<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110161144/636d1d0e9c7e80680e0af390jpeg.jpg" alt="" width="1500" height="1125"/><figcaption>Photo: PRATIBHA TULADHAR</figcaption></figure>Tara wanted to understand why she had been so angry all the time. But she could make no sense of <a href="https://www.nepalitimes.com/opinion/anger-management-for-nepali-women/" target="_blank" rel="noopener noreferrer">her anger</a>—anger that burst from within her like an inferno.Most days, she would wake up in the morning and go back to sleep. She could not comprehend what made getting out of bed so hard. Maybe the fear of having to face the world. Or just having to step out of bed—the act of moving her feet from underneath layers of bedclothes to the floor. Just the act. She would sometimes replay it in her head in repeat before actually doing it.Most days, she had zero courage to move her feet. But by mid-morning, she would usually make do.Read also: <a href="https://www.nepalitimes.com/opinion/no-direction/" target="_blank" rel="noopener noreferrer">No direction</a>, Pratibha TuladharSome days Tara worried about having to talk to Ama. Ama was constantly angry, too. Either angry or afraid. When she wasn’t one of the two, she would only talk about her grief.Ama saw the strangest details in everything around her. Even in pigeons shitting. She would say they must be having a bad stomach. Now, how on earth could she know what was going inside a pigeon’s belly! But she vouched for it. The pigeon. Diarrhetic.She would scoop out details in everything.Whenever Ama met some new fabric for the first time, she would pull the garment up to her eyes, looking through her glasses like they would bleed into the details. Even as she was going blind. Ama!Ama is stuck in between times. She has her ideals, and little else. Most of all, she has no money. Without money, ideals aren’t easy to sell to others. You can only use it as dinner table rants with Tara, who she was brought up to be just like her-- moralistic, semi-arrogant, awkward and afraid at the same time. Yet, every day, Tara promised herself she would never allow herself to become anything like Ama!Read also: <a href="https://www.nepalitimes.com/opinion/sita/" target="_blank" rel="noopener noreferrer">Sita</a>, Pratibha TuladharBut every day, Tara felt a part of her slide through the loophole of her promise. She was gradually turning out to be just like Ama. She had even started laughing like Ama and wheezing like her during asthmatic attacks.The change was so gradual, it did not escape either of them. Tara, now Ama’s spitting copy. Not in image. But in doing. That is who mothers and daughters are—they are each other. Without ever wanting to be.Some days, Tara is not so angry. And on those days, she reaches out with her hands to warm up Ama’s hands. Ama’s hands are a prettier, older version of Tara’s. But they are firm—calloused from years of caring.“Not a rupee for all the care work we do, us housewives!” yells Ama sometimes, after reading an article in the women’s column. After flinging the newspaper aside, off she goes and bends over the kitchen sink again.Ama.Some nights, when it rains, Tara is really cold. And she thinks it is the perfect excuse for her <a href="https://archive.nepalitimes.com/article/editorial/the-republic-of-insomnia,3311" target="_blank" rel="noopener noreferrer">insomnia</a>. In the morning, she will tell Ama she did not sleep because it was too cold.Last night was cold. It rained like mad, like the rain would sweep away all of Kathmandu. Tara regretted not having enough bedclothes. Tara reminded herself that she must get her quilt out in the morning.When she woke up this morning, timorous rays of the sun had begun to steal into the house. Tara asked Ama where her quilt was. She said she had put it away.Read also: <a href="https://www.nepalitimes.com/opinion/letter-to-a-nepali-aunty/" target="_blank" rel="noopener noreferrer">Letter to a Nepali aunty</a>, Anjana RajbhandaryIt irritated Tara to think she would have to go through the ordeal of digging up through a pile of bedclothes to find her quilt. Because Ama had the habit of stowing everything within sight, away. She thought of it as a way of cleaning up the house. And memory.It was a while before Tara dug up her quilt.“I hate the sight of that thing,” Ama said, when her daughter finally managed to pull it out.The quilt, you see, was among the things Ama had bought Tara as her wedding presents. In those days, she was still young and strong so the two had walked through nooks and gallies of Ason, finally deciding on the quilt and then lugging it home all the way to Siuchatar, jumping on and off public vehicles.The cover had massive red and green floral prints. While Tara was married, it had kept her warm—in matrimony and in her loneliness. <a href="https://www.nepalitimes.com/opinion/nepals-unequal-marriages/" target="_blank" rel="noopener noreferrer">Marriage can mean many things</a>. It can be a trail of sighs, hours of tears, punctuated by laughter. Who knows what stays with one when trials are actually over. Not the words, but the essence of experiences.So, when Tara’s marriage ended, bundles of things that belonged to her were sent back to Ama’s home. The quilt was one of the things.Tara wanted to carry it to the terrace and spread it out, so it could soak some sun. But when she carried it up to the terrace, Ama was already there.“I hate the sight of it,” Ama murmured.“It’s alright. It’s mine. You don’t need to deal with hating it.”Tara walked past Ama to the corner of the terrace where pansies and petunias were still in bloom. So unlike this time of the year, Tara thought. Ama’s flowers, just as mad as her. The overnight rain had tampered with them. But they were still there. Withering away, but swaying gently every time the softest, post-rain breeze gathered at their stems.And Tara thought, “We are in spring.”Suburban Tales is a monthly column in Nepali Times based on real people (with some names changed) in Pratibha’s life.

Pratibha Tuladhar

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Of anger and love

Recent outrage in Sikkim over an Indian Army expedition climbing <a href="https://nepalitimes.com/here-now/saving-kangchenjunga">Kangchenjunga</a>, the world’s third-highest peak, has spiked attention to the need to balance mountaineering jobs with indigenous reverence for sacred landmarks. Kangchenjunga (8,586m) is not a peak as much as it is a mountain range with 16 peaks above 7,000m on the border between India and Nepal -- the word itself means ‘five treasures of the snows’ in Tibetan. Some of the highest prominences like Kangchenjunga West and Kangbachen are in Nepal, while the Main, Central and South Peaks are on the border. Climbing the peak from the Indian side has been banned since 2001 because the indigenous Lepcha community there regard the mountain as the abode of Dzoe-nga, the patron deity of Sikkim, which was an independent Himalayan Kingdom until it was annexed by India in 1975.&nbsp; Buddhists in Sikkim say their saint, Padmasambhava, recognised the mountain as a protective spirit. The state has declared the base of the mountain Kangchenjunga National Park, which covers an area one-third of Sikkim. ‘The act of scaling this sacred peak is not only a matter of serious concern but also a violation of both the prevailing legal provisions and the deeply held religious beliefs of the people of Sikkim,’ read a letter from Chief Minister Prem Singh Tamang (Golay) to Amit Shah, India’s Minister of Home Affairs and Cooperation.&nbsp; Tamang continued: ‘We further request Your Honour to take up the issue with the Government of Nepal to ensure that no future expeditions are permitted on the sacred mountain, in deference to the deeply held beliefs and cultural values of the people of Sikkim.’ Kangchenjunga was climbed for the first time exactly 70 years ago by a British team who told King Tashi Namgyal, the Choegyal of Sikkim, that they would not set foot on the summit. Since then, there have been about 532 successful climbs of the peaks and 52 have died while trying.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250628060616_5c268e08cf49f36b79ef9b31933fc2d9bf9a6f65414e7ca06dd028bf04e7ccc1.png" data-media-id="editor_1" data-image-id="20250628060616_5c268e08cf49f36b79ef9b31933fc2d9bf9a6f65414e7ca06dd028bf04e7ccc1" data-rendition-name="original" width="1782" height="1178" loading="lazy" alt="Kangchenjunga: too sacred to climb NT"> <figcaption>Indigenous communities in Sikkim held purification ceremonies following the Indian expedition to Kangchenjunga. Photo: THE VOICE OF SIKKIM / FACEBOOK</figcaption> </figure>  <a href="https://nepalitimes.com/here-now/peak-climbing-season-2025-s4abrxny">This spring climbing season</a> alone, there were 70 climbing permits for foreigners issued for Kangchenjunga by the Nepal government, and made it to the top while one French climber died.&nbsp; One of the expeditions this year was an Indian Army team led by Col Ranveer Jamwal, who has summited the highest peaks on all seven continents, and Mt Everest thrice. Jamwal’s team was on the final leg of a ‘<a href="https://economictimes.indiatimes.com/news/india/nimas-summits-mt-kangchenjunga-concludes-historic-har-shikhar-tiranga-mission-successfully/articleshow/121341315.cms?from=mdr">Har Shikhar Tiranga</a>’ (The Tricolour on Every Peak) mission to plant the Indian flag at the highest points of each of India’s 28 states. Kanchenjunga was the last peak they had left, and the hardest, but the expedition put five climbers on the summit. What seems to have incensed the Sikkimese is that while it has banned climbing the mountain from its side, it was an Indian military expedition that went to Nepal to climb the mountain. After news broke of the climb in May, the Sikkim Indigenous Lepcha Tribal Association asked people to observe purification ceremonies in temples across the state. Mayalmit Lepcha of the association acknowledged that the Sikkim government was also partly at fault: “I don’t think such an expedition could have gone forward without the state government being informed, so it could have done something to intervene. It shows weakness. What’s done is done, all we can do is carry out these sanctification ceremonies.”&nbsp; In 2000, one year before Sikkim’s ban, the state allowed an Austrian team to attempt Kanchenjunga’s northeast face for a fee of $20,000, on agreement that they would stop 10m before the summit. Despite this, there was outrage over the expedition on the grounds that it violated Indian laws regarding the defiling of religious sites and Sikkim’s rights to maintain its culture after merging with India. The Indian Army expedition was also seen to have circumvented Sikkim’s law and violated religious sensibilities by going through Nepal. While the team may have thought they were respecting Sikkim’s beliefs by finding a way to complete the mission, the people of Sikkim saw it as defilement.&nbsp; The somber mood of the Sikkim people at the ritual contrasts sharply with Jamwal’s sense of accomplishment. “Without a doubt, the most difficult summit of my life,” he told reporters after the climb. “It tested every ounce of our will.”&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250628060616_ccfe079c78dab788d19fe2080ee8a5d5dcb11de4157316f6d94e5964da097157.jpg" data-media-id="editor_4" data-image-id="20250628060616_ccfe079c78dab788d19fe2080ee8a5d5dcb11de4157316f6d94e5964da097157" data-rendition-name="original" width="787" height="377" loading="lazy" alt="Kangchenjunga: too sacred to climb NT"> <figcaption>Prayer flags along the Sikkim-Kangchenjunga trekking route. Photo: TREKKINGININDIA.COM</figcaption> </figure>  The <a href="https://nepalitimes.com/news/the-rise-and-fall-of-nims-purja">controversial Nepali-British mountaineer Nirmal Purja</a> was also on Kangchenjunga this spring the mountain, on a mission to summit all 14 8,000m peaks for a third time. He echoed Jamwal about the tough conditions: “The conditions above camp were extremely tough, with deep snow and challenging terrain—more crevasses than usual.” Nepal’s government has not said anything publicly, but it is unlikely that it will ban climbing on Kangchenjunga, since it is becoming popular with expeditions because of its technical challenges, and overcrowding on Mt Everest. Nepal does have bans in place for some of its mountains out of respect for local beliefs. <a href="https://nepalitimes.com/banner/to-open-machapuchre-for-mountaineering-or-not">Mt Machapuchre</a> (6,990m) the imposing pyramid that looms over Pokhara, for example, is seen as an icon of purity by the Gurung people and a symbol of Vishnu by the Hindu communities who live at its base. A strict climbing ban has been in place since 1957, when a British expedition led by Col Jimmy Roberts stopped 45m short of the summit – either because the last bit was too difficult or out of deference to local sentiments.&nbsp; Khumbila that stands above Namche Bazar is only 5,761m high, but like Kanchenjunga is considered the protector deity of the Sherpa people. Gauri Shankar on the Nepal-China border, called Chomo Tseringma by the local community, was off-limits between 1965 and 1979 due to its association with Lord Shiva and Gauri, his consort. Although expeditions are now allowed, there are not too many takers. In Tibet, climbing Mount Kailash is prohibited by the Chinese government because it revered by the Hindus, Buddhists and followers of the Bon faith. Even Mt Everest is regarded as sacred, and its Sherpa name is Chomolungma, Goddess Mother of the Earth.&nbsp; Economically, climbs on Kanchenjunga bring in decent revenue. This climbing season, the 41 permits, at $1,800 each, brought in $73,800. This is somewhat comparable to Makalu, Lhotse, and Annapurna I, but these numbers are dwarfed by the $4 million in <a href="https://nepalitimes.com/news/the-everest-industry">Everest permits</a>. Revenue from Kanchenjunga climbing permits is something Nepal could potentially forgo if necessary, but the expeditions also provide jobs to hundreds of high altitude guides, porters, base camp support staff and other logistical costs.&nbsp; As the third highest mountain in the world and the tallest in India, there will always be significant motivation to climb it from the Nepal side, especially as climbers are drawn by the technical climbing at high altitude.

Kangchenjunga: too sacred to climb?

The monsoon this year arrived on time, and brought life-giving rain — irrigating paddy terraces, recharging groundwater, reviving springs, and increasing electricity generation.
But Nepal has to deal with either too much water or too little. On a clear April day before the monsoon, the hills of Sindhuli district were parched, and there were wildfires burning out of control. There had been no rain for the past six months.
And that has been the perennial crisis for Nepal’s farmers: that 85% of the rainfall occurs during just four months of the monsoon with little rain for the other eight months.&nbsp;
The water crisis is related to the powerful changes sweeping the mid-hill region of Nepal. With better roads, higher incomes and more exposure, many residents now aspire to have the kind of water supply seen in urban homes. They want hot or cold water at the turn of a tap, showers and flush tank toilets.&nbsp;
To meet this rising demand, many local and provincial governments are investing in large water supply projects often by lifting water from rivers hundreds of metres down the mountain. But these new systems may not be sustainable in the long run.
Many villages in Sindhuli are switching from local springs to piped systems, and even in rural homes, overhead tanks are becoming common.
But this new convenience comes with big challenges. Lifting water from rivers far below requires long pipes, electric pumps, and constant maintenance. These systems are costly, and the streams themselves often shrink to a trickle in the dry months. Big water-lifting schemes look impressive, but there is doubt if they can meet growing water demand.
A much more sustainable solution would be what some communities are doing: restoring old ponds or build new recharge systems. But those villages are exceptions, in most places traditional ponds and wallows are being filled up to be turned into sports fields, or make way for buildings.
Where there are new ponds, they are sometimes in the wrong places or without proper design. Roads and drains are not engineered properly and have increased landslides and erosion. Water management in hilly areas is not just about building things, it is about building in the right way, in the right place.
Traditional water systems were based on nature. They were not perfect, but they used the land wisely. Ponds used to hold rainwater and slowly refill springs which supported families, farms, and forests.&nbsp;
Not everything worked well in the past, but we can learn from traditional water management practices. Across Nepal, some rural municipalities have launched campaigns to store monsoon runoff — either in tanks, ponds or by recharging the aquifers.
But not all efforts have been successful. Some ponds are built without any hydrological study. Some are rushed to meet deadlines rather than real needs.&nbsp;
Now, the Muhan initiative hopes to revive springs to make households more resilient and help farmings. With the financial support of the Australian Centre for International Agricultural Research, research is being done to understand how springs work and how they are affected by changes in rainfall, land use, and development.&nbsp;
Instead of just building pipes and tanks, the project maps the entire springshed so we can understand the root cause of water shortage. In Sindhuli, the problem is not the amount of rain, but the loss of natural systems that store it and the social systems that manage water.&nbsp;
Nepal’s towns and villages now face a major challenge: how to manage water all year round as demand rises with people’s living standards. Depending only on river-lift systems is not a sustainable solution.&nbsp;
We need a mix of approaches that help store water from the rainy season to make it available for the rest of the year, whether by directly harvesting rainwater, restoring ponds, managing springsheds, or smart management of demand.
Rural Nepal is also seeing dramatic depopulation. Much of the outmigration can be stemmed if there is easier water supply for agriculture and household use. Across the mid hills, villages are emptying because springs are going dry. Government policy needs to catch up with the reality on the ground, and support solutions that work for people and nature. Every water supply plan should include recharge structures. Every road or building project should consider water flow and erosion. Local governments need more than budgets: they need training, tools, and data.
Ngamindra Dahal is with the Nepal Water Conservation Foundation, Kathmandu. Hemant Ojha collaborated in this piece and is associated with the Australian National University.

Water for Life

<a href="https://nepalitimes.com/multimedia/the-last-of-the-kusunda">The Kusunda</a> are among the last remaining hunter-gatherer communities left in Nepal, and it has only one fluent speaker left of a language that is not related to any other language group in South Asia.&nbsp; The Kusunda call themselves the King of the Forests ((गेम्येहाक़ in Kusunda,वन राजा in Nepali) and used to have a nomadic lifestyle till recently. But decades of exclusion from mainstream society and modernity have forced the Kusunda to assimilate. &nbsp; Today, most Kusunda live across Nepal’s mid-hills and western plains, choosing to identify themselves as Thakuri and adopting names like Sen, Shahi, and Khan to avoid ostracisation. Over time, inter-ethnic marriages between the Kusunda and other communities became increasingly common.&nbsp; However, the assimilation with other communities also meant that almost no one from the Kusunda community can speak their mother tongue – considered by linguists to be a ‘language isolate’ not related to any other language group in the world, and lacking set rules of grammar that are foundational to other languages. There are no words for ‘Yes’ or ‘No’ in Kusunda, nor are there words to signify direction. There are 23 languages with less than 1,000 speakers listed in Nepal's 2021 census, with Kusunda being the language with the least number of speakers. The number of people who identified as Kusunda has decreased with each subsequent census. Only 253 individuals identified themselves as Kusunda in the last National Census of 2021, down from 273 in 2011.&nbsp; <div class="embed-block"><iframe src="https://creators.spotify.com/pod/show/raithane-bhakha/embed/episodes/Kusundas---the-last-of-the-forest-kings-e23ge6p/a-a9peei1" height="102px" width="400px" frameborder="0" scrolling="no"></iframe></div> The government’s decision to provide a social security stipend to the community for the past few years has prompted many from the Kusunda community to reclaim their identity and in the process, explore their culture and language. Kamala Sen Kusunda, who lives in Dang, is the only fluent native Kusunda speaker alive, although there are now other Kusunda and non-Kusunda people learning how to speak the language. By the time Kamala Sen Kusunda was born in 1975, her family had settled in a village in Rolpa. Although she did not experience the nomadic life of her forebears, she still roamed the forests freely as a child and many of the values and socio-cultural practices of her community were instilled in her and her siblings.&nbsp; This meant that Kamala grew up speaking Kusunda with her family. But by then, the Kusunda had increasingly begun to interact with people beyond their community, and inter-ethnic marriages had become a norm.&nbsp; Kamala herself married at 18 to a 52-year-old man from the Chhetri community. She would go on to have four children, but they were brought up with her husband’s culture and community rather than her own, and teaching them her mother tongue seemed impractical.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250628030648_afaa298bf8ea3b7086e2ed086b11eab463ef2b20a82a4aad74df3dd2e922a4c3.jpg" data-media-id="editor_2" data-image-id="20250628030648_afaa298bf8ea3b7086e2ed086b11eab463ef2b20a82a4aad74df3dd2e922a4c3" data-rendition-name="original" width="855" height="641" loading="lazy" alt="Kusunda NT"> <figcaption>Gyani Maiya Kusunda with Kusunda youth in 2015.</figcaption> </figure>  “If I had spoken my language to them when they were children, they would have learned,” she tells us ruefully. “But they were growing up in a different community, so I never pushed, and they never expressed interest.” At the time, she had other things to worry about, such as earning a livelihood and sustaining her family. To find work, Kamala and her family moved to Shimla in India, where she worked at an apple orchard for six years.&nbsp; Over the next years, Kamala and her family moved back and forth between India and Nepal for work, and Kamala was not actively conversing in the language of her people or being able to connect with members of her community now scattered across Nepal.&nbsp; Had she not forgotten her language after all those years? “How could I forget the language of my ancestors?” she replies. “Not speaking it did not mean that it ceased to be a part of me.”&nbsp; Kamala had been working at a brick kiln in Thimi seven years ago when the National Language Commission tracked her down, offered her a paid position as a Kusunda language consultant and source person for basic language training in Dang.&nbsp; It was there that Kamala met her cousin Gyani Maiya Sen Kusunda, the only other person able to speak Kusunda fluently, who had been working with the Commission to conserve Kusunda language and culture. It was also where Kamala met language researcher and lexicographer Uday Raj Ale. Ale had been in the middle of his research into the Tharu language and community 15 years ago when he met Gyani Maiya Kusunda’s son, who told him that his mother was one of the few people who spoke Kusunda, but that no one had shown an interest in studying and preserving the language and culture. Ale met Gyani Maiya, spending time with her learning and researching Kusunda. By 2017, Ale had collected enough words to put together a Kusunda dictionary. The Kusunda vocabulary currently comprises 2,000 words. His research into the Kusunda language and culture has taken him to every known Kusunda household in Nepal. Although the census puts the number of Kusunda at 253, Ale reckons there are only 158.&nbsp; “Kusunda language is endangered due to its lack of use in everyday life, literature, and religious and socio-cultural practices, as well as the prevalence of inter-ethnic marriages,” explains Ale. In 2019 the Language Commission began its language transfer programs for youth from indigenous communities. Since then, the Commission has completed multiple phases of Kusunda language classes in Dang facilitated by Uday Raj Ale. The classes have 20 students, not just from the Kusunda community, but also interested non-native students.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250626120632_c6c378bc00af450f2b7f0cf17af1c3b2b6f7b7226927c458c3e01ec389869d33.jpg" data-media-id="editor_3" data-image-id="20250626120632_c6c378bc00af450f2b7f0cf17af1c3b2b6f7b7226927c458c3e01ec389869d33" data-rendition-name="original" width="1485" height="1535" loading="lazy" alt="Kusunda NT"> <figcaption>Students learning Kusunda with instructor Uday Raj Ale (second row, left)</figcaption> </figure>  Khamba Rokaya, who worked as a caretaker for young Kusunda children in Dang, became interested in learning the language as she sat in with the children during their lessons, and for the last few years has been among the few non-native Kusunda language learners in Dang. “I am not from the Kusunda community, but now that I have learned the language, I hope to do my part to carry on the work and share my knowledge with as many people as possible,” she says. “One way to ensure that we preserve this language is to extend its speaker base, both within the Kusunda and non-native communities.” Ale and Kamala have continued to work together since Gyani Maya’s passing in 2020, expanding the Kusunda vocabulary and creating appropriate curricula to fit the needs of the students as their knowledge of Kusunda expands.&nbsp; But without any documentation of Kusunda history, the community’s traditions, stories, values and language were at risk of being lost to time. “The loss of an ethnicity, language or culture in a country is akin to losing a vital organ, and a unique perspective of looking at the world,” says Ale. Which is why Archive Nepal in collaboration with the British Council’s Cultural Protection Fund and the UK’s Department of Culture, Media, and Sport in February launched a book of creative writings in the Kusunda language titled पिन्डा (meaning ‘The First’ in Kusunda): A Compilation of Kusunda Literature. The book is a collection of informative essays about the Kusunda language and culture, short stories that explore themes from nomadic life to universal Nepali experiences of poverty and migration, letters to loved ones, as well as conversational pieces by five Kusunda students ranging from ages 16 to 30. The works in the Kusunda language are also translated into Nepali and English.&nbsp; “Language is an important part of ethnic identity, and our indigenous languages cannot evolve or be conserved unless they are spoken or taught,” said Ale during the launch of the book earlier this year. “But most importantly, language exists as long as there exists literature in that language.” Kamala was in Kathmandu for the launch of the book, and smiled proudly as she looked at the young writers who had contributed to the collection. She said: “I’m glad the young people have chosen to learn and preserve Kusunda. Otherwise, our language would have died with me.” &nbsp;

Saving the Kusunda language from extinction

A lot of the most critical healthcare software used in the United States, from insurance, medical records, &nbsp;analytics, billings to general operations are made in Nepal.
Coding is outsourced to IT companies in Nepal because it is cheap, and there is a large pool of coders with 15,000 graduates entering the job market every year.&nbsp;
Churn is low, and programming remains a desirable career, with people able to work remotely for high pay with little investment, often even without a degree.
Indeed, building US healthcare software holds up the <a href="https://nepalitimes.com/here-now/nepal-needs-to-be-more-intelligent-about-ai">growing Nepali IT industry</a> which last year exported software worth $900 million, nearly as much as Nepal earns from tourism every year.
IT exports have a long history, starting from when Rudra Pandey co-founded D2Hawkeye, which pioneered healthcare analytics. The company is now Verisk Health. &nbsp;
There are over 15 technology companies that specialise in medical software, operating mostly as subsidiaries of US companies, but some are also ‘vendors’ that are completely Nepali-owned.
One such company is <a href="https://techkraftinc.com">TechKraft</a>, which builds software for clients across the world in healthcare, but also in finance. Its Executive Director Santosh Koirala says: “A big advantage Nepal has in making US healthcare software is simply how long it has been involved in it. This has created many domain experts, and new programmers here are technically excellent as well.”&nbsp;
The trust and skills that companies and individuals have built up is also how TechKraft gets clients, referrals and business, and they have to strictly ensure data security and privacy protection.
“This is personal information about people’s insurance, their visits to the hospital, their diseases. Any breaches could lead to expensive lawsuits,” says Koirala.&nbsp;
While it is much easier for subsidiary companies to keep data within their systems, vendors must put in place multiple layers of physical and cybersecurity to convince clients to work with them. They must work in what is called a ‘cleanroom’: a controlled environment where teams can work on sensitive data without compromising security or privacy.&nbsp;
Laptops and even pen and paper cannot leave the workplace, and all employees must pass training in globally recognised information security standards.
AI is transforming processing of healthcare data, and companies like TechKraft have integrated it in everything they do. Agentic AI is designed for a high level of autonomy, and can handle booking, rescheduling, and reminders for patient visits, detect anomalies in medical imagery, analyse patient data to create custom treatment plans, predict outcomes, even catch medical fraud.&nbsp;
AI also helps programmers at TechKraft write better code, faster. “AI has had a huge impact on our workflow, it is faster and more efficient,” says Koirala, ”but since it makes things so much easier, it may become harder to find business.”&nbsp;
It also means that a project may require only four engineers skilled with AI instead of say, ten. The remaining six are out of a job.
Another Nepali company, <a href="https://wiseyak.com">Wiseyak</a>, also works on a host of AI healthcare products. One is software that can diagnose diabetic retinopathy and pneumonia at least as well as the best doctors. Another is AI-EMR algorithms that can analyse patient data to provide insights and recommendations.&nbsp;
“We help doctors by building powerful tools, and not replace them.” says co-founder and CEO of Wiseyak Suresh Manandhar, who has been studying and working with AI for 40 years, long before it became a part of everyday life.&nbsp;
Wiseyak now wants to make software that can be used in Nepal’s hospitals to diagnose various diseases. For retinopathy, an AI is trained on publicly available datasets of retinal scans.&nbsp;
The model can then learn to detect a range of symptoms such as microaneurysms in the eye, ‘cotton wool’, and macular degeneration. It can then make a diagnosis based on the quantity and size of the anomalies it detects.&nbsp;
“AI can be fine tuned by feeding it retinal scans of Nepalis,” says Manandhar who admits to difficulties because medical records in Nepal are still paper-based and not digital, and few hospitals want to retool. “The government should &nbsp;invest and build momentum to adopt these technologies.”&nbsp;
Santosh Koirala of TechKraft is also president of Nepal Association for Software and IT Services Companies (NAS-IT), a group that focuses on <a href="https://nepalitimes.com/here-now/self-learning-comes-before-machine-learning">policy and advocacy with the government</a>. He is optimistic about gradual progress in lobbying efforts.&nbsp;
“The government is slowly getting it,” he told us. “Removing limits to Foreign Direct Investment and allowing Nepali companies to have offices abroad are big steps in the right direction.”&nbsp;
NAS-IT also advises universities on the development of courses to keep students up to date with the latest developments in AI, as well as pushing for data insurance to make clients less reluctant to work with Nepali companies.
Both Koirala and Manandhar are optimistic about the general direction Nepal’s IT sector is going in, and can build on.
&nbsp;“There is a lot of potential which is being recognised quite quickly,” says Koirala. “We know the technology now, and we know how things are done at a global level. The next step is for Nepal to start making products that can be used widely across the world.”&nbsp;
IT products for application within Nepal are now designed in Nepal itself, and software companies such as eSewa were ahead of their time in the region.
Manandhar is also bullish: “There is no limit to how helpful AI can be for Nepal. Trained, super-specialised doctors are scarce, so AI can be a substitute and make them three, four times more efficient.” &nbsp;&nbsp;

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