Orthopedic surgeon Anil Shrestha’s journey to medicine was laid down well before he was born. His father, noted industrialist Juddha Bahadur Shrestha, had aspired to become a doctor but was turned away from a medical school in India.&nbsp; "It became his mission that one of us, his sons, nephews, or nieces, would don that white coat," recalls Shrestha. That dream fell upon him, the youngest son, and he enrolled at Calcutta Medical College.&nbsp; Freshly graduated he returned to Nepal, where he hoped for a comfortable post at a hospital in Kathmandu. Instead, he was assigned to Jumla, a district which was even remoter and underserved than it is now. But that journey 40 years ago would prove transformative.&nbsp; "It was an eye-opener. I had no idea what rural Nepal was really like. When I reached Jumla, I asked myself why do we become doctors? It is because we have to make a difference," he recalls.&nbsp; The moment that would forever shape his approach to medicine happened at a government-run medical camp. An injured man had travelled from a remote village all the way to Kathmandu for surgery, selling his land to pay for it. He needed to remove his implants but faced a grim reality of having to sell more of his land to afford the procedure.&nbsp; "I thought to myself that we treat the x-rays, but we don’t treat the patients," &nbsp;Shrestha told us in an interview. &nbsp;"What good is a perfectly functioning hand if this man could no longer have a land to plough?" The encounter made the physician realise that healthcare in Nepal should look beyond symptoms and &nbsp;diagnoses, and consider the socio-economic realities of patients. He made it his mission to provide care that didn’t just fix bodies but addressed the underlying factors affecting people’s lives.&nbsp; He co-founded the <a href="https://noh.com.np">Nepal Orthopaedic Hospital</a> in 1998 to provide high-quality surgery at affordable prices. But when he arrived at the site near Gokarna, it was anything but promising.&nbsp; Read also:<a href="https://nepalitimes.com/here-now/nepali-surgeon-with-a-vision-for-the-world"> Nepali surgeon with a vision for the world</a>, Kunda Dixit  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2024101613108_1a9d74aa1c1b550ff9db42dd8092f214de353ffbb2eb48549db110201424cafd.jpg" data-media-id="editor_2" data-image-id="2024101613108_1a9d74aa1c1b550ff9db42dd8092f214de353ffbb2eb48549db110201424cafd" data-rendition-name="original" width="813" height="520" loading="lazy" alt="Nepal Orthopaedic Hospital"> <figcaption>Photo courtesy: NEPAL ORTHOPAEDIC HOSPITAL</figcaption> </figure>  "It was just two blocks of a one-story building," he recalls. "They said: Here’s the hospital. Run it. But buildings don’t make hospitals. You need doctors, you need equipment, you need patients."&nbsp; With a bold plan and support of friends and international donors, Shrestha started with 15 beds, providing care to anyone in need, regardless of their ability to pay. Initially, 93% of their operating expenses were covered by international donors but in less than 10 years, it had reversed the figures so that most of the cost was covered by internal resources. The hospital is self-sufficient today and does not turn away any patient that cannot afford the cost. Over the past 25 years, it has given more than $1 million in charity care.&nbsp; But Shrestha’s job was far from over. Realising the chronic lack of proper spinal care in Nepal, he got involved with the <a href="https://sisn.org.np/sirc/">Spinal Injury Rehabilitation Center in Sanga</a> in 2001, offering holistic treatment to paraplegic and quadriplegic patients. It was a leap of faith-started with a few friends, a handful of nurses, and no specialised doctors.&nbsp; "We just knew the need. People, especially women were falling off trees and cliffs, injuring their backs," Shrestha says, “They needed rehabilitation and physiotherapy, and we thought, why wait? You start small, and if you’re doing well, others will help you."&nbsp; Shrestha had long believed that healthcare in Nepal needed to reach the farthest corner, and after working with Nick Simons Institute (NSI) he realised that <a href="https://nepalitimes.com/news/jim-simon-s-gift-to-nepal">partnering with government hospitals</a> can better strengthen the overall health system. Shrestha’s journey took another turn when he was asked to join the board of OneHeart Worldwide, whose mission, to reduce maternal and neonatal mortality in Nepal’s most underserved areas, deeply resonated with him.&nbsp; Read also: <a href="https://nepalitimes.com/here-now/nepal-s-flying-doctor">Nepal's flying doctor</a>, Kunda Dixit  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241016131020_15d6c1483ea69455b998ba6fd6ecc0ac5eafe3af6effc2214f48f148bee0b540.jpg" data-media-id="editor_6" data-image-id="20241016131020_15d6c1483ea69455b998ba6fd6ecc0ac5eafe3af6effc2214f48f148bee0b540" data-rendition-name="original" width="2048" height="1365" loading="lazy" alt="Spinal Injury Rehabilitation Center"> <figcaption>A caretaker with a patient at the Spinal Injury Rehabilitation Center.</figcaption> </figure>  Shrestha’s approach to leadership is as grounded as his approach to medicine, it was never about control but rather always about enabler-ship. He explains: "Humility is key, and treating staff equally fosters a sense of unity and trust that is essential in difficult times.”&nbsp; He recalls a time at the Orthopaedic Hospital when funds were so tight that salaries could not be paid. The trust was so great that staff worked without pay for three months.&nbsp; Shrestha has a vision to open centres for spinal rehabilitation across all seven provinces of Nepal to provide specialised care – since the number of spinally injured patients rises dramatically because of highway accidents. He wants a health system where each district's hospital is properly equipped and functional, thereby discouraging referral of critical patients to Kathmandu over long and bumpy roads. &nbsp; His message to the next generation of Nepali doctors and social entrepreneurs: "You don't have to wait until everything is perfect to get started. All you need is an idea, and if you see a need, jump into it. Start small and you will always have people to help if you’re passionate and clear about your goals."&nbsp; Shrestha avoids the limelight, and had to be convinced to agree to this profile interview. He says, "When you build an institution, don’t think it’s yours. It belongs to everyone who helped along the way." Read also: <a href="https://nepalitimes.com/here-now/the-barefoot-doctor-of-rolpa">The barefoot doctor of Rolpa</a>, Pinki Sris Rana

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Doctor who does not just treat symptoms

<figure><img width="957" height="638" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109111152/636b866b9c7e80680e067852jpeg.jpg" alt=""/><figcaption>Photo: BIKRAM RAI</figcaption></figure>On 20 May, the Health Ministry released a condolence message for doctors including Ishwor Lal Acharya, Mukesh Chaudhary and Pujya Shree Karki who lost their lives to Covid-19.Nepal doesn't yet have an exact figure on the total number of <a href="https://www.nepalitimes.com/here-now/protecting-those-who-protect-us-from-the-epidemic/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/here-now/protecting-those-who-protect-us-from-the-epidemic/&amp;source=gmail&amp;ust=1622085873678000&amp;usg=AFQjCNE67Zklb3ITwY-EN9ZPs4LRP2MFtQ">medical staff</a> infected by the SARS-CoV-2 but the Nepal Health Research Council (NHRC) is currently conducting a study to find out. “Majority of our frontline health care provides have been fully vaccinated, so even if they are being infected, they are only mild to moderately sick,” says cardiologist and chair of the Nepal Medical Council (NMC) <a href="https://www.facebook.com/bhagawan.koirala" data-saferedirecturl="https://www.google.com/url?q=https://www.facebook.com/bhagawan.koirala&amp;source=gmail&amp;ust=1622085873678000&amp;usg=AFQjCNEOs-qwziT36jBSTwwrTvDCe4MA1A">Bhagawan Koirala.</a> “This combined with a better understanding of Covid-19, they are now more confident and have a better sense of responsibility this time around.”At the National Trauma Centre in Kathmandu, nursing staff Suman Chaudhary is back to work after recovering from the coronavirus herself and draws motivation from health workers who are battling the pandemic in major hotspots like Birganj.“This is our chance to make a real contribution and having been infected myself has given me a new perspective on how patients feel,” says Chaudhary who was pursuing Masters in Nursing at Bir Hospital during the first wave. “It is difficult to work in a PPE all day without water or bathroom breaks. I still feel weak and have shortness of breath, but watching people recover keeps us going.”Both Koirala and Chaudhary, however, agree that there is a <a href="https://www.nepalitimes.com/here-now/nepals-frontline-workers-brave-it-out/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/here-now/nepals-frontline-workers-brave-it-out/&amp;source=gmail&amp;ust=1622085873678000&amp;usg=AFQjCNG1eSnzgkQ-VmoauOQrzkj_c0eUzA">chronic shortage of medical staff</a> across the country. Hospitals outside Kathmandu and even Covid dedicated institutions are overstretched, and now doctors and nurses are themselves falling sick. In some hospitals, since patients and staff are all positive, nurses and doctors with mild symptoms have just kept working, since there is no one else to take care of the sick.Last week, more than 47 of Dhading District Hospital’s emergency and ward staff were infected with Covid-19, with many of them in isolation and some requiring ICU treatment even as the facility was finding it difficult to source enough <a href="https://www.nepalitimes.com/latest/why-is-there-still-an-oxygen-shortage/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/latest/why-is-there-still-an-oxygen-shortage/&amp;source=gmail&amp;ust=1622085873678000&amp;usg=AFQjCNGkShQk2X-gpsUuQceFplgqsL0bSg">oxygen for existing patients</a>.“We are a hospital of only 8 doctors, 5 paramedics and 23 nurses and with no backup, we were very close to collapsing,” says Medical Superintendent at Dhading District Hospital Tribhuvan Jha, adding that everyone had to be called back to work after 10 days of isolation. “We are in this position due to a lack of preparedness, shortage of staff and limited infrastructure.”At Charikot Hospital in Dolakha, which is also a Covid-dedicated hospital, the majority of coronavirus patients are critical and there is at least one fatality every day. The 17 nurses work three shifts a day, and are unable to handle patient inflow, so the hospital has brought in community nurses from outlying villages. The hospital is consistently reporting a 45% test positivity rate among those tested.“If a majority of our health workers get infected and are in isolation, we have no Plan B and this is especially worrying because we are the sole care provider for Covid here,” says Binod Dangal of Charikot Hospital. “Medical staff are all  overworked, and they do not have any insurance or allowances.”As dire as the situation is in Nepal’s big cities and district hospitals, the <a href="https://www.nepalitimes.com/editorial/nepals-humanitarian-emergency/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/editorial/nepals-humanitarian-emergency/&amp;source=gmail&amp;ust=1622085873678000&amp;usg=AFQjCNE3z3JV_9xnJ0reDy2ABkI8VuY16A">pandemic has now infiltrated rural Nepal</a> where there is just one doctor for every 15,000 people. Kathmandu’s doctor-to-patient ratio is 1:850.In her village of Phediguth of Okhaldhunga district, <a href="https://www.nepalitimes.com/banner/saving-nepali-mothers-on-mothers-day/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/banner/saving-nepali-mothers-on-mothers-day/&amp;source=gmail&amp;ust=1622085873678000&amp;usg=AFQjCNErggt96LmoW-c38IzduDUsayQwIg">Rita Khatri</a> is the only skilled birth attendant. Despite the growing risk of the second wave, she is still performing deliveries and ante-natal check-ups wearing a mask and her single PPE suit. There are no tests of health workers and the public.“We are working despite fears of transmission, I wish we had more PPEs, masks and gloves so that we could conduct more regular check-ups and make home visits,” adds Khatri. “At the moment many people in the community have high fever and are staying at home, but there is no way to test them.” This time last year while in the grip of the first wave of a new pandemic, there was stigma associated with Covid-19 and people who were infected were ostracised in the community. There were many instances where <a href="https://www.nepalitimes.com/here-now/nepal-health-workers-battle-covid-19-but-also-stigma/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/here-now/nepal-health-workers-battle-covid-19-but-also-stigma/&amp;source=gmail&amp;ust=1622085873678000&amp;usg=AFQjCNECgLl_SyeWRy6kuDEPnEbsSFoCyQ">healthcare providers were mistreated</a>.Doctors and nurses interviewed for this report say that is still the case, but there is also more praise for frontline medical workers risking their own health to save lives. However, there is growing concern about the worry and over-work affecting the mental health of nurses and doctors.“Among other things we need psychological support and counselling. I have seniors who have children infected with the new variant, and they are having a hard time coping,” says Suman Chaudhary, nursing staff at the Trauma Centre in Kathmandu.As most of Nepal enters the fourth week of lockdown, nationwide daily Covid-19 infections, positivity rate as well as fatalities are going down slightly. The number of recoveries have also risen to nearly equal new confirmed cases on some days.Bayalpata Hospital in remote Accham District had to turn its Emergency Room into a Covid-19 ward last month to cope with a flood of patients. It had 33 patients, 18 of them needing high flow oxygen support. On Wednesday, it had only 12 Covid-19 patients with only two on oxygen. Four of those infected are medical staff. “The situation is easing somewhat here, in Mangalsen, Doti and Dadeldhura. There are beds available, and oxygen is coming in. But we are desperately short of medical staff,” says Mandeep Pathak, a physician at Bayalpata which is also caring for trauma and maternity patients from surrounding districts.However, the cases and the test positivity rate <a href="https://www.nepalitimes.com/here-now/its-an-emergency/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/here-now/its-an-emergency/&amp;source=gmail&amp;ust=1622085873678000&amp;usg=AFQjCNHx4NfPYsEDb5xqY31L966E2avOdg">have not gone down as expected</a> and fatalities nationwide have stayed above 160 for nearly two weeks now as the highly contagious and more lethal B.1.617.2 variant spreads rapidly through communities.Health Minister Hridayesh Tripathi sounded optimistic at a virtual press meet on Monday, predicting that there would be a decline in the infection rate in the next four weeks. As Nepal receives large shipments of oxygen cylinders, liquid oxygen, test kits, PPEs and masks, doctors say the emphasis now needs to shift to more testing, mass vaccination, and replenishing exhausted and over-stretched medical staff at hospitals, both in the cities and the districts. A non-profit One Heart Worldwide that works primarily in maternal care in Nepal’s 21 districts has been helping district hospitals by mobilising oxygen cylinders and medical kits it procured from China.<a href="https://www.nepalitimes.com/banner/what-can-be-more-fulfilling-than-saving-lives/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/banner/what-can-be-more-fulfilling-than-saving-lives/&amp;source=gmail&amp;ust=1622085873678000&amp;usg=AFQjCNFzGOK8F0-jy4gwuRmK8iyNBD7AIA">Executive director Surya Bhatta</a> gives three reasons why despite the lockdown the infection rate is still high. “There is virtually no contact tracing, people are still not following health protocols and patients isolating at homes are not doing it right, resulting in a gross underestimation of total cases and fatalities.”		
			<h2>Weddings into hotspots</h2>		
		Gopal Dahal in DhankutaOn 30 April, when a young man in Okhre village in Dhankuta district got married, the whole . The whole community was invited for the feast.But a few days later, the groom suddenly fell sick. When he showed coronavirus symptoms, a test at the primary health care centre confirmed he was <a href="https://www.nepalitimes.com/here-now/its-an-emergency/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/here-now/its-an-emergency/&amp;source=gmail&amp;ust=1622085873678000&amp;usg=AFQjCNHx4NfPYsEDb5xqY31L966E2avOdg">Covid-19</a> positive.Now, every household in Okhre village has members showing similar symptoms. Most of them had attended the wedding. Of the 51 people tested, 25 tested positive. “This is a crisis, the pandemic has spread to the whole village now,” says Ward Chair Palak Basnet.One of the guests at the wedding was a man who had returned recently from the Tarai with mild symptoms. He was hired to wash dishes at the wedding, and had died a few days after the feast. No one tried to find the cause of death, and there was no PCR test done. Dhankuta MP Jitendra Rumdali Rai says there are probably many more cases than the ones who have tested positive so far. “The pandemic is spreading out of control here because the municipality wasn’t able to manage it on time,” he adds.Okhre village has now been sealed off till 8 June. Some of those infected are in critical condition, and six who were more serious were taken to hospital in Dharan. It is difficult for the others because the municipality does not have an ambulance, and some who had taken sick relatives to Dharan returned because there were no beds, or it was too expensive. “Initially they were charging Rs10,000 per day for the bed and we paid Rs4,000 daily for the doctor. But then they hiked it to Rs14,700 and I couldn’t pay it any more,” says one patient’s family who returned recently from Dharan’s Bijayapur Hospital.Another <a href="https://www.nepalitimes.com/latest/rural-nepal-fights-back-covid-19/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/latest/rural-nepal-fights-back-covid-19/&amp;source=gmail&amp;ust=1622085873679000&amp;usg=AFQjCNHu0t7Yl9XzW-TA064jBcggx4L-TA">coronavirus</a> patient says ambulances are also expensive, making it hard to get patients to hospitals. Buses refuse to take passengers who are sick.The municipality called an emergency all-party meeting and decided to set up a 10-bed isolation centre with two staff nurses, and a doctor. Talks are underway to get at least a pickup from Dhankuta Red Cross to use as an ambulance.

Sonia Awale

Protecting those who protect us from Covid

<figure><img width="957" height="638" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110131128/636cee759c7e80680e09ae2fjpeg.jpg" alt=""/><figcaption>Photo: BIKRAM RAI</figcaption></figure>On 20 May, the Health Ministry released a condolence message for doctors including Ishwor Lal Acharya, Mukesh Chaudhary and Pujya Shree Karki who lost their lives to Covid-19.Nepal doesn't yet have an exact figure on the total number of <a href="https://www.nepalitimes.com/here-now/protecting-those-who-protect-us-from-the-epidemic/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/here-now/protecting-those-who-protect-us-from-the-epidemic/&amp;source=gmail&amp;ust=1622085873678000&amp;usg=AFQjCNE67Zklb3ITwY-EN9ZPs4LRP2MFtQ">medical staff</a> infected by the SARS-CoV-2 but the Nepal Health Research Council (NHRC) is currently conducting a study to find out. “Majority of our frontline health care provides have been fully vaccinated, so even if they are being infected, they are only mild to moderately sick,” says cardiologist and chair of the Nepal Medical Council (NMC) <a href="https://www.facebook.com/bhagawan.koirala" data-saferedirecturl="https://www.google.com/url?q=https://www.facebook.com/bhagawan.koirala&amp;source=gmail&amp;ust=1622085873678000&amp;usg=AFQjCNEOs-qwziT36jBSTwwrTvDCe4MA1A">Bhagawan Koirala.</a> “This combined with a better understanding of Covid-19, they are now more confident and have a better sense of responsibility this time around.”At the National Trauma Centre in Kathmandu, nursing staff Suman Chaudhary is back to work after recovering from the coronavirus herself and draws motivation from health workers who are battling the pandemic in major hotspots like Birganj.“This is our chance to make a real contribution and having been infected myself has given me a new perspective on how patients feel,” says Chaudhary who was pursuing Masters in Nursing at Bir Hospital during the first wave. “It is difficult to work in a PPE all day without water or bathroom breaks. I still feel weak and have shortness of breath, but watching people recover keeps us going.”Both Koirala and Chaudhary, however, agree that there is a <a href="https://www.nepalitimes.com/here-now/nepals-frontline-workers-brave-it-out/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/here-now/nepals-frontline-workers-brave-it-out/&amp;source=gmail&amp;ust=1622085873678000&amp;usg=AFQjCNG1eSnzgkQ-VmoauOQrzkj_c0eUzA">chronic shortage of medical staff</a> across the country. Hospitals outside Kathmandu and even Covid dedicated institutions are overstretched, and now doctors and nurses are themselves falling sick. In some hospitals, since patients and staff are all positive, nurses and doctors with mild symptoms have just kept working, since there is no one else to take care of the sick.Last week, more than 47 of Dhading District Hospital’s emergency and ward staff were infected with Covid-19, with many of them in isolation and some requiring ICU treatment even as the facility was finding it difficult to source enough <a href="https://www.nepalitimes.com/latest/why-is-there-still-an-oxygen-shortage/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/latest/why-is-there-still-an-oxygen-shortage/&amp;source=gmail&amp;ust=1622085873678000&amp;usg=AFQjCNGkShQk2X-gpsUuQceFplgqsL0bSg">oxygen for existing patients</a>.“We are a hospital of only 8 doctors, 5 paramedics and 23 nurses and with no backup, we were very close to collapsing,” says Medical Superintendent at Dhading District Hospital Tribhuvan Jha, adding that everyone had to be called back to work after 10 days of isolation. “We are in this position due to a lack of preparedness, shortage of staff and limited infrastructure.”At Charikot Hospital in Dolakha, which is also a Covid-dedicated hospital, the majority of coronavirus patients are critical and there is at least one fatality every day. The 17 nurses work three shifts a day, and are unable to handle patient inflow, so the hospital has brought in community nurses from outlying villages. The hospital is consistently reporting a 45% test positivity rate among those tested.“If a majority of our health workers get infected and are in isolation, we have no Plan B and this is especially worrying because we are the sole care provider for Covid here,” says Binod Dangal of Charikot Hospital. “Medical staff are all  overworked, and they do not have any insurance or allowances.”As dire as the situation is in Nepal’s big cities and district hospitals, the <a href="https://www.nepalitimes.com/editorial/nepals-humanitarian-emergency/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/editorial/nepals-humanitarian-emergency/&amp;source=gmail&amp;ust=1622085873678000&amp;usg=AFQjCNE3z3JV_9xnJ0reDy2ABkI8VuY16A">pandemic has now infiltrated rural Nepal</a> where there is just one doctor for every 15,000 people. Kathmandu’s doctor-to-patient ratio is 1:850.In her village of Phediguth of Okhaldhunga district, <a href="https://www.nepalitimes.com/banner/saving-nepali-mothers-on-mothers-day/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/banner/saving-nepali-mothers-on-mothers-day/&amp;source=gmail&amp;ust=1622085873678000&amp;usg=AFQjCNErggt96LmoW-c38IzduDUsayQwIg">Rita Khatri</a> is the only skilled birth attendant. Despite the growing risk of the second wave, she is still performing deliveries and ante-natal check-ups wearing a mask and her single PPE suit. There are no tests of health workers and the public.“We are working despite fears of transmission, I wish we had more PPEs, masks and gloves so that we could conduct more regular check-ups and make home visits,” adds Khatri. “At the moment many people in the community have high fever and are staying at home, but there is no way to test them.” This time last year while in the grip of the first wave of a new pandemic, there was stigma associated with Covid-19 and people who were infected were ostracised in the community. There were many instances where <a href="https://www.nepalitimes.com/here-now/nepal-health-workers-battle-covid-19-but-also-stigma/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/here-now/nepal-health-workers-battle-covid-19-but-also-stigma/&amp;source=gmail&amp;ust=1622085873678000&amp;usg=AFQjCNECgLl_SyeWRy6kuDEPnEbsSFoCyQ">healthcare providers were mistreated</a>.Doctors and nurses interviewed for this report say that is still the case, but there is also more praise for frontline medical workers risking their own health to save lives. However, there is growing concern about the worry and over-work affecting the mental health of nurses and doctors.“Among other things we need psychological support and counselling. I have seniors who have children infected with the new variant, and they are having a hard time coping,” says Suman Chaudhary, nursing staff at the Trauma Centre in Kathmandu.As most of Nepal enters the fourth week of lockdown, nationwide daily Covid-19 infections, positivity rate as well as fatalities are going down slightly. The number of recoveries have also risen to nearly equal new confirmed cases on some days.Bayalpata Hospital in remote Accham District had to turn its Emergency Room into a Covid-19 ward last month to cope with a flood of patients. It had 33 patients, 18 of them needing high flow oxygen support. On Wednesday, it had only 12 Covid-19 patients with only two on oxygen. Four of those infected are medical staff. “The situation is easing somewhat here, in Mangalsen, Doti and Dadeldhura. There are beds available, and oxygen is coming in. But we are desperately short of medical staff,” says Mandeep Pathak, a physician at Bayalpata which is also caring for trauma and maternity patients from surrounding districts.However, the cases and the test positivity rate <a href="https://www.nepalitimes.com/here-now/its-an-emergency/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/here-now/its-an-emergency/&amp;source=gmail&amp;ust=1622085873678000&amp;usg=AFQjCNHx4NfPYsEDb5xqY31L966E2avOdg">have not gone down as expected</a> and fatalities nationwide have stayed above 160 for nearly two weeks now as the highly contagious and more lethal B.1.617.2 variant spreads rapidly through communities.Health Minister Hridayesh Tripathi sounded optimistic at a virtual press meet on Monday, predicting that there would be a decline in the infection rate in the next four weeks. As Nepal receives large shipments of oxygen cylinders, liquid oxygen, test kits, PPEs and masks, doctors say the emphasis now needs to shift to more testing, mass vaccination, and replenishing exhausted and over-stretched medical staff at hospitals, both in the cities and the districts. A non-profit One Heart Worldwide that works primarily in maternal care in Nepal’s 21 districts has been helping district hospitals by mobilising oxygen cylinders and medical kits it procured from China.<a href="https://www.nepalitimes.com/banner/what-can-be-more-fulfilling-than-saving-lives/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/banner/what-can-be-more-fulfilling-than-saving-lives/&amp;source=gmail&amp;ust=1622085873678000&amp;usg=AFQjCNFzGOK8F0-jy4gwuRmK8iyNBD7AIA">Executive director Surya Bhatta</a> gives three reasons why despite the lockdown the infection rate is still high. “There is virtually no contact tracing, people are still not following health protocols and patients isolating at homes are not doing it right, resulting in a gross underestimation of total cases and fatalities.”		
			<h2>Weddings into hotspots</h2>		
		Gopal Dahal in DhankutaOn 30 April, when a young man in Okhre village in Dhankuta district got married, the whole . The whole community was invited for the feast.But a few days later, the groom suddenly fell sick. When he showed coronavirus symptoms, a test at the primary health care centre confirmed he was <a href="https://www.nepalitimes.com/here-now/its-an-emergency/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/here-now/its-an-emergency/&amp;source=gmail&amp;ust=1622085873678000&amp;usg=AFQjCNHx4NfPYsEDb5xqY31L966E2avOdg">Covid-19</a> positive.Now, every household in Okhre village has members showing similar symptoms. Most of them had attended the wedding. Of the 51 people tested, 25 tested positive. “This is a crisis, the pandemic has spread to the whole village now,” says Ward Chair Palak Basnet.One of the guests at the wedding was a man who had returned recently from the Tarai with mild symptoms. He was hired to wash dishes at the wedding, and had died a few days after the feast. No one tried to find the cause of death, and there was no PCR test done. Dhankuta MP Jitendra Rumdali Rai says there are probably many more cases than the ones who have tested positive so far. “The pandemic is spreading out of control here because the municipality wasn’t able to manage it on time,” he adds.Okhre village has now been sealed off till 8 June. Some of those infected are in critical condition, and six who were more serious were taken to hospital in Dharan. It is difficult for the others because the municipality does not have an ambulance, and some who had taken sick relatives to Dharan returned because there were no beds, or it was too expensive. “Initially they were charging Rs10,000 per day for the bed and we paid Rs4,000 daily for the doctor. But then they hiked it to Rs14,700 and I couldn’t pay it any more,” says one patient’s family who returned recently from Dharan’s Bijayapur Hospital.Another <a href="https://www.nepalitimes.com/latest/rural-nepal-fights-back-covid-19/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/latest/rural-nepal-fights-back-covid-19/&amp;source=gmail&amp;ust=1622085873679000&amp;usg=AFQjCNHu0t7Yl9XzW-TA064jBcggx4L-TA">coronavirus</a> patient says ambulances are also expensive, making it hard to get patients to hospitals. Buses refuse to take passengers who are sick.The municipality called an emergency all-party meeting and decided to set up a 10-bed isolation centre with two staff nurses, and a doctor. Talks are underway to get at least a pickup from Dhankuta Red Cross to use as an ambulance.

Ancient heritage meets dern distillery craft as the US-based The Nepali Spirit Company this month makes its global debut with Kathmandu Ayla. Inspired by Nepal’s ancient rice whiskey tradition, the product is the first of four handcrafted spirits that brings Kathmandu Valley’s 1,000-year-old ayla tradition to the world stage. “The first four products combine history, culture, and tradition and it has taken eight years to get to this launch point,” says CEO of The Nepal Spirit Company Kashish Das Shrestha, who is also publishing a book on the history of alcohol in Nepali culture. The other three ayla products are Masala Whiskey aged in Brazilian Amburana casks and spiced with black cardamom from Nepal, Annapurna Ayla, and Haku Chaku Himalayan Espresso Liqueur made with organic Nepali coffee, and chaku (dark molasses).  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251216141244_ab74945dc60ce5ff83fe7a88596fc032c18705e7cda9dc62df21694d3ad83b85.jpg" data-media-id="editor_0" data-image-id="20251216141244_ab74945dc60ce5ff83fe7a88596fc032c18705e7cda9dc62df21694d3ad83b85" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="The American Ayla NT"> </figure>  “I started visiting international whiskey auctions six years ago and after reading about distilling, my passion for spirits grew, and I felt the urge to tell the story of Nepal’s heritage spirits to the world,” explains Shrestha. Once poured in Nepal’s royal courts, ayla is a clear rice whiskey that is a millennia-old living heritage of Kathmandu used in rituals from birth to death and traditional life milestones of its inhabitants. Ayla is distilled to capture the classic aromas and flavors, with a soft sweet after taste. It can be enjoyed neat, sipped through meals, or enjoyed as shots. With more than 15% of Nepal’s population living and working abroad, there is a cultural demand for ayla in the diaspora from Asan to Amstredam to Australia.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251216121236_0db0ec396832736fef60b636d7012a917be65471408c81383a40613f928f9e78.jpg" data-media-id="editor_1" data-image-id="20251216121236_0db0ec396832736fef60b636d7012a917be65471408c81383a40613f928f9e78" data-rendition-name="original" width="1000" height="1270" loading="lazy" alt="The American Ayla NT"> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251216141236_a84ede74c67a61e75af2f0cc1c985b4d04ff2292c6bd0bd0b841f4d2c7b593aa.jpg" data-media-id="editor_2" data-image-id="20251216141236_a84ede74c67a61e75af2f0cc1c985b4d04ff2292c6bd0bd0b841f4d2c7b593aa" data-rendition-name="original" width="1778" height="1000" loading="lazy" alt="The American Ayla NT"> </figure>  &nbsp;“We also believe ayla is a wonderful way to tell Nepal’s story to the world,” says Lilu KC Shrestha, Chief Operating Officer of the company. “We intend to use our platform to promote Nepal in any way we can, and also find ways to give back to the country. It was high time a world-class Nepali spirits brand entered the global market, and we are proud to take the lead.” Aside from the ayla itself, the bottle and packaging was conceived by New York-based designer Sahara Shrestha to reflect a complete Nepaliness. “Each bottle and box is a love letter to Nepal, and every detail is an expression of respect and appreciation of Nepali heritage and our desire to share it with the world,” says Kashish Das Shrestha. “And ayla itself is a sacred part of our culture, so we wanted to make sure the bottle reflects this reverence.”  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251216141244_d2746204c64802ff81453d7a8749f516bf3c62538fe3c98400a9b3978c03b273.jpg" data-media-id="editor_3" data-image-id="20251216141244_d2746204c64802ff81453d7a8749f516bf3c62538fe3c98400a9b3978c03b273" data-rendition-name="original" width="1920" height="1475" loading="lazy" alt="The American Ayla NT"> <figcaption>Aylarita</figcaption> </figure>  The bottom of each bottle has an embossed Mandala representing the universe and its interconnectedness. A glass molding of Himalayan peaks Chomolungma and Nuptse signifies the earth and heaven. The bottle cap is a black and gold rendering of the metal plates that hang from Kathmandu’s temples. The logo of The Nepali Spirit Company is also inspired by the unti, a traditional vessel used to pour ayla. While its top is typically adorned with a peacock, the company’s design replaces it with rice stalks. This motif is also on the label of Annapurna Whiskey named in honour of both the mountain and the goddess, the giver of grain. For a new take, ayla can be paired with a lime wedge lathered in honey, cumin, and salt, or on the glass rim. It can also be mixed into cocktails to make Aylarita, Aylatini, or Aylapolitan. <a href="http://www.thenepalispirit.com/" target="_blank">www.thenepalispirit.com</a>, @TheNepaliSpirit

The American Ayla

When Winston Churchill addressed the Canadian Parliament in December 1941, he recalled that generals of Nazi-occupied France had said that England would “have her neck wrung like a chicken”. Churchill went on to quip: “Some chicken.” As the laughter and applause subsided, he added: “Some neck.” (Even longer laughter and applause) We do not know who first started calling the narrow corridor that joins India to its northeastern states a 'Chicken’s Neck', but there also was the hint of a Churcillian connotation. Akhilesh Upadhayay in his new book In the Margins of the Empires: A History of the Chicken’s Neck, uses this strip as an entry point to explore a region adjoining Nepal, Bhutan, China, Sikkim, Darjeeling, India’s northeast and the tectonics that shaped its geo-strategic terrain.&nbsp; Upadhyay’s Chicken Neck is an organic whole, connected through centuries by transboundary traders, travellers, monks, spies, missionaries, mountaineers, and more. And as infrastructure and connectivity improves, smaller countries like Nepal and Bhutan (and earlier Sikkim) are caught up in the region’s rivalries. The tri-junction of the Chicken’s Neck is a potential flashpoint that has obsessed India’s military strategists ever since Partition in 1947 and the formation of East Pakistan, and the Chinese annexation of Tibet. India found itself squeezed between Chumbi Valley in China to the north and Pakistan to the south. So, when Sikkim started acting too independent for its own good 50 years ago, India engineered its annexation and turned it into its 22nd state. The 1962 Sino-Indian war elevated its strategic importance even more. Alarm bells ring in New Delhi each time there is trouble around the Chicken’s Neck: the Naxalite uprising had to be swiftly crushed, the Indian military moved in to liberate Bangladesh, Gorkhaland and ULFA activities were dangerously nearby, Bhutan had to be appeased. Every once in a while things would flare up between India and China, as in the 2017 Doklam standoff.&nbsp; And last year’s regime change in Bangladesh has rattled New Delhi enough to deploy its Rafael fighters and BrahMos cruise missiles in the Chicken’s Neck. It is now the most densely militarised strip of real estate in this part of the world. &nbsp; As a journalist and former editor of Kathmandu Post, Upadhyay also peers at the Chicken’s Neck through Nepal’s perspective. After all, Jhapa (where the author is originally from) sits right there astride India’s strategic lifeline.&nbsp; Geopolitics is at the front and centre of the book that takes readers back to the time Nepal was a closed Himalayan kingdom.&nbsp; Nepal may be a yam between two boulders, but it may just as well be a thicker Chicken’s Neck as far as New Delhi and Beijing are concerned. Nepal’s rulers have always had to walk the tightrope between China and India. Khampa guerrillas, covertly helped by American and Indian intelligence, raided Chinese military convoys from bases in Nepal, and King Mahendra had to do some intricate diplomatic footwork. India is often described as Nepal’s closest friend, but our relations with China go back as long in terms of the Lhasa trade, Bhrikuti and Arniko, religious exchanges and people-to-people relations. While Nepali researchers are wary of touching on Chinese, Indian or American sensitivities, Upadhyay’s journalistic background means he has no qualms about tackling the subject head-on, and objectively. He spent more than a year researching the book, sniffing around Siliguri, Bagdogra, Naxalbari, Darjeeling and the villages on the Jhapa side. Then he travelled to Olangchung Gola to listen to ordinary people of the Himalayan rimlands. Despite the perception about rigid frontiers between nation states, the book hints at how absurd the notion is. The Chicken’s Neck is also a wild elephant migration corridor, disturbed by the India-Bangladesh border fence, new expressway embankments, airport runways, and expanding cities. Similarly, the people on the Nepal-tibet border used to cross over to graze yaks — this expanded the gene pools of not just the yaks but also the nomadic humans who moved with the herds.&nbsp; Despite the hard borders, trade flourishes. Upadhyay marvels that a shop in Phungling in Taplejung has embroidered saris from Siliguri and fluffy jackets from China. he finds that residents in the northeastern and southeastern tips of Nepal have more in common with kin across the border in Tibet or India than with someone from Kathmandu. Nepal was once one of the biggest trade hubs in ancient times, and our products were treated as equals in Indian border cities. People too, could move freely, especially if they were and are from bordering Tarai cities.&nbsp; Nepal’s rich history and culture was shaped by the proximity to neighbours, and despite borders it is still cemented by marriages and trade — especially in the Nepali-speaking lands to the east. Its geographical positioning makes Nepal not landlocked but land-linked, adjacent to the largest emerging economies of the world. Nepal needs to deploy its soft power with effective diplomacy to take advantage of these two empires, and not be choked by their rivalry. The book was going to press when the GenZ protests ignited in September, but Upadhyay nevertheless managed to insert the current political transition into the pages with deft editing. &nbsp;The final section of the book examines at least three possible scenarios that may unfold as South Asia continues to be shaped by great power rivalries and imperial contests that have weakened the unilateral influence of the west.&nbsp; Akhilesh Upadhyay extrapolates from the Chicken’s Neck, zooming out for a wider perspective on the Subcontinent. &nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025121912124_0ae772e7736a65f53a99599b5724ca133a64fdea0e61c7170ea81f9dd95c7af0.jpg" data-media-id="editor_0" data-image-id="2025121912124_0ae772e7736a65f53a99599b5724ca133a64fdea0e61c7170ea81f9dd95c7af0" data-rendition-name="original" width="1136" height="702" loading="lazy" alt="In the Margins of Empires: A History of the Chicken’s Neck NT"> </figure>

Some chicken, some neck

This is the first instalment of our new series Nepal Made, where we profile world-class Nepali products and the people behind them. The Himalaya is the home to Ayurveda, the preventive and curative medicinal practice that relies on the tremendous diversity of plant life. This is where Hanuman is said to have come to find a specific rare herb when Ram was wounded in battle. When he could not find it, he tore off a whole mountain and hauled it down to Lanka. Since then, herbal medicines and care products have been steadily modernised in India and Nepal. Now, one Kathmandu-based company, Herveda, is going global with an all-natural skincare brand that blends traditional knowledge of medicinal plants with modern technology. Originally a Sanskrit word, Ayurveda literally means ‘the science of life’ and promotes physical and mental wellbeing through a holistic knowledge system that is 4,000 years old. Ayurvedic products have gotten more popular as global demand rises for all-natural, chemical-free cosmetic and wellness products, instead of wasteful fast fashion and beauty trends. Herveda was founded by Prativa Pandey, a scientist-entrepreneur and mother of two. She did her PhD in nanotechnology chemistry from Northwestern University in the United States and returned to Nepal in 2015 after the earthquake, staying back to explore the market and launch her brand.  <figure><img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251218141216_b699e74ee82333951b99b22648705dc916deb8eef3d425c77c1e2f3b1058a64d.jpg" data-media-id="editor_0" data-image-id="20251218141216_b699e74ee82333951b99b22648705dc916deb8eef3d425c77c1e2f3b1058a64d" data-rendition-name="original" width="1000" height="1500" loading="lazy" alt="Looking good by doing good NT"></figure>  “I wanted to do something in Nepal, but didn’t want to be a doctor or engineer,” says Pandey at the elegant Herveda showroom in Jhamsikhel. “Whatever knowledge that I had gathered, I wanted to spread it in my own country.” Nepal is rich in traditional medicinal herbs and Ayurvedic plants, but proper utilisation and mobilisation has always been lagging. Most of the benefits are reaped by large companies and not local farmers. Pandey wanted to change that. To ensure that it gives back to the community, Herveda collaborates with farmers and local traders for fair trade. “I have always been fascinated by the medicinal herbs found in Nepal, and wanted to create high value products with them. It was a way to combine valuable indigenous knowledge with my academic research background,” adds Pandey. “I did not require a huge investment, just a proper marketing strategy.”  <figure><img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251218141216_350f6eb1511523ea54a8aba468f20a7dffcb5def3fade4dcced30324417f83bc.jpg" data-media-id="editor_1" data-image-id="20251218141216_350f6eb1511523ea54a8aba468f20a7dffcb5def3fade4dcced30324417f83bc" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="Looking good by doing good NT"></figure>  According to the Trade and Promotion Center under the Ministry of Industry, Nepal’s import of cosmetic products is increasing every year, driven by demand from a younger population. These younger customers are also more conscious about the products they use. For brands like Herveda, it is important that customers engage in wellness and skincare in an ethical and sustainable manner. Apart from being all natural, Herveda’s flagship store in Jhamsikhel has a reuse box where consumers can drop used bottles, which are then recycled. The store also displays products from 35 local businesses. Pandey believes that Nepali brands should cross-promote and complement each other: “Rather than competing, I believe we should support each other. 1+1 can be 11, and not two.” Effectiveness and functionality hold great importance for Herveda. which employs 25 scientists to develop and lab test its products at its research institute. Currently, there are products ranging from Rs400-2,000, which include lip balms, serums, and essential oils. A signature product is the Berry Boost Radiance Mask, which contains Spikenard (Jatamansi), Ashwagandha, Orange Peel, and Rhododendron.  <figure><img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251218141216_7ec1104e0dd63db2fbbfe666034b468fe5b7e6876fde8b5446cb9d9fe27566cf.jpg" data-media-id="editor_2" data-image-id="20251218141216_7ec1104e0dd63db2fbbfe666034b468fe5b7e6876fde8b5446cb9d9fe27566cf" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="Looking good by doing good NT"></figure>  Herveda exports to the United States and plans to expand to China and Europe. The products get a 50-100% markup in the international market. The company recently received a grant from UKAid to expand the market as well as build capacity to scale up. It has partnered with Agriplayer software to help to develop QR codes on its products, which consumers will be able to scan to track the product sources and evaluate pricing. Nepal lags behind in rules and regulations, and the lack of monitoring has allowed low quality cosmetic products to penetrate into the market. Herveda has got an international certification from USFTA, which is important for its foray into the export market. “For the cosmetic industry to scale up, there should be a central testing facility that is well equipped and meets international standards. Additionally, export should be made easy,” adds Pandey. “If there are too many barriers to entry, no one will be willing to invest.”

Looking good by doing good

Samrat Upadhyay’s newest novel <a href="https://www.nytimes.com/2025/01/10/books/review/darkmotherland-samrat-upadhyay.html" target="_blank">Darkmotherland</a> imagines a Kathmandu in political turmoil after a large earthquake. In the aftermath, Home Minister Giridharilal Bhagirath Kumar stages a ‘koo’, and has convinced people that he is the answer to the crisis.&nbsp; He is now known as ‘PM Papa’, and picks up classic dictatorial ways — propaganda, statue-making, history-revising, and a gang of Shiva-worshipping ‘Fundys’.&nbsp; We are introduced to two complicated protagonists. The first is Kranti, a fetching young woman and ‘Madam Mao’, her Communist professor mother. The chef father loved classic rock and died by gas cylinder suicide. Kranti hates her mother, and the Communist group which congregates at her home to plot against PM Papa, although they seem to take forever to get anything done.&nbsp; Kranti has a complicated relationship with the handsome Bhaskar, the middle son of the Ghimirey family oligarchy that is aligned with the dictator. She loves him, but as Bhaskar gets more and more involved with her mother and the Communist group, finds herself heading out to the ‘Bhurey’ (Bhu-kampa Rey-fugee) tents, to spend time with poet Kabiraj.&nbsp; Kranti is also given to delusions, paranoia, and psychosis, convinced that Bhaskar’s family is spying on her, and that one in the Communist group has supernatural powers of suggestion that led to her father’s suicide. Despite mental issues, she marries Bhaskar and into the Ghimirey clan, and the complex nexus between business and politics.&nbsp; The second is Rozy, initially the genderqueer lover of PM Papa who he discovered in the streets, and is described as a ‘gorgeous homosexual’. She turns heads due to her sexuality and beauty, and gets more and more politically powerful as the story moves along.&nbsp; Upadhyay tells us Nepali writers writing in English often feel a pressure to create an “all-embracing world” (interview), but that is what he seems to be getting at with the monumental plot of his novel. Unlike the realism in his previous novels, this one drifts off into magical realism. His narrative blends the ever-present risk of a big earthquake and the actuality of political tremors. The speed of political upheaval seems a little unrealistic for anyone who lived through the 2015 earthquake, although the GenZ protests showed just how quickly a regime can be reduced to a heap of rubble. The age-old question: oppression can be overcome, but what comes after? The PM Papa character is a Gyanendra-Oli-Deuba-Prachanda-Modi-Trump-Papa Doc composite who is good friends with the not even thinly veiled President Corn Hair.&nbsp; Through the character of Kranti, Upadhyay conveys the dynamic between a parent and a child who is now a full adult, on relationships in Kathmandu as marriage looms, on pervasive corruption which one might denounce but have to take advantage of to get things done.&nbsp; Through Rozy, Upadhyay brings attention to the non-binary identity, one that has existed forever in Nepal, and although is discussed a lot in the West lately but not so much here. Upadhyay explores the origins, the present, and the various advantages and disadvantages of the queer.&nbsp; Storytelling in the early parts of the book oscillates between the real and absurd fantasy amidst the physical and political backdrop that does not have to be Nepal -- it could be Modi's India or Trump's America.&nbsp; The reader sees the world through Kranti’s psychosis, or PM Papa’s displays of power, such as when a ‘Sweej’ wrestler is beaten to death with a mace in a wrestling spectacle.&nbsp; These elements <a href="https://www.publishersweekly.com/pw/by-topic/authors/profiles/article/96329-samrat-upadhyay-wants-you-to-expect-the-unexpected.html" target="_blank">coagulate in the novel</a>, and Upadhyay has all the pages at his disposal to prod and push them against one another to see what happens. The novel is still at its best and most engaging when describing vulnerable scenes, of Kranti and her mister, or of Rozy’s messed-up childhood.&nbsp; Any Nepali reading his weighty novel can recognise the allusions and nudges such as the Tourist Area: Thamel, Open Stage: Khula Manch, Tri-Moon: Tri-Chandra etc. But anyone not from these parts may have a tough time keeping track. Keeping a notebook handy may be useful.&nbsp; Ultimately, the novel does work, it provokes and entertains. For best results, serialise the reading over 30 days, not 3 like this reviewer.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025122005124_88d92d9a2c5718436354d9c1ce6a2576931ef3242a37f6b90d84da15fe96dd8d.jpg" data-media-id="editor_2" data-image-id="2025122005124_88d92d9a2c5718436354d9c1ce6a2576931ef3242a37f6b90d84da15fe96dd8d" data-rendition-name="original" width="1136" height="702" loading="lazy" alt="Darkmotherland NT"> </figure>  <h2>More things change, more they remain the same</h2> First US-published Nepali Samrat Upadhyay is the award-winning author of novels and short story collections like Arresting God in Kathmandu, The City Son, Mad Country, and Buddha’s Orphans. Upadhyay is also the Martha C. Kraft Professor of Humanities at Indiana University, where he teaches Creative Writing.&nbsp; Recently in Kathmandu, he talked to the Nepali Times over coffee in Boudha about his writing, his teaching, and his newest novel, DARKMOTHERLAND.&nbsp; Nepali Times: Darkmotherland is 732 pages long. What was it like writing a much longer book? Samrat Upadhyay: Torturous Ha ha ha. Around 2014 I started a story. I knew it was going to be a novel. It was about this woman who is accused of being a Mangalik. Then the big earthquake happened in 2015. I was in the US but my parents were still here, they were living in tents. Then I started thinking, what would happen if a dictator came to power. That’s how PM Papa was born. I think mostly because of his character the novel exploded. I had never written a character like him before. I don’t do any plot outlines when I write. Let’s see where it goes. I like the process of writing to lead to discoveries. If I knew everything then I’d get bored. Not knowing where the storyline might go is very exciting. All these different threads started coming in, the character of Kranti started taking on a big role. Her mother, a Communist-leaning professor, started taking shape. Kranti also had a love-interest from an oligarchical family. The novel just took off and I just continued writing. A novel is as long as it needs to be. The initial draft was 1,700 pages. I was writing pretty fast. I don’t pause to see if the sentences are pretty. I whittled it down, and by the time I sent it to my agent it was 1,100 pages. He was able to sell it to Soho Press. I worked with an editor who suggested some further cuts and expansions. The editing part was even harder than the initial writing, because by that time I was tired of looking at the novel. There was a bit of a delay because of Covid, then we got back on track. What’s your daily process of getting the words on paper? I am a morning writer. I get up in the morning and start writing. You can have all kinds of theories but there is this saying, Shut Up and Write. The writing is where the meat is. You encounter difficulties in writing that you may not encounter when thinking about it. I see this in my students. I knew this was a big project so I knew that if I wanted to get it out I would need to write a lot per day. I got a couple fellowships in the university that gave me a few semesters off teaching. I would write for about 4 or 5 hours. Sometimes I would give myself a 1,000 word deadline, but I’m flexible with it if I don’t get there. You have to be kind and patient. What is your inspiration behind the gender-queer character, Rozy? I’ve always been a strong supporter of LGBT. I would say that at this point half of my students are non-binary or on the gender spectrum. Some of them are going through transitions. In some ways Nepal has become more accepting, but in other ways not. I did a workshop with Blue Diamond Society, and heard pretty harrowing stories. I didn’t intend to create a gender-queer character, but it seemed like the novel was demanding that. Especially in terms of the tyrannical stronghold that PM Papa has over the entire country, it made sense that there would be a counterpart, I wanted to put these things in motion and see how they interact. As I was writing Rozy, her character became very formidable. How much do you draw from Nepali politics? Do you form characters off people you know? Not in a very concrete sense, but I’m always drawing from them. I grew up in the Panchayat System, and lived in Lainchaur. The palace was there. The monarchy was such an institution. But then I was in the US, so I wasn’t here when the pro-democracy movement happened. In some ways it felt like things had changed, but were the same in other ways. I feel the same way now. I do draw upon people. I think my father makes an appearance in my work in various forms, I disguise him, of course. You’ve taught creative writing for a while now, how is literature changing?&nbsp; My students are also writing non-binary characters, because they want to be reflected in the stories. This is something new that we didn’t have. White authors, characters were the default. People of Color on the margins. African American and then Hispanic, South Asian authors were always pushing back on this status quo. When I was growing up in the classroom we were reading a lot of white male authors, but in my own life I was reading Salman Rushdie, African, South African friends and writers. My students have a lot more interest in fantasy, many are writing dystopian. One student is writing a novel where the characters start playing a game, and then they enter the game, and an entire new world opens up. On the one hand there are complaints that students aren’t reading enough, which is true, but my students are producing smarter work. Writing that is a lot more insightful. The calibre of discussion in my graduate-level novel writing classes is mind-boggling to me, and makes me want to keep on teaching. Do Nepali writers who write in English feel a certain pressure, from the market or self-imposed, to make their stories more Nepali? My experience for a long time was that there was a pressure, I felt it true in my case, I was supposed to be the representative of every Nepali. But Nepali writers writing in Nepali are not asked, how are you representing Nepal. At that time there was a lot of pressure to write a novel that is all-embracing, that is supposed to speak on all aspects of the country. Politics felt like an integral part of it, that these novels had to make big political statements. I always felt like this was wrong. I mean, people have to write what they want to write. &nbsp;You write what you want to write, and if it resonates with readers, that’s great. If it doesn’t, that’s fine too. Art isn’t going to speak to everyone. We do a competition every couple of years called Writing Nepal. We make a call for stories, and we decide the best ones. I find it refreshing now that the writing isn’t all about Nepal. The best stories are quite varied. What are Nepalis writing about?&nbsp; Several of the stories are about the role of women in our society, done with a lot of nuance, about the sort of multitasking they have to do. Some of it was deeply historical, some dystopian, the coming of AI. Some of them have an old-timey type of feel, and some of them are very modern, contemporary. The general level of art in movies, TV shows, and novels seems to have regressed compared to say the 90s.&nbsp; I don’t think that’s entirely true. Publishing has been harder, for sure, but there are a lot of novels being published every year. My writing workshop had always been a good vehicle for short stories, but a lot of my students now—even undergraduates—are working on novels. I haven’t formulated my thoughts on AI, it is so new and has hit us so hard. Many of my students are using AI, especially when writing response papers to works of literature or peers, which I find appalling. That’s going to be a struggle. I tell my students, who are you fooling? If you feel that you want to be an artist, or a writer, then what’s the point of using AI? AI-generated stories are also just not that good. They’re almost too perfect, too well put-together, making moves that are easy to detect. There is something about human-written stories that are messy and exciting. But there are also plenty of students who want to do original work and don’t want anything to do with AI.

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