<figure><img width="971" height="487" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022111410110/637204179c7e80680e0b2842jpeg.jpg" alt=""/><figcaption>Daily reported Covid-19 cases and deaths since January 2020, when the first case was detected in Nepal.</figcaption></figure>It was on 23 January 2020 that the first Covid-19 case was detected in Nepal. Two years later, the country is on the cusp of a <a href="https://www.nepalitimes.com/banner/vaccines-variants-and-a-third-wave/" target="_blank" rel="noopener noreferrer">third wave</a>.The time to sound an alarm about a new surge is long over. Action should have been taken months ago. All the government can do now is to launch a massive campaign to inoculate the unvaccinated, offer boosters to frontline workers, the elderly, and people in densely populated areas.Evidence elsewhere, including in neighbouring India, show that while the <a href="https://www.nepalitimes.com/opinion/omicron-is-coming-to-nepal-be-prepared/" target="_blank" rel="noopener noreferrer">Omicron strain</a> is 12 times more transmissible than previous variants, most of those infected do not need critical care in hospitals – unless unvaccinated or immuno-compromised.    Cases are rising fast in Nepal, doubling every 2 days to 3,075 new recorded infections on Wednesday. The positivity rate has soared 10 times in a week to 23.5%. At this rate, there will be 12,000 new confirmed cases by 16 January, which will be higher than the peak of the second wave in May 2021.“With Omicron now spreading in the community, we don’t need to gene sequence anymore,” says Epidemiology and Disease Control Division director Krishna Prasad Paudel.He is hoping Omicron will show a similar trajectory to elsewhere, and those infected will have <a href="https://www.nepalitimes.com/here-now/omicron-may-not-be-as-risky-but-take-care/" target="_blank" rel="noopener noreferrer">milder symptoms </a>compared to Delta. The new variant mostly impacts the upper respiratory tract, with lungs largely unaffected, hence lessening the need for oxygen and ventilators.However, Nepal’s low vaccination rate (50% partially, 40% fully) means that individuals need to continue taking precautions with masks and distancing.Read also: <a href="https://www.nepalitimes.com/latest/nepal-has-all-the-conditions-for-an-omicron-surge/">“Nepal has all the conditions for an Omicron surge”</a>, Nepali Times <figure><img width="2048" height="1366" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022111410110/637204199c7e80680e0b2843jpeg.jpg" alt=""><figcaption> </figcaption></figure>A double dose of the vaccine is not as effective against Omicron, and most Nepalis have passed six months since they were inoculated, meaning that their antibody levels have fallen considerably by now. <a href="https://www.nepalitimes.com/here-now/boosting-booster-jabs-against-omicron/" target="_blank" rel="noopener noreferrer">Boosters would provide more protection</a>, but the government is only offering those to high risk groups from next week.Although Omicron is now the dominant strain, Delta is still circulating, and causing deaths. We know from the past two years that it takes a few weeks for mortality to pick up after <a href="https://www.nepalitimes.com/latest/nepal-needs-to-prepare-for-new-covid-wave/" target="_blank" rel="noopener noreferrer">cases start rising</a>. This has been seen in India, and Nepal closely follows health trends there.“We need to keep a close watch on our mortality figures, find out which variant is causing most deaths, and we will have to prepare hospitals and healthcare workers once again,” warns epidemiologist Lhamo Yangchen Sherpa of IPAS.Across Nepal, many <a href="https://www.nepalitimes.com/here-now/at-the-covid-19-frontlines-in-rural-nepal/" target="_blank" rel="noopener noreferrer">rural hospitals are still understaffed</a> and do not have trained personnel to operate ventilators and run ICU wards. Not all new oxygen plants are functional yet.But Sangeeta Kaushal Mishra of the Health Coordination Division assures that the government is in a better position this time: “We are prepared for hospitalisations if cases are milder, but we don’t know how the virus will behave."The sheer transmissibility of Omicron could mean severe symptoms and even deaths among the elderly and those with pre-existing conditions like diabetes.  Elsewhere in the world, even vaccinated health workers have been infected, overwhelming hospitals.Read also: <a href="https://www.nepalitimes.com/latest/all-vaccines-prevent-severe-covid/">“All vaccines prevent severe Covid”</a>, Nepali Times <img width="1594" height="986" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022111410110/6372041d9c7e80680e0b2844jpeg.jpg" alt="">The first line of defence against Covid is still masks and distancing. The second is <a href="https://www.nepalitimes.com/latest/vaccines-are-the-only-solution/" target="_blank" rel="noopener noreferrer">mass vaccination</a>. Nepal still has a stockpile of over 10 million doses in refrigerated stores, and 6 million more doses in the pipeline. A syringe shortage reduced the vaccination rate, but Mishra expects the drive to pick up next week. More than 200,000 people were vaccinated on Wednesday.“We were lucky Omicron is mild, but we should use this  opportunity to inoculate both the unvaccinated and boost the  vulnerable on war footing,” says physician Buddha Basnyat of Patan Academy of Health Sciences.The government is starting mass inoculation of children from 12-17 years, and has shut down schools for three weeks until 29 January due to the new surge. Gatherings of more than 25 people have been banned, masks are mandatory outdoors, and people will need vaccine cards to enter public spaces from next week.“The fact that Omicron is much milder has made people even more careless, so we must once again reinforce the importance of masks, ventilation and distancing,” warns virologist Sher Bahadur Pun at Teku Hospital.Equally important is the institutional isolation of active cases and contact tracing. Experts believe official <a href="https://www.nepalitimes.com/latest/nepal-covid-19-impact-worse-than-official-figures/" target="_blank" rel="noopener noreferrer">figures are under-reported</a> and total cases and fatality figures are much higher. The Economist tracks ‘excess deaths’ across countries and estimates that 2.3 million people had died from Covid-19 by May 2021 in India, compared to only 200,000 official fatalities.Its calculations show that when Nepal recorded its highest daily Covid deaths of 246 on 19 May 2021, the actual number was 425. The real infection rate was also much higher than official data.Read also: <a href="https://www.nepalitimes.com/here-now/living-with-covid-in-2022/">Living with Covid in 2022</a>, Sonia Awale

Sonia Awale

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3rd wave in 2 years

<figure><img width="1221" height="814" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110161152/636d1eaf9c7e80680e0af423jpeg.jpg" alt=""/><figcaption>Photo: AMIT MACHAMASI</figcaption></figure>It has been two years since the coronavirus turned the world (and Nepal) upside down.  <a href="https://www.nepalitimes.com/banner/behind-the-masks/" target="_blank" rel="noopener noreferrer">Masks have become the norm</a>, physical distancing is a must, vaccines are mandated, and parts of the world are going back to lockdowns. The virus has infected 277,523,045 people and killed over 5.3 million, a figure that does not count ‘excess fatalities’. 
Just as everyone was waiting for business to go back to normal in 2022, countries have been hit with a <a href="https://www.nepalitimes.com/latest/nepal-on-high-alert-for-omicron/" target="_blank" rel="noopener noreferrer">highly contagious new variant</a>. There are now serious worries about the efficacy of vaccines against Omicron and <a href="https://www.nepalitimes.com/here-now/do-nepalis-need-covid-booster-shots/" target="_blank" rel="noopener noreferrer">who and when to boost</a>. 
Lab tests have shown that the AstraZeneca and VeroCell vaccines most used in Nepal may not be so effective against Omicron, and only m-RNA vaccines like Pfizer and Moderna may be effective as boosters to stop infections. However, researchers have said all vaccines, including AstraZeneca and the Chinese jabs, significantly protect against serious illness. 
Nepali Times spoke with national and international health experts to verify these initial findings and how it is likely to impact Nepal’s response to the new strain.
“The coronavirus is here to stay and it will remain with us for decades to come. To do this it will find ways to continue to infect people in communities even if they are vaccinated,” <a href="https://www.nepalitimes.com/latest/all-vaccines-prevent-severe-covid/" target="_blank" rel="noopener noreferrer">Andrew Pollard</a>,  who helped develop the AstraZeneca vaccine told Nepali Times from Oxford.
He added: “The important role of the vaccines is to prevent severe disease and the evidence so far, even with Omicron, does appear to indicate that vaccines are still holding up in preventing most of the severe outcomes.”
<a href="https://www.nepalitimes.com/latest/all-vaccines-prevent-severe-covid/">“All vaccines prevent severe Covid”</a>, Nepali Times 
Infectious diseases specialist at HAMS hospital in Kathmandu Anup Subedee agrees: “It is true that mRNA vaccines are more effective against the new variant but all the shots still significantly reduce severity and mortality. So our priority must be to vaccinate as many people as soon as possible and to boost the immune-compromised and frontliners.”
Researchers recommend using mRNA vaccines as booster for the vulnerable populations. Last week, Nepal received nearly 2 million doses of Moderna shots from Germany via the COVAX facility, which is sufficient to provide booster doses for the elderly. Health Minister Birodh Khatiwada announced on Wednesday that Nepal would start boosters from mid-January. 
A recent study by The Imperial College London estimated that the risk of reinfection with the Omicron variant is 5.4 times greater than that of the Delta variant. What this means is that the protection against reinfection by Omicron afforded by past infection may be as low as 19%. Early studies also suggest that Omicron is four-fold more infectious than the Alpha strain and two-fold more infectious than <a href="https://www.nepalitimes.com/banner/we-knew-the-tsunami-was-approaching/" target="_blank" rel="noopener noreferrer">Delta</a>.
“There is some evidence that shows that a natural immunity from past infection and or vaccine-induced immunity from prior vaccination may not be sufficient to prevent Omicron infection. But it is too early to make a concrete statement,” regional health expert Sushil Koirala told Nepali Times via email from Bangkok. 
Preliminary findings suggest that <a href="https://www.nepalitimes.com/here-now/omicron-may-not-be-as-risky-but-take-care/" target="_blank" rel="noopener noreferrer">Omicron may be milder than previous variants</a>, but its increased transmissibility could still result in high rates of severe disease and death particularly among vulnerable and unvaccinated groups, overwhelming ICU capacity. 
“The real question is not how many people Omicron is likely to kill but given its higher transmissibility, how Nepal’s limited health infrastructure will deal with a surge,” says Dibesh Karmacharya of the Centre for Molecular Dynamics Nepal. “We have to also see how Omicron affects vulnerable populations in Nepal that have already been vaccinated.”
The general consensus is to launch <a href="https://www.nepalitimes.com/banner/vaccines-variants-and-a-third-wave/" target="_blank" rel="noopener noreferrer">mass immunisation</a> and administer booster shots for the vulnerable population simultaneously. Early evidence based on lab studies shows a booster jab with any vaccine increases protection against Omicron and reduces hospitalisations and deaths.
“Boosters do seem to increase antibodies and some early evidence from the UK shows that boosters increase protection against these mild infections,” says Pollard. “Boosters may be important for some of the frailest in our communities to keep them safe if their protection has waned. Some countries have started booster programs focusing on these risk groups first.”<a href="https://www.nepalitimes.com/latest/nepal-has-all-the-conditions-for-an-omicron-surge/">“Nepal has all the conditions for an Omicron surge”</a>, Nepali Times 
The Ministry of Health has announced booster shots from mid-January 2022 provided that the World Health Organisation (WHO) permits it. The WHO has been prioritising first and second doses over boosters, especially where there is a short supply of vaccines, and recommended boosters only after 40% of the population is fully vaccinated.
“WHO might have its guidelines but we must also stick to our national priorities, we must provide boosters for frontliners so that Omicron does not shut down our health care system,” adds Subedee. “We must not miss immune-compromised and the elderly, it is more important for now to provide boosters for 80+ people than administer a single dose to 12-18 year olds.”
Nepal’s vaccine stockpile is now so big and vaccine uptake so slow that there is a danger of vials having to be destroyed because of the <a href="https://www.nepalitimes.com/here-now/from-scarce-vaccines-to-storage-shortage-in-nepal/" target="_blank" rel="noopener noreferrer">lack of refrigerated storage</a>,  and there are millions more vaccines in the pipeline. Nigeria this week destroyed 1 million vials saying the international community provided those doses close to expiry dates.
“We now need to get jabs into arms as soon as possible, we must continue inoculating those who haven’t yet been vaccinated while simultaneously also administering boosters, given the decreasing antibody levels and the rise of new variants,” says Buddha Basnyat, a physician at the Patan Academy of Medical Sciences.
So far, Nepal has confirmed three imported Omicron cases, the first in mid-November, meaning a small cluster transmission is already at play. Superspreader <a href="https://www.nepalitimes.com/latest/unconventional-party-conventions/" target="_blank" rel="noopener noreferrer">political events and large gatherings</a> have increased the risk of further transmission. 
Given relatively lower vaccination coverage, lack of booster doses, unknown efficacy of Chinese jabs used and insufficient safety measures, <a href="https://www.nepalitimes.com/latest/nepal-needs-to-prepare-for-new-covid-wave/" target="_blank" rel="noopener noreferrer">Nepal is a breeding ground</a> for a highly contagious variant to spread. But what will happen in Nepal will largely depend on how the Omicron outbreak plays out in India. 
Says Basnyat: “We have to prepare for a new surge, we have been caught too many times with our pants down."
The way to do that, Koirala says, is to increase surveillance on the Indian border, and <a href="https://www.nepalitimes.com/latest/vaccines-are-the-only-solution/" target="_blank" rel="noopener noreferrer">accelerate the vaccination drive</a>. “It is of utmost importance that Nepal start preparing critical care and for possible lockdowns for a large-scale Omicron outbreak. We can’t afford to wait.”
As we welcome 2022, the New Year’s resolution should be normalising the pandemic by increasing the global vaccine equity. Says Dibesh Karmacharya: “Some countries now have the fourth dose but unless we achieve vaccine equity and herd immunity, Omicron will just be one among a long line of variants.”

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Living with Covid in 2022

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110141152/636d02a39c7e80680e0a368fjpeg.jpg" alt="" width="1360" height="680"/><figcaption>Photo via PROJECT SYNDICATE</figcaption></figure>The upsurge of Covid-19 cases, hospitalisations, and deaths in the United States serves as a bitter reminder that the pandemic is not over. The global economy will not return to normal until the disease is under control everywhere.But the US case is a true tragedy, because what’s currently happening here is so unnecessary. While those in emerging markets and developing countries are longing to get the vaccine (with many dying because they cannot get it), the US supply is ample enough to provide a double dose – and <a href="https://www.nepalitimes.com/opinion/to-boost-or-not-to-boost/" target="_blank" rel="noopener noreferrer">now a booster shot</a> – to everyone in the country. And if almost everyone got vaccinated, Covid-19 would almost surely just “fade away,” as former President Donald Trump memorably put it.And yet not nearly enough people in the US have been vaccinated to prevent the highly contagious <a href="https://www.nepalitimes.com/here-now/delta-variants-wake-up-call-for-nepal/" target="_blank" rel="noopener noreferrer">Delta variant</a> from driving case numbers in many areas to new highs. How do so many in a country with seemingly well-educated people act so irrationally, against their own interest, against science, and against the lessons of history?Part of the answer is that the country, for all of its wealth, is not as well-educated as one might expect – which is reflected in the country’s comparative international performance on standardised assessments. In many parts of the country – including some with the highest rates of resistance to vaccination – science education is particularly poor, owing to politicisation of fundamental issues like evolution and <a href="https://www.nepalitimes.com/banner/un-climate-report-declares-planetary-emergency/" target="_blank" rel="noopener noreferrer">climate change</a>, which in many cases have been excluded from school curricula.In this environment, misinformation can gain traction with many people. And social-media platforms, insulated from liability for what they transmit, have made a business model of maximising “user engagement” by spreading misinformation, including about Covid-19 and the vaccines.But a key part of the answer is a deep misinterpretation, especially among the right, of individual liberty. Those who refuse to <a href="https://www.nepalitimes.com/here-now/3-pronged-strategy-to-save-nepal-from-covid-19/" target="_blank" rel="noopener noreferrer">wear masks</a> or socially distance often argue that requirements to do so infringe on their freedom. But one person’s freedom is another person’s “unfreedom.” If their refusal to wear a mask or get vaccinated results in others getting Covid-19, their behaviour is denying others the more fundamental right to life itself.The essence of the matter is that there are large externalities: In a pandemic, one person’s actions affect the well-being of others. And whenever there are such externalities, the well-being of society requires collective action: regulations to restrict socially harmful behaviour and to promote socially beneficial behaviour.Any ordered society entails restrictions. But while prohibitions against killing, stealing, and so on restrict an individual’s freedom, we all understand that society could not function without them. In our post-Covid world, we might interpret the Ten Commandments to include: “Thou shall not kill, including by spreading infectious diseases when thou can avoid doing so.”Similarly, “Thou shall get vaccinated.” Any infringement of an individual’s liberty by requiring safe and highly effective <a href="https://www.nepalitimes.com/opinion/why-vaccination-should-be-compulsory/" target="_blank" rel="noopener noreferrer">Covid-19 vaccination</a> pales in comparison to the social benefits – and consequent economic benefits – of public health. It is a no-brainer to require all individuals, with only limited medical exemptions, to be vaccinated. While many governments appear to be too timid to impose this requirement, employers, schools, and social organisations – any organised activity that brings individuals into contact with others – should do so.As we have been learning for the last 18 months, global health is a global public good. As long as the disease rages in some parts of the world, <a href="https://www.nepalitimes.com/latest/too-early-for-nepal-to-let-its-guard-down/" target="_blank" rel="noopener noreferrer">the risk of a deadlier</a>, more contagious, more vaccine-resistant mutation grows.In most of the world, however, the problem is not resistance to vaccination but a <a href="https://www.nepalitimes.com/opinion/hope-hyperbole-and-hypocrisy-of-covax/" target="_blank" rel="noopener noreferrer">severe shortage of vaccines</a>. Evidently, the private sector is unable to scale up production to ensure an adequate supply. Is that because vaccine producers lack capital? Is there a shortage of glass vials or syringes? Or is it because they hope that fewer doses will lead to higher prices and even bigger profits? Among the key barriers to greater supply is access to the requisite intellectual property, which is why the IP waiver being discussed at the World Trade Organisation is so important.Given the urgency and scale of the challenge, more is needed: Among the steps US President Joe Biden’s administration could take is to invoke the Defense Production Act and leverage the federal government’s ownership of key patents. The US has been allowing the pharmaceutical companies to use this public IP freely, while they reap billions of dollars in profits. The US must use every instrument at its disposal to increase production at home and abroad.This, too, is a no brainer. Even if the costs of global vaccination totaled tens of billions of dollars, the amount would pale in comparison to the costs of <a href="https://www.nepalitimes.com/banner/how-nepal-must-prepare-for-3rd-covid-wave/" target="_blank" rel="noopener noreferrer">persistent Covid-19 outbreaks</a> to lives, livelihoods, and the world economy.By arrangement with © <a href="https://www.project-syndicate.org/" data-saferedirecturl="https://www.google.com/url?q=https://www.project-syndicate.org/&amp;source=gmail&amp;ust=1607178503443000&amp;usg=AFQjCNHSbaaYvdpDj2FQzkDgwL7xNFnkWg">Project Syndicate</a>Joseph E. Stiglitz, a Nobel laureate in economics and University Professor at Columbia University, is a former chief economist of the World Bank (1997-2000), chair of the US President’s Council of Economic Advisers, and co-chair of the High-Level Commission on Carbon Prices. He is a member of the Independent Commission for the Reform of International Corporate Taxation and was lead author of the 1995 IPCC Climate Assessment.

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Covid-19 and Human Freedom

<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110141152/636d020c9c7e80680e0a365djpeg.jpg" alt="" width="1500" height="1125"/>After nearly <a href="https://www.nepalitimes.com/here-now/lessons-not-learned-from-the-pandemic/" target="_blank" rel="noopener noreferrer">two years of disruptions,</a> Nepalis are itching to get back to normal lives. But there are signs society is returning to an old normal.As soon as the daily caseload and infection rate started falling, the <a href="https://www.nepalitimes.com/banner/kathmandu-covid-19-lockdown-relaxed/" target="_blank" rel="noopener noreferrer">lockdown was lifted</a> even while more than 10% of those tested are still Covid-positive, there are still nearly 500 people in ICU and ventilators in hospitals, and the Delta variant is infecting even those vaccinated.And now schools are set to open next week. While we understand that there has been a tremendous social cost to students not attending in-person schools for nearly two years, why was there a need to reopen <a href="https://www.nepalitimes.com/latest/learning-during-the-pandemic-in-nepal/" target="_blank" rel="noopener noreferrer">just for a few weeks </a>before the holidays?Some teachers, not all, have only just got their first vaccine doses, and unvaccinated children will now be in crowded classrooms, and then going home for family and festival gatherings for Dasain-Tihar-Chhat.As our report this week warns, we have <a href="https://www.nepalitimes.com/banner/how-nepal-must-prepare-for-3rd-covid-wave/" target="_blank" rel="noopener noreferrer">been at this point before.</a> Last year this time, the government relaxed the lockdown and millions travelled to their hometowns. Cases soared as the first wave peaked during the holidays (see graph).<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110141152/636d020f9c7e80680e0a365ejpeg.jpg" alt="" width="1494" height="788">Experts have told us that a <a href="https://www.nepalitimes.com/banner/vaccines-variants-and-a-third-wave/" target="_blank" rel="noopener noreferrer">third wave is not likely</a>, given that 20% of the population are now vaccinated (probably rising to 30% by Dasain), as well as the presence of natural antibodies detected in nearly 70% of the population in a recent sample sero-prevalence survey.However, we <a href="https://www.nepalitimes.com/here-now/delta-variants-wake-up-call-for-nepal/" target="_blank" rel="noopener noreferrer">cannot let our guard down.</a> Delta is a sly virus, just waiting for an opportunity to pounce, and exploiting every weakness in human behaviour.Experience from Nepal and other countries have shown that fully vaccinated people can be infected, and spread the virus to others, including elderly and unvaccinated children at home. Because of Delta’s high transmissibility, experts warn that labels like ‘herd immunity’ and ‘breakthrough cases’ do not make sense anymore.By the time Nepal reaches 40% vaccinated population by December, it will also be time for the third booster shots. We also do not know how long the natural immunity will last in the 70% of the population with antibodies.Studies in India and elsewhere have shown that lockdowns and a high seropositivity rate did not protect children from being infected with Covid-19 if family members were not careful about mingling and mask-wearing.Research also shows that the risk of infection in the classroom is low if students wear masks properly at all times, and are physically separated in well-ventilated classrooms.Experts predict that there will be a slight increase in Covid-19 cases among students, teachers and family members at home when schools resume in-person classes. But as vaccination rates rise, and in areas with high sero-prevalence, it may not lead to another spike, or even a third wave.What no one can tell us is how ‘slight’ this ‘increase’ in Covid-19 cases will be in Nepal – especially since the <a href="https://www.nepalitimes.com/banner/once-nepal-gets-vaccines-they-need-to-be-fairly-distributed/?fbclid=IwAR0IGQM5l7WOvlo7nCpubILhVAcvoXeHdI-EUnSHShNKTUlswPNRcyndBfw" target="_blank" rel="noopener noreferrer">vaccination rate is still low </a>and most classrooms, school buses, playgrounds are crowded, and children will be excited to see each other after so many months away from friends.So, while the benefits of resuming physical classes may outweigh the risks, the government <a href="https://www.nepalitimes.com/editorial/ministry-of-education-gets-an-f/" target="_blank" rel="noopener noreferrer">has been ill-advised</a> to restart in person lessons just a few weeks before schools close again for the holidays.Instead, it should have used the coming weeks to launch a saturation awareness campaign with strict criteria for school opening, citing <a href="https://www.nepalitimes.com/latest/keep-wearing-masks-after-the-lockdown/" target="_blank" rel="noopener noreferrer">mask-wearing at all times,</a> spacing and limited mingling. Parents, teachers and students must be convinced that the risk has been minimised, and the cost of denying children education now exceeds the risks to them from Covid.Across South Asia, school closures and limited digital learning have deprived children for a prolonged period from education, widening socio-economic inequalities. In Nepal, the <a href="https://www.nepalitimes.com/here-now/digital-divide-exposes-class-divide-in-nepal-schools/">digital divide has created an education divide</a> with most of the 80% of students who attend government schools deprived of learning since March 2020.Most students have missed at least 70 weeks of school since the pandemic. Of the 29% of children in a recent survey who said they had access to distance learning via radio, television or online, only half were actually using it – mostly in cities and private schools. The pandemic has wrecked Nepal’s gains in school enrolment, especially among girl children.While keeping schools closed does not prevent the Delta variant from spreading, they should not reopen <a href="https://www.nepalitimes.com/here-now/3-pronged-strategy-to-save-nepal-from-covid-19/" target="_blank" rel="noopener noreferrer">without precautions in place</a> – and only after the festivities. Public awareness campaigns are needed before in-person classes resume, and compliance must be monitored. Last but not least, expedite full vaccination of teachers and school staff nationwide.

Two schools of thought

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110141132/636cfe379c7e80680e0a0c29jpeg.jpg" alt="" width="1384" height="898"/><figcaption>MASKING THE TRUTH: Of the approximately 130 people in this photograph of the steps of the Nyatapola Temple during the Saparu festival on Monday, only 12 were not wearing masks properly. But experts warn that masks alone will not provide full protection from the delta variant, people must also avoid crowds like this. Photo: AMIT MACHAMASI / PHOTOSHOP BY KIRAN MAHARJAN</figcaption></figure>In January Nepal became the first country in South Asia to <a href="https://www.nepalitimes.com/banner/nepal-begins-covid-19-vaccination-drive/" target="_blank" rel="noopener noreferrer">start the Covid-19 vaccination drive</a>. Today, despite delays and a <a href="https://www.nepalitimes.com/banner/we-knew-the-tsunami-was-approaching/" target="_blank" rel="noopener noreferrer">devastating second wave</a>, close to 15% of the population is fully inoculated.Recent surveys show that 97% of Nepalis would take the Covid vaccines if available. Used to pollution, mask wearing is also high among urban Nepalis.With minimal vaccine and mask resistance, Nepal should have by now had the pandemic under control. And although the spike in cases after the lockdown was partially lifted in July is flattening out, the daily <a href="https://www.nepalitimes.com/banner/nepals-uneven-covid-19-deaths/" target="_blank" rel="noopener noreferrer">death rate</a> is still high and the risk of a <a href="https://www.nepalitimes.com/banner/vaccines-variants-and-a-third-wave/" target="_blank" rel="noopener noreferrer">new Covid-19 surge</a> is greater than before.<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110141132/636cfe3a9c7e80680e0a0c2ajpeg.jpg" alt="" width="2770" height="1348"><a href="https://covid19.healthdata.org/global?view=cumulative-deaths&amp;tab=trend" data-saferedirecturl="https://www.google.com/url?q=https://covid19.healthdata.org/global?view%3Dcumulative-deaths%26tab%3Dtrend&amp;source=gmail&amp;ust=1630094210932000&amp;usg=AFQjCNGvdeV1UA0KTyh-ILmgK3DYs64LZQ">Graph from IHME for Nepal</a> showing reported total fatalities from Covid-19 (orange line) and the estimated actual deaths counting excess fatalities including unreported cases (green line). For example, on 25 August, the reported total was 10,614, but the excess deaths from Covid-19 including unreported was projected at more than 37,000. If 90% of the population started wearing masks (green dotted line), nearly 6,000 Covid-19 deaths would be prevented by 31 December (red dotted line). Go to <a href="https://covid19.healthdata.org/global?view=cumulative-deaths&amp;tab=trend" data-saferedirecturl="https://www.google.com/url?q=https://covid19.healthdata.org/global?view%3Dcumulative-deaths%26tab%3Dtrend&amp;source=gmail&amp;ust=1630094210932000&amp;usg=AFQjCNGvdeV1UA0KTyh-ILmgK3DYs64LZQ">IHME</a><a href="https://covid19.healthdata.org/global?view=cumulative-deaths&amp;tab=trend" data-saferedirecturl="https://www.google.com/url?q=https://covid19.healthdata.org/global?view%3Dcumulative-deaths%26tab%3Dtrend&amp;source=gmail&amp;ust=1630094210932000&amp;usg=AFQjCNGvdeV1UA0KTyh-ILmgK3DYs64LZQ"> site for interactive Nepal graphs.</a>Source: The <a href="http://www.healthdata.org/" data-saferedirecturl="https://www.google.com/url?q=http://www.healthdata.org/&amp;source=gmail&amp;ust=1630094210932000&amp;usg=AFQjCNEWLI_7338oGit9sBT_Fq-Ut4iofA">Institute for Health Metrics and Evaluation (IHME)</a> an independent global health research center at the University of Washington.Experts say the vaccination drive appears to have created a false sense of security among those with jabs to believe that they are now fully immune to the coronavirus.Ironically, the government’s <a href="https://www.nepalitimes.com/editorial/no-vax-ask-for-mask/" target="_blank" rel="noopener noreferrer">promotion of masks</a> also may have been too successful – with many thinking it will protect them from the virus even if they crowd around. A case in point is the Saparu festival crowd in Bhaktapur earlier this week (pictured above).“If you are going to crowd in that way for an extended period there is no point in wearing a mask,” states epidemiologist Lhamo Yangchen Sherpa.“Many still don’t know that the virus transmission is through the airborne route, and we cannot be careless knowing how infectious the delta variant is and that the majority of the people are still unvaccinated, particularly children,” she adds.Masks and vaccines just reduce infections and serious symptoms, <a href="https://www.nepalitimes.com/opinion/dying-to-get-vaccinated/" target="_blank" rel="noopener noreferrer">they are not foolproof</a>. And epidemiologists warn that available vaccines do not stop even those who are vaccinated from transmitting the virus.New studies have also shown that even the protection vaccines provide will be wearing off, so Nepalis with jabs will be needing third booster shots even before the eligible population is fully vaccinated.Covid-19 vaccines save lives by ensuring that infected people do not have serious symptoms, and do not require hospitalisation. But vaccinated people can be carriers at the same rate as those unvaccinated if they have been infected with a <a href="https://www.nepalitimes.com/here-now/delta-variants-wake-up-call-for-nepal/" target="_blank" rel="noopener noreferrer">delta variant</a>.“What I’m seeing now is a surge of overconfidence among younger people who are vaccinated, they are risking everyone else not yet vaccinated, especially as Dasain-Tihar nears,” says virologist Sher Bahadur Pun at Teku Hospital. “We are creating an ideal condition for the next surge or the third wave to take place.”Recent studies have shown that an individual infected with delta variant even if vaccinated can have a high viral load -- as high as that of an unvaccinated person. This means they can be carriers of the virus just like unvaccinated people.The real surge in Covid cases last year took place <a href="https://www.nepalitimes.com/latest/this-years-dangerous-dasain/" target="_blank" rel="noopener noreferrer">after the festivals</a> when millions of Nepalis travelled from Kathmandu to their home villages and took the virus to the remotest corners of the country.This resulted in higher fatalities, especially in rural Nepal with <a href="https://www.nepalitimes.com/latest/rural-nepal-fights-back-covid-19/" target="_blank" rel="noopener noreferrer">limited health care facilities</a>.  A recent report found that despite fewer cases, Dolpa, Mugu and Humla districts had fatality rates of 7%, 6% and 5% respectively – compared to only 0.9% in Kathmandu.The delta variant and its higher transmissibility despite vaccinations have made the situation worse this time around. <a href="https://www.nepalitimes.com/banner/how-nepal-must-prepare-for-3rd-covid-wave/" target="_blank" rel="noopener noreferrer">Covid-19 is here to stay</a>, and managing it requires behavioural change and taking safety measures such as hand washing, physical distancing and masking a necessary part of our lifestyle.Earlier this year, researchers at Yale and Stanford University ran a large-scale randomised controlled trial to identify a precise combination of strategies that are successful in changing mask-wearing habits.They found their <a href="https://www.nepalitimes.com/here-now/3-pronged-strategy-to-save-nepal-from-covid-19/" target="_blank" rel="noopener noreferrer">NORM strategy</a> worked well. NORM stands for:- No cost masks distributed at scale- Offering information about mask-wearing- Reinforcement in public places by intercepting non-mask wearers- Modelling and endorsement by trusted leadersAfter a successful pilot trial in Lahore with 5 million people, NORM is being scaled up to cover the whole of Pakistan. The Bangladesh Rural Advancement Committee (BRAC) is aiming to reach 81 million people with NORM methods. In India, the program is being tried out in Gujarat and other states by the Self Employed Women’s Association (SEWA).<a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/latest/keep-wearing-masks-after-the-lockdown/" target="_blank" rel="noopener noreferrer">Mask-wearing</a> rates have tripled where NORM methods have been implemented, helping save thousands of lives. The campaign was launched earlier this month in Nepal in the densely populated urban centre of Thimi, Sunsari’s rural areas, and Melamchi which has been battered by earthquakes and floods.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110141132/636cfe3d9c7e80680e0a0c2bjpeg.jpg" alt="" width="960" height="720"><figcaption> </figcaption></figure>The plan is to distribute up to 450,000 masks through volunteers who go back to the community every 10 days to monitor progress in uptake. The pilot will be scaled up across the country with one million masks donated by Hanes, a US clothing brand arriving in Nepal shortly.The NORM pilot in South Asia is being funded by the Bill &amp; Melinda Gates Foundation and the Covid-19 Crisis Management Centre (CCMC) has endorsed the campaign in Nepal.“We hope that the NORM mask-wearing approach will enable behaviour change throughout our nation and help to curb the negative effects of Covid-19,” says Brig Gen Arun Neupane, who heads the medical division of the CCMC.Preeti Adhikary of the NORMalizing Mask Project in Nepal says the campaign has been received well, with many more local governments willing to participate.She says: “Despite the vaccine rollout there is still a lot of uncertainty. So we must educate the public that even after vaccination we must follow safety protocols, which only comes with behavioural change which is what we are trying to do.”_________________<h2>How to get QR coded vaccine certificates</h2>Vaccine certificates are now the new passports for international travel, much like in the past when passengers from certain countries were required to present the WHO-approved yellow cards at airports.This month, there were <a href="https://www.nepalitimes.com/here-now/nepalis-queueing-up-all-night-for-proof-of-jab/" target="_blank" rel="noopener noreferrer">long queues of migrant workers </a>at Teku hospital waiting for rubber-stamped papers to certify vaccination before they flew off to destination countries. The letter did not have a digitally-registered QR code, and risked being invalid.This finally prompted the Health Ministry to set up an online application with photo, ID, vaccination card and a self-declaration form for a scannable <a href="https://www.nepalitimes.com/latest/nepali-workers-queue-up-for-qr-codes/">digital vaccine certificate</a> accessible with encrypted link and QR code acceptable internationally.The QR code is linked to the officially-authorised database hosted and managed by the Health Ministry so the system is authenticated.<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110141136/636cfe409c7e80680e0a0c2cjpeg.jpg" alt="" width="800" height="800">WHO Nepal has been helping the Health Ministry with technical support on the digitisation of vaccination records to ensure that no one is left behind from accessing the Covid-19 vaccination and facilitating the equitable allocation of Covid-19 vaccine.The WHO support includes training, design and development of the ministry’s software system and IT equipment, and electronic vaccination registration system in seven selected municipalities in seven provinces.Vaccination digitisation can be done in three ways: pre-registration, on-site registration and post digitisation. Pre and on-site registration are used for digitisation of new vaccination records whereas post digitisation will be used for the digitisation of people who are already vaccinated and have certificate cards.“Recordkeeping is important to ensure that there is no duplication but measures must be taken so that there is no crowding at the vaccination centres, turning them into breeding grounds for the virus,” says a virologist at Teku Hospital Sher Bahadur Pun. “We need more vaccination centres and safety protocols must be implemented strictly at every booth.”Public health experts say the digitisation can help control the pandemic in the long run if properly implemented, since the documentation will assist in <a href="https://www.nepalitimes.com/banner/once-nepal-gets-vaccines-they-need-to-be-fairly-distributed/" target="_blank" rel="noopener noreferrer">vaccine equity</a> as the inoculation drive gains pace.Epidemiologist Lhamo Yangchen Sherpa says that online registration is important in reducing crowds at vaccination centres. But, she adds, “Since this is more applicable in areas with Internet access and for people with a smartphone, SMS with individual inoculation timing might be more effective.”To register for online vaccine certificate, visit the <a href="https://vaccine.mohp.gov.np/public-request-form">website</a>: https://vaccine.mohp.gov.np/public-request-form

Behind the masks

<img width="1513" height="1019" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110141124/636cfc299c7e80680e0a0b72jpeg.jpg" alt=""/>In recent weeks, Nepal has resumed nationwide vaccinations against the Covid virus in earnest. While this is a crucial step towards ending the pandemic – with only 7.34% of the population fully vaccinated, <a href="https://www.nepalitimes.com/banner/vaccines-or-no-vaccines-mask-and-distance/" target="_blank" rel="noopener noreferrer">we are not out of the woods yet</a>, not by a long shot. 
<a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.washingtonpost.com/context/cdc-breakthrough-infections/94390e3a-5e45-44a5-ac40-2744e4e25f2e/" target="_blank" rel="noopener noreferrer">Leaked information from the US Center for Disease Control</a> last week has added renewed complications in this fight against Covid-19. 
The<a href="https://www.nepalitimes.com/banner/vaccines-variants-and-a-third-wave/" target="_blank" rel="noopener noreferrer"> Delta variant</a> was the dominant strain in Nepal, and caused more than 200,000 reported infections across the country within 30 days between May and June 2020. This has now become the main strain of the virus on the planet. 
Evidence now suggests that it is more transmissible than the viruses that cause MERS, SARS, Ebola, the common cold, the seasonal flu, and smallpox. This is one of the most effective virus variants to face modern society, spreading as effectively as the ubiquitous (but mostly harmless) chickenpox. 
When the Delta variant was first isolated, the global public health community understood that it transmitted more effectively, but many questions remained about whether or not it was more deadly or likely to cause serious complications. 
One of the first sources about the severity of Delta included a <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)01358-1/fulltext" target="_blank" rel="noopener noreferrer" data-saferedirecturl="https://www.google.com/url?q=https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)01358-1/fulltext&amp;source=gmail&amp;ust=1628338257263000&amp;usg=AFQjCNGrOA9yy_1CCG3ZKEzLPdBkRu_zAg">study</a> from Scotland which demonstrated that it was about twice as likely to result in hospitalisation for unvaccinated individuals than the original Alpha variant. 
Another analysis of 38,805 cases in England revealed that the Delta variant posed a 2.61 times higher risk of hospitalisation than Alpha. 
One reason for this faster spread is a mutation on the spike protein, which the virus uses to enter human cells. The Delta variant has <a href="https://covariants.org/variants/21A.Delta" target="_blank" rel="noopener noreferrer" data-saferedirecturl="https://www.google.com/url?q=https://covariants.org/variants/21A.Delta&amp;source=gmail&amp;ust=1628338257263000&amp;usg=AFQjCNFeDyT6pXrRRitXys-T0BmqKODhOg">a particular mutation called ‘D614G’</a>(colloquially referred to as ‘Doug’) <a href="https://pubmed.ncbi.nlm.nih.gov/33243994/" target="_blank" rel="noopener noreferrer" data-saferedirecturl="https://www.google.com/url?q=https://pubmed.ncbi.nlm.nih.gov/33243994/&amp;source=gmail&amp;ust=1628338257263000&amp;usg=AFQjCNFdbibR-uEEpwa7sjZ1qDZKgs9Xxg">that packs the surface of the virus with spike proteins</a> which, in turn, help it avoid the natural antibodies that human cells use for defenseand <a href="https://pubmed.ncbi.nlm.nih.gov/33558493/" target="_blank" rel="noopener noreferrer" data-saferedirecturl="https://www.google.com/url?q=https://pubmed.ncbi.nlm.nih.gov/33558493/&amp;source=gmail&amp;ust=1628338257263000&amp;usg=AFQjCNHAjuQ_dXz0EpZ-6MCfRroVslX3gA">enter our cells more easily. </a>
As if this wasn’t enough, Delta also has<a href="https://www.cdc.gov/coronavirus/2019-ncov/variants/variant-info.html" target="_blank" rel="noopener noreferrer" data-saferedirecturl="https://www.google.com/url?q=https://www.cdc.gov/coronavirus/2019-ncov/variants/variant-info.html&amp;source=gmail&amp;ust=1628338257263000&amp;usg=AFQjCNEoIFGa5Um_pxXGHNQwDefBsxQ6Pg"> a spike mutation called P681R</a>, which appears to produce higher viral loads in patients, making it easy to spread to more people, more quickly. A study in China demonstrated that people infected with Delta have <a href="https://virological.org/t/viral-infection-and-transmission-in-a-large-well-traced-outbreak-caused-by-the-delta-sars-cov-2-variant/724" target="_blank" rel="noopener noreferrer" data-saferedirecturl="https://www.google.com/url?q=https://virological.org/t/viral-infection-and-transmission-in-a-large-well-traced-outbreak-caused-by-the-delta-sars-cov-2-variant/724&amp;source=gmail&amp;ust=1628338257263000&amp;usg=AFQjCNEmgWymHmdImGh5su5H_IBjs9607A">1,000 times more viruses in their respiratory tract</a>. 
This means that there is more Covid virus per droplet that we expel. People exposed to the smaller droplets with higher concentrations of virus can be infected more quickly and when standing much further away from one another. 
This makes the virus much more likely to spread between people even with very limited contact: a review of CCTV footage from a shopping mall in Sydney, Australia proved that the virus was transmitted between two persons who were only casually passing by.
Delta has <a href="https://virological.org/t/viral-infection-and-transmission-in-a-large-well-traced-outbreak-caused-by-the-delta-sars-cov-2-variant/724" target="_blank" rel="noopener noreferrer" data-saferedirecturl="https://www.google.com/url?q=https://virological.org/t/viral-infection-and-transmission-in-a-large-well-traced-outbreak-caused-by-the-delta-sars-cov-2-variant/724&amp;source=gmail&amp;ust=1628338257264000&amp;usg=AFQjCNGIeRz4ZJuEq04MfnF6C2FmeOQZzw">an incubation period of only four days</a>, rather than six. This means that people are contagious sooner and end up infecting more people. A patient with the original Alpha variant would infect, on average, two or three other people. With Delta, this number soars to an average of eight. 
The good news is that vaccinations still offer significant protection against the Delta variant. While there is mounting evidence breakthrough infections do occur, and may result in death, the chances of ending up in the hospital or a morgue are vastly reduced once you’ve had a full dose. 
The bad news is that even if you are fully vaccinated, you can still be a major spreader of the virus. A <a href="https://khub.net/documents/135939561/390853656/Impact+of+vaccination+on+household+transmission+of+SARS-COV-2+in+England.pdf/35bf4bb1-6ade-d3eb-a39e-9c9b25a8122a" target="_blank" rel="noopener noreferrer" data-saferedirecturl="https://www.google.com/url?q=https://khub.net/documents/135939561/390853656/Impact%2Bof%2Bvaccination%2Bon%2Bhousehold%2Btransmission%2Bof%2BSARS-COV-2%2Bin%2BEngland.pdf/35bf4bb1-6ade-d3eb-a39e-9c9b25a8122a&amp;source=gmail&amp;ust=1628338257264000&amp;usg=AFQjCNHB5XqQ5B6aTBMVodh1VEJCSX1nJQ">Public Health England study</a> of more than 365,000 households found that full vaccination with either Pfizer or AstraZeneca was associated with only a 40 to 50% reduction in household transmission after a vaccinated person tested positive. 
The leaked documents from the CDC go so far as to suggest that the likelihood of further transmitting the virus is nearly the same for vaccinated and non-vaccinated individuals. This is particularly worrying for Nepal given that full vaccines for the majority of the population – including children in particular - <a href="https://www.nepalitimes.com/banner/once-nepal-gets-vaccines-they-need-to-be-fairly-distributed/" target="_blank" rel="noopener noreferrer">are still a long ways away</a>. 
Today, despite an increasing number of people receiving vaccinations, Delta has the upper hand. We cannot expect our government to take adequate and timely steps to avoid a third or fourth deadly wave of infections, and we can expect the virus to continue to mutate and find even more effective ways to continue to circulate through the global population. Ensuring the safety of ourselves and our communities is, once again, left in our own hands.
The standard practice of regular handwashing and wearing face masks is no longer sufficient to prevent the spread of COVID. 
With Delta, the most important prevention behaviour is to avoid crowded public spaces — particularly when there is poor air ventilation. A vaccine is not a passport to resume life as normal.
Indeed, the data shows that we all need to <a href="https://www.nepalitimes.com/latest/keep-wearing-masks-after-the-lockdown/" target="_blank" rel="noopener noreferrer">change our behavior immediately</a> and with a renewed vigour, and to amend our public messaging accordingly. If we fail to do so, the virus will win and more loss of life and prolonged, stricter lockdowns will be the inevitable result.
Sushil Koirala is a public health expert based in Bangkok, Thailand.
Ben Ayers is an American citizen based in Nepal for over 20 years.

Delta variant’s wake-up call for Nepal

<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110151120/636d08c39c7e80680e0a6037jpeg.jpg" alt="" width="1500" height="1000"/>When Covid-19 cases started to fall last month and the government relaxed the lockdown, most public health experts warned that it was premature because not enough people had been vaccinated.Sure enough, after falling steeply from 9,500 confirmed cases a day in mid-May to 1,500 cases, the daily caseload has now jumped to near 4,000 again. Daily fatalities dropped from 250 to 12 in mid-July, and have risen again to more than 30 a day. Active cases are once more passing 30,000. (See graph)<a href="https://www.nepalitimes.com/editorial/2am-is-too-late/">2AM is too late</a>, Editorial<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110151120/636d08c69c7e80680e0a6038jpeg.jpg" alt="" width="1414" height="794">The current trend is similar to October 2020 at the peak of the first wave, when there were over 5,000 daily new cases and 30 deaths. The decline in second wave infections and fatalities have now stalled, and the case positivity rate has increased to 25%.“After two months of lockdown, restrictions were suddenly lifted even though we were still reporting 2,000 cases. Everything is up and running and it is business as usual, crowding and no distancing,” says virologist Sher Bahadur Pun at Kathmandu’s Teku Hospital.He adds: “Now we have vaccination centres which risk being virus hotspots. People who have not been infected, and those not vaccinated yet are at greater risk.”The behaviour of the virus in Nepal has generally followed India’s pandemic trajectory after two weeks. After peaking at over 400,000 daily cases back in May, India has seen a decline in daily cases and fatalities. However, after registering less than 30,000 confirmed cases on 27 July, India registered 43,654 fresh cases the day after.With only 7% of its 1.3 billion people fully vaccinated, recovery from the second wave has tapered off in India, with states like Kerala are seeing a new surge.A recent survey showed that India’s seroprevalence rate is about 70% -- the proportion of the population infected in the recent past who carry antibodies. The rate is highest in the bordering states of Bihar (75%) and Uttar Pradesh (71%).The antibodies provide some immunity against the coronavirus, which is why Kerala is seeing a spike because the seroprevalence rate there is India’s lowest, at 44%.A seroprevalence survey is currently being carried out in Nepal, and experts predict that antibody rates will be similar to India, at least in the Tarai. However, they caution that this may not mean Nepal is protected by herd immunity.Nepal is administering more than 55,000 doses of Covid vaccines a day, but the government’s assurance that more vaccines are on the way may have sent the wrong message to people.“People who are vaccinated are being careless, they have stopped wearing masks and distancing themselves. I know of at least 10 acquaintances who with their families were fully vaccinated, but are now in quarantine,” says epidemiologist Lhamu Yangchen Sherpa. “Jabs protect us from hospitalisation, but we could still get infected and continue the chain of infection.”But despite projections of a new surge in late August, public health experts both in India and Nepal are cautiously optimistic that it will <a href="https://www.nepalitimes.com/banner/vaccines-variants-and-a-third-wave/" target="_blank" rel="noopener noreferrer">not be as deadly as the second wave</a> unless a new variant of concern emerges before a large portion of the population is vaccinated.So far, 1.5 million Nepalis, which is 5.1% of the total population, have been fully vaccinated with either AstraZeneca Covishield, Chinese VeroCell or the single-shot J&amp;J vaccine. Over 2.3 million have been partially inoculated.But <a href="https://www.nepalitimes.com/banner/once-nepal-gets-vaccines-they-need-to-be-fairly-distributed/" target="_blank" rel="noopener noreferrer">vaccine doses have been distributed unequally</a> across the country with about half of it concentrated in Bagmati Province. More than 14% of people in Bagmati are fully inoculated compared to only 2.5% in Province 2, 2.8% in Far West, and 3% in Karnali. (See map)<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110151120/636d08c89c7e80680e0a6039jpeg.jpg" alt="" width="1500" height="1000">Some public health experts suggest focusing on high-risk, crowded cities with mobile populations, instead of trying to achieve vaccine equity at a time when vaccine doses are scarce. This will allow for reduced transmission, particularly among the vulnerable groups as well as help revive the economy and restore jobs.“Highly mobile populations and people in densely crowded places should be vaccinated next. After the second wave I am convinced that they are a much higher risk group and hence must be prioritised,” says virologist Pun.Epidemiologist Sherpa, however, recommends factoring in the access to medical services in Nepal’s vaccination strategy. A survey shows that the fatality rate among infected people is <a href="https://www.nepalitimes.com/banner/nepals-uneven-covid-19-deaths/" target="_blank" rel="noopener noreferrer">highest in remote areas</a>, even though the number of infected people is much less.While only 0.9% of total Covid-19 patients in Kathmandu succumbed to the disease, in the remote mountains of Mustang, Dolpo and Mugu the figures were as high as 11%, 7% and 6% respectively.Nepal’s annual Dasain-Tihar festival season is only two months away. Going by last year’s experience, millions could once more travel from Kathmandu to home districts taking the virus with them and spreading it all over the country.This is why it is important to inoculate as many people as possible before the festivals. The elderly above 65 years who have only received the first dose of AstraZeneca Covishield are at most risk, but the good news is that they will be getting their second doses from a 1.6 million COVAX consignment that Japan is sending next week.Nepal is currently rolling out VeroCell and J&amp;J vaccines from its current stock. China is giving another 1.6 million doses of VeroCell, and Nepal is negotiating to buy another 6 million.While there is talk of purchasing additional 6 million doses of Pfizer-BioNTech vaccine in the next few months for the teens between 12-18 years, these will need -70°C storage facilities. The government is urging young people to register online for vaccines, and applicants will be prioritised once enough doses arrive.The UK government on Thursday announced <a href="https://www.gov.uk/government/news/uk-begins-donating-millions-of-covid-19-vaccines-overseas" target="_blank" rel="noopener noreferrer">9 million doses of Covid-19 vaccine</a> to the global COVAX facility to be donated starting this week. The first countries to receive the consignment are Indonesia (600,000 doses), Kenya (817,000) and Jamaica (300,000). It is not yet known if Nepal is on the list.But for now, vaccine or no vaccine, <a href="https://www.nepalitimes.com/latest/keep-wearing-masks-after-the-lockdown/" target="_blank" rel="noopener noreferrer">mask and separation</a> is the best protection.Says epidemiologist Sherpa: “Mass inoculation is our way out of this pandemic but while we chase after vaccines, let’s not forget safety measures and be prepared for a possible new wave."

Vaccines or no vaccines, mask and distance

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109121144/636b92f69c7e80680e06f17cjpeg.jpg" alt="" width="1500" height="1000"/><figcaption>Photo: MONIKA DEUPALA</figcaption></figure>This op-ed is being simultaneously published in the Indian Express (India), The Daily Star (Bangladesh), Nepali Times (Nepal) and DAWN (Pakistan).In February 2021, Covid-19 numbers started increasing again in South Asia with official daily case counts rising beyond 400,000 in India, 6,000 in Pakistan and 7,500 in Bangladesh, straining health systems.The massive surge in India soon <a href="https://www.nepalitimes.com/banner/we-knew-the-tsunami-was-approaching/" target="_blank" rel="noopener noreferrer">spilled over across the border into Nepal</a>, leading to ‘apocalyptic’ scenes of overwhelmed hospitals.This virus knows no borders. Containing it has necessitated global cooperation among scientists, policy makers and society. Despite a wide variation in how nations have responded to the pandemic, the most successful strategies adhere to science, and attention to local context.The <a href="https://www.nepalitimes.com/editorial/this-is-war/" target="_blank" rel="noopener noreferrer">deadly surge in 2021</a> makes a regionally-coordinated, evidence-driven strategy even more critical. The virus continues to challenge us with its mutations and new lines of attack. If we are to move at the speed of the virus, it is necessary to construct multi-stakeholder regional coalitions to devise new solutions and frugal innovations that can be applied across South Asia.Given our shared and mostly similar social, economic and cultural contexts, local successes must find means to be amplified across the region.Is that even possible, given the troubled history South Asian countries share? The mutual mistrust appears to have hit a new low, as <a href="https://www.nepalitimes.com/editorial/shared-futures/" target="_blank" rel="noopener noreferrer">SAARC</a> has not even managed to hold its summit since 2014.But today we write a positive, hopeful story about a new consortium we are involved in, with core team members from India, Pakistan, Nepal, and Bangladesh jointly developing Covid prevention strategies. The emerging consortium provides an example of how neighbours can work together for mutual benefit, despite political differences.Every country in South Asia has struggled to ensure consistent <a href="https://www.nepalitimes.com/opinion/the-economics-of-masks/" target="_blank" rel="noopener noreferrer">mask-wearing</a> to stem the spread of Covid. Beliefs, priorities, traditions, and aversions to behaviour change are more similar across South Asia than we care to admit. These commonalities mean that interventions that are successful in changing behaviour in one place are likely applicable in other parts of the Subcontinent.We have experienced this with Community-Led Total Sanitation (CLTS) campaigns to solve the <a href="https://www.nepalitimes.com/here-now/nature-calls/" target="_blank" rel="noopener noreferrer">problem of open defecation</a> -- originally developed by Bangladeshi NGOs in partnership with an Indian consultant --- and now broadly applied across South Asia and beyond.The Grameen Bank microcredit model was an indigenous South Asian innovation that spread rapidly. BRAC’s recent ‘Graduation’ program targeting the ultra-poor in Bangladesh was replicated with success in India and Pakistan. India’s digitised social protection ecosystem with Aadhar IDs and Jan Dhan accounts serves as a model (albeit with cautionary notes) for other countries in the region. E-governance programs in Pakistan, like eVaccs and Citizen Feedback Model have been replicated and provide strong models ready to be deployed regionally and globally.The new pan-South Asian consortium in response to Covid-19 evolved out of an experiment conducted in Bangladesh, that successfully changes social norms around mask-wearing in rural communities. We observed that a combination of No-cost distribution, Offering information, Reinforcing the message in markets, mosques and other public spaces, and Modelling and endorsement by community leaders (NORM) leads to large, sustained increases in mask usage that persisted beyond the period of active intervention.This <a href="https://www.nepalitimes.com/here-now/3-pronged-strategy-to-save-nepal-from-covid-19/" target="_blank" rel="noopener noreferrer">four-part NORM intervention</a> was originally examined in a cohort of 350,000 individuals across 600 villages. BRAC is implementing the model to reach 81 million people across Bangladesh.<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109121144/636b92f99c7e80680e06f17djpeg.jpg" alt="" width="1600" height="876">The team is now partnering with several organisations across Pakistan, India, Nepal, and Bangladesh to start adapting the model to fit each country’s context, and set up partnerships to pilot, implement, tinker, and learn.The Self Employed Women’s Association (SEWA) quickly implemented the model to reach over one million members in Gujarat. An additional 1.5 million masks were shipped from Bangladesh to support SEWA’s outreach to other states. Lahore’s Commissioner worked with our research team to adapt the NORM model to an urban setting, and devised new creative ideas to improve effectiveness.For example, it has prepared to deliver <a href="https://www.nepalitimes.com/opinion/masks-and-vaccines-to-stop-nepals-2nd-wave/" target="_blank" rel="noopener noreferrer">masks</a> at doorsteps using Pakistan’s postal service, and is targeting beneficiaries on the basis of billing information from utility companies. Philanthropists and private corporations are sponsoring the masks. We are re-importing some of these innovations back to Dhaka, inspiring further scale-ups in Dhaka, Chittagong, Rajshahi and Kathmandu.Effective mask promotion requires visits to thousands of remote villages, and those same visits can be used to prepare for more effective community-based healthcare responses. To that end, a host of physicians, scientists and community based organisations created the Swasth Community Science Alliance, committing to pragmatic, science-based protocols to manage mild and moderate cases of Covid-19 in rural India, where institutional health care access is limited.These guidelines (available at https://science.swasth.app) were translated to training tools for healthcare workers by digital health innovators like Noora Health, making them widely available across the region.NORM implementation teams based in Lahore, Ahmedabad, Peshawar, Hyderabad, Dhaka, Kathmandu, and Delhi are learning from each other’s successes and failures. The process usually starts with the original research team sharing evidence-based insights with implementing agencies, as the implementers adapt the design, co-create localised implementation protocols, and are threaded together in a collaborative environment across countries where each implementing team iterates while learning from others’ prior iterations, and all our sub-teams are connected in an active learning system that allows us to course-correct in real time. This coalition is poised to change mask-wearing norms amongst hundreds of millions of people across all of South Asia.The CSA is working with partners across rural, tribal belts around India. A team of physicians from India and the Indian diaspora work with local implementing partners to support design, implementation and monitoring of home-based programs and Covid-19 centres providing rigorously protocolised treatment for moderate cases, with oxygen, proning and steroids.Combining the NORM and CSA interventions, our Masking-Treatment-Vaccine Preparation (MTV) approach offers a sensible strategy to mitigate the pandemic until universal vaccination is achieved. These are regional solutions that thoughtfully apply scientifically sound interventions to the local context.The <a href="https://www.nepalitimes.com/editorial/nepals-humanitarian-emergency/" target="_blank" rel="noopener noreferrer">Covid-19 crisis</a> has increased policymakers’ appetite for evidence-informed policy measures that can be quickly implemented to stem transmission. This drive for quick action has created some unprecedented opportunities for enhanced cross-country collaborations that are normally hampered by politics and mistrust.We hope that the consortium that first formed around <a href="https://www.nepalitimes.com/opinion/how-nepal-can-survive-2nd-covid-wave/" target="_blank" rel="noopener noreferrer">mask-promotion</a>, and now around science-based treatment approaches, and that developed quickly and organically without regard to national boundaries, can serve as a model for a broader and deeper collaborative ecosystem that endures.We need to come together to solve problems that affect us all. Let the lasting legacy of this pandemic be a new era of partnership in social innovations that can benefit all South Asians.https://www.youtube.com/watch?v=d0hpuXRByic&amp;t=9sMushfiq Mobarak is Professor of Economics, Yale University, and Director of the Yale Research Initiative on Innovation and Scale. Twitter: @mushfiq_econ Maha Rehman is director of policy at the Mahbub-ul-Haq Research Centre at the Lahore University of Management Sciences. Twitter @MahaRehman1Satchit Balsari is assistant professor of emergency medicine, and of global health and population, at Harvard University. Twitter: @satchit_balsari

What can we do till vaccines arrive?

<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109121140/636b91c69c7e80680e06f10djpeg.jpg" alt="" width="1500" height="1000"/>Nepal will open its 2021 lockdown long before the country <a href="https://www.nepalitimes.com/here-now/aid-pours-into-nepal-but-where-be-vaccines/">has enough vaccines</a> to protect its citizens -- our aunts, uncles, and neighbours. We will not have substantial vaccine coverage for many months, if not longer.We will <a href="https://www.nepalitimes.com/here-now/its-an-emergency/">need more oxygen,</a> more testing, and better tracking and isolation procedures. Crucially, we will also have to maintain and strengthen our only effective tools: physical distancing and masks.Unfortunately, too many Nepalis are wearing low-quality masks, taking them off too often, touching them, and not washing them or replacing them often enough. More people should be wearing three-layer surgical masks, which, for only a few more rupees, offer greater protective power.The key problem Nepal faces has not changed: infected people do not know they have the virus and spread it around. And new variants make the virus even more easily transmissible. We need to behave not as if only a small number of people could have the virus, but as if everyone we encounter already has it. That includes the friendly neighbourhood fruit seller. That includes family members. That includes you.“Vaccinations will take a long time to arrive in South Asia to create a wall of immunity. Till then, masks are most essential,” says <a href="https://www.nepalitimes.com/here-now/3-pronged-strategy-to-save-nepal-from-covid-19/">Mushfiq Mobarak</a>, a Yale university professor who recently led a huge study of<a href="https://docs.google.com/forms/d/e/1FAIpQLSfMJkyBBtK74lqSsHZnx_8qb0_sJ0WaR7A7XA8IQHAobrBEQA/viewform"> mask-wearing in Bangladesh.</a>Many Nepalis wear cloth masks or one-layer surgical masks. These help, no question. But the 3-layer surgical masks and N95s offer more filtration efficiency and more protection, although they cost just a few rupees more. That is an investment well worth it to protect individuals, institutions, and governments.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109121140/636b91c99c7e80680e06f10ejpeg.jpg" alt="" width="2370" height="950"><figcaption> </figcaption></figure>I asked Biraj Vajracharya, an epidemiologist at Dhulikhel hospital, what kind of mask people should be buying and wearing. "Surgical mask, or if possible, N95 mask," he replied.The Yale researchers recommend high quality 3-layer masks because they filter more efficiently. They can be washed and reused without losing much efficiency. For more on the study's recommendations about masks, see this excellent <a href="https://www.youtube.com/watch?v=ifiR_5DuyfA">video</a>."We need to change mask-wearing norms amongst hundreds of millions of South Asians to mitigate the spread of COVID," Mushfiq Mobarak told me via email. "High-quality washable, reusable surgical masks are much more cost-effective, and offer a feasible path to scalability across the region."The <a href="https://www.business-standard.com/article/current-affairs/covid-19-crisis-india-draws-lessons-from-bangladesh-s-mask-study-121051401341_1.html">Yale study in Bangladesh</a>, involving over 300,000 people in 600 villages, identified simple policies that led to much greater mask wearing. They found that when <a href="https://docs.google.com/document/d/1EUhdri6CST9uzw_myffNmyUVPt8_UMsM75NOt5Q-54o/edit">authorities do four things together</a>, mask wearing more than tripled:<ol><li>Offer free masks</li> <li>Provide clear information about mask wearing in videos and brochures</li> <li>Find community leaders to speak in support of mask wearing</li> <li>Reinforce the message with gentle questioning for those not wearing</li></ol>The fourth policy was the most important: special monitors to verbally poke people who were not wearing masks. Those monitors, the Yale study explains, ‘walk around and if somebody is not wearing a mask, they intercept them and politely say, “We distributed masks here—why aren’t you wearing one?” If the person didn’t have a mask or couldn’t get one, the monitor gives them one.’What this combo of four actions does is establish a community expectation, a clear norm or standard for the community to follow. The norm shows everybody that the community expects them to wear the masks, that it takes masks seriously. That makes a big difference.The researchers call their recommended program NORM:No-Cost masksOffering InformationReinforcement in public places by intercepting non-mask wearersModelling and endorsement by trusted leadersHere's some useful mask info:<ol><li>All masks help, but 3-layer surgical masks and N95 masks offer greater protection.</li> <li>Double masking is good, especially with low-quality surgical or cloth masks.</li> <li>Masks should cover the mouth and nose. A tight fit on all four sides is good.</li> <li>If you touch the mask, you should wash your hands.</li> <li>Masks should be washed and replaced regularly.</li> <li>In general, you should wash your hands with soap several times a day.</li></ol>A historical reminder might be relevant here: when we think about the Covid-19 vaccine, we often recall the <a href="https://www.nepalitimes.com/opinion/how-nepal-eradicated-the-smallpox-virus/">big health breakthroughs of the past</a>, such as the discovery of the polio vaccine in the 1950s, and penicillin in the 1940s.But long before these headline-stealing medical heroes arrived to save the day, death rates had already dropped dramatically in Western Europe and North America. This health revolution came because of much less glamorous innovations: clean drinking water, efficient waste disposal, increased bathing, and expanded soap use.These basic sanitary measures saved millions and millions of lives. In Nepal in 2021, basic preventative measures such as physical<a href="https://www.nepalitimes.com/latest/nepal-covid-19-impact-worse-than-official-figures/">l distancing and careful mask wearing </a>can save lives as well.One other reminder: last year, after we were released from Lockdown I in July, Covid-19 <a href="https://www.nepalitimes.com/latest/nepal-its-no-time-to-let-your-guard-down/">infections spiked</a>. After Lockdown II was lifted in September, infections spiked again, reaching their highest level yet. The end of Lockdown III will <a href="https://www.nepalitimes.com/latest/learning-to-live-with-covid/">likely bring new risks.</a><a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/how-chitwan-was-opened,4159">Tom Robertson</a>, PhD, is researching the environmental history of the Kathmandu Valley.

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After lockdown, we will need masks more than ever

<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110131144/636cf29e9c7e80680e09d91cjpeg.jpg" alt="" width="1500" height="1000"/>Nepal will open its 2021 lockdown long before the country <a href="https://www.nepalitimes.com/here-now/aid-pours-into-nepal-but-where-be-vaccines/">has enough vaccines</a> to protect its citizens -- our aunts, uncles, and neighbours. We will not have substantial vaccine coverage for many months, if not longer.We will <a href="https://www.nepalitimes.com/here-now/its-an-emergency/">need more oxygen,</a> more testing, and better tracking and isolation procedures. Crucially, we will also have to maintain and strengthen our only effective tools: physical distancing and masks.Unfortunately, too many Nepalis are wearing low-quality masks, taking them off too often, touching them, and not washing them or replacing them often enough. More people should be wearing three-layer surgical masks, which, for only a few more rupees, offer greater protective power.The key problem Nepal faces has not changed: infected people do not know they have the virus and spread it around. And new variants make the virus even more easily transmissible. We need to behave not as if only a small number of people could have the virus, but as if everyone we encounter already has it. That includes the friendly neighbourhood fruit seller. That includes family members. That includes you.“Vaccinations will take a long time to arrive in South Asia to create a wall of immunity. Till then, masks are most essential,” says <a href="https://www.nepalitimes.com/here-now/3-pronged-strategy-to-save-nepal-from-covid-19/">Mushfiq Mobarak</a>, a Yale university professor who recently led a huge study of<a href="https://docs.google.com/forms/d/e/1FAIpQLSfMJkyBBtK74lqSsHZnx_8qb0_sJ0WaR7A7XA8IQHAobrBEQA/viewform"> mask-wearing in Bangladesh.</a>Many Nepalis wear cloth masks or one-layer surgical masks. These help, no question. But the 3-layer surgical masks and N95s offer more filtration efficiency and more protection, although they cost just a few rupees more. That is an investment well worth it to protect individuals, institutions, and governments.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110131144/636cf2a19c7e80680e09d91djpeg.jpg" alt="" width="2370" height="950"><figcaption> </figcaption></figure>I asked Biraj Vajracharya, an epidemiologist at Dhulikhel hospital, what kind of mask people should be buying and wearing. "Surgical mask, or if possible, N95 mask," he replied.The Yale researchers recommend high quality 3-layer masks because they filter more efficiently. They can be washed and reused without losing much efficiency. For more on the study's recommendations about masks, see this excellent <a href="https://www.youtube.com/watch?v=ifiR_5DuyfA">video</a>."We need to change mask-wearing norms amongst hundreds of millions of South Asians to mitigate the spread of COVID," Mushfiq Mobarak told me via email. "High-quality washable, reusable surgical masks are much more cost-effective, and offer a feasible path to scalability across the region."The <a href="https://www.business-standard.com/article/current-affairs/covid-19-crisis-india-draws-lessons-from-bangladesh-s-mask-study-121051401341_1.html">Yale study in Bangladesh</a>, involving over 300,000 people in 600 villages, identified simple policies that led to much greater mask wearing. They found that when <a href="https://docs.google.com/document/d/1EUhdri6CST9uzw_myffNmyUVPt8_UMsM75NOt5Q-54o/edit">authorities do four things together</a>, mask wearing more than tripled:<ol><li>Offer free masks</li> <li>Provide clear information about mask wearing in videos and brochures</li> <li>Find community leaders to speak in support of mask wearing</li> <li>Reinforce the message with gentle questioning for those not wearing</li></ol>The fourth policy was the most important: special monitors to verbally poke people who were not wearing masks. Those monitors, the Yale study explains, ‘walk around and if somebody is not wearing a mask, they intercept them and politely say, “We distributed masks here—why aren’t you wearing one?” If the person didn’t have a mask or couldn’t get one, the monitor gives them one.’What this combo of four actions does is establish a community expectation, a clear norm or standard for the community to follow. The norm shows everybody that the community expects them to wear the masks, that it takes masks seriously. That makes a big difference.The researchers call their recommended program NORM:No-Cost masksOffering InformationReinforcement in public places by intercepting non-mask wearersModelling and endorsement by trusted leadersHere's some useful mask info:<ol><li>All masks help, but 3-layer surgical masks and N95 masks offer greater protection.</li> <li>Double masking is good, especially with low-quality surgical or cloth masks.</li> <li>Masks should cover the mouth and nose. A tight fit on all four sides is good.</li> <li>If you touch the mask, you should wash your hands.</li> <li>Masks should be washed and replaced regularly.</li> <li>In general, you should wash your hands with soap several times a day.</li></ol>A historical reminder might be relevant here: when we think about the Covid-19 vaccine, we often recall the <a href="https://www.nepalitimes.com/opinion/how-nepal-eradicated-the-smallpox-virus/">big health breakthroughs of the past</a>, such as the discovery of the polio vaccine in the 1950s, and penicillin in the 1940s.But long before these headline-stealing medical heroes arrived to save the day, death rates had already dropped dramatically in Western Europe and North America. This health revolution came because of much less glamorous innovations: clean drinking water, efficient waste disposal, increased bathing, and expanded soap use.These basic sanitary measures saved millions and millions of lives. In Nepal in 2021, basic preventative measures such as physical<a href="https://www.nepalitimes.com/latest/nepal-covid-19-impact-worse-than-official-figures/">l distancing and careful mask wearing </a>can save lives as well.One other reminder: last year, after we were released from Lockdown I in July, Covid-19 <a href="https://www.nepalitimes.com/latest/nepal-its-no-time-to-let-your-guard-down/">infections spiked</a>. After Lockdown II was lifted in September, infections spiked again, reaching their highest level yet. The end of Lockdown III will <a href="https://www.nepalitimes.com/latest/learning-to-live-with-covid/">likely bring new risks.</a><a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/how-chitwan-was-opened,4159">Tom Robertson</a>, PhD, is researching the environmental history of the Kathmandu Valley.

One smoggy winter morning in February 2019, Ekta regretted coming to her sculpture class. It was the first day of her period, and the 19-year-old wished she was home, curled up in bed with a hot water bag to soothe her cramps.
Her class was at Kalapremi Ceramic Studio, a dark room on the ground floor of a house in Maharajganj, and Ekta’s teacher was the artist Gopal Das Shrestha ‘Kalapremi’, a noted sculptor.
Two other students were already there, using all their muscle strength to knead the sculpting clay. Ekta, now 24, recalls how Kalapremi asked her if she was feeling all right. She avoided him, as she did not want everyone to know she was menstruating.
Kalapremi repeatedly asked Ekta what was wrong. She finally muttered that she was having her period, after which he grabbed her hand and led her to a partitioned corner of the studio and sat her on a chair. Before she could stop him, he slid his hand under her dress, and started massaging her abdomen.
“I was horrified,” Ekta recalls. “I told him to stop, but he didn’t listen, asking me not to be shy, saying he knew how to relieve my pain. He stopped only after I protested furiously.”&nbsp;
The art tutor then said, “You’re like my daughter. I’m doing it out of love to make you feel better, but you’re so stubborn.”&nbsp;
“Instead of saying sorry he acted like I was the one having crazy thoughts,” remembers Ekta, adding that from April 2016 to August 2020 beginning the time she was 16, the artist sexually abused and harassed her on several occasions. &nbsp;
Now, Ekta and the artist’s other former students are finally sharing their experiences and some are pressing legal charges against him, hoping that others do not have to endure what they did.&nbsp;
Award-winning artist and teacher Gopal Das Shrestha ‘Kalapremi’ (the name means ‘Art Lover’) is known for his ceramic art, sculpture, and contemporary pottery. He was <a href="https://nepalitimes.com/review/the-house-of-kalapremi">profiled in Nepali Times after a collaborative exhibition</a>, ‘Where the Wild Things Are’ at the Siddhartha Art Gallery three years ago.&nbsp;
His pieces, titled Gaalis, featured sculpted female figures with the heads of dogs, sheep, and donkeys (pictured) to depict derogatory terms for women. Some critics said the collection was a satire on feminists.
Kalapremi started his artistic and teaching career in 1983 and over the years taught at Bhanubhakta School, Kathmandu University School of Arts, Lalitkala Campus and at his private Kalapremi Ceramic Studio. He has also lectured at Jeonju University in South Korea and recently at Tabor Academy in the United States.
Seven of Kalapremi’s former students were interviewed for this story. Five female students said he touched them inappropriately in his studio or at Kathmandu University. Two male students said they witnessed him abuse and harass the women. In all cases, the students struggled to recognise the abuse when it occurred, and the lack of reporting systems left them to cope on their own for years.&nbsp;
Earlier this year, students shared a social media post hinting at Kalapremi’s history of abusive behaviour following which more students of the artist reached out sharing similar experiences. Some students spoke of abuse that happened as long as 20 years ago.
Kalapremi, 60, has denied the allegations. He told Nepali Times: “Some years ago, there was a movement encouraging people to hug and kiss. I used to do it purely out of friendship and love. But after seeing posts on social media last year calling out my behaviour, I realised my actions may have hurt some people. I understand now that I should have been more mindful.”
He added: “I am also an auxiliary health worker, so I know the exact points to massage to relieve menstrual pain. It’s not just menstruation, I take anyone who is ill to the hospital.”
Sexual abuse is much more rampant than reported given how difficult it is to prove it in court. The law defines sexual abuse as occuring when someone touches another’s private parts, coerces them into touching theirs, uses vulgar language, shows degrading images, or behaves indecently towards them without consent.&nbsp;
Ekta and her fellow students are consulting lawyer Suneeta Regmi Pokhrel, who says they know that even if the court decides in their favour, it is difficult to survive after speaking up, and influential men defend themselves saying they are being framed.&nbsp;
“They are in a lot of pain and weep when recalling how he abused them,” Regmi Pokhrel told us. “They are angry and have filed a case against him, but they are also terrified. They know he is a powerful man and they have seen how our society treats women who speak up against abusers. Unless people speak up, perpetrators will be emboldened.”
Art and academia in Nepal simply reflect the power imbalances in society where people with intersecting identities experience worse forms of abuse. Theatre actors Raj Kumar Pudasaini, Rajan Khatiwada, and Sunil Pokhrel were called out during the #MeToo movement in the Nepali theatre scene in 2019. Even after the allegations Pokhrel went on to receive national awards, while others continued to work without repercussions.
“If you speak up against abusers, you gradually get sidelined from projects,” explained a theatre artist who wished anonymity fearing professional setbacks. “The theatre scene in Nepal is quite small, you just have to make peace with the perpetrators and work with them if you want to sustain yourself.”&nbsp;
In academia there is a history of faculty members sexually harassing students and getting away with it. After Tribhuvan University (TU) lecturer Krishna Bhattachan was accused of harassing women students, the university said it would follow Nepal’s sexual harassment law and set up a reporting mechanism. But nothing happened to the professor, who had already retired. Instead, he counter-accused the students of 'attacking the indigenous people’s movement with baseless allegations' as <a href="https://kathmandupost.com/letters/2019/01/29/bhattachan-responds">he told the Kathmandu Post in 2019</a>. He continues to be featured as a prominent speaker including at TU.
Other faculty members previously accused of sexual harassment include Jagadish Murti Koirala from TU, Bishnu Prasad Acharya from Ratna Rajya Campus, and Bodha Raj Tripathee from Lalitpur Madhyamik Vidhyalaya. A woman staff member from TU also filed a sexual abuse complaint against Dambar Chemjong from TU.
Prominent figures like <a href="https://nepalitimes.com/news/the-rise-and-fall-of-nims-purja">mountaineer Nims Purja</a> have been <a href="https://www.nytimes.com/2024/05/31/sports/mountaineering-sexual-harassment-abuse-nims-purja.html">accused of sexual assault</a>, and cricketer Sandeep Lamichhane, actor <a href="https://nepalitimes.com/news/celebrity-rape-case-spotlights-nepal-laws">Paul Shah</a>, and former speaker of Parliament <a href="https://nepalitimes.com/news/mahara-arrested">Krishna Bahadur Mahara</a> have been accused of rape, but society-at-large has let off the alleged perpetrators amdist a larger debate about justice for survivors and punishment of perpetrators.&nbsp;
‘Gaushala-26’ is the court name given to the 18-year-old who accused Sandeep Lamichhane, former captain of Nepal’s national cricket team and skipper of Biratnagar Kings in the <a href="https://nepalitimes.com/here-now/here-comes-the-nepal-premier-league">ongoing Nepal Premier League</a>, of rape. She left the country citing society questioning her character affecting her mental health while Lamichhane got an outpouring of support. In May, the Patan High Court overturned a prior verdict that found Lamichhane guilty of rape and had sentenced him to eight years in prison. During the 23-month legal battle to pursue justice, Gaushala-26 faced threats of gang rape and acid attacks.&nbsp;
Exhausted by the struggle, Gaushala-26 sought to “move to a new world” where she could live free without hiding her identity.
Actress Samragyee Rajya Laxmi Shah in an Instagram video now deleted detailed the harassment she faced from a filmmaker during a movie shoot. She did not name any name but veteran actor Bhuwan KC filed a defamation case against Rana, but the court ruled that the charge lacked sufficient evidence.&nbsp;
Former Kathmandu mayor <a href="https://nepalitimes.com/opinion/theytoo">Keshav Sthapit also mocked the #MeToo movement</a>, calling accusations against him by journalists Rashmila Prajapati and Ujjwala Maharjan “a rape of men’s rights”.
Serial Abuse
Back at the Kalapremi Ceramics studio, another former student, 24-year-old Rajiv, says he felt the need to speak out after seeing his female classmates being abused.&nbsp;
“He frequently kissed them on their cheeks,” he told Nepali Times. “Whenever they walked into the studio he flailed his arms like a child asking for a hug. They awkwardly hugged him from the side, but he pulled them closer, held their chin, and kissed their cheeks.”&nbsp;
Rajiv says he also saw Kalapremi pull the women’s bra straps, touch their breasts, and slap their buttocks. The young students would freeze, not knowing how to react, and if they protested, he would say it was “normal in art”. Rajiv, 19 at the time like his classmates, remembers thinking perhaps the well-respected artist was right after all.
Another student, Luna, who took lessons at Kalapremi’s studio from 2020 to 2022 did try to confront the tutor after he made an obscene proposal to her. She recalls: “One day when the other students had left the studio and it was just the two of us, he told me that God had given him special artistic talent and he could transfer those powers to me. But to do that both of us will have to be naked, inside a dark room, and have sex.”
Luna, who was 18 then, was livid and told him she did not want any of his powers, but she says he laughed at her as if he was joking. She did not tell her family about the incident because she thought no one would believe her.&nbsp;
“They were all in awe of this famous artist and felt I should be grateful that to be learning sculpting from him,” she says. “I was scared to be alone with him in case he talked about sex again. My coping mechanism was to be rude so he wouldn’t try to come close to me.”
Seeing how some classmates were standing up to Kalapremi, Ekta too tried to push back against his advances, but she said he found ways to coerce her. Since Ekta, Rajiv, and Luna could not afford Kalapremi’s Rs30,000 monthly fee for lessons, he had offered them all a stipend to assist him in the studio.
“He had spondylosis and took me to his therapy sessions to learn massage techniques, then he often made me and other students massage him,” says Ekta. Whenever she refused, he would feign pain to make her feel sorry for him. “He would insist that I put my hands under his shirt so that I could massage him better,” she adds.
The art tutor often tried to “seduce sympathy” from Ekta by sharing how he had never been loved as a child and was “sexually frustrated” as an adult.&nbsp;
“At 7PM, he would pour himself Signature whiskey and immediately go off again about how he was sex-starved. I didn’t know how to respond. It took me time to realise alcohol was just an excuse to talk about sex,” Ekta says.
If convicted, Kalapremi could face financial penalty and/or a prison sentence of up to three years according to Section 224 of National Penal (Code) Act 2017.&nbsp;
Data suggests that victims of child sexual abuse on average take nearly 24 years to tell someone about their trauma, and some may never disclose it at all.&nbsp;
“In our culture, children are rarely taught about boundaries. They often react, show anger when adults pinch their cheeks. But adults insist they did it out of love, and force the children to accept it,” says Sita Lama, a psychotherapist at Manka Kura. “And even when someone touches them inappropriately they struggle to identify and verbalise it.”
When perpetrators claim to be “acting out of love”, Lama says survivors are likely to perceive it as something safe, rather than recognising it as abuse.&nbsp;
“It may take years for them to realise they were abused,” she explains. "And even when they become aware, the power imbalance with the abuser and the associated shame often prevents survivors from speaking up."
Other former students from the School of Art at Kathmandu University have also come forward years later, saying Kalapremi sexually abused them. As young adults, they felt his behaviour was off but were uncertain if it was inappropriate, illegal, or they did not know how to respond. After having understood that it was indeed abuse, they say they are speaking out now to protect others.&nbsp;
Amina Singh, a visiting faculty member at Kathmandu University, says there is no clause against sexual abuse in contracts of teachers, and there is no formal grievance handling mechanism for the students.&nbsp;
“So the only way students can to deal with sexual abuse is approach someone they trust,” she says.
Eight other former art students of Lalit Kala Campus and Srijana College of Fine Arts of Tribhuvan University and other private art studios in Kathmandu say they were also sexually abused by their art teachers. Three faculty members interviewed from these institutions said they saw the abuse, but felt it was futile to report it given how powerful the teachers were.
In the absence of a formal system, some longtime women artists warned each other about “problematic” artists. They shared &nbsp;a “heads-up” to be more cautious when collaborating with them, and avoided responding to their calls and texts after work hours.
To ensure art institutions are safe for all, galleries, museums, artist studios, and smaller art spaces need to develop policies on sexual harassment. This would include a code of conduct or studio policies that hold the leadership accountable and outline the principles of professional ethics.&nbsp;
Students and employees should inquire about accountability mechanisms for raising concerns, both formally and informally, advocates say.
Three years after Ekta left the ceramics studio, she learnt that Kalapremi had harassed many other women. Still trying to get a footing in the art industry, she attended a workshop in Kathmandu where women artists discussed ways to stay safe in the art sector.&nbsp;
Since it was a close-knit group Ekta opened up about how she felt violated and realised she was not alone, he had been abusing underprivileged students for years, and this was common knowledge among artists in Nepal.
Ekta says that even after she quit, Kalapremi continued sending her text messages like ‘I am thinking of you’, ‘Why have you stopped speaking with me’, or ‘I am waiting for your call’.&nbsp;
But what really forced her to act was when Ekta found out that he was sending similar texts to her younger sister.&nbsp;
“I’ve had enough,” she told us. “He abused me all these years but I won’t let him abuse my sister.” &nbsp;
Ekta, Rajiv and Luna are not the real names of the students.&nbsp;

‘Art Lover’ accused of sexual abuse

It was 8:15 in the evening of 25 March 1968 when everyone in the village of Batulechaur near Pokhara heard a deafening sound like thunder as a bright flashing object hurtled down to land in a field.&nbsp; That field belonged to Kul Timilsina, and the next morning he retrieved a sheet of metal about 2m by 1m and carried it home with the help of a few others, thinking it would be useful for his buffalo shed.&nbsp; Before he died at age 83 three years ago, Timilsina had told photo archivist Sunil Ulak that the black metal sheet was not rectangular and had rounded corners. There are a few witnesses still alive who have a clear recollection of the object that fell from the sky that night.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2024120707128_75cc85aac56b9cc4a77366471f058d7b3eb6868776811b0923845c2d0a61f014.jpg" data-media-id="editor_0" data-image-id="2024120707128_75cc85aac56b9cc4a77366471f058d7b3eb6868776811b0923845c2d0a61f014" data-rendition-name="original" width="1170" height="601" loading="lazy" alt="UFO over Pokhara"> <figcaption>The field in Batulechaur belonging to Kul Timilsina where fragments of a flying object fell from the sky in 1968.</figcaption> </figure>  One of them is Timilsina’s wife Gyanu, who was 22 at the time. She had been at home, and remembers hearing the big bang and the sky becoming very bright. “We saw the thing in the field in the morning,” she told us. “It looked like a lid, a covering of some sort. The way it was stuck in the ground, it must have fallen from the sky. We thought we could use it to dry clothes on, and took it home.”&nbsp; Another witness is Kul Narayan Paudel. “I was only eight then. We ran to the field to see what had fallen. It was a four-sided metal sheet. The elders took it away, and I don't know what happened to it.” &nbsp; Ram Bahadur Baniya, a teacher at the local school, says he had heard the sheet had been brought to the school, and later handed over to the Zonal Commissioner at the time, Nanda Prasad Malla. “But that is all hearsay,” he says.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2024120707128_0bf207a12063fb8155b3c8d9a00a94887b126380c9e0627527c84cf5e1101f54.jpg" data-media-id="editor_1" data-image-id="2024120707128_0bf207a12063fb8155b3c8d9a00a94887b126380c9e0627527c84cf5e1101f54" data-rendition-name="original" width="1170" height="610" loading="lazy" alt="UFO over Pokhara"> <figcaption>Gyanu Timilsina, wife of Kul Timilsina.</figcaption> </figure>  There are two versions of what happened to Kul Timilsina’s metal sheet. One is that an American Peace Corp Volunteer teaching at the nearby Bindyabasini School took it, and another is that it was handed over to the government. Recently declassified Central Intelligence Agency (CIA) and US State Department documents from the time say that the US Embassy in Kathmandu tracked down the object two years later and had it shipped back to the US. A telegram from the Department of State and Department of Defense tagged as ‘MOON DUST / Space Fragments’ dated 1 March 1972 stated: ‘1. Restored space fragment will be on board Embassy support flight 115 arriving Kathmandu on or about March 10. Fragment is packed in shipping crate (cargo no. 72-33365) marked in care of DAO.&nbsp; 2. State and Defense representatives examined fragments prior to shipment finding restoration acceptable.’  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241207071212_929d903ee06d41baa4f6040e981cd7c7d7bd75cc9c37c9b617d307fc8538d2df.png" data-media-id="editor_2" data-image-id="20241207071212_929d903ee06d41baa4f6040e981cd7c7d7bd75cc9c37c9b617d307fc8538d2df" data-rendition-name="original" width="856" height="568" loading="lazy" alt="UFO over Pokhara"> <figcaption>Declassified CIA documents about the investigation into the object sighted in Pokhara. </figcaption> </figure>  The documents show that the US government, military and intelligence agencies investigated this incident thoroughly when it occurred, and have continued to revisit it ever since, as recently as five years ago. What is even more intriguing is that the object that fell in Pokhara was not the only unidentified space object that fell to earth that year. There were similar sightings of objects falling from the sky in Ladakh, Sikkim and Bhutan between 19 February and 25 March 1968.&nbsp; These mysteries were the subject of a CIA investigation in 1968 titled ‘<a href="https://www.cia.gov/readingroom/docs/CIA-RDP81R00560R000100070007-8.pdf">Sighting of Unidentified Flying Objects in Ladakh, Nepal, Sikkim and Bhutan</a>’, and the report is part of the recent online declassification of 800,000 top-secret documents from the period.&nbsp; &nbsp;Although unidentified flying objects (UFOs) have a connotation now of being alien craft, it could be pieces of satellite, missile, rocket or even aircraft. The CIA report documents six sightings in 1968 and quotes local sources as describing all of them having similar characteristics: bright blue or red streaks in the sky accompanied by loud sounds like lightning and thunder and objects falling to the ground. Aside from the metallic object that was found in Batlechaur, there were other items also found nearby in Tallakot, Tureypasal, Armalakot and Maidan. Whatever the object was, it seems to have disintegrated even before it hit the ground.&nbsp; The CIA report records the first sighting on 19 February 1968 in various parts of Sikkim and Olangchung Gola and Ghunsa in eastern Nepal. The light was said to be ‘long and thin’ and giving out ‘green and red light’. &nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241207071212_c3c825027d966a2aedc846970390eebe063957503c7eacc8e01e0517843f9bbb.png" data-media-id="editor_4" data-image-id="20241207071212_c3c825027d966a2aedc846970390eebe063957503c7eacc8e01e0517843f9bbb" data-rendition-name="original" width="892" height="596" loading="lazy" alt="UFO over Pokhara "> </figure>  Two days later on 21 February, a soundless blue object was seen traveling fast across the sky above Thimphu in Bhutan. Then on 4 March there were multiple daytime sightings or white streaks in the sky at Chang La Pass, Fukche and Koyul in Ladakh. There were more sightings in Ladakh on the very day fragments fell near Pokhara on 25 March 1968.&nbsp; After the sightings in Pokhara, rumours started flying in Kathmandu that these were aliens trying to land on Earth, it could be Russian or Chinese spy planes or satellites, and some even say it as a sign from heaven that the end of the world was near. This was at the height of the Cold War. The Russians and Americans were testing their thermonuclear devices as well as intercontinental ballistic missile delivery systems. The Washington-Beijing rapprochement had not yet happened, and China was making quick progress testing atomic bombs. Within two years after its first atomic test, in 1966 China exploded its first hydrogen bomb at the Lop Nur site in Xinjiang, 3,000km to the north from Nepal. After neary six decades, what is still intriguing is that all the sightings within a few months of each other in 1968 were along the Himalayan arc bordering Tibet: from Bhutan, Sikkim Nepal, to Ladakh. The US military intelligence seems to have concluded that this was not a coincidence and there were frequent research trips to the site in Pokhara by American officials in the months after the incident. With the help of the Royal Nepal Army, the region north of Pokhara was thoroughly searched.&nbsp; A confidential memo dated 25 June 1968 by Jerry C Trippy to a ‘Mr Farley’ mentions that the US Air Force’s Foreign Technology Division had decided that the debris could be important because it may be related to a Chinese missile test or a Soviet ‘Vehicle Venik’ rocket.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241207071216_feb5425692dc36b20187de4e4fcc2ce9fd12b6d9e1b8724398e50bcdbf9032fe.jpg" data-media-id="editor_5" data-image-id="20241207071216_feb5425692dc36b20187de4e4fcc2ce9fd12b6d9e1b8724398e50bcdbf9032fe" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="UFO over Pokhara"> </figure>  On 28 August 1968 the US Embassy in Kathmandu sent a letter to Washington DC saying that the object could be of Soviet origin, possibly from when the rocket carrying the ‘Kosmos 208’ satellite re-entered the atmosphere. But why were the fragments falling to earth several weeks apart, and in the same region? No one knows where the metal sheet that Kul Timilsina recovered is now. It was definitely packed in a crate and taken to the US, and although it is rumoured that it was returned that is not very likely. Archivist Sunil Ulak heard from the Timilsina family that CIA officials had returned to the site five years ago. &nbsp; Interest in UFOs peaked in the US in the 1950s, with the Cold War space race and tests of atomic weapons and delivery rockets. CIA and scientists were being sent to investigate sightings, both publicly and privately. Could the Pokhara fragments as well as the sightings in Ladakh and Bhutan actually be alien craft falling to earth? The renewal in interest in space travel in large part due to Elon Musk’s SpaceX, UFOs and sightings are again subjects of public interest.&nbsp; Even 57 years later, even if there was definitive proof about whether the Batlechaur fragment was from a Chinese missile or a soviet rocket, it has not been made public in documents declassified so far. We may never know.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241207071216_b6938795f40731e7657fd6dcbb3cf460a326186a15eb11d4f832f602201ff598.jpg" data-media-id="editor_6" data-image-id="20241207071216_b6938795f40731e7657fd6dcbb3cf460a326186a15eb11d4f832f602201ff598" data-rendition-name="original" width="642" height="320" loading="lazy" alt="UFO over Pokhara"> </figure>  Sunil Ulak speculates if the debris actually came from an American aircraft, perhaps on an intel mission upon China. “Which could explain why they were so thorough in collecting the fragments in Pokhara,” he says. But that still does not explain the multiple sightings weeks apart in 1968.&nbsp; Indeed, US military aircraft were at that time flying frequent night-time missions from air force bases in India to supply weapons to Khampa guerrilla camps in Nepal located north of Pokhara in Mustang. It could very well be that the Chinese shot down one such aircraft. The other sightings could have been contrails of US spy planes, or Chinese anti-aircraft missiles.&nbsp; There were quite a few developments regarding UFOs in 2024. In a US congressional hearing in July, former intelligence officer David Grusch claimed that the government had long been involved in a program to investigate and retrieve non-human craft crashes, and then try to reverse engineer them. However Grusch did not show any evidence.&nbsp; The UAP Disclosure Act of 2024 was signed into law by Joe Biden in December 2023. It plans to oversee the public disclosure of UFO information. However, there is a clause in it that prevents disclosure if it would cause threats to military defense, intelligence operations or foreign relations.&nbsp; It is unlikely that the declassified documents about sightings in the Himalayan will cause any real surprise about definite evidence of alien life even if it was found. It seems humanity will continue, at least for now, to wonder about curious lights in the sky and whether there is anybody out there.&nbsp;

UFO over Pokhara

When Rastriya Swatantra Party (RSP) president Rabi Lamichhane was arrested in October on charges of defrauding depositors of cooperatives, the party’s vice president Swarnim Wagle gifted him Fareed Zakaria’s book, Age of Revolutions.
Since then, Lamichhane has been shunted around from Kathmandu to Pokhara to Chitwan and back to Pokhara to attend police investigations and court proceedings. He was being flown to Birganj via Kathmandu on Buddha Air on Monday. There is another pending case in Janakpur.
Human rights groups and civil society have criticised the government for hounding Lamichhane with inhumane treatment that borders on physical torture. The two parties in the coalition, Nepali Congress (NC) and the UML, see Lamichhane’s RSP as a potentially formidable challenge to their power.
Even if the fraud charges against Lamichhane are true, the Nepali public is increasingly looking at the government’s actions through the police and courts as political vendetta.
Despite all the travelling, sometimes by plane and often by road at night, Lamichhane appears to be in high spirits, waving to supporters who often gather if they know he is going to be driven around. A social media video shows him giving high fives to fellow passengers on a recent flight to Pokhara.&nbsp;
In the past weeks, streets in Pokhara have erupted with parallel protests by Lamichhane’s supporters as well as depositors of cooperatives who lost their savings to the scam.&nbsp;
Although family visits are allowed, prison officials in Pokhara told Nepali Times that not many people visit Lamichhane these days. He added, “When he does get visitors, he asks them to bring him books.”
Lamichhane is currently Nepal’s most high-profile public figure in custody, and highlights the stark difference between how influential prisoners are treated compared to ordinary inmates.
There are six prison cells at Kaski District Police Office’s two-story detention centre, three on each floor. And while authorities pack prisoners into already overcrowded cells, Lamichhane has an entire room on the second floor to himself.&nbsp;
He has also been allowed to call his family every few days. Other prisoners are not permitted phone calls except for emergencies.
Meanwhile, Lamichhane’s former business partner Chhabilal Joshi, an ex-Deputy Inspector General of Police with whom he established his Gorkha Media Network, is in custody under the same charges in the prison cell next to him.
Lamichhane is accused of siphoning off depositors' money to the tv network in which he was part-owner and anchor. &nbsp;
Both Lamichhane and Joshi are able to buy food from the police canteen instead of being served the regular meal like other prisoners. Joshi has also given his statement to authorities in Rupandehi and Kathmandu for his alleged role in the scam. Lamichhane is yet to be presented in Kathmandu for questioning.
While he was in custody at the Kathmandu District Police Complex, Joshi expressed his desire to sleep in a police officer’s office, reportedly assuring authorities that he would not run away and he was entitled to certain facilities as a former officer of the law.
“He seemed to be under the impression that he is still a police officer,” says a source at the Kathmandu District Police. “We made it clear to him that as someone accused of a crime, he was not entitled to special treatment.”
Former ministers Balkrishna Khand and Top Bahadur Rayamajhi, and ex-home secretary Tek Narayan Pandey, who were arrested in connection with the fake refugee scam last year, were similarly housed in the offices of law enforcement officials instead of prison cells. Khand has since been released after six months in jail.
While there is no legal provision to keep high-ranking officials in separate detention centres when they are arrested, authorities granting them special facilities is not uncommon. Law enforcement officials say VIP detainees expect preferential treatment while in police custody.
Among those is former Kosi Province minister Lila Ballav Adhikari, who was arrested from Biratnagar on 10 November over his alleged involvement in human trafficking and brought to Kathmandu. Adhikari had flown to Japan without government approval with three individuals on 29 October to attend a cultural conference, but had been sent back to Nepal from Narita.&nbsp;
His three companions were arrested at Kathmandu airport upon their arrival, but Adhikari was able to exit unscathed from the VIP lounge. Adhikari had resigned as the Kosi Province Minister for Internal Affairs and Law when it became public that his companions had been taken into custody, and was himself arrested shortly after. He has since been cleared by the courts.
Throughout his detention, Adhikari was kept separately from other inmates. Senior Superintendent of Police (SSP) Basant Rajouri, head of the Bhadrakali complex, says that while there is no separate detention area for VIPs, some detainees are kept separately depending on the nature of their crime.
However, sources say that arrangements were made for retired judges and others to visit Adhikari frequently worked at the office of a Deputy Superintendent of Police (DSP) during his time in custody.&nbsp;
“He used to constantly pester the authorities to let him sit outside in the sun, and to be able to use the police officer’s shower area,” added an officer.
Adhikari was released on 25 November after the government prosecutor’s office decided not to charge him in a move that was seen to expose the government’s double standards.
Over at Kathmandu’s Dilli Bazar Prison, former Kist Bank CEO Kamal Gyawali emerges from his prison cell into the courtyard of the prison’s ‘Ka (क)’ block every morning with a thick book in his hands, ready to give his daily sermon.
With his long beard, Gyawali, who is serving a prison sentence for banking fraud, looks the part of a religious guru as he implores his rapt listeners to “walk the right path, abandon bad thoughts and turn to scripture and spirituality”.&nbsp;
Afterward, the attendees gather to discuss politics and current affairs. Inmates at his daily sermons at the prison include other high-profile detainees, including former MP Ichchha Raj Tamang, who is in jail for money laundering and cooperatives fraud, former joint secretary Chudamani Sharma, who was convicted of corruption, as well as NC leader Chandra Bahadur Lama and Krishna Bahadur Upreti of the UML both of whom are on trial for embezzling billions of rupees.
Victims of the cooperatives scam that former lawmaker Tamang was involved in have made trips to the prison and requested visits, but he has refused to meet with any of them.
“Tamang often complains that the state has prevented him from returning the money to the victims by locking him up,” says a police officer at the Dili Bazar jail.
“All you hear every day from the VIP prisoners is that they have been framed,” adds the officer. “No one admits that they were involved in misdeeds.”
But while most high-profile prisoners complain about prison conditions, one exception is former provincial lawmaker Deepak Manange, who is serving a sentence at Dilli Bazar Jail for attempted murder.
“He is the happiest prisoner here,” says a warden. “Unlike the others, he doesn’t claim to have been framed, in fact he doesn’t seem to care that he is in prison.”
Manange is detained in the ‘Kha (ख)’ block of the prison complex, which he renovated at his own expense. The block previously housed female prisoners, but Manange used his influence to transfer them elsewhere. He faces no shortage of visitors, who range from political leaders to people from the underworld.
Along with Manange, other well-known prisoners in this block include Nepal Telecom Managing Director Sunil Poudel, and former executive director of the Surakshan Printing Centre Bikal Poudel, who are serving time for corruption.
Former prisoners at Dilli Bazar prison include ex-ministers Khum Bahadur Khadka and Shyam Sundar Gupta, NC leader Ganesh Lama, Maoist MP Balkrishna Dhungel, Nagarik Unmukti Party leader Resham Chaudhary, as well as former IGs Ramesh Chand Thakuri, Om Bikram Rana, and Hem Bahadur Gurung.
Section 54 of Nepal’s Prison Act assigns each prison’s internal administration the
responsibility of governing its prisoners, which means the more favourable the jail management is, the more comfortable it is for prisoners.
Dilli Bazar prison has been the prison of choice for many high-ranking prisoners, especially those convicted of white collar crimes, due to its more accommodating administrators. The prison, which has the capacity to house 700 inmates, is also less crowded than other jails.
Anuj Bhattarai, spokesperson of the Department of Prison Management, says that there is no legal classification in Nepal for felons to be assigned prisons based on the nature of their crimes.
“That Dilli Bazar Jail has a higher number of prisoners convicted of crimes like corruption is most likely a coincidence,” says Bhattarai. “There is no provision for influential people to be able to choose where they will be incarcerated.”&nbsp;
Translated by Shristi Karki from the Nepali original published in himalkhabar.com

What Nepal’s VIP prisoners do in jail

If you were raised in Nepal, you must have picked up its unique set of vocabulary: आन्दोलन, चक्का जाम, बन्द, राँके जुलुस, आफ्नो मान्छे, हाम्रो दल, कर्फु and many more words connoting political protest.
We became familiar with the acrid smell of burning tyres, and eyes smarting from tear gas. And yet, everyone speaks of another revolution in the making. Not by desire, but by suffocation.
We heard speeches about नयाँ नेपाल, but the New Nepal never arrived. The governance system changed, but it did not reflect on people’s lives — except for those close to centres of power. The state is still unreachable and is not bothered about <a href="https://nepalitimes.com/here-now/matter-of-life-and-debt">victims of loan sharks</a>, cooperative scams and other injustices.
Politicians continue to speak in sound bites, but fail to deliver. They have mastered the game of pointing fingers towards an external enemy and convincing people that they are never at fault. The political narrative is so disconnected from the actual analysis of the problem that suffocation doesn’t go away after every revolution.
No genuine effort has been made to deliver at all, which is why there is a palpable sense of disillusionment in the air forcing us to seek another revolution, even if Nepal may not be able to afford it.
How has the current system successfully held power, even if the public is deeply frustrated? How is it that for three decades we continue to be led by the same faces, who have time and again, proved to us that they may be great politicians but not national leaders?
<a href="https://nepalitimes.com/opinion/improving-internet-governance-in-nepal">My experience at the epicentre of politics</a> has led me to identify three cultures that have enabled political parties to keep a tight hold on power: acceptance, silence and dependency.
We accept things the way they are. We use fatalistic phrases like “नेपालमा यस्तै हो” or “नेपालको कानुन दैब जानुन”. While this resilience enables us to rise back up from devastating calamities, it is also a reason for our compliance with the status quo.
Despite so many ‘revolutions’ that have led to significant reforms, these phrases keep getting reinforced, to the point that the upcoming generations have made it their lingo.&nbsp;
This acceptance is not a symbol of law-abiding citizens, but citizens living in fear of those in power, unable to ask the whys and why-nots.
Innovation suffocates in this culture of acceptance of the status quo. This is manifested in remarks like “but we don’t have any laws for this,” or “we don’t have the capacity to implement this”. An innovator or entrepreneur therefore has to spend that energy to become a political lobbyist, often educating and convincing the bureaucracy.&nbsp;
Remember when locally assembled <a href="https://nepalitimes.com/banner/designed-and-made-in-nepal">Yatri motorbikes</a>, despite having willing customers, had to suffer to secure license numbers because of a lack of regulations? Instead of creating new laws, the government kept chanting the “We will promote Nepal-made goods” mantra, leaving entrepreneurs in a labyrinth of bureaucracy. The weight of acceptance of the law lies heavily on innovators. Fatalism is a tactic used by those in power to generate mass fear in society.
When we accept, we become silent. This is a pervasive phenomenon. We are trained to keep quiet, lest we ruffle feathers, burn bridges, or not get the help we need in future. We know, yet we don’t speak.
Read also: <a href="https://nepalitimes.com/here-now/bureaucratic-hurdles-in-researching-nepals-bureaucracy">Bureaucratic hurdles in researching Nepal's bureaucracy</a>, Daniel W Edwards
Here is one example: the 2021 census shows that the number of baby boys born for every 100 baby girls is 112. This is a clear indication of female foeticide because of boy preference in society.
Despite such horrifying realities, there is finger-pointing within the government between the Ministry of Health and Population with the Ministry of Home Affairs. At the citizen level, we know those who are involved in killing girls. Yet, we don’t speak up. The Nepal Medical Council reports state that despite this gender imbalance at birth, there is no indication of any action.
But why would anyone speak against one's own fraternity, no matter how vile the act is?
When we accept and keep quiet, we become dependent on those who yield power. From getting our government procedure completed on time to getting transfers, to accessing any of our legally protected rights as well, we are forced to depend on our networks of चिनेको मान्छे people we know by blood, village, relations, political affiliation.
The culture of dependency has been the established way in Nepal. If you drive a two-wheeler or four-wheeler, and you get into a small accident, you will be asked to sort it yourself, dialing up the most powerful person you know. It becomes a competition of who knows who.
Recently I was told that there were calls from the Ministry of Health and Population and another from the Prime Minister's Office for just one medical position in a private hospital. Each was pushing its own candidate. Guess which candidate got the position.&nbsp;
The dependency of people is not on the laws or the state, it is with people in power, a reliance on the network of somebody who knows somebody, including those not officially in power.
These cultures are deeply ingrained in our heads, and in society. Collectively they form a vicious circle that helps those in power to retain power. This is not the society we want to live in.
Then, what do we do as a collective to break away from this? How do we break away from the cultures of acceptance and silence that have created this dependency? What can we do to ensure that our children do not have to learn the jargon of आन्दोलन before they learn about the state?
These are the cultures political parties need to shed rather than use them to perpetuate their power. This is what <a href="https://nepalitimes.com/opinion/comment/an-alternative-to-alternative-politics-in-nepal">alternative politics</a> needs to be about.
Sumana Shrestha is a member of Parliament’s Education, Health and Information Technology parliamentary committee and represents the Rastriya Swatantara Party.

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