I was a teenager when I was first exposed to the impact of climate breakdown, while staying with a family in Phakding in the aftermath of<a href="https://nepalitimes.com/here-now/lessons-not-learned-from-2015-o2etq6zu"> the 2015 earthquake</a>.&nbsp;
The communities living along the river were so scared of the Imja Tso glacial lake bursting that they hiked a few hours up the mountain every night for safety. During the day, they came back down to run their tea houses for volunteers and tourists still up in the Khumbu.
There is a clear correlation between livelihoods and the climate crisis. Seeing first hand, ten years ago, how the impact of climate change deepens poverty profoundly shifted my perspective, and motivated me to take up a career on climate finance.
I learnt everything about the subject, worked on projects to mobilise millions of dollars for climate action so that those most vulnerable would be safe.&nbsp;
Yet, <a href="https://nepalitimes.com/news/60-dead-64-missing-in-nepal-floods">this weekend’s floods</a> have shown me that on the ground, absolutely nothing has changed. Those most at risk from climate hazards are at even more risk.
Read also: <a href="https://nepalitimes.com/editorial/when-it-rains-it-pours-ksqprbu3">When it rains it pours</a>, Sonia Awale
Read also: <a href="https://nepalitimes.com/here-now/kathmandus-flash-floods-are-4-decades-in-the-making?fbclid=IwY2xjawFrHMtleHRuA2FlbQIxMQABHRth_4qOARkJl9oz8RSAdrfer4ox2p7uQH28wKYa0SOe1ZNXaS-Oa1qj9g_aem_9kYwBCg8maslUNwV0Dn_Uw">Kathmandu's ‘flash floods’ are 4 decades in the making</a>, Tom Robertson
It is dreadful to realise that the worst is yet to come. We in the climate finance sector are lost in words, actions and false promises of organisations purporting to help vulnerable countries, communities and families.&nbsp;
There are lofty climate targets and hopeful speeches on net-zero ambitions prepared by people who have no idea of the ground reality. Young people I used to respect proudly demonstrate their saviour complex and exoticise the poor to advance their brand image on social media to gain brownie points.&nbsp;
This week, early-rising <a href="https://nepalitimes.com/here-now/nepali-trail-running-champions">trail runners</a>, youth groups, and local communities became first responders on the muddy banks of rivers in Kathmandu Valley for rescue and recovery. From agencies claiming to work on 'disaster risk reduction', we heard only words and media campaigns.
Am I the only one losing hope in us collectively responding to what the future requires us to do? &nbsp;
Disasters are now increasingly normalised as Nepal crosses the tipping point on climate breakdown. Elitism and inequality has never been more apparent.&nbsp;
Read also: <a href="https://nepalitimes.com/opinion/guest-editorial/act-now-on-climate">Act now on climate</a>, Manjeet Dhakal
This week’s tragedy showed how the high and mighty were safe, and the lowly forced to live along river banks were not. Those who are thinking of moving away from flood-prone areas, buying home insurance and protecting themselves from future impact are perhaps the very people abetting the destruction of the natural environment.
The two rivers that saw the most devastation this week, Rosi Khola and Nakkhu Khola, had <a href="https://nepalitimes.com/banner/nepal-struggles-to-balance-nature-and-industry">unregulated sand mining and rampant quarrying</a> upstream — all happening in the name of ‘development’.
I spoke with a dairy farmer in Hatiban whose home and 13 cows were swept away by a stream that had turned into a raging mudflow. He is out in the streets now, with just the one cow that survived. He teared up telling me this. So did I.
A carpenter who lives in a small tin hut near the Karmanasa River told me he has had enough and is now headed back to his village. A neighbourhood garbage recycler has spent the past week living inside a stack of large concrete pipes meant to improve Kathmandu's drainage.&nbsp;
A decade after starting to work on climate change, I know nothing about what to actually do to adapt to the impact of the climate crisis like this one. The 800mm of rain in two days was caused by global warming, but the death toll was higher because of corruption and state negligence.
Read also: <a href="https://nepalitimes.com/editorial/climate-damage">Climate damage</a>
There are thousands of tragic stories from this flood, most of them will never be heard. Many are already forgotten.&nbsp;
The guilt coming from the privilege of even being in a position to help in times like these eats me up from the inside. I have spoken to many friends this week working tirelessly, without recognition or organisational support, to help with relief and rescue. Many share the same sentiment: the disaster swept away what little optimism we had.
Yet, there is also hope in the way we have all come together knee-deep in mud, carrying relief supplies and cash to those marooned, destitute and homeless. It is clear that top-down <a href="https://nepalitimes.com/latest/cash-for-climate">response from the government</a> or large relief organisations is always too little, too late and too ineffective. Those who lost everything do not know how to work the system.
Read also: <a href="https://nepalitimes.com/here-now/climate-breakdown-magnifies-western-nepal-s-woes">Climate breakdown magnifies western Nepal’s woes</a>, Unnati Chaudhary
In such situations, we must take matters into our own hands. We need to be aware of the impending impact of <a href="https://nepalitimes.com/opinion/the-climate-threat-multiplier">climate change</a>, and make our own decisions to build and rebuild resilience among those forced to live in harm's way. &nbsp;
The passion to tackle the climate crisis will not come if we do not have personal stories of how we ourselves are affected. Almost everyone in Kathmandu Valley, Kavre, Dhading and elsewhere now has a personal experience of this climate-induced calamity. The question is, what are we going to do about it?&nbsp;
As I write this on Thursday morning on 3 October, it is raining heavily again. &nbsp;
Rastra Raj Bhandari is a co-founder and fellow at the Himalayan Water Project, where he leads the research on climate finance opportunities for the Himalaya. He contributes regularly to Nepali Times on climate change. rastrarajbhandari@gmail.com
<h2>HOW TO HELP</h2>
· Civil society action is filling gaps in relief and rehab until bigger players take over. 9858000000
· Sudan Gurung, <a href="https://www.haminepal.org/">Hami Nepal</a>
· Saurav Rimal, <a href="https://karmayogfoundation.org/">Karmayog Foundation</a>, 9851139412&nbsp;

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Flood of despair

<figure><img width="3071" height="2284" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110161128/636d195f9c7e80680e0ac817jpeg.jpg" alt=""/><figcaption>Chanaute after the flood on the Melamchi River in 2021. All photos: RAJU PANDIT CHHETRI</figcaption></figure>On 15 June, the <a href="https://www.nepalitimes.com/latest/monsoon-hits-nepal-with-a-bang/">Melamchi River north of Kathmandu</a> saw a massive flash flood, killing 25 people and sweeping away 200 houses and 360 hectares of farmlands.Another debris flow on the river on 31 July added to the destruction and misery. The disaster was <a href="https://www.nepalitimes.com/latest/the-monsoon-mess-in-melamchi/">unprecedented in the Melamchi Valley</a>, and caught residents, trout farms, shops along the banks by surprise. Before the communities got a chance to fully rise from the massive double-earthquake in 2015, the region was hit yet again with another disaster.As a resident of the Chanaute, I lost close relatives and neighbours to the flood. My own house and farmland were destroyed. The river sliced through the bazar town, and its 56 houses are now ruined and abandoned. The hopes of my hard-working community have also been dashed.Local entrepreneurs, small shop owners and farmers whose arable land have turned into a boulder-strewn wasteland are shattered. Damage to roads and bridges hascut the valley’s connection to the outside world. Nepal’s most expensive water supply project has been damaged. <figure><img width="1024" height="768" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110161128/636d19639c7e80680e0ac818jpeg.jpg" alt=""><figcaption> </figcaption></figure>Any individual extreme weather event is difficult to directly attribute to the climate crisis. But the intensity and unpredictability of this year’s monsoon has been unprecedented. Manang and Mustang were hit by flash floods at the same time as Melamchi – even before the monsoon officially started. And even after the rainy season was formally over last week, <a href="https://www.nepalitimes.com/latest/post-monsoon-rain-ruins-nepals-crops/">parts of the country were hit by record-breaking rainfall.</a>For the past decade, my career has taken me to numerous international climate summits where we have discussed strong national and international advocacy to address the impact of the climate crisis – especially on developing countries like Nepal.At international climate negotiations under the United Nations Framework Convention on Climate Change (UNFCCC), I have observed climate-vulnerable countries make urgent pleas for ambitious action in tackling the climate crisis. Small, low-lying island states like the Vanuatu, Tuvalu and the Maldives have tried to show the urgency of it all – rising ocean levels will soon submerge their countries.The Philippines and Bangladesh continue to raise concern about the increasing intensity and frequency of typhoons and cyclones. Fragile mountain regions of the world are trying to get their concerns on the agenda.Next week, heads of state from around the world will start arriving in Glasgow for the 26th annual climate summit of the UNFCCC (called COP26). Recent impacts of extreme weather events around the world (wildfires in Siberia and the western US, heat waves in Canada, floods in Europe, landslides and floods in Japan, India, China) are likely to focus everyone’s mind on the climate emergency, and the message that we are all in this together. <figure><img width="1500" height="1125" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110161128/636d19669c7e80680e0ac819jpeg.jpg" alt=""><figcaption> </figcaption></figure>Reducing greenhouse gas emissions and adapting to climate impacts to avert and minimise some of the loss and damage will be at the forefront of the negotiations.  However, as the incoming president of COP26, the United Kingdom and the leaders of the industrialised world will have to face a new reality – to address the destruction unleashed by the climate crisis with rehabilitation, migration and financing.Industrialised countries have long brushed aside these issues, diluted their commitments to merely focusing on the weaker goal of reducing greenhouse gas emission, and providing token climate financing to allow low-income countries to adapt.In fact, addressing the <a href="https://www.nepalitimes.com/banner/disasters-in-nepal-come-in-waves/">loss and damage from disasters</a> like the one that hit Melamchi and parts of the Himalaya will be one of the main pillars of the COP26 in Glasgow. Nepal’s delegation will be led by Prime Minister Sher Bahadur Deuba, and he is expected to speak about this year’s climate-induced disasters starting with <a href="https://www.nepalitimes.com/banner/wildfires-ravage-nepal-mountains/">winter drought</a>, <a href="https://www.nepalitimes.com/banner/nepal-is-going-up-in-smoke/">nationwide wildfires</a>, and floods.Nepal will have strong moral grounds to persuade world leaders that low capacity vulnerable countries need help to deal with a crisis that is not of our making. Himalayan glaciers are shrinking and receding fast, extreme weather trends are more pronounced, and this is impacting on infrastructure projects and threaten to undermine decades of progress in achieving the UN’s Sustainable Development Goals. <figure><img width="4000" height="3000" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110161128/636d19699c7e80680e0ac81ajpeg.jpg" alt=""><figcaption> </figcaption></figure><a href="https://www.nepalitimes.com/here-now/nepals-glacial-lakes-in-danger-of-bursting/">A 2020 study by ICIMOD and UNDP</a> has shown that 47 glacial lakes in the Kosi, Gandaki and Karnali basins are in danger of bursting. Although 21 of these lakes are in Nepal, the others also drain into tributaries of rivers flowing into Nepal. These are ticking time bombs.<a href="https://www.nepalitimes.com/banner/climate-change-is-a-disaster-in-the-nepal-himalaya/">Glacial lake outburst floods</a> have been hitting Nepal’s Himalayan valleys with increasing frequency. In 2012, an <a href="http://archive.nepalitimes.com/article/nation/Anatom-of-a-Himalayan-tsunami,1330">avalanche on Annapurna</a> unleashed a catastrophic flood on the Seti River that killed at least 70 people. In <a href="http://archive.nepalitimes.com/blogs/kundadixit/2014/10/16/after-the-storm/">2014, a deadly post-monsoon blizzard</a> spawned by Cyclone Hudhud swept through the mountains catching many trekkers unawares. The Tarai have seen increasingly destructive floods in the past five years, and <a href="https://www.nepalitimes.com/banner/disastrous-management-in-nepal/">Bara district was hit by a rare tornado in 2019</a> that killed dozens.In Glasgow, Nepal will have to make a compelling case for <a href="https://www.nepalitimes.com/banner/himalayan-floods-a-sign-of-worse-to-come/">loss and damage compensation</a> for disasters like these. COP26 will be a make-or-break summit for reducing global carbon emissions by 45% by 2030. Nepal will also need to do its bit to achieve its updated Nationally Determined Contribution target to reduce emissions by 2030 by switching to renewable energy, and attain net zero by 2050.Glasgow will be an opportunity to link global targets to local impact, and to find ways to address the disproportionate destruction caused by climate crisis on the poorer parts of the poorest countries.Raju Pandit Chhetri is a resident of Chanaute in Nepal’s Melamchi Valley and works on climate change issues.

Think globally in Glasgow, and act locally

October is buckwheat harvest time in the <a href="https://www.nepalitimes.com/banner/dazzling-dolpo/">distant highlands of Dolpo</a>. In the village of Tso, Namdak Sangmo watches other women from her village fling their sickles, stoop over to sling the sheaves on their shoulders, and bring the crop in. Sangmo, 68, does not have her own crop to harvest because she does not have any land anymore. Her riverside terraces were washed away by a flash flood in 2012, and another one in 2019 destroyed what was left, leaving a barren boulder-strewn slope. “It was a raging torrent, and it came down suddenly and swept everything in its path, I do not have any land left to farm,” says Sangmo. She is not the only one, almost half the villagers in Tso lost their standing crop and fields when a wall of mud and boulders raced down from the slopes of the 6,883m high Mt Kanjiroba that towers over the district. Scientists have not drawn a direct correlation between the climate crisis and extreme weather events like this, but they say there is evidence that droughts, record downpours, and erratic monsoons in the Himalaya are a result of a hotter atmosphere. This year’s monsoon has seen freak downpours and unprecedented rainfall in the trans-Himalayan regions of Nepal. Unseasonal rains this week unleashed deadly floods and landslides, especially in western Nepal. The Himalayan mountains are warming between 0.3-0.7°C faster than the global average, causing glaciers to shrink, snowlines to recede, and increasing the danger of floods when expanding glacial lakes burst. <div class="embed-block"><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110161128/636d18e39c7e80680e0ac7edjpeg.jpg" alt="" width="1500" height="1000"></div> Sangmo remembers well that September day two years ago. “It had rained non-stop for two days, and suddenly we heard a big roar from up the mountain, my brother-in-law told us to run,” she recalls. There was unusually heavy rain where snow used to fall, and the fragile moraine ridges below Kanjiroba just dissolved, sending the debris flow racing down to the village below. A similar flood in June on the Melamchi River damaged Kathmandu’s water-supply project, Nepal’s most expensive infrastructure scheme. In Manang, a trans-Himalayan valley north of the Annapurnas, there was record-breaking rainfall that unleashed deadly floods. “There is more and more evidence that extreme rainfall events are caused by climate change, and these trigger sudden floods that destroy farms and settlements downstream,” says Arun Shrestha, a climate specialist with the River Basins and Cryosphere division at the Kathmandu-based International Centre for Integrated Mountain Development (ICIMOD). There has not been enough study to determine if the Dolpo flood was <a href="https://www.dhm.gov.np/uploads/climatic/467608975Observed%20Climate%20Trend%20Analysis%20Report_2017_Final.pdf">caused by a glacial lake outburst flood (GLOF)</a>, or just extra-heavy rainfall on sediment deposits in high mountain valleys, but the result was just as devastating. <div class="embed-block"><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110161128/636d18da9c7e80680e0ac7eajpeg.jpg" alt="" width="1500" height="1000">The tongue of the glacier below Kanjiroba from which the floods came down.</div> A recent Himalayan <a href="https://www.nepalitimes.com/here-now/nepals-glacial-lakes-in-danger-of-bursting/">Glacial Lake Inventory</a> by <a href="https://www.icimod.org/event/glacial-lake-inventory-launch/">ICIMOD </a>and UNDP mapped 3,624 new glacial lakes on Nepal’s main river basins and found that 47 of them could <a href="https://www.nepalitimes.com/editorial/more-himalayan-tsunamis/">burst at any time</a>, with the risk of catastrophic flooding down valley. Of these, <a href="https://www.nepalitimes.com/here-now/nepals-glacial-lakes-in-danger-of-bursting/">25 lakes are in Tibet,</a> but flow into tributaries of Nepal’s main rivers. While communities in Nepal have historically learnt to reduce risk from these floods by not settling along riverbanks, new poorly-designed roads, settlements and infrastructure are vulnerable to these climate induced disasters. While GLOFs can happen at some point in the future, weather extremes caused by the climate crisis have already unleashed a creeping disaster in Himalayan villages like Tso. This year, a 7-month <a href="https://www.nepalitimes.com/banner/no-smoke-without-fire-2/">winter drought led to wildfires</a> and floods in Dolpo, displacing farmers, and forcing them to migrate. As <a href="http://archive.nepalitimes.com/article/Nepali-Times-Buzz/Shey-Phoksundo-may-soon-become-a-bus-park,3975">Dolpo is connected by road</a>, most men have left rural areas for work in the cities or abroad to supplement their income, and it is the women who stay behind who bear the brunt of the impact of climate change -- the drudgery of having to walk farther for water, or suffer from failed harvests. <div class="embed-block"><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110161128/636d18dd9c7e80680e0ac7ebjpeg.jpg" alt="" width="1500" height="1000">Massive flashfloods in 2012 and 2019 that came down from Mt Kanjiroba washed away fields and homes in Tso village.</div> “Climate change adds to the extra load of women in rural areas because of unpredictable rain, floods droughts and springs going dry,” says <a href=".%20https:/www.icimod.org/team/abid-hussain/">Abid Hussain</a>, of the Mountain Agriculture and Livelihood division of ICIMOD. Most of Nepal’s subsistence farmers are dependent on rain-fed agriculture, and <a href="https://www.thestatesman.com/world/women-participation-in-agriculture-is-highest-in-nepal-1502659946.html">83% of the country's women are fulltime farmers</a>. Namdak Sasngmo’s husband died 15 years ago, and her children are married. Without her fields, she finds it difficult to take care of her family. Nepal’s central or local governments should be helping her, but there has been no compensation for the loss and damage. Without her fields, with <a href="https://www.nepalitimes.com/banner/trekking-to-save-nepals-snow-leopards/">no income from trekking tourism</a> due to the pandemic, and a decline in the yarsagumba crop, Sangmo is worried. Left to fend for themselves, she has fallen back on her faith in the Tibetan animist belief system that has deep reverence for the mountains as divine creations that have their serene and destructive sides that need to be appeased through prayer and good deeds. “We may have angered the gods of Kanjiroba with our deeds,” says Sangmo.“We made the river impure and many outsiders came and polluted the lake.” <div class="embed-block"><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110161128/636d18e09c7e80680e0ac7ecjpeg.jpg" alt="" width="1500" height="1000">Namdak Sangmo, 50, harvests buckwheat in a neighbour’s field because her farm was washed away by the flood.</div> To prevent future calamities, the monk at the local monastery, Khenpo Lama, performed a ritual to appeal to Mt Kanjiroba with a shebchu at a small stupa with offerings of buckwheat and barley. Sangmo believes it worked, because “everything has been quiet on the mountain after that”. From his monastery, Khenpo Nyima himself has noticed the change in weather, and the snow retreating higher and higher up Kanjiroba. Although he does not connect this to the global climate crisis, he is convinced outsiders are to blame. “We have seen the mountains changing, and that is because there are more and more outsiders coming here and they are desecrating nature,” he says, looking up at the icy tongue of a glacier below Kanjiroba, the top of which is veiled in monsoon clouds. He says the modern world has also changed the traditional ways in Dolpo. Local people no longer rely on dorima that determines the schedule for planting, harvesting, and the timings for taking yaks and goats up to high pasture. “They also do not put up prayer flags in the yulsa every year, and this has displeased the gods,” Khenpo Nyima adds. <div class="embed-block"><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110161128/636d18e39c7e80680e0ac7edjpeg.jpg" alt="" width="1500" height="1000"></div> However, the local government and the <a href="http://archive.nepalitimes.com/article/Nepali-Times-Buzz/saving-shey-phoksundo-in-nepal,3596">Shey Phoksundo National Park</a> are not relying on prayers to protect citizens here. They built an embankment along the river after the 2012 flood to shield Tso’s village and farms, but it was washed away in the second flood in 2019. “We may need a bigger budget to build a proper wall that will save the village the next time there is a big flood, I am trying to convince the municipality authorities, but we need more help,” says Nima Lama, the ward chair. However, studies have shown that people in mountain regions across the world have been adapting to the changing climate without knowing why it is changing, and using local belief systems and traditions to do so. <a href="https://phys.org/news/2019-06-mountain-dwellers-glaciers-climate.html">Anthropologist Ben Orlove of Columbia University’s Earth Institute</a> interviewed people in locales including the Peruvian Andes, and found that while villagers were aware of the changes, they were adapting to them without necessarily linking it to climate change. Orlove proposes framing the ‘climate change’ narrative as a need for ‘community change’ so the focus is on how villagers can benefit from the measures they take to adapt to lack of rain, water shortages, or flood-prevention embankments. That appears to be already happening here in Dolpo, an arid trans-Himalayan region of Nepal where people are falling back on a sense of community and traditional belief systems to cope with the impacts of the climate crisis. <div class="embed-block"><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110161128/636d18e69c7e80680e0ac7eejpeg.jpg" alt="" width="1500" height="1000">Yarsagumba is a fungus that grows on a caterpillar, and is harvested in spring in the Himalaya. It is in high demand across the border in China.</div> The climate and ‘Himalayan viagra’ As the climate crisis impacts on the pastoral lifestyle of the people of Dolpo, the women who remain in the remote villages have started relying more and more on <a href="https://www.nepalitimes.com/banner/its-yarsa-picking-time/">yarsagumba, the caterpillar fungus</a> that is prized in Chinese medicine for its supposed aphrodisiac properties. These days, it is mainly women who climb up to the high slopes where the fungus pokes out of the ground after snow melts in spring. They harvest the yarsagumba and sell it to middlemen who in turn sell it to wholesalers at the <a href="https://www.nepalitimes.com/banner/new-high-way-to-dolpo/">Chinese border, 4 days walk to the north.</a> However, a combination of <a href="https://www.nepalitimes.com/latest/heavy-snowfall-over-nepal-himalaya/">unseasonal snowfall</a>, long periods of drought and warmer weather is affecting the yarsagumba, too. Schools in Dolpo close at yarsa harvest time so students can accompany parents to the pick the fungus, but this year they have returned empty-handed. “We went up in April, but the yarsa was not fully mature and it was soggy, there was nothing to pick,” says one student, Sangmo Lama. <div class="embed-block"><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110161128/636d18e99c7e80680e0ac7efjpeg.jpg" alt="" width="1500" height="1000">With her trekking income gone, and farm washed away by floods, Namdak Sangmo used to depend on yarsagumba picking. But even the growth of the fungus has been affected by weather extremes caused by climate change.</div> While over-harvesting in the past has been one of the reasons for the decline in the yarsa crop, it should have revived in the past two years when the pandemic reduced the numbers of pickers. That lends support to the theory that a warmer Himalaya is also affecting growth of the valuable fungus and contributes to the end of the yarsa <a href="http://archive.nepalitimes.com/article/nation/yarsagumba-dispute-dolpa,1424">gold rush</a>. Local people who relied on tourism and livestock for income had <a href="http://archive.nepalitimes.com/news.php?id=18321#.XnOPvS2B3-Y">earnings from the fungus</a> as a fall back. Now, that option is also gone. Yarsa made up more than half of the annual income of an average Dolpo household. While the fungus is sold for only Rs5,000 per kg to the Chinese traders at the border, it can fetch as much as $75,000 per kg in Shanghai. After she lost her fields to the glacial floods, Namdak Sangmo of Tso village used to rely solely on yarsa income. She used to collect at least 100 pieces of fungus in the past, two years ago she found only six pieces, and this spring none at all. “Without yarsa what do we eat? How do we survive? The mountain was angry and took away my fields, there is nothing to do but pray,” says Sangmo, as she sharpens her sickle to help the other women in their buckwheat fields. This report was supported by the Road to COP26 campaign implemented by the British Council and funded by UKAID.

Climate change is a disaster in the Nepal Himalaya

<figure><img width="1859" height="1000" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110101156/636ccac69c7e80680e08bb88jpeg.jpg" alt=""/><figcaption>What remains of the Dhauliganga hydropower project in Chamoli district of India’s Uttarakhand state after Sunday’s deadly glacial flood. Photo: STR</figcaption></figure>The devastating <a href="https://theprint.in/science/uttarakhand-chamoli-disaster-likely-caused-by-landslide-not-glacial-outburst-satellite-images-reveal/600859/" target="_blank" rel="noopener noreferrer">collapse of the Nanda Devi glacier</a> in India’s Uttarakhand state on 7 February that killed hundreds should be a warning for Nepal to be prepared for similar disasters in future.
A <a href="https://www.planet.com/" target="_blank" rel="noopener noreferrer">PlanetLabs</a> image seems to confirm that a rock-ice slope detached completely from near the summit of the 7,816m high peak in the Garhwal Himalaya near Nepal’s western border, crashed on to the glacier below, and bulldozed the ice and debris into the Dhauliganga and the Alkananda Rivers.
There are tell-tale signs of new brown dust on the western side of the valley in satellite images. The ice melted as it reached a warmer, lower altitude and unleashed the flood that raced downstream. Two hydroelectric projects on the rivers were completely destroyed, highways were washed away and settlements buried under metres of water and debris. 
The Nanda Devi disaster is almost identical to the <a href="http://archive.nepalitimes.com/article/nation/Anatom-of-a-Himalayan-tsunami,1330" target="_blank" rel="noopener noreferrer">Seti River flash flood</a> of 2012 north of Pokhara that killed nearly 80 people. A massive chunk of rock near the summit of Annapurna IV broke off, fell on the glacier and the ensuing flood <a href="http://archive.nepalitimes.com/news.php?id=19479#.YCEipy8RoWo" target="_blank" rel="noopener noreferrer">barrelled down the Set</a>i, causing the fatalities.
Another <a href="https://nepalitimes.atavist.com/high-water" target="_blank" rel="noopener noreferrer">flash flood on the Arun River</a> in eastern Nepal in 2017 was traced to slope failure on a mountain on the Nepal-China border that fell on a glacial lake, triggering a flash flood that washed down so much debris that it dammed the main river.
In all three cases, disasters that at first thought to be a Glacial Lake Outburst Floods (GLOF) turned out to be rock-ice avalanches that led to a glacier collapse. The water and debris then cascaded down the valleys in a deadly paste obliterating everything in its path.
Whereas the increased risk of GLOFs in the Himalaya is linked directly to the climate crisis melting the ice and expanding moraine-impounded lakes, this does not appear to be the direct cause of the Nanda Devi event—just as it was not in the Seti and Arun. Rockfalls that lead to the collapse of glaciers, squeezing the water out of ponds in them and melting of the ice as it is pushed down to a warmer altitude.
Some of these glaciers may have lakes that top over when an avalanche or rockfall hit their surface, or global warming may have melted the ice within debris-covered glaciers. We do not know if these events are becoming more frequent due to a Himalayan thaw caused by the climate crisis.
Whatever the case, it is clear that the countries that share the Himalaya from Afghanistan to Burma have to be prepared for more frequent disasters of this type. The risk of GLOFs and flash floods have to be <a href="https://www.nepalitimes.com/banner/human-face-of-a-himalayan-climate-crisis/" target="_blank" rel="noopener noreferrer">factored into planning infrastructure</a> and human settlements downstream.
Although GLOFs and glacial collapse get all the attention, the Himalaya are also prone to landslide-blocked dams during the rainy season. The mountains are relatively young, they are seismically active and their slopes very unstable. Monsoon rains have been known to trigger landslides the block major rivers, as happened on the Bhote Kosi in Jure in 2014.
Fortunately, the river found a way around the blockage. But there have been cases when the impounded lake is large enough to cause catastrophic bishyari floods downstream when the landslide dams collapse.
The flat terraces where the city of Pokhara is situated today was probably formed, geologists say, when a landslide blocked the Seti upstream some 700 years ago. It gave way, <a href="http://archive.nepalitimes.com/blogs/kundadixit/2012/05/05/avalanche-flood-on-seti/" target="_blank" rel="noopener noreferrer">unleashing a tsunami</a> at least 150m high. Pokhara is located in the debris fan of this flood which dammed side rivers, forming Phewa, Begnas and other lakes.
To warn that <a href="https://www.nepalitimes.com/banner/tracing-past-glacial-floods-in-kangchenjunga/" target="_blank" rel="noopener noreferrer">similar catastrophes can strike</a> in the Himalaya is not panic-mongering. It is a call to be prepared. And let us hope the worst-case scenario of a mega-quake causing multiple glacial lake outburst floods does not happen any time soon.A Himalayan <a href="https://www.nepalitimes.com/here-now/nepals-glacial-lakes-in-danger-of-bursting/" target="_blank" rel="noopener noreferrer">Glacial Lake Inventory</a> launched at a <a href="https://www.icimod.org/event/glacial-lake-inventory-launch/" target="_blank" rel="noopener noreferrer">webinar</a> on Monday says that of the expanding glacial lakes in the Himalaya, 47 on the watersheds of Nepal’s three main rivers are at high risk of bursting, and causing catastrophic floods downstream. Of these, 42 lakes are on the Kosi River basin in eastern Nepal, three are on the Gandaki and two on the Karnali watersheds.A report last year by the <a href="https://www.icimod.org/event/glacial-lake-inventory-launch/" target="_blank" rel="noopener noreferrer">International Centre for Integrated Mountain Development (ICIMOD)</a> and UNDP mapped 3,624 glacial lakes in the Kosi, Gandaki and Karnali basins and found 47 lakes at risk from bursting. Of these 25 are in Tibet and drain into rivers that flow into Nepal. For now, existing towns along the rivers must have early warning systems. Infrastructure planning must take into account the glacial flood risk. And because so many of the high-risk glacier-fed rivers flow across national boundaries, international cooperation must be a must.

More Himalayan tsunamis

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

New year revolutions

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

What is invisible is more dangerous

82 in २०८२

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

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