Although smallpox is now ‘unfamiliar to the world today’ historian Elizabeth Fenn has written that it was ‘a misery commonplace in years gone by.’For centuries, the smallpox virus and the gruesome death and destruction it caused upended people's lives around the world and in Nepal. In this History of Disease series in Nepali Times in the past month I have recounted how smallpox traveled and killed in Europe and America, became a terrible test for survival for children in South Asia, and  struck down both royals and regular citizens in Nepal in the 19th century.We have seen how people devised inoculation and vaccination to fight the disease, and how vaccines and strong surveillance helped eradicate the disease around the world and in Nepal in the 1970s, but only 'by the slimmest of margins'.Several things about the history of the disease deserve special emphasis. As much as any influential king or prime minister, we sometimes forget that smallpox and other diseases shaped the course of human events.Part I: <a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/banner/big-story-of-small-pox-in-nepal/" target="_blank" rel="noopener noreferrer">Big story of smallpox in Nepal</a>Part II: <a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/opinion/the-smallpox-virus-in-british-india/" target="_blank" rel="noopener noreferrer">The smallpox virus in British India</a>Part III: <a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/opinion/smallpox-politics-and-power-in-kathmandu/" target="_blank" rel="noopener noreferrer">Smallpox, politics and power in Kathmandu</a>Part IV: <a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/opinion/how-nepal-eradicated-the-smallpox-virus/" target="_blank" rel="noopener noreferrer">How Nepal eradicated the smallpox virus</a><figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022112916110/63861ea39c7e80680e0ccdd9jpeg.jpg" alt="" width="1500" height="1001"/><figcaption>Photo: MANISH PAUDEL</figcaption></figure>Viruses such as measles, influenza, hepatitis, polio, rabies, and HIV – as well as non-viral diseases such as cholera, TB, syphilis, and malaria – remade not just individual lives, but also physical, economic, and political landscapes.The fury of smallpox reminds us of the inescapable power of nature. Despite all our efforts, humans are part of nature, and life is fragile.We are living beings made up of cells and nutrients, subject to the rules of geography and biology, death and disease. This reality held true in the past, and holds true today, as much as we hope otherwise. Smallpox may have been chased away, but COVID-19 stands at the doorstep.Each disease has its own characteristics, its own biological personality, its own way of spreading through society and attacking human bodies. <a href="https://www.nepalitimes.com/here-now/the-mosquito-that-changed-nepals-history/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/here-now/the-mosquito-that-changed-nepals-history/&amp;source=gmail&amp;ust=1590041413347000&amp;usg=AFQjCNEvpoGS7wd8yELy9-vJ0LG1oby5kw">Malaria moved via mosquitoes</a> which liked warm weather, <a href="https://www.nepalitimes.com/latest/kathmandu-in-the-time-of-cholera/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/latest/kathmandu-in-the-time-of-cholera/&amp;source=gmail&amp;ust=1590041413347000&amp;usg=AFQjCNGDo4ZWCamW139FFTuqWLpgRZuSoQ">cholera through germs in water</a>, and syphilis through sex. Due to these differences, each disease left its own unique imprint on history.<a href="https://www.nepalitimes.com/banner/big-story-of-small-pox-in-nepal/" target="_blank" rel="noopener noreferrer" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/banner/big-story-of-small-pox-in-nepal/&amp;source=gmail&amp;ust=1590041413347000&amp;usg=AFQjCNF3MVYYqp8ZY4QHWix_z0-R_ABxUA">Big story of small pox in Nepal</a>, Tom RobertsonSmallpox spread through the air, moved easily from person to person, caused searing pain, and, if it did not kill, left behind disfigured, broken human bodies. In Nepal, if it had struck older people, not children, or if it had not left its victim's faces scarred and their eyes damaged, it might have brought less terror.On the other hand, if it had had a reservoir in animals (as many viruses do) it would have been much harder to eliminate, and we might still be facing its burning fevers and excruciating rashes today. Small pox’s particular biology shaped history in a particular way.Nature is not just a passive stage on which we humans act out our dramas as we wish. Instead, it is an actor in every drama, sometimes in the background, sometimes centerstage, but often coming and going at its own will, not ours.<a href="https://www.nepalitimes.com/opinion/the-smallpox-virus-in-british-india/">The smallpox virus in Nepal</a>, Tom RobertsonLooking back, if we recount the stories just of kings and queens and their political chess matches, we overlook some of history's main drivers and its most important stories. In fact, if we overlook disease history we will not understand the stories of kings and queens as well as we think. Can we really tell the history of Rana Bahadur, Girvana, Bimsen Thapa, and Bir Shumshere -- much less the stories of ordinary people around the country -- without understanding the central role of disease?Looking forward, we would do well not to forget nature's power to completely take over the course of events. Smallpox also reminds us that, even though humans share the same biology, diseases often affect some subsets of society more than others, particularly those with less money and power. In other words, biological forces may be universal but they play out in social landscapes as complex and uneven as Nepal's dadakada.In the Americas, smallpox even more than guns, gave Europeans a huge advantage over the indigenous people who had never encountered the disease before, and thus lacked immunity. <a href="https://www.nepalitimes.com/opinion/the-smallpox-virus-in-british-india/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/opinion/the-smallpox-virus-in-british-india/&amp;source=gmail&amp;ust=1590041413347000&amp;usg=AFQjCNHRE-p56xptgt9wTBUUjoc05RxNwA">In colonial India, smallpox and ideas about how to treat it divided the British from Indians</a> more than it brought them together.<a href="https://www.nepalitimes.com/banner/big-story-of-small-pox-in-nepal/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/banner/big-story-of-small-pox-in-nepal/&amp;source=gmail&amp;ust=1590041413347000&amp;usg=AFQjCNF3MVYYqp8ZY4QHWix_z0-R_ABxUA">In Nepal, smallpox preyed upon both rich and poor</a>, powerful and powerless alike. But as the 19th century Newar song 'Sitalamaaju Mye' reminds us, it divided Gorkha conquerors and Newar families. <a href="https://www.nepalitimes.com/opinion/smallpox-politics-and-power-in-kathmandu/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/opinion/smallpox-politics-and-power-in-kathmandu/&amp;source=gmail&amp;ust=1590041413347000&amp;usg=AFQjCNFFHANLUtlK0myrUwhb4qdFGZg4Pg">Smallpox shaped power struggles between Bhimsen Thapa and his political rivals</a>, and later, in the effort at eradication, altered relations between government health workers and individuals from impoverished ethnic minorities.<a href="https://www.nepalitimes.com/opinion/smallpox-politics-and-power-in-kathmandu/">Smallpox, politics and power in Kathmandu</a>, Tom Robertson No doubt, smallpox also shaped gender relations in ways we need more historical research on. Just as differences between diseases mattered in the course of history, so, too, did social differences.<a href="https://www.nepalitimes.com/opinion/how-nepal-eradicated-the-smallpox-virus/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/opinion/how-nepal-eradicated-the-smallpox-virus/&amp;source=gmail&amp;ust=1590041413347000&amp;usg=AFQjCNGC0hhwCb-vpWbsy8-oT_gcbRcM6Q">Nepal's successful effort to eradicate smallpox in the 1960s and 1970s</a> seems particularly relevant to us today. Nepal's last case in 1975 shows what it took to banish a complex disease in challenging circumstances: sustained governmental focus and coordination, adequate long-term funding, scientific knowledge, talented and dedicated staff, careful record keeping, program flexibility and adaptation to local culture and conditions, and dogged surveillance.Yet even at this moment of seeming human control, nature's power was on display. Smallpox eradication happened only with help from nature. Compared to malaria and polio, smallpox was relatively easy to control. It was so intense that it was easy to spot, and that intensity also made it difficult for contagious victims to move around infecting others. Smallpox did not strike a person twice. And unlike other viruses, it proved very susceptible to a vaccine. This history suggests some of the special challenges that COVID-19 poses.Here, too, social difference mattered. Nepal's eradication campaign shows the enormous challenge of protecting individual rights in moments of public health crisis. In Nepal and other South Asian countries, government personnel sometimes used violence to force citizens to get vaccinated. Some health workers grew so convinced of their righteousness -- the 'purity of purpose' in one man's self-description -- that they felt comfortable steamrolling the wishes of others, often people from socially marginalised groups with little say in society to begin with.<a style="background-color: #ffffff; font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/opinion/how-nepal-eradicated-the-smallpox-virus/" target="_blank" rel="noopener noreferrer">How Nepal eradicated the smallpox virus</a>, Tom RobertsonSuch coercion probably could have been avoided through more nimble policies, more extensive training, and better public education. Problems often sprouted, the historian David Arnold noted, when doctors and other health workers didn't understand how ordinary people saw the world and quickly dismissed their concerns as backward or superstitious -- when, as he put it, the medical system had grown ‘culturally and politically distant from the lives of its subjects’.In the end, the history of smallpox shows the fragility of life, but also the power of human perseverance. Smallpox struck down one of every three it infected. It stole beautiful children from their mothers and fathers. It stole sight from survivors. In some places, it wiped out entire families and laid waste to whole villages. It was deadly, ruthless, and horrific. It sometimes brought out the worst in human nature.But it also often spurred great ingenuity, compassion, togetherness, and resilience. In the face of disease, humans have found surprising ways to support each other, learn from the past, endure the suffering of the present, and find hope again in the future.This is the fifth article in the <a href="https://www.nepalitimes.com/opinion/big-story-of-small-pox-in-nepal/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/opinion/big-story-of-small-pox-in-nepal/&amp;source=gmail&amp;ust=1590041413347000&amp;usg=AFQjCNHAaHCW0Y2UQjeFfh0UQoUPVtsqbA">series </a>History of Disease. The next column will deal with danger of dengue in Nepal. <a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/how-chitwan-was-opened,4159" data-saferedirecturl="https://www.google.com/url?q=https://archive.nepalitimes.com/article/Nepali-Times-Buzz/how-chitwan-was-opened,4159&amp;source=gmail&amp;ust=1590041413347000&amp;usg=AFQjCNEcTfdhSI0N9Tqo_qgoyZnrHCccug">Tom Robertson</a>, PhD, is researching the environmental history of Kathmandu Valley.Read other articles on smallpox in Tom Robertson’s History of Disease series in <a href="https://www.nepalitimes.com/opinion/how-nepal-eradicated-the-smallpox-virus/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/opinion/how-nepal-eradicated-the-smallpox-virus/&amp;source=gmail&amp;ust=1590041413347000&amp;usg=AFQjCNGC0hhwCb-vpWbsy8-oT_gcbRcM6Q">Nepali Times</a>.

Tom Robertson

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Viruses past, present and future

In 1966, the <a href="https://www.who.int/news-room/detail/13-12-2019-who-commemorates-the-40th-anniversary-of-smallpox-eradication" target="_blank" rel="noopener noreferrer">World Health Organization (WHO)</a> launched a worldwide campaign to eradicate smallpox. The aim was ‘zeropox’ -- not just control of the disease, but its complete elimination.After an aggressive campaign run by Nepal's autocratic government, the country saw its last case ever in 1975. The program should be celebrated. But what should also not be forgotten is that it sometimes resorted to heavy handed methods. Balancing public safety and individual rights was not easy.Historically, smallpox had been one of the world's biggest and most terrifying killers. <a href="https://www.nepalitimes.com/opinion/the-smallpox-virus-in-british-india/" target="_blank" rel="noopener noreferrer">In South Asia, the disease attacked young adults and children</a>, those born since the previous epidemic, leaving many disfigured or blind. In Nepal in the 19th  century, smallpox left few communities unscathed, and <a href="https://www.nepalitimes.com/opinion/smallpox-politics-and-power-in-kathmandu/" target="_blank" rel="noopener noreferrer">even killed a king</a>.In 1966, smallpox still plagued 31 countries, annually infecting 10-15 million people and killing 2 million. Two areas caused the most concern: the horn of Africa and South Asia, including Nepal.Part I: <a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/banner/big-story-of-small-pox-in-nepal/" target="_blank" rel="noopener noreferrer">Big story of smallpox in Nepal</a>Part II: <a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/opinion/the-smallpox-virus-in-british-india/" target="_blank" rel="noopener noreferrer">The smallpox virus in British India</a>Part III: <a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/opinion/smallpox-politics-and-power-in-kathmandu/" target="_blank" rel="noopener noreferrer">Smallpox, politics and power in Kathmandu</a>Part V: <a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/banner/viruses-past-present-and-future/" target="_blank" rel="noopener noreferrer">Viruses past, present and future</a>		
							<figure><img width="1282" height="1386" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022112916110/63861ea09c7e80680e0ccdd8jpeg.jpg" alt=""/><figcaption>Smallpox vaccination statue outside the World Health Organization headquarter entrance in Geneva.</figcaption></figure>Nepal, a WHO official wrote in the early 1960s, ‘must be considered as one of the areas most highly endemic for smallpox in South East Asia’. In 1958, a wave of smallpox hit Kathmandu. A 1965 survey revealed that <a href="https://www.nepalitimes.com/opinion/big-story-of-small-pox-in-nepal/" target="_blank" rel="noopener noreferrer">16% of the Valley's total population had struggled with the virus at some point in their lives</a>. Those were the ones the disease hadn't killed.Each year a few imported cases appeared in the western hills. Don Messerschmidt describes a late 1963 outbreak along the hulakibato in Lamjung, but the main problem areas were the Kathmandu Valley and the Tarai, particularly the eastern plains because of heavy cross-border movement.<a href="https://www.who.int/features/2010/smallpox/en/" target="_blank" rel="noopener noreferrer">WHO and the Nepal government launched a pilot program</a> in 1962 in Kathmandu Valley using new freeze dried vaccine, an improved version of the one Edward Jenner had devised in the 1790s, but got disappointing results.After two and a half years, only 30% of Valley residents were protected. WHO blamed ‘administrative problems and the religious and mundane objections of some sections of the population to vaccination’.In 1966, the program expanded countrywide, with new commitment and revised procedures, including better record keeping to prevent double counting. In 1971 the program started month-long mass vaccination campaigns. Each year for four straight years, several thousand temporary staff vaccinated 6 million Nepalis. Between 1967 and 1975, 39 million Nepalis got vaccinated or re-vaccinated.Another new strategy proved a game changer: aggressive surveillance and containment. Previously, officials had prioritised vaccinations. They had not traced and mapped infections, and thus did not know how many people had the virus and where. In 1971, a WHO official later wrote, ‘vigorous surveillance became the rule’.Surveillance meant routine house-to-house searches. Instead of waiting for cases to be reported, program workers went looking for them. Containment meant vaccinating and revaccinating the entire population near a newly discovered case. This was erring on the safe side by casting a broad net. The program also intensified tracing, detecting infection origins in a remarkable 95% of cases.The aggressive surveillance and containment methods delivered results. ‘It appeared that transmission had been interrupted,’ a WHO official noted later. Nepal had devised ‘a new and surprisingly effective tactic’.But then came a setback: ‘a tidal wave’ of new cases with nearly 2,000 new infections in 240 separate outbreaks. Three of every four of these cases were imports from Uttar Pradesh and Bihar in India where smallpox proved particularly recalcitrant. Of Nepal's 12 million population at the time, 90% lived within 100km of these Indian states.The program responded with more vaccination campaigns, surveillance, and containment, making steady progress. To address outbreaks in Morang the Nepal smallpox program in 1975 initiated a ‘watchdog’ system, a tactic recently devised in India. Staff were posted at the houses of infected people to ensure that they did not leave and that no unvaccinated person entered. Cash rewards were given to citizens and staff reporting new cases.In April 1975, Nepal saw its last case. A disease that had plagued Nepalis for centuries was gone. Looking back, WHO officials saw the surveillance and containment program as the key.‘The shift in strategy in 1971, laying great emphasis on surveillance-containment, was largely responsible for the success of the Smallpox Eradication Programme in Nepal,’ wrote the program's director in a 1977 wrap up report. ‘It is possible that transmission would have been interrupted earlier if the watchguard system had been adopted during 1974.’In many ways Nepal's eradication of smallpox was a heroic victory. The global smallpox program's director applauded Nepal's ‘remarkable accomplishments’. This narrative is not inaccurate but it is not the whole story.To begin with, smallpox eradication owed a great deal to biology. Compared to other diseases, smallpox was simply easier to eradicate. It was easy to see and diagnose (no asymptomatic infections) and did not re-infect people once gone. The disease's painful symptoms prevented movement, slowing transmission. Moreover, the vaccine was easy to administer and extremely effective. There was no virus reservoir among animals re-injecting the disease into human society again and again.Diseases like malaria and polio had far more natural advantages, and have proven much harder to eradicate globally.‘Without the particular characteristics of smallpox and the smallpox vaccine,’ historian Randall Packard has observed, ‘the disease would have been much more difficult to conquer, and the campaign would, in all likelihood, have failed. As it was, it only succeeded by the thinnest of margins.’One particular challenge was how to handle Nepalis who resisted vaccination. In the eastern Tarai, many people, particularly indigenous groups, held what a WHO report described as 'religious objections to vaccination’.WHO said this area became 'the scene of many problems of containment’. In Kathmandu, some Newar groups used to 'strongly object' to vaccination. In Kailali, some Tharus 'resisted vaccination for religious reasons'.Historian Susan Heydon notes that program workers often unjustifiably dismissed the concerns of Nepalis who resisted vaccination. Those who hesitated, she notes, were blamed as superstitious, derided as ‘backward and uneducated’.Instead, she faults the WHO program itself for not doing enough to educate the general population about the benefits of vaccination. She also notes that the program often administered vaccinations during hours next to impossible for ordinary working people.Eradication program workers also occasionally used unnecessary coercion. Coerced vaccinations were not common worldwide or in South Asia. But as historian Packard notes, there was a ‘tendency for aid workers to view themselves as somehow empowered to do whatever it takes to fulfill their mission, and to disregard local customs and laws’. In India and Bangladesh, historian Paul Greenough discovered that 'heavy-handed methods were sometimes relied upon'. On one occasion in Bihar in 1975, for example, health officials accompanied by police arrived at a tribal person's house by jeep at midnight, broke down the door, held down family members, and forcibly vaccinated them. Mandatory vaccinations and re-vaccinations as part of broad containment efforts sometimes sparked 'chaos' in villages.'Encounters with government vaccinators,' Greenough observes, were 'never about immunisation alone.' Religious, caste, and gender dynamics shaped interactions, as did ill will from previous health campaigns.One American health worker in India later recalled how a sense of unbridled self-righteousness led him to mistreat people. 'One of the rules was that everybody gets vaccinated. I was awful in my conviction of purity of purpose -- in breaking down doors and vaccinating crying women, etc.' To a large degree, the ends seemed to justify the means.Official reports, Greenough writes, often dismissed resistance and underreported coercion. He wishes there had been much more training for healthworkers and broader,more careful education for the public.In Nepal, one foreign smallpox fieldworker described how health workers sometimes had to search for Nepalis hiding from them in fear:‘... a good natured room to room search of houses with flashlights, accompanied by the village leader, would detect adults and children hiding under beds, in chests, large wicker baskets, and even in large clay storage vessels. However, the search was done as a game of hide and seek, with laughter after people were found and vaccinated, such as in one particular case where lifting the cover of a large wicker basket revealed two children hiding inside.’This may have been seemed like a game to health workers, but probably not to those Nepali men, women, and children with unknown government strangers searching for them. They seemed terrified.In the name of containing smallpox, a global health problem and an old scourge in Nepal, in the late 1960s and 1970s Nepal's government had tremendous authority to monitor and search Nepal's population. Maintaining public safety certainly justifies strong action, but the unnecessary infringement of individual rights and liberties must also be avoided as well.  This is the third in a <a href="https://www.nepalitimes.com/opinion/big-story-of-small-pox-in-nepal/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/opinion/big-story-of-small-pox-in-nepal/&amp;source=gmail&amp;ust=1588753218027000&amp;usg=AFQjCNEp4BFSGiWvId09CsLCgnF31j8F-w">series of articles</a> about the history of disease in Nepal. The fifth installment will look at what Nepal can learn from past epidemics in dealing with this one.  <a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/how-chitwan-was-opened,4159" data-saferedirecturl="https://www.google.com/url?q=https://archive.nepalitimes.com/article/Nepali-Times-Buzz/how-chitwan-was-opened,4159&amp;source=gmail&amp;ust=1588753218027000&amp;usg=AFQjCNGtSUyejPwwFFhYdaZjZohWFJUIQw">Tom Robertson</a>, PhD, is researching the environmental history of Kathmandu Valley.

How Nepal eradicated the smallpox virus

<figure><img width="1016" height="1280" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109121124/636b8dd59c7e80680e06b36djpeg.jpg" alt=""/><figcaption>Irish-born painter Thomas Hickey's painting in 1806 of three queens of Mysore where the royal woman on the right is pulling up her sari to spread awareness about small-pox vaccination. Photo: PRIVATE COLLECTION</figcaption></figure>The first record of smallpox in South Asia was in the 7th century, although the virus was probably widespread on the Subcontinent a millennia before that. In late 19th century India, for which we have the first reliable statistics, smallpox struck down more than 100,000 people a year, more in epidemic years. In some parts of north India, few escaped it. In Nepal, smallpox generally hit in the spring. ‘Transmission reached a peak during April and May,’ a 1977 WHO report notes, ‘and thereafter fell off rapidly as the monsoon increased relative humidity and hampered population movement.’Smallpox generally attacked children, and older people who hadn't already contracted the disease. ‘Since smallpox erupted epidemically roughly every five to seven years in most parts of India,’ historian of medicine David Arnold explains, ‘its principal victims were children born since the previous epidemic.’Smallpox was ‘the inevitable bridge which every child has to cross before entering into life,’ noted Sir Sayyid Ahmad Khan in India in 1879. ‘Recovery from the disease is considered second birth.’Part I: <a href="https://www.nepalitimes.com/banner/big-story-of-small-pox-in-nepal/" target="_blank" rel="noopener noreferrer">Big story of smallpox in Nepal</a>Part III: <a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/opinion/smallpox-politics-and-power-in-kathmandu/" target="_blank" rel="noopener noreferrer">Smallpox, politics and power in Kathmandu</a>Part IV: <a href="https://www.nepalitimes.com/opinion/how-nepal-eradicated-the-smallpox-virus/" target="_blank" rel="noopener noreferrer">How Nepal eradicated the smallpox virus</a>Part V: <a href="https://www.nepalitimes.com/banner/viruses-past-present-and-future/" target="_blank" rel="noopener noreferrer">Viruses past, present and future</a>‘It has become quite a saying among the agricultural and even wealthier classes,’ a British planter in the 1860s noted, ‘never to count children as permanent members of the family until they have been attacked with and recovered from smallpox.’Symptoms did not show during the virus's two-week incubation period. Those infected felt fine, and some even travelled, taking the disease with them, although they were not yet contagious.But after two weeks, the first of smallpox's horrific symptoms hit: intense fever, often with splitting headaches, body aches, and vomiting. Children often broke into convulsions. After a couple days, the patient might feel better for a day or two, and even rejoin normal life. But by this point contagious, they risked passing along the infection. Then came a red rash, at first on the tongue but soon all over the body, even on the palms of the hands and the soles of the feet, causing tremendous pain.By the fifth day, fluid started accumulating in the now bigger and bluish pockmarks. Fever deepened. Eyelids, lips, and nose grew swollen. The afflicted person had trouble swallowing. They might fall into delirium. Lesions could form on the eyes. The patient could be hard to recognise. A dreadful smell was common, as were secondary infections. <figure><img width="930" height="758" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109121124/636b8dd79c7e80680e06b36ejpeg.jpg" alt=""><figcaption> </figcaption></figure>At two weeks, scabs formed. They ‘encrust most of the body’, historian Fenn writes. The pain was awful, ‘any movement excruciating.’ The itching could be unbearable. Death, if it was to visit, normally arrived by this point. The disease also tore apart the lungs, heart, and liver. Smallpox consumed its human hosts ‘as a fire consumes its fuel, leaving spent bodies, dead or immune, behind,’ writes Fenn. In Nepal, as in much of north India, people thought of smallpox in religious terms, as a visitation by the goddess Sitala, ‘the cool one’. This understanding of disease came with its own remedy: ‘Smallpox was conceptualised,’ historian Arnold writes, ‘not as a disease but rather as a form of divine possession, and the burning fever and pustules that marked her entry into the body demanded ritual rather than therapeutic responses.’  Sufferers showed respect and honour to Sitala with the proper prayers and offerings. 'Oh Mother Sitala,' 19th century Newaris used to sing, 'do not afflict us! Deliver the people, we beg you a thousand times!'In addition to prayers to Sitala, some South Asians, including Nepalis, used inoculation to head off the disease. They intentionally give their children mild cases of smallpox, hoping that death would not result. Once recovered, the patient would have life-long immunity. Inoculation carried risks and did not work as well as the vaccine developed from cowpox by Edward Jenner in the 1790s, especially after it was improved during the mid 19th century. But inoculation did save many people from death. Otherwise, smallpox killed one in three of those who got it.As early as 1802, and for much of the nineteenth century, the British tried to introduce Jenner's vaccine into its Indian colony. But they ran into lots of obstacles, many of their own creation, so it took until the early 20th before vaccinations became common.What happened? For starters, until the 1850s, the British vaccine was not as effective as they thought, especially in India's heat. Vaccination required person to person contact. Vaccination also cost more than the British wanted to pay, so they did not build the necessary health and education infrastructure. In addition, cultural gaps surrounding the belief in Sitala, which the British tried to crush instead of to accommodate, also interfered. Many resisted vaccination. ‘To some Hindus,' Arnold explains, 'recourse to any form of prophylaxis or treatment was impious, likely to provoke the goddess and further imperil the child in whose body she currently resided.’ Ultimately, he emphasises, the big problem was that the British administration and medical system in India was‘culturally and politically distant from the lives of its subjects’. But by the early 20th, the British had improved the vaccine and its delivery, done a better job of explaining its benefits, and begun to meet with more success. In the decade after 1935, for instance, each year roughly 4.3 million people in Madras alone, almost 10% of the population, received vaccinations.Just as in India, the smallpox virus periodically ravaged Nepal, causing tremendous suffering, killing many, and leaving behind scarring and blindness. It affected all levels of society, even Nepal's royal family on several occasions in the 19th century.  This is the second in a <a href="https://www.nepalitimes.com/opinion/big-story-of-small-pox-in-nepal/" target="_blank" rel="noopener noreferrer">series of articles</a> about the history of disease in Nepal. Forthcoming columns will explore the role of smallpox in Kathmandu’s power struggles in the 19th century, and its eradication campaign in the 1960s. Tom Robertson, PhD, is researching the environmental history of Kathmandu Valley.

The smallpox virus in British India

When we think of Nepal's history, mostly political events jump to mind: the expansion of the Gorkhali state, Jang Bahadur's takeover, or the 'People's War’. We rarely think about disease. But diseases have shaped the course of history in the Himalaya in many unexpected and important ways. Perhaps no disease did so more than malaria, which plagued low hill valleys and especially Tarai forests for centuries. Its near complete eradication in the 1960s has altered the lives of almost every Nepali in one way or another. Viruses somewhat similar to the coronavirus have also touched the lives of countless Nepalis, and shaped larger events. Measles, influenza, hepatitis, <a style="letter-spacing: 0.01em;" href="https://www.nepalitimes.com/banner/polio-hunt/" target="_blank" rel="noopener noreferrer">polio</a>, and rabies have killed or maimed thousands. In 1918, the <a style="letter-spacing: 0.01em;" href="https://www.nepalitimes.com/opinion/remembering-a-pandemic-100-years-ago/" target="_blank" rel="noopener noreferrer">Spanish Influenza</a> cut down 12-18 million Indians, and probably tens of thousands of Nepalis. In some districts in north India, 1 in 10 died. Near Agra, 1 in 7 died. More recently, 50,000 Nepalis now live with HIV, many others have been lost to this virus which first appeared three decades ago.Part II: <a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/opinion/the-smallpox-virus-in-british-india/" target="_blank" rel="noopener noreferrer">The smallpox virus in British India</a>Part III: <a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/opinion/smallpox-politics-and-power-in-kathmandu/" target="_blank" rel="noopener noreferrer">Smallpox, politics and power in Kathmandu</a>Part IV: <a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/opinion/how-nepal-eradicated-the-smallpox-virus/" target="_blank" rel="noopener noreferrer">How Nepal eradicated the smallpox virus</a>Part V: <a href="https://www.nepalitimes.com/banner/viruses-past-present-and-future/" target="_blank" rel="noopener noreferrer">Viruses past, present and future</a> <figure><img width="2048" height="1393" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109121120/636b8d9e9c7e80680e06b359jpeg.jpg" alt=""/><figcaption>Health worker administering a small pox vaccine on a person in Sanischare of Jhapa. Photo: BETH PRENTICE AND BOB FRANK</figcaption></figure>Before COVID-19, perhaps the most feared virus in Nepali history was smallpox. Until its eradication in the mid 1970s, smallpox (biphar in Nepali, chechak in Hindi) regularly terrorised Nepali towns and villages. It struck mostly children, causing excruciating pain, killing many, and leaving survivors permanently disfigured. Every year saw new cases, but every five or ten years, a broader epidemic would tear through communities, particularly dense settlements such as Kathmandu and avenues of trade and communication, such as Nepal's postal routes. A large outbreak hit Kathmandu in 1958, and a pockmark survey in 1965 showed that 16% of the Valley's population had contracted smallpox at some time in their lives. And they were the survivors -- the virus killed roughly one of every three it afflicted.Unlike diseases like cholera that hit the poor in greater numbers, smallpox was an equal opportunity killer. It struck down both raja and raiti. Several times it invaded Nepal's royal palace.The last case of smallpox in Nepal appeared in 1975. The disease, historian <a href="https://www.colorado.edu/history/elizabeth-fenn" target="_blank" rel="noopener noreferrer">Elizabeth Fenn</a> has written, is ‘a misery commonplace in years gone by but unfamiliar to the world today'. <a href="https://www.nepalitimes.com/latest/kathmandu-in-the-time-of-cholera/">Kathmandu in the time of Cholera</a>, Tom RobertsonViruses like smallpox and COVID-19 originate in animals before spreading to humans. Coronavirus developed in bats, but no one knows where smallpox came from. Today, experts believe that as many as 100 million types of viruses exist in animals worldwide, waiting to jump to humans under the right conditions. Once in the human body, viruses become tiny engines of infection of simple but deadly design, little bits of genetic coding packaged in a protein that hijack the body's cells, transforming them into ‘virus producing factories', as historian of medicine Frank Swowden has put it. The virus then reproduces exponentially, killing its host cells and, unless checked, overwhelming the body's defenses.  All diseases have different characteristics and personalities. Their origins, methods of transmission, symptoms, and social impact vary widely. Smallpox spread easily. It moved not by bite of flea or mosquito but from human to human contact, normally through droplets coughed or sneezed into the air. Because the disease caused open sores in a patient's mouth and throat, a single sneeze or cough could launch thousands of infected particles into the air. The virus could also spread through beds and items of clothing. If you lived in a house with a relative suffering from smallpox, and if you had never had the disease before, you had a 50-50 chance of getting it. There was no cure.<a href="https://www.nepalitimes.com/here-now/the-mosquito-that-changed-nepals-history/">The insect that changed Nepal's history</a>, Tom Robertson <figure><img width="2300" height="2728" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109121120/636b8da19c7e80680e06b35ajpeg.jpg" alt=""><figcaption> </figcaption></figure>Smallpox was horrific. Perhaps only bubonic plague and cholera sparked more terror. It left survivors badly pockmarked and often blind. Historically, smallpox caused three-quarters of all blindness in India. Smallpox, an Indian observer noted in 1879, ‘touches the keenest of human susceptibilities; for there are thousands in this country who, though spared by it from death, still have traces of its violence in the deep marks on the face or the loss of an eye’.Around the world, the smallpox virus wrought havoc and dramatic social change. In Europe, it ripped through the dense, disorganised cities and towns of the 17th and 18th  centuries. Half of Europe's population carried scars from the disease. Smallpox afflicted rich and poor alike. It killed England's Queen Mary and Prince William, ending the house of Stuart.In the Americas, smallpox spurred even more devastation and turmoil. Because indigenous groups had no previous exposure and therefore no immunity, they died in much higher rates than Europeans. Whole communities were wiped out. <a href="https://www.nepalitimes.com/here-now/nepal-is-a-microcosm-of-all-of-the-changes-in-world-health/">“Nepal is a microcosm of all of the changes in world health”,</a> Nepali Times  <figure><img width="1278" height="716" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109121120/636b8da59c7e80680e06b35bjpeg.jpg" alt=""><figcaption> </figcaption></figure>The massive waves of death cleared the way for European settlement and spurred the import of slaves from Africa, many of whom had immunities from childhood. Smallpox acted as an ‘unwitting instrument of empire,’ according to Fenn.In its tragic wake, smallpox also prompted important public health innovations. In many parts of Asia, including India and Nepal, people for centuries used variolation -- inoculation using live virus -- to block the disease. A string infected from a mild case of the disease would be rubbed under the skin, thus actually giving the person the disease. Some would perish, but most survived, thereby gaining immunity from future outbreaks.A less risky and more broadly effective vaccine was developed in Britain in the 1790s. A country doctor named Edward Jenner, noticing that milkmaids never contracted smallpox, discovered that intentionally giving humans cowpox -- a virus related to smallpox -- could create immunity to the disease without inoculation's painful symptoms and risk of death. Jenner predicted that vaccines like his could one day eradicate smallpox from the planet. ‘The annihilation of the smallpox, the most dreadful scourge of the human species,' he wrote in 1801, 'must be the final result of this practice.’That prophecy became reality in the 1970s -- but only after a century of misguided British efforts in colonial India, and only after a complicated and controversial global eradication campaign in the 1960s and 1970s that only succeeded, as one historian of medicine put it, ‘by the thinnest of margins’. Coronavirus differs from smallpox in important ways. Nonetheless, revisiting smallpox's history in the Himalaya can help us better understand the interconnected social, medical, and political landscapes in which we live. This is the first in a <a href="https://www.nepalitimes.com/opinion/big-story-of-small-pox-in-nepal/" target="_blank" rel="noopener noreferrer">series of articles</a> about the history of disease in Nepal. Forthcoming columns will explore British attempts to spread vaccination in India and the role of smallpox in Kathmandu’s power struggles in the 19th century, and its eradication campaign in the 1960s. <a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/how-chitwan-was-opened,4159" target="_blank" rel="noopener noreferrer">Tom Robertson</a>, PhD, is researching the environmental history of Kathmandu Valley.

Big story of small pox in Nepal

Nepal’s only international aviation gateway, at Kathmandu airport, will cut night-time operation hours to allow construction of taxiways, and airlines have been told to curtail flights. This is expected to lead to more than normal chaos during the height of peak autumn and spring tourist seasons at an airport that is congested even at the best of times. The airport will close from 10PM to 8AM from 8 November-31 March 2025. The taxiways will now connect to the thresholds at both ends of the runway, making the airport more efficient in handling higher frequencies of landings and takeoffs. The parallel taxiway extension will allow international flights to land every 4 minutes instead of the current every 7 minutes. At present planes have to wait to land until a plane taking off backtracks along the runway.&nbsp; Kathmandu is Nepal’s only airport with international operations, and it has only one runway that is only one way in from the south over the mountains. With the taxiway improvement, the airport will be able to handle 42 aircraft landings and takeoffs per hour — double the current capacity.&nbsp; The Civil Aviation Authority of Nepal (CAAN) has been trying to entice international airlines to also start flying to and from the other two international airports at Pokhara and Bhairawa (Lumbini) by slashing landing and handling charges. But so far only Nepal Airlines operates a weekly flight to Bhairawa from Kuala Lumpur.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241018161016_046569e53d1d66cd445cc66c697c0ef724810aec9f54bdf827481e3cd6b80c32.jpg" data-media-id="editor_0" data-image-id="20241018161016_046569e53d1d66cd445cc66c697c0ef724810aec9f54bdf827481e3cd6b80c32" data-rendition-name="original" width="2356" height="1134" loading="lazy" alt="Kathmandu airport expansion"> <figcaption>Kathmandu Airport Expansion plan with extension of taxiways to the thresholds of runways 02 and 20 that will limit airport operations from 8 November 2024 - 31 March 2025. Areas in blue are existing structures, including the international terminal which in future will be the domestic airport, and the new international terminal near the north end of the runway,</figcaption> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241018121028_6e17cc2ee87c1b02d78cb54905825b7aa15299b7a00f5eddb01a59579ab85c1a.jpg" data-media-id="editor_1" data-image-id="20241018121028_6e17cc2ee87c1b02d78cb54905825b7aa15299b7a00f5eddb01a59579ab85c1a" data-rendition-name="original" width="1353" height="1328" loading="lazy" alt="Kathmandu airport NT"> </figure>  CAAN has reportedly told international airlines to cut their flight frequency to Kathmandu citing the shorter operation hours and has told budget airlines to shift some of their flights to Pokhara or Bhairawa, or face cuts. Many airlines currently operate regular flights to and from Kathmandu between 10PM and 8AM: Air Arabia to Sharjah, Fly Dubai to Dubai, Jazeera Airways to Kuwait, Cathay Pacific to Hong Kong, Singapore Airlines, several Nepal Airlines flights, and one of four daily flights by Qatar Airways to Doha. Jazeera Airways, FlyDubai, and Thai AirAsia have applied and got permission from CAAN to begin regular flights to Bhairawa’s Gautam Buddha International Airport. Starting 9 November, FlyDubai will start making a stopover in Bhairawa before flying on to Kathmandu. Immigration, customs and security are all fully functional in Bhairawa. In Kathmandu, the next phase of the airport upgrade includes converting the current international terminal for domestic operations, the construction of a new international terminal where the domestic departure area is now, as well as moving the hangars and the Nepal Army Air Wing to the eastern side of the runway. The apron area will also double its parking space for widebody jets. This is part of a Airport Capacity Enhancement Project that was initially funded through a $80 million loan from the Asian Development Bank (ADB), and the entire masterplan is expected to cost $800 million. This project is the latest upgrade to Nepal’s only international airport since it saw its first flight in 1949. The current international and domestic terminals are too small to handle the current annual traffic volume of 8.5 million passengers a year that is growing at 20% a year.

Kathmandu airport to cut flight hours

As Kathmandu becomes more congested and polluted, and with remote online work becoming the norm, many professional Nepalis are planning to retire in Pokhara, or move there.&nbsp; With its stunning mountain panorama, balmy winters and proximity to a profusion of wilderness areas, builders are responding to this demand with new townhouses, housing development and apartments. One such block of flats is the 10-storey <a href="https://sungavaapartment.com/">Sungava Apartment</a> located at Phulbari above the Seti River, near the point where it flows into and under Pokhara. The imposing structure near Manipal Hospital is almost complete, and on a recent visit the site was strewn with huge boulders unearthed while digging the foundation.&nbsp; The Seti brought down these boulders during a gigantic flood that geologists estimate happened 800 years ago when a chunk of Annapurna IV broke off and ploughed into the glacier below. Today, Sungava (means ‘orchid’) sits safely on a high terrace, 100m above the blue-green Seti and commands a view of Dhaulagiri, Annapurna South, Machapuchre, Annapurna III and IV.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2024102411104_5f8fc736c86ea3c08d7bef43bb727081d3cc1a2caa55ae2b441717e6044de7e9.jpg" data-media-id="editor_1" data-image-id="2024102411104_5f8fc736c86ea3c08d7bef43bb727081d3cc1a2caa55ae2b441717e6044de7e9" data-rendition-name="original" width="2016" height="1512" loading="lazy" alt="High living below the Himalaya NT"> </figure>  The soil here is conglomerate that has solidified like concrete, and the boulders were extracted by heavy earthmovers. It is intriguing to think that these metamorphic rocks as big as cars, rounded by glacial grinding, were once a part of a much higher Annapurna IV. Even for those with little interest in geology, Sungava is an ideal place to contemplate the tectonic forces that pushed these peaks into the sky to be sculpted into delicate shapes by wind, snow, earthquake and avalanche over millions of years. The view of the Himalayan panorama from Sungava’s many balconies are breathtaking when not obscured by clouds, or the haze that drifts in from across the southern border. On most days, just watching the towering pyramid of Machapuchre (Tamu name: कतासुँ क्लिको) play hide and seek with the clouds is mesmerising. There are rocks aplenty at Phulbari, and it is probably the flowers that grew along the flat terraces e that gave the place its flowery name. The boulders will hopefully be turned into a rock garden while landscaping. An nearby restaurant complex is making the best use of the stones in its design, using flat rocks as outdoor benches and tables. Sungava was designed by the husband-wife architect team of Deepak Sherchan and Jyoti Joshi of <a href="https://thedarkmermaidamarbshrestha.blogspot.com/2013/12/creative-builders-collaborative-cbc.html">Creative Builders Collaborative (CBC)</a>, which also built Heritage Plaza, Indreni Apartment and numerous other projects in Nepal. Sadbhavana retains CBC’s trademark Newari-style masonry and here it borrows from the orange brickwork of the old town of Pokhara, integrating it with modern design elements. A few of those heritage houses are still standing in Ganesh Tole and Ram Krishna Tole in Pokhara’s old quarter.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2024102411108_5eb64a4885961b6d30781cefeb1e8a313da313ac5227c7a66b60f0c7d48d6fab.jpg" data-media-id="editor_3" data-image-id="2024102411108_5eb64a4885961b6d30781cefeb1e8a313da313ac5227c7a66b60f0c7d48d6fab" data-rendition-name="original" width="1362" height="595" loading="lazy" alt="High living below the Himalaya NT"> </figure>  About 400m from the apartment past a bend on the river, and down below three tiers of terraces in the canyon is a suspension bridge. Below it, the Seti is still swollen with post-monsoon flow as it tumbles away in a hurry to head down south.&nbsp; Back at the apartment, it is quiet, far away from the hubbub of Lakeside a 15 minute drive away, and in the lap of greenery. There are 52 units at Sungava and it already has a close-knit prospective community of professionals, including doctors, publishers, engineers, and businesspeople from the renewable energy and IT sectors.&nbsp; Some residents say they opted for a second home in Pokhara to make it a ‘base camp’ to explore the Annapurnas with its many hiking trails made newly accessible with new roads. With the NRN citizenship law, overseas Nepalis can now also buy the flats. &nbsp; The floor plans include options for north and south-facing 3-bedroom apartments with verandas, and the facility has underground parking has EV charging, heated pool, sauna and gym. There are still some unsold apartments with panoramic views of the mountains and one can imagine oneself at the kitchen with its huge window, humming a ditty while preparing breakfast: “खाना पकाउँ हिमाल हेरेर...”

High living below the Himalaya

When the United Nations held its Summit of the Future at its headquarters in New York in September, many world leaders, including Nepal’s Prime Minister K P Oli, highlighted the effect of climate breakdown in increasing the frequency and intensity of natural disasters. What did not get as much attention was the long term impact of the climate crisis on food production. In fact, heat stress, weather extremes and the consequences on rain-fed agriculture is already being felt worldwide, undermining the chances of the <a href="https://unstats.un.org/sdgs/">UN’s Sustainable Development Goals (SDGs)</a> being met by 2030.&nbsp; The SDG’s 17 targets commit countries like Nepal to reduce poverty and inequality, end malnutrition, protect the natural environment, and ensure that citizens all enjoy health, justice and prosperity without leaving anyone behind.&nbsp; However, besides the impact of climate breakdown on agricultural production, in Nepal the area under cultivation is impacted by urban expansion, falling productivity and the need for expensive inputs like fertiliser and pesticides.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241019041052_626413c5baf4dae407ac9579231b41daeb51510aa636b75aeb7489d94cca6a62.jpg" data-media-id="editor_1" data-image-id="20241019041052_626413c5baf4dae407ac9579231b41daeb51510aa636b75aeb7489d94cca6a62" data-rendition-name="original" width="999" height="1500" loading="lazy" alt="urban agriculture in Kathmandu"> <figcaption>Kathmandu's urban sprawl is eating into its fertile cultivable lands. Photo: TAYLOR MASON</figcaption> </figure>  Now, a new study led by Nepali researcher Prajal Pradhan at the University of Groningen in The Netherlands looks at how urban agriculture may offer a solution to falling food production and meeting SDG targets. The researchers evaluated 1,450 publications exploring the contributions of urban agriculture with both positive and negative effects, and published their findings in the journal Cells Report Sustainability. Urban agriculture can help achieve 17 SDGs, positively influencing 81 targets. However, it could also undermine 51 goals.&nbsp; Read also: <a href="https://nepalitimes.com/here-now/the-vanishing-land">The vanishing land</a>, Taylor Mason “Urban agriculture offers immense potential for sustainable development, but realising this potential depends crucially on adopting practices that minimise its adverse effects while maximising its benefits,” Pradhan explains. Urban agriculture can substantially enhance urban food security, provide employment to the urban poor, serve as ground water recharge in built-up areas, and preserve open spaces that can serve as safe havens during disasters like earthquakes. However, it also presents problems like the potential health risks from contamination and the need for expensive inputs. &nbsp; “Urban agriculture plays a definitive role in advancing the SDGs, but achieving this requires tailored, context-specific solutions that address the unique challenges of different regions,” says Yuanchao Hu of Wuhan University in China and who is a researcher at the Potsdam Institute for Climate Impact Research. “But it needs equitable access and rigorous management of environmental risks.”&nbsp; Rapid urbanisation is eating into Nepal’s most fertile agricultural land, which means farming in remaining open spaces inside cities can be a viable alternative, especially as food prices rise.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241019041052_7b7c9413086226fbdc630d45acf772cfa1ced77a8970b9056ec5ec7e5226fdf8.jpg" data-media-id="editor_3" data-image-id="20241019041052_7b7c9413086226fbdc630d45acf772cfa1ced77a8970b9056ec5ec7e5226fdf8" data-rendition-name="original" width="1500" height="999" loading="lazy" alt="urban agriculture in Kathmandu"> <figcaption>A vegetable patch in between new houses in Thimi. Photo: TAYLOR MASON</figcaption> </figure>  “The conversion of Nepal’s most fertile land into cities is a severe problem,” Pradhan told Nepali Times. “Crop cultivation, horticulture, agroforestry, beekeeping, livestock rearing, or aquaculture can all be farming activities within and around cities.”&nbsp; The study makes recommendations for sustainable practices that build on the positive aspects of urban agriculture while mitigating the downsides, thereby promoting more resilient cities in future. Research shows that urban agriculture has been helping many countries attain SDG targets by enhancing food security and biodiversity while helping education and preservation of open spaces.&nbsp; Indeed, many farmers from the hinterland who have settled in Kathmandu Valley or other urban areas of the country have been practicing urban agriculture, leasing neighbourhood patches or cultivating roof gardens both out of necessity because of inflation and falling income to grow their own food, and also as a fulfilling hobby. Saurav Dhakal, a sustainability advocate with Story Cycle and now research fellow at the Asian Institute of Technology in Thailand, says there are socio-economic and environmental benefits of urban agriculture. “It provides benefits to all urban dwellers, regardless of their income status,” says Dhakal, “families get fresh food, and there are many other benefits like water retention, heat regulation and biodiversity. These are all public goods, so special government incentives may be needed.” It is not unusual to see vegetable patches and even paddy fields within inner city Kathmandu where an older generation of farmers are using available fertile land and <a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/rooftop-gardens-kathmandu,1415">roof gardens to produce fresh, nutritious food </a>to reduce their dependence on food items that have to be bought after being trucked in from large distances.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2024101905100_1291ce98dbbb8caed8702ac4b1d469b3e13016d7ecaaf3bfd5f91c974d3c0c77.jpg" data-media-id="editor_5" data-image-id="2024101905100_1291ce98dbbb8caed8702ac4b1d469b3e13016d7ecaaf3bfd5f91c974d3c0c77" data-rendition-name="original" width="1500" height="999" loading="lazy" alt="urban agriculture in Kathmandu"> <figcaption>An older generation of farmers are using any available fertile land to continue farming but it is getting more and more difficult. Photo: TAYLOR MASON </figcaption> </figure>  Nepal’s urban population grew rapidly from only 3.6% in 1991 to 25% today. There is large outmigration from the mountains to peri-urban areas of the Tarai, to Kathmandu Valley and Pokhara, with many young men then moving abroad for work. Kathmandu Valley’s population has swelled to nearly 3 million, and is growing at 6.5% a year. Dilip Shrestha, 71, used to work for Nepal Food Corporation, so he knew firsthand about inflation, shortages and vegetables with pesticide residue. So, when he designed his new house in Kathmandu, he built a spacious roof where he grows cucumber, ginger, garlic, coriander, onions, tomatoes, chili, beans, okra, pumpkin and lettuce. His family eats healthier, and he has reduced dependence on the market.&nbsp; The co-author of the Cell Reports Sustainability journal article, Daya Raj Subedi who is a PhD candidate at Beijing Forestry University, says urban agriculture also promotes inclusion and psycho-social wellbeing.&nbsp; He says, “A crucial finding of the study is the identification of opportunities and challenges associated with urban agriculture, it can promote sustainable transformation of society.” In Banepa, 55-year-old Bijaya Manandhar in her lifetime has watched the fertile farms of her neighbourhood that used to supply vegetables to Kathmandu, now completely built up with no open space left. The pandemic lockdown prompted her to turn to the family’s <a href="https://nepalitimes.com/banner/rooftop-agriculture-on-the-roof-of-the-world">ancestral livelihood by growing food</a> not on terrace farms, but on the roof terrace. Manandhar is now a part of <a href="https://nepalitimes.com/banner/rooftop-agriculture-on-the-roof-of-the-world%5C%5C">कौसी खेती र करेसाबारी क्रान्ती</a> (Rooftop Farming and Garden Revolution) which has an online membership of 52,000, and awards annual prizes to women who excel in urban agriculture.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241019041052_7257f5def8f823f35a799fa6f6825e153f2ffa406ac11325d4fe74049b79e96d.jpg" data-media-id="editor_8" data-image-id="20241019041052_7257f5def8f823f35a799fa6f6825e153f2ffa406ac11325d4fe74049b79e96d" data-rendition-name="original" width="1600" height="736" loading="lazy" alt="urban agriculture in Kathmandu"> <figcaption>Rooftop farming is gaining popularity as a form of urban agriculture. </figcaption> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241019041052_beff1a4494ce896dd8fd383ee1f518e5448bcf7ea8bb138255391c7bcb9769ed.jpg" data-media-id="editor_9" data-image-id="20241019041052_beff1a4494ce896dd8fd383ee1f518e5448bcf7ea8bb138255391c7bcb9769ed" data-rendition-name="original" width="4000" height="3000" loading="lazy" alt="urban agriculture in Kathmandu"> </figure>  Pradhan says the challenge now is to upscale such examples of successful urban agricultural practices so they support Neal’s efforts to meet SDG targets. He adds, “Crop cultivation around cities can be protected by land use plans and regulations. Promoting community-based agriculture, including rooftop gardens, requires community engagement and public-private partnerships across the food value chain.”&nbsp; Such support would accelerate the popularity of existing rooftop farming and community gardens in Kathmandu Valley, or kitchen garden initiatives in Pokhara, and building on traditional farming practices that are preserved and integrated into urban settings like in Bhaktapur and Banepa. In Lalitpur, the Women Entrepreneurship Facilitation Center promotes urban farming enhancing both sustainability and empowerment.&nbsp; Another co-author of the report, Yuanchao Hu from China says followup research of the team will aim to identify good practices in local urban agriculture practices. He adds, “There are examples of urban agriculture that optimise sustainability, ensuring that it remains a viable solution for cities globally while countries try to meet SDG targets.” Prajal Pradhan, Daya Raj Subedi, Kshitij Dahal, Yuanchao Hu, Prakriti Gurung, Sijal Pokharel, Sagar Kafle, Biplav Khatri, Sudeeksha Basyal, Monika Gurung, and Aruna Joshi. Urban Agriculture matters for sustainable development. Cell Reports Sustainability, 1:100217, 2024. [DOI: 10.1016/j.crsus.2024.100217] Prajal Pradhan (<a href="mailto:p.pradhan@rug.nl">p.pradhan@rug.nl</a>) This article is brought to you by <a href="https://nepalitimes.com/" target="_blank">Nepali Times</a>, in collaboration with <a href="https://inpsjapan.com/en/" target="_blank">INPS Japan</a> and <a href="https://sgi-peace.org/" target="_blank">Soka Gakkai International</a>, in consultative status with UN ECOSOC.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20240630110640_30c3782f9c09219bf1c249b51483a3cfb7a53a06d117d2aebd23ca7080d12758.jpg" data-media-id="editor_14" data-image-id="20240630110640_30c3782f9c09219bf1c249b51483a3cfb7a53a06d117d2aebd23ca7080d12758" data-rendition-name="original" width="680" height="103" loading="lazy" alt="SDG logo"> </figure>

Back to the land in the cities

The 700-year-old Lakshmi Narasingha temple in Bhaktapur houses a rare half-lion and half-human incarnation of Lord Vishnu carrying the Goddess Lakshmi. The temple was destroyed in the 1934 mega earthquake that killed 10,000 people and destroyed many monuments in Kathmandu Valley. It was rebuilt by a German project in the 1980s, but as a single-storey structure instead of its original two-tier pagoda design.&nbsp; With new findings from in-depth research, Bhaktapur municipality began re-restoring the temple in 2021, preserving its original architecture.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241017131016_2fae38cce543ad7b1f6de632feb3e212e08ed1acedd747830e949d7b8e878f18.jpg" data-media-id="editor_0" data-image-id="20241017131016_2fae38cce543ad7b1f6de632feb3e212e08ed1acedd747830e949d7b8e878f18" data-rendition-name="original" width="2048" height="1365" loading="lazy" alt="In with the old in Nepal NT"> </figure>  “Our temples and heritage sites hold deep meaning. It is disheartening to witness how often they lose their original elements, whether by design or accident,” explains Kumar Chawal of the Consumer Committee of Bhaktapur. “There is a need to preserve our architecture and protect its historical value for future generations. Otherwise, we risk losing a vital part of our identity.” The Laksmi Narsingha restoration is similar to the Bhai Dega temple in Patan Darbar Square which also collapsed in 1934, but was rebuilt with a Moghul-style dome by the Rana government at the time. Only two months before the 2015 earthquake, heritage conservationists had started to rebuild Bhai Dega as the original three-tier based on early photographs. But priorities shifted when four other temples in the square were brought down by the 7.8M earthquake on 25 April 2015.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241017131016_697ea707d9ad163be5de5f2efbf5b70d3cab771adcc22f0fae6bf937c6cb0130.jpg" data-media-id="editor_1" data-image-id="20241017131016_697ea707d9ad163be5de5f2efbf5b70d3cab771adcc22f0fae6bf937c6cb0130" data-rendition-name="original" width="2048" height="1365" loading="lazy" alt="In with the old in Nepal NT"> </figure>  This showed how damage to monuments in Kathmandu Valley spanned from one earthquake to the next. Bhai Dega restoration remains half-complete to this day because money for its restoration ran out.&nbsp; Whereas Bhai Dega restoration was done by the Kathmandu Valley Preservation Trust with grants from western embassies and international foundations, in Bhaktapur it is the municipality itself that allocated the Rs30.7 million needed to restore the Lakshmi Narasingha temple. The expected date of completion is early 2025. The municipality and local communities are focusing on two main aspects: preserving the past and promoting localisation. The restoration team has designed a blueprint for the temple by using historical photographs and insights from older generations.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241017131016_182882fdc393c99e70d1d0490319e415229563666c4934e3a582426ebf00ca30.jpg" data-media-id="editor_2" data-image-id="20241017131016_182882fdc393c99e70d1d0490319e415229563666c4934e3a582426ebf00ca30" data-rendition-name="original" width="1200" height="560" loading="lazy" alt="In with the old in Nepal NT"> </figure>  “At first, the Lakshmi Narasingha temple had only one entrance, but during the demolition process, we uncovered the foundations of four doors. Now, we are restoring all of them. This is an example of how our ancient structures have changed over time, often without our knowledge,” says Chawal. “Constructing temples is not like building houses. They carry historical and spiritual values, which is why they hold a special place in our hearts,” he adds. By replicating ancient design elements and rebuilding the temple as accurately as possible to its original form, the team has stayed true to Bhaktapur’s soul. But the restoration also revived ancient techniques that were in danger of being forgotten, generating employment for woodcarvers, masons, and contractors. The community of Bhaktapur’s Gahiti neighbourhood near the famous Nyatapola Temple has also set aside specific days for locals to volunteer in the reconstruction work. This has encouraged young people to take pride in ownership of their heritage. Families have also supported the effort by donating funds for bells, the temple pinnacle, and other structural features to the temple.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241017131016_db850ec0c084cdbe54f65bee92dad2ad8122d20fd60ec87ec086fbb9d2f72bd6.jpg" data-media-id="editor_3" data-image-id="20241017131016_db850ec0c084cdbe54f65bee92dad2ad8122d20fd60ec87ec086fbb9d2f72bd6" data-rendition-name="original" width="2048" height="1365" loading="lazy" alt="In with the old in Nepal NT"> </figure>  “I feel at peace knowing I have contributed my sweat to restoring this temple,” said one volunteer. “It is our duty to preserve our temples and heritage. The Nyatapola area will look magical once this temple is completed.” Community mobilisation is a long-standing tradition in Bhaktapur. In the past, locals have actively participated in the restoration of other temples in the city, such as Bhairav and Nyatapola fostering a strong sense of ownership. This collective engagement has not only been crucial in preserving the city's historical monuments but also in strengthening the bond between local communities and their heritage, says officials at the municipality. While securing funding is essential, and the municipality showed it values heritage conservation, the Lakshmi Narasingha restoration is proof that active involvement and sense of responsibility of the local community is as important, if not more. Local involvement also means that the monuments will be cared for into the future, When locals take ownership of these efforts, the restored monuments are not only protected in the present but are also cared for in the future.

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