usg=AFQjCNGi6UJyyN6-u3mKXwecTMbIgCwAOw">Michael Smercornish show on CNN</a> to warn that jails can incubate infections. Nepali Times: How serious is the danger of coronavirus or other infections spreading out of prisons into the general population?  Barun Mathema: For detainees under trail for longer term sentencing I would say we need to guided by two principles: 1) as a society we are obligated to protect detainees (in jails or prisons); 2) likewise, we should take actions to reduce risk to the surrounding communities. Given that COVID-19 thrives on social contact, having crowded jails with people coming in and out is likely to promote transmission into jails, transmission within jails and 'spillover' of infections out of the jails into the community. There are many bridge populations, i.e. jail staff, detainees and visiting members of the community, for example family, that can transport the virus into or out of the jails. Also a very important consideration is that there is likely a sizable population that have a variety of co-morbid conditions that predispose poor/bad COVID-19 clinical outcomes.So, in my opinion, we need to figure out way to lessen the load of inmates in jails (and prisons) that would require us to restrict or lessen numbers going into jails and prisons and release those in jails responsibly and safely. The criminal justice system should at least consider: i) dropping charges on low-level crimes, ii) relax charging low level offenses in the first place, and 3) release detainees who are the most vulnerable (aging or those with serious co-morbidity). All of this must of course be done safely, ethically and responsibly.The result will likely help lift some pressure within the jails, reducing the risk of outbreaks and potential spillover into the community ... in addition this will likely help in our general mitigation goal of flattening the curve.Read also:<a href="http://archive.nepalitimes.com/news.php?id=13002#.XoxhTsgzbIU">Unsafe in prison</a>, Himal Khabarpatrika<a href="https://www.nepalitimes.com/latest/nepalis-trapped-down-under/">Nepal trapped Down Under</a>, Upasana Khadka<a href="https://www.nepalitimes.com/latest/lockdown-and-the-surge-in-domestic-violence/">Lockdown and the surge in domestic violence</a>, Suvexa Pradhan TuladhaYour research is mainly on the spread of tuberculosis in Brazil’s jails. But what is your view on the probable immune-enhancing property of the BCG vaccine?I work primarily on tuberculosis, anti-microbial resistance in tuberculosis and in other bacterial pathogens. BCG vaccination is one of the most widely used vaccines in the world. Although role of BCG in preventing TB has been heavily debated over the decades, BCG vaccination is thought to prevent against severe forms of childhood TB. BCG induces a potent immune response (in fact reasons why it is also used for Bladder Cancer therapy). Previous studies have shown that BCG vaccination of infants reduces all-cause mortality, and a considerable amount of infant mortality is due to respiratory and enteric viral infections. Therefore, it is plausible that BCG may induce protective immune response against viral respiratory pathogens such as SARS-CoV2. If this is the case, we do not know the extent or how long this protective immune response would last. My guess is that it will be short term - which would be great at, for example, protecting health care workers. We would need a properly controlled clinical trials for example randomised clinical trials, to demonstrate benefit of BCG vaccination in protecting against SARS-CoV2 - such a trial is underway.How did you develop an interest in epidemiology and especially on anti-microbial resistance?I have always been interested in how things work in the real world. Of course, I quickly learned that the real world is quite complex to understand and certainly too simplistic using just one type of lens. Epidemiology, as a discipline, offered a framework to integrate both macro and micro level processes at play and thus was very attractive.My interest in TB stems from the history of the disease in society, arts, and science. It is one of the oldest diseases that is really part of our social and historical DNA - virtually everywhere in the world. This is the number one killer (due to an infectious agent) in the world with nearly 4,000 deaths a day. Controlling TB, including in places like Nepal, has been challenging and very humbling. Studying TB is really a study of biology, history and society. This disease has really eluded scientists since its discovery in 1882. There is so much we should know about this disease, but just do not.In my own research, I consider myself a student of evolution. Evolution, of course, is continual a process that cannot be stopped but is rarely so visible in our day to day. AMR is a case and point for evolution. Its emergence is fascinating from a biologic perspective and the consequences quite devastating from a human health perspective. This interface has drawn me to study AMR in TB as well as other bacterial pathogens.Any comments on the way Nepal has been handling the pandemic so far?I do not think I know enough to answer this question fairly. It is surprising that there are such few confirmed cases ... likely a consequence of testing.

"Prisons can be incubators for COVID-19"

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109101156/636b79ac9c7e80680e064717jpeg.jpg" alt="" width="550" height="388"/><figcaption>American Red Cross volunteers carrying a Spanish Flu victim in 1919. Photo: RED CROSS</figcaption></figure>The <a href="https://www.nepalitimes.com/opinion/what-is-novel-about-the-novel-coronavirus/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/opinion/what-is-novel-about-the-novel-coronavirus/&amp;source=gmail&amp;ust=1585031842556000&amp;usg=AFQjCNER7BK9EfiZTZ7HAcrRW7TMnI6jKg">current COVID-19 pandemic</a> has forced many to Google other historic outbreaks, and the search usually brings them to the 1918 influenza epidemic that killed between 20-40 million people – half of them in South Asia.Just over 100 years ago, as Europe was coming out of a ruinous four-year trench warfare, American soldiers brought the flu to the front lines from where it had spread like wildfire across Europe.Although it is called the ‘Spanish’ Flu, the virus first appeared in North America and crossed the Atlantic on US troopships bound for the front lines. It is called Spanish Flu because the virus was making people sick in the Pyrenees long after it had subsided elsewhere.After the war, British Army soldiers returning to India (some of them could very well have been Gurkhas) brought the virus to Bombay from where it spread along India’s vast railway network. 50 in every 1,000 Indians died of the virus.There were two waves of the influenza epidemic. It was probably transferred from returning migratory waterfowl to humans in Kansas in spring of 1918 before jumping across the Atlantic to Europe. The spread slowed over the summer, but returned with a vengeance in the autumn that year.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109101156/636b79ae9c7e80680e064718jpeg.jpg" alt="" width="2400" height="1816"><figcaption> </figcaption></figure>Although there are many books about the Spanish Flu in Western literature, in South Asia there is no properly archived documentation about the tragic pandemic that took many lives.Even Mahatma Gandhi was stricken by the bug, and bodies were piled high along river banks in India as cremation sites ran out of firewood. Unlike COVID-19, the 1918 influenza virus struck people in the 20-40 age group.While it affected 28% of all Americans, killing 675,000 – of the US soldiers killed in World War I, half died of influenza. But surprisingly, the pandemic had very little effect on China.Many viruses have an animal reservoir, and the Spanish Flu was associated with ducks and pigs as is usual for influenza viruses. The <a href="https://www.cdc.gov/coronavirus/mers/index.html" data-saferedirecturl="https://www.google.com/url?q=https://www.cdc.gov/coronavirus/mers/index.html&amp;source=gmail&amp;ust=1585031842556000&amp;usg=AFQjCNE-MAzB2oWqzXngSV-qeu_vZW781w">MERS coronavirus</a> that affected the Gulf region in 2012 is associated with camels, and the <a href="http://archive.nepalitimes.com/news.php?id=2664" data-saferedirecturl="https://www.google.com/url?q=http://archive.nepalitimes.com/news.php?id%3D2664&amp;source=gmail&amp;ust=1585031842556000&amp;usg=AFQjCNFPL8LEypjMiL-Zq9OumVczJ63a9w">SARS coronavirus of 2003</a> transferred from civet cats. While the COVID-19 probably originated in bats like the other coronaviruses, its host is believed to be <a href="https://www.nepalitimes.com/banner/coronavirus-outbreak-may-curb-wildlife-trafficking/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/banner/coronavirus-outbreak-may-curb-wildlife-trafficking/&amp;source=gmail&amp;ust=1585031842556000&amp;usg=AFQjCNGdAGDJ3BCYbsOftkHyaOipIJecdw">the pangolin</a>.As the ‘Spanish’ flu clearly showed, there is <a href="https://www.nepalitimes.com/opinion/covid-19-nepal-and-the-hygiene-hypothesis/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/opinion/covid-19-nepal-and-the-hygiene-hypothesis/&amp;source=gmail&amp;ust=1585031842556000&amp;usg=AFQjCNFhpeCjNw-lYwjui_QOmW3PKMnd3g">no evidence to show that we in South Asia have better immunity</a> towards the novel coronavirus COVID-19. So, what can be done?First thing is to increase tests for COVID-19 in suspected patients even without a travel history to affected areas. The more tests we do, the more we will know about the spread of  the actual disease.Read also: <a href="https://www.nepalitimes.com/editorial/this-is-a-test/" target="_blank" rel="noopener">This is a test</a>, EditorialIt is also crucial to do cross-sectional serological studies in communities to see if the virus has been introduced there. This test (unlike the RNA-based diagnostic test for a patient) can be done on asymptomatic people in the community to check for COVID-19 antibodies in the blood, and could give us an idea about the extent of the exposure to the community.Many of these antibody tests are new, and the Chinese have vast experience with them in treating COVID-19. The Nepali government would be well advised to seek Chinese help with antibody testing so that we are better prepared in the days and months ahead. Without more diagnostic and serological tests, we may continue to have a false sense of security as the virus continues to sneak up on us in South Asia.The silver lining (if there is one) in this unfolding COVID-19 pandemic is the attention that it has attracted to the importance of rapid diagnostic tests for other neglected infectious diseases in South Asia like <a href="https://www.nepalitimes.com/banner/tb/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/banner/tb/&amp;source=gmail&amp;ust=1585031842556000&amp;usg=AFQjCNEq-c2ak8GqLj2idm1BOUPOOAk46A">tuberculosis</a>, <a href="http://archive.nepalitimes.com/news.php?id=18178#.XnhYpkAza70" data-saferedirecturl="https://www.google.com/url?q=http://archive.nepalitimes.com/news.php?id%3D18178%23.XnhYpkAza70&amp;source=gmail&amp;ust=1585031842556000&amp;usg=AFQjCNHZKfS0Lv_GE4wqJrQaZ6OSfqTgdg">typhoid</a>, typhus, or leptospirosis.The tests need to be accurate, simple, affordable, and quick. Rapid diagnostics will not just help find infected people, but also to decide on specific therapy so that unnecessary antibiotics and other treatment are not administered. Proper diagnosis will lead to control of antimicrobial resistance, another medical crisis affecting the world today.At present, diagnostic tests take many hours if not days, so hopefully, after the dust from COVID-19 settles, there will be more work on rapid tests for these still-rampant ‘biblical’ afflictions that plague us.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109101156/636b79b19c7e80680e064719jpeg.jpg" alt="" width="1500" height="803"><figcaption> </figcaption></figure>Another positive effect of the COVID-19 pandemic may be the restoration of <a href="https://www.nepalitimes.com/banner/a-shot-in-the-arm-for-vaccines-in-nepal/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/banner/a-shot-in-the-arm-for-vaccines-in-nepal/&amp;source=gmail&amp;ust=1585031842556000&amp;usg=AFQjCNEk_tK3eXW25A_sGyzoFrJsJEBxww">people’s faith in effective tried and tested vaccines</a> in the western world.Rumours about side-effects of vaccines going viral on social media have convinced many parents not to inoculate their children, leading to outbreaks of vaccine-preventable diseases like diphtheria, polio and whooping cough in the West. If successful, the COVID-19 vaccine would set the record straight for the proliferation of ‘anti-vaxxers’.Pandemics are like earthquakes, they cannot be wished away. It is best we prepare for a potential COVID-19 outbreak as best and resourcefully as we can. This is not optional, since there will be more pandemics in future.Buddha Basnyat is a clinical researcher at Patan Academy of Health Sciences and a <a href="https://www.nepalitimes.com/opinion/what-is-novel-about-the-novel-coronavirus/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/opinion/what-is-novel-about-the-novel-coronavirus/&amp;source=gmail&amp;ust=1585631034431000&amp;usg=AFQjCNE0aoyspsOeHIBjtexE2rB8xE3KOw">frequent health columnist</a> for Nepali Times.

Buddha Basnyat

Remembering a pandemic 100 years ago

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109101156/636b79709c7e80680e064703jpeg.jpg" alt="" width="2460" height="1110"/><figcaption>Silk Air flight to Kathmandu from Singapore.</figcaption></figure>All 85 passengers from a Silk Air flight from Singapore carrying a Dutch national of Nepali origin have to self-quarantine after landing in Kathmandu on Saturday night.Earlier, the Civil Aviation Authority of Nepal had threatened to send the plane back to Singapore with all its passengers after discovering that there was a person from the Netherlands on board.Nepal had banned all flights from Europe and the Gulf as well as transit passengers as of midnight Friday. On Friday, Prime Minister Oli extended the ban to all international flights from 22-31 March.The confusion appears to have been created by the two orders, and doubts about whether one superseded the other.The Boeing 737 had been refused landing in Kathmandu at first after the European national was found to be on board, but was allowed to land to refuel at 8:30pm on Saturday. Passengers were prevented from disembarking for three hours as the authorities debated what to do, and passengers inside the plane grew increasingly angry.At first they ordered the plane to fly back to Singapore, but as political pressure mounted and passengers started calling relatives, Tourism and Civil Aviation Minister Yogesh Bhattarai is learnt to have intervened. He is said to have argued that it would send the wrong message internationally if Nepal refused to allow entry to its own citizens. Most of the passengers were Nepali nationals.Similarly, 64 Nepalis who had arrived on Thai International and Air India have also been sent to the Kharipati quarantine centre on Saturday because they arrived from countries restricted after Friday midnight, which include Europe, Malaysia, South Korea, Japan, and Iran. Most of the passengers were said to be Nepalis trying to get home from Malaysia and the Gulf and using Bangkok and New Delhi for transit.Kathmandu Airport immigration chief Sagar Aryal said the transit passengers were sent to Kharipati quarantine centre because they arrived from countries that had already been banned. The Dutch national on Silk Air has been sent to Kharipati isolation centre, while the other passengers were released with orders to self-quarantine.All Singapore bound passengers on the return Silk Air flight were taken to hotels in Kathmandu and will fly out on Sunday just before the ban on all international flights goes into effect.Short-term visitors will no longer be allowed to enter or transit through Singapore from 11.59pm on Monday March 23 after two patients died from Covid-9 complications. They were the first deaths in Singapore, which has seen 430 cases, of which 140 have recovered. Most new cases are brought in by visitors, the government said.

Nepal quarantines passengers on Singapore flight

In 2013, while writing <a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/Flu,294">a weekly health column</a> in this paper, I explored the potential for <a href="https://www.cdc.gov/coronavirus/mers/index.html" target="_blank" rel="noopener">MERS </a>(Middle Eastern Respiratory Syndrome) to spread among Nepalis working with camels in the Gulf states. Despite all the dire predictions of how that coronavirus could be brought back to Nepal and spread in the population, it is still a mystery why there was no MERS outbreak here. Viruses do have their own predilections.This time, although <a href="https://www.nepalitimes.com/banner/why-nepal-must-watch-about-coronavirus-but-not-panic/" target="_blank" rel="noopener">Nepal officially has had only one person diagnosed</a> with the novel coronavirus (COVID-19) who later recovered, it is utterly foolhardy to think that we may escape this pandemic. In Italy, there were only four cases in 20 February, but three days later it soared to 400 cases. That virulence is what is new about this novel coronavirus.Even if Nepal does not have a surge of cases now, there is every likelihood that we will have to deal with an outbreak next winter. In addition how COVID-19 will interact with a summer dengue outbreak like last year in Kathmandu is anyone’s guess. It is important to be prepared with preventive aspects.Read also: <a href="https://www.nepalitimes.com/editorial/this-is-a-test/" target="_blank" rel="noopener">This is a test</a>, Editorial<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109101152/636b79239c7e80680e0646e5jpeg.jpg" alt="" width="960" height="640"/><figcaption>An Army personnel demonstrates how to wear protective gear while treating possible COVID-19 patients in Nepal. All Photos: BIKRAM RAI</figcaption></figure>Masks for the general public are more for self-assurance than anything else. People who are coughing and have symptoms should wear masks. But widespread use of masks for the general public may only deplete the limited supply of masks where they are actually needed in hospitals. The most important prevention is <a href="https://www.nepalitimes.com/banner/covid-19-revives-nepals-wash-drive/" target="_blank" rel="noopener">washing hands </a>properly with soap and water 5 to 6 times per day and avoid touching the face. Keeping a reasonable distance from one another is also important. The elderly need to be especially careful.One of the most crucially helpful decisions that the Chinese government took in December 2019 after the novel coronavirus struck Wuhan was to rapidly share the molecular structure of the virus (its genomic sequence) with the world. This made it possible for drug manufacturing companies like <a href="https://www.modernatx.com/" target="_blank" rel="noopener">Moderna</a>, a biotechnology company based in the US, to start working on a vaccine.Read also: <a href="https://www.nepalitimes.com/banner/a-shot-in-the-arm-for-vaccines-in-nepal/" target="_blank" rel="noopener">A shot in the arm for vaccines in Nepal</a>, Sonia AwaleThe first human trial against COVID-19 will start later on this month. This is incredibly fast because in earlier times, it would take at least six years before a vaccine was developed. Although an effective vaccine is the best defence against COVID-19, what can be done for prevention in Nepal here and now is more important.First, the good news. It is now well known that about 80% of COVID-19 victims will have mild symptoms not requiring hospital admission. Of the rest, 15% will be severe and 5% may be critical, possibly requiring ventilators in an intensive care unit. Even if only 0.5% of patients from South Asia’s population of 1.8 billion require ventilators, it is easy to imagine the tragic scale of this potential  emergency.The Wuhan data from Chinese doctors also revealed that it was the elderly (mostly male) that took the brunt of the disease and that children were not symptomatic, even though they may be infected by the virus. The findings also showed that about 1% of the patients who suffer from  COVID-19 die.This is the stark difference between COVID-19 and other causes of influenza where the death rate is only 0.1%. That is, COVID-19 kills ten times more people, and they are mostly above 60 years old. Although 1% may sound small, actual numbers will be numbing when large populations are infected.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109101152/636b79249c7e80680e0646e6jpeg.jpg" alt="" width="3600" height="2400"><figcaption> </figcaption></figure>Besides vaccines, there are also drug studies going on to fight COVID-19. One such medicine is called <a href="https://www.kaletra.com/" target="_blank" rel="noopener">Kaletra</a>, commonly used for HIV patients. Many other drug trials (including the antimalarial drug cholroquin) are going on.The incubation period (the time from infection to symptoms) was also studied in Wuhan and forms the basis of the quarantine period of 14 days. The average incubation period is five days but may be up to 12 days. To be on the safe side a two-week quarantine is recommended, after which it is unlikely that the symptoms will manifest.Unlike some western countries, China, Singapore, Taiwan, and South Korea practiced widespread contact tracing to control the disease. If someone was diagnosed with COVID-19, the health professionals took a detailed history of  who their contacts (including family and friends) were, and followed up to see if they developed symptoms. Contact tracing helped stem the spread of the disease in these countries.Buddha Basnyat is a clinical researcher at Patan Academy of Health Sciences and a <a href="https://www.nepalitimes.com/opinion/what-is-novel-about-the-novel-coronavirus/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/opinion/what-is-novel-about-the-novel-coronavirus/&amp;source=gmail&amp;ust=1585631034431000&amp;usg=AFQjCNE0aoyspsOeHIBjtexE2rB8xE3KOw">frequent health columnist</a> for Nepali Times.

What is novel about the novel coronavirus?

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109101152/636b79289c7e80680e0646e7jpeg.jpg" alt="" width="960" height="640"/><figcaption>A quarantine zone at Nepal Army's headquarters in Tundikhel. Photo: BIKRAM RAI</figcaption></figure>By now the novel coronavirus pandemic has affected every corner of the globe. If it has not brought disease, it has at least brought the <a style="background-color: #ffffff; font-size: 16px; letter-spacing: 0.15px;" href="https://www.nepalitimes.com/editorial/fear-goes-viral/" target="_blank" rel="noopener">fear of infection</a>. Cities, and indeed entire countries, are in lockdown. Fortress Europe has raised its walls higher. Airlines are grounded. Nepal has banned trunk international routes from Friday night. Even countries with excellent public health facilities and emergency preparedness plans are overwhelmed.Nepal is now <a href="https://www.nepalitimes.com/opinion/global-thinking-and-local-action-on-coronavirus/" target="_blank" rel="noopener">so closely intertwined with globalisation</a> through migration, tourism and trade that its <a href="https://www.nepalitimes.com/here-now/nepals-economy-already-weak-takes-direct-hit/" target="_blank" rel="noopener">already-fragile economy has been badly hit</a> even before a full-blown health emergency hits. Ironically, less-developed countries seem to have a built-in resilience that comes from being crisis-prone -- since they are lower down in the economic ladder, they have a shorter distance to fall.Read also: <a href="https://www.nepalitimes.com/editorial/poor-health-makes-nepalis-poorer/" target="_blank" rel="noopener">Poor health makes Nepalis poorer</a>, EditorialDespite Nepal’s surprisingly <a href="https://www.nepalitimes.com/banner/born-in-nepal/" target="_blank" rel="noopener">dramatic improvements in mother-child survival </a>over the past two decades, <a href="https://www.nepalitimes.com/editorial/poor-health/" target="_blank" rel="noopener">the public health system here is in crisis</a>. State-of-the-art modern hospitals in the city, while reducing the need for Nepalis to go abroad for treatment, are out of reach of a majority of the population. Government health facilities are more affordable, but for the most part medical care there is not up to mark.Nepalis are still afflicted by easily preventable water-borne diseases like <a href="https://archive.nepalitimes.com/news.php?id=16988#.XnMUhagzbSF" target="_blank" rel="noopener">typhoid and diarrhoea</a>, vector-borne infections like malaria, encephalitis or dengue, and illnesses like <a href="https://www.nepalitimes.com/banner/nepal-tb-cases-grossly-underestimated/" target="_blank" rel="noopener">tuberculosis </a>and acute respiratory infections that spread through breathing. Great inroads have been made in reducing the impact of communicable diseases in the past decades through awareness programs, vaccinations and safer drinking water, but children in <a href="https://www.nepalitimes.com/banner/this-is-how-to-upgrade-nepals-rural-health/" target="_blank" rel="noopener">remoter parts of Nepal</a> are still dying of simple infections.Read also: <a href="https://www.nepalitimes.com/banner/a-shot-in-the-arm-for-vaccines-in-nepal/" target="_blank" rel="noopener">A shot in the arm for vaccines in Nepal</a>, Sonia AwaleOn top of this, urbanising Nepal now also has the added burden of <a href="https://www.nepalitimes.com/editorial/poor-health/" target="_blank" rel="noopener">non-communicable afflictions</a> like diabetes, cardio-vascular ailments and renal disease. As families move from the districts to the cities, changes in diet and more sedentary habits have given rise to an epidemic of lifestyle-related diseases. This is compounded by genetic susceptibility among South Asians for diabetes and heart disease.For example, a study by the BPKIHS in Dharan showed that while the national average for <a href="https://archive.nepalitimes.com/article/nation/diabetes-in-south-asia,3018" target="_blank" rel="noopener">Type 2 diabetes </a>prevalence is 8.1% of the population, the incidence in Dharan was 14%, while it was only 1% in Taplejung. The prime minister’s own second kidney transplant this month showed that <a href="https://archive.nepalitimes.com/article/editorial/health-tip-editorial,4032" target="_blank" rel="noopener">ignoring risk factors and not diagnosing non-communicable diseases</a> can lead to a huge health burden for families and the state. A small percentage of Nepalis have health insurance, so many middle income families fall below the poverty line due to medical expenses. Many Nepali migrant workers have been forced to seek jobs abroad to pay back debts incurred during hospitalisation of family members.Last summer’s explosion of dengue in Kathmandu Valley was <a href="https://www.nepalitimes.com/banner/mosquitoes-move-up-mountains-as-the-earth-warms/" target="_blank" rel="noopener">blamed on climate change</a>. But it was actually a perfect storm of crowded and squalid living conditions, poor drainage, greater mobility of people, and a particularly wet monsoon. None of these factors have been addressed, so we are staring at a recurrence of dengue this year even while we cope with <a href="https://www.nepalitimes.com/banner/why-nepal-must-watch-about-coronavirus-but-not-panic/" target="_blank" rel="noopener">a possible COVID-19 outbreak</a>.Public health has not been a national priority for successive governments in Nepal. Even if it has, it is only in paper and has not really been translated into <a href="https://www.nepalitimes.com/opinion/is-free-health-care-possible-in-nepal/" target="_blank" rel="noopener">accessible and affordable healthcare</a> for the general public. Governance failure has contributed to this state of affairs, but there is also the virus of corruption that has afflicted the entire government healthcare system. A politico-business nexus has also infected <a href="http://archive.nepalitimes.com/news.php?id=19560" target="_blank" rel="noopener">medical education</a>, putting it out of reach of deserving poorer students.Read also: <a href="https://www.nepalitimes.com/editorial/when-panic-goes-viral/" target="_blank" rel="noopener">When panic goes viral</a>, EditorialInto this mix, we now have the coronavirus scare. Officially, Nepal has just one case in which the patient recovered and has been discharged. The government has tested about 500 people, and all have been negative. Experts have confirmed that the tests are credible, and proper protocols are in place. But not enough tests have been done to determine if there are more people out there with the virus.At $75 per test, the kits are expensive. This is where international help would be needed, and if the case rate rises the country will also need help with containment and mitigation. Nepal has been lucky so far that there is no indication of community transmission yet. But our luck could turn any day.

This is a test

One smoggy winter morning in February 2019, Ekta regretted coming to her sculpture class. It was the first day of her period, and the 19-year-old wished she was home, curled up in bed with a hot water bag to soothe her cramps.
Her class was at Kalapremi Ceramic Studio, a dark room on the ground floor of a house in Maharajganj, and Ekta’s teacher was the artist Gopal Das Shrestha ‘Kalapremi’, a noted sculptor.
Two other students were already there, using all their muscle strength to knead the sculpting clay. Ekta, now 24, recalls how Kalapremi asked her if she was feeling all right. She avoided him, as she did not want everyone to know she was menstruating.
Kalapremi repeatedly asked Ekta what was wrong. She finally muttered that she was having her period, after which he grabbed her hand and led her to a partitioned corner of the studio and sat her on a chair. Before she could stop him, he slid his hand under her dress, and started massaging her abdomen.
“I was horrified,” Ekta recalls. “I told him to stop, but he didn’t listen, asking me not to be shy, saying he knew how to relieve my pain. He stopped only after I protested furiously.”&nbsp;
The art tutor then said, “You’re like my daughter. I’m doing it out of love to make you feel better, but you’re so stubborn.”&nbsp;
“Instead of saying sorry he acted like I was the one having crazy thoughts,” remembers Ekta, adding that from April 2016 to August 2020 beginning the time she was 16, the artist sexually abused and harassed her on several occasions. &nbsp;
Now, Ekta and the artist’s other former students are finally sharing their experiences and some are pressing legal charges against him, hoping that others do not have to endure what they did.&nbsp;
Award-winning artist and teacher Gopal Das Shrestha ‘Kalapremi’ (the name means ‘Art Lover’) is known for his ceramic art, sculpture, and contemporary pottery. He was <a href="https://nepalitimes.com/review/the-house-of-kalapremi">profiled in Nepali Times after a collaborative exhibition</a>, ‘Where the Wild Things Are’ at the Siddhartha Art Gallery three years ago.&nbsp;
His pieces, titled Gaalis, featured sculpted female figures with the heads of dogs, sheep, and donkeys (pictured) to depict derogatory terms for women. Some critics said the collection was a satire on feminists.
Kalapremi started his artistic and teaching career in 1983 and over the years taught at Bhanubhakta School, Kathmandu University School of Arts, Lalitkala Campus and at his private Kalapremi Ceramic Studio. He has also lectured at Jeonju University in South Korea and recently at Tabor Academy in the United States.
Seven of Kalapremi’s former students were interviewed for this story. Five female students said he touched them inappropriately in his studio or at Kathmandu University. Two male students said they witnessed him abuse and harass the women. In all cases, the students struggled to recognise the abuse when it occurred, and the lack of reporting systems left them to cope on their own for years.&nbsp;
Earlier this year, students shared a social media post hinting at Kalapremi’s history of abusive behaviour following which more students of the artist reached out sharing similar experiences. Some students spoke of abuse that happened as long as 20 years ago.
Kalapremi, 60, has denied the allegations. He told Nepali Times: “Some years ago, there was a movement encouraging people to hug and kiss. I used to do it purely out of friendship and love. But after seeing posts on social media last year calling out my behaviour, I realised my actions may have hurt some people. I understand now that I should have been more mindful.”
He added: “I am also an auxiliary health worker, so I know the exact points to massage to relieve menstrual pain. It’s not just menstruation, I take anyone who is ill to the hospital.”
Sexual abuse is much more rampant than reported given how difficult it is to prove it in court. The law defines sexual abuse as occuring when someone touches another’s private parts, coerces them into touching theirs, uses vulgar language, shows degrading images, or behaves indecently towards them without consent.&nbsp;
Ekta and her fellow students are consulting lawyer Suneeta Regmi Pokhrel, who says they know that even if the court decides in their favour, it is difficult to survive after speaking up, and influential men defend themselves saying they are being framed.&nbsp;
“They are in a lot of pain and weep when recalling how he abused them,” Regmi Pokhrel told us. “They are angry and have filed a case against him, but they are also terrified. They know he is a powerful man and they have seen how our society treats women who speak up against abusers. Unless people speak up, perpetrators will be emboldened.”
Art and academia in Nepal simply reflect the power imbalances in society where people with intersecting identities experience worse forms of abuse. Theatre actors Raj Kumar Pudasaini, Rajan Khatiwada, and Sunil Pokhrel were called out during the #MeToo movement in the Nepali theatre scene in 2019. Even after the allegations Pokhrel went on to receive national awards, while others continued to work without repercussions.
“If you speak up against abusers, you gradually get sidelined from projects,” explained a theatre artist who wished anonymity fearing professional setbacks. “The theatre scene in Nepal is quite small, you just have to make peace with the perpetrators and work with them if you want to sustain yourself.”&nbsp;
In academia there is a history of faculty members sexually harassing students and getting away with it. After Tribhuvan University (TU) lecturer Krishna Bhattachan was accused of harassing women students, the university said it would follow Nepal’s sexual harassment law and set up a reporting mechanism. But nothing happened to the professor, who had already retired. Instead, he counter-accused the students of 'attacking the indigenous people’s movement with baseless allegations' as <a href="https://kathmandupost.com/letters/2019/01/29/bhattachan-responds">he told the Kathmandu Post in 2019</a>. He continues to be featured as a prominent speaker including at TU.
Other faculty members previously accused of sexual harassment include Jagadish Murti Koirala from TU, Bishnu Prasad Acharya from Ratna Rajya Campus, and Bodha Raj Tripathee from Lalitpur Madhyamik Vidhyalaya. A woman staff member from TU also filed a sexual abuse complaint against Dambar Chemjong from TU.
Prominent figures like <a href="https://nepalitimes.com/news/the-rise-and-fall-of-nims-purja">mountaineer Nims Purja</a> have been <a href="https://www.nytimes.com/2024/05/31/sports/mountaineering-sexual-harassment-abuse-nims-purja.html">accused of sexual assault</a>, and cricketer Sandeep Lamichhane, actor <a href="https://nepalitimes.com/news/celebrity-rape-case-spotlights-nepal-laws">Paul Shah</a>, and former speaker of Parliament <a href="https://nepalitimes.com/news/mahara-arrested">Krishna Bahadur Mahara</a> have been accused of rape, but society-at-large has let off the alleged perpetrators amdist a larger debate about justice for survivors and punishment of perpetrators.&nbsp;
‘Gaushala-26’ is the court name given to the 18-year-old who accused Sandeep Lamichhane, former captain of Nepal’s national cricket team and skipper of Biratnagar Kings in the <a href="https://nepalitimes.com/here-now/here-comes-the-nepal-premier-league">ongoing Nepal Premier League</a>, of rape. She left the country citing society questioning her character affecting her mental health while Lamichhane got an outpouring of support. In May, the Patan High Court overturned a prior verdict that found Lamichhane guilty of rape and had sentenced him to eight years in prison. During the 23-month legal battle to pursue justice, Gaushala-26 faced threats of gang rape and acid attacks.&nbsp;
Exhausted by the struggle, Gaushala-26 sought to “move to a new world” where she could live free without hiding her identity.
Actress Samragyee Rajya Laxmi Shah in an Instagram video now deleted detailed the harassment she faced from a filmmaker during a movie shoot. She did not name any name but veteran actor Bhuwan KC filed a defamation case against Rana, but the court ruled that the charge lacked sufficient evidence.&nbsp;
Former Kathmandu mayor <a href="https://nepalitimes.com/opinion/theytoo">Keshav Sthapit also mocked the #MeToo movement</a>, calling accusations against him by journalists Rashmila Prajapati and Ujjwala Maharjan “a rape of men’s rights”.
Serial Abuse
Back at the Kalapremi Ceramics studio, another former student, 24-year-old Rajiv, says he felt the need to speak out after seeing his female classmates being abused.&nbsp;
“He frequently kissed them on their cheeks,” he told Nepali Times. “Whenever they walked into the studio he flailed his arms like a child asking for a hug. They awkwardly hugged him from the side, but he pulled them closer, held their chin, and kissed their cheeks.”&nbsp;
Rajiv says he also saw Kalapremi pull the women’s bra straps, touch their breasts, and slap their buttocks. The young students would freeze, not knowing how to react, and if they protested, he would say it was “normal in art”. Rajiv, 19 at the time like his classmates, remembers thinking perhaps the well-respected artist was right after all.
Another student, Luna, who took lessons at Kalapremi’s studio from 2020 to 2022 did try to confront the tutor after he made an obscene proposal to her. She recalls: “One day when the other students had left the studio and it was just the two of us, he told me that God had given him special artistic talent and he could transfer those powers to me. But to do that both of us will have to be naked, inside a dark room, and have sex.”
Luna, who was 18 then, was livid and told him she did not want any of his powers, but she says he laughed at her as if he was joking. She did not tell her family about the incident because she thought no one would believe her.&nbsp;
“They were all in awe of this famous artist and felt I should be grateful that to be learning sculpting from him,” she says. “I was scared to be alone with him in case he talked about sex again. My coping mechanism was to be rude so he wouldn’t try to come close to me.”
Seeing how some classmates were standing up to Kalapremi, Ekta too tried to push back against his advances, but she said he found ways to coerce her. Since Ekta, Rajiv, and Luna could not afford Kalapremi’s Rs30,000 monthly fee for lessons, he had offered them all a stipend to assist him in the studio.
“He had spondylosis and took me to his therapy sessions to learn massage techniques, then he often made me and other students massage him,” says Ekta. Whenever she refused, he would feign pain to make her feel sorry for him. “He would insist that I put my hands under his shirt so that I could massage him better,” she adds.
The art tutor often tried to “seduce sympathy” from Ekta by sharing how he had never been loved as a child and was “sexually frustrated” as an adult.&nbsp;
“At 7PM, he would pour himself Signature whiskey and immediately go off again about how he was sex-starved. I didn’t know how to respond. It took me time to realise alcohol was just an excuse to talk about sex,” Ekta says.
If convicted, Kalapremi could face financial penalty and/or a prison sentence of up to three years according to Section 224 of National Penal (Code) Act 2017.&nbsp;
Data suggests that victims of child sexual abuse on average take nearly 24 years to tell someone about their trauma, and some may never disclose it at all.&nbsp;
“In our culture, children are rarely taught about boundaries. They often react, show anger when adults pinch their cheeks. But adults insist they did it out of love, and force the children to accept it,” says Sita Lama, a psychotherapist at Manka Kura. “And even when someone touches them inappropriately they struggle to identify and verbalise it.”
When perpetrators claim to be “acting out of love”, Lama says survivors are likely to perceive it as something safe, rather than recognising it as abuse.&nbsp;
“It may take years for them to realise they were abused,” she explains. "And even when they become aware, the power imbalance with the abuser and the associated shame often prevents survivors from speaking up."
Other former students from the School of Art at Kathmandu University have also come forward years later, saying Kalapremi sexually abused them. As young adults, they felt his behaviour was off but were uncertain if it was inappropriate, illegal, or they did not know how to respond. After having understood that it was indeed abuse, they say they are speaking out now to protect others.&nbsp;
Amina Singh, a visiting faculty member at Kathmandu University, says there is no clause against sexual abuse in contracts of teachers, and there is no formal grievance handling mechanism for the students.&nbsp;
“So the only way students can to deal with sexual abuse is approach someone they trust,” she says.
Eight other former art students of Lalit Kala Campus and Srijana College of Fine Arts of Tribhuvan University and other private art studios in Kathmandu say they were also sexually abused by their art teachers. Three faculty members interviewed from these institutions said they saw the abuse, but felt it was futile to report it given how powerful the teachers were.
In the absence of a formal system, some longtime women artists warned each other about “problematic” artists. They shared &nbsp;a “heads-up” to be more cautious when collaborating with them, and avoided responding to their calls and texts after work hours.
To ensure art institutions are safe for all, galleries, museums, artist studios, and smaller art spaces need to develop policies on sexual harassment. This would include a code of conduct or studio policies that hold the leadership accountable and outline the principles of professional ethics.&nbsp;
Students and employees should inquire about accountability mechanisms for raising concerns, both formally and informally, advocates say.
Three years after Ekta left the ceramics studio, she learnt that Kalapremi had harassed many other women. Still trying to get a footing in the art industry, she attended a workshop in Kathmandu where women artists discussed ways to stay safe in the art sector.&nbsp;
Since it was a close-knit group Ekta opened up about how she felt violated and realised she was not alone, he had been abusing underprivileged students for years, and this was common knowledge among artists in Nepal.
Ekta says that even after she quit, Kalapremi continued sending her text messages like ‘I am thinking of you’, ‘Why have you stopped speaking with me’, or ‘I am waiting for your call’.&nbsp;
But what really forced her to act was when Ekta found out that he was sending similar texts to her younger sister.&nbsp;
“I’ve had enough,” she told us. “He abused me all these years but I won’t let him abuse my sister.” &nbsp;
Ekta, Rajiv and Luna are not the real names of the students.&nbsp;

‘Art Lover’ accused of sexual abuse

It was 8:15 in the evening of 25 March 1968 when everyone in the village of Batulechaur near Pokhara heard a deafening sound like thunder as a bright flashing object hurtled down to land in a field.&nbsp; That field belonged to Kul Timilsina, and the next morning he retrieved a sheet of metal about 2m by 1m and carried it home with the help of a few others, thinking it would be useful for his buffalo shed.&nbsp; Before he died at age 83 three years ago, Timilsina had told photo archivist Sunil Ulak that the black metal sheet was not rectangular and had rounded corners. There are a few witnesses still alive who have a clear recollection of the object that fell from the sky that night.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2024120707128_75cc85aac56b9cc4a77366471f058d7b3eb6868776811b0923845c2d0a61f014.jpg" data-media-id="editor_0" data-image-id="2024120707128_75cc85aac56b9cc4a77366471f058d7b3eb6868776811b0923845c2d0a61f014" data-rendition-name="original" width="1170" height="601" loading="lazy" alt="UFO over Pokhara"> <figcaption>The field in Batulechaur belonging to Kul Timilsina where fragments of a flying object fell from the sky in 1968.</figcaption> </figure>  One of them is Timilsina’s wife Gyanu, who was 22 at the time. She had been at home, and remembers hearing the big bang and the sky becoming very bright. “We saw the thing in the field in the morning,” she told us. “It looked like a lid, a covering of some sort. The way it was stuck in the ground, it must have fallen from the sky. We thought we could use it to dry clothes on, and took it home.”&nbsp; Another witness is Kul Narayan Paudel. “I was only eight then. We ran to the field to see what had fallen. It was a four-sided metal sheet. The elders took it away, and I don't know what happened to it.” &nbsp; Ram Bahadur Baniya, a teacher at the local school, says he had heard the sheet had been brought to the school, and later handed over to the Zonal Commissioner at the time, Nanda Prasad Malla. “But that is all hearsay,” he says.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2024120707128_0bf207a12063fb8155b3c8d9a00a94887b126380c9e0627527c84cf5e1101f54.jpg" data-media-id="editor_1" data-image-id="2024120707128_0bf207a12063fb8155b3c8d9a00a94887b126380c9e0627527c84cf5e1101f54" data-rendition-name="original" width="1170" height="610" loading="lazy" alt="UFO over Pokhara"> <figcaption>Gyanu Timilsina, wife of Kul Timilsina.</figcaption> </figure>  There are two versions of what happened to Kul Timilsina’s metal sheet. One is that an American Peace Corp Volunteer teaching at the nearby Bindyabasini School took it, and another is that it was handed over to the government. Recently declassified Central Intelligence Agency (CIA) and US State Department documents from the time say that the US Embassy in Kathmandu tracked down the object two years later and had it shipped back to the US. A telegram from the Department of State and Department of Defense tagged as ‘MOON DUST / Space Fragments’ dated 1 March 1972 stated: ‘1. Restored space fragment will be on board Embassy support flight 115 arriving Kathmandu on or about March 10. Fragment is packed in shipping crate (cargo no. 72-33365) marked in care of DAO.&nbsp; 2. State and Defense representatives examined fragments prior to shipment finding restoration acceptable.’  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241207071212_929d903ee06d41baa4f6040e981cd7c7d7bd75cc9c37c9b617d307fc8538d2df.png" data-media-id="editor_2" data-image-id="20241207071212_929d903ee06d41baa4f6040e981cd7c7d7bd75cc9c37c9b617d307fc8538d2df" data-rendition-name="original" width="856" height="568" loading="lazy" alt="UFO over Pokhara"> <figcaption>Declassified CIA documents about the investigation into the object sighted in Pokhara. </figcaption> </figure>  The documents show that the US government, military and intelligence agencies investigated this incident thoroughly when it occurred, and have continued to revisit it ever since, as recently as five years ago. What is even more intriguing is that the object that fell in Pokhara was not the only unidentified space object that fell to earth that year. There were similar sightings of objects falling from the sky in Ladakh, Sikkim and Bhutan between 19 February and 25 March 1968.&nbsp; These mysteries were the subject of a CIA investigation in 1968 titled ‘<a href="https://www.cia.gov/readingroom/docs/CIA-RDP81R00560R000100070007-8.pdf">Sighting of Unidentified Flying Objects in Ladakh, Nepal, Sikkim and Bhutan</a>’, and the report is part of the recent online declassification of 800,000 top-secret documents from the period.&nbsp; &nbsp;Although unidentified flying objects (UFOs) have a connotation now of being alien craft, it could be pieces of satellite, missile, rocket or even aircraft. The CIA report documents six sightings in 1968 and quotes local sources as describing all of them having similar characteristics: bright blue or red streaks in the sky accompanied by loud sounds like lightning and thunder and objects falling to the ground. Aside from the metallic object that was found in Batlechaur, there were other items also found nearby in Tallakot, Tureypasal, Armalakot and Maidan. Whatever the object was, it seems to have disintegrated even before it hit the ground.&nbsp; The CIA report records the first sighting on 19 February 1968 in various parts of Sikkim and Olangchung Gola and Ghunsa in eastern Nepal. The light was said to be ‘long and thin’ and giving out ‘green and red light’. &nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241207071212_c3c825027d966a2aedc846970390eebe063957503c7eacc8e01e0517843f9bbb.png" data-media-id="editor_4" data-image-id="20241207071212_c3c825027d966a2aedc846970390eebe063957503c7eacc8e01e0517843f9bbb" data-rendition-name="original" width="892" height="596" loading="lazy" alt="UFO over Pokhara "> </figure>  Two days later on 21 February, a soundless blue object was seen traveling fast across the sky above Thimphu in Bhutan. Then on 4 March there were multiple daytime sightings or white streaks in the sky at Chang La Pass, Fukche and Koyul in Ladakh. There were more sightings in Ladakh on the very day fragments fell near Pokhara on 25 March 1968.&nbsp; After the sightings in Pokhara, rumours started flying in Kathmandu that these were aliens trying to land on Earth, it could be Russian or Chinese spy planes or satellites, and some even say it as a sign from heaven that the end of the world was near. This was at the height of the Cold War. The Russians and Americans were testing their thermonuclear devices as well as intercontinental ballistic missile delivery systems. The Washington-Beijing rapprochement had not yet happened, and China was making quick progress testing atomic bombs. Within two years after its first atomic test, in 1966 China exploded its first hydrogen bomb at the Lop Nur site in Xinjiang, 3,000km to the north from Nepal. After neary six decades, what is still intriguing is that all the sightings within a few months of each other in 1968 were along the Himalayan arc bordering Tibet: from Bhutan, Sikkim Nepal, to Ladakh. The US military intelligence seems to have concluded that this was not a coincidence and there were frequent research trips to the site in Pokhara by American officials in the months after the incident. With the help of the Royal Nepal Army, the region north of Pokhara was thoroughly searched.&nbsp; A confidential memo dated 25 June 1968 by Jerry C Trippy to a ‘Mr Farley’ mentions that the US Air Force’s Foreign Technology Division had decided that the debris could be important because it may be related to a Chinese missile test or a Soviet ‘Vehicle Venik’ rocket.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241207071216_feb5425692dc36b20187de4e4fcc2ce9fd12b6d9e1b8724398e50bcdbf9032fe.jpg" data-media-id="editor_5" data-image-id="20241207071216_feb5425692dc36b20187de4e4fcc2ce9fd12b6d9e1b8724398e50bcdbf9032fe" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="UFO over Pokhara"> </figure>  On 28 August 1968 the US Embassy in Kathmandu sent a letter to Washington DC saying that the object could be of Soviet origin, possibly from when the rocket carrying the ‘Kosmos 208’ satellite re-entered the atmosphere. But why were the fragments falling to earth several weeks apart, and in the same region? No one knows where the metal sheet that Kul Timilsina recovered is now. It was definitely packed in a crate and taken to the US, and although it is rumoured that it was returned that is not very likely. Archivist Sunil Ulak heard from the Timilsina family that CIA officials had returned to the site five years ago. &nbsp; Interest in UFOs peaked in the US in the 1950s, with the Cold War space race and tests of atomic weapons and delivery rockets. CIA and scientists were being sent to investigate sightings, both publicly and privately. Could the Pokhara fragments as well as the sightings in Ladakh and Bhutan actually be alien craft falling to earth? The renewal in interest in space travel in large part due to Elon Musk’s SpaceX, UFOs and sightings are again subjects of public interest.&nbsp; Even 57 years later, even if there was definitive proof about whether the Batlechaur fragment was from a Chinese missile or a soviet rocket, it has not been made public in documents declassified so far. We may never know.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241207071216_b6938795f40731e7657fd6dcbb3cf460a326186a15eb11d4f832f602201ff598.jpg" data-media-id="editor_6" data-image-id="20241207071216_b6938795f40731e7657fd6dcbb3cf460a326186a15eb11d4f832f602201ff598" data-rendition-name="original" width="642" height="320" loading="lazy" alt="UFO over Pokhara"> </figure>  Sunil Ulak speculates if the debris actually came from an American aircraft, perhaps on an intel mission upon China. “Which could explain why they were so thorough in collecting the fragments in Pokhara,” he says. But that still does not explain the multiple sightings weeks apart in 1968.&nbsp; Indeed, US military aircraft were at that time flying frequent night-time missions from air force bases in India to supply weapons to Khampa guerrilla camps in Nepal located north of Pokhara in Mustang. It could very well be that the Chinese shot down one such aircraft. The other sightings could have been contrails of US spy planes, or Chinese anti-aircraft missiles.&nbsp; There were quite a few developments regarding UFOs in 2024. In a US congressional hearing in July, former intelligence officer David Grusch claimed that the government had long been involved in a program to investigate and retrieve non-human craft crashes, and then try to reverse engineer them. However Grusch did not show any evidence.&nbsp; The UAP Disclosure Act of 2024 was signed into law by Joe Biden in December 2023. It plans to oversee the public disclosure of UFO information. However, there is a clause in it that prevents disclosure if it would cause threats to military defense, intelligence operations or foreign relations.&nbsp; It is unlikely that the declassified documents about sightings in the Himalayan will cause any real surprise about definite evidence of alien life even if it was found. It seems humanity will continue, at least for now, to wonder about curious lights in the sky and whether there is anybody out there.&nbsp;

UFO over Pokhara

When Rastriya Swatantra Party (RSP) president Rabi Lamichhane was arrested in October on charges of defrauding depositors of cooperatives, the party’s vice president Swarnim Wagle gifted him Fareed Zakaria’s book, Age of Revolutions.
Since then, Lamichhane has been shunted around from Kathmandu to Pokhara to Chitwan and back to Pokhara to attend police investigations and court proceedings. He was being flown to Birganj via Kathmandu on Buddha Air on Monday. There is another pending case in Janakpur.
Human rights groups and civil society have criticised the government for hounding Lamichhane with inhumane treatment that borders on physical torture. The two parties in the coalition, Nepali Congress (NC) and the UML, see Lamichhane’s RSP as a potentially formidable challenge to their power.
Even if the fraud charges against Lamichhane are true, the Nepali public is increasingly looking at the government’s actions through the police and courts as political vendetta.
Despite all the travelling, sometimes by plane and often by road at night, Lamichhane appears to be in high spirits, waving to supporters who often gather if they know he is going to be driven around. A social media video shows him giving high fives to fellow passengers on a recent flight to Pokhara.&nbsp;
In the past weeks, streets in Pokhara have erupted with parallel protests by Lamichhane’s supporters as well as depositors of cooperatives who lost their savings to the scam.&nbsp;
Although family visits are allowed, prison officials in Pokhara told Nepali Times that not many people visit Lamichhane these days. He added, “When he does get visitors, he asks them to bring him books.”
Lamichhane is currently Nepal’s most high-profile public figure in custody, and highlights the stark difference between how influential prisoners are treated compared to ordinary inmates.
There are six prison cells at Kaski District Police Office’s two-story detention centre, three on each floor. And while authorities pack prisoners into already overcrowded cells, Lamichhane has an entire room on the second floor to himself.&nbsp;
He has also been allowed to call his family every few days. Other prisoners are not permitted phone calls except for emergencies.
Meanwhile, Lamichhane’s former business partner Chhabilal Joshi, an ex-Deputy Inspector General of Police with whom he established his Gorkha Media Network, is in custody under the same charges in the prison cell next to him.
Lamichhane is accused of siphoning off depositors' money to the tv network in which he was part-owner and anchor. &nbsp;
Both Lamichhane and Joshi are able to buy food from the police canteen instead of being served the regular meal like other prisoners. Joshi has also given his statement to authorities in Rupandehi and Kathmandu for his alleged role in the scam. Lamichhane is yet to be presented in Kathmandu for questioning.
While he was in custody at the Kathmandu District Police Complex, Joshi expressed his desire to sleep in a police officer’s office, reportedly assuring authorities that he would not run away and he was entitled to certain facilities as a former officer of the law.
“He seemed to be under the impression that he is still a police officer,” says a source at the Kathmandu District Police. “We made it clear to him that as someone accused of a crime, he was not entitled to special treatment.”
Former ministers Balkrishna Khand and Top Bahadur Rayamajhi, and ex-home secretary Tek Narayan Pandey, who were arrested in connection with the fake refugee scam last year, were similarly housed in the offices of law enforcement officials instead of prison cells. Khand has since been released after six months in jail.
While there is no legal provision to keep high-ranking officials in separate detention centres when they are arrested, authorities granting them special facilities is not uncommon. Law enforcement officials say VIP detainees expect preferential treatment while in police custody.
Among those is former Kosi Province minister Lila Ballav Adhikari, who was arrested from Biratnagar on 10 November over his alleged involvement in human trafficking and brought to Kathmandu. Adhikari had flown to Japan without government approval with three individuals on 29 October to attend a cultural conference, but had been sent back to Nepal from Narita.&nbsp;
His three companions were arrested at Kathmandu airport upon their arrival, but Adhikari was able to exit unscathed from the VIP lounge. Adhikari had resigned as the Kosi Province Minister for Internal Affairs and Law when it became public that his companions had been taken into custody, and was himself arrested shortly after. He has since been cleared by the courts.
Throughout his detention, Adhikari was kept separately from other inmates. Senior Superintendent of Police (SSP) Basant Rajouri, head of the Bhadrakali complex, says that while there is no separate detention area for VIPs, some detainees are kept separately depending on the nature of their crime.
However, sources say that arrangements were made for retired judges and others to visit Adhikari frequently worked at the office of a Deputy Superintendent of Police (DSP) during his time in custody.&nbsp;
“He used to constantly pester the authorities to let him sit outside in the sun, and to be able to use the police officer’s shower area,” added an officer.
Adhikari was released on 25 November after the government prosecutor’s office decided not to charge him in a move that was seen to expose the government’s double standards.
Over at Kathmandu’s Dilli Bazar Prison, former Kist Bank CEO Kamal Gyawali emerges from his prison cell into the courtyard of the prison’s ‘Ka (क)’ block every morning with a thick book in his hands, ready to give his daily sermon.
With his long beard, Gyawali, who is serving a prison sentence for banking fraud, looks the part of a religious guru as he implores his rapt listeners to “walk the right path, abandon bad thoughts and turn to scripture and spirituality”.&nbsp;
Afterward, the attendees gather to discuss politics and current affairs. Inmates at his daily sermons at the prison include other high-profile detainees, including former MP Ichchha Raj Tamang, who is in jail for money laundering and cooperatives fraud, former joint secretary Chudamani Sharma, who was convicted of corruption, as well as NC leader Chandra Bahadur Lama and Krishna Bahadur Upreti of the UML both of whom are on trial for embezzling billions of rupees.
Victims of the cooperatives scam that former lawmaker Tamang was involved in have made trips to the prison and requested visits, but he has refused to meet with any of them.
“Tamang often complains that the state has prevented him from returning the money to the victims by locking him up,” says a police officer at the Dili Bazar jail.
“All you hear every day from the VIP prisoners is that they have been framed,” adds the officer. “No one admits that they were involved in misdeeds.”
But while most high-profile prisoners complain about prison conditions, one exception is former provincial lawmaker Deepak Manange, who is serving a sentence at Dilli Bazar Jail for attempted murder.
“He is the happiest prisoner here,” says a warden. “Unlike the others, he doesn’t claim to have been framed, in fact he doesn’t seem to care that he is in prison.”
Manange is detained in the ‘Kha (ख)’ block of the prison complex, which he renovated at his own expense. The block previously housed female prisoners, but Manange used his influence to transfer them elsewhere. He faces no shortage of visitors, who range from political leaders to people from the underworld.
Along with Manange, other well-known prisoners in this block include Nepal Telecom Managing Director Sunil Poudel, and former executive director of the Surakshan Printing Centre Bikal Poudel, who are serving time for corruption.
Former prisoners at Dilli Bazar prison include ex-ministers Khum Bahadur Khadka and Shyam Sundar Gupta, NC leader Ganesh Lama, Maoist MP Balkrishna Dhungel, Nagarik Unmukti Party leader Resham Chaudhary, as well as former IGs Ramesh Chand Thakuri, Om Bikram Rana, and Hem Bahadur Gurung.
Section 54 of Nepal’s Prison Act assigns each prison’s internal administration the
responsibility of governing its prisoners, which means the more favourable the jail management is, the more comfortable it is for prisoners.
Dilli Bazar prison has been the prison of choice for many high-ranking prisoners, especially those convicted of white collar crimes, due to its more accommodating administrators. The prison, which has the capacity to house 700 inmates, is also less crowded than other jails.
Anuj Bhattarai, spokesperson of the Department of Prison Management, says that there is no legal classification in Nepal for felons to be assigned prisons based on the nature of their crimes.
“That Dilli Bazar Jail has a higher number of prisoners convicted of crimes like corruption is most likely a coincidence,” says Bhattarai. “There is no provision for influential people to be able to choose where they will be incarcerated.”&nbsp;
Translated by Shristi Karki from the Nepali original published in himalkhabar.com

What Nepal’s VIP prisoners do in jail

If you were raised in Nepal, you must have picked up its unique set of vocabulary: आन्दोलन, चक्का जाम, बन्द, राँके जुलुस, आफ्नो मान्छे, हाम्रो दल, कर्फु and many more words connoting political protest.
We became familiar with the acrid smell of burning tyres, and eyes smarting from tear gas. And yet, everyone speaks of another revolution in the making. Not by desire, but by suffocation.
We heard speeches about नयाँ नेपाल, but the New Nepal never arrived. The governance system changed, but it did not reflect on people’s lives — except for those close to centres of power. The state is still unreachable and is not bothered about <a href="https://nepalitimes.com/here-now/matter-of-life-and-debt">victims of loan sharks</a>, cooperative scams and other injustices.
Politicians continue to speak in sound bites, but fail to deliver. They have mastered the game of pointing fingers towards an external enemy and convincing people that they are never at fault. The political narrative is so disconnected from the actual analysis of the problem that suffocation doesn’t go away after every revolution.
No genuine effort has been made to deliver at all, which is why there is a palpable sense of disillusionment in the air forcing us to seek another revolution, even if Nepal may not be able to afford it.
How has the current system successfully held power, even if the public is deeply frustrated? How is it that for three decades we continue to be led by the same faces, who have time and again, proved to us that they may be great politicians but not national leaders?
<a href="https://nepalitimes.com/opinion/improving-internet-governance-in-nepal">My experience at the epicentre of politics</a> has led me to identify three cultures that have enabled political parties to keep a tight hold on power: acceptance, silence and dependency.
We accept things the way they are. We use fatalistic phrases like “नेपालमा यस्तै हो” or “नेपालको कानुन दैब जानुन”. While this resilience enables us to rise back up from devastating calamities, it is also a reason for our compliance with the status quo.
Despite so many ‘revolutions’ that have led to significant reforms, these phrases keep getting reinforced, to the point that the upcoming generations have made it their lingo.&nbsp;
This acceptance is not a symbol of law-abiding citizens, but citizens living in fear of those in power, unable to ask the whys and why-nots.
Innovation suffocates in this culture of acceptance of the status quo. This is manifested in remarks like “but we don’t have any laws for this,” or “we don’t have the capacity to implement this”. An innovator or entrepreneur therefore has to spend that energy to become a political lobbyist, often educating and convincing the bureaucracy.&nbsp;
Remember when locally assembled <a href="https://nepalitimes.com/banner/designed-and-made-in-nepal">Yatri motorbikes</a>, despite having willing customers, had to suffer to secure license numbers because of a lack of regulations? Instead of creating new laws, the government kept chanting the “We will promote Nepal-made goods” mantra, leaving entrepreneurs in a labyrinth of bureaucracy. The weight of acceptance of the law lies heavily on innovators. Fatalism is a tactic used by those in power to generate mass fear in society.
When we accept, we become silent. This is a pervasive phenomenon. We are trained to keep quiet, lest we ruffle feathers, burn bridges, or not get the help we need in future. We know, yet we don’t speak.
Read also: <a href="https://nepalitimes.com/here-now/bureaucratic-hurdles-in-researching-nepals-bureaucracy">Bureaucratic hurdles in researching Nepal's bureaucracy</a>, Daniel W Edwards
Here is one example: the 2021 census shows that the number of baby boys born for every 100 baby girls is 112. This is a clear indication of female foeticide because of boy preference in society.
Despite such horrifying realities, there is finger-pointing within the government between the Ministry of Health and Population with the Ministry of Home Affairs. At the citizen level, we know those who are involved in killing girls. Yet, we don’t speak up. The Nepal Medical Council reports state that despite this gender imbalance at birth, there is no indication of any action.
But why would anyone speak against one's own fraternity, no matter how vile the act is?
When we accept and keep quiet, we become dependent on those who yield power. From getting our government procedure completed on time to getting transfers, to accessing any of our legally protected rights as well, we are forced to depend on our networks of चिनेको मान्छे people we know by blood, village, relations, political affiliation.
The culture of dependency has been the established way in Nepal. If you drive a two-wheeler or four-wheeler, and you get into a small accident, you will be asked to sort it yourself, dialing up the most powerful person you know. It becomes a competition of who knows who.
Recently I was told that there were calls from the Ministry of Health and Population and another from the Prime Minister's Office for just one medical position in a private hospital. Each was pushing its own candidate. Guess which candidate got the position.&nbsp;
The dependency of people is not on the laws or the state, it is with people in power, a reliance on the network of somebody who knows somebody, including those not officially in power.
These cultures are deeply ingrained in our heads, and in society. Collectively they form a vicious circle that helps those in power to retain power. This is not the society we want to live in.
Then, what do we do as a collective to break away from this? How do we break away from the cultures of acceptance and silence that have created this dependency? What can we do to ensure that our children do not have to learn the jargon of आन्दोलन before they learn about the state?
These are the cultures political parties need to shed rather than use them to perpetuate their power. This is what <a href="https://nepalitimes.com/opinion/comment/an-alternative-to-alternative-politics-in-nepal">alternative politics</a> needs to be about.
Sumana Shrestha is a member of Parliament’s Education, Health and Information Technology parliamentary committee and represents the Rastriya Swatantara Party.

epidemic