<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

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"Nepalis are dying because they are poor”

<img width="3724" height="2151" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221114111144/63721c729c7e80680e0bd491jpeg.jpg" alt=""/><a href="https://archive.nepalitimes.com/news.php?id=12452#.YlFKe9NBxH0">Goitre</a> was once so <a href="https://www.nepalitimes.com/latest/from-pandemic-to-epidemic-to-endemic/">endemic</a> in Nepal that it was considered a sign of beauty. Entire villages across northern Nepal that relied on <a href="https://www.nepalitimes.com/banner/the-salt-of-the-earth/">Tibetan rock salt</a> suffered from iodine deficiency, and cretinism was widespread.Read also: <a href="https://www.nepalitimes.com/banner/the-salt-of-the-earth/">The salt of the earth</a>, Jag Bahadur BudhaUnlike sea salt which contains adequate iodine, the micronutrient mostly evaporates from rock salt, and people who used it were affected by <a href="http://archive.nepalitimes.com/news.php?id=9144#.YlFK49NBxH0">iodine deficiency</a>. Those suffering from it had throats disfigured with large growths.A successful public-private partnership between the government, Salt Trading Corporation and aid agencies <a href="http://archive.nepalitimes.com/news.php?id=9144#.YlFK49NBxH0">iodised salt</a> under the brand आयो नुन and this all but eradicated visible goitre — it went down from 55% in 1965 to only 0.4% in 2007. This is one of Nepal’s public health success stories.However, in solving one problem, we may have created another. The country is now facing thyroid disorders caused in part by excess iodine intake. Recent studies show an increasing prevalence of thyroid disorders, even among younger Nepalis.A 2019 community-level survey in five districts found the prevalence of thyroid disorders at 4.32%. Nearly three-fourths of those were subclinical hypothyroidism, 13.7% primary hypothyroidism and another 13.7% were hyperthyroidism.Hypothyroidism is when the thyroid gland does not produce enough hormones. In hyperthyroidism, on the other hand, the gland is overactive and produces too much hormones. Subclinical conditions do not need immediate treatment.The figures for hospital-based surveys are much higher. In a paper published in 2015 based on 5,230 cases from Teaching Hospital in Kathmandu, 29% were diagnosed with thyroid disorders. Higher prevalence was found in the 31-45 age group.However, experts are cautious about pinpointing excess iodine in the diet as the only cause for thyroid disorders.“The prevalence of thyroid disorders has indeed increased in the last 10-15 years, but this could also be a result of better diagnosis even in rural areas,” says endocrinologist Ansumali Joshi.The recommended daily intake of iodine is 150 micrograms, but is higher for <a href="https://www.nepalitimes.com/here-now/saving-one-nepali-mother-at-a-time/">pregnant and lactating women</a>. <img width="477" height="544" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221114111144/63721c759c7e80680e0bd492jpeg.jpg" alt="">A 2016 survey showed that 67.5% of households in Nepal have excessive iodine intake in food. School-age children were classified in the ‘excessive’ range, pregnant women in ‘adequate’ and women of childbearing age in ‘more than adequate’. Iodine intake was higher in the central and western parts of the country and the Tarai.“Iodised salt has reached every corner of Nepal and because there is excessive use of salt in food items, logically people are overdosing on iodine,” says cardiologist Prakash Regmi. “Excessive salt intake is already a leading cause of <a href="https://archive.nepalitimes.com/news.php?id=18115#.YlFMNtNBxH0">heart</a> and <a href="http://archive.nepalitimes.com/article/Nepali-Times-Buzz/A-mysterious-rash-of-kidney-failures,3639">kidney diseases</a>. And excess iodine is now adding thyroid dysfunction which can affect the brain and the nerves.”After the 2016 assessment, the government reduced iodine content in salt from 50PPM (parts per million) to 30PPM. Experts say it might be time to reduce it further, or even add the micronutrient in some other food item.Misinterpretation of iodine ‘overdosing’ could also send out the wrong message, they warn, leading to the public avoiding iodised salt, and thus reverse Nepal’s successful eradication of iodine deficiency.Other factors affecting thyroid glands include viral infections and endocrine disrupters like <a href="https://www.nepalitimes.com/latest/biodegradable-plastic-launched-in-nepal/">plastics</a> and certain chemicals. Thyroid disorders can also be hereditary. Covid-19 has also been associated with thyroid inflammation, resulting in hyperthyroidism or thyroiditis.Untreated hyperthyroidism can lead to ‘thyroid storm’, a very rare but life-threatening condition in patients often referred to Kathmandu hospitals due to <a href="http://archive.nepalitimes.com/news.php?id=4980#.YlFMxNNBxH0">lack of treatment facilities</a> elsewhere.“We know either too much or too little about thyroid disorders. But there is a general lack of clear understanding, I have a lot of patients who visit me all panicking about their thyroid test results,” says endocrinologist Jyoti Bhattarai. “But there is a spectrum to thyroid diseases, and many do not need treatment. Subclinical hypothyroidism is one example.”Read also: <a href="http://archive.nepalitimes.com/news.php?id=18379#.YlFJb9NBxH0">Diabetic dilemma</a>, Buddha Basnyat There are groups more at risk: pregnant women and those planning to conceive who should take thyroid function tests to prevent possible premature birth, miscarriage and even stillbirth. Women unable to conceive should also be screened.And ideally, all newborns should also take a test because early diagnosis of a congenital hypothyroidism can almost entirely prevent mental disability. Another risk factor is obesity.“Growing up in the mountains I had several family members afflicted with goitre. We have made much progress since then, but it is time to change our focus and study the prevalence of thyroid disorders today,” says Pokhara-based physician Bikash Gauchan. “It affects multiple systems and patients experience a wide range of symptoms with implications on both <a href="https://www.nepalitimes.com/latest/the-other-pandemic-mental-health/">mental</a> and <a href="https://archive.nepalitimes.com/article/nation/diabetes-in-south-asia,3018">physical health.</a>”Endocrinology and the study of hormones used to concern only the well-to-do. Public health in Nepal was all about preventing infectious diseases which afflicted the poor. Today, the lines are blurred, and Nepal needs treatment for chronic diseases of the vital organs like the lungs, heart, kidney and stomach for all sections of society.Says Jyoti Bhattarai: “The field of endocrinology in Nepal needs much more commitment and investment. While hormonal dysfunctions including thyroid disorders are often not immediately fatal, they can significantly affect one’s quality of life.” Read more: <a href="https://www.nepalitimes.com/latest/why-do-so-many-nepalis-have-high-blood-pressure/">Why do so many Nepalis have high blood pressure?</a> Sonia Awale

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Either too little, or too much iodine

<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108151120/636a664f9c7e80680e059974jpeg.jpg" alt="" width="1200" height="793"/>Around the world, in rich countries and poor, financing healthcare is one of the biggest challenges. In poor countries, it becomes a life-or-death issue.Over 40% of global healthcare expenses are still covered by patients and their families, and more than half the world’s population lacks access to essential health services. Medical bills push 100 million people into extreme poverty every year.Nepal has taken remarkable strides in healthcare in past decades despite internal conflict and instability, but <a href="https://archive.nepalitimes.com/article/nation/national-health-insurance-not-as-easy,4028" target="_blank" rel="noopener">medical care is still unaffordable</a> or inaccessible to most. More than half the healthcare expenditure of Nepalis is still covered out of pocket. Nearly a third of families spend over 10% of their annual income on medical care.Read also: <a style="background-color: #ffffff; font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/banner/this-is-how-to-upgrade-nepals-rural-health/" target="_blank" rel="noopener">This is how to upgrade Nepal's rural health</a>, Sewa Bhattarai <a style="background-color: #ffffff; font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/banner/state-of-the-art-rural-hospital/" target="_blank" rel="noopener">State of the art rural hospital</a>, Marty LoganThursday, 12 December, is Universal Health Coverage Day, an important date to remind ourselves of the next steps we need to take to achieve healthcare for all. The 2015 constitution of Nepal declares basic and emergency healthcare as fundamental rights of citizens, putting the responsibility of financing such care on the state. Following federalism, municipal governments have got the responsibility to manage basic and essential care. A national health insurance bill has been passed and is being implemented.The state guarantees quality healthcare without financial burden on citizens, for which the insurees pay Rs3,500 per year for a family of five, and receive care worth Rs100,000. This is expected to reduce the burden of out of pocket and catastrophic expenses, while the government covers the premium for citizens under the poverty line.Read also: <a href="https://archive.nepalitimes.com/article/nation/national-health-insurance-not-as-easy,4028" target="_blank" rel="noopener">A national health insurance scheme is not as easy as it looks</a>, Sonia Awale<a style="background-color: #ffffff; font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/editorial/poor-health/" target="_blank" rel="noopener">Poor health</a>, EditorialThere is also a provision for free essential drugs and free treatment for patients with cardiovascular disease, cancer, spinal injuries, renal ailments and sickle cell anaemia, through the Disadvantaged Citizens Medical Treatment Fund.None of these initiatives is being implemented fully yet, but with federalism Nepal has a chance to build an accountable and sustainable healthcare system. The country therefore needs to focus on the following areas to manage health financing to meet the targets of the Sustainable Development Goals:<ul><li>Increase public sector healthcare investment to at least 7% of annual national budget. This should also be targeted towards reducing external aid.</li> 	<li>Empower people for self-care and make treatment more strategic and efficient as the burden shifts from communicable to non-communicable diseases.</li> 	<li>Focus on primary health care and improve services at the first point of care with comprehensive, accessible and community based care.</li> 	<li>Coordinate multisectoral policy action involving education, agriculture and social behaviour.</li> 	<li>Launch a priority national campaign to spread insurance coverage. Enrollment can be top-down starting with all government officials and then the public at large.</li></ul>A mixed financing model using tax-based funds through the treasury, and premium-based funds through health insurance can work for public, private, community, and other hospitals that run under the state-non-state partnership. An example of state- non-partnership is Bayalpata Hospital in Achham district, managed through a public-private partnership between the ministry of health and population and the non-profit Nyaya Health Nepal, where insurance reimbursement covered over 60% of the hospital’s operating costs.The hospital provides healthcare with no user fees. The care is extended from hospital to communities using a network of community health workers. How can care delivery with no user fee sustain? Can Nepal afford to provide such care to its entire population?It is possible. The country should effectively implement the national health insurance program, and strategically invest tax based funding. In the mixed financing model, for a ‘district level hospital, insurance can cover 60% of healthcare operating costs, and tax-based funding can take care of the rest. But to ensure effectiveness, the tax-based investment will need to be unrestricted and tied to audited performance indicators. The cost of care should also incorporate the extension of hospital-based services into communities in the catchment area.Bayalpata Hospital serves both as a primary care facility and also as a referral hospital. In this case, the tax-based contribution can be split into the three government tiers, with the federal government providing support for infrastructure, and provincial and local governments covering the cost of basic healthcare, and referral care not covered by the insurance.Insurance reimbursement then covers the cost of insurance-covered care, the local government allocates funds required for basic and emergency healthcare, and the provincial government pays for managing the cost of referrals beyond insurance coverage.<a style="background-color: #ffffff; font-size: 15px; letter-spacing: 0.01em;" href="https://archive.nepalitimes.com/article/nation/Nation-Crowdfund-globally-act-locally,490" target="_blank" rel="noopener">Bayalpata Hospital</a> provides basic and referral care, and its tax-based contribution can be split into the three government tiers, with the federal government providing support for basic infrastructure and provincial and local governments covering the cost of basic and referral care not covered by the insurance.Insurance reimbursement then covers the cost of insurance-covered care, the local government allocates funds required for basic and emergency healthcare, and the provincial government pays for managing the cost of referrals beyond insurance coverage.The proposed model has a 60:25:15 ratio to pay for health care, with 60% from insurance and provincial and local governments paying 25% and 15% of the cost. When the benefit package increases to cover the cost of healthcare without capitation, the share of health insurance coverage percentage will increase significantly, thereby reducing the tax-based direct public sector investment.S P Kalaunee is Executive Director of Nyaya Health Nepal, which manages Bayalpata and other public hospitals in partnership with the ministry of health and population.

Is free health care possible in Nepal?

At 6 feet and one inch, Hira Bahadur Ghalan was exceptionally tall for a Nepali. In 1936, when people came to his Tamang village near Tistung looking for porters, they recruited him on the spot. This was no ordinary job, Hira Bahadur would lead gangs of 30 or more porters to carry cars bought by Rana rulers from Bhimphedi to Kathmandu.&nbsp; Those were the days when the only motorable roads in Nepal were in Kathmandu, but the capital was not connected to anywhere else by road. So, before cars could carry people, people had to carry cars. More Nepalis had carried cars than ridden in one. The porters were paid Rs5 for the job, and sometimes the Rana owners gave Hira Bahadur a Rs25 baksheesh. One of the cars his community helped carry was a 1939 Daimler Benz gifted by Adolf Hitler to King Tribhuvan to woo Nepal away from the British. The rusted dusty vehicle is now in the Narayanhiti Palace Museum.&nbsp; Hira Bahadur hauled cars for 25 years until his knees gave way, he died at age 90 eight years ago — the last surviving car porters of Nepal from Chitlang Valley.&nbsp; Hira Bahadur Ghalan had three sons and three daughters, one of them is Maila Kaji Lama, who at age 68, is a chauffeur in Kathmandu. His son, Manjil Lama is a pilot with Summit Air, flying to remote Himalayan airstrips. Three generations of one family worked in professions that followed a century of transportation history in Nepal. &nbsp; After the <a href="https://nepalitimes.com/multimedia/the-long-and-winding-road-to-india">Tribhuvan Rajpath was finished in 1957</a> and the ropeway upgraded, Hira Bahadur was out of a job. He tilled the family farm, watching trucks and buses headed to and from Kathmandu on the hairpins.&nbsp; As a child, Maila Kaji was fascinated by cars and wished one day to be able to drive one. After he failed Grade 8, he came to Kathmandu in 1975 and got a Rs20/month job at a petrol station in Maiti Devi. “I watched King Birendra’s coronation and was impressed by the glamour of Kathmandu, and decided to stay here,” Maila Kaji says.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2026041816040_a1a41e47dec8500727702f700e43af625f059043cbcd283f13b247344b3a20aa.png" data-media-id="editor_1" data-image-id="2026041816040_a1a41e47dec8500727702f700e43af625f059043cbcd283f13b247344b3a20aa" data-rendition-name="original" width="1974" height="1608" loading="lazy" alt="car carriers"> <figcaption>Maila Kaji</figcaption> </figure>  Former minister Ramesh Nath Pandey used to bring his Volkswagen Beetle to the station, and Maila Kaji started taking care of his car. Later, he drove a Russian Jeep for former minister and geographer Harka Gurung. Along the way, he fell in love with the daughter of a Brahmin colleague, and married her. “My father back in Tistung did not approve of our inter-ethnic marriage, and not speak to me for five years,” Maila Kaji recalls. Manjil Lama grew up in Kathmandu, and did well in science in school. He had wanted to go the US to become a pilot like his friends, but was denied a visa.&nbsp; “The visa officer told him I did not earn enough,” says Maila Kaji, “so I sold some property and sent Manjil to flying school in the Philippines.”  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2026041816040_e9091162840baa6d182de2d7cc6f09e43ec9cfd9a9b6e71e7e7b14bc72da3537.png" data-media-id="editor_2" data-image-id="2026041816040_e9091162840baa6d182de2d7cc6f09e43ec9cfd9a9b6e71e7e7b14bc72da3537" data-rendition-name="original" width="1434" height="1754" loading="lazy" alt="car carriers"> <figcaption>Manjil Lama</figcaption> </figure>  After returning to Nepal, Manjil Lama now flies Let 410s of Summit Air to difficult air strips like Lukla and Simkot, and has logged over 2,000 hours. He has to go to the Czech Republic regularly for simulator training. Says Maila Kaji Lama: “My father worked hard carrying cars to raise us, I started from scratch to become a driver to support my family, and my son is now a pilot with experience in flying in the world’s toughest terrain.” &nbsp; Watch <a href="https://www.youtube.com/watch?v=lvT3iTi8yw4" target="_blank">video clip from S Dillon Ripley here</a>.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260419020448_40f8b1bdaace08106ca5c24819b6e7a34fb2109a9a3ec5c6ac179b3309e686ed.png" data-media-id="editor_4" data-image-id="20260419020448_40f8b1bdaace08106ca5c24819b6e7a34fb2109a9a3ec5c6ac179b3309e686ed" data-rendition-name="original" width="900" height="1582" loading="lazy" alt="car carriers"> </figure>

Grandfather carried cars, son drives cars, grandson flies planes

Nepalis are insured but not covered

Only 70 years ago, Kathmandu was the isolated capital of a country that had no modern surface transport link with the rest of the world.&nbsp; The idea of building a road to connect Nepal with India actually first came up during the last years of the Rana regime, after the British had left India. Construction actually began in 1952, and the serpentine route took five years to complete.&nbsp; Named Tribhuvan Rajpath, after the reigning king who initiated it, the alignment was from Thankot (1,301 m) at the western edge of the Kathmandu Valley to Nagdunga, Naubise, Tistung, Palung, Daman, Sim Bhanjyang (2,504m), Lamidanda, and Bhainse.&nbsp; At Bhainse, the highway joined the existing road to Bhimphedi and it was another 31km to Hetauda and Amlekhganj. There was a railway line between Amlekhganj and Birganj.&nbsp; After regular bus and truck service from Raxaul to Kathmandu began in 1961, the entire road popularly became known as the Tribhuvan Rajpath.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2026041610044_a11b48a75c7877a0f68634f8be07d26a3f354e78ebd9adddc7d17252fddf1d1b.jpg" data-media-id="editor_0" data-image-id="2026041610044_a11b48a75c7877a0f68634f8be07d26a3f354e78ebd9adddc7d17252fddf1d1b" data-rendition-name="original" width="4608" height="3072" loading="lazy" alt="Highways NT"> <figcaption>The village of Chitlang on the main route to Kathmandu before the Rajpath was built. In the distance is the Chandragiri ridge above Thankot. Photo: DAN EDWARDS</figcaption> </figure>  <h2>Chronology&nbsp;</h2> (Based on US State Department cables and media reports) November 1945: Gen Bahadur SJB Rana asked an American official if a road could be constructed from the Indian border to Kathmandu. Nepal wanted such a road built across the mountains after first constructing an East-West artery road in the Tarai, and the government was interested in purchasing US surplus war equipment. Gen Rana inquired if there were US firms who could conduct a survey. April 1947: The Nepal government told a US official it was important to upgrade the 20-mile trail from Bhimphedi over the mountains to the Kathmandu Valley into an all-weather road and sought an estimate from the US for doing so. May 1948: Bijaya SJB Rana informed a US official that a survey for a one-lane motor road between Kathmandu and the Tarai had been completed. The road was to follow the Bagmati River to Makwanpur, then connect at Bhimphedi with the road to Amlekhgunj. The road from Tripureswor to Bhainse along the Bagmati River and via Bhimphedi would have been about 60km. (The distance from Kathmandu on the Tribhuvan Rajpath is 122 km.)  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2026041610044_bb531baf5d73e00d2032814ac8abb86979a87d781abc066fcb984997aad930e6.jpg" data-media-id="editor_1" data-image-id="2026041610044_bb531baf5d73e00d2032814ac8abb86979a87d781abc066fcb984997aad930e6" data-rendition-name="original" width="4608" height="3072" loading="lazy" alt="Highways NT"> <figcaption>The road climbing the hills toward its destination of Kathmandu. Photo: DAN EDWARDS</figcaption> </figure>  July 1948: The government decided to go ahead and build a motorable road from Amlekhganj to Thankot and complete it in two years. December 1948: Construction of the motor road from Kathmandu to Amlekhgunj via the Bagmati River corridor was started. April 1949: Gen Singha SJB Rana told a US official that the motor road from Kathmandu to the Tarai and the Indo-Nepal border would be completed by the spring of 1950. February 1950: Nepal sanctioned Rs300,000 to make the 6-foot-wide road from Kathmandu along the Bagmati River to Hetauda. Of this, Rs100,000 was allocated for road-building material and machinery. Subsequently, the road would be developed into a broader motorable road at a cost of Rs7.5 million. February 1952: Nepal’s budget speech noted that a plan was underway for a road between Bhainse and Kathmandu. PM Matrika Prasad Koirala laid a foundation stone near Teku for construction of the ‘Kathmandu Hetauda Roadway’.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2026041610044_e66d3b81848ec19da48be8b41cacfa8b8e2bad093719b39eda27755c9616ea9a.jpg" data-media-id="editor_2" data-image-id="2026041610044_e66d3b81848ec19da48be8b41cacfa8b8e2bad093719b39eda27755c9616ea9a" data-rendition-name="original" width="4608" height="3072" loading="lazy" alt="Highways NT"> <figcaption>Rajpath winding its way north of Bhainse. Photo: DAN EDWARDS</figcaption> </figure>  February 1952: A party of Indian engineers came to Nepal to determine the best route for a road from Raxaul to Kathmandu. March 1952: Prime Minister Jawaharlal Nehru told Parliament: “So far as India’s security is concerned, we consider the Himalayan mountains as our border.” Ministry of External Affairs official (S.N. Hakar) told a US official that the Indian government was willing to proceed with constructing the Raxaul-Kathmandu road and had sent a survey party to determine the most suitable mountain route. May 1952: Swiss experts had made surveys for a proposed new road between Bhimphedi and Thankot. Nepal government requested financial help to build the road, and India was considering the project.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2026041610044_35e390c1a4812f45af7892d681230e04c63727d9006b6614ed79aaa7c22c1ece.jpg" data-media-id="editor_3" data-image-id="2026041610044_35e390c1a4812f45af7892d681230e04c63727d9006b6614ed79aaa7c22c1ece" data-rendition-name="original" width="4608" height="3072" loading="lazy" alt="Highways NT"> <figcaption>With a constant stream of trucks, buses and jeeps, the narrow Rajpath once was Nepal's busiest highway. Photo: DAN EDWARDS</figcaption> </figure>  Summer 1952: Work on a new road was at a standstill, so Nepal asked India for assistance. Indian engineers surveyed two routes: one following the Bagmati River, the other road through Daman that was later adopted. July 1952: Nepal’s Ministry of Planning decided to construct a road between Kathmandu and Raxaul, awaiting Cabinet approval soon. Prime Minister Matrika Koirala said the proposed road was longer than necessary, but it was a better route ‘for strategic reasons’, because it did not require many bridges. August 1952: King Tribhuvan said road construction from Kathmandu to Bhimphedi would “begin soon”. September 1952: An Indian Military Team began construction of the Kathmandu-Bhainse road without a formal agreement being signed with the Nepal government.&nbsp; February 1953: The Indian Ambassador said the road would be hard surfaced within a year. September 1953: Prime Minister Matrika Koirala inspected the completion of a ‘jeepable track’. December 1953: The road was named ‘Tribhuvan Rajpath’. April 1954: Reports circulated that Swiss engineers criticised the alignment, arguing it would have been easier, faster, and cheaper to build over the existing foot trail between Bhimphedi and Thankot through Kulekhani. July 1954: Heavy monsoon rain damaged much of the roadway that had been built.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2026041610044_b5b2a1833f1366e532f1629f47c124d877df7b6f8a34b6c83f6c21ec3e4415dd.jpg" data-media-id="editor_4" data-image-id="2026041610044_b5b2a1833f1366e532f1629f47c124d877df7b6f8a34b6c83f6c21ec3e4415dd" data-rendition-name="original" width="855" height="1123" loading="lazy" alt="Highways NT"> <figcaption>Crown Prince Mahendra inspecting construction progress on the Tribhuvan Rajpath in October 1954. Photo: ROYAL PALACE</figcaption> </figure>  November 1954: The Indian ambassador said flood damage was so great that the road would be delayed by two years. May 1955: Twenty military trucks brought rice from Amlekhganj to Kathmandu on the Tribhuvan Rajpath. King Tribhuvan died in Zurich. December 1956: A gravel road was completed, with trucks and buses plying between Amlekhganj and Kathmandu. December 1956: Nepal government abolished regulations that required Nepali nationals to carry permits for travel within Nepal, except for women below the age of 45. 1957: Reduction in price of goods carried to Kathmandu by truck: Sugar, Rs0.13 per kg. Wheat flour Rs0.13 per kg. Kerosene Rs0.25 per litre. February 1957: An article in The Motherland newspaper in Kathmandu noted urgent action was needed to avoid Kathmandu being cut off from the Tarai during the monsoon. The correspondent wrote, ‘In a recent journey from Amlekhganj I found that almost all the bridges are in a very bad state…Now, because of the dry rivers the scores of vehicles that ply the road cross the rivers on the water level. But during monsoons… these rivers will be impossible to cross without bridges. On the road itself, landslides and big holes have made the journey a great undertaking.” April 1957: The first regular passenger bus left Amlekhganj at 12:30PM and arrived in Kathmandu completing a journey of 14 hours.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2026041610044_60807e067f2d0b80bdc5e59860e9bc240b495ef606efc9301ef54ea5731d42df.jpg" data-media-id="editor_5" data-image-id="2026041610044_60807e067f2d0b80bdc5e59860e9bc240b495ef606efc9301ef54ea5731d42df" data-rendition-name="original" width="5211" height="4000" loading="lazy" alt="Highways NT"> <figcaption>Daman, one of the highest points on the Rajpath, often saw snow in winter. Photo: DAN EDWARDS</figcaption> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2026041610044_baac4747267c751ab7b0e5ef24697fb5001c4c55e04a82d92c89282bd01a325c.jpg" data-media-id="editor_6" data-image-id="2026041610044_baac4747267c751ab7b0e5ef24697fb5001c4c55e04a82d92c89282bd01a325c" data-rendition-name="original" width="648" height="960" loading="lazy" alt="Highways NT"> <figcaption>Travelers could view the Himalayas from a view tower at Daman. Photo: DAN EDWARDS</figcaption> </figure>  June 1957: Eight thousand Nepali workers and about 500 Indian Army personnel were at work on the road.&nbsp; 30 June 1957: India officially handed the road over to Nepal. India had spent INR32.5 million on the project.&nbsp; January 1958: The road from Amlekhganj to Bhainse was upgraded. July 1961: The gravel road from Raxaul to Birganj was blacktopped. Trucks began transporting goods from Raxaul directly to Kathmandu, avoiding the need for transshipment from train to truck in Amlekhganj, or use the ropeway from Bhimphedi. 1961: Passengers could travel from Raxaul to Kathmandu in a day, whereas it took a week by train to Amlekhganj, bus to Bhimphedi and then on foot. September 1962: Nepal’s 3-Year Plan aimed at broadening and black-topping the road between Bhainse and Raxaul, bypassing the Chure tunnel, and constructing several bridges along the route. 1963: Travelers going to Kathmandu by land: Road, 158,000, Nepal Government Railway, 66,500. Railway passenger service ended in June 1965.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2026041610044_2a95eb144dad74271a0fa3a27fab6b45bbab0a1c4be59d21120ad14c08e258fd.jpg" data-media-id="editor_7" data-image-id="2026041610044_2a95eb144dad74271a0fa3a27fab6b45bbab0a1c4be59d21120ad14c08e258fd" data-rendition-name="original" width="2048" height="1344" loading="lazy" alt="Highways NT"> <figcaption>A bus providing ‘deluxe service’ in 1963 is ready to leave Amlekhganj for Kathmandu. Note the railway tracks of the Nepal Government Railway. Photo: RON ELLIOTT</figcaption> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2026041610044_d02013692e84d6add7a6e0ce66c2b552cd53bb084db2aa8df0593bbcf84c2c04.jpg" data-media-id="editor_8" data-image-id="2026041610044_d02013692e84d6add7a6e0ce66c2b552cd53bb084db2aa8df0593bbcf84c2c04" data-rendition-name="original" width="2048" height="1352" loading="lazy" alt="Highways NT"> <figcaption>Vehicles found it difficult to pass on many parts of the Rajpath in 1963. Photo: RON ELLIOTT</figcaption> </figure>  1965: Tribhuvan Highway was considered a useful addition to Nepal’s economic infrastructure, but it could not act as a prime mover in the nation’s economic development. It did play a major role in the 1960s in transporting material and equipment needed to implement development projects in the Kathmandu Valley. September 1966: Nepal took over maintenance of the Tribhuvan Rajpath from the Indian Aid Mission.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2026041610044_5488ba1e92f6395ff882392ccbaef2270622632682eccb412d8de7b128f6f397.jpg" data-media-id="editor_9" data-image-id="2026041610044_5488ba1e92f6395ff882392ccbaef2270622632682eccb412d8de7b128f6f397" data-rendition-name="original" width="1764" height="1184" loading="lazy" alt="Highways NT"> <figcaption>Trees still lined the Rajpath near Thankot in 1967. Photo: DAN EDWARDS</figcaption> </figure>  1971: A UN-Nepal study said the best alignment for an alternative road was from Kathmandu, Pharping, Kulekhani, Bhimphedi to Bhainse. 1975: Nepal's Department of Roads’ engineer concluded: ‘The Tribhuvan Rajpath has been built without design speed consideration… The pavement was not constructed to any designed standard… irrespective of quality of material, and later the road was black topped without consideration of traffic intensity and load-bearing capacity of sub-base… utilisation of low-quality material in the Bhainse-Thankot section… Quality control was neither maintained in Bhainse-Thankot nor the Bhainse-Raxaul section. Local materials were used irrespective of their quality to complete the work in the earliest possible time and in the cheapest possible manner. Brick work was done in negligible quantity. Cement used was ordinary portland cement…’ &nbsp;&nbsp;&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2026041610044_26c74f45991efb3dc29d616e8acafb3163661ae6573c5314538e59c54d5ca0a5.jpg" data-media-id="editor_10" data-image-id="2026041610044_26c74f45991efb3dc29d616e8acafb3163661ae6573c5314538e59c54d5ca0a5" data-rendition-name="original" width="2368" height="1365" loading="lazy" alt="Highways NT"> <figcaption>Bhainse in 2017. The road divided here, one going to Bhimphedi on the right, the main road proceeding to Kathmandu on the left. Photo: DAN EDWARDS</figcaption> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260416100416_4d9321abf4d912796842fe963a493501e1aceff462300ecdd9bd5e0b8ba7f294.jpg" data-media-id="editor_11" data-image-id="20260416100416_4d9321abf4d912796842fe963a493501e1aceff462300ecdd9bd5e0b8ba7f294" data-rendition-name="original" width="649" height="1667" loading="lazy" alt="Highway info NT"> </figure>  Even 70 years after it was built, there is still speculation about India's security concerns vis-a-vis China, and how Indian Army engineers purposely made the road longer than it needed to be over the 2,500 Sim Bhanjyang pass instead of following the river route.&nbsp; There is also some evidence that although the Rana regime had first requested the US for help with the highway, Nehru did not want the Americans involved in Nepal. Which is why the Tribhuvan Highway became an Indian military project.&nbsp; There was similar concern from India about the Kodari Highway linking Kathmandu to China, and King Mahednra is famously supposed to have said: "Communism will not come here in a taxi."&nbsp; Geopolitics still affects Nepal's strategic highways. After decades, links to China are still rough and often blocked. Kathmandu-Tarai Fast Track is delayed by years, and not expected to be completed during this decade. Trucks and buses still bypass the Tribuvan Highway with a 200km detour via Mugling because the other alternative routes like the Tika Bhairav or Chhaimale routes are not suitable for heavy vehicles.&nbsp; The shortcut through Chitlang that the Swiss proposed in the 1950s is still too difficult. And a 25km section of the Japanese-built BP Highway to the eastern Tarai has been knocked out by the 202 flood. Dan Edwards was a Peace Corps volunteer in 1966 and is the author of several books on Nepal. This is the fourth instalment in a new limited series in Nepali Times on the historic transportation infrastructures of Nepal.

The long and winding road to India

The series Nepal Made profiles Nepali products and the people who make them possible. Named after the mythical bird-like creature, GarudX is Nepal’s first precision manufacturer of UAV platforms. They offer a wide range of drone products and services. Last month, GarudX won first place at the US-Nepal Startup Weekend Challenge, a three-day accelerator-style program that gathered 25 of Nepal’s most promising early-stage companies. These include custom drones, cinematography, virtual tours, first-person-view (FPV), drone racing, 3D reconstruction, ground control software, and drone light shows. “I think they liked that we pitched the company as a Drone Enterprise System, as a company providing large-scale, integrated drone services,” says Dipawoli Malla, an AI software engineer with GarudX. The company sees a lot of potential in AI-based aerial computer vision, which is already used for infrastructure planning and land surveys, and could be vital in tracking wildlife poachers and assisting search and rescue during disasters. “Our vision for the company has always been to be the one stop solution for every drone problem,” says GarudX CEO Avash Thapa, who also oversees video production. Drones have gained high profile in the past five years due to their widespread adoption in war. While they do work with the Nepali army, GarudX wants to focus on the idea of drone for good. For Nepal, the potential is great for civilian applications especially because of the country’s terrain. Past efforts have been experimental, like a project to deliver tuberculosis treatment in Piuthan in 2019, and for wildlife censuses in Chitwan. Journalists now regularly use drone footage to get a bird’s-eye view for investigative stories on illegal sand-mining or delays in infrastructure projects. Drones were vital during the GenZ protests last September, in which aerial videos provided clues about what actually happened when the crowd surged towards Parliament. They also captured the dramatic aftermath of the destruction of government buildings featured in this paper. “A lot of people do not know or appreciate that drones are also made in Nepal,” notes Malla. “We export a lot of technology as software. It is a big achievement that we can also export hardware.” GarudX was informally started and active on social media since 2018, and officially registered as GarudX Multipurpose in 2024. Founder and Managing Director Adarsha Raj Bhusal had experience working with robotics and FPV drones when he launched the company, as an engineering group interested in custom-built high-performance aerial robotics. “I design our products,” says Bhusal. “We send designs to China where they are manufactured as individual parts. Costs are low when importing from China. Then we assemble and sell them here. It's a system that works well for us.” Among the UAVs GarudX makes include the Skyreaper, which is a long-range drone with advanced obstacle sensing; the GX8 Pyro which is Nepal’s first cinema-grade cinelifter; and the Aether Zoom which is a 4K UAV camera designed for tactical, industrial, or reconnaissance missions.  <figure><img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260417150440_d9f36b32e0b4d65dedded3e705aa7bf8769fd72417fc53669e77ce7a32f8ccd1.webp" data-media-id="editor_0" data-image-id="20260417150440_d9f36b32e0b4d65dedded3e705aa7bf8769fd72417fc53669e77ce7a32f8ccd1" data-rendition-name="original" width="960" height="1280" loading="lazy" alt="garudx"></figure>  NO CERTIFICATION The main obstacle to GarudX's growth has been the lack of a national certification system. Permits to use drones are convoluted and require applications to various government agencies. “We miss out on so many international projects, for national park footage for example, since there is no way to get our drones registered — even after the army thoroughly checks our craft,” says Adarsha Raj Bhusal. GarudX says it now has the capacity to export its drones overseas at competitive prices, but Nepal does not have a registration system in place. “We can’t legally ship them,” says Avaya Pokharel, Chief Operating Officer who oversees service and repairs. With a new RSP government in place with an ambitious blueprint for digitisation, things could soon change. Relevant bodies are the Home Ministry, the Civil Aviation Authority and the Ministry of Defence because of privacy, aviation safety and national security issues. “There are meetings going on, and there is hope that progress will be made. Of course we want certification to be easy, but it is hard for the government as they have to understand the technology and what is coming in future,” says Bhusal. Legislation could look like a Remote ID system to register every drone. It could also specify pilot verification, placing limitations on what a pilot can do based on their skill level. It could also look at revising drone policies in the capital. Most of Kathmandu Valley is technically a no-fly zone for drones at present because of the concentration of government buildings, army bases and the international airport flight path. To comply with current regulations, GarudX has focused on lightweight FPV drones: small, nimble craft that can be maneuvered at high speed in tight spaces, operated by a pilot wearing immersive goggles. This results in exciting fast-paced footage, particularly useful for clients like Redbull or vehicle companies. “It feels like you are flying,” testifies Bhusal, who has flown FPV for commercials and movies, and ranks way ahead of runner ups in drone races. His work can be seen @adars_fpv on Instagram. The company has built a community of FPV drone racers, and is working with the government to certify it as a sports competition. It holds race events at colleges in Kathmandu and also consults for FPV events in in India.  <figure><img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260417150440_43b27b1b6890e47028c5e780c2ed0147a057f625d9d551221ddbd504dc03a356.png" data-media-id="editor_1" data-image-id="20260417150440_43b27b1b6890e47028c5e780c2ed0147a057f625d9d551221ddbd504dc03a356" data-rendition-name="original" width="923" height="619" loading="lazy" alt="garudx"></figure>  MULTIPURPOSE Drones can be versatile tools, but they are particularly helpful in Nepal and the Himalaya. Powerful drones have been used for the last two years to transport ropes and ladders up Mt Everest to reduce the dangers on the Khumbu Icefall, and to bring trash down. If scaled with many pilots and drones, this could be a complete solution to the Everest trash problem while massively reducing risk to human lives. GarudX has also tested its products in the mountains. A recent blog entry on their website is titled, ‘Flying at 6,120m: What We Learned Testing Drones on Lobuche Peak’. They document the process of using different battery tricks and propellers to see what combination allows for more flight time in the thin, cold air. It is refreshing to see a Nepali company making such progress in a unique industry while also documenting advances.