<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110161148/636d1db19c7e80680e0af3d0jpeg.jpg" alt="" width="767" height="575"/><figcaption>Security personnel and relatives of the deceased attend a mourning at the premise of infectious disease hospital in Pokhara. Photos: BARSHA KAFLE</figcaption></figure>A 79-year-old woman lay on the emergency bed, diagnosed with pneumonia due to Covid-19. Even as she was gasping for breath she had a smile on her face, handing over an invitation card to the attending doctor who was also her relative.Her grandson’s wedding was four days later. Family members from across the world had flown into Pokhara for the ceremony. She died of severe acute respiratory distress syndrome with multiple organ failure a day before the wedding, and it had to be cancelled.As her physician, I had sleepless nights when her condition worsened. We <a href="https://www.nepalitimes.com/here-now/nepal-health-workers-battle-covid-19-but-also-stigma/" target="_blank" rel="noopener noreferrer">health-care workers are also human beings</a>. When we lose near and dear ones it takes a toll on our physical and mental health, we grieve when our patients die. We may hide our emotions but we suffer all the same.The woman was just one of many relatives I have lost during this pandemic. As I grieved with family members gathered at the hospital, we were once again reminded of the Buddhist teachings about impermanence. Yet none of us is ever ready.“But it must be easier for you to face death as a doctor,” one of the mourners said to me. No, it is just as difficult. If not more, because as a physician I had the added responsibility of saving her life.Army men dressed in PPE from head to toe had arrived to take her body for safe disposal. Relatives from across the world who had come to celebrate a wedding ended up attending a funeral.The Gandaki Province government established Nepal’s first provincial infectious disease hospital in July 2020. Since then, it has managed nearly 1,300 Covid-19 cases at a cost of Rs500 million.Tha Gandaki Province government established Nepal's first provincial infectious disease hospital in July 2020. Since then, it has managed nearly 1, 300 Covid-19 cases saving Rs500 million out of pocket expenditure of common people.We have lost 52 people to the coronavirus in the same period. The Covid-19 mortality rate in this provincial hospital is 4.1%, relatively high compared to the total number of people who were hospitalised.The global death rate now stands at 1.97% with a total of 5,318,277 fatalities. This figure is exceptionally high given it has only been two years. Even then, this figure does not include <a href="https://www.nepalitimes.com/banner/the-real-cost-of-nepals-second-wave/" target="_blank" rel="noopener noreferrer">the social, mental and economic consequences</a> to family and friends of the deceased.But each Covid death is also a lesson for us to learn from. Most of these deaths could have been prevented if only Nepal had a robust primary health care system, and if preventive measures were more strictly enforced.With the <a href="https://www.nepalitimes.com/here-now/omicron-may-not-be-as-risky-but-take-care/" target="_blank" rel="noopener noreferrer">rise of new variants like Omicron</a>, it is also advisable to up our vaccination drive and we should also start administering boosters to vulnerable populations given our stock of doses and those that are on the pipeline.A man in his late thirties was isolating at home in Pokhara after getting infected. He just had a common cold but I requested him to undergo hospital-based isolation as he was symptomatic. But just a few days after getting admitted, his symptoms worsened and his condition deteriorated. He was then transferred to another hospital, and died soon after.This was not a case that should have been fatal. Even after 12 years of clinical experience, some of the Covid-19 outcomes I have encountered in the past year have been unexpected and shocking. It must have been devastating for the young man’s family and friends.Earier this year, when a 86-year-old mukhiya from Mustang died at our hospital of Covid complications, hundreds of Thakalis travelled to Pokhara to show their respect to the deceased despite the coronavirus surge at the time. Young or old, the virus was indiscriminate.In November 2020, I myself had to self-isolate with an upper respiratory infection due to a coronavirus infection. I thought I would not survive the excruciating body ache, sleepless nights and high anxiety level. During those horrific 10 days at <a href="https://www.nepalitimes.com/here-now/at-the-covid-19-frontlines-in-rural-nepal/" target="_blank" rel="noopener noreferrer">Bayalpata Hospital in Achham</a> I was battling an infection that I was treating my patients for.An elderly couple had been admitted to our hospital with Covid, both of them had severe symptoms. The husband died within a few hours of admission, but his wife was not aware of his passing until she became critically ill herself, and the family decided to tell her the truth. She passed away a week after her spouse. Medical staff usually have seen it all, but so moved with sorrow they mourned too.Holistic <a href="https://www.nepalitimes.com/banner/this-is-how-to-upgrade-nepals-rural-health/" target="_blank" rel="noopener noreferrer">health care</a> is the central core of modern medicine. But the caregivers can provide only acute biomedical care to alleviate the suffering of Covid patients. Their psycho-social wellbeing and that of their family members are often ignored. And we have not even begun to think about the mental health and trauma of the frontline workers.Over 800,000 Nepalis have been infected with the coronavirus and 12,852 have died of the disease. It is time we study this data, in particular the common causes of Covid-19 deaths in Nepal. Is it heart attack, blockage of vessels in the lungs, multiple organ failure or acute respiratory distress syndrome?We must reshape our health policies based on these facts and evidence. We must ensure adequate preparation with ICU beds, oxygen supply, <a href="https://www.nepalitimes.com/latest/donated-ventilators-gather-dust-in-nepal/" target="_blank" rel="noopener noreferrer">ventilators</a> and other equipment that were in short supply earlier this year.Only then can we design a robust and customised care system to protect our population from future surges.Bikash Gauchan is the Executive Director of the Infectious and Communicable Disease Hospital in Gandaki Province.

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Diary of a Covid frontline worker in Nepal

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109101136/636b74e99c7e80680e0623bcjpeg.jpg" alt="" width="3600" height="2400"/><figcaption>Nepali students on their way to the quarantine centre in Bhaktapur after landing in Kathmandu Airport on Sunday morning. Photo: RSS</figcaption></figure>The global public health crisis caused by <a href="https://www.nepalitimes.com/banner/why-nepal-must-watch-about-coronavirus-but-not-panic/">the 2019 novel coronavirus </a>has  hospitalised tens of thousands and killed hundreds of people, wrecked tourism in the Asia-Pacific region, impacted civil aviation and slowed down the world economy.An <a href="https://www.theguardian.com/global-development/2020/feb/07/coronavirus-chinese-rage-death-whistleblower-doctor-li-wenliang">attempt by the Chinese authorities to suppress</a> first reports from Wuhan is blamed for the initial rise in case load, and its dissemination across China and the world. But it is also China’s willingness to quarantine a whole province that is stopping its spread.The epidemic has also exposed the challenges to containment in <a href="v">the age of social media</a>. Rumours and conspiracy theories resulting in stigmatisation and xenophobia have become the norm in a global village interconnected instantaneously by internet-based apps.The media’s habit of magnifying the negative is now exacerbated by the split-second reach of individual posts, click-baits, fake news, and the chain-reaction through shares and likes over web platforms.Till Wednesday, 2,012 people had died from <a href="https://www.nepalitimes.com/latest/a-nepali-in-beijing-during-coronavirus-scare/">the Wuhan virus</a>, and 75,227 are hospitalised. These statistics are constantly updated in the media, with countries where it has spread shaded ominously on a world map – giving the impression that it has spread globally.Yet there are very few mentions anywhere that nearly 15,000 infected people have made full recovery, or that the fatality rate for the virus is a low 2%. Even though no one has yet died in the United States from this virus strain, there is saturation coverage in the media that likens the epidemic to the one in the Hollywood thriller Contagion. Few compare Covid-19 to the common flu that killed nearly 35,000 people in the United States last winter.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109101136/636b74eb9c7e80680e0623bdjpeg.jpg" alt="" width="1800" height="1291"><figcaption> </figcaption></figure>The psychology of terror, irrationality of panic, and fear of diseases without cure are not new. What is new this time is mobile communication which allows panic about the virus to go viral.In Nepal, too, the media was obsessed with the plight of 182 students trapped in Hubei province. The issue was politicised by those opposed to Prime Minister Oli’s government – both within his NCP and without. Media gave prominence to tearful parents, highlighted a letter to the prime minister about his callousness and disregard. Under pressure already for non-performance, the government found <a href="https://www.nepalitimes.com/latest/nepalis-from-hubei-quarantined-in-bhaktapur/">the evacuation of the students to a quarantine camp</a> in Bhaktapur a convenient way to show-case action.If only the government reacted with similar efficiency to other, much more serious, national emergencies like Nepal’s unacceptably high maternal mortality rate. Although there has been a steep drop in the number of women who die in childbirth from 900 per 100,000 in 1990 to 239 today, Nepal has <a href="https://www.nepalitimes.com/banner/federalism-leaves-nepals-medical-sector-ailing/">missed the target</a> of reducing that number to 125 this year. It does not look like we will hit the SDG goal of 75 by 2030, either.<a href="https://www.nepalitimes.com/here-now/who-will-save-nepals-poor-new-mothers/">More than 1,200 women die</a> in child birth every year in Nepal, that is three every day. Most of these are easily preventable either by ensuring proper nutrition, enforcing the ban on <a href="https://www.nepalitimes.com/banner/child-marriage-in-nepal-eloped-at-13-mother-by-17/">child marriage</a>, ensuring access to ultrasound machines to detect complications in time, and encouraging institutional delivery.As Buddha Basnyat of the Patan Academy of Health Sciences (PAHS) comments, it is only political will that is stopping Nepal from adopting the game-changer drug Tranexamic acid (TXA) in the treatment of post-partum haemorrhage, (PPH) the most common cause of maternal death. There is a huge 44% <a href="https://www.nepalitimes.com/here-now/nepal-far-from-hitting-contraceptive-target/">unmet need for contraceptives</a>, which is leading to unwanted pregnancies and preventing a further drop in Nepal’s total fertility rate.<a href="https://www.nepalitimes.com/banner/tb/">Tuberculosis</a> kills 6,000 people in Nepal every year, and every other Nepali is a carrier of the bacillus, which means half the population should actually be quarantined. Yet the health system is supremely unconcerned, and the public is not aware of the risk.There were 2,736 fatalities in <a href="https://www.nepalitimes.com/banner/nepals-deadly-roads-take-their-toll/">road traffic accidents</a> in Nepal last year. Yet, even though the coronavirus has not killed anyone and there has been only one suspected case, Nepalis are hoarding supplies of masks and hand sanitisers. Meanwhile, vehicles continued to be driven recklessly over precarious roads. Where is the outrage?<a href="https://www.nepalitimes.com/here-now/air-pollution-is-more-dangerous-than-smoking/">Air pollution</a> in Kathmandu Valley, Chitwan and the Tarai is so bad that it is making many people die prematurely, reducing our lifespans by 3.5 years. Where is the peoples’ anger at having their lives cut short? It is ironic that residents of Kharipati are more worried about Nepali students from Wuhan being quarantined in their neighbourhood, than about the toxic fumes emitted by dozens of brick kilns nearby.To be sure, we cannot afford to be complacent when it comes to new epidemics like <a href="v">Covid-19</a>. However, it is the neglect of easily preventable diseases that kills more people in Nepal -- most often poor people in rural communities. We need a robust health system that prioritises primary health care, trains medical professionals, and builds a well-equipped infrastructure to handle future epidemics.But that does not make it into the news.Sonia Awale

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When panic goes viral

https://www.youtube.com/watch?v=FQ0-JH097iA&amp;feature=youtu.beDeukali Shahi, 26, looks relieved after delivering a healthy baby girl, but her calmness belies her traumatic childbirth. Her eyes fill with tears as she speaks haltingly of the previous baby she lost and the desperation she felt this time to reach the hospital fast enough so this one would live.Soon, Shahi is overcome with grief and cannot say more. Her sister-in-law Tulaja fills in the rest of the story. The baby was in breech position, but the family did not know this until Deukali was already in labour. They took her to a nearby healthpost, where the nurse said there was nothing they could do. They went on to the district hospital in Mangalsen, which did not have a surgeon to perform a caesarean.“We drove another four hours and arrived here at two in the night, and the doctors operated on her,” Tulaja said. “Now we have a healthy baby girl.”Deukali lost her first child due to the same complication, but the family did not know why the baby would not come out. In these remote mountains of Achham, home delivery is the norm and the district has one of the highest maternal mortality rates in Nepal.Read also: <a href="https://www.nepalitimes.com/banner/state-of-the-art-rural-hospital/" target="_blank" rel="noopener">State of the art rural hospital</a>, Marty Logan<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110814114/636a54559c7e80680e0523a4jpeg.jpg" alt="" width="2000" height="1333"/><figcaption>Photos: MONIKA DEUPALA</figcaption></figure>All that is changing with Bayalpata Hospital, which serves as the informal referral hospital for <a href="http://archive.nepalitimes.com/news.php?id=17650#.XWY3DeMzbIV" target="_blank" rel="noopener">Achham </a>and six surrounding districts. The government hospital is managed by the non-profit Possible Health (formerly <a href="http://archive.nepalitimes.com/news.php?id=17650#.XWY-WeMzaUk" target="_blank" rel="noopener">Nyaya Health</a>) as a private-public-partnership, and now serves 100,000 patients per year.Bayalpata’s safe <a href="https://archive.nepalitimes.com/regular-columns/Comment/mothers-in-Nepal-still-dying-at-childbirth,1007" target="_blank" rel="noopener">motherhood</a> program is accessible at any hour of the day. In the severely understaffed Far West region, Possible is practising an experimental model of healthcare that has become a lifeline for thousands of people in nearby districts. Province 7, which includes Achham, has 13 public hospitals, 16 primary health care centres and 376 health posts, but most of these are under-equipped, under-staffed and under-funded. Aside from government neglect, geography is a further <a href="https://www.nepalitimes.com/here-now/environmental-destruction-is-a-medical-emergency/" target="_blank" rel="noopener">challenge in these mountains</a>. Patients like Deukali have to walk or travel for days to reach a proper hospital like Bayalpata.<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110814114/636a54589c7e80680e0523a5jpeg.jpg" alt="" width="2000" height="855">The World Health Organiaation recommends a doctor-patient ratio of 1:1,000, and while it is 1:850 in Kathmandu Valley, the rate is 1:150,000 in rural areas. A recent report by the Nepal Government shows that 20% of staff positions in the healthcare system are not filled.When Nyaya Health took up an abandoned government hospital in Bayalpata 10 years ago, there were no doctors for the people living in the area. The unmet need was so great that the newly-opened hospital could not cope with demand, and soon expanded its facilities. (See box below)“Nepal’s per capita income is very low, and more than 70% of Nepalis <a href="https://archive.nepalitimes.com/article/nation/national-health-insurance-not-as-easy,4028" target="_blank" rel="noopener">cannot afford private healthcare</a>. So a model like this, which makes healthcare free and accessible, is very necessary in Nepal today,” says Bikash Gauchan, medical director of Bayalpata Hospital.With grants from the government and donations from philanthropic individuals and organisations, the hospital provides free medical care to up to 500 patients a day, covering a catchment of 230,000 people in Achham’s neighbouring districts.“The perception in Nepal is that a PPP model is meant to bring in investment for large-scale infrastructure projects like <a href="https://www.nepalitimes.com/opinion/climate-risk-to-hydropower-investment/" target="_blank" rel="noopener">hydropower</a>. When we proposed a model where hospitals would utilise the government funding they deserve, it went against the grain and people found it hard to understand,” says SP Kalaunee, executive director of Nyaya Health Nepal. “But we want to get the best of both worlds: use government funding and resources, but enhance them with our knowledge, skills and management expertise.”Among many things that make Bayalpata different from the average government hospital is its Integrated Healthcare System, <a href="https://archive.nepalitimes.com/article/nation/long-distance-medicine-in-nepal,3521" target="_blank" rel="noopener">digitising patient records</a>. The software is unique in Nepal and allows the facility to track the health of patients including pregnant women, children under two and those with chronic diseases. Community health workers reach out to these patients door-to-door instead of waiting for them to get so sick that they have to travel to hospital.“Each of us meets patients in our village once in 1-3 months, as per the need,” says community health worker Dwarika Rawal. “I meet women of <a href="https://www.nepalitimes.com/banner/implant-service-providers-take-contraception-to-nepals-poor/" target="_blank" rel="noopener">reproductive age and talk to them about family planning</a>, tell them about the different methods available. I also check the weight and health of children below 5, and counsel their parents about child health and hygiene.”<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110814114/636a545c9c7e80680e0523a6jpeg.jpg" alt="" width="3000" height="2000">Rawal also follows up with patients living with chronic diseases such as <a href="https://archive.nepalitimes.com/article/nation/diabetes-in-south-asia,3018" target="_blank" rel="noopener">diabetes</a>, <a href="https://archive.nepalitimes.com/article/nation/ending-AIDS-in-Nepal,2707" target="_blank" rel="noopener">HIV</a>, <a href="https://www.nepalitimes.com/banner/nepal-tb-cases-grossly-underestimated/" target="_blank" rel="noopener">TB</a>, high blood pressure and <a href="https://archive.nepalitimes.com/article/nation/stigma-and-silence-mental-health-nepal,3486" target="_blank" rel="noopener">mental disorders</a>, including to see if they are taking their medicines.In the past decade, health indicators in this region have shown a marked improvement because of Bayalpata Hospital, even surpassing targets in Nepal’s National Health Strategy (NHSS) for 2020 and the UN’s Sustainable Development Goals (SDGs) 2030. In the Sanfebagar area, institutional deliveries have gone up to 96%, compared to the NHSS target of 70% and the SDGs’ 90%. Neonatal mortality has fallen to 6 per 1,000 live births, a third of the NHSS target (18), and half of the SDGs target (12).Eventually, Possible hopes to not just improve service to its patients, but push through its Integrated Healthcare System, which would make local governments more responsible for providing overall healthcare rather than just operating a particular medical facility.“What makes our model successful is more accountability, and that is what is needed in our public healthcare system. We do not necessarily need more health facilities, we need to make them functional: make sure that the staff are always available, the medicines are stocked and the equipment functions as it is supposed to,” says Kalaunee. “Public healthcare needs to incorporate the use of technology and outreach to become comprehensive.”<h2>Building a rural hospital from scratch</h2><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110814114/636a545f9c7e80680e0523a7jpeg.jpg" alt="" width="3456" height="2592">When a group of Nepali and American public health students set up Nyaya Health and took over an abandoned district hospital in remote Achham district in 2009, there was not a single doctor for over 250,000 people.Ravaged by government neglect and endemic<a href="https://www.nepalitimes.com/banner/nepal-tests-and-treats-tb-with-a-flying-pharmacy/" target="_blank" rel="noopener"> TB</a> and <a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/stigma-ostracisation-for-HIV-patients-remain-in-western-nepal,1724" target="_blank" rel="noopener">HIV/AIDS</a>, the region had some of the worst child and maternal mortality rates in Nepal, and the shortest lifespan. Subsistence farmers moved to India to work most of the year so they could support families back home.Soon, <a href="https://archive.nepalitimes.com/regular-columns/GUEST-COLUMN/upgrading-health-care-through-public-private-partnership-model,582" target="_blank" rel="noopener">Bayalpata</a> was treating 12,000 people a year out of two rooms, and today it sees 100,000 patients from Achham and six surrounding districts. Renamed Possible, the organisation needed to expand to cater to the huge unmet healthcare demand of Far West Nepal.Paid for mostly by crowd-funding the $4 million three-phase expansion of Bayalpata Hospital is now complete. Coming round the bend on the highway from Surkhet, the modern facility with its <a href="https://www.nepalitimes.com/banner/starting-nepals-green-school-movement/" target="_blank" rel="noopener">state-of-the-art architecture</a> seems like a mirage in the middle of nowhere.Today, Bayalpata Regional Hospital is not just unique for its successful model of a private-public-partnership for rural medical care, but also for its distinctive design using rammed earth technology.An obsolete government facility is now one of the most modern and eco-friendly hospitals in Nepal, providing accessible and affordable health care to the most underserved part of the country.“Our specs were to use local materials as much as possible, keep energy costs low, and respect the local context,” explains Arun Rimal, a Nepali architect with the US-based Office of Structural Design (OSD). “The rammed earth uses local clay and sand from the river. The thick walls give thermal mass for insulation, and the skylights optimise sunlight and ventilation.”<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110814114/636a54639c7e80680e0523a8jpeg.jpg" alt="" width="2550" height="3300">The reliance on local material turned out to be a huge advantage because the project faced unforeseen logistical problems due to the 2015 earthquake and Blockade. However, the four-year construction was delayed by just six months because it did not rely too much on bricks, steel and other imported material.The facility has a <a href="http://archive.nepalitimes.com/news.php?id=5877#.XWZGkOMzaUk" target="_blank" rel="noopener">rainwater harvesting system</a>, treats its wastewater and has a network of greywater-irrigated terraces and bioswales to control erosion and recharge the acquifer. A 100kw solar array on the roof meets most of the hospital’s electricity needs, even powering the facility’s only air conditioning unit in the surgical ward.<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110814114/636a54679c7e80680e0523a9jpeg.jpg" alt="" width="4416" height="3312">“It was a deliberate design decision to work with the natural environment as much as possible and also to address the cultural context,” says Tyler Survant from Sharon Davis Design in New York, which also conceptualised the unique Women's Opportunity Centre in Rwanda. “We had to plan for a different kind of hospital from the West: here you have patients and relatives who have travelled for days on foot to get here.”Bayalpata has public outdoor spaces and canopied courtyards to serve as comfortable waiting areas, while the operating theatres and wards are recessed. Unlike in the US, staff housing also had to be integrated into the facility since it has fulltime resident doctors, who live with their families.Bayalpata has been shortlisted for the World Architecture Festival 2019, and besides providing vital medical care for much of the Far West, it is sure to become a landmark for sustainability in Nepal’s architectural landscape.

This is how to upgrade Nepal's rural health

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221107171136/636934889c7e80680e03dfffjpeg.jpg" alt="" width="1400" height="700"/><figcaption>Photo: UNICEF</figcaption></figure>Polio eradication is one of the most ambitious public health initiatives undertaken in human history. Launched in 1988 by the World Health Organization (WHO) the campaign aimed to rid the world of the virus by 2000. But 30 years on and $15 billion later, even though polio cases worldwide have been reduced by 99%, there are still isolated pockets of the disease. And unless every last case is removed, there will always a chance that the infection will come back.Encouraged by the eradication of small pox, WHO launched the campaign in 1988. The organisation debated the wisdom of spending so much time and money to exterminate a disease when there were many other more pressing health concerns like <a href="http://malaria https://www.nepalitimes.com/here-now/the-mosquito-that-changed-nepals-history/" target="_blank" rel="noopener">malaria</a>, <a href="https://www.nepalitimes.com/banner/tb/ or diarrhoea" target="_blank" rel="noopener">TB</a> or diarrhoea that kill many more people.https://www.youtube.com/watch?v=KQd_-6W_9Gg&amp;feature=youtu.beThomas Abraham, a journalist who taught health reporting at the University of Hong Kong, has tried to answer this and other questions in his new book <a href="https://www.amazon.co.uk/Polio-Odyssey-Eradication-Thomas-Abraham/dp/1849049564" target="_blank" rel="noopener">Polio: The Odyssey of Eradication</a>. He says polio was held hostage by geopolitics, and traces the reason why countries opted for a weak vaccine against a strong virus. The author concludes that future global campaigns that zero in on just one disease must be weighed against the necessity of upgrading public health, especially in poorer countries.In Nepal, indigenous <a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/Bouncing-back-higher-wheelchair-basketball,3802" target="_blank" rel="noopener">polio</a> was eliminated in 2000 after the country responded to WHO’s eradication goal by adding polio to its successful campaign of vaccination against other diseases. However, there were still polio cases in Nepal brought over the border from India. The last case of polio was detected in Rautahat district in 2010, and <a href="http://archive.nepalitimes.com/blogs/thebrief/2014/03/28/polio-free-nepal/" target="_blank" rel="noopener">Nepal was finally declared polio free</a> four years later.In response to a query from Nepali Times this week, however, Abraham said Nepal is not out of the woods yet. “If polio re-emerges in India, particularly UP and Bihar, this would be a major challenge to Nepal,” he said. “Also, if levels of routine childhood immunisation fall in Nepal there is a danger of outbreaks of vaccine derived polio, as we are seeing in a number of countries.”Even though polio has been largely removed, there are still cases in Pakistan, Afghanistan and Nigeria where vaccination campaigns have been thwarted by religious extremists. Ironically, enmity between India and Pakistan and the heavily guarded border between the two countries has minimised the risk of polio spreading via India to Nepal.Polio derived from oral vaccines has emerged as a new threat to the eradication campaign. By 2016, WHO deployed a combination of Inactivated Polio Virus (Salk vaccine) and bivalent oral vaccine to prevent further outbreaks.“Routine immunisation levels need to remain high in order to maintain Nepal’s polio-free status. Luckily, we have a strong disease surveillance system to detect any new polio cases,” said Jhalak Sharma Gautam of the Department of Health Services.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221107171136/6369348b9c7e80680e03e000jpeg.jpg" alt="" width="640" height="869"><figcaption> </figcaption></figure><a style="background-color: #ffffff; font-size: 15px; letter-spacing: 0.01em;" href="http://archive.nepalitimes.com/news.php?id=16116#.W_aWJTgzaUk" target="_blank" rel="noopener">Polio</a> is one of the oldest diseases to afflict humans, but it wasn’t until the beginning of 20thcentury that there were outbreaks in Europe, North America and Australia. US President Franklin D Roosevelt was paralysed by poliomyelitis, and because of this the US threw considerable political influence and funds to back polio vaccine research.The first was the Salk vaccine that used inactivated poliovirus, and protected individuals injected with right dose, but it did not stop the transfer of the disease. The Sabin vaccine in 1961 employed a weakened poliovirus to be administered orally. It was cheaper and easier to use and protected individuals from paralysis as well as stopped polio transmission, which eventually led to it being chosen as a tool of eradication.Despite its success, the Global Polio Eradication campaign has been criticised for its huge cost and for widening the gap between local health needs and global health programs. In his book, Abraham puts his experience as a foreign correspondent to good use by visiting the frontlines of the battle against polio in Pakistan, India and Nigeria. He writes about the <a href="https://www.nytimes.com/2018/01/22/health/polio-pakistan-killing.html" target="_blank" rel="noopener">assassinations of polio vaccinators in Pakistan</a> and Afghanistan by the Taliban.<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221107171136/6369348e9c7e80680e03e001jpeg.jpg" alt="" width="1250" height="441">A considerable portion of the book deals with a long-standing debate about whether targeting a single disease for eradication should take precedence over strengthening national health systems. This resonates with WHO’s own reluctance to endorse polio eradication for a long time in favour of a strong primary health care system.This book is a recommended read for public health professionals, but it has lessons for anyone who wants to better understand the inner workings of health systems, donor agency priorities, and what goes on behind the scenes in Geneva.Abraham is neither an epidemiologist nor a medical practitioner, he is a journalist with over 25 years of experience covering conflict, politics and health. Maybe that is why the book reads more like a thriller with an engaging real-life account of what goes right (and what can go wrong) in the fight against a disease-causing pathogen.Read also:<a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/Bouncing-back-higher-wheelchair-basketball,3802" target="_blank" rel="noopener">Bouncing back</a>, Shreejana Shrestha<a href="http://archive.nepalitimes.com/news.php?id=16116#.W_aWJTgzaUk" target="_blank" rel="noopener">Laxmi dreams of flying</a>, Rupa Joshi

Polio hunt

The daily 10-hour curfew at Tribhuvan International Airport from 8 November that will last five months has affected tourism during Nepal’s peak season, with some hotels and trekking agencies here reporting cancellations into spring next year. The reduced hours at Nepal’s main aviation gateway till 31 March means that a third of all flights have been cut. This has also caused ticket prices to surge by up to eight times of normal fares. For example a Kathmandu-Delhi ticket that used to cost Rs12,000 is now listed at Rs50,000, and even then seats are not available.&nbsp; “Especially if they are here to trek, change in flight dates can cause tourists to miss their connections,” says Jagan Timilsina, who runs a trail running and outdoor education business. &nbsp; Pokhara is feeling the brunt as hotels report last-minute cancellations for November because of flight disorders. Some hoteliers also say although there have been some cancelled trips, most itineraries have been rescheduled.&nbsp; Hari Prasad Sharma Gaire of the local chapter of the Hotel Association of Nepal says the Kathmandu airport closure should have been timed for the off-season. He told us: “Starting construction during the peak tourist season was a mistake and will cause the tourism industry to lose a lot of business. The upgrade could have been spread out over a longer time but closed for fewer hours at night so that disruption was minimal.”&nbsp; Nearly a third of the 1.2 million tourists who visit Nepal annually come to Pokhara, which is also the gateway to Mustang, the Annapurna treks and pilgrimage tourism to Muktinath. Located by scenic lakes with a range of adventure sports like hot air ballooning, paragliding, canyoning, bungee and ziplines, Pokhara is also popular among diaspora Nepalis. “Besides its own attractions, Pokhara is really the hub for central Nepal, and we have been trying to get visitors to extend their stay here,” says Timilsina, who started out as a trekking porter and rose up the ranks to be an expedition guide and entrepreneur. &nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2024111603114_0e071ce63ea9b0a9a7ee76f8c3cea0ff08c6767c41dd09f6bc4413d2db067a60.jpg" data-media-id="editor_0" data-image-id="2024111603114_0e071ce63ea9b0a9a7ee76f8c3cea0ff08c6767c41dd09f6bc4413d2db067a60" data-rendition-name="original" width="3500" height="2333" loading="lazy" alt="Pokhara's tourism woes NT"> <figcaption>Tourist arrivals in Pokhara have slumped since the disruptions at Kathmandu airport due to upgrading work. Photo: KRISHNA MANI BARAL/NEPALI TIMES ARCHIVE</figcaption> </figure>  Even without the Kathmandu airport closure affecting tourist arrivals, Pokhara was already suffering from a decline due to many factors like the poor state of the Prithvi Highway, the shortage of luxury accommodation for high-end tourists, and the reluctance of international airlines to start direct flights to Pokhara despite an expensive new airport that was inaugurated two years ago.&nbsp; “There was a lot of initial excitement on the construction of the international airport,” says Timilsina, “but it hasn’t delivered as expected due to politics. People have invested in nearby businesses, and have faced losses.” India has blocked direct flights from its cities to Pokhara because the facility was built by a Chinese company. Although tourists and pilgrims from India hit record levels this year, the poor state of the highways and the Indian bus accident on the highway to Kathmandu in July that killed 27 pilgrims from Maharashtra state dampened arrival figures. Gaire says, “While tourist arrivals to Pokhara are now approaching pre-Covid levels, we haven’t seen the improvement we were expecting. We need a better marketing strategy. What are our embassies abroad doing?”&nbsp; Indeed, Pokhara used to be a favourite destination for Chinese tourists. There was a boom in arrivals from China before Covid, especially after a popular Chinese tv serial was shot on location here. But arrivals from China have not really recovered since the pandemic because of the economic slowdown there. Promoting Pokhara airport to handle direct flights from Chengdu or Kunming could revive Chinese arrivals.&nbsp; Nepal’s Civil Aviation Authority (CAAN) has used the Kathmandu airport closure as an excuse to arm-twist international airlines to start flying to Bhairawa, which has barely been in operation for two years since it was inaugurated. So far, Fly Dubai, Thai AirAsia, Jazeera and Qatar are flying to Bhairawa, but most use it as a hop before flying on to Kathmandu, which does not reduce congestion at Kathmandu.&nbsp; An ideal situation could have been to get Pokhara to run to full capacity while Kathmandu is partially out of action. Pokhara entrepreneurs are puzzled why the CAAN and the national government have not taken more interest in promoting Pokhara as an alternative to reduce the congestion in Kathmandu. Nepal’s football team that was flying to Dushanbe this week couldn’t get tickets via Delhi, and took a domestic flight to Bhadrapur, crossed over to Bagdogra and flew on to Delhi to catch their flight to Tajikistan.

Pokhara’s tourism woes

An excerpt of a conversation between an anthropologist and linguist Mark Turin, PhD and Lava Deo Awasthi, PhD, the first Chairperson of the Language Commission of Nepal. Nepali Times: What is the role of Nepal’s Language Commission and when was it formed? Lava Deo Awasthi: The Constitution of Nepal (2015) created a Language Commission (LC) with the following four core mandates: (a) to develop eligibility criteria for gaining status as an official language and offer recommendations to the Government of Nepal about the official language(s) in each province; (b) to offer recommendations to the Government about measures to be taken for the conservation, promotion, and development of languages; (c) to suggest possible ways of using mother tongues in education by assessing their stage of development; and, (d) to conduct studies, carry out research and perform monitoring functions about the response to the constitutional provisions for the federalisation of languages in Nepal. The Commission was founded in 2016 and I was appointed as the Chairperson of the Commission in September of the same year by the Cabinet of Ministers. What in your own professional and educational background helped to prepare you for the role? I have worked with the Government of Nepal for about 30 years, alongside holding teaching appointments at universities in Nepal. Prior to assuming the role of the Chairperson of the Commission, I served as permanent Secretary to the Government of Nepal and worked as the Chief Administrator of the Central Development Region. I was appointed as Director General of the Department of Education and completed my assignments as Joint Secretary at the Planning, Monitoring and Educational Administration Divisions of the Ministry of Education.&nbsp; In addition, I have taught courses as a visiting professor at Tribhuvan University and Kathmandu University for more than three decades. Later, I also started supervising MPhil and PhD students at the Far Western University in Mahendranagar, Kanchanpur. My PhD project from the Danish University of Education was dedicated to making sense of Nepal’s social construct and commitment to multilingualism, exploring the persistence of monolingual school practices in the face of constitutional promises and state commitments to multilingualism. I conducted a survey of Nepal’s languages and carried out a qualitative study of the Tharu language in the district of Bardia. I analysed language policy statements and explored classroom pedagogies in schools. I documented how teachers showed a tendency to resist change and maintain the status quo because they were not consulted when new educational language policies were introduced. Teachers also exhibited a deeply-held adherence to the Gurukul education system which appears to have been harnessed as a way to resist newer pedagogical ideologies imported from the West. Recognising how engrained these rich traditions of knowledge transmission are, I wanted to know how students’ engagement in the learning process appeared to have dwindled, creating a gap between children’s home languages and the language(s) of the school. Whilst statutory provisions for education in the mother tongue were oriented towards promotion, classroom pedagogies remained resolutely monolingual and exclusionary. The result was that multilingual education policies that had been introduced in Nepal did not result in meaningful changes in classroom practices. My research was also a reflection of childhood traumas I had experienced at the earliest stage of formal education. My home language, Baitadeli, has a strong oral tradition and no written literature. English is my fifth language in terms of exposure and competence, and my home district of Baitadi is well-known for its loyalty to the local language. I had to drop out of school after completing my sixth grade. Staying at home, I received much attention from my family and had much greater exposure to my native language, culture and environment. My overall impression is that dropping out of school had a surprisingly positive impact on my life. The opportunity offered a surprising dividend for me as I gained mastery in my mother tongue and received extensive exposure to folk literature and Indigenous knowledge and survival skills, cultivating my interest in language, culture, literature and local cosmologies.&nbsp; Now that I reflect on it, I appreciate how language has always played a key role in my life. I grew up in a multilingual environment: brought up with Baitadeli, Hindi, Sanskrit, Nepali and English. Language played a major part in my decision to leave school and my later success is closely linked to my competence in several languages. It was rewarding to be at home with my family as I deepened my understanding of native language and culture, which in turn helped me to harness and refine my art of living. Languages matter so much to me because they are both software and hardware. Later, when I was in secondary school, I realised that my command of my home language contributed significantly to enhancing my Nepali and English. I used my mother tongue as a form of linguistic capital to strengthen my competence in both English and Nepali.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2024111811110_5400ba54792bf9e4854e1c1effde8bf09804e99647f23513700b450cc49adc4a.jpg" data-media-id="editor_0" data-image-id="2024111811110_5400ba54792bf9e4854e1c1effde8bf09804e99647f23513700b450cc49adc4a" data-rendition-name="original" width="1000" height="1500" loading="lazy" alt="Dr Lava Deo Awasthi"> </figure>  In your term as the Commission’s first Chairperson, what were your strategic goals and objectives? My first strategic goal was to create an environment conducive to implementing the provisions of the Constitution of Nepal in relation to language. My priority was to prepare a detailed action plan for my six-year tenure in consultation with language stakeholders, including language experts, professionals, activists, Indigenous community members and representatives of relevant national and local-level institutions. The Commission formed a body of high-level advisors to ensure that the Chairperson’s work was well-informed and credible. The advisors to the committee had highly visible professional and social reputations in Nepal and had much experience in the field of language conservation, promotion, research and development. Another strategy we adopted was to establish close institutional linkages with federal, provincial, and local level governments for collecting opinions and disseminating information widely.&nbsp; What critical issues did you have to consider while discharging your duty? When Nepal’s new Constitution was drafted, a number of concerns could not be adequately addressed. These related to the conservation of languages, the recognition of official languages at the provincial level, and the use of mother tongues at federal, provincial, and local levels. These unresolved issues and matters pertaining to the federalizsation of Nepal’s languages were passed on to the Language Commission to address and resolve.&nbsp; Regarding the recommendations for official languages, a five-year timeline had been set by the Constitution. With great effort, we succeeded in having all provinces agree to recognise their official languages as per the recommendations of the Commission.&nbsp; What were your greatest achievements during your term? One of the greatest achievements was that we succeeded in setting a language agenda at all levels. Nepal’s language communities and other stakeholders expressed the view that this was the first time their languages were recognised and their voices heard by the state. People participated in debates and discussed issues relating to language that in all likelihood had never before happened in their lifetimes, at least not in ways that were supported by the state. We encouraged people to speak in their own language(s) and provided translators during plenary sessions and group discussions. Another major achievement was developing criteria for the status planning of languages at federal, provincial, and local levels, and to recommend 11 province-level official languages, in addition to the Nepali language. Similarly, a notable achievement was recognising Indigenous languages spoken by smaller communities, all of whom faced ongoing marginalisation and high levels of endangerment. The Commission identified 9 new languages that had not been reported in the 2011 census, and provided a framework for recognising official languages within a municipality. The commission emphasised the need for documentation and digitisation of languages for developing corpora and archives at national and sub-national levels.&nbsp; Languages of historical importance as well as classical languages were given recognition for their protection, growth, and development. Recommendations were made for the conservation, promotion and development of Nepal’s marginalised languages that are threatened by majority languages and for those languages that hold particular power at local and global levels. Recommendations were also made for how best to safeguard Nepal’s languages from the ever-growing spread of English and other powerful, globalising languages.&nbsp; A further important aspect of the Commission’s work was to emphasise mother tongue medium instruction in schools across the nation. Recognising the role of language in children’s cognitive, socio-emotional and academic development, the Commission suggested strategies for linking schools with ward-level language clusters for use in the classroom. The importance of nurturing and respecting a child’s first language was reiterated in the Commission’s recommendations for children’s learning and all-round development. By the end of my term, a remarkable change could be observed in terms of building trust within and across Nepal’s diverse language communities. A network of language groups and stakeholders across the country proved to be a powerful way of bringing all language communities under one roof for a collective review of and response to the process of federalising language policy. The many language stakeholders across Nepal appreciated the opportunity to work within a coordinated framework, and—feeling empowered by this—seemed genuinely enthusiastic about the initiatives taken by the Commission.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2024111811114_b45297fdd2fedf17bdb6313e495a1062c0d87f1a19fa5349f871f220b75f93ab.jpg" data-media-id="editor_1" data-image-id="2024111811114_b45297fdd2fedf17bdb6313e495a1062c0d87f1a19fa5349f871f220b75f93ab" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="Dr Lava Deo Awasthi NT"> </figure>  What were the most significant challenges for you as Chairperson? One of the major challenges was winning people’s trust in advocating for the mission of the Language Commission. I faced considerable resistance as I sought to emphasise the use of native languages in families and communities. While the Commission advocated for multilingualism and promoted linguistic diversity, the prevailing policy circles and central level institutions had been deeply influenced by a one-language discourse and ideology of Nepali only. The spread of English also poses a huge threat to Nepal’s languages. However, people in power do not seem to see this as a problem. They tend to abandon their own languages in preference for English. The way that Nepal’s municipalities are increasingly introducing English as a medium of instruction at the earliest stage of a child’s school-based education has proven to be detrimental to their cognitive development, socio-emotional wellbeing and academic success. Most of Nepal’s elites have been heavily influenced by the spread of English and remain unaware about its impact on their home languages as well as on the inter-generational transmission of Indigenous languages in the country. I wish that we could have produced more compelling evidence to show the consequences of making poor policy choices for our children’s education. Demystification calls for a collective response. To make change happen across this entire, complex and federalising country was daunting work and left like a race against time. I feel that I could have done more to offer concrete examples in favour of using the mother tongue as a medium of children’s education at the earliest stages of a child’s education. What do you see the Language Commission achieving in the next 5-10 years? The Language Commission will have to ensure that all of its key recommendations are implemented at all levels of government. In 10 years’ time, all seven of Nepal’s provinces will have their official languages in place. These languages will also be recognised as languages of federal business, alongside Nepali. I anticipate that all official languages in the federal and provincial systems will have a national portal for inter-language corpora using machine translation to fulfil their federal, provincial and local level language functions, and that all languages spoken in Nepal will be represented through a digital database in the national archive. The Office of Statistics will monitor the status of Nepal’s languages over time. By the end of the next decade, each municipality in the country will have recognised one or two official languages at the local level, based on speech populations. Other local languages will have received community-level legal recognition and official status to fulfil their functional roles. Languages that are highly endangered or at risk will be entitled to receive state grants for enhancing local level capabilities to encourage families and young learners to speak the language. Incentive schemes will be introduced in municipalities that promote language within the family and at home. Inter-generational transmission of languages will have received welcome and timely attention across Nepal. It is my hope that all schools—public and private—will have introduced mother tongue medium instruction at the earliest stage of school education, at least up to class five. Nepali, English and other national as well as classical and foreign languages will be taught as subjects. The existing policy of English medium education at the early stage of education will be abolished. The Government of Nepal will be held accountable if the number of speakers of any language decreases or if local communities face language loss and greater endangerment. Under the aegis of the Language Commission, a Centre for Language Research and Innovation will be created with world-class facilities for language documentation and archiving in collaboration with Tribhuvan University’s Central Department of Linguistics and other relevant institutions. Harnessing the vastness of Nepal’s linguistic diversity, the Language Commission will morph into a centre of excellence for national and international communities to engage in collaborative language research, to share experiences and document best practices at in service of global linguistic diversity and Nepal’s many Indigenous languages.

Languages are both software and hardware

Nearly 750,000 Nepalis went abroad for employment in the past year, and more than 100,000 left on student visas. Most of them were young Nepali men and women, and the number has been increasing every year. As with other sections of society, Nepal’s security agencies also face a recruitment crisis. Nepal Police opened recruitment for 64 inspectors in September, and received 2,239 applications, compared to 2,718 candidates last year. Police also invited candidates for 256 assistant sub-inspectors this year for which it received 17,756 applications – down from 19,932 last year. It is the same story in the Nepal Army, the number of applicants for the post of Officer Cadet (Second Lieutenant) went down from 6,144 for 400 open seats in 2019 to 4,390 in 2020. Meanwhile, applicants in the paramilitary Armed Police Force went down from 857 applications for 75 posts in 2021 to 536 applicants for 99 posts last year. While the number of applicants appears higher than the demand, the data shows a significant decrease in applications for vacancies in Nepal’s law enforcement agencies. Security personnel are recruited on the basis of rank and age in Nepal, and the age cutoff for entry into Nepal’s security agencies is typically 25 years. Sociologist and migration expert Ganesh Gurung says that the demographic of young, physically fit Nepalis emigrating abroad in search of better opportunities has impacted recruitment into law enforcement and the military here at home. “The returns from working in Nepal’s police and army are minimal, whereas overseas job opportunities are more attractive,” Gurung says. “The work may be physically demanding abroad, but the pay is a lot higher.”  <figure><img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241116041148_a7e477e0ee2f56acf16c2559fdb24d8f0377f7bc1f9e56138bc40108fc4fa33f.jpg" data-media-id="editor_0" data-image-id="20241116041148_a7e477e0ee2f56acf16c2559fdb24d8f0377f7bc1f9e56138bc40108fc4fa33f" data-rendition-name="original" width="800" height="534" loading="lazy" alt="Nepal Police"><figcaption>Nepal Police</figcaption></figure>  Nepal Police spokesperson DIG Dan Bahadur Karki agrees that the physical and mental demands of a law enforcement job is incomparable to the income that security personnel earn. “A young Nepali who works in Dubai earns enough to build a home in the village within four years, while a Nepali with the same qualifications and physical ability in a security agency here barely makes enough to survive,” says Karki. “Obviously the youth prefer foreign employment.” Security agencies are now worried about the quality of inducted manpower. “There is a difference in work ethic between an applicant chosen from a competitive pool of 50 candidates versus one chosen from a pool of three candidates,” explains Gurung. “Unmotivated employees hamper the overall performance of the state apparatus.” Nepal Army spokesperson Brigadier General Gaurab Kumar KC says recruitment has not been hampered by outmigration: “We have still been getting more than three times the applicants than there are open posts, so we are not yet worried.” Even so, the passing rates of aspirants have gone down for security forces after the Public Service Commission began examinations for military recruitment in 2015. In fact, the Nepal Army complained about the Commission’s involvement in recruitment. Still, the number of vacant military posts tends to exceed the number of passing candidates. Nepal Army’s KC says that the military will not compromise on intake criteria even if there are fewer passing applicants. “Unqualified persons will not be admitted even if there are less-than-required passing candidates. We will re-advertise if that is the case.” But Nepal’s security forces now also have to worry about retention of existing personnel. About 900 Nepal Army, 600 Nepal Police, and 300 Armed police personnel resign every year before the completion of their tenure.  <figure><img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241116041148_b8cd62f70eea3aac7d3d3778615a5b70b1e20550c9bd76321f051f9c766fd2a9.jpg" data-media-id="editor_1" data-image-id="20241116041148_b8cd62f70eea3aac7d3d3778615a5b70b1e20550c9bd76321f051f9c766fd2a9" data-rendition-name="original" width="750" height="378" loading="lazy" alt="Armed police forces"><figcaption>Armed Police Force</figcaption></figure>  In 2020, Home Minister Ram Bahadur Thapa recalled almost 1,000 police personnel who had been deployed for the security of VIPs after long-standing criticism that security forces were being misused to cater to political and bureaucratic leadership. However, security personnel have continued to be assigned to high-ranking officials as glorified housekeepers. In December 2022, Rabi Lamichhane’s Home Ministry had instructed its offices to recall unauthorised security personnel assigned to high-ranking officials, following which 500 officers from Nepal Police and Armed Police Force were withdrawn from their details. But the Nepal Army does not have to follow such rules, and the practice of army personnel serving high-ranking active-duty and retired military personnel remains. Conditions here are dire enough that many active duty officers in Nepal’s military and police forces have chosen to leave their jobs to serve in the Russian Army to fight in the Ukraine war. The hierarchical culture and chain of command of politics, bureaucracy, law enforcement and military has also meant that abuse and mistreatment of subordinates is rife in Nepal’s security forces. “Feudalism is alive and well within our security institutions,” says Gurung. “When soldiers and security forces who swore to protect and serve the nation are made to be at the beck and call of politicians and bureaucrats, it is easy to understand why they are disillusioned with their jobs and why they choose to quit and find jobs abroad.”

Job insecurity in security forces

Earlier this month, Nepal received Rs1.6 billion from the World Bank as part of its <a href="https://nepalitimes.com/news/will-nepal-ever-be-paid-for-saving-trees">Forest Carbon Partnership Facility (FCPF)</a>, rewarding the country for increasing its carbon sink capacity. Nepal is the first in South Asia to benefit from this facility, and it is specifically to recompense the country for increasing forest cover in 13 Tarai districts between 2018-2024. “We are also trying to get another Rs13 billion from the facility while also preparing for free market-based carbon trading in the international market,” says Nabaraj Pudasaini of the REDD (Reducing Emissions from Deforestation and Forest Degradation in Developing Countries) Implementation Centre. Big emitters of greenhouse gases are under pressure to reduce their carbon emissions, and many have signed agreements to do so by investing in decarbonisation projects in developing countries. Countries that emit more than a specified amount of carbon would be able to buy emission rights from countries that emit less. Nepal is internationally known for its community forestry program which has been largely credited for <a href="https://nepalitimes.com/banner/tree-mendous">increasing tree cover to over 45%</a> in less than three decades. But this achievement had not been adequately recognised or rewarded internationally before. Forests, especially in the tropics, absorb and store large amounts of carbon while releasing oxygen in a process known as photosynthesis. <a href="https://www.fao.org/forest-resources-assessment/en/">Preventing deforestation</a> and increasing canopy cover is considered a much more achievable goal than reducing emission in the scale necessary to limit global average temperature to 1.5°C above pre-industrial levels. COP11 in Montreal in 2005 first proposed reducing carbon emissions by improving forest quality by halting degradation. By 2015, a new mechanism of financial assistance was created to help less developed countries with sustainable management of forests <a href="https://www.un-redd.org/">(called REDD+)</a>. Under this new mechanism, countries receive aid based on their efforts to prevent forest degradation and increase carbon sink, and in 2021 the World Bank was entrusted with implementing it. Nepal’s FCPF receipt this month was calculated on the basis of 2.4 million tons of carbon stored at a rate of $5 per ton. In the second phase, Nepal will receive more than Rs4 billion within the next year for storing an additional 7 million tons of carbon. Eighty per cent of this amount obtained from carbon trading needs to be spent on local beneficiaries and indigenous communities.&nbsp; But carbon trading is not easy, Nepal needs to prove that protected forests will not be destroyed in future.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241121091132_c8a381c9a95aa86fec558951650d97bb87914741f01766982ba2b086af001f16.jpg" data-media-id="editor_4" data-image-id="20241121091132_c8a381c9a95aa86fec558951650d97bb87914741f01766982ba2b086af001f16" data-rendition-name="original" width="1500" height="999" loading="lazy" alt="Greenbacks for greenery NT "> <figcaption>Photo: KUNDA DIXIT</figcaption> </figure>  Explains carbon trading expert Yugan Manandhar. “Forests should be handed over to the community and shown that they are managed sustainably. Proving this will be particularly challenging; forest encroachment and degradation is rife in the Tarai.” <a href="https://nepalitimes.com/multimedia/nepal-is-going-up-in-smoke">Deliberate forest fires</a> have also added to the challenge because they increase carbon emissions and reduce the sink capacity of forests. The basis for the amount that Nepal received was set five years ago by calculating the carbon reserves of forests in the 13 Tarai districts. In the meantime, sustainable forest management, tree plantation, forest destruction and erosion control were prioritised to increase carbon reserves in those forests. Nepal is signing another carbon trading agreement during the ongoing Baku climate conference. The <a href="https://www.leafcoalition.org/">Lowering Emissions by Accelerating Forest finance (LEAF Coalition) </a>proposes to sell the carbon stored in the forests of Bagmati, Gandaki and Lumbini provinces. For this, Nepal signed the letter of intent three years ago at COP26 in Glasgow. The target is to store 70 million tons of carbon in 32 million hectares of forest in the three provinces per which Nepal will receive Rs13 billion in four years at $10 per ton with provisions to increase the rate if various conditions are met. However, the agreement in itself doesn’t guarantee the amount. According to the targets set by Nepal, forest degradation should be stopped and carbon reserves increased by protecting tree cover. Preparations are also underway for clean air carbon trade because it has offset fossil fuel use by introducing 30,000 electric vehicles. Nepal has been selected for the first round to receive $40 million within one and a half years through the Clean Air System of the World Bank. Given that most of Nepal’s energy mix is from biomass, replacing them with electric stoves can significantly improve health by reducing indoor pollution as well as strengthen the country’s capacity for carbon trade. “Nepal's goal now is to sell carbon in the free market where carbon credits are bought and sold based on supply and demand in an open and transparent manner,” adds Pudasaini of the REDD Implementation Centre. “Nepal can now set its own price and bargain with interested buyer countries and organisations.” Lately, India has been discussing setting up a carbon market. Nepal has exported Rs12.72 billion worth of electricity to India so far this fiscal year, which can be traded under Nepal’s carbon market. “Carbon trading can create significant economic benefits for Nepal, which will help reinvest in development and environmental protection projects,” says Manandhar. “But we must prioritise sustainable management of forests, cutting older trees and allowing regrowth as well as promoting electric stoves and electric vehicles.”

primary-health-care