<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022111413114/63722f839c7e80680e0c251djpeg.jpg" alt="" width="1200" height="800"/><figcaption>Photo: PRASANSA BUDHA LAMA</figcaption></figure>From 1991 to 2016, the maternal mortality rate in Nepal declined by a staggering 72% -- from 850 deaths per 100,000 live births to 239 in 25 years.This was a dramatic advance, but since then progress has slowed and almost plateaued off, mainly due to high rates of neonatal deaths.And at the current rate, Nepal will have to further bring down this figure by 71% by 2030 to meet its Sustainable Development Goals (SDGs) on maternal health. This is a considerable challenge given that Nepal has the highest maternal and neonatal mortality rates in South Asia, behind only Afghanistan.A shortage of skilled birth attendants, weak referral systems and difficulty in accessing treatment for complex pregnancies all point to the government’s chronic neglect of women’s health and the subsequent high mother-baby death rate.It is well established that the six pillars of safe motherhood are family planning, HIV/STD control, antenatal care, obstetric care, postnatal care and abortion care. And these can be strengthened through education, gender equality and access to primary health care. However, the Ministry of Health has overlooked these aspects, and this is undermining past gains.The 2015 Right to Safe Motherhood and Reproductive Health Act guarantees women the right to necessary counseling and maternity services from a midwife. But this does not apply to a majority of women in rural areas due to a lack of trained staff.Read also: <a href="https://archive.nepalitimes.com/regular-columns/GUEST-COLUMN/Saving-one-mother-at-a-time,816">Saving one mother at a time</a>, Bikash GauchanThe government needs to produce more than 10,000 midwives with a minimum of a three-year certificate if it is to reduce the maternal mortality rate to 75 for every 100,000 births by 2030, as per the SDGs.Under the previous Millennium Development Goal (MDG), Nepal had committed to reducing maternal mortality by three-quarters by 2015, which included midwifery education and services in the five-year plan. A policy was then formulated in 2006 to produce skilled birth assistants (SBA) with other staff to be given two months of training to develop 27 basic maternity services.The strategy includes basic nursing skills in nursing and medical education such as ANMI certification, BSc Nursing, MBBS and MDGP and aims to produce professional midwives in the long run.At present, Sudeni Maternal and Child Health Workers and Assistant Nurse-Midwife (ANMI) who underwent midwifery training for two months are deployed to communities as maternal health service providers.Since 2006, the program has produced more than 10,000 SBAs and reduced maternal mortality by 15% in the past decade at the cost of Rs1 billion, but we are yet to see the kind of progress we aspired to. The program has significantly increased awareness about maternal healthcare, but has not produced as many professional midwives.Read also: <a href="https://www.nepalitimes.com/editorial/nepali-ama/">Nepali Ama</a>, EditorialIn India, ANMI must have passed high school and undergone two years of training. In Nepal, those who have passed grade 8 and trained for 29 months can become ANMI. Therefore, people at the forefront of providing maternal and child healthcare are already lagging in resources, skills and education levels.In urban centres, mothers have the choice of obstetricians and gynecologists, but in villages, their best bet are ANMIs, many of whom have not even completed remote obstetric training. This negligence has cost the lives of many young mothers.Further, women accessing health facilities face humiliation, and even violence, and are stigmatised. The main reason for this is the lack of midwives, and the shortage of such an important position within the National Health Care System.Read also: <a href="https://www.nepalitimes.com/here-now/another-babys-life-is-saved-in-rural-nepal/">Another baby’s life is saved in rural Nepal</a>, Naresh NewarThere is also a tendency to announce popular programs only to source large budgets from state coffers. The President’s Program for Women’s Upliftment is an initiative to save the lives of mothers at childbirth.Launched in 2018, the program has only spent Rs36.6 million in three years when its budget was Rs50 million a year. In the same period, while it saved 360 women, 789 died without treatment.Expecting women in remote areas are constantly at risk due to the delays: at home while making a decision, on-road in lack of proper transport and at health facilities.Even then we can mitigate the illiteracy, ignorance and financial constraints that cause decision delays at home and on roads with public awareness programs. But the bigger challenge is that of local health facilities take time to transfer women to better-equipped hospitals.According to 2020 Maternal Infant Mortality Monitoring and Response (MPDSR), most maternal deaths were due to preventable causes such as bleeding, high blood pressure, infections and prolonged labour pains. The analysis also showed that 37% of women died on the way from one health facility to another, 30% at home, 23% in private and non-government hospitals and 10% on the way home from health facilities. Most of these deaths were of women under 34.Read also: <a href="https://www.nepalitimes.com/banner/balancing-life-and-death-in-nepal/">Balancing life and death in Nepal</a>, Ashmita Hamal and Naresh NewarBy mobilising skilled midwives at local-level health facilities, we can manage many complications and counsel families if a mother needs to be relocated. And one way to achieve that is by providing the ANMIs with a 3-year certificate level midwifery education.Midwives in essence stand for women's rights. They advocate for all women of reproductive age to receive the quality and dignified services they deserve, especially during pregnancy and childbirth.Midwives have proven their effectiveness in countries like Norway, Finland, Sweden, Denmark and the Netherlands for the past 250 years and have reduced maternal mortality rates to as low as 2 per 100,000 live births.With the maternity knowledge, skill and behaviour they have, only a midwife can determine the true condition of a woman in labour pain when there is no obstetrician and gynecologist present which is often the case across Nepal’s rural villages.If we want to save our mothers, it is of utmost importance that the Nepali state act immediately to produce midwifery practitioners.Laxmi Tamang is the president of the Nepal Midwifery Society.Adapted from the <a href="https://www.himalkhabar.com/news/130974">Nepali original</a> in Himalkhabar monthly magazine by Aria Parasai.Read more: <a href="http://archive.nepalitimes.com/news.php?id=16327#.Ys5GPOxBzAM">Homeward bound</a>, Sabhyata Timsina

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Midwives to the rescue in Nepal

<figure><img width="429" height="488" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110111156/636cd94a9c7e80680e092e8fjpeg.jpg" alt=""/><figcaption></figcaption></figure>A year since Nepal went into lockdown to control the spread of the coronavirus, different facets of socio-political economy are being revisited. Findings of one such recent study, paints a grim picture of <a href="https://www.nepalitimes.com/opinion/uneven-pandemic-impact-on-nepali-women/" target="_blank" rel="noopener noreferrer">women’s economic status</a>.A large number of women both in the formal and informal sectors faced and continue to face pay-cuts since the start of the pandemic. Many have been laid off.South Asia Economic Policy Research COVID-19 &amp; The  New Normal for Women in the Economy in Nepal just as its elaborate title suggests, examines the conditions of women and their contribution to the economy in the days since the world braced for a pandemic.The report released this weekend highlights the already challenging status of Nepali women, that has been further compounded with increased unpaid household work and burgeoning instances of <a href="https://www.nepalitimes.com/latest/in-nepal-lockdown-a-domestic-violence-spike/" target="_blank" rel="noopener noreferrer">domestic violence and abuse</a> in 2020. This study is done by a team of young Nepali women and men in mid-twenties and aims at understanding the current socio-economic situation of Nepali women to pave ways forward, says Shilshila Acharya of the Himalayan Climate Initiative (HCI) which partnered with The Asia Foundation (TAF) on the report.The paper covers 401 women and 51 private sector firms from all seven provinces and focuses on three major aspects affecting women during the pandemic including economic, psycho-social, and sexual and reproductive health.“So many women have lost their jobs and income due to the pandemic. To help in their income generation, a lot of skill enhancement trainings, including digital, and entrepreneurship promotion work must be done,” says Acharya. <img width="349" height="213" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110111156/636cd94c9c7e80680e092e90jpeg.jpg" alt=""><img width="448" height="295" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110111156/636cd94d9c7e80680e092e91jpeg.jpg" alt=""><img width="444" height="238" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110111156/636cd94f9c7e80680e092e92jpeg.jpg" alt=""><img width="377" height="162" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110111156/636cd9519c7e80680e092e93jpeg.jpg" alt="">The study documents respondents’ concerns on issues related to the marginalised communities, mainly women. It highlights how the lack of planning has led womens’ <a href="https://www.nepalitimes.com/latest/new-contraceptive-for-increased-lockdown-use/" target="_blank" rel="noopener noreferrer">inability to access contraceptives</a>, increased chances of <a href="https://www.nepalitimes.com/here-now/baby-boom-expected-after-lockdown/" target="_blank" rel="noopener noreferrer">unintended pregnancies</a>, and starkly <a href="https://www.nepalitimes.com/here-now/birth-and-death-during-a-pandemic/" target="_blank" rel="noopener noreferrer">high maternal mortality</a>, among others. The impact on mental health of women has increased. This research also included a survey with 51 female employers representing individual employers (households), Small and Medium Enterprises (SMEs) and informal sector employers, and formal sector employers (large industries), including businesses primarily owned by women. The survey found that 37% of businesses imposed a pay cut on female employees, out of which 58% had inflicted a 50% deduction in salary. More than half of the businesses surveyed had laid off 50% to 100% women employees. A total of 631,000 female jobs are estimated to be at risk in the higher impact scenario. For women entrepreneurs, the pandemic has led to the closure of businesses, leading to financial distress and insecurity. In response to the dwindling economic situation, the government announced that it would provide coverage through the Social Security Fund (SSF) to private entities for the month of April 2020 worth Rs.180 million. But, none of the companies in the survey were aware of it. The report mentions that many rural women farmers who also take informal loans on high interest rates remain excluded from interest reduction schemes of the government, and farmers on credit were struggling to repay loans. A majority of women tenant farmers cannot access the government’s compensation  schemes, because they have no land entitlement. To avoid the risk of a permanent exit of women from the labor market, it is important to ensure assistance to the people currently in the informal economy, the report says. Complex bureaucratic vetting and red-tapism have to be replaced by opportunities for direct cash transfers and insurance programs. The lesson of the pandemic is that the informal economy needs to be registered in the government system and social security schemes for businesses established.  To prevent the progress related to work done on women’s rights from sliding back by decades, strategies are needed to support women not just during the pandemic but also in a post-pandemic world.  “The research information tells a story of the groundbreaking role women have already played in the pandemic adaptation and response,” says Meghan Nalbo of TAF.  “The data on differential economic impacts of Covid-19 validates a more accurate picture of reality against which policy makers, community leaders, and women themselves can make decisions as part of the economic recovery we now face ahead of us as we crawl out of the Covid-19 recession.”

Nepali women survive pandemic economy

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110111152/636cd8879c7e80680e092e49jpeg.jpg" alt="" width="1500" height="1125"/><figcaption>Phediguth village in Okhaldhunga where poor roads make access to health facilities difficult for complicated maternity cases. All photos: NARESH NEWAR</figcaption></figure>Stories of birthing are not the kind of conversation that children in Nepal usually have with their mothers. Surya Bhatta’s career path, however, took a new turn when his mother shared her own story of how she survived a near-death complication when she was giving birth to his elder sister.His mother was married at 11, and had her first baby at 16. Access to health services in their home village in Dhading was limited at the time, and she suffered from severe postpartum complications.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110111152/636cd88b9c7e80680e092e4ajpeg.jpg" alt="" width="640" height="364"><figcaption> </figcaption></figure>“Luckily, my mother survived but we all know many Nepali mothers still face similar risks due to poor maternal health,” says Bhatta, now executive director of One Heart Worldwide (OHW), a US-based organisation working in Nepal.At 34 Bhatta is proud to be playing a role to save the lives of mothers like his mother. Although the country has made vast improvements in reducing the maternal mortality rate from 539 per 100,000 live births 25 years ago to 240 today, it is still unacceptably high.An estimated 2,000 new <a href="https://www.nepalitimes.com/here-now/who-will-save-nepals-poor-new-mothers/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/here-now/who-will-save-nepals-poor-new-mothers/&amp;source=gmail&amp;ust=1615874753197000&amp;usg=AFQjCNEu5wCZ54G1e7vKzay3LB7DTXI7mA">mothers still die</a> in Nepal every year —  most of them because health posts are not properly equipped and staffed. The maternal mortality rate also went up in 2020 because the lockdown and pandemic prevented many mothers from getting to hospitals or birthing centres.Bhatta and his colleagues have been working to improve maternal neonatal health care, and with a 70-strong team is setting up birthing centres and hospitals in Nepal’s most remote districts to upgrade care for mothers and babies.<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110111152/636cd88e9c7e80680e092e4bjpeg.jpg" alt="" width="200" height="191">Starting from five villages of Baglung in 2010, One Heart has expanded to 21 districts and helped renovate and equip more than 500 birthing centres in 164 municipalities where road access is still limited. The centres work with local municipalities on a cost-sharing public-private-partnership formula.https://www.youtube.com/watch?v=tVA--CRk3nMMany government health posts in rural municipality wards are under-resourced and often struggle to even buy standard maternity delivery beds and lifesaving equipment. There is inadequate <a href="https://www.nepalitimes.com/banner/federalism-leaves-nepals-medical-sector-ailing/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/banner/federalism-leaves-nepals-medical-sector-ailing/&amp;source=gmail&amp;ust=1615874753197000&amp;usg=AFQjCNEX5KH1MBkZwv3gDbQd0uKEItLdXg">infrastructure</a> for pre-natal, delivery and post-natal care, and a chronic shortage of trained midwives in rural areas.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110111152/636cd88f9c7e80680e092e4cjpeg.jpg" alt="" width="1500" height="1710"><figcaption> </figcaption></figure>Nurses are not trained to handle complicated cases during and after delivery, and as frontline maternity workers face the wrath of local communities when mothers and babies die.Bhatta and his team have zeroed in on training nurses at health posts to become skilled birth attendants, an intervention that directly saves lives. One Heart’s trained nurses and renovated birthing centres now care for more than 72,000 pregnant women across Nepal annually.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110111152/636cd8929c7e80680e092e4djpeg.jpg" alt="" width="1500" height="1125"><figcaption> </figcaption></figure>“Even during the pandemic rural municipalities were able to find resources to share half the cost of construction to renovate the birthing centres,” says Bhatta who works in partnership with local governments and community groups.Bhatta sets program priorities after consultation with local elected representatives, tries to raise money locally, and then tops it up by competing globally for international grants. He says, “We can’t make our people always dependant on international aid. We need to be innovative by taking risks with new ideas.”<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110111152/636cd8959c7e80680e092e4ejpeg.jpg" alt="" width="1500" height="1125"><figcaption> </figcaption></figure>The partnership approach for upgrading birthing centres through cost-sharing is innovative, and one that encourages local ownership, clearly outlining outcomes. It went ahead because local governments under Nepal’s new federal structure were willing to start implementation immediately.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110111152/636cd8989c7e80680e092e4fjpeg.jpg" alt="" width="1500" height="1125"><figcaption> </figcaption></figure>“Entrepreneurship is needed in the social sector not for profit making, but for creating quality service that can go up to scale,” explains Bhatta. “Social entrepreneurship is all about evidence-based work that guide organisations to reduce risks and help improve through sustainable local health systems. There are challenges in Nepal, but there are so many opportunities to overcome them through partnerships like this.”<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110111152/636cd89b9c7e80680e092e50jpeg.jpg" alt="" width="1500" height="964"><figcaption> </figcaption></figure>Bhatta makes a case for Nepalis to return home after higher education overseas, just as he himself did after graduating from Dartmouth in the United States, fulfilling the promise he had made to his mother that he would make a difference for as many Nepali mothers like her as possible.He says, “I am proud of the team we have built, I feel we are making a difference especially for rural communities. What can be more fulfilling than helping save lives?

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“What can be more fulfilling than saving lives?”

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109141140/636bade89c7e80680e077fbdjpeg.jpg" alt="" width="1496" height="1146"/><figcaption>Min Bajracharya’s iconic photograph of Durga Thapa, 22, as she leapt up during a victory rally on 9 April 1990 to shout “Long live democracy!” All photos: MIN RATNA BAJRACHARYA</figcaption></figure>The <a href="https://www.nepalitimes.com/banner/one-moment-30-years-ago-today/" target="_blank" rel="noopener noreferrer">People’s Movement in 1990</a> erupted because for three decades of partylessness, Nepalis could not let off steam and socio-political pressure had been building up.We got a constitutional monarchy, the parties were unbanned, the mass media was unshackled. And soon enough, we started using our newfound freedoms to complain about the <a href="https://archive.nepalitimes.com/article/nation/nepal-from-royal-to-republic,3736" target="_blank" rel="noopener noreferrer">king and queen</a>. When the Maoists took the country to war, we complained about the violence.After the ceasefire of 2006, we were not happy about the restoration of peace – we started complaining about the political transition. Our constant moaning and groaning probably prolonged that transition.Then the <a href="http://archive.nepalitimes.com/blogs/kundadixit/2015/05/27/a-month-that-felt-like-a-year/" target="_blank" rel="noopener noreferrer">earthquake struck in 2015</a>, and even as the aftershocks rocked us, we whined about the relief being poorly distributed, and the slow pace of reconstruction. We then had the <a href="http://archive.nepalitimes.com/article/editorial/autopsy-of-a-blockade%20,2863" target="_blank" rel="noopener noreferrer">Indian blockade</a> to complain about. And as soon as the 2017 election was over, we started criticising the very leaders we had just elected to power.We were about to run out of things to complain about when there was the <a href="https://www.nepalitimes.com/editorial/nepals-new-normal/" target="_blank" rel="noopener noreferrer">COVID-19 pandemic</a>, and we could complain about <a href="https://www.nepalitimes.com/editorial/reduce-harm/" target="_blank" rel="noopener noreferrer">the lockdown</a> and the corruption in the procurement of medical supplies and the government’s general incompetence.It is human nature. Like most people around the world, Nepalis are never happy with the state of affairs. In fact, we do not score very high in the Happiness Index. That itself is a positive thing because it means we know there is plenty of room for improvement. Things can always be better. That is the whole idea behind the need to see the world as half full.Remember the days when there were 16 hour power cuts every day? <a href="https://www.nepalitimes.com/here-now/an-electric-shock-to-nepals-energy-future/" target="_blank" rel="noopener noreferrer">Now that there is surplus power</a>, we are complaining that the electricity we generate is going waste. What to do with it? Where to sell it?There was a time in the 1980s when the proponents of the Himalayan Degradation Theory predicted that Nepal would be a desert by the turn of the century. Here we are four decades later, and <a href="https://www.nepalitimes.com/banner/tree-mendous/" target="_blank" rel="noopener noreferrer">Nepal has doubled forest cover</a>. We have almost a quarter of our area designated as national parks, and 15% of Nepal is covered in <a href="https://www.nepalitimes.com/banner/who-now-owns-nepals-forests/" target="_blank" rel="noopener noreferrer">community-managed forests</a>.Enrollment in school is nearly 100%, infant and <a href="https://www.nepalitimes.com/here-now/who-will-save-nepals-poor-new-mothers/" target="_blank" rel="noopener noreferrer">maternal mortality</a> have seen dramatic reductions. Absolute poverty has been halved in 25 years. The education we got and the remittance economy has exposed many Nepalis to jobs all around the world, and the quality of life for many have improved with the money sent home.Yet we complain that our youth are away. But that is also good because the end goal should be to create jobs for them at home.There are many products in the market that require energy to produce. If Nepal is to select a few of these and manufacture them near our many <a href="https://www.nepalitimes.com/opinion/decentralising-hydropower/" target="_blank" rel="noopener noreferrer">hydropower</a> plants, we could become productive and competitive.In Birganj, for example, there are truck loads of metal sheets coming in from India. They are rolled into pipes and poles, and sent back out. This is the value added for Nepal’s abundant, clean, reliable energy.Entrepreneurs will begin to look for energy production sites where goods can also be produced. We will then see how education will be valued in these areas because it means jobs at the local level. We will no longer have the debate about exporting energy, and sending Nepali youth abroad to prop up the <a href="https://www.nepalitimes.com/editorial/remit-for-remittances/" target="_blank" rel="noopener noreferrer">remittance based economy</a>. Local agriculture will have a local market. Nepalis will also understand the true meaning of Value Added Tax.We can use spilled hydropower at night to pump water for to irrigate farms and boost food production, and during the day use the water to generate power. This is the chance for an entrepreneur to set up a factory to manufacture rice cookers and electric kettles so we <a href="https://www.nepalitimes.com/opinion/look-whats-cooking-in-nepal/" target="_blank" rel="noopener noreferrer">reduce our reliance on imported LPG</a>.Nepal’s poverty related problems can be solved with political will. Nepal’s problems are simple and so are their solutions. Unfortunately, we like to complicate things so we can seek complicated solutions. It is almost as if we want to remain poor so we keep getting grants for poverty alleviation, so our experts and consultants have jobs. It is precisely because we have only complained and not implemented solutions over the past seven decades that we would rather export manpower than value-added good and services.Historically we have always described Nepal with what we do not have. For example, we do not have access to the sea. Or the terrain is not easy. These were always top reasons given for why we remain poor, rather than look at poor governance and mediocre leadership.More and more Nepalis now live in comfortable homes, drive fancy cars, send their children to the best schools. And yet we complain. Human progress is about not being content and wanting things to improve. There is so much to do as we move ahead whether you see the glass half empty, or half full. It is time to take the lead and move ahead.Anil Chitrakar is President of Siddharthinc. This is his last written column, he will now be hosting a fortnightly Anil’s Walkabout video program on the Nepali Times YouTube channel.

Anil Chitrakar

Stop complaining, start contributing

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221129151140/638619f69c7e80680e0cccd2jpeg.jpg" alt="" width="1500" height="844"/><figcaption>Photo: MARTY LOGAN</figcaption></figure>It should not be surprising that <a href="https://www.nepalitimes.com/latest/the-story-of-nepals-first-covid-19-fatality/" target="_blank" rel="noopener noreferrer">Nepal’s first COVID-19 death was a new mother</a>. What was surprising was to hear Prime Minister K P Oli admitting in Parliament on Tuesday that Nepal’s coronavirus deaths represented a failure of his government.<a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/banner/3rd-month-of-lockdown/" target="_blank" rel="noopener noreferrer">Three Nepalis have died with coronavirus</a> since the pandemic hit Nepal. But that is the number of mothers who died every day across Nepal at childbirth. Despite dramatic strides in reducing the <a href="https://www.nepalitimes.com/here-now/who-will-save-nepals-poor-new-mothers/" target="_blank" rel="noopener noreferrer">maternal mortality</a> rate, 1,200 mothers still die while giving birth every year.Government statistics show that this number has risen dramatically in March and April, as women avoid hospitals because of the COVID-19 scare, as well as because of the lack of transport during the lockdown.The 29-year-old woman from Sindhupalchok, whose name has not been released, died on 16 May of post-partum sepsis and a <a href="https://www.nepalitimes.com/here-now/bhaktapurs-covid-19-heroes/" target="_blank" rel="noopener noreferrer">coronavirus infection</a> 10 days after safely delivering her baby at Teaching Hospital in Kathmandu, then returning home. There were delays in taking her to hospital after complications because the family could not find an ambulance.Even before the COVID-19 crisis, one of the reasons far too many Nepali women still give birth unsafely at home was the <a href="https://archive.nepalitimes.com/regular-columns/Comment/mothers-in-Nepal-still-dying-at-childbirth,1007" data-saferedirecturl="https://www.google.com/url?q=https://archive.nepalitimes.com/regular-columns/Comment/mothers-in-Nepal-still-dying-at-childbirth,1007&amp;source=gmail&amp;ust=1590230096851000&amp;usg=AFQjCNHGPAy4FgQc1EbtnlKIZJMxrFl6XA">high cost of ambulance</a> to take them to health facilities.Nepal has made <a href="http://archive.nepalitimes.com/article/nation/people-politics-placentas-child-delivery-complications,3922" target="_blank" rel="noopener noreferrer">progress in reducing maternal mortality</a> and <a href="https://www.nepalitimes.com/banner/born-in-nepal/" target="_blank" rel="noopener noreferrer">newborn deaths</a> thanks to the Safe Motherhood program, for which it received global recognition. But that improvement was nowhere enough to conclude that the job was done and the country could rest on its laurels.Figures show that in 1990, 901 women died per 100,000 births. That number was slashed to 239 per 100,000 live births in 2015. Yet the target for 2030 under the global Sustainable Development Goals is less than 70.If the health of pregnant women is still a government priority it has not been obvious during the lockdown. Pregnant women have been too fearful to visit clinics for crucial antenatal checkups, but by now arrangements should have been made for them to do so safely — or alternatives put in place — and those plans communicated to women.Of course, post-partum mothers are not the only Nepalis dying because of the broken health system. <a href="https://www.nepalitimes.com/here-now/kidney-patients-dying-due-to-covid-19-lockdown/" target="_blank" rel="noopener noreferrer">Non-communicable diseases </a> NCDs) are now the cause of most deaths in the country, led by heart disease, lung disease and stroke, but an NCD Multisectoral Action Plan spanning 2014-20 has yielded no visible results.The main causes of maternal mortality include post-partum bleeding, unsafe abortions, high blood pressure and post-delivery infection. Abortions aside — because there is still stigma attached to having one and a lack of knowledge about their legality — the other causes are treatable.Some initiatives have been taken. The President’s Women Uplift Program has used helicopters to rescue dozens of pregnant or post-partum mothers in emergency situations and many local governments have started programs to cajole or coerce women to give birth in facilities andto properly care for themselves and their newborns in the crucial days following delivery. But too many health facilities that should be providing services to pregnant women remain <a href="https://www.nepalitimes.com/here-now/who-will-save-nepals-poor-new-mothers/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/here-now/who-will-save-nepals-poor-new-mothers/&amp;source=gmail&amp;ust=1590230096851000&amp;usg=AFQjCNEb9E7sQYw1XzmTTnMfGji3UmNybQ">under-staffed, ill-equipped and short of medicines</a>, and there is no visible national action plan, certainly no sense of urgency.Contrast media coverage of deaths of new mothers with those of women and girls practising chhaupadi in far western Nepal. Temporarily exiled from their homes during menstruation or after giving birth, they are at risk of snakebite, asphyxiation in tiny, windowless huts, and rape and physical assault. While outlawed, the practice continues.In recent years chhaupadi has been reported widely in Nepal and garnered numerous headlines in major global media. Yet, while roughly 15 women have died in <a href="https://www.nepalitimes.com/opinion/tipping-point-on-menstrual-banishment-in-nepal/" target="_blank" rel="noopener noreferrer">chhaupadi</a> in Nepal since 2010, there have been 15,000 women who died in that time from causes associated with giving birth. For much of the media, death during pregnancy has become too routine to deserve coverage.The prime minister was right to admit failure over the COVID-19 deaths to date: his government <a href="https://www.nepalitimes.com/latest/has-nepals-lockdown-just-postponed-covid-19/" target="_blank" rel="noopener noreferrer">has had ample time to craft a much more effective response, and has not</a>  The deficits in the health system overall have been evident, and discussed, throughout the decades that the prime minister and his colleagues in all parties have been in power. That deserves an admission of failure, followed by corrective action.

3 Nepali mothers still die daily at childbirth

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109101152/636b79289c7e80680e0646e7jpeg.jpg" alt="" width="960" height="640"/><figcaption>A quarantine zone at Nepal Army's headquarters in Tundikhel. Photo: BIKRAM RAI</figcaption></figure>By now the novel coronavirus pandemic has affected every corner of the globe. If it has not brought disease, it has at least brought the <a style="background-color: #ffffff; font-size: 16px; letter-spacing: 0.15px;" href="https://www.nepalitimes.com/editorial/fear-goes-viral/" target="_blank" rel="noopener">fear of infection</a>. Cities, and indeed entire countries, are in lockdown. Fortress Europe has raised its walls higher. Airlines are grounded. Nepal has banned trunk international routes from Friday night. Even countries with excellent public health facilities and emergency preparedness plans are overwhelmed.Nepal is now <a href="https://www.nepalitimes.com/opinion/global-thinking-and-local-action-on-coronavirus/" target="_blank" rel="noopener">so closely intertwined with globalisation</a> through migration, tourism and trade that its <a href="https://www.nepalitimes.com/here-now/nepals-economy-already-weak-takes-direct-hit/" target="_blank" rel="noopener">already-fragile economy has been badly hit</a> even before a full-blown health emergency hits. Ironically, less-developed countries seem to have a built-in resilience that comes from being crisis-prone -- since they are lower down in the economic ladder, they have a shorter distance to fall.Read also: <a href="https://www.nepalitimes.com/editorial/poor-health-makes-nepalis-poorer/" target="_blank" rel="noopener">Poor health makes Nepalis poorer</a>, EditorialDespite Nepal’s surprisingly <a href="https://www.nepalitimes.com/banner/born-in-nepal/" target="_blank" rel="noopener">dramatic improvements in mother-child survival </a>over the past two decades, <a href="https://www.nepalitimes.com/editorial/poor-health/" target="_blank" rel="noopener">the public health system here is in crisis</a>. State-of-the-art modern hospitals in the city, while reducing the need for Nepalis to go abroad for treatment, are out of reach of a majority of the population. Government health facilities are more affordable, but for the most part medical care there is not up to mark.Nepalis are still afflicted by easily preventable water-borne diseases like <a href="https://archive.nepalitimes.com/news.php?id=16988#.XnMUhagzbSF" target="_blank" rel="noopener">typhoid and diarrhoea</a>, vector-borne infections like malaria, encephalitis or dengue, and illnesses like <a href="https://www.nepalitimes.com/banner/nepal-tb-cases-grossly-underestimated/" target="_blank" rel="noopener">tuberculosis </a>and acute respiratory infections that spread through breathing. Great inroads have been made in reducing the impact of communicable diseases in the past decades through awareness programs, vaccinations and safer drinking water, but children in <a href="https://www.nepalitimes.com/banner/this-is-how-to-upgrade-nepals-rural-health/" target="_blank" rel="noopener">remoter parts of Nepal</a> are still dying of simple infections.Read also: <a href="https://www.nepalitimes.com/banner/a-shot-in-the-arm-for-vaccines-in-nepal/" target="_blank" rel="noopener">A shot in the arm for vaccines in Nepal</a>, Sonia AwaleOn top of this, urbanising Nepal now also has the added burden of <a href="https://www.nepalitimes.com/editorial/poor-health/" target="_blank" rel="noopener">non-communicable afflictions</a> like diabetes, cardio-vascular ailments and renal disease. As families move from the districts to the cities, changes in diet and more sedentary habits have given rise to an epidemic of lifestyle-related diseases. This is compounded by genetic susceptibility among South Asians for diabetes and heart disease.For example, a study by the BPKIHS in Dharan showed that while the national average for <a href="https://archive.nepalitimes.com/article/nation/diabetes-in-south-asia,3018" target="_blank" rel="noopener">Type 2 diabetes </a>prevalence is 8.1% of the population, the incidence in Dharan was 14%, while it was only 1% in Taplejung. The prime minister’s own second kidney transplant this month showed that <a href="https://archive.nepalitimes.com/article/editorial/health-tip-editorial,4032" target="_blank" rel="noopener">ignoring risk factors and not diagnosing non-communicable diseases</a> can lead to a huge health burden for families and the state. A small percentage of Nepalis have health insurance, so many middle income families fall below the poverty line due to medical expenses. Many Nepali migrant workers have been forced to seek jobs abroad to pay back debts incurred during hospitalisation of family members.Last summer’s explosion of dengue in Kathmandu Valley was <a href="https://www.nepalitimes.com/banner/mosquitoes-move-up-mountains-as-the-earth-warms/" target="_blank" rel="noopener">blamed on climate change</a>. But it was actually a perfect storm of crowded and squalid living conditions, poor drainage, greater mobility of people, and a particularly wet monsoon. None of these factors have been addressed, so we are staring at a recurrence of dengue this year even while we cope with <a href="https://www.nepalitimes.com/banner/why-nepal-must-watch-about-coronavirus-but-not-panic/" target="_blank" rel="noopener">a possible COVID-19 outbreak</a>.Public health has not been a national priority for successive governments in Nepal. Even if it has, it is only in paper and has not really been translated into <a href="https://www.nepalitimes.com/opinion/is-free-health-care-possible-in-nepal/" target="_blank" rel="noopener">accessible and affordable healthcare</a> for the general public. Governance failure has contributed to this state of affairs, but there is also the virus of corruption that has afflicted the entire government healthcare system. A politico-business nexus has also infected <a href="http://archive.nepalitimes.com/news.php?id=19560" target="_blank" rel="noopener">medical education</a>, putting it out of reach of deserving poorer students.Read also: <a href="https://www.nepalitimes.com/editorial/when-panic-goes-viral/" target="_blank" rel="noopener">When panic goes viral</a>, EditorialInto this mix, we now have the coronavirus scare. Officially, Nepal has just one case in which the patient recovered and has been discharged. The government has tested about 500 people, and all have been negative. Experts have confirmed that the tests are credible, and proper protocols are in place. But not enough tests have been done to determine if there are more people out there with the virus.At $75 per test, the kits are expensive. This is where international help would be needed, and if the case rate rises the country will also need help with containment and mitigation. Nepal has been lucky so far that there is no indication of community transmission yet. But our luck could turn any day.

This is a test

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108141124/636a58c19c7e80680e054852jpeg.jpg" alt="" width="1400" height="933"/><figcaption>WELCOME TO THE WORLD: A child sleeps in a hammock while its parents work in a workshop making idols for the Dasain festival in Kupondol. Photo: GOPEN RAI</figcaption></figure>Giving birth is a life or death issue in Nepal. Even though the maternal mortality rate dropped from 1,000 per 100,000 live births 40 years ago to 239 today, inadequate birthing facilities is still a problem. But attention is now also shifting to preventing pregnancies.There is a big <a href="https://www.nepalitimes.com/banner/implant-service-providers-take-contraception-to-nepals-poor/">unmet need for contraceptives</a>: nearly a quarter of women surveyed nationwide in 2016 said they were not using birth control, even if they need it. Social stigma, patriarchy, ignorance and lack of access were reasons.Nepal’s contraceptive prevalence rate is 52%, but in remote Bajura it is only 34%. Although progress is being made, we are still a long way from the government’s target of raising the rate to 75% by 2030.Read also: <a href="https://www.nepalitimes.com/?p=33714&amp;preview_nonce=033aa12640&amp;preview=true" target="_blank" rel="noopener">Nepal far from hitting contraceptive target,</a> Sewa BhattaraiAs our reports in this edition from Bajura and Chitwan show, there are cultural hurdles. With <a style="background-color: #ffffff; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/here-now/migrating-males-and-population-decline/" target="_blank" rel="noopener">husbands away working for long periods</a>, their wives are reluctant to use contraceptives because of what others will say. The result: women suffer unwanted pregnancies, <a style="background-color: #ffffff; letter-spacing: 0.01em;" href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/globe-rallies-to-aid-nepals-women,3841" target="_blank" rel="noopener">unsafe abortions</a> and ultimately struggle to take care of large families.Almost every woman who visited a hospital in Bajura on a busy day last month had the same story: their husbands were away and they did not use birth control. Some were suffering from botched abortions.More than 800 abortion cases were registered in Bajura last year. Just one hospital in Achham terminated more than 600 pregnancies in one year. Meanwhile, Nepal’s total fertility rate has dropped from 6 in 1960 to near-replacement level at 2.05 today, and the country’s population growth rate is also down from 2.5% in 1990 to 1.1% today. Surveys in Province 2 and Far-western Province have shown a clear correlation between unwanted pregnancies, child marriage and fertility in regions with entrenched patriarchy.Among Nepalis, 21% use injectable contraceptives, 10% are on pills, 10% use condoms, 8% have IUDs and only 3% have implants. Depo-Provera was among the most used injectables, but it was difficult to administer and painful. Now, the government, with donor support, is field-testing in Nawalpur and Sindhuli a lower-dose injectable called Sayana Press, which could make contraceptives more accessible to women.Interventions like these, the government hopes, will reduce unwanted pregnancies, thus preventing unsafe abortions and reducing the number of women who have to take care of larger families.<a href="https://archive.nepalitimes.com/regular-columns/Comment/mothers-in-Nepal-still-dying-at-childbirth,1007" target="_blank" rel="noopener">Complications during pregnancy or at childbirth</a> are the leading causes of death among girls aged 15-19 in low-income countries like Nepal. Unwanted pregnancies also hamper women’s education and economic independence, and impact their family life, fuelling an intergenerational cycle of poverty and poor health.Read also: <a style="background-color: #ffffff; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/banner/implant-service-providers-take-contraception-to-nepals-poor/" target="_blank" rel="noopener">Implant service providers take contraception to Nepal's poor</a>, Rojita Adhikari

Born in Nepal

Earlier this month, Nepal received Rs1.6 billion from the World Bank as part of its <a href="https://nepalitimes.com/news/will-nepal-ever-be-paid-for-saving-trees">Forest Carbon Partnership Facility (FCPF)</a>, rewarding the country for increasing its carbon sink capacity. Nepal is the first in South Asia to benefit from this facility, and it is specifically to recompense the country for increasing forest cover in 13 Tarai districts between 2018-2024. “We are also trying to get another Rs13 billion from the facility while also preparing for free market-based carbon trading in the international market,” says Nabaraj Pudasaini of the REDD (Reducing Emissions from Deforestation and Forest Degradation in Developing Countries) Implementation Centre. Big emitters of greenhouse gases are under pressure to reduce their carbon emissions, and many have signed agreements to do so by investing in decarbonisation projects in developing countries. Countries that emit more than a specified amount of carbon would be able to buy emission rights from countries that emit less. Nepal is internationally known for its community forestry program which has been largely credited for <a href="https://nepalitimes.com/banner/tree-mendous">increasing tree cover to over 45%</a> in less than three decades. But this achievement had not been adequately recognised or rewarded internationally before. Forests, especially in the tropics, absorb and store large amounts of carbon while releasing oxygen in a process known as photosynthesis. <a href="https://www.fao.org/forest-resources-assessment/en/">Preventing deforestation</a> and increasing canopy cover is considered a much more achievable goal than reducing emission in the scale necessary to limit global average temperature to 1.5°C above pre-industrial levels. COP11 in Montreal in 2005 first proposed reducing carbon emissions by improving forest quality by halting degradation. By 2015, a new mechanism of financial assistance was created to help less developed countries with sustainable management of forests <a href="https://www.un-redd.org/">(called REDD+)</a>. Under this new mechanism, countries receive aid based on their efforts to prevent forest degradation and increase carbon sink, and in 2021 the World Bank was entrusted with implementing it. Nepal’s FCPF receipt this month was calculated on the basis of 2.4 million tons of carbon stored at a rate of $5 per ton. In the second phase, Nepal will receive more than Rs4 billion within the next year for storing an additional 7 million tons of carbon. Eighty per cent of this amount obtained from carbon trading needs to be spent on local beneficiaries and indigenous communities.&nbsp; But carbon trading is not easy, Nepal needs to prove that protected forests will not be destroyed in future.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241121091132_c8a381c9a95aa86fec558951650d97bb87914741f01766982ba2b086af001f16.jpg" data-media-id="editor_4" data-image-id="20241121091132_c8a381c9a95aa86fec558951650d97bb87914741f01766982ba2b086af001f16" data-rendition-name="original" width="1500" height="999" loading="lazy" alt="Greenbacks for greenery NT "> <figcaption>Photo: KUNDA DIXIT</figcaption> </figure>  Explains carbon trading expert Yugan Manandhar. “Forests should be handed over to the community and shown that they are managed sustainably. Proving this will be particularly challenging; forest encroachment and degradation is rife in the Tarai.” <a href="https://nepalitimes.com/multimedia/nepal-is-going-up-in-smoke">Deliberate forest fires</a> have also added to the challenge because they increase carbon emissions and reduce the sink capacity of forests. The basis for the amount that Nepal received was set five years ago by calculating the carbon reserves of forests in the 13 Tarai districts. In the meantime, sustainable forest management, tree plantation, forest destruction and erosion control were prioritised to increase carbon reserves in those forests. Nepal is signing another carbon trading agreement during the ongoing Baku climate conference. The <a href="https://www.leafcoalition.org/">Lowering Emissions by Accelerating Forest finance (LEAF Coalition) </a>proposes to sell the carbon stored in the forests of Bagmati, Gandaki and Lumbini provinces. For this, Nepal signed the letter of intent three years ago at COP26 in Glasgow. The target is to store 70 million tons of carbon in 32 million hectares of forest in the three provinces per which Nepal will receive Rs13 billion in four years at $10 per ton with provisions to increase the rate if various conditions are met. However, the agreement in itself doesn’t guarantee the amount. According to the targets set by Nepal, forest degradation should be stopped and carbon reserves increased by protecting tree cover. Preparations are also underway for clean air carbon trade because it has offset fossil fuel use by introducing 30,000 electric vehicles. Nepal has been selected for the first round to receive $40 million within one and a half years through the Clean Air System of the World Bank. Given that most of Nepal’s energy mix is from biomass, replacing them with electric stoves can significantly improve health by reducing indoor pollution as well as strengthen the country’s capacity for carbon trade. “Nepal's goal now is to sell carbon in the free market where carbon credits are bought and sold based on supply and demand in an open and transparent manner,” adds Pudasaini of the REDD Implementation Centre. “Nepal can now set its own price and bargain with interested buyer countries and organisations.” Lately, India has been discussing setting up a carbon market. Nepal has exported Rs12.72 billion worth of electricity to India so far this fiscal year, which can be traded under Nepal’s carbon market. “Carbon trading can create significant economic benefits for Nepal, which will help reinvest in development and environmental protection projects,” says Manandhar. “But we must prioritise sustainable management of forests, cutting older trees and allowing regrowth as well as promoting electric stoves and electric vehicles.”

Greenbacks for greenery

Khukri Rum is <a href="http://archive.nepalitimes.com/news.php?id=3719#.WurBk6SFPIU">one of Nepal’s most iconic brands</a>, and is now launching a new Cask Series premium product to sell in Nepal and abroad. The Cask Series Smoked Finish Khukri Rum is a limited edition with only about 7,000 bottles, most of it for export and rest to be sold to rum connoisseurs in Nepal itself. Each bottle is numbered and will mention the cask from which it is derived. “We are working on taking a classic Nepali rum to a new luxury premium brand category, the Cask Series will only be produced this year with new product ranges in future,” explains Subash Lamichhane, managing director of Nepal Distilleries that first started making Khukri rum in 1959 in Balaju and has never stopped. Fermented from molasses in Bara district in the Tarai after the annual sugarcane harvest, the rum is matured for at least eight months during distillation. The distillery bottles the classic Khukri XXX, Coronation Khukri XXX, Khukri White Rum and Khukri Spiced Rum.&nbsp; The distillery is now adding this limited edition of its ‘Cask Series’. While the original rum is stored in huge wooden vats, the rum used for this more exclusive line is in smaller casks made either from oak or sal, with charred insides to give the rum a smoky flavour. The Cask Series rum is indeed smokier than the classic, while the spiced rum tastes toasty and mostly of cardamom. The company has a tasting suite with a master blender and tasters who have to approve the palate test.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241122131124_10b8ddca93b37b0348bf964b4f09e7fac6ef4e754cca6231368850539cd558e2.jpg" data-media-id="editor_1" data-image-id="20241122131124_10b8ddca93b37b0348bf964b4f09e7fac6ef4e754cca6231368850539cd558e2" data-rendition-name="original" width="1498" height="1000" loading="lazy" alt="Khukri Rum"> </figure>  The packaging for the Cask Series is as special as the process. A sturdy patterned box that opens up to a black glass bottle with gold lettering, and an indication of which cask the rum is from. These are then shipped to premium customers around the world One of the reasons this is the more expensive premium line is because the casks are smaller than the vats and the blenders reject more than half of the rum in the casks when the aging period is complete. The trick for the blender is also to decide when to take the run out of the cask.&nbsp; Says Lamichhane: “If we have 25 casks, we expect to throw away about fifteen.”Over the decades, Nepal Distilleries have created and maintained a brand that feels quintessentially Nepali, and has served as Nepal’s ‘ambassador’ with exports to Germany, Korea, Belgium, Finland, the Czech Republic, besides the existing markets among Nepalis in the US, UK, Hong Kong and Australia. &nbsp;Its unique <a href="https://nepalitimes.com/here-now/khukri-rum-sharpens-its-act">khukri shaped bottle</a> first introduced for King Birendra’s coronation in 1975 has been a collector’s item. The bottle and rum have been a staple for Nepalis and visitors to take as gifts when they leave the country, and is used as decoration on bar tables around the world. Now, nearly 40 years later, even that bottle will soon be getting a makeover with a sharper design and sleeker handle. “Our bottle design has always been instantly recognisable, and it is,” says Lamichhane. The Himalayan restaurant at The Hague, for example, has a Khukri Coronation bottle adorning its bar (page 6-7). In Washington DC Himalayan Heritage Restaurant &amp; Bar offers ‘Nepalese Khukri Rum’ mojito in its drinks menu with fresh mint, soda water, lime juice and sugar syrup, for $12.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241122131124_b9474db3fc83c85845348dddc30c49652ee1f17229531867fa241de50849cedc.jpg" data-media-id="editor_3" data-image-id="20241122131124_b9474db3fc83c85845348dddc30c49652ee1f17229531867fa241de50849cedc" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="Khukri Rum NT"> <figcaption>Christopher Armes, master blender of the Cask Series.</figcaption> </figure>  A distinct element of the award-winning <a href="https://nepalitimes.com/business/khukri-rum-gets-award">classic Khukri rum</a> is its burgundy colour from caramel sourced from cooking sugar and blended with the raw rum. The spirits are then stored in a warehouse with floor-to-ceiling vats. The vats are not just for storage, the wood in the vats imparts flavour into the rum, and removes a lot of the harshness. &nbsp; On a visit this week, the bottling room was just about to begin for the day and the production line was churning out different shapes and sizes of Khukri Rum bottles. Most of the process is automated, including screwing bottle caps, sticking labels, placing the government seal, and packaging. The only manual intervention is the quality control where bottles are held against the light to check for sediment and colour. A mural on the wall of the distillery in Balaju depicts the rum-making process. A lady slings sugarcane on her shoulder, the molasses is churned in a pot, water is channelled into the distillation process, cinnamon, cloves and cardamom are added to a container, and finally there is a bottle of the classic Khukri Rum against a Kathmandu backdrop.

Khukri goes premium with new rum

Turkish Airlines has introduced a new amenity kit collection designed in collaboration with French fashion house Lanvin for international business class passengers on flights more than five hours. It consists of five pieces designed for sustainability and elegance. Bags are reusable and will consist of Lanvin cosmetic products like hand and body lotions and lip balm. Eye masks and socks are made from recycled materials, earplugs are packaged in paper and the toothbrush is bamboo.

Turkish amenity kit

Nepal now generates a surplus of electricity and it is all from renewable hydropower. Nearly half the country is under forest cover. Despite meeting these decarbonisation goals, Nepal’s hydropower plants are threatened by increased risk due to climate impact.&nbsp; Till <a href="https://nepalitimes.com/editorial/when-it-rains-it-pours-ksqprbu3">28 September</a>, Nepal was <a href="https://nepalitimes.com/news/india-nepal-sign-power-exchange-deal">exporting just over 1,000MW</a> of electricity to power-hungry India, when flash floods and landslides unleashed by historically heavy rains damaged over 30 hydropower plants across the country, temporarily <a href="https://nepalitimes.com/news/power-to-the-people">slashing nearly half the power generation.</a> The 456MW Upper Tamakosi in Dolakha was the hardest hit and it will take six months and Rs2 billion to repair. This has significantly reduced exports as well as domestic generation. Two months later, Nepal has still not been unable to fully keep its export commitment, and is actually paying Rs100 million in fines to India. Thirty-seven existing and under construction projects under the Independent Power Producers' Association Nepal (IPPAN) suffered Rs2.5 billion in damage. One of them is the 22MW Bagmati project in Makwanpur which was almost completely buried in flood debris. Even before <a href="https://nepalitimes.com/news/60-dead-64-missing-in-nepal-floods">record-breaking rain in September</a>, 15 other hydropower projects had been damaged by floods. Last year, floods caused by heavy localised rain damaged 28 hydropower plants. World governments met in Baku for COP29 to discuss the Loss &amp; Damage Fund and the Adaptation Fund, but for countries like Nepal the commas and brackets are meaningless until they are turned into $ and €. And likelihood of adequate compensation for climate-related damage is a long way off, if ever. Nepal’s national strategy is to use its vast hydropower resource as clean energy to spur economic growth, job creation, and boost export revenue. But the plants are located in narrow Himalayan valleys prone to landslides and floods even at the best of times. Now, those <a href="https://nepalitimes.com/opinion/comment/changing-climate-for-investment-in-nepal">risks have been heightened by weather extremes</a> due to climate breakdown. At present, Nepal generates over 3,300MW of clean hydropower, and the target is to reach 12,700MW in the next five years. Projects equivalent to 6,000MW are under construction or ready to start. The Ministry of Energy, Water Resources and Irrigation has an Energy Development Roadmap and Action Plan with the target of producing 28,500MW by 2035 by when more than half of it will be exported.&nbsp; “The climate crisis will further change the rainfall patterns making hydropower generation a big question mark in the future,” Manjeet Dhakal in Baku, who is also the Nepali adviser to the LDC Chair at the United Nations Framework Convention on Climate Change (UNFCCC). “We are building hydropower projects on rivers without evaluating risk. This whole process needs to be reviewed and reconsidered.” The report of the National Adaptation Plan published by the Ministry of Forest and Environment last year mentions that hydropower production, transmission and distribution will be at risk from flash floods, debris flows, glacial lake outbursts and rising temperatures.&nbsp; This risk is not confined to Nepal. Average global temperatures have increased by 1.3°C compared to the pre-industrial era. Worse, the Himalayan mountains are warming faster than the global average by 0.7°C because of elevation-dependent warming. A study conducted by our own Department of Hydrology and Meteorology in 2017 showed that the average temperature in Nepal has increased in the last four decades. Scientists say this is leading to extreme weather unleashing floods and landslides on slopes already destabilized by seismicity.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241124071128_d22901a360e8958f606d80ffa21defba05a671f65afec65539dc21a6885d8345.jpg" data-media-id="editor_5" data-image-id="20241124071128_d22901a360e8958f606d80ffa21defba05a671f65afec65539dc21a6885d8345" data-rendition-name="original" width="1333" height="1000" loading="lazy" alt="Right climate for Nepal’s energy transition NT"> <figcaption>BIBLICAL RAIN: Photo taken during catastrophic rain on 27-28 September at the Upper Tamakosi project site that destroyed the control room, killing four staff and burying the sedimentation tanks. Photo: RSS</figcaption> </figure>  Increased atmospheric temperatures has made the monsoon rains more erratic. It does not rain when it is supposed to, and it comes down in torrents when it is not supposed to. The September floods happened two weeks after the monsoon was supposed to retreat from central Nepal. Kathmandu Valley received half its annual precipitation in just over a day. &nbsp; Winter precipitation has also failed, especially in the high mountains and trans-Himalayan valleys. Thirteen of the past 19 years experienced winter drought. This impacts on dry season flows of the rivers, reducing hydropower generation. Nepal’s power capacity normally goes down by one-fourth during winter, but the gap is widening. The Kabeli corridor could only generate 20MW November-March even though plants there have an installed capacity of 200MW. Similarly, Upper Tamakosi only produced 65MW at most against its 456MW capacity last winter. The Nepal Electricity Authority (NEA) pays producers double the price for winter electricity, Rs8.40 per unit. Even though winter operation is highly profitable the rivers run low and NEA has to import from India to meet the winter demand. “This is not just a weather problem but a serious challenge also for the country's energy future, good climate-friendly design should be combined with policy and effective implementation,” says Subarna Das Shrestha, a hydropower investor and CEO of Sanima Mai Hydropower. “Insurance premiums have gone up as well, and settlement for damage is not timely.” <a href="https://nepalitimes.com/opinion/climate-risk-to-hydropower-investment">Hydropower investment</a> at one time was regarded as having a high rate of return. Now, some investors have become <a href="https://nepalitimes.com/banner/climate-smarter-himalayan-infrastructure">wary of the risks involved</a>. Says IPPAN’s Uttam Blon Lama: “Hydropower projects expected to give stable returns are now looking risky. Not only is climate adaptation design and planning expensive, but future repair and maintenance costs will also skyrocket.” Nepal has only one storage type dam <a href="https://nepalitimes.com/multimedia/rivers-be-dammed">in Kulekhani</a> and another one is being built in <a href="https://nepalitimes.com/multimedia/missing-pieces-of-the-hydropower-jigsaw">Tanahu</a>, but they are also at risk. In September, the sluice gates of Kulekhani Dam had to be opened causing loss of life and destruction downstream. Nepal has to learn lessons from the deadly collapse of the $1 billion <a href="https://nepalitimes.com/news/sikkim-flood-is-warning-to-nepal">Chungthang Dam in Sikkim</a> in October 2023 cause by a glacial lake burst. Glacial Lake Outburst Floods (GLOFs) in Nepal pose potentially catastrophic risk to infrastructure. The <a href="https://nepalitimes.com/here-now/lives-on-the-line-in-the-himalaya">Thame flood in August</a> was a relatively minor debris flow that damaged half of this village in the Everest region when <a href="https://nepalitimes.com/news/climate-breakdown-linked-to-thame-flood">two glacial lakes at 4,760m burst</a>. Luckily there was no loss of life. Of the <a href="https://nepalitimes.com/here-now/lives-on-the-line-in-the-himalaya">47 high-risk glacial lakes</a> in the eastern Nepal Himalaya, 21 are in Nepal and the rest are in rivers in China that are tributaries of the Arun and Bhote Kosi where Nepal has major hydropower plants under construction, or planned.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241123021128_b596cd8520c57a6c5476031e7a3ea6510f26b464c4d5351d2bc10f6f7d6b70d8.jpg" data-media-id="editor_14" data-image-id="20241123021128_b596cd8520c57a6c5476031e7a3ea6510f26b464c4d5351d2bc10f6f7d6b70d8" data-rendition-name="original" width="871" height="648" loading="lazy" alt="Page 10-11 map #1236 NT"> </figure>  Global temperature rise is accelerating the melting of Himalayan snow and ice, increasing the <a href="https://nepalitimes.com/here-now/living-below-nepal-s-melting-mountains">number and size of glacial lakes</a> so that we do not even have names for them. Imja Tso did not even exist in the old trekking maps until 25 years ago, but is now a 2km long lake. “Natural moraine dams in the mountains are weak, and the projects downstream can face major destruction if they burst, and the risk will only increase in future,” warns climatologist Arun Bhakta Shrestha at the <a href="https://www.icimod.org/">International Centre for Integrated Mountain Development (ICIMOD)</a>. <a href="https://nepalitimes.com/here-now/terrifying-assessment-of-a-himalayan-melting">An ICIMOD assessment in 2019</a> projected that if present heating trends continue, as they probably will, the Himalaya will lose two-thirds of our glaciers by the end of this century. “Generally speaking, hydropower developers hand over the project to the government after 30 years but by that time given the climate risks, they may not be an asset anymore,” says Manjeet Dhakal. Indeed, the cascade of expensive projects India is building on the Arun River are supposed to be handed back to Nepal in 25 years, but there is a big ‘if’ about whether they will survive that long. &nbsp;&nbsp; Planning of hydropower projects is still based on historical hydrological data, and does not take into account future temperature rise and its consequences. Investors, on the other hand, say that planning hydropower projects with climate components would make them even more expensive.&nbsp; “It’s not that we aren’t preparing for climate risk, we design keeping in mind the once-in-100-year flood,” says Blon of IPPAN. “But if we start designing based on once in 1,000 years flood, the cost would be so high that we won’t be able to build them at all.” Nonetheless, Subarna Das Shrestha of Sanima Mai Hydropower says that there is no option but to go for climate smart infrastructure despite the higher cost. Sanima Mai's powerhouse, for example, is completely underground. The strategy could also be to spread the risk by building less expensive plants located on rivers all over the country. Nepal is also diversifying away from its sole reliance on hydroelectricity, which at present supplies 92% of the power in the grid. Most of the rest comes from solar plants, where the total potential has not even been scratched. &nbsp; This article is brought to you by <a href="https://nepalitimes.com/" target="_blank">Nepali Times</a>, in collaboration with <a href="https://inpsjapan.com/en/" target="_blank">INPS Japan</a> and <a href="https://sgi-peace.org/" target="_blank">Soka Gakkai International</a>, in consultative status with UN ECOSOC.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20240630110640_30c3782f9c09219bf1c249b51483a3cfb7a53a06d117d2aebd23ca7080d12758.jpg" data-media-id="editor_21" data-image-id="20240630110640_30c3782f9c09219bf1c249b51483a3cfb7a53a06d117d2aebd23ca7080d12758" data-rendition-name="original" width="680" height="103" loading="lazy" alt="SDG logo"> </figure>  &nbsp;

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