<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

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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/20221110111152/636cd8879c7e80680e092e49jpeg.jpg" alt="" width="1500" height="1125"/><figcaption>Phediguth village in Okhaldhunga where poor roads make access to health facilities difficult for complicated maternity cases. All photos: NARESH NEWAR</figcaption></figure>Stories of birthing are not the kind of conversation that children in Nepal usually have with their mothers. Surya Bhatta’s career path, however, took a new turn when his mother shared her own story of how she survived a near-death complication when she was giving birth to his elder sister.His mother was married at 11, and had her first baby at 16. Access to health services in their home village in Dhading was limited at the time, and she suffered from severe postpartum complications.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110111152/636cd88b9c7e80680e092e4ajpeg.jpg" alt="" width="640" height="364"><figcaption> </figcaption></figure>“Luckily, my mother survived but we all know many Nepali mothers still face similar risks due to poor maternal health,” says Bhatta, now executive director of One Heart Worldwide (OHW), a US-based organisation working in Nepal.At 34 Bhatta is proud to be playing a role to save the lives of mothers like his mother. Although the country has made vast improvements in reducing the maternal mortality rate from 539 per 100,000 live births 25 years ago to 240 today, it is still unacceptably high.An estimated 2,000 new <a href="https://www.nepalitimes.com/here-now/who-will-save-nepals-poor-new-mothers/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/here-now/who-will-save-nepals-poor-new-mothers/&amp;source=gmail&amp;ust=1615874753197000&amp;usg=AFQjCNEu5wCZ54G1e7vKzay3LB7DTXI7mA">mothers still die</a> in Nepal every year —  most of them because health posts are not properly equipped and staffed. The maternal mortality rate also went up in 2020 because the lockdown and pandemic prevented many mothers from getting to hospitals or birthing centres.Bhatta and his colleagues have been working to improve maternal neonatal health care, and with a 70-strong team is setting up birthing centres and hospitals in Nepal’s most remote districts to upgrade care for mothers and babies.<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110111152/636cd88e9c7e80680e092e4bjpeg.jpg" alt="" width="200" height="191">Starting from five villages of Baglung in 2010, One Heart has expanded to 21 districts and helped renovate and equip more than 500 birthing centres in 164 municipalities where road access is still limited. The centres work with local municipalities on a cost-sharing public-private-partnership formula.https://www.youtube.com/watch?v=tVA--CRk3nMMany government health posts in rural municipality wards are under-resourced and often struggle to even buy standard maternity delivery beds and lifesaving equipment. There is inadequate <a href="https://www.nepalitimes.com/banner/federalism-leaves-nepals-medical-sector-ailing/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/banner/federalism-leaves-nepals-medical-sector-ailing/&amp;source=gmail&amp;ust=1615874753197000&amp;usg=AFQjCNEX5KH1MBkZwv3gDbQd0uKEItLdXg">infrastructure</a> for pre-natal, delivery and post-natal care, and a chronic shortage of trained midwives in rural areas.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110111152/636cd88f9c7e80680e092e4cjpeg.jpg" alt="" width="1500" height="1710"><figcaption> </figcaption></figure>Nurses are not trained to handle complicated cases during and after delivery, and as frontline maternity workers face the wrath of local communities when mothers and babies die.Bhatta and his team have zeroed in on training nurses at health posts to become skilled birth attendants, an intervention that directly saves lives. One Heart’s trained nurses and renovated birthing centres now care for more than 72,000 pregnant women across Nepal annually.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110111152/636cd8929c7e80680e092e4djpeg.jpg" alt="" width="1500" height="1125"><figcaption> </figcaption></figure>“Even during the pandemic rural municipalities were able to find resources to share half the cost of construction to renovate the birthing centres,” says Bhatta who works in partnership with local governments and community groups.Bhatta sets program priorities after consultation with local elected representatives, tries to raise money locally, and then tops it up by competing globally for international grants. He says, “We can’t make our people always dependant on international aid. We need to be innovative by taking risks with new ideas.”<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110111152/636cd8959c7e80680e092e4ejpeg.jpg" alt="" width="1500" height="1125"><figcaption> </figcaption></figure>The partnership approach for upgrading birthing centres through cost-sharing is innovative, and one that encourages local ownership, clearly outlining outcomes. It went ahead because local governments under Nepal’s new federal structure were willing to start implementation immediately.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110111152/636cd8989c7e80680e092e4fjpeg.jpg" alt="" width="1500" height="1125"><figcaption> </figcaption></figure>“Entrepreneurship is needed in the social sector not for profit making, but for creating quality service that can go up to scale,” explains Bhatta. “Social entrepreneurship is all about evidence-based work that guide organisations to reduce risks and help improve through sustainable local health systems. There are challenges in Nepal, but there are so many opportunities to overcome them through partnerships like this.”<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110111152/636cd89b9c7e80680e092e50jpeg.jpg" alt="" width="1500" height="964"><figcaption> </figcaption></figure>Bhatta makes a case for Nepalis to return home after higher education overseas, just as he himself did after graduating from Dartmouth in the United States, fulfilling the promise he had made to his mother that he would make a difference for as many Nepali mothers like her as possible.He says, “I am proud of the team we have built, I feel we are making a difference especially for rural communities. What can be more fulfilling than helping save lives?

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“What can be more fulfilling than saving lives?”

Violations of Nepal’s airspace during WWII

In 2025, Nepal’s Ministry of Tourism <a href="https://nepalitimes.com/news/the-everest-industry" target="_blank">added six new 8,000m peaks </a>to those listed on its website. These are subsidiary summits of <a href="https://explorersweb.com/kangchenjungas-challenging-confusing-subpeaks/" target="_blank">Kangchenjunga</a> and <a href="https://explorersweb.com/through-the-unknown-to-the-impossible-lhotse-middle/" target="_blank">Lhotse</a>, which some view as insufficiently independent to be called separate peaks. In 2024, the international mountaineering federation (UIAA) responded to a request by the Nepal Mountaineering Association (NMA) and the government to officially recognise these peaks. While recognising that ‘there is no one definition of a “mountain” or a “peak” or a “top” or “point” in topographic terms’, and encouraging further debate the UIAA’s opinion was that the 8,000m peaks should continue to the ‘Classic 14’, first completed by Reinhold Messner in 1986. The degree of prominence and isolation of <a href="https://www.climbing.com/news/new-8000-meter-mountains-nepal/?scope=initial" target="_blank">the six new peaks </a>varies, with Yalung Kang having the strongest claim to being a separate peak with a prominence of 135m, but they are all separate enough to be included on some peak-bagging lists. The UIAA’s own list of 4,000m summits in the European Alps includes Punta Giordani with a prominence of only 6m. Whatever the case for the six peaks being geographically separate mountains, they represent significant climbing challenges. They are not minor tops that can simply be ‘bagged’ on route to a main summit. In the case of <a href="https://explorersweb.com/through-the-unknown-to-the-impossible-lhotse-middle/" target="_blank">Lhotse Middle and Lhotse Shar</a>, no one has ever managed to traverse between them and Lhotse itself.  <figure><img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260107080144_881321a6e46818beb7bbd4fe6f21589d89d19bf77ae8218474d373ef7ab0c431.png" data-media-id="editor_5" data-image-id="20260107080144_881321a6e46818beb7bbd4fe6f21589d89d19bf77ae8218474d373ef7ab0c431" data-rendition-name="original" width="2888" height="1590" loading="lazy" alt="New 8,000ers"><figcaption>Nepal’s 8 existing 8,000ers: Chomolungma 8,848.86, Kangchenjunga 8,586, Lhotse 8,516, Makalu 8,485, Manaslu 8,163, Dhaulagiri 8,167, Annapurna 8,091, Cho Oyu 8,201. Photo: GOOGLE EARTH PRO</figcaption></figure>   <figure><img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260107080144_27bf905c1a559c46819dc96ca33d22c27fc301d415fc034f26b8acd105c12da7.png" data-media-id="editor_6" data-image-id="20260107080144_27bf905c1a559c46819dc96ca33d22c27fc301d415fc034f26b8acd105c12da7" data-rendition-name="original" width="1750" height="976" loading="lazy" alt="New 8,000ers"><figcaption>Nepal has listed six additional 8,000ers: Yalung Kang (8,505, Yalung Kang West 8,077, Kanchenjunga Central (8,473, Kanchenjunga South 8,476, Lhotse Middle 8,410, and Lhotse Shar 8,400. Photo: KUNDA DIXIT</figcaption></figure>  Several fine routes have already been climbed on these mountains, such as Slovenians Andrej Štremfelj and Marko Prezelj’s alpine style ascent of the South-West Ridge of Kangchenjunga South. The six peaks have not yet achieved universal acceptance, but it is possible that climbing an expanded list of 20 eight-thousanders could become a new mountaineering challenge, just as the 14 classic peaks are today. It is therefore interesting to analyse who is currently closest to achieving this goal, using data from The Himalayan Database and other Internet research. The first conclusion of my analysis is that these six additional peaks have received far less attention than the classic 14 eight-thousanders. One of them, Yalung Kang West, has never been climbed or even attempted: probably because it is a subsidiary peak of <a href="https://explorersweb.com/kangchenjungas-challenging-confusing-subpeaks/" target="_blank">Yalung Kang</a> which is itself a subsidiary peak. The other five peaks have seen a total of 138 ascents. Just 101 people have ever climbed one or more of the additional peaks, which compares with 354 people who climbed Everest on a single day: 23 May 2019. Russian Evgeni Vinogradski is unique in having climbed five of the six new peaks. He has also climbed six of the classic 8,000ers, giving him a total of 11 out of the 20 peaks on the expanded list. Vinogradski is now 80 and is unlikely to increase this total. Several other former Soviet climbers have climbed three of the new peaks, having participated in the 1989 traverse of the four main summits of Kangchenjunga. This includes two legends of Soviet climbing: Kazakh Anatoli Boukreev and Ukrainian Sergey Bershov, each of whom has climbed 13 out of the 20 peaks on the extended list. Boukreev died attempting Annapurna in 1997. Bershov, one of the only men to have ever climbed Lhotse South Face, is now 78 and, although he was in good form when I met him in Chamonix last summer, he is unlikely to further extend his tally. The addition of the new peaks does not take any of these climbers beyond the total of 14 peaks achieved by the 76 climbers who have completed the classic ‘Himalayan Crown’. Of those who have climbed all 14 classic eight-thousanders, only one, <a href="https://nepalitimes.com/here-now/um-hong-gil-s-project-impossible" target="_blank">Korean Um Hong-Gil</a>, has climbed any of the six additional peaks.  <figure><img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260107080144_5651fc6445f5e5fd838f28e1eac1da45da136b309a4a00db1e4aafa7d4836251.png" data-media-id="editor_9" data-image-id="20260107080144_5651fc6445f5e5fd838f28e1eac1da45da136b309a4a00db1e4aafa7d4836251" data-rendition-name="original" width="2142" height="1310" loading="lazy" alt="New 8,000ers"><figcaption>Only one mountaineer, Korean Um Hong-Gil, has climbed any of the six additional peaks.</figcaption></figure>  Um climbed both Lhotse Shar and Yalung Kang, giving him a total of 16 summits. He required four attempts to climb Lhotse Shar, including one attempt in which he turned back just 100m from the summit following the deaths of two teammates. He finally succeeded in 2007 via a route up the Lhotse South Face. If a race to climb all 20 eight-thousanders were to begin, Um is currently in the lead. <a href="https://www.himalayandatabase.com/" target="_blank">The Himalayan Database</a> also lists two additional mountains in Nepal not included among the peaks announced by the Ministry of Tourism: Annapurna Central and Annapurna East. If these are included, bringing the total to 22 peaks, a few additional climbers deserve mention. Poles Piotr Pustelnik and the great Jerzy Kukuczka have both climbed all 14 classic eight-thousanders as well as Annapurna East, giving them 15 out of 22. Swiss climber Erhard Loretan climbed all 14 as well, and both Annapurna subsidiary summits, giving him a total of 16 out of 22 peaks. Annapurna East has a greater prominence than some of the 6 new peaks proposed by Nepal, but Broad Peak Central in the Karakoram has the greatest prominence of any subsidiary 8000m summit. Kukuczka has also climbed Broad Peak Central, so if the list is extended to 23 peaks, he has 16, equal with Loretan and Um. Then, there is a case for Shishapangma Central in China, which further complicates the task of coming up with a definite extended list. At the moment, these subsidiary summits are not attracting a lot of attention: of the 138 summit climbs on them, only 12 occurred in the last 25 years and none since 2011. Most climbers like to have some wide recognition of a target before investing time and money in trying to achieve it, and this may make it hard to build interest. But as completing the classic 8,000m peaks starts to become a rather frequent occurrence, some may be attracted to the longer list. If this new challenge catches on, as the Ministry of Tourism presumably hopes, how long will it be before someone passes Um Hong-Gil’s total and how long before someone climbs all 20 or 22 or 23 summits? <a href="https://nepalitimes.com/opinion/comment/dispelling-myths-about-climbing" target="_blank">Edward Morgan</a> is a British author and climber based in Switzerland. His first book, Lhotse South Face - The Wall of Legends, has been published in several languages and his second book, Chasing Mallory's Dream is due out in the UK this year.

New 8,000ers may restart peak-grabbing race

One of the few Newa towns situated outside Kathmandu Valley, Panauti still evokes the feeling of a place frozen in time.&nbsp; Largely untouched by haphazard urbanisation, this town 32km east of Kathmandu used to be a kingdom revered for the sacred confluence of the Punyamati and Rosi rivers.&nbsp; The Bramhayani temple is the site of a 12 yearly Makar Mela which is attended by devotees from as far away as India.&nbsp; Panauti’s crumbling monuments were restored in the 1990s by the French government. Temples, resting places, traditional homes were rebuilt and locals trained to revive their craft. Panauti and France marked 50 years of cooperation in September.&nbsp; However, the priceless murals on the temple walls are fading and need urgent restitution. Now, these crumbling wall paintings are meticulously documented in the Wall Paintings of Panauti and Their Context.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260106090116_31f6acf06ef879037fec8274b85153eab4468566abf71616490679bf8468b85d.jpg" data-media-id="editor_0" data-image-id="20260106090116_31f6acf06ef879037fec8274b85153eab4468566abf71616490679bf8468b85d" data-rendition-name="original" width="1596" height="1074" loading="lazy" alt="Panauti murals"> </figure>  In his foreword, French researcher Gérard Toffin writes about some of the earliest wall paintings from the Malla period in Kathmandu, including a 17th century mural depicting the procession of Rato Machhindranath which has since been restored.&nbsp; Several other pieces still exist but in a pitiful state, defaced by scratches. ‘They were painted on a plaster coating made of soil, husks, or limestone, which were applied to the bricks making up the walls,’ Toffin notes.&nbsp; The book delves into the cult of Asta Matrika among Newa of all castes and classes, the first of which is Bramhayani. These all-pervading deities are linked to Shaktism which focuses on the importance of the female principle and together, combine the forces of life, sex and fertility with that of death and eros. The deities are painted on the wall, carved on the stone or moulded into metallic statues.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260106090120_836efd2b0a569d8ec0fb2c6651a29b8f2dd8f8f75b72e27bb86b0bfc0ad8461f.jpg" data-media-id="editor_1" data-image-id="20260106090120_836efd2b0a569d8ec0fb2c6651a29b8f2dd8f8f75b72e27bb86b0bfc0ad8461f" data-rendition-name="original" width="1074" height="1434" loading="lazy" alt="Panauti murals"> </figure>  Riddhi Baba Pradhan, former director general of the Department of Archaeology who oversaw the restoration of Panauti 30 years ago, writes that a colourful wall painting depicting Buddha's past life at the Chabahil Chaitya built or restored during the reign of Lichhavi king Vrisdev in the 3rd century might be the earliest mural in Nepal. As for Panauti, a fragment from a 400-year-old scroll which illustrates a scene of Triveni Ghat with Dalinchok Hill in the background is likely the oldest. But that relic is currently at the Virginia Museum of Fine Arts in the United States.&nbsp; Pradhan recalls first encountering wall paintings inside Bramhayani temple which were deteriorated by smoke, leaky roof, dust, vermilion, sprinkles of animal blood and lack of maintenance. The team led by chemist Bhimvar Singh Thapa treated the wall paintings and some of the details were recovered including the paintings of Astamatrika and Asta Bhairav on the east, west and southern walls.&nbsp; PAINTINGS ARE NOT VISIBLE The murals were painted during the reign of the last Malla King of Bhaktapur Ranjit Malla and Queen Viswalaxmi Devi 300 years ago. But 40 years after the restoration, Pradhan notes that the murals are again in poor condition: ‘The paintings are not visible, the plaster is severely damaged and the surface has peeled off … electrical wires hang haphazardly inside the temple.’ The second lot of murals at Ghat Sattal are thought to have been commissioned during the late Malla period or the beginning of the Shah dynasty. Exterior walls depict incarnations of Lord Vishnu as well as Sesh Narayan, Ganesh, a scene of Samundra Manthan, of angels Maya, Moha, Ganga. Their attributes, dresses, ornaments, facial expressions, body postures are all skilfully represented but in a deteriorated condition.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260106090116_88d06703ae23a271905d81f35056d41df92cbbc4b9966fac3f34821659e585a8.jpg" data-media-id="editor_2" data-image-id="20260106090116_88d06703ae23a271905d81f35056d41df92cbbc4b9966fac3f34821659e585a8" data-rendition-name="original" width="588" height="862" loading="lazy" alt="Panauti murals "> </figure>  The wall paintings of Bramhayani Dyochhen are 90% degraded even though they were restored and repaired 40 years ago by the Panauti Integrated Project. Compared to other artefacts, wall paintings are more delicate to external factors, and if not preserved an important part of Nepal’s heritage will be lost.&nbsp; Furthermore, most of the wall paintings in Nepal are temperas, and not frescos. Tempera is painted with water-soluble mineral or vegetable pigments fixed with glue on the cow dung clay plaster on the brick walls. While Nepal’s focus has been on the repatriation of stolen artefacts from abroad, religious and cultural objects within the country like the Panauti murals need urgent attention.&nbsp; This slim publication by Panauti Municipality is an important call to begin the work before it is too late.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260101120124_d0efa1e57b2710a206beb37c7e934ac34e694afc278985934eac2fc52124a92c.jpg" data-media-id="editor_3" data-image-id="20260101120124_d0efa1e57b2710a206beb37c7e934ac34e694afc278985934eac2fc52124a92c" data-rendition-name="original" width="1136" height="702" loading="lazy" alt="Wall Paintings of Panauti"> </figure>

Saving Panauti's murals

The American military action in Venezuela and the abduction of President Nicholas Maduro may redefine Nepal’s geopolitics as it juggles between three world powers, India, China and the United States.&nbsp;
Nepal’s interim government is busy preparing for elections on 5 March, and it was late issuing a statement on the American intervention in Venezuela, but the country may have to re-evaluate how it deals with its immediate neighbours and the global power.
“How does Nepal avoid being the next Ukraine or Venezuela? Small countries shouldn’t go around irritating big neighbours. And when big neighbours really get upset, they usually put up a moral fig leaf justifying their miltary action,” says energy economist Dipak Gyawali. “What we see with Venezuela today is bereft of such moral content, essentially banditry which in today’s day and age is unacceptable. Neither the rising new powers nor much of the Global South will take this lying down.”
International relations experts have said that there is now a new world order in which rules-based diplomacy has been thrown out of the window, and the world has been carved into America leading the western hemisphere, Russia is allowed to do what it wants in Ukraine and Europe, and China’s sphere of influence is now the Indo-Pacific.
Foreign affairs expert Nischal Pandey says there is a lesson for smaller nations like Nepal: “We have to be aware of the sensitivities of the major powers in the vicinity.”
There is also a lesson for smaller resource-rich countries not to give an excuse for intervention with poor governance and political instability due to inequity. In Venezuela’s case it was throttling democracy and not using its immense oil-wealth to uplift its people.
Nevertheless, the Trump administration’s abduction of a sitting president of a foreign government regardless of the dictatorial nature of his regime and Venezuela’s volatile internal politics, is illegal and breaches the international order that has been in place since after World War II and its devastation on humanity.
While Trump’s intervention in Venezuela, and threats against Colombia, Cuba and Greenland have brought international condemnation, here in Nepal it has not been taken as seriously as it should.
Says Amish Mulmi, author of the book All Roads Lead North: Nepal's Turn to China: “Some of the reaction on social media has been that of glee over the fall of a dictatorial Communist government on the other side of the world. However, the government statement about fully respecting the principles of sovereignty and the Charter of the United Nations is a strong statement that makes clear Nepal's position on the matter.”
“The abduction of Maduro is a clear sign of Trump's America ensuring its sphere of influence through might and a warning to toe the line,” Mulmi adds. “It also infringes on the sanctity of borders and the preservation of sovereignty. Trump's actions reek strongly of a bygone era of imperialistic control and resource capture.”
Venezuela has 17% of the world’s reserves of crude oil, even though refining this heavy tar-like oil will be costly, and is possible in only a few places including Texas.
“This has to do with a larger political economy of oil, the unravelling of pax Americana and the post-World war II order. This is USA’s heavy-handed response to remain on the top as well as to partly solve its debt of $39 trillion,” explains Gyawali. “But this is not going to help: China is far ahead, Russia has recovered from its 1990s low point, and manufacturing capital has moved away from America. So controlling only financial capital - and using military power so brazenly - is not going to work.”
The might also be specific lessons for Nepal as a smaller country with vast water resources. While water, unlike oil, is renewable, India’s interest in Nepal’s hydro resources cannot be ignored. Ironically, America’s capture of Venezuelan oil reserves could exacerbate climate breakdown and the melting of Himalayan glaciers, which will put Nepal’s water resources in jeopardy in the coming decades.
The only way to deal with this for Nepal and downstream India will be to build reservoirs on rivers to store monsoon precipitation, and that makes water a strategic commodity for the future.&nbsp;
“If we continue in the current mode of hydropower-biased water resources development ignoring irrigation, flood control, navigation, fisheries, tourism and other benefits, India will get the free benefit of regulated water while we pay the upstream environmental and social costs. History will blame our elected leaders for having undersold our resources,” adds Gyawali, who served as water resource minister in the early 2000s.
As for a larger geopolitical lesson: “We in Nepal are fortunate in having not one threatening hegemon but two superpowers India and China: they don’t agree with each other, but do agree on a peaceful Nepal for their own security. However, our current political leaders are irritating both the neighbours, unlike since the centuries past when our rulers looked solely after Nepal’s core interests and our neighbours knew that.”
American intervention in Venezuela also calls for strengthening of our institutions and diplomatic outreach. Nepal has been a non-aligned state, and for all its history has tried to follow a policy of equidistance between India and China. The difference with Venezuela is that Nepal has to deal with two giant neighbours, and not just one.
Says Mulmi: “It is no more only about balancing great power relations but also about benefiting from them. But that will be increasingly difficult as international law and the principles of sovereignty are encroached upon.”

okhaldhunga

Protecting those who protect us from Covid

Protecting those who protect us from Covid

“What can be more fulfilling than saving lives?”

Violations of Nepal’s airspace during WWII

New 8,000ers may restart peak-grabbing race

Saving Panauti's murals

Might might be right, after all