We have long speculated on the moment when the shift of global leadership from the United States to China would take place. From Washington to Beijing for the political power, from New York to Shanghai for the economic one. It seems that we are witnessing it now.Some saw the Beijing Olympics (2008), others marked the Asian Investment and Infrastructure Bank (2015) to replace the Bretton Woods system, a fundamental pillar of North American hegemony.Presidents Obama and Xi Jinping confirmed a de facto bipolar global regime manifested in the two leaders’ pact on climate change that made the <a href="http://archive.nepalitimes.com/blogs/kundadixit/2017/04/12/horror-story-of-a-climate-calamity/" target="_blank" rel="noopener">2015 Paris Agreement</a> feasible.However, with the arrival of Donald (Make America Great Again) Trump there was an escalation of this quarrel for global leadership. The trade war between the two countries, with the World Trade Organisation held hostage, or the open battle over the control of 5G, with the Huawei controversy at its the core were two recent examples.<a href="https://www.nepalitimes.com/here-now/the-climate-connection-to-covid-19/">Climate connection to COVID-19</a>, Rastraraj Bhandari<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109121120/636b8d9a9c7e80680e06b357jpeg.jpg" alt="" width="1200" height="800"/><figcaption>President Donald Trump's visit to China in 2017.</figcaption></figure>China is on a full-fledged offensive to increase its presence and influence in the multilateral system to fill a vacuum left by the Trump administration, by obtaining important positions to influence these institutions. The US administration has vacated for more than three years the position of ambassador in Geneva, a city with most diplomatic activity in the world.China stepped in by appointing a new high political-profile ambassador in November last year. However, the positions of the battles for the future of the WTO or the leadership of the International Telecommunication Union (key in the management of satellite orbits, the management of radio space or digital world governance) were already well advanced at that time.Then, in November last year something happened in the Huanan market in Wuhan. But it was not until 31 December that an ‘outbreak of an unknown pneumonia’ in this city was reported to the World Health Organization (WHO).<a href="https://www.nepalitimes.com/latest/pompeo-accuses-who-of-failing-in-basic-duty/">Pompeo accuses WHO of “failing in basic duty”</a>, Kunda DixitThe Huanan market was closed down on 1 January. The following day the new virus was confirmed, with the technical name of SARS-CoV-2. On 16 January, Japan reported its first case, on the 17th it was Thailand did. Taiwan and the United States reported first cases on 21 January, and France on 24th.On 30 January the WHO declared an International Public Health Emergency, the same day that Italy reported its first case. The next day it was Spain at the same time that the virus was already spread in India, Russia, the Philippines or Australia. On 11 March the WHO declared the global pandemic and, while the world trembles, global leadership transits.On 20 March, while the White House or Downing Street were still flirting with denialism in relation to COVID-19, the Chinese Ministry of Foreign Affairs announced a plan to support 82 countries in their fight against this virus.Two weeks later, as the virus wreaked havoc on hospitals on both coasts in the United States, and the British Prime Minister was admitted to the ICU, 18 countries in central and western Africa had already received hundreds of tons of Chinese donations of medical supplies, and 17 more were waiting to receive them in a matter of days.<a href="https://www.nepalitimes.com/latest/a-covid-19-third-wave-in-the-third-world/">A COVID-19 third wave in the Third World?,</a> Ed Holt, IPSPakistan, South Korea, Spain or Italy are other countries that have received help. In the latter, this help was not only of material, but accompanied by experts and medical staff.Putin’s Russia also took advantage of the pandemic in the first weeks to project its role as international power by sending military personnel to Italy – in a context of astonishing silence and blockage of the European institutions -- or aid in health supplies to his ‘friend’ Donald Trump.And even as COVID-19 spreads through Moscow and other cities and regions of the Federation these rather symbolic activities continue. Turkey also tried, by responding to Spain’s NATO urgency request, but soon changed its policy once they realised how the situation was deteriorating in Ankara and Istanbul itself.It is too early to evaluate the full scope of COVID-19. In fact, no one can really assert at this point what the evolution and global impact of the pandemic will be, neither in terms of public health, nor in its humanitarian, social or economic dimensions.<a href="https://www.nepalitimes.com/latest/climate-covid-19-and-china/">Climate, COVID-19 and China</a>, Rastraraj BhandariThe outlook is not good, and particularly worrisome is the uncertain effect that this pandemic will have in less developed countries, considering how it is affecting higher-income ones.However, it is quite clear that this will be a turning point in terms of global governance and hegemony. Once again, the arbitrariness of history precipitates change. The strategists, the intelligence agencies, the think tanks that for years have debated and conspired from Langley through Georgetown, Xijuan or Gouguan had not foreseen what would end up igniting in a provincial market in Wuhan.But what does seems plausible is that, in the midst of such drama, we are witnessing the handing over of global hegemony.<a href="http://www.ipsnews.net/author/manuel-manonelles/">Manuel Manonelles</a> is director of the Foundation for a Culture of Peace in Barcelona.<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109121120/636b8d9d9c7e80680e06b358jpeg.jpg" alt="" width="94" height="134">

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COVID-19 and the global power balance

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110814110/636a52e69c7e80680e05231fjpeg.jpg" alt="" width="1826" height="507"/><figcaption>Lhotse glacier, Chukung village to the far left. Photo: ALTON C BYERS</figcaption></figure>Most of the recent talk within the UN Framework Convention on Climate Change (UNFCCC) process and elsewhere has focused on <a href="https://www.nepalitimes.com/opinion/decarbonise-now/" target="_blank" rel="noopener">cutting greenhouse gas emissions</a> to reduce the impact of <a href="https://www.nepalitimes.com/banner/weather-warning-for-climate-meeting/" target="_blank" rel="noopener">climate change</a>.<a href="https://www.nepalitimes.com/here-now/from-playing-victim-to-proactive-leadership-on-climate/" target="_blank" rel="noopener">Mitigation</a> was the buzzword, and any mention of adaptation was avoided because for some it meant accepting defeat. But today, driven largely by the concerns of developing countries, which bear the brunt of the climate emergency, adaptation is the key issue. But since adapting to <a href="https://www.nepalitimes.com/editorial/climate-damage/" target="_blank" rel="noopener">climate change is so closely linked with issues of power, governance and politics</a>, it is not well understood. Successfully adapting to climate change is often based on how individuals, households and communities switch and improve livelihoods.Given Nepal’s geographical, climate and ecosystem diversity from plains to mountains, the question is: what do people actually adapt to? Is it <a href="https://www.nepalitimes.com/opinion/turning-on-the-heat/" target="_blank" rel="noopener">rising temperatures and heat</a>, erratic rains, droughts, <a href="https://www.nepalitimes.com/editorial/flood-of-recrimination/">floods</a>, forest fires or increased rates of diseases?Read also: <a href="https://www.nepalitimes.com/banner/living-below-nepals-melting-mountains/" target="_blank" rel="noopener">Living below Nepal's melting mountains</a>, Alton C Byers <a href="https://www.nepalitimes.com/opinion/look-whats-cooking-in-nepal/" target="_blank" rel="noopener">Look what's cooking in Nepal</a>, Anil ChitrakarFamilies in <a href="https://www.nepalitimes.com/banner/a-terrifying-assessment-of-himalayan-melting/" target="_blank" rel="noopener">high mountain valleys</a> may not have to worry about floods, but are affected when roads are blocked, severing access to markets. Those in the mid-mountains may be badly impacted by landslides, <a href="https://www.nepalitimes.com/opinion/nepals-silent-emergency-springs-going-dry/" target="_blank" rel="noopener">drying springs</a>, or declining agriculture production due to droughts.An adaptation strategy that works in an isolated mountain settlement will not work in Kathmandu. Though <a href="https://www.nepalitimes.com/editorial/climate-climax/" target="_blank" rel="noopener">climate change</a> is a global problem, its impacts are very local and different. National-level attempts to adapt will thus be unsuccessful, yet global conversations and the resultant aid flows continue to ignore sub-national differences.In 2001, the UNFCCC established a program for least developed countries that included financial and technical support to prepare National Adaptation Plans of Action (NAPA) to meet ‘immediate and urgent’ adaptation needs. Today the conversation has moved to National Adaptation Plans (NAP) that focus on integrating climate risks into development planning and implementation.Nepal was late in preparing its NAPA, which turned out to be a temporary blessing in disguise. Using additional donor funding, the Ministry of Science Technology and Environment prepared a NAPA 'Plus' in 2009, which included a more consultative process to capture local nuances. In 2011, Nepal formulated a LAPA framework and also promulgated a climate policy stipulating that 80% of resources earmarked for the climate crisis would be allocated to local levels.Donor support was available and the country implemented LAPA programs in a few selected regions. But we still don’t know if the resources were really spent in rural areas, or if they made any difference.There are three major challenges for successful adaptation to <a href="https://www.nepalitimes.com/banner/on-thin-ice-in-the-khumbu/" target="_blank" rel="noopener">climate impacts</a>. First is attribution: a localised weather event cannot be directly linked to climate change. Second relates to how people and institutions respond to new climate shocks, usually by <a href="https://www.nepalitimes.com/banner/living-below-nepals-melting-mountains/" target="_blank" rel="noopener">local people meeting local needs</a>.Finally, individual adaptation strategies are most successful and enduring when people have access to drinking water, <a href="https://www.nepalitimes.com/opinion/look-whats-cooking-in-nepal/" target="_blank" rel="noopener">clean energy</a>, information, finances and alternative sources of income, as well as the right to organise, express their voices and access political outlets.Given the rapid spread of the climate emergency, it is clear that existing project-based efforts cannot add up at scale. Our current understanding of adaptation offers very little by way of solutions for the scale of transformative shifts necessary now and into the future for Nepal and elsewhere. Based on the polluter pays principle, the developed world should indeed bear the cost of adaptation in developing countries to make up for historical emissions. But when our springs dry up, having more money may not be of much help.Even without climate change, Nepal faced challenges managing disasters and development. The climate emergency is a <a href="https://www.nepalitimes.com/opinion/life-in-the-time-of-tornadoes/" target="_blank" rel="noopener">threat multiplier</a> that will seriously strain our socio-economic, political and ecological futures.Ajaya Dixit is Executive Director of Kathmandu based ISET-Nepal. His monthly column Climate for Change deals with the impact of global warming in Nepal.

The climate threat multiplier

Gebru Jember Endalew has been involved in UN negotiations on climate change since 2008 as a core member of the Ethiopian negotiating team. Last year, he stepped down as Chair of the Least Developed Countries (LDCs) Group on Climate Change, of which Nepal is a member and Bhutan is the new Chair.Currently, Endalew is an adviser at the Korea-based <a href="http://gggi.org/" target="_blank" rel="noopener">Global Green Growth Institute</a>. Endalew was in Kathmandu this week for consultations on resilience and adaptation for Asia-Pacific members of the LDC group. He spoke to Nepali Times on how least-developed countries like Nepal can cope with <a href="https://www.nepalitimes.com/editorial/climate-climax/" target="_blank" rel="noopener">climate change</a>.Read also:'<a href="https://www.nepalitimes.com/?p=21122&amp;preview=true" target="_blank" rel="noopener">Climate damage</a>', Editorial<a href="https://www.nepalitimes.com/banner/a-terrifying-assessment-of-himalayan-melting/" target="_blank" rel="noopener">Terrifying assessment of a Himalayan Melting</a>, Kunda Dixit'<a href="https://www.nepalitimes.com/?p=21132&amp;preview=true" target="_blank" rel="noopener">Turning on the heat</a>', Ajaya DixitSimilarities between Nepal and EthiopiNepal and Ethiopia have a lot in common. We are LDCs, we are land-locked, face severe impacts of global climate change despite not being major greenhouse gas emitters. And we are both mountainous countries. Mountain ecosystems are <a href="https://archive.nepalitimes.com/regular-columns/guest-editorial/mountainous-change,887" target="_blank" rel="noopener">highly fragile in terms of climate change impacts</a>, as proven by the <a href="https://www.nepalitimes.com/banner/a-terrifying-assessment-of-himalayan-melting/" target="_blank" rel="noopener">study released this week</a> by ICIMOD Hindu Kush Himalaya Assessment and the <a href="https://www.nepalitimes.com/opinion/decarbonise-now/" target="_blank" rel="noopener">IPCC 1.5 Degree World report</a>.We know that a 1.5 degree world is achievable, but even an increase of one degree in global average temperature has major consequences ranging from forest fires, extreme weather events to changing monsoon patterns. Yet some of the countries were still in denial at the Climate Summit in Poland. But we LDCs have been consistent in terms of our reflections about the 1.5 degree report and we believe it will be taken up at the UN Secretary General’s meeting in September in New York.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108101144/636a25cb9c7e80680e0439e0jpeg.jpg" alt="" width="800" height="1067"/><figcaption>Photo: KUNDA DIXIT</figcaption></figure>Climate justiceWhile we need to continue to push big emitters for more pledges for adaptation, we cannot completely depend on compensation to address the <a href="https://www.nepalitimes.com/banner/on-thin-ice-in-the-khumbu/" target="_blank" rel="noopener">impact of climate change</a> on our people. Trillions were promised in Poland but it will take years to materialise. And now that the number of big emitters have increased, and include many of our own countries, reimbursement alone will not take us anywhere in terms of investments required.If we stick to <a href="http://archive.nepalitimes.com/news.php?id=9980#.XFvcbVUzaUl" target="_blank" rel="noopener">historical responsibility for carbon emissions</a>, we will not arrive at a solution. If we wait for developed countries to pledge resources, we will not be able to adapt to the urgent impacts that are already being felt. So government in countries like Nepal and Ethiopia need to look for domestic financial resources and engage the private sector in solutions to generate revenue. We need to move out of the victim narrative to proactive leadership to deal with it.In fact, Nepal can be a leader in terms of developing innovative mitigation actions, even if it may have a much <a href="https://www.nepalitimes.com/banner/from-a-fossil-past-to-an-electric-future/" target="_blank" rel="noopener">smaller carbon footprint</a> compared to other countries. Better ecosystem and resource management here can reduce the risks of flooding in lower catchment areas of India and Bangladesh.And to be honest, past actions cannot be blamed when people were just trying to improve their lives. Post-industrial emissions were not deliberate. The biggest blunder of all would be for our leaders to repeat the same mistakes with the knowledge they have today about the impact of greenhouse gases.Turning the clock backCountries like the US and Brazil are <a href="https://www.nepalitimes.com/banner/bypassing-trump-on-climate-action/" target="_blank" rel="noopener">regressing on prior commitments</a> when it comes to climate change action. But I’m a bit of an optimist myself. Despite a somewhat bleak scenario at the leadership level, what is happening on the ground is encouraging. We see consecutive peaks in investment on renewable energy around the world including in the US, and these newer cleaner technologies are cheaper and more easily accessible to the people.Read also: <a href="https://www.nepalitimes.com/banner/bypassing-trump-on-climate-action/" target="_blank" rel="noopener">Bypassing Trump on climate change</a>, Kunda DixitMitigation or adaptation?Mitigation, adaptation and development have to go together. There is no point in making distinction. Mitigation measures to reduce fossil fuel dependence eventually contributes to development and resilience. For example: electricity generated from hydropower improves the living standard of the people while also reducing greenhouse gases.Initially there was a misconception that mitigation was not for the developing countries. We know now that everyone has to be involved in the global mitigation process, not just to save the planet but also to save our economies.All of this requires good leadership. Unless there is a political guidance, whatever resources we have might be either least used or abused. Good governance is a key to better planning and implementation to cope with climate impact.

From playing victim to proactive leadership on climate

On Tuesday, leader of the monarchist RPP once again gathered on Kathmandu’s streets to deliver fiery speeches, but this time there was no arson and looting and no need for riot police to fire live rounds or tear gas.
RPP leaders demanded the release of their members including vice-president Rabindra Mishra and MP Dhawal Shamsher Rana were arrested during the violent <a href="https://nepalitimes.com/news/republicans-and-royalists-on-nepal-s-streets">28 March protests at Tinkune </a>which left two dead. 
They denounced the current leadership of the main parties, demanding the <a href="https://nepalitimes.com/editorial/nepal-party-reincarnating-hindu-monarchy">restitution of Nepal as a Hindu kingdom</a>. They also said the government was responsible for the fatalities on 28 March because it provoked its rally with a tear gas attack even before it started.
It has now been revealed that the police fired at least 100 live rounds from high powered assault rifles at the crowd. Twenty-one of the 120 injured received bullet wounds, and most of them were bystanders and people trying to reach home. 
Tuesday protest on the Ring Road in Balkhu was much more subdued, and comparatively fewer RPP supporters showed up. The arson and vandalism in the previous protest appears to have cost some support for <a href="https://nepalitimes.com/news/the-ghost-of-monarchy-returns-to-haunt-nepal">former king Gyanendra </a>especially for the anointment of medical tycoon and bank defaulter <a href="https://nepalitimes.com/news/street-politics">Durga Prasai </a>as ‘commander’ of the Tinkune rally.
Some monarchists acknowledge Gyanendra’s mistakes when was king 2001-2008, but say he has had a lot of time to reflect on his shortcomings and seems more disciplined and committed. His supporters have tried to build on nostalgia among some Nepalis for<a href="https://nepalitimes.com/news/why-invest-in-nepal"> domestic stability </a>and international respect that <a href="https://nepalitimes.com/here-now/if-birendra-was-alive-nepal-could-still-be-a-monarchy">the monarchy</a> commanded. 
“Nepalis were promised better service delivery, opportunities for the underserved, as well as better, more honest use of state resources, but the <a href="https://archive.nepalitimes.com/news.php?id=16992">people in leadership </a>have not been able to deliver on their commitments,” says RPP leader Prakash Chandra Lohani. “The gap between their rhetoric and reality has widened, the people feel betrayed, and the respect Nepali people had previously had for them has changed to revulsion.” 
Indeed, many commentators have warned the three main parties and their <a href="https://nepalitimes.com/editorial/politics-as-usual">serial prime ministers</a> who have ruled Nepal for much of the past 30 years should address rising public anger with them, and see the writing on the wall.
‘<a href="https://nepalitimes.com/news/nepal-government-changes-again">The UML, NC and Maoists</a> must introspect about their conduct,” warns Gunaraj Luitel, editor of Nagarik, in an op-ed this week. ‘These leaders for life may save themselves from simmering public anger, but they will not be able to save the system. The monarchist wave can only be dispelled when citizens are assured of <a href="https://nepalitimes.com/here-now/nepal-s-local-election-gives-power-back-to-people">better governance</a> through <a href="https://nepalitimes.com/latest/real-world-training-for-youth-leaders">younger leaders</a>, and reforms.’ 
Rifts between radical royals who are gunning for a return to <a href="https://nepalitimes.com/here-now/mob-movement-and-mayhem">Panchayat-style absolutism </a>and moderate monarchists who favour a constitutional king have also weakened the movement somewhat. The split between the RPP and RPP-Nepal cost the royalists numbers in Parliament in 2022, and both parties denounced the violence last month, albeit shifting the blame on the government.
The irony is that the same royalists who want to scrap the republican Constitution had formed electoral alliances with the UML during the 2022 elections. RPP-Nepal chair Kamal Thapa contested the 2022 election with the UML. Thapa has not taken part in the last two rallies, saying he will only be a part of a movement under a national flag, and not a RPP party banner.
For his part, the RPP’s Rajendra Lingden is said to be hesitant to censure some of his party’s more radical royalists for fear of fissure within his ranks, despite his aversion to Durga Prasai’s role. 
Analysts have questioned why <a href="https://nepalitimes.com/news/old-is-still-gold-in-nepali-politics">supporters of the monarchy </a>have decided to reestablish an institution that would not ultimately have executive decision-making power. There are doubts about whether authoritarian-minded Gyanendra will be satisfied being a <a href="https://archive.nepalitimes.com/news.php?id=13957">ceremonial king</a>. 
Read also: <a href="https://nepalitimes.com/news/nepal-s-deja-vu-on-black-friday">Nepal’s déjà vu on Black Friday</a>, Sonia Awale
"The Nepali people will not accept <a href="https://nepalitimes.com/here-now/forgotten-woman-who-sheltered-communist-activists">an absolute monarchy </a>at this point of time, and both the public as well as <a href="https://archive.nepalitimes.com/news.php?id=8371">king Gyanendra</a> are fully aware that there is no other possibility beyond a constitutional monarchy," asserts the RPP’s Lohani. “The traditional monarchy’s institutional capacity might have been enough to meet the needs of feudal Nepal, but an absolute monarchy is impossible both in concept and practice in the context of <a href="https://archive.nepalitimes.com/regular-columns/Economic-Class/waiting-for-an-industrial-revolution,784">modern day Nepal</a>.”

New year revolutions

Besides multiple <a href="https://nepalitimes.com/news/republicans-and-royalists-on-nepal-s-streets">street demonstrations </a>that gridlocked Kathmandu’s traffic for the past weeks, public discourse in Nepal has also been dominated by dangerously <a href="https://nepalitimes.com/here-now/air-pollution-is-more-dangerous-than-smoking">high air pollution levels</a>. Caused mostly by hundreds of <a href="https://nepalitimes.com/news/wildfire-season-starts-early-in-nepal">forest fires </a>raging across the country, the smoke contains suspended soot particles that harms <a href="https://nepalitimes.com/opinion/playing-with-poison">human health</a>. Thursday’s rain have cleared the air somewhat, and many people will soon forget how bad the air quality was. But the time to address the roots of next summer’s fire season is now.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250411060440_d1a119716a9031aadfdd611d299348d436842d376a03e664b8d773957a237524.jpg" data-media-id="editor_4" data-image-id="20250411060440_d1a119716a9031aadfdd611d299348d436842d376a03e664b8d773957a237524" data-rendition-name="original" width="502" height="540" loading="lazy" alt="Wildfires"> <figcaption>EXTINGUISHED: Forest fires raging all over Nepal in the week after 3 March (above) reduced air quality, creating a public health hazard in Kathmandu and across the country. Each red dot is a fire detected by infrared sensors on the NASA Fire Information for Resource Management System (FIRMS) satellite. But the rain on Thursday doused most of the fires (below) with more rain forecast over the weekend.</figcaption> </figure>  The reason everyone was talking about air pollution was because the<a href="https://nepalitimes.com/banner/nepal-is-going-up-in-smoke"> smoke from wildfires</a> was visible. But much more toxic are the invisible and odourless <a href="https://nepalitimes.com/news/nepal-doubles-its-carbon-footprint">gases from vehicular and industrial emissions </a>which have always been there. The theme of World Health Day on 7 April this week was ‘Healthy Beginnings, Hopeful Futures’ dedicated to <a href="https://nepalitimes.com/opinion/comment/saving-more-mothers-and-babies">preventing maternal and newborn deaths</a>. It is estimated that in Nepal, 30% of neonatal mortality can be blamed on air pollution. But that is only part of the story. Harmful as fine particulate matter is to human health, carbon monoxide, nitrogen dioxide, ground-level ozone and other gases in vehicular emissions are more hazardous to health. While the concentration of suspended particulate matter tinier than 1.5 microns (PM2.5) is closely monitored, these toxic gases are invisible, not measured much, and the public is not aware about the dangers they pose. Surface ozone is produced by the interaction of various gases found when <a href="https://nepalitimes.com/news/fossil-fuels-poison-air">burning fossil fuels</a>. Besides being poisonous, ground level ozone contributes up to 0.23°C to <a href="https://nepalitimes.com/here-now/nepal-s-mountains-are-melting">global warming</a> because it is also a greenhouse gas. A new policy brief by the Clean Air Fund titled The Case for Action on Tropospheric Ozone blames surface ozone for a half a million premature deaths every year, 54.8% of which are in South Asia. Ozone also stunts plant growth and reduces crop yields by 26% globally, and 11% loss in <a href="https://nepalitimes.com/news/economic-benefits-of-saving-the-ecology">forest productivity</a>, the report adds.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250411060456_aa02a923f8b27544ae54d0220162678f5bbb5eeb8fc3c466173c22c49b3e9a85.jpg" data-media-id="editor_11" data-image-id="20250411060456_aa02a923f8b27544ae54d0220162678f5bbb5eeb8fc3c466173c22c49b3e9a85" data-rendition-name="original" width="998" height="724" loading="lazy" alt="Gas Chambers"> </figure>  Read also: <a href="https://nepalitimes.com/here-now/bad-air-and-polluted-politics">Bad air and polluted politics</a>, Sonia Awale Ground-level ozone is not emitted directly into the air like other gases, but is formed when oxides of nitrogen (NOx), carbon monoxide (CO) and volatile organic compounds (VOCs) released from automobile tailpipes or industry smokestacks react chemically with each other in the presence of sunlight. The main source of carbon monoxide in Kathmandu Valley are its 1.2 million two-wheelers. “Usually the concentration of carbon monoxide is 200-500 parts per billion (ppb), this has increased up to 3,000 in Kathmandu. Meanwhile, ground-level ozone has gone from 70-80 ppb to 150 ppb,” says Ravi Sahu, regional air quality specialist with the Kathmandu-based International Centre for Integrated Mountain Development (ICIMOD).&nbsp; Sahu says <a href="https://nepalitimes.com/news/no-smoke-without-fire-p7vb9dcj">rampant forest fires of the past weeks</a> have also added to carbon monoxide and ozone in the air, not just the fine particles that make up the visible smoke. He adds, “There isn’t much awareness about <a href="https://nepalitimes.com/banner/poisoning-the-air-we-breathe">ground-level ozone and carbon monoxide</a>, we need to urgently look into it.” A distinction must be made between good and bad ozone. Stratospheric ozone protects living beings from harmful ultraviolet (UV) radiation from the sun.&nbsp; Tropospheric ozone can again be separated into two types: ozone in the free atmosphere which is a greenhouse gas much more potent than carbon dioxide, and ground-level ozone which has adverse impacts on health and agriculture. ‘Cutting tropospheric ozone presents a unique challenge as it requires smart and fast action across multiple greenhouse gases and air pollutants, as well as multiple economic sectors,’ notes the Clean Air Fund's policy briefing. ‘It is a growing and neglected problem that needs an integrated approach on both a local and global level to tackle climate change and air pollution together.’ Dying young There was a time when Nepal made it to international news bulletins only if there were fatalities on Mt Everest. Now, Kathmandu’s bad air frequently makes headlines all over the world. This past week, the concentration of PM2.5 that harms human health was up to 40 times the WHO recommended guideline — adding to the poisonous gases already present from vehicle emissions. The Department of Environment says 40% of the pollution in the past weeks was from wildfires sparked by nearly 6 months without substantial rain over central Nepal. Most of the rest is from vehicular and industrial emissions from Kathmandu itself and across the southern border. NASA’s Fire Information and Resource Management System (FIRMS) which issues daily maps of fires, showed hundreds of blazes raging across Nepal on Wednesday, mainly in Chitwan, Parsa and along the East-West Highway.&nbsp; “If we look at the figures for the last few years, it is clear that wildfires have become the biggest source of air pollution, they are seasonal but have overtaken vehicular emissions,” says urban planner and environmentalist Bhushan Tuladhar. “Forest fires, stubble burning, and open burning of garbage are the bigger problems now. Nepal, India, Bangladesh, and Pakistan are at risk every year, we shouldn’t further delay in finding solutions,” warned air quality expert Bhupendra Das during an event on air pollution organised on 7 March by the Nepal Forum of Environmental Journalists (NEFEJ).&nbsp; Indeed, studies have shown that in winter 60% of the air pollution over Kathmandu is transboundary from the south, and in November it is compounded by smoke from crop residue burning by farmers in India and Pakistan blown in by prevailing winds. Forest fires are a regular pre-monsoon occurrence in Nepal, often intentionally set by farmers and herders to stimulate new grass growth for livestock. Winter rains have failed for eight of the past ten years, and this means the fires often spread out of control. The other reason for the increase in wildfires is the doubling of forest fires to 46% of the country’s area in the past 25 years. But this has happened simultaneously with outmigration, with some mountain districts losing 30% of their population between 2011-2021. With less pressure on forests for fodder and firewood, the undergrowth of community forests is loaded with dry fuel just waiting for a spark. The bowl-shaped topography of Kathmandu, Pokhara and other valleys further concentrates pollutants as they are trapped by surrounding mountains. But a year with a high number of wildfires is usually followed by a year or two with fewer incidents. For example: there were 6,537 fires in 2021 but the following year the number was down to 1,528. There were 5,216 fires last year, this year the number has already reached 1,800, and the trend is likely to be broken. Heavy rains forecast for the coming days are expected to douse some of the fires and clean up the air. But the damage has been done: Kathmandu residents of all age groups this week crowded clinics and hospitals with burning eyes, itchy throats, difficulty breathing, headaches, and dizziness. But in the longer term, soot particles that are tiny enough to jump the blood-air divide in lung capillaries do not just cause Chronic Obstructive Pulmonary Disease (COPD), asthma, but also cancers, heart attacks, strokes, birth defects and other chronic diseases. The latest Air Quality Life Index (AQLI) report by the University of Chicago shows that the annual concentration of PM2.5 in Kathmandu’s air rose from 17.87µg/m3 in 1998 to 31.33µg/m3 in 2022. Air pollution has got worse by 75% in Kathmandu in 25 years. During this time, air pollution has reduced the average life expectancy of Kathmandu’s residents by 3.5 years. According to the Health Effects Institute in Boston, dirty air is among the biggest public health concerns in Nepal killing over 42,100 a year. The adverse impact of high levels of air pollution is not limited to public health, it is seriously affecting tourism. Operators in Pokhara this week said that there were many negative online posts by visitors unable to see the famous panorama of Machapuchre and the Annapurnas even from Sarangkot. Aviation is also affected, as planes have to circle sometimes for hours burning a lot of fuel because of runway visibility being below minima at Kathmandu airport. The higher fuel cost is just passed down to customers, making air tickets in and out of Kathmandu some of the highest in the world. Kathmandu, with a population of four million, has not implemented a concrete policy to curb toxic air despite having formulated various action plans and repeated commitments by the government to protect the environment and control air pollution. The Department of Environment’s 2017 Air Quality Management Action Plan for Kathmandu put forward a policy to reduce air pollution caused by vehicles which was approved by the Cabinet, but has yet to be put to practice. The action included the immediate implementation of the Euro 5 emission standard to reduce pollution emitted by vehicles. However, Nepal has not even been able to implement Euro 4 standards so far. India, meanwhile, has already moved forward with the implementation of the Euro 6 standards. Says Ravi Sahu: “Air pollution in Nepal is not just about air pollution, it has ties to tourism, aviation, the economy so we must be prepared for annual conditions like forest fires, and this requires urgent interdisciplinary collaboration.” &nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250411050452_821d09e283d8a590f1369bfb71b9b7fc6d950726e0651ea86c6488d04deb1742.jpg" data-media-id="editor_15" data-image-id="20250411050452_821d09e283d8a590f1369bfb71b9b7fc6d950726e0651ea86c6488d04deb1742" data-rendition-name="original" width="839" height="784" loading="lazy" alt="Silent Killers"> </figure>  &nbsp;

What is invisible is more dangerous

82 in २०८२

Here in the mountains of far-western Nepal, the biggest threat to life and limb is gravity. Women collecting fodder fall from trees, boys grazing goats fall off cliffs, heavily loaded tractors plunge from dirt roads carved out of steep slopes. There is nothing to be done about those who die on the spot. But for the severely wounded there is only one hospital: Bayalpata. And it is there that <a href="https://www.youtube.com/watch?v=CJzWlnYd0ZM&amp;t=8s" target="_blank">orthopaedic surgeon Mandeep Pathak</a> is the last hope for many wounded people. Pathak, 42, is too modest to tell us how many lives he has saved over the past 10 years he has worked at Bayalpata. But hospital records show he has performed more than 4,000 operations in the past decade, many of them so patients did not suffer permanent physical disabilities. Pathak also did 800 major life-saving surgeries in that time. “I treat patients with injuries, but I wish I could also treat poverty,” Pathak says, emerging from Bayalpata’s surgical theatre one recent afternoon. <div class="embed-block"><iframe width="700" height="415" src="https://www.youtube.com/embed/CJzWlnYd0ZM?si=s_rkbU4YDaw87gqH" title="YouTube video player" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share" referrerpolicy="strict-origin-when-cross-origin" allowfullscreen></iframe></div> Sudurpaschim Province in Nepal’s far-west is far away from everything: from Kathmandu, from adequate medical care, from food security, and far from the reach of government services. It has suffered state neglect for centuries, its men mainly migrating to India for seasonal work to families who depend on subsistence agriculture. Pathak remembers the searing sadness he felt when a patient once told him, “Doctor, I sold the last of my rice to pay to come here, please give me a medicine that I can take on an empty stomach.” Pathak was born in Kathmandu, and after getting his MBBS from Kathmandu University, he got an MD from The Philippines. At a time when many Nepali doctors and staff nurses were emigrating, Pathak did not just return to Kathmandu but decided to go to one of the remotest districts in Nepal to serve those most in need. The hospital was established in 2009 in the village of Bayalpata, and has been managed by the non-profit <a href="https://www.nyayahealthnepal.org/" target="_blank">Nyaya Health Nepal (NHN)</a> as a public-private partnership treating 100,000 patients a year for no fees at all. NHN is now preparing to hand over the running of the hospital to the Sudurpaschim provincial government so its <a href="https://nepalitimes.com/banner/this-is-how-to-upgrade-nepals-rural-health" target="_blank">model of hospital management</a> can be replicated.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250414130456_b59dabd4604a24426a55fe91c0e5866b5029858bdb4c4028c331557aeb5408ae.jpg" data-media-id="editor_4" data-image-id="20250414130456_b59dabd4604a24426a55fe91c0e5866b5029858bdb4c4028c331557aeb5408ae" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="Bayalpata hospital"> <figcaption>Bayalpata hospital in Achham.</figcaption> </figure>  People from not just Achham but surrounding districts, and from as far away as Humla, bring patients to Bayalpata, sometimes walking for days. Some with complicated pregnancies are brought in stretchers, young children with broken arms walk into the emergency, and sometimes there are mass casualties when a tractor or bus falls off a road. And Pathak is always there with his team performing triage, and doing orthopaedic surgeries that would be difficult even in Kathmandu. Recently, his team did a hip replacement at <a href="https://nepalitimes.com/banner/state-of-the-art-rural-hospital" target="_blank">Bayalpata Hospital</a>. Mild mannered, modest, soft-spoken, hard-working, professional are the words families of patients who have been treated at <a href="https://nepalitimes.com/here-now/nepal-s-rural-lifeline" target="_blank">Bayalpata Hospital </a>use to describe Mandeep Pathak. But the surgeon is too busy to let all this get to this head.&nbsp; Asked why he does not emigrate like his peers or get a lucrative position at a private hospital in Kathmandu, Pathak answers simply, without a trace of self-importance, “I do not think I could get the satisfaction or sense of fulfilment anywhere else.” When travelling to attend medical congresses overseas or visit family in Kathmandu, Bayalpata has other doctors to take care of patients, but many wait patiently till Pathak returns for their consultation or surgery.&nbsp; When he returns from seminars abroad after learning the latest skills, Pathak’s suitcases are not full of clothes or presents, but titanium bone implants, external fixation rods, or intramedullary nails to be used in <a href="https://nepalitimes.com/news/altruistic-healthcare-models-in-nepal" target="_blank">surgeries at Bayalpata</a>.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025041414040_5356278472c1eb2b9e4af1d593d6234cc8dc5e5161a8c614197c01abefadbd80.jpg" data-media-id="editor_8" data-image-id="2025041414040_5356278472c1eb2b9e4af1d593d6234cc8dc5e5161a8c614197c01abefadbd80" data-rendition-name="original" width="2048" height="1368" loading="lazy" alt="surgery"> </figure>  Before Bayalpata Hospital was established, most people suffering broken bones had to travel down to Dhangadi or Nepalganj for treatment. No more. Although Pathak’s specialisation is orthopaedic oncology, he is mostly treating fractures and rejoining broken bones.&nbsp; Now as Bayalpata’s Hospital Director, Pathak also has administrative and fundraising duties. He has to take the 10-hour ride down to Dhangadi often to meet various Sudurpaschim ministries to release the hospital’s budget — that is sometimes more difficult than the most complicated surgery. Recently, he had to cancel an appointment with the Chief Minister to rush back to Bayalpata because there was a patient who needed emergency surgery. “I told myself, let me save this patient first, then I will try to save the hospital,” he recalls.&nbsp; Once, when he had to be away for a month on emergency surgery training in the US, the family of a 90-year-old woman who had dislocated her hip after falling from a staircase was waiting for him to return. Her son told Pathak: “Doctor, either put her out of her suffering, or cure her.” Pathak told him it was too dangerous to operate at her age, but the son said his mother was in so much pain it was worth the risk. The operation was touch-and-go, but it was successful. The woman who had been brought in on a stretcher, walked out of the hospital three days after the operation.&nbsp; A few months later, a 27-year-old woman was brought into the ER bleeding profusely from an arm mangled by a thresher machine. Even in that state, she was breastfeeding her baby. Pathak welled up seeing this display of selfless motherhood, as he wheeled her into surgery. She needed three operations, but now has full use of her hand. <div class="embed-block"><iframe width="700" height="415" src="https://www.youtube.com/embed/xJdxLD0hBqo?si=mOpM2R_DsYL88Lfg" title="YouTube video player" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share" referrerpolicy="strict-origin-when-cross-origin" allowfullscreen></iframe></div> It is the sense of achievement from such recovery that keeps Mandeep Pathak here in this isolated village in the middle of nowhere. Bayalpata Hospital has not just saved lives, it also saves families from poverty because they do not have to take sick relatives to expensive city hospitals.&nbsp; In January, a woman was brought to Bayalpata with both hands broken. She said she had taken a fall, but Pathak did not believe her. When alone in the surgery, she finally admitted that her husband had beaten her.&nbsp; It was her husband who had brought her to hospital for treatment, but she refused to file a police report. Pathak quietly put both her arms in casts, thinking about the poverty, patriarchy and injustice in society that he is unable to treat.