Here in the mountains of far-western Nepal, the biggest threat to life and limb is gravity. Women collecting fodder fall from trees, boys grazing goats fall off cliffs, heavily loaded tractors plunge from dirt roads carved out of steep slopes. There is nothing to be done about those who die on the spot. But for the severely wounded there is only one hospital: Bayalpata. And it is there that <a href="https://www.youtube.com/watch?v=CJzWlnYd0ZM&amp;t=8s" target="_blank">orthopaedic surgeon Mandeep Pathak</a> is the last hope for many wounded people. Pathak, 42, is too modest to tell us how many lives he has saved over the past 10 years he has worked at Bayalpata. But hospital records show he has performed more than 4,000 operations in the past decade, many of them so patients did not suffer permanent physical disabilities. Pathak also did 800 major life-saving surgeries in that time. “I treat patients with injuries, but I wish I could also treat poverty,” Pathak says, emerging from Bayalpata’s surgical theatre one recent afternoon. <div class="embed-block"><iframe width="700" height="415" src="https://www.youtube.com/embed/CJzWlnYd0ZM?si=s_rkbU4YDaw87gqH" title="YouTube video player" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share" referrerpolicy="strict-origin-when-cross-origin" allowfullscreen></iframe></div> Sudurpaschim Province in Nepal’s far-west is far away from everything: from Kathmandu, from adequate medical care, from food security, and far from the reach of government services. It has suffered state neglect for centuries, its men mainly migrating to India for seasonal work to families who depend on subsistence agriculture. Pathak remembers the searing sadness he felt when a patient once told him, “Doctor, I sold the last of my rice to pay to come here, please give me a medicine that I can take on an empty stomach.” Pathak was born in Kathmandu, and after getting his MBBS from Kathmandu University, he got an MD from The Philippines. At a time when many Nepali doctors and staff nurses were emigrating, Pathak did not just return to Kathmandu but decided to go to one of the remotest districts in Nepal to serve those most in need. The hospital was established in 2009 in the village of Bayalpata, and has been managed by the non-profit <a href="https://www.nyayahealthnepal.org/" target="_blank">Nyaya Health Nepal (NHN)</a> as a public-private partnership treating 100,000 patients a year for no fees at all. NHN is now preparing to hand over the running of the hospital to the Sudurpaschim provincial government so its <a href="https://nepalitimes.com/banner/this-is-how-to-upgrade-nepals-rural-health" target="_blank">model of hospital management</a> can be replicated.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250414130456_b59dabd4604a24426a55fe91c0e5866b5029858bdb4c4028c331557aeb5408ae.jpg" data-media-id="editor_4" data-image-id="20250414130456_b59dabd4604a24426a55fe91c0e5866b5029858bdb4c4028c331557aeb5408ae" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="Bayalpata hospital"> <figcaption>Bayalpata hospital in Achham.</figcaption> </figure>  People from not just Achham but surrounding districts, and from as far away as Humla, bring patients to Bayalpata, sometimes walking for days. Some with complicated pregnancies are brought in stretchers, young children with broken arms walk into the emergency, and sometimes there are mass casualties when a tractor or bus falls off a road. And Pathak is always there with his team performing triage, and doing orthopaedic surgeries that would be difficult even in Kathmandu. Recently, his team did a hip replacement at <a href="https://nepalitimes.com/banner/state-of-the-art-rural-hospital" target="_blank">Bayalpata Hospital</a>. Mild mannered, modest, soft-spoken, hard-working, professional are the words families of patients who have been treated at <a href="https://nepalitimes.com/here-now/nepal-s-rural-lifeline" target="_blank">Bayalpata Hospital </a>use to describe Mandeep Pathak. But the surgeon is too busy to let all this get to this head.&nbsp; Asked why he does not emigrate like his peers or get a lucrative position at a private hospital in Kathmandu, Pathak answers simply, without a trace of self-importance, “I do not think I could get the satisfaction or sense of fulfilment anywhere else.” When travelling to attend medical congresses overseas or visit family in Kathmandu, Bayalpata has other doctors to take care of patients, but many wait patiently till Pathak returns for their consultation or surgery.&nbsp; When he returns from seminars abroad after learning the latest skills, Pathak’s suitcases are not full of clothes or presents, but titanium bone implants, external fixation rods, or intramedullary nails to be used in <a href="https://nepalitimes.com/news/altruistic-healthcare-models-in-nepal" target="_blank">surgeries at Bayalpata</a>.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025041414040_5356278472c1eb2b9e4af1d593d6234cc8dc5e5161a8c614197c01abefadbd80.jpg" data-media-id="editor_8" data-image-id="2025041414040_5356278472c1eb2b9e4af1d593d6234cc8dc5e5161a8c614197c01abefadbd80" data-rendition-name="original" width="2048" height="1368" loading="lazy" alt="surgery"> </figure>  Before Bayalpata Hospital was established, most people suffering broken bones had to travel down to Dhangadi or Nepalganj for treatment. No more. Although Pathak’s specialisation is orthopaedic oncology, he is mostly treating fractures and rejoining broken bones.&nbsp; Now as Bayalpata’s Hospital Director, Pathak also has administrative and fundraising duties. He has to take the 10-hour ride down to Dhangadi often to meet various Sudurpaschim ministries to release the hospital’s budget — that is sometimes more difficult than the most complicated surgery. Recently, he had to cancel an appointment with the Chief Minister to rush back to Bayalpata because there was a patient who needed emergency surgery. “I told myself, let me save this patient first, then I will try to save the hospital,” he recalls.&nbsp; Once, when he had to be away for a month on emergency surgery training in the US, the family of a 90-year-old woman who had dislocated her hip after falling from a staircase was waiting for him to return. Her son told Pathak: “Doctor, either put her out of her suffering, or cure her.” Pathak told him it was too dangerous to operate at her age, but the son said his mother was in so much pain it was worth the risk. The operation was touch-and-go, but it was successful. The woman who had been brought in on a stretcher, walked out of the hospital three days after the operation.&nbsp; A few months later, a 27-year-old woman was brought into the ER bleeding profusely from an arm mangled by a thresher machine. Even in that state, she was breastfeeding her baby. Pathak welled up seeing this display of selfless motherhood, as he wheeled her into surgery. She needed three operations, but now has full use of her hand. <div class="embed-block"><iframe width="700" height="415" src="https://www.youtube.com/embed/xJdxLD0hBqo?si=mOpM2R_DsYL88Lfg" title="YouTube video player" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share" referrerpolicy="strict-origin-when-cross-origin" allowfullscreen></iframe></div> It is the sense of achievement from such recovery that keeps Mandeep Pathak here in this isolated village in the middle of nowhere. Bayalpata Hospital has not just saved lives, it also saves families from poverty because they do not have to take sick relatives to expensive city hospitals.&nbsp; In January, a woman was brought to Bayalpata with both hands broken. She said she had taken a fall, but Pathak did not believe her. When alone in the surgery, she finally admitted that her husband had beaten her.&nbsp; It was her husband who had brought her to hospital for treatment, but she refused to file a police report. Pathak quietly put both her arms in casts, thinking about the poverty, patriarchy and injustice in society that he is unable to treat.

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The healer of far-western Nepal

<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022120710124/639057b99c7e80680e0ce16djpeg.jpg" alt="" width="4509" height="4147"/>When people who have gone on to devote their lives to public service are asked who has been their greatest inspiration while growing up, many cite parents, teachers or spiritual gurus.For Nepal’s noted paediatric orthopaedic surgeon Ashok Banskota, the inspiration was an author few today have heard of, and a book even fewer have read: Adventures in Two Worlds the 1952 biography of Scottish doctor and novelist <a href="https://en.wikipedia.org/wiki/A._J._Cronin">A J Cronin</a> and his dual career in a Welsh coalmine.“The story of a medical doctor rushing about in a motorcycle to treat miners somehow left a powerful imprint in my mind,” says Banskota, recalling days spent in the library of St Xavier’s School in Godavari in the 1960s where Jesuit teachers also inculcated values of service, integrity and perseverance.Those ideals have been the guiding principles of the Nepali surgeon who was awarded the <a href="https://www.sicot.org/">SICOT</a> TKS Gold Medal for Outstanding Work by an Orthopaedic Surgeon in a Developing Country at a ceremony in Kuala Lumpur. The prize is given by the Brussels based SICOT (Société Internationale de Chirurgie Orthopédique et de Traumatologie) and named after the veteran Indian surgeon T K Shanmugasunderam.This is just the latest of many awards Banskota has been conferred over a career lasting nearly 50 years. After getting his MBBS from the All India Institute of Medical Sciences (AIMS) in Delhi, Banskota went to the United States where he did his specialisation in various hospitals including Johns Hopkins.He came back to Nepal in 1977, where he had to pull powerful strings to get appointed as a ‘medical officer’ at Bir Hospital because officials would not recognise his American degree. After being discouraged and given the run-around, Banskota recalls tearing up his appointment letter in disgust.“Come hell or high water, I made up my mind never to work for an outfit that was so unmotivated in a place where the need was so great,” he says.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022120710124/639057bf9c7e80680e0ce16ejpeg.jpg" alt="" width="4200" height="2800"><figcaption>HRDC children.</figcaption></figure>Banskota then volunteered at Shanta Bhawan as a paediatric surgeon under Archie Fletcher, and felt that he had finally found his calling in life – helping children from underprivileged families who could not afford treatment. After Shanta Bhawan merged with Patan Hospital in 1982, Banskota turned down an offer to join Fletcher in Seattle, and continued volunteering at Anandaban leprosy hospital doing hand reconstruction, and at the Scheer Memorial Hospital in Banepa.It took another seven years of fund-raising and painstaking preparation for Banskota to finally set up his dream project: the Hospital and Rehabilitation Center for Disabled Children (HRDC) in Banepa in 1992.“As a young surgeon looking for challenges, I couldn’t have asked for more,” Banskota recalls. “The plight of the children was heart-breaking, and the personal sense of fulfilment of having the privilege to make them better was the greatest reward I could have. Yet, there was so much more to do and so little to do it with.”The hilltop facility in Banepa was also a great escape from the grime and congestion of Kathmandu for Banskota, who was working on a parallel project to set up the private B&amp;B Hospital with fellow-physician Jagdish Lal Baidya.Juggling two jobs was not easy, when not supervising construction and overseeing administrative work, he was operating nearly non-stop in the surgery from early morning till late at night. “I did not have much of a family life,” he admits.HDRC offers free medical care for children with congenital and <a href="https://www.nepalitimes.com/here-now/its-an-emergency-nepal-needs-to-improve-trauma-care/">trauma-related disabilities</a>, infections in its six operating theatres, and offers <a href="https://www.nepalitimes.com/here-now/injured-use-internet-to-reach-physiotherapists/">physiotherapy and rehabilitation</a>. Since the children are away from home for so long, the hospital also runs a school so they do not miss out on studies.This is a unique model, where a private city hospital supports a <a href="https://www.nepalitimes.com/latest/step-by-step-for-rural-health-care-in-nepal/">rural charity facility</a>. Besides Banepa, HRDC also runs a Community Based Rehabilitaiton program with four satellite centres and mobile clinics all over Nepal. In the past nearly 40 years, HRDC has changed for the better the lives of 105,000 children, nearly half of them female.<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022120710124/639057c29c7e80680e0ce16fjpeg.jpg" alt="" width="1200" height="1600">More than in Nepal, it appears that Banskota’s contribution is recognised internationally. Besides the recent SICOT TKS Award from the World Orthopaedic Concern, Banskota has received the <a href="https://worldofchildren.org/honoree/ashok-banskota/">World of Children Health Award in 2011</a>, the Stars Impact Award in 2014 and a citation in 2016 from the World of Children Hero Award.HRDC even employs former patients like Juddha Nepali on whom Banskota performed hip surgery when he was 13 years old in 1992. Today Nepali is a technician in the prosthetic department. He says, “There is a place in Nepal where children with physical disability can receive world-class treatment irrespective of their caste, ethnicity or economic status. I am a living example of that.”Sumitra was born in remote western Nepal with scoliosis, a deformity on her back and was often stigmatised by peers. A visiting HRDC mobile clinic came to her village, and took her to Banepa for spine surgery. Sumitra’s life has been transformed: she finished college, passed her civil service exam and now has a government job.HRDC’s Community Based Rehabilitation has conducted more than 30 camps in 22 districts all over Nepal, operating and offering post-operative physiotherapy to nearly 30,000 patients just in 2021.Ashok Banskota is not one of those flashy, flamboyant surgeons who craves celebrityhood. Even at age 74, he is more at home in his clinic or operating theatre, but is now devoting more time mentoring a new crop of surgeons and health workers, and trying to inculcate in them the same sense of commitment to public service that motivated him all his life.And when he needed spine surgery himself recently, he got the doctors he trained to operate on him in his own hospital. He says, “Whatever is good enough for my patients is good enough for me.”Read more: <a href="https://www.nepalitimes.com/banner/taking-wealth-out-of-health/">Taking wealth out of health</a>, Anita Shrestha

A life devoted to healing

<figure><img width="640" height="495" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221107161120/636922529c7e80680e03a120jpeg.jpg" alt=""/><figcaption>Goma Dulal participates in a rally marking International Wheelchair day.</figcaption></figure>If you can find time, do go to Jorpati to visit <a href="http://archive.nepalitimes.com/news.php?id=6946#.W5-Qc84zaUk" target="_blank" rel="noopener">Goma Dulal</a> who has just got an electric trolley to help her move about.I first met Goma 16 years ago, when the <a href="https://www.sirc.org.np/" target="_blank" rel="noopener">Spinal Injury Rehabilitation Centre</a> was being established at the Khagendra Nabajiban Kendra precincts in Jorpati. Capable of speaking but motionless other than the ability to move her hands, Goma was resident of the next-door facility known as the Ryder Cheshire Homes, which housed <a href="http://archive.nepalitimes.com/news.php?id=4956#.W5-QqM4zaUk" target="_blank" rel="noopener">differently-abled people</a>.Goma was always there to provide encouragement and good cheer to our fledgling organisation, which she and others began referring to simply as ‘Spinal’. After about five years, ‘Spinal’ moved to Kavre, but Goma has always followed our progress keenly.She was born in 1968, the second of five siblings, the eldest being a brother. When she was about 10, Goma began experiencing difficulty standing or walking. Her mobility worsened progressively, but the hospital only gave palliative care. The elbow and knee joints started swelling, and before long Goma was confined to bed.It was only in 1990 of orthopedic surgeon <a href="http://archive.nepalitimes.com/news.php?id=18607#.W5-SyM4zaUk" target="_blank" rel="noopener">Ashok Banskota</a> diagnosed Goma’s condition as Multiple Rheumatoid Arthritis, where there is no prevention, nor cure, only ‘management’.Banskota lobbied and found Goma residency at the Ryder Cheshire Homes, where she has lived for two decades. As the disease progressed relentlessly, Goma was moved from wheelchair to ‘wheel-bed’, a kind of trolley meant for those who cannot move, only lie supine. All these years, she relies on others for bodily care, to be wheeled in and out, and to be fed. <figure><img width="640" height="390" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221107161120/636922549c7e80680e03a121jpeg.jpg" alt=""><figcaption> </figcaption></figure><img width="640" height="471" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221107161120/636922579c7e80680e03a122jpeg.jpg" alt="">Goma’s mother has been gone now for a decade, her father died five years ago. Since then contact with her brother and sisters have been sporadic, and limited to phone conversations which requires a friend to secure her cellphone on the pillow to Goma’s ear.Her body is hard as rock, the limbs little more than bone and skin. And yet in Goma’s eyes there is a shine and a sweetness in her tongue. Her refuge is music on the radio.One of Goma’s most prized moments was the concert by <a href="http://archive.nepalitimes.com/news.php?id=19310#.W5-SBM4zaUk" target="_blank" rel="noopener">Amrit Gurung</a> and his folk-rock band <a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/Nepali-times-buzz-nepathya,581" target="_blank" rel="noopener">Nepathya</a> at the Khagendra Nabajiban Kendra compound. Goma looks forward to Fridays to hear the singer and lyricist Kumar Poudel, who volunteers his time to entertain the residents. “I would die if I did not have music in my life,” she says.The last four decades have weakened Goma considerably, and the one-size-fits-all treatment of residents does not do justice to her growing needs, including a specialised diet. But what has bothered her most is her decreasing mobility even in her manual trolley: “I have to shout for someone to move me, and it is frustrating that help is not always available.”A year go, Goma asked her friends from ‘Spinal’ in Kavre to get her a bijuli trolley with a joystick control. “I am tired of asking help to be moved in and out,” she told them. They ordered an electrical trolley, with battery, motor and steering from India, and it has now cleared customs, undergoing tests, and will soon be in Goma’s hands.Goma prizes her moments with visitors and she likes making new friends, learning new things. Her spirits are high, even as her body gets weaker. Do visit Goma Dulal in Jorpati. She will be wheeling herself out in her newly acquired bijuli gadi to greet you.Read also:<a href="http://archive.nepalitimes.com/news.php?id=6946#.W5-Qc84zaUk" target="_blank" rel="noopener">Standing up to spinal injuries</a>, Hemlata Rai<a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/the-wheel-of-life,4157" target="_blank" rel="noopener">The wheel of life</a>, Sanjeev Sharma

An electric trolley for Goma

Imagine a high-end fair trade tea brand from Nepal that has done everything right, with ethical sourcing practices and international certifications. It has built a loyal base of socially conscious, premium customers in an export market and focuses on quality over quantity. Then one day, a government in the export market introduces a new ‘listing criteria’ that requires exporting a certain amount of tea to at least three countries in the past five years. But this was never a numbers game, it was about a niche market of socially responsible tea lovers.&nbsp; Suddenly, fair trade tea companies are restricted from exporting tea to that country.&nbsp; Pretty unfair for the company, for consumers, for the tea sector. More importantly, for tea farmers and families benefiting from fair standards. The overseas labour industry is facing a similar risk as recruiters, including those that have adopted ethical standards, may soon be barred from finding workers for Malaysia.&nbsp; On 27 October, the Malaysian Ministry of Foreign Affairs sent letters to five countries including Nepal, Bangladesh, Burma, Pakistan and India to ‘rationalise the number of licensed private recruitment agencies permitted to facilitate recruitment and placement of workers to Malaysia’.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251030141040_050274dddc6cf10224b0ad9283eec7b3bc3c0acd650543a808a8ea473ecf40db.jpg" data-media-id="editor_0" data-image-id="20251030141040_050274dddc6cf10224b0ad9283eec7b3bc3c0acd650543a808a8ea473ecf40db" data-rendition-name="original" width="961" height="1135" loading="lazy" alt="Malaysia recruitment"> </figure>  The letter includes 10 criteria for private recruiting agencies including at least five years of operating experience, deployment of 3,000 workers in the past three years of operation, &nbsp;experience sending workers to at least three countries, a 10,000 sq m office maintained for three years, valid licenses and good conduct certificates, five employer testimonials, and operating their own training and accommodation centres. Two conditions stand out as potentially harmful to Nepal’s ethical recruitment movement. First, although the letter cites a minimum of 3,000 workers, it says three years in the heading and five in the body text. A big enough difference to affect a significant number of recruiters from making the cut, but problematic regardless.&nbsp; Second, the requirement to send workers to at least three countries disproportionately impacts responsible recruiters in Nepal and elsewhere. Turning the selection of workers into a numbers game is dehumanising. Responsible &nbsp;recruiters deprioritise volume, focus on quality of jobs even when business sustainability comes under threat as ethical opportunities that do not require workers to pay any feed and ensure greater transparency are difficult to come by. Sending workers is further impacted by a series of external shocks. For example, in the Malaysian context Nepal banned emigration to Malaysia for two years followed by the Covid pandemic, and then Malaysia’s decision to stop the intake of foreign workers for the last two years.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251030141040_b1b88b3ae2e94c6bc077529ac6f2a4e380a385ee9a22219edfed25067c9d25a1.jpg" data-media-id="editor_1" data-image-id="20251030141040_b1b88b3ae2e94c6bc077529ac6f2a4e380a385ee9a22219edfed25067c9d25a1" data-rendition-name="original" width="595" height="841" loading="lazy" alt="Malaysia recruitment"> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251030141040_2cf252908d18aaf09c875002eef2d92ab45897a56b560addd2dc02311725c8a7.jpg" data-media-id="editor_2" data-image-id="20251030141040_2cf252908d18aaf09c875002eef2d92ab45897a56b560addd2dc02311725c8a7" data-rendition-name="original" width="590" height="238" loading="lazy" alt="Malaysia recruitment"> </figure>  Many ethical recruiters have focused on Malaysia because it is a more common labour market for responsible recruitment than other destinations like the Gulf. There is no credible justification to why responsible recruiters well regarded by scores of Malaysia-based multinational companies and with decades of experience should be ‘disqualified’ for not diversifying. Finding jobs for Nepalis in new markets is difficult given fierce competition, challenges &nbsp;identifying companies which follow the employer-pays principle, lack of networks and shortcomings in marketing strategies. These factors hit responsible recruiters harder because profit-motivated employers are often unwilling to cover the costs and fees associated with workers’ recruitment.&nbsp; “The volume of deployment does not determine a recruiter’s capability or the quality of services provided,” says Sujit Shrestha of the Nepal Association of Foreign Employment Agencies (NAFEA). Nepal recently scrapped the licensing renewal requirement that mandated sending at least 100 workers a year as it was impractical. The new Malaysian criteria is similar in nature, he added. The ball is now in Nepal’s court at a time when the interim government does not even have designated heads in the Foreign Ministry and the Ministry of Labour, Employment Employment and Social Security. When rumours about the Malaysian action started circulating, NAFEA had raised the issue, but was assured that this was not an attempt to set up a syndicate.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251030141044_83c8a174ef116603f747d1cd254c4d353e8b855a41fb99feec54e701f5fc4c3f.jpg" data-media-id="editor_3" data-image-id="20251030141044_83c8a174ef116603f747d1cd254c4d353e8b855a41fb99feec54e701f5fc4c3f" data-rendition-name="original" width="3456" height="5184" loading="lazy" alt="Malaysia recruitment"> </figure>  How will governments and recruiters in other origin countries now respond? There is precedence from Bangladesh. Dhaka-based journalist at the Daily Star, Porimol Palma who says, “Earlier, the Malaysian authorities had selected 101 Bangladeshi recruiters unilaterally, despite Bangladesh’s call for a syndicate-free recruitment mechanism.” Between 2022-2024, 450,000 Bangladeshis were recruited under this system with workers paying between $4,500 and $6,000, even though the legal limit was $750. Palma attributes part of the high fees workers had to pay were for commissions or bribes to recruitment syndicates. Adrian Pereira heads the North South Initiative in Malaysia says: “The criteria seems a bit fishy, as they do not appear to address the actual problems in the the recruitment of foreign workers. Some of the criteria seem to encourage a system of monopoly or syndicate rather than a rights-based approach. Every government has the right to set criteria for recruiters, but conventions and ILO (International Labour Organization) standards on recruitment exist. It looks like we’re back to square one.”&nbsp; Whether migrant origin countries including Bangladesh and Nepal accept the terms sent without reservations or push back in good faith remains to be seen. In an ideal world, a collective stance should put workers’ needs and welfare at the centre. How rational is the proposed ‘rationalising strategy’? What aspects of it are promising to curb recruitment abuse and what merits serious reconsideration?&nbsp; Even if the move from the Malaysian side is well-intentioned to address rampant malpractices migrant workers face, Nepal should deliberate on the conditions set, the collateral damage especially on the responsible actors and small but capable recruiters. Alternate options that might serve everyone better before rushing to respond with a chosen list by 15 November. If the proposal is accepted, how would it be done in a transparent and accountable way? It is noteworthy that Indonesia was not listed even though it has the most workers in Malaysia among the 16 countries that send migrants to Malaysia.&nbsp; The Responsible Business Alliance (RBA), the ILO, the International Organization for Migration (IOM), and certification programs like On the Level (OTL) also need to use their leverage to ensure that recruiters, including those they have trained or certified on ethical recruitment principles, are not penalised.&nbsp; This is more than just about protecting the ethical recruitment movement, but raising even more basic questions: Who can legally be a recruiter in Nepal? There are already obligations like hefty security deposit and minimum office requirements. But requirements to have building facilities with ‘accommodations’ or ‘testing centres’ are not among them. There are 1,150 plus players in Nepal’s recruitment sector, with a few hundred engaged in the Malaysian market. A unilateral selection criteria could risk foul play, or lead to unintended, unfavourable consequences. To be sure, overseas recruitment in Nepal is known for ‘settings’, corruption, dog-eat-dog competition, and collusion. The profiteering is out of control, often at the expense of workers. But the solution does not lie in stifling the industry with criteria like deployment volume, building worker accommodations or expanding office floors.&nbsp; The focus should instead be on enforcing rules and laws in both countries that govern the industry, and the Malaysian labour agreement that has not been renewed since October 2023.&nbsp; Meddling in the industry in ways that harms fair competition and ethical actors means workers suffer. The only issue that should be taking precedence is: how will Malaysia’s 10-point criteria and planned arrangement affect migrant workers? We have seen how for identical Malaysia-based jobs, one worker might pay zero while another pays up to Rs400,000, depending on the employer and recruiter. It is unclear if the 10-point selection criteria rewards the responsible employers and recruiters.&nbsp; As a longstanding host country for Nepali migrants, Malaysia deserves credit for nurturing the small but growing ethical recruitment industry here. Export-oriented companies in Malaysia need responsible recruitment partners and have mentored recruiters to strengthen their practices and move away from worker-paid models.&nbsp; The business case for ethical recruitment standards has led many recruiters in Nepal to pivot with many now in various stages of transition from traditional to hybrid or purely ethical practices. This progress needs to be acknowledged and built upon.&nbsp; Large, well-networked recruiters with large physical assets and high volume of workers seem to be the winners of Malaysia’s 10-point criteria after two years of waiting for the Malaysian market to reopen. Responsible recruiters endure long periods of minimal or no deployments that threatens their survival. The letter now sitting on the desk of the interim government in Nepal deepens the concern: rather than just failing to recognise or reward responsible recruiters, does the international recruitment market actually punish them? Upasana Khadka heads Migration Lab, a social enterprise aimed at making migration outcomes better for workers and their families. Labour Mobility is a regular column in Nepali Times.

Who gets to recruit for Malaysia?

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

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

<a href="https://myrepublica.nagariknetwork.com/news/dhm-forecasts-above-average-rainfall-and-temperatures-for-2025-monsoon-28-10.html">This year, </a>Madhes Province received less rainfall than was forecast by the &nbsp;Department of Hydrology and Meteorology (DHM), reducing groundwater recharge of shallow aquifers which are the lifeline for domestic use and irrigation.&nbsp; The crisis was serious enough for the government to officially declare a drought emergency during the monsoon, with the province declared a '<a href="https://kathmandupost.com/national/2025/07/23/cabinet-declares-madhesh-province-a-disaster-crisis-zone?">disaster-hit zone</a>' in July.&nbsp; The monsoon scarcity hit farmers hardest, a majority of whom depend on rainfall for agriculture. Data from Dhanusa’s <a href="https://add.madhesh.gov.np/noticefiles/%E0%A4%A7%E0%A4%BE%E0%A4%A8-%E0%A4%B0%E0%A5%8B%E0%A4%AA%E0%A4%BE%E0%A4%87%E0%A4%95%E0%A5%8B-%E0%A4%B5%E0%A4%BF%E0%A4%B5%E0%A4%B0%E0%A4%A3-%E0%A5%A4-1752227917.pdf">Agriculture Development Directorate</a> shows that only 33% paddy plantation was completed by mid July, in comparison to <a href="https://kathmandupost.com/money/2024/07/31/fastest-transplantation-rate-sows-hope-for-bumper-paddy-harvest?">92% planting the same time last year</a>. Only 49% of agricultural land in Nepal is irrigated — farmers in the rest of the arable land rely on rainfall, private wells and groundwater extraction. During the dry seasons and droughts, water insufficient groundwater recharge worsens the water crisis.&nbsp; Nearly 88% of households depend on groundwater in Madhes Province which has about 100,780 shallow tube wells and 60,660 deep tube wells. But in recent times, the tube wells and hand pumps have dried up every year.&nbsp; This shortage disproportionately impacts low income families and small-scale farmers, who have no other alternative to irrigate their land. And because paddy accounts for up to 7% of Nepal’s economy, Madhes’ water crisis is not confined to within the province, but has serious implications on the national economy.&nbsp; Underground water Groundwater extraction for irrigation began in the <a href="https://jvs-nwp.org.np/wp-content/uploads/2018/09/Water-Nepal-A-historical-Perspective.pdf">1970s, </a>shallow and deep tube wells for irrigation were introduced with support from development partners. By the 2021 agriculture census, <a href="https://agricensusnepal.gov.np/upload_file/files/post/1731650149_1221316497_Agriculture%20Census%202021_District%20Summary%20Report_by%20Province.pdf">groundwater irrigated land had increased </a>to 41.7%, up from &nbsp;<a href="https://agricensusnepal.gov.np/upload_file/files/post/1694250757_1312300734_National%20Sample%20Census%20of%20Agriculture%202021_22%20(National%20Report).indd.pdf">29.8% in 2011.</a>&nbsp; A lack of strong policies and regulation to monitor unchecked extraction has meant that with the exception of some parts of Kathmandu Valley, domestic users, subsistence and commercial farmers, restaurants, hotels and industries across Nepal can draw any quantity of groundwater from desired depths and location. While the dependence on drilling for water has risen due to limited expansion of surface water infrastructure, there has been little attention to groundwater recharge. This competing use of groundwater threatens the fundamental right to drinking water.&nbsp; The ecologically sensitive Chure and Bhawar watershed play a crucial role in groundwater recharge. However, deforestation and indiscriminate riverbed mining has severely reduced its recharge potential over the years. In addition, widespread monoculture plantation of fast-growing non-native eucalyptus trees, replacing native sissoo and sal trees has compounded the crisis. Eucalyptus, a water intensive species indigenous to Australia, was introduced in the Bhawar region in 1978 for supplying wood. The Tarai’s recurring water crisis is not only climatic. Years of fragmented planning, inadequate budget allocation for groundwater management, as well as limited intra- and inter-government policies and coordination have contributed to the disaster just as much as droughts and floods caused by changing weather patterns. The United Nations said decades ago disasters are not natural, and they occur when we fail to prepare.&nbsp; Groundwater management is <a href="https://www.opmcm.gov.np/download/%e0%a4%86%e0%a4%af%e0%a5%8b%e0%a4%9c%e0%a4%a8%e0%a4%be-%e0%a4%b5%e0%a4%b0%e0%a5%8d%e0%a4%97%e0%a5%80%e0%a4%95%e0%a4%b0%e0%a4%a3%e0%a4%95%e0%a5%8b-%e0%a4%86%e0%a4%a7%e0%a4%be%e0%a4%b0-%e0%a4%a4/?wpdmdl=8990&amp;refresh=683b8df54ffef1748733429">the shared responsibility of federal, provincial and local</a> governments, but there is a lack of <a href="https://www.iwmi.org/blogs/stakeholders-in-nepal-work-together-to-enhance-collective-action-for-municipal-groundwater-management/">integrated planning, &nbsp;budgeting, data sharing</a>, and collective action for groundwater extraction and recharge.&nbsp; Sustainable groundwater use in the plains requires inclusive and equitable practices that combine water science-informed interventions with a long-term cross-disciplinary approach.&nbsp; Groundwater is mainly available either in shallow unconfined aquifers that are close to the surface and directly linked to rainfall and rivers, and deep confined aquifers between semi permeable or impermeable ground layers. Locating and mapping such aquifers would help us find what depth they lie at, how much water they hold, what we can do to recharge them and how much time recharging would take—enabling sustainable use of groundwater. Construction of surface water projects such as the Sun Kosi Marine Diversion Multipurpose Project, which serves a dual purpose of expanding irrigation and recharging groundwater, must be expedited.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251027071020_a9442084bc412998d3e7417cf0d057cae8a2b98f5e47ac1a8cc0630612ff2a55.jpg" data-media-id="editor_9" data-image-id="20251027071020_a9442084bc412998d3e7417cf0d057cae8a2b98f5e47ac1a8cc0630612ff2a55" data-rendition-name="original" width="1778" height="1000" loading="lazy" alt="Mitigating the Madhes water crisis NT"> <figcaption>Photo: ONION FILMS / IWMI</figcaption> </figure>  Such infrastructure have a conjunctive use recognised by the National Irrigation Master Plan 2019 and the National Irrigation Policy 2023, wherein farmers can rely on canals for irrigation during monsoon and groundwater during dry seasons.&nbsp; Nature-based solutions such as rainwater harvesting, managed aquifer recharge techniques, restoration of wetlands and retention ponds, and floodwater reservoirs, particularly in ecologically sensitive regions like the Chure Bhaban, should be explored. &nbsp; The management of green water — the water stored in soil and vegetation — is equally as critical as that of blue water (rivers, canals, and groundwater). Green water is lost through evapotranspiration, which contributes to nearly half of the rainfall on land. Deforestation, soil degradation, poor land use practices, and loss of wetlands contribute to the disruption of the evapotranspiration cycle, affecting rainfall patterns and groundwater recharge. Solutions Rising temperatures compound this situation by increasing evapotranspiration. Soil water conservation, vegetation cover, wetland restoration, and nature friendly land use practices must therefore be prioritised. Water-efficient technologies and practices including drip irrigation use of sprinklers, mulching, and soil fertility improvement should be scaled up.&nbsp; At the same time, we must promote irrigation techniques and technologies along with crop choices and cropping patterns that give more yield per drop of water so that food production and water conservation go hand in hand. &nbsp; The government provides subsidised electricity for irrigation starting at Rs2.3/unit, some local governments are even supplying power for free. While such subsidies support farmers and increase productivity, &nbsp;it also poses serious risk of over extraction of groundwater.&nbsp; Flat subsidies in electricity or solar irrigation must be replaced by targeted subsidies in order to balance domestic and agricultural needs with ecological conservation. The 2015 <a href="https://kvwsmb.gov.np/public/uploads/board_act_&amp;_rules/rule-1.pdf">directive for groundwater licensing</a> developed per the Drinking Water Management Board Act 2006 for Kathmandu valley prohibits groundwater extraction from shallow aquifers for commercial and industrial uses. The directive also has provisions for licensing, and renewals, and mandates for license holders to contribute to groundwater recharge. The Madhes needs similar context-specific policies to address its groundwater crisis and safeguard water rights. Shallow aquifers in the region should be prioritised for domestic use while <a href="https://link.springer.com/chapter/10.1007/978-981-10-3889-1_11">deep aquifers, which are still underutilised, should be tapped</a> in a sustainable manner for commercial, industrial and large scale irrigation and drinking water projects.&nbsp; While <a href="https://www.frontiersin.org/journals/human-dynamics/articles/10.3389/fhumd.2023.1181734/full">technical solutions</a> are important, they are not enough to solve Madhes’ water crisis. Nepal’s Constitution and the Local Governance Operation Act 2017 empower local governments for water management in their constituencies. But beyond the letter of the law, local units require community tailored groundwater policies, regular groundwater monitoring and up-to-date data, and investment in local recharge initiatives such as retention ponds, restoration of wetlands, and rainwater harvesting. Coordination between all three tiers of government is crucial, particularly among agencies that pertain to drinking water, water resources, irrigation, agriculture, land use, environment, climate change, and urban development. &nbsp; Heeding indigenous knowledge will be crucial to understanding the water crisis in Madhes and initiating solutions that will fit the context and needs of the region. Local engagement in groundwater monitoring can help to create self -aware, accountable, cost effective and participatory groundwater management practices.&nbsp; To ensure water security in Madhes, we thus need inclusive governance, coherent policies, active engagement of citizens, integration of local and indigenous knowledge and a principle of equity that puts people at the centre. &nbsp; Sumitra KC, a policy and governance researcher in natural resources management, is the National Researcher at the International Water Management Institute (IWMI), Nepal. Manohara Khadka, PhD, an expert in natural resources management, gender equality, and social inclusion, is the Country Representative of IWMI, Nepal.