<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

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221107121144/6368f05a9c7e80680e0359cdjpeg.jpg" alt="" width="2042" height="1417"/><figcaption>A massive rally organized in Kathmandu on Saturday in support of Dr. Govinda KC's demand for reforms in the Medical Education Bill.</figcaption></figure>Medical care should be affordable and accessible to all. In one sentence,<a href="http://archive.nepalitimes.com/article/from-nepali-press/what-govinda-kc-wants,3869" target="_blank" rel="noopener"> that is all Govinda KC</a> wants on behalf of Nepalis.On Thursday, the government ordered police to use force inside a Jumla hospital where KC was on the 20th day of his hunger-strike <a href="http://archive.nepalitimes.com/blogs/thebrief/2016/07/10/kcs-crusade/" target="_blank" rel="noopener">demanding an end to commercialisation of the medical sector</a>. Local administration admitted to media that it spread rumours that a policeman had been killed to convince KC to agree to go to Kathmandu.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221107121144/6368f05e9c7e80680e0359cejpeg.jpg" alt="" width="1500" height="1001"><figcaption> </figcaption></figure>Amidst protests in Jumla and Kathmandu, and a nationwide hospital strike, KC finally agreed to be flown back on an Army helicopter, saying he wanted to prevent any more violence.The reason quality health care is out of reach of Nepal’s predominantly poor people is that subsidised government hospitals are so shoddy, ill-equipped, poorly-managed, under-funded and under-staffed.State neglect and mismanagement at its facilities means expensive private hospitals have stepped in to fill the gap. Medical care has therefore become a lucrative business, where rampant over-charging is the norm.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221107121144/6368f0619c7e80680e0359cfjpeg.jpg" alt="" width="2048" height="1365"><figcaption> </figcaption></figure>But that is not where the real money is. <a href="http://archive.nepalitimes.com/article/nation/corruption-and-greed-in-nepali-health-sector,1075" target="_blank" rel="noopener">The bonanza is in medical education</a>, where billions can be made overnight charging students for admission fees and royalty to feed the demand from private hospitals. It is no secret that the medical mafia enjoys strong political protection.KC’s main demands follow the recommendations of the Kedar Bhakta Mathema Commission two years ago: an end to universities giving random affiliation to new medical colleges in return for kickbacks, restricting universities to maximum five affiliations, limiting private medical colleges in Kathmandu Valley to ten. Successive governments over the past decade have promised to meet these demands to make him end his fasts, but never fulfilled them.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221107121144/6368f0649c7e80680e0359d0jpeg.jpg" alt="" width="3510" height="2340"><figcaption> </figcaption></figure>After the government restricted protests in Kathmandu, KC went to Jumla for his 15th hunger strike last month, where he was hounded by the local administration, making him seek refuge in the Karnali Health Science Academy.That was where on Thursday the riot police fired tear gas and rubber bullets to dislodge students and protesters blocking access to KC’s room on the third floor.Although there are more doctors in Nepal today than 20 years ago, the population has also increased in that period. Nepal’s doctors to population ratio is one of the lowest in the world: 2 physicians for every 10,000 people. KC’s demand is to spread medical care evenly throughout the country, not just Kathmandu.<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221107121144/6368f0679c7e80680e0359d1jpeg.jpg" alt="" width="3510" height="2340">However, with so much money involved, KC’s hunger strike is a <a href="http://archive.nepalitimes.com/article/nation/Govinda-kc-charges,4137" target="_blank" rel="noopener">direct challenge to Prime Minister Oli</a>, who is beholden to powerful businessmen with investments in the medical sector. Tycoon Durga Prasai, who owns B&amp;C Hospital in Jhapa, was a key facilitator in uniting the UML and Maoists to form the Nepal Communist Party. Rajendra Pandey and comrades have invested heavily in the Man Mohan Memorial and the Kathmandu National Hospitals. NCP backer Upendra Mahato (whose brother-in-law is Transport and Infrastructure Minister Raghubir Mahaseth, who also owns Medicity Hospital) reportedly wants affiliation for a medical college in Kathmandu.An erroneous report from Jumla that a policeman had been killed has been corrected in this updateAlso read: <a href="http://archive.nepalitimes.com/article/nation/Nepal-medical-education-system-infested-by-corrupt-investors-with-political-protection,2585" target="_blank" rel="noopener">Manufacturing fake doctors</a>, Ramu Sapkota<a href="http://archive.nepalitimes.com/news.php?id=19560#.W1GhudUzbIU" target="_blank" rel="noopener">Why some doctors stay and others go away</a><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221107121144/6368f06b9c7e80680e0359d2jpeg.jpg" alt="" width="3510" height="2340">

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Risking his life to save lives

It was pure drama: the political transition in Madhes unfolded by the dawn’s early light. At around 4AM on Monday, Province Head Sumitra Subedi Bhandari quietly departed Janakpur saying she was headed to Kathmandu for health reasons.&nbsp;
Outgoing Chief Minister Jitendra Sonal, whose coalition had begun to unravel, even saw her off, asking supporters to clear the road for her motorcade.
But an hour later, instead of continuing on to the capital, Bhandari stopped in Bardibas on the East-West Highway. There, as the sun started rising over the misty plains, she administered the oath of office to Saroj Kumar Yadav of the CPN-UML, invoking Article 168(3) of the Constitution.&nbsp;
Bhandari is also a member of the CPN-UML. The provision she invoked is typically used only after coalitions fail under Article 168(2), and the timing and location of the swearing-in have since drawn scrutiny.
Bhandari was subsequently relieved of her duties, and former National Planning Commission member Surendra Labh Karna was sworn in as the new Madhes province head on Tuesday.
Sonal had formed his government barely a month ago, with the backing of 56 provincial lawmakers but it became evident he would not secure the 54 votes needed to survive a confidence motion.&nbsp;
Several lawmakers in his coalition publicly signalled they would abstain. Still, the seven-party alliance that opposed Yadav’s appointment argues that the Province Head, who is the highest constitutional rank in the provincial structure, acted prematurely and under pressure from central UML party command.&nbsp;
A coalition of seven parties, including the Nepali Congress (NC), had been urging the Province Head to invite them to form a new government under Article 168(2). At the same time, the UML, which had been holding demonstrations outside the Province Head’s office in Janakpur, was calling for the formation of a minority government under Article 168(3).
The alliance of the seven parties that included the NC and Maoist Centre took to the streets. By mid-morning, protests had escalated outside Madhes Bhawan with cadre vandalising both the Chief Minister’s office and the Province Head’s office.
This was the third government in Madhes to fall since the 2022 provincial elections, and it follows a similar pattern. The previous Chief Minister Satish Kumar Singh of the Janamat Party, resigned before a scheduled confidence vote after losing the support of his own party and others including NC and LSP.&nbsp;
His resignation unfolded amid nationwide GenZ protests against corruption, demanding accountability and reform. The recurring instability points to a structural tension in Nepal’s federalism.&nbsp;
Provincial politics remain closely tied to alliances shaped in Kathmandu. The withdrawal of support by parties like the NC and Maoist Centre in provinces often reflects national-level calculations rather than provincial priorities.
As a result, the Provincial Assembly is repeatedly consumed by survival of the coalition instead of governance. Development work stalls. Budget execution slows. Public frustration grows. In a province that was at the forefront of the movement for federalism to counter what is seen as neglect, apathy and discrimination by Kathmandu, the sense that the system may not delivering on its promise is becoming increasingly pronounced.
If federalism is to be strengthened, provincial governments must be able to function with a degree of autonomy that currently exists more in principle than in practice. Otherwise, the perception that federalism is costly, unstable, and ineffective will continue to expand, providing fertile ground for anti-federal sentiment that is already gaining traction.
Earlier examples such as the NC General Secretary Bishwo Prakash Sharma in January calling for a new government in Madhes led by his party demonstrates how the central party leadership deliberately intervenes in provincial affairs. His remarks came during campaigns for bi-elections in Madhes when former CM Singh had been in office for six months only.&nbsp;
Likewise, in early June 2024, the federal coalition in Kathmandu shifted from a Maoist Centre and NC to form a new alliance between the NC &nbsp;and the UML. Within a day, coalition negotiations in Madhes changed to mirror this.
UML leaders publicly stated: “The issues at the federal and provincial levels will be resolved together.” This indicated that the realignment in Madhes followed national party decisions rather than provincial deliberation.
The events that unfolded in Madhes are a reminder that federalism in Nepal is still in transition, and that its success depends on political actors honouring the constitutional framework.

Chronic instability in the Madhes

New and old, businessmen and former diplomats, engineers and academics — they have all been trooping to the Election Commission to register political parties ahead of the Sunday deadline.
Till press time Thursday, five new parties had been registered and 21 new parties were in the process of applying. Behind the scenes, new parties are head-hunting, well-known figures are shopping for parties to join, while older parties are splitting or uniting to form new united parties.
“It is reason for optimism that people are enthused to form new parties,” notes political analyst Indra Adhikari. But, she adds, this does not mean that despite the celebrity status they will win votes and succeed in politics.
The outlier in all this are the Nepali Congress (NC) and the UML, which are still licking the wounds after being swept out of power by the GenZ protests in September. Neither are too keen on elections because of the prospect of losing badly.
Former prime minister K P Oli is the most recalcitrant, and seems to want to scuttle elections so Parliament will be reinstated. After announcing that he was stepping down, the NC’s Sher Bahadur Deuba has had a change of heart in Singapore and is gunning to restore Parliament.
Neither party and their leaders have shown any remorse for the 8 September massacre, or understood the outrage on the streets against their decades-long incompetence and corruption. &nbsp;
Among those registering parties are various GenZ youth groups and family members of those killed during the September protests. Notable among the new parties certified this week was Gatishil Loktantrik Party (गतिलो) backed by Buddha Air founder Birendra Basnet and led by sociologist Dinesh Prasai. Dharan Mayor Harka Sampang’s Shram Sanskriti Party is also registered.
Energy and Infrastructure Minister in the interim government Kulman Ghising has backed the Ujyalo Nepal with former secretary Anup Kumar Upadhyaya as its chair. Ghising has been playing coy about his political ambitions, and is planning to resign from his cabinet post before elections.&nbsp;
Ghising had been talking to Rabi Lamichhane’s RSP about joining, but that negotiation failed. Former RSP lawmaker Sumana Shrestha was supposed to join Ghising, but pulled out following Ghising’s reluctance to resign from government.
Ghising has much public support because he is credited with ending power cuts as head of the Nepal Electricity Authority, but is now getting flak for being unwilling to give up his ministerial portfolios while still wanting to contest elections. &nbsp;
Ujyalo has hit other snags. GenZ activist Tashi Lhazom, who was considered for a Cabinet position last month but was dropped by Prime Minister Sushila Karki, has said she is not in Ujyalo despite being listed as a Central Committee member. Another member has said that he will not be a part of Ujyalo due its “a lack of political culture”.
Even though Nepalis from across backgrounds and professions are eager to participate in the country’s new political landscape, there are doubts about the structure of their parties, ideology and electoral platforms.&nbsp;
Hurriedly set up parties without a shared philosophy have less chance of political influence and longevity. For example, the RSP was formed just months before the 2022 polls to become the fourth-largest party in Parliament, has lost its momentum, and its leader is in jail.
“Parties like the RSP, which did some positive work after being elected, have still not been able to establish a clear ideological roadmap or organisational structure,” Adhikari says. &nbsp;“It is easy to form parties, the real work goes into building an institution, which is the hard part”
Meanwhile, despite expectations of increased and inclusive youth participation not just at the polling booths but also on the ballot, only a few GenZ-led parties are applying at the Election Commission. They include the Rastriya Pariwartan Party and the Rastriya GenZ Party Nepal. Most other parties are led by men in their 40s, even in their 70s.&nbsp;
Analysts note that despite hopes of young blood in politics, Nepalis are still inclined to trust those with experience, as evidenced by GenZ’s choice of Sushila Karki to succeed KP Oli as Prime Minister after the September protests.&nbsp;
“So it will be difficult for young Nepalis without prior political experience to lead parties and it will be even more difficult for them to cultivate enough public trust to get votes,” says Adhikari.&nbsp;
Then there are the old political players, who have been breaking up and making up new alliances. Resham Chaudhary quit his Nagarik Unmukti Party and registered a new one.
Last week, Puspha Kamal Dahal’s Maoist Centre, and Madhav Kumar Nepal’s Unified Socialists merged along with smaller leftist parties to form the Nepali Communist Party (NCP). Disgruntled former UML members like Bhim Rawal have also joined the NCP. On the other hand, Janardan Sharma has fallen out with Dahal and is going his own way.&nbsp;
Even though the NC, UML and NCP show little sign that they have learnt their lesson and will be turning a new leaf, they still have the party organisation and vote banks to fall back on at election time in the runup to 5 March. &nbsp;
Says Adhikari: “At the end of the day, Nepali society remains hyper-partisan. And although the newly-formed parties and their popular candidates may give older leaders a run for their money, established parties will still benefit from their solid vote base.”

Party Time

You do not have to be a climate expert or atmospheric pandit to claim that Nepal is not pulling its weight on the grand narratives of the Anthropocene. As a heavily populated ‘country-on-an-incline’ from the Tarai to the Himalaya, Nepal is a thermometer of global warming.&nbsp; Its people are human witnesses to environmental and climate breakdown, but remain mute observers to the unfolding crises. Nepal should be leading the pack at the COP30 climate conference in Belém, backed by science and lived experience. But it is doubtful that two of the most crucial climate-related subjects central to the culture, economies and human wellbeing in the Himalaya and South Asia will be discussed at the summit that started this week in Brazil.&nbsp; The first topic that should be raised at COP is Black Carbon or the South Asian Brown Cloud, made up of tiny suspended particles in the air. This is not just a transboundary health hazard, there is now enough science to make the case that Himalayan snowmelt is accelerated significantly by the albedo effect that makes ice melt faster because of reduced reflectivity. But Kathmandu has not been able to make governments near and far listen. In 2014, I wrote a short piece published in Outlook magazine explaining why India’s Prime Minister Modi looking northward from a SAARC Summit retreat in Dhulikhel was unable to see the Jugal Himal range barely 30km away. His view was obscured by the pollution layer arriving from as far away as Lahore with substantial contribution from the Delhi region. That summit itself was an opportunity for Nepal to inform the Indian and Pakistani prime ministers that much of the haze, smog, dust and soot that settles on our slopes was generated in Sindh, Punjab, Punjab, Haryana, Western UP and Delhi NCR, carried by prevailing westerly winds up to the Himalaya. The forest fires within Nepal as well as Kathmandu Valley’s pollution contribute to the haze, but the shroud that suffocates the region through autumn, winter and spring is mostly transnational. Last year, these anthropogenic fine aerosols actually curled over the Bay of Bengal and invaded the airspace of Sri Lanka and Maldives.&nbsp; Even as the soot particles accelerate glacial melt and impact everything from infrastructure to public health, the most visible effect is on tourism. Nepal’s economic future is based on tourism, and much of this relies on being able to see the snow mountains. Why should travellers go to Pokhara if they cannot see the Annapurnas?&nbsp; Hoteliers in Nagarkot have started a campaign: ‘Visit Nagarkot 2025: More than Sunrise and Sunset’. While clever, the slogan is a response to the acclaimed Himalayan vista from Everest to the Annapurnas from the hill station, now obscured by the brown curtain of haze for most of the year. As the bellwether country of South Asia when it comes to the climate crisis, Nepal must build diplomatic confidence to reach out to the governments of Pakistan and India even in their present state of antagonism. Kathmandu must launch ‘haze diplomacy’ for its own sake and for the region.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251113001132_16c9941da7b31c1d4683c06dc0f8a572803240701270606848851f915140329c.jpg" data-media-id="editor_0" data-image-id="20251113001132_16c9941da7b31c1d4683c06dc0f8a572803240701270606848851f915140329c" data-rendition-name="original" width="1005" height="695" loading="lazy" alt="permafrost"> </figure>  IMPERMANENT FROST&nbsp; Permafrost is understood mostly as a phenomenon of the Arctic, Antarctica, Siberia and Alaska. Mountains elsewhere did not figure, though it was natural for the ground to freeze all year round at high altitudes.&nbsp; In the Himalaya, besides the snowfields and glaciers, frozen moisture binds rocks and stabilises slopes. But global warming is melting the permafrost that used to cement mountain flanks, including boulders, sand and scree slopes. Some of the debris (गेग्रान) did tumble down, but much of it remained entombed on high, thanks to permafrost. Pokhara Valley and the Seti River reaching all the way up to the base of the Annapurnas, is the best place to observe this dance of geology between gravity and the mountain range. Rubble from the collapse about <a href="https://nepalitimes.com/here-now/remembering-the-seti-disaster">700 years ago of paleo-Annapurna IV </a>created the sediment field on which Pokhara is situated today. However, much of the debris from the crumbled mountain is still lodged up on and around Annapurna IV, but the binding is loosening with the warming earth. A <a href="https://www.icimod.org/event/analysing-permafrost-in-the-hindu-kush-himalaya-using-open-access-tools/">2024 report by the International Centre for Integrated Mountain Development (ICIMOD)</a> indicates that global warming is thawing the permafrost across High Asia. Among the unintended consequences of climate breakdown is that mountains and moraines are collapsing, with <a href="https://www.icimod.org/press-release/everest-region-a-hotspot-of-cryosphere-linked-hazards-icimods-new-study-on-nepals-2024-thame-flood-confirms/">cascading impact</a> that includes glacial lake outburst floods, reduced groundwater recharge as well as winter flow in the Ganga, Indus and Brahmaputra. No one has calculated the total volume of rubble locked in by permafrost across the Himalaya. Despite the increased risk, there is accelerated construction of highways, hydropower projects, housing and tourism infrastructure across the Himalaya. While the COP conferences discuss rising oceans and receding glaciers (without doing much about it), Himalayan permafrost has been melting unremarked. In their path-breaking September 2024 <a href="https://nepalitimes.com/multimedia/the-not-so-permanent-frost">article in Nepali Times</a>, Wilfried Haeberli and Alton C Byers argued that the extreme events of the past few years that led to mountain and moraine collapses, unleashing destructive debris flows downstream, were the result of melting permafrost. Haeberli and Byers suggest that the avalanches and floods including those of <a href="https://archive.nepalitimes.com/article/nation/Anatom-of-a-Himalayan-tsunami,1330">Seti (2012)</a>, <a href="https://www.icimod.org/article/understanding-the-chamoli-flood-cause-process-impacts-and-context-of-rapid-infrastructure-development/">Chamoli (2021)</a>, Birendra Tal (2023), <a href="https://www.sciencedirect.com/science/article/pii/S2772883825000251">Sikkim (2023)</a>, <a href="https://nepalitimes.com/news/climate-breakdown-linked-to-thame-flood">Thame (2024)</a>, <a href="https://himat.org/publication/byers-rockfall-induced-2019/">Barun (2017)</a> and <a href="https://nepalitimes.com/banner/drones-to-the-rescue-in-melamchi">Melamchi (2021)</a> were the result of the thawing of frozen ground. They say that the collapse of the lateral moraine on the <a href="https://nepalitimes.com/news/sikkim-flood-is-warning-to-nepal">South Lhonak glacial lake</a> in Sikkim on 4 October 2023 that swept away more than 100 people, destroyed the $1 billion Chungthang Dam as well as houses, roads and farms far downstream, was also caused by cloudburst on a lateral moraine that had lost its permafrost adhesive. There will be permafrost sceptics, as there have been climate change deniers. But it is time to wake up to the reality that the Himalayan peaks are no longer the immutable sentinels as regarded by humanity since prehistoric times.&nbsp; Modern society has pumped so much greenhouse gas into the atmosphere that now even the mountains are giving up. And we have not even begun to think about the bacteria and viruses locked away in the permafrost up the slope.&nbsp; Loss of permafrost adds to the cumulative impact of climate breakdown, including extreme weather events, drought and cloudbursts, heat waves in the plains affecting lives and livelihoods, creating mass migration, social unrest, and upending politics and geopolitics. The government and polity of Nepal have a duty to themselves and the larger humanity to wake up to the climate breakdown. The Sagarmatha Sambaad conclave organised by the Government in May failed to emerge as a pulpit for global warming and associated ills. Our political class, bureaucracy and academia should make up for lost opportunities to rise to the occasion and take the lead.&nbsp; Kanak Mani Dixit is writer, commentator and founding editor of Himal Southasian.

Climate of tragedy and apathy

The very first frame in The Lama’s Son starts with a vision of Shangrila and the quest of a mythical utopia in the Himalaya when the rest of the world is crumbling away. It is also the personal search of filmmaker Kesang Tseten, but what he finds there are adherents of the Bon Po faith clinging to the last remnants of a culture as it erodes away like the sandstone cliffs of Mustang. “It was while editing the documentary that the story became distilled: how does what we see in the high Himalaya relate to the notion of the Shangrila idyll that especially the West ascribed to them,” asked Tseten during a recent trip to Kathmandu from Berne where he now lives. He continued: “Often and perhaps rightly criticised as an orientalist construct, I wondered if there was any basis at all to the Shangrila notion, and I hung the film on that idea.”&nbsp; Tseten takes us to the vast visas of Mustang and Dolpo, a landscape of his Tibetan ancestors. This is as much an intimate documentation of families on Nepal’s Himalayan rimland torn between remoteness and globalness as it is about Tseten’s own quest for rootedness.&nbsp; We start from Lubra, a 3,000m village in Mustang the 15 households of which follow the Bon faith. Lama Tsultrim is from a 900-year-old lineage of the animist faith and an exponent of the tradition that is slowly being subsumed first by Buddhism and now modernism. For Tseten, the material is familiar, and not at all exotic as it is for non-Nepalis and indeed for many urban Nepalis. Bon, founded in Tibet, predates Buddhism, but over time, the two religions have come to resemble each other.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251113111156_ecf8148fbaa17b93c81ddfa3ed244bed266e3ef6af0cd5e6ca7b64c181b97d45.jpg" data-media-id="editor_0" data-image-id="20251113111156_ecf8148fbaa17b93c81ddfa3ed244bed266e3ef6af0cd5e6ca7b64c181b97d45" data-rendition-name="original" width="1920" height="1080" loading="lazy" alt="The periphery cannot hold NT"> </figure>  ‘Both believe in karma, rebirth, and that humans can become enlightened. Nature and spirits are predominant in Bon, and rituals are what keep them benign and alight,’ says Tseten, who rarely narrates in his documentaries. “This is not really a personal film as such, but it has a point of view,” Tseten said. “I decided to have a voice-over on this one and cast my presence in the film.”&nbsp; Lubra's Lama Tsultrim is called upon to perform rituals from Kagbeni and other villages, but there is no one to continue the tradition after him, which is passed from father to son. Lama Tsultrim’s son (hence the title of the film) is a sushi chef in New York and has been gone for 20 years. “The Lama is like a setting sun, his son should come back and take over his father’s responsibilities,” says a local youngster chatting with friends. “If he dies tomorrow, where do we go? We can’t just light butter lamps ourselves to the gods.” It is not only the Lama’s son who has left. The village is nearly empty, and more are planning to leave. One of them is Chimi, a teacher who will be joining her fiancé who is an Uber driver in New York. Her brother is already in Hong Kong. In Lo Manthang a local is back home for a three-month vacation after being in New York for 12 years. A shopkeeper was in Japan for several years, and has returned. “Everything has changed, our language, our tsampa, our religion. We used to work and live together, now the children live separately,” says a middle-aged woman. “There are roads now, and vehicles stop right outside our house, but what’s the point? No one stays home.”  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251113111156_47b4c4984fa33e42791b16dba1f078aaa7f9d8bd51ca3bfd5415b436c3a0bf2c.jpg" data-media-id="editor_1" data-image-id="20251113111156_47b4c4984fa33e42791b16dba1f078aaa7f9d8bd51ca3bfd5415b436c3a0bf2c" data-rendition-name="original" width="1920" height="1080" loading="lazy" alt="The periphery cannot hold NT"> </figure>  Like most of Tseten’s films, The Lama’s Son is an honest documentation of a place and people whose lifestyle, culture and heritage cling precariously to the past. In Dri village we come across local women filling their buckets with water. Tseten asks them why the village is so empty: “Where is everyone?” The women reply that they are “here, there and everywhere”. Then it is their turn to ask Tseten about where he lives and what he is doing in their village. Migration is a recurring theme in Tseten’s documentaries from We Corner People, In Search of the Riyal, or Saving Dolma. His previous film Diversity Plaza documented the lives of Nepali and Tibetan emigrants in Jackson Heights in the borough of Queens in New York.&nbsp; Diversity Plaza was shown at DOC NYC in 2023, and The Lama’s Son will be one of only two Asian films shown next week at one of the biggest documentary film festivals in the world.&nbsp; “The Lama’s Son is not loud, not attention grabbing but intimate, so I was surprised they chose a quiet film for a big, flashy event,” Tseten told us. In Lama’s Son, we also see how climate breakdown is impacting Nepal’s trans-Himalayan regions. Lama Tsultrim shows us the aftermath of a recent glacial flood that swept away houses and fields. The debris-covered farms are as hard as cement.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251113111156_c82126a3c2dc4577b99beb9bef20aafa16f532a3f41e59caea17c93914c59fff.jpg" data-media-id="editor_2" data-image-id="20251113111156_c82126a3c2dc4577b99beb9bef20aafa16f532a3f41e59caea17c93914c59fff" data-rendition-name="original" width="1920" height="1080" loading="lazy" alt="The periphery cannot hold NT"> </figure>  The nearby village of Dhey at 3,900m is a high and dry cold desert. Farmers get one crop in a year, but the springs have gone dry and there is no snow in winter. So they are relocating to New Dhey, closer to the road. We follow Kesang Tseten to Samling in Dolpo, which at 4,200m is another Bon village. Locals are preparing for the Walchu festival in which Lama Sherrab carries out elaborate rituals to appease spirits that can turn malevolent. But unlike Lama Tsultrim in Lubra, Lama Sherrab has a community of lamas to help him, including two sons, one of whom will eventually take on his role. We move on to the adjacent village of Bicher and listen in as locals talk about how despite being dirt poor, they thrive in scarcity and are resilient. “We wear sheepskin, eat stew and yak meat, and drink wine. But we are very poor, we have nothing. Look at how dirty our clothes are. We may be dirty, but we have few illnesses,” says one. But even here in Upper Dolpo, a week’s walk from the nearest road, things are changing. There are mobile phones, readymade clothes and instant noodles.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251113111156_d1472165cfa9ffa6edbf72de59167e8cbddcc2bf4a7928f7830e099966259a78.jpg" data-media-id="editor_3" data-image-id="20251113111156_d1472165cfa9ffa6edbf72de59167e8cbddcc2bf4a7928f7830e099966259a78" data-rendition-name="original" width="1920" height="1080" loading="lazy" alt="The periphery cannot hold NT"> </figure>  At the Walchu ritual, Tseten watches men and women with hand-woven blankets and down jackets sing and dance after the main ceremony. He narrates: “Bon is sustained by a way of life that fosters a fine but fragile balance between nature and people, where humans come before gods. This is what lies at the heart of Shangrila if there is such a thing.” The film then takes us half-way around the world to a Bon centre in New York, but (spoiler alert) the eponymous Lama’s son never appears. He did not want to be filmed, but it makes for a more powerful portrayal of the life of emigrants forever trapped between two worlds. “Bon villages may be in danger, but the Bon has spread widely across the world,” narrates Tseten, a director who likes to call his storytelling ethnographic, and avoids coming to an apt conclusion. Lama Sherrab’s words after the Walchu ritual is a perfect segue:&nbsp; “Whether you say om mani padme hum (in Buddhism) or matri mi yu (in Bon) they are the same. When you go up, it’s the same heavenly realm. If you go down, it’s still the lord of death who awaits. There isn’t a separate heaven and hell for Buddhists and Bon, it has to be the same for both.” &nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025111312110_82817ef48840bb6baa1732d5b0b90c90ead2f9bd9eb0c289940fa61d8058de8d.jpg" data-media-id="editor_4" data-image-id="2025111312110_82817ef48840bb6baa1732d5b0b90c90ead2f9bd9eb0c289940fa61d8058de8d" data-rendition-name="original" width="7087" height="10004" loading="lazy" alt="The Lama's Son NT"> </figure>  The Lama’s Son by Kesang Tseten, 2025 Shunyata Films To be screened at DOC NYC 16 November at 2:05PM local time, Online: 17-30 November Details <a href="https://www.docnyc.net/film/the-lamas-son/">here</a>.

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Climate of tragedy and apathy

The periphery cannot hold