Climate finance conversations are usually dominated by ways to fund switching to renewable energy, clean transportation and waste management. However, in the past few years there have been urgent calls to also finance adaptation, resilience, as well as loss and damage.&nbsp;
This is a much-needed shift as the impact of the climate crisis is being increasingly being felt worldwide, and the IPCC reports have been presenting more and more alarming scenarios year after year, so much so that reality has outpaced projections.
Public financing is often placed at the heart of finding funding to adapt and build resilience. The most notable example is the <a href="https://www.adaptation-fund.org/about/" target="_blank">Adaptation Fund</a> which has allocated over $850 million for projects and programs that help vulnerable communities in developing countries adjust to climate-induced impact.
Read also: <a href="https://www.nepalitimes.com/opinion/comment/nepali-cities-must-champion-climate-action" target="_blank">Nepali cities must champion climate action</a>, Rastraraj Bhandari and Simone Weichenrieder
However, public financing alone is simply not enough to meet the increasing demand for adaptation and resilience finance. Presently, only <a href="https://www.wri.org/insights/private-sector-climate-adaptation-finance" target="_blank">around 10% of overall climate finance</a> flows are allocated to climate adaptation even as the figure for developing countries needs to increase by 5 to 10 times. Within this, only <a href="https://www.wri.org/insights/private-sector-climate-adaptation-finance" target="_blank">around 2% of adaptation finance</a> comes from the private sector such as corporations and institutional investors whereas 98% were from public sources.
Private sector engagement and financing in climate adaptation and resilience is imperative if the world is to stand any chance in tackling the climate crisis. This is particularly relevant in the Himalaya as the conversations around the Third Pole Process, spearheaded by the U.A.E government as the COP28 presidency, continue.
The <a href="https://www.arcticcircle.org/third-pole-process" target="_blank">Third Pole Process</a> has been labelled as a comprehensive effort to introduce the Arctic model of collaboration to the Third Pole region. The process is expected to be a sustained effort to define the challenge, to initiate research collaboration, and to help identify effective dissemination of information to enable political deliberations and policy-making. Although engaging the political establishments across the region will indeed be crucial, leaving out the private sector will be a missed opportunity for the Third Pole Process.
Read also: <a href="https://www.nepalitimes.com/here-now/green-is-the-colour-of-money-and-nature" target="_blank">Green is the colour of money and nature</a>, Angel Li
This is easier said than done. There are fundamental barriers to attracting private sector engagement in adaptation and resilience financing, given the challenges with private financial returns. However, this discourse is picking up globally and efforts are underway to mobilise private sector investments.
Innovating financing mechanisms such as through the use of guarantees, co-financing, de-risking and blended finance can definitely help <a href="https://www.wri.org/insights/private-sector-climate-adaptation-finance" target="_blank">leverage the scarce public finance resources</a> to catalyse private sector finance.
Insurance companies can also play a key role as risk managers, risk carriers and investors. Traditionally, private insurers avoided insuring for disasters, in part because those who are insured are less likely to flood-proof their assets and only those at high risk of flooding will purchase insurance.
Read also: <a href="https://www.nepalitimes.com/news/turning-green-policies-into-greenbacks" target="_blank">Turning green policies into greenbacks</a>, Rastraraj Bhandari
Yet, with a growing insurance market, <a href="https://content.naic.org/cipr-topics/parametric-disaster-insurance#:~:text=The%20term%20parametric%20insurance%20describes,in%20a%20traditional%20indemnity%20policy." target="_blank">parametric insurance</a> and risk pooling may overcome these challenges. In addition, exposing the risk vulnerability of the private sector such as through mandatory climate risk assessment and disclosure requirements as regulatory measures may also increase private sector investments for their own long-term stability.
In addition to financing, the private sector also has access to innovative technologies, both digital and physical technologies, which is often a forgotten yet crucial detail. The Himalaya are home to global tech giants such as Baidu, Tencent, Infosys and Alibaba, who have <a href="https://www.himalayanwaterproject.org/post/tackling-climate-and-water-challenges-in-the-himalayas-using-ai" target="_blank">immense potential to contribute to the battle against climate change</a> not just by reducing their own operational footprint but also by developing, deploying and diffusing climate technologies, including with regards to adaptation and resilience.
The Third Pole Process can foster private sector engagement for adaptation and resilience in the Himalaya. Initiating a dialogue as well as research collaboration can be a key first step but it is imperative to ensure that such research is translated into evidence and impact-based action.
Read also: <a href="https://www.nepalitimes.com/opinion/nepal-can-lead-in-zero-carbon/" target="_blank">Nepal can lead in zero-carbon, </a>Nicola Pollitt
Outside of such multilateral processes, both national and sub-national governments also have a role in fostering private-sector engagement. Many of the countries in the Himalaya are making progress with greening their financial systems and creating guidelines for banks and financial institutions. Such efforts should also look into how adaptation and resilience can be incorporated in an otherwise climate mitigation-dominated space.
It is high time to scale both public and private finance for adaptation and resilience in the Himalaya, and only such coordinated efforts can ensure that the financing needs of the region are met in an inclusive manner.
Read also: <a href="https://www.nepalitimes.com/latest/nepals-chance-to-green-its-budget/" target="_blank">Nepal’s chance to green its budget</a>, Kaustubh Dhital
Rastraraj Bhandari works on climate finance and carbon markets, and contributes regularly to Nepali Times on issues related to climate change.

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Finding money to save the Third Pole

<figure><img width="640" height="427" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109121140/636b91e29c7e80680e06f117jpeg.jpg" alt=""/><figcaption>Photo: AMIT MACHAMASI</figcaption></figure>Nepal’s oxygen emergency <a href="https://www.nepalitimes.com/latest/why-is-there-still-an-oxygen-shortage/">has eased somewhat as the Covid-19 second wave crests,</a> but the crisis exposed serious gaps in the supply and distribution of medical oxygen with major implications for the future.At the peak of the second wave, many Covid-19 patients died as hospitals ran out of oxygen, but with an<a href="https://www.nepalitimes.com/latest/leading-public-figures-call-on-uk-government-for-oxygen-for-nepal/"> overwhelming international response </a>to rush cylinders, concentrators and generators, there is now the risk of over-capacity of medical oxygen post-pandemic. Nepal’s demand for oxygen cylinders shot up to 50,000 per day during the peak of the second wave in May, with the country’s oxygen factories and hospitals <a href="https://www.nepalitimes.com/here-now/its-an-emergency/">only able to fill 19,000 cylinders every day</a>. In contrast, pre-wave calculations had suggested that peak daily demand would only be about 6,000 cylinders.  <img width="640" height="338" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109121140/636b91e49c7e80680e06f118jpeg.jpg" alt=""><img width="640" height="319" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109121140/636b91e79c7e80680e06f119jpeg.jpg" alt="">Most of the 29 oxygen factories in Nepal were working at only half capacity pre-pandemic because of low demand. In fact, three of them had closed down. As the second wave hit, the plants went into full-scale production, but a shortage of cylinders meant that the excess production could not be sent to hospitals.Meanwhile, factories relying on liquid oxygen tankers were affected by an Indian ban on export. Empty cylinders from China, Oman and other countries alleviated the shortage somewhat, while oxygen plants grappled with increasing generation capacity. <figure><img width="640" height="361" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109121140/636b91ea9c7e80680e06f11ajpeg.jpg" alt=""><figcaption> </figcaption></figure>Too little too lateWhen the inter-ministerial Covid-19 Crisis Management Center (CCMC) finally reacted, it was too late. Its arbitrary quota system for every hospital proved disastrous.“The quota resulted in hard-hit hospitals being undersupplied and safer hospitals being unnecessarily saturated with cylinders,” explains Roop Jyoti, former chairman of Grande City Hospital, suggesting the problems lay in supply chain management rather than oxygen production. Faced with mounting criticism for bungling the oxygen quotas, the Health Ministry resorted to micromanaging, and ordered suppliers to only send filled cylinders to hospitals that had its recommendation letter. The result was catastrophic, many<a href="https://www.nepalitimes.com/here-now/helping-nepalis-breathe-again/"> hospitals were either forced to refuse service</a> or they asked families of patients to bring their own full cylinders.In a notice posted in mid-May, Kathmandu’s Om Hospital said: ‘Under the capping made by the government on oxygen supply, we are unable to take admissions despite our willingness to provide service. We have enough manpower such as doctors and nurses to take care of patients but not enough oxygen supply.’ Families with Covid-19 patients hoarded full cylinders at home, and desperate ones rushed to the gates of oxygen factories to buy the life-saving gas. Municipalities, especially in areas with spare capacity, prevented the transport of oxygen beyond district borders.Most of Nepal’s oxygen plants are in central and eastern Nepal. The Morang-Sunsari industrial corridor alone had five large oxygen factories with surplus capacity, but these were prevented from sending supplies to hospitals in Kathmandu and other areas with shortages. Lack of training in oxygen flow management and ventilator use did not help matters. Makeshift local isolation centres with non-medical staff were using full flow to treat patients with mild symptoms. Hoarding and black marketing was rampant, and while large hospitals ran out of oxygen supply, local isolation centres had one cylinder per patient.In Grande International Hospital, there was a 30% drop in oxygen demand when doctors were more judicious in oxygen use. Still, the shortage was serious enough for some doctors to ration oxygen even for their most serious patients. Others had to make the difficult choice between continuing to put patients who had little chance of survival on oxygen, or to give it to those who would immediately recover with oxygen. Even before the pandemic, government oversight on cylinders was non-existent with no standardisation or regulation in place regarding colour coding, pressure, price rates and deposits on oxygen cylinders.  “I used to get desperate calls at 3am from families of patients desperate for oxygen. We were able to call up spare capacity during the second wave, especially in the east of the country, but the shortage of cylinders for refilling did create a temporary shortage,” says Gaurav Sharda of the Nepal Oxygen Industries Association (NOIA). <figure><img width="640" height="427" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109121140/636b91ed9c7e80680e06f11bjpeg.jpg" alt=""><figcaption> </figcaption></figure>After the peak With the first week of June, Nepal’s Covid-19 curve started flattening with hospitals in Kathmandu and major cities seeing fewer patients who needed to be on oxygen or in ICU. “Compared to the devastating shortages in April and May, oxygen availability is relatively stable,” says Anup Bastola, a physician at Teku Hospital. The Ministry of Health also seems to have learnt from its mistakes, and is ensuring a more equitable supply of cylinders. Donated oxygen concentrators are now being flown to district hospitals where they are needed. However, even as demand for oxygen goes down, <a href="https://www.nepalitimes.com/here-now/nepals-diaspora-comes-to-the-rescue/">overseas Nepalis and international donors</a> are still rushing empty cylinders, concentrators, generators and liquid oxygen tanks on relief flights to Kathmandu. There are more oxygen generator plants arriving from France, the US and China this week. Ventilators from <a href="https://www.nepalitimes.com/latest/international-help-for-nepal-picks-up/">international donors</a> are sitting idle at some district hospitals in western Nepal because no one knows how to operate them. Domestic oxygen production itself is now reaching 100% capacity. Even though there is a challenge of logistics, equitable distribution, and cost, Nepal will soon have more oxygen than it needs. What the government needs to focus on is getting much-needed <a href="https://www.nepalitimes.com/latest/life-hangs-by-an-oxygen-tube-in-nepal/">oxygen to rural areas</a> where the virus is spreading house-to-house.  The flood of donated oxygen generators now means that there will be domestic over-capacity just as there was before the second wave. Nepal’s oxygen sector therefore needs to balance supply to meet demand surges and periods of low consumption.Explains Jyoti: “Ironically, many new donated oxygen plants are being set up in hospitals in response to the second wave, so when this passes, there will be tremendous over-capacity. Regular factories would probably have to function at less than 25% capacity and will be destroyed financially.”At Teku Hospital, Bastola says <a href="https://www.nepalitimes.com/banner/two-nepals-in-the-death-zone/">repurposing oxygen equipment</a> could help Nepal prepare for future spikes. If there is a third wave this autumn, for example, demand would go up again. Besides Covid-19, there is also the pre-existing need for oxygen to treat the rise in respiratory ailments such as COPD and heart disease caused by worsening air pollution. Says Sharda at NOIA: “One of two scenarios can now play out. The government could either continue its reliance on donated oxygen generation equipment, thereby driving Nepali producers out of existence, or it could encourage sustained domestic production to meet a spike in demand during future outbreaks.” Last month, reports of Pressure Swing Adsorption (PSA) oxygen plants failing in hospitals, and a CCMC finding of 70% oxygen leakage in many hospitals were overlooked. These issues are structural and if resolved can help alleviate future shortages.“The government’s approach to oxygen distribution was myopic,” says Sharda. “Oxygen is a basic product and can easily be bottled here. But they failed to consult with us producers, and now all this oversupply from abroad will jeopardise our ability to respond to future outbreaks. Plant staff should also be <a href="https://www.nepalitimes.com/banner/nepals-life-or-death-o2-quest/">treated as frontline workers</a> and have vaccinations.” The government and CCMC failed to acknowledge that assistance was needed in the oxygen supply chain rather than production, and by allowing import of production equipment but bungling on supply management, they failed to take into account domestic generation capacity, thus increasing vulnerability in the future.  The only solution to prevent another oxygen crisis is to stop the problem at the source, by <a href="https://www.nepalitimes.com/here-now/aid-pours-into-nepal-but-where-be-vaccines/">stemming the spread of Covid-19.</a> But the lesson from the second wave is that Nepal’s government, hospitals and oxygen plants need to have standby capacity at hand for future waves.

Pandemic and the political-economy of oxygen supply

It was pure drama: the political transition in Madhes unfolded by the dawn’s early light. At around 4AM on Monday, Province Head Sumitra Subedi Bhandari quietly departed Janakpur saying she was headed to Kathmandu for health reasons.&nbsp;
Outgoing Chief Minister Jitendra Sonal, whose coalition had begun to unravel, even saw her off, asking supporters to clear the road for her motorcade.
But an hour later, instead of continuing on to the capital, Bhandari stopped in Bardibas on the East-West Highway. There, as the sun started rising over the misty plains, she administered the oath of office to Saroj Kumar Yadav of the CPN-UML, invoking Article 168(3) of the Constitution.&nbsp;
Bhandari is also a member of the CPN-UML. The provision she invoked is typically used only after coalitions fail under Article 168(2), and the timing and location of the swearing-in have since drawn scrutiny.
Bhandari was subsequently relieved of her duties, and former National Planning Commission member Surendra Labh Karna was sworn in as the new Madhes province head on Tuesday.
Sonal had formed his government barely a month ago, with the backing of 56 provincial lawmakers but it became evident he would not secure the 54 votes needed to survive a confidence motion.&nbsp;
Several lawmakers in his coalition publicly signalled they would abstain. Still, the seven-party alliance that opposed Yadav’s appointment argues that the Province Head, who is the highest constitutional rank in the provincial structure, acted prematurely and under pressure from central UML party command.&nbsp;
A coalition of seven parties, including the Nepali Congress (NC), had been urging the Province Head to invite them to form a new government under Article 168(2). At the same time, the UML, which had been holding demonstrations outside the Province Head’s office in Janakpur, was calling for the formation of a minority government under Article 168(3).
The alliance of the seven parties that included the NC and Maoist Centre took to the streets. By mid-morning, protests had escalated outside Madhes Bhawan with cadre vandalising both the Chief Minister’s office and the Province Head’s office.
This was the third government in Madhes to fall since the 2022 provincial elections, and it follows a similar pattern. The previous Chief Minister Satish Kumar Singh of the Janamat Party, resigned before a scheduled confidence vote after losing the support of his own party and others including NC and LSP.&nbsp;
His resignation unfolded amid nationwide GenZ protests against corruption, demanding accountability and reform. The recurring instability points to a structural tension in Nepal’s federalism.&nbsp;
Provincial politics remain closely tied to alliances shaped in Kathmandu. The withdrawal of support by parties like the NC and Maoist Centre in provinces often reflects national-level calculations rather than provincial priorities.
As a result, the Provincial Assembly is repeatedly consumed by survival of the coalition instead of governance. Development work stalls. Budget execution slows. Public frustration grows. In a province that was at the forefront of the movement for federalism to counter what is seen as neglect, apathy and discrimination by Kathmandu, the sense that the system may not delivering on its promise is becoming increasingly pronounced.
If federalism is to be strengthened, provincial governments must be able to function with a degree of autonomy that currently exists more in principle than in practice. Otherwise, the perception that federalism is costly, unstable, and ineffective will continue to expand, providing fertile ground for anti-federal sentiment that is already gaining traction.
Earlier examples such as the NC General Secretary Bishwo Prakash Sharma in January calling for a new government in Madhes led by his party demonstrates how the central party leadership deliberately intervenes in provincial affairs. His remarks came during campaigns for bi-elections in Madhes when former CM Singh had been in office for six months only.&nbsp;
Likewise, in early June 2024, the federal coalition in Kathmandu shifted from a Maoist Centre and NC to form a new alliance between the NC &nbsp;and the UML. Within a day, coalition negotiations in Madhes changed to mirror this.
UML leaders publicly stated: “The issues at the federal and provincial levels will be resolved together.” This indicated that the realignment in Madhes followed national party decisions rather than provincial deliberation.
The events that unfolded in Madhes are a reminder that federalism in Nepal is still in transition, and that its success depends on political actors honouring the constitutional framework.

Chronic instability in the Madhes

This is the 73rd episode of Diaspora Diaries, a Nepali Times series in collaboration with Migration Lab providing a platform to share experiences of living, working and studying abroad. I don’t remember playing with dolls as a little girl. There is not much to remember from my childhood.&nbsp; My responsibilities began at a very young age, as I had two younger brothers to take care of. I was born in Sarlahi, but we moved around quite a bit as my father was in the government and got transferred frequently.&nbsp; From Rasuwa to Dang, from Nepalgunj to Kathmandu. I struggled to adjust in Kathmandu because I joined Grade 9 in the middle of the term. The education was different and fellow students also did not support me initially. But over time, I adjusted and made friends. I did not dream of becoming a nurse. It was by accident. I wanted to pursue medicine, but failed the entrance exam by a few marks. I did not want to lose a year, so decided to take up microbiology instead.&nbsp; I got married after my undergraduate, and my husband encouraged me to take up something more technical like nursing or engineering instead of Masters in Microbiology. As my quantitative background was weak, I chose nursing. I felt like I was born to be a nurse. Juggling my married life and studies was difficult. My teachers would often ask me why I am falling behind. It was not easy, but I managed and took up a full-time job as a nurse. There are challenges being a nurse in Nepal. You are overworked, underpaid, there is lack of appreciation. Superiors can be overbearing. These problems persist. But the bright spot is that you get to serve fellow Nepalis, and be close to your family.&nbsp; Just like I had no intention initially of becoming a nurse, I had no intention of migrating overseas. But life had different plans for me. After my baby boy was born, I noticed that something was off. Even at nine months he had not started crawling or sitting. As a nurse I knew something was wrong, and I took him for check-ups. He tested negative for down syndrome, but he had a heart defect.&nbsp; The cardiologist recommended that I take him to India where he was diagnosed with Williams Syndrome, a rare genetic condition that affects 1 in 10,000 people. It delayed his development. I looked for therapy. It was either not effective, or too expensive. Some schools also refused to admit him, and it drove me to tears.&nbsp; My family members overseas in the UK, US told me to emigrate as there were better facilities for differently abled children. So I decided to apply to the UK. Luckily just then there were calls for candidates under the Nepal-UK government-to-government pilot scheme for 100 nurses. Only 40 met the criteria, and I was one of them.&nbsp; I still remember the day I received the news on the day of my puja. There were people around me, and they told me that it was the result of my fasting and devotion on that auspicious day. Perhaps it was. Life was taking a new turn, and I was happy. I made it to the UK in February 2024 without paying a single paisa to any broker. The G2G scheme was unique as we were treated with dignity and valued for our skills: they covered costs for the ticket and visa, reimbursed us for exams we had taken and costs involved in the preparation and testing of the Objective Structured Clinical Examination were also covered.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251106071148_dc5a0d0ea3024b34a4f2735754f8eb67a650bc7f61b98c75d589676c65b02a0c.jpg" data-media-id="editor_0" data-image-id="20251106071148_dc5a0d0ea3024b34a4f2735754f8eb67a650bc7f61b98c75d589676c65b02a0c" data-rendition-name="original" width="1200" height="1600" loading="lazy" alt="Nurses NT"> </figure>  It was of course difficult to leave my son behind. But I was doing it for his future. I had the option of taking him from the start, but it was a new place and I wanted to be well-settled and knowledgeable about the options available for him before bringing him along. As I packed, he would ask me to take him with me in my suitcase. It did not seem like he was affected by my departure, and it was only later that his teachers said that he would express his feelings more openly at school. He just did not know how to tell me he missed me, and he would tell teachers he was worried I had forgotten him if we did not speak for a day.&nbsp; He missed me, and that realisation made me emotional. But I had to carry on. Life in the UK was difficult in the beginning. Even so, I wanted to prove to myself that I could do it. Fortunately I had cooperative staff who patiently answered my questions. I think I would have been irritated if I were in their place. But they did not seem to mind, and their support and guidance made it easy for me to adjust to the new work environment. APPRECIATION I still struggle to understand the accent of my English patients, and have ask the matron for help. They compliment me on my English, but I can speak better than I understand. The good thing about working in the UK is that you are appreciated for your work, which can be motivating. Sometimes, after a long day’s work you get a message from your supervisor acknowledging your work with a thank you. That’s enough to erase your tiredness.&nbsp; So far I have received 32 WOW nominations which are acknowledgements from patients for a job well done. It can be motivating, especially in the beginning. The main difference between the Alpana who first left Kathmandu for the UK and the Alpana now is that I am a much more confident person. What makes a good nurse? Skills, knowledge and qualifications are of course a given. But mostly, you need humanity. A smiling face. The way you communicate. Your empathy. These attributes can already solve many problems that patients are facing. This is my second time back home in the last 20 months. And this time, I have arranged for my son’s visa. I will go back after Tihar with my son and husband.&nbsp; I am happy, but also a little nervous about what awaits us. What kind of school will I put him in? Will it really be different from schools here? Will his needs be addressed? Will it be like here, or will he be able to adjust?&nbsp; But I am determined to make it work. Success for me would be if he adjusted well and there is a change in his condition. He still cannot recognise alphabets and read words like kids in his age group. Hopefully he will get learning support in the UK. He also has a knack for music, and this is common among individuals with Williams Syndrome. His ears perk up when he hears music, and he takes part in musical events at school. He still does not recognise letters &nbsp;but he uses voice commands to search for guitar videos on YouTube. I will enrol him in music classes, and help him develop this gift. For now, I worry how he will behave on his long flight. He has a short attention span and gets restless. He is also very social and will want to speak with everyone around him, and might irritate fellow passengers.&nbsp; I have already started trying to make him understand that he will need to behave on the flight. He nods in agreement. Let’s see how it goes. &nbsp;

“I felt like I was born to be a nurse”

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

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

Nepal haemorrhaging nurses

Prime Minister Juddha Shamsher Rana built the NJJR probably to transport logs cut on his forested birta land north of Janakpur to sell in India. The 2’6” narrow-gauge railway extended north from Jaynagar, India 29km to Janakpur and another 22km to Bhutaha/Bijalpura, cost 680,000 Indian rupees to build, and opened for business December 1937. The Nepali engineer in charge of construction was Capt Tilak Bahadur Rayamajhi, who in 1908 was one of the first Nepalis to receive a civil engineering degree in India.&nbsp; After 1950, the line from Janakpur to Bhutaha had little commercial value and was out of service. Until the late 1970s, there were no proper motorable roads connecting Dhanusha and Mahottari Districts with India. The NJJR was the only transportation alternative for people who had to otherwise go on foot, bicycle or ox carts to India.&nbsp; The NJJR also played an important role in religious tourism, as hundreds of thousands Indian pilgrims visited Janakpur annually to participate in the Bibaha Panchami, Rama Navami, and Janaki Navami. For the Bihari peasant bound for Janaki Mandir in 1955, sitting on the roof of a slow-moving train was a luxury compared to trudging 29km on foot from the Indian border. The first manager of the NJJR in Janakpur was Lt Hem Bahadur Gadtaula-Chhetri. The general manager from 1942-58 was Rekha Bahadur Rayamajhi of Bhojpur, posted at the railway’s main office at Jaynagar.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251106071140_971118917423dec021d89591fe5fef4f7218698595773f6006b4d50c5c57cf94.jpg" data-media-id="editor_0" data-image-id="20251106071140_971118917423dec021d89591fe5fef4f7218698595773f6006b4d50c5c57cf94" data-rendition-name="original" width="1014" height="680" loading="lazy" alt="NJJR Dan Edwards NT"> <figcaption>A steam train excursion for foreigners in 1999. The last steam excursion on the Janakpur Railway ran in 2006. Photo: GORDON EDGAR</figcaption> </figure>  Rama and Seeta, the railway’s first two appropriately named locomotives, were built in Berlin in 1936. In view of the rising power of Adolf Hitler’s Germany at that time, was Prime Minister Juddha trying to cultivate the Third Reich in hopes of reducing Nepal’s virtually total dependence on British India?&nbsp; In 1939 Adolf Hitler gifted a Mercedes-Benz 230 Pullman Landaulet to Juddha as a way to convince him not to let the British use their Gurkha regiments against Germany in World War II. The car had to be disassembled and carried over the mountains to Kathmandu and reassembled.&nbsp; The Nepali Congress-led campaign against Rana rule received considerable support in Janakpur and the eastern Tarai. In December 1951, King Tribhuvan rode the NJJR from Jaynagar to Janakpur, and thousands thronged to catch sight of a king of whom they had heard but never seen. As operations on the Nepali Government Railway came to an end, its European-made engines were transferred to the NJJR. King Mahendra ordered two more locomotives named Chandra and Surya for the NJJR in 1962. They were built in Leeds and traveled from Liverpool to Calcutta to Jaynagar to begin their service.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251106071140_55e4b768ef0ae7682dec8092169bbedc070656d46d9d0a80039fd960a23ae335.jpg" data-media-id="editor_1" data-image-id="20251106071140_55e4b768ef0ae7682dec8092169bbedc070656d46d9d0a80039fd960a23ae335" data-rendition-name="original" width="2144" height="1399" loading="lazy" alt="NJJR Dan Edwards NT"> <figcaption>Inside the Nepal Janakpur Jayanagar Railway workshop at Khajuri. By the early 2000s, management was unable to control rising payroll and administrative costs nor secure adequate funds for the railway. Photo: GEOFF WARREN</figcaption> </figure>  The NJJR was renamed Janakpur Railway (JR) in 1965 and became the Nepal Railway Company in 2004. Unlike most government-owned enterprises in Nepal of that era, the JR and Nepal Government Railway operated at a profit for many years. In 1947, its total income was 225,000 Indian rupees, with a profit exceeding 100,000 rupees.&nbsp; In FY1974/75, the railway had revenues of 2.6 million rupees and a profit of 443,000 rupees. It is unclear if depreciation expenses were accounted for. Only from the mid-1980s did the railway begin to lose money. The NJJR did a booming passenger business. Ridership increased from 197,000 in 1960/61 to 1.4 million in 1977/78. Revenue increased from 770,000 rupees in 1966/67 to 2.6 million rupees in 1974/75. Yet warning signs appeared in the 1970s that the railway was living on borrowed time.&nbsp; &nbsp;A foreign consultant conducted a comprehensive study of the railway in 1975 and concluded that ‘the entire railway is very old and worn out, and unless a total rehabilitation’ of the railway was undertaken, it would ‘be forced to close in a very short time’.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251106071140_240ed714ee4cb369005439a3fb982d6142fd028e7cf6b0c0338519a8abc6afd4.jpg" data-media-id="editor_2" data-image-id="20251106071140_240ed714ee4cb369005439a3fb982d6142fd028e7cf6b0c0338519a8abc6afd4" data-rendition-name="original" width="1387" height="784" loading="lazy" alt="NJJR Dan Edwards NT"> <figcaption>A second class ticket issued in 2004 costing Rs7.25 between Janakpurdham to Jaynagar. Photo: FUZZ JORDAN</figcaption> </figure>  CHUGGING ALONG An investment of two million rupees resulted in some improvements between 1976 and 1979 but rolling stock and most infrastructure were neglected for another 15 years. Yet somehow the JR’s trains kept chugging along for the next 42 years, often late, with service frequently suspended due to floods.&nbsp; Nearly every year, monsoon rains swept away some of the 135 bridges and tracks and embankments. An RSS News Agency bulletin in August 1975 noted that parts of Janakpur were ‘under 2.5 feet of water’, and the railway tracks near Khajuri were covered by four feet of water.&nbsp; The Jaynagar line was damaged in many places by the swollen Jaladi, Kamala and Jamuni Rivers. Trains to Bijalpura were suspended. For each week railway service was suspended a loss of 75,000 rupees resulted.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251108131132_4a189fa9999b50037f1774b183e62e2caad6177f594ba57a28d93bd674644163.jpg" data-media-id="editor_3" data-image-id="20251108131132_4a189fa9999b50037f1774b183e62e2caad6177f594ba57a28d93bd674644163" data-rendition-name="original" width="1202" height="770" loading="lazy" alt="NJJR MAP"> </figure>  There were also accidents. Trains made only two or three roundtrips daily between Jaynagar and Janakpur and ran at slow speeds, so there were few passenger fatalities, but there were frequent derailments due to the worn rails and overloaded carriages. A RSS report in 1976 said a train derailed near Mahinathpur, and some passengers riding on the roof fell off and were injured. ‘Such accidents occur because the coaches are not regularly maintained and repaired. The speed of the train has been reduced from 12 to 8 miles per hour, since the old and rickety coaches rattle and sway from side to side if driven too fast. The trains take an incredible 4 to 5 hours to cover 28 kilometres,’ the report noted. Gangs of dacoits occasionally boarded trains and robbed passengers. Another RSS report in December 1972 said ‘Six dacoits armed with guns and revolvers looted 13 railway passengers travelling from Janakpurdham to Jaynagar [last] Sunday. The [loot] included wrist watches, gold rings, currency notes and other paraphernalia of the passengers…The dacoits raided third-class bogie number 2 soon after the train started from Khajuri station. The dacoits after plundering the passengers jumped down from the running train about two miles from the Nepal-India border [and fled into India.]’  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251106071140_de60de1d7fdd0a9d29f19440ed68d773f754c10ef01a8c7e3385097eab6a8419.jpg" data-media-id="editor_4" data-image-id="20251106071140_de60de1d7fdd0a9d29f19440ed68d773f754c10ef01a8c7e3385097eab6a8419" data-rendition-name="original" width="1498" height="1000" loading="lazy" alt="NJJR Dan Edwards NT"> <figcaption>Narrow-gauge tracks in Jayanagar in India going north toward Nepal. Photo: FUZZ JORDAN</figcaption> </figure>  Strikes and political protests also stopped the train from time to time. From the early 2000s Maoist and Tarai-based groups enforced stoppages with threats and intimidation that closed schools, shops, government offices, and brought transport services to a halt. Six minor political parties organised a strike in Janakpur in May 2001. Agitators stopped a train near Janakpur and pelted it with stones, breaking windows and injuring the driver. The railway came to a standstill in May 2004 after Maoists set fire to the Mahinathpur station. During February-March 2006, the Maoists obstructed rail service six times. A cylinder bomb exploded inside a train near Parbaha station in May 2009 injuring 30 passengers. Between 1993-2003, the railway had nine general managers who had influence with Kathmandu’s political and bureaucratic elites, but none of whom knew much about railways. Management was unable to control rising payroll and administrative costs nor secure adequate funds for the railway.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251106071140_df754214acd19eaab3b56ceaa0d96f0b66f9f0f8fd29fb4a533d860f627f483f.jpg" data-media-id="editor_5" data-image-id="20251106071140_df754214acd19eaab3b56ceaa0d96f0b66f9f0f8fd29fb4a533d860f627f483f" data-rendition-name="original" width="1700" height="1140" loading="lazy" alt="NJJR Dan Edwards NT"> <figcaption>Coal was unavailable, so Seetaa-Ram, the railway’s first two locomotives, burnt wood for fuel. Photo: BASIL ROBERTS</figcaption> </figure>  Revenue ‘leakage’ was significant, as perhaps twenty percent of the passengers rode without tickets. Railway staff was bloated, in 1996 there were 340 on the payroll, many of them with political connections who needed jobs. Safety measures for railway operations were non-existent.&nbsp; There were no performance reviews, no criteria for promotion, and no training opportunities for workers to improve their skills. But the locals continued to ride their beloved railway. For 56 years, the Janakpur Railway received no foreign assistance, not even one rupee of foreign aid. That changed in 1994 when the Indian government provided two used diesel locomotives and 12 used coaches. Two years later, India supplied two more engines and 12 more coaches and promised some upgrades.&nbsp; This gave the railway a new lease on life, but the road network in the eastern Tarai had expanded,making the railway redundant. It also did not connect with the East-West Highway, the major transportation artery across the Tarai, nor could it seamlessly interconnect with India’s broad-gauge rail network at Jaynagar.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251106071140_7a52a3c5a3fe4e6320135d90632dcfcee6085a32637a3f71e1e644c5e8d3b19f.jpg" data-media-id="editor_6" data-image-id="20251106071140_7a52a3c5a3fe4e6320135d90632dcfcee6085a32637a3f71e1e644c5e8d3b19f" data-rendition-name="original" width="3239" height="1429" loading="lazy" alt="NJJR Dan Edwards NT"> <figcaption>Pashupati, Nepal's first locomotive, in retirement at Khajuri in 1996. Photo: FUZZ JORDAN</figcaption> </figure>  The railway carried no goods, all cargo traffic migrated to trucks. During the 1980s and 1990s, British and European train spotters traveled to India to ride its few remaining steam locomotives, including those of the Darjeeling Himalayan Railway. Some took a side trip to Jaynagar where they, without Nepal visas, were thrilled to ride a train to Janakpur without encountering a border check post or immigration officials. Other visa-complying tour groups arranged steam trains for 60,000 rupees or more.&nbsp; The last steam excursion ran in 2006, and after that, foreign interest in the railway evaporated. Cascading financial losses and government indifference coupled with irregular, unreliable service finished on the Janakpur Railway.&nbsp; Seventy-six years of remarkable narrow-gauge railroading in Nepal ended not with a bang but a whimper on January 20, 2014. Sic transit gloria. Dan Edwards was a Peace Corps volunteer in 1966 and is the author of several books on Nepal. This is the third instalment in a new limited series in Nepali Times on the historic transportation infrastructures of Nepal.

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