It was at 2:45AM in the morning, I was in a deep sleep when I got a call from the hospital. The nurse on duty said there was a woman in labour who had had two previous C-sections. Half-asleep, I realised our resident gynaecologist was away on training and immediately rushed to the ward. The patient was 39-year-old Nim Diki Sherpa, wincing in pain and fully dilated. She had not had a single <a href="https://nepalitimes.com/here-now/saving-one-nepali-mother-at-a-time">ante-natal checkup</a>, and said she did not even know she was pregnant because she had taken a depo<a href="https://archive.nepalitimes.com/article/from-nepali-press/Ftnp-the-curse-of-the-contraceptive,493"> contraceptive injection</a>. Her husband was away and she was brought to Bhojpur District Hospital by neighbours who also had no idea she was pregnant.&nbsp; As resident medical officer with only an advanced skilled assistant birth attendant (ASBA), I was clueless about what to do next. Because of her two previous C-sections, this could be a complicated case needing referral. But our referral centre was too far away for this <a href="https://nepalitimes.com/here-now/nepal-s-air-ambulance-saves-mothers">emergency</a>. With our medical superintendent, we gathered at the operation theatre <a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/book-review-Admissions-Henry-Marsh-Neurosurgeon,4055">for surgery</a> and took the patient’s consent. Pre-anaesthetic check-up and preloading were done and the patient wheeled in.&nbsp; Blood grouping and crossmatch was done, and two hospital staff donated their own blood since the blood bank did not have stock. Because the patient was writhing in pain, the spinal anesthesia was administered with some difficulty.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250522090524_8a340dc6217599bf9cce8eb2315731089307e3b06a31baef5b622d5ad40ac71e.jpg" data-media-id="editor_4" data-image-id="20250522090524_8a340dc6217599bf9cce8eb2315731089307e3b06a31baef5b622d5ad40ac71e" data-rendition-name="original" width="1280" height="643" loading="lazy" alt="Saving one mother at a time NT"> </figure>  I was the main surgeon with another <a href="https://nepalitimes.com/here-now/saving-nepali-mothers-on-mother-s-day">birth attendant</a>, an experienced nurse and anaesthesia assistant. An incision was made near the C-section scars, but as we entered the abdominal cavity there was a sudden gush of blood. We could not figure out where it was coming from.&nbsp; After separating the muscle, I could see that it was as we had feared: a uterine rupture. We made a T-shaped incision to deliver the baby which was drowning in blood. The anaesthesia assistant, medical superintendent and nurse started resuscitating the baby, and I waited for it to cry while trying to deal with the mother’s bleeding. I felt I had lost one life, and could not save the other. We took the uterus out from the incision, traced the source of the bleeding, and started clamping with all the instruments we had.&nbsp; I had seen one case of peripartum hysterectomy during my training, and knew that a case like this was touch and go. Remembering tips from the training, I asked for long artery forceps. It was not in the set, but the nurse tracked one down in the store, disinfected it with betadine and handed it to me.&nbsp; There was no time to autoclave it, and I remembered my trainer telling me that we should all adapt to the situation at hand (अवस्था अनुसारको ब्यबस्था). His advice rang loudly in my ear. There was little hope, but I tried to keep calm and started suturing layers of incisions. All the while the anaesthesia assistant managed to keep everything under control. There was massive bleeding and we transfused two-pints of whole blood. I remembered what the mother had said before she was anaesthetised: “Doctor, do everything to <a href="https://nepalitimes.com/here-now/saving-one-nepali-mother-at-a-time-c2plk4ko?fbclid=IwAR3pJwcfeEosJdmBoF623hnjWjHoqIddTwWGMkPoOFNWqMujm1irA1auFr4">save my life</a>.”  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250522090524_e63c9f48bc630d4dea355d15554f2228a1ae9879c816fbcad42396e7f7f11d40.jpg" data-media-id="editor_7" data-image-id="20250522090524_e63c9f48bc630d4dea355d15554f2228a1ae9879c816fbcad42396e7f7f11d40" data-rendition-name="original" width="1200" height="1600" loading="lazy" alt="Saving one mother at a time NT"> </figure>  After three continuous hours at surgery, dawn was breaking as the mother’s bleeding started to come under control and her blood pressure started rising. But we still had a long way to go. The medical superintendent had arranged for <a href="https://nepalitimes.com/here-now/nepal-s-air-ambulance-saves-mothers">helicopter medevac </a>and she was airlifted out soon after.&nbsp; With me in the surgery team that night were fellow doctors Praveen Mandal and Shivaji Rijal, anaesthesia assistant Durga Nanda Chaudhary and nurses Sumitra Shiwa and Basanta Moktan. Advanced skilled birth attendant (ASBA) is a 70-day training given to MBBS doctors by the National Health Training Center and Nick Simons Institute (NSI) with clinical exposure in obstetrics after which they are expected to manage <a href="https://nepalitimes.com/banner/saving-nepali-mothers-and-babies-district-by-district">complicated deliveries in rural government hospitals</a> with cesarean section independently. Nepal has dramatically reduced<a href="https://nepalitimes.com/here-now/now-and-then"> maternal mortality ratio</a> from 536 per 100,000 live births thirty years ago to 145 now – mainly because of antenatal checkups, institutional deliveries and an increased number of advanced skilled birth attendants.&nbsp; Over the past three decades, the lives of countless <a href="https://nepalitimes.com/opinion/comment/saving-more-mothers-and-babies">Nepali mothers </a>have been saved. Like Nim Diki Sherpa, mothers have been saved one at a time by dedicated doctors and nurses working with limited resources and equipment. Read also:<a href="https://nepalitimes.com/here-now/nepal-lagging-in-safe-motherhood"> Nepal lagging in safe motherhood</a>, Sudiksha Tuladhar There were many lessons we learnt that day. I learned what it is to take a leadership role in a life-or-death situation. Back at Paropakar Maternity Hospital training in Kathmandu a senior consultant gynecologist once told me to scrub when a patient is bleeding profusely. He knew that one day I would be alone trying to save a life. “There is no running away,” he had said. “There is no excuse, you either try or let a patient die.” Once trained, circumstances will not let you choose. You cannot say ‘I wasn’t trained for this’, you have to adapt to the situation at hand with whatever you have.

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Saving one mother at a time

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221114121112/637222f59c7e80680e0c0327jpeg.jpg" alt="" width="760" height="486"/><figcaption>Govinda KC, Nepal’s crusading surgeon and health activist, plastering a patient’s ankle at the Mugu District Hospital on Sunday. He saw 177 patients for free in five days before travelling on to Jumla on foot. Photos: ACHYUTRAJ BHANDARI</figcaption></figure>Nepal’s  crusading surgeon and health activist Govinda KC has been on hunger strike 19 times since 2012, demanding medical education  reform and equitable healthcare. After retiring from his government job, KC has served patients in all 77 districts and other disaster-stricken countries. He is currently at Khandbari District Hospital in Sankhuwasabha where Nepali Times caught up with him.Excerpt from the conversation:Nepali Times: What is the state of healthcare in Nepal?Govinda KC: Most citizens from both urban and rural areas do not have access to healthcare. Many patients are too poor to afford quality treatment, and those who can not get quality care.The law specifies that 70 types of medicines should be available free of cost in district hospitals, 50 in primary health centres, and 35 in health posts. That is not the case in practice.Some government hospitals even charge money for medicines that are supposed to be free. And hospital fees are just too expensive, so they end up dying, being disabled for life, or sinking deeper into poverty.Health facilities in many rural districts are under-equipped, under-staffed and many patients have to return home without treatment. There are no big hospitals there to begin with, and even the urban poor cannot afford priate city hospitals.Doctors, nurses and office assistants have stuck around in government hospitals only because they are bound by contract. Some hospitals are led by junior non-physicians, making a chaotic and inefficient system.So, where is the problem? The problem in providing basic healthcare arises when the local representatives and  politicians do not work to provide it. When the 2015 constitution was announced, I was in satyagraha. My only demand was that our representatives be treated in health facilities in the same place as their voters. That demand was not fulfilled.The Constitution guarantees the citizen's right to health, but elected politicians do not care about health reforms. They are too busy getting rich overnight by commodifying education and health.I have been fighting to have hospitals and schools in every village, but people prefer to open hospitals in the city. Locals can have access to specialist services at a hospital in their village. This can also help to produce doctors, nurses and public health workers in the provinces. But no one is willing to do that. Politicians are on the payroll of the medical mafia.Do you regret going through all those hunger strikes? Many of my demands were not met. Some promises have been made, but not been implemented in practice. But some have been addressed, like the Medical Education Act was formed after multiple satyagraha. Then the Medical  Education Commission was formed.Before the Act, MBBS entrance exams were conducted by colleges and institutes in their own way, but now it is regulated by the Medical Education Commission.Only those who pass the entrance exams are now eligible for government scholarships and can pick their own college. Action is taken against private institutions if they do not follow the regulationsNow, medical colleges are selected based on their infrastructure, equipment and human resource.  Fees have also  dropped from Rs7-9 million to Rs4.2 million. Medical school is a lot cheaper now, especially for students who are unable to get scholarships.Government medical schools charged up to Rs10 million for  specialised education. Now, students do not have to pay, but get paid instead. After getting an MD they also need to serve for two years in a place assigned by the government. These contract doctors run the country’s healthcare todaySo, the hunger strikes have not been in vain. One of my demands was to have one government medical college in every province. At present, the Karnali Institute of Health Sciences is in operation in Jumla, and the physical infrastructure of Geta Medical College in Dhangadi has been completed. One medical college is soon opening in Dadeldhura after my hunger strike.Despite this, some goals have been lost to the challenges posed by the alliance of political  parties with the mafia. The construction of the Rapti Institute of Health Sciences in Dang was halted due to obstruction from local leaders, and a medical college in  Bardibas due to land acquisition issues.What policies should the government focus on now?First of all, access to basic services, human resources, equipment and medicine should be extended to people in rural areas and the urban poor. If primary health centres and district and provincial hospitals are improved, then 80-90% of patients do not have to  come to Kathmandu for treatment. The government needs to add more human resources to meet the current demand for healthcare.There should be a 15-bed operational hospital in each municipality. Hospitals should also be made free for people to have quality healthcare. The government should take actions against hospitals that operate without meeting proper standards.Additionally, the Medical Education Commission, Nepal Medical Council and other organisations should appoint qualified applicants, not political activists. In fact, the practice of hiring contract-based employees should be eliminated. Contract doctors have a higher chance of fleeing if they are not given temporary incentives to stay.Despite the huge demand for rural doctors, the Public Service Commission opens only 20 seats for doctors each year. This has to change.Any more hunger strikes?I am committed to campaigning for medical education reforms. Along with health and education, we are also fighting for good governance and social justice, without which reform is impossible.I also want to serve in remote areas, which is why I am here in Okhaldhunga. I will fight for people in all parts of the country to have quality, free, affordable and equal access to healthcare as guaranteed by the Constitution for as long as I can.Read more: <a href="https://www.nepalitimes.com/latest/govinda-kc-treats-patients-in-remote-nepal/">Govinda KC treats patients in remote Nepal</a>, Achyutraj Bhandari

"Nepalis are dying because they are poor”

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221114121112/637222f09c7e80680e0c0324jpeg.jpg" alt="" width="960" height="640"/><figcaption>Photo: POSSIBLE HEALTH</figcaption></figure>Ever since Finance Minister Janardan Sharma in his budget speech last month announced a plan to hand over management of Nepal’s national health insurance program to the private sector, experts are concerned that it will make medical treatment unaffordable for most people.Indeed, privatising health insurance is like the government abandoning its people, experts say, and it defeats the very purpose of the program — to provide affordable care for the most underserved communities who can neither access private plans nor expensive hospitals."Health insurance delivers the right of citizens to proper healthcare. As soon as it is implemented through a for-profit company, the social security aspect will be forgotten and serve purely as a business,” warns public health expert Sharad Onta.Private companies already provide health insurance schemes to those who can afford its expensive premium. The private sector therefore mainly serves the affluent, as public health experts Gaj B Gurung and Sushil Koirala <a href="https://www.nepalitimes.com/opinion/dangers-of-privatising-health-insurance-in-nepal/" target="_blank" rel="noopener noreferrer">argue in their op-ed</a> for Nepali Times:‘But can they really contribute to national public health security, understand equity, expand access to the poorest and the most marginalised population, and negotiate with the government providers for quality services? Are they fundamentally designed to serve the poor?’Read also: <a href="https://www.nepalitimes.com/banner/sick-of-it/">Sick of it</a>, Sagar BudathokiIn 2017, then health minister Gagan Thapa introduced a national insurance scheme with a premium of Rs2,500 a year for a benefit package of Rs50,000 for a family of five. This was later increased to Rs3,500 premium and Rs100,000 payout. But this is still too low, and needs to be revised.Hospitals also complain of late reimbursement, and some are considering pulling out of the program. Dhulikhel Hospital alone is owed Rs250 million in reimbursements. Patients are not happy about the service either, and are dropping out.But it is too early to give up, says SP Kalaunee, former director of Nyaya Health Nepal which implements the national insurance scheme at its Bayalpata Hospital in Achham.“Nepal’s health insurance policy is fairly new and such challenges are to be expected,” he says, “But they can be and should be addressed within the existing structure.”He adds: “The goal of the program was to make healthcare accessible, affordable and equitable to all. The fact that we have an additional feature to the program to strengthen service providers means it was never just a financial mechanism.”Read also: <a href="https://www.nepalitimes.com/banner/taking-wealth-out-of-health/">Taking wealth out of health</a>, Anita BhetwalA mandatory health insurance scheme where people pay the premium based on their per capita income could eventually include benefits that include treatment of chronic illnesses, say experts.Hiring competent staff with expertise in the field at the Health Insurance Board (HIB) might be a good start to improving the existing program. HIB should also be an autonomous body capable of making its own decisions without interference from the Health or Finance Ministry.Digitising reimbursement will also address some of the grievances, especially as the program should also look into signing up as many hospitals and care providers including the private establishments for the scheme. The private sector can be involved, but only in carrying out research on the sustainability of the program and for technical expertise.Nepal’s healthcare is divided into three levels:<ol><li>Primary health care (PHC) which is free in government hospitals</li> 	<li>Secondary care which is paid for by national health insurance and has waived premiums of the elderly, completely disabled, leprosy and Multi-Drug Resistant TB patients, people living with HIV, and the ultra-poor.</li> 	<li>Tertiary care that needs specialised treatment of chronic illnesses like cancers for which the government provides up to Rs100,000.</li></ol>Read more: <a href="https://www.nepalitimes.com/banner/in-a-healthy-state/">In a healthy state</a>, EditorialAll three aim to eliminate user fees at the point of care, but there are implementation challenges — the main one being the lack of government investment in the health sector and the limited understanding of what constitutes good health.“Health is more than just treatment and hospitals. A large part of it is prevention, from preventive measures against infection to building safer roads so that there are fewer road traffic accidents,” explains Sangeeta Kaushal Mishra of the Ministry of Health and Population.But health is not the priority of the government and there is not much investment in training medical personnel, making it incapable of meeting public demand. This gap is now being filled by the private sector.The government’s lack of capacity can be addressed to some measure by working with non-profits much like Nyaya Health Nepal and Nick Simons Institute which work with government hospitals to upgrade service.Read also: <a href="https://www.nepalitimes.com/opinion/is-free-health-care-possible-in-nepal/">Is free health care possible in Nepal?</a> S P KalauneeCommunity outreach is another crucial aspect in building a people-centric health system, and Nepal has a head start with its thousands of female community health volunteers across the country. They are primarily responsible for high childhood immunisation rates and reducing maternal mortality.  This now needs to expand to also include healthcare professionals at the grassroots, and retaining them.In the meantime, Nepal’s national health insurance policy also needs to address emerging problems like non-communicable diseases which with injuries make up two-thirds of death and disabilities in Nepal. The program must also include provisions for geriatric care and mental health conditions, all the while making sure the interests of the most vulnerable in the society are addressed."Private entrepreneurs will not fulfil the responsibility of the state. The access to the health care of the poor will be further weakened as soon as health insurance is privatised,” warns Damodar Basaula of the Health Insurance Board.Ensuring accessible and affordable health care for the people is the prerequisite of any government. Passing the buck to the private sector or any other group will further impoverish families unable to pay the medical cost of treating relatives.Says SP Kalaunee: “If you do not invest in the lives of people now it will cost much more tomorrow. The national health insurance program is set to become our biggest investment soon, and we must prepare the groundwork for it."Read more: <a href="https://archive.nepalitimes.com/article/nation/national-health-insurance-not-as-easy,4028">A national health insurance scheme is not as easy as it looks</a>, Sonia Awale

Sonia Awale

Ensuring health insurance for all Nepalis

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

Kangchenjunga: too sacred to climb?

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

SLAPPing Democracy

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

In the heat of the moment

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