Orthopedic surgeon Anil Shrestha’s journey to medicine was laid down well before he was born. His father, noted industrialist Juddha Bahadur Shrestha, had aspired to become a doctor but was turned away from a medical school in India.&nbsp; "It became his mission that one of us, his sons, nephews, or nieces, would don that white coat," recalls Shrestha. That dream fell upon him, the youngest son, and he enrolled at Calcutta Medical College.&nbsp; Freshly graduated he returned to Nepal, where he hoped for a comfortable post at a hospital in Kathmandu. Instead, he was assigned to Jumla, a district which was even remoter and underserved than it is now. But that journey 40 years ago would prove transformative.&nbsp; "It was an eye-opener. I had no idea what rural Nepal was really like. When I reached Jumla, I asked myself why do we become doctors? It is because we have to make a difference," he recalls.&nbsp; The moment that would forever shape his approach to medicine happened at a government-run medical camp. An injured man had travelled from a remote village all the way to Kathmandu for surgery, selling his land to pay for it. He needed to remove his implants but faced a grim reality of having to sell more of his land to afford the procedure.&nbsp; "I thought to myself that we treat the x-rays, but we don’t treat the patients," &nbsp;Shrestha told us in an interview. &nbsp;"What good is a perfectly functioning hand if this man could no longer have a land to plough?" The encounter made the physician realise that healthcare in Nepal should look beyond symptoms and &nbsp;diagnoses, and consider the socio-economic realities of patients. He made it his mission to provide care that didn’t just fix bodies but addressed the underlying factors affecting people’s lives.&nbsp; He co-founded the <a href="https://noh.com.np">Nepal Orthopaedic Hospital</a> in 1998 to provide high-quality surgery at affordable prices. But when he arrived at the site near Gokarna, it was anything but promising.&nbsp; Read also:<a href="https://nepalitimes.com/here-now/nepali-surgeon-with-a-vision-for-the-world"> Nepali surgeon with a vision for the world</a>, Kunda Dixit  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2024101613108_1a9d74aa1c1b550ff9db42dd8092f214de353ffbb2eb48549db110201424cafd.jpg" data-media-id="editor_2" data-image-id="2024101613108_1a9d74aa1c1b550ff9db42dd8092f214de353ffbb2eb48549db110201424cafd" data-rendition-name="original" width="813" height="520" loading="lazy" alt="Nepal Orthopaedic Hospital"> <figcaption>Photo courtesy: NEPAL ORTHOPAEDIC HOSPITAL</figcaption> </figure>  "It was just two blocks of a one-story building," he recalls. "They said: Here’s the hospital. Run it. But buildings don’t make hospitals. You need doctors, you need equipment, you need patients."&nbsp; With a bold plan and support of friends and international donors, Shrestha started with 15 beds, providing care to anyone in need, regardless of their ability to pay. Initially, 93% of their operating expenses were covered by international donors but in less than 10 years, it had reversed the figures so that most of the cost was covered by internal resources. The hospital is self-sufficient today and does not turn away any patient that cannot afford the cost. Over the past 25 years, it has given more than $1 million in charity care.&nbsp; But Shrestha’s job was far from over. Realising the chronic lack of proper spinal care in Nepal, he got involved with the <a href="https://sisn.org.np/sirc/">Spinal Injury Rehabilitation Center in Sanga</a> in 2001, offering holistic treatment to paraplegic and quadriplegic patients. It was a leap of faith-started with a few friends, a handful of nurses, and no specialised doctors.&nbsp; "We just knew the need. People, especially women were falling off trees and cliffs, injuring their backs," Shrestha says, “They needed rehabilitation and physiotherapy, and we thought, why wait? You start small, and if you’re doing well, others will help you."&nbsp; Shrestha had long believed that healthcare in Nepal needed to reach the farthest corner, and after working with Nick Simons Institute (NSI) he realised that <a href="https://nepalitimes.com/news/jim-simon-s-gift-to-nepal">partnering with government hospitals</a> can better strengthen the overall health system. Shrestha’s journey took another turn when he was asked to join the board of OneHeart Worldwide, whose mission, to reduce maternal and neonatal mortality in Nepal’s most underserved areas, deeply resonated with him.&nbsp; Read also: <a href="https://nepalitimes.com/here-now/nepal-s-flying-doctor">Nepal's flying doctor</a>, Kunda Dixit  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241016131020_15d6c1483ea69455b998ba6fd6ecc0ac5eafe3af6effc2214f48f148bee0b540.jpg" data-media-id="editor_6" data-image-id="20241016131020_15d6c1483ea69455b998ba6fd6ecc0ac5eafe3af6effc2214f48f148bee0b540" data-rendition-name="original" width="2048" height="1365" loading="lazy" alt="Spinal Injury Rehabilitation Center"> <figcaption>A caretaker with a patient at the Spinal Injury Rehabilitation Center.</figcaption> </figure>  Shrestha’s approach to leadership is as grounded as his approach to medicine, it was never about control but rather always about enabler-ship. He explains: "Humility is key, and treating staff equally fosters a sense of unity and trust that is essential in difficult times.”&nbsp; He recalls a time at the Orthopaedic Hospital when funds were so tight that salaries could not be paid. The trust was so great that staff worked without pay for three months.&nbsp; Shrestha has a vision to open centres for spinal rehabilitation across all seven provinces of Nepal to provide specialised care – since the number of spinally injured patients rises dramatically because of highway accidents. He wants a health system where each district's hospital is properly equipped and functional, thereby discouraging referral of critical patients to Kathmandu over long and bumpy roads. &nbsp; His message to the next generation of Nepali doctors and social entrepreneurs: "You don't have to wait until everything is perfect to get started. All you need is an idea, and if you see a need, jump into it. Start small and you will always have people to help if you’re passionate and clear about your goals."&nbsp; Shrestha avoids the limelight, and had to be convinced to agree to this profile interview. He says, "When you build an institution, don’t think it’s yours. It belongs to everyone who helped along the way." Read also: <a href="https://nepalitimes.com/here-now/the-barefoot-doctor-of-rolpa">The barefoot doctor of Rolpa</a>, Pinki Sris Rana

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Doctor who does not just treat symptoms

<figure><img width="2082" height="1266" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110141132/636cfdb69c7e80680e0a0bfdjpeg.jpg" alt=""/><figcaption>The newly developed ayurvedic 'centre of excellence' is nestled beneath the forests of Nagarjun, just half an hour from Kathmandu. The centre is a legacy of ayurvedic doctor Rishi Ram Koirala who passed away last week.</figcaption></figure>I had an appointment with Rishi Ram Koirala the day before he suffered his fatal heart attack. Last week Nepal has lost one of its most celebrated ayurvedic practitioners, the founder and medical director of the renowned <a href="http://The newly developed ayurvedic 'centre of excellence' is nestled beneath the forests of Nagarjun, just half an hour from Kathmandu. The centre is a legacy of ayurvedic doctor Rishi Ram Koirala who passed away last week." target="_blank" rel="noopener noreferrer">Ayurveda Health Home</a>.
It was a fortuitous blessing that I was able to see him one last time, taking a friend for a consultation. Whilst we sipped glasses of tulsi tea in the clinic’s waiting area heavy with the scent of oil and powder, I struggled to find any bone fide complaints to waste his precious time.
Dr Rishi’s kind brown eyes seemed to sparkle with health. “It’s been years,” he greeted me. Wearing a voluminous green gown, blue hair net, surgical gloves, double masks and a face shield, the eyes were all I could see of his slight, sprightly figure. But enthusiasm and gentle wisdom shone through the clear plastic sheet.
“You are lucky to be so healthy at your age.” I muttered something about preferring to lose some weight and could feel his dismissive hidden humour: “It must be your inner nature. How are <a href="https://www.nepalitimes.com/opinion/dads-deception/" target="_blank" rel="noopener noreferrer">Tenzin and the boys</a>?” We caught up with family news and updates on his practice. I wish now the I had thought to ask him how he was.
Dr Rishi took my pulse in his little office across the courtyard of the Dhapasi clinic, flanked by two of his junior doctors similarly adorned in full PPE, learning skills from the master. On the walls were colourful renditions of the naked body showing ancient pressure points, chakras and energy channels. Stacked on shelves were rows of red-topped glass jars containing mysterious medicines of essential natural ingredients, herbs, tablets and dried plants.
“I’ve been busy, still lecturing all over the world via Zoom, and I’ve just submitted a paper on ayurvedic policy for the National Planning Commission and Ministry of Health.” His eyes sparkled. 
“And we are now producing our own medicines from home-grown herbs and plants on our land beyond Nagarjun. We are expanding our factory to process these, taking advantage of the government restrictions on importing pharmaceuticals and trying to break the stranglehold of the cartels exporting all <a href="https://www.nepalitimes.com/here-now/the-grass-is-greener-in-nepal/" target="_blank" rel="noopener noreferrer">Nepal’s best medicinal plants</a> to India.”
Dr Rishi’s reputation as a skilled and compassionate doctor, ayurvedic master and yogic practitioner with three decades of experience, extends across the globe. With degrees from Banaras and Kathmandu, his <a href="http://archive.nepalitimes.com/article/nation/the-return-of-the-baidyas,1623" target="_blank" rel="noopener noreferrer">ayurvedic expertise</a> was based on nearly 12 years of intensive studies. 
I ask about Covid-19, and Dr Rishi explains that ayurvedic remedies are particularly effective in its prevention, building up the body’s immunity, and to restore strength during the recovery period. Their 12 doctors and over 30 professionals do not provide healthcare for infectious diseases.
First established in 1995, the Dhapasi clinic was expanded in 2001 as a joint venture with Marilies Foerster, a German nurse who Dr Rishi describes as “our sister”. The extensive family partnership is anchored by Badri Koirala his younger brother, and their sons and daughters, some of whom have enriched the enterprise by combining conventional western medical qualifications with their knowledge of traditional techniques.
Dr Rishi and his family’s pioneering <a href="http://ayurvedacenternepal.com" target="_blank" rel="noopener noreferrer">panchakarma centre</a> in Nepal is unique in South Asia. Considered to be the essence of ayurveda, panchkarma is a holistic process designed for maintaining and supporting inner harmony. Consisting of cleansing, detoxifying, immune-enhancing, rejuvenating, and curative measures against disease, it restores harmony and balance to the mind, emotions and senses. Treatment programmes impart the benefits of pure natural products and holistic healing techniques developed from the subtle ancient knowledge of the Vedas.
Many foreigners and Nepalis have benefitted over the years with courses of therapy prescribed by Dr Rishi’s team of devoted trained professionals. Pre-pandemic groups of Europeans and Americans would arrive with a range of ailments, often staying for several weeks at a time. 
“Foreigners of 122 nations have taken our services, including high-ranking officials from Russia and the Middle East,” he said.
In anticipation of the return of this loyal international following, the Ayurvedic Health Resort is being developed as an ‘ayurvedic centre of excellence’ on a forested slope behind Nagarjun. Bordering on the national park and community forest, this sylvan retreat consists of a hotel of 28 rooms with wholesome vegetarian food and dedicated space for treatments, teachings, <a href="https://www.nepalitimes.com/opinion/yoga-in-the-time-of-covid-19/" target="_blank" rel="noopener noreferrer">meditation and yoga</a>. 
Nurseries and flower beds cultivate the finest quality herbal plants, and a production unit processes oils, potions and remedies according to the most efficacious medical tradition.
Huge picture windows at the comfortable new Nagarjun centre overlook the dense green cradle of forest that reverberates with life, birds call during the day and insects by night. An unseen river gurgles below the steep drop off below my balcony, and the occasional aircraft passes overhead. 
During our monsoon visit mists threaded the valleys, tendrils of clouds draped the hilltops and rain hammered the roof. Badri explains the building reflects the principles of vastu shastras, and it exudes peace and serenity from the moment we arrive. The weekend prescription plan of curative activities includes abhyanga massages, body scrubs, steam chambers, the oil flow of shirodhara and <a href="https://www.nepalitimes.com/review/reclaiming-singing-bowls/" target="_blank" rel="noopener noreferrer">Himalayan singing bowl</a> therapy.
Kathmandu Valley is a spiritual melting pot of great healers. From all points of the compass the ancient therapeutic traditions converge in the shadow of the Himalaya – Ayurveda from India, Tibetan and Chinese. Some practitioners are a well-kept secret, revealing themselves only when necessary and only to those in need.
Rishi Ram Koirala was a quiet modest man, but his <a href="http://archive.nepalitimes.com/news.php?id=10642#.YSHLzi2B2fQ" target="_blank" rel="noopener noreferrer">healing skills</a>, diagnostic expertise and extraordinary knowledge were widely respected throughout the world. His legacy will live on with the Ayurvedic Health Resort enterprise, but he himself will be sorely missed by many.

Lisa Choegyal

The good doctor

As the COVID-19 pandemic sweeps the globe, hospitals have been overwhelmed. <a href="https://www.nepalitimes.com/banner/why-nepal-must-watch-about-coronavirus-but-not-panic/" target="_blank" rel="noopener">Nepal is ahead of the curve, but if the case load is to rise steeply </a>as it has done in Italy or Spain, the government needs to start preparing ICUs, ventilators, and protective gear for hospital staff.At present, nurses, doctors, interns and resident doctors and other medical personnel in Nepal’s hospitals lack personal protective equipment (PPE), and they fear for their own lives while <a href="https://www.nepalitimes.com/editorial/this-is-a-test/" target="_blank" rel="noopener">treating patients with suspected coronavirus</a>.Patients can be carriers and spreaders of the virus without showing any symptoms. Thousands have been visiting hospitals to get tested, have chest x-rays done, and could be unknowingly infecting medical staff.“If we find issues with the patient’s lungs after the chest x-ray, we monitor them closely for infection,” says a doctor at a medical college in Kathmandu. “By the time we confirm whether they have been infected, the virus could infect many others in the hospital treating them, like myself.”<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109101156/636b7a029c7e80680e064735jpeg.jpg" alt="" width="714" height="960"/><figcaption>A doctor wearing makeshift protective gear while treating a patient in Karnali hospital.</figcaption></figure>Many doctors and even interns do not have a choice, and treat patients without PPE. “If you don’t go to work, the medical college won’t give a certificate,” the doctor complains.Staff at the Sukraraj Tropical and Infectious Diseases Hospital in Kathmandu which gets most of the referrals of suspected coronavirus cases are most at risk. Sagar Kumar Rajbhandary works 12 hour shifts at the Teku hospital, and says PPE are must-have given the number of patients coming in for checkups every day.“We need at least a 100 PPE units right away, but we have not got it yet,” says Rajbhandry. The anti-biohazard equipment include respirator masks, sterile hoods, gowns, and goggles.For the past month, hospitals across Nepal have been treating patients coronavirus symptoms without proper PPE, and the medical system is ill-prepared for a major outbreak.Read also: <a href="https://www.nepalitimes.com/opinion/nepal-locked-down-now-what/" target="_blank" rel="noopener">Nepal locked down, now what?</a>, Marty Logan <figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109101156/636b7a049c7e80680e064736jpeg.jpg" alt="" width="720" height="960"><figcaption> </figcaption></figure>“Since a few units of PPE are not going to be enough, and because they are so expensive we have no choice but to start making them locally,” says Paras Pandey at Bheri Hospital in Nepalganj who is not waiting for help from Kathmandu, and has already made 200 PPE at a local garment factory.The PPE gown is improvised from thin plastic, and the goggles have been made from transparent stationery, while the helmet is fashioned out of elastic apparel material. Pandey says other hospitals in the region have also copied the design.Protective gear are being manufactured at four other sites, including by the Innovation Centre of Mahabir Pun (see box), the Karnali Health Science Institute, the Dharan-based BP Koirala Health Science Institute.Although these Nepal-made PPE are not as high quality as imported ones, they at least offer some protection to medical staff. One imported PPE can cost anywhere up to Rs20,000, but a locally manufactured one costs only Rs250.“We got local tailors to make 50 PPEs on the first day itself, they are cheap but effective, and serve the purpose for now,” said Mangal Rawal of the Karnali Health Science Institute.https://youtu.be/c_57ssQF8Ywhttps://youtu.be/mGo7TuZu61ghttps://youtu.be/EVX4SlY28IUTourism entrepreneur Suman Pandey says if the government only gave him permission, her could get workers with experience in making trekking gear to start assembly line manufacture of PPEs. He has already made two prototypes which could be also worn by ambulance drivers and helicopter pilots transporting infected people.The PPE also needs to be disposed of properly after use in the medical wards, the ICU or even in front of a patient getting tested for COVID-19. One doctor or nurse needs at least eight units of PPE every day.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109101156/636b7a079c7e80680e064737jpeg.jpg" alt="" width="720" height="960"><figcaption> </figcaption></figure>Bhogendra Raj Dotel at the Ministry of Health, is currently working to procure more PPEs, but there is a shortage in the world market. In case, all flights have stopped, so there is no way to bring them here quickly.“It is not possible for donor countries to respond because they are dealing with shortages themselves,” Dotel explains. Suppliers who used to source PPEs from Singapore, Thailand, China and India are not getting new units because they have stopped exports.Nepal’s hospitals also have a chronic lack of oxygen cylinders and ventilators even at the best of times. If the pandemic hits Nepal with full force, medical facilities just do not have the equipment to treat critically ill patients.Read also: <a href="https://www.nepalitimes.com/opinion/nepal-locked-down-now-what/" target="_blank" rel="noopener">Protecting Nepal's elderly from COVID-19</a>, Alisha SijapatiBesides this, the government procurement process is cumbersome, and although a tender was issued for PPE, gloves, boots, digital thermometers and other essential items on 15 March, delivery is uncertain.The department had requested bids to supply materials for a 1,000 bed isolation ward and 235 ventilators. But even these would not be enough if the infection rate rises.The Nepal office of <a href="http://www.nsi.edu.np/en" target="_blank" rel="noopener">Nick Simons Institute (NSI) </a>flew in 11 portable ventilators from the United States and they arrived on 16 March. NSI is also committed to supply 1,000 locally-made PPE to the government.China has also committed to help with medical supplies including PPE, but Mahendra Shrestha of Department of Health Services said they had not yet arrived.<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109101156/636b7a099c7e80680e064738jpeg.jpg" alt="" width="640" height="853"><h2>How Facebook came to the rescue</h2>Ma<a href="https://www.nepalitimes.com/banner/drones-to-the-rescue/" target="_blank" rel="noopener">habir Pun</a>, the Magsaysay Award winning Nepali activist, knew that Nepal’s health system would not be able to function unless nurses, doctors and technicians had protective gear for treatment of patients.Since imports were impossible because of flights being cancelled, Pun decided that his centre would start churning out PPEs. He even brought 2,500 metres of fabric, but could not find a single tailor shop open in Kathmandu Valley.So on 23 March, he <a href="https://www.facebook.com/mahabir.pun">posted a message on his Facebook page</a> asking for tailors. He has nearly 100,000 followers, and the word spread quickly. Soon Pun started getting inundated with phone calls from tailors and garment shops all over the city.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109101156/636b7a0b9c7e80680e064739jpeg.jpg" alt="" width="600" height="400"><figcaption> </figcaption></figure>Garment factories in Balaju and Putali Sadak offered to stitch prototypes, which are now ready. “We will now show them to doctors, and if they approve we will start mass producing protective gear and distribute them to hospitals all over the country,” Pun told Nepali Times.

Protecting those who protect us from the epidemic

https://youtu.be/ZBGnZ7H7l_kThe yarsa gumba harvesting season this year coincides with the <a href="https://www.nepalitimes.com/opinion/what-is-novel-about-the-novel-coronavirus/" target="_blank" rel="noopener">coronavirus scare</a>  and as rumours spread about its supposed medicinal properties, there could be a run on the <a href="https://archive.nepalitimes.com/article/nation/overharvesting-yarsa-and-income,1546" target="_blank" rel="noopener">over-extracted Himalayan fungus</a> this year.Furthermore, with the spring trekking season wiped out by the <a href="https://www.nepalitimes.com/opinion/global-thinking-and-local-action-on-coronavirus/" target="_blank" rel="noopener">COVID-19 epidemic</a>  local people dependent on tourism income will now have to fall back on <a href="http://archive.nepalitimes.com/news.php?id=18321#.XnOPvS2B3-Y" target="_blank" rel="noopener">earnings from a fungus</a> that fetches high prices across the Himalaya in China.The highest-quality yarsa can fetch up to $70,000 per kg in China, and its collection each mid-May to mid-July can account for between 65% and 100% of a picker’s annual income. But the profits can be both a blessing and a curse.The additional income helps pay for food, education and support for aging parents, and donations to local monasteries. But the harvest season also brings an influx of tens of thousands of people each spring to Nepal’s fragile alpine ecosystem in a <a href="http://archive.nepalitimes.com/article/nation/yarsagumba-dispute-dolpa,1424" target="_blank" rel="noopener">stampede that looks like a gold rush</a>.Whole hillsides of slow-growing juniper are cut each year for fuel in Dolpo and Tibet, and there has been an increase in wildlife poaching, <a href="https://www.nepalitimes.com/banner/everest-fights-back/" target="_blank" rel="noopener">litter and garbage</a>  and free-range defecation. There has also been an increase in alcohol and drug consumption, conspicuous consumerism, the loss of traditional cultural values, violence, and even occasional murders.But here in <a href="https://nepalitimes.atavist.com/high-water" target="_blank" rel="noopener">the Barun Valley</a> the impact of the yarsa season is more benign due to closer engagement of the local community. The Barun is a beyul, a sacred valley blessed by Guru Rinpoche in the 8th century as a refuge for the faithful in times of stress. The landscape is dominated by the spectacular rock face of Shiva Danda, where three caves look like the eyes and nose of Lord Shiva. Each summer, pilgrims undertake the difficult and dangerous rock climb to the caves.There is also a pigmented cliff at Riphuk which pilgrims believe is a painting of a snow leopard by Guru Rinpoche. Ama Buchung is a rock massif in the shape of a pregnant woman, known for granting the gift of children to the devout. There is also the sacred Seto Pokhari glacial lake near Mt Makalu base camp.The main difference between the <a href="http://archive.nepalitimes.com/news.php?id=19381#.XnOPwi2B3-Y" target="_blank" rel="noopener">yarsa harvesting season</a> in the Barun and in western Nepal is terrain. While much of the yarsa in Dolpo are on rolling high-altitude meadows, in the Barun the fungus grows upon precipitous slopes dropping thousands of metres to the valleys below.<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109101152/636b792c9c7e80680e0646e9jpeg.jpg" alt="" width="960" height="720"/>Mt Makalu (8,485m) towers over the sacred Seto Pokhari glacial lake.<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109101152/636b792f9c7e80680e0646eajpeg.jpg" alt="" width="1080" height="608">Young yarsa harvesters comb the slopes high above the Barun River. Photo: TSERING SHERPAConversations with Makalu-Barun National Park officials, lodge owners, yarsa middlemen and harvesters showed that there are about 3,000 people who come to collect the fungus here every spring. Unlike in other regions in Nepal, they do not leave behind much trash, carry in their own fuelwood, and cannot remember any violence.Sherpa families from Tashigaon have been camping and harvesting yarsa here for years. Young men from Seduwa sleep in teahouses in the Valley and hike up 1,500m to the meadows each morning to pick yarsa. There are laughing school children on holiday, and everyone seems to have a good time.The main reason for the peaceful, non-competitive atmosphere is that the quality and value of yarsa in the Makalu-Barun region is not as high as that from Tibet or Dolpo. In 2016, a kilogram of Makalu yarsa fetched only $4,800 from the local middleman, as compared to $21,120 for the famously large, yellowish, and pungent smelling Dolpo yarsa.Furthermore, instead of representing up to 90% of a family’s income as it does in Dolpo, yarsa harvests here yield the same income as portering, raising livestock, lodge management or work at Makalu Base Camp that paid $20 per day. With the collapse of trekking this season, however, there could be more pressure.In the Barun Valley, yarsa has been just one more source of income in an already diversified economy. Income from yarsa has just not been worth fighting over.More importantly, villagers, the Buffer Zone Council, and the local government have developed a system to manage yarsa harvests that is fair and equitable.As a result the stunningly beautiful but fragile Barun Valley ecosystem remains largely undisturbed and intact.<h2>Yarsa gumba merchandise</h2><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109101156/636b79319c7e80680e0646ebjpeg.jpg" alt="" width="1034" height="522"><a style="font-size: 15px; letter-spacing: 0.01em;" href="https://archive.nepalitimes.com/article/nation/regulation-of-yarsa,1547" target="_blank" rel="noopener">Products containing yarsa gumba extracts</a> have become increasingly popular due to the fungus' purported health benefits. Yarsa is known to some by the nickname ‘Himalayan viagra’, and most commercial products that make use of it emphasise anti-aging and libido-inducing qualities. In China yarsa is even added to whiskey and cigarettes.Yu Chun Mei Cordyceps is a China-made skin cream (above, left) that claims to fight skin-ageing and eliminate wrinkles, black spots and pimples. The day-and-night cream claims to be made from 100% natural ingredients and is sold in various countries in Asia.Probably the most widely found product to use yarsa gumba extract is tea made from the fungus, of which the varieties are many (above, right). Manufacturers of the teas claim that they treat fatigue, sickness, kidney disease and low sex drive.Some bars in Kathmandu serve aged aila infused with yarsa gumba, which gives the spirit a tangy aroma that competes with the smell of the alcohol. A manufacturer in Nepal even markets yarsa gumba capsules as a ‘health supplement.’<h2>YARSA-NOMICS</h2><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109101156/636b79349c7e80680e0646ecjpeg.jpg" alt="" width="2144" height="580">Yarsa gumba has been used by the Chinese for hundreds of years to treat a variety of illnesses, and its more recent reputation as an aphrodisiac has added greatly to its marketability. Wealthy Chinese also use it in soups and tea as a status symbol when serving favored guests.Yarsa gumba, translated from the Tibetan as ‘summer grass winter worm’, carries the scientific name Ophiocordyceps sinensis. It is one of the most valuable medicinal fungi in the world and grows in Himalayan valleys above 4,000m from western India to Nepal, Tibet, and Bhutan.<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109101156/636b79379c7e80680e0646edjpeg.jpg" alt="" width="438" height="582"><figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109101156/636b79389c7e80680e0646eejpeg.jpg" alt="" width="1500" height="1125"><figcaption> </figcaption></figure>There are more than 200 species of Cordyceps (short for Ophiocordyceps) fungus worldwide, and in Nepal they parasitise the bodies of ghost-moth larva that live on the roots of alpine wildflowers found high up in summer yak pastures.Once contact with the larva is made, the fungus remains dormant for about four years, after which it begins to slowly consume the larva’s insides, leaving behind a shell that looks like a mummified caterpillar. The little mummy larva then slowly shifts its body to point upward toward the surface, after which a black ‘stromata’ grows from its forehead and emerges as a fruiting body 4cm long.It takes sharp eyes to find these pointed, black, stem-like mushrooms, and young children, with their keen eyesight and low proximity to the ground, are by far the most successful collectors. The stromata is ever-so-carefully pulled upward using forefinger and thumb to reveal the entire yarsa gumba body, which is then cleaned, dried, and stored in cloth bags.According to anthropologist Geoff Childs, the introduction of yarsa gumba harvesting since legalised by the Nepal Government in 2001 has ‘…contributed to economic and environmental transformations across the Tibetan Plateau and Himalayan region...than any development scheme could envision’.Alton C Byers, PhD is a mountain geographer at the Institute of Arctic and Alpine Research, (INSTAAR) University of Colorado at Boulder. In the mid-1990s, he worked as co-manager of the newly formed Makalu-Barun National Park. His recent paper on yarsa gumba harvesting in the Barun Valley is published in the journal Himalaya (v. 39, number 2)

It's yarsa-picking time

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109101152/636b789a9c7e80680e0646adjpeg.jpg" alt="" width="900" height="600"/><figcaption>Visitors arriving at Tribhuvan International Airport. Photo: BIKRAM RAI</figcaption></figure>The <a href="https://www.nepalitimes.com/banner/why-nepal-must-watch-about-coronavirus-but-not-panic/">COVID-19 epidemic</a> is subsiding in China where it originated, and is now erupting in outbreak clusters across the world. First carried by international travellers (mainly new year holiday makers from China in January-February), it spread through public places. Interestingly, pilgrimage sites like Qom in Iran, a little known evangelical sect in Daegu in Korea, churches in northern Italy, and a synagogue New York were cluster epicentres.A virus is a strand of genetic material that can infiltrate cell nuclei, splicing itself into the DNA of the host and commanding the organism to be its vehicle for transmission. Being a mutant, the COVID-19 is one step ahead of genetically engineered vaccines, and is so smart it piggy-backs on the mobility of human beings to go around the world.The virus has figured out that it does not make much sense to make the humans it infects so sick that they cannot travel – defeating the purpose of maximum infection. COVID-19 patients can be carriers even though they do not show any outward signs of being infected. Even if they have a sore throat or a cough, they are not bed-ridden and commute to work or travel on business, spreading the virus along the way.This mode of transmission is also designed for maximum effect. After leaping the animal-human barrier, it took the easiest path for human-to-human infection by entering the respiratory tract through touch or cough droplets. The virus likes the cold, which is why it spread so quickly during the northern hemisphere winter.Now that the epidemic has gone global, nationality profiling at airports is absurd. On Monday, police at Nagdhunga stopped buses and asked if there were any Chinese on board.  Removing visa on arrival for travelers from ‘infected countries’ does not make sense anymore – you either go whole hog and stop all outsider travel altogether like Bhutan has done, or you let everyone in after screening.In fact, for all we know Nepal is already an ‘infected country’ we just have not bothered to diagnose anyone. Nepal’s officials appear to believe in a vaccine called ‘Pashupatinath’, and expect the protector deity to see us through this crisis. Who knows, it may be our lackadaisical attitude towards personal hygiene, sanitation or waste management that has given Nepalis a certain immunity against viral infections.Scientist <a href="https://www.nepalitimes.com/banner/why-nepal-must-watch-about-coronavirus-but-not-panic/">Sameer Mani Dixit at the Central for Molecular Dynamics</a> calls this the ‘hygiene hypothesis’ – by allowing germs to thrive we develop an immunity to viral and bacterial infections just like a vaccine would. Dixit says it was “pure miracle” that the 2012 MERS epidemic did not affect Nepal in a big way.The coronavirus epidemic adds to the burden of older existing infections that afflict  Nepalis, and takes attention away from bigger bacterial killers like <a href="https://www.nepalitimes.com/banner/tb/">TB</a>, <a href="http://archive.nepalitimes.com/news.php?id=12158">typhoid</a> and <a href="https://archive.nepalitimes.com/news.php?id=16988">diarrhoea</a>, vector-borne eukaryote parasites like <a href="https://www.nepalitimes.com/banner/mosquitoes-move-up-mountains-as-the-earth-warms/">malaria</a>, or other insect-borne virus like <a href="https://www.nepalitimes.com/here-now/nepal-is-a-microcosm-of-all-of-the-changes-in-world-health/">dengue</a> and encephalitis. A public health system already overstretched to deal with these chronic epidemics is not at all prepared for yet another virulent onslaught.However, we cannot expect superstition or lack of sanitation to save us. Nepal is now linked to the global economy, and as such this worldwide epidemic has hit two of the mainstays of our economy: migration and tourism, which together account for nearly 40% of the GDP.As <a href="https://www.nepalitimes.com/opinion/labour-mobility/crossborder-virus-and-nepali-migrant-workers/">Upasana Khadka shows in her column</a>, Nepal is paying a price for such an overwhelming reliance on migration. The moratorium on migrant workers flying to Korea and Qatar is a gut punch to Nepal’s economy. Nepali workers in the Gulf, Malaysia and Korea-Japan are already affected by the slowdown in the global economy.And the COVID-19 scare hit Nepal right at the start of the <a href="https://www.nepalitimes.com/latest/lets-call-off-visit-nepal-year-2020/">Visit Nepal 2020</a>, which means the country will not meet the already unrealistic target of bringing 2 million tourists this year with an ill-planned campaign. March arrivals, except Chinese tourists, were still all right, but there have been massive cancellations of treks and expeditions for April. As our report shows, the impact on employment and income for service providers in hospitality and farmers dependent on selling produce to hotels is huge. VNY2020 has already been put off, and the government has taken the welcome step of using the budget to improve tourism infrastructure.Despite fear going more viral than the epidemic itself, there are some positive outcomes from COVID-19. Nepal’s hospitality industry has once more recognised the importance of domestic tourism. China’s recognition of the animal-transmission route may actually help <a href="https://www.nepalitimes.com/banner/coronavirus-outbreak-may-curb-wildlife-trafficking/">save endangered species like pangolins</a> from extinction. Oil prices have come down, and global economic downturn has reduced air pollution and carbon emissions.Read also: <a href="https://www.nepalitimes.com/editorial/when-panic-goes-viral/" target="_blank" rel="noopener">When panic goes viral</a>, Editorial

FEAR GOES VIRAL

https://www.youtube.com/watch?v=kJLBI7sim0M&amp;feature=youtu.beA revolutionary treatment for open wounds has dramatically reduced the healing period of <a href="http://archive.nepalitimes.com/news.php?id=711#.XSckw-szaUk" target="_blank" rel="noopener">leprosy patients in Nepal</a>, saving them money and prolonged pain. The new procedure has huge implications internationally, as it reduces the medical cost for treating patients with chronic open wounds.The technique, called Leukocyte Platelet Rich Fibrin (LPRF), was <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6089057/" target="_blank" rel="noopener">devised for dental surgery</a> by Nelson Pinto of Chile and has proven to accelerate the healing of tissue. Now, it is also being used to treat hard-to-heal skin lesions of <a href="https://archive.nepalitimes.com/article/nation/diabetes-in-south-asia,3018" target="_blank" rel="noopener">diabetes</a> and leprosy patients.“LPRF has shown miraculous results in the treatment of chronic wounds in Nepal,” says dental surgeon Sushil Koirala who is pushing the new treatment in government hospitals. “It does not need special equipment, is cheap and, so simple even paramedics and nurses can perform it.”<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108131140/636a4f009c7e80680e04fce5jpeg.jpg" alt="" width="1400" height="1050"/><figcaption>SECOND CHANCE: Surgeon Indra Bahadur Napit guides a paramedic during a session of LPRF on a patient with leprosy at Anandaban Hospital. Pic: KUNDA DIXIT</figcaption></figure>There are three specialised leprosy hospitals in Nepal: Ananadaban in Lele, Green Pastures in Pokhara, and Lalgadh in Dhanusa. Anandaban Leprosy Hospital 16 km south of Kathmandu has been trying out LPRF on patients with excellent results.Leprosy is a biblical disease in which bacteria called Mycobacterium leprae damages the patient’s nerves and causes the fingers, toes and limbs to go numb, leading to further injuries. Leprosy is treated with antibiotics, but some patients suffer antigen reaction and need long-term rehabilitation.One of the patients at Anandaban is Phelit Sahi, who was ostracised by her community in Jumla because she had leprosy and had been living in a cave for 25 years. Reporters who had gone to cover a local event in a helicopter found out about her, and flew her to Kathmandu for treatment.Every week, doctors draw 80cc of blood from her and place it in a special centrifuge for 12 minutes. The clear plasma separates from the red corpuscles and is compressed to form a high-density fibrin clot which is applied to her wound.“She is among more than 100 patients that we have treated with LPRF, and we have gained enough experience in this technique to lead the way for the world,” says surgeon Indra Bahadur Napit at Anandaban, who presented his results at WHO in Geneva.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108131140/636a4f039c7e80680e04fce6jpeg.jpg" alt="" width="1400" height="933"><figcaption> </figcaption></figure>Raju Lama was 27 when he was diagnosed with leprosy, but because of late diagnosis, his fingers and toes were deformed, and he had to abandon his job. Doctors recommended amputating his right leg, but became the first patient to get LPRF treatment. He is happy with his “ragat upachar” (blood treatment) and says after several LPRF procedures his wounds are healing much faster.Ram Kumari Sah and her husband from Janakpur have been living with leprosy for decades. She does not feel pain in her hands and legs and often hurts herself. Her lesions become infected and never healed. This week, she was waiting for her turn at the LPRF ward in Anandaban.The hospital’s LPRF pilot study has shown that 97% of the cases healed completely within seven weeks. The results are so encouraging that news of this revolutionary treatment has spread through word of mouth. A dozen patients, currently at Anandaban were referred by hospitals in India. A team of Nepali doctors is also training doctors in Burma, Bangladesh and Nigeria.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108131140/636a4f069c7e80680e04fce7jpeg.jpg" alt="" width="1400" height="1003"><figcaption> </figcaption></figure>The new treatment is expected to add to Nepal’s success in reducing the prevalence of leprosy from 21 cases per 10,000 in the 1980s to less than 1 today. Nepal was officially declared leprosy-free in 2010 when the prevalence rate came down to 0.79%.However, in recent years, the prevalence rate is creeping up again, and was 0.94% in 2018. More than 3,000 new patients are diagnosed with leprosy every year, with most of the cases found in Province 2. Experts say this could be a result of active case finding and may not mean that the prevalence is increasing.Leprosy is curable with multidrug therapy but many do not get treatment on time. The incubation period is five years on average and symptoms may occur within a year, but can also take as long as 30 years to become visible, making the disease difficult to diagnose, and the delay leads to nerve damage and deformities. Leprosy is transmitted through the air during close and frequent contact with untreated cases.“Leprosy can afflict anyone but there is a correlation between the disease and poverty,” explains dermatologist Mahesh Shah. “If one’s immune system is strong, the bugs do not do any damage. But poor hygiene and nutrition increases susceptibiltity. Neglected people from neglected countries suffer from leprosy the most.”<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108131140/636a4f0a9c7e80680e04fce8jpeg.jpg" alt="" width="1400" height="1169"><figcaption> </figcaption></figure>Up to 40% of patients undergoing multidrug treatment develop a reaction, and need long-term hospitalisation. Since the patients are poor, most private hospitals are not interested in treating them. At Anandaban, treatment is free as it is supported by government grants and charities.Since 1% of cases suffer from relapse in Nepal, active door-to-door case finding is important to meet the WHO target of zero leprosy transmission by 2030.Even more daunting is to counter societal stigma and ostracisation of leprosy patients. Family members regard the disease as punishment from the gods, and even some medical interns and nurses refuse to touch patients despite patients being on antibiotics and unable to spread the disease. Nepal’s laws still allow husbands to divorce their wives if they have leprosy.“It is a complicated disease made even more so by stigma and ignorance,” says Napit, “but with LPRF, we now have a powerful weapon in our arsenal. A vaccine would be the final solution, but no one cares about leprosy. All the funding goes for diseases like HIV.”   <h2>Miraculous healing</h2>When Nelson Pinto’s favourite horse broke its leg, he had two options: either put it down or amputate its leg. The Chilean dentist decided on a third option.He drew some blood from the horse, spun it in a centrifuge to separate the autologous fibrin matrix which is rich in platelets, and applied the plasma to the horse’s wound. After a few weeks, the horse was cantering again.Pinto knew about the technique because Leukocyte Platelet Rich Fibrin (LPRF) was developed for dental implant treatment. The surgeon was so convinced that the new process would be useful in treating chronic open wounds that he embarked on a global crusade to spread its use.Pinto convinced fellow-dentist from Nepal, Sushil Koirala, whom he met at an international conference, to adopt the technique. Since then, Koirala has been trying to convince the government and private hospitals to adopt the procedure, but without much success. However, Anandaban Leprosy Hospital in Lalitpur has seen phenomenal improvements in the healing time of lesions among its patients. (See adjoining report above)LPRF is now used to treat diabetic wounds, lesions caused by leprosy, localised <a href="http://archive.nepalitimes.com/article/nation/burning-in-the-aftermath,3757" target="_blank" rel="noopener">burns</a> and surgical wounds, and with this, healing time is often cut in half. It is also being used in cosmetic surgery to remove wrinkles and rejuvenate the skin. The reason why it is so effective, Pinto explained during a trip to Nepal last month, is because it is completely natural and autologous, which means a patient is not receiving any foreign tissues or chemicals.And the treatment is cheap. A similar treatment used in Europe, which involves a kit manufactured by a multinational pharmaceutical company, costs $3,000 per patient. LPRF costs only $30. But it seems as though private hospitals are not interested in this treatment as patients heal so quickly. Many doctors are also not enthusiastic because LPRF can be administered by a paramedic or a nurse.Says Sushil Koirala: “The reason they don’t like it is because there is no money in it. LPRF only uses the patient’s blood and there are no chemicals or equipment involved for multinational companies to make money out of.”Koirala’s Punyaarjan Foundation has donated centrifuge machines to a few hospitals in Nepal including the Sushma Koirala Memorial in Sankhu, Anandaban Leprosy Hospital, Bir Hospital in Kathmandu and to three hospitals in Burma with varying degrees of acceptance.The Bible relates how Jesus Christ miraculously and instantaneously cured ten lepers at the gates of Jerusalem. LPRF may not cure leprosy lesions as quickly, but the procedure is nearly as miraculous.<h2>Life after leprosy</h2><figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108131140/636a4f0d9c7e80680e04fce9jpeg.jpg" alt="" width="1400" height="1050"><figcaption> </figcaption></figure>Kumar Tamang, 47, is putting the final touches on his painting of an elephant with a bejewelled crown and a howdah. He dips his paintbrush on a palate and paints the border bright red. His fingers are numb and deformed by leprosy, yet he has been painting for 25 years. His love for Mithila art is on full display on the walls, pillars and ceiling of Shanti Sewa Griha, a leprosy clinic set up by the German charity, Leprahilfe, in 1992.Nearby, in a dark corner, is 50-year-old Nathuni Barai from Nawalparasi, who also has deformed fingers which he uses deftly to draw intricate patterns on a letter pad. Both Tamang and Barai are former patients at <a href="http://archive.nepalitimes.com/news.php?id=15213#.XSckyeszaUk" target="_blank" rel="noopener">Shanti Sewa Griha,</a> making a livelihood from products that Leprahilfe buys from fundraising. Their families live nearby, and their children attend a school set up by the charity.Now, nearly three decades after the clinic was set up, Shanti Sewa Griha runs a school and orphanage in Budhanilkantha, an organic farm in Sundarijal and a rehabilitation centre near Pashupati.As the number of patients grew, they were trained in painting, tailoring, quilt making, carpentry and jewellery making as a form of livelihood. Bags, uniforms, paintings, stationery and decorative items are sold as souvenirs to raise money for the upkeep of the shelters and to pay former patients.“This is a form of operational therapy which tries to break the vicious circle this disease has formed,” said Marianne Grosspietsch, one of the founders of Leprahilfe. “Our goal is to create hope in Nepal.”In 1974, Grosspietsch adopted a young boy named Puskar Limbu who had leprosy like the rest of his family. She took the boy to her home in Germany, treated his leprosy and sent him to school. Limbu went on to pursue a successful career in graphic design in Germany and is a grandfather himself today.Children of former leprosy patients have also gone on to become nurses and doctors.Kalpana Pariyar (pictured above) was 14 when she was diagnosed with leprosy before there was serious nerve damage to her fingers. She grew up in the shelter and married fellow-patient Krishna Majhi, whom she took care of until he died eight years ago. She now has a college going daughter and an eight-year-old son.“I have spent my entire life here. This is my home, this is where I made my life and found peace,” says Pariyar, looking up from her sewing machine on which she was weaving dhaka fabric.Sonia Awale

Sonia Awale

New treatment offers hope for Nepal’s leprosy patients

Devprakash Tripathi in Ghatana ra Bichar, 29 JanuaryNCP Co-chair Pushpa Kamal Dahal recently expressed strong support for the sovereignty of Venezuela’s elected communist government, and denounced foreign intervention, particularly that of the United States. This is ironic because his own political trajectory has depended on foreign intervention and support. As a rebel, Dahal sought shelter abroad while perpetrating violence in his home country. His signing of national agreements while in foreign land was already an open invitation for interference. Even when he was in power, Dahal pursued the agendas of foreign powers to support his own power.Historically, Dahal has shown no respect for Nepal’s sovereignty. He was involved in demolishing statues of Prithvi Narayan Shah, was irreverent of poet Bhanubhakta Acharya and other figures regarded as Nepal’s national heroes. Yet, Dahal is in effusive admiration of Marx, Lenin, Stalin and Mao who in no way contributed to Nepal’s development. Dahal’s statements are hypocritical, and inconsistent with his own past.There is speculation that Dahal issued the statement to regain China’s diminishing trust in him after his India visit. This was evident in the way the Chinese snubbed him on a recent trip to China. This latest statement calling for international support of Venezuela’s communist government may be intended to convince China that his communist stance is still intact.

A conflicting stance

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108101144/636a252e9c7e80680e0439b4jpeg.jpg" alt="" width="1000" height="507"/><figcaption>Photo: YOYOKHABAR</figcaption></figure>Nagarik, 31 JanuaryDoctors across the country have taken to the streets to protest the government’s inaction on Govinda KC’s demands and his deteriorating health. The House of Representatives passed the Medical Education bill on 25 January, amidst opposition, without addressing KC’s demands of reforms in medical education. Doctors, united under the leadership of Nepal Medical Association, have begun a relay hunger strike to pressurise the government.KC is on his 16th fast-unto-death at the TU Teaching Hospital at Maharajganj. His health is said to be critical after not eating for more than three weeks and he has difficulty breathing due to chest pains. Decreasing white blood cell count has put his life at grave danger. The amount of oxygen, glucose, and potassium in KC’s body has also decreased, he has trouble sleeping and is vulnerable to infections. KC needs to be treated in an Intensive Care Unit (ICU) but has refused to go to there.KC has been fasting since 10 January, asking the government to implement the agreement made with him after his 15th fast. But after the government prepared the Medical Education bill in contradiction of the agreement, KC began his current fast. The government claims that the bill fulfills KC’s demands.Nepal Medical Association says that doctors in major cities like Biratnagar, Dharan, Janakpur, Chitwan, Birgunj, Butwal, Pokhara, Nepalganj, Dhangadi and others have carried out protests in support of KC, and medical professionals working in Primary Health Care Centers have joined them.On Wednesday, former Chief Justice Sushila Karki visited KC and expressed her solidarity with his movement. “Not fulfilling Dr. KC’s demands would be a loss to the entire nation, and his victory is the victory of 30 million Nepalis,” she said as she asked the government to fulfill his demands.

Doctors solidarity with Govinda KC

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221107171136/6369343e9c7e80680e03dfe5jpeg.jpg" alt="" width="2000" height="1373"/><figcaption>Photo: HRA</figcaption></figure>Kathmandu is hosting the XII World Congress on Mountain Medicine 21-24 November, and the location is indeed appropriate considering that it was in the Nepal Himalaya that modern mountain medicine made great advances in altitude illness.Acute altitude illness requires two things in order to happen: 1) a person not adjusted to high altitude, and 2) going high quickly, faster than the body has time to adjust. Before the advent of modern transportation, no one could travel high enough fast enough to get into much trouble. Altitude illness is therefore mainly a problem of modern times. The largest experience with altitude illness prior to the advent of trekking in Nepal was when the Indian Army, in the Sino-Indian war of 1962, was airlifted rapidly to over 5,000 m.Read also:<a href="https://www.nepalitimes.com/latest/high-alert/" target="_blank" rel="noopener">High alert</a><a href="https://www.nepalitimes.com/opinion/trekkers-with-the-trots/" target="_blank" rel="noopener">Trekkers with the trots</a>, David R ShlimAlthough foreigners started walking around Nepal in the early 1950’s, larger scale trekking only began in the late 1960’s. Trekkers, unaware of the risks of ascending rapidly, began to die on their treks. The number of evacuations and deaths became alarming to the fledgling trekking industry and the few agencies in operation at that time banded together to start the Himalayan Rescue Association (HRA) in 1973, organised by a former Peace Corps Volunteer named John Skow.John Dickinson, who began work at the old Shanta Bhawan Hospital in Patan in 1969, became the receiving physician for severe cases of altitude illness. He and Dr Bond, the pathologist, published the first series of autopsy findings in trekkers dying from altitude illness. This work brought the world’s attention to the problem of altitude illness in Nepal, a rather mysterious condition that stuck down perfectly healthy young people venturing into thin air. Dickinson became the first medical advisor to the HRA.Under the leadership of Tek Chandra Pokharel, Mike Cheney, Dawa Norbu Sherpa and Robert Reiffel in the early 1970’s, the HRA staffed an aid post in the village of Pheriche, at 4,300 m on the path to Everest. When I first passed through Pheriche in 1974, the post was staffed by an American nurse and a famous climbing Sherpa, Tashi. Wanting to stay in Nepal, I volunteered for the next season, and many seasons after that. I became the medical director of the HRA until 1983 when David Shlim (see his contribution alongside) became the medical director after he moved to Nepal to run the CIWEC Clinic.In Pheriche, I conducted the first studies of altitude illness in trekkers. We ended up suggesting a schedule that included rest days on the ascent to Kala Pattar. This new schedule cut the incidence of altitude illness in half but did not completely eliminate it. We demonstrated the value of Diamox (acetazolamide) in preventing altitude illness. A 1977 paper in the Lancet was the first large study of altitude illness in a civilian population, and put Pheriche on the world map as a center for altitude illness research.The HRA now operates the clinic in Pheriche and a clinic in Manang, on the Annapurna trek. These clinics have been, and still remain, the best clinical experience a doctor can get in diagnosing and treating altitude illness. The HRA is currently operated by an all-Nepali board of directors with Buddha Basnyat, a former student of Dickinson’s, as medical director.Nepalis are not immune to the effects of altitude illness. Trekking guides, porters, and climbers have all suffered, and all too frequently, died of altitude illness in the course of their jobs. Basnyat was the first to study the risk of altitude illness in Hindu pilgrims to high altitude sites in Nepal. Just because they are Nepali and have the Himalaya in their backyard does not offer immunity to the effects of low oxygen at altitude.Pilgrims to events such as the Janai Purnima Festival are generally low-altitude people who ascend far too rapidly, such as from Dhunche at 1,960m to Gosainkund Lake at 4,380m, in only 48 hours instead of a safe 4 days. The HRA provides a temporary health camp at the lake for pilgrims and treats many cases of severe altitude illness, preventing deaths and difficult evacuations.The most auspicious development in mountain medicine in Nepal is the large cadre of young Nepali physicians who are now intensely interested in high-altitude medicine. Mentored by Basnyat, these young doctors are carrying on the tradition of quality care of victims of altitude illness, research on causes and treatments, and developing systems of administering care to diverse populations. The Nepal Himalaya, and the HRA, is still a backbone of modern mountain medicine.Peter Hackett is a world renowned high altitude expert and a leading authority on altitude illness, high altitude climbing, and the effects of altitude on people living and working in the mountains.

Going to great heights to prevent altitude illness

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221107121148/6368f0c79c7e80680e0359f1jpeg.jpg" alt="" width="1121" height="1500"/><figcaption>WUTHERING HEIGHTS: People in remote Jajarkot risk their lives even for a short journey to neighbouring villages. Photo: Hemanta Kc/RSS</figcaption></figure>M any decades ago, my management teacher taught me: “Money will never make you happy. That is not what money is for. It is to make others unhappy.”One meets many unhappy Nepalis these days: on the street, in public places, official events, at party palaces and on the phone and social media. It would be a really bad time to do any survey in Nepal for the Happiness Index.What is there to be happy about, anyway? Nepalis have to negotiate <a href="https://www.nepalitimes.com/banner/bhaktapur-inundated/" target="_blank" rel="noopener">water-logged streets</a>, highways that are death-traps, heritage sites being bulldozed, hospitals that bankrupt you, a doctor on hunger strike to make medical care more affordable, and the sight of a medical tycoon and top politicians feasting on red rice to protect a medical college.Read also: <a href="https://www.nepalitimes.com/editorial/red-rice/" target="_blank" rel="noopener">RED RICE</a>, EditorialWhatever the reason, many Nepalis are unhappy, and more and more are beginning to organise to address the cause of their unhappiness. Social media is full of stories and images of Croatian President <a href="https://en.wikipedia.org/wiki/Kolinda_Grabar-Kitarovi%C4%87" target="_blank" rel="noopener">Kolinda Grabar-Kitarović</a> flying economy class to the World Cup in Russia, and standing in the rain to hug her sweaty team. This was in stark contrast to the travel style of our own President, who leaves monstrous traffic jams in her wake wherever she goes, as well as lots of unhappy, angry citizens.Civil servants posted to provincial governments are unhappy, and taxi drivers are unhappy to go anywhere on the meter. Citizens are unhappy because they have to pay a lot for basic services like birth and death certificates. Elected politicians are unhappy about going to the people to tell them why their election promises have not been met.Then there are the Nepalis who are more confused than unhappy. What does it mean to elect a crony-capitalist Communist government to power? Many might have assumed that the poor will now finally be able to access affordable education and health services. They expected market prices to be controlled, and their quality of life to improve. Those who thought technology and internet connectivity could be an equaliser in a country with poor infrastructure have been slapped with new taxes for browsing. They also have to put up with threats of a new cyber crime law. Some are unhappy that Nepal is importing Chinese gundruk.Read also: <a href="https://www.nepalitimes.com/editorial/two-thirds-empty/" target="_blank" rel="noopener">Two-thirds empty</a>, EditorialNepali society is now polarised between the people who won the elections, and the losers. Between the happy and the unhappy. There is a growing divide between old money from land, and new money from corruption. There is a growing chasm between those in powerin Kathmandu, and the rest of Nepal. There is also a generational gap between the cynicism of the older folk and the aspirational young.In this divided society there is some room for dissent, but little room for debate. Many people come up with their positions on a particular issue and feel that they will win if they are loud enough. The size of the crowd shouting on the streets or trolling on social media counts for a lot. Questioning is not encouraged, hence a two way debate as a tool for resolution is not very popular.We may be unhappy about the relentless rain, but we are already looking forward to the post-monsoon holiday season when Nepalis stop working, start shopping and forget about their unhappiness. Family members who used to send money home or even come visit, are today inviting them to Japan, USA or Australia to celebrate <a href="http://archive.nepalitimes.com/article/nation/dasain-goes-global,3950" target="_blank" rel="noopener">Dasain</a> or Tihar.We may need to wait a bit before we carry out the Happiness Survey. Right now Nepalis may have hit the rock bottom in Gross National Happiness. But by Dasain, we will be a happy nation again. What a difference a month makes.Anil Chitrakar is President of Siddharthinc

Anil Chitrakar

Nepal's Gross National Sadness

The daily 10-hour curfew at Tribhuvan International Airport from 8 November that will last five months has affected tourism during Nepal’s peak season, with some hotels and trekking agencies here reporting cancellations into spring next year. The reduced hours at Nepal’s main aviation gateway till 31 March means that a third of all flights have been cut. This has also caused ticket prices to surge by up to eight times of normal fares. For example a Kathmandu-Delhi ticket that used to cost Rs12,000 is now listed at Rs50,000, and even then seats are not available.&nbsp; “Especially if they are here to trek, change in flight dates can cause tourists to miss their connections,” says Jagan Timilsina, who runs a trail running and outdoor education business. &nbsp; Pokhara is feeling the brunt as hotels report last-minute cancellations for November because of flight disorders. Some hoteliers also say although there have been some cancelled trips, most itineraries have been rescheduled.&nbsp; Hari Prasad Sharma Gaire of the local chapter of the Hotel Association of Nepal says the Kathmandu airport closure should have been timed for the off-season. He told us: “Starting construction during the peak tourist season was a mistake and will cause the tourism industry to lose a lot of business. The upgrade could have been spread out over a longer time but closed for fewer hours at night so that disruption was minimal.”&nbsp; Nearly a third of the 1.2 million tourists who visit Nepal annually come to Pokhara, which is also the gateway to Mustang, the Annapurna treks and pilgrimage tourism to Muktinath. Located by scenic lakes with a range of adventure sports like hot air ballooning, paragliding, canyoning, bungee and ziplines, Pokhara is also popular among diaspora Nepalis. “Besides its own attractions, Pokhara is really the hub for central Nepal, and we have been trying to get visitors to extend their stay here,” says Timilsina, who started out as a trekking porter and rose up the ranks to be an expedition guide and entrepreneur. &nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2024111603114_0e071ce63ea9b0a9a7ee76f8c3cea0ff08c6767c41dd09f6bc4413d2db067a60.jpg" data-media-id="editor_0" data-image-id="2024111603114_0e071ce63ea9b0a9a7ee76f8c3cea0ff08c6767c41dd09f6bc4413d2db067a60" data-rendition-name="original" width="3500" height="2333" loading="lazy" alt="Pokhara's tourism woes NT"> <figcaption>Tourist arrivals in Pokhara have slumped since the disruptions at Kathmandu airport due to upgrading work. Photo: KRISHNA MANI BARAL/NEPALI TIMES ARCHIVE</figcaption> </figure>  Even without the Kathmandu airport closure affecting tourist arrivals, Pokhara was already suffering from a decline due to many factors like the poor state of the Prithvi Highway, the shortage of luxury accommodation for high-end tourists, and the reluctance of international airlines to start direct flights to Pokhara despite an expensive new airport that was inaugurated two years ago.&nbsp; “There was a lot of initial excitement on the construction of the international airport,” says Timilsina, “but it hasn’t delivered as expected due to politics. People have invested in nearby businesses, and have faced losses.” India has blocked direct flights from its cities to Pokhara because the facility was built by a Chinese company. Although tourists and pilgrims from India hit record levels this year, the poor state of the highways and the Indian bus accident on the highway to Kathmandu in July that killed 27 pilgrims from Maharashtra state dampened arrival figures. Gaire says, “While tourist arrivals to Pokhara are now approaching pre-Covid levels, we haven’t seen the improvement we were expecting. We need a better marketing strategy. What are our embassies abroad doing?”&nbsp; Indeed, Pokhara used to be a favourite destination for Chinese tourists. There was a boom in arrivals from China before Covid, especially after a popular Chinese tv serial was shot on location here. But arrivals from China have not really recovered since the pandemic because of the economic slowdown there. Promoting Pokhara airport to handle direct flights from Chengdu or Kunming could revive Chinese arrivals.&nbsp; Nepal’s Civil Aviation Authority (CAAN) has used the Kathmandu airport closure as an excuse to arm-twist international airlines to start flying to Bhairawa, which has barely been in operation for two years since it was inaugurated. So far, Fly Dubai, Thai AirAsia, Jazeera and Qatar are flying to Bhairawa, but most use it as a hop before flying on to Kathmandu, which does not reduce congestion at Kathmandu.&nbsp; An ideal situation could have been to get Pokhara to run to full capacity while Kathmandu is partially out of action. Pokhara entrepreneurs are puzzled why the CAAN and the national government have not taken more interest in promoting Pokhara as an alternative to reduce the congestion in Kathmandu. Nepal’s football team that was flying to Dushanbe this week couldn’t get tickets via Delhi, and took a domestic flight to Bhadrapur, crossed over to Bagdogra and flew on to Delhi to catch their flight to Tajikistan.

Pokhara’s tourism woes

An excerpt of a conversation between an anthropologist and linguist Mark Turin, PhD and Lava Deo Awasthi, PhD, the first Chairperson of the Language Commission of Nepal. Nepali Times: What is the role of Nepal’s Language Commission and when was it formed? Lava Deo Awasthi: The Constitution of Nepal (2015) created a Language Commission (LC) with the following four core mandates: (a) to develop eligibility criteria for gaining status as an official language and offer recommendations to the Government of Nepal about the official language(s) in each province; (b) to offer recommendations to the Government about measures to be taken for the conservation, promotion, and development of languages; (c) to suggest possible ways of using mother tongues in education by assessing their stage of development; and, (d) to conduct studies, carry out research and perform monitoring functions about the response to the constitutional provisions for the federalisation of languages in Nepal. The Commission was founded in 2016 and I was appointed as the Chairperson of the Commission in September of the same year by the Cabinet of Ministers. What in your own professional and educational background helped to prepare you for the role? I have worked with the Government of Nepal for about 30 years, alongside holding teaching appointments at universities in Nepal. Prior to assuming the role of the Chairperson of the Commission, I served as permanent Secretary to the Government of Nepal and worked as the Chief Administrator of the Central Development Region. I was appointed as Director General of the Department of Education and completed my assignments as Joint Secretary at the Planning, Monitoring and Educational Administration Divisions of the Ministry of Education.&nbsp; In addition, I have taught courses as a visiting professor at Tribhuvan University and Kathmandu University for more than three decades. Later, I also started supervising MPhil and PhD students at the Far Western University in Mahendranagar, Kanchanpur. My PhD project from the Danish University of Education was dedicated to making sense of Nepal’s social construct and commitment to multilingualism, exploring the persistence of monolingual school practices in the face of constitutional promises and state commitments to multilingualism. I conducted a survey of Nepal’s languages and carried out a qualitative study of the Tharu language in the district of Bardia. I analysed language policy statements and explored classroom pedagogies in schools. I documented how teachers showed a tendency to resist change and maintain the status quo because they were not consulted when new educational language policies were introduced. Teachers also exhibited a deeply-held adherence to the Gurukul education system which appears to have been harnessed as a way to resist newer pedagogical ideologies imported from the West. Recognising how engrained these rich traditions of knowledge transmission are, I wanted to know how students’ engagement in the learning process appeared to have dwindled, creating a gap between children’s home languages and the language(s) of the school. Whilst statutory provisions for education in the mother tongue were oriented towards promotion, classroom pedagogies remained resolutely monolingual and exclusionary. The result was that multilingual education policies that had been introduced in Nepal did not result in meaningful changes in classroom practices. My research was also a reflection of childhood traumas I had experienced at the earliest stage of formal education. My home language, Baitadeli, has a strong oral tradition and no written literature. English is my fifth language in terms of exposure and competence, and my home district of Baitadi is well-known for its loyalty to the local language. I had to drop out of school after completing my sixth grade. Staying at home, I received much attention from my family and had much greater exposure to my native language, culture and environment. My overall impression is that dropping out of school had a surprisingly positive impact on my life. The opportunity offered a surprising dividend for me as I gained mastery in my mother tongue and received extensive exposure to folk literature and Indigenous knowledge and survival skills, cultivating my interest in language, culture, literature and local cosmologies.&nbsp; Now that I reflect on it, I appreciate how language has always played a key role in my life. I grew up in a multilingual environment: brought up with Baitadeli, Hindi, Sanskrit, Nepali and English. Language played a major part in my decision to leave school and my later success is closely linked to my competence in several languages. It was rewarding to be at home with my family as I deepened my understanding of native language and culture, which in turn helped me to harness and refine my art of living. Languages matter so much to me because they are both software and hardware. Later, when I was in secondary school, I realised that my command of my home language contributed significantly to enhancing my Nepali and English. I used my mother tongue as a form of linguistic capital to strengthen my competence in both English and Nepali.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2024111811110_5400ba54792bf9e4854e1c1effde8bf09804e99647f23513700b450cc49adc4a.jpg" data-media-id="editor_0" data-image-id="2024111811110_5400ba54792bf9e4854e1c1effde8bf09804e99647f23513700b450cc49adc4a" data-rendition-name="original" width="1000" height="1500" loading="lazy" alt="Dr Lava Deo Awasthi"> </figure>  In your term as the Commission’s first Chairperson, what were your strategic goals and objectives? My first strategic goal was to create an environment conducive to implementing the provisions of the Constitution of Nepal in relation to language. My priority was to prepare a detailed action plan for my six-year tenure in consultation with language stakeholders, including language experts, professionals, activists, Indigenous community members and representatives of relevant national and local-level institutions. The Commission formed a body of high-level advisors to ensure that the Chairperson’s work was well-informed and credible. The advisors to the committee had highly visible professional and social reputations in Nepal and had much experience in the field of language conservation, promotion, research and development. Another strategy we adopted was to establish close institutional linkages with federal, provincial, and local level governments for collecting opinions and disseminating information widely.&nbsp; What critical issues did you have to consider while discharging your duty? When Nepal’s new Constitution was drafted, a number of concerns could not be adequately addressed. These related to the conservation of languages, the recognition of official languages at the provincial level, and the use of mother tongues at federal, provincial, and local levels. These unresolved issues and matters pertaining to the federalizsation of Nepal’s languages were passed on to the Language Commission to address and resolve.&nbsp; Regarding the recommendations for official languages, a five-year timeline had been set by the Constitution. With great effort, we succeeded in having all provinces agree to recognise their official languages as per the recommendations of the Commission.&nbsp; What were your greatest achievements during your term? One of the greatest achievements was that we succeeded in setting a language agenda at all levels. Nepal’s language communities and other stakeholders expressed the view that this was the first time their languages were recognised and their voices heard by the state. People participated in debates and discussed issues relating to language that in all likelihood had never before happened in their lifetimes, at least not in ways that were supported by the state. We encouraged people to speak in their own language(s) and provided translators during plenary sessions and group discussions. Another major achievement was developing criteria for the status planning of languages at federal, provincial, and local levels, and to recommend 11 province-level official languages, in addition to the Nepali language. Similarly, a notable achievement was recognising Indigenous languages spoken by smaller communities, all of whom faced ongoing marginalisation and high levels of endangerment. The Commission identified 9 new languages that had not been reported in the 2011 census, and provided a framework for recognising official languages within a municipality. The commission emphasised the need for documentation and digitisation of languages for developing corpora and archives at national and sub-national levels.&nbsp; Languages of historical importance as well as classical languages were given recognition for their protection, growth, and development. Recommendations were made for the conservation, promotion and development of Nepal’s marginalised languages that are threatened by majority languages and for those languages that hold particular power at local and global levels. Recommendations were also made for how best to safeguard Nepal’s languages from the ever-growing spread of English and other powerful, globalising languages.&nbsp; A further important aspect of the Commission’s work was to emphasise mother tongue medium instruction in schools across the nation. Recognising the role of language in children’s cognitive, socio-emotional and academic development, the Commission suggested strategies for linking schools with ward-level language clusters for use in the classroom. The importance of nurturing and respecting a child’s first language was reiterated in the Commission’s recommendations for children’s learning and all-round development. By the end of my term, a remarkable change could be observed in terms of building trust within and across Nepal’s diverse language communities. A network of language groups and stakeholders across the country proved to be a powerful way of bringing all language communities under one roof for a collective review of and response to the process of federalising language policy. The many language stakeholders across Nepal appreciated the opportunity to work within a coordinated framework, and—feeling empowered by this—seemed genuinely enthusiastic about the initiatives taken by the Commission.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2024111811114_b45297fdd2fedf17bdb6313e495a1062c0d87f1a19fa5349f871f220b75f93ab.jpg" data-media-id="editor_1" data-image-id="2024111811114_b45297fdd2fedf17bdb6313e495a1062c0d87f1a19fa5349f871f220b75f93ab" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="Dr Lava Deo Awasthi NT"> </figure>  What were the most significant challenges for you as Chairperson? One of the major challenges was winning people’s trust in advocating for the mission of the Language Commission. I faced considerable resistance as I sought to emphasise the use of native languages in families and communities. While the Commission advocated for multilingualism and promoted linguistic diversity, the prevailing policy circles and central level institutions had been deeply influenced by a one-language discourse and ideology of Nepali only. The spread of English also poses a huge threat to Nepal’s languages. However, people in power do not seem to see this as a problem. They tend to abandon their own languages in preference for English. The way that Nepal’s municipalities are increasingly introducing English as a medium of instruction at the earliest stage of a child’s school-based education has proven to be detrimental to their cognitive development, socio-emotional wellbeing and academic success. Most of Nepal’s elites have been heavily influenced by the spread of English and remain unaware about its impact on their home languages as well as on the inter-generational transmission of Indigenous languages in the country. I wish that we could have produced more compelling evidence to show the consequences of making poor policy choices for our children’s education. Demystification calls for a collective response. To make change happen across this entire, complex and federalising country was daunting work and left like a race against time. I feel that I could have done more to offer concrete examples in favour of using the mother tongue as a medium of children’s education at the earliest stages of a child’s education. What do you see the Language Commission achieving in the next 5-10 years? The Language Commission will have to ensure that all of its key recommendations are implemented at all levels of government. In 10 years’ time, all seven of Nepal’s provinces will have their official languages in place. These languages will also be recognised as languages of federal business, alongside Nepali. I anticipate that all official languages in the federal and provincial systems will have a national portal for inter-language corpora using machine translation to fulfil their federal, provincial and local level language functions, and that all languages spoken in Nepal will be represented through a digital database in the national archive. The Office of Statistics will monitor the status of Nepal’s languages over time. By the end of the next decade, each municipality in the country will have recognised one or two official languages at the local level, based on speech populations. Other local languages will have received community-level legal recognition and official status to fulfil their functional roles. Languages that are highly endangered or at risk will be entitled to receive state grants for enhancing local level capabilities to encourage families and young learners to speak the language. Incentive schemes will be introduced in municipalities that promote language within the family and at home. Inter-generational transmission of languages will have received welcome and timely attention across Nepal. It is my hope that all schools—public and private—will have introduced mother tongue medium instruction at the earliest stage of school education, at least up to class five. Nepali, English and other national as well as classical and foreign languages will be taught as subjects. The existing policy of English medium education at the early stage of education will be abolished. The Government of Nepal will be held accountable if the number of speakers of any language decreases or if local communities face language loss and greater endangerment. Under the aegis of the Language Commission, a Centre for Language Research and Innovation will be created with world-class facilities for language documentation and archiving in collaboration with Tribhuvan University’s Central Department of Linguistics and other relevant institutions. Harnessing the vastness of Nepal’s linguistic diversity, the Language Commission will morph into a centre of excellence for national and international communities to engage in collaborative language research, to share experiences and document best practices at in service of global linguistic diversity and Nepal’s many Indigenous languages.

Languages are both software and hardware

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

Greenbacks for greenery

Nearly 750,000 Nepalis went abroad for employment in the past year, and more than 100,000 left on student visas. Most of them were young Nepali men and women, and the number has been increasing every year. As with other sections of society, Nepal’s security agencies also face a recruitment crisis. Nepal Police opened recruitment for 64 inspectors in September, and received 2,239 applications, compared to 2,718 candidates last year. Police also invited candidates for 256 assistant sub-inspectors this year for which it received 17,756 applications – down from 19,932 last year. It is the same story in the Nepal Army, the number of applicants for the post of Officer Cadet (Second Lieutenant) went down from 6,144 for 400 open seats in 2019 to 4,390 in 2020. Meanwhile, applicants in the paramilitary Armed Police Force went down from 857 applications for 75 posts in 2021 to 536 applicants for 99 posts last year. While the number of applicants appears higher than the demand, the data shows a significant decrease in applications for vacancies in Nepal’s law enforcement agencies. Security personnel are recruited on the basis of rank and age in Nepal, and the age cutoff for entry into Nepal’s security agencies is typically 25 years. Sociologist and migration expert Ganesh Gurung says that the demographic of young, physically fit Nepalis emigrating abroad in search of better opportunities has impacted recruitment into law enforcement and the military here at home. “The returns from working in Nepal’s police and army are minimal, whereas overseas job opportunities are more attractive,” Gurung says. “The work may be physically demanding abroad, but the pay is a lot higher.”  <figure><img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241116041148_a7e477e0ee2f56acf16c2559fdb24d8f0377f7bc1f9e56138bc40108fc4fa33f.jpg" data-media-id="editor_0" data-image-id="20241116041148_a7e477e0ee2f56acf16c2559fdb24d8f0377f7bc1f9e56138bc40108fc4fa33f" data-rendition-name="original" width="800" height="534" loading="lazy" alt="Nepal Police"><figcaption>Nepal Police</figcaption></figure>  Nepal Police spokesperson DIG Dan Bahadur Karki agrees that the physical and mental demands of a law enforcement job is incomparable to the income that security personnel earn. “A young Nepali who works in Dubai earns enough to build a home in the village within four years, while a Nepali with the same qualifications and physical ability in a security agency here barely makes enough to survive,” says Karki. “Obviously the youth prefer foreign employment.” Security agencies are now worried about the quality of inducted manpower. “There is a difference in work ethic between an applicant chosen from a competitive pool of 50 candidates versus one chosen from a pool of three candidates,” explains Gurung. “Unmotivated employees hamper the overall performance of the state apparatus.” Nepal Army spokesperson Brigadier General Gaurab Kumar KC says recruitment has not been hampered by outmigration: “We have still been getting more than three times the applicants than there are open posts, so we are not yet worried.” Even so, the passing rates of aspirants have gone down for security forces after the Public Service Commission began examinations for military recruitment in 2015. In fact, the Nepal Army complained about the Commission’s involvement in recruitment. Still, the number of vacant military posts tends to exceed the number of passing candidates. Nepal Army’s KC says that the military will not compromise on intake criteria even if there are fewer passing applicants. “Unqualified persons will not be admitted even if there are less-than-required passing candidates. We will re-advertise if that is the case.” But Nepal’s security forces now also have to worry about retention of existing personnel. About 900 Nepal Army, 600 Nepal Police, and 300 Armed police personnel resign every year before the completion of their tenure.  <figure><img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241116041148_b8cd62f70eea3aac7d3d3778615a5b70b1e20550c9bd76321f051f9c766fd2a9.jpg" data-media-id="editor_1" data-image-id="20241116041148_b8cd62f70eea3aac7d3d3778615a5b70b1e20550c9bd76321f051f9c766fd2a9" data-rendition-name="original" width="750" height="378" loading="lazy" alt="Armed police forces"><figcaption>Armed Police Force</figcaption></figure>  In 2020, Home Minister Ram Bahadur Thapa recalled almost 1,000 police personnel who had been deployed for the security of VIPs after long-standing criticism that security forces were being misused to cater to political and bureaucratic leadership. However, security personnel have continued to be assigned to high-ranking officials as glorified housekeepers. In December 2022, Rabi Lamichhane’s Home Ministry had instructed its offices to recall unauthorised security personnel assigned to high-ranking officials, following which 500 officers from Nepal Police and Armed Police Force were withdrawn from their details. But the Nepal Army does not have to follow such rules, and the practice of army personnel serving high-ranking active-duty and retired military personnel remains. Conditions here are dire enough that many active duty officers in Nepal’s military and police forces have chosen to leave their jobs to serve in the Russian Army to fight in the Ukraine war. The hierarchical culture and chain of command of politics, bureaucracy, law enforcement and military has also meant that abuse and mistreatment of subordinates is rife in Nepal’s security forces. “Feudalism is alive and well within our security institutions,” says Gurung. “When soldiers and security forces who swore to protect and serve the nation are made to be at the beck and call of politicians and bureaucrats, it is easy to understand why they are disillusioned with their jobs and why they choose to quit and find jobs abroad.”

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