Spring 2023 was the <a href="https://www.nepalitimes.com/news/on-mt-everest-s-70th-records-and-fatalities">deadliest season on Mt Everest</a>, with 17 climbers dead or missing on the world’s highest mountain. But the trail leading to the base of the mountain also saw record numbers of trekkers and porters falling sick due to altitude sickness. An unexpectedly high number of people had to be treated at the Himalaya Rescue Association (HRA) aid post at Pheriche (4,300m) and at the Everest ER at Base Camp for HAPE (high altitude pulmonary edema).&nbsp; In an average year, the HRA aid post used to get only about 15 cases of HAPE, but this spring season alone there were an alarming 50 cases with clear-cut clinical diagnosis confirmed by field ultrasound detection of lung fluid.&nbsp; Only five of the 50 patients were foreign trekkers, the rest were Nepalis and mostly porters. Medical personnel in Pheriche are scratching their heads to figure out the reasons for this high patient load. One reason is the post-Covid backlog of trekkers and mountaineers as Nepal’s climbing industry saw a surge on the <a href="https://www.nepalitimes.com/here-now/everest-70-years-on">70th anniversary of the first ascent</a> of Everest by Hillary and Tenzing. Many of the hikers and climbers said they were also drawn to Nepal by a <a href="https://www.nepalitimes.com/review/on-screen-mountains">series of adventure films about the Himalaya</a>, including Nims Purja’s 14 Peaks: Nothing is Impossible.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20230702110740_afa83e5d2e010a828bb566e909f6c004ebe50aebf5d82deabd70a503f38f725d.jpg" data-media-id="editor_3" data-image-id="20230702110740_afa83e5d2e010a828bb566e909f6c004ebe50aebf5d82deabd70a503f38f725d" data-rendition-name="original" width="1080" height="810" loading="lazy" alt="high altitude pulmonary edema"> <figcaption>Everest ER at Base Camp.</figcaption> </figure>  There was also a spurt in Indian trekkers and climbers, and one reason could be the Bollywood movie <a href="https://www.nepalitimes.com/here-now/lights-camera-action-in-nepal">Uunchai starring Anupam Kher and Ambitabh Bachchan</a> which was shot on location in the Khumbu and Manang last year. There were 50 companies guiding nearly 500 clients on Mt Everest alone, with more expeditions on Lhotse, Ama Dablam, Nuptse and other peaks. More expeditions meant more guides and support staff. There were nearly 2,500 people in May living for up to three months in the tent city at Everest Base Camp. &nbsp; There has also been a steady shift to other ethnic groups working as guides and porters in the Himalaya. Instead of Sherpa, who are in all likelihood genetically adapted to high altitude, the Rai, Tamang, even Chetris and Brahmins are more susceptible to high altitude sickness.&nbsp; HAPE can be life-threatening as the lungs drown in fluid. Unlike acute mountain sickness (AMS), which is relatively benign and common in sojourners even at lower altitudes in the Khumbu HAPE is similar to high altitude cerebral edema (HACE) in which the brain itself becomes water-logged. &nbsp; The other reason for the dramatic increase in HAPE this season could be that there was a greater disregard (possibly due to lack of awareness) for the most important risk factor for altitude illness, the rate of ascent. Many porters may have spent just one night in Namche Bazar (3,440 m) instead of 2 nights on their ascent to Pheriche and higher.&nbsp; Many scientific studies have clearly shown that spending only one night in Namche Bazar dramatically increases the risk for altitude illness. Other reasons for HAPE predisposition could be colder temperatures this spring with heavier snowfall, which meant greater physical exertion at high altitude. Whatever the reasons, this enormous increase in HAPE patients strained the resources of the HRA. Private clinics in the Khumbu region generally do not see these very sick, uninsured patients for free, so most of the 45 patients turned up at the HRA.&nbsp; “Many of the sick porters had no friends or support,” said HRA’s Gobi Bhasyal. “They were kept for at least night for observation with careful nursing care and oxygen from bottles or concentrators at the clinic.”&nbsp; Most were discharged after two days. None of the patients had health insurance and they had to rely on kind helicopter pilots who would give them a lift down to Lukla for free provided there was a western client who was paying to be rescued. &nbsp; “We not only had to look after the patients in the clinic but also find willing helicopter pilots who would allow the patient to piggy back on a paid ride,” said Thaneshwar Bhandari, HRA’s health assistant.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20230702110740_18f11710dd23940a59e98c0c4508452c5f57062f9e231f5679aa3629eeaf4301.jpg" data-media-id="editor_5" data-image-id="20230702110740_18f11710dd23940a59e98c0c4508452c5f57062f9e231f5679aa3629eeaf4301" data-rendition-name="original" width="1080" height="810" loading="lazy" alt="high altitude pulmonary edema"> <figcaption>HRA Pheriche Aid Post.</figcaption> </figure>  Indeed, it is a tribute to the dedication of HRA staff that all 50 patients treated at the clinic this season recovered. The high incidence of altitude sickness was also reflected in the rise in rescue helicopter traffic in the Khumbu this season. Heli medevacs are life saving for many patients where the most important treatment is descent.&nbsp; But helicopters were also being used indiscriminately for commercial purposes in the Khumbu for dubious indications, like for a patient with diarrhoea or just fatigue. &nbsp; There more than 50 daily helicopter flights in the Khumbu this season from 6AM to 6PM. This in turn had a detrimental effect on the wilderness experience for many trekkers, and could in the long term impact on future tourism prospects.&nbsp; This year’s Everest ER was staffed by physicians Andrew Nyberg, Sachin Subedi and Suraj Bhatta, and in Pheriche by Luke Apisa, Renata Bueno and Nishant Joshi. The HRA post in Manang had Craig Kutz, Catherine McBride and Shama Bhandari. Ken Zafren from Alaska has helped select volunteer doctors for almost 3 decades. Buddha Basnyat, MD, is Medical Director of the Himalayan Rescue Association (HRA).

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More porters sick on Everest trail

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221107171136/6369343e9c7e80680e03dfe5jpeg.jpg" alt="" width="2000" height="1373"/><figcaption>Photo: HRA</figcaption></figure>Kathmandu is hosting the XII World Congress on Mountain Medicine 21-24 November, and the location is indeed appropriate considering that it was in the Nepal Himalaya that modern mountain medicine made great advances in altitude illness.Acute altitude illness requires two things in order to happen: 1) a person not adjusted to high altitude, and 2) going high quickly, faster than the body has time to adjust. Before the advent of modern transportation, no one could travel high enough fast enough to get into much trouble. Altitude illness is therefore mainly a problem of modern times. The largest experience with altitude illness prior to the advent of trekking in Nepal was when the Indian Army, in the Sino-Indian war of 1962, was airlifted rapidly to over 5,000 m.Read also:<a href="https://www.nepalitimes.com/latest/high-alert/" target="_blank" rel="noopener">High alert</a><a href="https://www.nepalitimes.com/opinion/trekkers-with-the-trots/" target="_blank" rel="noopener">Trekkers with the trots</a>, David R ShlimAlthough foreigners started walking around Nepal in the early 1950’s, larger scale trekking only began in the late 1960’s. Trekkers, unaware of the risks of ascending rapidly, began to die on their treks. The number of evacuations and deaths became alarming to the fledgling trekking industry and the few agencies in operation at that time banded together to start the Himalayan Rescue Association (HRA) in 1973, organised by a former Peace Corps Volunteer named John Skow.John Dickinson, who began work at the old Shanta Bhawan Hospital in Patan in 1969, became the receiving physician for severe cases of altitude illness. He and Dr Bond, the pathologist, published the first series of autopsy findings in trekkers dying from altitude illness. This work brought the world’s attention to the problem of altitude illness in Nepal, a rather mysterious condition that stuck down perfectly healthy young people venturing into thin air. Dickinson became the first medical advisor to the HRA.Under the leadership of Tek Chandra Pokharel, Mike Cheney, Dawa Norbu Sherpa and Robert Reiffel in the early 1970’s, the HRA staffed an aid post in the village of Pheriche, at 4,300 m on the path to Everest. When I first passed through Pheriche in 1974, the post was staffed by an American nurse and a famous climbing Sherpa, Tashi. Wanting to stay in Nepal, I volunteered for the next season, and many seasons after that. I became the medical director of the HRA until 1983 when David Shlim (see his contribution alongside) became the medical director after he moved to Nepal to run the CIWEC Clinic.In Pheriche, I conducted the first studies of altitude illness in trekkers. We ended up suggesting a schedule that included rest days on the ascent to Kala Pattar. This new schedule cut the incidence of altitude illness in half but did not completely eliminate it. We demonstrated the value of Diamox (acetazolamide) in preventing altitude illness. A 1977 paper in the Lancet was the first large study of altitude illness in a civilian population, and put Pheriche on the world map as a center for altitude illness research.The HRA now operates the clinic in Pheriche and a clinic in Manang, on the Annapurna trek. These clinics have been, and still remain, the best clinical experience a doctor can get in diagnosing and treating altitude illness. The HRA is currently operated by an all-Nepali board of directors with Buddha Basnyat, a former student of Dickinson’s, as medical director.Nepalis are not immune to the effects of altitude illness. Trekking guides, porters, and climbers have all suffered, and all too frequently, died of altitude illness in the course of their jobs. Basnyat was the first to study the risk of altitude illness in Hindu pilgrims to high altitude sites in Nepal. Just because they are Nepali and have the Himalaya in their backyard does not offer immunity to the effects of low oxygen at altitude.Pilgrims to events such as the Janai Purnima Festival are generally low-altitude people who ascend far too rapidly, such as from Dhunche at 1,960m to Gosainkund Lake at 4,380m, in only 48 hours instead of a safe 4 days. The HRA provides a temporary health camp at the lake for pilgrims and treats many cases of severe altitude illness, preventing deaths and difficult evacuations.The most auspicious development in mountain medicine in Nepal is the large cadre of young Nepali physicians who are now intensely interested in high-altitude medicine. Mentored by Basnyat, these young doctors are carrying on the tradition of quality care of victims of altitude illness, research on causes and treatments, and developing systems of administering care to diverse populations. The Nepal Himalaya, and the HRA, is still a backbone of modern mountain medicine.Peter Hackett is a world renowned high altitude expert and a leading authority on altitude illness, high altitude climbing, and the effects of altitude on people living and working in the mountains.

Going to great heights to prevent altitude illness

From stone spouts to cast-iron mains, Nepal’s water system and its struggle to provide safe water tells a larger story of power, disease, dependency — and lessons for the future. From 1823 to 1891, the Nepali state made just two notable interventions in Kathmandu’s drinking water system. The first was when Prime Minister Bhimsen Thapa commissioned a stone pout (hiti) to tap groundwater within the valley’s traditional supply system. The second came nearly 70 years later with Nepal’s first industrial-era water system, the Bir Water Works in 1891 under Prime Minister Bir Shumsher Rana. Linking these two milestones was the spectre of cholera. From the 19th century on there were seven global cholera pandemics. <a href="https://www.sciencedirect.com/science/article/pii/S0264410X19309995#bb0325" target="_blank">Originating in Asia</a>, the disease reached Europe and the Americas, the Vibrio cholera bacillus breeding in poor sanitation wherever it found it. The first wave erupted in 1817, followed by others in 1829, 1852, 1863, 1881, 1889 and, finally, in 1961, the seventh pandemic which still lingers on. London, the epicentre of the Industrial Revolution, was repeatedly stricken. In Britain ‘miasma’ foul air was blamed. &nbsp;In Nepal, cholera was seen as divine damnation. By the late 19th century, as Nepal’s relationship with Britain deepened, the Bir Water Works was inaugurated in 1891 as a defence against cholera. Whether cholera also shaped Bhimsen Thapa’s decision in 1823 is less clear. Contemporary records note the commissioning of Sundhara, but do not refer to the cholera epidemic raging at the time. The silence itself is telling: Nepal’s elites were ruling in the shadow of the disease. Bhimsen Thapa first resided in Thapathali Palace, which was built in 1802 by Nain Singh Thapa, father of Mathabarsingh Thapa, who would briefly become prime minister in the 1840s. In 1806, Bhimsen Thapa moved to Bagh Durbar, a new complex on the western edge of Tundikhel. Historians are vague about the water supply in the residences of the nobility, but wells and water hauled from rivers, ponds, canals, and other sources were likely the primary sources. A small hiti north of Bagh Durbar, near today’s Sun Dhara, may have supplied the palace. In 1823, Bhimsen Thapa had it enlarged, making it the last and largest state-built hiti in Kathmandu. Even as Bhimsen Thapa was involved in palace intrigues and border conflicts, Britain was engineering pipelines. By the late 18th century, Sir Thomas Simpson had invented the bell-and-spigot joint, making long-distance pipes viable. Fluid dynamics, dealing with pumps, pipes, and filters, was becoming a foundational discipline. In Kathmandu, the scourge continued. Cholera struck Kathmandu repeatedly, in 1862, 1867, 1872, 1874 and 1875. The 1872 epidemic, <a href="https://nepalitimes.com/news/kathmandu-in-the-time-of-cholera" target="_blank">according to historian Tom Robertson</a>, claimed between 200 and 250 lives a day. On average, cholera killed between 1,200 and 1,500 people annually in Kathmandu Valley, an enormous toll for its small population. The summer of 1885 was especially calamitous: a cholera epidemic ravaged Kathmandu and its periphery from the beginning of June until late August. The disease even breached the royal palace, reportedly killing 23 people, mostly young girls. Records show that 909 people received treatment at the British Residency dispensary, and estimates suggest that as many as 10,000 people perished in a city of 50,000. In November that year, Bir Shumsher seized power in a coup. He inherited not only a premiership but a Valley ridden with disease. Cholera was endemic, and it was accompanied by typhoid, smallpox, goitre, syphilis, and chronic dyspepsia. The The British Residency dispensary at Lainchaur was inadequate. “In a poor country like ours, wealth means health,” Bir Shumsher remarked, an unusually pragmatic admission that epidemics were not divine punishment but structural afflictions of urban life. He soon pledged to expand health care. In 1889, he opened Bir Hospital and staffed it with Indian doctors to treat cholera, typhoid, smallpox, and other prevalent illnesses. PIPED WATER Bir Shumsher also recognised the need for safe drinking water. Between 1866 and 1872, he had served as Nepal’s ambassador in Calcutta, and he must have seen water mains already in operation there, and a filtration plant inaugurated in 1870. Madras had installed such a system as early as 1800, Bombay constructed the Vihar and Tulsi reservoirs in the mid-19th century. In Kathmandu British Residency personalities such as George Gimlette must have urged Bir’s government to quicken the construction of the hospital and water system, yet the archival traces of such exchanges still await historical scrutiny. By the late 19th century, the British had developed a technological ecosystem for water supply, intakes, pipes, fittings, reservoirs, and trained engineers. Bir Shumsher appealed to the British Government in India for engineering assistance. A British engineer named Mr Feigneur surveyed Kathmandu to prepare maps, and estimated the volume of water that could be brought from the Rudramati River. In 1889, a more experienced engineer, Lockhart Matthew Sinclair arrived. He was a Scotsman educated at Wellington College and the Royal Indian Engineering College, with prior experience in constructing waterworks in Jubbulpore and the Viceregal Palace in Shimla. Appointed State Engineer of Nepal (1889–1892), Sinclair reviewed Feigneur’s plans, updated them, and chose the Bishnumati River as the source of the city’s drinking water. Sinclair’s design included a reservoir at Panipokhari, at 1,330m elevation and 30m above &nbsp;Tundikhel, thereby enabling gravity-fed distribution in pipes. With a capacity of 7,327 cubic metres, the reservoir could store nine days of supply.&nbsp; The system was designed to serve about 70,000 residents through both private connections and public standpipes. The reservoir was a single-compartment tank with an arched brick roof covered in earth and turf. Its brick walls were bonded with lime mortar and aggregate, and its floor was dressed with fly stone. Work on the valley’s water supply began in 1888, three years after Bir Shumsher seized power. The following year, Bir Hospital and the Bir Water Works took shape. The project involved some 40km of imported cast-iron pipes, weighing 1.866 million kg and inscribed with the marks of Scottish foundries ‘Ally and McLean’ and ‘Glasgow’. Construction required 620,000 man-days of labour and cost over Rs600,000. Transport costs inflated prices: <a href="https://commons-nepal.com/the-first-kaldhara-in-the-four-cities-of-the-valley/" target="_blank">a load of cement</a> costing Rs10 in Calcutta was worth Rs33 by the time it reached Kathmandu. Bir Water Works was inaugurated in September 1891, six years after the cholera epidemic. Water flowed out of 131 taps, including eight in Lainchaur, six in the royal palace, eleven in the prime minister’s palace, sixteen around Tundikhel, thirteen in Thapathali, seven in Thamel, and two in Naxal. The system’s designation, the term ‘works’ , echoes the Chelsea, Calcutta, and Glasgow Water Works, underlining its industrial pedigree. Water was also supplied to Phora Durbar, Bir Shumsher’s palace of music and dance whose fountains sprayed rose-scented water in a display of opulence. The <a href="https://commons-nepal.com/the-first-kaldhara-in-" target="_blank">Bir Dhara Works</a> was more than an engineering scheme: it was Nepal’s first modern public-health intervention. Safer drinking water curbed waterborne disease, and the number of cholera outbreaks declined, but were not eliminated.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260103020144_d5c22de54c0eaab680a166c5a7482839fdc09b60679109021d0504252a810254.png" data-media-id="editor_4" data-image-id="20260103020144_d5c22de54c0eaab680a166c5a7482839fdc09b60679109021d0504252a810254" data-rendition-name="original" width="865" height="535" loading="lazy" alt="Cholera and drinking water in Kathmandu"> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260103020144_a46075b6d759585df56a2bb8e5a07d85de7d9a69406165c32784fe30012c9971.jpg" data-media-id="editor_5" data-image-id="20260103020144_a46075b6d759585df56a2bb8e5a07d85de7d9a69406165c32784fe30012c9971" data-rendition-name="original" width="2791" height="3859" loading="lazy" alt="Cholera and drinking water in Kathmandu"> </figure>  “Now we have water to fight cholera, and I believe cholera will no longer prevail. After four years of piped water, the benefits have been greater than expected,” Bir Shumsher said in a proclamation. Despite this, the prevalence of poor sanitation, open defecation, cramped housing, and malnutrition meant that typhoid, smallpox, and dyspepsia remained endemic. The Bir Dhara system marked Kathmandu’s transition from reliance on wells, rivers, springs, and hiti to piped water, operating for several decades and laying the foundation for the expansion of drinking water services across the country in the late twentieth century. <a href="https://commons-nepal.com/the-first-kaldhara-in-the-four-cities-of-the-valley/" target="_blank">Extensions followed in Patan</a> under Chandra Shumsher, and Bhim Shumsher later added the Tri Bhim Dhara. Piped water systems were subsequently constructed in towns such as Kirtipur, Bhaktapur, Dhankuta, Pokhara, Dhulikhel, and Jajarkot which itself saw a deadly cholera outbreak in 2009.&nbsp; CHOLERA METAPHOR In 1933, Nepal’s first water bureaucracy, the Pani Goswara, was established, formalising state involvement in urban water supply. Yet even till the late 20th century, households continue to rely on a mix of sources, including public water networks, private vendors, rooftop storage tanks, borewells, wells, hiti, and household filtration. The lack of reliable water supply places disproportionate financial, physical, and psychological burdens on low-income households, underscoring how decades of infrastructure expansion have not translated into universal, reliable service. during challenges in governance, investment priorities, and regulation. Bir Shumsher also attempted to introduce <a href="https://www.ukaalo.com/news/cholera-in-kathmandu-1958/" target="_blank">basic hygiene measures</a>, such as pit latrines with squatting slabs. However, there is no record of these facilities being built in his palaces, later built palaces, or elsewhere. Sanitation conditions remained poor for both the elite and the general population. Open defecation or the use of crude pit latrines without proper waste disposal was common. With no drainage or sewer systems, human waste accumulated near homes, contributing to the spread of waterborne diseases. In 2019, Nepal declared itself ‘open defecation free’, a policy milestone, but this achievement masks the persistence of deeper problems. Urban areas generate some 867 million litres of wastewater daily, yet only 7% of it is treated before being discharged. Sewage flows untreated into rivers and streams, spreading cholera, typhoid, dysentery, and other diseases, particularly among children and vulnerable communities. Safe disposal of faecal sludge continues to be a major struggle for many communities and local governments. Besides Jajarkot, Godavari in Kathmandu Valley had a localised outbreak in 2024. This year, Birganj was struck by a cholera outbreak caused by a lethal combination of unreliable water supply, groundwater overpumping, poor drainage and hygiene, and unsafe waste disposal. And Nepal’s peacekeepers deployed after the earthquake in Haiti in 2010 were blamed for spreading cholera that ultimately killed 30,000 people in the Caribbean nation. The Bir Water Works was more than a reservoir and pipes. It was Nepal’s first brush with modernity, mediated through engineering and haunted by cholera. More than 134 years on, cholera remains a threat and a reminder of Nepal’s challenges in water and sanitation governance. The issue is not merely ensuring access to safe water but also building public trust that quality essential services can be delivered equitably, sustainably, and with resilience. Ajaya Dixit is a Kathmandu-based researcher exploring Nepal’s water history since the mid-eighteenth century to inform ethical water and river management in a changing climate.

Life in a time of cholera

As someone born and raised in Patan, I knew that the city was rich in art, architecture and intangible heritage. But I never realised just how rich, and how little I knew about its hidden treasures until this book. Yala Mhasika/Exploring Lalitpur/Lalitpurko Chinari is published by the Lalitpur Chamber of Commerce &amp; Industry and introduces the city to the world, as well as to its own inhabitants. Lalitpur is popularly known as Patan, probably because of the pastures for livestock in its outskirts. Its original name in Nepal Bhasa is Yala, and is a blend of urban and rural, old and new.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260101120152_700fb4c7b27d78813f69347846403c492cd1d54e2f62e4ec097013714c4a2022.jpg" data-media-id="editor_0" data-image-id="20260101120152_700fb4c7b27d78813f69347846403c492cd1d54e2f62e4ec097013714c4a2022" data-rendition-name="original" width="2000" height="1333" loading="lazy" alt="Exploring Lalitpur book review"> <figcaption>Patan Dhoka</figcaption> </figure>  Like other kingdoms in the valley of Swoniga, the dense urban cluster of houses, temples, monasteries were situated along the higher ground, while the farmlands were on the slopes leading to the rivers below. This unique townscape combined an urban lifestyle within a distinctly agriculture-based rural setting. The fertile soil, replenished by organic nutrients washed down from the streets above, as well as Kathmandu’s location on the ancient trade route between India and Tibet, provided the Valley’s kingdoms with prosperity – and thus the flourishing of art and culture over centuries. Most of Yala’s residents were farmers, traders, or artisans. Chinese visitors who came to Nepal in the 6th century saw that there were more traders than farmers, and more temples than houses. An entire street is inhabited by the descendants of Lhasa traders. Arniko is supposed to have been born in Yala.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260101120152_0fb490355fac9b8252c9abfbf5ef1bbac844b29103744a421eb6ef6dbc77dff7.jpg" data-media-id="editor_1" data-image-id="20260101120152_0fb490355fac9b8252c9abfbf5ef1bbac844b29103744a421eb6ef6dbc77dff7" data-rendition-name="original" width="2000" height="1332" loading="lazy" alt="Exploring Lalitpur book review"> <figcaption>Kwonti area which houses five-storey Kumbeshwar temple dedicated to Shiva and Baglamukhi temple dedicated to Dasa Mahavidya shakti peeth.</figcaption> </figure>  Nepal exported goods and even minted coins for Tibet, and had a virtual monopoly of the major trans-Himalayan trade routes. This prosperity was reflected in monuments and shrines like the Kwa Baha Golden Temple. More so than the other three kingdoms of Swoniga, architecture flourished in Yala making it the centre for metal, stone and wood craft. The name Lalitpur means ‘city of fine art’ but with its sense of community, it might as well be a city of fine living. Legend also has it that the name Lalitpur comes from a farmer called Lalit who helped bring the rain god Karunamaya from Assam when the Valley was suffering a prolonged drought. Lalit’s shoulder beam stands to this day in Jhatapol. Disasters, invasion and <a href="https://nepalitimes.com/here-now/life-in-a-time-of-cholera">epidemics</a> were a recurring theme in Patan.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260101120152_b33b1024cb7a46f49fea35ecc9afa2740895907059d7a43c8bd6c463b1be05e7.jpg" data-media-id="editor_3" data-image-id="20260101120152_b33b1024cb7a46f49fea35ecc9afa2740895907059d7a43c8bd6c463b1be05e7" data-rendition-name="original" width="2000" height="1333" loading="lazy" alt="Exploring Lalitpur book review"> <figcaption>Ajima of Haugal Tole which is the oldest stone scripture in Nepal with the Gaja Laxmi in Chyasal.</figcaption> </figure>  The book was put together by the heritage expert team of Rosha Bajracharya, Sunil Pandey and Anil Chitrakar and provides a socio-economic and political history of Patan – how it was always food surplus, thanks to sustainable farming until recently. Ground and drone images by Photo Venture Nepal in the book give us a rare new perspective on Patan. There is an entire chapter on the chariot festival of Karunamaya (Machhindranath), a community-managed festival with Barahi carpenters assembling the woodwork, vine engineers Yamva weaving rope and rattan for the 25m tall chariot, and Ghaku drivers controlling the speed and brakes as the structure rolls through narrow streets in the annual festival.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260101120152_d27b23aeb4548b0b64ab8ed20f40baa331060498c6b5443e2cb999b876c670af.jpg" data-media-id="editor_4" data-image-id="20260101120152_d27b23aeb4548b0b64ab8ed20f40baa331060498c6b5443e2cb999b876c670af" data-rendition-name="original" width="2000" height="1333" loading="lazy" alt="Exploring Lalitpur book review"> <figcaption>Te Bahal in Patan which houses Karunamaya six months a year.</figcaption> </figure>  WALKING, WORSHIPPING The book can help in exploring Patan along five routes starting in Patan Dhoka, Pulchok, Shankhamul, Mahaboudha and Lagankhel with maps and details of the baha and bahil, shrines, ponds, open spaces, dhyochenn, courtyards and phalcha along the way. Because of its coffee-table size and heft, however, the guidebook is not practical to carry around. And despite detailed descriptions of the past and present of each site, readers are left wanting to know more about those places. It is proof of Patan’s vast treasures that even this book barely scratches the surface.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260101120152_31a597b7dc1bcc9f67b4f6a66b8c1c0e0a9406727389699e6aed9ac6c3c50901.jpg" data-media-id="editor_5" data-image-id="20260101120152_31a597b7dc1bcc9f67b4f6a66b8c1c0e0a9406727389699e6aed9ac6c3c50901" data-rendition-name="original" width="2000" height="1332" loading="lazy" alt="Exploring Lalitpur book review"> <figcaption>Patukodom where visitors can view what remains of the ancient Kirant palace.</figcaption> </figure>  Some of the lesser-known must-visit sites include Patukodom which is all that remains of a palace of the original Kirat inhabitants of Patan. An archaeological dig here would surely unearth hitherto unknown facets of pre-Newa Patan. Then there are the slightly out of the way shrines like Mahabouha, a replica of a temple in Bodhgaya which houses 3,341 terracotta Buddhas with 90 big statues and which took 35 years and four generations to complete.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260101120152_ffb657dc254f707dc1755f6f13b1ef67bb7183b6573da9678c54482129fb3878.jpg" data-media-id="editor_6" data-image-id="20260101120152_ffb657dc254f707dc1755f6f13b1ef67bb7183b6573da9678c54482129fb3878" data-rendition-name="original" width="2000" height="1333" loading="lazy" alt="Exploring Lalitpur book review"> <figcaption>Mahaboudha is a replica of a temple in Bodhgaya.</figcaption> </figure>  In a recent Patan by Night heritage walk, we learnt that Pim Bahal was the labour of love of a lakhe demon (now popularised as masked dancer) who had fallen for a local girl, and he dug the pond so she would not have to walk to a faraway spout to collect water. Nearby is the Charumati Chaitya, built by the daughter of Emperor Ashoka when she visited the Valley in the 3rd century BCE to spread Buddhism in Nepal. Interestingly, if Kathmandu is a city of temples, Patan is the centre of monasteries which represent a unique Tantric melding of Buddhist and Hindu forms. Examples are: the Tadham Cuka with relocated Licchavi-era chaityas symbolic of the four major events in Buddha’s life, Ajima of Haugal Tole which is the oldest stone scripture in Nepal with the Gaja Laxmi in Chyasal, and Bignantak Ganesa temple which is a manifestation of Shiva mingled with Vajrayana Buddhism.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260101120152_17a500e77f06b9881f684329e41d3482f6f6a639ffb929d8bb44e5af7934c61c.jpg" data-media-id="editor_7" data-image-id="20260101120152_17a500e77f06b9881f684329e41d3482f6f6a639ffb929d8bb44e5af7934c61c" data-rendition-name="original" width="2000" height="1333" loading="lazy" alt="Exploring Lalitpur book review"> <figcaption>Bignantak Ganesa temple.</figcaption> </figure>  &nbsp;Besides spatial descriptions, the book also explains the temporal by curating a detailed cultural calendar of Lalitpur with dates and places of jatra, rituals, devotional dances and festivals that weave the agricultural cycle with the zodiac.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260101120152_b8e1cc03653fea85dec84a7abee4fd594c35c6ad553769f37905eb5b38774e08.jpg" data-media-id="editor_8" data-image-id="20260101120152_b8e1cc03653fea85dec84a7abee4fd594c35c6ad553769f37905eb5b38774e08" data-rendition-name="original" width="2000" height="1125" loading="lazy" alt="Exploring Lalitpur book review"> <figcaption>Mipwa Lakhe of Patan which create fire in mid aid during performance.</figcaption> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260101120152_442e10bff842214e8c7522ebf6e63663599768db73bb57d999deff9de1b59375.jpg" data-media-id="editor_9" data-image-id="20260101120152_442e10bff842214e8c7522ebf6e63663599768db73bb57d999deff9de1b59375" data-rendition-name="original" width="2000" height="1333" loading="lazy" alt="Exploring Lalitpur book review"> <figcaption>Gan pyakhan or Astamatrika dance which is performed in Patan Darbar Squre during Dasain. </figcaption> </figure>  The very last chapter is dedicated to water and nature, what sustains lives and civilisations, and how Lalitpur continues to be the city it is because of the water supply system our ancestors left behind which function still, despite encroachment and pollution. ‘In the history of the world cities have been built, they thrived for some time and then became archaeological sites because they were not able to maintain the quality of air, water, and its soil,’ the authors write. ‘This led these cities to depopulate and ultimately die and are only referred to in history books. Lalitpur is not going to make the same mistake.’ &nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260104080132_3f403388d57da82b499d6c489a8f095002bf69f11e515e92fa96fb5ca3af69e9.jpg" data-media-id="editor_10" data-image-id="20260104080132_3f403388d57da82b499d6c489a8f095002bf69f11e515e92fa96fb5ca3af69e9" data-rendition-name="original" width="1136" height="702" loading="lazy" alt="Exploring Lalitpur"> </figure>

YALA

For daring to demand democracy, the Rana regime hanged activist Shukra Raj Shastri at midnight on 24 January 1941 by the side of the road at Teku. Across town in Siphal, Dharma Bhakta Mathema was also hanged. Four days later, Dasrath Chand and Gangalal Shrestha were executed by firing squad. These four young revolutionaries were members of the underground Nepal Praja Parishad that led the anti-Rana revolution with plans to assassinate key figures of the dynasty. The four martyrs sacrificed their lives for an unfulfilled cause. Monuments were put up in their honour (Shahid Gate) and their names glorified by the Shah monarchy that itself went on to ban political parties and persecute democracy activists. In 1950, the newly-formed Nepal National Congress launched an armed uprising against Rana rule after King Tribhuvan sought refuge at the Indian embassy to flee from the Rana regime. In 1951, the Ranas, Nepali Congress and King Tribhuvan signed a tripartite agreement that brought an end to 104 years of Rana rule.&nbsp; Thus began contemporary Nepal’s cycles of unfinished revolutions. Some 75 years later, on a sunny September morning, Nepal’s young and hopeful took to the streets demanding an end to the nation’s corrupt polity, envisioning a better democracy. They organised through digital platforms, played songs, danced, and chanted slogans. A few hours later, commandos fired on the protesters, massacring dozens. Over 8 and 9 September 2025, the government was overthrown, constitutional bodies were literally reduced to ashes, and 74 Nepalis were martyred.&nbsp; Nepal’s periodic revolutions have been ignited by anger against rulers, they have begun with great promise, spread with enthusiastic popular support despite rulers trying to crush them — but ultimately they have always fallen short of the expectations of citizens demanding reform. Through decades of dissent, Nepal’s periodic revolutions have remained incomplete, with the nation caught up in a cyclical search for stability.&nbsp; In 1960, king Mahendra staged a coup and overthrew an elected government led by prime minister B P Koirala -- a royal revolution against democracy. Mahendra is reported to have famously said to Koirala: “Nepal is not big enough for the two of us.” For the next 30 years Nepal resembled a one-party state under the absolute monarchy of the Panchayat. Elected leaders languished in jail or exile, political parties were banned, and the press controlled. This was the most frigid period of the Cold War, with Nepal’s neighbours India and China at war. Geopolitics was bound to have an impact. “After the 1816 Sugauli Treaty with British India, external forces magnified internal power struggles as outsiders played divide and rule,” explains editor and political analyst Rajendra Dahal. “Movements did not reach a logical conclusion because domestic politicians were forced to compromise.” Indeed, the departure of the British from India in 1947 meant that the days of the Anglophile Rana regime were numbered. Successive prime ministers sought patronage in Delhi, and the monarchy tried to counterbalance it with a policy of equidistance with China. The neighbours showed a keen strategic interest in Nepal’s domestic politics. “The Panchayat system did not deliver what it promised,” says Santosh Sharma Poudel of Nepal Institute of Policy and Research. “Nepalis suffered administrative and governance failure, politics was centralised in Kathmandu, leaving out the rest of Nepal.” With mainstream political parties and leaders were &nbsp;underground between 1961 till 1990, student activists became proxies for political parties. As pressure for change grew, a student-led pro-democracy movement spread across Nepal in 1979. In response, King Birendra announced a referendum to allow Nepalis to choose between the status quo and a ‘reformed’ Panchayat &nbsp;system.&nbsp; The Panchayat won by a slim margin with questions about the legitimacy of the plebiscite. The reforms never materialised and it would be another decade before street anger boiled over again. As the People’s Movement for democracy spread, king Birendra again relented, unbanning political parties and Nepal became a constitutional monarchy. Inspired by Mao Zedong, a faction of Nepal’s Communists felt that western-style parliamentary democracy was too slow to end a feudalist monarchy. They launched an armed struggle in 1996, and the war lasted ten years (editorial, page 2). “If the democratic government post-1990 had performed better, and brought real reform, the Maoists would not have a reason to launch a revolution,” says Poudel. After nearly a decade of bloodshed that left 17,000 dead and thousands still missing, the Maoists joined forces with the democratic parties that they had been fighting, to pressure king Gyanendra through street protests in 2006 to restore democracy. In 2008, an elected Constituent Assembly abolished the monarchy. &nbsp;Recalls Rajendra Dahal: “The second people’s movement did not aim to abolish the monarchy. In fact, the reinstated parliament even granted equal rights for royal daughters to be crowned queen. But eventually, the monarchy no longer fit the political framework that the parties envisioned.” It took two elections over the next eight years to draft a new Constitution that reflected Nepal’s socio-cultural and geographic diversity and met the demands of the Maoists. The new federal Constitution was finally promulgated in 2015, but failed to satisfy India and the aspirations of the Madhes communities for autonomy. The state’s effort to crush the Madhes movement cost 45 lives. The promise of the new Constitution was squandered over the next decade with rotating leadership of the NC, UML and the Maoists — all of whom had forgotten the sacrifices made in the name of revolution. Cronyism and corruption was the order of the day. And it was this never-ending cycle of political opportunism and malgovernance that brought Nepal’s youth to the streets on 8 September.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260101120128_bc50f6370ff80a6758199ea7ba9f4c214656a9322a8d2ba1c97e6cdfb88f7f62.jpg" data-media-id="editor_0" data-image-id="20260101120128_bc50f6370ff80a6758199ea7ba9f4c214656a9322a8d2ba1c97e6cdfb88f7f62" data-rendition-name="original" width="3372" height="1371" loading="lazy" alt="timeline"> </figure>  1951 Revolution against the &nbsp;Rana regime 1960 King Mahendra's coup, jails B P Koirala and launches the partyless Panchayat system 1979 Student protests for democracy, King Birendra announces referendum&nbsp; 1980 Continuation of the partyless Panchayat system narrowly wins plebiscite&nbsp; 1990 People’s Movement I 1996 Maoists launch armed struggle&nbsp; 2000 Royal Massacre 2005 King Gyanendra's military-backed coup&nbsp; 2006 Comprehensive Peace Accord and Parliament restored 2008 Monarchy is abolished 2015 Madhes Movement, New Constitution promulgated 2017 First 3-tier election under federal system 2022 Second elections under federal Constitution&nbsp; 2025 GenZ protests BRK ALLIANCE “The socio-political change sought in all these movements never matched the people’s expectations, because the central issue of clean and efficient government never materialised,” says Poudel. The post-September political landscape has injected new personalities and alliances still relatively new to politics, as evidenced by the new electoral partnership of the BRK — Balen Shah, Rabi Lamichhane, and Kulman Ghising (page 1).&nbsp; These leaders are not without flaws, but they have become the effective flag-bearers of the GenZ movement, hoping to represent Nepalis disillusioned by decades of democratic decay. The March election will pit them against the legacy parties. There is already criticism that BRK is behaving just like male-dominated opportunists of old parties. The troika is resembling the triumvirate of Oli, Deuba and Dahal and its culture of patronage and quid-pro-quo power-sharing between alpha males. Will this also be another unfinished revolution? Says political scientist Sucheta Pyakuryal: &nbsp;“The kind of destruction that happened after the revolution should have been followed by a ground-breaking shift in Nepal’s political ecosystem, but that did not happen. Today the situation is a lot grimmer because we have players who have learned how to use the democratic facade to sound ‘equitable’ and ‘accountable’. But look closely and you see how the same political chauvinism, cronyism and nepotism still continue.”&nbsp;

Nepal’s incomplete revolutions

One of the few Newa towns situated outside Kathmandu Valley, Panauti still evokes the feeling of a place frozen in time.&nbsp; Largely untouched by haphazard urbanisation, this town 32km east of Kathmandu used to be a kingdom revered for the sacred confluence of the Punyamati and Rosi rivers.&nbsp; The Bramhayani temple is the site of a 12 yearly Makar Mela which is attended by devotees from as far away as India.&nbsp; Panauti’s crumbling monuments were restored in the 1990s by the French government. Temples, resting places, traditional homes were rebuilt and locals trained to revive their craft. Panauti and France marked 50 years of cooperation in September.&nbsp; However, the priceless murals on the temple walls are fading and need urgent restitution. Now, these crumbling wall paintings are meticulously documented in the Wall Paintings of Panauti and Their Context.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260106090116_31f6acf06ef879037fec8274b85153eab4468566abf71616490679bf8468b85d.jpg" data-media-id="editor_0" data-image-id="20260106090116_31f6acf06ef879037fec8274b85153eab4468566abf71616490679bf8468b85d" data-rendition-name="original" width="1596" height="1074" loading="lazy" alt="Panauti murals"> </figure>  In his foreword, French researcher Gérard Toffin writes about some of the earliest wall paintings from the Malla period in Kathmandu, including a 17th century mural depicting the procession of Rato Machhindranath which has since been restored.&nbsp; Several other pieces still exist but in a pitiful state, defaced by scratches. ‘They were painted on a plaster coating made of soil, husks, or limestone, which were applied to the bricks making up the walls,’ Toffin notes.&nbsp; The book delves into the cult of Asta Matrika among Newa of all castes and classes, the first of which is Bramhayani. These all-pervading deities are linked to Shaktism which focuses on the importance of the female principle and together, combine the forces of life, sex and fertility with that of death and eros. The deities are painted on the wall, carved on the stone or moulded into metallic statues.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260106090120_836efd2b0a569d8ec0fb2c6651a29b8f2dd8f8f75b72e27bb86b0bfc0ad8461f.jpg" data-media-id="editor_1" data-image-id="20260106090120_836efd2b0a569d8ec0fb2c6651a29b8f2dd8f8f75b72e27bb86b0bfc0ad8461f" data-rendition-name="original" width="1074" height="1434" loading="lazy" alt="Panauti murals"> </figure>  Riddhi Baba Pradhan, former director general of the Department of Archaeology who oversaw the restoration of Panauti 30 years ago, writes that a colourful wall painting depicting Buddha's past life at the Chabahil Chaitya built or restored during the reign of Lichhavi king Vrisdev in the 3rd century might be the earliest mural in Nepal. As for Panauti, a fragment from a 400-year-old scroll which illustrates a scene of Triveni Ghat with Dalinchok Hill in the background is likely the oldest. But that relic is currently at the Virginia Museum of Fine Arts in the United States.&nbsp; Pradhan recalls first encountering wall paintings inside Bramhayani temple which were deteriorated by smoke, leaky roof, dust, vermilion, sprinkles of animal blood and lack of maintenance. The team led by chemist Bhimvar Singh Thapa treated the wall paintings and some of the details were recovered including the paintings of Astamatrika and Asta Bhairav on the east, west and southern walls.&nbsp; PAINTINGS ARE NOT VISIBLE The murals were painted during the reign of the last Malla King of Bhaktapur Ranjit Malla and Queen Viswalaxmi Devi 300 years ago. But 40 years after the restoration, Pradhan notes that the murals are again in poor condition: ‘The paintings are not visible, the plaster is severely damaged and the surface has peeled off … electrical wires hang haphazardly inside the temple.’ The second lot of murals at Ghat Sattal are thought to have been commissioned during the late Malla period or the beginning of the Shah dynasty. Exterior walls depict incarnations of Lord Vishnu as well as Sesh Narayan, Ganesh, a scene of Samundra Manthan, of angels Maya, Moha, Ganga. Their attributes, dresses, ornaments, facial expressions, body postures are all skilfully represented but in a deteriorated condition.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260106090116_88d06703ae23a271905d81f35056d41df92cbbc4b9966fac3f34821659e585a8.jpg" data-media-id="editor_2" data-image-id="20260106090116_88d06703ae23a271905d81f35056d41df92cbbc4b9966fac3f34821659e585a8" data-rendition-name="original" width="588" height="862" loading="lazy" alt="Panauti murals "> </figure>  The wall paintings of Bramhayani Dyochhen are 90% degraded even though they were restored and repaired 40 years ago by the Panauti Integrated Project. Compared to other artefacts, wall paintings are more delicate to external factors, and if not preserved an important part of Nepal’s heritage will be lost.&nbsp; Furthermore, most of the wall paintings in Nepal are temperas, and not frescos. Tempera is painted with water-soluble mineral or vegetable pigments fixed with glue on the cow dung clay plaster on the brick walls. While Nepal’s focus has been on the repatriation of stolen artefacts from abroad, religious and cultural objects within the country like the Panauti murals need urgent attention.&nbsp; This slim publication by Panauti Municipality is an important call to begin the work before it is too late.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260101120124_d0efa1e57b2710a206beb37c7e934ac34e694afc278985934eac2fc52124a92c.jpg" data-media-id="editor_3" data-image-id="20260101120124_d0efa1e57b2710a206beb37c7e934ac34e694afc278985934eac2fc52124a92c" data-rendition-name="original" width="1136" height="702" loading="lazy" alt="Wall Paintings of Panauti"> </figure>

high-altitude-sickness

More porters sick on Everest trail

Going to great heights to prevent altitude illness

Life in a time of cholera

YALA

Nepal’s incomplete revolutions

Saving Panauti's murals