<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110811110/636a290b9c7e80680e0458a4jpeg.jpg" alt="" width="1500" height="1128"/><figcaption>Nepal's world renowned eye doctor Sanduk Ruit with his patient at Tilganga Institute. Photo: GOPEN RAI</figcaption></figure>Despite a decade long conflict, the absence of local government for 20 years, instability and bad governance, Nepal has taken dramatic strides in improving the health of its citizens. And it is in <a href="http://archive.nepalitimes.com/news.php?id=6416#.XH43n8AzaUk" target="_blank" rel="noopener">eye care</a> that the achievement has been most impressive.Thirty years ago, the Nepal Blindness Survey showed that 0.8% of the population was blind. Nepal’s population then was 15 million, which means 118,000 people were blind. Cataracts was the cause in 72% of the cases, and trachoma, a bacterial infection of the eye, was the second leading cause of blindness. Poor eye-sight and blindness due to Vitamin A were also prevalent. Most of these were preventable or curable. Women were found to be 1.35 times more likely to get cataracts because of the detailed  nature of their work, and injuries stemming from household work and farming.Today, the prevalence of blindness has decreased to 0.3% out of a population of 29 million, which means only 87,000 are visually impaired. But most of them are blind still because of cataracts. Last year Nepal became the first country in South Asia to eliminate trachoma. Cataracts and other preventable cases can now be treated much earlier with modern surgery.“The quality of community cataract surgery here is one of the best among developing countries and people are coming forward for treatment because they trust us,” said <a href="http://archive.nepalitimes.com/article/Nepali-Times%20Buzz/sanduk%C2%ADruit%C2%ADtilganga,2574" target="_blank" rel="noopener">Sanduk Ruit</a>, Nepal’s world-renowned eye doctor who pioneered small incision cataract surgery. (See below)But modern lifestyles and changing <a href="https://archive.nepalitimes.com/regular-columns/GUEST-COLUMN/we-are-what-we-eat-aruna-uprety,1022" target="_blank" rel="noopener">dietary habits</a> have brought new dangers: diabetic retinopathy is on the rise, so is glaucoma. An ageing population also means cataract is still common, as is macular degeneration among elderly Nepalis.The most challenging ailment, however, is visual impairment due to refractive error which is increasing alarmingly among children, and at a much higher rate in urban areas. A 2008 study found that one in five school-going children in Kathmandu were short sighted and need to wear glasses. In remote rural areas, many do not even know they need spectacles or cannot afford them.<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110811110/636a290f9c7e80680e0458a5jpeg.jpg" alt="" width="1265" height="717">Ruit’s team at <a href="https://tilganga.org/" target="_blank" rel="noopener">Tilganga</a> and the group <a href="http://www.nnjs.org.np/" target="_blank" rel="noopener">Nepal Netra Jyoti Sangh</a> are now trying to test and treat the eye-sight of school children district-by-district. Free spectacles are provided, and complicated cases are referred to hospitals.“Our goal is to reach all school-going children in Nepal within five years,” said Sailesh Mishra of Netra Jyoti. “This needs regular monitoring and follow-up if children are using glasses or not, and we need to educate people about eye diseases.”While there has not been a study in Nepal to directly link the increased incidence of visual impairment with the use of mobile phones, computers and reading, research in other countries have shown a correlation.Nepali eye specialists and institutions have not just addressed blindness in Nepal, but have been world leaders in innovative interventions. Sanduk Ruit’s Tilganga Institute of Ophthalmology has been exporting intraocular lens for cataract surgery at $5 apiece since 1995. Elsewhere in the world it costs $200. Tilganga is now equipped to also perform retinal transplant.Eye hospitals in Lahan, Hetauda and Kathmandu now treat not just patients from Nepal, but also provide affordable cataract and other eye operations for patients from India, and even Bangladesh and Sri Lanka.Read also:<a href="http://archive.nepalitimes.com/news.php?id=19839#.XH4vDSIzbIU" target="_blank" rel="noopener"> Two Decades of Vision</a>, Skye MacparlandTilganga has is an international centre of excellence for ophthalmology training, and its surgeons have been conducting camps in Bhutan, Mongolia, North Korea, Ethiopia and Kenya. Much of this is credited to non-government initiatives by the likes of Sanduk Ruit and pioneer activist Ram Prasad Pokhrel.“One of our most important achievements was to provide eye care outside the government, creating high quality community hospitals at the grassroots that run on the social entrepreneurship model with highly motivated professional staff,” explained Ruit, whose community eye centres and hospitals are autonomous and self-sustaining.But with its Vision 2020 goal to eliminate avoidable blindness now only a year away, Nepal needs to develop more specialists and infrastructure. Some experts say the non-profits have done all they can, it is now time for the government to step in for the last push.“Nepal is far ahead of others in the region in term of eye care, we have reduced blindness, have sound modern surgical technology that has been recognised internationally,” said Hukum Pokhrel of Netra Jyoti. “It is now time the government included eye care into a more equitable health package that is sustainable into the future.”<h2>The Visionary Sanduk Ruit</h2><h2>New biography of the Nepali eye surgeon who overcame</h2>all odds to give the gift of sight to the world<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110811110/636a29119c7e80680e0458a6jpeg.jpg" alt="" width="1500" height="1000"><figcaption> </figcaption></figure>It was on the death bed of his young sister that <a href="http://archive.nepalitimes.com/news.php?id=12282#.XH448cAzaUl" target="_blank" rel="noopener">Sanduk Ruit</a> vowed to grow up to be a doctor so others like her did not have to die needlessly. Later, at a surgical camp he found his true calling after observing the magic of restored eyesight.There were many such instances that turned this boy from a family of salt traders in Olanchungola on the Tibet border into a world-renowned surgeon. Reading Ruit’s new biography, <a href="https://www.amazon.com/Barefoot-Surgeon-inspirational-Sanduk-surgeon-ebook/dp/B07BLJYZJ1" target="_blank" rel="noopener">The Barefoot Surgeon</a>, we find that it was sheer determination, hard work and perseverance that helped him overcome many obstacles on the way to rising from a remote village in Nepal to become an internationally acclaimed doctor.“I want this book to create awareness about how we alleviated blindness in Nepal, and how this experience can be fine-tuned and replicated in other parts of the world,” Ruit said in an interview, ahead of the launch of the soon to be released book.Australian journalist Ali Gripper recounts how his mother named Sanduk (sky dragon), and the family was so poor Ruit lost siblings to preventable infections like diarrhoea and tuberculosis. At boarding school in Darjeeling the young Ruit was bullied mercilessly, he spent hours with lab animals as a diligent student pulling all-nighters at King George’s Medical University in Lucknow, then operated on rhesus eyes in ophthalmology class at the All India Institute of Medical Sciences in New Delhi.Much of the book describes Ruit’s years as a junior eye surgeon trying to shake up the government health system in Nepal to introduce <a href="http://archive.nepalitimes.com/news.php?id=3804#.XGI_jtIza71">intraocular cataract surgery</a>. He is rebuffed by seniors who see his motivation as a threat. Gripper follows Ruit’s transformation into a young man with a vision to rid the world of <a href="http://archive.nepalitimes.com/news.php?id=6416#.XGI_adIza70">avoidable blindness</a>.Along the way, Ruit is mentored by famous Australian eye surgeon <a href="http://archive.nepalitimes.com/news.php?id=19839#.XGI_O9Iza70">Fred Hollows</a>, and much later American climber-surgeon Geoffrey Tabin becomes a protégé. Both individuals play a significant part in expanding Ruit’s transformative work, and leave a profound impact on the doctor.<iframe src="https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/585215052&amp;color=%23ff5500&amp;auto_play=false&amp;hide_related=false&amp;show_comments=true&amp;show_user=true&amp;show_reposts=false&amp;show_teaser=true&amp;visual=true" width="100%" height="300" frameborder="no" scrolling="no"></iframe>Ruit is known for pioneering the technique of small incision low-cost cataract surgery which he has used to restore the sight of more than 120,000 people so far in Nepal, China, North Korea, Ethiopia and other countries. He has won many accolades including the Ramon Magsaysay Award in 2006, and last year one of India’s highest civilian honours, the Padma Shri.As he interacts with patients in Kathmandu, he shows extraordinary kindness and humility for a doctor so famous. Ruit tells Gripper that he learned early in his career that giving back eyesight to people meant giving them back their life. Ruit’s life is not without personal tragedies, and the book is full of heartfelt moments. But it is as much about progress in eye care in Nepal as it is about Ruit himself.“Curing blindness is Nepal’s great success story,” said Ruit, who established the Tilganga Institute of Opthalmology in Kathmandu in 1994. At that time the prevalence of <a href="http://archive.nepalitimes.com/article/Nepali-Times-Buzz/Seeing-is-believing,2577">blindness in Nepal</a> was 0.8%, with cataract the major cause. Today, blindness is down to 0.3%, despite the population having doubled, and Ruit is operating much earlier with improved surgery on contracts.The world-class eye centre is also a training ground for young surgeons from around the world. Tilganga runs on the social entrepreneurship model with a sliding scale payment system where those who can afford treatment pay more than the less privileged.“Instead of investing time and money on mega projects, we should focus on developing small, self-sustaining grassroot independent community hospitals with qualified staff, and that is the most important thing we have achieved in eye care in Nepal,” said Ruit, who has opened eye centres in all 77 districts,  with community eye hospitals based on the <a href="http://archive.nepalitimes.com/news.php?id=17323#.XGI-U9Iza71">Tilgaganga model</a> in Hetauda, Biratnagar, Dhangadi, Nepalganj and Lumbini.The Barefoot Surgeon is being translated into Nepali by FinePrint, but it is not the first book about Ruit. <a href="https://www.amazon.com/Second-Suns-Trailblazing-Doctors-Blindness/dp/1615193626" target="_blank" rel="noopener">Second Suns</a> by <a href="http://archive.nepalitimes.com/article/review/helping-the-poor-to-see,2575">David Oliver Relin</a>, who also wrote <a href="https://books.google.com.np/books/about/Three_Cups_of_Tea.html?id=HbezCyqr3q0C&amp;redir_esc=y">Three Cups of Tea</a>, was about Ruit and Tabin’s quest to restore sight to the world’s poorest. But following an allegation of plagiarism in an earlier work, Relin committed <a href="https://www.nytimes.com/2012/12/03/business/media/david-oliver-relin-co-author-of-three-cups-of-tea-dies-at-49.html?_r=0">suicide</a> in 2013 right after handing over the manuscript of the Second Suns.Read also: <a href="http://archive.nepalitimes.com/article/review/helping-the-poor-to-see,2575" target="_blank" rel="noopener">Helping the poor to see</a>, Kunda DixitFor the new book, Gripper followed Ruit’s surgery team for more than three years in India, Bhutan and Burma. In Nepal she joined Ruit’s eye camps in Trisuli, Mustang, Hetauda and Solu Khumbu to see people seeing again. She noticed that Ruit preferred to work barefoot ‘allowing him complete control of the pedal under the table that pulls focus on his microscope’.The book recounts Ruit’s vision for Tilganga, the rapport he shares with Bhutan’s Queen grandmother, the eye camp in North Korea where minders followed their every move, his meeting with the Dalai Lama, the challenges in manufacturing low-cost intraocular lens in Kathmandu, and a treacherous journey to Mustang for a field camp.There will be tears of joy and of sadness, there will be elation and wonder as you turn the pages of The Barefoot Surgeon. This is a moving portrayal of a great Nepali whose work has transcended borders to transform many, many lives.Sonia AwaleThe Barefoot Surgeon: Inspirational story of Dr Sanduk Ruit, the eye surgeon giving sight and hope to the world's poorBy Ali GripperAllen &amp; Unwin, 2018305 pagesAUD $32.99<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110811110/636a29149c7e80680e0458a7jpeg.jpg" alt="" width="1500" height="2294"><h2>Ozone and Eyes</h2><figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110811110/636a29179c7e80680e0458a8jpeg.jpg" alt="" width="484" height="460"><figcaption> </figcaption></figure>The ozone layer in the outer atmosphere filters out harmful ultra-violet rays of the sun from reaching the Earth’s surface. There has been a steady <a href="http://archive.nepalitimes.com/news.php?id=2243#.XH44ecAzaUk" target="_blank" rel="noopener">depletion</a> of this, especially over the Southern Hemisphere, due to chemicals called CFCs used as a refrigerants. This has caused a rise in the incidence of skin cancer, but also of eye disorders. People living southern Argentina, Australia and New Zealand have been known to suffer more cataracts because of the solar UV-B radiation.A <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1298891/" target="_blank" rel="noopener">2005 study</a> carried out by the American Journal of Epidemiology found out that  ozone depletion would result in a 20% rise in the number of cataract cases by 2050. Ultraviolet rays is also responsible for the onset of cataract at an earlier age. Not just people in the southern hemisphere, but those living in high altitude areas like the Tibetan Plateau and Nepal also become more susceptible to cataracts due to ozone thinning.Apart from cataract, UV radiation can also cause photokeratitis (inflammation of the cornea), eye cancer, conjunctivitis, pterygium, conjuctivitis, acute solar retinopathy, and degeneration of the macula. Long term exposure to the harmful rays can cause permanent damage to cornea, lens and retina.As a result of the <a href="https://archive.nepalitimes.com/article/nation/bringing-kyoto-and-montreal-together,1405" target="_blank" rel="noopener">1985 Montreal Protocol</a> to phase out CFCs,  the ozone hole over Antarctica has started to shrink, but exposure to UV B radiation will be seen till the end of the century. HFCs  that replaced CFCs in refrigerators and air conditioners are very potent greenhouse gases that contribute to the global warming.Doctors say, minimising the time spent outdoors especially in the southern hemisphere and at high altitude is a useful precaution.

Sonia Awale

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Nepal's far-sighted eye care

https://www.youtube.com/watch?v=087QDbzzKCMMost residents of Kathmandu are aware of the <a href="http://archive.nepalitimes.com/article/editorial/polluted-politics-cartels,3533" target="_blank" rel="noopener">dust and smoke</a> in the air, but few know that their masks do not protect them from the poisonous gas emissions from the capital’s ubiquitous motorcycles.Because of the nature of their engines, two-wheeler exhausts give off carbon monoxide, nitrous oxides, and elevate the concentration of street-level ozone. Doctors say these poisonous gases have led to a worrying increase in respiratory ailments, cancers, Alzheimer’s Disease, diabetes and heart attacks.“A few motorcycles would not be so dangerous, but there are now nearly 1 million of them on the city streets and their emission is a great public health hazard,” warns respiratory health expert Raju Pangeni at HAMS Hospital in Dhumbarahi.Although motorcycles burn much <a href="http://archive.nepalitimes.com/page/every-breath-you-take-air-pollution" target="_blank" rel="noopener">less petrol than four-wheelers</a>, they are up to ten times more polluting per passenger- kilometre than buses and cars. The internal combustion engine of motorcycles is also less efficient, and their exhaust systems lack catalytic converters.Because there are fewer two-wheelers on the roads in the West, emission standards for them are more lax than for four-wheelers. However, in places like Nepal, Vietnam or Indonesia, where motorcycles outnumber cars, their cumulative emissions poison the city's air with noxious gases.Also Read: <a href="http://archive.nepalitimes.com/article/nation/Highway-robbery,3539" target="_blank" rel="noopener">Highway Robbery</a>, Shreejana Shrestha<a href="http://archive.nepalitimes.com/regular-columns/Comment/air-quality-data-to-figire-out-what-to-do,841" target="_blank" rel="noopener">Figuring out what to do</a>, Arnico Pande <img width="1400" height="933" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221107121144/6368eff39c7e80680e0359a9jpeg.jpg" alt=""/>A recent study showed that up to 2% of<a href="http://archive.nepalitimes.com/news.php?id=5115#.W0hkqtUzbIU" target="_blank" rel="noopener"> poorly-maintained</a> motorcycles contributed to close to half the total pollution from two-wheelers on Kathmandu’s streets.“The recent spike in cardio-vascular diseases in Kathmandu hospitals is partly a result of slow carbon monoxide poisoning, mainly from motorcycles,” confirms cardiologist Prakash Regmi at Bir Hospital. Residents near congested intersections in Kathmandu with thousands of motorcycles emitting gaseous pollutants are the most at risk (see map).Ozone is the other toxic gas formed when carbon monoxide and nitrous oxides in motorcycle exhaust react in the presence of sunlight with volatile organic carbons. Large parts of Nepal have ground-level ozone in much higher concentrations than the WHO standard in the spring, as per several studies published last year in the journal Atmospheric Chemistry and Physics.Arnico Panday, atmospheric scientist at the International Centre for Integrated Mountain Development (ICIMOD) who co-authored the papers, explains that incomplete combustion of fuel in motorcycles engines gives off carbon monoxide, volatile organic compounds like benzene, and oxides of nitrogen (NOx) which are precursor gases to ground-level ozone -- itself a highly reactive gas that can aggravate chronic respiratory diseases like asthma, bronchitis and emphysema.Also read: <a href="http://archive.nepalitimes.com/article/nation/increasing-concentration-of-carbon-dioxide-in-atmosphere,1409" target="_blank" rel="noopener">Not business as usual</a>, Nessim J Ahmad and Kaveh Zahedi <img width="900" height="812" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221107121144/6368eff79c7e80680e0359aajpeg.jpg" alt="">The studies showed that minor servicing of two-wheelers did not reduce gaseous pollutants much, and motorcycles were a major source of carbon monoxide in <a href="http://archive.nepalitimes.com/article/Nepali-Times-Buzz/air-pollution-decreases-life-span,3999" target="_blank" rel="noopener">Kathmandu Valley air</a>.Public awareness about air pollution has grown in the past two years after suspended dust particles from road-widening and water mains laying work <a href="http://archive.nepalitimes.com/article/nation/Sick-city,108" target="_blank" rel="noopener">worsened air quality</a> that was already thick with soot particles from diesel exhaust and garbage burning.But only a few commuters interviewed for this article in the past week knew of invisible and odourless gases like carbon monoxide, ozone and nitrous oxides. Nine of ten motorcyclists had no idea about the poisonous gases, and blamed only dust and diesel smoke for poor air quality.<a href="http://archive.nepalitimes.com/article/nation/air-pollution-in-Kathmandu,2737" target="_blank" rel="noopener">Kathmandu air pollution levels on most winter mornings</a> are the worst in the world. The hourly Air Quality Index (AQI) from the U.S. Embassy and Phora Darbar stations which feed live into the Nepali Times website is a composite of the concentration of ozone and particles finer than 2.5 microns in the air. The daily averages in this paper (page 10) show AQI is high even during the monsoon, proving that the rains are not enough to clean the air of pollutants. <img width="1400" height="680" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221107121144/6368eff99c7e80680e0359abjpeg.jpg" alt="">“Given that 80% of total vehicles today in Nepal are motorcycles and scooters, there should be a mechanism to monitor and control their emissions, like issuing green stickers," says BhusanTuladhar of UN-HABITAT. In the longer term, however, only an <a href="http://archive.nepalitimes.com/regular-columns/guest-editorial/public-transport-is-equal-to-public-health,844" target="_blank" rel="noopener">efficient public transportation service</a> can reduce the number of motorcycles and cars on the roads.Besides Nepal, Vietnam and Indonesia also grapple with two-wheeler congestion and poor air quality. Hanoi is banning scooters by 2030, and China now only allows electric two-wheelers.Energy expert Manjeet Dhakal says there is no sense banning motorcycles in Kathmandu without first offering a convenient alternative: “Two wheelers are polluting and unsafe, but environment-friendly public transport policy should be implementated first.”Moving to electric mass transit, a battery-operated Bus Rapid Transit, and offering tax incentives for electric scooters and motorcycles would be the first step. Experts say the cause of Kathmandu's air pollution is government policy that allowed unlimited vehicle imports so as to generate greater tax revenue. <img width="1400" height="1197" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221107121144/6368effd9c7e80680e0359acjpeg.jpg" alt="">“Lack of regulation on motorcycle numbers undermines the government’s own effort to promote zero-emission safa tempos and electric vehicles,” says communications officer Mona Sharma at ICIMOD. With local governments in place after 20 years, priority should also be on ending the monopoly of transportion syndicates so the existing public transport system is streamlined.An already-available alternative could be electric scooters, the prices of which have dropped to Rs138,000 for some models like the Japanese Terra Echo. Chinese-made Niu M1 scooters are costlier, but are stylish and convenient.Both have showrooms in Kathmandu. Tax rebates can bring prices down more.Says cariolodist Prakash Regmi: “The government has to decrease the number of petrol two wheelers, provide better public transport and promote electric vehicles to ensure a healthy future for us all.”Also read: <a href="http://archive.nepalitimes.com/news.php?id=17035#.W0hkptUzbIV" target="_blank" rel="noopener">Lost in the smog,</a> Dewan Rai and Suvayu Dev Pant <h4>SILENT KILLERS</h4> <img width="500" height="401" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221107121144/6368f0009c7e80680e0359adjpeg.jpg" alt="">Carbon monoxideCarbon monoxide (CO), a colourless, odourless and tasteless gas found in vehicular exhaust, is so poisonous it is one of the commoner methods of suicide.It is produced from incomplete combustion of fuel, and should not be mistaken for carbon dioxide (CO2) which is a gas essential for plant life while being the primary greenhouse gas warming the Earth.Motorcycles are particularly notorious for producing CO because of the incomplete combustion in their engines. A few recreational motorcycles on the roads may not pose a danger, but when there are 800,000 motorcycles in a city like Kathmandu, it poisons the air we breathe.“Prolonged exposure to carbon monoxide acts as a slow poison, causing various diseases of the heart,” explains cardiologist Prakash Regmi at Bir Hospital.Human blood is red because it contains the iron-rich protein haemoglobin (Hb) in the red corpuscles which has an affinity for oxygen and carries it to various organs and tissues in the body. But haemoglobin has a 240 times greater affinity for carbon monoxide than oxygen. When Hb binds with CO, the blood cannot absorb oxygen, leading to suffocation and eventually death.Kathmandu’s streets normally record 0.0012% CO, which will not kill people outright but can lead to cardiac and lung complications. Says respiratory expert Raju Pangeni at HAMS Hospital: “Carbon monoxide reduces the oxygen carrying capacity of the body, and can have lethal consequences.” <img width="500" height="373" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221107121144/6368f0019c7e80680e0359aejpeg.jpg" alt="">OzoneCarbon monoxide, volatile organic compounds and nitrous oxides in motorcycle exhaust go through complex chemical reactions in the presence of sunlight to form ground-level ozone. This is ‘bad’ ozone, and different from ‘good’ stratospheric ozone that blocks harmful solar radiation. The ozone molecule is composed of three atoms of oxygen, unlike the oxygen we breathe which contains two atoms.As traffic increases, bad ozone builds up during warm sunny days, harming lung functions. Kathmandu hospitals have recorded a sharp increase in patients with chronic respiratory diseases, and higher concentration of surface ozone is one of the factors.A 2017 study published in the journal Atmospheric Chemistry and Physics measured ground-level ozone at various points in Kathmandu and found that it was highest in the day, during pre-monsoon months, and at higher altitudes on the Valley rim, exceeding the WHO standard.Says ICIMOD atmospheric scientist Arnico Panday, who co-authored the paper: “Ozone is a growing problem in northern South Asia, and is a threat to both agriculture and human health.”

Poisoning the air we breathe

Fenerbahçe Beko won the Turkish Airlines EuroLeague finals in Abu Dhabi, held 23-25 May, defeating Monaco 81-70 in the final. Olympiacos, who defeated Panathinaikos 97-93, finished the series in third place. The Most Valuable Player (MVP) of the final match, Nigel Hayes-Davis from Fenerbahçe Beko, received a prize of 1,000,000 Miles&amp;Smiles from Turkish Airlines’ Chief Commercial Officer Ahmet Olmuştur. The carrier has been the title sponsor of the Turkish Airlines EuroLeague, a top tier tournament, since 2010.

Turkish Basketball

Thousands of Nepali students dreaming of an American education have been forced to look elsewhere as the Trump administration’s visa restrictions make their future uncertain.
The US was long considered a top destination for higher studies, making Nepal the 10th biggest country of origin for international students in America.&nbsp;
However, that number has seen a significant decline with the total for Nepali students now at 16,482. Some 8,000 Nepali students obtained no-objection certificates to study in the US from the Ministry of Education in the past year.&nbsp;
India, Australia, Canada, South Korea, United Kingdom and Japan are the other popular destinations for Nepali students. There are no clear numbers for Nepalis going to India, but a slight decline was noted this year after the deaths of two female students.
The US State Department has issued a circular to its embassies not to issue new visas to applicants until further notice. US Secretary of State Marco Rubio in the directive stated that the department planned to expand the screening of applicants' social media.&nbsp;
While new applicants are barred including those applying for visitor visas, students with scheduled interviews are allowed to proceed.
“Many of our students are affected by the new restrictions, but those who had applied for student visas earlier have got interview dates,” one Kathmandu-based college counsellor told us.
Meanwhile, even foreign students with spotless records already in the US have not been spared, as visa scrutiny intensifies under the new policy. In a move that underscores the growing sense of insecurity, many US colleges advised international students to carry their passports and documents at all times, even when traveling locally.
“Me and my friends did not go home this summer because we were not sure we would be allowed back, so we just went to Niagara Falls,” said a Nepali undergrad in Ohio, who like many interviewed for this report did not want her name used for fear of repercussion.
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Nepali students have adopted a cautious stance, with many choosing not to return home during summer vacation due to fear of visa revocations as well as travel bans. Meanwhile, over 7,000 Nepalis with Temporary Protected Status (TPS) will have to come back to Nepal by 5 August or face deportation. Thirty-seven were flown back to Kathmandu on Omni Air last week.
“The US is one of the most sought-after destinations for higher education, and the ban will definitely impact bright students,” says Narottam Aryal of the King’s College in Kathmandu.
Indeed, Nepali undergraduates admitted into Ivy League colleges for the 2025 academic year have been asked to look for alternatives. The entire Fulbright Foreign Scholarships Board resigned on Wednesday citing interference from the Trump administration on the selection of this year’s cohort. Some Nepali students already on Fulbright scholarships have noted disruptions, delays and even cancellation of stipends.&nbsp;
The student visa restrictions were initially just for foreign students admitted to Harvard University, but it was later extended to all Chinese students and now to all students. Universities like Columbia which actively recruit foreign students, face sharp enrolment declines, threatening their financial stability and diversity.
An Indian female PhD candidate at Columbia University had her visa revoked by the US State Department, and said she was targeted on the basis of her social media posts on Israeli military attacks in Gaza. Social media vetting of political activism has raised concerns about privacy and freedom of expression in a country where such rights were a given.
Many students have been informed via email that their visas have been revoked for getting speeding or parking tickets, but even others with no criminal record have been affected. The fear of deportation looms large amongst international students, including those from Nepal.&nbsp;
For most Nepalis who migrate to the US for education, the journey is a high-stakes investment. They come largely from middle-class families, often rely on a patchwork of scholarships, work-study programs, loans, or even the sale of family assets to afford fees.
Most Nepali students pursue STEM subjects which offer extended Optional Practical Training (OPT) periods that help fund their education. But with the US backsliding on education and humanitarian matters, countries like the UK and Canada are becoming more attractive despite their own recent stricter controls on student visas.&nbsp;
The UK universities saw a 63% rise in Nepali students’ admissions in 2024. Japan is another popular destination with 64,816 Nepali students enrolled as of 2024.
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Already, China, Hong Kong and Malaysia are poised to benefit from the increased scrutiny of US student visas. Several Hong Kong universities are offering unconditional admission to affected students, while Malaysian institutions are targeting previously US-bound Asian students. China and India have 330,000 and 280,000 students respectively in America, but the numbers for China have seen a sharp drop in the past year.
Elsewhere, branch campuses of American institutions such as NYU in Abu Dhabi, Georgetown in Dubai and Northwestern in Doha are getting more admission applications, and universities in the Gulf region are expanding infrastructure to accommodate those who would otherwise have gone to the US.&nbsp;
Even educational institutions in Nepal are hopeful that the US visa restrictions can be an opportunity to at least keep Nepali undergrads in Nepal, and also attract foreign students from the region.&nbsp;
“Many students might choose to complete their undergraduate degree here in Nepal and then move abroad for their Master’s degree later,” says Aryal of King’s College. “There was a need for quality higher education in Nepal anyway in terms of innovation and opportunities, so this could be the time to reduce our dependence on other countries.”
Nepal’s strategic position between India and China makes it sensitive to US policy shifts. India, a key ally, is also under US scrutiny for potential student travel restrictions. Chinese universities are already offering more scholarships to Nepali talent to capitalise on the US retreat.
American universities have challenged student visa restrictions in the courts. A federal court in Boston revoked the blanket ban on Harvard, and the State Department has ordered the resumption of processing student and exchange visitor visas.&nbsp;
Some are still hoping that President Trump will backtrack on the student visa restrictions, just like he has done with many of his more drastic executive orders.
Even so, the visa see-saw and longer-term uncertainties about living in the United States and its education system means students across the world are making alternative plans.
Says Aryal: “Policies of foreign countries change according to their needs, so excessive dependence was never a good idea. We should work to create different opportunities and choices of higher education within Nepal, so students are retained.” &nbsp;

America no longer prime destination for Nepali students

That winter day in January 1664 marked an exceptional event in the reign of King Pratap Malla of Kathmandu. It was 15 Paush 784 of the Nepal Sambat and for the first time, a historical event was being immortalised on canvas for generations to come.&nbsp; The occasion was the grand Tuladaan ceremony of the King’s youngest son Chakrabartendra Malla from his wife Anantapriya, an Indian princess from Cooch Behar in present-day Assam.&nbsp; During the ritual, the prince was weighed against gold, silver, pearls, and other precious stones, which were then offered to Goddess Taleju Bhavani, the guardian deity of the Malla dynasty.&nbsp; The 170 x120cm painting captures the time of King Pratap Malla in all its splendour and is more than a personal tribute to his son: it is a significant visual historical document. It was evidently completed five years later in 1669, and could be considered a photographic record, with retrospective recreation of the event by the unknown artist. A Tuladaan ceremony is performed to purify one’s karma, quell impending bad luck, or as an act of charity and devotion. Chakrabartendra Malla was not well, and the ritual was performed in hopes of restoring his health. King Pratap Malla had arranged for each of his sons to take turns ruling Kathmandu so they got administrative experience. But Chakrabartendra died just two days after assuming power in 1670 (790 NS). This painting is considered the earliest known example in which the composition is dominated by an architectural landscape: the Taleju Temple. Given the stylistic features such as side-profile facial depictions and the rendering of human forms, it is believed that the Nepali artist was trained by a Rajput master.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250615040624_ddad3bc27a327e3f9926c8473287e4f14b53081296c295049009f327a4d97051.jpg" data-media-id="editor_0" data-image-id="20250615040624_ddad3bc27a327e3f9926c8473287e4f14b53081296c295049009f327a4d97051" data-rendition-name="original" width="3248" height="4395" loading="lazy" alt="Tuladaan NT"> </figure>  During that era, there were regular exchanges of artists between Northern India and Kathmandu Valley. The painting is also a melding of Nepali, Tibetan, Mughal, and Rajput art styles of the time. Pratap Malla could have been inspired by a painting of Mughal Emperor Jahangir’s Tuladaan ceremony for his son Khurram in 1607. The Mallas and Mughals shared cordial relations, which is reflected in the cultural influences seen in the art and attire of the period.&nbsp; The clothing of the Malla ruling class, in particular, features colourful tunics, turbans, and jewelry that display strong Rajput and Mughal stylistic elements. The musicians in the upper tier are also dressed in Indian-style clothing, while the ensemble on the lower steps wear local attire, notably without turbans. Their hairstyles also differ, with the lower group wearing their hair tied in a bun at the front. This national treasure is currently in storage at the Collège de France in Paris, and has never been publicly displayed. Nepal’s art scholars like Gautam Vajracharya, Pratap Aditya Pal and Anne Vergati have written about this iconic paubha in the past, but the only detailed study is from the perspective of music history by researcher Richard Widdess who had access to high resolution copies of the original.&nbsp; Widdess from the Department of Music at the School of Oriental and African Studies (SOAS) in London describes the paubha as the most significant and richly detailed documentation of music in Nepali art. He identifies distinct musical ensembles on the terraces of the temple, and remarkably most of them are actively used today. One of them reflects the Mughal naqqārakhāna model — a loud outdoor ensemble typically composed of kettledrums, trumpets, and cymbals, traditionally performed from the gateway of the emperor’s palace to announce his entrances and exits. The depiction of such an ensemble in the tulādāna painting is likely the earliest known representation of a complete naqqārakhāna in Nepal — considered the forerunner of the panche baja, the traditional Nepali ensemble. On the stepped pyramid base of the temple are two groups of musicians playing local instruments: dhimey, bhushya, and dha. They are unmistakably Newar musicians, wearing short skirts and short-sleeved tops, with bare heads and legs—clearly distinguished as local performers.&nbsp; Higher still on the temple pyramid are musicians of apparently higher status, positioned close to the king, and his courtiers, possibly professional court musicians from India, well-versed in rāga and tāla. A dāphā group is also clearly depicted, identifiable by their characteristic instruments.&nbsp; Dāphā bhajan is likely the oldest surviving tradition of Newar devotional singing, and this paubha is the oldest visual record of it. Pratap Malla himself is believed to have composed songs that continue to be performed by dāphā groups throughout Kathmandu till today.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025061211064_d67636730cdc0ec778c02494817aca0b99654f2950d0fae4b95499a61faf7ef3.jpg" data-media-id="editor_1" data-image-id="2025061211064_d67636730cdc0ec778c02494817aca0b99654f2950d0fae4b95499a61faf7ef3" data-rendition-name="original" width="596" height="768" loading="lazy" alt="Priceless paubha in Paris NT"> </figure>  The artist’s thorough attention to musical detail may be attributed to King Pratap Malla’s own deep interest in music. His inscriptions on this painting and elsewhere proclaim his mastery of all branches of knowledge, including music. He is also known as the author of dance dramas and poems, penning his name as Kavindra (king of poets). Some noteworthy elements of new art techniques stand out: for example, the roof of the temple is filled with realistically rendered white doves, pigeons, and crows. This is a rare feature in paubha, where animals and birds are stylised, mythological forms. This remarkably talented unknown artist has managed to also render an orthographic projection: the front and side view of Nepal’s first architectural paubha. The Taleju Temple, with its staggering multi-tiered structure and numerous steps and platforms, is masterfully translated into layers within the painting. This represents a significant artistic achievement of the time, especially considering that dimensional perspectives had not started in deity-based paubha.&nbsp; The artist has also made a meticulous effort to capture architectural details such as the toran (ornamental arch) and temple struts with impressive precision. There are flickering lamps along the steps and some people carrying what appear to be oil pots.&nbsp; It is a full moon night and the dark sky is adorned with all the gods and goddesses, who are depicted as blessing the ceremony while seated on stylised thangka clouds. There is a lot happening in this painting, with people engaged in various activities. The artist has also rendered a forest backdrop behind the temple, complete with deer, trees, and flowers. Could there have once been a royal garden behind the Taleju Temple?&nbsp; More details and clarity can only be achieved if we are able to view the original or a high-resolution scanned version of the artwork. Many countries proudly display art depicting historical events in their national museums with great reverence. France, for example, has The Coronation of Emperor Napoleon and Empress Joséphine by Jacques-Louis David (1808–1822), along with numerous paintings of the Napoleonic Wars. Many were commissioned by Napoleon himself for future generations to remember.&nbsp; For Nepal, the equivalent is the Tuladaan paubha which is a visual record capturing a historic moment involving one of Kathmandu’s greatest kings, on the very day the event took place. Sadly, we await the day when this masterpiece is displayed, shared in high resolution for detailed study, or more rightfully — repatriated to its homeland, where it truly belongs. &nbsp; Shaguni Singh Sakya is the Director of the Museum of Nepali Arts (MoNA) at Kathmandu Guest House in Thamel. <h2>Gods homeward bound</h2> The Nepal Heritage Recovery Campaign and Nepal’s Department of Archaeology are convening the first international conference on the Recovery of Cultural Heritage from 16-18 June in Patan. The conference will address urgent issues of theft, illicit trafficking, the campaign to repatriate looted cultural artifacts, and explore how the return of sacred antiquities contributes to justice, healing, and reconciliation for communities and nations affected by cultural loss. American art crime professor Erin L Thompson and Saubhagya Pradhananga of the Department of Archaeology will deliver the keynote. Meanwhile, author and Nepali Times publisher Kunda Dixit will lead a conversation on Illicit Trafficking: Public Opinion and Role of Media with Erin Thompson, Amr Al Azm, associate professor of Middle East History and Anthropology at Shawnee State University in Ohio, as well as Bradley J Gordon, a lawyer based in Phnom Penh. There will be sessions looking at repatriation perspectives from Cambodia, India, Vietnam, China and Poland, international frameworks for repatriation, emerging digital technologies in the repatriation of cultural heritage, cultural property agreements, museums as well as trends in the art market, and heritage diplomacy and the role of media.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025061211068_59cfccfa8f5d73bfe8b4c5811a7f53abc09ea04e8cb7c638933d62e5283efdf6.jpg" data-media-id="editor_2" data-image-id="2025061211068_59cfccfa8f5d73bfe8b4c5811a7f53abc09ea04e8cb7c638933d62e5283efdf6" data-rendition-name="original" width="1080" height="1350" loading="lazy" alt="Heritage recovery NT"> </figure>  <h2> </h2> Some of the other highlights include James K. Reap, a professor in the Master of Historic Preservation Program at the University of Georgia who has a session on the US response to illicit trafficking. Art historian Lea Saint-Raymond is taking on “Gods at Auction: The Market for Himalayan Artefacts”, while lecturer of criminology at the University of Glasgow Emiline Smith is delving into transformative approaches to heritage ownership and repatriation. Helena Arose of Antiquities Coalition and Melina Antoniadis of NOSTOS Strategies that specialise on the return home of cultural heritage as well as Hao Liu of International Cultural Heritage Law at the School of Law at Shandong University are some of the others attending. The Nepal Heritage Recovery Campaign was set up in 2020 to develop a coordinated movement to reclaim Nepal’s stolen gods and goddesses, with an aim to ensure that recovered items are returned to their original shrines, niches or sanctums. Ahead of the conference opening organisers have arranged for a film screening of Loot &amp; Return: 4 Documentaries at YalaMaya Kendra in Patan Dhoka between 14-15 June. Following the conference is a multimedia exhibition titled Absent Gods: Nepal’s Lost Heritage from 31 July to 4 August at Patan Museum.

Priceless paubha in Paris

While Nepal was hosting the Sagarmatha Sambaad international climate conference in Kathmandu this month, on Mt Everest it was pretty much business as usual.&nbsp; The signs of climate breakdown are all there: a river now runs through Base Camp in summer, the Khumbu Icefall is more unstable, and there are more &nbsp;frequent avalanches. When expeditions arrived in March, the mountains were bare: it had not snowed since September, but then blizzards dumped unseasonal snow in May. And despite climate worries, such is the pull of Himalayan mountaineering that the Everest Industry showed no signs of slowdown. More than 600 international climbers and their Nepali guides had made it to the summit of the world’s highest mountain. At one point there were an estimated 2,000 people in the tent city on the Khumbu Glacier. All the ropes and ladders on the Icefall came down on Thursday, marking the official end of the spring climbing season, and just in time to avoid a monsoon cyclone approaching from the Bay of Bengal. It has been an action-packed season. One factor could be that Everest fees will go up from September: each foreign climber needs to pay a $15,000 royalty, up from the present $11,000. The cost for a Nepali climber on the South Col route will also go up: from Rs75,000 to Rs150,000.&nbsp; The fee to climb Everest in autumn is $7,500 (up from $5,500), but most climbers still prefer spring. Winter permit fee (December-February) is only $3,750 per person and the mountain is now also open for monsoon (June-August) climbs, when the fee is ever lower at $2,750. The revised rule also makes it mandatory for every two climbers on an 8,000m peak to hire one Nepali mountain guide.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025053004050_67f856fe52714e4bdcf21ae7d45c6f18c82117b9d0a5f73ed1efa04c96de1046.jpg" data-media-id="editor_0" data-image-id="2025053004050_67f856fe52714e4bdcf21ae7d45c6f18c82117b9d0a5f73ed1efa04c96de1046" data-rendition-name="original" width="931" height="732" loading="lazy" alt="The Everest Industry graph 1"> </figure>  In addition, climbers also have to pay for porters and guides, equipment, Base Camp costs, Ice Fall and fixed rope team fees, so climbing Everest does not come cheap. But such is the draw of climbing the world’s highest peak that some say the increased fees will not diminish the crowds next year. The government has tried to spread expeditions out to other seasons and other 8,000ers, but with not much success. Earlier this year, Nepal unilaterally increased the number of 8,000m peaks to 14 by adding six more sub-summits to broaden the choice for climbers. Added were: Yalung Kang (8,505m), Yalung Kang West (8,077m) &nbsp;Kangchenjunga Central (8,473m), Kangchenjunga South (8,476m), Lhotse Middle (8,410m) and Lhotse Shar (8,400m).&nbsp; The announcement could go against the accepted topographic criteria that a stand alone peak has to be at least 300m higher than an adjoining prominence, and at more than 3km isolation from it. The UIAA (Union Internationale des Associations d'Alpinisme) still recognises only 14 mountains as eight-thousanders, and only eight of those are in Nepal, or on the border with China. Nepal’s revised mountaineering regulations also increased the insurance coverage of high-altitude workers to protect porters and high altitude guides who usually take more risks on the mountains. Rescue teams and clean-up campaigners to collect trash and remove bodies of dead climbers up to Camp IV of Mt Everest do not need permits.&nbsp; The Sagarmatha Pollution Control Committee is now using drones to fly down trash in 20kg sacks. Each climber is also required to bring down at least 6kg of waste and not just their own, but this rule is erratically enforced. With five fatalities on Everest and Lhotse, Spring 2025 had a historically low death toll. Another five climbers died on Annapurna, Kangchenjunga and Makalu.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025053004050_38681de22f0fefb6faa12b01755566d09c5064d0ff84e12ccc7b5d68ea9ba38a.jpg" data-media-id="editor_1" data-image-id="2025053004050_38681de22f0fefb6faa12b01755566d09c5064d0ff84e12ccc7b5d68ea9ba38a" data-rendition-name="original" width="665" height="740" loading="lazy" alt="The Everest industry graph 2"> </figure>  Journalist Ben Ayers who ran the Everest Live social media channel from Everest Base Camp with daily updates credited the low death rate to dramatic rescues of climbers from the ‘Death Zone’ by their Nepali guides and longline helievacs — the visuals all uploaded on YouTube.&nbsp; “Ironically, this perception of safety is bringing more and more inexperienced climbers to the mountain, and they need more rescues,” Ayers said in one of his dispatches.&nbsp; American expedition chronicler and summiteer Alan Arnette suspects there is a lot of under-reporting given that the jet stream and storms were lashing Everest even till late in the season. He told us: “I heard a lot about frostbite and rescues that were not made public. It’s become practically impossible to cover the details on Everest. All the teams report nice news, and they don’t talk about bad stuff to avoid hurting businesses.” Although trash on Nepal’s mountains makes headlines, what does not receive as much attention is the climate impact of so many expeditions. The Sagarmatha Sambaad conference sidestepped this issue, which is ironic given that the impact of climate breakdown is most evident on Himalayan peaks and their glaciers.&nbsp; <h2>Need for Speed</h2> The big stories this year have been about speed-running from their home cities to the top of Everest. Ukrainian entrepreneur Andrew Ushakov flew out of JFK on 15 May at 10:15AM Nepal time, and was on the summit 3 days, 23 hours, and 7 minutes later on 19 May at 9:22AM.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250601080640_1c5cc6fc991307861768f07037ed9d30930fb20f35dbb57dc31c9a92a9e1a885.jpg" data-media-id="editor_2" data-image-id="20250601080640_1c5cc6fc991307861768f07037ed9d30930fb20f35dbb57dc31c9a92a9e1a885" data-rendition-name="original" width="1440" height="1800" loading="lazy" alt="The Everest Industry"> <figcaption>Andrew Ushakov at the summt. Photo: ELITE EXPED</figcaption> </figure>  “I could never find the time for the traditional 40-50 days of acclimatisation,” Ushakov explained matter-of-factly. His ‘Everest Sea-to-Summit’ climb was possible because he spent 400 hours in hypoxic sleep tents over the past four years in New York. However, Ushakov did use ropes already fixed, hired four Nepali guides, helicoptered to Base Camp, and used much more oxygen than an average climber. And after the climb, Ushakov was arrested at Kathmandu airport for being in possession of $20,000 of undeclared cash and spent a night in jail and fined $60,000.&nbsp; The other speedsters were Garth Miller, Alastair Cairns, Anthony Stazicker, and Kev Godlington, all former British Army commandos. They left London and summited five days later on 21 May, and flew right back. They also used hypoxic tents to simulate the thin air high on Everest.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250601080644_90c8dd5cc07b4b43f2989b1dc0c0650ab80f10ebb06680c25a6909c519957bd8.jpg" data-media-id="editor_3" data-image-id="20250601080644_90c8dd5cc07b4b43f2989b1dc0c0650ab80f10ebb06680c25a6909c519957bd8" data-rendition-name="original" width="810" height="668" loading="lazy" alt="The Everest Industry "> <figcaption>All four members of the Furtenbach team at the summit. Photo: Sandro Gromen-Hayes</figcaption> </figure>  But more controversial was their use of xenon gas therapy in a German hospital to ramp up the production of oxygen-carrying haemoglobins in their blood. Xenon is banned by the World Anti-Doping Agency for being performance enhancing in sports. Expedition leader Lukas Furtenbach said this rule does not apply to mountaineering, as it is not a regulated sport like swimming. Nepal has no rules about xenon, but the Department of Tourism said it was launching an ‘investigation’ to decide on future policy since it is difficult to ban xenon, but allow oxygen. The controversy has also divided the mountaineering community, with some climbers saying they just want to maximise their chances of survival. Spending less time on the mountain could make climbing safer by reducing avalanche risk. It would also mean less trash on the mountains, but it would reduce the income of Nepal’s expedition industry. It is also unclear how much of the success was due to xenon therapy and whether the ex-special forces were already in good physical shape.&nbsp; The need for speed hides the fact that climbing in the Himalaya is dangerous business, and climbers cannot sprint to the top just by huffing xenon. But ultra-fast climbs could be charged more, and the revenue generated can be used to establish state-of-the-art rescue operations, and increase pay and insurance for guides. Two other speed chasers this season were Swiss-Ecuadorian Karl Egloff and American Tyler Andrews, both on Everest without oxygen. Andrews choppered to Base Camp to catch a weather window, but turned back from 8,500m due to high winds. Heavy snow and wind also forced Egloff to descend from 7,000m. Slow and steady climbers like Anja Blacha from Germany did make it to the summit without oxygen, while Kami Rita Sherpa broke his own record with his 31st Everest summit as he led a 26-strong Indian Army group. There were 468 permits issued for foreign climbers from 48 expeditions to Everest this spring. Nepal’s other eight-thousanders together had only 17 expeditions. Nepal has more than 1,000 peaks above 6,000m, and has opened only 476 of them for climbing.&nbsp;