<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109101156/636b79ac9c7e80680e064717jpeg.jpg" alt="" width="550" height="388"/><figcaption>American Red Cross volunteers carrying a Spanish Flu victim in 1919. Photo: RED CROSS</figcaption></figure>The <a href="https://www.nepalitimes.com/opinion/what-is-novel-about-the-novel-coronavirus/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/opinion/what-is-novel-about-the-novel-coronavirus/&amp;source=gmail&amp;ust=1585031842556000&amp;usg=AFQjCNER7BK9EfiZTZ7HAcrRW7TMnI6jKg">current COVID-19 pandemic</a> has forced many to Google other historic outbreaks, and the search usually brings them to the 1918 influenza epidemic that killed between 20-40 million people – half of them in South Asia.Just over 100 years ago, as Europe was coming out of a ruinous four-year trench warfare, American soldiers brought the flu to the front lines from where it had spread like wildfire across Europe.Although it is called the ‘Spanish’ Flu, the virus first appeared in North America and crossed the Atlantic on US troopships bound for the front lines. It is called Spanish Flu because the virus was making people sick in the Pyrenees long after it had subsided elsewhere.After the war, British Army soldiers returning to India (some of them could very well have been Gurkhas) brought the virus to Bombay from where it spread along India’s vast railway network. 50 in every 1,000 Indians died of the virus.There were two waves of the influenza epidemic. It was probably transferred from returning migratory waterfowl to humans in Kansas in spring of 1918 before jumping across the Atlantic to Europe. The spread slowed over the summer, but returned with a vengeance in the autumn that year.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109101156/636b79ae9c7e80680e064718jpeg.jpg" alt="" width="2400" height="1816"><figcaption> </figcaption></figure>Although there are many books about the Spanish Flu in Western literature, in South Asia there is no properly archived documentation about the tragic pandemic that took many lives.Even Mahatma Gandhi was stricken by the bug, and bodies were piled high along river banks in India as cremation sites ran out of firewood. Unlike COVID-19, the 1918 influenza virus struck people in the 20-40 age group.While it affected 28% of all Americans, killing 675,000 – of the US soldiers killed in World War I, half died of influenza. But surprisingly, the pandemic had very little effect on China.Many viruses have an animal reservoir, and the Spanish Flu was associated with ducks and pigs as is usual for influenza viruses. The <a href="https://www.cdc.gov/coronavirus/mers/index.html" data-saferedirecturl="https://www.google.com/url?q=https://www.cdc.gov/coronavirus/mers/index.html&amp;source=gmail&amp;ust=1585031842556000&amp;usg=AFQjCNE-MAzB2oWqzXngSV-qeu_vZW781w">MERS coronavirus</a> that affected the Gulf region in 2012 is associated with camels, and the <a href="http://archive.nepalitimes.com/news.php?id=2664" data-saferedirecturl="https://www.google.com/url?q=http://archive.nepalitimes.com/news.php?id%3D2664&amp;source=gmail&amp;ust=1585031842556000&amp;usg=AFQjCNFPL8LEypjMiL-Zq9OumVczJ63a9w">SARS coronavirus of 2003</a> transferred from civet cats. While the COVID-19 probably originated in bats like the other coronaviruses, its host is believed to be <a href="https://www.nepalitimes.com/banner/coronavirus-outbreak-may-curb-wildlife-trafficking/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/banner/coronavirus-outbreak-may-curb-wildlife-trafficking/&amp;source=gmail&amp;ust=1585031842556000&amp;usg=AFQjCNGdAGDJ3BCYbsOftkHyaOipIJecdw">the pangolin</a>.As the ‘Spanish’ flu clearly showed, there is <a href="https://www.nepalitimes.com/opinion/covid-19-nepal-and-the-hygiene-hypothesis/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/opinion/covid-19-nepal-and-the-hygiene-hypothesis/&amp;source=gmail&amp;ust=1585031842556000&amp;usg=AFQjCNFhpeCjNw-lYwjui_QOmW3PKMnd3g">no evidence to show that we in South Asia have better immunity</a> towards the novel coronavirus COVID-19. So, what can be done?First thing is to increase tests for COVID-19 in suspected patients even without a travel history to affected areas. The more tests we do, the more we will know about the spread of  the actual disease.Read also: <a href="https://www.nepalitimes.com/editorial/this-is-a-test/" target="_blank" rel="noopener">This is a test</a>, EditorialIt is also crucial to do cross-sectional serological studies in communities to see if the virus has been introduced there. This test (unlike the RNA-based diagnostic test for a patient) can be done on asymptomatic people in the community to check for COVID-19 antibodies in the blood, and could give us an idea about the extent of the exposure to the community.Many of these antibody tests are new, and the Chinese have vast experience with them in treating COVID-19. The Nepali government would be well advised to seek Chinese help with antibody testing so that we are better prepared in the days and months ahead. Without more diagnostic and serological tests, we may continue to have a false sense of security as the virus continues to sneak up on us in South Asia.The silver lining (if there is one) in this unfolding COVID-19 pandemic is the attention that it has attracted to the importance of rapid diagnostic tests for other neglected infectious diseases in South Asia like <a href="https://www.nepalitimes.com/banner/tb/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/banner/tb/&amp;source=gmail&amp;ust=1585031842556000&amp;usg=AFQjCNEq-c2ak8GqLj2idm1BOUPOOAk46A">tuberculosis</a>, <a href="http://archive.nepalitimes.com/news.php?id=18178#.XnhYpkAza70" data-saferedirecturl="https://www.google.com/url?q=http://archive.nepalitimes.com/news.php?id%3D18178%23.XnhYpkAza70&amp;source=gmail&amp;ust=1585031842556000&amp;usg=AFQjCNHZKfS0Lv_GE4wqJrQaZ6OSfqTgdg">typhoid</a>, typhus, or leptospirosis.The tests need to be accurate, simple, affordable, and quick. Rapid diagnostics will not just help find infected people, but also to decide on specific therapy so that unnecessary antibiotics and other treatment are not administered. Proper diagnosis will lead to control of antimicrobial resistance, another medical crisis affecting the world today.At present, diagnostic tests take many hours if not days, so hopefully, after the dust from COVID-19 settles, there will be more work on rapid tests for these still-rampant ‘biblical’ afflictions that plague us.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109101156/636b79b19c7e80680e064719jpeg.jpg" alt="" width="1500" height="803"><figcaption> </figcaption></figure>Another positive effect of the COVID-19 pandemic may be the restoration of <a href="https://www.nepalitimes.com/banner/a-shot-in-the-arm-for-vaccines-in-nepal/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/banner/a-shot-in-the-arm-for-vaccines-in-nepal/&amp;source=gmail&amp;ust=1585031842556000&amp;usg=AFQjCNEk_tK3eXW25A_sGyzoFrJsJEBxww">people’s faith in effective tried and tested vaccines</a> in the western world.Rumours about side-effects of vaccines going viral on social media have convinced many parents not to inoculate their children, leading to outbreaks of vaccine-preventable diseases like diphtheria, polio and whooping cough in the West. If successful, the COVID-19 vaccine would set the record straight for the proliferation of ‘anti-vaxxers’.Pandemics are like earthquakes, they cannot be wished away. It is best we prepare for a potential COVID-19 outbreak as best and resourcefully as we can. This is not optional, since there will be more pandemics in future.Buddha Basnyat is a clinical researcher at Patan Academy of Health Sciences and a <a href="https://www.nepalitimes.com/opinion/what-is-novel-about-the-novel-coronavirus/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/opinion/what-is-novel-about-the-novel-coronavirus/&amp;source=gmail&amp;ust=1585631034431000&amp;usg=AFQjCNE0aoyspsOeHIBjtexE2rB8xE3KOw">frequent health columnist</a> for Nepali Times.

Buddha Basnyat

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Remembering a pandemic 100 years ago

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109101148/636b779f9c7e80680e064648jpeg.jpg" alt="" width="1500" height="997"/><figcaption>Eco Soap Bank Nepal's Nicky Lama teaching a student about hand hygiene. Photo: ECO SOAP BANK NEPAL</figcaption></figure>Many Nepalis woke up on Wednesday to an early-morning SMS from the Ministry of Health and Population: ‘Let’s wash our hands with soap and water regularly and if possible refrain from going to crowded places to be safe from coronavirus disease. Cover your mouth and nose while coughing or sneezing.’The public service announcement was aimed at stopping the spread of <a href="https://www.nepalitimes.com/banner/why-nepal-must-watch-about-coronavirus-but-not-panic/" target="_blank" rel="noopener">COVID-19</a>, but will revive Nepal’s hand-washing drive to control other infections like diarrohea and typhoid that kill mainly children.COVID-19 has now hit 78 countries. New infections and fatalities are tapering off in China, but the outbreak is spreading in Iran, Europe and the United States. Visit Nepal Year 2020 has been shelved, the Sagarmatha Sambaad postponed, and the US Embassy has put off its Independence Day celebration at Phora Darbar.Read also: <a href="https://www.nepalitimes.com/editorial/when-panic-goes-viral/" target="_blank" rel="noopener">When panic goes viral</a>, Editorial“There is still widespread lack of awareness about hand-washing, even right here in Kathmandu among marginalised communities,” says Diwakar Acharya, principal of Pulchoki School in Godavari. “Schools play an important role in educating children, their families and the community as a whole. This becomes especially important with the rise of new emerging diseases like coronavirus.”Nicky Lama of <a href="https://ecosoapbank.org/" target="_blank" rel="noopener">Eco Soap Bank</a> Nepal, which supplies recycled hotel soap to schools, has been visiting government schools in Kathmandu to train children in hand hygiene. “We have been training students and teachers so parents are also sensitised. It is a protective measure against not only coronavirus but already existing seasonal flus and common infections like typhoid,” says Lama.<a href="https://www.nepalitimes.com/here-now/nature-calls/" target="_blank" rel="noopener">Nepal was declared free of open defecation last year</a>, and is a model for the region. While this is dramatic progress from 1990 when only 6% of households had toilets, public health experts have raised questions about poorly maintained toilets and lack of water supply.In a 2018 study, the Global Sanitation Fund Programme found that 3% of households in communities declared ‘open defecation free’ did not in fact have toilets, and that in 5% of families who had a toilet at home, at least one member continued to defecate outdoors.“Despite declaring open defecation free, toilet infrastructure is not always optimum, septic tanks are now filling up and availability and quality of water is questionable, particularly in urban slums,” says Sandhya Chaulagain, Hygiene officer at WaterAid Nepal. “But most  health workers are focused on curative measures and often wait for the outbreaks to happen instead of preventing them.”Read also: <a href="https://www.nepalitimes.com/opinion/do-not-fail-students-in-wash/" target="_blank" rel="noopener">Do not fail students in WASH</a>, Marty LoganThe additional challenge for the WASH (Water, Sanitation and Hygiene) campaign in Nepal comes from the lack of clarity about  jurisdiction and roles of each tier of government in the new federal structure. A new bill on WASH is undergoing review at the parliament.Good news is that some municipalities have started collecting household-level sanitation, hygiene and water data using the GIS-based app NWASH. Says Govind Shrestha, policy specialist at the NGO WaterAid Nepal, “Moving ahead we need to find and then reach all the areas that do not have proper water and sanitation facilities yet. The challenge is to reach all 753 local bodies and as soon as possible.”<h2>Recycling soap</h2><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109101148/636b77a29c7e80680e064649jpeg.jpg" alt="" width="1500" height="1068">Nicky Lama was volunteering at a hospital in Cambodia when she met Samir Lakhani, of Eco Soap Bank fame and Top Ten CNN Hero of 2017. She was so moved by his commitment to improve child health that she decided to return to Nepal and bring with her the campaign of collecting used soap from fancy hotels and recycling it to improve hygiene in schools.Thousands of children die unnecessarily or fall sick due to diarrhoeal dehydration and <a href="http://archive.nepalitimes.com/news.php?id=17306#.XmGoynIzbIU" target="_blank" rel="noopener">typhoid</a>. These illnesses have faecal-oral transmission, which can be easily prevented through regular handwashing.Lakhani founded Eco Soap Bank in 2014 with the aim of saving, sanitising, and supplying recycled hotel soap for the developing world. The soap bank is currently operating in ten countries: Cambodia, Laos, Bangladesh, Lebanon, Rwanda, South Africa, Tanzinia, Ghana, Sierra Leone, and now Nepal.Read also: <a href="https://www.nepalitimes.com/banner/virtuous-cycle/" target="_blank" rel="noopener">Virtuous cycle</a>, Yuvaraj ShresthaThe Nepal branch works independently from the network and was set up three years ago. It networks with 23 hotels in Kathmandu including the Hyatt Regency, Hotel Annapurna, Soaltee Crowne Plaza and Kathmandu Guest House. Women in its Swayambhu workshop process the soaps to produce 7,000 bars of recycled soap per year, most of which are distributed in government schools in parts of Kathmandu Valley.“At the moment we are a small set-up, but we plan to expand to hotels in Chitwan and Pokhara, set up workshops there, employ many more disadvantaged women and help spread hand-hygiene awareness in schools,” says Lama, who is now country director of Eco Soap Bank Nepal.After finishing high school in Kalimpong, Lama went to the UK to study International Development. She then worked in Zambia, introducing tablet computers in community schools. Later, in Cambodia, she volunteered at a children’s hospital.Read also: <a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/Alcohol,276" target="_blank" rel="noopener">Alcohol to the rescue</a>, Buddha Basnyat Eco Soap Bank Nepal is looking to collaborate with agencies working on the WASH (Water, Sanitation and Hygiene) campaign. “We want to not only promote eco soap banks but also create employment and spread the message about handwashing with a focus on the prevention side of healthcare,” says Niall Kavanagh, an adviser to the Nepal operation.The added benefit of the Eco Soap Bank concept is that it promotes a cost-effective hygiene product that also reduces waste generated by the hotel industry. Says project coordinator Narendra Lamichhane: “There is a misconception that recycled goods cannot be used. We need to change that, while at the same time creating jobs for women.”

Sonia Awale

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COVID-19 revives Nepal’s WASH drive

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109101136/636b74e09c7e80680e0623b9jpeg.jpg" alt="" width="900" height="600"/><figcaption>Photo: BIKRAM RAI</figcaption></figure>Nepal has restructured its polity and installed local, provincial and central governments. People have been promised economic prosperity and happiness by a Communist majority government at all three tiers of government.Though there is confusion on the devolution of rights and responsibilities to local government, urban and rural municipalities have created plans for the benefit of the local populations.Many elected representatives have also gone abroad on study tours to see how other ‘municipalika’s around the world serve their people. There are examples of recognized good work: The mayors of Seoul and London have gone on to become President and Prime Minister of their respective countries. And in the US a Democratic Party candidate for president is also a mayor.Many of Nepal’s local governments have made tourism a key pillar of their economic development agenda. Tourism appears as low-hanging fruit until a deadly virus strikes, reminding us of the risks of dependence on visitors, and how having a beautiful landscape and monuments is not enough.Many municipalities are in a Catch 22 situation because the things that they must do are not popular with their voters. How can an elected official start taxing the informal economy, fraudulent businesses and net tax evaders when these very people are his/her voters or party funders? This is the dark flip side of the democratic system that we have chosen. The right thing to do may not be the popular thing to do.Local governments need to clean up the air and water, clear litter and manage waste if they are to make urban spaces more liveable, and if they are to benefit the local population from tourism income.There were simpler times when we could drink from the neighbourhoodwater spout, well, or street-side tap. As water became polluted and spread disease, we were forced to buy and drink bottled water. We are not alone in this unfortunate trajectory. The world-famous brand Evian started selling bottled water in Switzerland in 1929 because of the fear of cholera.What will we do if the <a href="https://www.nepalitimes.com/here-now/air-pollution-is-more-dangerous-than-smoking/">air is as polluted</a>? Breathe bottled air? That is already happening in some bars across the world that offer piped oxygen. The day may not be far away when we start seeing tourists at Darbar Square not just carrying bottled water but also oxygen cylinders in their backpacks. With the <a href="https://www.nepalitimes.com/latest/nepalis-from-hubei-quarantined-in-bhaktapur/">Covid19</a> scare, we are already seeing them masked.If, god forbid, a disease outbreak were to occur in Nepal, could our elected officials impose a strict quarantine of the kind we have seen in Hubei? Can they clear illegally occupied land or river banks? Will they stop breweries from polluting rivers upstream from national parks? Or shut down an illegal asphalt factory in the middle of a residential area in the capital?China can build a 1,000 bed hospital in two weeks because it never had free and fair elections. This is not the path Nepal has chosen, but something is not working if officials elected to protect the public only protect those who fund them.The government wasted tax rupees to ‘train’ rivers by building gabion embankments which did not even last the next monsoon due to poor design and bad engineering. Local governments now make a fortune allowing corrupt contractors to extract of sand and boulders from rivers. Tipper trucks mine river beds and have killed the <a href="http://archive.nepalitimes.com/article/editorial/The-economy-needs-oxygen,459">Trisuli, Sun Kosi and Indrawati rivers</a>. They are not done yet: now they are moving upstream to damage watersheds and water sources.Nepal needs a national compact to protect air, water sources, springs, wells, and <a href="https://www.nepalitimes.com/editorial/crushers-of-justice/">watersheds like the Chure Hills</a>. Timber, sand and boulders will allow <a href="https://archive.nepalitimes.com/page/crushing-tale-of-Chure">contractors to make a fortune</a>, and government officials to strike rich with kickbacks. But the people need water tomorrow for drinking and irrigation, and not so much that it <a href="https://www.nepalitimes.com/banner/monsoon-2019-deluge/">floods the downstream Tarai</a>.Governments were elected to ensure development that can sustain us into the future, not to irreversibly destroy it. We must all work together to get our elected governments to protect open spaces for the next disaster, our monuments and cultural assets for the next generations, and plants, birds and animals for the sake of humanity. In a federal Nepal, these responsibilities are greater at the local level.Anil Chitrakaris President of <a href="http://www.siddharthinc.com/">Siddharthinc</a>.

Anil Chitrakar

What next for Kathmandu: bottled air?

For many decades it was an accepted truth that Nepal’s main public health threat was from infectious diseases, and the most cost-effective way to address that was through prevention. In other words, the first line of defence against communicable diseases was communication.Whether it was gastric infections caused by contaminated water, respiratory ailments due to cold and pollution, or diseases spread by insect vectors like malaria – the goal was to spread public awareness about prevention. Radio jingles about oral rehydration salts or acute respiratory infections in children indirectly helped save millions of lives over the years.Many of these challenges remain. Despite dramatic progress, many Nepalis still lack safe drinking water – not just in the roadless hinterland but right here in the heart of the capital. There are frequent <a href="http://archive.nepalitimes.com/article/nation/%20jajarkot-open-defecation-free,2023">cholera</a> epidemics. Children’s lungs are still affected by indoor smoke from wood fires. Malaria is on the comeback due to resistance and there is an annual epidemic of dengue and encephalitis.Yet, compounding these endemic infections, there is now an <a href="http://archive.nepalitimes.com/article/nation/Communicati-about-non-communicable-diseases,1153">increasing burden of non-communicable diseases and injuries</a> (NCDI). New lifestyle-related cardio-vascular afflictions, chronic obstructive pulmonary disease (COPD) caused by <a href="http://archive.nepalitimes.com/article/Nepali-Times-Buzz/every-breath-we-take-air%20pollution,3536">pollution</a>, or <a href="http://archive.nepalitimes.com/article/nation/stigma-and-silence-mental-health-nepal,3486">mental health disorders</a> have added to the burden of disease and disability. <a href="http://archive.nepalitimes.com/article/nation/diabetes-in-south-asia,3018">South Asians are already genetically susceptible to diabetes</a>, and now there are new risk factors due to migration to urban centres. While the world average for prevalence of both types of diabetes is 8%, more than 14% of people in urban centres like Dharan have diabetes – even though the prevalence for rural Taplejung, for instance, is only 1%.A study by The Nepal NCDI Poverty Commission released this week shows that the burden of NCDIs has doubled in the last 25 years. More than half of all death and disability today are caused by NCDIs, with nearly 15% caused by injuries in conflict, natural disasters or highway accidents. <img width="900" height="802" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221104141144/636517699c7e80680e02c275jpeg.jpg" alt=""/>Being afflicted with an NCDI (or chronic disease) is more fatal in Nepal than in developed countries because of affordability and restricted accessibility to adequate medical treatment. The poor are disproportionately vulnerable. The NCDI burden in Nepal is also different than in other parts of the world – there is a higher incidence of ischemic cardiac conditions, asthma, neurological disorders, cancers caused by untreated infections and injuries, for instance.For us, the report’s main finding, and most damning inference, is about how <a href="http://archive.nepalitimes.com/article/nation/national-health-insurance-not-as-easy,4028">treatment of NCDIs is driving Nepalis into indebetedness and penury</a>. The survey shows that half of all medical expenditure of families is out-of-pocket, and 60% of that is for treatment of NCDIs. This is because the government spends only 11% of its budget on health care, and only 6.4% of that is for treatment of non-communicable diseases.Despite the proven link between chronic ailments and poverty, donors still allocate only 1% of their development assistance for NCDIs.Treatment of injuries, gastro-intestinal infections, heart diseases, cancers, kidney and liver diseases are the most impoverishing NCDs for households. The report’s main conclusions are corroborated by our <a href="https://www.nepalitimes.com/banner/state-of-the-art-rural-hospital/">field report</a> from Achham and Kavre this week  about how the lack of even basic surgical facilities in district hospitals and health posts is forcing Nepalis to undertake expensive and extended trips to private hospitals in the cities.Another recent study of 39 government hospitals commissioned by the Nick Simons Institute (NSI) showed a huge unmet need in remote areas for basic surgery like caesarians, orthopaedics, and abdominal operations. Nepal’s surgery rate is well below the Lancet Commission’s target of 5,000 operations per 100,000 population. Only one-third of patients currently can reach an orthopedic surgeon within two hours of travel. <img width="640" height="456" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221104141144/6365176b9c7e80680e02c276jpeg.jpg" alt="">The public-private partnership models that NSI and Possible are carrying out in remote government hospitals are ways to plug this gap: ensuring minimum staffing of a MDGP physician, anaesthesia assistant, staff nurse and biomedical technician in each hospital can offer basic treatment and surgery in remote areas, reduce the need for referrals, and save household income. At present Nepal’s density of hospitals with such staffing and equipment is at 0.4 per 100,000 population, as against the Lancet Commission’s recommendation of 20/100,000.The Nepal NCDI Poverty Commission report suggests additional measures: national health care delivery should respond to the increasing burden of NCDIs by decentralising.Impoverishment of households due to the high cost of treatment should be addressed through disease-specific policies for high-cost conditions and expansion of insurance coverage.It is often said that health is wealth, but in Nepal wealth is health. That can only be changed by making treatment of chronic conditions and injuries accessible, affordable, inclusive and equitable.Read also:<a href="https://www.nepalitimes.com/banner/state-of-the-art-rural-hospital/">State of the art rural hospital</a>, Marty logan <a href="http://archive.nepalitimes.com/article/nation/national-health-insurance-not-as-easy,4028">A national health insurance scheme is not as easy as it looks</a>,  Sonia Awale<a href="http://archive.nepalitimes.com/article/nation/Communicati-about-non-communicable-diseases,1153">Communicating about non-communicable diseases</a>,  Elina Pradhan and Bigyan R Bista

Poor  health

Fenerbahçe Beko won the Turkish Airlines EuroLeague finals in Abu Dhabi, held 23-25 May, defeating Monaco 81-70 in the final. Olympiacos, who defeated Panathinaikos 97-93, finished the series in third place. The Most Valuable Player (MVP) of the final match, Nigel Hayes-Davis from Fenerbahçe Beko, received a prize of 1,000,000 Miles&amp;Smiles from Turkish Airlines’ Chief Commercial Officer Ahmet Olmuştur. The carrier has been the title sponsor of the Turkish Airlines EuroLeague, a top tier tournament, since 2010.

Turkish Basketball

Thousands of Nepali students dreaming of an American education have been forced to look elsewhere as the Trump administration’s visa restrictions make their future uncertain.
The US was long considered a top destination for higher studies, making Nepal the 10th biggest country of origin for international students in America.&nbsp;
However, that number has seen a significant decline with the total for Nepali students now at 16,482. Some 8,000 Nepali students obtained no-objection certificates to study in the US from the Ministry of Education in the past year.&nbsp;
India, Australia, Canada, South Korea, United Kingdom and Japan are the other popular destinations for Nepali students. There are no clear numbers for Nepalis going to India, but a slight decline was noted this year after the deaths of two female students.
The US State Department has issued a circular to its embassies not to issue new visas to applicants until further notice. US Secretary of State Marco Rubio in the directive stated that the department planned to expand the screening of applicants' social media.&nbsp;
While new applicants are barred including those applying for visitor visas, students with scheduled interviews are allowed to proceed.
“Many of our students are affected by the new restrictions, but those who had applied for student visas earlier have got interview dates,” one Kathmandu-based college counsellor told us.
Meanwhile, even foreign students with spotless records already in the US have not been spared, as visa scrutiny intensifies under the new policy. In a move that underscores the growing sense of insecurity, many US colleges advised international students to carry their passports and documents at all times, even when traveling locally.
“Me and my friends did not go home this summer because we were not sure we would be allowed back, so we just went to Niagara Falls,” said a Nepali undergrad in Ohio, who like many interviewed for this report did not want her name used for fear of repercussion.
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Nepali students have adopted a cautious stance, with many choosing not to return home during summer vacation due to fear of visa revocations as well as travel bans. Meanwhile, over 7,000 Nepalis with Temporary Protected Status (TPS) will have to come back to Nepal by 5 August or face deportation. Thirty-seven were flown back to Kathmandu on Omni Air last week.
“The US is one of the most sought-after destinations for higher education, and the ban will definitely impact bright students,” says Narottam Aryal of the King’s College in Kathmandu.
Indeed, Nepali undergraduates admitted into Ivy League colleges for the 2025 academic year have been asked to look for alternatives. The entire Fulbright Foreign Scholarships Board resigned on Wednesday citing interference from the Trump administration on the selection of this year’s cohort. Some Nepali students already on Fulbright scholarships have noted disruptions, delays and even cancellation of stipends.&nbsp;
The student visa restrictions were initially just for foreign students admitted to Harvard University, but it was later extended to all Chinese students and now to all students. Universities like Columbia which actively recruit foreign students, face sharp enrolment declines, threatening their financial stability and diversity.
An Indian female PhD candidate at Columbia University had her visa revoked by the US State Department, and said she was targeted on the basis of her social media posts on Israeli military attacks in Gaza. Social media vetting of political activism has raised concerns about privacy and freedom of expression in a country where such rights were a given.
Many students have been informed via email that their visas have been revoked for getting speeding or parking tickets, but even others with no criminal record have been affected. The fear of deportation looms large amongst international students, including those from Nepal.&nbsp;
For most Nepalis who migrate to the US for education, the journey is a high-stakes investment. They come largely from middle-class families, often rely on a patchwork of scholarships, work-study programs, loans, or even the sale of family assets to afford fees.
Most Nepali students pursue STEM subjects which offer extended Optional Practical Training (OPT) periods that help fund their education. But with the US backsliding on education and humanitarian matters, countries like the UK and Canada are becoming more attractive despite their own recent stricter controls on student visas.&nbsp;
The UK universities saw a 63% rise in Nepali students’ admissions in 2024. Japan is another popular destination with 64,816 Nepali students enrolled as of 2024.
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Already, China, Hong Kong and Malaysia are poised to benefit from the increased scrutiny of US student visas. Several Hong Kong universities are offering unconditional admission to affected students, while Malaysian institutions are targeting previously US-bound Asian students. China and India have 330,000 and 280,000 students respectively in America, but the numbers for China have seen a sharp drop in the past year.
Elsewhere, branch campuses of American institutions such as NYU in Abu Dhabi, Georgetown in Dubai and Northwestern in Doha are getting more admission applications, and universities in the Gulf region are expanding infrastructure to accommodate those who would otherwise have gone to the US.&nbsp;
Even educational institutions in Nepal are hopeful that the US visa restrictions can be an opportunity to at least keep Nepali undergrads in Nepal, and also attract foreign students from the region.&nbsp;
“Many students might choose to complete their undergraduate degree here in Nepal and then move abroad for their Master’s degree later,” says Aryal of King’s College. “There was a need for quality higher education in Nepal anyway in terms of innovation and opportunities, so this could be the time to reduce our dependence on other countries.”
Nepal’s strategic position between India and China makes it sensitive to US policy shifts. India, a key ally, is also under US scrutiny for potential student travel restrictions. Chinese universities are already offering more scholarships to Nepali talent to capitalise on the US retreat.
American universities have challenged student visa restrictions in the courts. A federal court in Boston revoked the blanket ban on Harvard, and the State Department has ordered the resumption of processing student and exchange visitor visas.&nbsp;
Some are still hoping that President Trump will backtrack on the student visa restrictions, just like he has done with many of his more drastic executive orders.
Even so, the visa see-saw and longer-term uncertainties about living in the United States and its education system means students across the world are making alternative plans.
Says Aryal: “Policies of foreign countries change according to their needs, so excessive dependence was never a good idea. We should work to create different opportunities and choices of higher education within Nepal, so students are retained.” &nbsp;

America no longer prime destination for Nepali students

While Nepal was hosting the Sagarmatha Sambaad international climate conference in Kathmandu this month, on Mt Everest it was pretty much business as usual.&nbsp; The signs of climate breakdown are all there: a river now runs through Base Camp in summer, the Khumbu Icefall is more unstable, and there are more &nbsp;frequent avalanches. When expeditions arrived in March, the mountains were bare: it had not snowed since September, but then blizzards dumped unseasonal snow in May. And despite climate worries, such is the pull of Himalayan mountaineering that the Everest Industry showed no signs of slowdown. More than 600 international climbers and their Nepali guides had made it to the summit of the world’s highest mountain. At one point there were an estimated 2,000 people in the tent city on the Khumbu Glacier. All the ropes and ladders on the Icefall came down on Thursday, marking the official end of the spring climbing season, and just in time to avoid a monsoon cyclone approaching from the Bay of Bengal. It has been an action-packed season. One factor could be that Everest fees will go up from September: each foreign climber needs to pay a $15,000 royalty, up from the present $11,000. The cost for a Nepali climber on the South Col route will also go up: from Rs75,000 to Rs150,000.&nbsp; The fee to climb Everest in autumn is $7,500 (up from $5,500), but most climbers still prefer spring. Winter permit fee (December-February) is only $3,750 per person and the mountain is now also open for monsoon (June-August) climbs, when the fee is ever lower at $2,750. The revised rule also makes it mandatory for every two climbers on an 8,000m peak to hire one Nepali mountain guide.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025053004050_67f856fe52714e4bdcf21ae7d45c6f18c82117b9d0a5f73ed1efa04c96de1046.jpg" data-media-id="editor_0" data-image-id="2025053004050_67f856fe52714e4bdcf21ae7d45c6f18c82117b9d0a5f73ed1efa04c96de1046" data-rendition-name="original" width="931" height="732" loading="lazy" alt="The Everest Industry graph 1"> </figure>  In addition, climbers also have to pay for porters and guides, equipment, Base Camp costs, Ice Fall and fixed rope team fees, so climbing Everest does not come cheap. But such is the draw of climbing the world’s highest peak that some say the increased fees will not diminish the crowds next year. The government has tried to spread expeditions out to other seasons and other 8,000ers, but with not much success. Earlier this year, Nepal unilaterally increased the number of 8,000m peaks to 14 by adding six more sub-summits to broaden the choice for climbers. Added were: Yalung Kang (8,505m), Yalung Kang West (8,077m) &nbsp;Kangchenjunga Central (8,473m), Kangchenjunga South (8,476m), Lhotse Middle (8,410m) and Lhotse Shar (8,400m).&nbsp; The announcement could go against the accepted topographic criteria that a stand alone peak has to be at least 300m higher than an adjoining prominence, and at more than 3km isolation from it. The UIAA (Union Internationale des Associations d'Alpinisme) still recognises only 14 mountains as eight-thousanders, and only eight of those are in Nepal, or on the border with China. Nepal’s revised mountaineering regulations also increased the insurance coverage of high-altitude workers to protect porters and high altitude guides who usually take more risks on the mountains. Rescue teams and clean-up campaigners to collect trash and remove bodies of dead climbers up to Camp IV of Mt Everest do not need permits.&nbsp; The Sagarmatha Pollution Control Committee is now using drones to fly down trash in 20kg sacks. Each climber is also required to bring down at least 6kg of waste and not just their own, but this rule is erratically enforced. With five fatalities on Everest and Lhotse, Spring 2025 had a historically low death toll. Another five climbers died on Annapurna, Kangchenjunga and Makalu.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025053004050_38681de22f0fefb6faa12b01755566d09c5064d0ff84e12ccc7b5d68ea9ba38a.jpg" data-media-id="editor_1" data-image-id="2025053004050_38681de22f0fefb6faa12b01755566d09c5064d0ff84e12ccc7b5d68ea9ba38a" data-rendition-name="original" width="665" height="740" loading="lazy" alt="The Everest industry graph 2"> </figure>  Journalist Ben Ayers who ran the Everest Live social media channel from Everest Base Camp with daily updates credited the low death rate to dramatic rescues of climbers from the ‘Death Zone’ by their Nepali guides and longline helievacs — the visuals all uploaded on YouTube.&nbsp; “Ironically, this perception of safety is bringing more and more inexperienced climbers to the mountain, and they need more rescues,” Ayers said in one of his dispatches.&nbsp; American expedition chronicler and summiteer Alan Arnette suspects there is a lot of under-reporting given that the jet stream and storms were lashing Everest even till late in the season. He told us: “I heard a lot about frostbite and rescues that were not made public. It’s become practically impossible to cover the details on Everest. All the teams report nice news, and they don’t talk about bad stuff to avoid hurting businesses.” Although trash on Nepal’s mountains makes headlines, what does not receive as much attention is the climate impact of so many expeditions. The Sagarmatha Sambaad conference sidestepped this issue, which is ironic given that the impact of climate breakdown is most evident on Himalayan peaks and their glaciers.&nbsp; <h2>Need for Speed</h2> The big stories this year have been about speed-running from their home cities to the top of Everest. Ukrainian entrepreneur Andrew Ushakov flew out of JFK on 15 May at 10:15AM Nepal time, and was on the summit 3 days, 23 hours, and 7 minutes later on 19 May at 9:22AM.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250601080640_1c5cc6fc991307861768f07037ed9d30930fb20f35dbb57dc31c9a92a9e1a885.jpg" data-media-id="editor_2" data-image-id="20250601080640_1c5cc6fc991307861768f07037ed9d30930fb20f35dbb57dc31c9a92a9e1a885" data-rendition-name="original" width="1440" height="1800" loading="lazy" alt="The Everest Industry"> <figcaption>Andrew Ushakov at the summt. Photo: ELITE EXPED</figcaption> </figure>  “I could never find the time for the traditional 40-50 days of acclimatisation,” Ushakov explained matter-of-factly. His ‘Everest Sea-to-Summit’ climb was possible because he spent 400 hours in hypoxic sleep tents over the past four years in New York. However, Ushakov did use ropes already fixed, hired four Nepali guides, helicoptered to Base Camp, and used much more oxygen than an average climber. And after the climb, Ushakov was arrested at Kathmandu airport for being in possession of $20,000 of undeclared cash and spent a night in jail and fined $60,000.&nbsp; The other speedsters were Garth Miller, Alastair Cairns, Anthony Stazicker, and Kev Godlington, all former British Army commandos. They left London and summited five days later on 21 May, and flew right back. They also used hypoxic tents to simulate the thin air high on Everest.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250601080644_90c8dd5cc07b4b43f2989b1dc0c0650ab80f10ebb06680c25a6909c519957bd8.jpg" data-media-id="editor_3" data-image-id="20250601080644_90c8dd5cc07b4b43f2989b1dc0c0650ab80f10ebb06680c25a6909c519957bd8" data-rendition-name="original" width="810" height="668" loading="lazy" alt="The Everest Industry "> <figcaption>All four members of the Furtenbach team at the summit. Photo: Sandro Gromen-Hayes</figcaption> </figure>  But more controversial was their use of xenon gas therapy in a German hospital to ramp up the production of oxygen-carrying haemoglobins in their blood. Xenon is banned by the World Anti-Doping Agency for being performance enhancing in sports. Expedition leader Lukas Furtenbach said this rule does not apply to mountaineering, as it is not a regulated sport like swimming. Nepal has no rules about xenon, but the Department of Tourism said it was launching an ‘investigation’ to decide on future policy since it is difficult to ban xenon, but allow oxygen. The controversy has also divided the mountaineering community, with some climbers saying they just want to maximise their chances of survival. Spending less time on the mountain could make climbing safer by reducing avalanche risk. It would also mean less trash on the mountains, but it would reduce the income of Nepal’s expedition industry. It is also unclear how much of the success was due to xenon therapy and whether the ex-special forces were already in good physical shape.&nbsp; The need for speed hides the fact that climbing in the Himalaya is dangerous business, and climbers cannot sprint to the top just by huffing xenon. But ultra-fast climbs could be charged more, and the revenue generated can be used to establish state-of-the-art rescue operations, and increase pay and insurance for guides. Two other speed chasers this season were Swiss-Ecuadorian Karl Egloff and American Tyler Andrews, both on Everest without oxygen. Andrews choppered to Base Camp to catch a weather window, but turned back from 8,500m due to high winds. Heavy snow and wind also forced Egloff to descend from 7,000m. Slow and steady climbers like Anja Blacha from Germany did make it to the summit without oxygen, while Kami Rita Sherpa broke his own record with his 31st Everest summit as he led a 26-strong Indian Army group. There were 468 permits issued for foreign climbers from 48 expeditions to Everest this spring. Nepal’s other eight-thousanders together had only 17 expeditions. Nepal has more than 1,000 peaks above 6,000m, and has opened only 476 of them for climbing.&nbsp;

The Everest Industry

While Nepal marked <a href="https://nepalitimes.com/news/mt-everest-pvt-ltd">Mt Everest</a> Day on 29 May, on the other side of the planet in the US state of Colorado dozens of Nepalis who have climbed the world’s highest peak multiple times were busy working as chefs and Uber drivers. Among them is Nima Doma Sherpa, who climbed Mt Everest in 2019 after her husband Tshering Wangchu was among 16 crushed by an avalanche on <a href="https://nepalitimes.com/banner/on-thin-ice-in-the-khumbu">the Khumbu Icefall</a> five years earlier. A large serac broke off the West Shoulder of <a href="https://nepalitimes.com/news/the-everest-industry">Mt Everest </a>and fell directly on a group of <a href="https://nepalitimes.com/opinion/more-porters-sick-on-everest-trail">porters and guides</a> making their way up the Icefall at 5,800m. Their bodies were flown by helicopter to Khumjung where Tshering Wangchu was born. He was excited about climbing Mt Everest for the first time.&nbsp; In Khumjung, Nima Doma felt like her own life had also ended. This was the kind of news Sherpa wives, mothers and sisters dreaded every <a href="https://nepalitimes.com/here-now/peak-climbing-season-2025-s4abrxny">mountaineering season</a>. She stayed home for more than two years grieving, but ultimately gathered up all her emotional strength to take care of her 6-year-old son and 3-year-old daughter. Nima had grown up in Khumjung hearing <a href="https://nepalitimes.com/review/stories-of-nepal-s-summiteers">tales of adventure on the mountains </a>from their father, Ang Chubi Sherpa who had climbed Everest in 1993. He used to bring her and her sisters and brother European chocolates after every expedition, and used to tell them that the chocolate bars grew on the mountains. “It was only after we got older did we realise that he told us that chocolates grew in the mountains so we would not worry about him putting himself in harm's way,” Nima Doma recalled with a faraway look at her home in Boulder this week. Nima went to the school that <a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/commemorating-edmund-hillary-in-nepal,4145">Edmund Hillary</a> opened in Khumjung till Grade 8, and then dropped out to help in the kitchen and <a href="https://nepalitimes.com/here-now/when-yaks-go-so-does-culture">tend yaks</a>. She was married off to Tshering Wangchu, who was also a high altitude guide. When Tshering went on expeditions, Nima also started working as a porter from Namche to Base Camp. It was perhaps her father’s tales of mountains of chocolates that had always attracted her to <a href="https://nepalitimes.com/here-now/knowing-our-mountains-43v4iyvo">the peaks</a>. After her husband was killed ten years ago this month, being a widow with children was not easy for Nima Doma. But she was not alone: there were at least 200 single mothers in <a href="https://nepalitimes.com/here-now/khumbu-since-1950-jaww4qn0">the Khumbu</a>, and 20 of them just in Khumjung whose husbands had been killed in <a href="https://archive.nepalitimes.com/article/nation/tragic-start-to-himalayan-spring-nepal,3695">mountaineering accidents</a>. Some were not even 20 years old, and had children growing up without fathers. But there were also women in the 50s whose husbands had been killed in the 1980s. Nima found sponsors for her children’s education, and moved to Kathmandu. In the capital, Sherpa widows used to meet to help each other. Some of them had joined the Nepal Mountaineering Association (NMA) training for rock and ice climbing. “I decided that it was no use sitting home and crying anymore, after meeting other single mothers I felt less alone,” remembers Nima, who joined the Juniper Foundation and enrolled in an NMA training camp in Manang. There she climbed Chulu East (6,584m) and met Furadiki Sherpa, whose rope-fixing husband had also been <a href="https://nepalitimes.com/news/on-mt-everest-s-70th-records-and-fatalities">killed on Everest</a> in 2013. They set themselves the goal of climbing Everest one day, and started a fund-raising drive.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250530090544_621be0724b9182c8e3594b2c562a71ec32ac01d985a71d0cf31646de9d51e15a.png" data-media-id="editor_12" data-image-id="20250530090544_621be0724b9182c8e3594b2c562a71ec32ac01d985a71d0cf31646de9d51e15a" data-rendition-name="original" width="2678" height="1274" loading="lazy" alt="Everest summiteers find new life in the US"> </figure>  “We decided we had to overcome society’s stigma of <a href="https://archive.nepalitimes.com/article/nation/widows-personal-happiness-comes-last-in-face-of-social-financial-hardships,1855">widowhood</a> and prove that <a href="https://nepalitimes.com/here-now/remembering-junko-tabei">women could also climb mountains</a>,” Nima said, adding that she was inspired by Nepal’s first woman Everest summiteer Pasang Lhamu Sherpa, who died during her descent in 1993. Nima Doma and Furdiki climbed the technically-difficult Ama Dablam (6,812m) and then arrived at Everest Base Camp in April 2019 as part of their Two Widows Expedition with the motto, ‘So Can We’. While climbing up the Icefall Nima passed the spot where her husband had been killed. It was a jumble of constantly-shifting ice blocks bigger than houses. She closed her eyes and said a prayer. “I remember thinking, this is so difficult and dangerous. This is what my husband had to do to support our family,” Nima Doma said. “I was determined to fulfil my husband’s dream of climbing Chomolungma, and to prove to ourselves that we two women could do it.” It was 23 May 2019 when <a href="https://www.reuters.com/article/world/two-sherpa-widows-scale-everest-and-smash-stigma-idUSKCN1SU0MV/" target="_blank">Nima and Furdiki stepped on the summit</a> and looked over into Tibet, and down at Tengboche Monastery to the south.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250530090544_6b822582b5d88ba5e972db084f184690b40653c6efd9901b2dd082ffba2a263b.png" data-media-id="editor_16" data-image-id="20250530090544_6b822582b5d88ba5e972db084f184690b40653c6efd9901b2dd082ffba2a263b" data-rendition-name="original" width="2700" height="1522" loading="lazy" alt="Everest summiteers find new life in the US"> </figure>  Nima Doma hugged Furdiki, took off her mask and wept. But for the first time in five years, it was not from grief but relief — relief for being free of all the sadness and sacrifices and for fulfilling her husband’s dream. They had found <a href="https://nepalitimes.com/here-now/life-after-death">life after death</a>. “I felt this immense joy to be on top of the world, it was indescribable,” Nima Doma said, “I have wept only twice in my life. Once when my husband died, and once there on top of Everest.” The tears had frozen on Nima Doma’s cheeks, as she and Furdiki headed back down the mountain.