<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221114111140/63721bbc9c7e80680e0bd453jpeg.jpg" alt="" width="1198" height="679"/><figcaption>Locals from Budhinanda in Bajura transporting a woman in labour to the hospital in district headquarters of Martadi. Photo: PRAKASH SINGH</figcaption></figure>N[]/dropcapepal’s medical system continues to suffer from lack of access, <a href="https://www.nepalitimes.com/opinion/is-free-health-care-possible-in-nepal/">affordability</a> and equity. Government hospitals are under-funded, under-staffed and under-motivated. <a href="https://www.nepalitimes.com/latest/khumbu-shuts-trekker-clinics/">Private clinics</a> are too costly for most Nepalis.In the absence of an <a href="https://archive.nepalitimes.com/article/nation/national-health-insurance-not-as-easy,4028">efficient nationwide insurance system</a>, families are forced to sell land, take expensive loans for prolonged treatment of relatives. A recent WHO report states that nearly half-a-million Nepalis are pushed below the poverty line every year because of <a href="https://www.nepalitimes.com/latest/rise-in-poverty-due-to-covid-19-to-affect-children/">high medical expenses</a>.Despite this, there are shining examples of hospitals that offer <a href="https://www.nepalitimes.com/opinion/is-free-health-care-possible-in-nepal/">quality health care at low cost</a>.One of them is in Tikapur of Kailali district where elected local leaders provide affordable care despite limited resources. In nine wards, there are two health posts, seven health centres and a hospital.“It is a question of priorities, citizens need health care they can afford and trust,” explains Bal Bahadur Kunwar of Tikapur Municipality, one of the few that  allocate 10% of the budget for health services.Read also:<a href="https://www.nepalitimes.com/opinion/is-free-health-care-possible-in-nepal/"> Is free health care  possible in Nepal?</a> S P KalauneeThe result has been dramatic: in the past five years since the mayor and municipal council were elected to office, the district’s high maternity and <a href="https://www.nepalitimes.com/banner/infant-deaths-up-during-nepal-lockdown/">infant mortality rates</a> have gone down. Patients do not have to travel to nearby cities like Nepalganj or Dhangadi seeking expensive treatment.Demand has grown so much that Tikapur municipality has had to add gynecologists, pediatricians, two staff nurses and two vaccine administrators to its 50-bed hospital which is also supported by the Far-west Province.It is not just health care that is free of cost, the deputy mayor’s office also provides food and allowances to pregnant women and new mothers through its ‘Aama sanga Upamayor’ program to pay for transport and other costs. This means the rate of <a href="https://www.nepalitimes.com/editorial/nepali-ama/">institutional delivery</a> has gone up, despite the pandemic lockdowns.Another forward-looking initiative is Tikapur’s ‘Hamri Chhori, Pyari Chhori’ with which parents can open a bank account in the name of newborn girls with a Rs1,000 deposit every year, which she can withdraw when she grows up — as long as she does not get married before age 20.Rapti Municipality of Dang district has 7% of its budget for health, and was awarded by the District Public Health Office last year for exemplary service. All its nine wards now have health posts. Community volunteers get incentives to make home visits to check up on the elderly, pregnant women and newborn babies.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221114111140/63721bbf9c7e80680e0bd454jpeg.jpg" alt="" width="1200" height="700"><figcaption> </figcaption></figure>“Providing <a href="https://www.nepalitimes.com/banner/state-of-the-art-rural-hospital/">basic health care</a> is not rocket science, it just needs a modest budget, good management and a commitment to the people,” says Rapti Municpality’s health section chief, Narayan Raut. Rapti is putting up another 15-bed hospital just for maternity cases.In Athbiskot Rural Municipality of West Rukum, high up in the mountains of Karnali Province, there used to be just five understaffed basic health posts. Now, there is a <a href="https://www.nepalitimes.com/here-now/kcs-fast-highlights-nepals-covid-19-failure/">well-equipped municipal hospital</a>, four health posts, nine basic health care centres and eight urban health units.From 21 healthcare workers, staff has grown to 94 with recruitment of MDGPs, public health inspectors, radiologists, and staff nurses. All this is paid for by the municipality, which sets aside 10% of its budget for health care.“There is an immediate impact on saving lives,” says Athbiskot’s health section chief Prem Prakash Rokaya. “Besides, families do not have to take sick relatives all the way to Kohalpur or Nepalganj for expensive treatment.”Read also: <a href="https://www.nepalitimes.com/editorial/nepals-humanitarian-emergency/">Nepal's humanitarian emergency</a>, EditorialThis progress in equitable healthcare in rural Nepal is not just because it is enshrined in the Constitution, but a direct result of local governments being answerable to people for whom health care is an over-riding priority.Despite its relative accessibility, Ichakamana Rural Municipality in Chitwan district did not have a resident <a href="http://archive.nepalitimes.com/article/nation/Nepal-medical-education-system-infested-by-corrupt-investors-with-political-protection,2585">MBBS doctor</a> in its hospital. But elected municipal officials responded to public demand during the pandemic, and the hospital now has a resident doctor, it provides maternity care, has a functioning laboratory and video x-ray equipment.In its 10 health centres across seven wards, Ichakamana now has four birthing centres. Says municipality chair Gita Kumari Gurung: “We don’t have to rush to Bharatpur, Kathmandu or Pokhara for medical treatment. It is all here.”Ironically, it is the government hospitals in big cities where medical care is not of high enough quality. Hospital staff often moonlight in private clinics, or get cuts from pharmacies which sell medicines they prescribe to patients. Families are therefore forced to admit relatives in expensive private hospitals in the cities, or go to India.Nepalganj Municipality built an urban health promotion centre and laboratory with Rs9.8 million from the Ministry of Health three years ago, but it is <a href="http://archive.nepalitimes.com/news.php?id=6644#.Ykg0H-5Bz0s">understaffed</a> because of insufficient budget.In Ghorahi of Dang, the health centre was upgraded with a medical doctor. An electrocardiogram and video x-ray were also added. But with no specialists, the equipment is in storage.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221114111140/63721bc29c7e80680e0bd455jpeg.jpg" alt="" width="1200" height="700"><figcaption> </figcaption></figure>Local health facilities are now supposed to be managed by municipalities themselves, but even while the <a href="https://www.nepalitimes.com/latest/nepal-unveils-covid-19-budget/">budget</a> from the centre has been cut, they have not been given the authority to raise enough local taxes to pay for these services.“The central government still controls the budget, which makes it difficult to meet local needs,” admits Baburam Marasini, the former chief of the Epidemiology and Disease Control Division. “This means most local governments do not have the wherewithal to make the necessary policies, budgets, plans, and implement them.”Before 2017, it was the district health office that made all health related plans and polices under direction from the national government. With federalism, there is confusion about budget and jurisdiction that has not been cleared up in the last five years.“There is no consistency in policy and implementation,” laments former health secretary Senendra Raj Uprety. “Most local officials do not possess the qualifications or experience to draw up proper budgets.”Nepal set aside Rs141 billion for healthcare last year of which the largest chunk (74%) was for the federal level, only 5.16% for provinces, and 20.93% for municipalities.Read also: <a href="https://www.nepalitimes.com/editorial/devolution-for-development/">Devolution for development</a>, EditorialLocal government budgets are <a href="https://www.nepalitimes.com/here-now/at-the-covid-19-frontlines-in-rural-nepal/">not enough to address needs</a> at the grassroots. Health specialist Kedar Baral says the pressure on central hospitals can only be lessened by decentralising quality health care and making it more affordable.“If we do not improve the primary service, not only does access to health become more expensive, but the entire system can collapse,” he adds.Aside from <a href="https://www.nepalitimes.com/editorial/devolution-for-development/">municipalities that have prioritised health</a>, other local governments have wasted money on unnecessary infrastructure, buildings, or view towers.The reason local officials are not too interested in investing in health is because it takes up to two decades for returns on investment, remarks Guna Raj Awasthi of the Far-West Health directorate.WHO recommends that low-income countries must invest $83 per person per year in the health sector. In Nepal, this figure is a woeful $17.3 per person.According to the Nepal Health Sector Strategy 2015-2020, 31% of people are forced to travel to city hospitals, to pay above their means for essential services that should have been provided free locally.Says Marasini: “The increase in the number of admissions at hospitals in Kathmandu means that local health centres have failed. Otherwise, why would anyone spend five times as much for treatment in Kathmandu?”Translated by Ashish Dhakal from the <a href="https://www.himalkhabar.com/news/129086?fbclid=IwAR2C5ivPJUyvJjhJQdg6MTbMfctgza1RHHaglVxT_RvPY8sj942APHoQ56o">Nepali original</a> in Himalkhabar monthly.Read more: <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

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Grassroots democracy promotes good health

https://youtu.be/FmieAvLuWBoFederalism was supposed to bring the government closer to the people, decentralise medical care and improve <a href="https://www.nepalitimes.com/editorial/poor-health/" target="_blank" rel="noopener">public health</a> at the grassroots. But the new three-tier government structure threatens to undo Nepal’s gains in improving health services.The government’s ‘adjustment policy’ in the medical sector, which lets staff to pick their preferred tier of work, has led many to choose the federal level, leaving provinces and municipalities underserved. The biggest losers are the areas already lacking in services: Province 6 (Karnali) and the Far Western Province.Read also: <a style="background-color: #ffffff; font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/?p=37757&amp;preview=true" target="_blank" rel="noopener">Poor health makes Nepalis poorer</a>, Editorial At the Kolti Primary Health Care Centre in Bajura, there is no doctor, after the one serving here chose to be transferred to Kathmandu. Bajura District Hospital has five doctors but the contracts of three of them will soon expire.“I have not been informed of my new hospital yet, but I am about to be transferred. In two months, there will be a shortage of doctors here,” predicts Chief Medical Officer Rup Chandra BK, adding that all technicians, including a paramedic, a radiographer and health assistants, have been transferred or will be soon.Read also: <a href="https://www.nepalitimes.com/opinion/is-free-health-care-possible-in-nepal/" target="_blank" rel="noopener">Is free health care possible in Nepal?</a>, S P Kalaunee <a href="https://www.nepalitimes.com/banner/this-is-how-to-upgrade-nepals-rural-health/" target="_blank" rel="noopener">This is how to upgrade Nepal's rural health</a>, Sewa Bhattarai<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108151124/636a66a79c7e80680e059998jpeg.jpg" alt="" width="640" height="427"/>With a population of 135,000 people, Bajura has no private hospitals and only one government hospital, a primary health care centre, and 26 health posts. WHO recommends a doctor-patient ratio of 1:1,000, but here it is 1:150,000, while Kathmandu has a ratio of 1:850.This is nothing new: Far Western Province has long faced medical staff shortages. According to the Department of Health Services Report 2018, only 80% of positions in health facilities were filled, and only 56 of the 142 sanctioned doctor positions were staffed. That number will decrease further after adjustment.According to a list of adjustments of 8th level general practitioners (GPs) by the ministry of health, 36 doctors were serving in Far Western Province, but only 9 of them have chosen to remain. Of the 631 doctors at this level, as many as 326 chose the federal level, which means they are concentrated in Province 3. It is the same story in all other provinces. There are only 14 doctors in Province 6.“Far Western Province has always faced a shortage of doctors. We have a lot of nurses, assistants, and technicians, and even if they are transferred there are others to replace them. But specialist doctors earn a lot in the cities and a government hospital cannot offer them as much. No wonder they do not want to stay here if they have a choice,” says Ramesh Kunwar at the ministry of social welfare in the province.Read also:<a href="https://www.nepalitimes.com/editorial/poor-health/" target="_blank" rel="noopener">Poor health</a>, Editorial<a href="https://www.nepalitimes.com/here-now/henry-marsh-returns-to-the-institute-created-by-his-neurosurgeon-colleague-upendra-devkota/" target="_blank" rel="noopener">Henry Marsh returns to the institute created by his neurosurgeon colleague Upendra Devkota</a><figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108151124/636a66a99c7e80680e059999jpeg.jpg" alt="" width="1500" height="1000"><figcaption> </figcaption></figure>The Government Doctors’ Association of Nepal (GODAN) is also unhappy. “From the beginning we have said that the medical sector is different from others and adjustment would result in neglect of underserved regions and migration of doctors to the cities, and we were right,” says Dipendra Pandey, president of GODAN. “We proposed that a federal bridge should be created, so that medical professionals working at the federal level can be sent back to their previous working area.”Ironically<a href="https://www.nepalitimes.com/banner/risking-his-life-to-save-lives/" target="_blank" rel="noopener">, physician Govinda KC</a> had to call off his 17th fast unto death in Dadeldhura because the district hospital did not have proper facilities in case his health deteriorated. KC has been protesting the commercialisation of medical education, which forces doctors to work in the cities to recoup their investments.“If the government does not replace those who are leaving the province, there is going to be a great crisis in healthcare in the Far West,” says Gunaraj Awasthi, chief of the Far West Regional Health Directorate in Dipayal. “It should immediately reinstitute those medical professionals on contract service.”<h2>Neglect kills mothers</h2><figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108151124/636a66ad9c7e80680e05999ajpeg.jpg" alt="" width="640" height="427"><figcaption> </figcaption></figure>Lalita Bohora, 27, was ten months pregnant when her husband helped her walk for three days from Kolti to Bajura District Hospital to deliver her baby earlier this year. The staff told her it was a complicated pregnancy and there were no doctors to perform a caesariean section.Bohora was lucky — many other mothers are in no position to walk to the district hospital. Although Nepal’s maternal mortality rate (MMR) has come down drastically from 600 per 100,000 live births two decades ago to 239 today, many mothers in remote districts like Bajura continue to <a href="http://archive.nepalitimes.com/article/nation/people-politics-placentas-child-delivery-complications,3922" target="_blank" rel="noopener">lose their lives</a> just because maternity wards are not staffed, or properly equipped.Read also: <a href="http://archive.nepalitimes.com/article/nation/people-politics-placentas-child-delivery-complications,3922" target="_blank" rel="noopener">People, Politics, and Placentas</a>, Bikrash Gauchan<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108151124/636a66b09c7e80680e05999bjpeg.jpg" alt="" width="643" height="376">Since it started in 1997, the government’s safe motherhood program has provided cash to mothers if they do all four antenatal checkups, and mothers, and medical staff, are given cash incentives for institutional delivery. The number of birthing centres staffed by at least one skilled birth attendant has reached 1,755 nationwide.Despite the progress, Nepal is unlikely to bring MMR down to 125 by next year as planned, or meet the Sustainable Development Goal (SDG) target of 70 by 2030. Nepal’s topography and lack of roads are not the only reasons progress in MMR has stalled. According to a recent survey, half of public health facilities in Nepal lack running water and electricity at all times.Bajura District Hospital is constructing a new building, but it still operates out of an old, partly demolished building, where the operation theatre is a tin shed and there is irregular water supply and  electricity.“We hook up machines to the power supply during complicated operations, and the electricity suddenly goes off — we have to improvise a lot here,” says surgeon Durga Maharjan.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108151124/636a66b19c7e80680e05999cjpeg.jpg" alt="" width="640" height="427"></figure>Ward at Bajura District HospitalHaemorrhage during birth used to be the biggest cause of maternal mortality in the 1990s, now it is hospital-borne infections like sepsis. Many older women still think babies should be born at home, and dissuade their daughters-in-law from giving birth at a health facility.“There is still the idea that childbirth is a normal, natural thing, and not something you need to visit a hospital for,” says Latika Maskey at the UN Population Fund (UNFPA).Only 30% of women in Bajura go for all four of the antenatal checkups, while the average for the Far West region is 55%, and nationally it is still a high 44%. Because settlements are scattered in roadless remote Nepal, the government has focused on basic health facilities and birthing centres instead of large well-equipped hospitals, explains Punya Poudel at the safe motherhood program in the ministry of health.“We have a roadmap to reduce MMR to 70 by 2030 by focusing on postnatal checkups, midwives will be trained for delivery and community nurses will visit women at home during ante and postnatal periods,” says Poudel.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108151124/636a66b49c7e80680e05999djpeg.jpg" alt="" width="640" height="427"><figcaption> </figcaption></figure>However, many of the new birthing centres are near bigger health facilities, which makes them less useful. There is a concern among health professionals that populist agendas have fuelled construction sprees, and that the birthing centres are not always staffed and ready to provide service.“Simply building birthing centres is not the solution. They should be properly mapped and located where they will be most effective. They should be functional so that at least one person is available 24 hours a day to provide simple delivery services,” says Pavan Agarwal at Bayalpata Hospital in nearby Achham district.Neetu Shrestha of UNFPA says reproductive health should not be limited to treatment of birth as an event. She says: “To improve maternal health, we need to focus on sex education, invest in <a href="https://www.nepalitimes.com/here-now/nepal-far-from-hitting-contraceptive-target/" target="_blank" rel="noopener">family planning</a> knowledge and methods, ante and post-natal care, and address cultural barriers.”

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Federalism leaves Nepal’s medical sector ailing

Nepal showed inconsistent performance at the T20 World Cup 2026 in Mumbai with flashes of brilliance, but ultimately snatched defeat from the jaws of victory. The <a href="https://nepalitimes.com/news/rhinos-hit-the-ground-running">near-win against England</a>, a test cricket team by an associate country, in the opening game showed promise and suggested that Nepal’s cricket was on the cusp of glory. The Nepal Premier League and a flawless performance in the qualifiers had raised hopes that perhaps the Rhinos could progress out of the group stage. However, subsequent losses against newcomers Italy and the West Indies were harsh reality checks about the true state of the game: there is a lot of catching up to do in the present, and structural changes to put in place to win big in the future. Head Coach Stuart Law summed it all up quite harshly: “To go from that high to then go to an extreme low four days later, that’s not showing mental toughness.” He was worried about the distraction of social media and lack of focus among players: “When you’re in cricket, do your cricket. It’s a difficult one for me because I’m a social media dinosaur, I don’t understand it. You don’t have to keep showing your face if we’re winning games.” Finally a late-night win against Scotland on Tuesday redeemed some of Nepal’s pride. A strong opening partnership, yet another rugged Dipendra Singh Airee innings and Sompal Kami’s vindictive 3 for 25 helped Nepal beat Scotland in their last group game at the T20 World Cup.  <figure><img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260218010220_6ca369f6aefc8b653c2572467f050e96b029c96b71fed5fb4213898c7d469325.jpg" data-media-id="editor_1" data-image-id="20260218010220_6ca369f6aefc8b653c2572467f050e96b029c96b71fed5fb4213898c7d469325" data-rendition-name="original" width="1366" height="2048" loading="lazy" alt="T20 World Cup Nepal"></figure>  There was nothing riding on the game but honour, it means at least that Nepal do not crash out on zero. The game ebbed and flowed. Scotland started well and looked set to score 200 before collapsing in the end at 170. The Nepal batting effort also started out well, but in the middle overs after some wickets had fallen, it looked like the team was whimpering out again. Boundaries dried up, the run rate creeped up to almost 13, before Airee and Jha woke up and took charge and got to 171 with a few balls to spare. The dhaka topi crowd in the stands loved it. A big part of the reason Nepal’s performance was so much better against England than in the other games was the mentality going in. Against England, Nepal were clear underdogs and could play freely. Even a nasty defeat would have been forgiven. Against newcomers Italy, these roles were flipped. Fans and perhaps the players underestimated Italy, a nation much better known for its football culture. But it had put together a smart, experienced team made up of Italian cricketers with South African, Australian, English, Indian, Pakistani and Sri Lankan heritage. And Nepal may have won a series against West Indies last year, but against the full strength Caribbean squad they were easily beaten.  <figure><img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260218010220_dc27adaa2102b493f940a97f9572769e695c2c1c41c8558fc4c23657cc1c3261.jpg" data-media-id="editor_2" data-image-id="20260218010220_dc27adaa2102b493f940a97f9572769e695c2c1c41c8558fc4c23657cc1c3261" data-rendition-name="original" width="2048" height="1366" loading="lazy" alt="T20 World Cup Nepal"></figure>  Another key difference is that Nepal was batting second against England. Against Italy and the West Indies, having to set a target rather than chase it, there was miserable batting failure. The front of the order — openers Kushal Bhurtel and Aasif Sheikh, captain Rohit Poudel — did not pace themselves well. They started much too slow, not able to take advantage of the first six powerplay overs. Airee’s 58 and Sompal Kami’s 26 off 11 against the West Indies were the only innings of any note. The middle order of Bam, Jha, Aarif Sheikh was not much better. Nepal really struggled with the ball too in that game, taking the one wicket against the West Indies and none against Italy. Of course, it is a huge ask of your bowling attack to defend anything below 150 in the modern T20 game. There were questionable tactical choices. Early wickets are essential when defending a low score. But key wicket taker Sandeep Lamichhane was not brought on until the middle overs, when the opponents had made too many runs to feel any fear. So they took him on and he had a really poor tournament, going for a lot of runs.  <figure><img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260218010220_b0301b854ddf235e1bcb84e8ed58060a68c8f3f13d3bb5a7596e1f51184e0d03.jpg" data-media-id="editor_3" data-image-id="20260218010220_b0301b854ddf235e1bcb84e8ed58060a68c8f3f13d3bb5a7596e1f51184e0d03" data-rendition-name="original" width="1366" height="2048" loading="lazy" alt="T20 World Cup Nepal"></figure>  To captain Poudel’s credit, he acknowledged the bad showing against Italy: “It was not a 123 all-out wicket. We are professionals and not turning up for the game was disappointing.” Coach Law thinks that Nepal is going to get to the next step. If the team is ambitious, and hopes to compete at the elite level, then it cannot celebrate a loss against England. If it wants to win consistently, it has to shed the ‘Cardiac Kids’ nickname. It is better to win than to be fun to watch but lose. The T20 game is so brisk and so it is often won in the margins. Good catching and fielding can create momentum and save a team the 5, 10 runs that win the game. Nepal were uncharacteristically poor in the field against Italy and West Indies, often fumbling and leaking boundaries. Airee didn’t get any of his usual run-outs either. Nepal lost cheap wickets through run-outs and stumpings. All these unforced errors right through the match add up on the scoreboard.  <figure><img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260218010220_1630c283f277631dfbddd3d7f29b930b124bde97c8f6a411cc2e1d089e452f45.jpg" data-media-id="editor_4" data-image-id="20260218010220_1630c283f277631dfbddd3d7f29b930b124bde97c8f6a411cc2e1d089e452f45" data-rendition-name="original" width="1366" height="2048" loading="lazy" alt="T20 World Cup Nepal"></figure>  SKILL SET Mentality is important but sport performance ultimately comes down to skill. There looked to be a large gap, and perhaps one of the reasons is because the Nepal team is so full of all-rounders. Airee’s two-way performance is undeniable, but Bhurtel, Paudel and Karan KC do plenty of both too and they do not do it super well very often. If the team wants to get consistent, it must have consistent performers with the bat and ball. That calls for some of these players to focus completely on one skill over the other. You do not see openers bowling so much in the top teams as Bhurtel does. The main reason for this skill gap, and one of the hardest parts about being an associate nation, is how little cricket the members of the team play compared to the test nations. Said Stuart Law: “The longer format is where you learn how to play the game. The shorter formats are where you have your fun. We need some sort of multi-day games.”  <figure><img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260218010220_652ef3ba6fceab394a94c18cabd322dca8ba4a1266557660064339de9169c91d.jpg" data-media-id="editor_5" data-image-id="20260218010220_652ef3ba6fceab394a94c18cabd322dca8ba4a1266557660064339de9169c91d" data-rendition-name="original" width="2048" height="1366" loading="lazy" alt="T20 World Cup Nepal"></figure>  The contrast in experience showed during the Italy game. Most of the members of the Italy team were well into their thirties, had played a high volume of domestic cricket and were more self-assured. So, while the young Nepali team were more athletic, they seemed to lack the skill and experience to know what to do when things were going wrong. The Italians seemed to go about their game with a lot more self assurance. In the long run, this means setting up grassroot structures, getting kids into formal training when young, and setting up a longer format domestic league. In the short term, CAAN could organise frequent series with other associate nations, and individual athletes could go play long form club cricket abroad. Surely some team in the world has to have a spot for a player like Airee, for example. It has been Airee’s tournament. Scores of 44 v England, 58 v West Indies, and now a match-winning 50 against Scotland that gives the travelling Nepali support something to cheer for. The tournament could have been a lot more, but it is wholesome to end on a win.

Nepal goes in and out of T20

After his critically acclaimed 2023 book of essays सुन्यताको मुल्य on the state of women and children in the <a href="https://nepalitimes.com/banner/the-karnali">Karnali</a>, paediatrician and writer Nawaraj KC has come out with a next one, Swasparsh. The new book is almost a sequel to the first one, with real-life stories drawn from his medical practice and social engagement. Both are powerful accounts of suffering, resilience, and the search for human dignity in Nepal’s most remote and underserved districts. The book opens with deeply disturbing yet real incidents of the suicide of a Grade 2 student. A &nbsp;frantic mother rushes in with a son who had already written a suicide note but was saved at the last moment. There is a desperate call from a young woman threatening to jump into the Karnali River.&nbsp; We meet children carrying immense trauma: a toddler who refuses to eat after losing her mother, and another child who stops speaking after experiencing sexual abuse within the family. The emotional climax comes when KC himself falls into depression after being violently attacked by a drug addict patient, leaving him with a serious head injury.&nbsp; But this is not a book of only sad stories of deprivation and poverty. It is how people who find themselves in the worst circumstances struggle to overcome what life has thrown their way, and triumph in the end. By just surviving against all odds, people emerge stronger, often with a renewed commitment to helping others. As a paediatrician working out of his native Surkhet in Karnali Province, KC's work brings him face-to-face with the human side of what a centralised government’s neglect and apathy can do to communities in <a href="https://nepalitimes.com/banner/no-dasain-in-kalikot">Nepal’s most far-flung region</a>. KC shows empathy not just to human beings in trouble, but also animals and underlines the importance of coexisting with the natural world. By helping others individuals ultimately help themselves. Although a paediatrician by profession, KC demonstrates a deep understanding of structural oppression, gender discrimination, caste hierarchy, class inequality, and regional marginalisation within the Nepali state.&nbsp; He also captures moments of tenderness, such as young couples supporting one another through hardship. How poverty can drive families to take heartbreaking decisions — like a patient forced to discontinue life-saving medicine in order to qualify for disability allowances needed to repay debt.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260217030252_ffd67815063cffe51a0310f10405a554f6094ba05564993f34086fe4b31543f6.jpg" data-media-id="editor_2" data-image-id="20260217030252_ffd67815063cffe51a0310f10405a554f6094ba05564993f34086fe4b31543f6" data-rendition-name="original" width="1646" height="2048" loading="lazy" alt="Swasparsha"> </figure>  A former teacher is forced to beg despite receiving treatment, exposing the failure of conventional development models that ignore sustainable livelihoods.&nbsp; Then there are inspirational stories like the one of Mandire, who ran away at age 12 to work as a labourer in India, suffered severe burns while unloading coal, and lost a hand. Despite this, his infectious smile and fortitude transformed him into a local symbol of hope both in India and Nepal.&nbsp; Even in old age, he is always smiling and helping others less fortunate.&nbsp; Through Mandire’s story, KC explores the science of the healing power of a smile, the positive psychology of a ‘mental gymnasium’ in which optimism is cultivated through conscious practice.&nbsp; For example, a young girl from the historically marginalised Badi community which faces deep social exclusion refuses to accept her circumstances, and grows into an advocate for other disadvantaged children. A devoted foster mother dedicates her life to raising orphans, empowering them despite her own hardships. One of the book’s strengths lies in its accessibility. In Nepali language, KC blends science, philosophy, and lived experience into everyday language that resonates with villagers and ordinary readers. He comes across not only as a doctor and healer, but also as a teacher, nature lover, and social activist. He tries to introduce greenery to a remote school, and how this transformed children’s learning experience. He reflects that his patients are his greatest teachers helping to expand knowledge beyond medicine and technology into the realms of humanity and ethics. I read Swasparsh after witnessing the recent GenZ movement. The book’s recurring calls to youth, appearing at the end of several chapters, has special relevance today. KC reminds young readers that hardship is part of everyday life, but within struggle lies the potential for healing and growth.&nbsp; He encourages self-reflection, self-healing, and cultivating a positive mindset. Above all, he asserts that humanity’s greatest gift is its own human capacity henceforth solutions to all problems lie within oneselves rather than outside forces. The GenZ movement represents an urban youth revolt against traditional political parties and state institutions that have failed to deliver opportunities and accountability. Rising unemployment, widespread corruption, and frustration with stagnant governance have fuelled demands for new political alternatives.&nbsp; With the 5 March election less than three weeks away, many young people hope that new forces will be capable of bringing systemic change. Yet whether these forces can truly meet their aspirations remains uncertain. Established political actors are reluctant to relinquish power, while emerging groups often lack organisational depth and historical experience. In many ways, these new political actors resemble the people of Karnali: resource-poor, And in the periphery of power, yet rich in commitment and determination. Drawing from Buddhist teachings that recognise suffering, understanding its causes, and seeking pathways to overcome it, KC indirectly inspires today’s youth. Every problem contains the seeds of its own solution, provided we learn to know ourselves, care for ourselves, and care for others. Ultimately, the title Swasparsh means self-healing, self-reflection, and self-confidence. At a time of political uncertainty and generational change, this book speaks directly to Nepal’s younger and the emerging alternative forces — reminding them that transformation begins from within.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2026021704020_1d2a855730bc14acbea596cce7b3a00b20f85c79c3a7d8ca46274a15eb642f59.jpg" data-media-id="editor_3" data-image-id="2026021704020_1d2a855730bc14acbea596cce7b3a00b20f85c79c3a7d8ca46274a15eb642f59" data-rendition-name="original" width="1136" height="702" loading="lazy" alt="Swasparsha"> </figure>  Hisila Yami served as CA member, Minister of Physical Planning &amp; Works, Minister of Tourism &amp; Minister of Land Reform. At present, she is a member of Central Political Council in Pragatishil Loktantrik Party and is a lecturer in IOE Pulchok.

Essays on self-realisation and self-healing

Chronic winter drought and decades of unmanaged forest biomass have turned wildfires into a systemic risk for Nepal. We need to re-learn to convert fire fuel in forests into fertilizer for crops.&nbsp; On 11 January, a huge forest fire spread rapidly from China into the forests of Sindhupalchok, 40km northeast of Kathmandu. The newly-opened Tatopani border checkpoint was closed. Smoke from the fire spread across central Nepal, blocking the sun.&nbsp; The fire burnt itself out within a few days, but the border stayed closed for longer. Such wildfires were once rare in mid-winter, and traditionally peaked between March and May as temperatures rose ahead of pre-monsoon showers. What is unsettling is not just the early onset of the fires, but also their scale. This shift is not accidental, the pattern has been unfolding over years due to winter drought, weakening post-monsoon moisture, and the accumulation of dry forest biomass as Nepal’s forest area doubled in the past 30 years.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2026022009024_5f4a84bb389f9b56f4fa47d4f694adcd464eb13b192d184af0f1eb20efdfeebf.jpg" data-media-id="editor_0" data-image-id="2026022009024_5f4a84bb389f9b56f4fa47d4f694adcd464eb13b192d184af0f1eb20efdfeebf" data-rendition-name="original" width="2000" height="1055" loading="lazy" alt="Wildfire season NT"> <figcaption>A NASA FIRMS image of Nepal with red dots signifying fires in February 2025.</figcaption> </figure>  Together, these factors have made forests tinder dry in spring, just waiting for a spark. Nepal has experienced winter drought in eight of the past ten years (this winter was an exception). Winter rain and snow at higher elevations play a decisive role in maintaining surface moisture, recharging shallow aquifers, and keeping forest floors damp enough to resist ignition. When winter rains fail, forests dry out months earlier than usual. Satellite-based assessments show a steep decline in surface moisture across the middle mountains of Nepal, particularly in areas with dense forest cover but limited undergrowth management. Springs that once flowed year-round are now seasonal.&nbsp; More than half of the springs in the mid-hills have either dried up or show significantly reduced discharge, a trend closely linked to declining soil moisture and disrupted recharge zones. Dry soil does not just threaten water security — it helps the vegetation ignite. FUEL WITHOUT FUNCTION For decades, Nepal’s forests have been accumulating dry leaf litter, fallen branches, shrubs, and deadwood. Historically, this biomass was not considered waste because rural households regularly collected leaf litter for livestock bedding, which was later composted and returned to farms as fertilizer.&nbsp; Forest floors were therefore relatively clean while the mulch fertilized farms. That relationship has steadily eroded due to outmigration, changes in livestock systems, restrictions on access to community forests, and the growing availability of chemical fertilisers.&nbsp; Community forests across the country today are thick with dry twigs, branches and leaves — a highly combustible carpet. When prolonged drought dries this biomass, even a small spark from a herder’s intentional fire, a cigarette, or lightning strike can trigger massive fires.&nbsp; Under such conditions, the question is no longer whether fires will occur, but how intense and widespread they will be. Forest fires are often framed as an environmental issue concerning trees and wildlife. In reality, their impact extends far beyond forest boundaries.&nbsp; Smoke travels faster and further than flames. Fine particulate matter, especially harmful PM2.5, spreads across countries. In recent fire seasons, air quality monitors in Kathmandu have recorded air quality levels several times higher than WHO guidelines. The smoke adds to Kathmandu’s own pollution and lingers for days.&nbsp; Flights are cancelled or delayed in cities like Pokhara, and poor visibility blocks mountain views affecting tourism. Health facilities report spikes in respiratory complaints, particularly among children and the elderly. Just as wildfires have multi-sectoral causes, the impact of forest fires go beyond forests. One critical dimension remains largely invisible: the soil. The fires cause silent damage beneath the ash, and the emergency does not end when the flames subside. Beneath the surface, soil suffers long-term damage. Organic matter burns away, beneficial microorganisms die. The soil structure weakens, reducing the land’s ability to absorb and retain water. The scorched earth is more prone to erosion, increasing the risk of floods and landslides once the rains return.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2026022009028_cc54ff056b2cac8b789cfd4d11afef9eaf943368e47b99aabd57c7b63b776cf2.jpg" data-media-id="editor_1" data-image-id="2026022009028_cc54ff056b2cac8b789cfd4d11afef9eaf943368e47b99aabd57c7b63b776cf2" data-rendition-name="original" width="1717" height="2143" loading="lazy" alt="Wildfire season NT"> <figcaption>Wildfire risk map based on the validated Random Forest model (a) Overall reclassified wildfire risk map of Nepal, (b) District level wildfire risk, and (c) Municipality wildfire risk map.</figcaption> </figure>  In many of Nepal’s agricultural areas, soil organic matter levels are already below 2% -- lower than what is needed for resilient and productive farming. Repeated fires push these levels even lower, undermining soil fertility and forcing farmers to rely more heavily on chemical fertilisers, unleashing a vicious cycle of higher costs and food insecurity.&nbsp; Climate breakdown is often cited as the primary culprit, and rightly so. Rising temperatures and erratic rainfall have intensified fire risk. But fires in Nepal are increasingly the result of human intervention.&nbsp; The response of all three levels of government remains too little, and too reactive. Each year, resources are mobilised to extinguish fires once they have already spread. Far less attention is paid to managing the fuel load within forest undergrowth that makes such fires inevitable.&nbsp; Meanwhile, forestry and agriculture policies are not coordinated, missing opportunities to address shared challenges. Forest fires are not natural disasters, but predictable outcomes of governance choices. National plans and climate pledges set an ambitious target of raising soil organic matter to 4%. The science behind this goal is solid. Higher organic matter improves water retention, stabilises yields, reduces fertiliser dependence, and enhances long-term food security. What remains unclear is the pathway.&nbsp; Where will the organic inputs come from? How will they be processed and applied safely at scale? Without practical answers, the 4% target risks remaining aspirational rather than achievable. Forest undergrowth can be turned into fuel and fertiliser. Biochar is produced by heating organic biomass in a low-oxygen environment, converting it into a stable form of carbon that can be added to soil.&nbsp; When properly produced and applied, it improves soil structure, enhances water and nutrient retention, supports microbial activity, and locks carbon into the ground for decades. In Nepal biochar addresses two interconnected problems: reducing the accumulation of combustible biomass in forests, lowering fire risk, while simultaneously rebuilding depleted soils. In doing so, it restores the broken link between forest management and agriculture.&nbsp; Done well, biochar is not merely an environmental intervention. It is an economic one, with potential to create local employment, reduce farmers’ input costs, and support climate-smart agriculture. But biochar propagation depends on improved governance. If promoted as isolated pilots or short-term projects, it will fail. What is needed is institutional clarity: standards for production and safety, quality control mechanisms, farmer extension services, and coordination across local, provincial, and federal levels.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2026022009028_e6e2218f38fae5b1fe81d9f99078fe01f58d04b4b3b2c41447f017c3f838a1d4.jpg" data-media-id="editor_2" data-image-id="2026022009028_e6e2218f38fae5b1fe81d9f99078fe01f58d04b4b3b2c41447f017c3f838a1d4" data-rendition-name="original" width="1536" height="2048" loading="lazy" alt="Wildfire season NT"> <figcaption>Freshly prepared biochar under control tempature (350-600°C).</figcaption> </figure>  Community forest user groups could manage biomass collection. Local governments then support safe, decentralised production units. Agricultural extension services guide farmers on application, linked to soil testing and monitoring. Such an approach would reduce fire risk, improve soil health, and generate rural livelihoods.&nbsp; Poorly produced biochar or contaminated feedstock can harm soils and human health. Without training, standards, and oversight, good intentions can backfire. Nepal needs to move beyond fire-fighting to fire prevention and confront the structural causes that make them a growing risk. It is not just a technical choice – it is one that demands political will from newly-elected leaders after March. &nbsp;&nbsp; Ngamindra Dahal is a hydrometeorologist with the Nepal Water Conservation Foundation specialising on climate and water management issues.&nbsp;

RED ALERT: Get ready for the wildfire season

There is a growing tendency to frame Nepal’s current political turmoil primarily through the language of Foreign Hands.
Across talk circuits and commentary today, Nepal’s unfolding crisis is increasingly being explained through external influence —foreign powers, hidden backers, geopolitical plots.
In a tense regional environment, this framing is understandable, but it also risks becoming a convenient shortcut. By looking outward first, it subtly shifts attention away from the harder, less comfortable work political parties and institutions have long postponed: internal reform, accountability, and rule-bound governance.
Three collapses in three decades and seven constitutions in as many decades should force us to pause for self-reflection. Add to this nearly thirty changes of government in just as many years.&nbsp;
Nepal’s democratic century, which began in 1950, has been marked by repeated conflicts, transitions, and crises. Not all of these can be explained by — or blamed on — &nbsp;forces from outside. This persistent finger pointing pattern indicates structural weaknesses at home.
Long before the September GenZ uprising, many observers (including myself) had been warning that Nepal was approaching a tipping point.&nbsp;
The concern was not foreign interference, but accumulated internal fragility: weak checks and balances, cartel-like party arrangements, politicised constitutional bodies, episodic accountability, and the near absence of credible, nonpartisan civic watchdogs.&nbsp;
Together, these produced a system operating at the edge of collapse. In such systems, small triggers — a protest, a ban, a spark — can produce cascading effects far beyond their immediate cause.
Explaining this rupture mainly through foreign influence can feel reassuring, but it ultimately absolves domestic actors of responsibility. External pressures do exist, but they become decisive only when internal institutions are already hollowed out and exposed.&nbsp;
When institutions are weak and compromised, outside forces stop dealing with the state as an institution and begin negotiating directly with individual political powerbrokers. At that point, sovereignty erodes quietly — not through invasion, but through leverage.
This is why the current obsession with identifying external hands risks missing the deeper lesson. The more revealing symptom may not be foreign maneuvering, but the ease with which, for example, militant cadres, informal networks, and extra-institutional actors are able to step in and exert influence, right under our nose during this election cycle. This is just the tip of the ever fragile institutional iceberg that needs tending.
CADRE MACHINES
As some have recently noted, these 'cadre machines' are not causes of the crisis so much as indicators of a broken system — filling a vacuum left by institutional decay.
Nepal’s deeper challenge, therefore, is not denying or ignoring outside influence. It is rebuilding the internal capacity that makes such influence less consequential: credible institutions, internal party democracy, transparent rules, and steady and independent civic oversight that operates beyond election cycles. Without this foundation, every crisis will continue to invite external interpretation — and external leverage.
Several recent essays on my Nepal Unplugged newsletter may be of interest to some: why Nepal’s current crisis is better understood through internal institutional fragility than through the language of 'foreign hands'. &nbsp;&nbsp;
Alok K. Bohara, PhD, is Emeritus Professor of Economics at the University of New Mexico, and writes his newsletter <a href="https://substack.com/@nepalunplugged">Nepal Unplugged</a> as an independent observer on Nepal’s socio-economic and political landscape. &nbsp;

medical-care

Grassroots democracy promotes good health

Federalism leaves Nepal’s medical sector ailing

Nepal goes in and out of T20

Essays on self-realisation and self-healing

RED ALERT: Get ready for the wildfire season

Foreign hands, or homegrown failure?