James Harris (‘Jim’) Simons, the mathematician and billionaire philanthropist who set up a foundation to improve Nepal’s healthcare system, died in New York on 10 May, aged 86. Jim Simons was an award-winning mathematician who pioneered quantitative investing and gave away much of his billions to support mathematics education, scientific research and various humanitarian causes. But his life was marked by family tragedies. His elder son, Paul, was killed in New York in 1996 in a traffic accident, and his younger son, Nick drowned in Bali in 2003 after a volunteering stint in Nepal.&nbsp; Nick Simons had written letters home from Nepal about his experience in rural health posts, and was determined to become a physician so he could help the underprivileged in poorer parts of the world.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20240511120528_08e9e9ec5b9faa6a852fb5a4b5a8586526935cb8a9c8c61fd329fb8e4d7466e4.png" data-media-id="editor_0" data-image-id="20240511120528_08e9e9ec5b9faa6a852fb5a4b5a8586526935cb8a9c8c61fd329fb8e4d7466e4" data-rendition-name="original" width="596" height="812" loading="lazy" alt="Nick Simons"> <figcaption>Nick Simons with a friend in Nepal in 2003. He died soon after while swimming in Bali.</figcaption> </figure>  After Nick’s tragic death, Jim Simons and his economist wife Marilyn travelled to Nepal several times to set up the <a href="https://www.nsi.edu.np/overview" target="_blank">Nick Simons Institute (NSI)</a> to back up government hospitals in rural areas with training, equipment and budgetary support. Since it was established in 2006, NSI has invested more than $100 million in Nepal’s health sector and now supports 45 district hospitals and health facilities. Most of the institute’s work is behind-the-scenes and not visible to the public, like its help with training nurses and anaesthesiologists, maintaining biomedical equipment, and in retaining qualified medical staff in remote rural hospitals by topping up salaries. <a href="https://archive.nepalitimes.com/news.php?id=11436" target="_blank">Jim Simons once told Nepali Times</a>: "Rural health care is not a new problem in Nepal, and there are lots of people addressing the issue. What makes NSI unique is that it will do this job better than it has ever been done with an emphasis on quality and training.”  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20240511020552_a9bbf2070d0ace34db48799e7c76f8f18a221750b5f2bcb5fda3a87b2eb97769.jpg" data-media-id="editor_3" data-image-id="20240511020552_a9bbf2070d0ace34db48799e7c76f8f18a221750b5f2bcb5fda3a87b2eb97769" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="Jim Simons NT"> <figcaption>Marilyn and Jim Simons in Nepal in 2012. Photo: KUNDA DIXIT</figcaption> </figure>  Indeed, the Simons made several visits to Nepal in 2003 soon after their son died, talking to health experts to see where support would be most catalytic and meaningful. They decided to do this not by running their own hospitals, but by working with the government in developing sustainable solutions in rural healthcare and scaling it up. "With the establishment of the Nick Simon's Institute in 2006, Jim was clearly a game changer for enhancement of rural health in Nepal. &nbsp;Also what is unforgettable about Jim was his amazing sense of humor in telling a story, his sharp intellect, and how he did not suffer fools lightly," says <a href="https://archive.nepalitimes.com/news.php?id=18356" target="_blank">Buddha Basnyat</a>, a physician who is in the executive committee of NSI. The Simons often said they would probably never have been involved in Nepal’s health sector had it not been for their son Nick, who had found fulfilment helping Nepalis and wanted to return to live and work here.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20240511020556_761b7ed7926bbf26b24c5e8ab06df077019280451bc1d4efc5bd3c5d44e740bb.jpg" data-media-id="editor_5" data-image-id="20240511020556_761b7ed7926bbf26b24c5e8ab06df077019280451bc1d4efc5bd3c5d44e740bb" data-rendition-name="original" width="904" height="1382" loading="lazy" alt="Jim Simons NT"> <figcaption>Marilyn and Jim Simons in Nepal in 2023 with Patty Weisenfeld of Nick Simons Foundation. Photo: KUNDA DIXIT</figcaption> </figure>  Jim Simons went through three phases in his life: as a mathematician, an investor and a philanthropist. As a maths professor, he found solutions that are still used to solve problems in physics and astronomy. He then set up <a href="https://www.rentec.com/Home.action?about=true" target="_blank">Renaissance Technologies</a> that used his talent in mathematics to analyse complex financial data and forecast global share markets. That is how he made billions, much of which he re-invested in improving STEM education in American schools, in exploring the universe, or trying to find the causes of autism.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20240515170536_5ea1f3742ee715ce95ee11a82dfcc6991be56b827f5dff8d6c58824f836763e1.jpg" data-media-id="editor_7" data-image-id="20240515170536_5ea1f3742ee715ce95ee11a82dfcc6991be56b827f5dff8d6c58824f836763e1" data-rendition-name="original" width="1001" height="784" loading="lazy" alt="Jim Simons"> <figcaption>Health expert Aruna Uprety at a school algebra class in western Nepal.</figcaption> </figure>  After the death of his sons, Jim Simons sought solace in solving mathematical puzzles in his head. One morning at the leafy Summit Hotel in Kathmandu, the proof came to him in a flash of a puzzle that had bedevilled him for a long time.&nbsp; ‘Jim was an exceptional leader who did transformative work in mathematics and developed a world-leading investment company,’ the <a href="https://www.simonsfoundation.org/2024/05/10/simons-foundation-co-founder-mathematician-and-investor-jim-simons-dies-at-86/" target="_blank">Simons Foundation</a> said in a statement announcing his death on Friday.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20240515170536_e4c458bcc5f9daf7d8833bb0bffc98304224be100b88cde3ade7c7ae41067cd5.jpg" data-media-id="editor_9" data-image-id="20240515170536_e4c458bcc5f9daf7d8833bb0bffc98304224be100b88cde3ade7c7ae41067cd5" data-rendition-name="original" width="2008" height="1396" loading="lazy" alt="Jim Simons"> </figure>  Besides NSI, the <a href="https://www.nicksimonsfoundation.org/" target="_blank">Nick Simons Foundation</a> was involved in other health-related activities in Nepal, including building the new <a href="https://archive.nepalitimes.com/news.php?id=15138" target="_blank">maternity wing at Patan Hospital</a> and supporting <a href="https://www.nyayahealthnepal.org/" target="_blank">Nyaya Health Nepal (NHN)</a> that runs <a href="https://nepalitimes.com/here-now/nepal-s-rural-lifeline" target="_blank">Bayalpata Hospital in Achham District.</a>&nbsp; Jim Simons once said: “Nick opened up a whole new world to us. We have met so many wonderful people who otherwise we never would have known. Nepal is a gift that Nick gave us.”

Kunda Dixit

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Jim Simons' gift to Nepal

In 2009, Samir Lama completed his MBBS and then passed all three stages of the United States Medical Licensing Examination (USMLE), making him eligible to practice in the US. However, he returned to Nepal in a year, opting to serve his own people instead. Lama pursued a three-year residency in General Medical Practice at the Teaching Hospital in Kathmandu sponsored by the Nick Simons Institute and was later placed at the District Hospital in Piuthan under a three-year contract. Eventually, at a medical college in Chitwan, Lama’s monthly salary was Rs80,000, a relatively meagre sum for someone with three years of post-MD work experience. Dissatisfied, he established his own polyclinic in Chitwan. But today, he is based in Britain, working as a resident physician in general practice. “There are difficulties living and working in Nepal,” Lama tells us by phone. “Becoming a doctor through civil service is difficult, and a physician’s life is financially challenging even in private practice.” In 2017, Murari Barakoti completed a one-year fellowship in Interventional Cardiology, and preferred to work in Singapore and the Maldives rather than stay in Nepal. He blames the lack of expertise-based remuneration in Nepal for his decision.&nbsp; “In the Maldives, doctors get ten to twenty times the pay they would normally get in Nepal,” says Barakoti, who is among 1,100 Nepali doctors working in the Maldives today. Ironically, many students from Maldives come to Nepal’s medical colleges for their education. Sandesh Parajuli, a government scholarship recipient for MBBS in Pakistan, worked for two years at Gandaki Provincial Hospital after he returned. In 2020, he took the medical officer exam at Lumbini Provincial Hospital, and the results are still pending. Tired of waiting, Parajuli completed his USMLE online and is now in the US. He says, “There is a sense of fulfilment serving patients in my own country, but the working environment in Nepal for doctors is not conducive. Of my 20 closest friends, only one is still working in Nepal.” It is generally known that young Nepalis are leaving the country by the tens of thousands every year for undergraduate studies in Australia, Canada or Japan. Less well known is this haemorrhage of doctors and nurses. <div class="embed-block"><iframe title="Specialists" aria-label="Grouped Bars" id="datawrapper-chart-3jT6V" src="https://datawrapper.dwcdn.net/3jT6V/1/" scrolling="no" frameborder="0" style="border: none;" width="600" height="492" data-external="1"></iframe></div> The depletion of medical personnel has further weakened the country’s already fragile healthcare system, and added to the shortage of specialists. Despite an annual turnover of 2,000 to 2,500 MBBS graduates, Nepal faces a severe shortage of doctors, especially in remote parts of the country. The Nepal Medical Council (NMC) has nearly 35,000 registered doctors, including 10,588 specialists. But there is no exact figure for working professionals. A 2015 study by the Council reported that approximately 36% of doctors are working abroad, but the actual proportion is estimated to be much higher.&nbsp; Doctors planning to leave are mandatorily required to present a Good Standing Certificate (GSC), and the Medical Education Commission issued 1,025 GSCs just between April to December 2023. Commission sources say the demand for GSCs has surged in the past four years.&nbsp; The majority of Nepali doctors have chosen to migrate to the UK, with 1,578 physicians acquiring certificates since 2020. The US is the second most popular destination, with 888 Nepali doctors moving there to practice in the same period. Opportunities in Australia, UAE, Canada, and Qatar are also on the rise. Sanjeev Sapkota, president of the Non-Resident Nepali Association (NRNA), estimates that of its total membership, 5,000 are doctors and medical specialists. Many others who have migrated have not bothered to become NRNA members. Worryingly, government scholarship recipients make up a rising number of migrant physicians — depriving state-run hospitals in the country of specialists. Some doctors seek improved working conditions, while others, frustrated with unemployment or exploitation in Nepal’s private hospitals, choose to start anew. They are attracted by the promise of higher earnings, and a better future for their families. 1:150,000 Completing an MBBS degree generally takes six years, and those studying on government scholarships are obligated to work in a rural hospital for an additional two years. During this period, they have no time for further study or to sit for civil service exams. However, once the commitment is fulfilled, they are left without a paying job. “Despite some incentives for further studies after MBBS, many graduates struggle because of low salaries and uncertain future prospects,” says Shambu Khanal of the Lumbini Provincial Hospital.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20240128110120_63d9c40da537cbdad3dc2307a31623607227185a5768b1999359f53cc6c17b88.jpg" data-media-id="editor_1" data-image-id="20240128110120_63d9c40da537cbdad3dc2307a31623607227185a5768b1999359f53cc6c17b88" data-rendition-name="original" width="2500" height="1667" loading="lazy" alt="Nepali healthcare NT"> </figure>  Postgraduate study opportunities are also hard to get due to limited annual seats of around 2,000. Additionally, a small number of subject-specific seats further complicates matters, particularly for those candidates below the top 500, barring them from pursuing preferred medical disciplines. Without government support, individuals must bear all expenses themselves, discouraging many more aspiring Nepali doctors from pursuing MD/MS degrees. This in turn is leading to a chronic shortage of specialists in Nepal. The 'Human Resources for Health (HRH) Projection in Nepal, 2079-2087' reveals a deficit of 5,779 specialists, with the annual production growth rate falling short at 6.41%, thus widening the gap in the doctor-to-population ratio. At present, there is only 1 doctor for every 850 people in the Kathmandu Valley which is better than the WHO-recommended 1 per 1,000. But this ratio goes down to 1 per 150,000 in remote districts. &nbsp;Despite depopulation of the mountain districts, there is a dire need to retain qualified medical staff in rural Nepal. The absence of diverse medical expertise, coupled with government oversight of emerging disciplines, leaves returning professionals with no acknowledgment or motivation. The country therefore faces a critical shortage of specialised doctors, particularly in cardiology, surgery, gynaecology, and neurology. A recent study by the Medical Education Commission showed a shortfall in surgeons: there are only 660 when the country needs a minimum of 808. Medical generalists face a similar deficit, with just 349 working actively against the 1,115 required. The study also foresees a demand for 1,223 medical generalists in 7 years, factoring in population growth. Doctors in specialised services in new fields face challenges due to inadequate infrastructure and equipment. Even those willing to work in government hospitals struggle to secure positions.&nbsp; Dharmagat Bhattarai, who is specialising in paediatric clinical immunology and rheumatology, says there is an urgent need for specialised doctors, especially for diagnosing and treating rare diseases in children. “After MBBS, graduates work as interns in hospitals for a year. Although hospital administrators assign them duties, they do not get adequate compensation,” says Bijay Parajuli, who specialises in pediatric critical care, rheumatology, congenital heart diseases, and neurosurgery. He adds: “In Pakistan, I received a monthly stipend of Rs44,000 after MBBS while interns in Nepal are getting only Rs9,000.” <div class="embed-block"> <iframe title="Total ‘Good Standing’ certificated from NMC" aria-label="Interactive line chart" id="datawrapper-chart-N0vyK" src="https://datawrapper.dwcdn.net/N0vyK/1/" scrolling="no" frameborder="0" style="border: none;" width="600" height="400" data-external="1"></iframe></div> Resident doctors pursuing MD/MS face a similar fate. Overworked doing hospital health check-ups, filling prescriptions, and handling ward responsibilities, their studies are often hampered—and all this for poor pay. While countries like the USA, UK, and Canada waive tuition fees for MD/MS programs, resident doctors in Nepal have to struggle for better remuneration. A government hospital resident earns an average of Rs48,000 monthly. However, those working in private medical colleges are compelled to work for less than Rs20,000. Some doctors say residents in private hospitals often have to work for 36 hours straight, multiple times a month. Vishad Dahal, an internal medicine student at Kathmandu Medical College, faced suspension for questioning a 20 extra-curricular health camp. His suspension has now been revoked. NMC’s &nbsp;'Regulations for Postgraduate Medical Education (MD-MS Programs) 2017' states that postgraduate residents should not be assigned duty for more than 24 hours per week. Typically, it takes an average of 12 years to complete MD, even after graduation. This means most doctors would not have finished their studies even in their early 30s. Moreover, the cost of private medical education is expensive and often exceeds Rs10 million. And after all that, there is still no job security, not to mention the years it takes to recover the investment. This prompts many to consider working or studying abroad. “The rise in Nepali doctors moving abroad demands urgent attention. While it may seem routine at first glance, the trend can potentially cause a scarcity of experts,” admits Shri Krishna Giri, past president of the Medical Education Commission. He adds: “Restricting doctors from seeking opportunities overseas may not be a practical solution. The challenge lies in finding a nuanced approach that recognises and addresses the multifaceted factors contributing to this exodus.” &nbsp; With additional reporting by Yugottam Koirala.

Grass is greener overseas for Nepal's doctors

Pratikshya Roka Magar was a sickly baby ever since she was born in a faraway village in Rukum district. As years went by, the girl’s spine started to bend. Her mother Namrata Roka had given up hope that her daughter would ever get better when she heard about a Japanese doctor who was conducting a mobile health camp in the village.&nbsp; Partikshya was seven years old in 2013 when Japanese physician Ryukichi Ishida examined her, and diagnosed a rare case of spinal scoliosis that ultimately affects the lungs and heart.&nbsp; Now 17, Pratikshya has undergone six major operations in which two rods were inserted to her spine to straighten it. The Japanese benefactor has since been supporting her financially, and checks up on Pratikshya routinely.&nbsp; Read also: <a href="https://www.nepalitimes.com/here-now/nepali-doctors-love-for-urdu-poetry">Nepali doctor's love for Urdu poetry</a>, Abdullah Zahid  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20230817070836_da4e6800792c2aba1c4f41e664f24db51fbc25142c2e41e46b77e2da9d602f29.jpg" data-media-id="editor_1" data-image-id="20230817070836_da4e6800792c2aba1c4f41e664f24db51fbc25142c2e41e46b77e2da9d602f29" data-rendition-name="original" width="1504" height="1000" loading="lazy" alt="Ryukichi Ishida NT"> <figcaption>Photo: SUMAN NEPALI</figcaption> </figure>  “He is like god for us,” says a grateful Namrata. &nbsp; Pratikshya is not the only one who has received Ishida’s healing touch in these mountains where the health system is still rudimentary, and the ravages of the Maoist conflict still linger. During voluntary work with tuberculosis control while walking through Nepal’s remotest districts in 1968 as a 21-year-old medical student, Ryukichi Ishida made a promise that he would return one day to serve the people of this country. Back in Japan, while heading the orthopaedic department at Osaka's Ueda-Shimotanabe Hospital, he constantly felt the tug of Nepal. In 2006, he left his family and a satisfying job to fulfil his pledge to return to Nepal. A question that had nagged him all those years was why medical care around the world, including in Japan and Nepal, was not more equitable. Read also: <a href="https://www.nepalitimes.com/news/paul-farmer-on-my-mind">Paul Farmer on my mind</a>, Bibhav Acharya  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20230817070836_6a2d16dbb69aaaf7f900a41835ca9e091d427f2de37a1411b5df7199749fcf6c.jpg" data-media-id="editor_3" data-image-id="20230817070836_6a2d16dbb69aaaf7f900a41835ca9e091d427f2de37a1411b5df7199749fcf6c" data-rendition-name="original" width="1494" height="1000" loading="lazy" alt="Ryukichi Ishida NT"> <figcaption>Photo: JHUMLAWANG VILLAGE FOUNDATION NEPAL</figcaption> </figure>  Ishida was inspired by his physician father who also ran a clinic in the most underserved part of Japan. He has travelled through Dolakha, Jumla, Jajarkot, Rukum and Rolpa, conducting free medical camps carrying just a backpack — just like when he trekked through Nepal as an idealistic student all those years ago. He has been working at Rolpa's Jaljala Health Post since 2011, a place so remote that even Nepali health workers are reluctant to be posted there. The facility has since been turned into a hospital and research centre and is in the process of becoming a 15 bedded municipality hospital.&nbsp; The hospital has Nepali staff, but none of them stay more than a year. “The only thing constant here is Dr Ishida and his commitment to serve the people,” says Ajay Magar of the Jhumluwang Village Foundation, a non-profit that conducts health camps in collaboration with Ishida.&nbsp; Read also: <a href="https://www.nepalitimes.com/review/the-good-doctor-0pqhzm7t">The good doctor</a>, Lisa Choegyal  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20230817070836_909cd240e9e4ea3b0da86e6038a2a163f6d5e9e94df5117008cbdbf0cf8946f6.jpg" data-media-id="editor_5" data-image-id="20230817070836_909cd240e9e4ea3b0da86e6038a2a163f6d5e9e94df5117008cbdbf0cf8946f6" data-rendition-name="original" width="1531" height="1000" loading="lazy" alt="Ryukichi Ishida NT"> <figcaption>Photo: JHUMLAWANG VILLAGE FOUNDATION NEPAL</figcaption> </figure>  Besides treating patients, Ishida has also supported locals like Sahanshila Buda Magar who is the first female MBBS graduate from Thawang thanks to a scholarship he provided.&nbsp; Sahanshila, 27, got her degree from Changsha Medical University in China, and is undergoing a three-month training at Patan Hospital. She plans to go back home and work at the Jaljala Hospital. &nbsp; Ishida says the staffing challenges of remote area facilities in places like Rolpa can only be met by producing their own crop of young doctors with a commitment to the place they belong.&nbsp; Despite his years of experience as an orthopaedic surgeon, Ishida believes in integrating modern medical practices with traditional healing, especially for bone-setting and birthing. Read also: <a href="https://www.nepalitimes.com/banner/nepals-far-sighted-eye-care">Nepal's far-sighted eye care</a>, Sonia Awale  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20230817070836_03aa6692c46a7850cb8d05acb0e89f7928a5dab973fcfa466ab9417fcd85c165.jpg" data-media-id="editor_7" data-image-id="20230817070836_03aa6692c46a7850cb8d05acb0e89f7928a5dab973fcfa466ab9417fcd85c165" data-rendition-name="original" width="3711" height="2770" loading="lazy" alt="Ryukichi Ishida NT"> <figcaption>Photo courtesy: RYUKICHI ISHIDA</figcaption> </figure>  The only reward Ishida has for his work is the respect and affection of Thawang's people. Villagers refer to him simply as “हाम्रो डाक्टर” (our doctor) — indicating they have ownership over a surgeon who they consider to be rightfully theirs. That same recognition is not reflected in the way the Nepali state regards Ishida. Now 76, and increasingly frail, Ishida has applied unsuccessfully for honorary Nepali citizenship. His visa requires Ishida to make frequent expensive trips back to Japan, and says he no longer wants to go back and forth.&nbsp; When he is away on his visa run, Rolpa’s villagers count the days for Ishida’s return so they can be treated. The surgeon does not take a salary, lives frugally and depends on the Jaljala Hospital for food and lodging.&nbsp; “I was born in Kobe, but I want to die here in Thawang,” says the soft-spoken Ishida. “This is my home now.” Read also: <a href="https://www.nepalitimes.com/here-now/an-eye-for-two-eyes">An eye for two eyes</a>, Yugottam Koirala

Pinki Sris Rana

The barefoot doctor of Rolpa

Nepali Congress (NC) President Gagan Thapa's candidacy in Sarlahi-4 has thrust this Madhes constituency into rare national focus. If Thapa wins and the NC emerges as the largest party, Sarlahi-4 will send Nepal's next prime minister to Parliament. But if he does not, Nepal’s grand old party will face the next years in the opposition to fight another day. There is a troubling paradox in Sarlahi-4 where the district bordering the Indian state of Bihar has been a battleground for national politicians with fierce electoral competition, all while remaining one of the region's most underserved and underdeveloped constituencies.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260305140344_069cbbc11e971a851b444866dee57f760c0cc611ed40bdf96c627e343e3c0485.png" data-media-id="editor_0" data-image-id="20260305140344_069cbbc11e971a851b444866dee57f760c0cc611ed40bdf96c627e343e3c0485" data-rendition-name="original" width="1802" height="1276" loading="lazy" alt="Sarlahi-4 voting"> <figcaption>Photo: MADHES PAHARA MEDIA</figcaption> </figure>  Ever since Mahant Thakur split from NC in 2008 to form the Tarai Madhes Loktantrik Party, the district has seen rotating political alliances and fragmented votes. Yet, despite 18 years of candidates promising change irrigation schemes remain incomplete, market access for farmers has not improved, unemployment is high.&nbsp; On election day, voters here marked their ballots with fingers stained by dye from the Holi festival the day before. The road leading to Barathawa Bazar was deserted for the most part, except for some youth riding in motorcycles. This is where the high-profile contest between Gagan Thapa and RSP nominee Amresh Singh is being staged. Among the other aspirants is 27-year-old UML candidate Amnish Yadav, the son of former MP Shiv Pujan Yadav. The Yadavs are a political family with considerable caste influence in the constituency. In 2022 Yadav’s daughter Madhumala Yadav received over 14,000 votes here, ranking third overall. Yadav was voted MP from the Maoist party, but defected to the UML this time. His other son is the chair of Sarlahi’s Ramnagar Rural Municipality. Sarhali-4 has 121,012 voters, and the Yadav is banking on the 27,000-strong Yadav vote bank. Sarlahi-4 voter Avishek Sah told us he wanted his vote to go to a young nominee and not someone who has been MP thrice already, like Amresh Singh. &nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260305140344_527c5c2f9aa6a6c7e3bbdfbfe79fdafb0a0b56a62427e9ced86b924c6c563b10.jpg" data-media-id="editor_1" data-image-id="20260305140344_527c5c2f9aa6a6c7e3bbdfbfe79fdafb0a0b56a62427e9ced86b924c6c563b10" data-rendition-name="original" width="1200" height="1600" loading="lazy" alt="Sarlahi-4 voting"> <figcaption>Photo: AYUSHA CHALISE</figcaption> </figure>  To make local loyalties even more complicated, Amnish Yadav’s uncle, Harinder Yadav is an active NC member and walked side by side with Gagan Thapa during his door-to-door campaigns.&nbsp; The NC is betting on Thapa getting over 60% of the total votes. Amresh Singh’s tally could be limited to 10,000 votes — that too because of the nationwide RSP wave, and the popularity of its prime ministerial hopeful Balendra (Balen) Shah. “Amresh Singh lost his appeal when he played victim after he was denied a ticket by the NC in 2022,” Harinder Yadav says. Voters we spoke to here agreed with this assessment that Singh did not do much for the district once he got elected in the past, and being a part of the RSP seems to be his biggest asset. “The only reason I voted for Amresh Singh is because Balen is in RSP,” local voter Mahendra Gupta from Barathawa. &nbsp;“This is his last chance to return the people’s trust.”&nbsp; Gupta is aware of the institutional presence of the NC here. The party received the most votes in 2022 local elections, adding that the candidacy of someone as high-profile as Thapa is a positive sign for Sarlahi-4.&nbsp; Other voters like Ruby Gupta are rooting for both the NC and the RSP. “I will vote for Gagan and for Balen,” she says, adding that her FPTP vote will go to Thapa while her PR ballot would be for the RSP. RSP supporters are confident that their candidate will win big because even though many voters may not have openly voiced their support they still voted for the party and candidate. The Balen Wave was not limited to RSP voters, but also to UML candidate Yadav, who said in a gathering that he will be “the voters Balen” if they elect him. He touted his party’s track record in government, and largely campaigned on administrative efficiency, infrastructural expansion, and local service delivery. Amresh Singh ran on the RSP’s anti-establishment brand, promising to fight corruption, challenge traditional party politics, improve basic services such as education, health, jobs, and infrastructure, while pushing for stronger representation and development for Madhes.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260305140344_982df01801fa7d3532ca0555ecb8a0756e3223be3d93650e08ca82a312dc2ebd.jpg" data-media-id="editor_2" data-image-id="20260305140344_982df01801fa7d3532ca0555ecb8a0756e3223be3d93650e08ca82a312dc2ebd" data-rendition-name="original" width="1600" height="1200" loading="lazy" alt="Sarlahi-4 voting"> <figcaption>Photo:AYUSHA CHALISE</figcaption> </figure>  Singh’s rivalry with his NC competitor goes beyond the ballot— he allegedly blames Thapa for being denied the NC ticket in 2022, which led him to win the election from Sarlahi-4 as an independent. &nbsp; For his part, Gagan Thapa focused on a more pragmatic development agenda that includes upgrading roads and irrigation, improving schools and hospitals, supporting farmers, and creating employment opportunities with improved governance at the centre. He also promised to build an engineering college in the constituency.&nbsp; Thapa also promoted his own anti-establishment image within the NC, repeatedly reminding voters on the campaign trail that he represents the aspirations of the youth.&nbsp; On Thursday, as voting progressed, there were violent disruptions in two centres where voting was briefly halted. But Sarlahi district police spokesperson Saroj Rai told Nepali Times that there were no major problems. Police in collaboration with the Nepal Army sent the ballot papers to the district’s counting stations, where the votes are expected to be tallied through the night and the winner announced Friday morning.

Sarlahi-4 nervously watches ballot count

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Nepal election live results

As this report is uploaded, the latest results in Nepal’s election show that the Rastriya Swatantra Party (RSP) is headed for an even bigger sweep than most had predicted.
The RSP was leading by large margins in 49 of 165 constituencies, &nbsp;with the UML, NC and NCP trailing far behind. Prominent political figures from the old parties like K P Oli, Minwndra Prasad Rijal, Ishwar Pokhrel, Bishnu Prasad Poudel, Bimalendra Nidhi all seem headed for defeat.
It does look like the RSP’s bell election symbol is ringing right across Nepal — from cities to the remotest districts in the mountains and plains. The party’s blue colour is sweeping the land.
The Nepali people seem to have sent a clear message that they were throughly dissatisfied with the chronic failure of the three main parties to work in the national interest to create jobs and deliver development. It was also an expression of lingering outrage over the the 8 September massacre outside Parliament. &nbsp;
It now looks almost certain that Balendra Shah will get to be Nepal’s next, and youngest, prime minister. Hopefully he will be leading a cabinet of competent and honest technocrats. It remains to seen how the power equation between Shah and the RSP’s leader, Rabi Lamichhane will play out.
Lamichhane is out of jail on bail for fraud cases which he has called political vendetta by the previous regime. Both he and Shah are charismatic and ambitious. Their working relationship will determine Nepal's political stability and whether it can avoid the political cronyism of the past.
This election was not just about casting votes. It was about standing up to principles and a value system, and respecting the hopes and aspirations of Nepal’s youth. It to push for transparent government and against impunity — including for the gunning down of young Nepalis in cold blood.
<div class="embed-block"><iframe src="https://election-geo-dashboard.pages.dev/" width="100%" height="600" frameborder="0"> </iframe>Live election results as winners of candidates are announced.</div>
CAN DO MAN
Shah got mixed reviews as mayor. He was impulsive and ad hoc, but most people inKathmandu and beyond liked his can-do attitude and unconventional style which stood in sharp contract to the legacy leaders. Over his three year mayorship he showed more maturity and planning capacity.&nbsp;
But he always ran headlong into opposition from the federal government over his urban planning and other initiatives to make Kathmandu more liveable. Coming from a civil and structural engineering background, he was involved in building low-cost housing after the 2015 earthquake.
But his public persona is more tied to his irreverent rap lyrics that stood up for the marginalised underprivileged in society, while exposing the high-handedness and apathy of the state. But this also exposed contradictions because he also used his own municipal guards to beat and chase away street vendors and squatters.
But there is no doubt that a combination of the sharp messaging in his rap videos amplified by the algorithms of social media ignited Nepal’s youth to rise up. It was more about optics and emotion than policy and strategy.
He studied Kathmandu district for five years, visiting experts in every field before announcing his independent candidacy for mayor in 2022. Many like me in his own constitunecy did not know who he was and where he came from.
He is a year younger than my architect son, and I saw in him a reflection of my own son’s commitment to serving the nation. I voted for him to be mayor despite his sometimes erratic behaviour, which could be attributed to his youth.
The best sign of his strategic planning, which unsettled septuagenarian and octogenarian politicians, is the he did not grab the first easy option of becoming prime minister in September when GenZ activists offered him the post.&nbsp;
Joining RSP was a masterstroke, as was his challenge to Oli in Jhapa to project national branding. He needed a party platform and Lamichhane needed a popular prime ministerial persona since he himself could not hold the post.
Shah has shown the capacity to take risks when he believes the value justifies the action for the country. Now, he will have to show more strategic thinking on a national scale, as well as understand the delicate geopolitics of Nepal.&nbsp;
He must rise above the kind of crude social media posts that earned him followers on X, but did nothing to erase his erratic and impulsive image.&nbsp;
Some assume that behind his trademark RayBan shades is a closet dictator, and his past remarks about Hitler are still up on social media. He has in the past shown impatience with criticism, unleashing supporters on social media to troll detractors.&nbsp;
Even so, the public seems willing to place their hope on an educated young man with integrity and a proven record for planning at the helm. By tomorrow it will be clear whether the hope Nepalis have held has been fulfilled, and the coming years will show if the RSP will lead Nepalis to a better future.
The voters seem to have shown the door even to the NC despite the fact that under Gagan Thapa, the party had turned a new leaf. A strong government under Prime Minister Balendra Shah heading a carefully selected cabinet and a strong opposition of the NC, UML and other parties for check and balance may be just what we need for a stable Nepal.&nbsp;
Nepalis have collectively always shown maturity in elections. This time they have given a resounding endorsement for integrity and for good governance.

Bells ring all over Nepal

After Thursday’s election, Nepalis are in a wait-and-watch mode. The Election Commission says counting ballot papers will be expedited this time, and the results for the First-Past-The-Post (FPTP) will start being declared within days. In 2022, it took three weeks for the final results to be tallied.&nbsp;
But winning an election is only half the challenge for the parties, forming a government under parliamentary politics is like a complicated mathematical equation.&nbsp;
In 2022, the Nepali Congress (NC) emerged as the biggest party, winning 89 seats. But the UML with 78 seats and the Maoists with 32 formed a minority government. In fact, Sher Bahadur Deuba did not become PM then despite leading the biggest party in Parliament.
This time, there is an unmistakeable Rastriya Swatantra Party (RSP) wave led by its prime ministerial candidate, Balendra Shah. Besides his own popularity, Shah represents change which most Nepalis are clamouring for after decades of corrupt and feckless coalitions that did not deliver.&nbsp;
The past months of campaigning has seen massive youth engagement on social media through memes, AI clips, and viral images. Digital content that appeals to emotion rather than policy debate between candidates shape electoral outcomes in Nepal and elsewhere. &nbsp;
Shah represents GenZ aspirations, and was their candidate for prime minister. It was only when he declined that Sushila Karki was nominated. None of the political parties in the recent past -- new, old, or revolutionary — have won enough seats to go it alone.&nbsp;
The most recent majority government was formed by the short-lived Communist Party of Nepal after the UML-Maoist merger in 2022. But that rare two-thirds majority collapsed after a power struggle between K P Oli and Pushpa Kamal Dahal. The only party to have won a majority was the NC in the 1991 and 1999 elections. But it is near impossible for it to repeat this success now, even with Gagan Thapa's rebranding of the party.&nbsp;
We have compiled these possible scenarios for election outcome in order of likelihood:
RSP gets a majority
RSP hits the magic 138 to form a government entirely on its own. Balendra Shah wins Jhapa-5, and becomes the new prime minister at 35, the youngest ever to hold the office in Nepal. But danger lurks: there could be a personality clash between Shah and Lamichhane who are both equally ambitious. History could repeat itself.&nbsp;
RSP wins but does not get a majority
RSP is likely to sweep the most votes, but what if it does not secure enough seats for a majority? It would need a coalition partner and Nepali Communist Party (NCP) under Pushpa Kamal Dahal could fit the bill, but only if it has the numbers. The RSP is not likely to team up with the UML or NC.
The NCP is relatively untainted by the 8 September events, and also has former UML defectors like Madhav Kumar Nepal and Bhim Rawal who could bag their rural vote banks. After all, there are no permanent foes in politics. If the royalist RPP and Tarai-based Janata Samajwadi have enough seats, those could be options for the RSP. &nbsp;
NC is second
The NC under the new leadership of Gagan Thapa could become the second biggest force and form a government with RSP in a power-sharing deal with Shah. This would be the most stable scenario since the RSP and NC have competent and idealistic young technocrats. Thapa himself embodies a strong combination of both old and new politics to navigate the system for more efficient government. But then Thapa and the RSP's Rabi Lamichhane do not get along.
NC and NCP form a majority
If the NC becomes the largest party but not by a big margin, it could join up with the NCP and Ujyalo. Teaming up with the UML would likely face backlash with the party and outside. If Gagan Thapa becomes prime minister he will face internal pressure from both Deuba loyalists. Same old story.
Minority coalition of NC, UML and NCP
RSP becomes the first party but does not get a majority, paving the way for the three legacy parties to cobble together a minority government. While this is possible in Nepal’s parliamentary system, such a scenario is likely to lead to more instability and dissatisfaction among young Nepalis demanding change, and even trigger street unrest. &nbsp;