A month after September’s GenZ movement in Nepal, nurses working in private hospitals took to the streets demanding better work conditions, and salaries equal to what government nurses are paid.&nbsp;
The strike started at Pokhara’s Manipal Teaching Hospital before spreading nationwide, and nurses working at government hospitals joined in.&nbsp;
Nurses at private hospitals are forced to work for far less than Nepal’s minimum monthly wage of Rs19,550 — without overtime, breaks, and other benefits and under physically and mentally taxing conditions. This is driving many qualified nurses to emigrate.
For newly-appointed Health Minister Sudha Sharma Gautam in the interim government, the strike became her first order of business. She met representatives of the Nursing Association of Nepal (NAN), the protesting nurses, and others from the health sector.&nbsp;
An agreement was reached under which private hospitals and medical colleges will pay nurses a minimum monthly salary of Rs34,730. &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
“It is a shame that nurses have been working under such exploitative conditions all this time” says Radha Adhikari, at the School of Health and Life Sciences of the University of the West of Scotland. “The agreement is basic, and there is a long way to go to improve their working conditions. But it is a start.”
NAN chair Chandrakala Sharma has said the ministry’s task force to look into working conditions will also look into facilities for nurses in government hospitals.&nbsp;
“We are committed to solidifying the wage agreement by amending relevant laws within this month,” Sharma said in a video posted by NAN on Facebook. “Our movement is not over, we are still protesting and &nbsp;following up with the Ministry.”
NAN issued an ultimatum to the government to implement the agreements within 48 hours. That deadline has now lapsed and the nurses are back on strike. Many of those protesting now accuse NAN of betraying them.
Jyoti Ranabhat of the Nurses Struggle Committee was present in the meeting, but refused to sign the agreement. “It did not address what we were demanding, we will now go it alone into Plan B,” she tells Nepali Times.&nbsp;
Previous grievances of the nurses did result in similar agreements, but private hospitals failed to comply with government’s past directives — most recently the minimum salary and benefit determined by the state in December 2024.&nbsp;
The Nepal Nursing Council says there are 126,580 registered nurses, specialists, midwives, and Auxiliary Nurse Midwife (ANM) professionals in Nepal. Yet, nursing positions at hospitals remain vacant.&nbsp;
The reason for understaffing is a mass emigration of medical professionals, including nurses. Nursing student enrollment is also declining and there is disinterest in a profession that does not afford health workers quality of life, respect, or dignity.
“Our fight is not with the private sector, it is by definition profit-oriented, our grievance is with the state,” says Ranabhat. “The government is responsible to provide us dignity, respect, and fair pay.”&nbsp;
GREENER PASTURES
Poor pay and working conditions are driving doctors and nurses abroad in large numbers in recent years. Many have simply quit the profession, leading to a shortfall in medical professionals. 

The shortage of nurses is a global phenomenon, and countries like the US, UK and Australia have compensated for their own shortage by offering jobs from countries like the Philippines, India and Nepal.&nbsp;
Nepal Nursing Council data shows that outmigration of nurses rose sharply after 2002, and an estimated &nbsp;20,000-45,000 nurses have left since.
“The state’s denial, derision, and disregard of nurses has caused resentment and disillusionment in the community, driving nurses out,” says Ranabhat. “Ultimately, Nepalis will pay the price when there are no nurses left here.”
Many Nepali nurses who have gone abroad are happy with the respect and quality of life in their jobs abroad. But many others face exploitative recruiters in Nepal and employers abroad. Nursing consultancies have mushroomed as nursing colleges struggle to meet demand.&nbsp;
Adhikari herself worked at United Mission Hospital Tansen before moving to the UK 30 years ago, and remembers that working conditions then were much better for nurses.&nbsp;
“Nepal’s health sector has gone downhill since privatisation,” she states. “Medical colleges are only concerned with supplying doctors and nurses internationally, because that is what makes money.”
But once Nepal’s nurses are abroad, there is no guarantee that they will have jobs in the nursing sector. Many find themselves working outside their field of expertise, in hospitality or sales.&nbsp;
“Nepal has become a production hub for nurses, and Nepali nurses have become products for export,” adds Ranabhat. &nbsp;“People might think this will add to remittances, but no one is thinking about what will happen to Nepal’s health sector.”&nbsp;
For many, nursing has become a way out of Nepal rather than a vocation. In 2022, the government signed an agreement with the UK to send Nepali nurses to work there at zero cost, with benefits and protection equal to UK nurses.&nbsp;
The pilot phase was expected to recruit 100 nurses, and applications opened in July 2023, with 45 nurses said to be selected by Britain’s NHF representatives by the end of 2023. Forty-one of them obtained labour permits.&nbsp;
They may be treated well, but the reality of working in the international health sector is not as straightforward.
Radha Adhikari told us from Scotland: “Market saturation, exploitation, discrimination based on race, gender, and foreignness prevent nurses from finding the right, respectful jobs even here. Ultimately, migration cannot be sustainable for Nepal’s nurses.”

Shristi Karki

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Nepal haemorrhaging nurses

Ritu got her nursing licence in 2017 and started working at a hospital in Bansbari for a monthly salary of Rs15,000. She had a heavy workload, had no overtime pay and could not always get a day off. &nbsp; Two years into her job, Ritu’s brother fell ill and she took two days’ leave to go to Pokhara to care for him. Nursing her sibling back to health took her two additional days, and when her hospital demanded clarification Ritu was so outraged she quit. &nbsp; Ritu then approached another clinic, where she had to work two weeks as a trainee without pay. After that she was offered a salary even less than her previous job. She was so overworked, she left that job after three months even though she had got only a month’s pay check.&nbsp; Ritu went back home to Pokhara and has been out of work for six years. Her mental health has deteriorated during this time. She told Nepali Times: “Experiencing the exploitation and abuse makes me want to tear up my nursing certificate.” Puja is another Proficiency Certificate Level (PCL) nurse from Nepalganj who got a job through a recruitment office that paid only R12,000 a month. Her middle-income family is in debt after spending Rs1.2 million on her nursing education. Puja reluctantly accepted the job, which was harrowing.&nbsp; There were only seven nurses in the 50-bed hospital, and Puja had 18-hour shifts with no overtime. She quit after a year, and has been without a job at home in Nepalganj for the last six months. “Becoming a nurse was a dream that turned into a nightmare,” she told us by phone. Read Also: <a href="https://nepalitimes.com/here-now/nepali-nurses-gone-and-going-to-the-uk">Nepali nurses gone and going to the UK</a> Anjali Pokharel from Dang got the same nurse job in the same hospital as Puja, but she was offered only Rs11,000. Her monthly hostel rent in Kathmandu alone was Rs12,000.&nbsp; “There is no earning, respect, or professional satisfaction in nursing,” says Anjali. “I never &nbsp;imagined that the nursing sector in Nepal was so bleak.”&nbsp; Another nurse with a decade of nursing experience is working at Ihsan Children’s Hospital in Kathmandu for Rs18,000, and says she was threatened with dismissal when she spoke out about low pay and overwork. She told us confidentially: “Despite great dissatisfaction, nurses are forced to keep working because there is no other choice.” All 20 nurses Nepali Times spoke to for this story said they were subjected to exploitation at their workplaces. Says a nurse currently at Norvic Hospital in Kathmandu: “Most nurses fall ill due to the workload, and many speak of wanting to go abroad for more respect and money.”&nbsp; For Nepal’s aspiring nurses, exploitation begins in the classroom. While the government has set a fee of Rs475,000 for the post-SEE three year PCL diploma course, many nurses spend up to Rs1.5 million to complete the course. The four-year BSc nursing fee is capped at Rs750,000, but nursing colleges set fees as high as Rs2.2 million, tacking expenses for food, accommodation, educational tours, etc.&nbsp; Read Also: <a href="https://nepalitimes.com/opinion/comment/nepal-health-workers-at-risk-of-workplace-hazards">Nepal health workers at risk of workplace hazards</a>, Ramita Marasini Female students are also subject to harassment and disciplinary practices that put restrictions on how they can dress, as well as how they do their hair and make-up. Nurse training itself is book-based with outdated curricula, and many nurses will not have interacted with actual patients throughout their academic career. Seema KC, who works at the Civil Hospital in Bhaktapur, says that the lack of practical knowledge means nursing graduates are incapable of the real-world working environment.&nbsp; This is one reason why even the country’s largest, international-level hospitals keep new nurses on probation at very low wages. The government also does not have a fixed minimum wage for nurses, a loophole private hospitals have taken full advantage of.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20240317100332_10a449da404b46c671bc9baef588c76762ef41f787de5cd018a87a7eafe3a24e.jpg" data-media-id="editor_2" data-image-id="20240317100332_10a449da404b46c671bc9baef588c76762ef41f787de5cd018a87a7eafe3a24e" data-rendition-name="original" width="768" height="1024" loading="lazy" alt="Nepali Nurses in UK"> <figcaption>Nepali nurses working in the UK. Nurses have started leaving Nepal in search of better professional and academic opportunities abroad. </figcaption> </figure>  A nurse interviewed for this story said she had been offered merely Rs4,000 at Megha Hospital despite having had previous work experience, while Norvic pays PCL nurses up to Rs16,000 and nurses who have a Bachelor’s in Nursing Science (BNS) Rs25,000. Although working hours for nurses at private hospitals are supposed to be only six hours, many work for twice as long daily. The Nepal Health Service Regulations stipulate that health workers should only work 40 hours per week, and are entitled to compensation and additional service leave if their working hours are extended beyond the set hours. &nbsp; Salaries at government hospitals are better compared to private hospitals, but nurses are reluctant to work there because of lack of opportunities for career progression, and are forced to tolerate lower pay at private hospitals. Exploitation, low pay, high nursing college fees, lack of academic or professional growth are driving Nepal’s nurses overseas in droves.&nbsp; “Most nurses at Teaching Hospital have decided to go abroad because there are more academic and professional opportunities outside Nepal,” says Sarita Poudel, a nurse there. Government hospital directors say three to five nurses resign every week, some to pursue nursing abroad, and some to leave the sector entirely.&nbsp; Read Also: <a href="https://nepalitimes.com/latest/nepali-nurses-now-britain-bound">Nepali nurses now Britain-bound</a>, Radha Adhikari Nepal’s Department of Labour granted work permits to 40 nurses to go abroad in 2013. This number increased to 160 in 2019, 109 in 2020, 287 in 2021 and 582 in 2022. In 2023, 607 nurses received permits to go overseas. However, many nurses who go abroad do not appear in these official statistics. Some have gone abroad on student visas to study other subjects. A nurse working at Vayodha Hospital says she is going to Canada on a non-nursing student visa, adding that she will need nothing more than her Nepali nursing license to sit for the nursing license exam there. Data from the Ministry of Health and Population states that there are 14,099 vacancies for nurses across the country, while there are only 9,951 nurses currently employed. The shortage of nurses is affecting medical care across Nepal. In government hospitals, the nurse-patient ratio is 1:40. The Health Institution Operating Standards stipulates one nurse for four to six beds in the general ward, one nurse per two beds in emergency and postoperative rooms, and one nurse per bed in ICUs and CCUs. Meanwhile, there must be two Skilled Birth Attendants (SBA), trained nurses or midwives per patient in delivery rooms. None of Nepal’s hospitals – private or government – meet this requirement. Bir Hospital alone requires at least 938 nurses for its 550 beds, but only 400 are currently employed. The 350-bed Kanti Children’s Hospital requires 600 nurses but has only 169. It is even worse at the Prasuti Griha maternity hospital which needs at least 735 nurses but only has 154.&nbsp; The minimum service standards of the Health Ministry means Nepal’s government hospitals alone need 32,000 nurses, but have only half that number. The irony is that while the nursing posts remain vacant, many nurses are unemployed. The Ministry of Health’s Nepal Health Workforce Projection, (2022-2030), states that Nepal had produced 72,550 staff nurses until 2021. Excluding those who went abroad or had retired, 50,785 staff nurses were available against an estimated requirement of 39,249 professionals. This means that Nepal should theoretically have an excess of 11,536 staff nurses. According to the report, Nepal will need 43,056 nurses by 2031, including 22,255 who have completed the Auxiliary Nurse Midwife (ANM) diploma course as well as 240 graduate nurses and midwives. There are currently 115,793 registered staff nurses and ANM professionals in Nepal. Meanwhile, new nursing colleges are mushrooming with little regard to meeting accepted standards. They produce 7,000 nurses every year, but few get jobs overseas because they are not deemed qualified enough. The Ministry of Health in 2012 gave medical colleges a deadline until 2016 to build their hospitals of up to 100 beds to employ graduating nurses, but most never followed this directive even after multiple deadline extensions. In response, the Medical Education Commission stopped admissions to institutions that did not have 100-bed facilities, but colleges have been lobbying to be allowed to teach students without meeting those standards. The Nursing Association of Nepal has forced the government to agree to reforms in the sector, but few of those agreements were ever implemented. Nurses who spoke with Nepali Times said that many of their problems would be solved if the Nursing Association of Nepal and the Nepal Nursing Council took more initiative.&nbsp; Mana Kumari Rai, president of the Nursing Association blames the Health Ministry for failing to meet past commitments. Last week’s government change has again brought in Upendra Yadav of the JSP as health minister, but few nurses have hope that things will change for the better any time soon. &nbsp; Some names have been changed.

Nursing grievances against the state

As a nurse, Anju Chaudhary has to often test the limits of her skills when dealing with <a href="https://www.nepalitimes.com/here-now/another-babys-life-is-saved-in-rural-nepal">complicated pregnancies</a> that arrive at the government hospital here in Katari.&nbsp; She is also the leader of a team of nurses who are on duty for 24 hours a day, seven days a week, caring for patients. Chaudhary has helped deliver over 1,000 babies and <a href="https://www.nepalitimes.com/banner/saving-nepali-mothers-and-babies-district-by-district">prevented the deaths of many mothers and newborns</a>. But no case was as challenging as that of Sharmila Surkheti. One morning in March, the 30-year-old Dalit woman arrived at the hospital, weak and bleeding profusely.&nbsp; “We had never seen a mother in such a near-death situation, but we were prepared, and we got into action immediately to save her life,” recalls Chaudhary. Surkheti had already been pregnant 13 times in her young life. All six of her newborns were delivered at home, and she had undergone seven abortions. Barely a year ago, she had another baby who died at childbirth. Read also: <a href="https://www.nepalitimes.com/here-now/who-will-save-nepal-s-poor-new-mothers">Who will save Nepal's poor new mothers?</a>, Rojita Adhikari This year, she decided to try to risk her own life to try for another son but there was post partum haemorrhage after the baby was born. Her husband helped get her to Katari Hospital while leaving behind the newborn. It was a two hour walk from home. There was no General Physician at the hospital that day so it was up to Chaudhary and her nurse team to save her life. A quick decision had to be made. They used the bundle approach in postpartum haemorrhage (PPH) management to control the bleeding. As a chronic anaemic patient, the mother had a low haemoglobin of only 6.1, which was alarming. To save her life, the nurses planned to take Surkheti to a better-equipped hospital in Gaighat but the family could not even afford transportation. Read also: <a href="https://www.nepalitimes.com/here-now/nepal-s-rural-lifeline">Nepal's rural lifeline</a>, Sonia Awale Her blood pressure dropped alarmingly low, and the nurses immediately created an emergency fund to pay for the private ambulance to reach Gaighat. She also needed blood transfusion, but Surkheti’s husband was malnourished and there were concerns about his health. The nurses then found a male colleague at the hospital who agreed to donate his blood. They closely monitored the mother, and her haemoglobin improved to 8.8. The hospital’s Acting Medical Superintendent, Dr. Gaurab Shah, an MD Pathologist, also put a lot of effort into managing a blood donor.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20230902040916_6d4eb5e618d116e1cbcc72776152080ad55f53e026f67be55044f350d2849c2e.png" data-media-id="editor_4" data-image-id="20230902040916_6d4eb5e618d116e1cbcc72776152080ad55f53e026f67be55044f350d2849c2e" data-rendition-name="original" width="2100" height="1500" loading="lazy" alt="Nurses in rural Nepal"> </figure>  The next day, the nurses gave her iron tablets, B complex, and vitamins and she was sent home. But during a post-natal home visit, the nurses were dismayed to see the utter poverty of the Surkheti’s family, including her husband and six children. Read also: <a href="https://www.nepalitimes.com/banner/this-is-how-to-upgrade-nepals-rural-health">This is how to upgrade Nepal's rural health</a>, Sewa Bhattarai Given her anaemic state and being very weak, Surkheti was unable to produce milk and had been feeding biscuits to her baby which worried the nurses. The family had no money to buy formula milk.&nbsp; So the nurses started collecting cash from their own pockets and started a fundraiser through online requests and on the phone. But there was very little response, and the six nurses put in their own money to save the mother and baby.&nbsp; “The greatest gift for me was to hear the words of gratitude from the mother who survived the ordeal,” says Chaudhary modestly. Despite her training as a <a href="https://www.nepalitimes.com/multimedia/saving-nepali-mothers-on-mother-s-day">Skilled Birth Attendant</a> that she had done many years ago, Chaudhary had no knowledge of uterine balloon tamponade, which can help in the treatment of PPH.&nbsp; After graduating from her nursing education, she was transferred to Bir Hospital where she never got the chance to work with mothers and babies, as she was too busy handling injuries and accidents in the emergency department. It was only after she moved back to Katari Hospital in Udaypur that her career path changed with the help of the non-profit <a href="https://www.nepalitimes.com/banner/what-can-be-more-fulfilling-than-saving-lives">One Heart Worldwide</a> (OHW). She received an invitation from OHW to attend its Simulation-based Mentorship Program in 2017 which allowed her to learn new skills. “I feel fortunate that my team was there to help Surkheti, and today, both she and her baby are healthy,” she says.&nbsp; Indeed, at a time when many Nepali nurses aim to migrate abroad the nation should be thankful for the dedication and passion of nurses like Anju Chaudhary.&nbsp;

Saving one Nepali mother at a time

Nepali nurses gone and going to the UK

<img width="800" height="438" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20230228150236/63fe119b9c7e80680e0da4eajpeg.jpg" alt=""/>Nurse Sabita Gyawali goes to school bright and early as the first rays of the sun hit Mt Dhaulagiri to the north, and she gets to work right away. Shen the students start arriving, she checks that they follow cleanliness routines, and teaches them how to wash hands properly. She provides first-aid to those who need it, and is responsible for the students’ physical and mental health. But her main priority is to make sure that no student has brought junk food for lunch. In fact, she has prohibited packaged chips and noodles from the school grounds.   Gyawali has been a nurse for nine years, much of it at Kathmandu’s Sahid Gangalal National Heart Center. In 2019, she came to Baglung to work at Bidya Mandir Secondary school under the Health Ministry’s new 'One School, One Nurse' program.  Once there, Gywali designed the school’s lunch menu and already there has been a positive change in the eating habits of students – even teachers.  “Initially, students from elementary to high school would eat packaged store-bought lunch, she explains. “It was very difficult to wean the children off their junk food habit, but it is now under control.”The World Food Programme (WFP) has been managing school meals across Nepal for 45 years, and the government has been gradually assuming responsibility and expanding the project. Now, thanks to the initiative, students don’t go home for lunch anymore and attendance rates have increased, resulting in fewer dropouts.However, there are challenges. The Rs15 per student charge for lunch is beyond the means of some students who have working parents, or are in single parent households, and there is not enough time to bring a tiffin box.  For some students, this means coming to school on empty stomachs. For others, it was cheaper and more convenient to buy quick-and-easy junk food.  <img width="1350" height="2400" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20230228150236/63fe119e9c7e80680e0da4ebjpeg.jpg" alt="">“The budget provided by the government was low enough that only little snacks or small meals used to be served," notes Gyawali, who then came up with a lunch menu that would fit the budget.And while the school lunch menus made by the government might be applicable to rural schools, they do not work for public schools in urban areas with the same budget.The other problem is not having enough nurses. There are 82 public schools within Baglung Municipality, out of which only five secondary schools have nurses. <img width="1232" height="693" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20230228150236/63fe11a19c7e80680e0da4ecjpeg.jpg" alt="">Ram Prasad Khanal, the head of the municipality's health department, says that the municipality has asked the state government to appoint nurses to all the schools. “Every school that has a nurse has shown positive growth,” notes Khanal.At Bageshwari Secondary School in Bhaktapur’s Chyamasing, students have stopped consuming junk food for lunch due to the efforts of nurse Sajina Manandhar. “It is very difficult to take students off instant noodles, but we have managed to do it.”The ‘One School, One Nurse’ program is run by the Nursing and Social Security Division under Nepal’s Department of Health Services (DoHS) and aims to  encourage children to have a balanced diet and improved hygiene. The program also supports adolescent sexual and reproductive health, as well as mental health.“The school nurse program has brought about a noticeable improvement in nutrition-related problems, mental health, menstrual health, and even school dropout issues,” says Bala Rai, a senior hospital nursing administrator at the Nursing and Social Security Division.But there is a long way to go. So far, only about 1,000 schools out of 10,644 public secondary schools nationwide have appointed school nurses.The DoHS measures nutrition impact through 'anthropometry' — measuring the heights and weights of children to determine whether or not they are malnourished. A recent Demographic Health Survey (DHS) revealed that 25% of children under five have stunted growth while 8% are underweight as compared to 36% and 10% respectively in 2016.There is improvement, but more can be done, and the government has set a target to reduce the growth stunt down to 15% by 2030.   <img width="800" height="450" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20230228150236/63fe11a59c7e80680e0da4edjpeg.jpg" alt="">The survey also revealed the program, which involves nurses also making home visits, has been instrumental in identifying children who have learning disorders, mental health issues, or those who have been victims of domestic violence. Illnesses have been identified and reported to hospitals, and it has also become easier to educate adolescents about sexual and reproductive health."We have appointed health-in-charges to each class so that students feel comfortable speaking to and about themselves,” explains Sajina Manandhar. “We continuously meet with those in charge, and provide them information related to reproductive health and family planning.”Nurse Anamika Sharma says that the number of girls who miss school while having their period has gone down by 90% since she began working as a school nurse, largely because it is easier for female students to ask for pads at school. Menstrual health counseling is also more readily available.Binu Kakshapati is the School Nurse Focal Person of Bagmati Province, and says the attendance of female students has gone up since the province began distributing pads in public schools. “Students have started to become more open to using pads since the government started distributing them in Bagmati,” she adds.In some schools, nurses even fill in when a math or science teacher is absent. Bala Rai says she had to send a circular to the local units to ask them to stop forcing nurses to do jobs that they are not there to do.Translated from the Himal Khabar <a href="https://www.himalkhabar.com/news/133436" data-saferedirecturl="https://www.google.com/url?q=https://www.himalkhabar.com/news/133436&amp;source=gmail&amp;ust=1676366852671000&amp;usg=AOvVaw2z3rWSO2Xmif-YMO_MB9wL">original</a> by Shristi Karki.

Nurses ensure nutrition for Nepal’s children

<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022111414114/63723d469c7e80680e0c9667jpeg.jpg" alt="" width="1882" height="1248"/>Nepal’s agreement in August to supply an initial 100 nurses to Britain with an option for several thousand more in future was followed by <a href="https://www.theguardian.com/politics/2022/sep/25/plan-to-recruit-nepal-nurses-for-nhs-puts-them-at-risk-of-exploitation" target="_blank" rel="noopener noreferrer" data-saferedirecturl="https://www.google.com/url?q=https://www.theguardian.com/politics/2022/sep/25/plan-to-recruit-nepal-nurses-for-nhs-puts-them-at-risk-of-exploitation&amp;source=gmail&amp;ust=1667191551913000&amp;usg=AOvVaw0jEsiELAF23WOoR1iMe-Q0">debate in both countries</a> about the pros and cons of the deal.Nursing workforce managers and researchers in Nepal, Britain and in international agencies have drawn attention to the fact that the nurses are being diverted from greater need back home to fulfil the UK's shortfall. But there is support for Britain's international recruitment of healthcare professionals from nursing colleges in Nepal and the <a href="https://www.nepalitimes.com/here-now/new-uk-options-for-nepali-chefs-and-nurses/" target="_blank" rel="noopener noreferrer" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/here-now/new-uk-options-for-nepali-chefs-and-nurses/&amp;source=gmail&amp;ust=1667191551913000&amp;usg=AOvVaw00lunMQfm5PaWjBAuKTKwL">global aspirations of nurses themselves</a>.Presently, the UK faces a considerable shortfall in the hiring and retention of student nurses. Scotland has <a href="https://www.bbc.com/news/uk-scotland-62985343" target="_blank" rel="noopener noreferrer" data-saferedirecturl="https://www.google.com/url?q=https://www.bbc.com/news/uk-scotland-62985343&amp;source=gmail&amp;ust=1667191551913000&amp;usg=AOvVaw2uoO5Ht7E0kSxSASuPVAS7">not been able to meet its student nurse recruitment targets</a>, with a gap this year of over 700 student candidates. This means Scotland alone will be short of 700 nurses in three years’ time, when the current intake of students graduates. Furthermore, the student dropout rate is currently around 25%.Across Britain, by the time the current cohort graduates there will already not be enough nurses in the UK labour market even without the previous shortfall. And there are said to be vacancies for up to 50,000 health professionals in the NHS with the post-Brexit departure of East European staffers.Britain therefore has very little choice but to recruit nurses from other countries. In the past nurses have been hired from English-speaking countries with weaker economies like the Philippines or India (see graph).<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022111414114/63723d499c7e80680e0c9668jpeg.jpg" alt="" width="2044" height="1310">British nurse recruitment policy now displays little concern for source countries’ workforce situations, and of World Health Organization’s ethical recruitment guidelines which bars hiring medical workforce from ‘red list’ countries that do not have sufficient nurses and doctors for their own populations. But the staffing gap is so serious that countries like the UK, Japan, the <a href="https://www.nepalitimes.com/here-now/overseas-nepalis-on-the-covid-19-frontlines/" target="_blank" rel="noopener noreferrer" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/here-now/overseas-nepalis-on-the-covid-19-frontlines/&amp;source=gmail&amp;ust=1667191551913000&amp;usg=AOvVaw1BVT7aW5dfuYKp8X5LHeH_">United States,</a> Canada, <a href="https://www.nepalitimes.com/here-now/demand-grows-for-nepali-caregivers-in-israel/" target="_blank" rel="noopener noreferrer" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/here-now/demand-grows-for-nepali-caregivers-in-israel/&amp;source=gmail&amp;ust=1667191551913000&amp;usg=AOvVaw2OzwZhw_Mum2Z_ml8roKHV">Israel</a> and other European countries are competing to attract health professionals, disregarding the WHO guideline.For Nepal, the situation is just the opposite. There is no shortage of nursing students considering a professional education. And as a result of increased nursing education capacity, there are more students successfully graduating than Nepal’s hospitals can employ. Unlike the UK, there is no major concern about student dropout rates in Nepal, and most nursing students complete their education and graduate.Then there is also the push-factor of low starting salaries back home that makes overseas work attractive. Many nursing graduates struggle to find suitable employment within Nepal. For them international jobs are the best option. In fact, a majority of nursing students in Nepal are pursuing their studies with the sole focus on emigration.Given the lack of a clear and appropriate migration pathways to the international labour market, Nepali nurses are going abroad as students to further their education. The number of nurses taking this route is much higher than those going abroad directly as employees.Because of the lack of safe and effective avenues for Nepali nurses to get jobs abroad, including in the UK, recruitment agencies in Kathmandu have found this a lucrative option. They are known to collude with international nurse recruiters to exploit nurses whose desperation to earn more makes them vulnerable.The laws of supply and demand mean that this happens not only in Nepal and the UK, but globally. Migrant nurses seeking employment, or further education abroad, often fall victim to recruiters who charge exorbitant fees from nurses yearning to leave their home country.To break this vicious cycle, there is an urgent need to create transparent and fair employment options for Nepali nurses for the UK's NHS.The UK for its part should improve the working terms and conditions for all of its nurses, including retention of its own nursing students.Nepal must also have a proper workforce plan in place, and create gainful employment for its own graduate nurses at home.  Indeed, improving the recruitment and retention of nursing workforces should be a top priority for all developing countries supplying health professionals to well-off ones.Countries like Nepal need to improve  investment in the health sector if they are to provide Universal Health Coverage by 2030, which is a Sustainable Development Goal of the United Nations of which Nepal is a signatory.Radha Adhikari is a Lecturer in School of Health and Life Sciences, at the University of the West of Scotland, and has published extensively on international nurse migration and global health workforce challenges. Her latest research monograph, Migrant health professionals and the global labour market: the dreams and traps of Nepali nurses, was published in 2019, by <a href="https://www.taylorfrancis.com/books/9780429325731">Routledge</a>.Read more: <a href="https://nepalitimes.com/here-now/new-uk-options-for-nepali-chefs-and-nurses/">New UK job options for Nepalis</a>,  Upasana Khadka

Radha Adhikari

Nepali nurses now Britain-bound

<figure><img width="957" height="638" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109111152/636b866b9c7e80680e067852jpeg.jpg" alt=""/><figcaption>Photo: BIKRAM RAI</figcaption></figure>On 20 May, the Health Ministry released a condolence message for doctors including Ishwor Lal Acharya, Mukesh Chaudhary and Pujya Shree Karki who lost their lives to Covid-19.Nepal doesn't yet have an exact figure on the total number of <a href="https://www.nepalitimes.com/here-now/protecting-those-who-protect-us-from-the-epidemic/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/here-now/protecting-those-who-protect-us-from-the-epidemic/&amp;source=gmail&amp;ust=1622085873678000&amp;usg=AFQjCNE67Zklb3ITwY-EN9ZPs4LRP2MFtQ">medical staff</a> infected by the SARS-CoV-2 but the Nepal Health Research Council (NHRC) is currently conducting a study to find out. “Majority of our frontline health care provides have been fully vaccinated, so even if they are being infected, they are only mild to moderately sick,” says cardiologist and chair of the Nepal Medical Council (NMC) <a href="https://www.facebook.com/bhagawan.koirala" data-saferedirecturl="https://www.google.com/url?q=https://www.facebook.com/bhagawan.koirala&amp;source=gmail&amp;ust=1622085873678000&amp;usg=AFQjCNEOs-qwziT36jBSTwwrTvDCe4MA1A">Bhagawan Koirala.</a> “This combined with a better understanding of Covid-19, they are now more confident and have a better sense of responsibility this time around.”At the National Trauma Centre in Kathmandu, nursing staff Suman Chaudhary is back to work after recovering from the coronavirus herself and draws motivation from health workers who are battling the pandemic in major hotspots like Birganj.“This is our chance to make a real contribution and having been infected myself has given me a new perspective on how patients feel,” says Chaudhary who was pursuing Masters in Nursing at Bir Hospital during the first wave. “It is difficult to work in a PPE all day without water or bathroom breaks. I still feel weak and have shortness of breath, but watching people recover keeps us going.”Both Koirala and Chaudhary, however, agree that there is a <a href="https://www.nepalitimes.com/here-now/nepals-frontline-workers-brave-it-out/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/here-now/nepals-frontline-workers-brave-it-out/&amp;source=gmail&amp;ust=1622085873678000&amp;usg=AFQjCNG1eSnzgkQ-VmoauOQrzkj_c0eUzA">chronic shortage of medical staff</a> across the country. Hospitals outside Kathmandu and even Covid dedicated institutions are overstretched, and now doctors and nurses are themselves falling sick. In some hospitals, since patients and staff are all positive, nurses and doctors with mild symptoms have just kept working, since there is no one else to take care of the sick.Last week, more than 47 of Dhading District Hospital’s emergency and ward staff were infected with Covid-19, with many of them in isolation and some requiring ICU treatment even as the facility was finding it difficult to source enough <a href="https://www.nepalitimes.com/latest/why-is-there-still-an-oxygen-shortage/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/latest/why-is-there-still-an-oxygen-shortage/&amp;source=gmail&amp;ust=1622085873678000&amp;usg=AFQjCNGkShQk2X-gpsUuQceFplgqsL0bSg">oxygen for existing patients</a>.“We are a hospital of only 8 doctors, 5 paramedics and 23 nurses and with no backup, we were very close to collapsing,” says Medical Superintendent at Dhading District Hospital Tribhuvan Jha, adding that everyone had to be called back to work after 10 days of isolation. “We are in this position due to a lack of preparedness, shortage of staff and limited infrastructure.”At Charikot Hospital in Dolakha, which is also a Covid-dedicated hospital, the majority of coronavirus patients are critical and there is at least one fatality every day. The 17 nurses work three shifts a day, and are unable to handle patient inflow, so the hospital has brought in community nurses from outlying villages. The hospital is consistently reporting a 45% test positivity rate among those tested.“If a majority of our health workers get infected and are in isolation, we have no Plan B and this is especially worrying because we are the sole care provider for Covid here,” says Binod Dangal of Charikot Hospital. “Medical staff are all  overworked, and they do not have any insurance or allowances.”As dire as the situation is in Nepal’s big cities and district hospitals, the <a href="https://www.nepalitimes.com/editorial/nepals-humanitarian-emergency/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/editorial/nepals-humanitarian-emergency/&amp;source=gmail&amp;ust=1622085873678000&amp;usg=AFQjCNE3z3JV_9xnJ0reDy2ABkI8VuY16A">pandemic has now infiltrated rural Nepal</a> where there is just one doctor for every 15,000 people. Kathmandu’s doctor-to-patient ratio is 1:850.In her village of Phediguth of Okhaldhunga district, <a href="https://www.nepalitimes.com/banner/saving-nepali-mothers-on-mothers-day/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/banner/saving-nepali-mothers-on-mothers-day/&amp;source=gmail&amp;ust=1622085873678000&amp;usg=AFQjCNErggt96LmoW-c38IzduDUsayQwIg">Rita Khatri</a> is the only skilled birth attendant. Despite the growing risk of the second wave, she is still performing deliveries and ante-natal check-ups wearing a mask and her single PPE suit. There are no tests of health workers and the public.“We are working despite fears of transmission, I wish we had more PPEs, masks and gloves so that we could conduct more regular check-ups and make home visits,” adds Khatri. “At the moment many people in the community have high fever and are staying at home, but there is no way to test them.” This time last year while in the grip of the first wave of a new pandemic, there was stigma associated with Covid-19 and people who were infected were ostracised in the community. There were many instances where <a href="https://www.nepalitimes.com/here-now/nepal-health-workers-battle-covid-19-but-also-stigma/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/here-now/nepal-health-workers-battle-covid-19-but-also-stigma/&amp;source=gmail&amp;ust=1622085873678000&amp;usg=AFQjCNECgLl_SyeWRy6kuDEPnEbsSFoCyQ">healthcare providers were mistreated</a>.Doctors and nurses interviewed for this report say that is still the case, but there is also more praise for frontline medical workers risking their own health to save lives. However, there is growing concern about the worry and over-work affecting the mental health of nurses and doctors.“Among other things we need psychological support and counselling. I have seniors who have children infected with the new variant, and they are having a hard time coping,” says Suman Chaudhary, nursing staff at the Trauma Centre in Kathmandu.As most of Nepal enters the fourth week of lockdown, nationwide daily Covid-19 infections, positivity rate as well as fatalities are going down slightly. The number of recoveries have also risen to nearly equal new confirmed cases on some days.Bayalpata Hospital in remote Accham District had to turn its Emergency Room into a Covid-19 ward last month to cope with a flood of patients. It had 33 patients, 18 of them needing high flow oxygen support. On Wednesday, it had only 12 Covid-19 patients with only two on oxygen. Four of those infected are medical staff. “The situation is easing somewhat here, in Mangalsen, Doti and Dadeldhura. There are beds available, and oxygen is coming in. But we are desperately short of medical staff,” says Mandeep Pathak, a physician at Bayalpata which is also caring for trauma and maternity patients from surrounding districts.However, the cases and the test positivity rate <a href="https://www.nepalitimes.com/here-now/its-an-emergency/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/here-now/its-an-emergency/&amp;source=gmail&amp;ust=1622085873678000&amp;usg=AFQjCNHx4NfPYsEDb5xqY31L966E2avOdg">have not gone down as expected</a> and fatalities nationwide have stayed above 160 for nearly two weeks now as the highly contagious and more lethal B.1.617.2 variant spreads rapidly through communities.Health Minister Hridayesh Tripathi sounded optimistic at a virtual press meet on Monday, predicting that there would be a decline in the infection rate in the next four weeks. As Nepal receives large shipments of oxygen cylinders, liquid oxygen, test kits, PPEs and masks, doctors say the emphasis now needs to shift to more testing, mass vaccination, and replenishing exhausted and over-stretched medical staff at hospitals, both in the cities and the districts. A non-profit One Heart Worldwide that works primarily in maternal care in Nepal’s 21 districts has been helping district hospitals by mobilising oxygen cylinders and medical kits it procured from China.<a href="https://www.nepalitimes.com/banner/what-can-be-more-fulfilling-than-saving-lives/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/banner/what-can-be-more-fulfilling-than-saving-lives/&amp;source=gmail&amp;ust=1622085873678000&amp;usg=AFQjCNFzGOK8F0-jy4gwuRmK8iyNBD7AIA">Executive director Surya Bhatta</a> gives three reasons why despite the lockdown the infection rate is still high. “There is virtually no contact tracing, people are still not following health protocols and patients isolating at homes are not doing it right, resulting in a gross underestimation of total cases and fatalities.”		
			<h2>Weddings into hotspots</h2>		
		Gopal Dahal in DhankutaOn 30 April, when a young man in Okhre village in Dhankuta district got married, the whole . The whole community was invited for the feast.But a few days later, the groom suddenly fell sick. When he showed coronavirus symptoms, a test at the primary health care centre confirmed he was <a href="https://www.nepalitimes.com/here-now/its-an-emergency/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/here-now/its-an-emergency/&amp;source=gmail&amp;ust=1622085873678000&amp;usg=AFQjCNHx4NfPYsEDb5xqY31L966E2avOdg">Covid-19</a> positive.Now, every household in Okhre village has members showing similar symptoms. Most of them had attended the wedding. Of the 51 people tested, 25 tested positive. “This is a crisis, the pandemic has spread to the whole village now,” says Ward Chair Palak Basnet.One of the guests at the wedding was a man who had returned recently from the Tarai with mild symptoms. He was hired to wash dishes at the wedding, and had died a few days after the feast. No one tried to find the cause of death, and there was no PCR test done. Dhankuta MP Jitendra Rumdali Rai says there are probably many more cases than the ones who have tested positive so far. “The pandemic is spreading out of control here because the municipality wasn’t able to manage it on time,” he adds.Okhre village has now been sealed off till 8 June. Some of those infected are in critical condition, and six who were more serious were taken to hospital in Dharan. It is difficult for the others because the municipality does not have an ambulance, and some who had taken sick relatives to Dharan returned because there were no beds, or it was too expensive. “Initially they were charging Rs10,000 per day for the bed and we paid Rs4,000 daily for the doctor. But then they hiked it to Rs14,700 and I couldn’t pay it any more,” says one patient’s family who returned recently from Dharan’s Bijayapur Hospital.Another <a href="https://www.nepalitimes.com/latest/rural-nepal-fights-back-covid-19/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/latest/rural-nepal-fights-back-covid-19/&amp;source=gmail&amp;ust=1622085873679000&amp;usg=AFQjCNHu0t7Yl9XzW-TA064jBcggx4L-TA">coronavirus</a> patient says ambulances are also expensive, making it hard to get patients to hospitals. Buses refuse to take passengers who are sick.The municipality called an emergency all-party meeting and decided to set up a 10-bed isolation centre with two staff nurses, and a doctor. Talks are underway to get at least a pickup from Dhankuta Red Cross to use as an ambulance.

Sonia Awale

Protecting those who protect us from Covid

<figure><img width="957" height="638" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110131128/636cee759c7e80680e09ae2fjpeg.jpg" alt=""/><figcaption>Photo: BIKRAM RAI</figcaption></figure>On 20 May, the Health Ministry released a condolence message for doctors including Ishwor Lal Acharya, Mukesh Chaudhary and Pujya Shree Karki who lost their lives to Covid-19.Nepal doesn't yet have an exact figure on the total number of <a href="https://www.nepalitimes.com/here-now/protecting-those-who-protect-us-from-the-epidemic/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/here-now/protecting-those-who-protect-us-from-the-epidemic/&amp;source=gmail&amp;ust=1622085873678000&amp;usg=AFQjCNE67Zklb3ITwY-EN9ZPs4LRP2MFtQ">medical staff</a> infected by the SARS-CoV-2 but the Nepal Health Research Council (NHRC) is currently conducting a study to find out. “Majority of our frontline health care provides have been fully vaccinated, so even if they are being infected, they are only mild to moderately sick,” says cardiologist and chair of the Nepal Medical Council (NMC) <a href="https://www.facebook.com/bhagawan.koirala" data-saferedirecturl="https://www.google.com/url?q=https://www.facebook.com/bhagawan.koirala&amp;source=gmail&amp;ust=1622085873678000&amp;usg=AFQjCNEOs-qwziT36jBSTwwrTvDCe4MA1A">Bhagawan Koirala.</a> “This combined with a better understanding of Covid-19, they are now more confident and have a better sense of responsibility this time around.”At the National Trauma Centre in Kathmandu, nursing staff Suman Chaudhary is back to work after recovering from the coronavirus herself and draws motivation from health workers who are battling the pandemic in major hotspots like Birganj.“This is our chance to make a real contribution and having been infected myself has given me a new perspective on how patients feel,” says Chaudhary who was pursuing Masters in Nursing at Bir Hospital during the first wave. “It is difficult to work in a PPE all day without water or bathroom breaks. I still feel weak and have shortness of breath, but watching people recover keeps us going.”Both Koirala and Chaudhary, however, agree that there is a <a href="https://www.nepalitimes.com/here-now/nepals-frontline-workers-brave-it-out/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/here-now/nepals-frontline-workers-brave-it-out/&amp;source=gmail&amp;ust=1622085873678000&amp;usg=AFQjCNG1eSnzgkQ-VmoauOQrzkj_c0eUzA">chronic shortage of medical staff</a> across the country. Hospitals outside Kathmandu and even Covid dedicated institutions are overstretched, and now doctors and nurses are themselves falling sick. In some hospitals, since patients and staff are all positive, nurses and doctors with mild symptoms have just kept working, since there is no one else to take care of the sick.Last week, more than 47 of Dhading District Hospital’s emergency and ward staff were infected with Covid-19, with many of them in isolation and some requiring ICU treatment even as the facility was finding it difficult to source enough <a href="https://www.nepalitimes.com/latest/why-is-there-still-an-oxygen-shortage/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/latest/why-is-there-still-an-oxygen-shortage/&amp;source=gmail&amp;ust=1622085873678000&amp;usg=AFQjCNGkShQk2X-gpsUuQceFplgqsL0bSg">oxygen for existing patients</a>.“We are a hospital of only 8 doctors, 5 paramedics and 23 nurses and with no backup, we were very close to collapsing,” says Medical Superintendent at Dhading District Hospital Tribhuvan Jha, adding that everyone had to be called back to work after 10 days of isolation. “We are in this position due to a lack of preparedness, shortage of staff and limited infrastructure.”At Charikot Hospital in Dolakha, which is also a Covid-dedicated hospital, the majority of coronavirus patients are critical and there is at least one fatality every day. The 17 nurses work three shifts a day, and are unable to handle patient inflow, so the hospital has brought in community nurses from outlying villages. The hospital is consistently reporting a 45% test positivity rate among those tested.“If a majority of our health workers get infected and are in isolation, we have no Plan B and this is especially worrying because we are the sole care provider for Covid here,” says Binod Dangal of Charikot Hospital. “Medical staff are all  overworked, and they do not have any insurance or allowances.”As dire as the situation is in Nepal’s big cities and district hospitals, the <a href="https://www.nepalitimes.com/editorial/nepals-humanitarian-emergency/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/editorial/nepals-humanitarian-emergency/&amp;source=gmail&amp;ust=1622085873678000&amp;usg=AFQjCNE3z3JV_9xnJ0reDy2ABkI8VuY16A">pandemic has now infiltrated rural Nepal</a> where there is just one doctor for every 15,000 people. Kathmandu’s doctor-to-patient ratio is 1:850.In her village of Phediguth of Okhaldhunga district, <a href="https://www.nepalitimes.com/banner/saving-nepali-mothers-on-mothers-day/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/banner/saving-nepali-mothers-on-mothers-day/&amp;source=gmail&amp;ust=1622085873678000&amp;usg=AFQjCNErggt96LmoW-c38IzduDUsayQwIg">Rita Khatri</a> is the only skilled birth attendant. Despite the growing risk of the second wave, she is still performing deliveries and ante-natal check-ups wearing a mask and her single PPE suit. There are no tests of health workers and the public.“We are working despite fears of transmission, I wish we had more PPEs, masks and gloves so that we could conduct more regular check-ups and make home visits,” adds Khatri. “At the moment many people in the community have high fever and are staying at home, but there is no way to test them.” This time last year while in the grip of the first wave of a new pandemic, there was stigma associated with Covid-19 and people who were infected were ostracised in the community. There were many instances where <a href="https://www.nepalitimes.com/here-now/nepal-health-workers-battle-covid-19-but-also-stigma/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/here-now/nepal-health-workers-battle-covid-19-but-also-stigma/&amp;source=gmail&amp;ust=1622085873678000&amp;usg=AFQjCNECgLl_SyeWRy6kuDEPnEbsSFoCyQ">healthcare providers were mistreated</a>.Doctors and nurses interviewed for this report say that is still the case, but there is also more praise for frontline medical workers risking their own health to save lives. However, there is growing concern about the worry and over-work affecting the mental health of nurses and doctors.“Among other things we need psychological support and counselling. I have seniors who have children infected with the new variant, and they are having a hard time coping,” says Suman Chaudhary, nursing staff at the Trauma Centre in Kathmandu.As most of Nepal enters the fourth week of lockdown, nationwide daily Covid-19 infections, positivity rate as well as fatalities are going down slightly. The number of recoveries have also risen to nearly equal new confirmed cases on some days.Bayalpata Hospital in remote Accham District had to turn its Emergency Room into a Covid-19 ward last month to cope with a flood of patients. It had 33 patients, 18 of them needing high flow oxygen support. On Wednesday, it had only 12 Covid-19 patients with only two on oxygen. Four of those infected are medical staff. “The situation is easing somewhat here, in Mangalsen, Doti and Dadeldhura. There are beds available, and oxygen is coming in. But we are desperately short of medical staff,” says Mandeep Pathak, a physician at Bayalpata which is also caring for trauma and maternity patients from surrounding districts.However, the cases and the test positivity rate <a href="https://www.nepalitimes.com/here-now/its-an-emergency/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/here-now/its-an-emergency/&amp;source=gmail&amp;ust=1622085873678000&amp;usg=AFQjCNHx4NfPYsEDb5xqY31L966E2avOdg">have not gone down as expected</a> and fatalities nationwide have stayed above 160 for nearly two weeks now as the highly contagious and more lethal B.1.617.2 variant spreads rapidly through communities.Health Minister Hridayesh Tripathi sounded optimistic at a virtual press meet on Monday, predicting that there would be a decline in the infection rate in the next four weeks. As Nepal receives large shipments of oxygen cylinders, liquid oxygen, test kits, PPEs and masks, doctors say the emphasis now needs to shift to more testing, mass vaccination, and replenishing exhausted and over-stretched medical staff at hospitals, both in the cities and the districts. A non-profit One Heart Worldwide that works primarily in maternal care in Nepal’s 21 districts has been helping district hospitals by mobilising oxygen cylinders and medical kits it procured from China.<a href="https://www.nepalitimes.com/banner/what-can-be-more-fulfilling-than-saving-lives/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/banner/what-can-be-more-fulfilling-than-saving-lives/&amp;source=gmail&amp;ust=1622085873678000&amp;usg=AFQjCNFzGOK8F0-jy4gwuRmK8iyNBD7AIA">Executive director Surya Bhatta</a> gives three reasons why despite the lockdown the infection rate is still high. “There is virtually no contact tracing, people are still not following health protocols and patients isolating at homes are not doing it right, resulting in a gross underestimation of total cases and fatalities.”		
			<h2>Weddings into hotspots</h2>		
		Gopal Dahal in DhankutaOn 30 April, when a young man in Okhre village in Dhankuta district got married, the whole . The whole community was invited for the feast.But a few days later, the groom suddenly fell sick. When he showed coronavirus symptoms, a test at the primary health care centre confirmed he was <a href="https://www.nepalitimes.com/here-now/its-an-emergency/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/here-now/its-an-emergency/&amp;source=gmail&amp;ust=1622085873678000&amp;usg=AFQjCNHx4NfPYsEDb5xqY31L966E2avOdg">Covid-19</a> positive.Now, every household in Okhre village has members showing similar symptoms. Most of them had attended the wedding. Of the 51 people tested, 25 tested positive. “This is a crisis, the pandemic has spread to the whole village now,” says Ward Chair Palak Basnet.One of the guests at the wedding was a man who had returned recently from the Tarai with mild symptoms. He was hired to wash dishes at the wedding, and had died a few days after the feast. No one tried to find the cause of death, and there was no PCR test done. Dhankuta MP Jitendra Rumdali Rai says there are probably many more cases than the ones who have tested positive so far. “The pandemic is spreading out of control here because the municipality wasn’t able to manage it on time,” he adds.Okhre village has now been sealed off till 8 June. Some of those infected are in critical condition, and six who were more serious were taken to hospital in Dharan. It is difficult for the others because the municipality does not have an ambulance, and some who had taken sick relatives to Dharan returned because there were no beds, or it was too expensive. “Initially they were charging Rs10,000 per day for the bed and we paid Rs4,000 daily for the doctor. But then they hiked it to Rs14,700 and I couldn’t pay it any more,” says one patient’s family who returned recently from Dharan’s Bijayapur Hospital.Another <a href="https://www.nepalitimes.com/latest/rural-nepal-fights-back-covid-19/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/latest/rural-nepal-fights-back-covid-19/&amp;source=gmail&amp;ust=1622085873679000&amp;usg=AFQjCNHu0t7Yl9XzW-TA064jBcggx4L-TA">coronavirus</a> patient says ambulances are also expensive, making it hard to get patients to hospitals. Buses refuse to take passengers who are sick.The municipality called an emergency all-party meeting and decided to set up a 10-bed isolation centre with two staff nurses, and a doctor. Talks are underway to get at least a pickup from Dhankuta Red Cross to use as an ambulance.

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109191120/636bef674b0ad905ca02efa6jpeg.jpg" alt="" width="1200" height="708"/><figcaption>105-year-old Chandra Kumari Joshi after beating the coronavirus. All photos: JOSHI FAMILY</figcaption></figure>Six weeks ago, the live-in nurse who takes care of my<a href="https://www.nepalitimes.com/here-now/who-runs-the-world-girls/" target="_blank" rel="noopener noreferrer" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/here-now/who-runs-the-world-girls/&amp;source=gmail&amp;ust=1608281673384000&amp;usg=AFQjCNEXylkJd6i9QhI2aGHlWa-nof2rmA"> 105-year-old grandmother-in-law (Muwa)</a> fell ill. She had developed cold-like symptoms and a headache, but not a fever. After she went back home for Tihar, Muwa developed a dry cough, but no fever.She began to take cough medicine, but we also applied every home remedy, steam treatments, turmeric water, honey, ginger, what have you. The fact that this could be indicative of Covid did not even cross my mind because I still somehow believed that having the coronavirus meant high fever. On the third day, Muwa’s cough got better.But then I developed a fever the day before भाइ टिका on 16 November and isolated immediately. I could only  get tested the day after Tihar, and the next day my husband developed a fever as well. My report came back positive 24 hours later, and all other seven members in our house -- including my grandmother-in-law--tested positive.<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109191120/636bef6a4b0ad905ca02efa7jpeg.jpg" alt="" width="440" height="681"><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109191120/636bef6b4b0ad905ca02efa8jpeg.jpg" alt="" width="418" height="681">The news of Muwa at her age testing positive was chilling. We had taken every possible precaution, ensured every measure to keep her safe. So the coming days were filled with worry.However, if we could look for a silver lining during this ordeal, it was that we did not need to follow strict measures of isolation, since everyone in our household had tested positive. We had been worrying about making different sleeping, cooking, and bathroom arrangements while we were waiting for all our results to come back, but that was not necessary anymore.So we shut the front gate, and sealed ourselves from the world. No one was allowed in or out. Our daughter and my sister-in-law had left enough essentials on our doorstep to last the duration of our isolation.Of the eight people in our home, my husband and I were the only ones who developed a fever, the others all had only mild symptoms. But while my fever peaked at 100°F, my husband, who is diabetic, had a high fever right from the start. When his oxygen level began to drop, he had to be admitted to hospital where he stayed for two weeks, completing a course of steroid and antibiotic treatments for secondary lung infection.It was an extremely stressful time back at home. On one hand, I worried about my husband alone in the hospital. On the other, I worried over what to tell his grandmother whenever she asked about her grandson.One day, Muwa said, “It’s so lonely here with just you and me.” Maybe she realised that it would just be the two of us in that family from now onwards. So when her grandson returned home after two weeks in hospital, she exclaimed in relief, “Finally, I can see you like this.”<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109191120/636bef6d4b0ad905ca02efa9jpeg.jpg" alt="" width="640" height="952"><figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109191120/636bef704b0ad905ca02efaajpeg.jpg" alt="" width="900" height="544"><figcaption>Chandra Kumari Joshi sees her grandson, who recovered from Covid-19 after a hospital stay.</figcaption></figure>Muwa likes to watch the tv news every day, and when she asks, “What happened today?”. She wants us to know how many people died of Covid-19 that day, and we give her the figure.Muwa often asks when her great-grandchildren, who live abroad, are going to come back home. We told her that planes were not flying because the pandemic was spreading all over the world. But since the lockdown was lifted and flights resumed, she sits on the terrace and keenly watches the planes fly by.Some days she notices that there were very few planes. Other days, she muses, “Quite a lot of flights today.” The planes in the sky have become symbols of hope for her to be reunited with her family one day.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109191120/636bef734b0ad905ca02efabjpeg.jpg" alt="" width="900" height="438"><figcaption>Chandra Kumari Joshi meets her great-great granddaughter a month after testing positive for the coronavirus.</figcaption></figure>Muwa lost her only daughter-in-law, <a href="https://www.nepalitimes.com/here-now/who-runs-the-world-girls/" target="_blank" rel="noopener noreferrer" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/here-now/who-runs-the-world-girls/&amp;source=gmail&amp;ust=1608281673384000&amp;usg=AFQjCNEXylkJd6i9QhI2aGHlWa-nof2rmA">Angurbaba Joshi, </a>during the pandemic. A month after her passing, she lost her sister Binda Shakya with whom she was very close. We broke the news of her passing two months later when Muwa began to ask why her sister had not been visiting.One day, as she was expressing her annoyance over Binda Didi’s continued absence, without thinking I said, “She can’t come anymore.” She immediately asked, “Why? Is she dead?” I answered, “Yes.”<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109191120/636bef754b0ad905ca02efacjpeg.jpg" alt="" width="1500" height="1094">Muwa was inconsolable over the next three weeks. She has begun to forget a lot of things, but she has not forgotten that her sister has passed. In her grief, she has started to reconcile with her own mortality. “My time has come, this is it,” she said one day.The grief of her having outlived  all of her younger siblings, a son, a daughter-in-law, and other loved ones shows clearly on her face. Sometimes, she sees her own longevity as a  curse. “Why hasn’t god taken me away yet?” she asks.Muwa overcame ‘Karuna’ (what she calls the coronavirus, and a Sanskrit word that means ‘compassion’) better than any of us. The doctors have always told us that her lungs and her heart are as healthy as a young woman’s. Her immune system is strong, perhaps from the clean and fresh surroundings and food she grew up with. She has hardened, enduring  a great deal in life, as a child widow, and as an old woman who has seen many loved ones pass on.Muwa’s mental fortitude is a testament to the fact that she is still here with us. Her memories may be blurred, but she is not inactive and silent, and will never be.

How a 105-year-old beat the virus

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109181148/636be8749c7e80680e08785djpeg.jpg" alt="" width="1200" height="708"/><figcaption>105-year-old Chandra Kumari Joshi after beating the coronavirus. All photos: JOSHI FAMILY</figcaption></figure>Six weeks ago, the live-in nurse who takes care of my<a href="https://www.nepalitimes.com/here-now/who-runs-the-world-girls/" target="_blank" rel="noopener noreferrer" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/here-now/who-runs-the-world-girls/&amp;source=gmail&amp;ust=1608281673384000&amp;usg=AFQjCNEXylkJd6i9QhI2aGHlWa-nof2rmA"> 105-year-old grandmother-in-law (Muwa)</a> fell ill. She had developed cold-like symptoms and a headache, but not a fever. After she went back home for Tihar, Muwa developed a dry cough, but no fever.She began to take cough medicine, but we also applied every home remedy, steam treatments, turmeric water, honey, ginger, what have you. The fact that this could be indicative of Covid did not even cross my mind because I still somehow believed that having the coronavirus meant high fever. On the third day, Muwa’s cough got better.But then I developed a fever the day before भाइ टिका on 16 November and isolated immediately. I could only  get tested the day after Tihar, and the next day my husband developed a fever as well. My report came back positive 24 hours later, and all other seven members in our house -- including my grandmother-in-law--tested positive.<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109181148/636be8779c7e80680e08785ejpeg.jpg" alt="" width="440" height="681"><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109181148/636be8789c7e80680e08785fjpeg.jpg" alt="" width="418" height="681">The news of Muwa at her age testing positive was chilling. We had taken every possible precaution, ensured every measure to keep her safe. So the coming days were filled with worry.However, if we could look for a silver lining during this ordeal, it was that we did not need to follow strict measures of isolation, since everyone in our household had tested positive. We had been worrying about making different sleeping, cooking, and bathroom arrangements while we were waiting for all our results to come back, but that was not necessary anymore.So we shut the front gate, and sealed ourselves from the world. No one was allowed in or out. Our daughter and my sister-in-law had left enough essentials on our doorstep to last the duration of our isolation.Of the eight people in our home, my husband and I were the only ones who developed a fever, the others all had only mild symptoms. But while my fever peaked at 100°F, my husband, who is diabetic, had a high fever right from the start. When his oxygen level began to drop, he had to be admitted to hospital where he stayed for two weeks, completing a course of steroid and antibiotic treatments for secondary lung infection.It was an extremely stressful time back at home. On one hand, I worried about my husband alone in the hospital. On the other, I worried over what to tell his grandmother whenever she asked about her grandson.One day, Muwa said, “It’s so lonely here with just you and me.” Maybe she realised that it would just be the two of us in that family from now onwards. So when her grandson returned home after two weeks in hospital, she exclaimed in relief, “Finally, I can see you like this.”<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109181148/636be87a9c7e80680e087860jpeg.jpg" alt="" width="640" height="952"><figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109181148/636be87d9c7e80680e087861jpeg.jpg" alt="" width="900" height="544"><figcaption> </figcaption></figure>Muwa likes to watch the tv news every day, and when she asks, “What happened today?”. She wants us to know how many people died of Covid-19 that day, and we give her the figure.Muwa often asks when her great-grandchildren, who live abroad, are going to come back home. We told her that planes were not flying because the pandemic was spreading all over the world. But since the lockdown was lifted and flights resumed, she sits on the terrace and keenly watches the planes fly by.Some days she notices that there were very few planes. Other days, she muses, “Quite a lot of flights today.” The planes in the sky have become symbols of hope for her to be reunited with her family one day.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109181148/636be87f9c7e80680e087862jpeg.jpg" alt="" width="900" height="438"><figcaption> </figcaption></figure>Muwa lost her only daughter-in-law, <a href="https://www.nepalitimes.com/here-now/who-runs-the-world-girls/" target="_blank" rel="noopener noreferrer" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/here-now/who-runs-the-world-girls/&amp;source=gmail&amp;ust=1608281673384000&amp;usg=AFQjCNEXylkJd6i9QhI2aGHlWa-nof2rmA">Angurbaba Joshi, </a>during the pandemic. A month after her passing, she lost her sister Binda Shakya with whom she was very close. We broke the news of her passing two months later when Muwa began to ask why her sister had not been visiting.One day, as she was expressing her annoyance over Binda Didi’s continued absence, without thinking I said, “She can’t come anymore.” She immediately asked, “Why? Is she dead?” I answered, “Yes.”<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109181148/636be8829c7e80680e087863jpeg.jpg" alt="" width="1500" height="1094">Muwa was inconsolable over the next three weeks. She has begun to forget a lot of things, but she has not forgotten that her sister has passed. In her grief, she has started to reconcile with her own mortality. “My time has come, this is it,” she said one day.The grief of her having outlived  all of her younger siblings, a son, a daughter-in-law, and other loved ones shows clearly on her face. Sometimes, she sees her own longevity as a  curse. “Why hasn’t god taken me away yet?” she asks.Muwa overcame ‘Karuna’ (what she calls the coronavirus, and a Sanskrit word that means ‘compassion’) better than any of us. The doctors have always told us that her lungs and her heart are as healthy as a young woman’s. Her immune system is strong, perhaps from the clean and fresh surroundings and food she grew up with. She has hardened, enduring  a great deal in life, as a child widow, and as an old woman who has seen many loved ones pass on.Muwa’s mental fortitude is a testament to the fact that she is still here with us. Her memories may be blurred, but she is not inactive and silent, and will never be.

Nepal’s cricket team first beat powerhouse West Indies in two out of three matches in September, the first time it won a match and then a series against a test-playing nation.&nbsp; Then the Rhinos played six qualifiers in Oman for the 2026 T20 World Cup which is being held in India and Sri Lanka from 7 February to 8 March next year. The national team qualified comfortably with two games to spare, and won all six matches anyway. In the three months before the World Cup, cricketers will play the second season of the Nepal Premier League from 17 November to 13 December.&nbsp; After a hugely successful first season, steady upgrades have been made. The flood-lit Tribhuvan University Cricket Ground has been fitted with 15,000 seats, even though this takes away from the festival-like atmosphere of fans on their feet on the grassy slope.&nbsp; Last season, matches began at noon and three in the afternoon. Late-evening matches in winter under flood lights will increase attendance and viewership.&nbsp; There is also now technology that will display how far a six was hit and how fast a ball was bowled. Foreign players who will play in the league include Chris Lynn, D’arcy Short, Ravi Bopara, and Sohail Tanvir, all good ex-international players that people have heard of.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251101031128_9db0830fb65d0743e3d36cc4b4473e61d750789028a130f5dff8a619307b0215.jpg" data-media-id="editor_0" data-image-id="20251101031128_9db0830fb65d0743e3d36cc4b4473e61d750789028a130f5dff8a619307b0215" data-rendition-name="original" width="1365" height="1803" loading="lazy" alt="Nepal cricket"> <figcaption>Aasif Sheikh drives through the covers on his way to 69 off 41 vs Samoa.</figcaption> </figure>  But the most important point of the Nepal Premier League will be to prepare and experiment for the World Cup, which starts less than two months after the NPL ends. Team Nepal will be extra eager to play well, given that the matches are happening in South Asia and Nepali fans can make the trip.&nbsp; Head coach Stuart Law will be watching each NPL match keenly, to gain more insight into how to best use his current starters.&nbsp; As each of the eight teams are only allowed a maximum of four foreign players in their starting eleven, Law and Nepali fans will also be scouting new talent who will be hungry to emerge and prove themselves to earn a place in the World Cup Squad.&nbsp; ALL-ROUNDERS One of the most unusual features of the current Nepali squad is how many all-rounders there are. Kushal Bhurtel, Rohit Paudel, Kushal Malla, Gulshan Jha, and Dipendra Singh Airee are all regular starters, and they all bat and bowl. Opener Aasif Sheikh is also the wicketkeeper.&nbsp; Airee, of course, is also an excellent fielder. In the first five games of the qualifiers, he got a record five runouts with direct hits, and was on a roll with a run in every single game. This depth means that almost always seven players bowl for Nepal, and the wealth of options keeps the opponent batting order guessing, but it may create hesitancy within the team in tough situations against stronger teams.&nbsp; Countries at the top level of the sport tend to have more specialists. Perhaps Stuart Law might want to tell Bhurtel to really focus on his batting, or Airee to hone his bowling, which seems to be their strengths. The team would be better off with them performing one aspect consistently well than being hit or miss with both. &nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251101031128_c30fdbab65736ea728f2f94fa121d2169e4d3627194ce1fe9de26eebdb3fc5b3.jpg" data-media-id="editor_1" data-image-id="20251101031128_c30fdbab65736ea728f2f94fa121d2169e4d3627194ce1fe9de26eebdb3fc5b3" data-rendition-name="original" width="957" height="1269" loading="lazy" alt="Nepal cricket"> <figcaption>Lalit Rajbhansi with tricky left arm spin, 3/13 vs Samoa.</figcaption> </figure>  POWERPLAYS The Nepali team likes batting first. It chased only against Japan, but they struggle to put up really competitive scores of say, above 170 unless two batsmen do really well.&nbsp; In the second match against the West Indies, Aasif Sheikh’s 68 and Sundeep Jora’s 63 set up Nepal at 173/6. Against Samoa, Aasif Sheikh had 69 and Airee had 53, before Lokesh Bam’s fierce 39 off 12 featuring 4 sixes set up 211/4.&nbsp; Besides these games, Nepal tends to score up to 150 batting first. To the experienced teams that Nepal will face at the world cup, this is not at all an intimidating score. One reason is that Nepal just cannot seem to get going in the first six powerplay overs, when there are limited fielders on the boundaries.&nbsp; A solution to this might be to promote Gulshan Jha up the order. Although Jha has also been an excellent batter in the end overs, using him at three or four might help set up a more productive powerplay and bigger scores. He should try it out with the Karnali Yaks.&nbsp; Despite all the controversy that comes with Sandip Lamichhane, and his strange decision to sit out the West Indies series minutes before the first match started, his output with the ball is undeniable.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251101031128_453d54ce627367c537d459c38d260d8aca1d56949c49c8023de582f3e72bb678.jpg" data-media-id="editor_2" data-image-id="20251101031128_453d54ce627367c537d459c38d260d8aca1d56949c49c8023de582f3e72bb678" data-rendition-name="original" width="1499" height="1000" loading="lazy" alt="Nepal cricket"> <figcaption>Nepalis turn out to support the team vs Samoa at Al Ameret Stadium in Oman.</figcaption> </figure>  He took wickets in each of the six qualifiers, most notably five vital ones in the match against Qatar that Nepal won by five runs. Lamichhane also gives away very few runs, which cuts some of the more part-time bowlers some slack.&nbsp; Airee is also economical, and his 3/22 was vital in the one-run win against the UAE. Together with Lamichhane the duo constricted the opposition in the middle overs. Veteran Sompal Kami has not been as productive with the ball, and gave away a lot of runs in the series against the West Indies.&nbsp; This is a weakness, because Kami does not contribute with the bat much. While his experience is valuable to ground the young Nepali team, Stuart Law should look out for fast bowlers during the NPL to help balance out quality spinners.&nbsp; One of the most impressive and professional parts of Nepal’s winning streak has been the attention to detail. The players have been generally excellent in the field, giving away very few runs due to wides or no balls. They had three run outs against the UAE and two against Qatar and Japan and in the first game against the West Indies.&nbsp; The fielders seem much calmer and focused when executing difficult catches, a welcome change from past complacency. This attention to detail makes the difference in narrow games and keeps morale high.&nbsp; The Nepali team has performed well, but besides the narrowly-beaten UAE, all the matches were against teams ranked lower in the world T20 rankings. And the series against the West Indies was against a weakened team. In the world cup, Nepal will be facing much stronger teams and will lack the element of surprise it had in the 2024 World Cup.&nbsp; If Nepal wants to keep improving, it now has to be able to dominate teams like Kuwait and Oman. It also should set up more series with associate nations like Scotland, Ireland, Namibia and The Netherlands. This will help accurately gauge the team’s progress and expose its weaknesses.

Nepal’s prospects at World Cup 2026

With the holidays over and elections only four months away, Nepal’s interim government led by Prime Minister Sushila Karki is trying to get down to brass tacks. But it is not easy.
On Wednesday, Karki held the first three-way meeting between GenZ representatives, political parties and the government. Despite some acrimony, there was near unanimity about creating the environment for elections on 5 March. 
Only the UML is holding out, still not taking responsibility for the 8 September massacre, and calling for the reinstatement of Parliament. GenZ delegates poured their wrath on the unrepentant UML, but were themselves talking at cross purposes on the demand for a directly-elected executive. 
Karki was on the defensive, her exasperation spilling over: “How do we undo the damage done by corruption, exploitation, and discrimination over the last 35 years in a single month?” 
She is reported to have added, “There is a tendency to not allow this government to work, and then turn around to criticise it for not achieving anything. We are trying our best, and will fulfil our goal of elections no matter what.” 
The Wednesday meeting does seem to have turned the attention of old parties towards elections, and spurred the GenZ and others with political ambition to form parties.
With the deadline for party registration looming, several like-minded individuals and collectives are coalescing, or trying to. The Election Commission is already reviewing applications from more than a dozen new political parties. 
Kathmandu Mayor Balen Shah has held talks with RSP members, but his popularity on social media is not matched by public visibility and accessibility. Intriguingly, Shah and his supporters on social media have been publicly asking for the resignation of Home Minister Om Aryal for not arresting members of the UML-NC government for the 8 September killings. Aryal used to be Mayor Shah’s legal adviser.
Sudan Gurung of GenZ, ex-RSP Sumana Shrestha, and Energy Minister Kulman Ghising are all shopping for existing or new political parties to join. 
The RSP with its alternative anti-corruption agenda would be the logical choice, but there is a question mark over the role of its head Rabi Lamichhane, who is back in jail on charges of embezzlement.
LARGER CABINET
This week, Karki expanded her Cabinet for the third time by inducting Sudha Sharma Gautam as Minister for Health and activist Bablu Gupta as the Minister for Youth and Sports. 
Recommended by GenZ members, Gupta, 28, is the youngest Minister in Karki’s team. But, as has become the norm with this electoral government, two other controversial nominations fell through. Khagendra Sunar was dropped as Minister for Labour because of several ongoing criminal charges, including for assault and inflammatory speech. And Ganapati Lal Shrestha for Minister of Land Management declined at the last moment after he was not given the Tourism and Culture portfolio as preferred. 
Critics say there is a lack of due diligence on the part of Karki’s advisers in selecting candidates. Last month, Sangeeta Mishra who was nominated for Health Minister was dropped after it turned out that she was under investigation at the CIAA. However, Kulman Ghising also had complaints filed at the anti-corruption body, but was still given three portfolios. 
Then the nomination of Tashi Lhazom was withdrawn after an online controversy over her citizenship. There was also outrage on social media about Mishra and Lhazom being singled out for their ethnicity and gender.
Internal leaks making her choices prematurely public has made Karki’s team overcautious about Cabinet expansion. It is also distracting her from her main goal — to hold credible elections by striking a balance between the political parties and GenZ groups.
After a preliminary hearing on 16 writ petitions against the House dissolution and appointment of new government, the Supreme Court on Wednesday refused to issue an interim order.
“The formation of the government is unconstitutional, and a government formed unconstitutionally is not allowed to make any decisions, until the final hearing,” stated advocate Surendra Bhandari. 
The UML, still smarting from the September protests, is trying to put a spanner in the works of the election government. The GenZ, meanwhile, still do not have a consensus over fundamental demands prior to elections. Combined, these two factors portend a precarious future.

Future imperfect

A little more than one month into its six-month term, Nepal's interim government recalled ambassadors from 11 countries: China, Japan, Malaysia, Qatar, Saudi Arabia, Israel, Russia, Spain, Germany, the UK, the US, and Japan.&nbsp;
Mostly appointed by previous governments, they have to return to Kathmandu by 6 November. The envoys who were retained, even if they were political appointees, tended to be women or from various ethnic minorities.
The recall has met with criticism back home. Prime Minister Sushila Karki is blamed for borrowing a page out of its predecessors’ playbook. Although it was a symbolically inclusive move in a diplomatic corps dominated by established groups, the government may have got its timing wrong.
On Sunday, however, the Supreme Court issued an interim order against government decision to recall the 11 ambassadors. The court questioned the neccesssity and justification of such a move, concerned that it could affect Nepal's relations with the host countries.&nbsp;
Karki has said <a href="https://nepalitimes.com/news/future-imperfect">her priority is to hold elections in March</a>, and by recalling Nepal’s emissaries from important capitals like Washington, London, Bonn, Tokyo, Abu Dhabi and Kuala Lumpur her government has cut channels of communication and support from development partners and with the international community.&nbsp;
Nepal’s anti-corruption GenZ protest and the devolution of the youth movement into <a href="https://nepalitimes.com/here-now/relocate-reallocate-recover">arson, looting, and violence</a> after the targeted killing of protestors in September put the nation in the international spotlight. And the interest was especially keen in neighbouring New Delhi and Beijing.&nbsp;
The Nepal unrest has sparked similar protests across the world from <a href="https://nepalitimes.com/here-now/nepal-genzs-inspired-filipinos">the Philippines</a> to East Timor, Madagascar and Peru. But there is also worry in India where exposure of #nepokids on social media as well as corruption in high places could instigate copycat youth unrest.
And in China, there is still a lingering memory of the deadly protests in 1989 Tiananmen Square. But the Chinese also suspect that some in the GenZ movement have links to free-Tibet. &nbsp;
Foreign policy experts in Nepal reject conspiracy theories about foreign backing for the GenZ, characterising it as mostly triggered by home-grown outrage over chronic corruption of the governing elite.&nbsp;
Throughout its history Nepal has always had to balance the geo-strategic interests of its neighbours: the British in India and the Chinese Empire, and more recently independent India and Communist China.
When former PM K P Oli resigned, he had <a href="https://nepalitimes.com/opinion/comment/when-xi-meets-modi-and-oli">just returned from a visit to Beijing</a> and was a week away from making an official visit to India. A new Nepali prime minister typically makes the first visit to India, but Oli broke that tradition last year by going to China to sign the Belt and Road Initiative (BRI) framework agreement.
"Oli was China's trusted partner supporting <a href="https://nepalitimes.com/news/china-syndrome">Nepal’s participation in BRI</a> and SCO (Shanghai Cooperation Organization)," says geopolitical analyst Sanjay Upadhya. "Now, some in Beijing are apprehensive that there is external support for the youth protests that contributed to Oli’s sudden departure. It is perceived as a strategic setback for China."
Despite an ongoing dispute with India over a 364 sq km border territory, Nepal is heavily dependent economically on India with which it has an open border.&nbsp;
Rulers in Kathmandu have usually leaned over backwards to be closer to China to counterbalance India’s gravitational pull following a strategy of ‘equidistance’ between the two giant neighbours.&nbsp;
Growing American and Western disinterest in the region is making India and China more assertive towards smaller nations. Educator Dovan Rai says, “China is also becoming more aggressive and trying to show its presence in and around South Asia.”
She adds, “Nepal is an important neighbour for China, especially considering issues it regards as sensitive, like the Dalai Lama and Tibet.”
Indeed, the Chinese are said to be suspicious about the links that the <a href="https://nepalitimes.com/here-now/nepal-s-historic-youth-dissensus">GenZ movement</a> was infiltrated by elements linked with Free Tibet or with US-based interests.&nbsp;
What must have especially raised eyebrows at the Chinese Embassy in Kathmandu was that the Dalai Lama’s office in exile in India congratulated Sushila Karki — the first time in history it has sent such a greeting to a new prime minister of Nepal.&nbsp;
Although Nepal’s two neighbours do not see eye-to-eye, both agree and are worried about instability in Nepal, and if it might trigger a refugee crisis, empower extremist factions, or attract Western interference.&nbsp;
Nepal’s September protests were preceded and succeeded by similar movements in the region and around the world. In light of this global eruption of youth frustration, and desire to lead from the front, the hardline governments of Nepal’s two neighbours are undoubtedly wary of the possibility of similar unrest within their own borders.&nbsp;
‘India advocates democratic legitimacy, while China prioritises control and predictability. Recent upheavals demonstrate that neither democracy nor stability alone suffices for sustainable nationhood,’ Upadhya wrote in a recent blog.
With early elections scheduled for 5 March, <a href="https://nepalitimes.com/news/one-month-later">the main challenge for Karki’s transition government</a> is to maintain dialogue and establish consensus between youth groups, political parties, and other agitating forces to participate in polls — all while ensuring there is no covert external influence.&nbsp;
Indeed, with <a href="https://nepalitimes.com/here-now/nepals-democracy-keeps-doubting-itself">Nepal’s democracy</a> at stake as well as new political forces with competing interests set to battle it out in a new political landscape, experts warn that there could be powers that will want to fish in troubled waters.&nbsp;
Explains Dovan Rai: “Along with soft power, foreign countries including our neighbours could intervene in the online information space to promote their interests in Nepal. Fake narratives and disinformation could be spread &nbsp;through digital platforms. We must be careful and vigilant about our digital space.”

Neighbourhood watch on Nepal

Climber, expedition leader and later a supplier of bottled oxygen to Himalayan mountaineers, Henry Barclay Todd died on 3 November 2025 in his favourite place on earth, Kathmandu.&nbsp;
Todd was larger than life, a metaphor often used, yet it could not be more fitting. Standing nearly 2m tall, and possessing an unshakeable will, he lived life on a grand scale, both in body and spirit.&nbsp;
Todd was a pillar in the Himalayan climbing community, supporting many mountaineers across Nepal and Pakistan, making it possible for them to fulfil the dream of standing on the world’s highest peaks. He believed deeply in the strength, skill, and potential of the Sherpa people, and offered them opportunities that might otherwise have remained out of reach.&nbsp;
“Thank you, Henry. Your trust changed my life. Rest in peace, my leader, my teacher, my friend,” said Dorjee Gyelzen Sherpa in his tribute.
Born in 1945 to Royal Air Force officer Henry Todd and May Todd of the Women’s Royal Air Force, Henry spent his early years in Singapore. He led a lively childhood with his two brothers, far removed from the mountains that would later define his path.&nbsp;
A gifted swimmer like his father, Henry never pursued the sport professionally. Instead, after returning to Dundee as a teenager and attending seven different schools, he set off for London, where he began working for an insurance company before finding his true calling in adventure.
Henry Todd first came to Nepal in the mid-1980s and made his first attempt on Ama Dablam in 1987, an expedition that marked the beginning of an extraordinary and colourful climbing career. <a href="https://www.himalayandatabase.com/" target="_blank">The Himalayan Database</a> lists 61 expeditions that he led in Nepal alone — there were more in the Karakoram, Argentina and the Alps.&nbsp;
But Todd would joyfully say that a few hard Scottish ascents held a more personal meaning to him than even the greatest Himalayan summits.
Over the decades, he crossed paths with many legendary climbers like Anatoli Boukreev, Jerzy Kukuczka, Doug Scott and Chris Bonington as well as celebrities including members of Pink Floyd and Nobel Prize laureates whom he befriended.&nbsp;
He had a gift to never name-drop, but would simply mention that he had had lunch with Minnie Driver (niece of his long-time friend Andra) or that he had bought his first car from Donald Sutherland. For Todd, these were not bragging rights, they were simply part of the colourful tapestry of his life.
Todd’s life was filled with extraordinary experiences from surviving plane crashes, avalanches and earthquakes to quietly solving countless problems, which was one of his favourite past-times. His hands, famously large and steady, were always ready to help whether in the chaos of the mountains or the calm of a base camp.&nbsp;
With his sharp sense of humour and the beloved exclamation “Whoopie!”,he could bring lightness even to the toughest moments. He never tired of taking on challenges or helping when someone was in need, and he enriched so many people’s lives with his endless stories.
His legacy is immense. He helped build the human backbone of Himalayan climbing, enabling generations of climbers to test themselves in the world’s highest places. With his passing, an era of bold, spirited Himalayan guiding has come to a close.
Todd survived by a loving family, many close friends and a global community of climbers and Sherpas who will never forget him and his endless tales.&nbsp;
His family said in a statement: ‘Henry’s strength, warmth and unyielding belief in others will live on far above the clouds. He was indestructible in our eyes and in our hearts, he always will be.’
There will be a memorial service at Pashupati Temple in Kathmandu on 8 November 2025 around lunchtime.

nurses

Nepal haemorrhaging nurses

Nursing grievances against the state

Saving one Nepali mother at a time

Nepali nurses gone and going to the UK

Nurses ensure nutrition for Nepal’s children

Nepali nurses now Britain-bound

Protecting those who protect us from Covid

Protecting those who protect us from Covid

How a 105-year-old beat the virus

How a 105-year-old beat the virus

Nepal’s prospects at World Cup 2026

Future imperfect

Neighbourhood watch on Nepal

Henry Barclay Todd, 80