Usually in winter, air quality in Kathmandu is equivalent to smoking two packs of cigarettes a day. But <a href="https://nepalitimes.com/news/wildfire-season-starts-early-in-nepal">wildfires raging</a> across central Nepal for the past weeks may have increased that to four packs a day. <a href="https://firms.modaps.eosdis.nasa.gov/map/#d:24hrs;@86.3,28.9,7.0z" target="_blank">NASA’s Fire Information and Resource Management System (FIRMS)</a> uses infrared heat detecting satellites to map the world for fires. While central India and Burma are the worst affected, forests along the central Tarai and the mountains south of Kathmandu have hundreds of red dots — each representing a forest fire. Kathmandu Valley had the worst air quality of any city in the world on Monday afternoon, according to <a href="https://www.iqair.com/world-air-quality">Swiss-based air quality tracker IQ Air</a>. Air Quality Index (AQI) which measures the concentration of tiny suspended particles in the air smaller than 2.5 microns hit 250 because of soot particles from smoke combined with pre-existing pollution from vehicular and industrial emissions.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250331110320_6ea6ed9ab5fceefd0b46e5ba59222eefe6f838b475a75a5ec2c12598ffccb6eb.jpg" data-media-id="editor_3" data-image-id="20250331110320_6ea6ed9ab5fceefd0b46e5ba59222eefe6f838b475a75a5ec2c12598ffccb6eb" data-rendition-name="original" width="1896" height="1000" loading="lazy" alt="NASA FIRMS 29 March"> <figcaption>More than 200 forest fires are burning in central Nepal with prevailing winds blowing it up the valleys to Pokhara and Kathmandu, worsening air quality. This NASA FIRMS satellite image was taken on Sunday afternoon.</figcaption> </figure>  This was ten times higher than what the World Health Organization (WHO) has set as the threshold for healthy air. The microscopic particles cannot be seen by the naked eye and can jump the blood-air divide in capillaries in the lungs causing not just lung infections but also heart disease and cancer.&nbsp; The immediate effects of air pollution are felt in dry and burning eyes, itchy throats, difficulty breathing, headaches, and dizziness. In the longer term, Chronic Obstructive Pulmonary Disease (COPD) is a major cause of death in Nepal, with the average life expectancy of Kathmandu’s residents has been reduced by 3.5 years.&nbsp; Despite studies, Nepal’s leaders are preoccupied with coalition politics, and little action has been taken to control vehicular emissions with green stickers, curb open garbage burning and industrial pollution. Studies have shown that in winter 60% of the air pollution over Kathmandu is transboundary from the south, and in November it is compounded by crop residue burning by farmers in India and Pakistan which prevailing winds blow up the Himalayan mountains.&nbsp; Forest fires are common in Nepal in the pre-monsoon months as farmers and herders set fire to slopes hoping for green shoots when the rains arrive for their livestock. But successive years of winter drought have meant that the wildfires have been starting earlier, and they spread fast because of high afternoon winds this time of year.&nbsp; On 29 March, there were at least 200 fires burning across central Nepal. The FIRMS satellite image also shows thick blue smoke blanketing the river valleys, reducing visibility and affecting flights. On Monday morning three flights attempting to land at Kathmandu airport had to divert due to runway visibility being below minimum.&nbsp; This level of pollution is classified as ‘extremely unhealthy, and &nbsp;has serious health impact not only on <a href="https://nepalitimes.com/here-now/poisoning-children-at-school">vulnerable groups</a> like children, the elderly, and those who live with health conditions, but across Kathmandu’s population.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250331110324_b0f149ef5fc3f2657e883c311520b87d45e9636a7464ab418c691dd2bb6f6c7a.jpg" data-media-id="editor_5" data-image-id="20250331110324_b0f149ef5fc3f2657e883c311520b87d45e9636a7464ab418c691dd2bb6f6c7a" data-rendition-name="original" width="1000" height="1778" loading="lazy" alt="Pokhara Wildfire NT"> <figcaption>A fiery sunset over Phewa Lake in Pokhara on Sunday afternoon was caused by thick smoke from forest fires. Photo: KUNDA DIXIT</figcaption> </figure>  After the<a href="https://nepalitimes.com/news/the-revenge-of-the-rivers"> devastating September floods last year,</a> Kathmandu Valley and much of the country experienced a prolonged drought with little to no winter rain. Such prolonged dry spells raises fire risk, and with Kathmandu’s bowl-shaped topography concentrates pollutants. There are indications that high pollution levels do not just harm human health, but are also beginning to affect tourism. Operators in Pokhara said that there were many negative online posts by visitors unable to see the famous panorama of Machapuchre and the Annapurnas even from Sarangkot. Aviation is also affected, as planes have to circle sometimes for hours burning fuel for visibility to get better at Kathmandu airport. The higher fuel cost is just passed down to customers, making air tickets in and out of Kathmandu some of the highest in the world.&nbsp; Kathmandu’s toxic air quality is not a temporary phenomenon, it has consistently gotten worse. IQ Air places Kathmandu eighth out of 121 capital cities with the worst air quality in 2024, and Nepal is seventh among countries with the highest air pollution. The State of Global Air (SOGA) Report published last June <a href="https://nepalitimes.com/here-now/bad-air-and-polluted-politics">revealed </a>more than 50,000 Nepalis died from air pollution in 2021, accounting for 19% of all mortality, just behind high blood pressure. Kathmandu, with a population of four million, has not implemented a concrete policy to curb toxic air despite having formulated various action plans and repeated commitments by the government to protect the environment and control air pollution. The Department of Environment’s &nbsp;2017 Air Quality Management Action Plan for Kathmandu put forward a policy to reduce air pollution caused by vehicles which was approved by the Cabinet, but has yet to be put to practice. The action included the immediate implementation of the Euro 5 emission standard to reduce pollution emitted by vehicles. But Nepal has not even been able to implement Euro 4 standards so far. India, meanwhile, has already moved forward with the implementation of the Euro 6 standards.&nbsp;

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No smoke without fire

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109181116/636be0df9c7e80680e083e18jpeg.jpg" alt="" width="750" height="1083"/><figcaption>The south face of Mt Gauri Shankar (7,134m) on the border between Nepal and China is bare rock, and shows how dramatically the snowline has receded, and the glaciers have shrunk. Photo: KUNDA DIXIT</figcaption></figure>With just 4% of the world’s population, the United States is responsible for over 15% of annual global carbon emissions. What America does or does not do will affect how fast the Himalayan ice cap will melt during this century.Which is why Joe Biden’s win in the US election is <a href="https://www.nepalitimes.com/latest/ununited-states-of-america/" target="_blank" rel="noopener noreferrer">such a big deal for the global environment</a>, including the Himalaya. Biden has announced he will reverse Donald Trump’s decision to withdraw from the 2015 Paris Climate Agreement, which ironically came into effect on 4 November, the day after the US vote.The Himalayan arc from Burma to Afghanistan is the bigg<a href="https://www.nepalitimes.com/banner/the-third-pole-is-warming-faster-than-expected/" target="_blank" rel="noopener noreferrer">est storehouse of fresh water</a> after the two polar regions, and it is warming between 0.3-0.7°C faster than the global average. The loss of Himalayan ice would have <a href="https://www.nepalitimes.com/banner/a-terrifying-assessment-of-himalayan-melting/" target="_blank" rel="noopener noreferrer">devastating consequences for 1.6 billion people</a> living in the mountains, and in downstream countries.<a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/banner/in-just-2-years-a-nepal-peak-becomes-snowless/" target="_blank" rel="noopener noreferrer">In just 2 years, a Nepal peak becomes snowless</a>, Basanta Pratap Singh“Reversing these warming trends will begin with Biden’s commitment to re-joining the Paris agreement, as the US is not only one of the world’s greatest climate offenders but also one of its best potential leaders and sources of needed funding,” said Alton C Byers of the University of Colorado, who has <a href="https://www.nepalitimes.com/banner/tracing-past-glacial-floods-in-kangchenjunga/" target="_blank" rel="noopener noreferrer">studied Himalayan glaciers</a> for the past 30 years.The Paris Agreement aims to cap the global temperature rise in this century ‘well below’ 2°C by reducing carbon emissions through renewable energy technologies, and protecting forests and biodiversity.But rejoining the Paris accord will be the easy part. Much harder for the Biden presidency will be overcoming domestic opposition to cutting emissions at home, push rapid transition to clean energy, and funding global carbon reduction initiatives.The Biden administration may be more supportive of projects like USAID efforts in the past that have helped Nepal become a global leader in <a href="https://www.nepalitimes.com/here-now/nepals-glacial-lakes-in-danger-of-bursting/" target="_blank" rel="noopener noreferrer">glacial lake risk reduction</a>, adaptation, and climate mitigation measures.“These projects are in need of resurrection, along with the development of renewable energy technologies, sustainable tourism, and other opportunities as part of Nepal’s post-coronavirus recovery plans,” Byers added in an email interview with Nepali Times.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109181116/636be0e19c7e80680e083e19jpeg.jpg" alt="" width="1503" height="1000"><figcaption> </figcaption></figure>Joe Biden ran on a bold climate action platform, unveiling a $2 trillion investment plan with a promise to clean up the energy sector by 2035, boost renewables and create high paying green jobs.The <a href="https://www.nepalitimes.com/opinion/a-good-man-won/" target="_blank" rel="noopener noreferrer">Biden-Harris win</a> has raised hopes among environmentalists around the world, but the world has a lot of catching up to do to reverse Trump’s systematic effort over the past four years to undermine <a href="https://www.nepalitimes.com/opinion/the-climate-threat-multiplier/" target="_blank" rel="noopener noreferrer">climate mitigation measures</a>. The new administration in January will also likely face a serious opposition from a possible Republican-led Senate as it seeks to transition America off fossil fuels."To regain credibility on climate, the US now has to show the world that it is on a path to net zero emissions by 2050, only then can America press other high-emitting countries to act with the urgency required by the climate crisis," added <a href="https://www.nepalitimes.com/banner/more-trekkers-more-trees/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/banner/more-trekkers-more-trees/&amp;source=gmail&amp;ust=1605077751622000&amp;usg=AFQjCNE5ey5t5tQc3eeXYvXO5z5rMSahSQ">Adam Stern</a>, a California-based climate leader, formerly with the Environmental Defense Fund."If Biden can restore the role of science in determining US climate policy, he may also be able to focus world attention on regions like the Himalaya that are already experiencing extreme climate changes,” said Stern, who has written about energy use in Nepal’s Khumbu region.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109181116/636be0e59c7e80680e083e1ajpeg.jpg" alt="" width="1500" height="568"><figcaption> </figcaption></figure>International climate policies will have a lasting impact on the Himalaya where measurements of ice mass, temperature rise, <a href="https://www.nepalitimes.com/here-now/forests-replace-glaciers-in-the-himalaya/" target="_blank" rel="noopener noreferrer">glacial shrinking</a> and <a href="https://www.nepalitimes.com/opinion/climate-for-change/the-great-himalayan-thaw/" target="_blank" rel="noopener noreferrer">receding snowlines</a> have been more serious than previous estimates.However, experts say that Nepal also has to do its bit to accelerate its <a href="https://www.nepalitimes.com/here-now/an-energy-windfall-for-nepal/" target="_blank" rel="noopener noreferrer">shift to solar</a> and <a href="https://www.nepalitimes.com/opinion/decentralising-hydropower/" target="_blank" rel="noopener noreferrer">hydropower in generating electricity</a> for transport and household use. And since nearly a quarter of melting of Himalayan glaciers is attributed to the <a style="font-size: 16px; letter-spacing: 0.01em;" href="https://archive.nepalitimes.com/article/nation/black-carbon-easier-to-control-than-carbon-dioxide-to-reduce-global-warming%20,2079" target="_blank" rel="noopener noreferrer">deposition of soot and dust on the snow</a>, transboundary collaboration in pollution control is a must.Since October, for example, northern India has been blanketed by thick smoke from crop residue burning, and this black carbon is being blown up to the snows by prevailing westerlies. And as winter sets in, industrial and vehicular pollution will be trapped by inversion across the Indo-Ganetic plains and ultimately reduce the reflectivity of Himalayan ice cover.Air pollution was already decreasing the average lifespan of tens of millions of people in north India by 3.7 years. It killed <a href="https://www.nepalitimes.com/latest/double-whammy-air-pollution-and-covid-19/" target="_blank" rel="noopener noreferrer">42,100 people in Nepal last year</a> alone, studies show, and this winter that risk for patients with respiratory issues is combined with Covid-19 complications.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109181116/636be0e79c7e80680e083e1bjpeg.jpg" alt="" width="1200" height="675"><figcaption> </figcaption></figure>The causes and solutions of air pollution and climate change <a href="https://www.nepalitimes.com/opinion/one-atmosphere/" target="_blank" rel="noopener noreferrer">are intricately interconnected</a>, both largely affected by human activities over time and space. In fact, short-lived pollutants like black carbon, ozone and other gases exacerbate global warming.“Dark coloured pollutants such as soot particles from diesel and forest fires absorb sunlight and warm up the air at the altitude at which they are located,” explained atmospheric scientist Arnico Panday. “If they warm the air near snow or ice surfaces they can contribute to melting. And when dark particles, including windblown desert dust, settle on snowfields or glaciers they can darken the surfaces and melt the snow and ice. <a href="http://archive.nepalitimes.com/article/nation/reducing-black-carbon-in-the-himalayas,2031" target="_blank" rel="noopener noreferrer">Certain air pollutants</a> therefore accelerate glacier melt in the Himalaya.”Even though a Biden presidency has given some hope for climate activists in the Himalaya, they point out that China has overtaken the United States, responsible for 28% of total carbon emissions in 2018. Carbon emissions in China and India are growing at a faster rate than in North America, and the two countries already contribute 37% of global greenhouse gases annually.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109181116/636be0ea9c7e80680e083e1cjpeg.jpg" alt="" width="1884" height="1250"><figcaption> </figcaption></figure>So, while a greener America will help, the real action to slow Himalayan melting <a href="http://archive.nepalitimes.com/news.php?id=19368" target="_blank" rel="noopener noreferrer">will have to come from the immediate region</a>. The good news is there are already proven <a href="http://archive.nepalitimes.com/article/nation/brick-factories-still-using-old-polluting-technology,2078" target="_blank" rel="noopener noreferrer">clean technologies for brick kilns</a>, cement industries, solar and hydro here in Nepal and in South Asia. Governments need to incentivise these, provide subsidies, and investors need to back them up.“Air pollution has never made it to the priority of our politicians, their mentality of focusing on short-terms gains like tax revenue over long-term gains can’t be changed,” says <a href="https://www.nepalitimes.com/latest/ipcc-report-and-nepals-food-security/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/latest/ipcc-report-and-nepals-food-security/&amp;source=gmail&amp;ust=1605077751622000&amp;usg=AFQjCNGQzD9EPDBRXFun8S0H0x_qaZ-bbg">Manjeet Dhakal</a>, adviser to the Least Developed Countries support group at the UN Framework Convention on Climate Change (UNFCCC).He adds: “We must deploy our own young population to lobby and take part in climate action. What happens in the United States, whether international funds will be available will only help temporarily. We must cut emissions at source, educate our own people about the cost of the climate crisis, and provide alternatives.”

Sonia Awale

A Biden presidency, climate and the Himalaya

https://www.youtube.com/watch?v=087QDbzzKCMMost residents of Kathmandu are aware of the <a href="http://archive.nepalitimes.com/article/editorial/polluted-politics-cartels,3533" target="_blank" rel="noopener">dust and smoke</a> in the air, but few know that their masks do not protect them from the poisonous gas emissions from the capital’s ubiquitous motorcycles.Because of the nature of their engines, two-wheeler exhausts give off carbon monoxide, nitrous oxides, and elevate the concentration of street-level ozone. Doctors say these poisonous gases have led to a worrying increase in respiratory ailments, cancers, Alzheimer’s Disease, diabetes and heart attacks.“A few motorcycles would not be so dangerous, but there are now nearly 1 million of them on the city streets and their emission is a great public health hazard,” warns respiratory health expert Raju Pangeni at HAMS Hospital in Dhumbarahi.Although motorcycles burn much <a href="http://archive.nepalitimes.com/page/every-breath-you-take-air-pollution" target="_blank" rel="noopener">less petrol than four-wheelers</a>, they are up to ten times more polluting per passenger- kilometre than buses and cars. The internal combustion engine of motorcycles is also less efficient, and their exhaust systems lack catalytic converters.Because there are fewer two-wheelers on the roads in the West, emission standards for them are more lax than for four-wheelers. However, in places like Nepal, Vietnam or Indonesia, where motorcycles outnumber cars, their cumulative emissions poison the city's air with noxious gases.Also Read: <a href="http://archive.nepalitimes.com/article/nation/Highway-robbery,3539" target="_blank" rel="noopener">Highway Robbery</a>, Shreejana Shrestha<a href="http://archive.nepalitimes.com/regular-columns/Comment/air-quality-data-to-figire-out-what-to-do,841" target="_blank" rel="noopener">Figuring out what to do</a>, Arnico Pande <img width="1400" height="933" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221107121144/6368eff39c7e80680e0359a9jpeg.jpg" alt=""/>A recent study showed that up to 2% of<a href="http://archive.nepalitimes.com/news.php?id=5115#.W0hkqtUzbIU" target="_blank" rel="noopener"> poorly-maintained</a> motorcycles contributed to close to half the total pollution from two-wheelers on Kathmandu’s streets.“The recent spike in cardio-vascular diseases in Kathmandu hospitals is partly a result of slow carbon monoxide poisoning, mainly from motorcycles,” confirms cardiologist Prakash Regmi at Bir Hospital. Residents near congested intersections in Kathmandu with thousands of motorcycles emitting gaseous pollutants are the most at risk (see map).Ozone is the other toxic gas formed when carbon monoxide and nitrous oxides in motorcycle exhaust react in the presence of sunlight with volatile organic carbons. Large parts of Nepal have ground-level ozone in much higher concentrations than the WHO standard in the spring, as per several studies published last year in the journal Atmospheric Chemistry and Physics.Arnico Panday, atmospheric scientist at the International Centre for Integrated Mountain Development (ICIMOD) who co-authored the papers, explains that incomplete combustion of fuel in motorcycles engines gives off carbon monoxide, volatile organic compounds like benzene, and oxides of nitrogen (NOx) which are precursor gases to ground-level ozone -- itself a highly reactive gas that can aggravate chronic respiratory diseases like asthma, bronchitis and emphysema.Also read: <a href="http://archive.nepalitimes.com/article/nation/increasing-concentration-of-carbon-dioxide-in-atmosphere,1409" target="_blank" rel="noopener">Not business as usual</a>, Nessim J Ahmad and Kaveh Zahedi <img width="900" height="812" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221107121144/6368eff79c7e80680e0359aajpeg.jpg" alt="">The studies showed that minor servicing of two-wheelers did not reduce gaseous pollutants much, and motorcycles were a major source of carbon monoxide in <a href="http://archive.nepalitimes.com/article/Nepali-Times-Buzz/air-pollution-decreases-life-span,3999" target="_blank" rel="noopener">Kathmandu Valley air</a>.Public awareness about air pollution has grown in the past two years after suspended dust particles from road-widening and water mains laying work <a href="http://archive.nepalitimes.com/article/nation/Sick-city,108" target="_blank" rel="noopener">worsened air quality</a> that was already thick with soot particles from diesel exhaust and garbage burning.But only a few commuters interviewed for this article in the past week knew of invisible and odourless gases like carbon monoxide, ozone and nitrous oxides. Nine of ten motorcyclists had no idea about the poisonous gases, and blamed only dust and diesel smoke for poor air quality.<a href="http://archive.nepalitimes.com/article/nation/air-pollution-in-Kathmandu,2737" target="_blank" rel="noopener">Kathmandu air pollution levels on most winter mornings</a> are the worst in the world. The hourly Air Quality Index (AQI) from the U.S. Embassy and Phora Darbar stations which feed live into the Nepali Times website is a composite of the concentration of ozone and particles finer than 2.5 microns in the air. The daily averages in this paper (page 10) show AQI is high even during the monsoon, proving that the rains are not enough to clean the air of pollutants. <img width="1400" height="680" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221107121144/6368eff99c7e80680e0359abjpeg.jpg" alt="">“Given that 80% of total vehicles today in Nepal are motorcycles and scooters, there should be a mechanism to monitor and control their emissions, like issuing green stickers," says BhusanTuladhar of UN-HABITAT. In the longer term, however, only an <a href="http://archive.nepalitimes.com/regular-columns/guest-editorial/public-transport-is-equal-to-public-health,844" target="_blank" rel="noopener">efficient public transportation service</a> can reduce the number of motorcycles and cars on the roads.Besides Nepal, Vietnam and Indonesia also grapple with two-wheeler congestion and poor air quality. Hanoi is banning scooters by 2030, and China now only allows electric two-wheelers.Energy expert Manjeet Dhakal says there is no sense banning motorcycles in Kathmandu without first offering a convenient alternative: “Two wheelers are polluting and unsafe, but environment-friendly public transport policy should be implementated first.”Moving to electric mass transit, a battery-operated Bus Rapid Transit, and offering tax incentives for electric scooters and motorcycles would be the first step. Experts say the cause of Kathmandu's air pollution is government policy that allowed unlimited vehicle imports so as to generate greater tax revenue. <img width="1400" height="1197" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221107121144/6368effd9c7e80680e0359acjpeg.jpg" alt="">“Lack of regulation on motorcycle numbers undermines the government’s own effort to promote zero-emission safa tempos and electric vehicles,” says communications officer Mona Sharma at ICIMOD. With local governments in place after 20 years, priority should also be on ending the monopoly of transportion syndicates so the existing public transport system is streamlined.An already-available alternative could be electric scooters, the prices of which have dropped to Rs138,000 for some models like the Japanese Terra Echo. Chinese-made Niu M1 scooters are costlier, but are stylish and convenient.Both have showrooms in Kathmandu. Tax rebates can bring prices down more.Says cariolodist Prakash Regmi: “The government has to decrease the number of petrol two wheelers, provide better public transport and promote electric vehicles to ensure a healthy future for us all.”Also read: <a href="http://archive.nepalitimes.com/news.php?id=17035#.W0hkptUzbIV" target="_blank" rel="noopener">Lost in the smog,</a> Dewan Rai and Suvayu Dev Pant <h4>SILENT KILLERS</h4> <img width="500" height="401" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221107121144/6368f0009c7e80680e0359adjpeg.jpg" alt="">Carbon monoxideCarbon monoxide (CO), a colourless, odourless and tasteless gas found in vehicular exhaust, is so poisonous it is one of the commoner methods of suicide.It is produced from incomplete combustion of fuel, and should not be mistaken for carbon dioxide (CO2) which is a gas essential for plant life while being the primary greenhouse gas warming the Earth.Motorcycles are particularly notorious for producing CO because of the incomplete combustion in their engines. A few recreational motorcycles on the roads may not pose a danger, but when there are 800,000 motorcycles in a city like Kathmandu, it poisons the air we breathe.“Prolonged exposure to carbon monoxide acts as a slow poison, causing various diseases of the heart,” explains cardiologist Prakash Regmi at Bir Hospital.Human blood is red because it contains the iron-rich protein haemoglobin (Hb) in the red corpuscles which has an affinity for oxygen and carries it to various organs and tissues in the body. But haemoglobin has a 240 times greater affinity for carbon monoxide than oxygen. When Hb binds with CO, the blood cannot absorb oxygen, leading to suffocation and eventually death.Kathmandu’s streets normally record 0.0012% CO, which will not kill people outright but can lead to cardiac and lung complications. Says respiratory expert Raju Pangeni at HAMS Hospital: “Carbon monoxide reduces the oxygen carrying capacity of the body, and can have lethal consequences.” <img width="500" height="373" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221107121144/6368f0019c7e80680e0359aejpeg.jpg" alt="">OzoneCarbon monoxide, volatile organic compounds and nitrous oxides in motorcycle exhaust go through complex chemical reactions in the presence of sunlight to form ground-level ozone. This is ‘bad’ ozone, and different from ‘good’ stratospheric ozone that blocks harmful solar radiation. The ozone molecule is composed of three atoms of oxygen, unlike the oxygen we breathe which contains two atoms.As traffic increases, bad ozone builds up during warm sunny days, harming lung functions. Kathmandu hospitals have recorded a sharp increase in patients with chronic respiratory diseases, and higher concentration of surface ozone is one of the factors.A 2017 study published in the journal Atmospheric Chemistry and Physics measured ground-level ozone at various points in Kathmandu and found that it was highest in the day, during pre-monsoon months, and at higher altitudes on the Valley rim, exceeding the WHO standard.Says ICIMOD atmospheric scientist Arnico Panday, who co-authored the paper: “Ozone is a growing problem in northern South Asia, and is a threat to both agriculture and human health.”

Poisoning the air we breathe

On Tuesday, leader of the monarchist RPP once again gathered on Kathmandu’s streets to deliver fiery speeches, but this time there was no arson and looting and no need for riot police to fire live rounds or tear gas.
RPP leaders demanded the release of their members including vice-president Rabindra Mishra and MP Dhawal Shamsher Rana were arrested during the violent <a href="https://nepalitimes.com/news/republicans-and-royalists-on-nepal-s-streets">28 March protests at Tinkune </a>which left two dead. 
They denounced the current leadership of the main parties, demanding the <a href="https://nepalitimes.com/editorial/nepal-party-reincarnating-hindu-monarchy">restitution of Nepal as a Hindu kingdom</a>. They also said the government was responsible for the fatalities on 28 March because it provoked its rally with a tear gas attack even before it started.
It has now been revealed that the police fired at least 100 live rounds from high powered assault rifles at the crowd. Twenty-one of the 120 injured received bullet wounds, and most of them were bystanders and people trying to reach home. 
Tuesday protest on the Ring Road in Balkhu was much more subdued, and comparatively fewer RPP supporters showed up. The arson and vandalism in the previous protest appears to have cost some support for <a href="https://nepalitimes.com/news/the-ghost-of-monarchy-returns-to-haunt-nepal">former king Gyanendra </a>especially for the anointment of medical tycoon and bank defaulter <a href="https://nepalitimes.com/news/street-politics">Durga Prasai </a>as ‘commander’ of the Tinkune rally.
Some monarchists acknowledge Gyanendra’s mistakes when was king 2001-2008, but say he has had a lot of time to reflect on his shortcomings and seems more disciplined and committed. His supporters have tried to build on nostalgia among some Nepalis for<a href="https://nepalitimes.com/news/why-invest-in-nepal"> domestic stability </a>and international respect that <a href="https://nepalitimes.com/here-now/if-birendra-was-alive-nepal-could-still-be-a-monarchy">the monarchy</a> commanded. 
“Nepalis were promised better service delivery, opportunities for the underserved, as well as better, more honest use of state resources, but the <a href="https://archive.nepalitimes.com/news.php?id=16992">people in leadership </a>have not been able to deliver on their commitments,” says RPP leader Prakash Chandra Lohani. “The gap between their rhetoric and reality has widened, the people feel betrayed, and the respect Nepali people had previously had for them has changed to revulsion.” 
Indeed, many commentators have warned the three main parties and their <a href="https://nepalitimes.com/editorial/politics-as-usual">serial prime ministers</a> who have ruled Nepal for much of the past 30 years should address rising public anger with them, and see the writing on the wall.
‘<a href="https://nepalitimes.com/news/nepal-government-changes-again">The UML, NC and Maoists</a> must introspect about their conduct,” warns Gunaraj Luitel, editor of Nagarik, in an op-ed this week. ‘These leaders for life may save themselves from simmering public anger, but they will not be able to save the system. The monarchist wave can only be dispelled when citizens are assured of <a href="https://nepalitimes.com/here-now/nepal-s-local-election-gives-power-back-to-people">better governance</a> through <a href="https://nepalitimes.com/latest/real-world-training-for-youth-leaders">younger leaders</a>, and reforms.’ 
Rifts between radical royals who are gunning for a return to <a href="https://nepalitimes.com/here-now/mob-movement-and-mayhem">Panchayat-style absolutism </a>and moderate monarchists who favour a constitutional king have also weakened the movement somewhat. The split between the RPP and RPP-Nepal cost the royalists numbers in Parliament in 2022, and both parties denounced the violence last month, albeit shifting the blame on the government.
The irony is that the same royalists who want to scrap the republican Constitution had formed electoral alliances with the UML during the 2022 elections. RPP-Nepal chair Kamal Thapa contested the 2022 election with the UML. Thapa has not taken part in the last two rallies, saying he will only be a part of a movement under a national flag, and not a RPP party banner.
For his part, the RPP’s Rajendra Lingden is said to be hesitant to censure some of his party’s more radical royalists for fear of fissure within his ranks, despite his aversion to Durga Prasai’s role. 
Analysts have questioned why <a href="https://nepalitimes.com/news/old-is-still-gold-in-nepali-politics">supporters of the monarchy </a>have decided to reestablish an institution that would not ultimately have executive decision-making power. There are doubts about whether authoritarian-minded Gyanendra will be satisfied being a <a href="https://archive.nepalitimes.com/news.php?id=13957">ceremonial king</a>. 
Read also: <a href="https://nepalitimes.com/news/nepal-s-deja-vu-on-black-friday">Nepal’s déjà vu on Black Friday</a>, Sonia Awale
"The Nepali people will not accept <a href="https://nepalitimes.com/here-now/forgotten-woman-who-sheltered-communist-activists">an absolute monarchy </a>at this point of time, and both the public as well as <a href="https://archive.nepalitimes.com/news.php?id=8371">king Gyanendra</a> are fully aware that there is no other possibility beyond a constitutional monarchy," asserts the RPP’s Lohani. “The traditional monarchy’s institutional capacity might have been enough to meet the needs of feudal Nepal, but an absolute monarchy is impossible both in concept and practice in the context of <a href="https://archive.nepalitimes.com/regular-columns/Economic-Class/waiting-for-an-industrial-revolution,784">modern day Nepal</a>.”

New year revolutions

Besides multiple <a href="https://nepalitimes.com/news/republicans-and-royalists-on-nepal-s-streets">street demonstrations </a>that gridlocked Kathmandu’s traffic for the past weeks, public discourse in Nepal has also been dominated by dangerously <a href="https://nepalitimes.com/here-now/air-pollution-is-more-dangerous-than-smoking">high air pollution levels</a>. Caused mostly by hundreds of <a href="https://nepalitimes.com/news/wildfire-season-starts-early-in-nepal">forest fires </a>raging across the country, the smoke contains suspended soot particles that harms <a href="https://nepalitimes.com/opinion/playing-with-poison">human health</a>. Thursday’s rain have cleared the air somewhat, and many people will soon forget how bad the air quality was. But the time to address the roots of next summer’s fire season is now.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250411060440_d1a119716a9031aadfdd611d299348d436842d376a03e664b8d773957a237524.jpg" data-media-id="editor_4" data-image-id="20250411060440_d1a119716a9031aadfdd611d299348d436842d376a03e664b8d773957a237524" data-rendition-name="original" width="502" height="540" loading="lazy" alt="Wildfires"> <figcaption>EXTINGUISHED: Forest fires raging all over Nepal in the week after 3 March (above) reduced air quality, creating a public health hazard in Kathmandu and across the country. Each red dot is a fire detected by infrared sensors on the NASA Fire Information for Resource Management System (FIRMS) satellite. But the rain on Thursday doused most of the fires (below) with more rain forecast over the weekend.</figcaption> </figure>  The reason everyone was talking about air pollution was because the<a href="https://nepalitimes.com/banner/nepal-is-going-up-in-smoke"> smoke from wildfires</a> was visible. But much more toxic are the invisible and odourless <a href="https://nepalitimes.com/news/nepal-doubles-its-carbon-footprint">gases from vehicular and industrial emissions </a>which have always been there. The theme of World Health Day on 7 April this week was ‘Healthy Beginnings, Hopeful Futures’ dedicated to <a href="https://nepalitimes.com/opinion/comment/saving-more-mothers-and-babies">preventing maternal and newborn deaths</a>. It is estimated that in Nepal, 30% of neonatal mortality can be blamed on air pollution. But that is only part of the story. Harmful as fine particulate matter is to human health, carbon monoxide, nitrogen dioxide, ground-level ozone and other gases in vehicular emissions are more hazardous to health. While the concentration of suspended particulate matter tinier than 1.5 microns (PM2.5) is closely monitored, these toxic gases are invisible, not measured much, and the public is not aware about the dangers they pose. Surface ozone is produced by the interaction of various gases found when <a href="https://nepalitimes.com/news/fossil-fuels-poison-air">burning fossil fuels</a>. Besides being poisonous, ground level ozone contributes up to 0.23°C to <a href="https://nepalitimes.com/here-now/nepal-s-mountains-are-melting">global warming</a> because it is also a greenhouse gas. A new policy brief by the Clean Air Fund titled The Case for Action on Tropospheric Ozone blames surface ozone for a half a million premature deaths every year, 54.8% of which are in South Asia. Ozone also stunts plant growth and reduces crop yields by 26% globally, and 11% loss in <a href="https://nepalitimes.com/news/economic-benefits-of-saving-the-ecology">forest productivity</a>, the report adds.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250411060456_aa02a923f8b27544ae54d0220162678f5bbb5eeb8fc3c466173c22c49b3e9a85.jpg" data-media-id="editor_11" data-image-id="20250411060456_aa02a923f8b27544ae54d0220162678f5bbb5eeb8fc3c466173c22c49b3e9a85" data-rendition-name="original" width="998" height="724" loading="lazy" alt="Gas Chambers"> </figure>  Read also: <a href="https://nepalitimes.com/here-now/bad-air-and-polluted-politics">Bad air and polluted politics</a>, Sonia Awale Ground-level ozone is not emitted directly into the air like other gases, but is formed when oxides of nitrogen (NOx), carbon monoxide (CO) and volatile organic compounds (VOCs) released from automobile tailpipes or industry smokestacks react chemically with each other in the presence of sunlight. The main source of carbon monoxide in Kathmandu Valley are its 1.2 million two-wheelers. “Usually the concentration of carbon monoxide is 200-500 parts per billion (ppb), this has increased up to 3,000 in Kathmandu. Meanwhile, ground-level ozone has gone from 70-80 ppb to 150 ppb,” says Ravi Sahu, regional air quality specialist with the Kathmandu-based International Centre for Integrated Mountain Development (ICIMOD).&nbsp; Sahu says <a href="https://nepalitimes.com/news/no-smoke-without-fire-p7vb9dcj">rampant forest fires of the past weeks</a> have also added to carbon monoxide and ozone in the air, not just the fine particles that make up the visible smoke. He adds, “There isn’t much awareness about <a href="https://nepalitimes.com/banner/poisoning-the-air-we-breathe">ground-level ozone and carbon monoxide</a>, we need to urgently look into it.” A distinction must be made between good and bad ozone. Stratospheric ozone protects living beings from harmful ultraviolet (UV) radiation from the sun.&nbsp; Tropospheric ozone can again be separated into two types: ozone in the free atmosphere which is a greenhouse gas much more potent than carbon dioxide, and ground-level ozone which has adverse impacts on health and agriculture. ‘Cutting tropospheric ozone presents a unique challenge as it requires smart and fast action across multiple greenhouse gases and air pollutants, as well as multiple economic sectors,’ notes the Clean Air Fund's policy briefing. ‘It is a growing and neglected problem that needs an integrated approach on both a local and global level to tackle climate change and air pollution together.’ Dying young There was a time when Nepal made it to international news bulletins only if there were fatalities on Mt Everest. Now, Kathmandu’s bad air frequently makes headlines all over the world. This past week, the concentration of PM2.5 that harms human health was up to 40 times the WHO recommended guideline — adding to the poisonous gases already present from vehicle emissions. The Department of Environment says 40% of the pollution in the past weeks was from wildfires sparked by nearly 6 months without substantial rain over central Nepal. Most of the rest is from vehicular and industrial emissions from Kathmandu itself and across the southern border. NASA’s Fire Information and Resource Management System (FIRMS) which issues daily maps of fires, showed hundreds of blazes raging across Nepal on Wednesday, mainly in Chitwan, Parsa and along the East-West Highway.&nbsp; “If we look at the figures for the last few years, it is clear that wildfires have become the biggest source of air pollution, they are seasonal but have overtaken vehicular emissions,” says urban planner and environmentalist Bhushan Tuladhar. “Forest fires, stubble burning, and open burning of garbage are the bigger problems now. Nepal, India, Bangladesh, and Pakistan are at risk every year, we shouldn’t further delay in finding solutions,” warned air quality expert Bhupendra Das during an event on air pollution organised on 7 March by the Nepal Forum of Environmental Journalists (NEFEJ).&nbsp; Indeed, studies have shown that in winter 60% of the air pollution over Kathmandu is transboundary from the south, and in November it is compounded by smoke from crop residue burning by farmers in India and Pakistan blown in by prevailing winds. Forest fires are a regular pre-monsoon occurrence in Nepal, often intentionally set by farmers and herders to stimulate new grass growth for livestock. Winter rains have failed for eight of the past ten years, and this means the fires often spread out of control. The other reason for the increase in wildfires is the doubling of forest fires to 46% of the country’s area in the past 25 years. But this has happened simultaneously with outmigration, with some mountain districts losing 30% of their population between 2011-2021. With less pressure on forests for fodder and firewood, the undergrowth of community forests is loaded with dry fuel just waiting for a spark. The bowl-shaped topography of Kathmandu, Pokhara and other valleys further concentrates pollutants as they are trapped by surrounding mountains. But a year with a high number of wildfires is usually followed by a year or two with fewer incidents. For example: there were 6,537 fires in 2021 but the following year the number was down to 1,528. There were 5,216 fires last year, this year the number has already reached 1,800, and the trend is likely to be broken. Heavy rains forecast for the coming days are expected to douse some of the fires and clean up the air. But the damage has been done: Kathmandu residents of all age groups this week crowded clinics and hospitals with burning eyes, itchy throats, difficulty breathing, headaches, and dizziness. But in the longer term, soot particles that are tiny enough to jump the blood-air divide in lung capillaries do not just cause Chronic Obstructive Pulmonary Disease (COPD), asthma, but also cancers, heart attacks, strokes, birth defects and other chronic diseases. The latest Air Quality Life Index (AQLI) report by the University of Chicago shows that the annual concentration of PM2.5 in Kathmandu’s air rose from 17.87µg/m3 in 1998 to 31.33µg/m3 in 2022. Air pollution has got worse by 75% in Kathmandu in 25 years. During this time, air pollution has reduced the average life expectancy of Kathmandu’s residents by 3.5 years. According to the Health Effects Institute in Boston, dirty air is among the biggest public health concerns in Nepal killing over 42,100 a year. The adverse impact of high levels of air pollution is not limited to public health, it is seriously affecting tourism. Operators in Pokhara this week said that there were many negative online posts by visitors unable to see the famous panorama of Machapuchre and the Annapurnas even from Sarangkot. Aviation is also affected, as planes have to circle sometimes for hours burning a lot of fuel because of runway visibility being below minima at Kathmandu airport. The higher fuel cost is just passed down to customers, making air tickets in and out of Kathmandu some of the highest in the world. Kathmandu, with a population of four million, has not implemented a concrete policy to curb toxic air despite having formulated various action plans and repeated commitments by the government to protect the environment and control air pollution. The Department of Environment’s 2017 Air Quality Management Action Plan for Kathmandu put forward a policy to reduce air pollution caused by vehicles which was approved by the Cabinet, but has yet to be put to practice. The action included the immediate implementation of the Euro 5 emission standard to reduce pollution emitted by vehicles. However, Nepal has not even been able to implement Euro 4 standards so far. India, meanwhile, has already moved forward with the implementation of the Euro 6 standards. Says Ravi Sahu: “Air pollution in Nepal is not just about air pollution, it has ties to tourism, aviation, the economy so we must be prepared for annual conditions like forest fires, and this requires urgent interdisciplinary collaboration.” &nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250411050452_821d09e283d8a590f1369bfb71b9b7fc6d950726e0651ea86c6488d04deb1742.jpg" data-media-id="editor_15" data-image-id="20250411050452_821d09e283d8a590f1369bfb71b9b7fc6d950726e0651ea86c6488d04deb1742" data-rendition-name="original" width="839" height="784" loading="lazy" alt="Silent Killers"> </figure>  &nbsp;

What is invisible is more dangerous

82 in २०८२

Here in the mountains of far-western Nepal, the biggest threat to life and limb is gravity. Women collecting fodder fall from trees, boys grazing goats fall off cliffs, heavily loaded tractors plunge from dirt roads carved out of steep slopes. There is nothing to be done about those who die on the spot. But for the severely wounded there is only one hospital: Bayalpata. And it is there that <a href="https://www.youtube.com/watch?v=CJzWlnYd0ZM&amp;t=8s" target="_blank">orthopaedic surgeon Mandeep Pathak</a> is the last hope for many wounded people. Pathak, 42, is too modest to tell us how many lives he has saved over the past 10 years he has worked at Bayalpata. But hospital records show he has performed more than 4,000 operations in the past decade, many of them so patients did not suffer permanent physical disabilities. Pathak also did 800 major life-saving surgeries in that time. “I treat patients with injuries, but I wish I could also treat poverty,” Pathak says, emerging from Bayalpata’s surgical theatre one recent afternoon. <div class="embed-block"><iframe width="700" height="415" src="https://www.youtube.com/embed/CJzWlnYd0ZM?si=s_rkbU4YDaw87gqH" title="YouTube video player" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share" referrerpolicy="strict-origin-when-cross-origin" allowfullscreen></iframe></div> Sudurpaschim Province in Nepal’s far-west is far away from everything: from Kathmandu, from adequate medical care, from food security, and far from the reach of government services. It has suffered state neglect for centuries, its men mainly migrating to India for seasonal work to families who depend on subsistence agriculture. Pathak remembers the searing sadness he felt when a patient once told him, “Doctor, I sold the last of my rice to pay to come here, please give me a medicine that I can take on an empty stomach.” Pathak was born in Kathmandu, and after getting his MBBS from Kathmandu University, he got an MD from The Philippines. At a time when many Nepali doctors and staff nurses were emigrating, Pathak did not just return to Kathmandu but decided to go to one of the remotest districts in Nepal to serve those most in need. The hospital was established in 2009 in the village of Bayalpata, and has been managed by the non-profit <a href="https://www.nyayahealthnepal.org/" target="_blank">Nyaya Health Nepal (NHN)</a> as a public-private partnership treating 100,000 patients a year for no fees at all. NHN is now preparing to hand over the running of the hospital to the Sudurpaschim provincial government so its <a href="https://nepalitimes.com/banner/this-is-how-to-upgrade-nepals-rural-health" target="_blank">model of hospital management</a> can be replicated.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250414130456_b59dabd4604a24426a55fe91c0e5866b5029858bdb4c4028c331557aeb5408ae.jpg" data-media-id="editor_4" data-image-id="20250414130456_b59dabd4604a24426a55fe91c0e5866b5029858bdb4c4028c331557aeb5408ae" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="Bayalpata hospital"> <figcaption>Bayalpata hospital in Achham.</figcaption> </figure>  People from not just Achham but surrounding districts, and from as far away as Humla, bring patients to Bayalpata, sometimes walking for days. Some with complicated pregnancies are brought in stretchers, young children with broken arms walk into the emergency, and sometimes there are mass casualties when a tractor or bus falls off a road. And Pathak is always there with his team performing triage, and doing orthopaedic surgeries that would be difficult even in Kathmandu. Recently, his team did a hip replacement at <a href="https://nepalitimes.com/banner/state-of-the-art-rural-hospital" target="_blank">Bayalpata Hospital</a>. Mild mannered, modest, soft-spoken, hard-working, professional are the words families of patients who have been treated at <a href="https://nepalitimes.com/here-now/nepal-s-rural-lifeline" target="_blank">Bayalpata Hospital </a>use to describe Mandeep Pathak. But the surgeon is too busy to let all this get to this head.&nbsp; Asked why he does not emigrate like his peers or get a lucrative position at a private hospital in Kathmandu, Pathak answers simply, without a trace of self-importance, “I do not think I could get the satisfaction or sense of fulfilment anywhere else.” When travelling to attend medical congresses overseas or visit family in Kathmandu, Bayalpata has other doctors to take care of patients, but many wait patiently till Pathak returns for their consultation or surgery.&nbsp; When he returns from seminars abroad after learning the latest skills, Pathak’s suitcases are not full of clothes or presents, but titanium bone implants, external fixation rods, or intramedullary nails to be used in <a href="https://nepalitimes.com/news/altruistic-healthcare-models-in-nepal" target="_blank">surgeries at Bayalpata</a>.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025041414040_5356278472c1eb2b9e4af1d593d6234cc8dc5e5161a8c614197c01abefadbd80.jpg" data-media-id="editor_8" data-image-id="2025041414040_5356278472c1eb2b9e4af1d593d6234cc8dc5e5161a8c614197c01abefadbd80" data-rendition-name="original" width="2048" height="1368" loading="lazy" alt="surgery"> </figure>  Before Bayalpata Hospital was established, most people suffering broken bones had to travel down to Dhangadi or Nepalganj for treatment. No more. Although Pathak’s specialisation is orthopaedic oncology, he is mostly treating fractures and rejoining broken bones.&nbsp; Now as Bayalpata’s Hospital Director, Pathak also has administrative and fundraising duties. He has to take the 10-hour ride down to Dhangadi often to meet various Sudurpaschim ministries to release the hospital’s budget — that is sometimes more difficult than the most complicated surgery. Recently, he had to cancel an appointment with the Chief Minister to rush back to Bayalpata because there was a patient who needed emergency surgery. “I told myself, let me save this patient first, then I will try to save the hospital,” he recalls.&nbsp; Once, when he had to be away for a month on emergency surgery training in the US, the family of a 90-year-old woman who had dislocated her hip after falling from a staircase was waiting for him to return. Her son told Pathak: “Doctor, either put her out of her suffering, or cure her.” Pathak told him it was too dangerous to operate at her age, but the son said his mother was in so much pain it was worth the risk. The operation was touch-and-go, but it was successful. The woman who had been brought in on a stretcher, walked out of the hospital three days after the operation.&nbsp; A few months later, a 27-year-old woman was brought into the ER bleeding profusely from an arm mangled by a thresher machine. Even in that state, she was breastfeeding her baby. Pathak welled up seeing this display of selfless motherhood, as he wheeled her into surgery. She needed three operations, but now has full use of her hand. <div class="embed-block"><iframe width="700" height="415" src="https://www.youtube.com/embed/xJdxLD0hBqo?si=mOpM2R_DsYL88Lfg" title="YouTube video player" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share" referrerpolicy="strict-origin-when-cross-origin" allowfullscreen></iframe></div> It is the sense of achievement from such recovery that keeps Mandeep Pathak here in this isolated village in the middle of nowhere. Bayalpata Hospital has not just saved lives, it also saves families from poverty because they do not have to take sick relatives to expensive city hospitals.&nbsp; In January, a woman was brought to Bayalpata with both hands broken. She said she had taken a fall, but Pathak did not believe her. When alone in the surgery, she finally admitted that her husband had beaten her.&nbsp; It was her husband who had brought her to hospital for treatment, but she refused to file a police report. Pathak quietly put both her arms in casts, thinking about the poverty, patriarchy and injustice in society that he is unable to treat.