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

Tom Robertson

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Big story of small pox in Nepal

<figure><img width="1400" height="1048" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110714118/636904189c7e80680e037cffjpeg.jpg" alt=""/><figcaption>Royal Asiatic Society</figcaption></figure>After the <a href="http://archive.nepalitimes.com/blogs/thebrief/2015/04/25/massive-earthquake-rattles-nepal/" target="_blank" rel="noopener">earthquake of 2015</a>, many Nepalis recalled how well Rana Prime Minister Juddha Shumsher had handled relief and rehabilitation after the <a href="http://archive.nepalitimes.com/news.php?id=5065#.W36JW84zbIU" target="_blank" rel="noopener">megaquake of 1934</a> that leveled the capital and killed 10,000 people. Many felt that even though Juddha Shumsher was a dictator, he was better than most of Nepal's later elected leaders in organising disaster relief.In the last three years, the Nepali social mediasphere has been replete with praise for the oligarch who nearly 81 years ago rushed back to Kathmandu immediately from his travels, refused foreign money for rebuilding, and waived loans for the reconstruction of homes.However, as British historian John Whelpton says, the truth is much more complicated. <a href="http://archive.nepalitimes.com/article/nation/Rebuilding-what-is-holy,2614" target="_blank" rel="noopener">Juddha was keen to avoid economic help</a> from the British, because the Viceroy Fund then was used to help India’s princely states, and Juddha did not want Nepal to be classified as one.Whelpton is working on a <a href="https://sway.soscbaha.org/" target="_blank" rel="noopener">project with Martin Chautari and Social Science Baha</a> and has come up with other interesting archival anecdotes about the 1934 earthquake: a surgeon from the British legation who treated the wounded wrote that the ‘inhabitants were behaving splendidly, there seemed to be no panic, the people ... were settling down in family groups in those open spaces and preparing to pass the night as best as they could.’ In fact, that could also describe the reaction of survivors after the 2015 earthquake. The <a href="https://www.nepalitimes.com/opinion/reconstruction-and-resilience-2/" target="_blank" rel="noopener">Nepalis seem to be as resilient as ever</a>.The British Resident during the earthquake, Clendon Daukes, was confident homes would be rebuilt by the monsoon of the same year, but his successor, Frederick Bailey reported three years later in 1937 that ‘houses of the poor had been reconstructed hurriedly and were of poor quality…’. Again, <a href="https://www.nepalitimes.com/here-now/building-homes-on-a-deadline/" target="_blank" rel="noopener">something else that has not changed in 81 years.</a> Most public buildings, however, had been reconstructed with local resources by 1938.Juddha may not have been as benevolent as portrayed for waiving loans. Whelpton found evidence that he was coerced to do so by royal courtiers who feared a popular uprising. The Rana prime minister was also not so generous with his Army, refusing to reimburse a four month salary advance after the quake. Whelpton puts forth a theory, based on the papers of one of the ambassadors Betham, that it was an important factor in the growth of  disenchantment with the regime in the army. Read also: <a href="http://archive.nepalitimes.com/article/Nepali-Times-Buzz/the-rana-reign-a-recap-of-history,3751" target="_blank" rel="noopener">The Rana reign</a>, Kunda Dixit <figure><img width="400" height="544" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110714118/6369041b9c7e80680e037d00jpeg.jpg" alt=""><figcaption> </figcaption></figure><figure><img width="400" height="545" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110714118/6369041d9c7e80680e037d01jpeg.jpg" alt=""><figcaption> </figcaption></figure><figure><img width="400" height="563" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110714118/6369041e9c7e80680e037d02jpeg.jpg" alt=""><figcaption> </figcaption></figure><figure><img width="400" height="537" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221107141112/636904209c7e80680e037d03jpeg.jpg" alt=""><figcaption> </figcaption></figure>The earthquake project is part of Whelpton’s ongoing research into <a href="http://archive.nepalitimes.com/news.php?id=10003#.W36KY84zbIU" target="_blank" rel="noopener">Nepali history</a>. But his own personal history is as fascinating: an English teacher who became one of Nepal’s most dedicated historians.Whelpton signed up to be a VSO volunteer to teach English in South Asia, wanting to go to India but ended up by chance in Nepal in 1972. He took an 8-week course in Nepali, but realised it was of no use in Birganj where he was stationed -- everyone spoke Hindi.He hiked to Jomsom and Pokhara, and once walked into the main courtyard of Pashupati by mistake, almost getting beaten up by a drunken English-speaking devotee before he was rescued and sent on his way by a policeman.By late 1970s, his Nepali was good enough to translate Jang Bahadur ko Belayat Yatra from Nepali into English. This first-time translation of the travelogue was published with commentary as Jang Bahadur in Europe: The First Nepalese Mission to the West. In its reprint it also contained a <a href="http://archive.nepalitimes.com/news.php?id=152#.W36LO84zbIU" target="_blank" rel="noopener">first-person account of the journe</a>y by Moti Lal Singh, who is considered the first Nepali to get to London and was befriended by Jung and employed as translator. The text of his account, discovered by earlier historians, was republished in full in English for the first time in Whelpton's book.Whelpton’s PhD led to another book on Jang Bahadur: Kings, Soldiers and Priests: Nepalese Politics and the Rise of Jang Bahadur Rana, which included previously unseen archival material. He then went back to his job as an English teacher in Hong Kong, and in his spare time wrote History of Nepal, and surveyed Christianity in Nepal.Foreigners are not allowed access to Nepal’s Foreign Ministry archives which limited Whelpton, but then he had easy access to the British Library where missives sent by residents between 1830-1870 are stored. These records come with their own complications. “Nepali records are mostly official documents, but British documents contain policy debates. They discuss not just what happened but argue about what should be done,” says Whelpton. “So while they often give the bigger picture, there is more danger of bias colouring the information.”After 1870, the British government in India stopped sending records to London, so Whelpton is currently researching in the Foreign Ministry archives in Delhi. Nepal-related documents were classified under the ‘Political’ section meant for internal affairs, until Chandra Shumsher specifically asked that Nepal be put under the ‘Foreign’ department.Though Ranas are seen to be Anglophiles, Whelpton cites this and other examples to claim that they were actually quite patriotic. He adds: “What determines Kathmandu rulers’ attitude to outside powers is the strength of the outside powers. At any given time there is a balance between independence and keeping on the right side of powerful neighbours. For Jang Bahadur, China was becoming weaker, and it made sense to get closer to the British. Even Bhimsen Thapa, seen as a patriot who resisted the British, was swinging more towards the British in his last days.”Despite a shift in academia towards anthropological history of the people rather than a list of rulers, Whelpton calls himself “an old fashioned political historian”, and says Nepal’s politics has become much more complicated, which is why he wants to research it as a historian.A lot needs to be done before Nepal has a comprehensive and complete history, but Whelpton feels that every bit counts: “Scholarship in history can be compared to a cairn on a mountain pass which grows as each traveller throws another stone.”Read also: <a href="http://archive.nepalitimes.com/news.php?id=16227#.W36LL84zbIU" target="_blank" rel="noopener">Jung Bahadur's "tip"</a>, Subodh Rana<a href="http://archive.nepalitimes.com/news.php?id=3246#.W36MDc4zbIU" target="_blank" rel="noopener">Looking for Mr Hodgson</a>, Kanak Mani Dixit

The rest is history for John Whelpton

It was pure drama: the political transition in Madhes unfolded by the dawn’s early light. At around 4AM on Monday, Province Head Sumitra Subedi Bhandari quietly departed Janakpur saying she was headed to Kathmandu for health reasons.&nbsp;
Outgoing Chief Minister Jitendra Sonal, whose coalition had begun to unravel, even saw her off, asking supporters to clear the road for her motorcade.
But an hour later, instead of continuing on to the capital, Bhandari stopped in Bardibas on the East-West Highway. There, as the sun started rising over the misty plains, she administered the oath of office to Saroj Kumar Yadav of the CPN-UML, invoking Article 168(3) of the Constitution.&nbsp;
Bhandari is also a member of the CPN-UML. The provision she invoked is typically used only after coalitions fail under Article 168(2), and the timing and location of the swearing-in have since drawn scrutiny.
Bhandari was subsequently relieved of her duties, and former National Planning Commission member Surendra Labh Karna was sworn in as the new Madhes province head on Tuesday.
Sonal had formed his government barely a month ago, with the backing of 56 provincial lawmakers but it became evident he would not secure the 54 votes needed to survive a confidence motion.&nbsp;
Several lawmakers in his coalition publicly signalled they would abstain. Still, the seven-party alliance that opposed Yadav’s appointment argues that the Province Head, who is the highest constitutional rank in the provincial structure, acted prematurely and under pressure from central UML party command.&nbsp;
A coalition of seven parties, including the Nepali Congress (NC), had been urging the Province Head to invite them to form a new government under Article 168(2). At the same time, the UML, which had been holding demonstrations outside the Province Head’s office in Janakpur, was calling for the formation of a minority government under Article 168(3).
The alliance of the seven parties that included the NC and Maoist Centre took to the streets. By mid-morning, protests had escalated outside Madhes Bhawan with cadre vandalising both the Chief Minister’s office and the Province Head’s office.
This was the third government in Madhes to fall since the 2022 provincial elections, and it follows a similar pattern. The previous Chief Minister Satish Kumar Singh of the Janamat Party, resigned before a scheduled confidence vote after losing the support of his own party and others including NC and LSP.&nbsp;
His resignation unfolded amid nationwide GenZ protests against corruption, demanding accountability and reform. The recurring instability points to a structural tension in Nepal’s federalism.&nbsp;
Provincial politics remain closely tied to alliances shaped in Kathmandu. The withdrawal of support by parties like the NC and Maoist Centre in provinces often reflects national-level calculations rather than provincial priorities.
As a result, the Provincial Assembly is repeatedly consumed by survival of the coalition instead of governance. Development work stalls. Budget execution slows. Public frustration grows. In a province that was at the forefront of the movement for federalism to counter what is seen as neglect, apathy and discrimination by Kathmandu, the sense that the system may not delivering on its promise is becoming increasingly pronounced.
If federalism is to be strengthened, provincial governments must be able to function with a degree of autonomy that currently exists more in principle than in practice. Otherwise, the perception that federalism is costly, unstable, and ineffective will continue to expand, providing fertile ground for anti-federal sentiment that is already gaining traction.
Earlier examples such as the NC General Secretary Bishwo Prakash Sharma in January calling for a new government in Madhes led by his party demonstrates how the central party leadership deliberately intervenes in provincial affairs. His remarks came during campaigns for bi-elections in Madhes when former CM Singh had been in office for six months only.&nbsp;
Likewise, in early June 2024, the federal coalition in Kathmandu shifted from a Maoist Centre and NC to form a new alliance between the NC &nbsp;and the UML. Within a day, coalition negotiations in Madhes changed to mirror this.
UML leaders publicly stated: “The issues at the federal and provincial levels will be resolved together.” This indicated that the realignment in Madhes followed national party decisions rather than provincial deliberation.
The events that unfolded in Madhes are a reminder that federalism in Nepal is still in transition, and that its success depends on political actors honouring the constitutional framework.

Chronic instability in the Madhes

You do not have to be a climate expert or atmospheric pandit to claim that Nepal is not pulling its weight on the grand narratives of the Anthropocene. As a heavily populated ‘country-on-an-incline’ from the Tarai to the Himalaya, Nepal is a thermometer of global warming.&nbsp; Its people are human witnesses to environmental and climate breakdown, but remain mute observers to the unfolding crises. Nepal should be leading the pack at the COP30 climate conference in Belém, backed by science and lived experience. But it is doubtful that two of the most crucial climate-related subjects central to the culture, economies and human wellbeing in the Himalaya and South Asia will be discussed at the summit that started this week in Brazil.&nbsp; The first topic that should be raised at COP is Black Carbon or the South Asian Brown Cloud, made up of tiny suspended particles in the air. This is not just a transboundary health hazard, there is now enough science to make the case that Himalayan snowmelt is accelerated significantly by the albedo effect that makes ice melt faster because of reduced reflectivity. But Kathmandu has not been able to make governments near and far listen. In 2014, I wrote a short piece published in Outlook magazine explaining why India’s Prime Minister Modi looking northward from a SAARC Summit retreat in Dhulikhel was unable to see the Jugal Himal range barely 30km away. His view was obscured by the pollution layer arriving from as far away as Lahore with substantial contribution from the Delhi region. That summit itself was an opportunity for Nepal to inform the Indian and Pakistani prime ministers that much of the haze, smog, dust and soot that settles on our slopes was generated in Sindh, Punjab, Punjab, Haryana, Western UP and Delhi NCR, carried by prevailing westerly winds up to the Himalaya. The forest fires within Nepal as well as Kathmandu Valley’s pollution contribute to the haze, but the shroud that suffocates the region through autumn, winter and spring is mostly transnational. Last year, these anthropogenic fine aerosols actually curled over the Bay of Bengal and invaded the airspace of Sri Lanka and Maldives.&nbsp; Even as the soot particles accelerate glacial melt and impact everything from infrastructure to public health, the most visible effect is on tourism. Nepal’s economic future is based on tourism, and much of this relies on being able to see the snow mountains. Why should travellers go to Pokhara if they cannot see the Annapurnas?&nbsp; Hoteliers in Nagarkot have started a campaign: ‘Visit Nagarkot 2025: More than Sunrise and Sunset’. While clever, the slogan is a response to the acclaimed Himalayan vista from Everest to the Annapurnas from the hill station, now obscured by the brown curtain of haze for most of the year. As the bellwether country of South Asia when it comes to the climate crisis, Nepal must build diplomatic confidence to reach out to the governments of Pakistan and India even in their present state of antagonism. Kathmandu must launch ‘haze diplomacy’ for its own sake and for the region.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251113001132_16c9941da7b31c1d4683c06dc0f8a572803240701270606848851f915140329c.jpg" data-media-id="editor_0" data-image-id="20251113001132_16c9941da7b31c1d4683c06dc0f8a572803240701270606848851f915140329c" data-rendition-name="original" width="1005" height="695" loading="lazy" alt="permafrost"> </figure>  IMPERMANENT FROST&nbsp; Permafrost is understood mostly as a phenomenon of the Arctic, Antarctica, Siberia and Alaska. Mountains elsewhere did not figure, though it was natural for the ground to freeze all year round at high altitudes.&nbsp; In the Himalaya, besides the snowfields and glaciers, frozen moisture binds rocks and stabilises slopes. But global warming is melting the permafrost that used to cement mountain flanks, including boulders, sand and scree slopes. Some of the debris (गेग्रान) did tumble down, but much of it remained entombed on high, thanks to permafrost. Pokhara Valley and the Seti River reaching all the way up to the base of the Annapurnas, is the best place to observe this dance of geology between gravity and the mountain range. Rubble from the collapse about <a href="https://nepalitimes.com/here-now/remembering-the-seti-disaster">700 years ago of paleo-Annapurna IV </a>created the sediment field on which Pokhara is situated today. However, much of the debris from the crumbled mountain is still lodged up on and around Annapurna IV, but the binding is loosening with the warming earth. A <a href="https://www.icimod.org/event/analysing-permafrost-in-the-hindu-kush-himalaya-using-open-access-tools/">2024 report by the International Centre for Integrated Mountain Development (ICIMOD)</a> indicates that global warming is thawing the permafrost across High Asia. Among the unintended consequences of climate breakdown is that mountains and moraines are collapsing, with <a href="https://www.icimod.org/press-release/everest-region-a-hotspot-of-cryosphere-linked-hazards-icimods-new-study-on-nepals-2024-thame-flood-confirms/">cascading impact</a> that includes glacial lake outburst floods, reduced groundwater recharge as well as winter flow in the Ganga, Indus and Brahmaputra. No one has calculated the total volume of rubble locked in by permafrost across the Himalaya. Despite the increased risk, there is accelerated construction of highways, hydropower projects, housing and tourism infrastructure across the Himalaya. While the COP conferences discuss rising oceans and receding glaciers (without doing much about it), Himalayan permafrost has been melting unremarked. In their path-breaking September 2024 <a href="https://nepalitimes.com/multimedia/the-not-so-permanent-frost">article in Nepali Times</a>, Wilfried Haeberli and Alton C Byers argued that the extreme events of the past few years that led to mountain and moraine collapses, unleashing destructive debris flows downstream, were the result of melting permafrost. Haeberli and Byers suggest that the avalanches and floods including those of <a href="https://archive.nepalitimes.com/article/nation/Anatom-of-a-Himalayan-tsunami,1330">Seti (2012)</a>, <a href="https://www.icimod.org/article/understanding-the-chamoli-flood-cause-process-impacts-and-context-of-rapid-infrastructure-development/">Chamoli (2021)</a>, Birendra Tal (2023), <a href="https://www.sciencedirect.com/science/article/pii/S2772883825000251">Sikkim (2023)</a>, <a href="https://nepalitimes.com/news/climate-breakdown-linked-to-thame-flood">Thame (2024)</a>, <a href="https://himat.org/publication/byers-rockfall-induced-2019/">Barun (2017)</a> and <a href="https://nepalitimes.com/banner/drones-to-the-rescue-in-melamchi">Melamchi (2021)</a> were the result of the thawing of frozen ground. They say that the collapse of the lateral moraine on the <a href="https://nepalitimes.com/news/sikkim-flood-is-warning-to-nepal">South Lhonak glacial lake</a> in Sikkim on 4 October 2023 that swept away more than 100 people, destroyed the $1 billion Chungthang Dam as well as houses, roads and farms far downstream, was also caused by cloudburst on a lateral moraine that had lost its permafrost adhesive. There will be permafrost sceptics, as there have been climate change deniers. But it is time to wake up to the reality that the Himalayan peaks are no longer the immutable sentinels as regarded by humanity since prehistoric times.&nbsp; Modern society has pumped so much greenhouse gas into the atmosphere that now even the mountains are giving up. And we have not even begun to think about the bacteria and viruses locked away in the permafrost up the slope.&nbsp; Loss of permafrost adds to the cumulative impact of climate breakdown, including extreme weather events, drought and cloudbursts, heat waves in the plains affecting lives and livelihoods, creating mass migration, social unrest, and upending politics and geopolitics. The government and polity of Nepal have a duty to themselves and the larger humanity to wake up to the climate breakdown. The Sagarmatha Sambaad conclave organised by the Government in May failed to emerge as a pulpit for global warming and associated ills. Our political class, bureaucracy and academia should make up for lost opportunities to rise to the occasion and take the lead.&nbsp; Kanak Mani Dixit is writer, commentator and founding editor of Himal Southasian.

Climate of tragedy and apathy

This is the 73rd episode of Diaspora Diaries, a Nepali Times series in collaboration with Migration Lab providing a platform to share experiences of living, working and studying abroad. I don’t remember playing with dolls as a little girl. There is not much to remember from my childhood.&nbsp; My responsibilities began at a very young age, as I had two younger brothers to take care of. I was born in Sarlahi, but we moved around quite a bit as my father was in the government and got transferred frequently.&nbsp; From Rasuwa to Dang, from Nepalgunj to Kathmandu. I struggled to adjust in Kathmandu because I joined Grade 9 in the middle of the term. The education was different and fellow students also did not support me initially. But over time, I adjusted and made friends. I did not dream of becoming a nurse. It was by accident. I wanted to pursue medicine, but failed the entrance exam by a few marks. I did not want to lose a year, so decided to take up microbiology instead.&nbsp; I got married after my undergraduate, and my husband encouraged me to take up something more technical like nursing or engineering instead of Masters in Microbiology. As my quantitative background was weak, I chose nursing. I felt like I was born to be a nurse. Juggling my married life and studies was difficult. My teachers would often ask me why I am falling behind. It was not easy, but I managed and took up a full-time job as a nurse. There are challenges being a nurse in Nepal. You are overworked, underpaid, there is lack of appreciation. Superiors can be overbearing. These problems persist. But the bright spot is that you get to serve fellow Nepalis, and be close to your family.&nbsp; Just like I had no intention initially of becoming a nurse, I had no intention of migrating overseas. But life had different plans for me. After my baby boy was born, I noticed that something was off. Even at nine months he had not started crawling or sitting. As a nurse I knew something was wrong, and I took him for check-ups. He tested negative for down syndrome, but he had a heart defect.&nbsp; The cardiologist recommended that I take him to India where he was diagnosed with Williams Syndrome, a rare genetic condition that affects 1 in 10,000 people. It delayed his development. I looked for therapy. It was either not effective, or too expensive. Some schools also refused to admit him, and it drove me to tears.&nbsp; My family members overseas in the UK, US told me to emigrate as there were better facilities for differently abled children. So I decided to apply to the UK. Luckily just then there were calls for candidates under the Nepal-UK government-to-government pilot scheme for 100 nurses. Only 40 met the criteria, and I was one of them.&nbsp; I still remember the day I received the news on the day of my puja. There were people around me, and they told me that it was the result of my fasting and devotion on that auspicious day. Perhaps it was. Life was taking a new turn, and I was happy. I made it to the UK in February 2024 without paying a single paisa to any broker. The G2G scheme was unique as we were treated with dignity and valued for our skills: they covered costs for the ticket and visa, reimbursed us for exams we had taken and costs involved in the preparation and testing of the Objective Structured Clinical Examination were also covered.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251106071148_dc5a0d0ea3024b34a4f2735754f8eb67a650bc7f61b98c75d589676c65b02a0c.jpg" data-media-id="editor_0" data-image-id="20251106071148_dc5a0d0ea3024b34a4f2735754f8eb67a650bc7f61b98c75d589676c65b02a0c" data-rendition-name="original" width="1200" height="1600" loading="lazy" alt="Nurses NT"> </figure>  It was of course difficult to leave my son behind. But I was doing it for his future. I had the option of taking him from the start, but it was a new place and I wanted to be well-settled and knowledgeable about the options available for him before bringing him along. As I packed, he would ask me to take him with me in my suitcase. It did not seem like he was affected by my departure, and it was only later that his teachers said that he would express his feelings more openly at school. He just did not know how to tell me he missed me, and he would tell teachers he was worried I had forgotten him if we did not speak for a day.&nbsp; He missed me, and that realisation made me emotional. But I had to carry on. Life in the UK was difficult in the beginning. Even so, I wanted to prove to myself that I could do it. Fortunately I had cooperative staff who patiently answered my questions. I think I would have been irritated if I were in their place. But they did not seem to mind, and their support and guidance made it easy for me to adjust to the new work environment. APPRECIATION I still struggle to understand the accent of my English patients, and have ask the matron for help. They compliment me on my English, but I can speak better than I understand. The good thing about working in the UK is that you are appreciated for your work, which can be motivating. Sometimes, after a long day’s work you get a message from your supervisor acknowledging your work with a thank you. That’s enough to erase your tiredness.&nbsp; So far I have received 32 WOW nominations which are acknowledgements from patients for a job well done. It can be motivating, especially in the beginning. The main difference between the Alpana who first left Kathmandu for the UK and the Alpana now is that I am a much more confident person. What makes a good nurse? Skills, knowledge and qualifications are of course a given. But mostly, you need humanity. A smiling face. The way you communicate. Your empathy. These attributes can already solve many problems that patients are facing. This is my second time back home in the last 20 months. And this time, I have arranged for my son’s visa. I will go back after Tihar with my son and husband.&nbsp; I am happy, but also a little nervous about what awaits us. What kind of school will I put him in? Will it really be different from schools here? Will his needs be addressed? Will it be like here, or will he be able to adjust?&nbsp; But I am determined to make it work. Success for me would be if he adjusted well and there is a change in his condition. He still cannot recognise alphabets and read words like kids in his age group. Hopefully he will get learning support in the UK. He also has a knack for music, and this is common among individuals with Williams Syndrome. His ears perk up when he hears music, and he takes part in musical events at school. He still does not recognise letters &nbsp;but he uses voice commands to search for guitar videos on YouTube. I will enrol him in music classes, and help him develop this gift. For now, I worry how he will behave on his long flight. He has a short attention span and gets restless. He is also very social and will want to speak with everyone around him, and might irritate fellow passengers.&nbsp; I have already started trying to make him understand that he will need to behave on the flight. He nods in agreement. Let’s see how it goes. &nbsp;

“I felt like I was born to be a nurse”

A month after September’s GenZ movement in Nepal, nurses working in private hospitals took to the streets demanding better work conditions, and salaries equal to what government nurses are paid.&nbsp;
The strike started at Pokhara’s Manipal Teaching Hospital before spreading nationwide, and nurses working at government hospitals joined in.&nbsp;
Nurses at private hospitals are forced to work for far less than Nepal’s minimum monthly wage of Rs19,550 — without overtime, breaks, and other benefits and under physically and mentally taxing conditions. This is driving many qualified nurses to emigrate.
For newly-appointed Health Minister Sudha Sharma Gautam in the interim government, the strike became her first order of business. She met representatives of the Nursing Association of Nepal (NAN), the protesting nurses, and others from the health sector.&nbsp;
An agreement was reached under which private hospitals and medical colleges will pay nurses a minimum monthly salary of Rs34,730. &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
“It is a shame that nurses have been working under such exploitative conditions all this time” says Radha Adhikari, at the School of Health and Life Sciences of the University of the West of Scotland. “The agreement is basic, and there is a long way to go to improve their working conditions. But it is a start.”
NAN chair Chandrakala Sharma has said the ministry’s task force to look into working conditions will also look into facilities for nurses in government hospitals.&nbsp;
“We are committed to solidifying the wage agreement by amending relevant laws within this month,” Sharma said in a video posted by NAN on Facebook. “Our movement is not over, we are still protesting and &nbsp;following up with the Ministry.”
NAN issued an ultimatum to the government to implement the agreements within 48 hours. That deadline has now lapsed and the nurses are back on strike. Many of those protesting now accuse NAN of betraying them.
Jyoti Ranabhat of the Nurses Struggle Committee was present in the meeting, but refused to sign the agreement. “It did not address what we were demanding, we will now go it alone into Plan B,” she tells Nepali Times.&nbsp;
Previous grievances of the nurses did result in similar agreements, but private hospitals failed to comply with government’s past directives — most recently the minimum salary and benefit determined by the state in December 2024.&nbsp;
The Nepal Nursing Council says there are 126,580 registered nurses, specialists, midwives, and Auxiliary Nurse Midwife (ANM) professionals in Nepal. Yet, nursing positions at hospitals remain vacant.&nbsp;
The reason for understaffing is a mass emigration of medical professionals, including nurses. Nursing student enrollment is also declining and there is disinterest in a profession that does not afford health workers quality of life, respect, or dignity.
“Our fight is not with the private sector, it is by definition profit-oriented, our grievance is with the state,” says Ranabhat. “The government is responsible to provide us dignity, respect, and fair pay.”&nbsp;
GREENER PASTURES
Poor pay and working conditions are driving doctors and nurses abroad in large numbers in recent years. Many have simply quit the profession, leading to a shortfall in medical professionals. 

The shortage of nurses is a global phenomenon, and countries like the US, UK and Australia have compensated for their own shortage by offering jobs from countries like the Philippines, India and Nepal.&nbsp;
Nepal Nursing Council data shows that outmigration of nurses rose sharply after 2002, and an estimated &nbsp;20,000-45,000 nurses have left since.
“The state’s denial, derision, and disregard of nurses has caused resentment and disillusionment in the community, driving nurses out,” says Ranabhat. “Ultimately, Nepalis will pay the price when there are no nurses left here.”
Many Nepali nurses who have gone abroad are happy with the respect and quality of life in their jobs abroad. But many others face exploitative recruiters in Nepal and employers abroad. Nursing consultancies have mushroomed as nursing colleges struggle to meet demand.&nbsp;
Adhikari herself worked at United Mission Hospital Tansen before moving to the UK 30 years ago, and remembers that working conditions then were much better for nurses.&nbsp;
“Nepal’s health sector has gone downhill since privatisation,” she states. “Medical colleges are only concerned with supplying doctors and nurses internationally, because that is what makes money.”
But once Nepal’s nurses are abroad, there is no guarantee that they will have jobs in the nursing sector. Many find themselves working outside their field of expertise, in hospitality or sales.&nbsp;
“Nepal has become a production hub for nurses, and Nepali nurses have become products for export,” adds Ranabhat. &nbsp;“People might think this will add to remittances, but no one is thinking about what will happen to Nepal’s health sector.”&nbsp;
For many, nursing has become a way out of Nepal rather than a vocation. In 2022, the government signed an agreement with the UK to send Nepali nurses to work there at zero cost, with benefits and protection equal to UK nurses.&nbsp;
The pilot phase was expected to recruit 100 nurses, and applications opened in July 2023, with 45 nurses said to be selected by Britain’s NHF representatives by the end of 2023. Forty-one of them obtained labour permits.&nbsp;
They may be treated well, but the reality of working in the international health sector is not as straightforward.
Radha Adhikari told us from Scotland: “Market saturation, exploitation, discrimination based on race, gender, and foreignness prevent nurses from finding the right, respectful jobs even here. Ultimately, migration cannot be sustainable for Nepal’s nurses.”

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