https://www.youtube.com/watch?v=Xf4OpwoblRc&amp;feature=youtu.beProblem: Some 70% of Nepalis are carriers of the tuberculosis bacillus and many of them have full-blown versions of the disease. Although diagnosis and treatment is available, the sick cannot travel to hospitals. How to test the sputum of patients, and deliver antibiotics in remote and road-less parts of Nepal?Solution: By drones.Nepal has been acclaimed for its directly observed treatment short course (DOTS) for treating tuberculosis, which demands a combination of antibiotics that are administered under supervision. However, TB is difficult to diagnose and treat in remote parts of this country.That is why the Britain Nepal Medical Trust (BNMT) is taking a big leap in treating TB with a pilot project in a remote part of Piuthan district in the mountains of central Nepal. Read also: <a href="https://www.nepalitimes.com/banner/tb/" target="_blank" rel="noopener">TB</a>, Sonia Awale<a href="https://www.nepalitimes.com/editorial/tb-or-not-tb/" target="_blank" rel="noopener">TB or not TB</a>, EditorialThe Trust has cleverly recycled the <a href="http://archive.nepalitimes.com/news.php?id=294#.XPkeWBYzaUk" target="_blank" rel="noopener">DOTS</a> acronym to DrOTS, this time to mean Drone Optimised Therapy System, and is running test flights in the district to collect sputum samples and deliver both diagnoses and treatment to patients living in up-country villages.The drone flies to health posts in the mountains, and returns sputum samples to the district hospital in Swargadwari Municipality and the public health centre (PHC) in Piuthan Municipality. The samples are tested using a <a href="http://archive.nepalitimes.com/news.php?id=17747#.XPkeaxYzaUk" target="_blank" rel="noopener">GenExpert kit</a>. If they are positive, patients are given DOTS treatment using smart pill boxes, which keep electronic records of whether or not patients have taken the antibiotics.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110813110/636a44c69c7e80680e04d34djpeg.jpg" alt="" width="1500" height="1125"/><figcaption>Photo: RAMU SAPKOTA</figcaption></figure>“We are using the drones experimentally to ensure that we can reach the hidden cases of tuberculosis, since every untreated patient is a potential carrier of the disease and can spread it,” explains Shraddha Acharya, BNMT coordinator in Piuthan.During the pilot phase, drones will be used only to collect sputum samples from remote settlements. If the tests are successful, the Trust hopes to use the unmanned craft to also deliver medicine.Thanks to the initiative, health personnel will no longer need to walk for days to deliver sputum samples from health centres in the villages to the district hospital and PHC for testing, and then return with medicines for those who test positive. The current system results in delays in getting medicines to patients, and also lack of supervision administering the antibiotics.Read also:<a href="https://www.nepalitimes.com/banner/for-nepal-a-game-changer-in-tb-control/" target="_blank" rel="noopener">For Nepal, a game-changer in TB control</a>, Buddha Basnyat and Maxine CawsCommunity Health Worker Sita GC (pictured above) says the drones are god-sent because they can deliver samples in 25 minutes, where earlier it took 2-3 days. “Logistics was a huge problem because of unreliable transport; now it is easy to diagnose and treat quickly,” she adds.<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110813110/636a44ca9c7e80680e04d34ejpeg.jpg" alt="" width="640" height="427">Maxine Caws (pictured above) of BNMT, an epidemiologist with the Liverpool School of Tropical Medicine, says the drones are being tested in Piuthan because it is the mountain district in Nepal with the highest TB prevalence. Last year, the district treated 379 patients for tuberculosis, but 335 new cases were detected in the same period.The remote-controlled craft are handled by drone specialist Nepal Flying Lab. “We found this to be an exciting project because the drones are ideal for bridging distances to remote areas and the sputum samples and medicines are not too heavy,” says the lab’s Uttam Pudasaini, who adds this is the first time such deliveries are being tested in Asia.The drones weigh 9kg when empty and can carry another 7kg in a cargo hold designed to protect against biohazards; they can be airborne for 30 minutes. The craft flies at speeds of up to 1km per minute, and is controlled by a pilot at the takeoff point who coordinates with a health worker at the destination. In future, the project plans to train health workers to fly the drones themselves.<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110813110/636a44cd9c7e80680e04d34fjpeg.jpg" alt="" width="640" height="427"><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110813110/636a44d19c7e80680e04d350jpeg.jpg" alt="" width="640" height="427"><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110813110/636a44d49c7e80680e04d351jpeg.jpg" alt="" width="640" height="359">The technology has been used for TB control in Zimbabwe and Papua New Guinea. In Nepal, the pilot project is funded by the Nick Simons Institute till December. “Further extension will be determined by whether it is successful and cost-effective,” says Caws.Sita GC says so far up to 35 positive cases of TB have been detected from sputum samples in Piuthan this month. However, many people refuse to give samples, and others do not follow instructions on taking antibiotics.The ministry of health is also involved in the drone trials. Spokesperson Mahendra Shrestha says that if the tests are successful the government will take over the program and try to replicate it for TB control in other remote areas.“If this project is successful, Piuthan and Nepal will be famous worldwide. But the biggest challenge is to first make the tests work,” says Shrestha.<h2>TB or not TB</h2><figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110813110/636a44d79c7e80680e04d352jpeg.jpg" alt="" width="1500" height="1000"><figcaption> </figcaption></figure>There are 10 million new cases of tuberculosis every year, and the medieval disease still takes the lives of 1.5 million people annually worldwide.South Asia accounts for 40% of the global TB burden, with over 4 million cases as well as 40% of total fatalities, a third of them patients who succumbed after they failed to respond to treatment. But worsening air pollution, smoking and alcoholism are big risk factors for TB infection in the region.Some 11 Nepalis die every day from the highly contagious infection.There are 40,000 new cases of TB here every year, and Nepal also has a very high rate of latent TB infection. Despite antibiotics, it is often difficult to reach patients in underserved parts of the country and Nepal’s harsh terrain makes it hard to access diagnosis and treatment on time. Experts say there is huge under-reporting of cases.Nepal is a role model in the community-based DOTS (directly observed treatment short course), with its supervised administration of antibiotics to patients. Yet, experts say much more aggressive <a href="https://www.nepalitimes.com/banner/for-nepal-a-game-changer-in-tb-control/" target="_blank" rel="noopener">case detection and an early treatment system</a> should be in place if the country is to meet the UN target of reducing TB mortality by 95% and cutting new cases by 90%, by 2035.This means developing techniques to reach the poorest in the remotest parts of the country, and also requires increases in Nepal’s TB control budget and prioritising the infection otherwise known as the ‘poor man’s disease’.<a href="https://archive.nepalitimes.com/page/resistance-to-live-saving-drugs-threatens-to-set-back-progress-in-nepal" target="_blank" rel="noopener">MDR (multi-drug resistant) TB</a> is also spreading, as patients develop resistance to commonly used drugs for treatment. The last survey in Nepal showed that among previously treated cases, anti-microbial resistance was found in 15.8% of cases, against the world average of 18%.Nepal also has the added challenge of an open border with India and migrant workers continue to bring infections home, while many patients from India come to this country for treatment.The UN General Assembly held its first-ever, high-level meeting on tuberculosis last year to draw attention and generate investment for TB research, treatment and diagnosis. The SAARC TB Centre located in Kathmandu focuses on prevention and control of tuberculosis and TB/HIV co-infection. Research is also needed for non-resistant drugs with shorter regimen.Sonia Awale

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Nepal tests and treats TB with a flying pharmacy

<figure><img width="1400" height="1050" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221107171136/636934429c7e80680e03dfe6jpeg.jpg" alt=""/><figcaption>HAMMERS AND SICKLES: Basanta Mahatara (left) and Nirmala Thapa’s husbands were murdered by opposing forces during the Nepal conflict. Twelve years later, both are now fighting for the same cause: truth and justice. Pic: Om Astha Rai</figcaption></figure>Basanta Mahatara was just 22 and pregnant with her second child when her husband, a policeman, was executed by the Maoists after being captured during a raid in Pyuthan in 1999.After that, police began hunting down Maoists in reprisal attacks among Pyuthan’s mountains. Nirmala Thapa’s husband was a Maoist, and was dragged out of his house and later shot in 2002. Like Mahatara, Thapa was also pregnant with her second child when her husband was killed. <img width="640" height="605" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221107171136/636934459c7e80680e03dfe7jpeg.jpg" alt="">The two war widows, both from Dharmawati village of Pyuthan, struggled to raise their children. They met after the signing of <a href="http://archive.nepalitimes.com/news.php?id=12806#.W_aXRjgzbIU" target="_blank" rel="noopener">the Comprehensive Peace Accord</a> in November 2006, and were united for a cause: truth and justice. They say their husbands were both summarily killed in detention, and not during battles.Mahatara and Thapa were among 200 conflict victims who came to Kathmandu this week on the 12th anniversary of the peace accord seeking truth, justice, reparations, and a guarantee of non-recurrence. They have issued a charter, pressing the government to reboot the lingering transitional justice process. Bhagi Ram Chaudhary of Conflict Victims’ Common Platform says: “We want the government to give the process a fresh start, involving us and respecting international norms.” Transitional justice has been the most neglected component of the peace process. After the peace accord of 2006, political leaders were preoccupied with <a href="http://archive.nepalitimes.com/news.php?id=12499#.W_aXqTgzbIU" target="_blank" rel="noopener">demobilising and disarming the guerrillas</a>, reintegrating them into the Nepal Army, and <a href="http://archive.nepalitimes.com/blogs/thebrief/2015/09/20/peoples-constitution/" target="_blank" rel="noopener">writing the new Constitution</a>. They <a href="http://archive.nepalitimes.com/article/editorial/justice-delayed-justice-denied-transitional-justice,3556" target="_blank" rel="noopener">delayed investigating war crimes</a>, waiting for victims to tire out and give up. It took the government a decade to even form the Truth and Reconciliation Commission (TRC) and Commission on Investigation of Enforced Disappeared Persons (CIEDP). Conflict victims questioned the legitimacy and intention of these bodies from the beginning, arguing that a mechanism led by political appointees would serve the perpetrators, and not victims. Chaudhary told us: “As we predicted, the TRC and the CIEDP have failed. We now need to dismantle them, and form a new mechanism that involves conflict victims and civil society.”He adds: “So far, we have looked at transitional justice just as a technical issue. It should be dealt with as a political problem. We need to forge a political consensus to resolve it.” Civil society leaders, human rights activists and conflict victims began discussing the need for a new mechanism, also owned by political leaders allegedly involved in war-time atrocities, after <a href="https://www.nepalitimes.com/here-now/just-not-justice/" target="_blank" rel="noopener">the controversial draft of the new TRC law</a> was out. The draft bill, if passed, will allow perpetrators to wash their hands of blood by doing time in open jails or community service.Conflict victims say it is not just the content of the TRC bill that is problematic but also the process of drafting it. But won’t the new mechanism settle conflict-era cases by just doling out compensation to victims and granting amnesty to perpetrators? Chaudhary answers: “We will not allow amnesty for those involved in gross human rights violations.”Read also:<a href="https://www.nepalitimes.com/here-now/just-not-justice/" target="_blank" rel="noopener">Just not justice</a>, Om Astha Rai<a href="http://archive.nepalitimes.com/article/editorial/justice-delayed-justice-denied-transitional-justice,3556" target="_blank" rel="noopener">Justice delayed is justice denied</a>, Editorial

Peace on a war footing

India and Pakistan are twins separated at birth. Tensions between them have been at a hair trigger ever since independence and has erupted into full scale conflict at least four times in the past 80 years.
The 22 April terrorist attack in Kashmir that killed 25 Indian tourists and a Nepali citizen, threatens to escalate tension between the two nuclear-armed nations. India has squarely blamed Pakistan for the attacks, and Prime Minister Narendra Modi has given his military “operational freedom” to respond. Pakistan has said it has credible intelligence of an Indian military strike and its officials have promised a “full spectrum” response — a code for a <a href="https://nepalitimes.com/editorial/thinking-the-thinkable">nuclear retaliation</a>.
For Nepal, the killing of its national in the Pahalgam attack comes as another stark reminder that in conflicts from Afghanistan to Iraq, from <a href="https://nepalitimes.com/opinion/how-to-agree-an-armistice-in-ukraine">Ukraine</a> to Israel, <a href="https://nepalitimes.com/news/10-nepalis-from-one-town-fighting-in-ukraine">Nepalis are getting caught in the crossfire</a>. The last time full-scale fighting broke out between <a href="https://nepalitimes.com/opinion/peacemongers-at-india-pakistan-border">India and Pakistan</a> on Kargil in 1999, at least 22<a href="https://nepalitimes.com/here-now/india-s-trial-by-fire-for-soldiers-from-nepal?%27%5C%22="> Nepalis fighting for the Indian Army</a> were killed in action.
Three of Nepal’s immediate neighbours (China, India, Pakistan) have nuclear weapons, and they do not have good relations. With China supplying weapons, <a href="https://nepalitimes.com/editorial/war-and-warming">missile technology</a> and other support to Pakistan, this triangular friction could set off a regional conflagration.&nbsp;
<a href="https://www.nature.com/articles/s43016-022-00573-0" target="_blank">Research at Rutgers University</a> has calculated that even a week-long tactical nuclear exchange between India and Pakistan would throw up so much smoke and debris into the atmosphere that it would block out the sun for years, and lead to a collapse of the <a href="https://nepalitimes.com/news/grow-nourish-sustain-together-world-food-day">global food system</a>. This does not take into account the radioactive fallout that prevailing winds would blow up to <a href="https://nepalitimes.com/here-now/lives-on-the-line-in-the-himalaya">the Himalaya</a>, contaminating glaciers that are the sources of <a href="https://nepalitimes.com/here-now/saving-what-is-left-of-himalayan-rivers">Asia’s main rivers</a>.
The impact of <a href="https://nepalitimes.com/news/climate-breakdown-linked-to-thame-flood">climate breakdown </a>on High Asia was already ringing alarm bells about its <a href="https://nepalitimes.com/news/himalayan-icecap-melting-faster-than-thought">shrinking ice cap</a> reducing the dry season flow of water downstream. Water was going to be the next strategic commodity, geopolitical experts warned, and the next wars in Asia would be over water.
That water war is already happening. India retaliated to the Kashmir attack by suspending the <a href="https://www.nytimes.com/2025/04/24/world/asia/india-pakistan-indus-waters-treaty.html" target="_blank">Indus Waters Treaty</a> of 1960 mediated by the World Bank that has withstood at least three wars between India and Pakistan. The treaty gives India control over the three eastern tributaries of the Indus (<a href="https://en.wikipedia.org/wiki/Beas_River" target="_blank">Beas</a>, <a href="https://en.wikipedia.org/wiki/Ravi_River" target="_blank">Ravi</a> and <a href="https://en.wikipedia.org/wiki/Sutlej" target="_blank">Sutlej</a>), while Pakistan got water from the Indus and two of its western tributaries (<a href="https://en.wikipedia.org/wiki/Indus_River" target="_blank">Indus</a>, <a href="https://en.wikipedia.org/wiki/Chenab_River" target="_blank">Chenab</a> and <a href="https://en.wikipedia.org/wiki/Jhelum_River" target="_blank">Jhelum</a>.
Pakistan was assured of 70% of the annual flow, and India could use a reasonable amount of water for<a href="https://archive.nepalitimes.com/news.php?id=15231"> irrigation and hydropower</a>. &nbsp;Within days of its threat, India stopped water flowing down to Pakistan from the Chenab river and is reportedly preparing to do the same on the Jhelum.
The sabre-rattling has reached a crescendo. Besides threats and counter-threats there are also symbolic drills, with the Indian Air Force practicing landing on an expressway in Uttar Pradesh by its Rafale, Su-30 and Jaguar fighter jets to demonstrate ‘operational readiness’. In response Pakistan test-fired its Abdali ballistic missile that can carry a nuclear warhead and has a range of 450km.&nbsp;
The danger is that with ultra-nationalist rhetoric and the beating the war drums by both sides, India’s government and Pakistan’s military may have to ‘do something’ to appease domestic public opinion. But any tactical strike, an artillery exchange, or territorial incursion could quickly escalate out of control.
Expecting an Indian retaliation for the Pahalgam killings, Pakistan is using<a href="https://nepalitimes.com/opinion/interfaith-collaboration-for-nuclear-disarmament"> nuclear deterrence </a>and warning of “catastrophic consequences”. The two neighbours came close to a nuclear exchange in 2019 after an attack on the Indian military in Kashmir, and prompt international intervention led by the United States cooled tensions.&nbsp;
This time, the <a href="https://nepalitimes.com/news/trump-shock-wave-hits-nepal">Trump administration</a> is too distracted and not as engaged. Pakistan has denied it was responsible for the terrorist attack and called on Washington to stop a possible Indian retaliation. India and Pakistan have stopped overflights by each other’s airlines, and some international carriers have even stopped flying over Pakistan fearing an air war.
Washington, Beijing, the UN and the EU have all urged restraint. Iran, which has good relations with both India and Pakistan has sent its foreign minister to urge both countries not to go into a tit-for-tat war. Iran has its own nuclear flashpoint to worry about with tensions in Israel, &nbsp;Yemen and Syria.
India and Pakistan both share similar problems of joblessness, <a href="https://nepalitimes.com/here-now/why-nepal-s-poverty-rate-is-stuck">poverty </a>and <a href="https://nepalitimes.com/here-now/climate-change-new-threat-to-nepal-s-rhinos">environmental threats</a>. Neither side needs the threat of a senseless war, and we in the neighbourhood do not need it either.&nbsp;
Kunda Dixit
This Editorial is brought to you by <a href="https://nepalitimes.com/" target="_blank">Nepali Times</a>, in collaboration with <a href="https://inpsjapan.com/en/" target="_blank">INPS Japan</a> and <a href="https://sgi-peace.org/" target="_blank">Soka Gakkai International</a>, in consultative status with UN ECOSOC.

Nukes in the neighbourhood

The streets of Patan are alive this month with lavender jacaranda trees under rain-washed skies as <a href="https://nepalitimes.com/banner/the-red-god-rises-again-in-patan">the chariot of Rato Matsyendranath</a> is pulled across town. This is the festival of the rain god, and inevitably the heavens opened up and pre-monsoon showers pelted the chariot as it started being pulled in Pulchok last week. Thousands of devotees, onlookers and the chariot procession organisers thronged the streets on the first day last week. The rhythmic cymbals and drums exuded a vibrant energy as the enormous four wheels turned and the chariot lurched.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025051007050_81df97744db16f732a419dc1f1579d235ce3df37642b078f50b83bd4bd026688.jpg" data-media-id="editor_1" data-image-id="2025051007050_81df97744db16f732a419dc1f1579d235ce3df37642b078f50b83bd4bd026688" data-rendition-name="original" width="1000" height="1503" loading="lazy" alt="Divine chariot"> </figure>  The<a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/Red-rain-god,3141"> red rain god</a> has Hindu and Buddhist antecedents, alternatively called Bungadya and<a href="https://nepalitimes.com/here-now/kathmandu-s-gravity-defying-chariot-festival"> Karunamaya</a> — reflecting Kathmandu Valley’s syncretic mixture of the two religions.&nbsp; “Bungadya is a profoundly <a href="https://nepalitimes.com/opinion/12-full-opinion/marketing-the-intangible">intangible form of heritage</a>,” explains heritage expert Monalisa Maharjan. “It embodies traditional knowledge,<a href="https://nepalitimes.com/multimedia/reviving-nepal-s-craft"> artisanal skills passed down through generations</a>. Local communities and specific families have specified roles in being custodians of the heritage, ensuring their survival over the centuries.” There are many legends and stories about this annual tradition. Lichhavi king Narendra Dev is supposed to have brought Rato Matsyendranath from Assam to Kathmandu Valley to convince Guru Gorakhnath to lift a spell that created a two-year drought in Kathmandu.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250510050520_347a9a398f8a9abc4a7fb4e2774fde8264cccbdce8bdab23851ab3f0e73c3e8a.jpg" data-media-id="editor_6" data-image-id="20250510050520_347a9a398f8a9abc4a7fb4e2774fde8264cccbdce8bdab23851ab3f0e73c3e8a" data-rendition-name="original" width="1503" height="1000" loading="lazy" alt="Divine chariot"> </figure>  Matsyendranath was Gorakhnath’s mentor, and upon seeing him, the serpents were released, unleashing the rains. The chariot festival honours the return of this life-giving rain. The deity is seen as an icon for thriving agriculture, t<a href="https://nepalitimes.com/here-now/before-the-next-monsoon">he arrival of monsoon</a> showers, and the welfare of the community. Read also: <a href="https://nepalitimes.com/opinion/the-reign-of-the-god-of-rain">The reign of the god of rain</a>, Vidhu Prakash Kayastha Till this day, the Rato Matsyendranath festival is no ordinary celebration. Patan does not sleep for a month as the chariot is pulled through various neighbourhoods. It unfolds at a state level with the president (formerly the king) attending the climax of the Bhoto Jatra in Jawalakhel later this month.&nbsp; The intergenerational transmission of tradition is unique in the world, and the reason the festival is one of the most vibrant cultural expressions that thrives despite inroads of modernity. The other unique aspect is that it is a transnational festival, binding Patan with Guwahati in the Indian state of Assam.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025051005058_8bc685ada13045d863b28e3eed91c931da2b510714586af6fd7eb5d1e298a24a.jpg" data-media-id="editor_9" data-image-id="2025051005058_8bc685ada13045d863b28e3eed91c931da2b510714586af6fd7eb5d1e298a24a" data-rendition-name="original" width="1000" height="1503" loading="lazy" alt="Divine chariot"> </figure>  “Unlike Nepal, where the deity commands grandeur and devotion, many in Assam are unaware of Rato Matsyendranath,” says Khagen Sharma of Gauhati University, which convened <a href="https://nepalitimes.com/news/nepal-assam-connection-revived">a symposium in February in Guwahati on the rain god</a>. Attending was a delegation led by Lalitpur Mayor Chiribabu Maharjan, organisers of the festival, and builders of the chariot. After the symposium, a committee was formed to explore and revive the tradition in Assam as well. Although the team had planned to visit Nepal this month, logistical challenges delayed the trip. Still, there are plans to build a Guru Matsyendranath statue in Assam to reestablish regular worship practices in the Guwahati shrine.&nbsp; The vines used to build the chariot in Patan are sourced from the jungles of Assam. But Sharma notes that in recent years unclear regulations have blocked the official import of the vines, although they are still brought to Nepal informally. The <a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/makers-of-machhindranath,2204">chariot making</a> has also had a taste of modernisation in recent times. In the past, even a single nail or piece of steel was avoided. But over time, the wooden structure, particularly the shaft between the wheels, has been replaced with bronze. When that too proved unstable, metal clamps were introduced, which have become a pragmatic compromise.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250510050524_b2a819a5791612f14c81d30fc393dbd3f99f0c64b90a9110e8b0855d944bfa93.jpg" data-media-id="editor_12" data-image-id="20250510050524_b2a819a5791612f14c81d30fc393dbd3f99f0c64b90a9110e8b0855d944bfa93" data-rendition-name="original" width="1500" height="998" loading="lazy" alt="Divine chariot"> </figure>  Another welcome change is the focus on safety. Builders climbing the chariot’s tower now wear harnesses and there are efforts in crowd control. The most visible change in recent years has been the involvement of Patan’s enthusiastic youth in the festival — the tradition is now passing to a new generation. Says Matsyendranath expert Vidhu Kayastha: “There is more energy, the young people in red t-shirts this year were very organised, these modern touches aren’t diluting our culture, they’re keeping it alive in new forms.” He adds, “We are <a href="https://nepalitimes.com/here-now/searching-for-a-homeland-away-from-home">reconnecting with our roots</a>, we have more resources, more awareness than ever before. We must not be swept away by western values that may not serve us, and in some ways, cause more harm than good. We must revive our own culture.”&nbsp;

Divine chariot

Most Nepalis thought they had seen the last of it after <a href="https://nepalitimes.com/news/11-56-25-april-2015-wkc9q2an">the 25 April 7.8 magnitude </a>earthquake ten years ago. But the Himalaya had more surprises in store. On 12 May, another 7.3 magnitude tremor that some said was an aftershock, but was strong enough to itself be a major earthquake, struck Dolakha.&nbsp; Not many people had heard of Singati till then — a cluster of houses by the Tama Kosi River along a narrow gorge that is the roadhead to Rolwaling Valley.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250508110520_57b6e316656851f71eca56ca6f98d9bbcc820c1a00d62af3c990725b4361244d.jpg" data-media-id="editor_1" data-image-id="20250508110520_57b6e316656851f71eca56ca6f98d9bbcc820c1a00d62af3c990725b4361244d" data-rendition-name="original" width="1000" height="1500" loading="lazy" alt="Climate magnifies earthquake risk in Nepal village NT"> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250508110520_016534fb2b6a79957402281cda768efb83a146786377e39e11df3e251d37159e.jpg" data-media-id="editor_2" data-image-id="20250508110520_016534fb2b6a79957402281cda768efb83a146786377e39e11df3e251d37159e" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="Climate magnifies earthquake risk in Nepal village NT"> </figure>  It was here that dozens were killed on 25 April in the first earthquake. Hundreds of <a href="https://archive.nepalitimes.com/article/nation/Singati-rising-from-rubble-rebuilding,3703">Singati survivors</a> had lined up for food and relief supplies in the morning of 12 May when the second earthquake triggered a rock slide that buried a nearby camp. At least 50 people were killed. &nbsp; Three hours later, a US Marine Corps UH-1Y Venom helicopter landed in a nearby cornfield to pick up the wounded, and flew off. The aircraft lost contact with air traffic control in Kathmandu and its wreckage was located high on Kalinchok four days later. Six American servicemen, two Nepal Army soldiers, and five wounded civilians from Singati were killed. Today, Singati bears little physical scar of the multiple tragedies that struck the town ten years ago. Most <a href="https://nepalitimes.com/multimedia/bungamati-builds-back">houses have been rebuilt</a> as urban-style concrete structures, and Singati has become an economic hub on the road leading up to several hydropower plants and a<a href="https://nepalitimes.com/banner/off-the-beaten-trek-in-nepal"> popular trekking destination</a>.&nbsp; The town looks less like a village and more like a suburb of the Dolakha district headquarter of Charikot, 47km away.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250508110520_196f341d1df1403ba133e5dfeb837eec20d7cbcb4c8c56b17cc5598810de5df2.jpg" data-media-id="editor_6" data-image-id="20250508110520_196f341d1df1403ba133e5dfeb837eec20d7cbcb4c8c56b17cc5598810de5df2" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="Climate magnifies earthquake risk in Nepal village NT"> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250508110524_ae66c4a92430f67db51b5e11e017059eedfbac4cb18c8e073f2a50cca1fe904e.jpg" data-media-id="editor_7" data-image-id="20250508110524_ae66c4a92430f67db51b5e11e017059eedfbac4cb18c8e073f2a50cca1fe904e" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="Climate magnifies earthquake risk in Nepal village NT"> </figure>  “The demand for construction material, cement, iron rods and bricks peaked after the earthquakes,” says Suresh Khadka, who owns a hardware business here and now supplies material to the 456MW Upper Tama Kosi hydropower project that is undergoing repairs after it was damaged by a landslide last year. The demand for cement boomed since most residents believe, not necessarily correctly, that <a href="https://nepalitimes.com/banner/in-a-disastrous-state">cement houses are safer</a>. Although Khadka did well selling construction material after the earthquake, he worries that most new structures do not follow seismic-resistant building codes.&nbsp; The construction boom financed by bank loans has in turn forced many from Singati to <a href="https://nepalitimes.com/banner/making-overseas-migration-better">migrate overseas for work</a> so they can service their debt.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250508110524_50caa4530bd5ff9120cf7ab70a62173846d337ef448ff8bac339f3faa375a9e2.jpg" data-media-id="editor_10" data-image-id="20250508110524_50caa4530bd5ff9120cf7ab70a62173846d337ef448ff8bac339f3faa375a9e2" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="Climate magnifies earthquake risk in Nepal village NT"> <figcaption>Suresh Khadka</figcaption> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250508110520_ef8b7d3993fc3b5df852bbf952feb3fbabc96d6883b0d5eb74ee5c60f4123b83.jpg" data-media-id="editor_11" data-image-id="20250508110520_ef8b7d3993fc3b5df852bbf952feb3fbabc96d6883b0d5eb74ee5c60f4123b83" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="Climate magnifies earthquake risk in Nepal village NT"> <figcaption>Phu Doma Sherpa (right)</figcaption> </figure>  “My family had no choice but to borrow money to rebuild our home since the government compensation was not enough, and ten years later we are still paying off the loan,” says Phu Doma Sherpa, 60. Because of the shortage of qualified masons and proper seismic engineering, <a href="https://nepalitimes.com/here-now/structural-problems">many of the buildings are of questionable building standards </a>and the traditional architecture has been abandoned, admits Kul Bahadur Budathoki, deputy chair of the municipality. “But these buildings were more expensive than what the government grants could cover, many people here are heavily in debt and the men have <a href="https://nepalitimes.com/here-now/every-day-is-closer-to-pay-day">migrated to the Gulf to pay their loans</a>,” Budathoki says.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250508110520_32f89e97b7e757fc9286c0bbb671f48ea8d4468e9634fa646d7247c650ad8480.jpg" data-media-id="editor_14" data-image-id="20250508110520_32f89e97b7e757fc9286c0bbb671f48ea8d4468e9634fa646d7247c650ad8480" data-rendition-name="original" width="1501" height="1079" loading="lazy" alt="Climate magnifies earthquake risk in Nepal village NT"> <figcaption>Kul Bahadur Budathoki</figcaption> </figure>  Singati is in a multi-hazard zone. The <a href="https://archive.nepalitimes.com/article/nation/Singati,3091">12 May 2015 earthquake </a>could have led to the collapse of Nepal’s largest glacial lake, <a href="https://nepalitimes.com/here-now/stairway-to-heaven">Tso Rolpa</a>, upstream. Due to global warming, the glacier has turned into an expanding lake 3.5km long, and its collapse would have unleashed a catastrophic Himalayan tsunami down the Tama Kosi Valley, with Singati directly in its path. Singati has literally risen from the ashes of 2015, with its residents beginning to recover from the trauma and financial toll. But it is not out of danger as <a href="https://nepalitimes.com/news/climate-breakdown-linked-to-thame-flood">climate breakdown </a>magnifies the risk from future earthquakes.

Climate magnifies earthquake risk in Nepal village

This is the 67th 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. <h2>Alpana Adhikari, UK</h2> Back in Nepal, I had worked as a nurse for a decade, but I had my heart set to go overseas. My reason for <a href="https://nepalitimes.com/banner/migration-not-a-wish-but-necessity-for-nepalis">wanting to migrate</a>, however, was a bit different as it was for my son. He has a disability, and considering his situation from multiple perspectives—including <a href="https://nepalitimes.com/here-now/it-s-all-in-the-mind">societal attitudes</a>, the preparedness of schools, and the availability of facilities for individuals with his condition—Nepal did not feel safe for my baby.&nbsp; I had to migrate, no matter what, for his sake. The facilities here in the UK for children with his condition are significantly better, and I am glad he and my husband will join me in a few months.&nbsp; I was applying via private routes like everyone else when the Government to Government pilot program between Britain and Nepal was announced. Even though the initial program targeted 100 nurses, only 40 of us were able to meet the criteria.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250511160536_46f6a3c05fd2d9bdac06a9a478f49079c2c69c783fcf0cc58b75da6128319745.jpg" data-media-id="editor_2" data-image-id="20250511160536_46f6a3c05fd2d9bdac06a9a478f49079c2c69c783fcf0cc58b75da6128319745" data-rendition-name="original" width="720" height="1280" loading="lazy" alt="DD 67"> <figcaption>Alpana Adhikari started working as a nurse in a hospital in the UK in March.</figcaption> </figure>  I made it to the UK &nbsp;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 <a href="https://nepalitimes.com/opinion/free-visa-free-ticket-policy-in-limbo">ticket and visa</a>, 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; I started work in March last year, and currently am based in the respiratory ward of a hospital. I am enjoying my work a lot. In one year, I have received 26 WOW nominations which are notes of<a href="https://nepalitimes.com/here-now/the-healer-of-far-western-nepal"> appreciation from patients </a>we have served. ‘Alpana is one of the kindest nurses I have seen. Awesome and talented … always smiling, never appears tired and helps everyone,’ one patient testimonial said. Another: ‘You can see clearly that she cares about her patients…She was cool amidst great stress and ALWAYS with a smile which gave me confidence.’ I am also the International Educated Nurses Advocate which means I can raise issues with management about issues facing <a href="https://nepalitimes.com/opinion/comment/nepali-nurses-now-britain-bound">international nurses</a> here.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250511160536_87b959c7550bbd1272ebf840d9f24735db008307ad825e4aa15e66c1662a7fd4.jpg" data-media-id="editor_6" data-image-id="20250511160536_87b959c7550bbd1272ebf840d9f24735db008307ad825e4aa15e66c1662a7fd4" data-rendition-name="original" width="1590" height="1600" loading="lazy" alt="DD 67"> <figcaption>One reason Alpana Adhikari migrated to the UK was so there would be better facilities for her son, who has a disability. </figcaption> </figure>  Recruitment from NHS linked hospitals is free but when we <a href="https://nepalitimes.com/editorial/safer-migration-for-women">migrate through private routes</a>, agencies either charge upfront costs or in some cases, there is wage deduction once the nurses start earning.&nbsp; I have met Nepalis who have paid up to Rs 1 million for the same job. These costs can go even as high as Rs3 million for work in caregiving or nursing homes. I am lucky not to have to pay anyone for my posting.&nbsp; But beyond costs, I think there is also a reputational advantage of coming through the government selection process at the hospital. Such programs need to be expanded more because <a href="https://nepalitimes.com/editorial/nepal-s-nurse-flight">nurses are migrating </a>anyway and it would save people a lot of unnecessary costs and hassles. I will always be protective about Nepal and am grateful for the experience I gained, but it is true that nurses lack dignity in the workplace back home. Nursing is laborious work and completing the education takes a fortune but the <a href="https://nepalitimes.com/here-now/nursing-grievances-against-the-state">pay for nurses in Nepal</a>, other than at a handful of hospitals, is unfairly low.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250511160540_2a483361070e6e65413cf3bcf3be7af0581044f85c3e6da25a66dc87042af9d9.jpg" data-media-id="editor_10" data-image-id="20250511160540_2a483361070e6e65413cf3bcf3be7af0581044f85c3e6da25a66dc87042af9d9" data-rendition-name="original" width="2048" height="1536" loading="lazy" alt="DD 67"> <figcaption>Alpana Adhikari while working as a nurse in Nepal.</figcaption> </figure>  It naturally makes nurses want to migrate. People often ask me what the difference in the UK and Nepal is. Work is similar but in terms of technology, there is less paperwork here as everything is digitised. Treatment is also more nurse-led and we have more say while making recommendations about medicine and discharging decisions which can be empowering. Read also: <a href="https://nepalitimes.com/here-now/nepali-nurses-gone-and-going-to-the-uk">Nepali nurses gone and going to the UK</a> I am not sure what it is about nursing but I am always in high spirits and energetic about showing up to work every day. To be a good nurse, you have to have the passion for <a href="https://nepalitimes.com/news/step-by-step-for-rural-health-care-in-nepal">patient care</a>.&nbsp; Sometimes people tell me it is because my family has not yet joined me which has freed up my time to singularly focus on work, but I do not believe that is true. Back home, too, I used to be as passionate about my job.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250511160540_47851c2c850c936b7bfb23da0f0e8a07620ea213ad929c229b6cca8711adc5d4.jpg" data-media-id="editor_13" data-image-id="20250511160540_47851c2c850c936b7bfb23da0f0e8a07620ea213ad929c229b6cca8711adc5d4" data-rendition-name="original" width="1024" height="768" loading="lazy" alt="DD 67"> <figcaption>Alpana Adhikari (left) during an International Nurses Day rally in Kathmandu.</figcaption> </figure>  What fuels my passion here is the appreciation we get. It is not just about the income. Sometimes after <a href="https://nepalitimes.com/here-now/you-must-be-having-so-much-fun-there?fbclid=IwZXh0bgNhZW0CMTEAAR0OsTusz4rvYDQLvB0bnwhlDvkS3zCQ-UvuoO5manWHC0LGI2c3XY7e6ZY_aem_hR-tZOp4xg1mINPJvwD7Nw">long hours at work</a> when it has been a particularly busy day, a phone message from my manager and colleagues appreciating me for a job well done can go a long way.&nbsp; Likewise, the WOW recommendations from my patients have boosted my confidence. One of my elderly patients who had a <a href="https://archive.nepalitimes.com/article/nation/stigma-and-silence-mental-health-nepal,3486">mental illness </a>and I bonded, and she felt comfortable enough to open up with me. She would then refer to me as her friend with everyone.&nbsp; It is little things like this that can make a big difference. Perhaps that is why my flat mate and colleagues often question why I don’t look tired even after a long shift. <h2>Binu Gurung, Japan</h2> It has been five-and-half years since I came to Japan under the Specified Skilled Workers (SSW) visa in the nursing category. I had previously come to Japan as a language student as well.&nbsp; I grew up in Ghandruk and had just started my Bachelor’s course when a friend suggested we try<a href="https://nepalitimes.com/business/nepalis-in-japan"> to go to Japan </a>so I just followed the trend and stayed here for three years as a student.&nbsp; Two years after returning to Nepal, I re-migrated to Japan under the SSW scheme which was at its early stages and only open to nursing initially.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250511160536_305bb5cb5095da6148911dae8b07356ece5b292148e6c8e57a39fd31d811624b.jpg" data-media-id="editor_17" data-image-id="20250511160536_305bb5cb5095da6148911dae8b07356ece5b292148e6c8e57a39fd31d811624b" data-rendition-name="original" width="720" height="960" loading="lazy" alt="DD 67"> <figcaption>Binu Gurung on arrival in Japan to work as a nurse three years ago.</figcaption> </figure>  I take care of the elderly Japanese who are mostly above 80 years of age, a few even above 100. I try not to get too attached to patients but it is of course not always easy because of the nature of the job and patients we serve.&nbsp; Patients dying of age is common as it is not a care facility where patients recover to return to their homes. Just recently, an elderly lady who had been here from the day I joined 5.5 years ago passed.&nbsp; These leave you a bit खिन्न and emotionally drained. Most are <a href="https://archive.nepalitimes.com/article/nation/dementia-brings-new-problem-that-families-have-little%20knowledge-of,2151">dementia patients</a> who do not &nbsp;even recognise their family members. Some elderly patients are reserved and do not feel comfortable as the work entails helping with personal care tasks like using the toilet or bathing and they can be irritable.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250511160536_c840a0b12c20c3d52d9eceec06a0bc8c90208f13e402c50f319583b1c1a93b87.jpg" data-media-id="editor_19" data-image-id="20250511160536_c840a0b12c20c3d52d9eceec06a0bc8c90208f13e402c50f319583b1c1a93b87" data-rendition-name="original" width="694" height="960" loading="lazy" alt="DD 67"> <figcaption>Binu Gurung's work involves taking care of elderly Japanese.</figcaption> </figure>  Building trust and rapport takes time, patience and familiarity. I do not think there is a way to explain how happy I feel when they are happy with the care we provide and thank us in smiles like we are their own family members.&nbsp; My own grandmother back in Nepal was in a similar situation requiring care before she passed and I am able to extend that kind of care to many patients.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250511160536_0f41ad57ae1ac5bd2f406d86cdc5f542b613cef6961d8fdf20c883ee38404b5e.jpg" data-media-id="editor_20" data-image-id="20250511160536_0f41ad57ae1ac5bd2f406d86cdc5f542b613cef6961d8fdf20c883ee38404b5e" data-rendition-name="original" width="1600" height="1067" loading="lazy" alt="DD 67"> <figcaption>Binu Gurung in Yokohama.</figcaption> </figure>  I know that this job is not for everyone. That is why some nurses who come to Japan because they want to just<a href="https://nepalitimes.com/banner/making-overseas-migration-better"> migrate overseas </a>at any cost without considering the kind of employment realise that caregiving might not be for them.&nbsp; You have to be mentally, physically and emotionally prepared for it. If you are short-tempered by nature, for example, it may not be the best fit. However, for those who are genuinely interested in care work like I am, there are many growth opportunities in nursing which are also financially rewarding.&nbsp; While working under the SSW visa, I was able to take training classes on the side and passed the national exam for nursing. I was then able to change my visa from SSW to nursing caregiver visa. My son joined my husband and I recently in Japan and has started school.

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