<figure><img width="1000" height="1500" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108111156/636a35fe9c7e80680e0482dfjpeg.jpg" alt=""/><figcaption>Pic: BIKRAM RAI</figcaption></figure>Suresh Shakya (pictured above) was sitting down for lunch with his family in his house in Itum Bahal four years ago when there was a terrifying, subterranean growl, and his building started shaking.Shakya, 46, knew it was an earthquake, and while he was concerned the house could collapse, he was even more afraid that an adjacent, new 10-floor highrise that a neighbour had built would topple on him.<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108111156/636a36019c7e80680e0482e0jpeg.jpg" alt="" width="1000" height="454">Outside, it was difficult to stand as the ground rolled. An hour later, there was a big aftershock and Shakya remembers the tall building swaying like a tree in a storm, creating deep gashes on his house, which remains propped up by timber to this day.Seismologists warn that the quake four years ago this month was just a warning, and that Nepal faces serious risk from even bigger earthquakes in future. This precarious highrise is not likely to survive those ones.Read also: <a href="https://www.nepalitimes.com/?p=25092&amp;preview=true" target="_blank" rel="noopener">Lessons Unlearnt</a>, Editorial<a href="https://www.nepalitimes.com/?p=25110&amp;preview=true" target="_blank" rel="noopener">Shaking up the health sector</a>, Sewa Bhattarai<a style="background-color: #ffffff; font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/?p=25119&amp;preview=true" target="_blank" rel="noopener">Quake was a learning experience for Nepal’s schools</a>, Prakriti KandelOn the fourth anniversary of the 25 April 2015 earthquake, experts warn that attention should now shift to retrofitting and strengthening hospitals and schools across the country. More than 1,000 health facilities and 5,000 schools were completely destroyed in 2015, and tens of thousands of children could have been killed if the disaster had happened on a weekday.  Hospitals and schools flattened in the 2015 earthquake are being rebuilt, but what about the rest of Nepal vulnerable to future quakes? A recent Ministry of Health (MoH) study showed the government hospital in Nepalganj was structurally so weak that it needs to be demolished, and recommends retrofitting four other hospitals in Western Nepal that do not meet the WHO Health Safety Index."The study is a warning. The condition of rural health facilities across Nepal is similar, and we need to quickly retrofit them before the next disaster strikes,” says Chudamani Bhandari of the Health Emergency and Disaster Management Unit at the MoH. "Western Nepal is in greater danger of a big earthquake, so we have decided to focus there."The Disaster Risk Reduction and Management Act of 2018 stipulates that the main responsibility of managing crises now lies at the local level, but the MoH says it first wants to build capacity at the provincial level.Read also:<a href="https://www.nepalitimes.com/here-now/nepals-traditional-seismic-resistant-designs/" target="_blank" rel="noopener"> </a><a href="https://www.nepalitimes.com/here-now/nepals-traditional-seismic-resistant-designs/" target="_blank" rel="noopener">Nepal's traditional seismic resistant designs</a>, Sheilin Teo<a style="background-color: #ffffff; font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/here-now/building-back-cheaper-and-stronger/" target="_blank" rel="noopener">Building back cheaper and stronger</a>, Sapana Shakya and Aman Raj KhatakoHowever, the first step must be to carry out a baseline safety inspection of medical centres all over the country. The National Reconstruction Authority (NRA) plans a survey of schools and hospitals, but only after it is done with reconstruction.The National Society for Earthquake Technology (NSET) is also resuming its retrofitting of schools in Western Nepal that it had started before 2015. Says NSET’s Surya Narayan Shrestha: "We need to concentrate on Western Nepal because the vulnerability of public buildings there is high.” Western Nepal is said to be particularly at risk because it has not had a mega-earthquake for the past 500 years. DFID is supporting NSET with a Safer Schools Project to retrofit classrooms in the region.Schools are important community hubs and strengthening them can raise public awareness about safer construction in areas that are at high risk. In fact, 2015 itself provided a lesson for schools. Deepak Sharma of the Ministry of Education explains: "The few schools that were retrofitted before 2015 suffered no damage, so we are trying to retrofit schools in all districts for future earthquakes."Read also:  <a href="https://www.nepalitimes.com/here-now/nirmala-pariyars-2nd-life/" target="_blank" rel="noopener">Nirmala Pariyar's second life</a>, Ramu Sapkota<a style="background-color: #ffffff; font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/opinion/nepal-is-being-loved-to-death/" target="_blank" rel="noopener"> Nepal is being loved to death</a>, Anil Chitrakar

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Tall Order

Nepal’s oldest maternity hospital is still recovering from the April 2015 earthquake: its main building had to be demolished after earning a red sticker because of its structural damage. Soon, it will move into a new seismic-resistant wing, designed to withstand future earthquakes. For now, the hospital is working out of temporary cramped quarters offering only 375 beds out of the normal 415. But when the new building is inaugurated next month, the hospital will have more capacity, lecture rooms, an emergency ward, operating theatres and an ante-natal section. <div class="embed-block"><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108111156/636a36329c7e80680e0482f4jpeg.jpg" alt="" width="1000" height="454"></div> Hospital director Jageshwor Gautam looks excited to show &nbsp;visitors around the construction site. “We expect our work to be much easier when the new building is completed and we can use the new space,” he says. Read also: <a href="https://www.nepalitimes.com/?p=25119&amp;preview=true" target="_blank">Quake was a learning experience for Nepal’s schools</a>, Prakriti Kandel <a href="https://www.nepalitimes.com/?p=25092&amp;preview=true" target="_blank">Lessons Unlearnt</a>, Editorial&nbsp; <a href="https://www.nepalitimes.com/here-now/tall-order/" target="_blank">Tall order</a>, Sewa Bhattarai and Prakriti Kandel The project is supported by the Japan International Cooperation Agency (JICA), built by consultant Hazama Ando and is expected to be handed over on 15 May. The 2015 earthquake damaged 1,197 health facilities across Nepal, offering them a chance to rebuild so they can withstand future quakes. A survey done before the 2015 disaster had shown that of the 14 hospitals tested in Kathmandu, only 2 (Teaching Hospital and Patan Hospital, built by the Japanese) were seismic resistant. The situation in other parts of the country was even worse. <div class="embed-block"><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108111156/636a36329c7e80680e0482f4jpeg.jpg" alt="" width="1000" height="454"></div> JICA is working to rebuild modern and safe hospital wings at Paropakar Maternity Hospital (pictured, right) and Bir Hospital, both in Kathmandu. They will enjoy advanced technologies like motion-sensor taps in order to reduce infections in washrooms, flush systems that reuse water from handwashing, handicapped-friendly toilets and treatment plants for hospital waste. Elsewhere in the quake-affected areas, however, reconstruction of health facilities is not going as well. Only 55% of the health posts and hospitals that were damaged or destroyed have been repaired, according to the National Reconstruction Authority (NRA). “The construction of hospitals was delayed due to technical reasons, but now they are our top priority,” says Manohar Ghimire of the NRA. “Of the 643 structures built, most are pre-fab structures which have already been handed over to the communities. Now we are focusing on rebuilding the rest.” The reconstruction of health facilities was delayed because the central government could not agree on who should rebuild them. The Ministry of Health and Population had planned to do it, before passing it on to the NRA almost a year after the earthquake, where the plans faced further delays. That cost a total delay of two years, resulting in a reconstruction rate of only 53%, when the target was 65%. Read also:&nbsp; &nbsp;<a href="https://www.nepalitimes.com/here-now/nepals-traditional-seismic-resistant-designs/" target="_blank">Nepal's traditional seismic resistant designs</a>, Sheilin Teo <a href="https://www.nepalitimes.com/here-now/building-back-cheaper-and-stronger/" target="_blank">Building back cheaper and stronger</a>, Sapana Shakya and Aman Raj Khatako <div class="embed-block"><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108111156/636a36369c7e80680e0482f6jpeg.jpg" alt="" width="1400" height="786">Nepal's oldest maternity hospital is currently operating out of cramped quarters, forced to put some beds in corridors due to lack of space.</div> Of the 524 medical facilities that need to be rebuilt, 145 are under construction, while the rest seem to be inordinately delayed due to technical reasons. "Many health centres do not have their own land, and there are no guidelines for buying land. We can only build on already available land," says Pranaya Upadhyaya, senior Public Health Administrator at the Ministry of Health. "Before the earthquake, many were operating from schools or other government buildings. But now we have strict standards for medical facilities including size of land, type of soil, etc. The institutes that are having a hard time fulfilling these criteria are the one that are delayed." Upadhyay informs that work has not begun on the 250 health centres that the Indian government committed to, which contributes to the reason more than 500 of them remain to be built. Even if the earthquake had not occurred, Nepal’s health sector needed a structural revamp. A survey two decades ago of 14 hospitals in Kathmandu by the National Society for Earthquake Technology (NSET) showed that only two of the facilities would be fully functional if hit by a high-intensity earthquake, and four would be partially operational. Read also:&nbsp; <a href="https://www.nepalitimes.com/here-now/nirmala-pariyars-2nd-life/" target="_blank">Nirmala Pariyar's second life</a>, Ramu Sapkota <a href="https://www.nepalitimes.com/opinion/nepal-is-being-loved-to-death/" target="_blank">Nepal is being loved to death</a>, Anil Chitrakar Survey leader Ramesh Guragain explains that quake intensity is not just &nbsp;measured in the Richter scale, but by many other factors like depth, type of soil and distance from the epicentre. Which means that the intensity of the 2015 earthquake caused greater damage nearer the epicentre than in districts around Kathmandu. A subsequent NSET survey of five regional hospitals outside Kathmandu also showed that Nepal’s health care centres are structurally unprepared for future large-scale disasters. Although services and facilities in some of the hospitals have improved, the structures within which they are housed are weak and could collapse. Kathmandu’s oldest medical centre, Bir Hospital, in the heart of the city, has no space for expansion. After the 2015 earthquake damaged its mortuary, the hospital is constructing a new building in its place, which will also house its nephrology, cardiology and gastrology departments, but it is still short of space. “Even after we start using our new facilities, we will need more space for the nursing campus, pediatric and maternity departments, organ transplant centre and many other services,” says Bir’s director Kedar Prasad Century, adding that there is no option but to expand to Duwakot in Bhaktapur, outside of Kathmandu. Hospitals with large capacity will be much in demand after the next earthquake, and if they are knocked out of service, the injured will have nowhere to go. In 2015, many hospitals worked in the open or out of tents for months after the earthquake. “In order to avoid such a situation in future, it is imperative that the reconstruction and retrofitting of hospitals be carried out with the utmost priority,” says NSET’s Guragain. If this is the situation in Nepal’s privileged capital, one can only imagine what it is like in district hospitals. Many of the buildings are in advanced stages of disrepair, lack hygiene and are overcrowded, even in normal times. During disasters, hospitals will have to cope with a large influx of patients but the medical centres themselves will have suffered damage. Read also: <a href="https://www.nepalitimes.com/editorial/aint-seen-nothing-yet/" target="_blank">Ain't seen nothing yet</a>, Editorial

Shaking up the health sector

<figure><img width="1000" height="2392" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108111156/636a36059c7e80680e0482e1jpeg.jpg" alt=""/><figcaption>Photo: BIKRAM RAI</figcaption></figure>Four years later, Central Nepal is still being rocked by aftershocks of 2015. That peculiar earthquake shook everything to the east of the epicentre, and inflicted almost no damage at all to its west. The release of tectonic energy appears to have travelled along a rupture zone from Gorkha and ground to a halt somewhere beneath the southern edge of the Kathmandu Valley. The <a href="https://www.nepalitimes.com/editorial/aint-seen-nothing-yet/" target="_blank" rel="noopener">stored tension</a> of the 7.8 magnitude earthquake is only partially spent.Read also: <a href="https://www.nepalitimes.com/?p=25110&amp;preview=true" target="_blank" rel="noopener">Shaking up the health sector</a>, Sewa Bhattarai<a style="background-color: #ffffff; font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/?p=25119&amp;preview=true" target="_blank" rel="noopener">Quake was a learning experience for Nepal’s schools</a>, Prakriti Kandel<a href="https://www.nepalitimes.com/here-now/tall-order/" target="_blank" rel="noopener">Tall order</a>, Sewa Bhattarai and Prakriti Kandel<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108111156/636a36079c7e80680e0482e2jpeg.jpg" alt="" width="1000" height="454">For the first two years after the earthquake, memory was still fresh and we were careful about building back better. There was even talk of strictly enforcing the building code. <a href="http://archive.nepalitimes.com/article/nation/A-concrete-future,2251" target="_blank" rel="noopener">Look at us now</a>. The kinds of structures that are going up in Kathmandu prove that we have all but forgotten what an earthquake can do. There is still <a href="http://archive.nepalitimes.com/page/not-out-of-danger-the-big-one" target="_blank" rel="noopener">the unfinished business</a> of 2015 beneath the Valley, and below western Nepal is <a href="https://www.nepalitimes.com/here-now/past-disasters-foretold/" target="_blank" rel="noopener">the ticking time bomb</a> of tension from the <a href="https://www.unr.edu/nevada-today/news/2016/nepal-earthquake-danger" target="_blank" rel="noopener">subduction</a> of the Indian plate into the Eurasian landmass, which has not been released for nearly 700 years.We still don’t seem to fathom <a href="http://archive.nepalitimes.com/article/from-nepali-press/not-destructive-as-predicted-but-the-loss-is-still-great,2221" target="_blank" rel="noopener">how lucky we were</a> that the 2015 earthquake occurred on a Saturday, did not happen at night, and that it was below 8 magnitude. April 25 was a warning to enforce seismic-resistant designs in private homes, but especially public buildings. <a href="https://www.nepalitimes.com/banner/class-struggle/" target="_blank" rel="noopener">Schools</a> may not be so lucky next time, and classrooms need to be strengthened. Our hospitals have poor construction, as the destruction of a newly-built <a href="http://archive.nepalitimes.com/article/nation/being-prepared-for-monsoon-and-outbreaks,2293" target="_blank" rel="noopener">district hospital in Chautara</a> in 2015 proved. Pre-positioning supplies, digging equipment and designating open spaces for evacuation needs to happen now. Across Nepal, earthquake drills will be more important than singing the national anthem at assembly.https://www.youtube.com/watch?v=hpABIXZIp2k&amp;feature=youtu.beWhile thinking and preparing ourselves for future shocks, there is also all the catching up we have to do to reach the most vulnerable survivors of the 2015 earthquake. It is not just about distributing the insufficient amount earmarked for rebuilding homes, but also rehabilitating families, providing skills training and finding jobs near home for them.The <a href="https://www.nepalitimes.com/banner/disastrous-management-in-nepal/" target="_blank" rel="noopener">National Disaster Management Act</a> has been passed, but where is the <a href="https://nepalitimes.atavist.com/reconstruction-in-ruins" target="_blank" rel="noopener">Authority</a>? The NRA now needs to be phased out (it wasn’t much help anyway) to prepare for the Next Big Ones. It is a feeble hope, but let us not get bogged down in turf battles and allow the Home Ministry to mess it up with political appointments and job distribution to party faithful again.Under the federal structure, we have a new opportunity to decentralise disaster preparedness, planning and management.  Every municipality now has to take responsibility from ward level up, so that there is a search, rescue and relief plan in place. But given that so many mayors and local elected officials are contractors who are awarding construction jobs to themselves, there is not much hope. We wish the incompetence of Kathmandu Municipality in earthquake rehabilitation of monuments was an exception, but it is the rule. The delays in rebuilding <a href="http://archive.nepalitimes.com/blogs/thebrief/2016/08/29/halt-rani-pokhari-reconstruction/" target="_blank" rel="noopener">Rani Pokhari</a> and <a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/rebuilding-kasthamandap-nepal,4012" target="_blank" rel="noopener">Kastamandap</a> are national disasters in themselves. It is hard to figure out who is more culpable — Mayor Shakya or the Department of Archaeology. There are lessons to be learnt about how not to organise compensation for rebuilding. While a lot more of the grants have been cleared, there are many families who have found loopholes to build tiny cement sheds just to get their hands on the cash.As our coverage this past month in the run-up to the fourth anniversary of the quake, and in this issue, indicate: it is now time to also turn our attention to the seismic risk in the rest of the country. For the past four years, we have been in rehab mode, picking up the pieces of the damage in Central Nepal’s 14 districts. It bears repeating that the risk is now to the whole country from the massive slip that is bound to occur sooner or later in Western Nepal. There is no other way to put it: the death and destruction from it will be nationwide and catastrophic. Read also: <a href="https://www.nepalitimes.com/editorial/aint-seen-nothing-yet/" target="_blank" rel="noopener">Ain't seen nothing yet</a>, Editorial <h2>10 years ago this week</h2> This Editorial titled ‘Half full’ from issue #447 of 16-23 April 2009 tried to look at the bright side, but could not find much to be cheerful about. Not much has changed in Nepal in 10 years. Excerpt:‘Wonder if Pushpa Kamal Dahal, sitting in Baluwatar and preparing for his China visit, has any clue about the rising frustrations of the people. The Maoists may have got three of the six seats in the by-elections, but that is not the real barometer. Ask people stuck inside buses for 24 hours because the government can’t clear the week-long blockade of the country’s main national highway by flood victims. Ask city-dwellers who have seen no respite from power and water shortages.This coalition has spectacularly failed to deliver. There is no law and order, youth wings of ruling parties roam the streets and the police have no orders to intervene.’<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108111156/636a36089c7e80680e0482e3jpeg.jpg" alt="" width="508" height="811">

Lessons Unlearnt

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

How the Peace Corps changed a volunteer’s life

· On the night of 15 May, two glacial lakes burst in Tharka in Humla and the debris flow washed away homes and bridges.&nbsp; · Last week, a slurry surge on the Kali Gandaki in Upper Mustang caused at least Rs15 million in damage, and was traced to a melting glacier. · Dozens are feared dead after <a href="https://nepalitimes.com/news/rasuwa-flood-likely-a-glof">an expanding glacial lake in Tibet overflowed</a>, sweeping down into Nepal and damaging four hydropower plants generating 230MW, nearly 8% of the country’s total grid supply.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250718060748_45225dc707c1e9c2968ca8dbf6e564e01e4eb6e2ff254fb8eb940cf62cdd910b.jpg" data-media-id="editor_1" data-image-id="20250718060748_45225dc707c1e9c2968ca8dbf6e564e01e4eb6e2ff254fb8eb940cf62cdd910b" data-rendition-name="original" width="2667" height="1500" loading="lazy" alt="Rasuwa flood"> <figcaption>Miteri friendship bridge connecting Nepal and China was swept away in the Rasuwa flood. Photo: PRAKASH CHANDRA TIMILSENA / NPL</figcaption> </figure>  And those are just in the past month. Climate scientists say Himalayan glacial lake outbursts are becoming more frequent and destructive, and a warning for Nepal not to put all its eggs in the hydropower basket.&nbsp; <a href="https://nepalitimes.com/editorial/when-it-rains-it-pours-ksqprbu3">Record precipitation last September</a> unleashed floods that killed 200 people, and temporarily slashed Nepal’s total generation capacity of 3,000MW by nearly half. The <a href="https://nepalitimes.com/banner/nepal-valley-suffers-quadruple-disaster">Melamchi flood of 2021</a> caused by <a href="https://nepalitimes.com/multimedia/the-not-so-permanent-frost">permafrost melting</a> on a glacier upstream nearly destroyed a $800 million water supply scheme, Nepal’s largest infrastructure project which four years later still has not resumed full operation. The <a href="https://nepalitimes.com/news/sikkim-flood-is-warning-to-nepal">glacial lake overflow in Sikkim</a> caused by record rainfall in September 2023 that destroyed the $1.2 billion Chungthung Dam and caused catastrophic damage to infrastructure on the Teesta River. This was a warning to the cascade of hydropower plants on the Arun and Marsyangdi river basins.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250718060736_6f61797a6be308321e3bae26e55d2f64cba4b9e5eb262adacb9e92fb5f3c6152.jpg" data-media-id="editor_6" data-image-id="20250718060736_6f61797a6be308321e3bae26e55d2f64cba4b9e5eb262adacb9e92fb5f3c6152" data-rendition-name="original" width="919" height="549" loading="lazy" alt="hydro disasters and hydropower plants"> </figure>  Nepal has set a target of generating an additional 28,500MW by 2035 -- out of the feasible 48,000MW -- but how viable is an energy strategy that is exposed to heightened risk due to climate breakdown? &nbsp; “As extreme weather events increase, we must design and build infrastructures respecting river flow and topography,” says former Energy Secretary Dwarika Nath Dhungel. “We must make the best use of our water resources, but not by letting excavators loose everywhere mining riverbeds and building haphazardly where we shouldn’t.”&nbsp; Although no project can be disaster-proof, <a href="https://nepalitimes.com/banner/climate-smarter-himalayan-infrastructure">climate smart design</a> can minimise damage from flash floods and landslides. Recent disasters have driven up insurance premiums for energy projects in Nepal, and smaller ones cannot even afford them. The 456MW Upper Tamakosi hydroelectric project which is still not fully functional after the September floods has claimed insurance worth Rs1.8 billion. The alternative to high risk high investment hydropower projects is <a href="https://nepalitimes.com/here-now/what-s-cooking-in-nepal-besides-politics">energy diversification</a> to other renewables such as solar, wind or biogas. Nepal gets annual sunlight of 300 days with 6-7 hours on average to total 50,000 terawatt-hours (TWh) per year.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250718060744_4acd452b4117180ca9bb5d3be839ff46dfd5464e4d507f5ad3704cef6253bc48.jpg" data-media-id="editor_9" data-image-id="20250718060744_4acd452b4117180ca9bb5d3be839ff46dfd5464e4d507f5ad3704cef6253bc48" data-rendition-name="original" width="1080" height="720" loading="lazy" alt="solar power"> <figcaption>Farmers in Tarai using solar powered water pump. Photo: GHAMPOWER</figcaption> </figure>  The Solar and Wind Energy Resource Assessment (SWERA) calculates that Nepal could source 3,000MW from wind energy alone, considering 10% of the area with more than 300W/m2 wind power density. <a href="https://nepalitimes.com/opinion/people-power/decentralising-power-in-nepal">Solar energy</a> stations are cheaper and quicker to build, and would be an ideal alternative to reliance on hydropower.&nbsp; “There has been some investment in solar power, especially from the state sector,” says water expert Madhukar Upadhyay. “But there is an issue of land acquisition since the arrays need a lot of space. It is comparatively easier to get a permit to put up a hydropower plant on a river.” As for biogas, there is simply no incentive to build on past success with household level plants to <a href="https://nepalitimes.com/here-now/more-bullshit">promote industrial-scale production</a>. Scaling up biogas by integrating it with urban biodegradable waste would still be a viable alternative to LPG.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250718060744_715d44afd5eb4ba8dafa209b0ad0f19400665797b5f078f5636821e600f96684.jpg" data-media-id="editor_12" data-image-id="20250718060744_715d44afd5eb4ba8dafa209b0ad0f19400665797b5f078f5636821e600f96684" data-rendition-name="original" width="1419" height="954" loading="lazy" alt="windmill"> <figcaption>A wind mill in Hapsikot in Nawalpur. Photo: WINPOWER NEPAL</figcaption> </figure>  Nepal’s public sphere is buzzing with excitement over the discovery of potentially 430 billion cubic metres of methane gas beneath Dailekh district that, if properly harnessed, would meet the country’s energy demand for the next 50 years. Even though a feasibility study is awaited, politicians from the prime minister down see this as a petro bonanza that will make Nepal rich. But drilling, storage and distribution of CNG in the country’s current kleptocratic state make that unlikely. If Nepal was to get rich solely on its hydro-energy potential, it could have done so in the past 50 years. Says Dhungel: “This is not exactly a new discovery, but it is premature to celebrate until its extraction is proven to be cost effective. And let us hope it does not get <a href="https://nepalitimes.com/news/balance-of-power">tangled in geopolitics</a>, since China is involved in the prospecting and drilling, which could make India uneasy.”&nbsp; The country suffers from the Dutch Disease curse even before its resource is fully exploited. And the same cronyism, corruption and rent-seeking structure cannot deliver the riches we expect from Dailekh’s methane discovery. Now, <a href="https://nepalitimes.com/here-now/right-climate-for-nepal-s-energy-transition">with hydropower in jeopardy</a>, Nepal’s planners will have to evolve a new strategy for energy security into the future. But first, governance needs to be cleaned up with long-term strategic planning that takes climate risk into account. For example, do we need to mine fossil gas when there are renewable options? Will Dailekh take Nepal away from its climate commitments? Says Madhukar Upadhyay: “Nepal has always been resource rich and management poor. And the larger the resource, the bigger our management incapacity. It is a societal malaise.”&nbsp;

Nepal’s Resource Curse

चौतारा rest stops have long been an integral part of scenic touristic town of <a href="https://nepalitimes.com/news/pokhara-six-decades-ago">Pokhara </a>but are now rarely seen as the city bursts at the seams. They say inhabitants of Pokhara saw a plane before they saw cars. Indeed, the grass airfield was built in the 1950s, while the Kathmandu highway 20 years later. Before roads, people walked to get around, pausing to rest or even nap under the shade of banyan-pipal trees. <a href="https://nepalitimes.com/here-now/pokhara-s-desperation-and-hope">Pokhara airport’</a>s ‘terminal’ in those days was a shady chautara where passengers waited for their flights. The chautara bore silent witness to daily life, whether it was travellers seeking a brief respite from the summer heat or villagers gathering for a chat in the mornings and evenings. But with the roads came vehicles, and then houses started filling up spaces, even farmlands. Pokhara began transforming from a serene village to a <a href="https://nepalitimes.com/news/pokhara-comes-alive-at-night">bustling city</a>.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250719010724_d101fa482441ce67afdf5bc4e4547b334e7662c1cf0a20e9d31a0e8dff66f04b.jpg" data-media-id="editor_3" data-image-id="20250719010724_d101fa482441ce67afdf5bc4e4547b334e7662c1cf0a20e9d31a0e8dff66f04b" data-rendition-name="original" width="2147" height="1581" loading="lazy" alt="Trees of life and living NT"> <figcaption>Photo: DURGA RANA MAGAR</figcaption> </figure>  The banyan-pipal trees were chopped down to make way for wider intersections and buildings. The once-iconic rest stops that carried Pokhara’s identity had all but vanished. “Building chautara was once considered a religious duty, which is why so many of them were constructed across Pokhara,” says archivist Sunil Ulak. <a href="https://archive.nepalitimes.com/news.php?id=10927">Ekai Kawaguchi</a>, a Japanese Buddhist monk, who visited Nepal 120 years ago en route to Tibet, documented <a href="https://nepalitimes.com/banner/no-visitors-in-pokhara-to-admire-view">the landscape of Pokhara</a> and its surroundings. In his book, Three Years in Tibet, he reflects on the natural beauty of the town and its shady trees. A chautara used to be surrounded by ponds, where shepherds would bring their cattle to drink from while they took a nap under the shade. The gentle rustling of leaves in the cool breeze lent a soothing melody as did the chirping of birds, while the insects took refuge in the branches and leaves. Read also: <a href="https://nepalitimes.com/here-now/pokhara-800-years-ago">Pokhara 800 years ago</a>, Kunda Dixit This ‘nature’s breeze’, as botanist Kalyan Panta puts it, is now history due to <a href="https://nepalitimes.com/banner/cost-of-living-in-a-big-city">haphazard urbanisation</a>. “When the wind strikes against one leaf, it creates a domino effect and other leaves start waving as well,” he explains. There were 632 chautara in the city until 1977, and by 2000 the number had fallen to 278. But in some wards the number of trees fell from 55 in 1984 to only five now.&nbsp; The gradual loss of these resting places has meant habitat <a href="https://nepalitimes.com/banner/between-existence-and-extinction-in-nepal">destruction of birds and insects</a>, it has also damaged the environment and natural beauty of the city.&nbsp; Researcher Jagannath Adhikari’s study showed that infrastructure projects ignored the environment, and concluded that that urbanisation in Pokhara was unsustainable.&nbsp; The destruction continues to this day. Recently, old chaurata in wards 6, 13 and 14 were cleared to make way for a sacrificial ritual. In fact, ward 6 got a permit from the local government to clear its remaining trees.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250719010724_cee1d4faf8376e7ba18b9c7012ea4215b7c3fbf7e0983b0c97005df5567d6de0.jpg" data-media-id="editor_9" data-image-id="20250719010724_cee1d4faf8376e7ba18b9c7012ea4215b7c3fbf7e0983b0c97005df5567d6de0" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="Trees of life and living NT"> <figcaption>Photo: DURGA RANA MAGAR</figcaption> </figure>  But in wards 13 and 14, the Human Service Foundation cut down some 33 trees for which it is in a dispute with the metropolitan city as there is no unclear jurisdiction regarding who gives the permit. The Kaski Division Forest Office is currently investigating the matter. Elsewhere in ward 19, the ward office had launched ‘मेरो रूख, म काट्छु’ campaign due to an alleged chaos caused by monkeys in the area. The decision was rescinded after an all-around opposition.&nbsp; To be sure, there are policies in place to protect trees such as the Gandaki Province Forestry Act, 2080, and the Regulations, 2081. The province government also introduced an act in 2019 per which no tree, including pipal, silk cotton and other <a href="https://nepalitimes.com/opinion/suburban-tales/trees-trees?%2F">trees of natural and historical importance</a> shall be damaged, eroded or removed. But the local government, responsible for implementing the Act, is doing the opposite. “If this rapid rate of tree felling continues, neither trees nor chautara will survive for the future generation,” conservationist Ram Bahadur Poudel tells us, adding that old trees are being cleared under the pretext of pruning branches. Interestingly, Ulak notes that Pokhara-8 was called सिमलचौर in the past because there were so many majestic silk cotton trees, but there are very few left, if any, and hence altering the identity of a place. With modernisation, people have questioned the significance of chautara in this day and age. But they still have relevance. Urban centres in Pokhara and Kathmandu are much hotter than the outskirts because of the <a href="https://nepalitimes.com/news/in-the-heat-of-the-moment-5xcycyot">urban heat island effect</a>. Says archivist Ulak: “While their original purpose was to provide rest, today they continue to play a crucial role in regulating temperature, beautifying the city, and preserving our environment.”

Trees of life and living

Nepalis are living longer than ever. By 2028, the country is set to join the ranks of other <a href="https://nepalitimes.com/news/nepals-demographic-window-is-closing">ageing societies</a> around the world, and by 2054, 1 out of every 7 people in Nepal will be over 65. Life expectancy at birth has risen dramatically from just 55 in 1990 to 71 today, &nbsp;thanks to improvements in public health and access. But as more people live longer, the country must also prepare for a parallel rise in age-related illnesses and the complex social and medical needs that come with an <a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/need-to-prepare-for-ageing-society,3624">ageing population</a>. Extended families have always acted as a safety net for <a href="https://nepalitimes.com/news/home-sweet-home-for-older-nepalis">the elderly</a>, with children and grandchildren shouldering most caregiving duties. But with more than 1,600 <a href="https://nepalitimes.com/banner/migration-not-a-wish-but-necessity-for-nepalis">Nepalis migrating </a>every day, older parents are left behind with no one to care for them. <a href="https://nepalitimes.com/editorial/the-new-equaliser">Remittances</a> from migrating youth, which account for nearly a third of Nepal’s GDP, have kept the economy afloat. But money sent home cannot make up for the chronic departure of kin and caregivers, who are often the first to catch the signs and symptoms of disease in elders. In rural areas where over 85% of Nepal’s elderly live, the absence of this daily vigilance means early signs of illness often go unnoticed until they become debilitating. As a result, chronic conditions like hypertension, diabetes, and depression are left unmanaged.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250720130748_213f2c65f2638872e9ac0550a7ac251e4960c3726dc5c76215962a23ba71dff1.jpg" data-media-id="editor_5" data-image-id="20250720130748_213f2c65f2638872e9ac0550a7ac251e4960c3726dc5c76215962a23ba71dff1" data-rendition-name="original" width="1064" height="701" loading="lazy" alt="Smart ageing is Nepal’s next frontier"> </figure>  Geriatric medicine is largely absent from medical curricula and there is no national plan in place to manage cognitive decline, memory loss and confusion. These are often mistaken for signs of normal ageing, instead of <a href="https://archive.nepalitimes.com/article/nation/dementia-brings-new-problem-that-families-have-little%20knowledge-of,2151">dementia</a>, delaying care until it is too late. The same pattern plays out with strokes, osteoarthritis, and vision problems — conditions that could be managed early but are instead allowed to spiral into <a href="https://nepalitimes.com/opinion/comment/changing-disability-to-this-ability-h68f6sq2">disability</a>. Nepal is not ready for an older future. It needs a strategy for ‘smart ageing’ where the focus is not adding years to life, but enhancing years lived through the intelligent application of policy, infrastructure, and crucially, <a href="https://nepalitimes.com/opinion/comment/tech-and-transition-in-nepal">technology</a>. Many models of smart ageing, however, are sculpted around modern societies where independent living in later life is the norm. Furthermore, eroding traditional family care and an underdeveloped formal care system means there is a large gap that can’t simply be filled by copy-pasting from foreign models. Nepal must shape its own version of smart ageing. The <a href="https://nepalitimes.com/news/healthcare-moving-from-hospitals-to-homes?%2F">tech boom</a> has led to homegrown digital healthcare apps such as Hamro Doctor, Cura Health, Jeevee and Health Yaad Ayo which offer teleconsultations, online appointments, and at-home test bookings. As <a href="https://nepalitimes.com/review/nepal-s-new-digital-landscape">smartphones and internet access</a> extend to the most rural fringes of the Nepali countryside, geography is no longer a barrier to the use of these digital tools. What limits their use is the lack of digital proficiency among the older generation. Others find the idea of turning to a device instead of a familiar, reassuring face unfathomable. That is why <a href="https://nepalitimes.com/opinion/addressing-nepals-digital-divide?ref=blog.togglecorp.com">digital literacy</a> efforts must be paired with guided human support to build trust alongside technical skill. Such a model of community-led digital mediation is already gaining traction elsewhere. In the UK, ‘digital health ambassadors’—often young people or even schoolchildren—are trained to co-design and advocate for online platforms that resonate with peers who might otherwise feel excluded from automated health services. A Nepali version could engage cohorts of nursing students, tech-savvy youngsters and returnee migrants to assist elders in navigating digital health platforms and troubleshooting problems, and most of all, normalising the idea of health apps being a reliable recourse.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250720130748_fcb94ab76e76b5574189757e88d76fccad4e115e78dd9eae92a3bd4c882c3431.png" data-media-id="editor_12" data-image-id="20250720130748_fcb94ab76e76b5574189757e88d76fccad4e115e78dd9eae92a3bd4c882c3431" data-rendition-name="original" width="2246" height="1590" loading="lazy" alt="Smart ageing is Nepal’s next frontier"> </figure>  Nepal’s own network of Female Community Health Volunteers (FCHVs), whose credibility is rooted in long-standing relationships across rural communities, could be similarly upskilled, their roles in <a href="https://nepalitimes.com/here-now/target-2030-for-maternal-and-newborn-health">maternal and child health </a>expanded and repurposed to also include geriatric tech support. However, there is a limit to how much older adults can adapt to new technologies. So, Nepal should simultaneously invest in passive technologies—tools that monitor and act for the elderly, instead of demanding active use. That is where wearables and in-home smart health devices collectively known as 'gerontechnology' come in. Picture an 82-year-old in far-flung Rolpa, away from the facilities of an urban hospital. Installed in her home are low-cost motion sensors that monitor prolonged inactivity or signs of a fall, instantly triggering alerts to the nearest health post when necessary. On her wrist, a wearable bracelet continuously tracks her sleep, vital signs, oxygen saturation, and glucose levels. This data is encrypted and synced to a digital dashboard accessible by health staff at the local post. If the system flags an acute risk—such as a potential stroke or hypoglycemia—a nearby health worker is dispatched immediately to her home. If her readings over time indicate a trend toward a <a href="https://nepalitimes.com/news/why-do-so-many-nepalis-have-high-blood-pressure">chronic condition</a> like diabetes, community health volunteers step in. They help schedule a virtual consultation with an endocrinologist in Butwal. Based on the advice received, she gets a prescription and picks up her medication from the local community pharmacy, along with a smart dispenser to ensure she sticks to her treatment plan without missing doses. This is not as far-fetched as it may sound. Many of the individual devices forming this connected medical system called an Internet of Medical Things (IoMT) already exist in Nepal as imported commercial products. What is missing is a stronger framework for <a href="https://nepalitimes.com/business/public-health-partnership">public-private collaboration</a>: one where health tech companies continue developing locally adapted tools, and the government actively integrates these innovations into public health delivery. <a href="https://nepalitimes.com/opinion/people-power/nepal-as-an-ai-power-bank">Nepal’s tech ecosystem</a> is maturing, but policymaking must evolve in tandem, especially when it affects an older generation largely resistant to change. The backlash against the recent mandate requiring National Identity Cards for accessing social security benefits revealed the pitfalls of imposing top-down reforms without adequate preparation or support for seniors. For Nepalis to age well, community caregivers, doctors, innovators, and above all, the state, must step in where families have stepped away. The goal is not to replicate traditional care, but to build a coordinated system of support that connects everyone through technology. The future is older for Nepal, let us be wiser too. The writers are pursuing their undergraduate studies in biomedical engineering at the Hong Kong Polytechnic University.