Lack of access to and awareness of family planning, the prevalence of unhealthy superstitions and taboos, and the desire to produce a son together explain why Nepal’s average fertility rate has stalled after a steep drop in the last decades.Many families in the far western hills and the central Tarai still believe that contraceptive use is against god’s wishes. These areas also tend to be steeped in patriarchy, with low female literacy rates and a high incidence of child marriage.It is a vicious cycle: women are anemic, malnourished, uneducated, disempowered, physically weak because of annual pregnancies, and poor. And they do not use family planning methods even when they are available at rural health posts.Read also:<a style="background-color: #ffffff; font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/opinion/miracle-drug-to-reduce-maternal-deaths/" target="_blank" rel="noopener">Miracle drug to reduce maternal deaths</a>, Buddha Basnyat<a href="https://www.nepalitimes.com/here-now/who-will-save-nepals-poor-new-mothers/" target="_blank" rel="noopener">Who will save Nepal’s poor pregnant women … a government plan, or God?</a>, Rojita Adhikari<a href="http://archive.nepalitimes.com/blogs/thebrief/2011/09/22/nepals-work-in-maternal-health-noticed/" target="_blank" rel="noopener">Global recognition for Nepal’s maternal health program</a>, Nepali TimesIn these villages in the mountains of Bajura, Achham and Baitadi there are many families where a mother and her daughter are giving birth simultaneously. The region’s medical services are also basic, which means a low incidence of institutional delivery and a maternal mortality rate that remains more than twice the national average.The government offers five types of contraception for free in health posts: condoms, pills, injectables, implants and intrauterine contraceptive devices (IUCDs). However, belief that contraceptives affect health or the unavailability of the desired device means many do not opt for family planning.“Every day an average of five women come to our health post to ask about long-acting contraceptives like IUCDs or implants, but we either do not have the devices or the trained health workers to insert them,” shrugs Sabina Thapa, a nurse at a Bajura health post. “Even women on pills miss the timeline and get pregnant.”Read also: <a href="https://www.nepalitimes.com/here-now/nepal-far-from-hitting-contraceptive-target/" target="_blank" rel="noopener">Nepal far from hitting contraceptive target</a>, Sewa Bhattarai<a href="http://archive.nepalitimes.com/news.php?id=14551#.Xk6ENzIzbIU" target="_blank" rel="noopener">Treating pain and shame</a>, Mallika AryalCurrently, 43% of all married women of reproductive age in Nepal use modern contraceptives, and another 10 % use traditional family planning methods. A 2016 survey showed that there is a 44% unmet need for family planning measures in Nepal.A recent report by the <a href="https://www.guttmacher.org/fact-sheet/adding-it-up-meeting-contraceptive-mnh-needs-nepal" target="_blank" rel="noopener">Guttmacher Institute</a> showed that Nepali women have 1.2 million pregnancies each year, of which 539,000 are unintended. Nearly a quarter of these result in unplanned births and two-thirds are aborted.“Actually, we have achieved a lot with the little money we have invested,” explains Bhim Singh Tinkari of the Family Welfare Division in Kathmandu. “But the money is mainly to buy contraception and family planning products. There is a huge gap in contraceptive supply, public awareness and trained health workers.”“If all unmet need for modern contraception were met, unintended pregnancies would be reduced by 87%, or 469,000 annually, and unplanned births, abortions and miscarriages would decline by the same proportion. Fully meeting women’s need for contraception would reduce maternal deaths,” The Guttmacher Institute report concludes.To address the unmet need would cost only $30million according to a survey, but this is five times more than the government’s current family-planning budget. Without this funding Nepal is unlikely to meet the Sustainable Development Goals (SDG) target of 75% contraceptive prevalence.“The situation has become more complicated than before with the new federal system. Local health needs are now the responsibility of provincial and municipality governments, but work has not started yet,” says Tinkari. “We need the money and we need to act soon if we are to meet the 2030 target.”<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109101136/636b75319c7e80680e0623d8jpeg.jpg" alt="" width="1500" height="1000"/><figcaption>Kewara Koli, 34, is already mother to seven daughters and one son. Her eldest daughter, Laxmi, is in Grade 10 at a local school in Baitadi. Laxmi advised her mother to get an implant from a nearby health post. “My mother was giving birth every two years, and she became weaker after every baby,” says Laxmi (standing at back).</figcaption></figure><figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109101136/636b75349c7e80680e0623d9jpeg.jpg" alt="" width="1500" height="1000"><figcaption> </figcaption></figure><figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109101136/636b75379c7e80680e0623dajpeg.jpg" alt="" width="1500" height="1000"><figcaption> </figcaption></figure><figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109101136/636b753b9c7e80680e0623dbjpeg.jpg" alt="" width="1500" height="1000"><figcaption> </figcaption></figure><figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109101136/636b753e9c7e80680e0623dcjpeg.jpg" alt="" width="1500" height="1000"><figcaption> </figcaption></figure>Read also: <a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/globe-rallies-to-aid-nepals-women,3841" target="_blank" rel="noopener">Cutting the lifeline</a>, Kate Ryan<a href="http://archive.nepalitimes.com/article/nation/people-politics-placentas-child-delivery-complications,3922" target="_blank" rel="noopener">People, Politics, and Placentas</a>, Bikash Gauchan

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No conceivable reason for unwanted pregnancies

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109101120/636b70d49c7e80680e06009bjpeg.jpg" alt="" width="1500" height="803"/><figcaption>Photo : UNICEF</figcaption></figure>Last month, the prestigious <a href="https://www.nejm.org/" target="_blank" rel="noopener">New England Journal of Medicine</a> published a study of the <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa1905047" target="_blank" rel="noopener">successful trial of a new typhoid vaccine</a> that could prevent thedeaths of many children around the world. The vaccine research was conducted at Patan Hospital by a Nepali researcher.The randomised control trial of the typhoid conjugate vaccine (TCV) was conducted among more than 20,000 participants in Lalitpur district, and the efficacy of the new vaccine was found to be 81.6% -- a major improvement on previous vaccines. (See box below).The positive news from Nepal came as various parts of the world, including the US, Europe, Samoa and Africa, struggled to cope with the biggest measles outbreak in decades. Most of the cases have now been associated with people forgoing recommended preventive shots because of fears of side-effects fanned by social media.Fear of vaccination started ever since a paper in 1998 in the medical journal <a href="https://www.thelancet.com/" target="_blank" rel="noopener">The Lancet</a> cited a link between autism and the <a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/maurice-hilleman-the-vaccine-man,1852" target="_blank" rel="noopener">measles, mumps, rubella (MMR) vaccine</a>. The research was later found to be fraudulent and retracted, but the anti-vaccine movement gained traction again in the past year after the rumours resurfaced on the Internet resulting in families rejecting early childhood immunisation against diseases like polio, rubella and measles.“The good news is that unlike in the rest of the world, people in Nepal demand vaccines. If we miss to vaccinate a child for any reason, parents come knocking, asking for the shots,” says Jhalak Gautam of the Family Welfare Division at Teku.Sameer Mani Dixit of The Centre for Molecular Dynamics Nepal concurs. “Entire communities actively participate in vaccination programs and are well aware of the benefits. Every mother in Nepal knows the immunisation schedule by heart.”The Centre for Molecular Dynamics Nepal has just completed a study on why the country has been so successful with its immunisation program, and the results will be published later this month. This study and similar studies underway in Senegal and Zambia are being conducted with  funding from the Bill and Melinda Gates Foundation, in an effort to analyse the success of vaccination programs in developing nations.Nepal’s national immunisation program started in 1988 and now vaccinates some 620,000 children under 15 months of age every year against 11 infectious diseases such as <a href="https://www.nepalitimes.com/banner/tb/">tuberculosis</a>, <a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/Bouncing-back-higher-wheelchair-basketball,3802" target="_blank" rel="noopener">polio</a>, pneumonia and measles.The last case of <a href="https://www.nepalitimes.com/banner/polio-hunt/" target="_blank" rel="noopener">polio</a> was detected in Rautahat district in 2010, and Nepal was declared polio free four years later. The country also eliminated maternal and neonatal tetanus in 2005. Similarly, Japanese encephalitis, diphtheria, pertussis and pneumonia have all been controlled, and there are regular vaccinations against congenital rubella syndrome and hepatitis B.Despite the high immunisation rate, thousands of Nepali children continue to die due to easily preventable and treatable communicable diseases <a href="https://archive.nepalitimes.com/news.php?id=16988#.XiBL7_4zaUk" target="_blank" rel="noopener">like diarrhoea</a> and according to Nepal Demographic Health Survey 2016, one in a hundred Nepali children have still not been vaccinated against any infectious diseases.Read also: <a href="https://www.nepalitimes.com/here-now/nepal-is-a-microcosm-of-all-of-the-changes-in-world-health/" target="_blank" rel="noopener">"Nepal is a microcosm of all the change in world health"</a>Immunisation coverage data from last year also shows a worryingly high dropout rate. While 93% of newborns received BCG jabs, the first in the national immunisation schedule, the coverage dropped to 73% by the time children received the last vaccine, an immunisation against measles and rubella, recommended at the age of 15 months.Several cases of <a href="http://archive.nepalitimes.com/news.php?id=186#.XiBGW_4zaUk" target="_blank" rel="noopener">measles</a> have been detected in Kapilvastu, Dang, Makwanpur, Sarlahi and Manang districts recently, and Nepal has not been able to meet its previously set target to eliminate measles and rubella by 2019. The new goal is to eliminate the diseases by 2023.“Dropout rate is a challenge, we have not been able to reach the remotest corners of the country, and children miss their shots because of migration,” says Jhalak Gautam. “We now have a strategy to identify missed pockets and deliver shots at home if required.”The Immunisation Section of the Ministry of Health is now gearing up for a nation-wide measles-rubella vaccination campaign aimed at those who might have missed routine shots. Three million children between the ages 9 months to 5 years are expected to participate in two phases of the campaign later this year.Polio drops will also be administered at the same time to 1.5 million children under five in 19 Tarai districts. The Immunisation Section is also introducing a new vaccine against rotavirus this June to reduce the prevalence of childhood diarrhoea.The new challenge to vaccination comes from an unlikely quarter: federalism. There is confusion about where the vaccines are sourced and who should pay for them. There is concern about the quality of vaccines, many of which need a cold chain with refrigeration to the point of delivery.Warns Patan Hospital physician Buddha Basnyat: “Nepal’s immunisation program is a model of success, but we cannot afford to be complacent.We have to introduce newer and more effective vaccines while also prioritising hygiene and <a href="https://www.nepalitimes.com/banner/toilet-trained/" target="_blank" rel="noopener">sanitation</a> simultaneously.”<h2>Successful trial of new typhoid vaccine</h2><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109101120/636b70d79c7e80680e06009cjpeg.jpg" alt="" width="1500" height="1000">Over 20,000 children between 9 months and 16 years of age in Lalitpur district participated in the <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa1905047" target="_blank" rel="noopener">first large-scale randomised controlled trial</a> of a new vaccine against <a href="http://archive.nepalitimes.com/news.php?id=17306#.XiBGav4zaUk" target="_blank" rel="noopener">typhoid</a>, a disease that affects millions across South Asia.Half of them received the vaccine and the other half received control shots. The efficacy of Typhoid Conjugate Vaccine (TCV) was found to be 81.6%, and the results were published last month in the prestigious New England Journal of Medicine.Prior to this, a small-scale TCV trial was conducted in Britain, and the World Health Organisation (WHO) has since strongly recommend the use of the vaccine for countries and regions where the water and food-borne infection is most common. "Pakistan has been able to control typhoid with this vaccine and <a href="https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(19)30320-1/fulltext" target="_blank" rel="noopener">Vietnam</a> has eliminated it," says lead author of the paper, Mila Shakya, "Administration of this new, effective vaccine by our government will help control the most common bacterial disease in Nepal and South Asia."<a href="http://archive.nepalitimes.com/news.php?id=12158#.XiBGbP4zaUk" target="_blank" rel="noopener">Typhoid</a> is a contagious infection caused by the bacteria Salmonella typhi, which is found in contaminated food and water and which causes fever, diarrhoea and vomiting. It can easily be prevented with awareness, safe drinking water and frequent hand-washing.The vaccine is useful because it is a prophylactic in places where preventive measures are taking time to implement. There are some 21 million typhoid cases and 161,000 typhoid-related deaths annually worldwide. South Asia has been often dubbed as the hub of typhoid and there are some 500 cases per 100,000 population in the region.“This study is Nepal taking a lead in preventing typhoid, after never having really prioritised it. It might not kill as many people as other diseases do, but it still affects thousands of school-going children,” says physician Buddha Basnyat at Patan Hospital.TCV is <a href="http://archive.nepalitimes.com/news.php?id=18178#.XiBGdP4zaUk" target="_blank" rel="noopener">not the first typhoid vaccine to be developed</a>. Currently there is an injectable unconjugated polysaccharide vaccine for persons aged two years and above, and an oral capsule for those over six years of age. But they do not work well on young children and they provide protection only for a few years. TCV on the other hand can be given to children below 2 years and the immunisation lasts up to five years.“A single dose of the new vaccine is safe, immunogenic, and effective, and the deployment of the vaccine will reduce the burden of <a href="https://www.nepalitimes.com/opinion/so-far-so-good/infectious-enthusiasm-for-travel/" target="_blank" rel="noopener">typhoid</a> in high-risk populations,” stated the interim analysis. “This new evidence of efficacy is especially timely with the recent spread of extensively drug resistant typhoid fever, which threatens child health in affected regions.”Pakistan, which has been struggling against an outbreak of drug resistant typhoid fever since 2016 is already using TCV with positive results and its Sindh province will become the first region in the world to include TCV in routine childhood immunisations.<a href="https://www.gavi.org/" target="_blank" rel="noopener">Gavi, the Vaccine Alliance</a>, which has earmarked $85 million to fund the introduction of the vaccine in the world’s poorest countries, is supporting the program. Nepal is also eligible for funding from the alliance.Says Basnyat: “We should take action before we are also hit, like Pakistan, by the drug-resistant typhoid. What are we waiting for, when Gavi is ready to fund the vaccination program for free and its benefits are so clear. This is a case of vaccine under-utilisation.”Sonia Awale

Sonia Awale

A shot in the arm for vaccines in Nepal

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108151124/636a66fa9c7e80680e0599b4jpeg.jpg" alt="" width="1500" height="1081"/><figcaption>Photo : BIKRAM RAI</figcaption></figure>Nepal is recognised as the only low-income country to have made rapid progress cutting poverty and boosting public health and education in recent decades. But can these achievements be sustained in the 2020-2030 decade?The <a href="https://archive.nepalitimes.com/regular-columns/GUEST-COLUMN/Saving-one-mother-at-a-time,816" target="_blank" rel="noopener">country’s maternal mortality rate decreased</a> from 539 deaths per 100,000 live births to 239 deaths between 1996 and 2016. The adult literacy rate rose from 20% in the 1980s to 67% in 2018, and the proportion of Nepalis living below the poverty line <a href="https://www.nepalitimes.com/banner/nepals-great-income-divide/" target="_blank" rel="noopener">dropped from 42% to 21% in two decades</a>.Yet the poorest still <a href="https://www.nepalitimes.com/banner/federalism-leaves-nepals-medical-sector-ailing/" target="_blank" rel="noopener">do not have access to affordable healthcare</a>. The school dropout rate is as high as the <a href="http://archive.nepalitimes.com/news.php?id=41#.XftNv5MzaUk" target="_blank" rel="noopener">enrolment rate</a>. In urban centres, people breathe <a href="https://www.nepalitimes.com/here-now/air-pollution-is-more-dangerous-than-smoking/" target="_blank" rel="noopener">some of the foulest air in the world</a>, reducing their life expectancy by up to four years. Many lack safe drinking water.Read also: <a href="https://www.nepalitimes.com/?p=38023&amp;preview_nonce=024823c344&amp;preview=true" target="_blank" rel="noopener">Towards 2030</a><a style="background-color: #ffffff; font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/?p=38038&amp;preview_nonce=e8166bf726&amp;preview=true" target="_blank" rel="noopener">Another decade to get it right,</a> Editorial<a style="background-color: #ffffff; font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/?p=38061&amp;preview_nonce=012fb23553&amp;preview=true" target="_blank" rel="noopener">Nepal in the 2020s,</a> Sewa BhattaraiLocal elections in 2017, after a gap of 20 years, were supposed to close these gaps by delivering accountable, elected leaders. Two years later, the euphoria has evaporated. The state of the state remains stagnant.“The elections helped us rebuild grassroots democracy and decentralise power, but the lack of accountability at all levels of government continues to be a major challenge,” says Min Bahadur Shahi of the National Planning Commission (NPC). “This is why the primary agenda of the NPC’s 15th periodic plan is governance reform, controlling corruption and promoting transparency.”As we step into the new decade, there are questions about Nepal’s progress in human development, including whether we are on track to meet the UN’s Sustainable Development Goals (SDGs) and achieve double-digit growth. Reaching these targets will require huge investments in healthcare, schools and nutrition. With the <a href="https://www.nepalitimes.com/editorial/poor-health-makes-nepalis-poorer/" target="_blank" rel="noopener">emergence of non-communicable diseases</a>, Nepal now faces a double burden: rising rates of <a href="https://archive.nepalitimes.com/article/nation/diabetes-in-south-asia,3018" target="_blank" rel="noopener">diabetes</a>, cardiovascular diseases and cancer, which are expensive to treat, while the poor continue to die of easily curable infections.Said Sanjib Sharma, doctor at the BP Koirala Institute for Health Sciences in Dharan: “Our efforts now should be on strengthening primary health care and prevention and early detection of diseases using existing tools, as well as new technologies such as artificial intelligence for virtual expert consultation and drug delivery.”Read also: <a style="background-color: #ffffff; font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/?p=38051&amp;preview_nonce=38f8426e6c&amp;preview=true" target="_blank" rel="noopener">Nepal in 2030,</a> Sanghamitra Subba<a style="background-color: #ffffff; font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/?p=38046&amp;preview_nonce=d2d7129548&amp;preview=true" target="_blank" rel="noopener">A future written in the stars,</a> Sanghamitra SubbaDespite poverty falling by half, one-third of Nepali children <a href="https://www.nepalitimes.com/banner/nearly-half-of-nepali-children-still-malnourished/" target="_blank" rel="noopener">are still malnourished</a>. Anaemia among women has actually increased in recent years. The government’s Multi-sectoral Nutrition Plan, developed in 2012, works to improve maternal and child health, vaccination rates and malnutrition.“Development in Nepal is still synonymous with roads, but investing in early childhood development is equally important, it is a component of development,” said Kiran Rupakheti of the NPC, which wants nutrition programs to reach the grassroots.Even as literacy rates rise, gender disparity is expected to continue in the coming decade. As female literacy improves, for instance, <a href="https://www.nepalitimes.com/banner/child-marriage-in-nepal-eloped-at-13-mother-by-17/" target="_blank" rel="noopener">child marriage</a> and <a href="http://archive.nepalitimes.com/news.php?id=19596#.XftPh5MzaUk" target="_blank" rel="noopener">girls’ dropout rates</a> will persist. Experts say improving the <a href="https://www.nepalitimes.com/banner/after-quantity-nepals-education-needs-quality/" target="_blank" rel="noopener">quality of instruction</a> at community schools, encouraging female students in technical fields and promoting applied education should be priority areas in the 10 years ahead.Nepal is expected to graduate from lower-middle-income country status by 2030, but that is unlikely if the SDGs goals are not met. For this, the government will need to spend $1billion a year in infrastructure alone. Nepal is hoping to sustain <a href="http://archive.nepalitimes.com/regular-columns/guest-editorial/guest-editorial-Nepal-economic-growth,923" target="_blank" rel="noopener">double-digit growth</a> of above 10% and achieve per capita income of $1,595 by the end of the decade.“I’m hopeful about our prospects but if we uplift the economic status of women, who make up more than half of the population, we will get there sooner,” said Saru Joshi, gender and development expert.<a href="http://archive.nepalitimes.com/blogs/thebrief/2017/05/24/bleak-economic-report/" target="_blank" rel="noopener">A 2017 World Bank report</a>, however, stated that if present trends continue Nepal will not reach its middle-income target. It pointed out that despite rapid reduction in the poverty rate, the country’s development path has not led to economic growth but perpetuated a shortage of jobs at home, which in turn is fuelling further <a href="https://www.nepalitimes.com/editorial/reducing-labour-pain/" target="_blank" rel="noopener">outmigration</a>. And while remittance accounts for one-third of the national GDP, it is a symptom of deep-seated, chronic problems.Planners say that a slew of new hydropower and large infrastructure projects planned for the next 10 years, a boom in <a href="https://www.nepalitimes.com/opinion/guiding-nepals-tourism-industry/" target="_blank" rel="noopener">tourism and the service sector</a>, and better connectivity will create jobs at home, discouraging youth from seeking employment elsewhere.“We know our targets are ambitious but we also have the most favourable environment to achieve it. There is finally stability, the present growth is already at 7%, some <a href="https://www.nepalitimes.com/opinion/decentralising-hydropower/" target="_blank" rel="noopener">major hydropower projects</a> are taking off and we have made huge investments in information technology,” said Rupakheti.Shahi forecasts optimistically: “The 2020s will be a progressive decade of sustainable and just development. There will be prosperity along with social justice. There will be double-digit growth, increased investment from the government and the focus will be on quality, not quantity.”

How will Nepal develop in the next decade?

Fenerbahçe Beko won the Turkish Airlines EuroLeague finals in Abu Dhabi, held 23-25 May, defeating Monaco 81-70 in the final. Olympiacos, who defeated Panathinaikos 97-93, finished the series in third place. The Most Valuable Player (MVP) of the final match, Nigel Hayes-Davis from Fenerbahçe Beko, received a prize of 1,000,000 Miles&amp;Smiles from Turkish Airlines’ Chief Commercial Officer Ahmet Olmuştur. The carrier has been the title sponsor of the Turkish Airlines EuroLeague, a top tier tournament, since 2010.

Turkish Basketball

Thousands of Nepali students dreaming of an American education have been forced to look elsewhere as the Trump administration’s visa restrictions make their future uncertain.
The US was long considered a top destination for higher studies, making Nepal the 10th biggest country of origin for international students in America.&nbsp;
However, that number has seen a significant decline with the total for Nepali students now at 16,482. Some 8,000 Nepali students obtained no-objection certificates to study in the US from the Ministry of Education in the past year.&nbsp;
India, Australia, Canada, South Korea, United Kingdom and Japan are the other popular destinations for Nepali students. There are no clear numbers for Nepalis going to India, but a slight decline was noted this year after the deaths of two female students.
The US State Department has issued a circular to its embassies not to issue new visas to applicants until further notice. US Secretary of State Marco Rubio in the directive stated that the department planned to expand the screening of applicants' social media.&nbsp;
While new applicants are barred including those applying for visitor visas, students with scheduled interviews are allowed to proceed.
“Many of our students are affected by the new restrictions, but those who had applied for student visas earlier have got interview dates,” one Kathmandu-based college counsellor told us.
Meanwhile, even foreign students with spotless records already in the US have not been spared, as visa scrutiny intensifies under the new policy. In a move that underscores the growing sense of insecurity, many US colleges advised international students to carry their passports and documents at all times, even when traveling locally.
“Me and my friends did not go home this summer because we were not sure we would be allowed back, so we just went to Niagara Falls,” said a Nepali undergrad in Ohio, who like many interviewed for this report did not want her name used for fear of repercussion.
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Nepali students have adopted a cautious stance, with many choosing not to return home during summer vacation due to fear of visa revocations as well as travel bans. Meanwhile, over 7,000 Nepalis with Temporary Protected Status (TPS) will have to come back to Nepal by 5 August or face deportation. Thirty-seven were flown back to Kathmandu on Omni Air last week.
“The US is one of the most sought-after destinations for higher education, and the ban will definitely impact bright students,” says Narottam Aryal of the King’s College in Kathmandu.
Indeed, Nepali undergraduates admitted into Ivy League colleges for the 2025 academic year have been asked to look for alternatives. The entire Fulbright Foreign Scholarships Board resigned on Wednesday citing interference from the Trump administration on the selection of this year’s cohort. Some Nepali students already on Fulbright scholarships have noted disruptions, delays and even cancellation of stipends.&nbsp;
The student visa restrictions were initially just for foreign students admitted to Harvard University, but it was later extended to all Chinese students and now to all students. Universities like Columbia which actively recruit foreign students, face sharp enrolment declines, threatening their financial stability and diversity.
An Indian female PhD candidate at Columbia University had her visa revoked by the US State Department, and said she was targeted on the basis of her social media posts on Israeli military attacks in Gaza. Social media vetting of political activism has raised concerns about privacy and freedom of expression in a country where such rights were a given.
Many students have been informed via email that their visas have been revoked for getting speeding or parking tickets, but even others with no criminal record have been affected. The fear of deportation looms large amongst international students, including those from Nepal.&nbsp;
For most Nepalis who migrate to the US for education, the journey is a high-stakes investment. They come largely from middle-class families, often rely on a patchwork of scholarships, work-study programs, loans, or even the sale of family assets to afford fees.
Most Nepali students pursue STEM subjects which offer extended Optional Practical Training (OPT) periods that help fund their education. But with the US backsliding on education and humanitarian matters, countries like the UK and Canada are becoming more attractive despite their own recent stricter controls on student visas.&nbsp;
The UK universities saw a 63% rise in Nepali students’ admissions in 2024. Japan is another popular destination with 64,816 Nepali students enrolled as of 2024.
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Already, China, Hong Kong and Malaysia are poised to benefit from the increased scrutiny of US student visas. Several Hong Kong universities are offering unconditional admission to affected students, while Malaysian institutions are targeting previously US-bound Asian students. China and India have 330,000 and 280,000 students respectively in America, but the numbers for China have seen a sharp drop in the past year.
Elsewhere, branch campuses of American institutions such as NYU in Abu Dhabi, Georgetown in Dubai and Northwestern in Doha are getting more admission applications, and universities in the Gulf region are expanding infrastructure to accommodate those who would otherwise have gone to the US.&nbsp;
Even educational institutions in Nepal are hopeful that the US visa restrictions can be an opportunity to at least keep Nepali undergrads in Nepal, and also attract foreign students from the region.&nbsp;
“Many students might choose to complete their undergraduate degree here in Nepal and then move abroad for their Master’s degree later,” says Aryal of King’s College. “There was a need for quality higher education in Nepal anyway in terms of innovation and opportunities, so this could be the time to reduce our dependence on other countries.”
Nepal’s strategic position between India and China makes it sensitive to US policy shifts. India, a key ally, is also under US scrutiny for potential student travel restrictions. Chinese universities are already offering more scholarships to Nepali talent to capitalise on the US retreat.
American universities have challenged student visa restrictions in the courts. A federal court in Boston revoked the blanket ban on Harvard, and the State Department has ordered the resumption of processing student and exchange visitor visas.&nbsp;
Some are still hoping that President Trump will backtrack on the student visa restrictions, just like he has done with many of his more drastic executive orders.
Even so, the visa see-saw and longer-term uncertainties about living in the United States and its education system means students across the world are making alternative plans.
Says Aryal: “Policies of foreign countries change according to their needs, so excessive dependence was never a good idea. We should work to create different opportunities and choices of higher education within Nepal, so students are retained.” &nbsp;

America no longer prime destination for Nepali students

While Nepal was hosting the Sagarmatha Sambaad international climate conference in Kathmandu this month, on Mt Everest it was pretty much business as usual.&nbsp; The signs of climate breakdown are all there: a river now runs through Base Camp in summer, the Khumbu Icefall is more unstable, and there are more &nbsp;frequent avalanches. When expeditions arrived in March, the mountains were bare: it had not snowed since September, but then blizzards dumped unseasonal snow in May. And despite climate worries, such is the pull of Himalayan mountaineering that the Everest Industry showed no signs of slowdown. More than 600 international climbers and their Nepali guides had made it to the summit of the world’s highest mountain. At one point there were an estimated 2,000 people in the tent city on the Khumbu Glacier. All the ropes and ladders on the Icefall came down on Thursday, marking the official end of the spring climbing season, and just in time to avoid a monsoon cyclone approaching from the Bay of Bengal. It has been an action-packed season. One factor could be that Everest fees will go up from September: each foreign climber needs to pay a $15,000 royalty, up from the present $11,000. The cost for a Nepali climber on the South Col route will also go up: from Rs75,000 to Rs150,000.&nbsp; The fee to climb Everest in autumn is $7,500 (up from $5,500), but most climbers still prefer spring. Winter permit fee (December-February) is only $3,750 per person and the mountain is now also open for monsoon (June-August) climbs, when the fee is ever lower at $2,750. The revised rule also makes it mandatory for every two climbers on an 8,000m peak to hire one Nepali mountain guide.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025053004050_67f856fe52714e4bdcf21ae7d45c6f18c82117b9d0a5f73ed1efa04c96de1046.jpg" data-media-id="editor_0" data-image-id="2025053004050_67f856fe52714e4bdcf21ae7d45c6f18c82117b9d0a5f73ed1efa04c96de1046" data-rendition-name="original" width="931" height="732" loading="lazy" alt="The Everest Industry graph 1"> </figure>  In addition, climbers also have to pay for porters and guides, equipment, Base Camp costs, Ice Fall and fixed rope team fees, so climbing Everest does not come cheap. But such is the draw of climbing the world’s highest peak that some say the increased fees will not diminish the crowds next year. The government has tried to spread expeditions out to other seasons and other 8,000ers, but with not much success. Earlier this year, Nepal unilaterally increased the number of 8,000m peaks to 14 by adding six more sub-summits to broaden the choice for climbers. Added were: Yalung Kang (8,505m), Yalung Kang West (8,077m) &nbsp;Kangchenjunga Central (8,473m), Kangchenjunga South (8,476m), Lhotse Middle (8,410m) and Lhotse Shar (8,400m).&nbsp; The announcement could go against the accepted topographic criteria that a stand alone peak has to be at least 300m higher than an adjoining prominence, and at more than 3km isolation from it. The UIAA (Union Internationale des Associations d'Alpinisme) still recognises only 14 mountains as eight-thousanders, and only eight of those are in Nepal, or on the border with China. Nepal’s revised mountaineering regulations also increased the insurance coverage of high-altitude workers to protect porters and high altitude guides who usually take more risks on the mountains. Rescue teams and clean-up campaigners to collect trash and remove bodies of dead climbers up to Camp IV of Mt Everest do not need permits.&nbsp; The Sagarmatha Pollution Control Committee is now using drones to fly down trash in 20kg sacks. Each climber is also required to bring down at least 6kg of waste and not just their own, but this rule is erratically enforced. With five fatalities on Everest and Lhotse, Spring 2025 had a historically low death toll. Another five climbers died on Annapurna, Kangchenjunga and Makalu.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025053004050_38681de22f0fefb6faa12b01755566d09c5064d0ff84e12ccc7b5d68ea9ba38a.jpg" data-media-id="editor_1" data-image-id="2025053004050_38681de22f0fefb6faa12b01755566d09c5064d0ff84e12ccc7b5d68ea9ba38a" data-rendition-name="original" width="665" height="740" loading="lazy" alt="The Everest industry graph 2"> </figure>  Journalist Ben Ayers who ran the Everest Live social media channel from Everest Base Camp with daily updates credited the low death rate to dramatic rescues of climbers from the ‘Death Zone’ by their Nepali guides and longline helievacs — the visuals all uploaded on YouTube.&nbsp; “Ironically, this perception of safety is bringing more and more inexperienced climbers to the mountain, and they need more rescues,” Ayers said in one of his dispatches.&nbsp; American expedition chronicler and summiteer Alan Arnette suspects there is a lot of under-reporting given that the jet stream and storms were lashing Everest even till late in the season. He told us: “I heard a lot about frostbite and rescues that were not made public. It’s become practically impossible to cover the details on Everest. All the teams report nice news, and they don’t talk about bad stuff to avoid hurting businesses.” Although trash on Nepal’s mountains makes headlines, what does not receive as much attention is the climate impact of so many expeditions. The Sagarmatha Sambaad conference sidestepped this issue, which is ironic given that the impact of climate breakdown is most evident on Himalayan peaks and their glaciers.&nbsp; <h2>Need for Speed</h2> The big stories this year have been about speed-running from their home cities to the top of Everest. Ukrainian entrepreneur Andrew Ushakov flew out of JFK on 15 May at 10:15AM Nepal time, and was on the summit 3 days, 23 hours, and 7 minutes later on 19 May at 9:22AM.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250601080640_1c5cc6fc991307861768f07037ed9d30930fb20f35dbb57dc31c9a92a9e1a885.jpg" data-media-id="editor_2" data-image-id="20250601080640_1c5cc6fc991307861768f07037ed9d30930fb20f35dbb57dc31c9a92a9e1a885" data-rendition-name="original" width="1440" height="1800" loading="lazy" alt="The Everest Industry"> <figcaption>Andrew Ushakov at the summt. Photo: ELITE EXPED</figcaption> </figure>  “I could never find the time for the traditional 40-50 days of acclimatisation,” Ushakov explained matter-of-factly. His ‘Everest Sea-to-Summit’ climb was possible because he spent 400 hours in hypoxic sleep tents over the past four years in New York. However, Ushakov did use ropes already fixed, hired four Nepali guides, helicoptered to Base Camp, and used much more oxygen than an average climber. And after the climb, Ushakov was arrested at Kathmandu airport for being in possession of $20,000 of undeclared cash and spent a night in jail and fined $60,000.&nbsp; The other speedsters were Garth Miller, Alastair Cairns, Anthony Stazicker, and Kev Godlington, all former British Army commandos. They left London and summited five days later on 21 May, and flew right back. They also used hypoxic tents to simulate the thin air high on Everest.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250601080644_90c8dd5cc07b4b43f2989b1dc0c0650ab80f10ebb06680c25a6909c519957bd8.jpg" data-media-id="editor_3" data-image-id="20250601080644_90c8dd5cc07b4b43f2989b1dc0c0650ab80f10ebb06680c25a6909c519957bd8" data-rendition-name="original" width="810" height="668" loading="lazy" alt="The Everest Industry "> <figcaption>All four members of the Furtenbach team at the summit. Photo: Sandro Gromen-Hayes</figcaption> </figure>  But more controversial was their use of xenon gas therapy in a German hospital to ramp up the production of oxygen-carrying haemoglobins in their blood. Xenon is banned by the World Anti-Doping Agency for being performance enhancing in sports. Expedition leader Lukas Furtenbach said this rule does not apply to mountaineering, as it is not a regulated sport like swimming. Nepal has no rules about xenon, but the Department of Tourism said it was launching an ‘investigation’ to decide on future policy since it is difficult to ban xenon, but allow oxygen. The controversy has also divided the mountaineering community, with some climbers saying they just want to maximise their chances of survival. Spending less time on the mountain could make climbing safer by reducing avalanche risk. It would also mean less trash on the mountains, but it would reduce the income of Nepal’s expedition industry. It is also unclear how much of the success was due to xenon therapy and whether the ex-special forces were already in good physical shape.&nbsp; The need for speed hides the fact that climbing in the Himalaya is dangerous business, and climbers cannot sprint to the top just by huffing xenon. But ultra-fast climbs could be charged more, and the revenue generated can be used to establish state-of-the-art rescue operations, and increase pay and insurance for guides. Two other speed chasers this season were Swiss-Ecuadorian Karl Egloff and American Tyler Andrews, both on Everest without oxygen. Andrews choppered to Base Camp to catch a weather window, but turned back from 8,500m due to high winds. Heavy snow and wind also forced Egloff to descend from 7,000m. Slow and steady climbers like Anja Blacha from Germany did make it to the summit without oxygen, while Kami Rita Sherpa broke his own record with his 31st Everest summit as he led a 26-strong Indian Army group. There were 468 permits issued for foreign climbers from 48 expeditions to Everest this spring. Nepal’s other eight-thousanders together had only 17 expeditions. Nepal has more than 1,000 peaks above 6,000m, and has opened only 476 of them for climbing.&nbsp;

The Everest Industry

That winter day in January 1664 marked an exceptional event in the reign of King Pratap Malla of Kathmandu. It was 15 Paush 784 of the Nepal Sambat and for the first time, a historical event was being immortalised on canvas for generations to come.&nbsp; The occasion was the grand Tuladaan ceremony of the King’s youngest son Chakrabartendra Malla from his wife Anantapriya, an Indian princess from Cooch Behar in present-day Assam.&nbsp; During the ritual, the prince was weighed against gold, silver, pearls, and other precious stones, which were then offered to Goddess Taleju Bhavani, the guardian deity of the Malla dynasty.&nbsp; The 170 x120cm painting captures the time of King Pratap Malla in all its splendour and is more than a personal tribute to his son: it is a significant visual historical document. It was evidently completed five years later in 1669, and could be considered a photographic record, with retrospective recreation of the event by the unknown artist. A Tuladaan ceremony is performed to purify one’s karma, quell impending bad luck, or as an act of charity and devotion. Chakrabartendra Malla was not well, and the ritual was performed in hopes of restoring his health. King Pratap Malla had arranged for each of his sons to take turns ruling Kathmandu so they got administrative experience. But Chakrabartendra died just two days after assuming power in 1670 (790 NS). This painting is considered the earliest known example in which the composition is dominated by an architectural landscape: the Taleju Temple. Given the stylistic features such as side-profile facial depictions and the rendering of human forms, it is believed that the Nepali artist was trained by a Rajput master.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250615040624_ddad3bc27a327e3f9926c8473287e4f14b53081296c295049009f327a4d97051.jpg" data-media-id="editor_0" data-image-id="20250615040624_ddad3bc27a327e3f9926c8473287e4f14b53081296c295049009f327a4d97051" data-rendition-name="original" width="3248" height="4395" loading="lazy" alt="Tuladaan NT"> </figure>  During that era, there were regular exchanges of artists between Northern India and Kathmandu Valley. The painting is also a melding of Nepali, Tibetan, Mughal, and Rajput art styles of the time. Pratap Malla could have been inspired by a painting of Mughal Emperor Jahangir’s Tuladaan ceremony for his son Khurram in 1607. The Mallas and Mughals shared cordial relations, which is reflected in the cultural influences seen in the art and attire of the period.&nbsp; The clothing of the Malla ruling class, in particular, features colourful tunics, turbans, and jewelry that display strong Rajput and Mughal stylistic elements. The musicians in the upper tier are also dressed in Indian-style clothing, while the ensemble on the lower steps wear local attire, notably without turbans. Their hairstyles also differ, with the lower group wearing their hair tied in a bun at the front. This national treasure is currently in storage at the Collège de France in Paris, and has never been publicly displayed. Nepal’s art scholars like Gautam Vajracharya, Pratap Aditya Pal and Anne Vergati have written about this iconic paubha in the past, but the only detailed study is from the perspective of music history by researcher Richard Widdess who had access to high resolution copies of the original.&nbsp; Widdess from the Department of Music at the School of Oriental and African Studies (SOAS) in London describes the paubha as the most significant and richly detailed documentation of music in Nepali art. He identifies distinct musical ensembles on the terraces of the temple, and remarkably most of them are actively used today. One of them reflects the Mughal naqqārakhāna model — a loud outdoor ensemble typically composed of kettledrums, trumpets, and cymbals, traditionally performed from the gateway of the emperor’s palace to announce his entrances and exits. The depiction of such an ensemble in the tulādāna painting is likely the earliest known representation of a complete naqqārakhāna in Nepal — considered the forerunner of the panche baja, the traditional Nepali ensemble. On the stepped pyramid base of the temple are two groups of musicians playing local instruments: dhimey, bhushya, and dha. They are unmistakably Newar musicians, wearing short skirts and short-sleeved tops, with bare heads and legs—clearly distinguished as local performers.&nbsp; Higher still on the temple pyramid are musicians of apparently higher status, positioned close to the king, and his courtiers, possibly professional court musicians from India, well-versed in rāga and tāla. A dāphā group is also clearly depicted, identifiable by their characteristic instruments.&nbsp; Dāphā bhajan is likely the oldest surviving tradition of Newar devotional singing, and this paubha is the oldest visual record of it. Pratap Malla himself is believed to have composed songs that continue to be performed by dāphā groups throughout Kathmandu till today.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025061211064_d67636730cdc0ec778c02494817aca0b99654f2950d0fae4b95499a61faf7ef3.jpg" data-media-id="editor_1" data-image-id="2025061211064_d67636730cdc0ec778c02494817aca0b99654f2950d0fae4b95499a61faf7ef3" data-rendition-name="original" width="596" height="768" loading="lazy" alt="Priceless paubha in Paris NT"> </figure>  The artist’s thorough attention to musical detail may be attributed to King Pratap Malla’s own deep interest in music. His inscriptions on this painting and elsewhere proclaim his mastery of all branches of knowledge, including music. He is also known as the author of dance dramas and poems, penning his name as Kavindra (king of poets). Some noteworthy elements of new art techniques stand out: for example, the roof of the temple is filled with realistically rendered white doves, pigeons, and crows. This is a rare feature in paubha, where animals and birds are stylised, mythological forms. This remarkably talented unknown artist has managed to also render an orthographic projection: the front and side view of Nepal’s first architectural paubha. The Taleju Temple, with its staggering multi-tiered structure and numerous steps and platforms, is masterfully translated into layers within the painting. This represents a significant artistic achievement of the time, especially considering that dimensional perspectives had not started in deity-based paubha.&nbsp; The artist has also made a meticulous effort to capture architectural details such as the toran (ornamental arch) and temple struts with impressive precision. There are flickering lamps along the steps and some people carrying what appear to be oil pots.&nbsp; It is a full moon night and the dark sky is adorned with all the gods and goddesses, who are depicted as blessing the ceremony while seated on stylised thangka clouds. There is a lot happening in this painting, with people engaged in various activities. The artist has also rendered a forest backdrop behind the temple, complete with deer, trees, and flowers. Could there have once been a royal garden behind the Taleju Temple?&nbsp; More details and clarity can only be achieved if we are able to view the original or a high-resolution scanned version of the artwork. Many countries proudly display art depicting historical events in their national museums with great reverence. France, for example, has The Coronation of Emperor Napoleon and Empress Joséphine by Jacques-Louis David (1808–1822), along with numerous paintings of the Napoleonic Wars. Many were commissioned by Napoleon himself for future generations to remember.&nbsp; For Nepal, the equivalent is the Tuladaan paubha which is a visual record capturing a historic moment involving one of Kathmandu’s greatest kings, on the very day the event took place. Sadly, we await the day when this masterpiece is displayed, shared in high resolution for detailed study, or more rightfully — repatriated to its homeland, where it truly belongs. &nbsp; Shaguni Singh Sakya is the Director of the Museum of Nepali Arts (MoNA) at Kathmandu Guest House in Thamel. <h2>Gods homeward bound</h2> The Nepal Heritage Recovery Campaign and Nepal’s Department of Archaeology are convening the first international conference on the Recovery of Cultural Heritage from 16-18 June in Patan. The conference will address urgent issues of theft, illicit trafficking, the campaign to repatriate looted cultural artifacts, and explore how the return of sacred antiquities contributes to justice, healing, and reconciliation for communities and nations affected by cultural loss. American art crime professor Erin L Thompson and Saubhagya Pradhananga of the Department of Archaeology will deliver the keynote. Meanwhile, author and Nepali Times publisher Kunda Dixit will lead a conversation on Illicit Trafficking: Public Opinion and Role of Media with Erin Thompson, Amr Al Azm, associate professor of Middle East History and Anthropology at Shawnee State University in Ohio, as well as Bradley J Gordon, a lawyer based in Phnom Penh. There will be sessions looking at repatriation perspectives from Cambodia, India, Vietnam, China and Poland, international frameworks for repatriation, emerging digital technologies in the repatriation of cultural heritage, cultural property agreements, museums as well as trends in the art market, and heritage diplomacy and the role of media.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025061211068_59cfccfa8f5d73bfe8b4c5811a7f53abc09ea04e8cb7c638933d62e5283efdf6.jpg" data-media-id="editor_2" data-image-id="2025061211068_59cfccfa8f5d73bfe8b4c5811a7f53abc09ea04e8cb7c638933d62e5283efdf6" data-rendition-name="original" width="1080" height="1350" loading="lazy" alt="Heritage recovery NT"> </figure>  <h2> </h2> Some of the other highlights include James K. Reap, a professor in the Master of Historic Preservation Program at the University of Georgia who has a session on the US response to illicit trafficking. Art historian Lea Saint-Raymond is taking on “Gods at Auction: The Market for Himalayan Artefacts”, while lecturer of criminology at the University of Glasgow Emiline Smith is delving into transformative approaches to heritage ownership and repatriation. Helena Arose of Antiquities Coalition and Melina Antoniadis of NOSTOS Strategies that specialise on the return home of cultural heritage as well as Hao Liu of International Cultural Heritage Law at the School of Law at Shandong University are some of the others attending. The Nepal Heritage Recovery Campaign was set up in 2020 to develop a coordinated movement to reclaim Nepal’s stolen gods and goddesses, with an aim to ensure that recovered items are returned to their original shrines, niches or sanctums. Ahead of the conference opening organisers have arranged for a film screening of Loot &amp; Return: 4 Documentaries at YalaMaya Kendra in Patan Dhoka between 14-15 June. Following the conference is a multimedia exhibition titled Absent Gods: Nepal’s Lost Heritage from 31 July to 4 August at Patan Museum.