<figure><img width="780" height="520" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109121140/636b921a9c7e80680e06f12cjpeg.jpg" alt=""/><figcaption>HAPSA Nepal and White Grain Foundation team assemble home isolation kits for distribution in rural nepal. Photos: HAPSA NEPAL</figcaption></figure>Even as the Nepal’s Covid-19 second wave appears to be cresting, and many hospitals do not have to turn away patients anymore, there are still at least 80,000 active cases across the country, most them isolating at home often without proper medical consultation.The pandemic is also <a href="https://www.nepalitimes.com/latest/in-nepal-virus-climbs-from-plains-to-mountains/" target="_blank" rel="noopener noreferrer">spreading rapidly in villages</a> across Nepal’s remote districts, where there is not much testing being done and no medical care for the severe cases. There is an urgent need to ensure essential healthcare and hygiene products to local communities and infected people.This is where the non-profit Health Advancement Programs to Serve All (HAPSA) Nepal and the White Grain Foundation have stepped. They are distributing home isolation kits in more than 20 municipalities in the remotest parts of Nepal in Jajarkot, Khotang, Baglung, Gulmi and Sindhupalchok districts.The money was mainly raised via a crowdfunding campaign on the <a href="https://www.gofundme.com/f/help-nepal-fight-covid19-support-hapsa-nepal" target="_blank" rel="noopener noreferrer">GoFundMe platform</a>. The project is a brainchild of Ramu Kharel, and HAPSA Nepal and has received $50,000 so far through hundreds of donors. The German non-profit Impact Week, Nepal Rising in the US, and Pasa Puchah Guthi UK are also supporting the cause. Students from the local Nawa Asha Griha school sewed the first 100 kits.   <figure><img width="780" height="585" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109121140/636b921d9c7e80680e06f12djpeg.jpg" alt=""><figcaption>Local in Galkot Rural Municipality, Baglung receiving the home isolation kits items and receiving training on how to use them. </figcaption></figure>“Currently we are on a mission to deliver 20,000 home isolation kits across the country. They are distributed by the concerned municipality to affected households,” says Kharel, whose team works directly with mayors and local representatives to distribute the kit. He adds: “We value partnering with the local government and building the government’s capacity to serve its people. That is why our work is done in partnership with the municipal administration.” Kharel works as an emergency medicine physician in the United States and has been in Nepal for the past three months. In collaboration with <a href="https://www.nepalitimes.com/latest/vaccines-are-the-only-solution/" target="_blank" rel="noopener noreferrer">the Covid Alliance for Nepal</a>, his team has also been actively involved in providing training to isolation centres, medical professionals, frontline doctors, and clinical care providers. Kharel’s team had also been conducting meetings with mayors across the country to find out the kind of technical or material need the group could help with to counter the surge of <a href="https://www.nepalitimes.com/latest/rural-nepal-fights-back-covid-19/" target="_blank" rel="noopener noreferrer">Covid-19 cases in the villages</a>.In the course of our conversation with the mayor of Dhangadi, Nripa Odd, it became clear that one immediate point of intervention was encoring the large population of folks coming in from the district and from India to isolate at home for as long as possible," says Kabita Parajuli of the Covid Alliance for Nepal. "With that in mind, some quick brainstorming yielded the isolation kit idea. The municipality's enthusiasm and use of local resources was also instrumental in getting this off the ground."  The kit includes a pulse oximeter, thermometer, at least 25 surgical masks, medications that are important during home isolation, sanitiser and soap, as well as a brochure on what to do and not to do while isolating at home. The brochure includes a video with detailed instructions on how to use the kit. <figure><img width="780" height="547" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109121140/636b92209c7e80680e06f12ejpeg.jpg" alt=""><figcaption>Contents of the home isolation kits, including pulse oximeter and thermometer. </figcaption></figure>Presently there are 77,858 active cases in Nepal. 5,860 of them are undergoing treatment in various hospitals across the country with 1,261 in ICU and 382 requiring ventilator support.On Thursday, Nepal recorded 3,749 new confirmed cases, with 5,293 having recovered. There were 59 fatalities in the last 24 hours. Kathmandu registered record low new infections at 540. Lalitpur and Bhaktapur have 125 and 99 new cases.“Eighty per cent of those infected with the coronavirus are managed at home or at an institutional isolation centre. We have started providing home isolation kits to facilitate the process and reduce the burden in hospitals,” says Aman Bhattarai from HAPSA’s strategic partner <a href="https://www.impactweek.net" target="_blank" rel="noopener noreferrer">Impact Week</a>.The team recently delivered its first batch of home isolation kits to Shankharapur Municipality, Sindhupalchok, where HAPSA has been working on health advancement for more than 10 years.“We very much appreciate this support from HAPSA, the kits will be crucial in our battle against coronavirus in the region,” says the Mayor of Shankharapur Municipality Subarna Shrestha. <figure><img width="780" height="520" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109121140/636b92239c7e80680e06f12fjpeg.jpg" alt=""><figcaption>Ramu Kharel of HAPSA Nepal training locals on how to use pulse oximeter at Shankarapur Municipality in Sindhupalchok.</figcaption></figure>, Once a household has recovered, local recipients are expected to return the pulse oximeters to the municipality which are them re-distributed to other isolation centres or local health facilities, according to HAPSA Nepal president Pankaj Bhattarai. Says Kharel: “Each kit costs nearly $20, and for the goal of 20,000 Home Isolation Kits, we need to raise nearly $400,000. Funding for this important work is our biggest bottleneck right now.” Interested individuals can <a href="https://www.gofundme.com/f/help-nepal-fight-covid19-support-hapsa-nepal?utm_campaign=p_cp_url&amp;utm_medium=os&amp;utm_source=customer" target="_blank" rel="noopener noreferrer">GoFundMe</a> or by visiting the HAPSA Nepal <a href="http://www.hapsaglobe.org" target="_blank" rel="noopener noreferrer">website</a>.

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2020’s tips for 2021

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109181148/636be8269c7e80680e087841jpeg.jpg" alt="" width="747" height="600"/><figcaption></figcaption></figure>As <a href="https://www.nepalitimes.com/here-now/pandemic-stress-grips-nepals-journalists/" target="_blank" rel="noopener noreferrer">part of my job as a journalist</a>, I have interviewed many in the past months who were seriously sick with Covid-19. On all those occasions, at the back of my mind was always the fear that I myself might be infected one day.Our work takes us to the <a href="https://www.nepalitimes.com/latest/nepals-journalists-are-also-on-the-frontlines/" target="_blank" rel="noopener noreferrer">frontlines of this pandemic</a>. When the lockdown was imposed, I started working out of my home in Butwal. Regardless, I had to travel to nearby regions to report. And while I tried to follow all the necessary safety measures, I never really found out where I caught the coronavirus.The infection hits patients with varying degrees of intensity. Some show severe symptoms, while others have milder ones, followed by a quick recovery. Mine were mild, and did not last long. I have since recovered.I experienced those 15 <a href="https://www.nepalitimes.com/latest/kathmandu-homes-and-hotels-turn-into-hospitals/" target="_blank" rel="noopener noreferrer">days of isolation</a> were different for me. As a journalist, I was constantly exposed to how the news, social media interactions and conversations with friends can affect the morale of those infected. It was on the day of <a href="https://www.nepalitimes.com/latest/rani-pokhari-open-for-bhai-tika/" target="_blank" rel="noopener noreferrer">Bhai Tika</a> on (16 November, 2020) that I started feeling lethargic and weak. By evening, I was running a slight temperature. This was not unusual, I often had fevers and they passed.But these were extraordinary times, and I suspected it might be the dreaded coronavirus. So, I isolated myself at home.I took a paracetamol and managed to get some sleep, but at 3AM I was wide awake with 37.3° fever. This was not high, but I had a hard time going back to sleep.In the morning, I went to Lumbini Regional Hospital in Butwal for <a href="https://www.nepalitimes.com/latest/why-nepal-lags-in-covid-19-testing/" target="_blank" rel="noopener noreferrer">PCR test</a>. At around 4PM, I received my report. I was confirmed Covid-19 positive.I had been preparing myself for it mentally, so I took it well. I had no other symptoms besides fever. Once I took a paracetamol, my fever would go down, but it would return every six hours. This went on for three days.I found my CT (cycle threshold) value to be at 14, which is considerably low, so I visited the hospital to get further tests done. The reports came back normal. After the third day I no longer had fever, but a blocked nose.But it was after Day 6, that I started to experience a sore throat. Gargling with salt water and hot water steaming with a dash of sancho twice a day, helped gradually reduced the cold and the soreness by Day 8.I had heard about how a positive mental attitude builds up physical immunity. From the beginning of isolation, I was careful not to let external factors influence me. I removed Facebook and Twitter from my phone, stopped checking online portals to keep myself away from news about Covid-19 deaths.I had noticed that negative news made me anxious. It made me sweat profusely and I had difficulty breathing. Because my oxygen saturation level was normal at 97, I was clearly overthinking. It was my exposure to media that was affecting my physical recovery.So, I tried my best to forget about my circumstance by watching travel and environmental documentaries. I listened to folk music and positive discourses. I took in the sun.I asked my wife to forward to me any positive news she came across. Politician Chitra Bahadur KC’s recovery, and news about <a href="https://www.nepalitimes.com/here-now/when-will-nepals-covid-vaccine-turn-come/" target="_blank" rel="noopener noreferrer">successful vaccine trials</a> gave me hope.Throughout my career, I have heard people complain that journalists only report negative news. As a Covid-19 patient in isolation, I realised how true this is.Positive news is like the oxygen for those who are trying to recover from the coronavirus. Positive thoughts can be half the cure.While recovering, there were many who tried to give me advice. Not all of it reassuring. “Can’t say anything with coronavirus, even the healthiest have died just like that,” said one friend. Another called to say: “You should have had severe symptoms, but you seem normal.”Take it from me: trust only the experts.Doctors confirm that the <a href="https://www.nepalitimes.com/latest/dont-take-covid-19-lightly/" target="_blank" rel="noopener noreferrer">impact of the virus is stronger in people with weaker immunity</a>. Many acquaintances have been severely affected. But because I was conscious about my diet and fitness, it seems I was able to fight back. More importantly, I was mentally prepared.It has been a week since I tested negative, but my health is still not back to what it used to be. I feel lethargic and listless, and cannot concentrate on work. But I am getting there because to be negative you have to be positive.Mukesh Pokhrel is the Himal Khabarpatrika and Nepali Times reporter based in Nawalparasi, covering the environment and development.

Staying positive to become negative

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109191116/636bef1f4b0ad905ca02ef8ajpeg.jpg" alt="" width="747" height="600"/><figcaption></figcaption></figure>As <a href="https://www.nepalitimes.com/here-now/pandemic-stress-grips-nepals-journalists/" target="_blank" rel="noopener noreferrer">part of my job as a journalist</a>, I have interviewed many in the past months who were seriously sick with Covid-19. On all those occasions, at the back of my mind was always the fear that I myself might be infected one day.Our work takes us to the <a href="https://www.nepalitimes.com/latest/nepals-journalists-are-also-on-the-frontlines/" target="_blank" rel="noopener noreferrer">frontlines of this pandemic</a>. When the lockdown was imposed, I started working out of my home in Butwal. Regardless, I had to travel to nearby regions to report. And while I tried to follow all the necessary safety measures, I never really found out where I caught the coronavirus.The infection hits patients with varying degrees of intensity. Some show severe symptoms, while others have milder ones, followed by a quick recovery. Mine were mild, and did not last long. I have since recovered.I experienced those 15 <a href="https://www.nepalitimes.com/latest/kathmandu-homes-and-hotels-turn-into-hospitals/" target="_blank" rel="noopener noreferrer">days of isolation</a> were different for me. As a journalist, I was constantly exposed to how the news, social media interactions and conversations with friends can affect the morale of those infected. It was on the day of <a href="https://www.nepalitimes.com/latest/rani-pokhari-open-for-bhai-tika/" target="_blank" rel="noopener noreferrer">Bhai Tika</a> on (16 November, 2020) that I started feeling lethargic and weak. By evening, I was running a slight temperature. This was not unusual, I often had fevers and they passed.But these were extraordinary times, and I suspected it might be the dreaded coronavirus. So, I isolated myself at home.I took a paracetamol and managed to get some sleep, but at 3AM I was wide awake with 37.3° fever. This was not high, but I had a hard time going back to sleep.In the morning, I went to Lumbini Regional Hospital in Butwal for <a href="https://www.nepalitimes.com/latest/why-nepal-lags-in-covid-19-testing/" target="_blank" rel="noopener noreferrer">PCR test</a>. At around 4PM, I received my report. I was confirmed Covid-19 positive.I had been preparing myself for it mentally, so I took it well. I had no other symptoms besides fever. Once I took a paracetamol, my fever would go down, but it would return every six hours. This went on for three days.I found my CT (cycle threshold) value to be at 14, which is considerably low, so I visited the hospital to get further tests done. The reports came back normal. After the third day I no longer had fever, but a blocked nose.But it was after Day 6, that I started to experience a sore throat. Gargling with salt water and hot water steaming with a dash of sancho twice a day, helped gradually reduced the cold and the soreness by Day 8.I had heard about how a positive mental attitude builds up physical immunity. From the beginning of isolation, I was careful not to let external factors influence me. I removed Facebook and Twitter from my phone, stopped checking online portals to keep myself away from news about Covid-19 deaths.I had noticed that negative news made me anxious. It made me sweat profusely and I had difficulty breathing. Because my oxygen saturation level was normal at 97, I was clearly overthinking. It was my exposure to media that was affecting my physical recovery.So, I tried my best to forget about my circumstance by watching travel and environmental documentaries. I listened to folk music and positive discourses. I took in the sun.I asked my wife to forward to me any positive news she came across. Politician Chitra Bahadur KC’s recovery, and news about <a href="https://www.nepalitimes.com/here-now/when-will-nepals-covid-vaccine-turn-come/" target="_blank" rel="noopener noreferrer">successful vaccine trials</a> gave me hope.Throughout my career, I have heard people complain that journalists only report negative news. As a Covid-19 patient in isolation, I realised how true this is.Positive news is like the oxygen for those who are trying to recover from the coronavirus. Positive thoughts can be half the cure.While recovering, there were many who tried to give me advice. Not all of it reassuring. “Can’t say anything with coronavirus, even the healthiest have died just like that,” said one friend. Another called to say: “You should have had severe symptoms, but you seem normal.”Take it from me: trust only the experts.Doctors confirm that the <a href="https://www.nepalitimes.com/latest/dont-take-covid-19-lightly/" target="_blank" rel="noopener noreferrer">impact of the virus is stronger in people with weaker immunity</a>. Many acquaintances have been severely affected. But because I was conscious about my diet and fitness, it seems I was able to fight back. More importantly, I was mentally prepared.It has been a week since I tested negative, but my health is still not back to what it used to be. I feel lethargic and listless, and cannot concentrate on work. But I am getting there because to be negative you have to be positive.Mukesh Pokhrel is the Himal Khabarpatrika and Nepali Times reporter based in Nawalparasi, covering the environment and development.

<figure><img width="2048" height="1364" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109181140/636be6219c7e80680e08778bjpeg.jpg" alt=""/><figcaption>Photo: MONIKA DEUPALA</figcaption></figure>Going by the Ministry of Health figures, Nepal’s Covid-19 pandemic has peaked, and the number of daily cases, the positivity rate and the number of active cases are all going down. The recovery rate now exceeds 90%. Is Nepal turning the corner on the pandemic? Experts say no. The number of fatalities is at an all-time high. There were 29 deaths reported each on Monday and Tuesday, taking the total to 1,538. And the reason the daily case rate is lower is because the government is conducting fewer tests, there is virtually no official contact tracing, and active cases are at home and going to hospital only when they are really serious. These are ideal conditions for community spread. “The fact that the fatalities are increasing, especially in Kathmandu, won’t allow us to say that fewer people are getting infected. This coronavirus isn’t going anywhere just yet,” explains Sher Bahadur Pun of the Ministry of Health. “Yes, the positivity rate has gone down, but the government has also more or less stopped contact tracing.” Since the government started charging for RT PCR tests and hospital admissions, patients and their families are reluctant to have tests despite symptoms, and do not want to go to hospital. The rates have remained high because <a href="https://www.nepalitimes.com/banner/heat-map-of-nepals-covid-19-hotspots/" target="_blank" rel="noopener noreferrer">those infected during Dasain-Tihar</a> are developing symptoms. The current marriage season is another super-spreader event.   There are 77 hospitals and labs across the country conducting an average of  9,000 PCR tests a day, which went down from a daily total of 15,000 after the government directive to charge Rs2,000 for PCR tests in public facilities. The positivity rate went down, which is a good thing – but it happened for the wrong reason. In October a quarter of people tested came out positive, it is now down to 15% despite the onset of the winter season.   “The risk cannot be underestimated based on numbers of infected people by reducing tests itself at a time when increasingly more people are getting sick or dying of coronavirus,” says infectious diseases specialist Pravat Adhikari. “This argument would be valid only if the infection rate goes down despite an increase in total tests. However, very few tests are being conducted at the moment.” In fact, such hidden positives lead to more unidentified Covid-19 deaths, adding to the risk. It is reckless of the government to still not launch low-cost PCR tests with quick results, adds Adhikari. <figure><img width="2340" height="1216" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109181140/636be6249c7e80680e08778cjpeg.jpg" alt=""><figcaption>Total Covid-19 cases from January 23 until 1 December in Province 2 and in Bagmati province. Source: MINISTRY OF HEALTH</figcaption></figure>The problem is further exacerbated by unmanaged home isolation, and quarantine cases. According to the Ministry of Health, 10,741 people across seven provinces are self-isolating at home, often without much resources or knowledge on how to manage their condition.Ideally, asymptomatic or mildly symptomatic <a href="https://www.nepalitimes.com/latest/kathmandu-homes-and-hotels-turn-into-hospitals/" target="_blank" rel="noopener noreferrer">people self-isolating at homes</a> should have a separate room and a bathroom. Patients should confine themselves in their rooms, wash their own utensils, wear masks while going to the toilet and sanitise it after use and wipe touch points with disinfectant.  Individuals need to keep track of their temperature and symptoms, measure oxygen saturation level if possible, take paracetamol for body ache and fever and make sure to eat nutritious food. One must be aware of danger signs: oxygen level below 93, chest pain, difficulty in breathing and blue tint to lips and limbs.But most families who have members in home isolation do not have this information, or live in such crowded quarters that it is impossible to fulfil all precautions. Conflicting directives from the government haven’t helped.At one point, overwhelmed with the surge of Covid-19 cases in Kathmandu, the Ministry of Health spokesperson Jageswar Gautam advised people live on television to go to hospital only if they feel faint. By then it is too late because it means the patient’s oxygen saturation is already dangerously low.The government has left the people to their own devices, and ignored expert advice on <a href="https://www.nepalitimes.com/here-now/when-will-nepals-covid-vaccine-turn-come/" target="_blank" rel="noopener noreferrer">increasing the number of beds in wards with basic oxygen supply</a> instead of spending money on ICUs and ventilators."When I tested positive for coronavirus and had slight difficulty breathing, I called a government health expert for advice, and he himself dissuaded me from going to a public hospital," says Rajendra Dahal, Editor of the magazine Shiskyak. “This is why the death rate is going up, while the positive totals are going down. People are at home, and their oxygen levels are falling, and they have no idea. The main point is that the people have lost their trust in the government health system.”The chief consultant at the Infectious Diseases Hospital in Teku Anup Bastola agrees that the risk has been heightened because health experts are unaware about the actual condition of people isolating at homes. “Nepalis have a tendency to not visit hospitals until it’s too late. We have found that this is even more true for coronavirus,” he says. With much of the 2020 overshadowed by the pandemic and its impact on all the sectors, young people wanting to get back to their lives are now ignoring the signs and symptoms, preferring not to voluntarily test in case they might have to isolate for two weeks.Even according to government figures, the number of people testing positive in Kathmandu Valley is not going down. With the marriage season, and people intermingling indoor in banquet halls, the surge is not expected to subside. At Pashupati Aryaghat, there are five times more <a href="https://www.nepalitimes.com/latest/with-3rd-covid-19-fatality-nepal-issues-funeral-guideline/" target="_blank" rel="noopener noreferrer">cremations</a> happening compared to the same period last year, according to reports. It is not clear how many of these extra deaths are due to Covid-19.The movement of the younger people has had a <a href="https://www.nepalitimes.com/here-now/spared-at-first-elderly-hit-hard-by-covid-19/" target="_blank" rel="noopener noreferrer">direct impact on the elderly</a>, as they take home the virus and make parents and grandparents seriously sick. People in their sixties and above now make up over 60% of Covid-19 fatalities in Nepal.Even without the added risk of coronavirus, senior citizens are prone to <a href="https://www.nepalitimes.com/latest/covid-19-will-get-worse-before-it-gets-better/" target="_blank" rel="noopener noreferrer">pneumonia and other chronic respiratory illness in winter</a>. Public health experts advise being alert in regards to their condition even before they complain of symptoms and keeping communication channels open.Says Sher Bahadur Pun: “These are extraordinary times and we need to take extraordinary measures to protect the more vulnerable among us. <a href="https://www.nepalitimes.com/latest/vax-populi/" target="_blank" rel="noopener noreferrer">Until we get a vaccine</a>, we must realise our responsibility in containing the virus and not become a medium for more deaths.”

Why Nepal’s Covid-19 figures are deceptive

<figure><img width="2048" height="1364" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110919118/636bed424b0ad905ca02eed4jpeg.jpg" alt=""/><figcaption>Photo: MONIKA DEUPALA</figcaption></figure>Going by the Ministry of Health figures, Nepal’s Covid-19 pandemic has peaked, and the number of daily cases, the positivity rate and the number of active cases are all going down. The recovery rate now exceeds 90%. Is Nepal turning the corner on the pandemic? Experts say no. The number of fatalities is at an all-time high. There were 29 deaths reported each on Monday and Tuesday, taking the total to 1,538. And the reason the daily case rate is lower is because the government is conducting fewer tests, there is virtually no official contact tracing, and active cases are at home and going to hospital only when they are really serious. These are ideal conditions for community spread. “The fact that the fatalities are increasing, especially in Kathmandu, won’t allow us to say that fewer people are getting infected. This coronavirus isn’t going anywhere just yet,” explains Sher Bahadur Pun of the Ministry of Health. “Yes, the positivity rate has gone down, but the government has also more or less stopped contact tracing.” Since the government started charging for RT PCR tests and hospital admissions, patients and their families are reluctant to have tests despite symptoms, and do not want to go to hospital. The rates have remained high because <a href="https://www.nepalitimes.com/banner/heat-map-of-nepals-covid-19-hotspots/" target="_blank" rel="noopener noreferrer">those infected during Dasain-Tihar</a> are developing symptoms. The current marriage season is another super-spreader event.   There are 77 hospitals and labs across the country conducting an average of  9,000 PCR tests a day, which went down from a daily total of 15,000 after the government directive to charge Rs2,000 for PCR tests in public facilities. The positivity rate went down, which is a good thing – but it happened for the wrong reason. In October a quarter of people tested came out positive, it is now down to 15% despite the onset of the winter season.   “The risk cannot be underestimated based on numbers of infected people by reducing tests itself at a time when increasingly more people are getting sick or dying of coronavirus,” says infectious diseases specialist Pravat Adhikari. “This argument would be valid only if the infection rate goes down despite an increase in total tests. However, very few tests are being conducted at the moment.” In fact, such hidden positives lead to more unidentified Covid-19 deaths, adding to the risk. It is reckless of the government to still not launch low-cost PCR tests with quick results, adds Adhikari. <figure><img width="2340" height="1216" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110919118/636bed454b0ad905ca02eed5jpeg.jpg" alt=""><figcaption> </figcaption></figure>The problem is further exacerbated by unmanaged home isolation, and quarantine cases. According to the Ministry of Health, 10,741 people across seven provinces are self-isolating at home, often without much resources or knowledge on how to manage their condition.Ideally, asymptomatic or mildly symptomatic <a href="https://www.nepalitimes.com/latest/kathmandu-homes-and-hotels-turn-into-hospitals/" target="_blank" rel="noopener noreferrer">people self-isolating at homes</a> should have a separate room and a bathroom. Patients should confine themselves in their rooms, wash their own utensils, wear masks while going to the toilet and sanitise it after use and wipe touch points with disinfectant.  Individuals need to keep track of their temperature and symptoms, measure oxygen saturation level if possible, take paracetamol for body ache and fever and make sure to eat nutritious food. One must be aware of danger signs: oxygen level below 93, chest pain, difficulty in breathing and blue tint to lips and limbs.But most families who have members in home isolation do not have this information, or live in such crowded quarters that it is impossible to fulfil all precautions. Conflicting directives from the government haven’t helped.At one point, overwhelmed with the surge of Covid-19 cases in Kathmandu, the Ministry of Health spokesperson Jageswar Gautam advised people live on television to go to hospital only if they feel faint. By then it is too late because it means the patient’s oxygen saturation is already dangerously low.The government has left the people to their own devices, and ignored expert advice on <a href="https://www.nepalitimes.com/here-now/when-will-nepals-covid-vaccine-turn-come/" target="_blank" rel="noopener noreferrer">increasing the number of beds in wards with basic oxygen supply</a> instead of spending money on ICUs and ventilators."When I tested positive for coronavirus and had slight difficulty breathing, I called a government health expert for advice, and he himself dissuaded me from going to a public hospital," says Rajendra Dahal, Editor of the magazine Shiskyak. “This is why the death rate is going up, while the positive totals are going down. People are at home, and their oxygen levels are falling, and they have no idea. The main point is that the people have lost their trust in the government health system.”The chief consultant at the Infectious Diseases Hospital in Teku Anup Bastola agrees that the risk has been heightened because health experts are unaware about the actual condition of people isolating at homes. “Nepalis have a tendency to not visit hospitals until it’s too late. We have found that this is even more true for coronavirus,” he says. With much of the 2020 overshadowed by the pandemic and its impact on all the sectors, young people wanting to get back to their lives are now ignoring the signs and symptoms, preferring not to voluntarily test in case they might have to isolate for two weeks.Even according to government figures, the number of people testing positive in Kathmandu Valley is not going down. With the marriage season, and people intermingling indoor in banquet halls, the surge is not expected to subside. At Pashupati Aryaghat, there are five times more <a href="https://www.nepalitimes.com/latest/with-3rd-covid-19-fatality-nepal-issues-funeral-guideline/" target="_blank" rel="noopener noreferrer">cremations</a> happening compared to the same period last year, according to reports. It is not clear how many of these extra deaths are due to Covid-19.The movement of the younger people has had a <a href="https://www.nepalitimes.com/here-now/spared-at-first-elderly-hit-hard-by-covid-19/" target="_blank" rel="noopener noreferrer">direct impact on the elderly</a>, as they take home the virus and make parents and grandparents seriously sick. People in their sixties and above now make up over 60% of Covid-19 fatalities in Nepal.Even without the added risk of coronavirus, senior citizens are prone to <a href="https://www.nepalitimes.com/latest/covid-19-will-get-worse-before-it-gets-better/" target="_blank" rel="noopener noreferrer">pneumonia and other chronic respiratory illness in winter</a>. Public health experts advise being alert in regards to their condition even before they complain of symptoms and keeping communication channels open.Says Sher Bahadur Pun: “These are extraordinary times and we need to take extraordinary measures to protect the more vulnerable among us. <a href="https://www.nepalitimes.com/latest/vax-populi/" target="_blank" rel="noopener noreferrer">Until we get a vaccine</a>, we must realise our responsibility in containing the virus and not become a medium for more deaths.”

Sonia Awale

This week at the National Population Policy launch Prime Minister K P Oli exhorted Nepalis to get married by age 20 and have three babies by the time they are 30. This was the first indication that the highest office in the land has understood the need to address Nepal’s dramatically <a href="https://nepalitimes.com/news/nepals-demographic-window-is-closing">falling birth rate</a>, but Oli’s statement was greeted with ridicule on<a href="https://nepalitimes.com/banner/avoiding-the-quicksand-of-social-media"> social media</a> — especially by women. Most urban young are already grappling with economic pressures and shifting life priorities. Even with a university degree,<a href="https://nepalitimes.com/here-now/workers-return-to-jobless-nepal?%2F"> many cannot find jobs</a>, and are taking the first flight out for overseas employment. Having a child is now a fraught decision shaped by income, individual autonomy, and family pressure. The <a href="https://www.unfpa.org/swp2025">UNFPA’s State of the World Population report </a>released last month, highlighted a significant <a href="https://nepalitimes.com/here-now/migrating-males-and-population-decline">decline in fertility rates </a>around the world. The global average fertility rate is 2.25 children per woman, and 18% of the reproductive adults said they will not be able to have the number of children they desire. The total fertility rate in Nepal has plummeted to 2.1 births per woman — down from 5 just 30 years ago. This is considered replacement level, meaning the newborns will replace their parents.&nbsp; However, birth rates are not declining as rapidly everywhere. The Tarai in has a total fertility rate of 2.20, and northwestern mountains is still 2.24.&nbsp; There are multiple factors in play, and the report broadly divides them into four categories: health issues, economic concerns, fears about the future, and lack of a supportive partner or their absence. More than half of the respondents said finance, which includes unemployment and increased cost of housing, as well as parenthood, was a barrier to having children. “More and more people prefer one or two children at maximum. Many women also decide to have children at a much later age,” says Kamala Devi Lamichhane of Tribhuvan University. “The opportunity cost is far higher for women.” But there is also a cost for the country, as the National Population Policy notes. At the rate the total fertility rate is falling it will soon be below replacement level — meaning that in the next three decades Nepal will be confronted with an <a href="https://nepalitimes.com/opinion/the-future-is-older">ageing population</a>.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250714140740_bac3e5a284b69a77d97b3b99daf2e7fd3019bc48f1a399fb2771381c751d8291.png" data-media-id="editor_6" data-image-id="20250714140740_bac3e5a284b69a77d97b3b99daf2e7fd3019bc48f1a399fb2771381c751d8291" data-rendition-name="original" width="1302" height="501" loading="lazy" alt="Nepalis having fewer babies. Why?"> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250714140740_251115b0a88d4e82be70245c43cb74477f3be18042ef1aa3b904c597d815f13b.png" data-media-id="editor_7" data-image-id="20250714140740_251115b0a88d4e82be70245c43cb74477f3be18042ef1aa3b904c597d815f13b" data-rendition-name="original" width="1125" height="500" loading="lazy" alt="Nepalis having fewer babies. Why?"> </figure>  Besides income, there are also cultural factors at play in women having fewer babies — they are expected to do all the childcare duties, even putting their careers on hold. In general, there is little help from spouses, and with more nuclear families there is less support from relatives. “Women today are well educated, career-oriented, and economically independent, allowing them to delay marriage as well as being conscious about their body and <a href="https://nepalitimes.com/multimedia/nepal-far-from-hitting-contraceptive-target?%2F">reproductive rights</a>,” says Laxmi Tamang of the International Confederation of Midwives (ICM). Also present at the policy launch was demographer Yagya Bahadur Karki, who said that women are more educated and hence, empowered to take their own informed decisions regarding having children.&nbsp; He adds, “But the fertility rates have reached replacement rate, and that stands as a warning for the future.”&nbsp; Fertility rates have fallen in inverse proportion to the rise in female literacy. The regions of Nepal where couples have more babies is where women are less educated. Couples in Madhes and Sudur Paschim provinces, where child marriage, gender-based discrimination, menstrual huts and dowry are still widespread are where the fertility rate is still high.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250717120740_ababfd31ed5ff79ded427e1f1adfff02e6af2384bd541e51dfe05e52fbbccb39.jpg" data-media-id="editor_9" data-image-id="20250717120740_ababfd31ed5ff79ded427e1f1adfff02e6af2384bd541e51dfe05e52fbbccb39" data-rendition-name="original" width="994" height="682" loading="lazy" alt="TFR Map"> </figure>  And because female literacy also has a direct correlation with <a href="https://nepalitimes.com/news/fatal-discrimination">infant and child mortality</a>, couples in those regions tend to have more babies so some of them survive.&nbsp; But it is Nepal’s urban centres among the educated where the increased choices in reproductive health, including alternative methods of conception like IVF and treatment for infertility, as well as <a href="https://nepalitimes.com/banner/implant-service-providers-take-contraception-to-nepals-poor">contraceptives</a> offer more options for family planning. “There are more choices regarding reproductive health, and there is more awareness as well, which is why people decide carefully on whether or not to bear a child,” says population expert Yogendra Gurung. <a href="https://nepalitimes.com/here-now/migrants-returning-from-the-gulf-with-infertility">Migration is another factor</a> adding to the decline in fertility rates. Many young Nepalis of reproductive age leave every day in pursuit of better jobs overseas. Spousal separation means fewer children.&nbsp; “Once away, even if not educated, they realise that child-rearing costs are high, and try to have fewer and even no children in some cases,” Gurung adds. Recent studies have also shown that men returning after their stint in the Gulf and Malaysia, where they are <a href="https://nepalitimes.com/news/gulf-workers-need-protection-from-heat">exposed to extreme heat </a>for extended periods as well as various chemicals and toxins in their work environment &nbsp;have a range of health problems, including infertility. To increase the birth rate, Nepal will have to reverse its family planning strategy of the past 40 years. Complicating this is that some regions of Nepal will need measures to control the birth rate, while urban areas will need a strategy to help parents have more babies. One way to help families have more children is to develop more <a href="https://nepalitimes.com/here-now/future-proofing-nepal-s-population-strategy?s=04&amp;fbclid=IwY2xjawFQf-NleHRuA2FlbQIxMQABHRxSwwGPfm7_2cBhDVAowPxEmFXP0Os-KRs1DXqIW_84wDhciExtZuNi1g_aem_jzRqN2cEVAppfwr5qedxRg">family-friendly policies</a> that favour women and youth as the Nordic countries, which also have falling birth rates, have done. They have introduced flexible parental leaves for both parents, including financial and health incentives. China, also concerned about its declining birth rate and an ageing population, now has a three-child policy as well as tax deductions, expanded childcare services, and leave policies to encourage couples to have more children. “We must work towards childbirth and childcare policies and plans that are suitable for Nepal, so that couples planning for children do not have to think twice about it because of finances or other reasons,” adds Gurung. Tamang of the International Confederation of Midwives says a gender transformative approach is needed to address the issues of the gender gap which is adding to the decline in childbirth. Husbands need to play a more important role in child-rearing. Instead of increasing fertility for the sake of it, the objective should be to assist young people to start the families they desire, at a point and time of their choice. Respect for everyone’s rights and dignity lays a foundation for a more balanced demographic trend. Lamichhane sums it up: “If fertility rates are to be sustained, it requires changes in the gender roles and behaviour, keeping the youth’s aspirations in mind.”

Nepalis are having fewer babies. Why?

Does anyone know that 2023-33 was declared the <a href="https://nepalitimes.com/banner/visit-nepal-again">Visit Nepal</a> Decade? Or that Pokhara announced that 2025 is a Special Tourism Year? The fuselage of Nepal Airlines jets still carry the Visit Nepal Year 2020 logos. Such ad hoc and unnoticed promotion is emblematic of the way Nepal has tried to increase visitor arrivals <a href="https://nepalitimes.com/news/nepal-hopes-for-tourism-rebound-in-2021-rk4dlo9t">post-Covid</a> — and of the country’s wider political disarray. Deepak Raj Joshi of the Nepal Tourism Board (NTB) has his work cut out to coordinate various agencies of the government to boost arrivals.&nbsp; He says, “We have been working on marketing strategies to revive the tourism sector, and are hopeful that this year will mark a 8-10% increase in arrivals compared to the pre-pandemic times.” On paper, tourist numbers have rebounded to pre-Covid numbers with over 1 million last year, but official figures do not give a true picture of duration of stay, average spending, and the fact every visitor is counted as a ‘tourist’, even repeat visitors who come on business. The few bright spots are largely a result of private sector promotion of niche tourism products, individual social media posts of <a href="https://archive.nepalitimes.com/page/top-10-treks">adventurous treks in Nepal</a>, or the fact that Indians are allowed to enter China again to visit Lake Mansarovar and Mt Kailash via Nepal. Indeed, Simkot airport has up to 15 flights a day from Nepalganj bringing in <a href="https://nepalitimes.com/opinion/borderlines/nepal-india-trans-boundary-bonds">Indian pilgrims</a> who are then ferried by helicopter to the border in Hilsa, or Lapcha Pass from where the holy sites in Tibet are visible. The rudimentary hotels and rest houses along the route in Humla have been bursting at the seams for the past month, to the point that some establishments are no longer able to provide patrons basic amenities.&nbsp; Last year, 1.14 million tourists visited Nepal, and the government has projected up to 10% increase in tourist arrivals this year. International tourist arrivals to Nepal have been steadily increasing, especially from the US, Europe, and India. Domestic and regional travel has also increased after the <a href="https://nepalitimes.com/news/lockdown-5-utlzqtvs">Covid lockdowns</a>.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250717120756_e1c8f08e7e26496d2b2394e0be776e147fb46c415347b781ed9e5c64d9c9e505.jpg" data-media-id="editor_5" data-image-id="20250717120756_e1c8f08e7e26496d2b2394e0be776e147fb46c415347b781ed9e5c64d9c9e505" data-rendition-name="original" width="1145" height="668" loading="lazy" alt="Tourist numbers"> </figure>  The tourism industry employs at least 1 million people, trekking injects money directly into the <a href="https://nepalitimes.com/editorial/not-rising-nepal">rural economy </a>and sustains ancillary sectors like handicrafts and domestic aviation. In the last fiscal year, tourism brought in Rs82.33 billion, according to Nepal Rastra Bank. But the industry has been affected by negative publicity about poor infrastructure, air pollution in Kathmandu, travel safety and news of disasters like the <a href="https://nepalitimes.com/news/rasuwa-flood-likely-a-glof">China-Nepal flood last week</a> that made international headlines. Growing worries about the climate crisis is also affecting youth travel, especially from Europe. Read also: <a href="https://nepalitimes.com/news/missing-out-on-nepal-s-tourism-potential">Missing out on Nepal’s tourism potential</a> “The limitations of airport and road infrastructure has hindered the development of the tourism sector,” admits Joshi. “And many are put off by the appalling state of our road network, especially during <a href="https://nepalitimes.com/opinion/managing-the-monsoon">the monsoon season</a>.” Nepal is home to 20 protected areas, 10 heritage sites, and eight out of the world’s 10 highest mountains, and despite all the obstacles it is still the perfect destination for the modern social media savvy traveller, who are experience-driven and inclined to look for itineraries that emphasise wellness and cultural immersion.&nbsp; Some hotels around Kathmandu, Pokhara, Jomsom and the Khumbu have strived to adapt to this new tourism landscape, expanding facilities with significant international investment. <a href="https://nepalitimes.com/business/a-thamel-within-thamel">Luxury hotels like Aloft Kathmandu</a> in Thamel were inaugurated just before the pandemic lockdowns, survived the crisis and thrived as it. Says General Manager Vikram Singh (pictured, below): “Our prime location in Thamel enhances the guest experience, especially for those seeking convenience and immersion in the local scene and travellers who want to be in the centre of it all.”  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025071805070_8d29803e8b52bcd4439422e7b7a0bc25aa68ef3d227b9130bd0e079af626677d.jpg" data-media-id="editor_11" data-image-id="2025071805070_8d29803e8b52bcd4439422e7b7a0bc25aa68ef3d227b9130bd0e079af626677d" data-rendition-name="original" width="1066" height="1600" loading="lazy" alt="Aloft GM"> </figure>  <a href="https://nepalitimes.com/here-now/what-sustainable-tourism-means-in-practice">Sustainability </a>and environmental consciousness has also become an integral part of the hospitality industry. ISO certifications as well as sustainability initiatives like the Travelife sustainability certification for eco-friendly resorts validate credibility of hotels. Aloft is the first five-star hotel in Nepal to have earned the Waste Smart Certificate, and it has also been awarded the ISO 14001:2015 certification, which is the internationally recognised standard for environmental management systems (EMS). But such investments will not amount to much unless Nepal makes serious efforts to promote itself as a<a href="https://nepalitimes.com/here-now/peak-tourism-in-2023-9ukoi8iz?utm="> tourism destination</a>, especially to its two giant neighbours. More importantly, the country needs to increase activities in which tourists can spend the money they want to. “While <a href="https://nepalitimes.com/here-now/nepal-pushes-mountain-bike-tourism?fbclid=IwAR1MNH0iFGv1vRz5G9uZ4AzUlKxB6nY7JKq0qT6je_FV4_SuxPZqviwKGn0">mountaineering and adventure tourism</a> are extensively promoted, we have fallen short of marketing other elements such as wildlife, pilgrimage and cultural heritage,” says Joshi. “There is a need to diversify promotion to increase income from the tourism sector.” Meanwhile, making Nepal more accessible to international and domestic visitors, must also be a priority. Kathmandu remains the sole aerial gateway despite new airports in Pokhara and Bhairawa. “International airlines have shown interest, and if access and flights are increased these airports can be fully functional,” says Joshi. But Sichuan Airlines has stopped flying to Pokhara, and there does not seem to be much interest from Thai, Vietnamese and Cambodian carriers to fly directly to Lumbini. Says Singh: “There’s tremendous opportunity to strengthen Nepal’s destination marketing by telling richer, more compelling stories that <a href="https://nepalitimes.com/opinion/comment/culture-cannot-be-an-afterthought">connect travellers with our culture</a>, nature, and people.”

Tourism needs a new push

Many of us former Nepal Peace Corps volunteers (PCVs) would agree that our time in Nepal changed in significant but very different ways our perspectives on life if not the future paths we chose to follow. Of no one was this truer than Dorothy Mierow. Dorothy was born in 1920, in Colorado Springs. Her father Charles C Mierow was a classics scholar and Latin professor, who served for ten years as president of Colorado College.&nbsp; Dorothy developed an interest in animals as a child, graduated with a BA degree in natural history from Carlton College in 1942, a Master’s in biology from the University of Pittsburgh, and another Master’s in geography from the University of Minnesota.&nbsp; As a young woman, Dorothy traveled with her father throughout Europe, including a visit to ancient Greek ruins, and took a Magellan Tour by cruise ship around the world in 1958.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025071901074_0bad133ab22aada319e74bbad95d563e191371db291c08f373839fbd15440262.jpg" data-media-id="editor_0" data-image-id="2025071901074_0bad133ab22aada319e74bbad95d563e191371db291c08f373839fbd15440262" data-rendition-name="original" width="903" height="1178" loading="lazy" alt="How the Peace Corps changed a volunteer's life"> <figcaption>HOME AWAY FROM HOME: Dorothy Mierow as a college student in her native Colorado.</figcaption> </figure>  She was a college teacher during much of the 1940s, also teaching at a girls’ school in Hawaii. Then back to her native Colorado in 1953, where she became a curator and later director of the Colorado College Natural History Museum. She taught geography classes, and in her free time, Dorothy climbed 22 of Colorado’s 14,000-foot peaks. Traveling in India in 1960, Dorothy decided to spend two weeks in Nepal. In late 1961, she filled out an application to join the Peace Corps and specified that she wanted to go to Nepal, ‘because I admired the people so much when my father and I were there on our trip’.&nbsp; Dorothy reached Kathmandu in September 1962 as the first group of American Peace Corps volunteers in Nepal. She stood out from the others: one of the few women in that group, surely the oldest at age 41, a world traveler, and a woman who already had established a professional career.&nbsp; One doubts if Dorothy had had a husband and children whether she would ever have gone to work and spend much of the rest of her life in Nepal.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025071901078_68e84ade1ffb0f6c83c7f8fa5c1e7315b5f6c543217f96cde012e4d86f171515.jpg" data-media-id="editor_1" data-image-id="2025071901078_68e84ade1ffb0f6c83c7f8fa5c1e7315b5f6c543217f96cde012e4d86f171515" data-rendition-name="original" width="1259" height="910" loading="lazy" alt="How th Peace Corps changed a volunteer's life NT"> <figcaption>Pokhara Bazar in 1962.</figcaption> </figure>  The Peace Corps assigned Dorothy to teach geography at Tri-Chandra College. After the school closed in the winter due to lack of heating, USAID and the College of Education asked Dorothy to help train general science teachers.&nbsp; She taught for two months and became involved in a textbook-writing project, commenting: ‘I would like the children to know something about public health, conservation (the trees are going fast and so is the soil), and learn the names of some of their common birds, trees, and flowers. They are more impressed with electricity, airplanes, and cell structure.’ When a new college opened in Pokhara in 1963, Dorothy was transferred there and lived with a Nepali family. The college boasted 30 students and no permanent buildings.&nbsp; In October 1963, Dorothy wrote: ‘Pokhara is a town of almost 5,000 people … We are in a fertile valley surrounded by foothills … There is a small Mission Hospital … a Leper Hospital and Tibetan Refugee Camp started by the Red Cross and now run by the Swiss. With winter approaching, more Tibetans are appearing in town, often with pack horses or donkeys. Some have been carrying large boxes of powdered milk,donated (by USAID) to the camp from the airport … There is no electricity, and the transportation problems make many items scarce and expensive. I am really a sort of a museum. The landlord brings all kinds of people in to see how I live and count my shoes and dresses. They express amazement at my books, pictures, tin oven, Nepali dolls from Kathmandu, screened food shelves and curtained closet.’ The standard term for Peace Corps volunteers was two years, but Dorothy extended her term and was still at Prithvi Narayan College at the end of 1965, when she wrote that she had 20 Geography students in the first-year class and 6 in the second year preparing for the IA Examination. The college enrollment was 125 students, and the foundation for a new science building was being excavated.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025071901074_c6a80e5e0db0c705b2f8733c6d30dc0386fe3abbd2238ea9d947b7d746f94a29.jpg" data-media-id="editor_2" data-image-id="2025071901074_c6a80e5e0db0c705b2f8733c6d30dc0386fe3abbd2238ea9d947b7d746f94a29" data-rendition-name="original" width="902" height="605" loading="lazy" alt="How the Peace Corps changed a volunteer's life"> <figcaption>Mierow and friends at Phewa Lake.</figcaption> </figure>  Dorothy noted that she ate one meal a day at the (Shining Mission) Hospital but otherwise lived on dal-bhat, momo, and potato curry at local shops. However, she had developed a new passion: to build what she initially called the Pokhara Museum of the Himalaya. In commendable Peace Corps fashion, Dorothy always worked with Nepalis and respected the culture. ‘The greatest joy and satisfaction I have had has been from the building of a Museum-Library in memory of my parents … It has been possible to feel like a wealthy benefactor with the money saved by father for the family’s education and now available for the education of others… (Father) would have loved to be in on the founding of a new college and be able to plan a library. Several hundred of the books to be in the museum-library came from his collection and were carefully selected to be of use for students in Nepal…’&nbsp; ‘The museum part is to satisfy my own inclinations and was thought of when I found how little diversion there was for the people of Pokhara… It is part of the University requirements for the college that it should have a geography and biology museum. The museum building is small but adequate.&nbsp; I have tried to design it in harmony with Nepalese architecture and decorate it with some of the art of the best artists or woodcarvers… Posts holding up the porch roof are carved by Cottage Industries to represent different peoples of Nepal in typical costumes. The door was carved by a local wood carver and has typical birds of Nepal around it. Inside are 10 roof-support carvings designed by the retired Director of the National Museum in Kathmandu, Mr. C.M. Maskey.&nbsp; They were carved by the best wood carvers in Patan very skilfully. The building has three rooms: the library, the exhibition room, and a smaller workroom which can be used by our newly formed Woman’s Club as well as other groups or classes.’  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025071901074_03d3359c65389d30a0134e9a4862778994121e7e833b7d28b18e06e36fc76ff8.jpg" data-media-id="editor_3" data-image-id="2025071901074_03d3359c65389d30a0134e9a4862778994121e7e833b7d28b18e06e36fc76ff8" data-rendition-name="original" width="629" height="599" loading="lazy" alt="How the Peace Corps changed a volunteer's life"> <figcaption>Mierow with local women in Pokhara in 1969.</figcaption> </figure>  Dorothy promoted her project to influential Nepalis connected with organisations whose support she solicited: The Department of Archaeology, the Department of Agriculture, the Godavari Botanical Gardens; Tribhuvan University’s Science and Education Department, Nature Conservation Society.&nbsp; The museum was opened officially in early 1967. The Annapurna Natural History Museum, the building Dorothy designed and had constructed, is still open and features some exhibits which she created many years ago.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025071901074_54326a8a0685e980e782378076de2f5cd02d2426e9b0d94eed972d3dbe83af26.jpg" data-media-id="editor_4" data-image-id="2025071901074_54326a8a0685e980e782378076de2f5cd02d2426e9b0d94eed972d3dbe83af26" data-rendition-name="original" width="1333" height="1000" loading="lazy" alt="How the Peace Corps changed a volunteer's life"> <figcaption>The Annapurna Natural History Museum.</figcaption> </figure>  Dorothy returned to America in 1967, but she longed for Nepal. In the spring of 1969, she again tried to enroll as a Peace Corps volunteer but was told that as she had spent more than four years, she would not be eligible for another assignment. Undeterred, she persuaded the college in Pokhara to invite her to return as a teacher.&nbsp; UNICEF and the Forestry Department sponsored Dorothy to prepare charts on trees, birds, animals and flowers in colour for distribution to the schools of Nepal. Dorothy, back in the Peace Corps, returned to Pokhara and the Museum in 1972. She formed a friendship with her former geography student from Sikles, Chandra Prasad Gurung, and in 1974, she brought Chandra to America, where he enrolled in Colorado College and studied cultural anthropology.&nbsp; Chandra subsequently earned his PhD in geography from the University of Hawaii and returned to Pokhara to become director of the Annapurna Conservation Area Project. Gurung actively promoted ecotourism, landscape conservation, and biodiversity conservation in Nepal. His life was cut short along with those of 23 other Nepalis and foreigners who perished in a helicopter crash near Taplejung in September 2006.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025071901074_322d3c3ac6f1b08ffa07c44a19998b937a7db9eb43527f7539cf6481e1546314.jpg" data-media-id="editor_5" data-image-id="2025071901074_322d3c3ac6f1b08ffa07c44a19998b937a7db9eb43527f7539cf6481e1546314" data-rendition-name="original" width="2500" height="1000" loading="lazy" alt="How the Peace Corps changed a volunteer's life"> <figcaption>Mierow's four books on Nepal and its biodiversity. </figcaption> </figure>  Dorothy worked with several well-known Nepalis to publish her paintings and photos in beautifully illustrated books. She and Hemanta Mishra of the National Parks and Wildlife Service wrote Wild Animals of Nepal (Ratna Pustak Bhandar, 1976). More than 400 photos Dorothy took on treks to the Everest region, Gosaikunda, Muktinath, Jumla and Rara Lake, as well as travels in the Tarai, appeared in Himalayan Flowers and Trees (Sahayogi Prakashan, 1978).&nbsp; The botanist Tirtha Bahadur Shrestha identified the species. Dorothy and Kesar Lall published This Beautiful Nepal (Sahayogi Press, 1981). Birds of the Central Himalayas (1988) contained Dorothy’s paintings of 250 species of birds found along the areas of the Kali Gandaki River, Pokhara, Chitwan and the central Tarai. Dorothy summed up her life and work in Nepal in Thirty Years in Pokhara (Pilgrims Book House, 1997). Dorothy returned to Pokhara and her adopted Gurung family several times during the 1980s and 1990s to celebrate festivals and meet old friends. Her final years were spent at her mountain cottage in Green Mountain Falls north of Colorado Springs. She died at the age of 79 in August, 2000. Nepal gave new meaning and purpose to Dorothy Mierow’s life. Daniel W Edwards was a Peace Corps volunteer in 1966 and is the author of several books on Nepal. The author thanks Special Collections, Tutt Library, Colorado College.

How the Peace Corps changed a volunteer’s life

Local residents of Mustang, including a sitting MP and several politicians, submitted a petition to Prime Minister KP Oli in Kathmandu this week urging the government to lift the region’s ‘restricted’ status. This is not the first time such a demand has been raised, and as infrastructure the region’s accessibility improved over the years, calls to remove the long-standing restriction have grown louder.&nbsp; Upper Mustang is no longer weeks away <a href="https://nepalitimes.com/here-now/postcards-from-kathmandu">from Kathmandu.</a> Nearly 85% of the road from Beni to Kagbeni has been blacktopped, and one can drive from Kathmandu to Lo Manthang with an overnight stop in Pokhara. Between April 2024 and April 2025, Lower Mustang received 144,745 international tourists, a near 50% increase compared to the previous year. Most of these were <a href="https://nepalitimes.com/opinion/borderlines/nepal-india-trans-boundary-bonds">Indian pilgrims </a>travelling to Muktinath. <a href="https://nepalitimes.com/here-now/comings-and-goings-in-mustang">Mustang</a> is also gaining popularity among Nepali visitors, with 700,000 visiting the region in 2024. A hotel operator in Kagbeni estimated that about 20% of Nepali visitors to Muktinath also travel to Korala, the trade and transit checkpoint on the <a href="https://nepalitimes.com/latest/north-of-the-border">China border</a>. That would mean that nearly 100,000 domestic tourists visit Upper Mustang annually. In stark contrast, international tourist numbers to Upper Mustang (north of Kagbeni) have remained stagnant, hovering around 4,000 visitors per year. The primary reason is the continued enforcement of the region’s restricted status. Foreign visitors must pay a steep permit fee: a minimum of $500 for 10 days, with an additional $50 per day thereafter. Tourism some entrepreneurs, politicians, and residents want these fees to be abolished so Upper Mustang can attract a broader range of international travellers. The success of Lower Mustang, where relaxed restrictions have led to a<a href="https://nepalitimes.com/here-now/boom-time-in-central-tarai"> tourism boom</a>, is often cited as proof of what lifting restrictions could achieve. Upper Mustang is not the only region in Nepal with a restricted status. Several northern areas prefixed with ‘Upper’ (Upper Manaslu, Upper Dolpo, Upper Kanchenjunga, and Upper Arun) also need similar permits and fees. Although no clear official explanation exists, these areas were primarily restricted due to historical inaccessibility, ecological and cultural fragility and security concerns. Read also: <a href="https://nepalitimes.com/news/upper-mustang-opposes-prohibited-areas">Call to scrap Upper Mustang tourist fee</a> In the 1960s and 1970s, these remote regions served as shelters for Khampa guerrilla fighters who launched cross border ambushes on the <a href="https://nepalitimes.com/here-now/the-last-days-of-the-khampa">Chinese military </a>across the border.&nbsp; Though the Khampa have long gone, security concerns rooted in that era seem to persist. The government in Kathmandu is seemingly unaware of the changed political and security landscape. If concerns do remain, they are not made public. One of the main reasons for maintaining the restricted designation is to limit visitor numbers. But with <a href="https://nepalitimes.com/opinion/the-road-out-of-nepal">improved road access and services</a>, as Upper Mustang has seen, this justification no longer holds. When Upper Mustang first opened to international tourists in 1992, it had no formal lodges or hotels, and it took four to five days of trekking from Jomsom to Lo Manthang.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250716120744_4e4405cf10e6f127f90a1cd40feda0b9d8d69efd13093a2563530ca31489ba9f.jpg" data-media-id="editor_8" data-image-id="20250716120744_4e4405cf10e6f127f90a1cd40feda0b9d8d69efd13093a2563530ca31489ba9f" data-rendition-name="original" width="2000" height="509" loading="lazy" alt="Lift restrictions on Upper Mustang"> <figcaption>Photo: DINESH SHRESTHA</figcaption> </figure>  Without a nechyang (a household with traditional friendship), it was difficult to find a place to stay or get a proper meal. Only a few elite households offered accommodation. Today, there are now more than 80 lodges and hotels above Kagbeni, spread across nearly every village. Several upmarket hotels now struggle to stay afloat during the off-season, relying on low-spending domestic visitors to survive. Lo Manthang, once a remote destination, is now just a few hours’ drive from Jomsom, easily reachable by lunchtime for early starters. Once the remaining road sections are blacktopped, travel time will be further reduced. Yet, the government still charges a flat $500 fee for a 10-day permit based on outdated &nbsp;assumptions from a bygone era. There has been no serious review of the permit structure to align with current realities, nor any response to local aspirations to attract more international tourists and <a href="https://nepalitimes.com/here-now/peak-tourism-in-2023-9ukoi8iz">harness tourism for economic development</a>. Concerns about over tourism are valid. There is a risk that increasing visitor numbers could erode Upper Mustang’s <a href="https://nepalitimes.com/here-now/a-million-mantras-in-mustang">cultural heritage</a>, social fabric, and fragile natural environment, precisely the features that make it special. However, the region’s 33 years of tourism experience have been largely positive.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250716120744_5c7e5e05097cd0e5a1027b51c7e3db3be0bd67e0f7cbaea6d2c447b1dacafc8a.jpg" data-media-id="editor_11" data-image-id="20250716120744_5c7e5e05097cd0e5a1027b51c7e3db3be0bd67e0f7cbaea6d2c447b1dacafc8a" data-rendition-name="original" width="1400" height="1050" loading="lazy" alt="Lift restrictions on Upper Mustang"> <figcaption>Photo: MUKESH POKHREL / NT ARCHIVE</figcaption> </figure>  Tourism has contributed significantly to the restoration and <a href="https://nepalitimes.com/here-now/the-history-of-heritage?%2F">preservation of religious and historical sites</a> like the Thubchen and Jampa monasteries in Lo Manthang, the ongoing conversion of the old palace in Ghami into a premium hotel, and the rehabilitation of many monasteries and chortens.&nbsp; These efforts, supported by international donors and heritage experts, demonstrate that tourism—when well managed—can be a powerful driver of <a href="https://nepalitimes.com/here-now/shrinking-tourism-s-ecological-footprint">conservation</a>. The high permit fees have been somewhat effective in limiting international visitors, but they have no influence on the growing number of domestic tourists, particularly during the Dasain and Tihar holidays. The most pressing need now is for all levels of government—federal, provincial, and local—to<a href="https://nepalitimes.com/news/why-invest-in-nepal"> invest in </a>managing tourist flows and maintaining tourist sites. These efforts are essential not only to enhance visitor experience but also to build long-term resilience and sustainability for the destination. Read also: <a href="https://nepalitimes.com/news/greening-nepal-s-tourism">Greening Nepal’s tourism</a>, Hanna Wells Visitor numbers are central to any tourism development strategy that aims to balance economic, social, and environmental goals. Clinging to obsolete policies and concerns to justify Upper Mustang’s restricted status is not only unfair, it also suggests an undemocratic and discriminatory attitude toward a remote district.&nbsp; Shailendra Thakali, PhD, is from Jomsom and is a freelance consultant on protected areas, tourism, conservation, and sustainable livelihoods.

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