Throughout human history, civilisations have been named after the rivers along which they flourished: Indus Valley, Nile, Tigris-Euphrates. Many of these cultures later collapsed, partly because they could not manage their water needs properly. Three recent books about Himalayan rivers look at their history and geography, and how they nourished civilisations downstream. The rivers gave birth to the world’s major religions, their waters and the mountains from which they sprang were revered. Mythology and geology converge in High Asia. Mt Kailash is holy to the Hindu, Jain, Buddhist and Bon faiths as the centre of the world and the abode of the gods. Indeed, from its vicinity emerge Asia’s great rivers: the Indus and Sutlej, Ganga and the Yarlung Tsangpo (Brahmaputra) and Karnali (Mapcha Tsangpo).&nbsp; Legend has it that Kathmandu Valley was once a primordial lake drained by Manjushree who cut a mountain with his flaming sword. There is scientific evidence that the paleo lake was indeed emptied in stages starting 40,000 years ago after a tsunami unleashed by a major earthquake epicentred in Langtang. The Bon faith describes the Tibetan Plateau being pushed up from a roiling primeval sea, confirming current evidence about the orogenesis of the Himalaya. In local lore, supernatural lha (animal deities) and lu (serpents, naga) moved from sea to land, just as the theory of evolution explains the emergence of early amphibians and land creatures. In <a href="https://www.routledge.com/Rivers-of-the-Asian-Highlands-From-Deep-Time-to-the-Climate-Crisis/Gamble-Tan-Xu-Beavis-Maurer-Pittock-Powers-Wasson/p/book/9781032490595?srsltid=AfmBOopjkpgcN1_7t1jTI_Z1_27yRthBTbdHA15OWcE9Ge3S409jhUX3">Rivers of the Asian Highlands: From Deep Time to the Climate Crisis</a>, Himalayan historian <a href="https://scholars.latrobe.edu.au/rgamble">Ruth Gamble</a> and co-authors begin by tracing the genesis of the Himalaya, citing evidence that the Tibetan Plateau pre-dated the collision of the Indian and Eurasian plates 50 million years ago. Asia’s main rivers co-emerged with the mountains, their waters cutting canyons through rocks as they were uplifted. The gigantic pileup acted as a moisture trap for the proto-monsoon, the rain and ice sculpting peaks as they rose. But so strong were tectonic forces that the uplift outpaced erosion on the Tibetan Plateau. These dynamic processes are still at work, but in many places across High Asia there is a new factor at play: modern infrastructure (like haphazard road-building in Nepal) is increasing erosion faster than the uplift rate.&nbsp; ‘This is an example of human action overcoming tectonics,’ write the authors in Rivers of the Asian Highlands, in which the chapters look at Himalayan rivers from a planetary scale, their socio-cultural histories, to present-day engineering to regulate them. An ongoing dam-building spree and anthropogenic climate breakdown combine to bring about the most rapid change the Himalaya and their rivers have seen for millions of years. One example is the Medog Hydropower Station being built on the Yarlung Tsangpo at a bend on the Brahmaputra before it enters India. The river drops 2,000m within a 50km stretch, the gradient allowing it to generate 60,000MW — the biggest single hydroelectric plant in the world. Gamble and the authors of Rivers of the Asian Highlands highlight the Gravitational Potential Energy (GPE) of the Himalaya that allows falling water to be converted into electricity. But GPE also unleashes landslides, rockfalls, avalanches, Glacial Lake Outburst Floods (GLOFs) and Landslide Lake Outburst Floods (LLOFs), the risks posed by them magnified by climate change and seismicity. <blockquote>The Asian Highlands’ abundance of Gravitational Potential Energy (GPE) can support the region’s energy transition, but it needs to be produced in much less hazardous and less environmentally and socially impactful ways. The best means of doing this is through off-river, pumped-storage hydropower stations that back up solar and wind energy generators. Smaller projects such as this would also involve less risky tunneling and displacement.</blockquote> Rivers of the Asian Highlands: From Deep Time to the Climate Crisis by Ruth Gamble, et al. There is geological evidence that megafloods on Himalayan rivers are more responsible than mass wasting in weathering down the mountains. One big LLOF, for example, could ‘move 1,000 times more sediment than would otherwise be transported over millions of years’. Permafrost melting in the Tibetan Plateau and inside moraines caused recent back-to-back GLOFs in Chamoli in the Indian Himalaya, Melamchi in Nepal, and the South Lhonak in Sikkim — all deadly disasters that together destroyed billions of dollars worth of infrastructure downstream. Rivers of the Asian Highlands travels from deep time to the present climate crisis, taking readers through neatly divided chapters titled Mountain Rivers, Climatic Rivers, Frozen Rivers, Living Rivers, Human Rivers, Territorializing Rivers, Agricultural and Pastoral Rivers, even NGOs and Rivers.&nbsp; Although the book’s title is about the ‘Asian highlands’, it <a href="https://www.himalmag.com/comment/eastern-himalaya-cradle-ethnogenesis">focuses mainly on the Dri Chu (Yangtse)</a> and Yarlung Tso (Brahmaputra). Readers looking for references to Nepal’s rivers will be disappointed, although there is quite a bit about Bhutan. This is surprising because 70% of the annual flow in the Ganga is from tributaries in Nepal, some of them rivers like Karnali, Arun or Bhote Kosi that traverse the Tibetan rimlands. As demand for water and energy grows in the large and increasingly affluent population of north India, and climate breakdown melts Himalayan glaciers, storing monsoon runoff on reservoirs in Nepal is going to be the geopolitical issue of the next decades.&nbsp; The chapter on NGOs and Rivers also fails to cite the work of Nepal’s civil society groups like the Alliance for Energy that built international solidarity in 1995 against the Arun III project on a river that starts in Tibet and flows into Nepal. Ultimately, the World Bank pulled out of the project and the Nepal government invested in smaller decentralised plants. Today, a cascade of power plants are being built by Indian companies on the Arun which do not seem to have taken into account the <a href="https://www.science.org/doi/10.1126/science.ads2659">2023 Sikkim GLOF</a> that swept away the $1 billion dollar Teesta III and destroyed other infrastructure. The World Bank itself is back with the Upper Arun project located directly below expanding glacial lakes in Tibet.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250222020256_f2b33e60e6b386308bdf59b58b59e116e90e2e4466a06200faf76fd851f53505.jpg" data-media-id="editor_4" data-image-id="20250222020256_f2b33e60e6b386308bdf59b58b59e116e90e2e4466a06200faf76fd851f53505" data-rendition-name="original" width="5712" height="3213" loading="lazy" alt="Teesta"> <figcaption>The Super Trisuli project in Nepal has ruined the most scenic and ecologically sensitive part of the river to generate just 100MW of power. Photo: KUNDA DIXIT</figcaption> </figure>  Despite geographical gaps, Rivers of the Asian Highlands reads like an encyclopedia of Himalayan rivers. The authors look at them not in isolation but as interconnected systems which need a multidisciplinary approach to study the geological, religio-cultural, infrastructure, climate and ecosystem services aspects of catchments.&nbsp; Mt Kailash (Kang Rinpoche) is a case in point. It is fascinating to think that it was part of a mountain range even before the collision of the continents that formed the Himalaya, and was probably buried in ice 3km thick till 15,000 years ago during the Last Glacial Maximum.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025022203020_23c02ec4671f5c3c561fa6b450c1f209720a25794e067b9bb5db0f4649b1b6dc.jpg" data-media-id="editor_5" data-image-id="2025022203020_23c02ec4671f5c3c561fa6b450c1f209720a25794e067b9bb5db0f4649b1b6dc" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="Mt Kailash"> <figcaption>Mt Kailash. Photo: NABIN BARAL</figcaption> </figure>  Lake Mansarovar and Mt Kailash are also the subject of the new Nepali language book छालबाटो (Road by the Waves) by environmental journalist <a href="https://nepalitimes.com/news/nepal-and-china-to-study-trans-himalayan-railway">Ramesh Bhushal</a> in which he walked, rafted and drove from the source of the Karnali in Tibet, right through 500km of western Nepal, and on to India <a href="https://nepalitimes.com/banner/dancing-with-the-river">where the river meets the Ganga</a>. In his entourage is activist, <a href="https://archive.nepalitimes.com/regular-columns/Comment/rivers-fighting-back,993">Megh Ale</a>, who is on a campaign to stop dams and infrastructure on <a href="https://nepalitimes.com/banner/dams-and-dreams-a-journey-down-the-karnali">Nepal’s longest and only free-flowing river</a>. The book profiles his lonely upstream struggle to conserve the country’s rivers. “We worship rivers, but we don’t love them,” laments Ale. Bhushal’s book is as much about the landscape of this transboundary river as it is about the people he meets along the way, and their relationship with <a href="https://nepalitimes.com/banner/climate-denial-in-the-himalaya">a river that most regard as a curse </a>keeping them poor because they believe it flows out of Rakshas Tal (Lagngar Tso) in Tibet, regarded as a lake of demons, unlike the sacred Mansarovar nearby. The expedition is out to prove that the <a href="https://nepalitimes.com/banner/a-karnali-portrait">Karnali River</a> actually starts in the mountains 50km southwest of the Mansarovar (Mapamyu Tso) at the <a href="https://www.youtube.com/watch?v=jQ9Za5QDkvY">Peacock Falls (Mapchu Khambap)</a>. The Indus is called Sengge (Lion), Sutlej is Langchen (elephant) and the Brahmaputra is Tamchok (horse), all starting within 60km of Mansarovar but flowing out in different directions. <blockquote>“I have visited hundreds of rivers around the world, but for some reason I have never seen a river as beautiful as the Karnali. One day I would like to visit its source.”</blockquote> River conservation activist Megh Ale quoted in छालबाटो by Ramesh Bhusal. But all this reverence for the mountains and rivers may not be enough to save the region from the impact of climate breakdown. Heat stress in the Subcontinent will coincide with a shortage of water in the coming decades.&nbsp; <a href="https://www.nytimes.com/2018/12/01/opinion/himalayas-mountains-dams.html">Sunil Amrith</a> in his 2019 book, <a href="https://nepalitimes.com/here-now/the-monsoon-and-nature-s-arithmetic">Unruly Waters: How Mountain Rivers and Monsoons Have Shaped South Asia’s History</a> takes a broader look at how geotectonics, geopolitics, colonialism and nationalism have determined the relations between human beings and rivers. The Himalayan water cycle starts from monsoon moisture that precipitates with orographic uplift along the mountains, atmospheric rivers unleash cloudbursts, ground water emerges from springs that join up to flow down to rivers and the ocean. The Third Pole is the biggest repository of fresh water stored as ice after the polar regions. But it is a hotspot both because of the climate crisis and geopolitical tensions, which impacts on river basin cooperation, early warning data sharing, and ultimately in mitigation of greenhouse gas emission and planning for new risks faced by infrastructure. After independence, India adopted the colonial extraction model for rivers. Inaugurating the Bhakra-Nangal Dam in 1953, Jawaharlal Nehru called it “a temple of &nbsp;modern India … worthy of worship’. Gamble also alludes to this in her book about the European attitude about rivers as a resource to be ‘enclosed, extracted, scrutinised, commodified’. <a href="https://dialogue.earth/en/water/review-unrully-waters/" target="_blank">Amrith</a> profiles the work of Sir Arthur Cotton who was building canals linking rivers in British India at about the same time his contemporaries like botanist <a href="https://nepalitimes.com/here-now/republic-of-nepal-s-animal-kingdom" target="_blank">Joseph Dalton-Hooker </a>were exploring the <a href="https://nepalitimes.com/here-now/saving-kangchenjunga" target="_blank">Teesta and other rivers</a> in the Himalaya to catalogue new plant species. India's current National River Linking Project that would join 37 rivers with 9,000km of canals builds on Cotton’s early work. <blockquote>If there is one consistent lesson in Unruly Waters, it is that water management never has been, and can never be, a purely technical or a scientific question; neither can it be addressed on a purely national scale … the battle continues to understand the monsoons and mountain rivers that shape Asia.</blockquote> Unruly Waters: How Mountain Rivers and Monsoons Have Shaped South Asia’s History by Sunil Amrith And in Nepal, hydropower has become the holy grail as the government unveiled an Energy Development Roadmap to generate 28,500MW by 2035 at a cumulative cost of nearly $50billion. This means no river in Nepal will be left free-flowing. The Trisuli along the Prithvi Highway is being dammed for only 100MW of power, destroying the most scenic part of a river that has rapids famous internationally for white water rafters. Even before it was completed, the dam site suffered Rs200 million in damage in last September’s flood.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025022203020_d9610a11bccb593d32bf4d214479caa17dfbdd6cdfe5e8c38fdcb8eb752fc0ec.jpg" data-media-id="editor_18" data-image-id="2025022203020_d9610a11bccb593d32bf4d214479caa17dfbdd6cdfe5e8c38fdcb8eb752fc0ec" data-rendition-name="original" width="4032" height="2268" loading="lazy" alt="Trisuli"> <figcaption>Boulders and sediment 80m deep were brought down by the Teesta after a GLOF destroyed the $1 billion Teesta III plant in Sikkim in 2023. Photo: KUNDA DIXIT</figcaption> </figure>  In Sikkim, there is strong <a href="https://india.mongabay.com/2025/02/political-stir-follows-expert-panels-approval-to-rebuild-teesta-dam-in-sikkim/">local opposition to rebuild Teesta III</a> but investors are looking at the huge economic windfall from the river as it drops from 5,000m below Kangchenjunga to 300m within 80km — one of the highest Gravitational Potential Energy of any river in the world. Besides Nepal and Bhutan, the ‘watersheds’ of the Himalaya are turning into ‘powersheds’ as India and China compete for hydro-hegemony. India is said to be planning to dam the Brahmaputra to offset the disruption caused by China’s Medog Dam upstream (see map, below).&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025022203024_37c60bd2a45a32cd23928c900615b6c7045b2e0265050c4761c3749361181999.png" data-media-id="editor_20" data-image-id="2025022203024_37c60bd2a45a32cd23928c900615b6c7045b2e0265050c4761c3749361181999" data-rendition-name="original" width="1918" height="668" loading="lazy" alt="Himalayan rivers map"> </figure>  The thread running through all three books is the need to recognise the ecosystem services that the inhabitants of High Asia provide by protecting our rivers. Not all rivers need to be monetised, conserving rivers and the cultures they retain protects a nation’s natural wealth into the future as the humans of High Asia try to survive climate breakdown. The highlands will be under even more pressure in the coming decades as people in the plains migrate en masse to higher latitudes or higher altitudes to escape deadly heat and ocean expansion.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025022203028_524a74bf65111db3826bfd246576329c45cd4bd0a48b15024b6a520582bbf05a.jpg" data-media-id="editor_21" data-image-id="2025022203028_524a74bf65111db3826bfd246576329c45cd4bd0a48b15024b6a520582bbf05a" data-rendition-name="original" width="1136" height="702" loading="lazy" alt="River of Asian Highlands cover"> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025022203028_20c17a9b92b11c8bb33df5f2fc2781498464288533c310ccd61e1245e709d99c.jpg" data-media-id="editor_22" data-image-id="2025022203028_20c17a9b92b11c8bb33df5f2fc2781498464288533c310ccd61e1245e709d99c" data-rendition-name="original" width="1136" height="702" loading="lazy" alt="Unruly waters cover"> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250222030212_649cc2ba02e806da2b128fccaf5de2e5c830e10646ba0b43d56da39f65a70f9f.jpg" data-media-id="editor_23" data-image-id="20250222030212_649cc2ba02e806da2b128fccaf5de2e5c830e10646ba0b43d56da39f65a70f9f" data-rendition-name="original" width="1136" height="702" loading="lazy" alt="Chaalbato cover"> </figure>

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Saving what is left of Himalayan rivers

<figure><img width="1500" height="1000" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108101128/636a21f99c7e80680e041767jpeg.jpg" alt=""/><figcaption>Gurla Mandhata mountain (7,700 metres) south of Mount Kailsh. Locals in Tibet say that mountains are getting less snow in recent years. Photo: NABIN BARAL</figcaption></figure>“It isn’t as cold as it used to be a few years ago at this time of year,” says our Tibetan guide Mingmar Tashi as we walk near Mt <a href="https://en.wikipedia.org/wiki/Mount_Kailash">Kailash</a> to the source of the Karnali, Nepal’s longest river. This is the biggest tributary of the Ganga by volume, and Nepal’s longest river. It originates in Tibet’s Burang county where in late September residents were all busy harvesting and moving livestock down valley for winter.But winters are changing. Chinese studies show the Tibetan plateau is warming <a href="https://uk.reuters.com/article/us-china-climatechange/temperatures-significantly-rise-on-chinas-qinghai-tibetan-plateau-state-media-idUKKCN1N10E5">three times faster</a> than other parts of the world. In southwestern China the mean annual temperature <a href="https://www.sciencedirect.com/science/article/pii/S1674927813500347">increased 0.12 degrees Celsius per decade</a>from 1961 to 2010. Other <a href="http://www.icimod.org/?q=20533">studies</a> project that by 2050, the mean temperatures in the Hindu Kush Himalayas will increase by 1-2o Celsius, even 4-5o in some places. Read also:Part 1: <a style="background-color: #ffffff; font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/banner/faith-to-reality/" target="_blank" rel="noopener">Faith to reality</a>Part 2: <a style="background-color: #ffffff; font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/banner/dams-and-dreams-a-journey-down-the-karnali/" target="_blank" rel="noopener">Dams and dreams a journey down the Karnali</a>“Snow in the mountains in Tibet is declining and I can see that clearly,” says Mingmar Tashi. A recent Lanzhou University <a href="https://www.researchgate.net/publication/312168748_Impact_of_climate_and_elevation_on_snow_cover_using_integrated_remote_sensing_snow_products_in_Tibetan_Plateau">study</a> confirms this: snow-cover in Tibet has decreased at altitudes above 2,000m above sea level, but increased at lower altitudes. <figure><img width="1500" height="1000" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108101128/636a21fd9c7e80680e041768jpeg.jpg" alt=""><figcaption>Aitan Bhandari from Mohoti, Bajura harvests paddy. This area was hard hit by drought in last few years but due to adequate rainfall this year the production was good. Photo: NABIN BARAL </figcaption></figure>Rising temperatures will lead to more rapid snowmelt, with severe impacts on people living in the region. Flow of rivers that originate in the Tibetan Plateau will be affected, impacting agriculture and hydropower projects. Changes in hydrology in high altitude areas are poorly understood due to high meteorological variability, lack of accessibility and complex interplay between climate, glaciated areas and hydrological processes. Nevertheless, available research shows that seasonal snow cover impacts the water storage capacity of glaciers in a warming climate. Read also:Part 4: <a style="background-color: #ffffff; font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/banner/dancing-with-the-river/" target="_blank" rel="noopener">Dancing with the river</a>Part 5: <a style="background-color: #ffffff; font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/banner/a-karnali-portrait/" target="_blank" rel="noopener">A Karnali portrait </a>“Global warming may lead to either rising or decreasing river flows, depending on the state of glacier retreat,” stated a <a href="https://www.pnas.org/content/113/33/9222">recent study</a> published in the proceedings of US National Academy of Sciences , comparing glacier melt and river flows in Nepal and Chile.<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108101128/636a22009c7e80680e041769jpeg.jpg" alt="" width="1500" height="1061">Map: STEFANO WROBLESKIA 2015 <a href="http://lib.icimod.org/record/32006/files/StatKraft_Review_final.pdf">report</a> by the <a href="http://www.icimod.org/">International Centre for Integrated Mountain Development</a>(ICIMOD) reviewed the impacts of climate change in the Hindu Kush Himalayan region, including Nepal: ‘The changing probabilities and magnitudes of extreme events can place additional risk on power generation infrastructure (dams and hydropower plants) as well as secondary infrastructure (roads and transmission lines). Further, hazards associated with shrinking glaciers, such as glacial lake outburst floods, can jeopardise large infrastructure investment.’  It added that since most of the agriculture in mountains is rain-fed it makes farmers highly vulnerable to rainfall variability. Devi Fadera, from Srinagar village in Nepal’s <a href="https://en.wikipedia.org/wiki/Humla_District">Humla</a> district bordering Tibet, was in a rush in early October to harvest golden fields of ripening rice. “The weather is becoming more uncertain every year, so I have to harvest during these sunny days. Who knows what will happen tomorrow,” he says. <figure><img width="1500" height="1000" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108101128/636a22029c7e80680e04176ajpeg.jpg" alt=""><figcaption>A woman collects yak dung to be used as cooking fuel in Kardung village in Tibet. This is the first village on the bank of Karnali River in Tibet and is also called Mapcha Khambab. Photo: NABIN BARAL</figcaption></figure>There has been very little rainfall in the region over the last three years. The drought of 2016 was the worst in the last three decades, but there was sufficient rainfall this year. “Rain was sufficient this year, so the paddy was good,” adds Fadera, whose harvest only feeds his family for six months in a good year. From Fader’s farm, the Karnali can be seen at the bottom of a deep gorge, and there is no way to bring any of that water up for irrigation. Most of the villages along the river depend on monsoon rains. When the food runs out, mule trains bring supplies from elsewhere in the country, but that doesn’t really help much. People in this region have the <a href="http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.663.3552&amp;rep=rep1&amp;type=pdf">lowest purchasing capacity</a> in Nepal. Malnutrition is common, and only 0.9% of the land in Humla is <a href="http://bora.uib.no/bitstream/handle/1956/16997/dr-thesis-2017-Yograj-Gautam.pdf?sequence=1&amp;isAllowed=y">arable</a>. Most men migrate to cities or India to work to supplement their income.Dirgha Shahi was hurrying to Kermi in Upper Humla to get some flour transported from Tibet’s Burang county. The only way to get food from the southern plains of Nepal is via air, and that is expensive. The abundant rainfall in 2018 brought only misery to Shahi. “It was continuous from July and August. Too much water destroyed our vegetables, especially beans,” he says. <figure><img width="1500" height="1000" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108101128/636a22069c7e80680e04176bjpeg.jpg" alt=""><figcaption>Rangmal Thapa of Sarkegadh in Humla takes out rice stored two years ago from underground. Locals store rice by digging a hole nearby their homes for emergency use in the case of famine or other disasters. Photo: NABIN BARAL</figcaption></figure>Maheshwar Dhakal, chief of the Climate Change division at Nepal’s Ministry of Forests and Environment admits that it is difficult for the government to integrate climate change into its plans. “However, we have been providing support to several vulnerable communities through local level adaptation projects like <a href="http://www.np.undp.org/content/nepal/en/home/projects/nccsp.html">Nepal climate change support programme</a> which has its major focus in the Karnali region,” he adds. Roads construction was the most visible development activity during our 1,100 km journey down the Karnali from Tibet via Nepal to India. But in Nepal the roads are poorly planned, poorly constructed, and there is thought to the debris as it tumbles down the mountains. In Tibet there is a massive construction spree of huge embankments, highways and urban infrastructure. In Nepal, addressing environmental concerns during construction is not a priority. The government’s project to link the southern plains in <a href="https://en.wikipedia.org/wiki/Banke_District">Banke</a> district to the northern border in Humla has cut through the mountains. Dynamite blasts were a constant menace as we walked, drove and rafted for down the Karnali River. Geologist Karen Bennett who was a member of our team is shocked to see the unnecessary level of destruction.  <figure><img width="1500" height="1000" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108101128/636a22089c7e80680e04176cjpeg.jpg" alt=""><figcaption>Rampant road construction along the Karnali river. Karnali corridor highway which is under construction will link Nepal's Dailekh to Hilsa in Tibet border. Photo: NABIN BARAL</figcaption></figure>“Roads are necessary, but the situation is worrisome,” she says. Most of the settlements along the river corridor are built on landslide-prone areas, and people have built over previous landslides. These are inherently unstable, and improper road construction increases their vulnerability. Incremental investment during construction would have saved the billions that will be needed for future maintenance. Bennet says: “If such haphazard construction continues, villages along the Karnali will suffer badly.”Rampant road construction has already led to <a href="https://thehimalayantimes.com/nepal/haphazard-road-construction-increases-landslide-risk-in-bajura/">serious problems</a> in recent years. The Karnali Highway linking Nepal’s western border with Tibet was on the drawing board for two decades but moved forward after 2015 when the job was given to the Nepal Army. One of the biggest projects in the country, the 500-km road will link India and China. But it is being built with no attention to basic principles of road engineering in mountain regions. <figure><img width="1500" height="1000" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108101128/636a220d9c7e80680e04176djpeg.jpg" alt=""><figcaption>Construction of Karnali Coridor in Nepal's Bajura. Haphazard construction has increased vulnerability of the communities in the fragile landscape. Photo: NABIN BARAL</figcaption></figure>All rural municipalities in Nepal have a mission to link each village ward with roads in the next few years. “In the next three to five years we will have all the villages linked with rough roads,” boasts Devraj Devkota, mayor of Panchadeol rural municipality in Nepal’s Accham district. As the hills and mountains are excavated, most of the debris is thrown directly into the river. “This will create geological instability and will have severe impacts on aquatic species,” warns Deep Narayan Shah of the Central Department of Environmental Science, Tribhuvan University. Blacktopped highways from Tibet have reached the Nepal border, and Nepal is also focusing on enhancing road connectivity with its northern neighbour and all the main corridors are along the major rivers: Sun Kosi, Trisuli, Kali Gandaki and the Karnali. The Indian states of Bihar and Uttar Pradesh are already connected with Nepal by road. Experts say there is also a need to connect people and governments to be prepared for disasters and the impact of climate change.  <figure><img width="1500" height="1000" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108101132/636a22109c7e80680e04176ejpeg.jpg" alt=""><figcaption>Chudari Village in Bajura sits on the landslide debris on the bank of Karnali River. Several villages along Karnali river are on similar kind of old landslides. Photo: NABIN BARAL</figcaption></figure>Rajan Kotru, from the <a href="http://www.icimod.org/">International Centre for Integrated Mountain Development</a>, headed the <a href="http://www.icimod.org/?q=9456">Kailash Sacred Landscape</a> conservation program, the first of its kind involving all three countries in the region. Asked about what he had achieved over the last five years, his answer was diplomatic: “We were able to lay the foundation for dialogue between countries and people at local level. There is also a greater realisation that coming together will benefit all and is necessary.”  Despite this realisation cooperation between Nepal, India and China on river basins is negligible. Nepal shares a 1,400 km border with China and Nepal’s Foreign Ministry has several bilateral mechanisms to talk with China, but none of them involve water resources, even though Nepal’s rivers originate in Tibet.Nepal’s relationship with India on water issues is also sensitive. There is no real cooperation, just formalities, and even so there is no mention of the impact of climate change on shared water resources. The story is jointly published by Nepali Times and <a href="https://www.thethirdpole.net/en/" target="_blank" rel="noopener">The Third Pole</a>. Subsequent instalments of this five-part series will appear from 8-11 January.

Climate denial in the Himalaya

On Tuesday, leader of the monarchist RPP once again gathered on Kathmandu’s streets to deliver fiery speeches, but this time there was no arson and looting and no need for riot police to fire live rounds or tear gas.
RPP leaders demanded the release of their members including vice-president Rabindra Mishra and MP Dhawal Shamsher Rana were arrested during the violent <a href="https://nepalitimes.com/news/republicans-and-royalists-on-nepal-s-streets">28 March protests at Tinkune </a>which left two dead. 
They denounced the current leadership of the main parties, demanding the <a href="https://nepalitimes.com/editorial/nepal-party-reincarnating-hindu-monarchy">restitution of Nepal as a Hindu kingdom</a>. They also said the government was responsible for the fatalities on 28 March because it provoked its rally with a tear gas attack even before it started.
It has now been revealed that the police fired at least 100 live rounds from high powered assault rifles at the crowd. Twenty-one of the 120 injured received bullet wounds, and most of them were bystanders and people trying to reach home. 
Tuesday protest on the Ring Road in Balkhu was much more subdued, and comparatively fewer RPP supporters showed up. The arson and vandalism in the previous protest appears to have cost some support for <a href="https://nepalitimes.com/news/the-ghost-of-monarchy-returns-to-haunt-nepal">former king Gyanendra </a>especially for the anointment of medical tycoon and bank defaulter <a href="https://nepalitimes.com/news/street-politics">Durga Prasai </a>as ‘commander’ of the Tinkune rally.
Some monarchists acknowledge Gyanendra’s mistakes when was king 2001-2008, but say he has had a lot of time to reflect on his shortcomings and seems more disciplined and committed. His supporters have tried to build on nostalgia among some Nepalis for<a href="https://nepalitimes.com/news/why-invest-in-nepal"> domestic stability </a>and international respect that <a href="https://nepalitimes.com/here-now/if-birendra-was-alive-nepal-could-still-be-a-monarchy">the monarchy</a> commanded. 
“Nepalis were promised better service delivery, opportunities for the underserved, as well as better, more honest use of state resources, but the <a href="https://archive.nepalitimes.com/news.php?id=16992">people in leadership </a>have not been able to deliver on their commitments,” says RPP leader Prakash Chandra Lohani. “The gap between their rhetoric and reality has widened, the people feel betrayed, and the respect Nepali people had previously had for them has changed to revulsion.” 
Indeed, many commentators have warned the three main parties and their <a href="https://nepalitimes.com/editorial/politics-as-usual">serial prime ministers</a> who have ruled Nepal for much of the past 30 years should address rising public anger with them, and see the writing on the wall.
‘<a href="https://nepalitimes.com/news/nepal-government-changes-again">The UML, NC and Maoists</a> must introspect about their conduct,” warns Gunaraj Luitel, editor of Nagarik, in an op-ed this week. ‘These leaders for life may save themselves from simmering public anger, but they will not be able to save the system. The monarchist wave can only be dispelled when citizens are assured of <a href="https://nepalitimes.com/here-now/nepal-s-local-election-gives-power-back-to-people">better governance</a> through <a href="https://nepalitimes.com/latest/real-world-training-for-youth-leaders">younger leaders</a>, and reforms.’ 
Rifts between radical royals who are gunning for a return to <a href="https://nepalitimes.com/here-now/mob-movement-and-mayhem">Panchayat-style absolutism </a>and moderate monarchists who favour a constitutional king have also weakened the movement somewhat. The split between the RPP and RPP-Nepal cost the royalists numbers in Parliament in 2022, and both parties denounced the violence last month, albeit shifting the blame on the government.
The irony is that the same royalists who want to scrap the republican Constitution had formed electoral alliances with the UML during the 2022 elections. RPP-Nepal chair Kamal Thapa contested the 2022 election with the UML. Thapa has not taken part in the last two rallies, saying he will only be a part of a movement under a national flag, and not a RPP party banner.
For his part, the RPP’s Rajendra Lingden is said to be hesitant to censure some of his party’s more radical royalists for fear of fissure within his ranks, despite his aversion to Durga Prasai’s role. 
Analysts have questioned why <a href="https://nepalitimes.com/news/old-is-still-gold-in-nepali-politics">supporters of the monarchy </a>have decided to reestablish an institution that would not ultimately have executive decision-making power. There are doubts about whether authoritarian-minded Gyanendra will be satisfied being a <a href="https://archive.nepalitimes.com/news.php?id=13957">ceremonial king</a>. 
Read also: <a href="https://nepalitimes.com/news/nepal-s-deja-vu-on-black-friday">Nepal’s déjà vu on Black Friday</a>, Sonia Awale
"The Nepali people will not accept <a href="https://nepalitimes.com/here-now/forgotten-woman-who-sheltered-communist-activists">an absolute monarchy </a>at this point of time, and both the public as well as <a href="https://archive.nepalitimes.com/news.php?id=8371">king Gyanendra</a> are fully aware that there is no other possibility beyond a constitutional monarchy," asserts the RPP’s Lohani. “The traditional monarchy’s institutional capacity might have been enough to meet the needs of feudal Nepal, but an absolute monarchy is impossible both in concept and practice in the context of <a href="https://archive.nepalitimes.com/regular-columns/Economic-Class/waiting-for-an-industrial-revolution,784">modern day Nepal</a>.”

New year revolutions

Besides multiple <a href="https://nepalitimes.com/news/republicans-and-royalists-on-nepal-s-streets">street demonstrations </a>that gridlocked Kathmandu’s traffic for the past weeks, public discourse in Nepal has also been dominated by dangerously <a href="https://nepalitimes.com/here-now/air-pollution-is-more-dangerous-than-smoking">high air pollution levels</a>. Caused mostly by hundreds of <a href="https://nepalitimes.com/news/wildfire-season-starts-early-in-nepal">forest fires </a>raging across the country, the smoke contains suspended soot particles that harms <a href="https://nepalitimes.com/opinion/playing-with-poison">human health</a>. Thursday’s rain have cleared the air somewhat, and many people will soon forget how bad the air quality was. But the time to address the roots of next summer’s fire season is now.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250411060440_d1a119716a9031aadfdd611d299348d436842d376a03e664b8d773957a237524.jpg" data-media-id="editor_4" data-image-id="20250411060440_d1a119716a9031aadfdd611d299348d436842d376a03e664b8d773957a237524" data-rendition-name="original" width="502" height="540" loading="lazy" alt="Wildfires"> <figcaption>EXTINGUISHED: Forest fires raging all over Nepal in the week after 3 March (above) reduced air quality, creating a public health hazard in Kathmandu and across the country. Each red dot is a fire detected by infrared sensors on the NASA Fire Information for Resource Management System (FIRMS) satellite. But the rain on Thursday doused most of the fires (below) with more rain forecast over the weekend.</figcaption> </figure>  The reason everyone was talking about air pollution was because the<a href="https://nepalitimes.com/banner/nepal-is-going-up-in-smoke"> smoke from wildfires</a> was visible. But much more toxic are the invisible and odourless <a href="https://nepalitimes.com/news/nepal-doubles-its-carbon-footprint">gases from vehicular and industrial emissions </a>which have always been there. The theme of World Health Day on 7 April this week was ‘Healthy Beginnings, Hopeful Futures’ dedicated to <a href="https://nepalitimes.com/opinion/comment/saving-more-mothers-and-babies">preventing maternal and newborn deaths</a>. It is estimated that in Nepal, 30% of neonatal mortality can be blamed on air pollution. But that is only part of the story. Harmful as fine particulate matter is to human health, carbon monoxide, nitrogen dioxide, ground-level ozone and other gases in vehicular emissions are more hazardous to health. While the concentration of suspended particulate matter tinier than 1.5 microns (PM2.5) is closely monitored, these toxic gases are invisible, not measured much, and the public is not aware about the dangers they pose. Surface ozone is produced by the interaction of various gases found when <a href="https://nepalitimes.com/news/fossil-fuels-poison-air">burning fossil fuels</a>. Besides being poisonous, ground level ozone contributes up to 0.23°C to <a href="https://nepalitimes.com/here-now/nepal-s-mountains-are-melting">global warming</a> because it is also a greenhouse gas. A new policy brief by the Clean Air Fund titled The Case for Action on Tropospheric Ozone blames surface ozone for a half a million premature deaths every year, 54.8% of which are in South Asia. Ozone also stunts plant growth and reduces crop yields by 26% globally, and 11% loss in <a href="https://nepalitimes.com/news/economic-benefits-of-saving-the-ecology">forest productivity</a>, the report adds.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250411060456_aa02a923f8b27544ae54d0220162678f5bbb5eeb8fc3c466173c22c49b3e9a85.jpg" data-media-id="editor_11" data-image-id="20250411060456_aa02a923f8b27544ae54d0220162678f5bbb5eeb8fc3c466173c22c49b3e9a85" data-rendition-name="original" width="998" height="724" loading="lazy" alt="Gas Chambers"> </figure>  Read also: <a href="https://nepalitimes.com/here-now/bad-air-and-polluted-politics">Bad air and polluted politics</a>, Sonia Awale Ground-level ozone is not emitted directly into the air like other gases, but is formed when oxides of nitrogen (NOx), carbon monoxide (CO) and volatile organic compounds (VOCs) released from automobile tailpipes or industry smokestacks react chemically with each other in the presence of sunlight. The main source of carbon monoxide in Kathmandu Valley are its 1.2 million two-wheelers. “Usually the concentration of carbon monoxide is 200-500 parts per billion (ppb), this has increased up to 3,000 in Kathmandu. Meanwhile, ground-level ozone has gone from 70-80 ppb to 150 ppb,” says Ravi Sahu, regional air quality specialist with the Kathmandu-based International Centre for Integrated Mountain Development (ICIMOD).&nbsp; Sahu says <a href="https://nepalitimes.com/news/no-smoke-without-fire-p7vb9dcj">rampant forest fires of the past weeks</a> have also added to carbon monoxide and ozone in the air, not just the fine particles that make up the visible smoke. He adds, “There isn’t much awareness about <a href="https://nepalitimes.com/banner/poisoning-the-air-we-breathe">ground-level ozone and carbon monoxide</a>, we need to urgently look into it.” A distinction must be made between good and bad ozone. Stratospheric ozone protects living beings from harmful ultraviolet (UV) radiation from the sun.&nbsp; Tropospheric ozone can again be separated into two types: ozone in the free atmosphere which is a greenhouse gas much more potent than carbon dioxide, and ground-level ozone which has adverse impacts on health and agriculture. ‘Cutting tropospheric ozone presents a unique challenge as it requires smart and fast action across multiple greenhouse gases and air pollutants, as well as multiple economic sectors,’ notes the Clean Air Fund's policy briefing. ‘It is a growing and neglected problem that needs an integrated approach on both a local and global level to tackle climate change and air pollution together.’ Dying young There was a time when Nepal made it to international news bulletins only if there were fatalities on Mt Everest. Now, Kathmandu’s bad air frequently makes headlines all over the world. This past week, the concentration of PM2.5 that harms human health was up to 40 times the WHO recommended guideline — adding to the poisonous gases already present from vehicle emissions. The Department of Environment says 40% of the pollution in the past weeks was from wildfires sparked by nearly 6 months without substantial rain over central Nepal. Most of the rest is from vehicular and industrial emissions from Kathmandu itself and across the southern border. NASA’s Fire Information and Resource Management System (FIRMS) which issues daily maps of fires, showed hundreds of blazes raging across Nepal on Wednesday, mainly in Chitwan, Parsa and along the East-West Highway.&nbsp; “If we look at the figures for the last few years, it is clear that wildfires have become the biggest source of air pollution, they are seasonal but have overtaken vehicular emissions,” says urban planner and environmentalist Bhushan Tuladhar. “Forest fires, stubble burning, and open burning of garbage are the bigger problems now. Nepal, India, Bangladesh, and Pakistan are at risk every year, we shouldn’t further delay in finding solutions,” warned air quality expert Bhupendra Das during an event on air pollution organised on 7 March by the Nepal Forum of Environmental Journalists (NEFEJ).&nbsp; Indeed, studies have shown that in winter 60% of the air pollution over Kathmandu is transboundary from the south, and in November it is compounded by smoke from crop residue burning by farmers in India and Pakistan blown in by prevailing winds. Forest fires are a regular pre-monsoon occurrence in Nepal, often intentionally set by farmers and herders to stimulate new grass growth for livestock. Winter rains have failed for eight of the past ten years, and this means the fires often spread out of control. The other reason for the increase in wildfires is the doubling of forest fires to 46% of the country’s area in the past 25 years. But this has happened simultaneously with outmigration, with some mountain districts losing 30% of their population between 2011-2021. With less pressure on forests for fodder and firewood, the undergrowth of community forests is loaded with dry fuel just waiting for a spark. The bowl-shaped topography of Kathmandu, Pokhara and other valleys further concentrates pollutants as they are trapped by surrounding mountains. But a year with a high number of wildfires is usually followed by a year or two with fewer incidents. For example: there were 6,537 fires in 2021 but the following year the number was down to 1,528. There were 5,216 fires last year, this year the number has already reached 1,800, and the trend is likely to be broken. Heavy rains forecast for the coming days are expected to douse some of the fires and clean up the air. But the damage has been done: Kathmandu residents of all age groups this week crowded clinics and hospitals with burning eyes, itchy throats, difficulty breathing, headaches, and dizziness. But in the longer term, soot particles that are tiny enough to jump the blood-air divide in lung capillaries do not just cause Chronic Obstructive Pulmonary Disease (COPD), asthma, but also cancers, heart attacks, strokes, birth defects and other chronic diseases. The latest Air Quality Life Index (AQLI) report by the University of Chicago shows that the annual concentration of PM2.5 in Kathmandu’s air rose from 17.87µg/m3 in 1998 to 31.33µg/m3 in 2022. Air pollution has got worse by 75% in Kathmandu in 25 years. During this time, air pollution has reduced the average life expectancy of Kathmandu’s residents by 3.5 years. According to the Health Effects Institute in Boston, dirty air is among the biggest public health concerns in Nepal killing over 42,100 a year. The adverse impact of high levels of air pollution is not limited to public health, it is seriously affecting tourism. Operators in Pokhara this week said that there were many negative online posts by visitors unable to see the famous panorama of Machapuchre and the Annapurnas even from Sarangkot. Aviation is also affected, as planes have to circle sometimes for hours burning a lot of fuel because of runway visibility being below minima at Kathmandu airport. The higher fuel cost is just passed down to customers, making air tickets in and out of Kathmandu some of the highest in the world. Kathmandu, with a population of four million, has not implemented a concrete policy to curb toxic air despite having formulated various action plans and repeated commitments by the government to protect the environment and control air pollution. The Department of Environment’s 2017 Air Quality Management Action Plan for Kathmandu put forward a policy to reduce air pollution caused by vehicles which was approved by the Cabinet, but has yet to be put to practice. The action included the immediate implementation of the Euro 5 emission standard to reduce pollution emitted by vehicles. However, Nepal has not even been able to implement Euro 4 standards so far. India, meanwhile, has already moved forward with the implementation of the Euro 6 standards. Says Ravi Sahu: “Air pollution in Nepal is not just about air pollution, it has ties to tourism, aviation, the economy so we must be prepared for annual conditions like forest fires, and this requires urgent interdisciplinary collaboration.” &nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250411050452_821d09e283d8a590f1369bfb71b9b7fc6d950726e0651ea86c6488d04deb1742.jpg" data-media-id="editor_15" data-image-id="20250411050452_821d09e283d8a590f1369bfb71b9b7fc6d950726e0651ea86c6488d04deb1742" data-rendition-name="original" width="839" height="784" loading="lazy" alt="Silent Killers"> </figure>  &nbsp;

What is invisible is more dangerous

82 in २०८२

Here in the mountains of far-western Nepal, the biggest threat to life and limb is gravity. Women collecting fodder fall from trees, boys grazing goats fall off cliffs, heavily loaded tractors plunge from dirt roads carved out of steep slopes. There is nothing to be done about those who die on the spot. But for the severely wounded there is only one hospital: Bayalpata. And it is there that <a href="https://www.youtube.com/watch?v=CJzWlnYd0ZM&amp;t=8s" target="_blank">orthopaedic surgeon Mandeep Pathak</a> is the last hope for many wounded people. Pathak, 42, is too modest to tell us how many lives he has saved over the past 10 years he has worked at Bayalpata. But hospital records show he has performed more than 4,000 operations in the past decade, many of them so patients did not suffer permanent physical disabilities. Pathak also did 800 major life-saving surgeries in that time. “I treat patients with injuries, but I wish I could also treat poverty,” Pathak says, emerging from Bayalpata’s surgical theatre one recent afternoon. <div class="embed-block"><iframe width="700" height="415" src="https://www.youtube.com/embed/CJzWlnYd0ZM?si=s_rkbU4YDaw87gqH" 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> Sudurpaschim Province in Nepal’s far-west is far away from everything: from Kathmandu, from adequate medical care, from food security, and far from the reach of government services. It has suffered state neglect for centuries, its men mainly migrating to India for seasonal work to families who depend on subsistence agriculture. Pathak remembers the searing sadness he felt when a patient once told him, “Doctor, I sold the last of my rice to pay to come here, please give me a medicine that I can take on an empty stomach.” Pathak was born in Kathmandu, and after getting his MBBS from Kathmandu University, he got an MD from The Philippines. At a time when many Nepali doctors and staff nurses were emigrating, Pathak did not just return to Kathmandu but decided to go to one of the remotest districts in Nepal to serve those most in need. The hospital was established in 2009 in the village of Bayalpata, and has been managed by the non-profit <a href="https://www.nyayahealthnepal.org/" target="_blank">Nyaya Health Nepal (NHN)</a> as a public-private partnership treating 100,000 patients a year for no fees at all. NHN is now preparing to hand over the running of the hospital to the Sudurpaschim provincial government so its <a href="https://nepalitimes.com/banner/this-is-how-to-upgrade-nepals-rural-health" target="_blank">model of hospital management</a> can be replicated.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250414130456_b59dabd4604a24426a55fe91c0e5866b5029858bdb4c4028c331557aeb5408ae.jpg" data-media-id="editor_4" data-image-id="20250414130456_b59dabd4604a24426a55fe91c0e5866b5029858bdb4c4028c331557aeb5408ae" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="Bayalpata hospital"> <figcaption>Bayalpata hospital in Achham.</figcaption> </figure>  People from not just Achham but surrounding districts, and from as far away as Humla, bring patients to Bayalpata, sometimes walking for days. Some with complicated pregnancies are brought in stretchers, young children with broken arms walk into the emergency, and sometimes there are mass casualties when a tractor or bus falls off a road. And Pathak is always there with his team performing triage, and doing orthopaedic surgeries that would be difficult even in Kathmandu. Recently, his team did a hip replacement at <a href="https://nepalitimes.com/banner/state-of-the-art-rural-hospital" target="_blank">Bayalpata Hospital</a>. Mild mannered, modest, soft-spoken, hard-working, professional are the words families of patients who have been treated at <a href="https://nepalitimes.com/here-now/nepal-s-rural-lifeline" target="_blank">Bayalpata Hospital </a>use to describe Mandeep Pathak. But the surgeon is too busy to let all this get to this head.&nbsp; Asked why he does not emigrate like his peers or get a lucrative position at a private hospital in Kathmandu, Pathak answers simply, without a trace of self-importance, “I do not think I could get the satisfaction or sense of fulfilment anywhere else.” When travelling to attend medical congresses overseas or visit family in Kathmandu, Bayalpata has other doctors to take care of patients, but many wait patiently till Pathak returns for their consultation or surgery.&nbsp; When he returns from seminars abroad after learning the latest skills, Pathak’s suitcases are not full of clothes or presents, but titanium bone implants, external fixation rods, or intramedullary nails to be used in <a href="https://nepalitimes.com/news/altruistic-healthcare-models-in-nepal" target="_blank">surgeries at Bayalpata</a>.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025041414040_5356278472c1eb2b9e4af1d593d6234cc8dc5e5161a8c614197c01abefadbd80.jpg" data-media-id="editor_8" data-image-id="2025041414040_5356278472c1eb2b9e4af1d593d6234cc8dc5e5161a8c614197c01abefadbd80" data-rendition-name="original" width="2048" height="1368" loading="lazy" alt="surgery"> </figure>  Before Bayalpata Hospital was established, most people suffering broken bones had to travel down to Dhangadi or Nepalganj for treatment. No more. Although Pathak’s specialisation is orthopaedic oncology, he is mostly treating fractures and rejoining broken bones.&nbsp; Now as Bayalpata’s Hospital Director, Pathak also has administrative and fundraising duties. He has to take the 10-hour ride down to Dhangadi often to meet various Sudurpaschim ministries to release the hospital’s budget — that is sometimes more difficult than the most complicated surgery. Recently, he had to cancel an appointment with the Chief Minister to rush back to Bayalpata because there was a patient who needed emergency surgery. “I told myself, let me save this patient first, then I will try to save the hospital,” he recalls.&nbsp; Once, when he had to be away for a month on emergency surgery training in the US, the family of a 90-year-old woman who had dislocated her hip after falling from a staircase was waiting for him to return. Her son told Pathak: “Doctor, either put her out of her suffering, or cure her.” Pathak told him it was too dangerous to operate at her age, but the son said his mother was in so much pain it was worth the risk. The operation was touch-and-go, but it was successful. The woman who had been brought in on a stretcher, walked out of the hospital three days after the operation.&nbsp; A few months later, a 27-year-old woman was brought into the ER bleeding profusely from an arm mangled by a thresher machine. Even in that state, she was breastfeeding her baby. Pathak welled up seeing this display of selfless motherhood, as he wheeled her into surgery. She needed three operations, but now has full use of her hand. <div class="embed-block"><iframe width="700" height="415" src="https://www.youtube.com/embed/xJdxLD0hBqo?si=mOpM2R_DsYL88Lfg" 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> It is the sense of achievement from such recovery that keeps Mandeep Pathak here in this isolated village in the middle of nowhere. Bayalpata Hospital has not just saved lives, it also saves families from poverty because they do not have to take sick relatives to expensive city hospitals.&nbsp; In January, a woman was brought to Bayalpata with both hands broken. She said she had taken a fall, but Pathak did not believe her. When alone in the surgery, she finally admitted that her husband had beaten her.&nbsp; It was her husband who had brought her to hospital for treatment, but she refused to file a police report. Pathak quietly put both her arms in casts, thinking about the poverty, patriarchy and injustice in society that he is unable to treat.

mt-kailash

Saving what is left of Himalayan rivers

Climate denial in the Himalaya

New year revolutions

What is invisible is more dangerous

82 in २०८२

The healer of far-western Nepal