<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022111410118/637205c69c7e80680e0b28d5jpeg.jpg" alt="" width="1400" height="933"/><figcaption>Photo: SONIA AWALE</figcaption></figure>The last Sunday in January is World Leprosy Day. Since 2006, I have issued an annual Global Appeal to End Stigma and Discrimination against Persons Affected by Leprosy, supported by influential individuals and organisations around the world.Amid the coronavirus pandemic, which has shown how easily fear and anxiety about a disease can fuel prejudice, I believe this call to eliminate <a href="http://archive.nepalitimes.com/news.php?id=711#.YfYlNi2B3ow" target="_blank" rel="noopener noreferrer">stigma and discrimination</a> is more important than ever.Leprosy, also known as Hansen’s Disease, is a chronic infectious disease caused by the bacillus Mycobacterium leprae. It mainly affects the skin and peripheral nerves and is one of the oldest diseases in human history. Yet each year, around 200,000 new cases are reported globally.In Nepal, 2,304 new cases were reported in 2020 and it is one of 23 countries on the WHO’s priority list for leprosy. Most cases are found in Madhes Province bordering India.Today an effective treatment exists in the form of multidrug therapy (MDT) and with early detection and treatment, the disease can be cured without complications. But if treatment is delayed, <a href="http://archive.nepalitimes.com/news.php?id=39#.YfYl-S2B2b8" target="_blank" rel="noopener noreferrer">leprosy can cause progressive impairment</a> and lead to permanent disability.There are an estimated 3-4 million people living with some form of disability due to leprosy. This fact, together with deep-seated fears and misperceptions about this age-old disease, has subjected persons affected by leprosy and even their family members to severe discrimination, which continues to this day.Since becoming WHO Goodwill Ambassador for Leprosy Elimination in 2001, I have visited some 120 countries to see the situation for myself. This has led me to think of leprosy in terms of a motorcycle: the front wheel symbolises curing the disease, and the back wheel represents eliminating discrimination. Unless both wheels are turning together, we will not reach our ultimate goal of zero leprosy.As regards to the front wheel, efforts against the disease, including new case detection, have been badly disrupted by the spread of the novel coronavirus and efforts to prevent transmission. In 2020, the number of new cases reported was down to 37% year on year, according to the WHO, largely due to the impact of Covid-19.Concerning the rear wheel, I have worked hard to have leprosy recognised internationally as a human rights issue since the early 2000s, when I first approached the Office of the UN High Commissioner for Human Rights. One result has been the adoption in 2010 of a UN General Assembly on elimination of discrimination against <a href="http://archive.nepalitimes.com/news.php?id=15213#.YfYl_y2B2b8" target="_blank" rel="noopener noreferrer">persons affected by leprosy</a> and their family members.But the real measure of success will be when principles and guidelines accompanying the resolution are fully implemented. Because of the pandemic, however, awareness-raising efforts in many areas have stalled, and some people have found that Covid-19 is exacerbating the discrimination they already experience as persons affected by leprosy.This is why last August I launched a <a href="https://www.shf.or.jp/en/dont-forget-leprosy-campaign/" target="_blank" rel="noopener noreferrer">campaign called ‘Don't Forget Leprosy’</a> to ensure that leprosy and the needs of those affected by the disease are not overlooked, even amid the pandemic. The campaign stresses the importance of early detection and treatment, as well as the need to eliminate stigma and discrimination.The term 'don't forget' covers many things: that leprosy still exists, that people affected by leprosy and their families still face social prejudice, and that there are healthcare professionals doing their best in difficult circumstances to provide needed services.In Nepal, a country I have visited many times over the years, what has impressed me has been the strong cooperation I have found between the <a href="http://mohp.gov.np/eng/program/communicable-disease/leprosy-control-program" target="_blank" rel="noopener noreferrer">Ministry of Health and Population</a> and leprosy NGOs. They make the most of their respective strengths and complement each other’s efforts, and in this way have helped to advance measures against leprosy throughout the country.Working in partnership with the ministry’s leprosy control program, <a href="https://tlmnepal.org/blog/anandaban-hospital/" target="_blank" rel="noopener noreferrer">Anandaban Hospital</a> near Kathmandu, Lalgadh Leprosy Hospital &amp; Services Center in Janakpur and the Green Pastures Hospital in Pohkara provide both medical and social support. They provide treatment and rehabilitation, and assist with reintegration into the community.I would also like to give a mention to the leprosy center established in Surkhet with the support of the Sasakawa Health Foundation, operated with the dedicated effort of local people and contributing to community medical care.Nepal has also pioneered a <a href="https://www.nepalitimes.com/banner/new-treatment-offers-hope-for-nepals-leprosy-patients/" target="_blank" rel="noopener noreferrer">revolutionary treatment for leprosy wounds</a> saving money and prolonged pain for the patients. The technique called Leukocyte Platelet Rich Fibrin (LPRF) originally devised for dental surgery accelerates the healing of tissue and is now being used widely in the country to treat hard-to-heal skin lesions of diabetes and leprosy patients.Over the past 50 years we have come a long way toward our goal of a world free from leprosy and the discrimination it causes. We must not allow the progress we have made to be undone by the impact of <a href="https://www.nepalitimes.com/here-now/omnipresent-omicron-starts-to-lose-its-edge/" target="_blank" rel="noopener noreferrer">the Covid-19 pandemic</a>.Together with my annual Global Appeal and the activities that partner organisations will be carrying out for World Leprosy Day this year, I hope it will put the disease back in the spotlight and show that our work to end the medical and social problems related to leprosy is not yet done.Please add your voice to the campaign and make this a collective effort. Together we can be heard loud and clear: “Don’t Forget Leprosy.”Yohei Sasakawa is WHO Goodwill Ambassador for Leprosy Elimination as well as the Japanese Government Goodwill Ambassador for the Human Rights of Persons Affected by Leprosy. He is the chair of The Nippon Foundation.

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During the pandemic, don’t forget leprosy

https://www.youtube.com/watch?v=kJLBI7sim0M&amp;feature=youtu.beA revolutionary treatment for open wounds has dramatically reduced the healing period of <a href="http://archive.nepalitimes.com/news.php?id=711#.XSckw-szaUk" target="_blank" rel="noopener">leprosy patients in Nepal</a>, saving them money and prolonged pain. The new procedure has huge implications internationally, as it reduces the medical cost for treating patients with chronic open wounds.The technique, called Leukocyte Platelet Rich Fibrin (LPRF), was <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6089057/" target="_blank" rel="noopener">devised for dental surgery</a> by Nelson Pinto of Chile and has proven to accelerate the healing of tissue. Now, it is also being used to treat hard-to-heal skin lesions of <a href="https://archive.nepalitimes.com/article/nation/diabetes-in-south-asia,3018" target="_blank" rel="noopener">diabetes</a> and leprosy patients.“LPRF has shown miraculous results in the treatment of chronic wounds in Nepal,” says dental surgeon Sushil Koirala who is pushing the new treatment in government hospitals. “It does not need special equipment, is cheap and, so simple even paramedics and nurses can perform it.”<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108131140/636a4f009c7e80680e04fce5jpeg.jpg" alt="" width="1400" height="1050"/><figcaption>SECOND CHANCE: Surgeon Indra Bahadur Napit guides a paramedic during a session of LPRF on a patient with leprosy at Anandaban Hospital. Pic: KUNDA DIXIT</figcaption></figure>There are three specialised leprosy hospitals in Nepal: Ananadaban in Lele, Green Pastures in Pokhara, and Lalgadh in Dhanusa. Anandaban Leprosy Hospital 16 km south of Kathmandu has been trying out LPRF on patients with excellent results.Leprosy is a biblical disease in which bacteria called Mycobacterium leprae damages the patient’s nerves and causes the fingers, toes and limbs to go numb, leading to further injuries. Leprosy is treated with antibiotics, but some patients suffer antigen reaction and need long-term rehabilitation.One of the patients at Anandaban is Phelit Sahi, who was ostracised by her community in Jumla because she had leprosy and had been living in a cave for 25 years. Reporters who had gone to cover a local event in a helicopter found out about her, and flew her to Kathmandu for treatment.Every week, doctors draw 80cc of blood from her and place it in a special centrifuge for 12 minutes. The clear plasma separates from the red corpuscles and is compressed to form a high-density fibrin clot which is applied to her wound.“She is among more than 100 patients that we have treated with LPRF, and we have gained enough experience in this technique to lead the way for the world,” says surgeon Indra Bahadur Napit at Anandaban, who presented his results at WHO in Geneva.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108131140/636a4f039c7e80680e04fce6jpeg.jpg" alt="" width="1400" height="933"><figcaption> </figcaption></figure>Raju Lama was 27 when he was diagnosed with leprosy, but because of late diagnosis, his fingers and toes were deformed, and he had to abandon his job. Doctors recommended amputating his right leg, but became the first patient to get LPRF treatment. He is happy with his “ragat upachar” (blood treatment) and says after several LPRF procedures his wounds are healing much faster.Ram Kumari Sah and her husband from Janakpur have been living with leprosy for decades. She does not feel pain in her hands and legs and often hurts herself. Her lesions become infected and never healed. This week, she was waiting for her turn at the LPRF ward in Anandaban.The hospital’s LPRF pilot study has shown that 97% of the cases healed completely within seven weeks. The results are so encouraging that news of this revolutionary treatment has spread through word of mouth. A dozen patients, currently at Anandaban were referred by hospitals in India. A team of Nepali doctors is also training doctors in Burma, Bangladesh and Nigeria.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108131140/636a4f069c7e80680e04fce7jpeg.jpg" alt="" width="1400" height="1003"><figcaption> </figcaption></figure>The new treatment is expected to add to Nepal’s success in reducing the prevalence of leprosy from 21 cases per 10,000 in the 1980s to less than 1 today. Nepal was officially declared leprosy-free in 2010 when the prevalence rate came down to 0.79%.However, in recent years, the prevalence rate is creeping up again, and was 0.94% in 2018. More than 3,000 new patients are diagnosed with leprosy every year, with most of the cases found in Province 2. Experts say this could be a result of active case finding and may not mean that the prevalence is increasing.Leprosy is curable with multidrug therapy but many do not get treatment on time. The incubation period is five years on average and symptoms may occur within a year, but can also take as long as 30 years to become visible, making the disease difficult to diagnose, and the delay leads to nerve damage and deformities. Leprosy is transmitted through the air during close and frequent contact with untreated cases.“Leprosy can afflict anyone but there is a correlation between the disease and poverty,” explains dermatologist Mahesh Shah. “If one’s immune system is strong, the bugs do not do any damage. But poor hygiene and nutrition increases susceptibiltity. Neglected people from neglected countries suffer from leprosy the most.”<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108131140/636a4f0a9c7e80680e04fce8jpeg.jpg" alt="" width="1400" height="1169"><figcaption> </figcaption></figure>Up to 40% of patients undergoing multidrug treatment develop a reaction, and need long-term hospitalisation. Since the patients are poor, most private hospitals are not interested in treating them. At Anandaban, treatment is free as it is supported by government grants and charities.Since 1% of cases suffer from relapse in Nepal, active door-to-door case finding is important to meet the WHO target of zero leprosy transmission by 2030.Even more daunting is to counter societal stigma and ostracisation of leprosy patients. Family members regard the disease as punishment from the gods, and even some medical interns and nurses refuse to touch patients despite patients being on antibiotics and unable to spread the disease. Nepal’s laws still allow husbands to divorce their wives if they have leprosy.“It is a complicated disease made even more so by stigma and ignorance,” says Napit, “but with LPRF, we now have a powerful weapon in our arsenal. A vaccine would be the final solution, but no one cares about leprosy. All the funding goes for diseases like HIV.”   <h2>Miraculous healing</h2>When Nelson Pinto’s favourite horse broke its leg, he had two options: either put it down or amputate its leg. The Chilean dentist decided on a third option.He drew some blood from the horse, spun it in a centrifuge to separate the autologous fibrin matrix which is rich in platelets, and applied the plasma to the horse’s wound. After a few weeks, the horse was cantering again.Pinto knew about the technique because Leukocyte Platelet Rich Fibrin (LPRF) was developed for dental implant treatment. The surgeon was so convinced that the new process would be useful in treating chronic open wounds that he embarked on a global crusade to spread its use.Pinto convinced fellow-dentist from Nepal, Sushil Koirala, whom he met at an international conference, to adopt the technique. Since then, Koirala has been trying to convince the government and private hospitals to adopt the procedure, but without much success. However, Anandaban Leprosy Hospital in Lalitpur has seen phenomenal improvements in the healing time of lesions among its patients. (See adjoining report above)LPRF is now used to treat diabetic wounds, lesions caused by leprosy, localised <a href="http://archive.nepalitimes.com/article/nation/burning-in-the-aftermath,3757" target="_blank" rel="noopener">burns</a> and surgical wounds, and with this, healing time is often cut in half. It is also being used in cosmetic surgery to remove wrinkles and rejuvenate the skin. The reason why it is so effective, Pinto explained during a trip to Nepal last month, is because it is completely natural and autologous, which means a patient is not receiving any foreign tissues or chemicals.And the treatment is cheap. A similar treatment used in Europe, which involves a kit manufactured by a multinational pharmaceutical company, costs $3,000 per patient. LPRF costs only $30. But it seems as though private hospitals are not interested in this treatment as patients heal so quickly. Many doctors are also not enthusiastic because LPRF can be administered by a paramedic or a nurse.Says Sushil Koirala: “The reason they don’t like it is because there is no money in it. LPRF only uses the patient’s blood and there are no chemicals or equipment involved for multinational companies to make money out of.”Koirala’s Punyaarjan Foundation has donated centrifuge machines to a few hospitals in Nepal including the Sushma Koirala Memorial in Sankhu, Anandaban Leprosy Hospital, Bir Hospital in Kathmandu and to three hospitals in Burma with varying degrees of acceptance.The Bible relates how Jesus Christ miraculously and instantaneously cured ten lepers at the gates of Jerusalem. LPRF may not cure leprosy lesions as quickly, but the procedure is nearly as miraculous.<h2>Life after leprosy</h2><figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108131140/636a4f0d9c7e80680e04fce9jpeg.jpg" alt="" width="1400" height="1050"><figcaption> </figcaption></figure>Kumar Tamang, 47, is putting the final touches on his painting of an elephant with a bejewelled crown and a howdah. He dips his paintbrush on a palate and paints the border bright red. His fingers are numb and deformed by leprosy, yet he has been painting for 25 years. His love for Mithila art is on full display on the walls, pillars and ceiling of Shanti Sewa Griha, a leprosy clinic set up by the German charity, Leprahilfe, in 1992.Nearby, in a dark corner, is 50-year-old Nathuni Barai from Nawalparasi, who also has deformed fingers which he uses deftly to draw intricate patterns on a letter pad. Both Tamang and Barai are former patients at <a href="http://archive.nepalitimes.com/news.php?id=15213#.XSckyeszaUk" target="_blank" rel="noopener">Shanti Sewa Griha,</a> making a livelihood from products that Leprahilfe buys from fundraising. Their families live nearby, and their children attend a school set up by the charity.Now, nearly three decades after the clinic was set up, Shanti Sewa Griha runs a school and orphanage in Budhanilkantha, an organic farm in Sundarijal and a rehabilitation centre near Pashupati.As the number of patients grew, they were trained in painting, tailoring, quilt making, carpentry and jewellery making as a form of livelihood. Bags, uniforms, paintings, stationery and decorative items are sold as souvenirs to raise money for the upkeep of the shelters and to pay former patients.“This is a form of operational therapy which tries to break the vicious circle this disease has formed,” said Marianne Grosspietsch, one of the founders of Leprahilfe. “Our goal is to create hope in Nepal.”In 1974, Grosspietsch adopted a young boy named Puskar Limbu who had leprosy like the rest of his family. She took the boy to her home in Germany, treated his leprosy and sent him to school. Limbu went on to pursue a successful career in graphic design in Germany and is a grandfather himself today.Children of former leprosy patients have also gone on to become nurses and doctors.Kalpana Pariyar (pictured above) was 14 when she was diagnosed with leprosy before there was serious nerve damage to her fingers. She grew up in the shelter and married fellow-patient Krishna Majhi, whom she took care of until he died eight years ago. She now has a college going daughter and an eight-year-old son.“I have spent my entire life here. This is my home, this is where I made my life and found peace,” says Pariyar, looking up from her sewing machine on which she was weaving dhaka fabric.Sonia Awale

Sonia Awale

New treatment offers hope for Nepal’s leprosy patients

Nepal’s Gurkha soldiers have a well-deserved reputation worldwide for uncommon valour and loyalty. However, what happened in Hawaii in 1986 and the long struggle for fair pay and pension shows that the formidable fighters from Nepal also do not tolerate injustice. The Hong Kong-based 1st Battalion of the 7th Duke of Edinburgh’s Own Gurkha Rifles was in Hawaii for jungle warfare training exercises at the Joint Pacific Multinational Readiness Center when they beat up their commanding officer, Major Corin Pearce. &nbsp;&nbsp; The Gurkhas said Pearce had insulted them, and 111 soldiers were dismissed. Pearce suffered broken ribs and a head injury, and was himself also discharged. The incident got worldwide publicity and enforced the belief that the Nepalis were not treated fairly in the British Army. It also led some retired soldiers to begin a decades-long struggle for compensation at par with their British peers.&nbsp; Retired British Gurkha soldier Shankar Rai in his book Triumph and Tears revisits the Hawaii incident which he witnessed, and also his experience in the Falkland Islands/Malvinas war in 1982.&nbsp; He has lots of grievances: unequal treatment and injustice from the British Army towards himself and his comrades. This is an indignant and disillusioned account of the good, the bad and the ugly of being a British Gurkha, which he says let him down despite his service and belief in it.&nbsp; The book could also be a cautionary tale of how one person on a power-trip can tarnish two centuries of the shared history of Nepal and the UK, as well as ruin the lives of those involved. It also is proof that loyalty should never be taken for granted. Four years after defeating the Argentinians in the Falklands, several companies and platoons of Gurkha rifles were stationed in Hawaii in 1986 for joint US-UK ‘Exercise Union Pacific’ military exercises. The goal was to ‘perfect the art of marine warfare in collaboration with the US Marine Force’. The rules were that a British Gurkha company commander needed to have the rank of major and pass a Nepali language test. Captain Pearce was the son-in-law of a British Brigadier on extra-regiment employment, and this rule was waived. He was appointed Acting Major. Pearce didn’t bother to learn Nepali language or culture, and from Rai’s account took every chance to belittle and embarrass the Gurkhas as poor, stupid, rude, backward, and lucky to be there. He writes: ‘After Captain Pearce reached Hawaii, he began to project himself as a master and the Gurkhas as servants, to show off to the Americans.’ The author also recounts other slights, such as only receiving a fourth of the rations they were due during hard training, being forced to train even when some of the soldiers had high fever, and claims to have ‘civilised’ the Nepalis.&nbsp; Pearce had been to eastern Nepal before the training and seen the grinding poverty. He kept telling the Gurkhas how lucky they were to be in the job, and that they were making ‘more money than Nepal’s prime minister’. During the final farewell party in Hawaii, Pearce set up tables to form a saluting platform, and asked the Gurkha pipe and drum band to march around him while playing. The enraged soldiers could not take it anymore, and after the party an inebriated group ran Captains Pearce and Chandra Kumar Pradhan out of their tents and beat them up. Both officers broke ribs, and the major needed 15 stitches on his head. ‘This sorry and unseemly episode is considered to have been entirely at odds with the Brigade of Gurkhas’ tradition of loyalty and gallant service in the British Army. It is regarded as an isolated and untypical event, which will not be permitted to detract from the high esteem in which the Brigade is held,’ reads the report of an investigation. Most of the 1/7 company soldiers were dismissed whether they had been involved in the assault or not. The author describes the shame that followed, with dismissed soldiers returning to Nepal with lost face.&nbsp; ‘I burned with humiliation, and life scared me,’ writes the author, whose father told him that he was ashamed to call him his son. ‘Many of my friends’ girlfriends left them and married other people. Rifleman Khem Gurung (21162015) of Itahari committed suicide,’ writes Rai, adding that those dismissed were blacklisted, and could not get other jobs.&nbsp; They tried to pursue legal action against the British Government, but backed down when they could not afford expensive hotshot lawyers, and would not have the money to cover the British government’s legal fees in the likely case of a loss in court. Gurkhas who had served for four years in the UK were allowed to move there, an option that many of those dismissed in the Hawaii incident took, including the author, who now lives in Oxford. Rai pours out his hurt and emotion in the book. Towards the end, he writes: ‘I depend on small jobs for livelihood. In the remaining time, I actively raise the issue of the victims of the Hawaii incident. We are burdened with insults, hatred, and contempt for a lifetime. It was harsher than a court martial, too heavy to bear.’ The is a slim book, and is a quick, engaging read of an incident 30 years ago, and Rai writes with a soldier’s precision. Even though the anger shows even after all these years, there is no over-dramatisation in the narrative.&nbsp; The first part of the book is about sailing across the South Atlantic in the QEII, which had been converted into a troop ship to take the Gurkhas to war. The soldiers from landlocked Nepal were mostly sea-sick, but were happy to get two cans of beer a day. Barclays Bank even had a branch on board. Rai’s descriptions of the friendships he developed in the Company and on the battlefield are poignant. They braved Argentinian bombs, dug trenches and fought through the rain in the Southern Hemisphere winter. There are vignettes of sharing tea with fellow Nepalis, seeing comrades fall, and finding pictures of wives and children in the pockets of dead young Argentine soldiers. Behind the prestige, honour and myths of being a Gurkha soldier, it seems this is just another job with nepotism, horrible bosses and bad pay. But such is the desperation that up to 20,000 young Nepalis still apply for 300 openings in the British Army every year. &nbsp;&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251227041256_694a253e782c83b0bf89fc1b9840b0ade3f7beca2d0b01dbc4fcd3e63c207f50.jpg" data-media-id="editor_0" data-image-id="20251227041256_694a253e782c83b0bf89fc1b9840b0ade3f7beca2d0b01dbc4fcd3e63c207f50" data-rendition-name="original" width="1136" height="702" loading="lazy" alt="Triumph and tears book details NT"> </figure>

Not taking loyalty for granted

After a week of to-and-fro that culminated in all-night bargaining, two populist young figures in Nepali politics agreed at 4AM on Sunday to join forces ahead of elections in March. Rabi Lamichhane of the RSP, who came out of jail a week ago, has forged an alliance with Kathmandu mayor Balen Shah. Both are keen to ride on the GenZ wave that radically changed the direction of Nepal’s politics that has been dominated by three mainstream parties for the past three decades. Under the 7-point deal, Lamichhane will still head the RSP, while Shah has been promised prime ministership if the party wins a majority in the federal elections. Shah will also be the parliamentary party leader. The RSP will keep its name and election symbol. “Agreements must be made not on the basis of what leaders want, but on what the country needs,” Lamichhane wrote on social media announcing the alliance. The RSP chair is said to have put his own prime ministerial aspirations on hold to ensure the Kathmandu Mayor's support for the March polls. This is an alliance of convenience. Lamichhane requires the backing from Shah’s youth voters to face the legacy parties, while the mayor needs a political platform. Ultimately the prospect of leading not just Kathmandu but Nepal itself appears to have been the deciding factor for Balen Shah. The Kathmandu mayor is reportedly keen to contest the election from Jhapa against former prime minister K P Oli in his constituency.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251228041212_1b26fd7f14e418a9bdb827a7b733914c08183c36b4a93694fc1aefda9f45d85a.jpg" data-media-id="editor_0" data-image-id="20251228041212_1b26fd7f14e418a9bdb827a7b733914c08183c36b4a93694fc1aefda9f45d85a" data-rendition-name="original" width="900" height="900" loading="lazy" alt="Balen-Rabi alliance"> <figcaption>Photo: BALEN SHAH, RABI LAMICHHANE / FACEBOOK</figcaption> </figure>  The two have much in common. Lamichhane, a former tv anchor, returned from the United States and launched the RSP as an alternative party four months before elections in 2022. He served as Home Minister twice in Pushpa Kamal Dahal's coalition government before being jailed for defrauding cooperatives depositers. He made a jail break during the September protests, returned to prison voluntarily, and was released on bail last week. Balen Shah stood as an independent candidate for mayor of Kathmandu in local elections in 2022, and was catapulted to victory because of anti-incumbent protest votes among urban youth.&nbsp; Both campaigned on social media, pushing a populist anti-corruption agenda and against the governance failure of the three establishment parties — the same logic that drove the GenZ protests in September that escalated into violence and brought down the UML-NC coalition. Even as government buildings smouldered on 10 September, GenZ members were strongly urging Balen Shah to be the interim prime minister, but when he declined they voted on Discord for former chief justice Sushila Karki.&nbsp; With just over two months to go for elections on 5 March, Prime Minister Karki has been trying desperately to get the mainstream parties on board. She has met twice with the top leaders of the UML, NC and the NCP. All three parties have been dealing with internal power struggles, and the UML appears to be the most reluctant to face elections.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251228051212_d42944e014b278d6864270b74f924ac842d6f7a68d5bd6817148d120522ba60b.jpg" data-media-id="editor_1" data-image-id="20251228051212_d42944e014b278d6864270b74f924ac842d6f7a68d5bd6817148d120522ba60b" data-rendition-name="original" width="2048" height="1365" loading="lazy" alt="Sushila Karki with political leaders"> <figcaption>Prime Minister Sushila Karki has been meeting with leaders of the mainstream parties to get them on board for the election. Photo: PMO</figcaption> </figure>  The UML’s former prime minister K P Oli has refused summons by the Judicial Inquiry Commission charged with investigating the massacre of protesters on 8 September and the arson and vandalism the next day. Then home minister Ramesh Lekhak is scheduled to give his deposition to the Commission this week. The legacy parties appear to be taking the threat from the Rabi-Balen partnership strongly, and have been trying to forge an electoral alliance so they do not compete against each other.&nbsp; They are relying on traditional vote banks among the rural electorate, and calculate that alternative forces will cancel themselves out. They could also be hoping that Balen Shah’s erratic behaviour and Rabi Lamichhane’s prison conviction will put voters off. A total of 837,094 first-time voters have been registered in Nepal ahead of the elections.&nbsp; The Kathmandu mayor is an engineer and rap artist, and had till now been reclusive, preferring to post on social media rather than face the press. His late-night online posts have been impulsive: like the one urging that Singha Darbar be burnt down, or another one recently in which he used the f-word against the US, China, India and the mainstream parties. He later deleted both posts.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251228041212_a2f87881e36fb40b82bf77e1b07003aaf36b91e2a9eb5da096f1e562654c31e3.jpg" data-media-id="editor_2" data-image-id="20251228041212_a2f87881e36fb40b82bf77e1b07003aaf36b91e2a9eb5da096f1e562654c31e3" data-rendition-name="original" width="1112" height="1440" loading="lazy" alt="Balen Rabi agreement NT"> <figcaption>The seven-point agreement between Shah and Lamichhane. </figcaption> </figure>  Lamichane and Shah had also been negotiating with Energy Minister Kulman Ghising’s newly-forced Ujyalo Nepal Party, but the bargaining did not go well because Ghising refused to fight elections under the RSP banner. If the three had been successful in coming together, it would have been a formidable alliance. There are misgivings about the RSP-Balen Shah deal, even among some GenZ who see the two prominent men dividing up the power structure as just the kind of political culture they wanted to reform. Many are already predicting exactly the kind of clash of egos between the two alpha males that characterised Nepali politics since the restoration of democracy in 1990. In the coming days, as with most political change in Nepal, there will be much speculation about the geopolitics behind the Rabi-Balen deal. Balen Shah’s angry post against India-US-China as well as his past nationalistic pronouncements on Nepal’s territorial dispute with India over Kalapani will be recalled, while Beijing has misgivings about the antecedents of some GenZ figures. Dharan-mayor Harka Sampang, who has also formed his own political party, has already pronounced the Rabi-Balen deal as being “foreign backed”.

Old vs New in Nepal in 2026

Everyone in the world is running some kind of race. Some chase recognition. Some chase money. Others run simply to stay ahead of others. But there are some who run for others. They are not trying to overtake anyone, they do not do it for fame, they are not getting paid to do it. But they run to pay for the upliftment of those less privileged. Bal Joshi, 41, is originally from Surkhet. His father was involved in the democratic movement during the days of absolute monarchy and he remembers frequent police searches of the house. And with his father in hiding, the young Joshi had to take care of the family. When the family’s small shop failed, his mother took the young Bal and his brother back to the village, and that is where he completed his education, walking four hours roundtrip every day between home and school. He ran most of the way, and without realising it he has been running ever since. Life was hard. Rent, food, education. His mother struggled constantly. There were days when there was no money even to buy kerosene for the stove. At one point, he sold his calculator, worth Rs 300, for just Rs 80 to get by.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251229031252_edb16b64a3d362a8dc86870bfa5deaad03a84e67d47f37cfd0bb5a8e584691fe.jpg" data-media-id="editor_0" data-image-id="20251229031252_edb16b64a3d362a8dc86870bfa5deaad03a84e67d47f37cfd0bb5a8e584691fe" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="Running for dear life NT"> </figure>  At 15, Joshi moved to Nepalganj to continue his education. He initially stayed with his uncles, but eventually began living on his own. The transition to city life was difficult, and he experienced significant economic hardship while trying to pursue his studies. There were times when he struggled to meet basic needs, and at one point he sold his calculator just to get by. When he was 17, after hearing that his father was seriously ill, Joshi travelled to Gujarat to bring him back home. His father died soon after, and Joshi took on responsibility for supporting his family. It was his mother who taught him that despite scarcity, life had to be lived with dignity. Joshi started working at a newspaper at the age of 16 as a proofreader, and later became a journalist. During the Maoist war when children were being orphaned as a result of violence by both sides, he became active in the Sahara Group, and at 19, he began managing an orphanage that took in conflict-affected children. In Bajhang, after the army killed a man on suspicion of being a Maoist, his wife jumped into the Seti River and ended her life. Their two children were taken into army custody. During the rescue process, Joshi met Sunaina Adhikari of the ICRC and back in Nepalganj they decided to get married. The conflict was still raging in western Nepal in 2005, when Joshi went to the United States. In Maryland, he initially worked at a Bengali-owned Subway outlet, spending long hours on his feet behind the counter. He changed jobs frequently, financing his education along the way, and ultimately graduated with a degree in finance in 2008. He joined Hancock Whitney Bank in Texas, and has risen up the ranks to be Senior Vice President. A colleague inspired him to run as a way to stay healthy. But it soon turned into something more meaningful — running more than a dozen 50km marathons for charity.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251229031252_165a6d935860cf6707178aa2ac7395733883158f425bbe0ebed125529d601f61.jpg" data-media-id="editor_1" data-image-id="20251229031252_165a6d935860cf6707178aa2ac7395733883158f425bbe0ebed125529d601f61" data-rendition-name="original" width="999" height="1500" loading="lazy" alt="Running for dear life NT"> </figure>  Last year, Joshi returned to Nepal to run the Everest Marathon, and raised $42,000 which he donated to <a href="https://onestepfoundation.org/" target="_blank">One Step Foundation</a> which works on health care, child welfare and cultural preservation in Nepal and around the world. In June this year, Joshi and his family climbed Kilimanjaro, raising $19,000 for 80 HIV-affected orphaned children in Tanzania. During the Diwali festival he ran 220km in Nevada’s Red Canyon and raised $25,000 for cataract surgeries through the the <a href="https://www.theruitfoundation.org/" target="_blank">Ruit Foundation</a> in Nepal for cataract surgeries.&nbsp; Joshi does not run competitions, and is not trying to break any records. His motto is: “My race, my pace.”&nbsp; Turning his childhood scarcity into helping others, he says: “We all share sunlight, rain, air, and soil, nothing is truly just your own. I grew up without shoes, and I am fortunate to be able to distribute shoes to those who walk barefoot.” We ask Bal Joshi what (and where) next? His answer: the <a href="https://www.worldmarathonchallenge.com/" target="_blank">World Marathon Challenge</a> that will go around the world to run seven marathons in seven continents in seven days beginning in Antarctica at end-January.&nbsp; Joshi aims to run wearing the daura suruwal and Nepal’s flag as to show where he comes from, and how far in life he has come.

Running for dear life

A day after Rabi Lamichhane and Balen Shah <a href="https://nepalitimes.com/news/old-vs-new-in-nepal-in-2026-z6l4fgrd">came together to form an electoral alliance</a>, Kulman Ghising has also joined forces with the two leaders, merging his Ujyalo Nepal Party with the RSP.&nbsp; Following last-minute negotiations before Monday’s midnight deadline for parties to file their list of candidates for the Proportional Representation (PR) seats, Lamichhane and Ujyalo Nepal chair Anup Kumar Upadhyay signed a seven-point agreement to unify the two parties, with Balen Shah as witness.&nbsp; Per the deal, Ghising will be the vice-chair of the RSP, joining DP Aryal and Swarnim Wagle as the party’s seconds-in-command. The earlier agreement between Lamichhane and Shah retained Lamichhane as RSP chief, and promised Shah prime ministership if the party wins a majority in Parliament in March.&nbsp; Ghising’s team reportedly has a 17% share on the list of PR candidates filed by the RSP at the Election Commission. Balen has also fielded his own picks, and together the party has the likes of cricketer Gyandenra Malla, actress Reema Biswokarma, rights activist Mohna Ansari, climate activist Tashi Lhazom, and singer Prakash Saput as PR candidates. Ghising had held multiple rounds of talks with the RSP chair and the Kathmandu Mayor to discuss possible collaborations, but had failed to reach a power-sharing agreement. On Monday, Ghising had met with Lamichhane heeding a last-ditch effort from GenZ leaders, in particular Sudan Gurung, as they tried for the final time to get the interim Minister on board with Lamichhane and Shah before the PR list submission deadline.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025123004128_99e23ae7b6a042e71d271e3e74f7527086a7bb55779e6781bc9e7b711c8303e7.jpg" data-media-id="editor_1" data-image-id="2025123004128_99e23ae7b6a042e71d271e3e74f7527086a7bb55779e6781bc9e7b711c8303e7" data-rendition-name="original" width="1595" height="1087" loading="lazy" alt="Sudan Kulman Balen"> <figcaption>Photo: SUDAN GURUNG / FACEBOOK</figcaption> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025123004128_d9f530704ab4c6e27eebf51f8e9fb55fed1d4281c99d089d06455cc7448bfda7.jpg" data-media-id="editor_2" data-image-id="2025123004128_d9f530704ab4c6e27eebf51f8e9fb55fed1d4281c99d089d06455cc7448bfda7" data-rendition-name="original" width="1026" height="1084" loading="lazy" alt="Balen and Sudan NT"> <figcaption>Photo: BALEN SHAH / FACEBOOK</figcaption> </figure>  The three are now set to make a formidable team to challenge mainstream parties at the polls. News of this alliance has been welcome to Nepalis who are looking for any alternatives to break the stronghold of the Oli-Deuba-Dahal trio over Nepali politics in recent history.&nbsp; But they will also carry each other’s baggage.&nbsp; Lamichhane, who was jailed for defrauding cooperatives depositors last year, was welcomed back as RSP party chair with open arms after he was released on bail last week. And while he has maintained his base of loyal supporters, he was subject to widespread criticism after he walked out of detention amid the jailbreak during the September protests, prompting his eventual voluntary return to prison.&nbsp; His party’s silencing and expulsion of critics within the RSP has also drawn direct comparison with the leadership structure of Nepal’s mainstream parties. Prominent leaders like Sumana Shrestha have left the party over disagreements with leadership.&nbsp; Meanwhile, Balen’s impassioned campaign resonated with Nepalis disillusioned with establishment leaders during the 2022 election and made him mayor of Kathmandu. The mayor’s direct, no-holds-barred style of communication and commentary has attained him much support beyond his constituency.&nbsp; But his unyielding, often unempathetic leadership style and policies— like his dismissal of street vendors and informal businesses during his drive to free up Kathmandu’s footpaths— have also earned him detractors. His recent outburst on social media in November that included expletives against both of Nepal’s neighbours and the US, as well as Nepal’s three main parties and the RSP was also widely criticised.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251230041212_fc2088daf32bac93541ebf25ca07725d75a721ae83440749ac8fa09d8fe308f2.jpg" data-media-id="editor_3" data-image-id="20251230041212_fc2088daf32bac93541ebf25ca07725d75a721ae83440749ac8fa09d8fe308f2" data-rendition-name="original" width="890" height="1255" loading="lazy" alt="Agreement NT"> <figcaption>The seven-point agreement between RSP and Ujyalo Nepal Party.</figcaption> </figure>  Ghising, credited with ending Nepal’s prolonged load-shedding during his tenure as the chief of Nepal Electricity Authority, has a reputation of getting the job done. His public goodwill earned him a seat on Prime Minister Sushila Karki’s interim Cabinet following the youth protest.&nbsp; But he has also been under scrutiny for funds misappropriation as well as controversial power purchase agreements during his tenure as NEA chief. Ghising had foregone the leadership position at his Ujyalo party, preferring to play the role of patron until closer to the election date, but was nonetheless criticised for his political and electoral aspirations while being a member of the transitional government. It now remains to be seen if and when Ghising will step away from his position in the interim Cabinet and begin campaigning with his new partners.&nbsp; As it stands, the involvement of prominent GenZ figures in bringing together Ghising, Shah, and Lamichhane has established youth leaders as major players in Nepal’s post-September political landscape. These leaders will have significant pull with young and first-time voters. But not all young leaders are impressed with this new triumvirate. Some have pointed out that the unity between these three leaders is no different from the political opportunism and quid-pro-quo power-sharing culture established and followed by Nepal’s mainstream leadership for the last three decades which culminated into the GenZ movement of September.

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