<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

One aspect of colonial cartography of South Asia leaps out in this must-see exhibition – while the coastline of India, Ceylon, Burma are extraordinarily accurate in maps made more than 200 years ago, the Himalayan hinterland is wholly approximate and inexact. The accuracy improves as modern survey techniques are introduced by atlas-makers, but even then formidable terrain and forbidden lands thwart precision. Map aficionados will be fascinated by the 40 antique maps from The Rajbhandari Collection on display at the exhibition ‘Imaging South Asia: Nepal in the Making at Kathmandu Art Gallery’ at Baber Mahal Revisited from 13 February - 17 March.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260211090252_0cbeb88674a97c6292e2b43b2135df219257ca641cbd4723e9aabf5541c2b258.jpg" data-media-id="editor_0" data-image-id="20260211090252_0cbeb88674a97c6292e2b43b2135df219257ca641cbd4723e9aabf5541c2b258" data-rendition-name="original" width="4160" height="3485" loading="lazy" alt="Map Land NT"> </figure>  The first maps were made on clay tablets and cave paintings, but maps improved with Chinese maritime charts of Southeast Asia and beyond. Nautical maps created during the European Age of Exploration used geometry, latitude and longitude. Competition for colonial riches rested on the accuracy of these maps. The Portuguese had the lead in the 15th century, but were soon overtaken by the Spanish with Columbus voyaging to India but landing up in the Americas.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260211090252_1fb21d20cf29b408119f5279ce666e73dee089356e52277d753a27e3440364eb.jpg" data-media-id="editor_1" data-image-id="20260211090252_1fb21d20cf29b408119f5279ce666e73dee089356e52277d753a27e3440364eb" data-rendition-name="original" width="4030" height="3407" loading="lazy" alt="Map Land NT"> </figure>  European mapping of the coastline of peninsular India &nbsp;began after Vasco de Gama sailed around the Horn of Africa to arrive at what is now Kerala in 1498. The British and French struggled for control of India, and the Carnatic Wars of the 19th century were extensions of their rivalry in Europe.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260211090252_0fb0969dc3e07c5a77123b4aa5eb0f11d2ffea73c108077f7e4d1892d6bd4bb6.jpg" data-media-id="editor_2" data-image-id="20260211090252_0fb0969dc3e07c5a77123b4aa5eb0f11d2ffea73c108077f7e4d1892d6bd4bb6" data-rendition-name="original" width="2842" height="4160" loading="lazy" alt="Map Land NT"> </figure>  While most of the maps at this exhibition were commissioned by the East India Company and the Survey of India, there are quite a few made by Parisian cartographers and feature Pondicherry and the Danish trading outpost at Tranquebar. Followed chronologically, the maps show improvements in cartographic techniques. The earliest French map L’Inde of J D Barbié du Bocage from 1760 is a copper engraving with hand painted colours demarcating boundaries. ‘Napaul’, ‘Gorka’ and ‘Catmando’ are depicted. The rivers of India are precisely drawn, as is the Brahmaputra (Yarou Tsanpou) even though locations across the rest of Tibet are rough estimates.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260211090252_486dc1b12f391550516be164f27170d4702a69b5125c1b8c4b10f76fdae4c0b1.jpg" data-media-id="editor_3" data-image-id="20260211090252_486dc1b12f391550516be164f27170d4702a69b5125c1b8c4b10f76fdae4c0b1" data-rendition-name="original" width="1675" height="604" loading="lazy" alt="Map Land NT"> </figure>  The 1781 map Carte des Indes en deçà et au-delà du Gange of Rigobert Bonne has slightly more detail about Nepal with even ‘Pattan’ and ‘Bagmally’ river marked. William Darton’s 1802 map has ‘Nogarcot’ and ‘Mocaumpour’ wrongly placed to the east of the valley of ‘Napaul’. Samuel Arrowsmith’s 1828 map ‘India and the Birman Empire’ has Nepal’s rough boundaries demarcated for the first time within a hand-coloured green border, with the mountain ‘Dholagiri’ and ‘Dhunchi’ appearing for the first time. The 1835 map by Boston-based American cartographer Thomas Bradford has a more precise ‘Burrampooter’ river with ‘Sgigatoe’, ‘Lassa’ and ‘Bootan’ marked. In Nepal, ‘Batgan’, ‘Macwampour’ and ‘Lelit Pattan’ appear near ‘Catmandu’.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260211090252_5509c8e043a74b3e34e399c0684ca8eef7fc79953ee0dd18aedc738e8189d552.jpg" data-media-id="editor_4" data-image-id="20260211090252_5509c8e043a74b3e34e399c0684ca8eef7fc79953ee0dd18aedc738e8189d552" data-rendition-name="original" width="4094" height="3646" loading="lazy" alt="Map Land NT"> </figure>  One striking landmark appears consistently through a century of map-making from 1760 onwards, and that is the sacred Yamdrok Tso near Lhasa. It is precisely located, although it is drawn as a circular lake called ‘Jamdro or Palto Lake’ till J Bartholomew’s lithographic map in 1893 Constable’s Hand Atlas of India. Bartholomew’s map is also where ‘Mt Everest’ appears for the first time with its altitude ’29,002ft’ after Peak XV was calculated to be the highest mountain in the world by the Survey of India. Meanwhile, ‘Kinchinjunga’ appears in some of the earlier maps from the mid-1800s, north of ‘Dorjeloo’. The maps did not only have locations of towns, rivers and mountains but also other interesting facts about places. History buffs will find much to pore over in these maps.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260211090252_8280c979b175946a2ac29e22b7a2b2427f7f36f22093c3456524f1f529311498.jpg" data-media-id="editor_5" data-image-id="20260211090252_8280c979b175946a2ac29e22b7a2b2427f7f36f22093c3456524f1f529311498" data-rendition-name="original" width="4160" height="2762" loading="lazy" alt="Map Land NT"> </figure>  Many have sites of major British battles while conquering India. The ‘British India’ map by J Rapkin has dates and times of the ‘Principle Massacres’ during the Indian Mutiny of 1857. The map also shows India’s growing railway network with completed lines and those ‘in progress’. Narrow gauge lines can be seen in successive maps snaking up to the Nepal border to haul sal logs for sleepers for India’s expanding railway network. Many maps were drawn by British military intelligence. One even has the Kuti route of the Nepal Army while invading Tibet in 1791, and the Chinese Army’s advance in hot pursuit through Kerung to Nuwakot.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260211090252_a41ff6a7453f95d1e83c12ed3f831911d65ebd4d2389e0e3b774252dfa037132.jpg" data-media-id="editor_6" data-image-id="20260211090252_a41ff6a7453f95d1e83c12ed3f831911d65ebd4d2389e0e3b774252dfa037132" data-rendition-name="original" width="1173" height="679" loading="lazy" alt="Map Land NT"> </figure>  Pre-1857 maps show the western Tarai as a part of British India, but in later ones the Naya Muluk districts of Banke, Bardia, Kailali and Kanchanpur have reverted back to Nepal. The maps clearly mark Nepal as an independent nation, and represent it differently from Indian princely states. The Atlas of India of 1846 shows the ‘Dominion of the King of Nepal’.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260211090252_52132146d9ee8b922560b98e90d866149715d7f53ced408b5f3af8f3b142a07b.jpg" data-media-id="editor_7" data-image-id="20260211090252_52132146d9ee8b922560b98e90d866149715d7f53ced408b5f3af8f3b142a07b" data-rendition-name="original" width="4149" height="3682" loading="lazy" alt="Map Land NT"> </figure>  Visitors will be curious about Nepal's claim to Limpiyadhura and Lipu Lek. A map by Mason &amp; Payne from 1846 clearly shows the ‘Kallee River’ as being the border between Nepal and British India, with Kalapni within Nepal. The Lipu Gad tributary (which India claims is the border) is not marked. Some other maps, however, seem to show the border not following the Kali river to Limpiyadhura but the tributary up to Lipu Lek.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2026021112024_9a1b6055a9fbecca7b64c3882c205efb336aac03e64ecf43a2044cb079cd699f.jpg" data-media-id="editor_8" data-image-id="2026021112024_9a1b6055a9fbecca7b64c3882c205efb336aac03e64ecf43a2044cb079cd699f" data-rendition-name="original" width="875" height="1215" loading="lazy" alt="Map Land NT"> </figure>  Imaging South Asia: Nepal in the Making&nbsp; Kathmandu Art Gallery, Baber Mahal Revisited&nbsp; 13 February – 17 March For guided walk-throughs and curatorial tours: +977 1-5318048 Panel discussions: -Cartographic Practices from the &nbsp;Gorkha Polity to the Present with Buddhi Narayan Shrestha and Kanak Mani Dixit&nbsp; Friday, 13 February, 4pm -Mapping Beyond Borders with Akhilesh Upadhyay and Amish Raj Mulmi Wednesday, 25 February, 4pm&nbsp;

Map land

The arrest on 25 January of six people on charges of insurance fraud has brought the scandal of fake helicopter rescue of trekkers in Nepal to the fore once more, denting the image of the tourism industry. Trekking companies, helicopter operators and hospitals were said to be in cahoots to carry out medical evacuations that were not necessary. In some cases, even the rescues were said to be fake with false names of ‘patients’ and their ailments. The six who were arrested were charged by the Central Bureau of Investigation (CIB) with <a href="https://asia.nikkei.com/business/travel-leisure/nepal-s-rescue-helicopter-scam-casts-doubt-on-tourism-credibility2" target="_blank">cheating insurance companies</a>of millions of dollars in the past four years with more than 300 <a href="https://nepalitimes.com/multimedia/heli-rescue-fraud-tarnishes-nepal-s-image" target="_blank">fake chopper medevacs</a> from the base of Himalayan peaks to hospitals in Kathmandu. Nepali personnel of three companies, Nepal Charter Service, Everest Experience and Mountain Rescue were accused of heavily overcharging &nbsp;for fraudulent rescues, faking or inflating medical bills, and claiming payment of over $18 million over the years, the CIB said.&nbsp; In some cases, trekkers themselves who do not want to walk back along the same trail to Everest Base Camp or other routes, and pretend to be sick, are also said to be involved in the scam. “Tourism will attract opportunists, that is true everywhere,” explains Raj Gyawali of <a href="https://socialtours.com/" target="_blank">socialtours</a> and a partner of <a href="https://ethicaltravelportal.com/" target="_blank">Ethical Travel Portal</a>. “Our responsibility as an industry is to weed them out, protect what matters, and keep tourism rooted in passion, integrity, and long-term value.” The scam got <a href="https://www.nytimes.com/2026/02/03/world/asia/mount-everest-helicopter-insurance-fraud.html" target="_blank">wide international attention</a>, and tainted the reputation of Nepal’s mountain tourism sector that employs up to 1 million people. International media headlined allegations that trekker food was spiked to cause diarrhoea to force evacuations. Despite the bad publicity, tourism operators see a silver lining. It shows that Nepal is cleaning up its act and the system is working. Besides, the cheaters are in a minority in an industry that provides some of the best organised and most experienced mountain tourism service in the world.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260210040232_141217f8e5dc8a584642f7cb8d130de1a05cdcf149467334f9ab4e392f7d67aa.jpg" data-media-id="editor_5" data-image-id="20260210040232_141217f8e5dc8a584642f7cb8d130de1a05cdcf149467334f9ab4e392f7d67aa" data-rendition-name="original" width="1584" height="1500" loading="lazy" alt="Helicopter medevac scam NT"> </figure>  “After years of talk and investigation, we are now seeing arrests and it’s encouraging to finally see action. This didn’t happen overnight,” Gyawali says. “The post GenZ interim government works with much less politics, we are seeing a functional system for the first time in decades in Nepal.”&nbsp; This is not a new story. <a href="https://archive.nepalitimes.com/article/nation/Insurance,361" target="_blank">Nepali Times first covered </a>trekking insurance scams in 2013, following up on an investigation by the British Mountaineering Council in <a href="https://www.thebmc.co.uk/" target="_blank">Summit magazine</a> about insurance fraud involving fake helicopter rescues. In <a href="https://nepalitimes.com/multimedia/heli-rescue-fraud-tarnishes-nepal-s-image" target="_blank">another news item</a> published in this paper in 2018 cited an investigation by insurance watchdog <a href="https://www.travellerassist.co/" target="_blank">Traveller Assist</a> which showed that a third of the 1,600 helicopter rescues in Nepal that year were fraudulent, costing up to $4 million. Insurance companies gave the Nepal government <a href="https://nepalitimes.com/banner/nepal-trekking-industry-in-damage-control-mode" target="_blank">an ultimatum</a> to clean up its act, and an investigation committee was formed and 13 companies said to be involved were named. It now looks like although insurance fraud declined, it was still continuing to some extent till 2025. In the cut-throat competition in Nepal’s mountain tourism industry, companies undercut each other, and there are some trying to make a quick buck. These rotten apples spoil the whole barrel. Given Nepal’s remote terrain and extreme weather along Himalayan trekking routes, helicopter rescues are vital in saving hundreds of lives every year, rescuing trekkers and mountaineers suffering from acute mountain sickness, stomach or lung infections. “Nepal has a unique advantage over other Himalayan countries like India, Pakistan, or China because it allows private helicopter companies to conduct rescues,” Gyawali says. “This makes rescues faster and more accessible, often life-saving.” The real problem is that sometimes rescues take too long because of &nbsp;permission needed from multiple government agencies to conduct rescues near the Chinese border, which is considered sensitive. Last year, a mountaineer died on Himlung Himal because a helicopter company could not get clearance in time for a rescue.

Fake rescues hurt Himalayan tourism

The recent Nepali Times Substack post titled ‘Unresident Nepalis’ made me realise I also belong to the category of Nepalis who are technically Non-resident Nepali (NRN), but want to ‘permanently reside inside Nepal’.&nbsp;
Although this was meant as a joke, it is ironic that many of those who go abroad long to come back home, and those who have not emigrated cannot think of a good enough reason to stay back in Nepal.&nbsp;
As soon as the NRN Citizenship was officially introduced in late 2023, I had tried to apply for one but was shut down before even submitting my documents as the district administration office firmly told my then lawyer that I needed to prove “तिन पुस्ता” proof of three generations of Nepalis from my father’s side.&nbsp;
My late father was from Japan and relinquished his citizenship to become a Naturalised Nepali citizen in 2006. Three years ago, I dismissed the rejection with the thought that I will try again later when government officials would gain more experience with such applications.&nbsp;
Now, with an ailing mother and an energetic toddler, I felt the need to act soon and reached out to a law firm that specialises in NRN citizenship applications. To my surprise, they were positive after reviewing my documents, although they did warn me that we may need to overcome some obstacles.&nbsp;
In 2023, I had applied in the district office where my father had received his naturalised citizenship, but now the suggestion was to try from the district where my mother had received her Nepali ancestral origin “बंसागज” citizenship.&nbsp;
The lawyers pointed to the NRN citizenship mandate which clearly states that it can be acquired via a Nepali origin father, mother, grandfather or grandmother. The firm helped arrange the necessary documents required and the first step was to get a “सिफारिस” &nbsp;recommendation letter from my mother’s ward office.&nbsp;
This was the first hurdle as the ward office was unsure if they could issue such a letter, so they checked in with their head office, and luckily we received the go ahead. After persistent follow up from the law associates, they were able to provide us with a recommendation letter and we filled out the application forms.&nbsp;
The law firm wisely suggested that I take the paperwork myself to my mother’s district office while they stayed in the background in case I needed help explaining my situation.&nbsp;
With a big smile and cheerful tone, I dutifully followed the process and to my surprise, I found most of the officials ready to help without creating unnecessary hurdles. The application has to be signed off by the Chief District Officer (CDO) or Assistant CDO and just when I thought wow, I am going to breeze through this, one officer noticed that my father’s naturalised citizenship was from a different district and told me that I should apply for my NRN from there.&nbsp;
I explained that my father has already passed away and as he was not originally a Nepali, therefore it is not possible for me to get my NRN from his documents, as the requirement is ancestral “बंसागज” citizenship. The officer then went to check with their seniors and later told me that I would need police verification as an extra precaution.&nbsp;
Off I went to the police headquarters where they issued a sealed letter to be given to the police station that was in the same vicinity as my mother’s ward office. At the station I was told to get four people who are not my relatives to testify our documents are true.&nbsp;
This process happened to be more stressful than dealing with the government offices. At first, it turned out that most of my mother’s old neighbours had already passed away or had citizenship papers from another area. Others confirmed their availability, but later had conflicting schedules. Luckily, one very helpful old neighbour was able to arrange for enough people to verify the documents.&nbsp;
Encouraged that the end of the tunnel was in sight, I went back to the district office with all the requested documents, and after some initial pushback, I was finally referred to meet the official who signs off the documents before it goes to the CDO.&nbsp;
As luck would have it, the officials were in a meeting that lasted more than two hours, and I had to give my mother her insulin shot and noodles from the cafeteria in the waiting area.&nbsp;
When we were finally able to meet the officer, he didn’t even look at my papers properly and started questioning my lawyers whether they had even read the law, how could I apply for Nepali citizenship when I already had a Japanese passport, etc. He somehow assumed that I was looking to get a normal Nepali citizenship from my mother’s side, and we informed him that I was only looking to get an NRN citizenship, after which his tone became more apologetic and said that he would need to look into the law more closely.&nbsp;
It had already been three full days of working through each step of the process, and I had no problem waiting another day for the conclusion.&nbsp;
Perhaps because this NRN citizenship is a fairly new law and perhaps a lot of NRNs apply from the Nepal’s embassies in their country of domicile, throughout my experience, officials kept on telling me that a case such as mine has not been processed before.&nbsp;
My case being that I have never had a Nepali citizenship, my father having a naturalised Nepali citizenship and my mother being the only 100% Nepali in the family. I kept on saying that just because it has never been done before does not mean that it cannot be done, and sure enough, the next day the officer signed off on my documents, even kindly saying that they should have highly respected my application upon learning about my late father and his contributions to Nepal.&nbsp;
Although the intricacies of the NRN citizenship law have not been fully hacked out such as the transfer of land ownership, it is definitely a positive step in securing the rights and aspirations of fellow NRNs as many would agree that no matter where we go, “यो मन त मेरो नेपाली हो!”&nbsp;
Sonia Miyahara, Managing Director of Hotel Everest View, Trans Himalayan Tours &amp; Trekking Pvt Ltd &amp; Himalaya Kanko Kaihatsu Co. Ltd.

How I got my NRN Citizenship in Nepal

This is the 83rd episode of Diaspora Diaries, a Nepali Times series in collaboration with Migration Lab providing a platform to share experiences of living, working and studying abroad. Spain is regularising over 500,000 undocumented workers, and Nepalis come to me inquiring about the program. Those who benefit from it will be very lucky, as it is a life-changing opportunity. I know because I too benefited from the last large scaled regularisation program back in 2005. I left Nepal in 2000 and went to Germany, Belgium, France before landing in Spain. Things were pretty bad in Nepal back then with the Maoist conflict and strikes.&nbsp; Our business was impacted. There was not much hope. When you leave Nepal, you want to make something of yourself and support your family back home. But you have to dream in phases.&nbsp; The first dream is to get ‘kagaj’ or a temporary residence card (TRC). Only then can you focus on your actual dreams. Whether it was because the countries I traveled were not a good fit or because the chances of getting the document was low, I kept country hopping until I reached Spain in 2004. I have not left since.&nbsp; In Spain, I felt at home. The European dream had brought me here, salaries were higher than Gulf which I thought was too strict. Then there was the possibility of traveling to seven European countries back then with the Schengen visa.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260210150228_b57c873801361755cf25048f294b2d1d0574796ef70a0e270531ced2508f64ed.jpg" data-media-id="editor_0" data-image-id="20260210150228_b57c873801361755cf25048f294b2d1d0574796ef70a0e270531ced2508f64ed" data-rendition-name="original" width="2048" height="1536" loading="lazy" alt="Nepalis in Spain"> </figure>  But mostly, I just wanted a secure life for me and my family. What I valued the most about Europe was free healthcare and education. This is very important because in other parts of the world including Nepal, people from our background are just one small disease away from losing half our capital and we spend a significant amount of money on educational expenses. Nepali dais back then told me it would be best to go to either Italy, Spain or Portugal if we wanted to establish ourselves as paper work was relatively easier there than in other European countries. My initial days in Spain without the paper work were difficult. Not concerns about being raided or deported because if we had our apartment, even police let us be.&nbsp; But it was because of unfair pay. You could not go home. It made you tense and irritable. It affects your mental well-being. Some are smart enough to invest time in skills as they wait that will prove useful. Others get depressed. The main reason we migrate is to support our family and when you cannot do it properly and are uncertain about when things will get better, it bothers you. This happened to me too, sometimes I would be staring at the TV and would flinch when other Nepalis asked me what is wrong, and why I look so lost.&nbsp; The newspaper Canarias also interviewed us about our conditions (pictured). I had not gone home since five years, and there was no way to. There was no social media like now to talk to family. Calling home from booths was expensive, just once every three weeks. You did not talk. It was just to hear voices, pass the phone around to say a quick hello.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260210150232_8af8b6f6acb1252e0d67a43556e21ff8074543acfcc318c985816479c6146fd9.jpg" data-media-id="editor_1" data-image-id="20260210150232_8af8b6f6acb1252e0d67a43556e21ff8074543acfcc318c985816479c6146fd9" data-rendition-name="original" width="2048" height="1536" loading="lazy" alt="Nepalis in Spain"> </figure>  When you are undocumented, you don’t get fair wages. But you make that sacrifice because my bigger goal was to establish myself and in the meantime, to support family with whatever I could earn with my wages. All we could do was wait for a regularisation program to open. When Spain initiated such a program in 2005, we were so relieved. We were relatively new so did not understand the language. Other Nepalis guided us and were well-versed in the latest updates via news and consultation with immigration lawyers which they would pass on to us. This time, the regularisation program will come through within 30 days, but back then it took time. I had to wait for nine months. Those nine months felt like nine years. I would keep visiting the cyber café to check my online status. When friends got their notification, I would get even more anxious and wonder if I would get rejected. Maybe today? Maybe tomorrow? It was a long wait. I wanted to know what it felt like to hold the card in my hand. Then I could hold my five-year-old baby back in Nepal in my hand. She was born after I left for Europe. When I finally got it after nine months, I could not be happier. I informed my family. I thanked God. Even when I was having food, I would put the card right in front of me on my table. Food never tasted better, I would eat twice the amount with happiness. It was a different kind of elation — it opened the doors for me to think about my dreams, my targets and how to realise them.&nbsp; There was no stopping me now, I was going to go far. But mostly, I could go home. In that flight back to Nepal after six years my heart swelled and I knelt on the tarmac to pay respect to my motherland. The minute I saw my parents, I touched their feet for blessings. My wife and I cried. My daughter was scared of me and would run away - it took some time for her to get comfortable with my presence. I still break down when I think about it.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260210150232_beba1745d845e219eaeaaf1bc33e0a02c07748ebd80bcc74a467c933cc5602e3.jpg" data-media-id="editor_2" data-image-id="20260210150232_beba1745d845e219eaeaaf1bc33e0a02c07748ebd80bcc74a467c933cc5602e3" data-rendition-name="original" width="2048" height="1536" loading="lazy" alt="Nepalis in Spain"> </figure>  A few trips to Nepal later, I brought my family to Spain after I had fulfilled various rules for family migration. As expenses rise for a migrant, the choice is to either work extra hours or start your own business. Since I got the TRC, I have done it all: various jobs, businesses from selling handicraft from India to a cyber cafe, and the restaurant business.&nbsp; As an entrepreneur, I have seen highs when I could open a second restaurant branch or earn enough to buy an apartment. I have seen lows where I closed down businesses and sold apartment. I have gone from an entrepreneur to a wage job to recoup the losses I made by working extra hours. When I felt comfortable enough, I have gone back to starting a new business.&nbsp; I have met wonderful people who have supported me when I started my business either by providing me financial help or as business partners. I have been duped by my own business partner or worked with colleagues who did not want me to prosper. I now run a handicraft shop, an Indian restaurant and a café. The struggle never ends. There are many Nepalis like me who are running businesses here and have bought property. Back in 2004, Nepalis were mostly working in jobs and for a slight salary bump, we would keep switching jobs. Now, they run their own businesses and have bought property. The power of honesty and hard work that Nepalis are known for helps in businesses. Malaga is incredibly beautiful and reminds me of Thamel. The brilliant weather and beautiful beaches attracts tourists. The houses are kept small to preserve the culture and civilisation.&nbsp; I miss Nepal. I especially miss my father who passed in 2020. He was my biggest cheerleader as I struggled thousands of miles away, and always reminded me that he was here for back support. My mother reminds me to keep at it without worrying.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260210150232_2cea4b66ad47c15859980c696446362603b10981a1b471ab5e076a22a58727b1.jpg" data-media-id="editor_3" data-image-id="20260210150232_2cea4b66ad47c15859980c696446362603b10981a1b471ab5e076a22a58727b1" data-rendition-name="original" width="2077" height="1433" loading="lazy" alt="Nepalis in Spain"> </figure>  Sometimes I ask myself, what did I leave behind to earn money and provide a good life to my family? I regret not getting to spend more time with my father before he died. I am not sure what would have happened if I had not left Nepal, but I would have figured something out. Whatever determination I have shown in Spain to navigate my life here, I would have used it back home, too.&nbsp; I have missed important milestones like weddings, births, deaths and festivals. I have missed it all. Of my three daughters I missed the births of the first two in Nepal. I was only there for my youngest’s birth, in Spain.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260210150232_a6295e4f58d73e5b340235caf916b98eba785e3559341ea4622629c262e7b1a4.jpg" data-media-id="editor_4" data-image-id="20260210150232_a6295e4f58d73e5b340235caf916b98eba785e3559341ea4622629c262e7b1a4" data-rendition-name="original" width="1630" height="1125" loading="lazy" alt="Nepalis in Spain"> </figure>  The regularisation program from 2005 that allowed me to raise the living standards of a number of living around me and reunite with my family. This platform was life changing for me, and my loved ones. There are many Nepalis who will be applying for the 2026 regularisation program if they meet the criteria like presence in the country for at least five months before December 31, 2025. Other European countries have tightened their policies so many Nepalis are in Spain. This is a great opportunity for Nepalis. There are many more undocumented workers than the available quota, a majority from Latin America in Spain who want to benefit. The Nepali diaspora is helping raise awareness and provide accurate information about the processes so they can benefit and no one is left out. I do whatever I can to support young Nepalis because I was in the same position 20 years ago.

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