South of Janakpur near the Indian border is the village of Phulgama. Out of its population of 4,500, nearly every household here has at least one son who is a migrant worker abroad.&nbsp; Some 40% of Nepali men between the ages of 20-35 are <a href="https://nepalitimes.com/news/die-first-get-paid-later">migrant workers abroad</a>, mainly in India, the Gulf states or Malaysia. In the last nine months alone, 741,297 people travelled overseas: mostly to the UAE, Saudi Arabia, Qatar, Malaysia and Kuwait. This does not include those who left on student visas, and there are no records of how many went to India. Most end up working in ‘3D jobs’ — &nbsp;dirty, dangerous and difficult. There is also a fourth D: dehydrating work.&nbsp; Risky outdoor as manual workers, <a href="https://nepalitimes.com/editorial/too-hot-to-work">excessive heat of the desert in the Gulf</a> or humidity of the tropical jungles of Malaysia, poor diet, dehydration and unhealthy lifestyles all contribute to a <a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/A-mysterious-rash-of-kidney-failures,3639">higher risk of kidney failure among Nepali migrant workers</a>. Dhanusha district has one of the highest proportions of workers migrating for work to India and abroad. Nephrologists call kidney disease ‘the silent killer’ because patients do not show symptoms until it is too late, and migrant workers are especially susceptible to Chronic Kidney Disease (CKD) or End-Stage Renal Disease (ESRD).&nbsp; Increasing demand for cheap labour and minimum pre-departure health awareness training makes migration more risky than it should be. From a survey of hospitals and dialysis centres in Dhanusha and Kathmandu, the risk of kidney failure<a href="https://nepalitimes.com/opinion/comment/saving-kidneys-to-save-nepal"> appears higher among male migrant workers</a> than in Nepali men of the same age group.&nbsp; “This disease is idiopathic, meaning it is not caused by one specific factor,” explains Rishi Kafle of the National Kidney Center Nepal. “But after screening migrant workers going to the Gulf and developing End-Stage Renal Disease in 3-4 years, we can say that migration increases the likelihood of kidney failure.” Kafle adds: “Because of the need to maximise earnings, working in extreme heat for long hours dehydrates them. And many opt for Coca-Cola and meat instead of healthier water and vegetables.”  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250118070128_b86cd132e88fecad9cde6d6faa648f76b40979660e6d28e846b25469668df9d8.jpg" data-media-id="editor_4" data-image-id="20250118070128_b86cd132e88fecad9cde6d6faa648f76b40979660e6d28e846b25469668df9d8" data-rendition-name="original" width="4032" height="3024" loading="lazy" alt="Dirty, dangerous, difficult, and dehydrating NT"> <figcaption>All photos: PINKI SRIS RANA</figcaption> </figure>  While the risk of kidney failure is higher in returnee migrant workers in Nepal, the disease is on the rise globally due to <a href="https://nepalitimes.com/banner/sick-of-it">lifestyle changes,</a> diabetes or undiagnosed hypertension. Currently, there are 28,266 kidney patients enrolled in the <a href="https://dohs.gov.np/">Department of Health Services</a> for free treatment under the government’s <a href="https://mohp.gov.np/program/medical-treatment-of-deprived-citizens/np">Bipanna Nagarik Kosh</a>, of which 17,044 are male and 11,222 female. Just in the past year, 9,176 more patients were added to the fund. Most hospitalised kidney patients are from age 15-65. In a healthy person, toxins and waste in the blood are filtered by the kidneys. But patients with kidney failure need to circulate their blood regularly through a haemodialysis machine. The whole process takes about 3-4 hours and causes blood vessels in the arms to swell over time. Nearly 2 million Nepalis suffer from chronic kidney disease (CKD), which is about 8% of the population. The rise in diabetes and hypertension is contributing to an increase in the disease. Everyone from migrant workers to many of Nepal’s top politicians suffer from kidney failure. Prime Minister Oli himself has had two kidney transplants. Even with dialysis twice a week, some patients develop nausea, swelling and other problems when they eat or drink. The extra dialysis sessions cost money, and the livelihood allowance given to patients is never enough or timely. Not every migrant working in hot climates returns with kidney disease, but a recent yet-to-be-published study led by nephrologist Sailendra Sharma states that one-fourth of all kidney patients in Nepal are migrant returnees. It points to recurrent heat stress as a primary risk factor. The<a href="https://mihs.edu.np/"> Madhesh Institution of Health Sciences</a> in Janakpur has 103 regular patients who come for dialysis. Of them, 30 are returnee migrants not just from Dhanusha, but also Sarlahi, Siraha, Mahottari and Sindhuli. “Not by the nature of the disease, but the way kidney disease is growing, I would call it an epidemic,” adds Kafle. &nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250118070128_43731248e116cfdc42bfc08b8f7d71e5ff3d44b938065a5ad9e9a337e666b9c7.jpg" data-media-id="editor_9" data-image-id="20250118070128_43731248e116cfdc42bfc08b8f7d71e5ff3d44b938065a5ad9e9a337e666b9c7" data-rendition-name="original" width="1463" height="798" loading="lazy" alt="Dirty, dangerous, difficult, and dehydrating NT"> <figcaption>HARD LABOUR: Jagdish Sah shows a picture from his time in Malaysia.</figcaption> </figure>  Jagdish Sah left for Malaysia ten years ago. He had taken a loan for his sister’s marriage and he had to pay it back. As the eldest son, he was also expected to get married next, but he faced multiple rejections. “Women have expectations too. They want to get married to well-to-do families. They didn’t want to get married to a family that lived in a mud house like ours,” says Sah, now 35. Foreign employment was a one-stop solution to his problems. Or so he thought. Sah was 24 when he left for a tailoring job at a garment factory in Malaysia. He often worked overtime, sometimes up to 12 hours a day in the hopes of earning extra ringgits. Even so, his highest monthly income would only be Rs35,000.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250118070128_7dd5030951c805302adec46afdef623bbdbb6fe1c0f12b7a77fd612531865af1.jpg" data-media-id="editor_10" data-image-id="20250118070128_7dd5030951c805302adec46afdef623bbdbb6fe1c0f12b7a77fd612531865af1" data-rendition-name="original" width="2048" height="1536" loading="lazy" alt="Dirty, dangerous, difficult, and dehydrating NT"> <figcaption>Sah at a garment factory in Malaysia where he worked, often dehydrated, and not taking toilet breaks to earn more.</figcaption> </figure>  Workers got a 30-minute break for lunch, and there were limited toilet breaks. So, Sah just worked straight out. Back in Nepal for a break in 2017, Sah had blurred vision and fainted. He thought it was high blood pressure, but a few months later at age 28, he was diagnosed with double kidney failure. “Whatever he saved in Malaysia went for his treatment in Kathmandu. We even sold a plot of our land,” recalled Sah’s mother, Mantoriya Devi.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250118070128_dc353dd6ce449c05bda6d562907dd961d8900c1b747dc4afec1680bb65b805b7.jpg" data-media-id="editor_11" data-image-id="20250118070128_dc353dd6ce449c05bda6d562907dd961d8900c1b747dc4afec1680bb65b805b7" data-rendition-name="original" width="3995" height="2871" loading="lazy" alt="Dirty, dangerous, difficult, and dehydrating NT"> <figcaption>Sah is now gaunt and frail in this picture taken duing his biweekly dialysis at Madhesh Institute of Health Sciences in Janakpur recently.</figcaption> </figure>  Sah drives his motorcycle twice a week from his village to the Madhesh Institute of Health Sciences in Janakpur for free dialysis. His family says it is as if the Jagdish who went to Malaysia and the one who came back are two different people. &nbsp; “This disease has already doomed my life. Why ruin someone else’s?” says Sah of his lack of marriage prospects. “It is because of dialysis that I have survived so far.” His parents are too old and occupied with their chores to accompany him. Since Jagdish cannot work, his father, Ram Dev sells popcorn by the sidewalk from a wheeled cart. Mithu Kumar went to Saudi Arabia to work as an electrical supervisor two years ago. He was 25. Recently when he started vomiting, he was taken to a local hospital. He was diagnosed with chronic kidney disease and was sent back to Nepal. As Kumar lays down for his dialysis treatment at Save Lives Hospital in Janakpur, he says, “My only wish is that I am healthy enough to work again.”&nbsp; Umesh Kumar Yadav also worked in Saudi Arabia as a guard. He returned with chronic kidney disease, but he says he is the only one to contract the ailment among all the returnees from his village. “Only the ill-fated people have this disease,” says Yadav. “Otherwise, it would have been the same for every other person from the village who is abroad working.” Ambar Bahadur Sarki, 46, travels from Sindhuli for three hours every Monday and Thursday to Janakpur for his free dialysis at the Madesh Institute of Health Sciences. Sarki worked in a palm oil plantation in Malaysia, where heat stress often exceeded the wet-bulb threshold for heat and humidity. “It was extremely hot at all times,” he remembers. He first got hypertension, which made both his kidneys fail. Ram Udgar Mandal from Dhanusha started working in Saudi Arabia in his late twenties. He spent the next 17 years in the desert working as a driver. Now in his late forties, he was diagnosed with End-Stage Renal Disease (ESRD) four years ago.&nbsp; But this is an intergenerational cycle. Mandal’s son has now also gone to Malaysia to supplement the family income. He fears his son will meet the same fate as him. “We do not have a choice, do we?” he says. Lalit Balampaki, 28, from Dhanusa was diagnosed with ESRD a year earlier in Dubai. He stays in Kathmandu along with his older brother’s family on a rented floor. Balampaki worked in extreme heat conditions in a smelting factory in Dubai. He had to work night shifts twice or thrice a week. Sleep deprivation and extended periods without food were part of his daily routine. The pay was good, but his savings have all gone now towards hospital fees. “More than the money, I earned the disease,” says Balampaki. &nbsp; Suraj Thapa Magar, 30, was the sole breadwinner of his family. He installed aluminum windows and doors in Kuwait “It was the hottest in summer and coldest in winter,” says Magar, who worked for 10 hours a day even in 50°C. He also often neglected hydration, and one night he vomited blood. At 26, he was diagnosed with ESRD and has been in Nepal ever since. Thapa has no other choice than to rely on the Rs5,000 allowance, but even that is not timely and not enough. He has to take loans to travel for his dialysis. The government hospitals are supposed to provide some medicines for free, but they are often out of stock. Thapa has looked for jobs, but kidney disease is a stigma and no one wants to hire him. &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;*** In 2016, Nepal started providing free hemodialysis treatment for the poorest patients. Two years later, a monthly livelihood allowance of Rs5,000 was to be distributed to patients suffering from chronic diseases like dual-kidney failure and cancer. Free dialysis is provided in 107 hospitals across the country, but that is only in theory. Many facilities do not have nephrologists because the government does not provide salaries. The machines also often are not working because they need constant maintenance. Among the 11 hospitals that provide free dialysis in Madhes Province, three are in Janakpur. Nepali Times visited the enlisted hospitals but there were no nephrologists to supervise the treatment, and they were run by general physicians or senior nurses.&nbsp; “The government does not provide adequate salaries for the nephrologists,” says Kafle. “That is why nephrologists are mainly affiliated with the private hospitals.” Bagmati Province has 44 hospitals with free dialysis, which is why many dual-kidney failure patients have opted to live in Kathmandu. The hospitals service over 8,000 kidney patients.&nbsp; Since most of them are migrant workers, the end result is that Nepal’s poorly-resourced health system ends up bearing the cost of treating kidneys that failed while working as labourers in hot, rich countries. &nbsp;

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Dirty, Dangerous, Difficult ... and Dehydrating

At the National Kidney Centre in Kathmandu, a substantial number of the staggering 800 patients who come for regular kidney dialysis are migrant returnees from the Gulf and Malaysia.&nbsp;
Last month alone, 90% of the 90,000 Nepalis who went abroad were migrant workers. Most of them went to West Asia. They are healthy when they leave, but are <a href="https://nepalitimes.com/editorial/too-hot-to-work">exposed to extreme temperatures</a>, and many return with ruined kidneys.
Nepal is suffering an epidemic of renal failure due to the workers’ continuous exposure to excessive heat, chronic dehydration, harsh work environment, and the tendency to go for energy drinks immediately after returning from work. The problem will get worse in coming decades with nonsurvivable wet-bulb summer temperatures in the countries where Nepali migrants work.&nbsp;
Truth be told, renal failure is not confined to migrant workers. Increasingly high numbers of young Nepalis are suffering from lifestyle-related ailments. Individuals as young as 25 are living with high blood pressure, fatty liver, and diabetes, among others.
In the past 40 years, Nepal has seen a dramatic transformation from a country with mortality mostly from infectious diseases to one where people are living longer but are dying due to lifestyle-related ailments. A <a href="https://nhrc.gov.np/wp-content/uploads/2022/02/BoD-Report-Book-includ-Cover-mail-6_compressed.pdf">2019 study by the Nepal Health Research Council</a> found that non-communicable diseases accounted for 71% of deaths in the country.&nbsp;
Diabetes, high blood pressure, and the irrational use of painkillers are some of the main reasons behind this figure. Kidney failure can be prevented if diabetes and hypertension are controlled in the initial stages.
Renal health is very much linked to the quality of life and economy. Patients do not suffer alone, often they are the sole breadwinners and their condition will greatly impact their families.
As per the World Health Organization, 10% percent of Nepal’s total population (300,000 people) suffer from kidney issues, 30,000 of them are in the final stage, and 3,000 need dialysis or transplant every year.
The increasing burden of non-communicable diseases is a global phenomenon but developing countries like Nepal face a double whammy as we continue to battle preventable infections too.
The chances of survival for people suffering from renal failure are slim, but the good news is that the government provides dialysis and transplantation services free of cost.&nbsp;
Currently, over 90 health facilities throughout the country provide free dialysis services to over 6,000 patients with renal failure. Over 3,000 patients have undergone kidney transplants since the service started about a decade ago, including a former prime minister and other senior government officials.&nbsp;
Every year Nepal spends Rs2.11 billion on the treatment of patients with renal failure. Local governments also provide monthly livelihood allowances to those with kidney failure or undergoing transplants. This is the highest amount the government has been spending for any single disease.&nbsp;
Even so, the focus is on the treatment of the 3,000 people living with kidney failure and scant attention has been paid to 270,000 others who suffer from some sort of kidney disease, and another 270,000 who are at risk of kidney disease.
Providing free dialysis service is not a sustainable solution. Authorities concerned should promote prevention, and encourage renal failure patients to opt for transplants. Despite the legal provision that allows any immediate family to donate a kidney, many with renal failure cannot find one.&nbsp;
Road traffic accidents are one of the biggest causes of deaths today and a kidney from brain-dead donors is a viable option. But this requires increased awareness about organ donation.
Preventing kidney disease is the best way, and the first step is to launch awareness campaigns, the cost of which is minimal compared to the treatment cost of renal patients.
The public should be told about the dangers of obesity, excessive consumption of alcohol, tobacco, salt, and junk food as well as insufficient intake of vegetables and fruits. Regular exercise, drinking plenty of water, and cutting on sugar should be promoted.
Screening is crucial to early diagnosis and a lot of lives can be saved if testing for non-communicable diseases is made free once a year for all age groups. Even then, most Nepalis do not undergo tests unless it is an emergency.&nbsp;
The government has established laboratories at the health post level to carry out the test, but very few make use of the service. People can monitor protein levels in urine and do a creatinine test, a measure that shows how well one’s kidneys are performing or filtering waste from blood. The tests cost just Rs100.
Above all, these awareness campaigns should be launched at the school and community levels so that we have an early chance to save every kidney from severe damage. Before things get worse, we Nepalis and Nepal can bring down the burden of non-communicable diseases, cut medical costs, and save lives.
Rishi Kumar Kafle is a senior Nephrologist and is the founding President of the National Kidney Center in Kathmandu.

Saving kidneys to save Nepal

<a href="https://nepalitimes.com/here-now/waiting-for-bipin-joshi" target="_blank">Nepali student Bipin Joshi</a>, who was taken captive by Hamas on 7 October 2023, was not on the list of those freed following the end of the bombardment and fighting in Gaza.&nbsp; On Monday morning, the Israeli military notified Bipin's family and Nepal’s ambassador to Israel Dhan Prasad Pandit, that there is no evidence of him still being alive. However, Nepal's Foreign Ministry is yet to be notified by Israel's government of Bipin's status. The news came three days after a US-brokered ceasefire between Israel and Hamas came into effect, and hostage and prisoner exchanges by the two sides started Monday morning.&nbsp; Almost 2,000 Palestinians held in Israeli prisions are expected to be released by Israel in exchange for the hostages during the next phase of the peace deal between the two parties, and the bodies of deceased hostages remaining in Gaza are also expected to be returned.&nbsp; Bipin Joshi was among a group of Nepalis who had arrived in Israel in 2023 just weeks before 7 October 2023 as part of a ‘learn and earn’ program to work and earn in kibbutz farms there.&nbsp; Along with other students Joshi had been working on a farm in Kibbutz Alumim in southern Israel near Gaza. <a href="https://nepalitimes.com/here-now/war-in-israel-earthquake-and-grief-in-nepal">Ten Nepali students were killed </a>while taking cover in shelters near their farms in two separate attacks by Hamas fighters.&nbsp; Joshi’s colleagues, fellow Nepalis who survived the attack, recall gunmen lobbing two grenades into the bunker that they had taken cover in. Bipin hurled one of the grenades out, they say, but the other one exploded, killing and injuring Nepalis inside. &nbsp;&nbsp;&nbsp;&nbsp; Shortly after, Bipin was captured by Hamas along with a Thai national and led away into Gaza. CCTV footage showed Bipin alive and at a hospital in Gaza on the day of the attack itself after he was taken hostage.&nbsp; Thirty-one Thai citizens, who like Nepalis worked in farms in Israel, were taken hostage during the Hamas attack, the highest number of foreign captives in October 2023.&nbsp; <a href="https://nepalitimes.com/news/deft-diplomacy-freed-thai-hostages">Deft Thai diplomatic engagement</a> with officials from Iran, Egypt, and Qatar brought about the release of 23 of its nationals in 2023. Five more Thai nationals were released earlier this year.&nbsp; In August, Joshi’s family visited Israel at the invitation of the government and urged the international community to push for his return. Bipin’s mother Padma and sister Pushpa have been at the United Nations to lobby for his release.&nbsp; His family last week also released a video clip of Bipin briefly speaking on camera, reportedly obtained by Israel and said to be filmed in November 2023, around a month after he was taken captive. Joshi looks healthy in that video.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251013091028_d551c7f88204c52217152fb5db655bb5a5f8bf2cff1e6a055326ebf64453ff9f.png" data-media-id="editor_3" data-image-id="20251013091028_d551c7f88204c52217152fb5db655bb5a5f8bf2cff1e6a055326ebf64453ff9f" data-rendition-name="original" width="2848" height="1528" loading="lazy" alt="Bipin Joshi NT"> </figure>  More than 67,000 Palestinians have been killed during the last two years of the genocide in Gaza. About 1,200 people were killed during the Hamas attack on 7 October 2023, while more than 251, including Bipin Joshi, were taken as captives.&nbsp; This is the third ceasefire implemented in Gaza since 7 October 2023 after previous ones in November 2023 and January 2025. This 20-point deal facilitated by intermediaries US, Qatar, Turkey, and Egypt included terms for Hamas to give up its arms, and for a devastated Gaza to be governed by a Palestinian body of independent technocrats, while Israeli troops will withdraw in stages from Gaza.&nbsp; Hamas has agreed to relinquish control of Gaza, but has rejected the demand for disarmament, saying the group will demobilise but is prepared to resume fighting if Israel breaches the ceasefire.&nbsp; Following the ceasefire, Palestinians in Gaza have begun long journeys back to homes reduced to rubble by Israel’s two-year assault on the strip. The flow of humanitarian aid in the city has also increased following the peace deal.&nbsp; Israel's closure of humanitarian corridors in the past months had blocked the entry of food and medicine into Gaza, causing widespread famine. The United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) has said that the restriction of aid into the beseiged city has left as many as <a href="https://www.unrwa.org/newsroom/news-releases/gaza-unrwa%E2%80%99s-lancet-study-reveals-alarming-surge-child-malnutrition">54,600 children acutely malnourished</a>.&nbsp; Meanwhile, US president Donald Trump landed in Israel on Monday as hostages were being released, and world leaders are expected to head to Egypt for an international summit to discuss the next steps in Gaza, Israel, and West Asia.&nbsp;

Nepali hostage in Gaza not alive: Israel

In the very first page of the first chapter of Nepal 2043: The Road to Prosperity are two maps. The first places Nepal right at the epicentre of Asia, and in the second the Kathmandu is at exactly the midpoint between Mumbai and Beijing. With his trademark optimism, author Sujeev Shakya says Nepal is not land-locked but land-linked to three billion people in China and India. We just need those two economic engines to pull us in the same direction. ‘With China and India becoming the two largest economies in the world in the next two decades … Nepal is the most valuable piece of real estate in the world,’ Shakya writes. For one thing, Nepal does not look beyond India and China for tourism — with the right policies it can attract millions of tourists just from those two countries. Nepal is set to graduate from a low- to a middle-income country by 2026 and to a high-income country in 2043 — hence the name of the book. The year 2043 in the Bikram Sambat calendar is also 2100 — a new Nepali century. The book delves into the past, present and future of Nepal and analyses enablers including hydropower, a fundamental transformation of which will drive the 2043 goal. The commoditisation of electricity will be the biggest transformation. Nepal can deploy ‘Cyber Gurkhas’ to attract foreign investors with the management of data centres with climate friendly renewable energy. Access to technology such as precision agriculture, a data-driven approach to farming to improve food production, reduce environmental impact and enhance profitability could be Nepal’s strategy into 2043 and beyond. ‘Earlier, we needed ploughs and strong hands in agriculture. Now, you need a computer and strong fingers,” Shakya writes, citing a neighbour’s son who inspects his crops from drone cameras. A farmer in an Ilam teashop tells the author he asks AI questions in Nepali, and it answers promptly. The biggest enabler of all is Nepal’s young demography with 62% of the population in the active 15-60 age bracket, while 28% are younger than 14. Nepal’s dependency ratio has dropped to the lowest in history with 100 Nepalis having to support 62 dependents. But this demographic dividend window is closing. Nepal’s total fertility rate declined from 2.62% in 1981 to 0.92% in 2021 — below replacement level. We have less than 30 years left to make the best use of the youth, many of whom are currently studying and working abroad. Nepal’s biggest resource, therefore, is its diaspora spread across the world who send home $20 billion a year. Migration is not just a necessity but an aspiration for many Nepalis, and they are an important source of contacts, investment and soft power. This young and educated group has taken advantage of connectivity and digitisation in all arenas of national life. TikTok and Instagram have become e-commerce platforms, or mobile app-riven digital services. Nepal’s software companies exported over $1 billion worth of IT products last year. Next we need a change in the bureaucratic mindset to eliminate paper and manual processes, which would also contribute to reducing corruption. Shakya comes up with many revelations: 81% of Nepalis live in houses they own, much higher than most other South Asian countries which means higher disposable income. Nepal has the highest tax-to-GDP ratio in South Asia. The banking sector is twice the size of Bangladesh despite Nepal having just one-fifth of its population. In 2021, 12.62% of the population had demat accounts in Nepal, while India had only 5.32%. For every five male investors, there are four women in Nepal while it is 10:1 in India. With such figures and prospects, how come Nepal just went through a violent uprising that took the shortest time to topple a democratically-elected government in modern history? One early chapter of 2043 is actually dedicated to how Nepalis have always thrived on chaos. When people faced up to 20 hours of power cuts a day, people worked around the load-shedding schedule, woke up at ungodly hours to cook and stock up on inverters. They did not put up a fight, or even protest. ''Generally, Nepalis are used to taking things lying down, and perhaps this also needs to change,' says Shakya, writing that line before last month’s uprising. ‘On the one hand, some of these issues speak volumes about the average Nepali’s patience and perhaps optimism that things will change in the long run. On the other hand, one is also forced to wonder how much longer they will be able to put up with unfavourable conditions if things don’t change.’ It does seem Nepali had enough with corruption, governance failure and political apathy to the concerns of ordinary people. The final chapter lists the non-negotiables to realise the 2043 Nepal Roadmap: democratic values and freedom of speech, a capitalist welfare state and socio-political transformation to tackle corruption and impunity. The book notes, ‘Countries transitioning to democratic rule experienced a 20% increase in GDP over a 25 year period compared to what they would have achieved under authoritarian regimes. After the end of the Shah rule in 2006, Nepal’s GDP rose from US$10 billion to US$44 billion by 2024.’ The government’s Vision 2030 document projects Nepal’s GDP at US$100 billion, and the Vision 2043 estimates that it will be a US$423 billion economy with a per capita of US$12,100. However, it will need more than optimism and practical action to make these projections real. China and India loom large throughout the book with examples of small city states like Singapore which have taken advantage of their strategic location. Despite the tension between India and China, the two will have to collaborate given the inherent advantages. China has replaced the United States as India’s biggest trading partner. Sujeev Shakya is a great admirer of former Singaporean diplomat and author Kishore Mahbubani, and he has written a blurb for the book. He quotes Mahbubani saying that for the past 2,000 years, apart from the last two hundred, Asian countries have dominated the world, and it is quite natural that the world’s economic centre is returning to Asia. And Nepal is strategically placed to make the most of it because of its location between two of the world’s fastest growing economies. We just have to get our politics right, and have a strategy for equitable growth in the new Nepali century.  <figure><img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251016091052_78b2d1495d59cd492a17693e0e770b65230c7cb749393ac6643f4676b73832ef.jpg" data-media-id="editor_0" data-image-id="20251016091052_78b2d1495d59cd492a17693e0e770b65230c7cb749393ac6643f4676b73832ef" data-rendition-name="original" width="1136" height="702" loading="lazy" alt="Sujeev Shakya book details NT"></figure>

Retrofitting Nepal for future shocks

In the aftermath of the GenZ protests last month, as new PM Sushila Karki chose the first members of her Council of Ministers, youth collectives urged that it reflect the country’s diversity by including women, youth and people from various ethnic and socio-cultural backgrounds.&nbsp;
It took another couple of weeks for Karki to include &nbsp;bureaucrat and public health expert Sangeeta Mishra as &nbsp;Health Minister in her next tranche of ministers. Almost immediately, people dug up a video of Mishra calling herself “Nepali, but a native Indian”.
She was telling it like it was: Mishra is a naturalised Nepali citizen. But there was outrage in the ultra-nationalistic cybersphere. Mishra’s name was withdrawn from the list of ministers, with government officials citing an ongoing investigation at the CIAA.&nbsp;
With her Cabinet still incomplete a month after taking office, Prime Minister Karki was preparing to induct GenZ as ministers. A leak in the media floated the names, one of which was of Tashi Lhazom, a climate activist and filmmaker from Humla’s Limi Valley.&nbsp;
Almost immediately, social media erupted with discriminatory, xenophobic and misogynistic epithets against her: that she supported a separatist movement, that she was a foreign agent, that her citizenship was disputed, that she did not ‘look’ or ‘speak’ like a Nepali.&nbsp;
Political figures like Gyanendra Shahi, a prominent voice calling for the restoration of a Hindu monarchy, added fuel to the fire by making bigoted and false remarks about her heritage.
The former Commissioner of the National Human Rights Commission, Mohna Ansari, wrote on social media that it was shameful to question Lhazom’s identity: ‘Ms Tashi Lhazom is as Nepali as you are. Our society’s ugliest face and biggest flaw is doubting our own. Real patriotism embraces diversity — fake nationalism must end.’
Ansari, a human rights lawyer and activist, has also often been subject to Islamophobic and derogatory comments on digital platforms. &nbsp;
In response, the Indigenous GenZ Collective released Lhazom’s Nepali citizenship certificate to debunk the mistruths spreading on digital as well as mainstream media.
What makes a Nepali? What does a Nepali look or sound like? Who is a Nepali?
‘Had my name been Tashi Poudel, Thapa, Bhattarai or Ghimire, this would not have happened,’ Lhazom said in an interview with Kantipur following an avalanche of bigotry against her. ‘They questioned me because I do not look Nepali, or speak Nepali like a Khas. Because it is not my mother tongue.’
It is an indictment of Nepali society that indigenous Nepalis have to present proof, at the slightest inconvenience of mostly the dominant groups, of being a citizen of this nation simply because they might not fit into an imagined idea of Nepali nationhood by virtue of physical appearance, speech, geography, or faith.
And while we celebrate the successes of Nepal-born naturalised foreign citizens (some now hold elected office in the US) we refuse to afford the same respect to naturalised Nepali citizens, and those born in Nepal to excluded groups, nor do we expect them to work in the national interest if they are given responsibility to govern. And women are singled out twice as much for scrutiny.
Then cyber Nepal went into a tizzy when videos appeared of a biker’s group clad in black t-shirts emblazoned with the acronym ‘TOB’ which was interpreted to stand for ‘Tibetan Original Blood’ and linked to the Free Tibet movement.
The accusations snowballed into disinformation, xenophobia, and even calls for violence against Nepalis of Tibetan heritage and the Tibetan community in Nepal.&nbsp;
In the aftermath of the September protest, the hope was that politics and the bureaucracy would finally be rid of orthodox political actors. But first, we as a nation need to collectively examine the biases and bigotry that exist in Nepal’s socio-cultural space.&nbsp;
Otherwise, Nepal’s multiculturalism will be limited to just words in the Constitution and political tokenism.
No one who is in government now or in future can be expected to be completely free of subjective opinions, ideology, affiliation to a cause, or prior activism. And such criticism falls disproportionately on activists, advocates, and members from underserved and underrepresented communities.&nbsp;
One cannot be apolitical and hope to participate in politics, and as we move forward to rebuild the system it must not just reflect diverse communities, but also celebrate diversity of thought and beliefs.&nbsp;
Resorting to ethnocentrism, racism and chauvinism with conspiracy theories and discriminatory dog-whistling about fellow citizens is a disservice to Nepali nationhood. It is Nepal’s diversity that makes us strong.&nbsp;
Shristi Karki

What makes a Nepali?

Nepali Times: You just climbed Mt Everest without oxygen and then skied down the mountain. How does one even train for something like that?&nbsp; Andrzej Bargiel: What made skiing down Everest possible was all the years of experience I’ve gained in high-altitude mountains. Spending a lot of time in the high mountains helps me read the snow, the conditions, and potential hazards. I need to ski often, especially in steep and exposed terrain, so that it becomes a place where I feel completely at home.&nbsp; I also climb regularly, I am an IFMGA mountain guide. I also run, ride a bike, and work out in the gym. Like in any endurance sport, I have to prepare my body for the demands of an expedition.&nbsp; What motivated you to do Everest? This was actually my third attempt on Everest. After many years of ski mountaineering and racing, I felt it would be great to use that experience to take on a meaningful project in the Himalaya. It’s about exploring what’s really possible, testing my limits, and seeing how far I can go. I was inspired by people like Davo Karničar, Fredrik Ericsson, and Hans Kammerlander, who showed that skiing in the high mountains can truly be done.&nbsp; What do you have to be most careful about when skiing at such high altitude? You really have to manage your energy well, because you need to be ready to spend many hours at very high altitude — even above 8,000 meters. Risk management is essential. You have to read the signals nature gives you and make the right decisions, choosing safe moments to move. The dangers are always there: avalanches, crevasses, extreme fatigue, and exposed terrain, so you have to stay fully aware and focused. Safety comes first, always. You also need to stay open to changing your plans, because in the mountains, things don’t always go the way you expect.&nbsp; Why did you choose autumn and not spring?&nbsp; Autumn is really the only season when you can think about making a full ski descent from the summit all the way to base camp. In the spring there’s much more ice left after winter, and the snow cover is broken. A full descent simply isn’t possible then, because too much rock and ice are exposed. Of course, in spring it’s easier to climb the mountain. The conditions are more stable, the snow is firmer, there’s less avalanche risk, and you don’t have to wade through deep snow. The autumn ascent is very complex and demanding, which is why so few expeditions attempt it. But in autumn, skiing becomes possible. Several meters of fresh snow fall on Everest’s slopes, covering the rocks and ice, and that transforms the mountain into something wild, beautiful, and most importantly skiable. What was your favourite part this time? The moment I remember most fondly was reaching the summit — and that first stretch just below the top, when I clicked into my skis and started moving down through surprisingly nice snow. It felt smooth and natural, a kind of free, easy glide down toward the Hillary Step. I could feel the movement, the flow, and at the same time this awareness that I was skiing from the highest point on Earth. It was just a really good feeling. The Icefall was another special moment. I felt from a skier’s point of view that it really worked. I could make my turns, and the descent itself was fun, technical, but a beautiful one too — full of variety, weaving through ice towers and seracs that looked incredible in the sunlight. It was challenging, but also just pure joy.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251015141012_e9e671e07b089a7d59e4b9ba34df993180ae2dfcae3786113a4d48c515427b3d.jpg" data-media-id="editor_0" data-image-id="20251015141012_e9e671e07b089a7d59e4b9ba34df993180ae2dfcae3786113a4d48c515427b3d" data-rendition-name="original" width="1365" height="2048" loading="lazy" alt="Andrzej Bargiel NT"> </figure>  And what was most challenging? The hardest moment came on 14 September, during our first summit push attempt. We were breaking trail in deep snow and reached the South Col in the evening. I already knew we wouldn’t be going higher that night, so I decided to stay there, to use the climb to acclimatise.&nbsp; But after that attempt failed, the team completely lost faith that the project could still succeed. Almost everyone started packing up, convinced it was over, nobody thought that the snow would stabilise enough.&nbsp; I skied down from the Col early the next morning in really good conditions, while the rest of the team descended on foot. Rebuilding belief within the team that it could still be done was the toughest part, mentally. It took me several days to bring that energy and motivation back, to make everyone believe again that we could try once more. What was your support crew like?&nbsp; I want to thank the whole team — all team members from Poland, all those who contributed to the project, all the sponsors, and the Seven Summit Treks crew, especially Dawa Sherpa, who had the courage to go to the top with me.&nbsp; In the end, his courage made it possible. Doing it alone would have been almost impossible. With him there, I felt safe, and that made all the difference. What potential for skiing do you see in the Himalaya?&nbsp; Huge. There’s massive potential here both for ski touring and for a more recreational form of skiing. In the Himalaya, there are so many mountains you can ski from, and they don’t have to be eight-thousanders.&nbsp; There is an incredible amount of snow even in the lower valleys during the winter, which makes it a really interesting place for skiing. You can find great powder and enjoy long, wide runs.&nbsp; The key, I think, is to keep developing local guiding structures. There should be more certified guides in Nepal, Sherpas gaining guiding qualifications, and a proper professional rescue service. That would definitely increase the sense of safety for both skiers and tourists coming to the mountains. I’d love to come back to the Himalayas one winter just to ski in those lower parts — in deep snow, on much longer and wider skis – that would be pure pleasure. At those lower altitudes, the fun can be so much greater, with a more relaxed, freeride kind of feeling.

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