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

One smoggy winter morning in February 2019, Ekta regretted coming to her sculpture class. It was the first day of her period, and the 19-year-old wished she was home, curled up in bed with a hot water bag to soothe her cramps.
Her class was at Kalapremi Ceramic Studio, a dark room on the ground floor of a house in Maharajganj, and Ekta’s teacher was the artist Gopal Das Shrestha ‘Kalapremi’, a noted sculptor.
Two other students were already there, using all their muscle strength to knead the sculpting clay. Ekta, now 24, recalls how Kalapremi asked her if she was feeling all right. She avoided him, as she did not want everyone to know she was menstruating.
Kalapremi repeatedly asked Ekta what was wrong. She finally muttered that she was having her period, after which he grabbed her hand and led her to a partitioned corner of the studio and sat her on a chair. Before she could stop him, he slid his hand under her dress, and started massaging her abdomen.
“I was horrified,” Ekta recalls. “I told him to stop, but he didn’t listen, asking me not to be shy, saying he knew how to relieve my pain. He stopped only after I protested furiously.”&nbsp;
The art tutor then said, “You’re like my daughter. I’m doing it out of love to make you feel better, but you’re so stubborn.”&nbsp;
“Instead of saying sorry he acted like I was the one having crazy thoughts,” remembers Ekta, adding that from April 2016 to August 2020 beginning the time she was 16, the artist sexually abused and harassed her on several occasions. &nbsp;
Now, Ekta and the artist’s other former students are finally sharing their experiences and some are pressing legal charges against him, hoping that others do not have to endure what they did.&nbsp;
Award-winning artist and teacher Gopal Das Shrestha ‘Kalapremi’ (the name means ‘Art Lover’) is known for his ceramic art, sculpture, and contemporary pottery. He was <a href="https://nepalitimes.com/review/the-house-of-kalapremi">profiled in Nepali Times after a collaborative exhibition</a>, ‘Where the Wild Things Are’ at the Siddhartha Art Gallery three years ago.&nbsp;
His pieces, titled Gaalis, featured sculpted female figures with the heads of dogs, sheep, and donkeys (pictured) to depict derogatory terms for women. Some critics said the collection was a satire on feminists.
Kalapremi started his artistic and teaching career in 1983 and over the years taught at Bhanubhakta School, Kathmandu University School of Arts, Lalitkala Campus and at his private Kalapremi Ceramic Studio. He has also lectured at Jeonju University in South Korea and recently at Tabor Academy in the United States.
Seven of Kalapremi’s former students were interviewed for this story. Five female students said he touched them inappropriately in his studio or at Kathmandu University. Two male students said they witnessed him abuse and harass the women. In all cases, the students struggled to recognise the abuse when it occurred, and the lack of reporting systems left them to cope on their own for years.&nbsp;
Earlier this year, students shared a social media post hinting at Kalapremi’s history of abusive behaviour following which more students of the artist reached out sharing similar experiences. Some students spoke of abuse that happened as long as 20 years ago.
Kalapremi, 60, has denied the allegations. He told Nepali Times: “Some years ago, there was a movement encouraging people to hug and kiss. I used to do it purely out of friendship and love. But after seeing posts on social media last year calling out my behaviour, I realised my actions may have hurt some people. I understand now that I should have been more mindful.”
He added: “I am also an auxiliary health worker, so I know the exact points to massage to relieve menstrual pain. It’s not just menstruation, I take anyone who is ill to the hospital.”
Sexual abuse is much more rampant than reported given how difficult it is to prove it in court. The law defines sexual abuse as occuring when someone touches another’s private parts, coerces them into touching theirs, uses vulgar language, shows degrading images, or behaves indecently towards them without consent.&nbsp;
Ekta and her fellow students are consulting lawyer Suneeta Regmi Pokhrel, who says they know that even if the court decides in their favour, it is difficult to survive after speaking up, and influential men defend themselves saying they are being framed.&nbsp;
“They are in a lot of pain and weep when recalling how he abused them,” Regmi Pokhrel told us. “They are angry and have filed a case against him, but they are also terrified. They know he is a powerful man and they have seen how our society treats women who speak up against abusers. Unless people speak up, perpetrators will be emboldened.”
Art and academia in Nepal simply reflect the power imbalances in society where people with intersecting identities experience worse forms of abuse. Theatre actors Raj Kumar Pudasaini, Rajan Khatiwada, and Sunil Pokhrel were called out during the #MeToo movement in the Nepali theatre scene in 2019. Even after the allegations Pokhrel went on to receive national awards, while others continued to work without repercussions.
“If you speak up against abusers, you gradually get sidelined from projects,” explained a theatre artist who wished anonymity fearing professional setbacks. “The theatre scene in Nepal is quite small, you just have to make peace with the perpetrators and work with them if you want to sustain yourself.”&nbsp;
In academia there is a history of faculty members sexually harassing students and getting away with it. After Tribhuvan University (TU) lecturer Krishna Bhattachan was accused of harassing women students, the university said it would follow Nepal’s sexual harassment law and set up a reporting mechanism. But nothing happened to the professor, who had already retired. Instead, he counter-accused the students of 'attacking the indigenous people’s movement with baseless allegations' as <a href="https://kathmandupost.com/letters/2019/01/29/bhattachan-responds">he told the Kathmandu Post in 2019</a>. He continues to be featured as a prominent speaker including at TU.
Other faculty members previously accused of sexual harassment include Jagadish Murti Koirala from TU, Bishnu Prasad Acharya from Ratna Rajya Campus, and Bodha Raj Tripathee from Lalitpur Madhyamik Vidhyalaya. A woman staff member from TU also filed a sexual abuse complaint against Dambar Chemjong from TU.
Prominent figures like <a href="https://nepalitimes.com/news/the-rise-and-fall-of-nims-purja">mountaineer Nims Purja</a> have been <a href="https://www.nytimes.com/2024/05/31/sports/mountaineering-sexual-harassment-abuse-nims-purja.html">accused of sexual assault</a>, and cricketer Sandeep Lamichhane, actor <a href="https://nepalitimes.com/news/celebrity-rape-case-spotlights-nepal-laws">Paul Shah</a>, and former speaker of Parliament <a href="https://nepalitimes.com/news/mahara-arrested">Krishna Bahadur Mahara</a> have been accused of rape, but society-at-large has let off the alleged perpetrators amdist a larger debate about justice for survivors and punishment of perpetrators.&nbsp;
‘Gaushala-26’ is the court name given to the 18-year-old who accused Sandeep Lamichhane, former captain of Nepal’s national cricket team and skipper of Biratnagar Kings in the <a href="https://nepalitimes.com/here-now/here-comes-the-nepal-premier-league">ongoing Nepal Premier League</a>, of rape. She left the country citing society questioning her character affecting her mental health while Lamichhane got an outpouring of support. In May, the Patan High Court overturned a prior verdict that found Lamichhane guilty of rape and had sentenced him to eight years in prison. During the 23-month legal battle to pursue justice, Gaushala-26 faced threats of gang rape and acid attacks.&nbsp;
Exhausted by the struggle, Gaushala-26 sought to “move to a new world” where she could live free without hiding her identity.
Actress Samragyee Rajya Laxmi Shah in an Instagram video now deleted detailed the harassment she faced from a filmmaker during a movie shoot. She did not name any name but veteran actor Bhuwan KC filed a defamation case against Rana, but the court ruled that the charge lacked sufficient evidence.&nbsp;
Former Kathmandu mayor <a href="https://nepalitimes.com/opinion/theytoo">Keshav Sthapit also mocked the #MeToo movement</a>, calling accusations against him by journalists Rashmila Prajapati and Ujjwala Maharjan “a rape of men’s rights”.
Serial Abuse
Back at the Kalapremi Ceramics studio, another former student, 24-year-old Rajiv, says he felt the need to speak out after seeing his female classmates being abused.&nbsp;
“He frequently kissed them on their cheeks,” he told Nepali Times. “Whenever they walked into the studio he flailed his arms like a child asking for a hug. They awkwardly hugged him from the side, but he pulled them closer, held their chin, and kissed their cheeks.”&nbsp;
Rajiv says he also saw Kalapremi pull the women’s bra straps, touch their breasts, and slap their buttocks. The young students would freeze, not knowing how to react, and if they protested, he would say it was “normal in art”. Rajiv, 19 at the time like his classmates, remembers thinking perhaps the well-respected artist was right after all.
Another student, Luna, who took lessons at Kalapremi’s studio from 2020 to 2022 did try to confront the tutor after he made an obscene proposal to her. She recalls: “One day when the other students had left the studio and it was just the two of us, he told me that God had given him special artistic talent and he could transfer those powers to me. But to do that both of us will have to be naked, inside a dark room, and have sex.”
Luna, who was 18 then, was livid and told him she did not want any of his powers, but she says he laughed at her as if he was joking. She did not tell her family about the incident because she thought no one would believe her.&nbsp;
“They were all in awe of this famous artist and felt I should be grateful that to be learning sculpting from him,” she says. “I was scared to be alone with him in case he talked about sex again. My coping mechanism was to be rude so he wouldn’t try to come close to me.”
Seeing how some classmates were standing up to Kalapremi, Ekta too tried to push back against his advances, but she said he found ways to coerce her. Since Ekta, Rajiv, and Luna could not afford Kalapremi’s Rs30,000 monthly fee for lessons, he had offered them all a stipend to assist him in the studio.
“He had spondylosis and took me to his therapy sessions to learn massage techniques, then he often made me and other students massage him,” says Ekta. Whenever she refused, he would feign pain to make her feel sorry for him. “He would insist that I put my hands under his shirt so that I could massage him better,” she adds.
The art tutor often tried to “seduce sympathy” from Ekta by sharing how he had never been loved as a child and was “sexually frustrated” as an adult.&nbsp;
“At 7PM, he would pour himself Signature whiskey and immediately go off again about how he was sex-starved. I didn’t know how to respond. It took me time to realise alcohol was just an excuse to talk about sex,” Ekta says.
If convicted, Kalapremi could face financial penalty and/or a prison sentence of up to three years according to Section 224 of National Penal (Code) Act 2017.&nbsp;
Data suggests that victims of child sexual abuse on average take nearly 24 years to tell someone about their trauma, and some may never disclose it at all.&nbsp;
“In our culture, children are rarely taught about boundaries. They often react, show anger when adults pinch their cheeks. But adults insist they did it out of love, and force the children to accept it,” says Sita Lama, a psychotherapist at Manka Kura. “And even when someone touches them inappropriately they struggle to identify and verbalise it.”
When perpetrators claim to be “acting out of love”, Lama says survivors are likely to perceive it as something safe, rather than recognising it as abuse.&nbsp;
“It may take years for them to realise they were abused,” she explains. "And even when they become aware, the power imbalance with the abuser and the associated shame often prevents survivors from speaking up."
Other former students from the School of Art at Kathmandu University have also come forward years later, saying Kalapremi sexually abused them. As young adults, they felt his behaviour was off but were uncertain if it was inappropriate, illegal, or they did not know how to respond. After having understood that it was indeed abuse, they say they are speaking out now to protect others.&nbsp;
Amina Singh, a visiting faculty member at Kathmandu University, says there is no clause against sexual abuse in contracts of teachers, and there is no formal grievance handling mechanism for the students.&nbsp;
“So the only way students can to deal with sexual abuse is approach someone they trust,” she says.
Eight other former art students of Lalit Kala Campus and Srijana College of Fine Arts of Tribhuvan University and other private art studios in Kathmandu say they were also sexually abused by their art teachers. Three faculty members interviewed from these institutions said they saw the abuse, but felt it was futile to report it given how powerful the teachers were.
In the absence of a formal system, some longtime women artists warned each other about “problematic” artists. They shared &nbsp;a “heads-up” to be more cautious when collaborating with them, and avoided responding to their calls and texts after work hours.
To ensure art institutions are safe for all, galleries, museums, artist studios, and smaller art spaces need to develop policies on sexual harassment. This would include a code of conduct or studio policies that hold the leadership accountable and outline the principles of professional ethics.&nbsp;
Students and employees should inquire about accountability mechanisms for raising concerns, both formally and informally, advocates say.
Three years after Ekta left the ceramics studio, she learnt that Kalapremi had harassed many other women. Still trying to get a footing in the art industry, she attended a workshop in Kathmandu where women artists discussed ways to stay safe in the art sector.&nbsp;
Since it was a close-knit group Ekta opened up about how she felt violated and realised she was not alone, he had been abusing underprivileged students for years, and this was common knowledge among artists in Nepal.
Ekta says that even after she quit, Kalapremi continued sending her text messages like ‘I am thinking of you’, ‘Why have you stopped speaking with me’, or ‘I am waiting for your call’.&nbsp;
But what really forced her to act was when Ekta found out that he was sending similar texts to her younger sister.&nbsp;
“I’ve had enough,” she told us. “He abused me all these years but I won’t let him abuse my sister.” &nbsp;
Ekta, Rajiv and Luna are not the real names of the students.&nbsp;

‘Art Lover’ accused of sexual abuse

It was 8:15 in the evening of 25 March 1968 when everyone in the village of Batulechaur near Pokhara heard a deafening sound like thunder as a bright flashing object hurtled down to land in a field.&nbsp; That field belonged to Kul Timilsina, and the next morning he retrieved a sheet of metal about 2m by 1m and carried it home with the help of a few others, thinking it would be useful for his buffalo shed.&nbsp; Before he died at age 83 three years ago, Timilsina had told photo archivist Sunil Ulak that the black metal sheet was not rectangular and had rounded corners. There are a few witnesses still alive who have a clear recollection of the object that fell from the sky that night.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2024120707128_75cc85aac56b9cc4a77366471f058d7b3eb6868776811b0923845c2d0a61f014.jpg" data-media-id="editor_0" data-image-id="2024120707128_75cc85aac56b9cc4a77366471f058d7b3eb6868776811b0923845c2d0a61f014" data-rendition-name="original" width="1170" height="601" loading="lazy" alt="UFO over Pokhara"> <figcaption>The field in Batulechaur belonging to Kul Timilsina where fragments of a flying object fell from the sky in 1968.</figcaption> </figure>  One of them is Timilsina’s wife Gyanu, who was 22 at the time. She had been at home, and remembers hearing the big bang and the sky becoming very bright. “We saw the thing in the field in the morning,” she told us. “It looked like a lid, a covering of some sort. The way it was stuck in the ground, it must have fallen from the sky. We thought we could use it to dry clothes on, and took it home.”&nbsp; Another witness is Kul Narayan Paudel. “I was only eight then. We ran to the field to see what had fallen. It was a four-sided metal sheet. The elders took it away, and I don't know what happened to it.” &nbsp; Ram Bahadur Baniya, a teacher at the local school, says he had heard the sheet had been brought to the school, and later handed over to the Zonal Commissioner at the time, Nanda Prasad Malla. “But that is all hearsay,” he says.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2024120707128_0bf207a12063fb8155b3c8d9a00a94887b126380c9e0627527c84cf5e1101f54.jpg" data-media-id="editor_1" data-image-id="2024120707128_0bf207a12063fb8155b3c8d9a00a94887b126380c9e0627527c84cf5e1101f54" data-rendition-name="original" width="1170" height="610" loading="lazy" alt="UFO over Pokhara"> <figcaption>Gyanu Timilsina, wife of Kul Timilsina.</figcaption> </figure>  There are two versions of what happened to Kul Timilsina’s metal sheet. One is that an American Peace Corp Volunteer teaching at the nearby Bindyabasini School took it, and another is that it was handed over to the government. Recently declassified Central Intelligence Agency (CIA) and US State Department documents from the time say that the US Embassy in Kathmandu tracked down the object two years later and had it shipped back to the US. A telegram from the Department of State and Department of Defense tagged as ‘MOON DUST / Space Fragments’ dated 1 March 1972 stated: ‘1. Restored space fragment will be on board Embassy support flight 115 arriving Kathmandu on or about March 10. Fragment is packed in shipping crate (cargo no. 72-33365) marked in care of DAO.&nbsp; 2. State and Defense representatives examined fragments prior to shipment finding restoration acceptable.’  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241207071212_929d903ee06d41baa4f6040e981cd7c7d7bd75cc9c37c9b617d307fc8538d2df.png" data-media-id="editor_2" data-image-id="20241207071212_929d903ee06d41baa4f6040e981cd7c7d7bd75cc9c37c9b617d307fc8538d2df" data-rendition-name="original" width="856" height="568" loading="lazy" alt="UFO over Pokhara"> <figcaption>Declassified CIA documents about the investigation into the object sighted in Pokhara. </figcaption> </figure>  The documents show that the US government, military and intelligence agencies investigated this incident thoroughly when it occurred, and have continued to revisit it ever since, as recently as five years ago. What is even more intriguing is that the object that fell in Pokhara was not the only unidentified space object that fell to earth that year. There were similar sightings of objects falling from the sky in Ladakh, Sikkim and Bhutan between 19 February and 25 March 1968.&nbsp; These mysteries were the subject of a CIA investigation in 1968 titled ‘<a href="https://www.cia.gov/readingroom/docs/CIA-RDP81R00560R000100070007-8.pdf">Sighting of Unidentified Flying Objects in Ladakh, Nepal, Sikkim and Bhutan</a>’, and the report is part of the recent online declassification of 800,000 top-secret documents from the period.&nbsp; &nbsp;Although unidentified flying objects (UFOs) have a connotation now of being alien craft, it could be pieces of satellite, missile, rocket or even aircraft. The CIA report documents six sightings in 1968 and quotes local sources as describing all of them having similar characteristics: bright blue or red streaks in the sky accompanied by loud sounds like lightning and thunder and objects falling to the ground. Aside from the metallic object that was found in Batlechaur, there were other items also found nearby in Tallakot, Tureypasal, Armalakot and Maidan. Whatever the object was, it seems to have disintegrated even before it hit the ground.&nbsp; The CIA report records the first sighting on 19 February 1968 in various parts of Sikkim and Olangchung Gola and Ghunsa in eastern Nepal. The light was said to be ‘long and thin’ and giving out ‘green and red light’. &nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241207071212_c3c825027d966a2aedc846970390eebe063957503c7eacc8e01e0517843f9bbb.png" data-media-id="editor_4" data-image-id="20241207071212_c3c825027d966a2aedc846970390eebe063957503c7eacc8e01e0517843f9bbb" data-rendition-name="original" width="892" height="596" loading="lazy" alt="UFO over Pokhara "> </figure>  Two days later on 21 February, a soundless blue object was seen traveling fast across the sky above Thimphu in Bhutan. Then on 4 March there were multiple daytime sightings or white streaks in the sky at Chang La Pass, Fukche and Koyul in Ladakh. There were more sightings in Ladakh on the very day fragments fell near Pokhara on 25 March 1968.&nbsp; After the sightings in Pokhara, rumours started flying in Kathmandu that these were aliens trying to land on Earth, it could be Russian or Chinese spy planes or satellites, and some even say it as a sign from heaven that the end of the world was near. This was at the height of the Cold War. The Russians and Americans were testing their thermonuclear devices as well as intercontinental ballistic missile delivery systems. The Washington-Beijing rapprochement had not yet happened, and China was making quick progress testing atomic bombs. Within two years after its first atomic test, in 1966 China exploded its first hydrogen bomb at the Lop Nur site in Xinjiang, 3,000km to the north from Nepal. After neary six decades, what is still intriguing is that all the sightings within a few months of each other in 1968 were along the Himalayan arc bordering Tibet: from Bhutan, Sikkim Nepal, to Ladakh. The US military intelligence seems to have concluded that this was not a coincidence and there were frequent research trips to the site in Pokhara by American officials in the months after the incident. With the help of the Royal Nepal Army, the region north of Pokhara was thoroughly searched.&nbsp; A confidential memo dated 25 June 1968 by Jerry C Trippy to a ‘Mr Farley’ mentions that the US Air Force’s Foreign Technology Division had decided that the debris could be important because it may be related to a Chinese missile test or a Soviet ‘Vehicle Venik’ rocket.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241207071216_feb5425692dc36b20187de4e4fcc2ce9fd12b6d9e1b8724398e50bcdbf9032fe.jpg" data-media-id="editor_5" data-image-id="20241207071216_feb5425692dc36b20187de4e4fcc2ce9fd12b6d9e1b8724398e50bcdbf9032fe" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="UFO over Pokhara"> </figure>  On 28 August 1968 the US Embassy in Kathmandu sent a letter to Washington DC saying that the object could be of Soviet origin, possibly from when the rocket carrying the ‘Kosmos 208’ satellite re-entered the atmosphere. But why were the fragments falling to earth several weeks apart, and in the same region? No one knows where the metal sheet that Kul Timilsina recovered is now. It was definitely packed in a crate and taken to the US, and although it is rumoured that it was returned that is not very likely. Archivist Sunil Ulak heard from the Timilsina family that CIA officials had returned to the site five years ago. &nbsp; Interest in UFOs peaked in the US in the 1950s, with the Cold War space race and tests of atomic weapons and delivery rockets. CIA and scientists were being sent to investigate sightings, both publicly and privately. Could the Pokhara fragments as well as the sightings in Ladakh and Bhutan actually be alien craft falling to earth? The renewal in interest in space travel in large part due to Elon Musk’s SpaceX, UFOs and sightings are again subjects of public interest.&nbsp; Even 57 years later, even if there was definitive proof about whether the Batlechaur fragment was from a Chinese missile or a soviet rocket, it has not been made public in documents declassified so far. We may never know.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241207071216_b6938795f40731e7657fd6dcbb3cf460a326186a15eb11d4f832f602201ff598.jpg" data-media-id="editor_6" data-image-id="20241207071216_b6938795f40731e7657fd6dcbb3cf460a326186a15eb11d4f832f602201ff598" data-rendition-name="original" width="642" height="320" loading="lazy" alt="UFO over Pokhara"> </figure>  Sunil Ulak speculates if the debris actually came from an American aircraft, perhaps on an intel mission upon China. “Which could explain why they were so thorough in collecting the fragments in Pokhara,” he says. But that still does not explain the multiple sightings weeks apart in 1968.&nbsp; Indeed, US military aircraft were at that time flying frequent night-time missions from air force bases in India to supply weapons to Khampa guerrilla camps in Nepal located north of Pokhara in Mustang. It could very well be that the Chinese shot down one such aircraft. The other sightings could have been contrails of US spy planes, or Chinese anti-aircraft missiles.&nbsp; There were quite a few developments regarding UFOs in 2024. In a US congressional hearing in July, former intelligence officer David Grusch claimed that the government had long been involved in a program to investigate and retrieve non-human craft crashes, and then try to reverse engineer them. However Grusch did not show any evidence.&nbsp; The UAP Disclosure Act of 2024 was signed into law by Joe Biden in December 2023. It plans to oversee the public disclosure of UFO information. However, there is a clause in it that prevents disclosure if it would cause threats to military defense, intelligence operations or foreign relations.&nbsp; It is unlikely that the declassified documents about sightings in the Himalayan will cause any real surprise about definite evidence of alien life even if it was found. It seems humanity will continue, at least for now, to wonder about curious lights in the sky and whether there is anybody out there.&nbsp;

UFO over Pokhara

Four international names in architecture, Shigeru Ban, Rem Koolhaas, Tadao Ando and Louis Isadore Kahn, all left their mark in Nepal. But despite their best intentions, the ambitious designs fizzled out. Ban, Koolhaas and Ando won Pritzkers, the best known international award for architecture, and Kahn could have won it had the prize been given in his lifetime. But their designs fell short of transforming Nepali architecture and did not help inspire local architects.&nbsp; Why were these four ‘starchitects’ unable to pull off their Nepal projects and enrich the country with exemplary contemporary designs? The failure, especially the violation of Kahn’s design, also raises larger questions about how much contemporary architecture is valued in Nepal.&nbsp; Whereas Sri Lanka had Geoffrey Bawa and Bangladesh had Mazharul Islam, the pioneers of contemporary architecture in Nepal have had far less public appreciation. One wonders if Nepali architecture only refers to the monuments and heritage of the past. Nepal does have examples of outstanding modern architecture such as the &nbsp;पाङ्रे घर ‘Wheel House’ and खुट्टे घर &nbsp;‘House on Legs’ by Shankar Nath Rimal in the 1960s. These are the best examples of how some Nepali designers successfully tailored modern architecture to the Nepali context.&nbsp; Ten years ago, Nepal had three architecture magazines, SPACES, praXis and Business Architecture, but none of these survived. This newspaper has prominently covered contemporary architecture, and the built environment, but these are exceptions in Nepal’s media. There have been a few encouraging signs. The 2024 exhibition Modern Encounters in Architecture in Kathmandu Valley (1945-1985) at the Taragaon Museum had many visitors and its accompanying book is a seminal document.&nbsp; In 2023, the Mountain Architecture Dialogue (MAD) that focused on examples of good-practice sustainable contemporary architecture for the mountainous terrains of Nepal was a packed event with over 300 young architects, engineers, environmentalists and architecture students. <h2>Shigeru Ban</h2>  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2024122003128_8bb8dde080c5698c2585966bef27ce4c08e4ee488d3432b2caac98b9de762dfe.png" data-media-id="editor_0" data-image-id="2024122003128_8bb8dde080c5698c2585966bef27ce4c08e4ee488d3432b2caac98b9de762dfe" data-rendition-name="original" width="990" height="1074" loading="lazy" alt="Forgotten international starchitects in Nepal NT"> </figure>  Shigeru Ban had already built a name for himself in post-disaster construction when he came to Nepal following the 2015 earthquakes in which 500,000 people lost their homes. The basic design and its 3D-rendered images were reviewed in upbeat articles on DOMUS, Architectural Review, Dezeen, and Arch Daily.&nbsp; But his signature cardboard tubes could not handle the monsoon and the roof structure had to be re-designed with timber. Only two shelters were completed in Sindupalchok, and only one of them still stands at the Hyatt Regency grounds today, as Ban’s souvenir to Nepal.&nbsp; <h2>Rem Koolhaas</h2>  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2024122003128_58afec9b57accfa38327af0936648c6eb2f2e11ff18f1af8ca27383dc57dc222.png" data-media-id="editor_1" data-image-id="2024122003128_58afec9b57accfa38327af0936648c6eb2f2e11ff18f1af8ca27383dc57dc222" data-rendition-name="original" width="750" height="722" loading="lazy" alt="Forgotten international starchitects in Nepal NT"> </figure>  The designs of Dutch architect Rem Koolhaas have a specific signature: bold shapes and an intriguing architectural typology that challenges standard building blocks. Some designs even seem to defy gravity, like the CCTV headquarters in Beijing: an angular, continuous geometry of glass and steel.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241220031216_a18dc8a8d6b97bc6fa9d590036cf374f9dc3709c699fe5c5787304bbd05cb17d.png" data-media-id="editor_2" data-image-id="20241220031216_a18dc8a8d6b97bc6fa9d590036cf374f9dc3709c699fe5c5787304bbd05cb17d" data-rendition-name="original" width="1812" height="1168" loading="lazy" alt="Forgotten international starchitects in Nepal"> <figcaption>Rem Koolhaas' design for Ullen's School in Khumaltar.</figcaption> </figure>  Koolhaas was commissioned by Belgian billionaire Guy Ullens to design a new building for Ullens School in Khumaltar. The most prominent feature is its vertical glass block staircase. Some interior spaces have lowered windowsills, which provide ample views and daylight. But the school building has gone unremarked in Nepal. <h2>Tadao Ando</h2>  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241220031212_cc16bd6feb8be07a7198285b847a45d2126dc3a479e0cc7370331861fc544675.png" data-media-id="editor_3" data-image-id="20241220031212_cc16bd6feb8be07a7198285b847a45d2126dc3a479e0cc7370331861fc544675" data-rendition-name="original" width="626" height="628" loading="lazy" alt="Forgotten international starchitects in Nepal"> </figure>  Doctors providing aid to victims of the Great Hanshin earthquake in 1995 in Japan requested Tadao Ando, who had donated his Pritzker money to the victims, to also make a design for a hospital in Butwal.&nbsp; Ando’s contribution would be pro-bono and the construction was funded by the Hanshin Earthquake victims and by the popular Japanese newspaper Mainichi, as a tribute to Nepali doctors. The first block that Ando designed for the Siddhartha Children and Women’s Hospital (SCWH) was the out-patient department. He quickly realised that he would not be able to pull off structures with his typical style of smooth-finished, high-quality concrete.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241220031216_73ec0950d52320277ccc81d4a66fa6aa6acb38141e7b7633683e4cf8179dc579.png" data-media-id="editor_4" data-image-id="20241220031216_73ec0950d52320277ccc81d4a66fa6aa6acb38141e7b7633683e4cf8179dc579" data-rendition-name="original" width="1594" height="958" loading="lazy" alt="Forgotten international starchitects in Nepal"> <figcaption>Tadao Ando's Siddhartha Children and Women Hospital in Butwal.</figcaption> </figure>  Ando wrote in the online architectural catalog Architectuul, that the two main problems with the project were costs and the availability of local technology. ‘It became a facility that has a slightly different expression from the buildings I have completed so far,’ he wrote. He designed a colonnade for the west façade that would provide shelter from harsh sunlight, and the exposed brick walls were locally manufactured bricks.&nbsp; The hospital is characterised by modernist cuboidal massing, but the outer brick façades now appear unintentionally badly weathered by monsoons. The interiors lack both sufficient natural light and natural ventilation. <h2>Louis I Kahn</h2>  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2024122003128_612e199d62fb3e72b6b8f6a936b0fa0451d8c0aa3d831c071320bf423ee3d67f.png" data-media-id="editor_5" data-image-id="2024122003128_612e199d62fb3e72b6b8f6a936b0fa0451d8c0aa3d831c071320bf423ee3d67f" data-rendition-name="original" width="694" height="926" loading="lazy" alt="Forgotten international starchitects in Nepal NT"> </figure>  American architect Louis I Kahn had experience of projects in South Asia, and several were under construction when he died suddenly in 1974. Amongst these were the National Assembly complex in Dhaka, the Indian Institute of Management in Ahmedabad and the Family Planning and Maternal Child Welfare Centre in Kathmandu.&nbsp; Kahn had started the USAID funded project in Nepal by developing a master plan for the government institutional zone in Kathmandu, which included a building for the Health Ministry. The building’s façade in exposed brick has deeply recessed vertical windows for shading.&nbsp; The balancing of accentuated horizontal lines in the brickwork with the verticality of the larger composition is the work of a master. The brick walls rise up into punctured parapet walls at the roof level. These square apertures ‘frame the sky’.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241220031216_69c2e4972dbe38773e0a3a3f1129485c9c87033ee84cd454e24ae0dc772d05cf.png" data-media-id="editor_6" data-image-id="20241220031216_69c2e4972dbe38773e0a3a3f1129485c9c87033ee84cd454e24ae0dc772d05cf" data-rendition-name="original" width="1924" height="1242" loading="lazy" alt="Forgotten international starchitects in Nepal"> <figcaption>Louis Kahn's plan for the Ministry of Health.</figcaption> </figure>  When Kahn died, only the eastern half of the building was finished. The Western part was never built and Nepal’s bureaucrats decided that without paint, the exposed brick façade was not finished. Then in 1995, citing roof leakage and a space crunch, the Health Ministry added a floor.&nbsp; The frames-to-the-sky in the roof parapet were converted into windows and topped off with a sloping roof of corrugated steel sheets, whose only virtue was that it was cost-effective.&nbsp; Kahn’s orthogonal composition, which clean horizontal and vertical lines, was desecrated despite a public outcry and legal challenges from architects and cultural organisations. A version of this article was first published in HIMAL Southasian. Illustrations by Varun S Bapu.

Forgotten international starchitects in Nepal

If you were raised in Nepal, you must have picked up its unique set of vocabulary: आन्दोलन, चक्का जाम, बन्द, राँके जुलुस, आफ्नो मान्छे, हाम्रो दल, कर्फु and many more words connoting political protest.
We became familiar with the acrid smell of burning tyres, and eyes smarting from tear gas. And yet, everyone speaks of another revolution in the making. Not by desire, but by suffocation.
We heard speeches about नयाँ नेपाल, but the New Nepal never arrived. The governance system changed, but it did not reflect on people’s lives — except for those close to centres of power. The state is still unreachable and is not bothered about <a href="https://nepalitimes.com/here-now/matter-of-life-and-debt">victims of loan sharks</a>, cooperative scams and other injustices.
Politicians continue to speak in sound bites, but fail to deliver. They have mastered the game of pointing fingers towards an external enemy and convincing people that they are never at fault. The political narrative is so disconnected from the actual analysis of the problem that suffocation doesn’t go away after every revolution.
No genuine effort has been made to deliver at all, which is why there is a palpable sense of disillusionment in the air forcing us to seek another revolution, even if Nepal may not be able to afford it.
How has the current system successfully held power, even if the public is deeply frustrated? How is it that for three decades we continue to be led by the same faces, who have time and again, proved to us that they may be great politicians but not national leaders?
<a href="https://nepalitimes.com/opinion/improving-internet-governance-in-nepal">My experience at the epicentre of politics</a> has led me to identify three cultures that have enabled political parties to keep a tight hold on power: acceptance, silence and dependency.
We accept things the way they are. We use fatalistic phrases like “नेपालमा यस्तै हो” or “नेपालको कानुन दैब जानुन”. While this resilience enables us to rise back up from devastating calamities, it is also a reason for our compliance with the status quo.
Despite so many ‘revolutions’ that have led to significant reforms, these phrases keep getting reinforced, to the point that the upcoming generations have made it their lingo.&nbsp;
This acceptance is not a symbol of law-abiding citizens, but citizens living in fear of those in power, unable to ask the whys and why-nots.
Innovation suffocates in this culture of acceptance of the status quo. This is manifested in remarks like “but we don’t have any laws for this,” or “we don’t have the capacity to implement this”. An innovator or entrepreneur therefore has to spend that energy to become a political lobbyist, often educating and convincing the bureaucracy.&nbsp;
Remember when locally assembled <a href="https://nepalitimes.com/banner/designed-and-made-in-nepal">Yatri motorbikes</a>, despite having willing customers, had to suffer to secure license numbers because of a lack of regulations? Instead of creating new laws, the government kept chanting the “We will promote Nepal-made goods” mantra, leaving entrepreneurs in a labyrinth of bureaucracy. The weight of acceptance of the law lies heavily on innovators. Fatalism is a tactic used by those in power to generate mass fear in society.
When we accept, we become silent. This is a pervasive phenomenon. We are trained to keep quiet, lest we ruffle feathers, burn bridges, or not get the help we need in future. We know, yet we don’t speak.
Read also: <a href="https://nepalitimes.com/here-now/bureaucratic-hurdles-in-researching-nepals-bureaucracy">Bureaucratic hurdles in researching Nepal's bureaucracy</a>, Daniel W Edwards
Here is one example: the 2021 census shows that the number of baby boys born for every 100 baby girls is 112. This is a clear indication of female foeticide because of boy preference in society.
Despite such horrifying realities, there is finger-pointing within the government between the Ministry of Health and Population with the Ministry of Home Affairs. At the citizen level, we know those who are involved in killing girls. Yet, we don’t speak up. The Nepal Medical Council reports state that despite this gender imbalance at birth, there is no indication of any action.
But why would anyone speak against one's own fraternity, no matter how vile the act is?
When we accept and keep quiet, we become dependent on those who yield power. From getting our government procedure completed on time to getting transfers, to accessing any of our legally protected rights as well, we are forced to depend on our networks of चिनेको मान्छे people we know by blood, village, relations, political affiliation.
The culture of dependency has been the established way in Nepal. If you drive a two-wheeler or four-wheeler, and you get into a small accident, you will be asked to sort it yourself, dialing up the most powerful person you know. It becomes a competition of who knows who.
Recently I was told that there were calls from the Ministry of Health and Population and another from the Prime Minister's Office for just one medical position in a private hospital. Each was pushing its own candidate. Guess which candidate got the position.&nbsp;
The dependency of people is not on the laws or the state, it is with people in power, a reliance on the network of somebody who knows somebody, including those not officially in power.
These cultures are deeply ingrained in our heads, and in society. Collectively they form a vicious circle that helps those in power to retain power. This is not the society we want to live in.
Then, what do we do as a collective to break away from this? How do we break away from the cultures of acceptance and silence that have created this dependency? What can we do to ensure that our children do not have to learn the jargon of आन्दोलन before they learn about the state?
These are the cultures political parties need to shed rather than use them to perpetuate their power. This is what <a href="https://nepalitimes.com/opinion/comment/an-alternative-to-alternative-politics-in-nepal">alternative politics</a> needs to be about.
Sumana Shrestha is a member of Parliament’s Education, Health and Information Technology parliamentary committee and represents the Rastriya Swatantara Party.

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