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.

The Himalayan mountains are also known as the Third Pole because it is the largest repository of water stored as ice outside the two polar regions. However, it is divided by political boundaries that nature does not recognise – be it the air pollutants that flow or migratory birds that fly over the peaks. The Himalaya is also a geopolitical and climate change hot spot. In these geopolitically and environmentally challenging times, it becomes even more important to create oases of conversations, where candid and future-oriented discussions can take place at a people-to-people level. Platforms dominated by inter-governmental agencies have been able to do little. The Himalayan Future Forum (HFF) aims to be a platform that stands at the crossroads of climate, community, and connectivity, fostering dialogue and promoting citizen-led action. Growing up in the Indian Himalayan town of Kalimpong and spending the nascent stages of my career helping in setting up offices of the award-winning Annapurna Conservation Area Project (ACAP) that fostered community involvement in conservation, I have witnessed transformations both good and bad.  <figure><img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260205070244_6e2087b11fff0cc6704eebaee6f169848a9cfd57c4a02d7d1fd45db2526d2f67.jpg" data-media-id="editor_0" data-image-id="20260205070244_6e2087b11fff0cc6704eebaee6f169848a9cfd57c4a02d7d1fd45db2526d2f67" data-rendition-name="original" width="5559" height="3711" loading="lazy" alt="HFF 2026"></figure>  There are initiatives like Nepal’s forest cover doubling in 30 years, or Bhutan’s drive for high-end sustainable tourism. At the same time, I have seen landscapes destroyed by bulldozers and tall buildings competing for air and sunlight in expanding cities. From crony capitalists patronised by political leaders engaged in plundering natural resources to citizen-led initiatives on cleanliness drives and waste management, the Himalayan region is full of stories from both ends of the spectrum of disappointment and hope. Life is about observing and, in one’s little sphere of influence, taking baby steps towards catalysing positive transformation. This is why, Nepal Economic Forum (NEF) had been hosting the Himalayan Consensus Summit in Nepal from 2014 to 2020 following which the Himalayan Future Forum (HFF) was incubated since 2023. HFF is an initiative to encourage multi-faceted dialogues on the topics of climate, community, and connectivity in the Himalayan region by bringing together leaders, experts, institutions, and practitioners from different countries and sectors.  <figure><img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260205070244_a7e673507dcdb6e265cb6f76f2890f17af36f17006a7f6d0f2f0e1a288c89a09.jpg" data-media-id="editor_1" data-image-id="20260205070244_a7e673507dcdb6e265cb6f76f2890f17af36f17006a7f6d0f2f0e1a288c89a09" data-rendition-name="original" width="5364" height="3581" loading="lazy" alt="HFF 2026"></figure>  In this year’s edition, there are a series of sessions on 6 February with 34 speakers including ten international panelists. On day two the Himalayan Haat aims to showcase a variety of local, indigenous, and sustainable products. As in 2024, it is believed that the conversations and interactions at the HFF will lead to more partnerships and collaborations from climate financing to managing disasters to taking Himalayan brands global. YOUNG FELLOWS Beyond this, there are sessions on topics such as geopolitics and the Himalaya, as well as on migration which are especially relevant considering the past few years that have seen many events which impacted the global world order. One of the key features of HFF, guided by our ethos of bringing together experts, experiences, and enthusiasm, is also to ensure stronger youth representation through the HFF Youth Fellowship. This year, following a rigorous screening process, youth fellows were selected out of an overwhelming response. Those chosen will be able to attend the events as well as collaborate in future research and publications. Selected fellows will also be provided with full scholarships to the public policy program at Takshashila Institution, an independent centre for research and education in public policy in Bangalore. In a region where half of the population is under 25 years, it is important to get the future generations also in the room.  <figure><img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260205070244_3416bd14d5249afeb357b11f760f49b0cd1d77feeac71d820406b2d9e86696bc.jpg" data-media-id="editor_2" data-image-id="20260205070244_3416bd14d5249afeb357b11f760f49b0cd1d77feeac71d820406b2d9e86696bc" data-rendition-name="original" width="5273" height="3520" loading="lazy" alt="HFF 2026"></figure>  Nepal presents an ideal location to hold meetings such as this, where no-holds-barred conversations can take place face-to-face. The country has good air connectivity and one of the most liberal visa policies in Asia. And while Davos is a good example to follow for convening global voices, we need not have so many private planes burning fossil fuel, as we can have participants take scheduled commercial flights or have regional participants simply take a road trip. Ultimately, the Himalayan region is also about festivities. No exchange of ideas is complete without immersing in art, culture, culinary experiences, and music. This is why HFF envisages graduating to a Himalayan Jatra, rooted in a region where people smile from the heart, and teach the world to smile with them. Join us at HFF 2026 as we move closer to this vision. See the schedule <a href="file:///Z:/%231297%20February%206/pix/page%209/HFF%202026%20Program%20Schedule%20(1)_compressed.pdf">here</a>. Sujeev Shakya is Chair of Nepal Economic Forum and Convenor of the Himalayan Future Forum.

Himalayan Futures Forum 2026

Kathmandu Valley alone now has over 700 cafes serving mugs made from freshly ground beans. ‘Americano double shot’, ‘Cappuccino’ and ‘Mocha’ have entered the Nepali language. It has also become a cash crop for thousands of farmers with near-perfect growing conditions along the Himalayan foothills.&nbsp; Yet, annual coffee production has declined by 15% to only 550 tons in the past years, and this meets only a fraction of the domestic demand of 6,000 tons.&nbsp; Nepali coffee fetches $22 per kg in the international market, but Nepal only exports 3% of its crop. If cleverly promoted, the international demand for Nepali coffee can be 8,000 tons. “Coffee is all about story-telling,” explains <a href="https://archive.nepalitimes.com/article/business/Gagan-Pradhan-and-Himalayan-Java,1076">Gagan Pradhan, founder of Himalayan Java Coffee</a>. “Nepali coffee has brand value because it is grown in the highest elevations on earth and is a cash crop for cooperatives and small farmers. There is tremendous potential for growth.”  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260205100216_1f366d8a85cc133fedee0ee72d7768d3a23bf51f8d43edbdadf98443bc0c01ba.jpg" data-media-id="editor_1" data-image-id="20260205100216_1f366d8a85cc133fedee0ee72d7768d3a23bf51f8d43edbdadf98443bc0c01ba" data-rendition-name="original" width="2000" height="1518" loading="lazy" alt="coffee culture in Nepal"> </figure>  The reason for the decline in coffee production lately is attributed to erratic weather caused by climate change, but mostly it is because it is manual-intensive, needing initial capital and patience for a return on investment. The strategy that makes most sense for <a href="https://nepalitimes.com/here-now/make-way-for-makalu-coffee">Nepal’s coffee industry</a> is to sell it as a rare, specialty product.&nbsp; Says Raj Kumar Banjara, master trainer at Nepal Coffee Academy and originator of the Himalayan Arabica brand: “There is no better crop for Nepal because we have the ideal soil and weather to grow specialty coffee, which can be exported to third countries directly instead of sending it through India like with ginger, cardamom, or tea.” These favorable conditions are at altitudes between 800m to 1,600m along the mid-mountains and temperature not exceeding 22°C, which allows cherries to &nbsp;develop slower, giving it a denser taste with complex flavours of fruits and nuts.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260205100216_35e470381d258d9598d30165d0dbb6b4294c389c61695bf8c47d72d2273b4629.jpg" data-media-id="editor_3" data-image-id="20260205100216_35e470381d258d9598d30165d0dbb6b4294c389c61695bf8c47d72d2273b4629" data-rendition-name="original" width="3872" height="2592" loading="lazy" alt="coffee culture in Nepal"> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260205100216_f7ccb42d7a7fb656dadc7ba5132a6243b8f99a28f7877875172411b7a4c96bc0.jpg" data-media-id="editor_4" data-image-id="20260205100216_f7ccb42d7a7fb656dadc7ba5132a6243b8f99a28f7877875172411b7a4c96bc0" data-rendition-name="original" width="1024" height="768" loading="lazy" alt="coffee culture in Nepal"> </figure>  This is ‘Arabica’ coffee, and it is also considered ‘organic by default’ because farmers have limited access to chemical pesticides and fertilisers, adding to its premium. All of Nepal’s coffee is grown in only 4,300 hectares total, and this is just 0.36% of the area suitable for coffee farming. Still 31,000 households across 44 districts depend on this cash crop.&nbsp; Challenges include out-migration, limits on land ownership, and climate breakdown leading to colder, drier winters, droughts and heat stress. Shreeyanch Shrestha is the founder of Samparka Cloud Loyalty, a startup that helps businesses retain customers by giving them insights about customer behaviour. Among the services offered is a digital loyalty card for coffee shops, one of his biggest clientele.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260205100216_c80e17ac78016ae5a90f4b27105e16af6c39d1422665f9f9c9b1d8404e5e7d54.jpg" data-media-id="editor_5" data-image-id="20260205100216_c80e17ac78016ae5a90f4b27105e16af6c39d1422665f9f9c9b1d8404e5e7d54" data-rendition-name="original" width="1280" height="960" loading="lazy" alt="coffee culture in Nepal"> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260205100212_968c5b264ec2fb65014dc3ebc2777f0bf19f596a4152c59f9cad9d99dee79df7.jpg" data-media-id="editor_6" data-image-id="20260205100212_968c5b264ec2fb65014dc3ebc2777f0bf19f596a4152c59f9cad9d99dee79df7" data-rendition-name="original" width="1200" height="900" loading="lazy" alt="coffee beans"> </figure>  Shrestha is also a coffee enthusiast, and recently collaborated with Baato Maps on the playfully designed ‘Kathmandu Coffee Map’.&nbsp; “This was a marketing campaign but also a way to pay tribute to cafe owners we worked with,” he says. “A new generation of coffee farmers, processors, roasters and consumers seem to want to invest in upgrading their coffee experience.” COFFEE CULTURE Operators such as Raj Kumar Banjara have been in that game for over 30 years, even earning a PhD in Coffee Agriculture, running farms and teaching roasting and barista courses. Now, he makes short how-to videos on social media. Banjara’s Academy is run by Specialty Coffee Association certified Q Graders and Authorised Trainers.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260205100216_22433d3a8b71224cd8cb38105b9eb5502a104e03ccec2e3864c8b23efc9f3fc6.png" data-media-id="editor_7" data-image-id="20260205100216_22433d3a8b71224cd8cb38105b9eb5502a104e03ccec2e3864c8b23efc9f3fc6" data-rendition-name="original" width="3612" height="2028" loading="lazy" alt="coffee culture in Nepal"> </figure>  Also promoting a coffee culture through social media is Santosh Shah of Bariko Coffee. He documents his process on Instagram, from hand picking and processing coffee cherries to brewing.&nbsp; Nepal appears to be riding the Third Wave of Coffee (see box) as the beverage moves away from the café chain culture to one that values knowledge of the cherries, beans, the roasting process and brewing -- right from the plant to the cup.&nbsp; Along the way, there are tales to be told about where the coffee is grown, who grows it, and how farmers get a fair price for the product. Coffee then becomes a shared social experience that directly connects the consumer to the producer. Nima Tenzing Sherpa returned to Nepal from the United States to start Lekali Coffee Estate in 2018, and produces fine single origin coffee beans so that the quality of the product improves the quality of life of the growers.&nbsp; He told Nepali Times: “Specialty-grade beans are the only future for Nepal’s coffee industry. I am continuously hunting for the best coffee origins in Nepal.” &nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260205100212_e08ba44d6396eb75da868404dd8cf2a26b71cd6d90ab3afaf7175790c111d21e.jpg" data-media-id="editor_8" data-image-id="20260205100212_e08ba44d6396eb75da868404dd8cf2a26b71cd6d90ab3afaf7175790c111d21e" data-rendition-name="original" width="3000" height="4000" loading="lazy" alt="coffee beans"> <figcaption>Photo: LEKALI COFFEE ESTATE </figcaption> </figure>  HISTORY OF COFFEE Human consumption of coffee began in Ethiopia when herders found their goats became perky after eating beans from a wild Arabica bush. The first commercial cultivation of the brew began in Yemen 600 years ago. &nbsp;&nbsp; Nepal’s coffee history is much younger. A holy man is said to have brought coffee seeds from Burma in 1938, and planted them in Gulmi, the district in the mid-mountains where the first coffee nursery was set up in 1981. The Nepal Coffee Company was founded in 1983 by Krishna Ghimire in Manigram near Butwal which educated farmers about the crop and recruited them to cultivate it. He then roasted the beans, and convinced the BhatBhateni stores, which had just opened, to sell it. The company still supplies coffee to cafes and has its own brands and farm. It supplies green beans to those who want to self-roast, or build a brand. In the 1990s, the National Tea and Coffee Development Board was established, and Himalayan Java Coffee (Nepal Made, right) opened its first shop in Kamaladi before moving to Thamel. Itr now has nearly 100 franchises across Nepal and overseas.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260207030236_1908f4a4246d373f51affa8ac48be90129e888f1222b8f10e5cd25421e931dd8.jpg" data-media-id="editor_9" data-image-id="20260207030236_1908f4a4246d373f51affa8ac48be90129e888f1222b8f10e5cd25421e931dd8" data-rendition-name="original" width="2052" height="1455" loading="lazy" alt="coffee map"> </figure>  What is the Third Wave? First Wave: Profit-driven, mass marketing, air tight containers and instant coffee. Consumption of coffee worldwide starts growing.&nbsp; Second Wave: Artisan-driven, origin and roasting style become important, epitomised by Starbucks and espresso. &nbsp; <a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/Nepali-specialty-coffee,4106">Third Wave</a>: Characteristics of the beverage take centre stage: origin of the beans, consistent processing techniques, and roasting style. Independent coffee shops demonstrate craftsmanship and knowledge of coffee beans from plant to the cup, promoting ethics and transparency.&nbsp; Coffee Districts Coffee is grown in over 44 districts of Nepal (see map, above). In the last fiscal year, Nepal produced 550 tonnes of Bourbon, Typica and Yellow Caturra varieties of Arabica coffee. The total plantation area in Nepal is 4,300 hectares, a fraction of the total suitable land. &nbsp;

Caffeine buzz

When I landed in Kathmandu last November, I arrived with a Diwali hangover. Not the festive kind, but the coughing, dust-coated, throat-scratching kind gifted by North India’s winter air. After a decade of breathing in Delhi’s seasonal gas chamber, my lungs were in an open revolt. But within days of landing in Kathmandu, my cough vanished. It felt almost miraculous. The air was crisper. The Air Quality Index was kinder, and the Himalayan peaks rose on the horizon.&nbsp;
But by the third week, the familiar grey veil returned. First as a faint blur, then peak by peak the Himalaya began to disappear. Locals said it had been getting worse every year.&nbsp;
Much of this haze is not Kathmandu’s doing. What drifts into Nepal each winter is a toxic spillover from the plains of North India and Pakistan: black carbon, brown clouds, and fine particulate matter carried across borders by seasonal winds. Kathmandu’s bowl-shaped valley simply traps what the region exhales.
Abid Omar, founder of the <a href="https://pakairquality.com/" target="_blank">Pakistan Air Quality Initiative</a>, put it bluntly: “We often view air pollution and climate change as separate silos, but in the Himalaya, they are one and the same.”
Black carbon is essentially soot from diesel emissions, brick kilns, and crop burning. It may be short-lived in the atmosphere, but when ash settles on snow and ice, it reduces reflectivity and accelerates melting.&nbsp;
Omar adds, “Black carbon is a threat to the water security of the entire Indus and Ganges basins.”
What burns on both sides of Punjab do not stay in Punjab. It ends up on glaciers that feed rivers, sustaining hundreds of millions of people downstream.
In November 2024, AQI levels in New Delhi hovered near 500 and about the same time Lahore briefly became the world’s most polluted city, with the AQI count crossing 1,100. These numbers are not abstract.
According to the <a href="https://www.stateofglobalair.org/resources/archived/state-global-air-report-2024" target="_blank">State of Global Air 2024 report</a>, India recorded more than 2 million deaths attributable to air pollution in 2023. Bangladesh and Pakistan each saw over 200,000 deaths. Air pollution is now one of the leading causes of premature death across South Asia.
Nepal, often imagined as cleaner by default, tells a sobering story of its own. Air pollution in Nepal led to an estimated <a href="https://www.worldbank.org/en/news/press-release/2025/06/17/air-pollution-is-the-number-one-health-risk-factor-in-nepal#:~:text=Vehicle%20Emissions:%20Continuing%20to%20electrify,airflows%20carry%20pollutants%20across%20borders." target="_blank">48,500 premature deaths</a>, with the loss of more than 1.4 million disability-adjusted life years. The University of Chicago’s <a href="https://aqli.epic.uchicago.edu/post/nepal-capital-chokes-as-wildfires-rage-en" target="_blank">Air Quality Life Index</a> estimates that particulate pollution cuts 3.4 years off the life of the average Nepali. In the Tarai region, life expectancy drops by nearly five years. In Kathmandu, residents lose 2.6 years.
Says infectious disease specialist Anup Subedee: “Air pollution is killing at a far higher rate than Covid-19 did during its worst years in Nepal. People are dying in their twenties of cancer, or having heart attacks and strokes in their thirties and forties.”
Nearly <a href="https://www.icimod.org/press-release/kathmandu-choked-on-polluted-air-for-75-of-the-last-90-days/?utm_source=chatgpt.com" target="_blank">40 per cent of winter particulate pollution in the Kathmandu</a> valley originates outside Nepal. Black carbon carried from Punjab, Haryana, and Uttar Pradesh in India, besides parts of Pakistan, rides the winds north, settles on Himalayan snow, and accelerates glacier melt by absorbing heat.
“The pollutants travel across borders within shared airsheds, creating one gigantic plume of polluted air over India, Nepal, Bangladesh, and Pakistan several times a year,” says Subedee.
In some Himalayan regions, <a href="https://www.icimod.org/success-stories/chapter-2/black-carbon-and-glacier-melt/" target="_blank">scientists estimate</a> that black carbon can increase localised melt rates by up to 30%. Yet global climate negotiations continue to treat glacial loss primarily as a carbon dioxide problem.&nbsp;
CHINA’S APPROACH
The South Asian story is transboundary, and more immediate as well as more preventable. This is not only about emissions. It is about coordination, and China offers an instructive contrast.
Since 2013, China has dramatically improved its air quality by declaring a '<a href="https://www.aljazeera.com/opinions/2025/12/12/what-new-delhi-can-learn-from-chinas-war-on-air-pollution#:~:text=In%20the%20following%20years%2C%20Beijing,29.3%CE%BCg%2Fm%C2%B3%20in%202024." target="_blank">war on pollution</a>'. A major air pollutant, suspended PM2.5 levels fell sharply through strict controls on coal, vehicles, and industry, massive investment in renewables, and legally binding national action plans.
Crucially, China shifted from city-by-city firefighting to a regional airshed approach. Provinces shared data, coordinated emergency responses, enforced unified standards, and tied environmental performance to political accountability. South Asian countries have done none of this.
Isolated national actions are insufficient when pollution itself ignores borders. India, Nepal, Bangladesh, and Pakistan share the same airshed. Without cooperation, each country keeps breathing its neighbour’s mistakes.
“As the government representing the largest population affected by air pollution, India should lead this effort. Instead, the region has drifted away from cooperation, and the cost is becoming catastrophic,” Subedee says.
The haze over Kathmandu is not only Nepal’s burden. It is a <a href="https://sapannews.com/2024/12/27/could-climate-diplomacy-be-the-googly-a-gamechanger-for-regional-cooperation/" target="_blank">regional failure</a>. The melting of South Asia’s glaciers is not just a global warming story. It is also a local one, written in the smoke rising from our own fields, factories, and highways.
If we keep ignoring black carbon, the Himalayas will keep losing time, snow, and stability. The disappearing peaks of Kathmandu are not a metaphor. They are a warning.
And like the air itself, that warning is already crossing borders. ©Sapan News
Pragyan Srivastava is an Indian journalist and associate editor at <a href="http://www.sapannews.com/" target="_blank">Sapan News</a>. <a href="mailto:pragyan@sapannews.com" target="_blank">pragyan@sapannews.com</a>

Cleaning up the Himalayan airshed

This is the 82nd episode of Diaspora Diaries, a Nepali Times series in collaboration with Migration Lab providing a platform to share experiences of living, working and studying abroad. In September, under pressure from GenZ activists, Home Minister Om Prakash Aryal pledged to ensure that overseas Nepalis would be able to vote in the March election. The analysis from experts, election officials, and much of the public was that the Election Commission was not prepared to ensure out-of-country voting in such a short time.&nbsp; But just because the diaspora cannot exercise its franchise does not mean Nepalis abroad cannot influence the election outcome. The 2021 census said 2.1 million Nepalis lived abroad, but realistically three times more live, work and study overseas.&nbsp; Being breadwinners also makes them decision makers for families back home. Most have left because they could not get meaningful jobs and sought opportunities abroad, which means they are not happy with the way Nepal has been governed by the established parties and leaders.&nbsp; The diaspora is therefore mostly an anti-incumbent vote bank, which was one reason the political leadership blocked out-of-country voting for so long – despite a Supreme Court ruling that all citizens had a constitutional right to vote, wherever they lived. &nbsp; In the 2022 polls, overseas Nepalis had already shown considerable influence by backing newer and alternative candidates like Balendra Shah for Kathmandu mayor, and parties like the RSP. In the four years since, and especially since the GenZ movement, support for a political shakeup has grown even stronger. So has technological reach that enables the diaspora to politically organise from overseas. &nbsp;‘Technology has reduced the distance in communication, but has also lowered the barrier in a way that allows overseas Nepalis to pressure family members,’ author Narayan Wagle wrote in an op-ed on Setopati this week. Indeed, all it takes for family members to be convinced whom to vote for is an ultimatum that relatives will stop sending money. With less than a month to go for the 5 March election, many Nepalis overseas are campaigning remotely for preferred candidates, even if they cannot themselves cast ballots.&nbsp; The overwhelming feeling seems to be that younger candidates should be given a chance. &nbsp;&nbsp; Read what some Nepalis abroad have to say. NEPAL'S NON-VOTING MIGRANTS <h2>My Respected Parents</h2> Anil Gole, Romania [This letter is a letter to my parents ahead of the election. They are UML supporters, my uncle is for the Nepali Congress (NC), and my grandfather supports the Nepali Communist Party (NCP).] My Respected Parents, I hear that election fever has picked up in the village. New faces with new ways of thinking have emerged this time. I don’t really understand politics, so what I say may feel bitter. But Father, when I see the flag with the sun in your hands, I remember the heat of Qatar from 12 years ago, your sunburnt skin and mother’s cheeks wrinkled with worry. Perhaps Uncle, too, found the Saudi heat so intolerable that he returned home. That may be why while seeking shade, he found the NC tree symbol endearing. &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Great uncle spent his whole life back home in the village, which is perhaps why he identifies with symbols like the plough, the sickle, and the hoe.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260206040236_669402ff85bdbd58360c12e10d23900ad99596b7a8dc196b8db1bcfe7e81e80e.jpg" data-media-id="editor_0" data-image-id="20260206040236_669402ff85bdbd58360c12e10d23900ad99596b7a8dc196b8db1bcfe7e81e80e" data-rendition-name="original" width="1200" height="1600" loading="lazy" alt="Overseas vote bank NT"> <figcaption>Anil Gole</figcaption> </figure>  Even then, at any cost, vote for the same politicians. Vote for the same politicians who have not developed the country, who have not fed the poor, whose sons have not been shot.&nbsp; What if the country does not change? I have changed my country. When homesick, I have learnt what it feels like to suffocate in tears under a blanket. Now my younger brother is old enough. Send him here as well. We brothers will earn together. We will marry off our sister in a grand way. So what if the country does not develop? We will build a small, cute house with a big yard. You can play with the grandchildren there. And when they grow up, they too can migrate. But if you vote for the right people and the country gets good leaders, future generations will not have to sweat in foreign lands. They will not have to leave the comfort of a mother’s lap to spend nights abroad in unknown cities. No matter how hard things get, they will not have to lie in letters to their mothers,saying, “I’m doing fine, Mother.” I have not lost courage because of your blessings. My body is here, but my mind is always back home in Nepal. Your children are here, but my children’s future is in your hands. That is why vote for the same politicians whose hearts did not bleed even when the young were killed, the same politicians whose children have not come home in a box. Mother and Father, please take care of each other. Yours truly, Your fortunate migrant son <h2>Algorithm versus vision</h2> Ambika Paudel, Qatar I have been in Qatar for 18 years, and work in the facilities management, engineering, shipping and logistics &nbsp;industry. I get to interact with people from across the world, and they are closely connected with their embassies through online systems and communities. I lead the Nepal Expatriate Community that has multidisciplinary professionals and have observed the need to revise the narrative around migrants. We are here for our families. The sacrifices we make are for them. We are working for our own career growth and families because there were no opportunities back home. Many of us have achieved a good standard of living through our hard work and merit. When I send money to Nepal, it is for my family and the benefit to the government is a byproduct. It would have been good if we got to vote, too. That possibility and promise got lost somewhere in the policy confusion and lack of technical capacity. Overseas Nepalis are also deeply invested in the election, but it is largely algorithm based. We are not questioning the vision of the candidates.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260206040236_dc05b31d3abcf126360d923615a785a36de5b62a8695af9cbff000b586d0336d.jpg" data-media-id="editor_1" data-image-id="20260206040236_dc05b31d3abcf126360d923615a785a36de5b62a8695af9cbff000b586d0336d" data-rendition-name="original" width="1200" height="1600" loading="lazy" alt="Overseas vote bank NT"> <figcaption>Ambika Paudel</figcaption> </figure>  Our parents back home are the actual voters, and those overseas &nbsp;are talking to them. I don’t think they will be swayed just based on calls, and they shouldn’t be either. We are prioritising algorithms and words and social media boosts over vision, experience, and concrete plans. I am for the NC but I am not a blind supporter. Despite being at the forefront of every significant democratic change in Nepal’s history, the party has had lapses but it is currently on a new trajectory. Not all candidates of all parties are good so we have to elect competent leaders and question them. Whatever promises they make need to be examined for delivery and vision.&nbsp; There are also Congress loyalists who are swayed and influenced by the new, but I let it be — it is their right, their choice. Change requires vision and experience, it should not be based on hype, I remind them. Over online conversations, I tell them to vote wisely so they don’t regret it later. I returned from my break just recently so I cannot come home to vote as it will be too expensive. There are good human resources back in Nepal and in the diaspora which can be used. There are people in decision-making positions in their companies who are very capable and intelligent who could contribute to Nepal. These are missed opportunities in our policymaking and governance: Nepal needs to create opportunities for capable Nepalis.&nbsp; The new government can make the investment climate better through a one-door system so that services are accessible, quick and there is no need to go to multiple offices to start a company or pay taxes. This would also stop unnecessary bribes and other hassles. I don’t have plans to return in the near future. I have a good job and am earning well. I came to Nepal between 2016 and 2019 and remigrated again after things did not work out. <h2>The young need convincing</h2> Jeevan Kumar Dewan, Malaysia I have been living in Malaysia since 2001, and am an active member of the UML wing here. There is excitement about the upcoming election, but we are bound by contracts so cannot go home to vote.&nbsp; There was hope that we would be able to vote from overseas, but there were questions of security. Even though we won’t be able to vote, people are actively participating online and using social media to show their support to their candidates and parties of choice.&nbsp; Political parties prioritise organisational expansion overseas but there is no direct campaigning during elections. It is through conversations and social media engagement that people are participating, debating and expressing their support and loyalty.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260206040240_2ed54377199b995f0a19b7be98fff79004c13787c7a07185a47427467237277a.jpg" data-media-id="editor_2" data-image-id="20260206040240_2ed54377199b995f0a19b7be98fff79004c13787c7a07185a47427467237277a" data-rendition-name="original" width="2048" height="1536" loading="lazy" alt="Overseas vote bank NT"> <figcaption>Jeevan Kumar Dewan</figcaption> </figure>  &nbsp;As a UML supporter, it is my duty to remind people to cut through the noise and to separate facts and truth. While elderly voters don’t need much convincing as they are loyal to the party, I do engage a fair amount with the young voters. I have to remind them not to get distracted by the videos shared in social media platforms. All new is not good just because it is new if there is no real political agenda. There is no doubt that we need change but being new is not enough nor can we overlook the contributions and experience of the old parties. All we can do is talk to the voters and try to get our message across. It is important to prioritise better managed migration and also to ensure migrants have proper guidance on how to invest their hard-earned money in productive sectors, even when it is not much, so they have something to fall back on after returning. I don’t have plans to return immediately, I go back and forth quite frequently. I have a stable job and I have seen how my friends who left secure jobs to return home ended up remigrating after their investment failed. I will stay here and continue with my job which I am happy with. <h2>The old need convincing</h2> Prajwal Poudel, Saudi Arabia I work as a data entry analyst in Saudi Arabia. People overseas have seen development, but have also experienced challenges of being away from home. Politicians are aware of this and didn’t want us to vote.&nbsp; When I was in Nepal, I did not care much about politics. It was not for me. But overseas we care about Nepal even more. Perhaps you don’t know the value of something unless you lose it. Perhaps distance makes hearts grow fonder. I am definitely more invested in Nepali politics after leaving.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260206040240_43ea30dfb58b873760e40177d84dca4bb34f1c9cdffdbc9a7c5a0c26b15e78b9.jpg" data-media-id="editor_3" data-image-id="20260206040240_43ea30dfb58b873760e40177d84dca4bb34f1c9cdffdbc9a7c5a0c26b15e78b9" data-rendition-name="original" width="738" height="1600" loading="lazy" alt="Overseas vote bank NT"> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260206040240_dfbc2302411e1ae32a4ab048fa34d940147942c00845d82d9cf59574f5c2e0fe.jpg" data-media-id="editor_4" data-image-id="20260206040240_dfbc2302411e1ae32a4ab048fa34d940147942c00845d82d9cf59574f5c2e0fe" data-rendition-name="original" width="1080" height="1200" loading="lazy" alt="Overseas Nepali vote bank NT"> </figure>  So I have to make sure that family members back home make the right decision this election. My cousin is also with me in Saudi Arabia and I was talking to his parents and telling them to vote correctly. They have voted for the same faces for two decades. I said that if there had been changes we would not have had to migrate. That this time they should accept the masu-bhat and alcohol, say UML-Congress jindaawaad, take the money offered but finally stamp on Ghanti.&nbsp; My cousin posted a recording of that call spontaneously on Tiktok. It went viral perhaps because it resonated with the youth. We cannot vote but we have to make sure at least our close family members vote correctly. My mother also seems ready for a change despite her loyalty to the UML, but I tell her she does not need to change her party just change her vote this year.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260206040240_0234dfec6f97a726f67120124833bb3fdc84cbf794eee910736649c5624e7576.jpg" data-media-id="editor_5" data-image-id="20260206040240_0234dfec6f97a726f67120124833bb3fdc84cbf794eee910736649c5624e7576" data-rendition-name="original" width="1168" height="1556" loading="lazy" alt="Overseas vote bank NT"> <figcaption>Prajwal Poudel</figcaption> </figure>  We need to give the new ones a chance. But it’s also true that the new will not bring dramatic changes overnight. Conversations here are all about the election back home. We talk about who is getting elected from their areas. Who they think will win. But the hottest topic of conversation is of course Jhapa. For those of us abroad, the government should make our embassies stronger. Back home, I hope corruption will be curbed and that good roads will reach all corners of the country. This will allow people to develop the country themselves.&nbsp; I am the son of a Malaysia returnee. I even worked as a teacher in Nepal. I could not even afford decent clothes so I left everything and came here. I don’t know when I will return.

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