Most disasters strike without warning. But dengue fever which spreads when infected mosquitos breed in monsoon puddles, is largely predictable and preventable. Densely populated Kathmandu with stagnant pools of water has all the ingredients for another outbreak like the deadly one in 2022. Last year there were about<a href="https://www.nepalitimes.com/news/new-dengue-outbreak-likely-this-monsoon" target="_blank"> 55,000 infections and 88 fatalities</a> officially reported across Nepal in its biggest dengue outbreak yet, the real figure is probably higher. Hospitals were out of capacity, over-medication was rampant, and almost every house in Kathmandu had multiple members struck down with infection. This year, Nepal had already seen <a href="https://kathmandupost.com/health/2023/07/08/dengue-spreads-to-66-districts-one-person-dead-over-1-200-test-positive" target="_blank">over 1,000 dengue infections </a>by end-June. Starting in Dharan where one person has already died, the disease has now reached most of the 77 districts. Even so, many cases are never reported, and many recuperate at their homes. Furthermore, 80% of dengue cases are asymptomatic. “We are not even at the peak of the dengue season, and cases are already surging. It is very likely that this will further increase as rains begin to dwindle post-monsoon,” warns Sher Bahadur Pun, virologist at the Sukraraj Tropical and Infectious Disease Hospital in Kathmandu. “Nepal’s poor surveillance and record keeping also means diseases like dengue are seriously under-reported.”&nbsp; Lack of public awareness about dengue management and prevention adds to the problem. A third of dengue patients admitted to Teku Hospital last year <a href="https://www.nepalitimes.com/banner/as-covid-abates-nepal-sees-dengue-outbreak" target="_blank">did not even know</a> that the disease is mosquito-borne and spreads in the daytime.&nbsp; “At least this wasn’t the case with Covid-19, but with dengue, people struggled to adopt the correct precautions due to lack of knowledge,” explains Pun. “Even more alarming: once infected, people took strong medications like painkillers and antibiotics unaware that they are ineffective and often even harmful in dengue.”&nbsp; Although there is no specific medication for dengue, doctors recommend paracetamol to ease the fever and enough fluids to replenish the body. Dengue has no cure.&nbsp; Dengue was first reported in Nepal in 2004, but it was not until 2019 that it spread like wildfire in major urban centres. Two years of Covid lockdowns significantly reduced the caseload after the 2019 outbreak, but last year, it struck again.&nbsp; Read also: <a href="https://www.nepalitimes.com/news/new-dengue-outbreak-likely-this-monsoon">New dengue outbreak likely this monsoon</a>, Sonia Awale  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20230717150716_97f01f95d37cc29c4c2a68ba54185635449829fa53a3064d0b83ba5714263db9.png" data-media-id="editor_4" data-image-id="20230717150716_97f01f95d37cc29c4c2a68ba54185635449829fa53a3064d0b83ba5714263db9" data-rendition-name="original" width="1072" height="577" loading="lazy" alt="Dengue graph NT"> <figcaption>Trend of dengue cases in Nepal 2006 - 2023 June, SOURCE: MoHP Situation Update</figcaption> </figure>  But even as dengue starts to spread in Kathmandu Valley, elected local officials do not seem to be too concerned. When the Ministry of Health and Population called on all local unit representatives in the Valley to discuss the outbreak on 9 July, 12 out of the 18 units <a href="https://kathmandupost.com/health/2023/07/11/dengue-search-and-destroy-campaign-to-be-launched-in-kathmandu-valley" target="_blank">avoided the meeting altogether.</a> Although there are some fumigation and dengue search and destroy campaigns <a href="https://kathmandupost.com/health/2023/07/11/dengue-search-and-destroy-campaign-to-be-launched-in-kathmandu-valley" target="_blank">set to be launched in Kathmandu</a> soon, with the monsoon already started, it may be a case of too little <a href="https://www.nepalitimes.com/banner/state-of-malaise" target="_blank">too late</a>. It should have started before the onset of the monsoon. “Though not as many as last year, we are already seeing a worrying number of mosquitoes near areas with stagnant water. And when they fly into homes, chances are the virus is already spreading from those infected,” explains Pun.&nbsp; This negligence and delay in action comes despite repeated warnings from experts. Officials knew far in advance that <a href="https://www.nepalitimes.com/news/new-dengue-outbreak-likely-this-monsoon" target="_blank">last year’s virus is still in mosquito larvae, waiting for the monsoon</a>, and yet, preventive measures, emergency preparedness, and capacity building were ignored. The risk of dengue fever will rise in the coming months of August and September, although some public health experts say serious dengue outbreaks seem to happen after a gap of two years. With climate change, mosquitos are moving up the mountains in Nepal, bringing mosquito-borne disease like malaria, encephalitis and dengue higher. The number of cases officially recorded between January and June this year is nine times higher than last year. Districts like Sankhuwasabha are on the <a href="https://edcd.gov.np/uploads/resource/64a3d5414aad6.pdf#:~:text=This%20figure%20was%20more%20than,of%20cases%20reported%20in%202019.&amp;text=As%20of%2030th%20June%2C%202023,listed%20details%20in%20Figure%202." target="_blank">top-ten list</a> for most cases reported, even though it is in the high mountains, and indicating how global warming is <a href="https://www.nepalitimes.com/banner/mosquitoes-move-up-mountains-as-the-earth-warms" target="_blank">pushing mosquito breeding grounds further north.</a> Bagmati is once again the hardest-hit province, possibly due to higher population density. Read also:<a href="https://www.nepalitimes.com/banner/dengue-days-are-here-to-stay"> Dengue days are here to stay</a>, Sonia Awale  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20230717150716_b1a8b5c7b8e50f5e388f04a41877f2520ffa8f334c04343b357fd034d4166e6d.png" data-media-id="editor_12" data-image-id="20230717150716_b1a8b5c7b8e50f5e388f04a41877f2520ffa8f334c04343b357fd034d4166e6d" data-rendition-name="original" width="1088" height="433" loading="lazy" alt="Dengue graph"> <figcaption>Dengue cases reported by province in 2023 January to June.  SOURCE: MoHP Situation Update</figcaption> </figure>  Tackling Dengue: what does it really take? Ugonnaya Caleb-Ugwuowo recalls treating children and pregnant women struck down with dengue fever in a local hospital in Lagos. The Nigerian doctor and public health expert specialises in managing outbreaks, and says she often felt helpless at being unable to correctly diagnose and treat them due to lack of facilities. Nepal could learn from Nigeria's experience. Dengue fever is endemic in almost all states in Nigeria. “Although the country is still struggling, the challenges and epidemics Nigeria has faced over the years have shaped our understanding of what it takes to tackle outbreaks like the ones Nepal faced last year and in 2019,” says Ugonnaya.&nbsp; It starts with surveillance, she says, adding: “The government in Nepal should, as a matter of urgency, conduct dengue surveys in all provinces to assess the proportion and magnitude of different <a href="https://www.nature.com/scitable/topicpage/dengue-viruses-22400925/#:~:text=The%20Dengue%20Serotypes,antibodies%20in%20human%20blood%20serum." target="_blank">dengue serotypes</a> circulating freely. Following this, dengue should be made reportable from all local health institutions directly into the national health information system." Dengue fever for the first time, though debilitating, often does no harm. But getting it a second time with a different serotype poses a significantly higher risk of the disease progressing to haemorrhagic fever, where blood thins out and can start leaking from veins, causing potentially fatal internal bleeding. This is what makes serotype surveys so important. A <a href="https://academic.oup.com/jtm/advance-article-abstract/doi/10.1093/jtm/taad034/7087081?redirectedFrom=fulltext" target="_blank">study</a> aiming to report dengue serotypes seen in Kathmandu during last year’s outbreak showed DEN-1 and DEN-3 to be the dominant serotypes, with only negligible cases of DEN-2 reported. But such studies should be conducted nationwide, so that the risk of infection with other serotypes can be correctly determined. Sri Lanka and Bangladesh, both of which have reported elevated levels of dengue infections this year, have direct flights into Nepal. “Although the inflow of infected tourists also poses a great threat, the greater concern should be the mosquitoes in and around places where these tourists go, like airports, temples and major tourist sites,” warns Pun. If barring flights is not an option, vector control is the best way to minimise transmission. For this, fumigation and dengue search and destroy efforts should be concentrated in tourist sites first. Simple source reduction strategies like covering open water containers, using insecticides in canals, parks and fields exist, but deploying genetically modified mosquitoes to reduce the population of disease carriers can also control vector-borne diseases. Caleb-Ugwuowo adds that Nepal already has a decentralised framework of healthcare, so proper surveillance is possible. More importantly, the two previous outbreaks have given experts an idea of what needs to be done: capacity building in hospitals, sanitation and drainage facilities, public awareness, and emergency preparedness before the disease strikes. Pun agrees: “We must learn from other countries as well as from our own past experience, and act to contain this outbreak. Things will get progressively worse in the next few weeks, so there is no time to beat around the bush, especially with dengue already knocking at our doors.” Read also: <a href="https://www.nepalitimes.com/banner/mosquitoes-move-up-mountains-as-the-earth-warms">Mosquitoes move up mountains as the earth warms</a>, Sonia Awale

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Dengue danger returns with monsoon

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221114131128/637235369c7e80680e0c4975jpeg.jpg" alt="" width="5827" height="3885"/><figcaption>All Photos: Suman Nepali</figcaption></figure>For the past two years, the preoccupation of the government and people of Nepal has been with the pandemic. But just as the fourth wave of Covid-19 started to subside, Kathmandu and other towns across Nepal have been hit by dengue outbreaks.For the past few weeks, Shukraraj Tropical and Communicable Disease Hospital in Teku has been crowded with patients with fever. At first, epidemiologists there thought it was a new Covid strain, but the symptoms were different: severe body ache, eye pain, high fever and nausea.<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221114131128/6372353a9c7e80680e0c4976jpeg.jpg" alt="" width="2304" height="1536"><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221114131128/6372353d9c7e80680e0c4977jpeg.jpg" alt="" width="2304" height="1536">In Kathmandu Valley, there were hotspots mostly in inner city Patan and the outskirts. Hundreds of patients have been admitted into hospitals, and the number of cases diagnosed in hospitals has surpassed 1,000 -- more than in the previous outbreak in the summer of 2019.Last year, there were only 10 patients at the Teku hospital in the second week of August last year, whereas there were 295 dengue patients just in the past week.This week, 120 dengue cases were reported in Lalitpur, 70 in Rupandehi, 110 in Kathmandu, and dozens more in Nawalparasi West and Bhaktapur, seven each in Dhading, Gulmi and Kapilvastu, six from Arghakhanchi, and five each from Tehrathum, Sindhuli and Makwanpur. There are six patients with dengue in ICU.<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221114131132/637235419c7e80680e0c4978jpeg.jpg" alt="" width="2304" height="1536">The number of dengue patients in hospitals has now exceeded those suffering from Covid. Doctors say there are probably thousands more with dengue fever recovering or being treated at home.  Dengue is transmitted from one infected person to the next by bites of the Aedes aegyti mosquitos during the day, and is caused by four different virus sero-types. Patients infected with one serotype of the virus will not have immunity against the other three types and there can be multiple infections.  Also called 'break-bone fever' patients contract the disease 3-7 days after the mosquito bite, and the high fever usually lasts up to a week, although it leaves the weak for up to a month.<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221114131132/637235459c7e80680e0c4979jpeg.jpg" alt="" width="2304" height="1536"><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221114131132/637235489c7e80680e0c497ajpeg.jpg" alt="" width="2304" height="1536">There is no treatment for dengue, since antibiotics are not effective against viruses. Doctors recommend paracetamol to ease pains and to bring down fever, and plenty of fluids. More severe cases of dengue can result in internal haemorhage and may require hospitalisation.“People still do not believe that mosquitoes bite during the day. While sleeping at night, they adopt all the safety standards from the hammock, but they ignore it during the day," says Sher Bahadur Pun, the head of the hospital’s clinical research unit.He says that measures should be taken to avoid mosquito bites in schools and offices as well as at home. “People are aware when they are at home, but they should be most aware in schools, offices, areas where houses are under construction and there are pools of stagnant water,” he says.<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221114131132/6372354b9c7e80680e0c497bjpeg.jpg" alt="" width="5905" height="3937">Pun's informal survey among patients at Teku showed that a third of them do not even know that dengue is transmitted by mosquito bites during the day. This is why the viral fever is spreading among students, with cases of entire classes of some schools being sick.Pun also warns against taking strong medications for dengue, and says that certain pain-killers and antibiotics can actually make the patients' condition worse.“Dengue causes severe body ache, so people look for strong medications for this. We have been giving cetamol for fever, which sometime does not alleviate pain like other painkillers,” says Pun. "However, using Brufen, Flexzone, Nims can be very harmful."<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221114131132/6372354f9c7e80680e0c497cjpeg.jpg" alt="" width="5210" height="3473">A study conducted  at Teku Hospital on the outbreak of dengue in Nepal from 2006 to 2019 found that many patients had become sicker because of prescription medicines they took without consultation, or because doctors had prescribed the wrong medicine thinking it was some other kind of fever.Recently, Pun came across a dengue patient  who was bleeding from the eyes after taking Flexzone continuously for five days. "I had never seen such a case before," he says, "patients who are being treated at home should be admitted to the hospital immediately if they have serious problems."Read more: <a href="https://www.nepalitimes.com/opinion/the-dangers-of-the-dengue-virus/">The dangers of the dengue virus</a>, Tom Robertson

As Covid abates, Nepal sees dengue outbreak

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022112916110/63861ea79c7e80680e0ccddajpeg.jpg" alt="" width="799" height="536"/><figcaption></figcaption></figure>There have been few days without rain this April and May in Kathmandu. That means more disease for Kathmandu. Not COVID-19, but the virus we used to talk about -- last year's scary unknown disease, dengue.The year 2019 saw Nepal's worst ever outbreak of dengue, with 15,000 people infected, many times the previous high. Dengue was particularly bad in the Kathmandu Valley. At least six people died.The medical journal The Lancet has warned that Kathmandu could see a dengue ‘explosion’ because it has become ‘an ideal breeding ground’ for the mosquito that carries dengue -- the notorious Aedes aegypti. Already in 2020, four cases have been reported in Kathmandu, and four in Lalitpur.<a href="https://www.nepalitimes.com/banner/big-story-of-small-pox-in-nepal/" target="_blank" rel="noopener noreferrer">Big story of smallpox in Nepal</a>, Tom Robertson<a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/banner/viruses-past-present-and-future/" target="_blank" rel="noopener noreferrer">Viruses past, present and future</a>, Tom RobertsonDengue spiked in 2019 with outbreaks around the developing world. In recent years, Delhi, Dhaka, Ho Chi Minh City, Senegal and Singapore have faced bad outbreaks. A dengue outbreak in Delhi in 2015 inundated hospitals and clinics across the city.Dengue likes warm humid conditions. Before corona, dengue was the world's fastest growing dangerous virus, increasing four-fold in just over a decade. Two of every five people around the world, nearly 3 billion people, live in dengue risk areas where it is a leading cause of illness. Each year approximately 100 million people contract the disease, and over 20,000 die.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022112916110/63861eaa9c7e80680e0ccddbjpeg.jpg" alt="" width="961" height="540"><figcaption> </figcaption></figure>Like malaria, dengue is actually several different diseases that we give a single name. There are four dengue viruses: Dengue 1, 2, 3, and 4. A person can catch each one, and get sick as many as four times.A first infection generally brings only mild flu symptoms, if any at all. But a second infection can cause ‘severe dengue’ with plasma leakage, bleeding, and shock. This can kill. No treatment exists for dengue, but generally symptoms can be managed.<a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/here-now/climate-health-emergency/" target="_blank" rel="noopener noreferrer">Climate health emergency</a>, Sonia Awale<a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/banner/mosquitoes-move-up-mountains-as-the-earth-warms/" target="_blank" rel="noopener noreferrer">Mosquitoes move up mountains as the earth warms</a>, Sonia AwaleDengue's main mosquito host, Aedes aegypti, is no ordinary mosquito. In a species known for death and deviousness, it has few rivals. Not many mosquitoes have so successfully defied human efforts at control, including in recent decades.Long before dengue, Aedes aegypti carried a far deadlier disease: yellow fever. During the 16th and 17th, slave ships brought yellow fever carrying A. aegypti from Africa to the Americas, devastating indigenous populations and reshaping the region's balance of power. In the early twentieth century, the A. aegypti -- yellow fever combination almost blocked the construction of the Panama Canal.Most wildlife avoid humans. Not A. aegypti. It loves us, particularly the ecological disorder we often create. The more humans, the more disturbed ecosystems, the more A. aegypti. Cities, especially disorganised cities, create ideal habitat: lots of standing water for breeding and lots of humans for feeding.Dengue's other mosquito carrier is A. albopictus.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022112916110/63861eac9c7e80680e0ccddcjpeg.jpg" alt="" width="640" height="463"><figcaption> </figcaption></figure><figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022112916110/63861eaf9c7e80680e0ccdddjpeg.jpg" alt="" width="640" height="635"><figcaption> </figcaption></figure>The Lancet points to dengue's major causes: climate change, relentless and haphazard urbanisation, brisk trade and transit from dengue-infested areas, and poor health infrastructure. As Kathmandu grows and gets more connected to other parts of Asia, dengue spreads.Climate change has been overrated as a cause. Warming temperatures can extend the range of Aedes carriers but other causes deserve more attention. ‘Last summer’s explosion of dengue in Kathmandu Valley was <a href="https://www.nepalitimes.com/banner/mosquitoes-move-up-mountains-as-the-earth-warms/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/banner/mosquitoes-move-up-mountains-as-the-earth-warms/&amp;source=gmail&amp;ust=1590920172779000&amp;usg=AFQjCNHqCreNEFDji4GDyS_wUW1JkpUOGA">blamed on climate change</a>,’ the Nepali Times recently noted, ‘but it was actually a perfect storm of crowded and squalid living conditions, poor drainage, greater mobility of people, and a particularly wet monsoon.’The real problem is disorganised urbanisation. The A. aegypti carrier thrives in small collections of clean water in flower pots, old car and truck tyres, uncovered water containers, and even puddles. It bites people early morning and at dusk.<a href="https://www.nepalitimes.com/here-now/nepal-is-a-microcosm-of-all-of-the-changes-in-world-health/" target="_blank" rel="noopener noreferrer">"Nepal is a microcosm of all of the changes in world health"</a><a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/here-now/ke-garne-attitude-kills-people/" target="_blank" rel="noopener noreferrer">K garne attitude kills people</a>, Laxmi BasnetNepal, like much of the developing world, has witnessed dramatic and disorderly urban growth in recent years, much in the lowlands along highways. ‘Nepal's Tarai," Mukesh Pokhrel recently wrote also in this newspaper, "is turning into one endless elongated metropolis.’Kathmandu itself grew four-fold between 1980 and 2010, and is one of the fastest growing cities in one of the world's fastest urbanising regions.'<a href="https://www.nepalitimes.com/banner/mosquitoes-move-up-mountains-as-the-earth-warms/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/banner/mosquitoes-move-up-mountains-as-the-earth-warms/&amp;source=gmail&amp;ust=1590920172779000&amp;usg=AFQjCNHqCreNEFDji4GDyS_wUW1JkpUOGA">Cities like Kathmandu are perfect breeding grounds</a> for the Aedes mosquito,' says Jeremy Farrar of the Wellcome Trust in an interview with this paper. 'Kathmandu’s climate is changing, the city is growing exponentially in a haphazard way and the mosquito loves highly dense populations of people.'<a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/banner/east-west-city/" target="_blank" rel="noopener noreferrer">East-West City</a>, Mukesh Pokhrel<a href="http://archive.nepalitimes.com/news.php?id=19301#.XtI_7y2B3-Y" target="_blank" rel="noopener noreferrer">Dengue fever</a>, Buddha BasnyatThe Lancet highlights what might happen in a dengue explosion in Kathmandu. ‘A tug-of-war might occur between the worried well and the truly sick,’ it says. ‘Hospitals might be overwhelmed and many needy patients with other diseases could be turned away.’Doctors inexperienced with the disease pose a particular worry. They could misunderstand its dynamics and cause unnecessary deaths by over-treating with unneeded antibiotics, transfusions, and excessive intravenous fluids. This has happened elsewhere.The dengue-carrying Aedes aegypti mosquito is difficult to control. Brazil eradicated it twice, in the 1950s and in the 1970s, and twice it returned. Several factors explain why: a lack of sustained careful epidemiological surveillance, insecticide resistance, the high costs of materials and wages, insufficient community participation and coordination with the health sector, and, crucially, the spread of haphazard urban development. Narrow control programs inevitably run into trouble.The World Health Organisation (WHO) stresses both micro and macro efforts to fight dengue. Individual families can put tight lids on water containers. They can eliminate breeding spots such as empty cans, bottles, and tires. It also says community engagement and building country capacity for environmental management and disease surveillance is important.“Locally adapted vector control measures such as household water storage management and, more importantly, engaging individuals and communities to manage their immediate environment are essential to controlling the spread of the disease,” says Raman Velayudhan, head of WHO’s Vector and Ecology Management Unit.School-based awareness programs, The Lancet authors noted, can help block dengue's spread. ‘Students are good learners and can be taught to effectively use repellents and mosquito nets and get rid of water collections near their homes and schools; students will then spread this information to their parents.’ Several countries have implemented successful school programs.Historian Frank Snowden sums it up: "Dengue takes full advantage of societal neglect and the absence or cessation of vector control programs."Tom Robertson, Ph D, is an environmental historian who writes about the history of malaria in Nepal. And just wrote a <a href="https://www.nepalitimes.com/banner/big-story-of-small-pox-in-nepal/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/banner/big-story-of-small-pox-in-nepal/&amp;source=gmail&amp;ust=1590920172779000&amp;usg=AFQjCNFk193f6QnfjiWqivawrVZt2FPA4A">five-part series on smallpox</a> for Nepali Times as part of his History of Disease column.

Tom Robertson

The dangers of the dengue virus

Nepal has shut down dozens of social media platforms in a move that is widely seen as an effort to tax the revenue they generate in the country, and to control content critical of government. The sites were blocked as of midnight on Thursday, 4 September and affects all Meta products including WhatsApp and Messenger, Threads, and others. Although YouTube, Google and X are also on the government’s list, they were still working as of Friday midday.&nbsp; The government says it took the action after repeated warnings to the platforms to open offices in Nepal, a Cabinet decision last month setting a deadline, as well as a 17 August Supreme Court ruling also requiring them to register and pay requisite taxes. However, the Bill cited in the ban, ‘The Operation, Use, and Regulation of Social Media in Nepal’ has not yet been passed by Parliament. Some social media platforms which were already paying taxes in Nepal even though they are not officially registered, have also been blocked. The move is the latest in <a href="https://nepalitimes.com/news/big-beautiful-bills" target="_blank">a slew of draft legislations</a> designed to undermine Nepal’s open society. A Bill amending the Print and Publications Act would allow district bureaucrats to shut down media. Another draft Bill would allow political appointees to head a new Media Council with the power to revoke the licenses of journalists.&nbsp; A counter-intelligence Bill would let just about anyone in government to arbitrarily tap phones, read emails and trail citizens. On Wednesday the government announced new immigration requirements that would allow it to track the movement of all foreigners in the country. Yet another draft Bill has been set to Parliament to dissolve the <a href="https://archive.nepalitimes.com/news.php?id=10675" target="_blank">Social Welfare Council (SWC)</a> and move registration and monitoring of non-governmental organisations, nonprofits and charities to the Ministry of Social Welfare. Seen in this light, the blockage of social media platforms this week is seen as the latest government attempt to constrict freedom of press. Nepal is one of the few remaining open societies in Asia, and now appears to be drifting towards authoritarianism. The government’s sudden shutdown of social media has been greeted with howls of protest on platforms that still remain open, like Viber and TikTok, as well as in Nepal’s mainstream press. Even senior members of the ruling UML-NC coalition have sharply criticised the move, asking if the government is trying to “turn Nepal into North Korea”.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025090508098_a2ab330e403e8418a7006cd5e915607382628dd6984524332bf7b99c74743656.jpg" data-media-id="editor_2" data-image-id="2025090508098_a2ab330e403e8418a7006cd5e915607382628dd6984524332bf7b99c74743656" data-rendition-name="original" width="4280" height="5187" loading="lazy" alt="social media ban in Nepal"> </figure>  The Regional Director of the New York-based Committee to Protect Journalists (CPJ) Beh Lih Yi said in a statement: ‘Nepal’s sweeping ban on social media sets a dangerous precedent for press freedom. Blocking online news platforms vital to journalists will undermine reporting and the public’s right to information. The government must immediately rescind this order and restore access to social media platforms, which are essential tools for exercising press freedom.’ Besides undermining press freedom, blocking social media platforms will also hurt commerce and the economy since so many small and medium business trade through Instagram, Facebook and other platforms. Nepal’s vibrant social media has also been a boost or citizens to assert identity, build solidarity against injustice and play an adversarial role when the mainstream media does not do it. Social media platforms have also become the tenuous link for Nepali families scattered across the world to keep in touch with each other — its importance growing with the increasing size of the diaspora. The government wants social media platforms to register, pay taxes and remove posts on their sites that ‘undermine the national interest and Nepal’s territorial integrity, disturb social and religious harmony’.&nbsp; In response, rights activists have said while there is need for the government to regulate extreme content and hate speech, officials appear to be more intent on clamping down on free speech and trying to force platforms to share the revenue. On Friday, the government had allowed WhatsApp back online, but there were reports that it had instructed the Nepal Telecommunication Authority (NTA) to instruct mobile and internet service providers to block by Friday night all platforms, including Facebook, Instagram, Messenger, WhatsApp, X (Twitter), YouTube, LinkedIn, Reddit, Threads, Snapchat, Pinterest, Signal, Clubhouse, Rumble.&nbsp; Platforms that have registered and are allowed include TikTok, Viber, Nimbuzz, Popo Live, WeTalk, Global Diary and the Nepali portal Hamro Patro. TikTok was banned last year for ‘disturbing social harmony’ and it was lifted after the platform registered its office in Nepal. But even while it was banned, many users simply switched to VPN. Telegram was also banned for ‘financial crimes’ and it has since also been allowed back. NTA officials confirmed that some Asia-Pacific regional offices of platforms, including Meta had been in touch overnight inquiring about the registration process.&nbsp; Nepal is not alone in regulating social media. China bans most Western platforms, Russia and Turkey regulate their and require platforms to locate their data servers in the country. Gulf countries allow social media but keep a tight control on dissent.&nbsp; Experts have said even the government will not dare close down YouTube since so many Nepali individuals and companies make money with posts on that platform, and closing it would also impact on Google and Gmail. Facebook had also just launched a monetisation scheme for videos and reels, and Nepalis uploading content would lose revenue.&nbsp; Blocking the platforms has already hit content creators, influencers and cut small businesses from reaching customers. A survey of social media use in Nepal by Sharecast Initiative showed that 94% of those with smart phones used YouTube, followed by Facebook (92%) while TikTok was in the 50-60% range. X and Instagram were in the single digits. A YouTube ban will also hurt the mainstream media since up to 20% of the revenue of Nepal’s main tv channels came through YouTube. Some 11.1 million Nepalis watch YouTube content every day, the survey showed. ‘For global giants like Meta or Google, Nepal is a small market, and they may not even flinch — but for millions of Nepalis, these platforms are central to daily life, livelihoods, and connections across the world,’ wrote AI consultant Naresh Newar in a LinkedIn post. Some experts said the government’s sweeping ban on social media networks was untenable and the government would be forced to rollback sooner or later. Said editor Shiva Gaunle: “The platforms had given citizens a voice and broken the monopoly of the government, legislators, the courts and journalists over public opinion. This is an effort to reassert that monopoly, but Nepal can never be turned into a North Korea.”

Protest grows against Nepal’s social media ban

<a href="https://www.youtube.com/watch?v=x2fZXyjsE28" target="_blank">Yog Narendra Malla</a> became king at age 18, and ruled Patan from 1684-1705 — his reign marked by a cultural and architectural renaissance of the city state. He put up a statue of himself in the palace square with a little bronze bird sitting on the guardian serpent above his head. It is said he told his subjects that he would look after their welfare till the day the bird flew off. During<a href="https://nepalitimes.com/here-now/lessons-not-learned-from-2015-o2etq6zu"> the 2015 earthquake</a>, the pedestal collapsed and the statue was damaged. The bird was lost, only to be located in a pile of debris and reinstated when the <a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/piece-by-piece-patan-darbar-square-reconstruction,3782" target="_blank">statue was consecrated</a> two years later. <div class="embed-block"><iframe width="560" height="315" src="https://www.youtube.com/embed/x2fZXyjsE28?si=jYfIb4p6zCLXYQ1T" title="YouTube video player" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share" referrerpolicy="strict-origin-when-cross-origin" allowfullscreen></iframe></div> History remembers Yog Narendra Malla as a wise king, but like most<a href="https://nepalitimes.com/here-now/preserving-king-birendra-s-family-home"> royalty of the day</a>, he had a weakness for women. He is supposed to have consorted with 30 queens and numerous concubines. At least 33 of them self-immolated themselves on the king's funeral pyre when he died, adhering to the prevailing <a href="https://archive.nepalitimes.com/article/review/Jhola,947">practice of sati</a>. When Yog Narendra Malla’s favourite queen found out that he was carrying on with yet another woman, she got the local community of the Kwelachhi neighbourhood to stage a shadow sex play to quite literally expose his unfaithfulness. Actors enacted the explicit exploits of the king and his mistress, a bright butter lamp projecting the moving shadows of their lovemaking on a thin white drape to entertain those gathered in the square below. The queen made sure that the show was designed to face the home of the king’s paramour to shame them both. She also paid for a group to chant a bhajan with lyrics that ridiculed the king’s extramarital affair. The Jhyalcha Guthi community trust that the queen set up three-and-half century ago is still active to this day, and performs the annual shadow play in the same building in Kwelachhi the day before <a href="https://nepalitimes.com/banner/the-legend-behind-the-myth-of-indra-jatra">Indra Jatra </a>every year. This year’s show is on Friday evening, 5 September. The opening lines of the chants that accompany the play are the same words approved by the queen all those years ago: “Raja Yog Narendra ya aparadh…” (King Yog Narendra’s crime…) The community leader of the Kwelachhi neighbourhood, 62-year-old Baburaja Awale, explains the importance of the event: “This Jhyalcha is our<a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/saving-the-intangible,3303"> intangible heritage</a> and oral history. We do not have a written format, it has been passed down from generation to generation. Every word of the bhajan is the story of King Yog Narendra Malla.”  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250904070952_249e85b32cbd99bb8515151557e0ec1a65d44a34ef1aacabaaeb469622d12664.jpg" data-media-id="editor_8" data-image-id="20250904070952_249e85b32cbd99bb8515151557e0ec1a65d44a34ef1aacabaaeb469622d12664" data-rendition-name="original" width="1750" height="1167" loading="lazy" alt="Sex and the city of Patan"> <figcaption>The statue of Yog Narendra Malla being reinstated after it toppled in the 2015 earthquake. Photo: GOPEN RAI/ NEPALI TIMES ARCHIVE</figcaption> </figure>  Jhyalcha Pyankha, as the ceremony is called, starts with a puja for the Bhimsen — the god of wealth and prosperity, a popular <a href="https://nepalitimes.com/here-now/the-homecoming-of-nepal-s-gods">deity in Patan</a> who has a temple dedicated just to him in the palace square. This is immediately followed by a bhajan of Bhairab performed with <a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/Buzz-house,670">traditional Newa musical instruments</a>. Community members serve snacks consisting of samay baji beaten rice, water buffalo chunks, soybean, green veggies, lentils, ginger, garlic and aila liquor. “In the first act of the shadow play, the man initiates the lovemaking, and in the third it is the woman,” says Laxmi Lal Awale, also a member of the trust that organises the show. The shadow action is all uncensored, but interspersed with <a href="https://nepalitimes.com/review/between-the-sacred-and-everyday">scenes of everyday life</a>: the woman is spinning a thread, the king is going about his royal chores, and the two sit down to share sanacha fermented pickle that is popular this time of year. <div class="embed-block"><iframe width="560" height="315" src="https://www.youtube.com/embed/qZ3twuG1wNQ?si=yRfkoC3A-X9cIl8r" title="YouTube video player" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share" referrerpolicy="strict-origin-when-cross-origin" allowfullscreen></iframe></div> “Back then, there was no tv, films or YouTube, and yet we managed to stage the shadow play using our own resourcefulness,” says Baburaja Awale. “It is important to continue the tradition.” The challenge now is to ensure that the<a href="https://nepalitimes.com/opinion/the-reign-of-the-god-of-rain"> younger generation takes over</a>, learning the lyrics of the ancient bhajan. The dafa khala group that performs all over Patan during festivals and religious events is now training teenagers to play the musical instruments and act in the shadow play. The Jhyalcha was staged even after the 2015 earthquake when the falcha where the bhajan is performed collapsed and they made-do in a tin shed. The structure was later rebuilt with a grant from the group, Photo Circle. Lalitpur Metropolitan City sets aside a budget of Rs50,000 to organise the Jhyalcha Pyankha every year, but this is not enough and is supplemented by individual donations. The performers including musicians and actors are all volunteers, and take part in it because it is their community duty. The erotic shadow play was way ahead of its time, not just in its graphic content but the use of contemporary local technology as well as improvisation and pure imagination. Says Laxmi Lal: “Whatever its origin in the legend of King Yog Narendra Malla and his queen, Jhyalcha also served as a medium of <a href="https://nepalitimes.com/here-now/lets-talk-about-it">sex education</a>. In the past, women were discouraged from watching the shadow play, but today everyone is welcome, we all watch it together.” Jhyalcha Pyankha Kwelachhi, Chyasal, Patan 7PM onwards Friday, 5 September

Sex and the city of Patan

Unlike many countries, there is not much incentive in Nepal for the private sector to fund charities and non-profits. Donations and grants are not tax-deductible.
Yet there are corporate entities that have Corporate Social Responsibility (CSR) in their portfolio of activities through foundations that they have set up. Some do it loudly to gain public relations mileage, while others are quiet about their <a href="https://nepalitimes.com/opinion/comment/norway-supports-himalayan-climate-research?mdrv=www.nepalitimes.com&amp;=1">generous support</a>.
The CSR outlay of factories and manufacturing companies is regulated by Industrial Enterprise Act (IEA), while the Nepal Rastra Bank oversees grants banks and financial institutions contribute and requires them to set aside 1% of their net profit for CSR activities.
The guideline requires banks and financial institutions to donate to activities covering education, health, environment and financial literacy, among others. Recently, the Supreme Court directed the government to formulate a Bill in the parliament to standardise and regulate the private sector’s CSR activities.
“We receive guidelines from Nepal Rastra Bank and follow them,” says Pranisha Shrestha who heads the CSR Department at NMB Bank. “We have got a notice about updates on those guidelines, and we will adapt accordingly.”
<a href="https://nepalitimes.com/news/greening-nepal-s-tourism">Environmental sustainability </a>is one of the important components of CSR for Nepali companies, and there have been many initiatives aimed at urban renewal. One of the most visible is of the telecommunication company Ncell, which is among Nepal’s largest taxpayers.
Five years ago, Ncell adopted a 6km stretch of the Ring Road from Ekantakuna to Koteswor-Kalanki, planting 12,000 saplings. They have now grown into<a href="https://nepalitimes.com/opinion/seeing-the-forest-and-trees-in-nepal"> a thick forest</a> along the embankment of the road.
Not only is the lush greenery in an overbuilt part of Lalitpur soothing to the eye, it also helps in reducing temperature within <a href="https://nepalitimes.com/news/in-the-heat-of-the-moment-5xcycyot">the urban heat bubble</a>, and also contributes to reducing air pollution and traffic noise.
“We started a pilot project along 600m of the Ekantakuna section of the Ring Road during the pandemic,” recalls Bishakha Lakshmi Khadka, Director of Corporate Communications and Sustainability at Ncell. “It went really well, and after that we extended the<a href="https://nepalitimes.com/here-now/saving-cities-with-trees"> tree planting</a> and upkeep to Kalanki.”
Sustainability also means making younger Nepalis aware of <a href="https://nepalitimes.com/banner/natures-fragile-gift-to-nepal">the value of nature </a>and environmental sustainability, which is why Ncell has also undertaken a Green School initiative in and around Kathmandu Valley. Besides its One-Tree-One-Youth and 1 Million Trees campaigns, the initiative also aims at behavior change about littering with its waste hackathon in schools.
“The young students can be catalysts with a multiplier effect beyond their schools to society at large, and it has inter-generational impact into the future,” explains Khadka.
Indeed, while <a href="https://nepalitimes.com/banner/tree-mendous">Nepal has doubled its forest cover </a>in the past 30 years to 46% of the country’s area, urban centres like Kathmandu do not have much open spaces and greenery left. And that is where companies like Ncell, Jawalakhel Group of Industries, and others have focused on CSRs.
NMB Bank also runs financial literacy programs for youth where they can learn more about social media safeguards, digital payment systems, with a focus on safety and security. Such training not only helps build skills for the future but also protects young Nepalis from online crime.
“<a href="https://nepalitimes.com/opinion/protecting-children-from-anti-social-media">Threats to young minds through social media</a> use are growing as platforms feed algorithm-driven content,” says Shrestha. “We felt media and digital literacy are important in all seven provinces not just to protect young people, but also give them the confidence to use digital financial systems.”
The bank has a special focus on women in leadership programs, and provides scholarships provided in schools across Nepal on environment and sustainability in higher education. Health is another sector where private companies have worked with donating medical equipment, sponsoring health camps and conducting blood donation drives.
CSR or PR?
Other companies heavily involved in CSR include NIMB Bank which contributes to heritage conservation and education, Buddha Air helps farmers in Morang to increase productivity, VOITH with its motto ‘Little things We Do’ provides scholarships to students and has gifted &nbsp;vehicles to hospitals and nature conservation groups, Dwarika’s Hotel promotes organic farming and zero waste initiatives, heritage conservation and helps revive traditional handicrafts.
Although some CSR activities have been criticised for masquerading as PR and for greenwashing, many Nepali companies are actually contributing to improve the situation for individuals in need and underserved communities.
It also brings a sense of accountability to the corporate sector so they look beyond shareholder profit with greater involvement in the public good. In Nepal, where government delivery mechanisms are not up to speed in the social sector and environmental sustainability, CSR is a vehicle for public-private partnerships.
Collaboration with the government is an important aspect of these initiatives since that allows localised campaigns to be scaled up by showing what is possible. For example, the three Metropolitan Cities of the Valley and other private companies are trying to emulate what Ncell has achieved on the Ring Road.
“The Ring Road plantation project has been massively successful,” says Khadka “We were recognised by the Lalitpur Metropolitan City and the Forestry Department for adding greenery to what would have been just an asphalt strip.”

Corporates responsible to society

This is the 72nd 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. My father ran a store and that is where I spent all my time till Grade 6. Doing my homework. Serving customers. I then moved to my maternal grandparents’ house because I used to get along with my cousin who was a year older than me. We did everything together, and were best friends. We took turns studying: I was a night owl, and he was an early riser. Before I went to bed after studying all night, I woke him up. My mother was 44 when I was born, the same year my eldest brother got married. My sister-in-law becoming a part of our family was how my mother referenced my age. I liked making money, and was always a hustler. In Grade 7, I learnt to handle a tractor and helped my brother-in-law to plough, earning Rs10 a day. As I got better, he paid me more. By Grade 9, I was already making Rs500 per day, but had to slow down to prepare for my exams. From an early age I knew I did not want a 9-5 job. There just wasn’t enough money in it. I wanted to get into business, and compared my brother who worked in the post office and what businessmen made. It did not help that my brother was honest, and never took bribes. A friend and I made money selling cheap Chinese phones at a premium to our friends. We blasted music on the phones and pretended that we were giving them a discount. After SLC, I started teaching math and other subjects. I was soon a shareholder in the same school and in the evening I was involved in our family’s floriculture business, growing amaranth and marigold for garlands.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250831020844_1b54b999d67122a50c4c7e6204cc737bcc99bf2a68db6499a4566a7f61a880b4.jpg" data-media-id="editor_0" data-image-id="20250831020844_1b54b999d67122a50c4c7e6204cc737bcc99bf2a68db6499a4566a7f61a880b4" data-rendition-name="original" width="955" height="1314" loading="lazy" alt="Diaspora Diaries 72"> </figure>  It was then that a friend suggested we learn the Korean language. We could be earning significantly higher in Korea for similar efforts. I had no plans to go abroad but he convinced me. I did not know anything about Korea, and was scolded at the language institute when I asked someone to point Korea on the map.&nbsp; It was only there that I learnt you had to pass an exam for the Korean Employment Permit System (EPS), and pay for language classes. After a week, I decided it was not for me and dropped out. But my friend convinced me to give it one more try. I did not prepare much for the exam, and it was no surprise that I failed. But it was just by one mark, and people would pity me for failing “just by one mark”. It was a brand of failure. It hurt my ego. I had to turn things around by taking the exams seriously, and locked myself up to study hard.&nbsp; Even when we had visitors, my wife told them I was not home. If I was not in my room learning Korean, I would be with a group of ten of us test-takers comparing notes and practicing late into the night. The exam was difficult, but this time I passed, the only one in my group who did.&nbsp; As someone who never liked the idea of doing a job, I still had my doubts about going to Korea. It did not help that one of my acquaintances had returned a month after he had left, and he discouraged me from migrating given that I was already making good money in Nepal.&nbsp; But my wife suggested that I give it a shot since I had worked so hard for it. And if it really turned out not to be my cup of tea, I could always return. What did I have to lose, I thought, at least I would get to visit Korea. My job there was in an electrical company that made circuit boards. I worked all day, earned good money. In the evenings, I kept myself busy with my real estate business back in Nepal. I had learnt the tricks of the trade from fellow real estate agents back home, but at the time did not have the capital to invest.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250831020848_941e961e2045058f255ad89884b51faa7d2365c68236e5cbe573d63d769ac6c5.jpg" data-media-id="editor_1" data-image-id="20250831020848_941e961e2045058f255ad89884b51faa7d2365c68236e5cbe573d63d769ac6c5" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="Diaspora Diaries 72"> </figure>  In Korea, it helped that I had salary records that allowed me to get loans from financial institutions both in Korea and in Nepal. Ultimately, I started earning more from my real estate deals in Nepal than from my job in Korea. This was all thanks to my ability to take loans because of the EPS scheme. My wife has been managing the flower business while I was away. My finances grew stronger over the eight years I was in Korea. I paid off the loans that I had borrowed to buy land. But real estate did not satisfy me entirely. I wondered: what is my brand? What will I be known for? What is my contribution to society? Real estate is for wealth, but that is about it. I needed to sell one piece of land and use the revenue to start a venture. I took classes in business, and returned to Nepal six months ago and got back to my family’s ancestral roots in floriculture. In Nepal too, I am continuing the entrepreneurship training I had started in Korea with the Bridge International. Such exposure helps us reflect on our business such as our branding, vision, and proactive aspects like the importance of strong recordkeeping.&nbsp; I am now working to upgrade and expand my floriculture business. With a friend who is still in Korea I am building a cooling room to increase the shelf-life of flowers and other produce and set up a market in my village where others can sell their produce. Floriculture is our primary business, but it is seasonal and earns good money only during festivals like Tihar.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250831020848_a008ffeba13896e6918f68ff6e687c8fe11140d86a96f1ec11690547f2bcd415.jpg" data-media-id="editor_2" data-image-id="20250831020848_a008ffeba13896e6918f68ff6e687c8fe11140d86a96f1ec11690547f2bcd415" data-rendition-name="original" width="1280" height="720" loading="lazy" alt="Diaspora Diaries 72"> </figure>  So, I grow tomatoes to ensure year-round earnings. I also am engaged in other businesses like real estate and online shopping. I work round the clock in Nepal — a strong work ethic is something I picked up in Korea.&nbsp; My Korean bosses would work alongside us, that motivated us. I work just as hard in Nepal as I did in Korea. People here often ask me why I am pushing myself so hard. But making garlands comes easy to me, it is work my forebears were involved in. My childhood memories are about plucking flowers with my sister. I have a comparative advantage in this work. It comes naturally to me, it is easy and I enjoy it. And sometimes, if there are too many garlands to make, I can multitask while holding meetings. My fingers just fly. I am good at this job, but my wife is even better and faster.&nbsp; When there is too much load, we can also outsource the work. To be known as the flower guy would be great personal branding. The मखमली guy. Or the सयपत्री guy. I decided to come home for just this with a one-way ticket. “अब पासा: जाँदैन ल्हासा!” &nbsp;