<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022111412118/6372219c9c7e80680e0c02c6jpeg.jpg" alt="" width="1000" height="662"/>This year’s health budget kept the contribution to health insurance of the previous year's allocation of Rs7.5 billion. However, the plan to hand over the institutional management of health insurance programs to the private sector through the Ministry of Finance defeats the fundamental goal of the health security.This is not entirely surprising, of course, because the Health Ministry had passed a <a href="https://archive.nepalitimes.com/article/nation/national-health-insurance-not-as-easy,4028">narrow and poorly thought model of health security</a> for Nepal, and there were already concerns that it would eventually be handed over to the private sector and traded as a commodity.A private company can contribute to a health insurance program. But can they really contribute to national public health security, understand equity, expand <a href="https://www.nepalitimes.com/editorial/poor-health-makes-nepalis-poorer/">access to the poorest and the most marginalised</a> population, and negotiate with the government providers for quality services? Are they fundamentally designed to serve the poor?Read also: <a href="https://archive.nepalitimes.com/article/nation/national-health-insurance-not-as-easy,4028">National health insurance not as easy</a>, Sonia AwaleThe private sector has a role in contributing to achieving Universal Health Coverage by mainly serving the affluent. The poor neither can afford private health insurance nor access expensive private hospitals. Even if they are admitted to hospitals, they have to bear <a href="https://www.nepalitimes.com/opinion/is-free-health-care-possible-in-nepal/">catastrophic expenses</a> pushing them into the vicious cycle of poverty.The private insurance companies only pool the resource, they do not share the risk for those who cannot afford to pay the premium. It will be naïve to assume that such companies could be easily maneuvered to deliver services as a fair-price approach. There are around 20 registered private health insurance companies and 366 private hospitals in Nepal, and some are <a href="https://www.nepalitimes.com/latest/nepal-tries-to-ensure-covid-19-insurance/">selling health insurance at exorbitant premiums</a> many times higher than the current premium cap.There are six national health security indexes: prevent, detect, response, health, norms, and risk. During the pandemic, insurance companies got richer by <a href="https://www.nepalitimes.com/latest/nepal-tries-to-ensure-covid-19-insurance/">selling fake insurance schemes</a> while the hospital profits bulged through expensive Covid treatment. Very few hospitals treated Covid patients with a humanitarian approach. None of their technical advancements helped effectively prevent, detect, and respond to the pandemic.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022111412118/6372219f9c7e80680e0c02c7jpeg.jpg" alt="" width="1641" height="1000"><figcaption> </figcaption></figure>The current health insurance program has identified the elderly, completely disabled, leprosy, Multi-Drug Resistant TB patients, people living with HIV, and ultra-poor as target populations to waive their premium. Though not adequate, this is an equity approach.But none of these target populations are <a href="https://archive.nepalitimes.com/article/nation/national-health-insurance-not-as-easy,4028">eligible for private health insurance</a>, or they will have to pay a much higher premium. It will be unwise to assume that these companies will change overnight and be equitable. They are powerful enough to influence government policy and have the power to bend them to suit their commercial interests.Read also: <a href="https://www.nepalitimes.com/editorial/poor-health-makes-nepalis-poorer/">Poor health makes Nepalis poorer</a>, EditorialInstead, the government should <a href="https://archive.nepalitimes.com/article/editorial/health-tip-editorial,4032">strengthen the Health Insurance Board</a> and explore ways to integrate health security with the broader social security scheme. In the short term, there are urgent but straightforward reforms like recruiting adequate and skilled human resources, strengthening the organisational systems, revising the design of service purchase strategy and equity, and gradually, having effective providers/purchasers split for better implementation.Ultimately, the program will benefit by forming a broader and more robust social security structure, co-incidentally introduced at the same time by the government. It would be able to absorb costs by pooling tax-based health care contributions and merging subsidies given to the treatment of cancer, renal failure, and other chorionic diseases under one integrated umbrella.But the current government does not appear serious about <a href="https://www.nepalitimes.com/opinion/health-insurance-must-be-an-election-agenda/">reforming health insurance</a>, and simply does not understand the fundamental principles of health security. Health insurance is not just limited to providing health care, but is a part of broader health security.Read also:  <a href="https://archive.nepalitimes.com/article/editorial/health-tip-editorial,4032">Health tip</a>, EditorialThe idea that health security can be strengthened by passing the buck to the private sector amounts to abandoning the constitutional commitment to provide health care, not as a service but as a citizen's fundamental right. The Nepal government is a signatory to achieving the health targets of the Sustainable Development Goals.As argued by Nepali Congress leader Gagan Thapa, who is one of the pioneers who <a href="https://archive.nepalitimes.com/article/editorial/health-tip-editorial,4032">pushed health insurance</a> in Nepal, they contribute to strengthening the health system, strive for healthy populations, cushion the poor and provide them access to health services. It is a vehicle for mobilising adequate health resources, enhancing health security, and ultimately achieving Universal Health Coverage.These goals cannot be met by trading the people's health as mere commodities.Gaj Gurung has a PhD in public health from Chulalongkorn University and Sushil Koirala is a public health expert. Both are based in Bangkok.Read more: <a href="https://www.nepalitimes.com/opinion/is-free-health-care-possible-in-nepal/">Is free health care possible in Nepal?</a> S P Kalaunee

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Dangers of privatising health insurance in Nepal

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221114111124/6372175d9c7e80680e0ba9e2jpeg.jpg" alt="" width="1500" height="1000"/><figcaption>Photo: BIKRAM RAI/NEPALI TIMES ARCHIVE</figcaption></figure>If Nepalis are to vote on issues rather than personalities in this year’s elections, they should pay attention to the manifesto of the Nepali Congress (NC) which has put an emphasis on the 2017 National Health Insurance Act.It was the NC’s firebrand leader <a href="http://archive.nepalitimes.com/article/from-nepali-press/Reviving,3589" target="_blank" rel="noopener noreferrer">Gagan Thapa</a> who pushed that legislation when he served as Health Minister. He is now the party’s general secretary, and sees <a href="https://archive.nepalitimes.com/article/nation/national-health-insurance-not-as-easy,4028" target="_blank" rel="noopener noreferrer">health insurance</a> as a way to improve the access and affordability of quality health care in Nepal.Even for a country like Nepal, universal health coverage is not a distant dream if there is the necessary political will. The Covid-19 pandemic has already made it evident that investing in health care and prevention is central to the well-being of the society with added economic benefits.Many countries in the region have health insurance for their citizens. An example is <a href="https://www.social-protection.org/gimi/gess/RessourcePDF.action?ressource.ressourceId=54059" target="_blank" rel="noopener noreferrer">Thailand's Universal Health Coverage Scheme</a>, lauded as the best model for a developing country.The Nepal Health Insurance program was initiated to achieve universal health coverage and was one of the key agendas in the 2015 election with widespread political support. The program actually started in 2016 and the Health Insurance Act was enacted in 2017.With Ministry of Finance (MoF) funding, it offers monetary protection to people by paying directly to the service providers’ on-behalf of insured members.In a few years, Nepal’s health insurance program has had a scalable impact. Our 2020 study in the Kaski district showed that in patient expenses of insured families was less than that of non-insured ones, and were also better protected against catastrophic expenses than the non-insured.Broadly, the program aimed to improve the health quality through provider and purchaser split, and by employing a strategic purchasing approach. For instance, in Thailand, the National Health Security Office purchases services for 43 million people independently which has played a large role in improving health care services.Health insurance generates an additional health budget, as it is a pooling mechanism. The MoF has allocated the insurance budget without curtailing the current national health budget.Unfortunately, the insurance scheme design and implementation have been drowned out by political rhetoric resulting in operational ambiguity and erratic implementation. Without a serious political will to strengthen the program, it is likely to come to grief before long.Insured people are dissatisfied with service providers for their historically low-quality services. In fact, the quality of care has worsened in places after the insurance scheme was introduced, resulting in a high drop-out rate.In turn, service providers are frustrated over the Health Insurance Board (HIB)’s sluggish reimbursement process and some have even stopped their facilities. The HIB does not have adequate skilled human resources to speed up the reimbursement, nor has it formulated an efficient service purchase mechanism.The Board has not been able to function as a prudent insurance manager because of the lack of basic organisational policies on human resources, finance, monitoring and evaluation, communication etc. There are also crucial design errors in the insurance program, such as reimbursement strategy, un-equitable premiums, and provider/purchaser split, to name a few.The current program primarily employs fee-for-service (FES) which is a traditional, retrospective and input-based approach with a cumbersome process to review, validation of cost, and payment. The FES was selected despite other programs including <a href="https://www.nepalitimes.com/opinion/is-free-health-care-possible-in-nepal/" target="_blank" rel="noopener noreferrer">free health service</a> and safer motherhood implementing relatively efficient, output-based and prospective approaches such as capitation.There are also traditional and cultural problems within the MoH, and HIB as a semi-autonomous body does not have the influence or muscle to monitor and negotiate with service providersThe premium amount and benefit package was fixed through very limited study which was a modest Rs2,500 and Rs 50,000 respectively in the beginning, later increased to Rs 3,500 and Rs100,000 but with no scientific basis.This benefit package is quite small for a family of five. The amount gets smaller with increased cost for the high prevalence of non-communicable and chronic diseases in the general population.Apart from the targeted groups (with premium subsidy), the flat premium amount of Rs3,500 for the rest is largely unbalanced. The richest 10% of Nepal's population has more than 26 times the wealth of the poorest 40%. What this means is that while Rs3,500 is peanuts for some households, it could be a monthly household food expense for others.Despite this, the HIB claims that there is no clear provider and purchaser split between MoH and HIB, the former has a high influence on the latter’s organisational structure, as such, many staffing decisions are still pending the ministry’s approval years later.The majority of the HIB staff are seconded from the Ministry of Health,  none of them are health economists or have financial background. Learning by doing is a costly, ineffective and inefficient approach for a high-priority national program.Similarly, the Health Insurance Board is incapable of coordinating with line ministries for the program's effective implementation. For example, the Act has delegated the NIB’s members to standardise service providers' quality control. However, its board is dominated by MoH members.This results in poor service quality, leading to dissatisfaction amongst insured populations and in the high dropout rate and under-utilisation of the services.Nepal’s health insurance program must undergo a serious and urgent reform to prevent it from becoming obsolete:Short to medium term recommendations:<ol><li>HIB needs to develop organisational guidelines to streamline reimbursement. The focus must be on demand generation to enrol rich, healthy and poorest groups equitably.</li> 	<li>The health service purchasing strategy must be reviewed, and this should also guide the structure and human resources needed.</li> 	<li>Private health service providers will inevitably be integrated into the program given the access gaps created by the limited number of public providers. But private providers are often more politically placed and vested interest can put HIB in a weaker negotiating position.</li> 	<li>HIB should develop standards for hospital/PHCC preparedness, provide additional training and incentives for the health workers and develop monitoring tools.</li> 	<li>Integration with other social security funds and health programs will improve efficiency and reduce duplication and wastage. Coordination with these funds will help access data on informal, and formal sector populations and cross-share promising practices particularly on investment.</li> 	<li>HIB should partner with existing research agencies and health economists to conduct studies and use ground-up feedback to reform.</li></ol>Long term recommendations:<ol><li>Premium-based pricing won't be fair or sustainable because of poverty and amidst high informal sector employees. So HIB should look into the possibility of fully tax-funded schemes for the informal sector populations.</li> 	<li>Provider and purchaser split: The provider and purchase split might go through lengthy technical and political discussion after HIB fulfils the majority of short and medium plans eventually. It requires having clear roles and responsibilities between MoH and HIB, understanding of the scope of work and mutual trust.</li></ol>Gaj Gurung is a public health practitioner currently based in Bangkok, Thailand. He has PhD in public health from College of Public Health and Sciences, Chulalongkorn University. His PhD evaluated the Nepal Health Insurance Program implementation fidelity and its effectiveness in reducing the out-of-pocket health expenses amongst insured populations.

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Health insurance must be an election agenda

<a href="https://nepalitimes.com/here-now/waiting-for-bipin-joshi" target="_blank">Nepali student Bipin Joshi</a>, who was taken captive by Hamas on 7 October 2023, was not on the list of those freed following the end of the bombardment and fighting in Gaza.&nbsp; On Monday morning, the Israeli military notified Bipin's family and Nepal’s ambassador to Israel Dhan Prasad Pandit, that there is no evidence of him still being alive. However, Nepal's Foreign Ministry is yet to be notified by Israel's government of Bipin's status. The news came three days after a US-brokered ceasefire between Israel and Hamas came into effect, and hostage and prisoner exchanges by the two sides started Monday morning.&nbsp; Almost 2,000 Palestinians held in Israeli prisions are expected to be released by Israel in exchange for the hostages during the next phase of the peace deal between the two parties, and the bodies of deceased hostages remaining in Gaza are also expected to be returned.&nbsp; Bipin Joshi was among a group of Nepalis who had arrived in Israel in 2023 just weeks before 7 October 2023 as part of a ‘learn and earn’ program to work and earn in kibbutz farms there.&nbsp; Along with other students Joshi had been working on a farm in Kibbutz Alumim in southern Israel near Gaza. <a href="https://nepalitimes.com/here-now/war-in-israel-earthquake-and-grief-in-nepal">Ten Nepali students were killed </a>while taking cover in shelters near their farms in two separate attacks by Hamas fighters.&nbsp; Joshi’s colleagues, fellow Nepalis who survived the attack, recall gunmen lobbing two grenades into the bunker that they had taken cover in. Bipin hurled one of the grenades out, they say, but the other one exploded, killing and injuring Nepalis inside. &nbsp;&nbsp;&nbsp;&nbsp; Shortly after, Bipin was captured by Hamas along with a Thai national and led away into Gaza. CCTV footage showed Bipin alive and at a hospital in Gaza on the day of the attack itself after he was taken hostage.&nbsp; Thirty-one Thai citizens, who like Nepalis worked in farms in Israel, were taken hostage during the Hamas attack, the highest number of foreign captives in October 2023.&nbsp; <a href="https://nepalitimes.com/news/deft-diplomacy-freed-thai-hostages">Deft Thai diplomatic engagement</a> with officials from Iran, Egypt, and Qatar brought about the release of 23 of its nationals in 2023. Five more Thai nationals were released earlier this year.&nbsp; In August, Joshi’s family visited Israel at the invitation of the government and urged the international community to push for his return. Bipin’s mother Padma and sister Pushpa have been at the United Nations to lobby for his release.&nbsp; His family last week also released a video clip of Bipin briefly speaking on camera, reportedly obtained by Israel and said to be filmed in November 2023, around a month after he was taken captive. Joshi looks healthy in that video.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251013091028_d551c7f88204c52217152fb5db655bb5a5f8bf2cff1e6a055326ebf64453ff9f.png" data-media-id="editor_3" data-image-id="20251013091028_d551c7f88204c52217152fb5db655bb5a5f8bf2cff1e6a055326ebf64453ff9f" data-rendition-name="original" width="2848" height="1528" loading="lazy" alt="Bipin Joshi NT"> </figure>  More than 67,000 Palestinians have been killed during the last two years of the genocide in Gaza. About 1,200 people were killed during the Hamas attack on 7 October 2023, while more than 251, including Bipin Joshi, were taken as captives.&nbsp; This is the third ceasefire implemented in Gaza since 7 October 2023 after previous ones in November 2023 and January 2025. This 20-point deal facilitated by intermediaries US, Qatar, Turkey, and Egypt included terms for Hamas to give up its arms, and for a devastated Gaza to be governed by a Palestinian body of independent technocrats, while Israeli troops will withdraw in stages from Gaza.&nbsp; Hamas has agreed to relinquish control of Gaza, but has rejected the demand for disarmament, saying the group will demobilise but is prepared to resume fighting if Israel breaches the ceasefire.&nbsp; Following the ceasefire, Palestinians in Gaza have begun long journeys back to homes reduced to rubble by Israel’s two-year assault on the strip. The flow of humanitarian aid in the city has also increased following the peace deal.&nbsp; Israel's closure of humanitarian corridors in the past months had blocked the entry of food and medicine into Gaza, causing widespread famine. The United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) has said that the restriction of aid into the beseiged city has left as many as <a href="https://www.unrwa.org/newsroom/news-releases/gaza-unrwa%E2%80%99s-lancet-study-reveals-alarming-surge-child-malnutrition">54,600 children acutely malnourished</a>.&nbsp; Meanwhile, US president Donald Trump landed in Israel on Monday as hostages were being released, and world leaders are expected to head to Egypt for an international summit to discuss the next steps in Gaza, Israel, and West Asia.&nbsp;

Nepali hostage in Gaza not alive: Israel

Already trying to balance youth demands with legal provisions in the Constitution, Prime Minister Sushila Karki’s interim government faced yet another challenge over Dasain: a receding monsoon dumped unseasonal rain unleashing floods and landslides that killed at least 60, mostly in eastern Nepal.&nbsp; The government was rated positively for its early warning and the ‘visibility’ of its disaster response, with many comparing it to the inaction of the NC-UML coalition during last year’s floods.&nbsp; Government agencies and police proactively closed off hazardous sections of highways as Kathmandu was marooned from the rest of the country in the peak holiday season. Stranded passengers were taken care of, with police, army and local governments in Ilam coordinating rescue and relief efforts. Many of the problems were structural and inherited from decades of neglect and corruption in highway contracts. Shoddy bridges and encroachment of settlements along river banks have increased risk from more frequent extreme weather caused by climate breakdown. With Dasain over Tihar around the corner and the worst of the disaster behind, the Karki administration is trying to balance the separate demands of GenZ movers and shakers who installed her in office with constitutional provisions. It has not helped that the badly-mauled political parties are spoiling for a fight, and the three top leaders show little signs of stepping down. “Nepal’s movement did not happen in a democratic vacuum, so this government walks a very fine line in political legitimacy," says Bidushi Dhungel of the National Democratic Institute in Nepal. "In this fragile space, whatever the work done — or not done— by the interim government within its limited mandate, it may open up avenues for further dissent from old and new actors. They are &nbsp;caught between a rock and a hard place.” Civil society activists issued a statement on Wednesday calling on the main political parties to heed the writing on the wall and reform themselves. Signed by professor Krishna Khanal and former ambassador Keshab Mathema, the statement said: 'The main leaders of the main parties should say sorry, and voluntarily resign ... they must respect public sentiments and work to reform and transform their parties to be more accountable to the public, or risk being irrelevant.'&nbsp; Complicating matters further are the sometimes contradictory demands of various GenZ factions on punishing those responsible for the carnage and rampage of 8-9 September, Constitution and elections. Karki faces calls to immediately detain former PM KP Oli and Home Minister Ramesh Lekhak for their involvement in the massacre outside Parliament. Under pressure from GenZ delegates, Home Minister Om Aryal fired off a letter to the police to arrest Oli and Lekhak. But later at a confrontational midnight meeting at the prime minister’s residence in Baluwatar, all four security chiefs advised Karki that arresting the UML and NC ex-ministers could unleash violent confrontation on the streets. The interim government is in a bind. It has formed a committee headed by Gauri Bahadur Karki to investigate the killings last month as well as the arson and vandalism that followed. The question is: should it wait for the committee to submit its report before punishing perpetrators, or let police arrest those who can easily be identified in social media posts setting fire to Singha Darbar, the Supreme Court and other sites.&nbsp; GenZ’s Sudan Gurung faction has gone beyond its original demand to submit an 8-point ultimatum that includes the sacking of the Chief Justice and officials of the anti-corruption bureau.&nbsp; The Prime Minister is caught in the crossfire between managing the expectations of a movement that appointed her, and working within the framework of her interim government’s mandate and Constitution. But it is not just the government that faces challenges. The lack of clear consensus among youth factions and their outspoken collectives is surfacing.&nbsp; &nbsp;“This has been a leaderless and decentralised movement, and the traditional variables typically seen in a political revolt seem missing here," notes political scientist Sucheta Pyakuryal. “There is no organised structure, nor any ideological pull factor, therefore a big question is how much bargaining power does a movement like this have, and how sustainable will it be.” GenZ leaders seem to be in two main camps. Demands like the one for a directly elected prime minister, and the constitutional processes that can make for such an outcome, have emerged as a major point dividing the movement.&nbsp; Nepalis both within and outside the youth movement are watching Hami Nepal’s Sudan Gurung closely — especially after his recent interview with Al-Jazeera during which he expressed his interest to run for Prime Minister and seemed to not accept a win by political parties in the March elections.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251009201044_fcba7e92bb9a8812fd0ad4e9770d6f4d4189972de5229f91e9a832a26e388901.jpg" data-media-id="editor_0" data-image-id="20251009201044_fcba7e92bb9a8812fd0ad4e9770d6f4d4189972de5229f91e9a832a26e388901" data-rendition-name="original" width="2916" height="1000" loading="lazy" alt="One month on NT"> <figcaption>GROUND ZERO: The destroyed centre of Nepal's government with Singha Darbar (in green scaffolding), the Attorney General's Office, Supreme Court, and in the distance, Parliament building. Also seen are the nearly finished new Parliament Complex and the new Supreme Court buildings. Drone shot taken on Thursday morning. Photo: SUMAN NEPALI</figcaption> </figure>  Gurung’s participation in the NDRRMA’s disaster management meeting and manner of his interaction with officials at the event was met with both bouquets and brickbats. Interestingly, some of the criticism was youth activists themselves. &nbsp;“There's a lot of self-involvement and self-importance that seems to be guiding a fragmented young leadership, as opposed to constructively engaging in how to concretise reforms,” says Dhungel. “There seems to be very little stocktaking of what's happened in the past, and what's happened in other countries to try identify where lapses could be before they occur."&nbsp; In the absence of unified positions and level-headed leadership, the youth who spearheaded post-protest negotiations, as well as the GenZ movement in general, risk losing public goodwill already dented by the destruction of state property on 9 September. This also leaves an opening for political parties which are on the defensive and licking their wounds to capitalise on youth discord.&nbsp; Says Pyakuryal: “Post revolution, the political landscape becomes extremely unpredictable and therefore there is a risk of co-optation from several Machiavellian political actors including political parties, monarchists, as well as other forces, and that is concerning.” The immediate and visible transformation that Nepal’s youth expect will not manifest right away, and while there is a need for long-term political planning, the caretaker government must also undertake measures that have a palpable impact on the daily life of citizens. &nbsp;&nbsp; “While youth frustrations must be addressed urgently, statecraft isn’t just about fulfilling short-term goals,”says Pyakuryal. &nbsp; Many, including the youth themselves, now see the need for GenZ to have a more united stance and to move beyond making demands that the interim government cannot fulfil and start mobilising for elections — even by forming its own party.&nbsp; A strong showing in elections can enable them to enact the changes they want to strengthen Nepal’s democracy, and make future governments more accountable.&nbsp; This week, the Election Commission announced 16 November as the deadline to register new parties for the 5 March polls.&nbsp; Youth representatives have said that they want to be active participants in the political process, particularly in national-level politics. The Constitution defines ‘youth’ as being between the ages of 16-40. In the 2022 elections, the Election Commission stated that over 41% of locally-elected representatives were from ages 21-40 years.&nbsp; If young Nepalis are to contest the election outside the banner of mainstream parties, this leaves electoral aspirants little more than a month to decide whether to form a loose coalition with existing parties, a separate political party, or to contest elections independently. “This is first of a kind movement, where political language is digital, not ideological, where organising is done through online platforms and where there is no one leader spearheading the movement,”says Pyakuryal. “I don’t know if ‘anti-corruption’ or ‘political reform’ have a strong enough ideological pull to band people together in the long run.” Indeed, the RSP was formed only four months before the 2022 elections and cashed in on anti-incumbent and anti-corruption sentiments of voters — mainly driven by social media. But controversy and strife within their party means it has largely lost its public trust.&nbsp; Nepal’s September Uprising and its aftermath have shown that a majority of young people are entirely disillusioned with establishment parties and politicians, even using ‘ex-political parties’ as a phrase of reference. Any new young political figures that emerge from this movement and this election will have to work with mainstream parties in a multiparty democracy.&nbsp; &nbsp;“The reality of politics is that change is not possible without engaging with existing political institutions and actors,” says Dhungel. “To say that they do not want to engage, negotiate, or identify allies or proactively seek out input from at least the reform-minded individuals within each of those outfits is political naivety, and may lead to a lack of institutionalised reform.” However, Dhungel notes that the youth leadership would have more agency if they are clear not just on what they want to change, but about whether they are interested in active politics or civic engagement. “The window of opportunity that is fast closing is to really negotiate hard and push for internal reforms within political parties and across the electoral system,” she adds. Pyakurel also adds: “GenZ are smart and politically mature, I hope they see these loopholes. I am optimistic about the direction they take.”

One month on

Scenic Phortse in the lap of Mt Everest is called ‘the village of mountaineers’ because just about every household has someone who has summited the world’s highest mountain multiple times. However, while the international mountaineers they assist to make it to the top go on to fame and glory, their Sherpa guides from Phortse <a href="https://nepalitimes.com/news/without-sherpas-there-is-no-mountaineering" target="_blank">barely get a mention</a>. It is a risky occupation for Nepal’s high altitude guides, and every other family in this village has lost a member in Himalayan expeditions. Sherpa guides are <a href="https://nepalitimes.com/news/on-mt-everest-s-70th-records-and-fatalities" target="_blank">disproportionately more at risk </a>on Mt Everest because they have to traverse the Khumbu Icefall many times during an expedition. One third of the over 300 climbers who have died climbing Mt Everest are Nepali high altitude guides and porters. In 2014, <a href="https://archive.nepalitimes.com/article/nation/everest-dangerous-place-to-work,1316" target="_blank">16 guides were killed</a> when an avalanche fell on them while going up the treacherous Icefall carrying expedition gear. Then in 2015, the <a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/big-drops-in-Everest-bookings-affect-livelihoods-of-Nepali-high-altitude-guides,2048" target="_blank">earthquake triggered a massive avalanche</a> that killed 22 climbers at Base Camp. Many of the fatalities in both years were Sherpa guides from Phortse. Despite the danger, Phortse honours and celebrates its climbers like heroes. One such is the late &nbsp;Nima Tshiring Sherpa, who was a porter and guide in the 1953 John Hunt expedition in which Edmund Hillary and Tenzing Norgay became the first to set foot on the world’s highest summit.&nbsp; Nima Tshiring and his eldest son Pasang Gyalzen both reached 8,000m carrying expedition gear for the Hunt expedition in 1953. Nima Tshiring had eight sons and a daughter and although he never submitted himself, most of them have climbed Mt Everest at least once. In fact, his children and grandchildren have been to the top of Mt Everest a total of 81 times — a record for any family in Nepal.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251011171048_a55e45bee2b5bbf38e4ee5bcea101edcc3041f40e331b8fee44e473457f42553.png" data-media-id="editor_4" data-image-id="20251011171048_a55e45bee2b5bbf38e4ee5bcea101edcc3041f40e331b8fee44e473457f42553" data-rendition-name="original" width="2144" height="1436" loading="lazy" alt="Sherpa climbers"> <figcaption>Nima Tshiring Sherpa with wife and children in Phortse. An unanmed Everest climber on right.</figcaption> </figure>  “We were born in Phortse which is in the lap of Everest, our identity is Chomolungma,” says one of his sons, Panuru, using the Sherpa name for the mountain. “In fact, I feel our entire family was born to climb Everest.”&nbsp; Phortse has a population of 350 people living in 95 households. Besides Nima Tshiring’s clan, more than 75 of the inhabitants have climbed Everest, many of them multiple times.&nbsp; Another one of Nima Tshiring’s sons, Ngawang climbed Everest 11 times, his brother Mingma Dorje has summited 14 times, and another brother Ngati not only got to the top seven times, but was the first climber to reach the peak from the Chinese side and descend down the Nepal part of Mt Everest. Ngati was killed in an avalanche on Annapurna while climbing with an American expedition in 1993.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251011171044_60693527b31aba22fe6f6c233cf367a3683b88be8dc2a53bfb5c2c02b2db1e5b.png" data-media-id="editor_5" data-image-id="20251011171044_60693527b31aba22fe6f6c233cf367a3683b88be8dc2a53bfb5c2c02b2db1e5b" data-rendition-name="original" width="2242" height="1660" loading="lazy" alt="Sherpa climbers"> <figcaption>Mingma Dorje has climbed Everest 14 times.</figcaption> </figure>  Panuru himself has reached the summit of Everest 16 times, and set up the<a href="https://www.khumbuclimbingcenter.com/" target="_blank"> Khumbu Climbing Centre</a> in 2003 to train others in climbing techniques. Following in his footsteps was another brother Mingma Tshiring, who has been up 15 times and <a href="https://nepalitimes.com/here-now/sherpaland-co-usa" target="_blank">now lives in Colorado</a>.&nbsp; Nima Tshiring’s only daughter Mingma Yanjin has also climbed Cho Oyu, Ama Dablam and other &nbsp;Himalayan mountains. Her husband Lhakpa Chiri Sherpa has climbed Everest 11 times. Counting him, the total summits for the family would be 92. This number also does not include other Himalayan eight-thousanders besides Mt Everest that the family from Phortse has summited. Nima Tsiring’s youngest son is Danuru who has climbed Everest 16 times, and has been on top of North American peaks from his base in Colorado. He is giving Everest yet another try.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251011171048_cd3e2961567ca507fc4110c97e01d85ee1c7e35f787276564ff59a4a76151fe2.png" data-media-id="editor_8" data-image-id="20251011171048_cd3e2961567ca507fc4110c97e01d85ee1c7e35f787276564ff59a4a76151fe2" data-rendition-name="original" width="1308" height="980" loading="lazy" alt="Sherpa climbers"> <figcaption>Nima Tshiring Sherpa and his son Danuru.</figcaption> </figure>  Even his grandchildren are following Nima Tshiring’s footsteps up Everest. Panuru’s son Lhakpa has climbed Everest from both sides and wants to break previous Everest records.&nbsp; “It is a dangerous occupation, but the rewards in terms of fame and money are substantial,” says Danuru. “One season’s income is enough for a Phortse climber to support his family for a year. And we have Chomolungma to be thankful for.”  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251011171048_d1f16e3925890663cadf3e20d955a531f21c479708f662df371fad3fdb87cf7a.png" data-media-id="editor_9" data-image-id="20251011171048_d1f16e3925890663cadf3e20d955a531f21c479708f662df371fad3fdb87cf7a" data-rendition-name="original" width="760" height="1040" loading="lazy" alt="Sherpa climbers"> <figcaption>Mingma Chhiring Sherpa who has climbed the Everest 16 times with a client.</figcaption> </figure>

Nepal’s most prolific mountaineering clan

The meeting called by Prime Minister Sushila Karki at Baluwatar on 4 October was supposed to be about completing the interim cabinet with GenZ representatives. But it ended with factions putting up rival demands.
It is ironic that a movement that voted for Karki on Discord is itself marred by discord.
But such jostling was to be expected. This was an amorphous and leaderless group of young Nepalis that was suddenly elevated to fill a national power vacuum, and is now expected to redesign the country from scratch. &nbsp;
At least two camps have emerged within the youth groups. One is led by Sudan Gurung of Hami Nepal with Barsa Raut, Anil Baniya, Purshotam Yadav and Ojaswi Raj Thapa, while the second under Rakshya Bam has Pradeep Gyawali, Aditya Karn, Yujan Rajbhandari and Dheeraj Joshi.
Just like it was at Nepal Army Headquarters on 10 September, there is distrust and dissent within these disparate group. For the sake of stability, and in memory of the 72 who lost their lives last month, Nepalis want these groups to be more united in their stances. &nbsp;
Prime Minister Karki did not attend the Baluwatar meeting last week, wanting the GenZs to first work out their differences. Home Minister Om Prakash Aryal and Finance Minister Rameshore Khanal were present, and entreated the young delegates to cooperate.
Sudan Gurung has demanded the resignation of the Chief Justice and the head of the anti-graft body, the CIAA. However, some even within Gurung’s camp are said to want constitutional provisions to be respected, and do not agree with some of his eight demands.
Rakshya Bam accuses Gurung of trying to do away with the Constitution and issuing arbitrary statements on governance. Her group also issued a statement warning against any attempt to deviate from the values of democratic change.
The conflict between various GenZ groups has exposed the nature and limitations of street revolt, proving that it is always easier to destroy than to rebuild. A revolution can bring rapid and transformative change, but then comes the task of agreeing on new structures and processes — while dealing with the ego and ambition of the protagonists.
TIGHT-ROPE WALK
One year after a similar student-led uprising, Bangladesh is struggling to stabilise the system and preparing for elections while dealing with extremism and geopolitical fallout. Sri Lanka held elections and brought in a new youthful leader, but it has not been smooth sailing.
Prime Minister Karki’s caretaker government is on a tight-rope walk. Moving too fast on arresting the previous prime minister and investigating others for corruption risks igniting renewed street violence, but delaying justice will anger the impatient youth, who want immediate results.&nbsp;
The longer the uncertainty and instability lasts, the more likely it will be for radical forces to take advantage of the fluidity. The communal clashes in Birganj and Janakpur over Dasain, inspired by what is happening across the border, should be a wakeup call. Hate speech and ethnic slurs on social media could be incendiary if left unregulated.
The Prime Minister has said her foremost priority is to ensure free, fair and inclusive elections on 5 March — mindful that various forces are out to sabotage it for their own interests.
Amending the Constitution to meet GenZ demands may have to wait for polls next year, and real change that improves lives, creates jobs and makes the bureaucracy cleaner and more efficient will take longer.
But till then, the interim administration could deliver tangible benefits to people with do-able improvements like speeding up the driving license process, removing middlemen from all levels of the bureaucracy, expeditiously completing highway repairs, controlling food prices.
The youth want immediate course correction, given how the old political parties, politicians and bureaucracy had plundered the state for years. But idealism alone cannot make a state machinery function. Every decision during this sensitive transition must be taken without undermining previous gains.
Factional friction within the GenZ will allow the old leaders in the old parties to regroup and plot revenge. Meanwhile, the three main parties, which fuelled the youth and class rage with their corruption and reckless disregard for the public good for the past three decades, do not seem to have learnt their lessons.&nbsp;
Despite being disgraced, K P Oli of UML, Sher Bahadur Deuba of the Nepali Congress and Pushpa Kamal Dahal of the Maoist Centre, are still not willing to retire. The tragic loss of life and the mayhem that followed does not seem to have opened their eyes to the writing on the wall. They are intent on blaming everyone but themselves.
The Election Commission has already set a deadline for party registration by 16 November. Some in the GenZs want provisions to vote for a directly elected executive head of the country by even changing the Constitution.
There is a lot of confusion about what exactly the mandate of the interim government is, what it can and cannot do. With the dissolution of Parliament, the interim government cannot amend the Constitution, its only mandate is to conduct elections to form a new government that would then work on amendments.&nbsp;
At most, it can pass ordinances but only for the peace and good governance of the country or when there is an immediate need to enact a law.
To make things murkier, Sudan Gurung in a widely-shared interview on Al Jazeera said that he would run for prime minister, and that he would not accept the old parties and their leaders even if they win the elections unless they completely reform their political stance. He is also willing to work with pro-monarchists if they are for the betterment of the country.
Dharan Mayor Harka Sampang has already registered a new party called Shram Sanskriti Party while the likes of Kathmandu Mayor Balen Shah, Energy Minister Kulman Ghising and for RSP Sumana Shrestha are expected to follow another corporate backer for a new party.
All parties, including any new ones representing the youth, must learn from the failures of the newer alternatives such as Sajha, Bibeksheel and more recently RSP. Parties go nowhere without a clear ideology, organisation and a vision and pathway post-elections.
The interim government is made of most capable technocrats and a Prime Minister with zero tolerance for incompetence and who says she has no intention of continuing in the position a minute longer than necessary.&nbsp;
We now have to move beyond destruction to rebuilding, and not be distracted by discord.
Sonia Awale

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