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

Recent outrage in Sikkim over an Indian Army expedition climbing <a href="https://nepalitimes.com/here-now/saving-kangchenjunga">Kangchenjunga</a>, the world’s third-highest peak, has spiked attention to the need to balance mountaineering jobs with indigenous reverence for sacred landmarks. Kangchenjunga (8,586m) is not a peak as much as it is a mountain range with 16 peaks above 7,000m on the border between India and Nepal -- the word itself means ‘five treasures of the snows’ in Tibetan. Some of the highest prominences like Kangchenjunga West and Kangbachen are in Nepal, while the Main, Central and South Peaks are on the border. Climbing the peak from the Indian side has been banned since 2001 because the indigenous Lepcha community there regard the mountain as the abode of Dzoe-nga, the patron deity of Sikkim, which was an independent Himalayan Kingdom until it was annexed by India in 1975.&nbsp; Buddhists in Sikkim say their saint, Padmasambhava, recognised the mountain as a protective spirit. The state has declared the base of the mountain Kangchenjunga National Park, which covers an area one-third of Sikkim. ‘The act of scaling this sacred peak is not only a matter of serious concern but also a violation of both the prevailing legal provisions and the deeply held religious beliefs of the people of Sikkim,’ read a letter from Chief Minister Prem Singh Tamang (Golay) to Amit Shah, India’s Minister of Home Affairs and Cooperation.&nbsp; Tamang continued: ‘We further request Your Honour to take up the issue with the Government of Nepal to ensure that no future expeditions are permitted on the sacred mountain, in deference to the deeply held beliefs and cultural values of the people of Sikkim.’ Kangchenjunga was climbed for the first time exactly 70 years ago by a British team who told King Tashi Namgyal, the Choegyal of Sikkim, that they would not set foot on the summit. Since then, there have been about 532 successful climbs of the peaks and 52 have died while trying.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250628060616_5c268e08cf49f36b79ef9b31933fc2d9bf9a6f65414e7ca06dd028bf04e7ccc1.png" data-media-id="editor_1" data-image-id="20250628060616_5c268e08cf49f36b79ef9b31933fc2d9bf9a6f65414e7ca06dd028bf04e7ccc1" data-rendition-name="original" width="1782" height="1178" loading="lazy" alt="Kangchenjunga: too sacred to climb NT"> <figcaption>Indigenous communities in Sikkim held purification ceremonies following the Indian expedition to Kangchenjunga. Photo: THE VOICE OF SIKKIM / FACEBOOK</figcaption> </figure>  <a href="https://nepalitimes.com/here-now/peak-climbing-season-2025-s4abrxny">This spring climbing season</a> alone, there were 70 climbing permits for foreigners issued for Kangchenjunga by the Nepal government, and made it to the top while one French climber died.&nbsp; One of the expeditions this year was an Indian Army team led by Col Ranveer Jamwal, who has summited the highest peaks on all seven continents, and Mt Everest thrice. Jamwal’s team was on the final leg of a ‘<a href="https://economictimes.indiatimes.com/news/india/nimas-summits-mt-kangchenjunga-concludes-historic-har-shikhar-tiranga-mission-successfully/articleshow/121341315.cms?from=mdr">Har Shikhar Tiranga</a>’ (The Tricolour on Every Peak) mission to plant the Indian flag at the highest points of each of India’s 28 states. Kanchenjunga was the last peak they had left, and the hardest, but the expedition put five climbers on the summit. What seems to have incensed the Sikkimese is that while it has banned climbing the mountain from its side, it was an Indian military expedition that went to Nepal to climb the mountain. After news broke of the climb in May, the Sikkim Indigenous Lepcha Tribal Association asked people to observe purification ceremonies in temples across the state. Mayalmit Lepcha of the association acknowledged that the Sikkim government was also partly at fault: “I don’t think such an expedition could have gone forward without the state government being informed, so it could have done something to intervene. It shows weakness. What’s done is done, all we can do is carry out these sanctification ceremonies.”&nbsp; In 2000, one year before Sikkim’s ban, the state allowed an Austrian team to attempt Kanchenjunga’s northeast face for a fee of $20,000, on agreement that they would stop 10m before the summit. Despite this, there was outrage over the expedition on the grounds that it violated Indian laws regarding the defiling of religious sites and Sikkim’s rights to maintain its culture after merging with India. The Indian Army expedition was also seen to have circumvented Sikkim’s law and violated religious sensibilities by going through Nepal. While the team may have thought they were respecting Sikkim’s beliefs by finding a way to complete the mission, the people of Sikkim saw it as defilement.&nbsp; The somber mood of the Sikkim people at the ritual contrasts sharply with Jamwal’s sense of accomplishment. “Without a doubt, the most difficult summit of my life,” he told reporters after the climb. “It tested every ounce of our will.”&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250628060616_ccfe079c78dab788d19fe2080ee8a5d5dcb11de4157316f6d94e5964da097157.jpg" data-media-id="editor_4" data-image-id="20250628060616_ccfe079c78dab788d19fe2080ee8a5d5dcb11de4157316f6d94e5964da097157" data-rendition-name="original" width="787" height="377" loading="lazy" alt="Kangchenjunga: too sacred to climb NT"> <figcaption>Prayer flags along the Sikkim-Kangchenjunga trekking route. Photo: TREKKINGININDIA.COM</figcaption> </figure>  The <a href="https://nepalitimes.com/news/the-rise-and-fall-of-nims-purja">controversial Nepali-British mountaineer Nirmal Purja</a> was also on Kangchenjunga this spring the mountain, on a mission to summit all 14 8,000m peaks for a third time. He echoed Jamwal about the tough conditions: “The conditions above camp were extremely tough, with deep snow and challenging terrain—more crevasses than usual.” Nepal’s government has not said anything publicly, but it is unlikely that it will ban climbing on Kangchenjunga, since it is becoming popular with expeditions because of its technical challenges, and overcrowding on Mt Everest. Nepal does have bans in place for some of its mountains out of respect for local beliefs. <a href="https://nepalitimes.com/banner/to-open-machapuchre-for-mountaineering-or-not">Mt Machapuchre</a> (6,990m) the imposing pyramid that looms over Pokhara, for example, is seen as an icon of purity by the Gurung people and a symbol of Vishnu by the Hindu communities who live at its base. A strict climbing ban has been in place since 1957, when a British expedition led by Col Jimmy Roberts stopped 45m short of the summit – either because the last bit was too difficult or out of deference to local sentiments.&nbsp; Khumbila that stands above Namche Bazar is only 5,761m high, but like Kanchenjunga is considered the protector deity of the Sherpa people. Gauri Shankar on the Nepal-China border, called Chomo Tseringma by the local community, was off-limits between 1965 and 1979 due to its association with Lord Shiva and Gauri, his consort. Although expeditions are now allowed, there are not too many takers. In Tibet, climbing Mount Kailash is prohibited by the Chinese government because it revered by the Hindus, Buddhists and followers of the Bon faith. Even Mt Everest is regarded as sacred, and its Sherpa name is Chomolungma, Goddess Mother of the Earth.&nbsp; Economically, climbs on Kanchenjunga bring in decent revenue. This climbing season, the 41 permits, at $1,800 each, brought in $73,800. This is somewhat comparable to Makalu, Lhotse, and Annapurna I, but these numbers are dwarfed by the $4 million in <a href="https://nepalitimes.com/news/the-everest-industry">Everest permits</a>. Revenue from Kanchenjunga climbing permits is something Nepal could potentially forgo if necessary, but the expeditions also provide jobs to hundreds of high altitude guides, porters, base camp support staff and other logistical costs.&nbsp; As the third highest mountain in the world and the tallest in India, there will always be significant motivation to climb it from the Nepal side, especially as climbers are drawn by the technical climbing at high altitude.

Kangchenjunga: too sacred to climb?

The debate about who is less accountable to the public: politicians or bureaucrats is as old as Nepal’s democracy itself.
Some blame politicians for being beholden to the businessmen who finance their electoral campaigns, and are forced to return the favour with contracts and kickbacks when in power.&nbsp;
Others say it is civil servants who are neither civil nor servants, and know the inner workings of the system to exploit loopholes – they then teach ministers, MPs, mayors, or ward chairs which juicy projects can be squeezed. And everyone gets their share.
In reality, it is probably not a case of either, or. Both have their hands deep in the honey pot. Corruption is now such a given that yet another exposé in the mainstream press, like the latest visit-visa scam, does not raise eyebrows anymore.
We may have to edit Lord Acton’s famous quote to say that in Nepal we do not even need absolute power to corrupt absolutely. The ruling cartel has divvied up the spoils, so that no one ever faces charges. The three parties all know about the skeletons rattling in each other’s closets, and they cancel each other out.
Politicians and bureaucrats get all the blame for taking bribes, but what of the givers of bribes? In this crony capitalism, businesses invariably need political patrons in an elaborate <a href="https://nepalitimes.com/here-now/nepals-only-growth-industry-private-sector-corruption" target="_blank">national network of give-and-take</a>.
<a href="https://nepalitimes.com/here-now/nepals-only-growth-industry-private-sector-corruption" target="_blank">Politicians and businesses work hand-in-glove</a> so that conflict of interest in contracts, insider trading, cartelling, and non-performing assets of banks become the norm. Our survey after the 2017 local election showed that out of the 753 newly-elected local government chairs, <a href="https://nepalitimes.com/news/elected-contractors" target="_blank">nearly 300 were contractors</a> involved in sand-mining, quarrying, or transportation syndicates.
Nepal’s tycoons have discovered that instead of donating to election war chests of politicians, it is a much surer return on investment to spend the money to <a href="https://nepalitimes.com/news/the-business-of-politics-in-nepal" target="_blank">become legislators and politicians themselves</a>.
In democracies, there are checks and balances to control corruption when it becomes endemic. The Nepal Police and Central Bureau of Investigation (CBI) are supposed to do the detective work without political interference. The courts are required to be independent in dispensing justice and punishing crooks.
But the less said about the judiciary the better. A writ petition in the Supreme Court last week accused our sister magazine <a href="https://www.himalkhabar.com/" target="_blank">HimalKhabar</a> of contempt of court for two stories: one about how high courts have been overturning a majority of verdicts of district courts in cases of rape, and another about the Biratnagar High Court clearing a self-proclaimed holy man, Krishna Bahadur Giri, of rape despite police presenting physical evidence.
The doctrine of the separation of powers stipulates that it is when the other three pillars in a democracy are compromised that the role of the free press becomes even more vital. The world over, as soon as populist autocrats are elected to the executive, their first order of business is to co-opt the legislature and the judiciary. Then they buy off, intimidate, or neutralise the media with Strategic Lawsuits Against Public Participation (SLAPP).
Nepal’s officialdom seems to be taking midnight Zoom lessons from other despots on how to gag the media. Last month, popular talk show host Dil Bhushan Pathak was served an arrest warrant by the Kathmandu District Court for <a href="https://www.youtube.com/watch?v=-CntsnTrtG8" target="_blank">a YouTube explainer</a> about the alleged involvement of the son of Foreign Minister Arzu Deuba Rana in a reported purchase of Kathmandu’s Hilton Hotel.
The Lalitpur District Court ruled that Pathak could not be arrested without fair trial, but this week the Kathmandu District Court filed another case against the journalist based on a complaint by the Cyber Bureau, and put him on a fugitive list.&nbsp;
Without going into the veracity of Pathak’s explainer, it is deeply problematic that the Electronic Transaction Act has been invoked – proof that politicians are getting the courts and investigating agencies to make an example of a high profile journalist.&nbsp;
The intention is to silence media investigations into the fake refugee scandal in which the main partner in the ruling coalition is implicated, and in which one of its former home ministers was jailed last year.
The Kathmandu High Court has been mysteriously active in targeting journalists these days. <a href="https://bizmandu.com/" target="_blank">Bizmandu</a> and <a href="https://nepalkhabar.com/" target="_blank">Nepalkhabar</a> were served a notice last month <a href="https://nepalitimes.com/news/no-freedom-after-expression-y4inku06" target="_blank">to withdraw a story they did</a> on the Chair of the <a href="https://www.sebon.gov.np/" target="_blank">Security and Exchange Board of Nepal (SEBON</a>) Santosh Narayan Shrestha allegedly demanding kickbacks from hydropower investors.&nbsp;
Incredibly, the court even asked the two portals not to report on the subject anymore – a ruling so absurd that the Patan High Court overturned it a week later.&nbsp;
The allegations against Shrestha were made in a public meeting of the <a href="https://www.ippan.org.np/members/3060/bungal-hydro-ltd" target="_blank">Independent Power Producers Association of Nepal (IPPAN)</a>, and MPs demanded a <a href="https://myrepublica.nagariknetwork.com/news/parliament-demands-probe-into-sebon-chairman-over-alleged-commission-demand-40-32.html" target="_blank">Parliament inquiry</a> into the regulator. <a href="https://www.himalkhabar.com/144523/santosh-narayan-shrestha" target="_blank">HimalKhabar</a> reported this week that while Shrestha was reportedly demanding commissions from private investors for IPOs, he cleared primary share sales in Bajhang’s 10.75MW <a href="https://www.ippan.org.np/members/3060/bungal-hydro-ltd" target="_blank">Bungal Hydro</a> in which his family members have investments, company records show.
And then just on Monday, bureaucrats hoodwinked MPs by deleting references in a bill requiring a two-year ‘cooling off’ period under which retiring civil servants could be barred from holding constitutional positions for two years.
The contest for who is more corrupt: bureauacrats, politicians, or the private sector is on.
Kunda Dixit

SLAPPing Democracy

The monsoon this year arrived on time, and brought life-giving rain — irrigating paddy terraces, recharging groundwater, reviving springs, and increasing electricity generation.
But Nepal has to deal with either too much water or too little. On a clear April day before the monsoon, the hills of Sindhuli district were parched, and there were wildfires burning out of control. There had been no rain for the past six months.
And that has been the perennial crisis for Nepal’s farmers: that 85% of the rainfall occurs during just four months of the monsoon with little rain for the other eight months.&nbsp;
The water crisis is related to the powerful changes sweeping the mid-hill region of Nepal. With better roads, higher incomes and more exposure, many residents now aspire to have the kind of water supply seen in urban homes. They want hot or cold water at the turn of a tap, showers and flush tank toilets.&nbsp;
To meet this rising demand, many local and provincial governments are investing in large water supply projects often by lifting water from rivers hundreds of metres down the mountain. But these new systems may not be sustainable in the long run.
Many villages in Sindhuli are switching from local springs to piped systems, and even in rural homes, overhead tanks are becoming common.
But this new convenience comes with big challenges. Lifting water from rivers far below requires long pipes, electric pumps, and constant maintenance. These systems are costly, and the streams themselves often shrink to a trickle in the dry months. Big water-lifting schemes look impressive, but there is doubt if they can meet growing water demand.
A much more sustainable solution would be what some communities are doing: restoring old ponds or build new recharge systems. But those villages are exceptions, in most places traditional ponds and wallows are being filled up to be turned into sports fields, or make way for buildings.
Where there are new ponds, they are sometimes in the wrong places or without proper design. Roads and drains are not engineered properly and have increased landslides and erosion. Water management in hilly areas is not just about building things, it is about building in the right way, in the right place.
Traditional water systems were based on nature. They were not perfect, but they used the land wisely. Ponds used to hold rainwater and slowly refill springs which supported families, farms, and forests.&nbsp;
Not everything worked well in the past, but we can learn from traditional water management practices. Across Nepal, some rural municipalities have launched campaigns to store monsoon runoff — either in tanks, ponds or by recharging the aquifers.
But not all efforts have been successful. Some ponds are built without any hydrological study. Some are rushed to meet deadlines rather than real needs.&nbsp;
Now, the Muhan initiative hopes to revive springs to make households more resilient and help farmings. With the financial support of the Australian Centre for International Agricultural Research, research is being done to understand how springs work and how they are affected by changes in rainfall, land use, and development.&nbsp;
Instead of just building pipes and tanks, the project maps the entire springshed so we can understand the root cause of water shortage. In Sindhuli, the problem is not the amount of rain, but the loss of natural systems that store it and the social systems that manage water.&nbsp;
Nepal’s towns and villages now face a major challenge: how to manage water all year round as demand rises with people’s living standards. Depending only on river-lift systems is not a sustainable solution.&nbsp;
We need a mix of approaches that help store water from the rainy season to make it available for the rest of the year, whether by directly harvesting rainwater, restoring ponds, managing springsheds, or smart management of demand.
Rural Nepal is also seeing dramatic depopulation. Much of the outmigration can be stemmed if there is easier water supply for agriculture and household use. Across the mid hills, villages are emptying because springs are going dry. Government policy needs to catch up with the reality on the ground, and support solutions that work for people and nature. Every water supply plan should include recharge structures. Every road or building project should consider water flow and erosion. Local governments need more than budgets: they need training, tools, and data.
Ngamindra Dahal is with the Nepal Water Conservation Foundation, Kathmandu. Hemant Ojha collaborated in this piece and is associated with the Australian National University.

Water for Life

<a href="https://nepalitimes.com/multimedia/the-last-of-the-kusunda">The Kusunda</a> are among the last remaining hunter-gatherer communities left in Nepal, and it has only one fluent speaker left of a language that is not related to any other language group in South Asia.&nbsp; The Kusunda call themselves the King of the Forests ((गेम्येहाक़ in Kusunda,वन राजा in Nepali) and used to have a nomadic lifestyle till recently. But decades of exclusion from mainstream society and modernity have forced the Kusunda to assimilate. &nbsp; Today, most Kusunda live across Nepal’s mid-hills and western plains, choosing to identify themselves as Thakuri and adopting names like Sen, Shahi, and Khan to avoid ostracisation. Over time, inter-ethnic marriages between the Kusunda and other communities became increasingly common.&nbsp; However, the assimilation with other communities also meant that almost no one from the Kusunda community can speak their mother tongue – considered by linguists to be a ‘language isolate’ not related to any other language group in the world, and lacking set rules of grammar that are foundational to other languages. There are no words for ‘Yes’ or ‘No’ in Kusunda, nor are there words to signify direction. There are 23 languages with less than 1,000 speakers listed in Nepal's 2021 census, with Kusunda being the language with the least number of speakers. The number of people who identified as Kusunda has decreased with each subsequent census. Only 253 individuals identified themselves as Kusunda in the last National Census of 2021, down from 273 in 2011.&nbsp; <div class="embed-block"><iframe src="https://creators.spotify.com/pod/show/raithane-bhakha/embed/episodes/Kusundas---the-last-of-the-forest-kings-e23ge6p/a-a9peei1" height="102px" width="400px" frameborder="0" scrolling="no"></iframe></div> The government’s decision to provide a social security stipend to the community for the past few years has prompted many from the Kusunda community to reclaim their identity and in the process, explore their culture and language. Kamala Sen Kusunda, who lives in Dang, is the only fluent native Kusunda speaker alive, although there are now other Kusunda and non-Kusunda people learning how to speak the language. By the time Kamala Sen Kusunda was born in 1975, her family had settled in a village in Rolpa. Although she did not experience the nomadic life of her forebears, she still roamed the forests freely as a child and many of the values and socio-cultural practices of her community were instilled in her and her siblings.&nbsp; This meant that Kamala grew up speaking Kusunda with her family. But by then, the Kusunda had increasingly begun to interact with people beyond their community, and inter-ethnic marriages had become a norm.&nbsp; Kamala herself married at 18 to a 52-year-old man from the Chhetri community. She would go on to have four children, but they were brought up with her husband’s culture and community rather than her own, and teaching them her mother tongue seemed impractical.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250628030648_afaa298bf8ea3b7086e2ed086b11eab463ef2b20a82a4aad74df3dd2e922a4c3.jpg" data-media-id="editor_2" data-image-id="20250628030648_afaa298bf8ea3b7086e2ed086b11eab463ef2b20a82a4aad74df3dd2e922a4c3" data-rendition-name="original" width="855" height="641" loading="lazy" alt="Kusunda NT"> <figcaption>Gyani Maiya Kusunda with Kusunda youth in 2015.</figcaption> </figure>  “If I had spoken my language to them when they were children, they would have learned,” she tells us ruefully. “But they were growing up in a different community, so I never pushed, and they never expressed interest.” At the time, she had other things to worry about, such as earning a livelihood and sustaining her family. To find work, Kamala and her family moved to Shimla in India, where she worked at an apple orchard for six years.&nbsp; Over the next years, Kamala and her family moved back and forth between India and Nepal for work, and Kamala was not actively conversing in the language of her people or being able to connect with members of her community now scattered across Nepal.&nbsp; Had she not forgotten her language after all those years? “How could I forget the language of my ancestors?” she replies. “Not speaking it did not mean that it ceased to be a part of me.”&nbsp; Kamala had been working at a brick kiln in Thimi seven years ago when the National Language Commission tracked her down, offered her a paid position as a Kusunda language consultant and source person for basic language training in Dang.&nbsp; It was there that Kamala met her cousin Gyani Maiya Sen Kusunda, the only other person able to speak Kusunda fluently, who had been working with the Commission to conserve Kusunda language and culture. It was also where Kamala met language researcher and lexicographer Uday Raj Ale. Ale had been in the middle of his research into the Tharu language and community 15 years ago when he met Gyani Maiya Kusunda’s son, who told him that his mother was one of the few people who spoke Kusunda, but that no one had shown an interest in studying and preserving the language and culture. Ale met Gyani Maiya, spending time with her learning and researching Kusunda. By 2017, Ale had collected enough words to put together a Kusunda dictionary. The Kusunda vocabulary currently comprises 2,000 words. His research into the Kusunda language and culture has taken him to every known Kusunda household in Nepal. Although the census puts the number of Kusunda at 253, Ale reckons there are only 158.&nbsp; “Kusunda language is endangered due to its lack of use in everyday life, literature, and religious and socio-cultural practices, as well as the prevalence of inter-ethnic marriages,” explains Ale. In 2019 the Language Commission began its language transfer programs for youth from indigenous communities. Since then, the Commission has completed multiple phases of Kusunda language classes in Dang facilitated by Uday Raj Ale. The classes have 20 students, not just from the Kusunda community, but also interested non-native students.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250626120632_c6c378bc00af450f2b7f0cf17af1c3b2b6f7b7226927c458c3e01ec389869d33.jpg" data-media-id="editor_3" data-image-id="20250626120632_c6c378bc00af450f2b7f0cf17af1c3b2b6f7b7226927c458c3e01ec389869d33" data-rendition-name="original" width="1485" height="1535" loading="lazy" alt="Kusunda NT"> <figcaption>Students learning Kusunda with instructor Uday Raj Ale (second row, left)</figcaption> </figure>  Khamba Rokaya, who worked as a caretaker for young Kusunda children in Dang, became interested in learning the language as she sat in with the children during their lessons, and for the last few years has been among the few non-native Kusunda language learners in Dang. “I am not from the Kusunda community, but now that I have learned the language, I hope to do my part to carry on the work and share my knowledge with as many people as possible,” she says. “One way to ensure that we preserve this language is to extend its speaker base, both within the Kusunda and non-native communities.” Ale and Kamala have continued to work together since Gyani Maya’s passing in 2020, expanding the Kusunda vocabulary and creating appropriate curricula to fit the needs of the students as their knowledge of Kusunda expands.&nbsp; But without any documentation of Kusunda history, the community’s traditions, stories, values and language were at risk of being lost to time. “The loss of an ethnicity, language or culture in a country is akin to losing a vital organ, and a unique perspective of looking at the world,” says Ale. Which is why Archive Nepal in collaboration with the British Council’s Cultural Protection Fund and the UK’s Department of Culture, Media, and Sport in February launched a book of creative writings in the Kusunda language titled पिन्डा (meaning ‘The First’ in Kusunda): A Compilation of Kusunda Literature. The book is a collection of informative essays about the Kusunda language and culture, short stories that explore themes from nomadic life to universal Nepali experiences of poverty and migration, letters to loved ones, as well as conversational pieces by five Kusunda students ranging from ages 16 to 30. The works in the Kusunda language are also translated into Nepali and English.&nbsp; “Language is an important part of ethnic identity, and our indigenous languages cannot evolve or be conserved unless they are spoken or taught,” said Ale during the launch of the book earlier this year. “But most importantly, language exists as long as there exists literature in that language.” Kamala was in Kathmandu for the launch of the book, and smiled proudly as she looked at the young writers who had contributed to the collection. She said: “I’m glad the young people have chosen to learn and preserve Kusunda. Otherwise, our language would have died with me.” &nbsp;

renal-failure

Dirty, Dangerous, Difficult ... and Dehydrating

Saving kidneys to save Nepal

Kangchenjunga: too sacred to climb?

SLAPPing Democracy

Water for Life

Saving the Kusunda language from extinction