When Sajadi Khatun felt the familiar pain, she knew what to do: she, her husband, her mother and a neighbour quickly left their house in Laxmipur village and started the 20-minute walk to nearby Sundarpur Health Post. They did not get far. Ten minutes later, Sajadi delivered a baby boy on the roadside.&nbsp; After delivery, the tired new mother returned to her home on the outskirts of Sarlahi’s district headquarters Malangwa while the rest took the newborn — the family’s fifth child, and third boy — to the health post for a check-up. A nurse visited and found both mother and child health.&nbsp; “I wasn’t worried about giving birth on the roadside," says Sajadi, stoically, although she and her husband had wanted to deliver the new baby in the health post, like her previous three children. The first was delivered at home as there was no health post in the community at the time.&nbsp; Ahead of the last birth, Sajadi had gone to the health post for check-ups (known as ante-natal care, ANC, visits) eight times before her due date. Recently, Nepal increased the recommended number of ANC visits from four to eight, but in 2022 just 68.4% of women in Madhes Province did four or more ANCs.&nbsp; The local Female Community Health Volunteer (FCHV) had also visited her house many times. On the advice of those health workers, Sajadi was eating as healthy as possible to keep up her own weight and that of the baby.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20230623080636_18c6ee1ef9c231899017a764b9a89ff1ab5d9d3cd4eb417cf91e4868d2041f1f.png" data-media-id="editor_0" data-image-id="20230623080636_18c6ee1ef9c231899017a764b9a89ff1ab5d9d3cd4eb417cf91e4868d2041f1f" data-rendition-name="original" width="1496" height="828" loading="lazy" alt="Map Sarlahi"> </figure>  At the health post, Sajadi, who is not sure of her age but is probably about 30 according to the FCHV sitting nearby during our interview, also started taking calcium and iron supplements and got a tetanus/diphtheria vaccination. Because the facility did not have an ultrasound machine, she and her husband, who do not own a vehicle, paid to go to a nearby private clinic and get the examination. It revealed no problems but staff there estimated her due date 20 days later than the actual delivery day.&nbsp; We do not know what would have happened if the ultrasound had been done at the health post, and produced a more accurate delivery date, but the roadside birth highlights again how lack of resources plays a role in maternal and child health in Nepal, despite the best intentions of health personnel and, of course, families. There was no ultrasound machine at the health post, and no ambulance to call when Sajadi’s labour started.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20230623080612_a44aa91ec02c4b2996c3b0bbdfc17847b279fefd6720b65fb5d2cf0fa5d40e78.jpg" data-media-id="editor_1" data-image-id="20230623080612_a44aa91ec02c4b2996c3b0bbdfc17847b279fefd6720b65fb5d2cf0fa5d40e78" data-rendition-name="original" width="3007" height="2619" loading="lazy" alt="Sajadi Khatun"> <figcaption>New mother Sajadi Khatun, holding her fifth child, talks to nurse Sunita Rai in front of her home near Malangwa in Sarlahi district. </figcaption> </figure>  “The problem is that we don’t have an ambulance in the municipality,” says Auxiliary Nurse Midwife Sunita Rai, who accompanies us to Sajadi’s house. “If we had an ambulance when a woman has a problem like a roadside delivery, we could send it right away and reduce the number of home deliveries.” Sarlahi district, and Madhes Province overall, still have a high number of home deliveries. Statistics from the district health office show that 53.5% of births happened in health facilities in 2021-22. That leaves 46.5% occurring at home or en route to facilities. The Nepal Demographic Health Survey (NDHS) 2022 found that 66.6% of births in Madhes Province occur in a facility versus 79.3% for Nepal overall.&nbsp; “The health situation in Madhes Province is a little worrisome to us, despite all the facilities there,” said the secretary of the Ministry of Health, Roshan Pokhrel. “We’re thinking about giving different targets to different provinces, rather than having a central target,” he added.&nbsp; Nepal is aiming to reach the global Sustainable Development Goals (SDG) target of 70 maternal deaths per 100,000 births. The 2022 rate was 151, according to the NDHS.&nbsp; Read Also:<a href="https://www.nepalitimes.com/banner/this-is-how-to-upgrade-nepals-rural-health"> This is how to upgrade Nepal's rural health</a>, Sewa Bhattarai In Sarlahi, health infrastructure is a key factor affecting maternal health. Medical Superintendent of Malangwa Hospital, Nawal Kishore Jha, told us that the facility has burst its seams. For example, when the Covid-19 pandemic displaced the emergency and in-patient departments, they moved to what was the waiting area, where they remain when we visit in April.&nbsp; Also, two years ago the hospital delivered one or two babies daily, but today it is closer to 20, including a growing number of Caesarean sections, yet the facility lacks a gynaecologist, meaning that non-specialists perform the 3-5 ‘C-sections’ done daily.&nbsp; Reached again on budget day, 16 June, Jha has good news: his hospital will be upgraded to a 100-bed facility. That could mean more buildings, more trained staff and equipment, including a CT scan machine.&nbsp; In case of a maternal emergency, accessing the district hospital — the best-resourced health facility in Sarlahi — should not be an issue as it is only a one-hour drive away from anywhere in the district, unless there is monsoon flooding, adds Jha. Yet as Sajadi’s example shows, lack of resources — like ambulances — can still be a barrier.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20230623080636_749b8cb16b39c940e487ba9770a57df181a69ce80f9878240eb273c16e5d4096.png" data-media-id="editor_3" data-image-id="20230623080636_749b8cb16b39c940e487ba9770a57df181a69ce80f9878240eb273c16e5d4096" data-rendition-name="original" width="2880" height="1800" loading="lazy" alt="Mothers of Sarlahi 2"> <figcaption>Women harbest wheat during the pre-monsoon Tarai heat wave recently in Malangwa.</figcaption> </figure>  While Jha and the nurses at health posts all say people’s awareness of maternal health and its potential complications could be higher overall, in the diverse communities near Malangwa, most women and their families are motivated to use health facilities, both to get as healthy as possible before giving birth and for the actual delivery.&nbsp; Besides awareness, living conditions are a major factor, says nurse Kanchen Rai at Laxmipur Khodra Health Post: “We can provide education, but the biggest problem is people’s lack of money. There has been some improvement but the poorest people still don’t have clean water and toilets.”&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20230623080620_b68ff8cb3b3aa01e13dd5ae964c1a4b71296a0ac601a42d47eaa2ce4698db618.jpg" data-media-id="editor_4" data-image-id="20230623080620_b68ff8cb3b3aa01e13dd5ae964c1a4b71296a0ac601a42d47eaa2ce4698db618" data-rendition-name="original" width="4032" height="3024" loading="lazy" alt="Rabena Khatun"> <figcaption>First time mother Rabena Khatun with her baby in front og her house near Malangwa in Sarlahi district. ALL PHOTOS: MARTY LOGAN</figcaption> </figure>  “Pockets” that are away from urban areas and further marginalised by diverse factors are where home births still happen, and must be targeted for improvement, says Jha.&nbsp; First-time mother Rabena Khatun, 22, told us she felt “very happy” when she knew she was pregnant. Within three months she had visited the health post for her first ANC, following it up “3 or 4” more times before delivery, accompanied by her mother-in-law.&nbsp; Read Also: <a href="https://www.nepalitimes.com/opinion/midwives-to-the-rescue-in-nepal">Midwives to the rescue</a>, Laxmi Tamang “The nurses told me I should eat more nutritious food so that I gain weight,” she tells us, crouching on the ground outside of her small thatch-roofed bamboo home, cradling her son Ehsan, now 37 days old, on her lap.&nbsp; When Rabena’s labour pains began, she went to the health post with her mother-in-law and two other relatives. After 10-12 hours the baby was born, without complications. Instructed by a nurse, the first-time mother started breastfeeding within 30 minutes.&nbsp; She tells us that no one in her family or community suggested during her pregnancy that she deliver at home, adding, “All the facilities are there (in the health post) so I felt confident.”&nbsp; <h2>Promise of a healthier district</h2>  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2023062308068_9211b4979e6bafea6f5138663b56b17c33b42294bb53e81c7d3280b5a34fe400.png" data-media-id="editor_6" data-image-id="2023062308068_9211b4979e6bafea6f5138663b56b17c33b42294bb53e81c7d3280b5a34fe400" data-rendition-name="original" width="1297" height="664" loading="lazy" alt="saving lives"> </figure>  The Medical Superintendent of Sarlahi District Hospital in Malangwa, Nawal Kishore Jha, sounded upbeat after hearing in the Madhes Province government budget on 16 June that the facility will be upgraded to a 100-bed hospital.&nbsp; “I’m very happy with the decision, it responds to all our demands,” Jha said on a call from Malangwa. The larger facility will receive more trained staff, more space, including to provide maternal healthcare services, and more equipment such as a machine for CT scans.&nbsp; The government also announced it would build two 50-bed hospitals elsewhere in the district, and that all other municipalities would have 15-bed facilities.&nbsp; The budget revealed that Sarlahi will become a 'completely safe motherhood district'. Among other things, that means all births will be in health facilities, accompanied by skilled health workers, and all pregnant women will have the required number of pre and post-natal checkups.&nbsp; “It is possible,” says Jha, “but it will take some time.” <h2>Bumpy ride triggers birth</h2>  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20230623070656_11438bd7c592e3d356ed26bfcb7de4ae014f8b23549bcafe2f383d6083c61224.png" data-media-id="editor_7" data-image-id="20230623070656_11438bd7c592e3d356ed26bfcb7de4ae014f8b23549bcafe2f383d6083c61224" data-rendition-name="original" width="2794" height="1608" loading="lazy" alt="Mother of sarlahi 1"> <figcaption>Anita Kumari Yadav with her baby and husband. </figcaption> </figure>  Anita Kumari Yadav had felt a pain for three days that she thought meant she was going into labour for her first baby. She walked to nearby Sisautiya Health Post, but was always told it hadn’t started.&nbsp; On the third day, nursing staff referred her to the district hospital because of the delay. When she arrived with her in-laws after a bumpy ambulance ride, she was told she would need a Caesarean section.&nbsp; “I was scared to have an operation,” says Anita, 20. She called her husband, a bus driver who was en route from Kathmandu. He told the family to wait until he arrived. But they didn’t have to. The baby was born half an hour later, one positive outcome of the bone-jarring ambulance ride, speculates Auxiliary Nurse Midwife Ringku Kumari Raut.&nbsp; Like the other women interviewed in the Malangwa area, Anita diligently did her ANC check-ups, once also visiting the district hospital to have a test confirmed. She took iron and calcium supplements (when in stock) and added fortified flour to her diet to gain weight.&nbsp; Nurse Raut says she is happy with how she and her colleagues managed Anita’s delivery, despite the health post’s limited resources: “Everything is fine now but if something had happened, the hospital had resources and facilities to deal with it.” <h2>Maternal deaths deliver lessons</h2> A day before the central government budget was released on 29 May, officials in the Family Welfare Division (FWD) of the Department of Health were resigned to the fact that the status quo was the most they could achieve in programming for the 2023-24 fiscal year.&nbsp; But Section Chief Gauri Pradhan had her fingers crossed that a verbal promise of more funding would allow the section to expand at least one program — for <a href="https://www.nepalitimes.com/news/3-nepali-mothers-still-die-daily-at-childbirth">maternal and perinatal death</a> surveillance and response (MPDSR).&nbsp; Started in Nepal at the Maternity Hospital in Thapathali in 1992, guidelines were created for the program in 2015 and revised in 2021. Today, MPDSR takes place in 42 districts, both in hospitals and where there are maternal and newborn deaths in communities.&nbsp; The promised funding, from an external partner, will permit the program to expand to more hospitals and communities. Pradhan displays the WhatsApp app on her mobile, which shows a group for reporting of mother and newborn deaths in hospitals and another for community deaths.&nbsp; Asked why this one program is likely to be the only maternal and newborn health initiative in the FWD to expand next year, Pradhan says: “It is the basic thing to take action to learn the cause of death. Without knowing the causes, how can we develop activities to make childbirth safer?”&nbsp; Expenses for this trip were paid by One Heart Worldwide.

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Mothers of Sarlahi

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109121144/636b92f49c7e80680e06f17bjpeg.jpg" alt="" width="2550" height="1429"/><figcaption></figcaption></figure>Nepal has had one emergency heaped on top of another for more than a year now. The Covid-19 emergency, <a href="https://www.nepalitimes.com/banner/nepal-is-going-up-in-smoke/" target="_blank" rel="noopener noreferrer">wildfires</a>, and <a href="https://www.nepalitimes.com/latest/monsoon-hits-nepal-with-a-bang/" target="_blank" rel="noopener noreferrer">now floods</a>.Political flux in Kathmandu continues to undermine the state’s ability to respond adequately. But this is nothing new. The most glaring governance failure of Nepal’s rulers for the past decades has been their incompetence in being able to ensure nutrition for its youngest citizens.Be it during the absolute and constitutional monarchy days, the post-democracy period or now, in the new federal system, the state has failed abjectly in its primary responsibility to fulfil the most basic of all human rights – access to adequate food.Nepal did reduce childhood stunting from 57% to 36% in the two decades after 1990. <a href="https://www.nepalitimes.com/banner/nearly-half-of-nepali-children-still-malnourished/" target="_blank" rel="noopener noreferrer">But progress stalled</a> because of the conflict and political upheavals. Nearly a third of Nepali children are still stunted due to lack of adequate food, 12% are wasted, and 24% low weight.The statistics are shocking. Nepal’s hunger hotspots are Far Western Province where 41% of children are stunted, and in Province 2 where 34% of children have low height due to lack of food. A survey in May by Sharecast Initiative and UNICEF shows that one in five families across Nepal <a href="https://www.nepalitimes.com/latest/nepalis-eating-less-due-to-lockdown-hardships/" target="_blank" rel="noopener noreferrer">reduced the quantity of meals</a> their children ate during the lockdown.Children have so far been largely spared by the SARS-CoV-2 virus and its variants, but they have become <a href="https://www.nepalitimes.com/banner/children-are-collateral-damage-in-nepal-lockdown/" target="_blank" rel="noopener noreferrer">collateral damage in the pandemic</a>. Schools have been closed for most of the past year, and half the students had no access to distance learning. Immunisation drives against pre-existing killer diseases have been disrupted.<a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/latest/half-of-nepalis-lost-jobs-in-past-month/" target="_blank" rel="noopener noreferrer">More than half of Nepalis lost their jobs</a> in the past month amidst the second wave, and loss of household income has led directly to insufficient food for children.Hunger is Nepal’s real national epidemic and rampant malnutrition pre-dated the Covid-19 outbreak. The pandemic has undermined the country’s past gains in battling childhood malnutrition.To meet its UN sustainable Development Goals (SDG) targets, Nepal has to reduce stunting well below 15% and wasting and low weight to less than 5% in the next nine years. At the present rate, we will not meet those goals.Horrific as the statistics are, zooming down to <a href="https://www.nepalitimes.com/banner/nepals-epidemic-of-hunger/" target="_blank" rel="noopener noreferrer">ground level in Dhanusha and Mahottari districts</a> of Province 2, our Saglo Samajtv magazine report this week shows how much worse things have got during the lockdowns.Despite Nepal being declared open-defecation free amidst much fanfare, Dalit and other marginalised communities in Dhanusha and Mahottari do not have toilets. If they do have one, there is no running water or soap. They use the same village pond for both humans and cattle, for cleaning and drinking. Things are not much better in pockets in the western mountains. Gastric infections compound malnutrition.The least the government could do is equitably distribute the ‘nutrition allowance’ allocated for the Dalit families and educate the communities on the basics of <a href="https://www.nepalitimes.com/banner/toilet-trained/" target="_blank" rel="noopener noreferrer">sanitation and hygiene</a>.Nutrition Rehabilitation Centres for severely malnourished children must be set up closer to the communities so that the neediest can access the service. The annual budget on nutrition should be increased so that local health posts have sufficient supplements and micronutrients for new mothers and their children.The government’s Multi-Sector Nutrition Plan has not delivered as expected, tangled up over jurisdiction under the new federal structure. But it could just as easily deploy Female Community Health Volunteers, and local representatives to discourage <a href="https://www.nepalitimes.com/banner/child-marriage-in-nepal-eloped-at-13-mother-by-17/" target="_blank" rel="noopener noreferrer">child marriage</a> that feeds the vicious cycle of malnutrition and high maternal and child deaths.Malnutrition is <a href="https://www.nepalitimes.com/banner/junk-food-is-making-nepali-children-shorter/" target="_blank" rel="noopener noreferrer">more than the availability of food</a> and access to clean water, it is also confronting patriarchy, casteism and gender discrimination. It is a result of poor governance, lack of accountability and corruption.But nothing is stopping newly-empowered local governments with technical and financial backing from the centre to now achieve results that Kathmandu’s past centralised governments could not. Training of farmers on climate-smart agriculture, and leasing land to the landless is a good place to start.<a style="font-size: 15px; letter-spacing: 0.01em;" href="https://archive.nepalitimes.com/article/nation/the-face-of-hunger-debt-malnutrition,3604" target="_blank" rel="noopener noreferrer">Children are hungry</a> because of poverty. Their families are poor because of state neglect. We must draw that causal link between lack of food and failure to deliver it by elected representatives. That is the real scandal the evening news bulletins should be highlighting.

Hunger for governance

Where will Nepal be in 2050? It is only 25 years away. The country’s population will be peaking at 36 million, the poverty rate will drop to near zero. Maternal and child mortality rates will fall further. Nepal will be generating up to 40,000MW of hydro and solar power, more than half of that for export. Upgraded highways will improve connectivity, railways will make transport cheaper. Pokhara and Birganj will only be two hours away from Kathmandu. Nijgad airport could be Nepal’s new aviation hub, reducing Kathmandu’s congestion. Nepal will hitch its wagon to the engines of economic growth in India and China. Investment and job creation will reduce outmigration, Nepal's data centres will be powered with surplus electricity. Remote areas will prosper with high-value tourists. That is if all goes well. But if Nepal’s politics remains dysfunctional with incompetent leadership, then the country will muddle along as it is doing now. Society will be more unequal, public discontent may boil over as politicians resort to faith to hide failures, the exodus abroad of youth will continue. Climate breakdown will exacerbate these crises. Global average temperature will have risen to 2.7°C above pre-industrial levels (it is 1.1°C now). The remaining Himalayan icecap will shrink by half, glacial lakes will threaten valleys. The hydrology of rivers will change, reducing dry season flow. Severe and prolonged heat waves in the Tarai will force people to migrate back to the mountains. In the final analysis, it all boils down to a political system that is more accountable, and displays more integrity and efficiency. <h2>Mission 2050</h2> · Melamchi Water Supply Project · Pokhrara International Airport · Bhairawa International Airport · Upper Tama Kosi Hydroelectric Project . Kathmandu-Tarai Expressway What do these biggest infrastructure projects in Nepal have in common? All ended up being more expensive than they should, all have been delayed and are not fully operational, two were badly damaged in climate-related disasters that should have been foreseen. The $800 million Melamchi is Nepal’s most expensive infrastructure project to date. It took 30 years to build, but was nearly destroyed by a glacial debris flow in June 2021. The headworks need major repairs. The 456MW Upper Tama Kosi was severely damaged by a rockfall and floods in last September’s floods. It is still not operating at full capacity, and other hydropower plants were damaged in recent glacial floods. Pokhara and Bhairawa airports were supposed to be the new aviation gateways to Nepal to take the pressure off Kathmandu, and become game changers for tourism and pilgrimage. Nearly three years later, both handle domestic flights. Poor and inadequate design, kickbacks on contracts, cost overruns, failure of diplomacy to get India’s nod on air routes, and lack of planning and marketing have made the airports a pair of white elephants. Some of these setbacks can be blamed on natural calamities, but mostly it is political incompetence and greed, lack of accountability and poor implementation. That is no surprise, since these are the hallmarks of doing business in Nepal, often delaying projects, adding to the cost, and even when completed they are already outdated. That is the story of the last 25 years, are the next 25 going to be any different? Not if governance does not improve. “What we really need for the future is vision, idea, and understanding, and then the domestic capacity to implement them,” says infrastructure expert Surya Raj Acharya, who laments the total absence of technical and planning expertise. “None of our national highways meet technical standards, our cities are unplanned. The priority was never on quality. Politicians sold us short-term infrastructure that have now become a barrier to prosperity,” he adds. One silver lining has been private sector involvement in hydropower, and the energy strategy aims to generate 11,769MW by 2030. But hydropower is high-investment, high-risk due to climate breakdown, and ecologically damaging. “Hydropower is a good example of how government incentives and public-private partnership can work wonders, although we now have to take climate change into account,” explains economist Kalpana Khanal of the Policy Research Institute. She adds, “We now have to identify other key infrastructure areas that also enhance the growth of other sectors.” The National Planning Commission’s periodic plans guide overall social and economic strategy for the country into the coming decade. Nepal’s current five-year plan (2024-2029) has set a target of 7.3% annual economic growth against the current 3.9%, $2,351 per capita income up from $1,456 at present, and poverty reduction to 12%. The plan aims to export nearly half the hydropower generated by 2030, earning the country Rs41 billion annually. But there is no real coordination between line agencies, and bureaucratic lethargy leads to constant delays, says former member of the National Planning Commission (NPC) Min Bahadur Shahi. “Development in Nepal is still very much synonymous with building roads and bridges, and infrastructure is rudimentary,” he says. “Elsewhere in the world, digital infrastructure and governance go hand in hand, we are far behind.” The frustration of a man who served in the National Planning Commission is an indication where the problem lies: in actually executing plans and implementing strategies. “We need to prioritise projects based on our geography, climate, societal needs,” Shahi continues. “We want to push Nijgad airport when we can’t even operate Pokhara and Bhairawa. Have we even studied potential air routes and needs of international carriers?”  <figure><img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250726070744_0547e5a7fd4424b5de8c279cab637ee7ebd9e65f2673b15e6dbd4eb2aa2524f2.jpg" data-media-id="editor_0" data-image-id="20250726070744_0547e5a7fd4424b5de8c279cab637ee7ebd9e65f2673b15e6dbd4eb2aa2524f2" data-rendition-name="original" width="3600" height="2400" loading="lazy" alt="Pokhara airport"><figcaption>NO FLY ZONE: Pokhara airport was supposed to be the new aviation gateway to Nepal but nearly three years after its inaguration, it mostly handles domestic flights. Photo: RADHIKA KANDEL </figcaption></figure>  TARGET PRACTICE Export of hydropower, manpower and lately information technology are the mainstays of Nepal’s economy, and will carry the country to its graduation from Least Developed Country status to a developing country in November 2026, and hopefully to middle-income by 2030. Nepal has an installed capacity of about 3,800MW, most of it from hydropower, and increased adoption of electric cars has reduced the import of petroleum products, decreasing the trade deficit with India. Meanwhile, Nepalis abroad sent home $11 billion in remittances last year, and at least $900 million in backend IT exports. But demographer Yogendra B Gurung is not impressed: “Despite the reduction in the poverty rate, and our improving income status, life expectancy, income, even maternal and infant mortality are not on par with countries with similar economic status.” He says relying on remittances is an unsustainable economic model, vulnerable to external factors and remittances are mostly spent on day-to-day needs, and not invested in productive sectors. Remittance is credited with reducing poverty in Nepal which is down to 20.27% from 42% in 1990. Money sent home by workers abroad has allowed families to afford basic healthcare and education, in turn helping to reduce childhood malnutrition and maternal mortality while improving female literacy. But the progress has stalled in recent years, and many doubt Nepal will meet its Sustainable Development Goals (SDGs) targets. The National Planning Commission has said Nepal is likely to achieve just 60% of the targets by 2030. Sex ratio at birth, which is 112 boys to 100 girls in Nepal in particular, is worrying, as it is much higher than the biological ratio of 105 to 100. This is much more pronounced in Karnali, Sudurpaschim and Madhes Provinces which suffer from historical neglect. Despite a rise in female literacy, patriarchy is still deeply entrenched and the provinces are behind the rest of the country for gender equality, education, healthcare, nutrition and economic opportunities. “Karnali is resource-rich, especially hydropower and the recent discovery of the methane gas, but inequality is much greater,” says Shahi, who is with the Karnali Integrated Rural Development and Research Centre (KIRDARC). “Federalism in Nepal is only on paper, we need a total structural reform to devolve political power to really bring about change.”  <figure><img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250726070744_fd4a218656e1fbf6f13f5f87a47bfe624516c6a0232481b6be77875ae866deb9.jpg" data-media-id="editor_1" data-image-id="20250726070744_fd4a218656e1fbf6f13f5f87a47bfe624516c6a0232481b6be77875ae866deb9" data-rendition-name="original" width="3600" height="2400" loading="lazy" alt="Butwal-Narayangadh "><figcaption>The Daunne section of the Butwal-Narayangadh road notorious for traffic jams and accidents, it has been in never-ending construction for three years. Photo: BISHNU PRASAD GAUDEL / RSS </figcaption></figure>  Despite limited resources, Nepal also suffers from wasteful investment as a result of politically (mis)guided decision-making, instead of people-centric plans and policies, says demographer Gurung. “People are overwhelmingly moving to the cities but our leaders are hell bent on building roads to every village and now there are empty schools in the mountains,” he adds. Nepal needs data-driven planning but its long-term economic vision 2020-44 seems more of a wish-list than realistic goals, including average annual GDP growth of 10.5%, $12,000 per capita income and population under the absolute poverty line at 0. Other goals include raising electricity generation capacity to 40,000MW, access to motor transport to 99%, life expectancy at birth to 80, maternal mortality down to 20% and literacy to 99% and 100% access to the internet, among others. Meanwhile, Nepal is committed to net-zero by 2045 and 100% renewable energy by 2050. “Our planners have no idea what kind of infrastructure we need 20, 30 years down the line to sustain and accelerate growth. We need a big structural change in the political leadership, in technocratic planning, and for policy implementation,” says infrastructure expert Surya Raj Acharya. Meeting such targets would require large investment, and it would be unwise to rely on remittances for the longer run, especially as Nepal’s demographic dividend will diminish as it turns into an aged society by 2065. Reversing out migration requires a favourable investment climate so jobs are created. Good governance marked by accountability and transparency are the basic prerequisite for ease of doing business. But lack of rule of law and illicit funds put Nepal in the grey list of the Financial Action Task Force (FATF), the global money-laundering watchdog. “Everything comes down to a political will. The established parties must realise that if they don’t perform, they will be replaced by alternatives,” says Kalpana Khanal. “In the meantime, we must engage the youth and find ways to retain them as well as attract the diaspora to invest in Nepal.”

Nepal in 2050

MetLife Nepal has signed Rohit Paudel and Indu Barma, the captains of the national men’s and women’s cricket teams, to promote the importance of life insurance.

Metlife signs Nepal cricket captains

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

How the Peace Corps changed a volunteer’s life

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

maternal-death

Mothers of Sarlahi

Hunger for governance

Nepal in 2050

Metlife signs Nepal cricket captains

How the Peace Corps changed a volunteer’s life

Nepal’s Resource Curse