Between mid-June and mid-October alone, almost 37,500 Nepalis left for the UAE for jobs, placing it among the top destination countries. Many of these workers will likely be engaged in the delivery of the COP28 Climate Summit that will ironically be held in the UAE, the world’s fifth <a href="https://nepalitimes.com/news/nepal-s-greenwashing-in-glasgow">biggest</a> exporter of refined petroleum, with the head of the Abu Dhabi National Oil Company (ADNOC) service as conference president. Prime Minister Pushpa Kamal Dahal will lead the Nepali delegation.Migrant workers form <a href="https://worldmigrationreport.iom.int/wmr-2022-interactive/">88% of the UAE population</a>, so one cannot talk about COP28 or the UAE by ignoring migration. For Nepal, too, the climate crisis and the migration economy are linked.<a href="https://www.hrw.org/news/2023/11/21/uae-migrant-worker-abuses-linked-broader-climate-harms">New research</a> by Human Rights Watch (HRW) states that the COP28 host’s role in climate injustice goes beyond it being one of the largest fossil fuel producers and among the highest per capita emitters. It also relates to its treatment of migrant workers. HRW interviewed 151 current and former migrant workers and their families from Bangladesh, Pakistan and Nepal. Despite negligible per capita greenhouse gas emissions, the three countries are among the most climate vulnerable and have suffered extreme weather and slow-onset events linked to climate change.&nbsp; The climate impact countries like Nepal face should also be considered from the perspective of their mobile populations in the UAE and other countries. Migrant workers are exposed to extreme heat with inadequate protection, and because widespread abuse like wage theft and exorbitant recruitment fees limit the ability of workers to send home remittances, including during climate-linked emergencies. Dubai’s maximum temperature on some days <a href="https://www.khaleejtimes.com/uae/weather/uae-temperatures-cross-50oc-for-first-time-this-summer">exceeded</a> 50 Celsius this summer, and the UAE itself is vulnerable to heat stress due to atmospheric warming.The Intergovernmental Panel on Climate Change (IPCC) has said that the Gulf <a href="https://www.ipcc.ch/report/ar6/wg2/downloads/report/IPCC_AR6_WGII_Chapter10.pdf">states’</a> wet bulb globe temperature (WBGT) is ‘expected to approach, and possibly exceed, the physiological threshold for human adaptability (35°C) by the end of the century’. Migrant workers, including Nepalis, are disproportionately exposed.The most common heat mitigation strategy used in the Gulf including the UAE are ‘summer midday bans’ that stop outdoor work in the afternoons for a few hours. But a <a href="https://oem.bmj.com/content/80/6/347">study</a> in <a href="https://oem.bmj.com/content/80/6/347">Kuwait</a> found that despite the ban there was a substantial increase in the risk of occupational injuries associated with extremely hot temperatures. Another <a href="https://www.researchgate.net/publication/333293731_Assessment_of_Heat_Stress_Exposure_among_Construction_Workers_in_the_Hot_Desert_Climate_of_Saudi_Arabia">study </a>found that the highest heat intensity for workers in Saudi Arabia was from 9 am to noon, while the ban is in effect between noon and 3 pm. HRW’s research recommends that the UAE move away from arbitrary, calendar-based midday bans towards risk-based measures such as the WBGT.&nbsp; Heat is a health hazard. It can exacerbate pre-existing conditions, impair cognitive function, and increase the risk of workplace injuries and long-term illnesses like end-stage renal failures. Dialysis rooms across Nepal that are filled with Gulf returnees. &nbsp; HRW’s <a href="https://www.hrw.org/video-photos/interactive/2023/11/21/migrant-workers-bear-the-brunt-of-uae-extreme-heat">research</a> follows three dialysis patients who are all UAE returnees describing how they did not get support from the UAE. The Nepal government provides dialysis for free, but the cost of medicines, injections, and transportation add up. Chitrakala, the wife of a dialysis patient, Til, who accompanies him to the hospital multiple times a week for his dialysis says, “In some ways, I find it comforting to be at the hospital because in the waiting room, I realise I am not alone. It is not just my family that is facing this.”&nbsp; Another UAE returnee, Purna, says it is after he frequented the dialysis centre that he realised that kidney failure is common among migrant worker returnees. The situation will worsen in a changing climate. “The UAE is externalising their own climate risks onto migrant workers who are labouring under woefully inadequate protections. These workers often experience chronic health harms linked to extreme heat, and then return home without any compensation from the UAE and instead let countries like Nepal bear all the serious health costs like dialysis treatment,” says Michael Page of HRW.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20231124031152_7daf43db2cba93c6e81c6607aa61d07d3f3fbd4e2b338aadd2aaa4720828cb76.jpg" data-media-id="editor_9" data-image-id="20231124031152_7daf43db2cba93c6e81c6607aa61d07d3f3fbd4e2b338aadd2aaa4720828cb76" data-rendition-name="original" width="4032" height="2268" loading="lazy" alt="COP28 and migtants NT"> </figure>  There are other labour abuses like wage theft and exorbitant recruitment fees that also contribute to climate injustice, the HRW report argues. Climate emergencies back home exacerbate the mental stress of wage theft and recruitment debt as families in Nepal are in increasingly dire and even life-threatening situations.&nbsp; Workers HRW spoke to who were unable to send remittances because of labour abuses spoke of the dilemma they face: their families lose both critical financial support and the help they could have provided for urgent tasks like rebuilding damaged property had they stayed home. But for many, even exiting the UAE with outstanding recruitment debts or unpaid wages during such climate emergencies posed a challenge. Workers had to pay fees to retrieve their passports including by obtaining ‘reverse remittances’ on loan from families back home already reeling from life-threatening climate emergencies. Good migration can be transformative, but bad migration can be devastating for families. To be sure, remittances have been critical for economies of Nepal and other South Asian countries, but they do not substitute their responsibility. Historical and major greenhouse gas emitters also have a duty to support communities heavily impacted by the climate crisis. <a href="https://www.knomad.org/sites/default/files/publication-doc/migration_development_brief_38_june_2023_0.pdf">Remittances</a> are equivalent to a quarter of Nepal’s GDP, while Pakistan and Bangladesh are among the top 10 remittance recipients globally. Remittances have also been a lifeline including post-earthquake and during Covid. But these numbers mask the individual experiences of migrant workers and their families who face abuses and many of whom end up in financially worse situations than they did pre-migration. Virtually all migrant workers pay hefty fees for jobs which itself creates a huge dent on the returns to migration while excluding some of the poorest communities from even attempting to migrate. But even that does not guarantee a good job. The July 2021 <a href="https://www.icimod.org/article/the-melamchi-flood-disaster/">Melamchi flood</a> was a climate-induced disaster in Nepal, and one of its victims told HRW researchers: “During the flood, all we wanted was to save our lives. We survived, but we lost everything. The flood finished us.”His wife is headed to the UAE for a waitressing job which cost her Rs &nbsp;200,000, and borrowed at 24% annual interest. If all goes well, her first year’s salary of a mere $262 a month will just go to repay the loan. Another Sindhupalchok returnee from the UAE said, “Whether climate change or not, we have to migrate. We used to be self-sufficient but now have to buy food. Yields are lower. Insects and diseases are more common.” Climate change can be a compounding factor for longstanding emigration such as from Nepal to the Gulf, and adds to the burden of past, present and future migrant workers. The UAE is also being criticized for its restrictions on civil society and free expression during COP28. The HRW research states these affect migrant workers by limiting their ability to raise workplace concerns and seek structural, worker-centered reforms. The government’s opacity around <a href="https://pomeps.org/climate-the-environment-and-health-of-migrant-workers-lessons-from-kuwait">health data</a> hampers research for <a href="https://vitalsignsproject.org/wp-content/uploads/2023/06/Vital_signs_3_online.pdf">evidence-based</a> policymaking including for better outdoor protections, while academics and journalists tend to <a href="https://www.hrw.org/news/2021/10/01/uae-tolerance-narrative-sham-0">self-censor</a> to avoid reprisals. At the COP 28 in Dubai, Prime Minister Dahal would do well to dwell on the links between the host country and increasing climate vulnerability that Nepalis face both at home from weather extremes and heat stress at their workplaces in the UAE.

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Too hot to work

Migrant workers returning from the Gulf and Malaysia make up 40% of infertility cases at Paropakar Maternity and Women's Hospital in Kathmandu. Studies have highlighted the problem of sterility among men who have<a href="https://www.nepalitimes.com/news/caring-for-nepals-women"> returned from working abroad</a> in extreme temperatures and are prone to unhealthy lifestyles including smoking and alcohol consumption. Sarlahi resident Sanjeev Sah had gone to Saudi Arabia for work just a year into his marriage. Concerned about his wife having to raise a child alone during his absence, 32-year-old Sah and his wife postponed their plans for a baby. Three years later after his return, the couple has not been able to conceive. They sought treatment at Paropakar Hospital in Thapathali. Sah was diagnosed with azoospermia, with no measurable sperm count. “Doctors told me that working in high temperatures abroad reduced the quality of my sperm,” says Sah. Suraj Adhikari from Dhading worked in Malaysia for three years, He married at 28 but was unable to conceive with his wife and was also diagnosed with azoospermia at an infertility clinic. Adhikari worked at a construction site in Malaysia which left him little time for basics such as food and water. Despite<a href="https://www.nepalitimes.com/news/gulf-workers-need-protection-from-heat"> extremely high temperatures</a>, he often went without water for prolonged periods because it was not always available. Doctors blame his time and lifestyle for the decline in his sperm quality. “Neglecting essentials while working abroad has led to a costly and time-consuming treatment for me,” Adhikari laments.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20230903040916_17d0de92dd3eb03aa0e268ca5e30187ad21900f10f86f1bc6b7e9cc7ca1d540b.jpg" data-media-id="editor_2" data-image-id="20230903040916_17d0de92dd3eb03aa0e268ca5e30187ad21900f10f86f1bc6b7e9cc7ca1d540b" data-rendition-name="original" width="1200" height="800" loading="lazy" alt="Migrant infertility NT"> </figure>  Infertility is on the rise, globally and in Nepal. This is especially true for <a href="https://www.nepalitimes.com/banner/migration-not-a-wish-but-necessity-for-nepalis">workers returning</a> from the Gulf and Malaysia, having worked in hotter temperatures. Half of the patients with childlessness visiting the outpatient department at Paropakar Maternity and Women's Hospital every day are migrant returnees. “Working conditions with high temperatures reduces the quality and quantity of sperm in young men,” confirms Vinita Thapa, sperm specialist at the hospital. Shree Prasad Adhikari, the director of Paropakar Maternity and an infertility pathologist, notes that 25 out of every 100 couples face infertility presently, and the problem has now grown particularly among those returning from foreign employment. Two years ago, Tribhuvan University Teaching Hospital conducted tests on 186 men seeking infertility treatment at the institute. Of these, 46.2% had previously worked in the Gulf. The research report, published in the journal PubMed, revealed low sperm quantity and quality in some cases as well as a very low number of sperm capable of fertilising eggs in others. According to the WHO, one in every six adults, or 17.5% of the world’s population suffers from infertility. In Nepal, where children are seen as a form of security and add to the social prestige, infertility can have far-reaching implications. An increase in infertility could also be a contributing factor to an ultimate decline in <a href="https://www.nepalitimes.com/editorial/counting-on-nepal">population</a> together with delayed marriages. And yet, assisted reproductive technologies such as in vitro fertilisation (IVF) remain financially inaccessible and carry social stigma for many individuals.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20230903040916_fc6932b9f60d4f08e3c9834b4e141afba4d939726f297f9d4f1bcd8a674ebb23.jpg" data-media-id="editor_5" data-image-id="20230903040916_fc6932b9f60d4f08e3c9834b4e141afba4d939726f297f9d4f1bcd8a674ebb23" data-rendition-name="original" width="1200" height="800" loading="lazy" alt="Migrant infertility NT"> </figure>  A study by the Hebrew University of Israel and Mount Sinai School of Medicine in the US found that the average sperm count globally has decreased by half over the past 50 years. The study also revealed a decline in sperm quality, including a decrease in the number of sperm capable of fertilising eggs. Between the 1970s and 1990s, the rate of sperm count decline increased from 1.16% per year to 2.64% by the early 2000s. Paropakar Maternity and Women's Hospital introduced a semen storage service in June, allowing Nepalis to preserve semen and eggs if they require delayed childbirth. For instance, young individuals going abroad for a long time can <a href="https://archive.nepalitimes.com/article/nation/freezing-a-future-family-IVF-embryo-surrogacy,3881">store semen for reproduction</a> upon their return. Additionally, if the husband is absent, the wife can undergo artificial insemination using the stored semen, a technique called intrauterine insemination (IUI). In the IUI process, women are given medication and injections to stimulate egg production. Once mature eggs are produced, they are released through an injection. About 36-40 hours after releasing the eggs, a viable sperm is selected and placed into the uterus using a catheter, explains sperm specialist Thapa. The hospital is performing IUI on four to five women on a daily basis, at Rs5,000-10,000 per procedure. If pregnancy doesn’t occur after six IUI attempts, IVF is recommended. Adds Thapa: “Many are not aware but 90% of couples facing childlessness can be treated.” Since the introduction of the storage service in June, 15 couples have inquired but only two couples have agreed to store semen. The maternity home is also launching semen and egg donation programs wherein women having difficulty producing eggs can use donor eggs and the husband’s sperm. Similarly, when their husband’s sperm isn’t viable, the wife’s egg can be combined with donor semen for insemination.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20230903040916_bb962f67de4e8325418117724d37ab0d9cc744195c68224e45973832aad89be1.jpg" data-media-id="editor_7" data-image-id="20230903040916_bb962f67de4e8325418117724d37ab0d9cc744195c68224e45973832aad89be1" data-rendition-name="original" width="1200" height="800" loading="lazy" alt="Migrant infertility NT"> </figure>  “The stored semen remains effective for almost six years, retaining 60% of its initial quality,” assures Thapa. But more often than not, most childless couples fail to seek medical attention on time, resorting instead to shamans, witch doctors, and other ineffective measures. <a href="https://www.nepalitimes.com/news/nepal-s-first-human-milk-bank">Paropakar </a>is the sole government facility providing effective treatment for childlessness at present. Hospitals often lack counselling services. Infertility treatment depends on the underlying cause ranging from pharmaceuticals to embryo implantation through assisted reproductive technologies (ART). Some 80-90% of childless couples can find solutions through regular treatment, says Paropakar director Adhikari. He adds that weight loss could be a solution for obese women struggling with infertility. In the case of blocked fallopian tubes, there are medications. For those with uterine tissue growth causing pregnancy complications, surgery can help their chances. But while normal medication can stimulate egg production, up to 50% of women facing infertility lack viable eggs. “Some older women might have reduced fertility despite having eggs. In such cases, medications and hormones can increase their capacity,” says Adhikari, adding that the government doesn’t need as much resources to fight infertility as much as it needs commitment. Treatment needs to be scaled up to reach all the district hospitals so that couples can easily access artificial insemination and other services while also promoting awareness and reducing the <a href="https://www.nepalitimes.com/opinion/maybe-baby">stigma associated with childlessness</a> in Nepal. The fact that migrant workers who are in every sense the backbone of Nepal’s economy don't have access to treatment means it is even more crucial that infertility, the stigma and the treatment are prioritised and effectively addressed. &nbsp;

Migrants returning from the Gulf with infertility

Climber, expedition leader and later a supplier of bottled oxygen to Himalayan mountaineers, Henry Barclay Todd died on 3 November 2025 in his favourite place on earth, Kathmandu.&nbsp;
Todd was larger than life, a metaphor often used, yet it could not be more fitting. Standing nearly 2m tall, and possessing an unshakeable will, he lived life on a grand scale, both in body and spirit.&nbsp;
Todd was a pillar in the Himalayan climbing community, supporting many mountaineers across Nepal and Pakistan, making it possible for them to fulfil the dream of standing on the world’s highest peaks. He believed deeply in the strength, skill, and potential of the Sherpa people, and offered them opportunities that might otherwise have remained out of reach.&nbsp;
“Thank you, Henry. Your trust changed my life. Rest in peace, my leader, my teacher, my friend,” said Dorjee Gyelzen Sherpa in his tribute.
Born in 1945 to Royal Air Force officer Henry Todd and May Todd of the Women’s Royal Air Force, Henry spent his early years in Singapore. He led a lively childhood with his two brothers, far removed from the mountains that would later define his path.&nbsp;
A gifted swimmer like his father, Henry never pursued the sport professionally. Instead, after returning to Dundee as a teenager and attending seven different schools, he set off for London, where he began working for an insurance company before finding his true calling in adventure.
Henry Todd first came to Nepal in the mid-1980s and made his first attempt on Ama Dablam in 1987, an expedition that marked the beginning of an extraordinary and colourful climbing career. <a href="https://www.himalayandatabase.com/" target="_blank">The Himalayan Database</a> lists 61 expeditions that he led in Nepal alone — there were more in the Karakoram, Argentina and the Alps.&nbsp;
But Todd would joyfully say that a few hard Scottish ascents held a more personal meaning to him than even the greatest Himalayan summits.
Over the decades, he crossed paths with many legendary climbers like Anatoli Boukreev, Jerzy Kukuczka, Doug Scott and Chris Bonington as well as celebrities including members of Pink Floyd and Nobel Prize laureates whom he befriended.&nbsp;
He had a gift to never name-drop, but would simply mention that he had had lunch with Minnie Driver (niece of his long-time friend Andra) or that he had bought his first car from Donald Sutherland. For Todd, these were not bragging rights, they were simply part of the colourful tapestry of his life.
Todd’s life was filled with extraordinary experiences from surviving plane crashes, avalanches and earthquakes to quietly solving countless problems, which was one of his favourite past-times. His hands, famously large and steady, were always ready to help whether in the chaos of the mountains or the calm of a base camp.&nbsp;
With his sharp sense of humour and the beloved exclamation “Whoopie!”,he could bring lightness even to the toughest moments. He never tired of taking on challenges or helping when someone was in need, and he enriched so many people’s lives with his endless stories.
His legacy is immense. He helped build the human backbone of Himalayan climbing, enabling generations of climbers to test themselves in the world’s highest places. With his passing, an era of bold, spirited Himalayan guiding has come to a close.
Todd survived by a loving family, many close friends and a global community of climbers and Sherpas who will never forget him and his endless tales.&nbsp;
His family said in a statement: ‘Henry’s strength, warmth and unyielding belief in others will live on far above the clouds. He was indestructible in our eyes and in our hearts, he always will be.’
There will be a memorial service at Pashupati Temple in Kathmandu on 8 November 2025 around lunchtime.

Henry Barclay Todd, 80

The autumn mountaineering season is not over yet, and already there have been 12 fatalities on Himalayan peaks in Nepal.
Of the 1,450 climbing permits issued, 436 were for Mt Ama Dablam (6,812m), 374 for Mt Manaslu (8,163m) and 186 for Himlung Himal (7,126m). There were deaths on all three mountains.
The death of two French climbers on Ama Dablam happened before unseasonal blizzards hit the mountains. But Cyclone Montha from the Bay of Bengal brought on high winds and up to 1m of snow in the peak trekking and mountaineering season.
This increased avalanche conditions, and made helicopter evacuation of stranded and injured climbers difficult. Lower down the mountains, more than 1,000 trekkers from Nepal and around the world were stuck in the Annapurnas, Manaslu circuit and the Khumbu.
However, there have also been allegations that it was not just the weather that delayed rescues. Multiple levels of bureaucracy and the need for flight permits to restricted areas like Manang and Manaslu critically delayed evacuation flights.
Italian climbers Farronato Stefano and Caputo Alessandro were found dead in their tent at Panbari Himal Camp I (6,887m) in the Manaslu area. They had been trapped by heavy snowfall since 28 October, and their bodies were found on 4 November by a team from the expedition organisers, Sherpa Alpine Trekking Service. The team was made up of high level mountain guides and expedition leader Valter Perlino.
The team had been climbing to Camp 3 but decided to descend to base camp because of thrombosis in Perlino’s left foot. The two climbers who would eventually get trapped decided to break at Camp I, a decision that would prove fatal after the projected six-day snowfall arrived two days early.
“They were sleeping in a tent and were buried under 2.5 metres of compacted snow. It happened during the night between Thursday and Friday. While they were sleeping, absurd,” said Perlino.
A deadly incident took place the morning of 3 November, when five foreigners and two Nepalis died in an avalanche on Yalung Ri at 5,630m in the Rolwaling. They were part of a larger group of 15 that were acclimatising for an attempt on the nearby Dolma Khang (6,332m).
Local authorities in Gauri Shankar Conservation Area say calls were immediately made to helicopter companies as well as various ministries in Kathmandu that have to issue permits to fly to the region bordering China.
But the permits for rescue flights to Rolwaling Valley were delayed by eight hours. Rescue flights in these areas require permission from the Ministry of Tourism, the Ministry of Defence, the Home Ministry, and the Civil Aviation Authority of Nepal (CAAN).
Experts say this should be exempted in times of emergency when time is of the essence. CAAN spokesperson Pratap Babu Tiwari claimed to not know of the avalanche on Yalung Ri and deflected questions to the permission department.&nbsp;
There was a similar tragedy on Himlung Himal in Manang as well. Australian Chin-Tark Chan, 49, was climbing with 8K Expeditions and fell ill on 27 October at about 6,800m, developing snow blindness and loss of mobility. The guides immediately called the US insurance company Global Rescue for authorisation of a longline rescue.
Global Rescue refused, saying a rescue at that height would violate Nepal’s aviation rules and put the pilot at unacceptable risk. They asked the guides to transport Chan to Camp 3 at 6,400m to a permitted altitude. Seeing it was a life-or-death situation for its client, 8K called in an aerial rescue anyway, but the helicopter could not land due to bad weather. Chan died slightly below Camp 3 on 29 October.
Global Rescue said in a statement that it was ready to send in a helicopter after Chan had been transported to Camp 3, but several hours were lost for that attempt, and the weather did not get better in the next few days.
To underscore just how dangerous helicopter rescues in the Himalaya can be in bad weather, a chopper from Altitude Air skidded off the helipad at Lobuche below Mt Everest while trying to rescue trekkers in whiteout conditions.&nbsp;
CAAN announced a ban on flights during blizzards or dense fog. While rescue missions are often heroic and courageous, they should not be foolhardy if conditions are unsafe and the risk to pilots and rescuers too high. This autumn was a lesson for future expeditions and for the Nepal government.&nbsp;
The Italian duo on Panbari were caught out by snow that arrived two days ahead of schedule, but the group on Yalung Ri should have postponed their ascent after multiple warnings from the Department of Hydrology and Meteorology to avoid high altitudes.

Deadly autumn in Himalayan climbing

This is the 73rd episode of Diaspora Diaries, a Nepali Times series in collaboration with Migration Lab providing a platform to share experiences of living, working and studying abroad. I don’t remember playing with dolls as a little girl. There is not much to remember from my childhood.&nbsp; My responsibilities began at a very young age, as I had two younger brothers to take care of. I was born in Sarlahi, but we moved around quite a bit as my father was in the government and got transferred frequently.&nbsp; From Rasuwa to Dang, from Nepalgunj to Kathmandu. I struggled to adjust in Kathmandu because I joined Grade 9 in the middle of the term. The education was different and fellow students also did not support me initially. But over time, I adjusted and made friends. I did not dream of becoming a nurse. It was by accident. I wanted to pursue medicine, but failed the entrance exam by a few marks. I did not want to lose a year, so decided to take up microbiology instead.&nbsp; I got married after my undergraduate, and my husband encouraged me to take up something more technical like nursing or engineering instead of Masters in Microbiology. As my quantitative background was weak, I chose nursing. I felt like I was born to be a nurse. Juggling my married life and studies was difficult. My teachers would often ask me why I am falling behind. It was not easy, but I managed and took up a full-time job as a nurse. There are challenges being a nurse in Nepal. You are overworked, underpaid, there is lack of appreciation. Superiors can be overbearing. These problems persist. But the bright spot is that you get to serve fellow Nepalis, and be close to your family.&nbsp; Just like I had no intention initially of becoming a nurse, I had no intention of migrating overseas. But life had different plans for me. After my baby boy was born, I noticed that something was off. Even at nine months he had not started crawling or sitting. As a nurse I knew something was wrong, and I took him for check-ups. He tested negative for down syndrome, but he had a heart defect.&nbsp; The cardiologist recommended that I take him to India where he was diagnosed with Williams Syndrome, a rare genetic condition that affects 1 in 10,000 people. It delayed his development. I looked for therapy. It was either not effective, or too expensive. Some schools also refused to admit him, and it drove me to tears.&nbsp; My family members overseas in the UK, US told me to emigrate as there were better facilities for differently abled children. So I decided to apply to the UK. Luckily just then there were calls for candidates under the Nepal-UK government-to-government pilot scheme for 100 nurses. Only 40 met the criteria, and I was one of them.&nbsp; I still remember the day I received the news on the day of my puja. There were people around me, and they told me that it was the result of my fasting and devotion on that auspicious day. Perhaps it was. Life was taking a new turn, and I was happy. I made it to the UK in February 2024 without paying a single paisa to any broker. The G2G scheme was unique as we were treated with dignity and valued for our skills: they covered costs for the ticket and visa, reimbursed us for exams we had taken and costs involved in the preparation and testing of the Objective Structured Clinical Examination were also covered.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251106071148_dc5a0d0ea3024b34a4f2735754f8eb67a650bc7f61b98c75d589676c65b02a0c.jpg" data-media-id="editor_0" data-image-id="20251106071148_dc5a0d0ea3024b34a4f2735754f8eb67a650bc7f61b98c75d589676c65b02a0c" data-rendition-name="original" width="1200" height="1600" loading="lazy" alt="Nurses NT"> </figure>  It was of course difficult to leave my son behind. But I was doing it for his future. I had the option of taking him from the start, but it was a new place and I wanted to be well-settled and knowledgeable about the options available for him before bringing him along. As I packed, he would ask me to take him with me in my suitcase. It did not seem like he was affected by my departure, and it was only later that his teachers said that he would express his feelings more openly at school. He just did not know how to tell me he missed me, and he would tell teachers he was worried I had forgotten him if we did not speak for a day.&nbsp; He missed me, and that realisation made me emotional. But I had to carry on. Life in the UK was difficult in the beginning. Even so, I wanted to prove to myself that I could do it. Fortunately I had cooperative staff who patiently answered my questions. I think I would have been irritated if I were in their place. But they did not seem to mind, and their support and guidance made it easy for me to adjust to the new work environment. APPRECIATION I still struggle to understand the accent of my English patients, and have ask the matron for help. They compliment me on my English, but I can speak better than I understand. The good thing about working in the UK is that you are appreciated for your work, which can be motivating. Sometimes, after a long day’s work you get a message from your supervisor acknowledging your work with a thank you. That’s enough to erase your tiredness.&nbsp; So far I have received 32 WOW nominations which are acknowledgements from patients for a job well done. It can be motivating, especially in the beginning. The main difference between the Alpana who first left Kathmandu for the UK and the Alpana now is that I am a much more confident person. What makes a good nurse? Skills, knowledge and qualifications are of course a given. But mostly, you need humanity. A smiling face. The way you communicate. Your empathy. These attributes can already solve many problems that patients are facing. This is my second time back home in the last 20 months. And this time, I have arranged for my son’s visa. I will go back after Tihar with my son and husband.&nbsp; I am happy, but also a little nervous about what awaits us. What kind of school will I put him in? Will it really be different from schools here? Will his needs be addressed? Will it be like here, or will he be able to adjust?&nbsp; But I am determined to make it work. Success for me would be if he adjusted well and there is a change in his condition. He still cannot recognise alphabets and read words like kids in his age group. Hopefully he will get learning support in the UK. He also has a knack for music, and this is common among individuals with Williams Syndrome. His ears perk up when he hears music, and he takes part in musical events at school. He still does not recognise letters &nbsp;but he uses voice commands to search for guitar videos on YouTube. I will enrol him in music classes, and help him develop this gift. For now, I worry how he will behave on his long flight. He has a short attention span and gets restless. He is also very social and will want to speak with everyone around him, and might irritate fellow passengers.&nbsp; I have already started trying to make him understand that he will need to behave on the flight. He nods in agreement. Let’s see how it goes. &nbsp;

“I felt like I was born to be a nurse”

A month after September’s GenZ movement in Nepal, nurses working in private hospitals took to the streets demanding better work conditions, and salaries equal to what government nurses are paid.&nbsp;
The strike started at Pokhara’s Manipal Teaching Hospital before spreading nationwide, and nurses working at government hospitals joined in.&nbsp;
Nurses at private hospitals are forced to work for far less than Nepal’s minimum monthly wage of Rs19,550 — without overtime, breaks, and other benefits and under physically and mentally taxing conditions. This is driving many qualified nurses to emigrate.
For newly-appointed Health Minister Sudha Sharma Gautam in the interim government, the strike became her first order of business. She met representatives of the Nursing Association of Nepal (NAN), the protesting nurses, and others from the health sector.&nbsp;
An agreement was reached under which private hospitals and medical colleges will pay nurses a minimum monthly salary of Rs34,730. &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
“It is a shame that nurses have been working under such exploitative conditions all this time” says Radha Adhikari, at the School of Health and Life Sciences of the University of the West of Scotland. “The agreement is basic, and there is a long way to go to improve their working conditions. But it is a start.”
NAN chair Chandrakala Sharma has said the ministry’s task force to look into working conditions will also look into facilities for nurses in government hospitals.&nbsp;
“We are committed to solidifying the wage agreement by amending relevant laws within this month,” Sharma said in a video posted by NAN on Facebook. “Our movement is not over, we are still protesting and &nbsp;following up with the Ministry.”
NAN issued an ultimatum to the government to implement the agreements within 48 hours. That deadline has now lapsed and the nurses are back on strike. Many of those protesting now accuse NAN of betraying them.
Jyoti Ranabhat of the Nurses Struggle Committee was present in the meeting, but refused to sign the agreement. “It did not address what we were demanding, we will now go it alone into Plan B,” she tells Nepali Times.&nbsp;
Previous grievances of the nurses did result in similar agreements, but private hospitals failed to comply with government’s past directives — most recently the minimum salary and benefit determined by the state in December 2024.&nbsp;
The Nepal Nursing Council says there are 126,580 registered nurses, specialists, midwives, and Auxiliary Nurse Midwife (ANM) professionals in Nepal. Yet, nursing positions at hospitals remain vacant.&nbsp;
The reason for understaffing is a mass emigration of medical professionals, including nurses. Nursing student enrollment is also declining and there is disinterest in a profession that does not afford health workers quality of life, respect, or dignity.
“Our fight is not with the private sector, it is by definition profit-oriented, our grievance is with the state,” says Ranabhat. “The government is responsible to provide us dignity, respect, and fair pay.”&nbsp;
GREENER PASTURES
Poor pay and working conditions are driving doctors and nurses abroad in large numbers in recent years. Many have simply quit the profession, leading to a shortfall in medical professionals. 

The shortage of nurses is a global phenomenon, and countries like the US, UK and Australia have compensated for their own shortage by offering jobs from countries like the Philippines, India and Nepal.&nbsp;
Nepal Nursing Council data shows that outmigration of nurses rose sharply after 2002, and an estimated &nbsp;20,000-45,000 nurses have left since.
“The state’s denial, derision, and disregard of nurses has caused resentment and disillusionment in the community, driving nurses out,” says Ranabhat. “Ultimately, Nepalis will pay the price when there are no nurses left here.”
Many Nepali nurses who have gone abroad are happy with the respect and quality of life in their jobs abroad. But many others face exploitative recruiters in Nepal and employers abroad. Nursing consultancies have mushroomed as nursing colleges struggle to meet demand.&nbsp;
Adhikari herself worked at United Mission Hospital Tansen before moving to the UK 30 years ago, and remembers that working conditions then were much better for nurses.&nbsp;
“Nepal’s health sector has gone downhill since privatisation,” she states. “Medical colleges are only concerned with supplying doctors and nurses internationally, because that is what makes money.”
But once Nepal’s nurses are abroad, there is no guarantee that they will have jobs in the nursing sector. Many find themselves working outside their field of expertise, in hospitality or sales.&nbsp;
“Nepal has become a production hub for nurses, and Nepali nurses have become products for export,” adds Ranabhat. &nbsp;“People might think this will add to remittances, but no one is thinking about what will happen to Nepal’s health sector.”&nbsp;
For many, nursing has become a way out of Nepal rather than a vocation. In 2022, the government signed an agreement with the UK to send Nepali nurses to work there at zero cost, with benefits and protection equal to UK nurses.&nbsp;
The pilot phase was expected to recruit 100 nurses, and applications opened in July 2023, with 45 nurses said to be selected by Britain’s NHF representatives by the end of 2023. Forty-one of them obtained labour permits.&nbsp;
They may be treated well, but the reality of working in the international health sector is not as straightforward.
Radha Adhikari told us from Scotland: “Market saturation, exploitation, discrimination based on race, gender, and foreignness prevent nurses from finding the right, respectful jobs even here. Ultimately, migration cannot be sustainable for Nepal’s nurses.”

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