Shyam Lama had just fallen asleep on the early morning of 28 September when he heard a loud bang outside his shop on the side of the highway in Dhading, 15km from Kathmandu. It had been r<a href="https://nepalitimes.com/news/60-dead-64-missing-in-nepal-floods">aining incessantly for two days</a>, landslips and fallen trees had blocked the Kathmandu-Mugling highway. Many buses were stranded, and some of them were parked at a bend on the road in Jhyaple Khola, waiting for the debris to be cleared. The bang that Lama heard was another landslide from the mountain above falling near his shop and covering the highway with 4m of mud and stones. Some of the buses were damaged, and injured passengers were running for safety in the darkness and pouring rain. In the light of dawn, they could see the damaged buses heading to Kathmandu from the west. But it was not till later in the day that Lama and some of the other rescuers saw the top of another bus sticking out of the mud.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241008141044_a0b528829a4230da6b7b26102a42f0a061de6c26a4fb1d1e201dabfcfc647519.jpg" data-media-id="editor_1" data-image-id="20241008141044_a0b528829a4230da6b7b26102a42f0a061de6c26a4fb1d1e201dabfcfc647519" data-rendition-name="original" width="5726" height="3817" loading="lazy" alt="jhyaple khola landslides"> <figcaption>Photos: SUMAN NEPALI(Photo: suman)</figcaption> </figure>  They dug through the slush to find 11 bodies. But then they spotted the tyre of another vehicle, then a van. Altogether 35 passengers perished that night in the three buses heading to Kathmandu from Chitwan, Butwal and Gorkha.&nbsp; “The buses were all stuck because the highway was blocked, and the landslide fell and buried them with the passengers sleeping inside,” Lama says. “If the debris up the road had been cleared in time, the buses would have been able to continue on to Kathmandu.” Read also: <a href="https://nepalitimes.com/multimedia/a-flood-of-tears-on-the-rosi">A flood of tears on the Rosi</a>, Archana Darji Archana Koirala runs a convenience store nearby, and was also awoken by muffled shouts for help almost drowned out by the sound of the rain on the tin roof. “In the darkness, I saw people escaping from two buses, some of them injured and covered in blood,” recalls Koirala. “I gathered up my little girls and ran for my life.”  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241008141044_ec79cc7198b54bad77c3f03bc1420ea64cb6776eaaec29581209614194b862fa.jpg" data-media-id="editor_3" data-image-id="20241008141044_ec79cc7198b54bad77c3f03bc1420ea64cb6776eaaec29581209614194b862fa" data-rendition-name="original" width="5680" height="3787" loading="lazy" alt="jhyaple khola landslides"> </figure>  Another shop owner Ajita Tamang, heard the landslide coming down and nearly burying her house. She ran with her mother to the nearby woods. Her shop did not survive. Krishna Tamang heard the sound of a bus windshield shattering, and went outside to check. &nbsp;He saw one of the buses half-buried in debris before it disappeared before his eyes, swallowed up by a fresh wave of mud. Unable to do anything to help, he ran up the mountain to save his own life.&nbsp; Shop owners and residents in Jhyaple Khola say that the landslide was so massive and came down so suddenly that the passengers in the vehicles probably did not even know what hit them. A week later, the mangled mass of the three buses are all that remain on the roadside, and excavators were trying to open the road for the expected heavy Dasain traffic on the arterial highway that connects Kathmandu to western Nepal. A visit to the site shows the mountain above scarred by open red wounds of landslides. The biggest slope failure originates in a local road about 100m above the highway and has brought down debris that was just dumped over the edge by bulldozers. <a href="https://nepalitimes.com/opinion/flood-of-despair">When the record-breaking rain came</a>, the mud turned into paste and raced down the mountain carrying tree trunks and large stones. &nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241008141044_64f6af7e300ed517f6bd161491a69d85706caed35839cfeee7c87e6671a8fdc3.png" data-media-id="editor_5" data-image-id="20241008141044_64f6af7e300ed517f6bd161491a69d85706caed35839cfeee7c87e6671a8fdc3" data-rendition-name="original" width="1320" height="1346" loading="lazy" alt="jhyaple khola landslides"> <figcaption>The bend on the highway where the landslide, triggered by a sub-standard road up the mountain buried three buses, killing 35 people on the night of 28 September. Other buses also blocked by another landslide further up the road were also damaged. Photo: SOCIAL MEDIA(Photo: Sonia Awale)</figcaption> </figure>  Typically, Dasain is the busiest time of year for businesses along the highway in Jhyaple Khola as people leave Kathmandu by busloads to get home for the festival. “We do not stay here for long anymore, we are already home before the sun sets,” says Krishna Tamang. “We fear another landslide will hit us at any time.” In July, a debris flow <a href="https://nepalitimes.com/here-now/100-101-102-hh5uvzf9">swept two intercity buses into the Trisuli River</a> along the Mugling-Narayangad Highway 60km west of here. Of the 62 passengers on the two buses, only three were able to swim to safety. Search and rescue teams recovered 27 passengers from the river in the aftermath of the landslide, but neither the buses nor the rest of the passengers have been found.&nbsp; A committee formed by the government to investigate the Simaltal disaster concluded that a new local road constructed farther up the mountain was <a href="https://nepalitimes.com/opinion/managing-the-monsoon">mainly responsible for the debris flow</a>. The Jhyaple Khola mudslide was a repeat of the July disaster. Locals in Dhading say that the Department of Roads had just completed the retaining wall, and the debris from the excavation done to construct the road had piled up, which the rain swept down to the highway below.&nbsp; Similar unplanned roads constructed further above in Nagdhunga have also clogged up the culverts, which remain uncleared.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241008141044_d46e7f612ce53b0c3133219a36ab81c5ef8f7494dc002452580c086d70028652.jpg" data-media-id="editor_8" data-image-id="20241008141044_d46e7f612ce53b0c3133219a36ab81c5ef8f7494dc002452580c086d70028652" data-rendition-name="original" width="2340" height="1560" loading="lazy" alt="jhyaple khola landslides"> <figcaption>Photo: SUMAN NEPALI(Photo: Sonia Awale)</figcaption> </figure>  “This disaster occurred because of the locally elected representatives, the Road Department and the contractors,” says local business owner Shyam Kumar Lama. “<a href="https://nepalitimes.com/editorial/when-it-rains-it-pours-ksqprbu3">You cannot blame it on a natural disaster</a>." “They keep tearing down the retaining walls to build haphazard roads, and replace them with brick walls,” adds Lama. “How is a barely one-foot-thick wall going to stop a landslide?” Geologist Sri Kamal Dwivedi says that the Department of Roads has not heeded the geological risks in excavations for road expansion across the country. “The soil above Jhyaple Khola was loosened by torrential rain, causing a high-speed debris flow onto the highway below,” &nbsp;explains Dwivedi. “Additionally, the possibility of disasters like landslides increases when slopes are cut to make way for road expansion.” Transport expert Kamal Pandey says that disasters like the ones in Simaltal and Jhyaple Khola happen frequently because environmental risks are ignored during investments in road expansion. Read also: <a href="https://nepalitimes.com/news/the-revenge-of-the-rivers">The revenge of the rivers</a>, Shamshad Ahmad “New roads are dug up like it is some kind of competition,” says Pandey. “But as long as unmanaged excavation continues without plans in place to mitigate landslides, disasters like the one at Jhyaple Khola will continue to happen.” Indeed, this is not the first time a disaster of this scale has struck in Jhyaple Khola. In 2001, a similar debris flow from higher up the hill buried a vehicle on the highway below, killing nine people.&nbsp; Landslides of smaller scales occur in the area every monsoon, but they do not make it to the news. But even as they are used to the frequent landslides, there is now a new kind of fear among residents.&nbsp; “I am overcome with terror every time I look up to the overcast sky,” says Shyam Lama. “We will never be safe in this place as long as the mountains keep falling on top of us.” &nbsp;

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"The mountain fell on top of us"

<ul>
 <li>BREAKING: Seven people were killed and 30 injured when a bus collided with a parked truck on the East-West Highway in Banke at 9pm on Friday night.</li>
 <li>A Beni-bound bus veered off the Prithivi Highway on 23 August and plunged into the Trisuli River, killing eight passengers and injuring many more (pictured above).&nbsp;</li>
 <li>Less than 24 hours later a bus carrying Indian pilgrims from Kathmandu to Janakpur swerved off the road in Bara district, killing seven passengers.</li>
 <li>A week earlier a jeep heading towards Butwal was hit by a rockslide in Palpa. Three people were killed.</li>
 <li>On 3 September, a jeep heading to Mugu from Jumla fell off the road, and rolled 300m down the steep mountainside. The driver and a passenger were killed.&nbsp;</li>
</ul>
These deadly accidents all took place within a fortnight across Nepal, and do not include pedestrians killed by vehicles. They have become so frequent that the mishaps do not even make headlines anymore.&nbsp;
Road Traffic Accidents (RTAs) <a href="https://archive.nepalitimes.com/article/nation/nation-nepal-highways,622">take more lives annually in Nepal </a>than floods, landslides, plane crashes, and other accidents and natural disasters combined.
A total of 2,320 people lost their lives in road traffic accidents between April 2022 and April 2023, while 28,856 people were injured, many of them impaired for life. &nbsp;
In that same time frame, floods killed 19 people and injured 17, while landslides took the lives of 96 people and injured 88. There were two aircraft accidents in that period that killed 79 passengers and crew. &nbsp;
Most RTA are concentrated in the Kathmandu Valley and the Tarai, where urbanisation and better quality roads and expressways have led to over-speeding and reckless driving. But in accidents in the rural mountains it is usually the poor condition of the roads that is the main factor. &nbsp;
Read also: <a href="https://nepalitimes.com/editorial/dying-to-travel">Dying to travel</a>, Editorial
Nepal’s topography and weather make it difficult to build and maintain roads. Highways and rural roads wrap around mountains, traverse cliffs, follow narrow river gorges. Entire sections of Nepal’s arterial highways are in a permanent state of disrepair during the monsoon, like the landslide-prone Mugling-Narayanghat Highway.&nbsp;
Poor highway engineering is a major factor in deadly accidents, says transport expert Chandra B Shrestha, now a consultant with the Asian Infrastructure Investment Bank. The rockslide in Palpa, he notes, was caused by an inability to properly stabilise the slope.
“Most accidents happen when the curves on the road and the speed of vehicles do not match,” adds Shrestha. “We also have a lot of blind spots along our highways which makes driving difficult.” &nbsp;
Nepal’s <a href="https://nepalitimes.com/banner/the-women-connecting-nepal">motorable roads</a> are classified into Strategic Road Networks, which include major highways under the purview of the Department of Roads, and Local Road Networks which are built and maintained by local governments.&nbsp;
While the main highways have to follow engineering parameters to be approved for construction, local roads are built without adequate engineering, making them more dangerous.&nbsp;
“Local governments have taken charge of the construction of rural roads without fulfilling any of the required technical criteria,” says transport expert Madhu Sudan Acharya, adding that they are built without an understanding of road geometry or slope geology.&nbsp;
Read also: <a href="https://nepalitimes.com/news/deadly-dasain-on-nepal-s-highways">Deadly Dasain on Nepal’s highways</a>, Nepali Times
<div class="embed-block"><iframe title="Deaths on the roads and injuries between 16 July 2021-17 July 2023" aria-label="Multiple Donuts" id="datawrapper-chart-xI5Rd" src="https://datawrapper.dwcdn.net/xI5Rd/1/" scrolling="no" frameborder="0" style="border: none;" width="600" height="339" data-external="1"></iframe></div>
Shrestha agrees that rural road networks are not only <a href="https://nepalitimes.com/banner/from-nowhere-to-nowhere">sub-engineered</a>, but are being dug across fragile slopes by excavators at breakneck speed on a massive scale without oversight. “Such roads have become death traps,” he warns.
Political interference and collusion between local contractors and their governments (in many cases the same person) to haphazardly build roads near private property has not helped matters.
Some major highways face similar problems. The Nepal Road Standard 2013 stipulates that highways, feeder roads, and district roads must have a Total Right of Way of 50m, 30m, and 20m respectively, but that rule has not been followed. &nbsp;
As land value increases, encroachment along Prithivi, Siddhartha and Arniko Highways by buildings is rampant and that increases the chances of human-vehicle collisions.
“Nepal’s highway network does not have Right of Way, and the concept is not even discussed during the construction of projects,” says Shrestha. “There should be extensive study into the road and land-use interface, and guidelines must be followed.”
Yet, driver negligence and poor vehicle maintenance play a bigger role in road accidents than climate, weather, or the way Nepal’s highways are constructed. Reckless driving on poorly built roads then turn things deadly.
Read also: <a href="https://nepalitimes.com/here-now/nepal-s-deadly-roads-take-their-toll">Nepal’s deadly roads take their toll</a>, Gopal Gartaula
Acharya is part of a seven-member task force created by the Ministry of Physical Infrastructure and Transport earlier this year to study vehicular pollution, safety and accident reduction.
He says, “Nepal’s highways would be much safer if drivers were properly trained or if vehicles were better maintained. But they have little understanding of highway traffic rules, reading signage or basic mechanical knowledge.”&nbsp;
The Land Transportation agency has also been lax in licensing and training drivers, especially those who seek to operate trucks, buses and long-haul four-wheelers. Fines for speeding and other traffic infractions, especially for two-wheelers, have not brought down the fatality rate. Motorcycles cause most of the road accidents in Kathmandu Valley and the Tarai.&nbsp;
In a recent example in Kathmandu, two people died and several were injured when a speeding bus collided with a Bolero as it swerved to avoid a motorbike coming from the opposite direction.&nbsp;
“Nepal’s existing road safety practices and protocols make it pretty clear that transport management authority is unable to govern properly, and needs massive overhaul,” Shrestha explains.&nbsp;
Acharya adds: “The result is that the wrong people are behind the wheel.” &nbsp;
Read also: <a href="https://archive.nepalitimes.com/page/maps-showing-increase-in-road-accident-fatality-rates">6 years of road traffic accidents</a>, Sunir Pandey
<div class="embed-block"> <iframe title="Road accident deaths and injuries between 16 July 2021-17July 2023" aria-label="Map" id="datawrapper-chart-E9O4w" src="https://datawrapper.dwcdn.net/E9O4w/1/" scrolling="no" frameborder="0" style="border: none;" width="600" height="441" data-external="1"></iframe></div>
<h2>Treating trauma</h2>
A motorcycle was hit by a car along the East-West Highway one recent evening, and the driver was writhing on the road, bleeding profusely.&nbsp;
Bystanders gathered, taking videos of the injured man with their mobiles to post on TikTok. No one helped for fear of being involved. Police took an hour to arrive. The driver bled to death while being taken to hospital.
In a similar case, a motorcyclist was hit by a car on his way to work and he felt pain in his arms, legs, and neck but it did not seem too severe. Bystanders gathered and carried him to hospital on their back.&nbsp;
Well-meaning as they were, they were not trained in handling the injured. The patient was eventually examined by Raju Dhakal of the Spinal Injury Rehabilitation Centre in Sanga, but the rescue attempt itself worsened the trauma and he will now suffer life-long physical complications.&nbsp;
<a href="https://nepalitimes.com/here-now/it-s-an-emergency-nepal-needs-to-improve-trauma-care">Trauma care</a> is inaccessible to a larger number of Nepalis as the road network expands across the country. Specialised surgery and emergency treatment are centralised in Kathmandu or main cities, and the cost of rescue, ambulance, airlifting and treatment are too costly for most.
But even at hospitals, there is a lack of trained rescue and emergency first responders, which means untrained bystanders step in and inadvertently make injuries worse.&nbsp;
Read also: <a href="https://nepalitimes.com/multimedia/nepal-s-other-pandemic-road-fatalities">Nepal’s other pandemic: road fatalities</a>, Anita Bhetwal
“There is a weakness in the life-saving mechanism that brings patients from accident sites to hospitals, and there are not many trained emergency responders,” says Dhakal. “Even not-critical injuries become life-threatening because police and rescuers do not reach accident sites on time.”&nbsp;
Traffic authority Sitaram Hachhethu agrees that the<a href="https://archive.nepalitimes.com/news.php?id=18715"> role of traffic police and police personnel</a> in case of road accidents on highways is limited to reaching the site which itself takes time due to distance and road conditions, adding to the number of casualties.&nbsp;
Moreover, the police do not even have proper equipment to rescue those who have been in accidents, such as metal and seat cutters. Says Hachhethu: “We use whatever we have to get them out, all the while not knowing the protocol of rescuing an injured person.”
He adds: “90% of RTA deaths would be prevented if we had proper emergency and first response services and trained medical professionals on standby. Until then traffic police, police and rescue personnel need to be trained to provide first aid and basic emergency medical care.”
The state needs to identify which hospitals are primary, secondary, or tertiary to help doctors to direct trauma patients to relevant hospitals. That way, first responders can triage so that the resources of tertiary hospitals can be directed towards the critical patients. Additionally, basic first aid and emergency training can also be provided at the local levels so that people seeking to help accident victims have a basic knowledge of what to do and what not to do.
Read also: <a href="https://archive.nepalitimes.com/article/nation/lack-of-trauma-centres-along-nepal’s-highways-worsened-fatality-rate,1383">Highways of death</a>, Sunir Pandey
A 2023 study by the Emergency Department of the College of Medical Sciences and Teaching Hospital over a six-month period from January to June 2022 revealed that 9.58% of the 7,654 patients had been admitted to the emergency unit for Road Traffic Accidents, and 65% of the cases had occurred along highways.
The study in the Journal of the Nepal Medical Association found that 38% of total patients admitted for RTA had soft tissue injuries, while 31% had suffered head injuries.
The situation is dire in the remoter parts of Nepal where medical facilities are few and far between, and the roads are all sub-standard. At <a href="https://nepalitimes.com/here-now/nepal-s-rural-lifeline">Achham’s Bayalpata Hospital</a>, orthopaedic surgeon Mandeep Pathak has seen an increase in mass casualties from bus and tractor accidents.
“Hospitals along highways need trauma centres and ICUs so serious patients do not need to be referred to the city,” Pathak says, adding that many do not survive the long bumpy journeys in poorly equipped ambulances. &nbsp;
People are also not aware that the healing process does not end after hospital treatment. Rehabilitation is just as crucial to ensuring there are no long-term complications.&nbsp;
Says Dhakal: “Deaths, critical injuries and long-term disabilities can be prevented provided emergency services and trained professionals reach accident sites on time, identify what level of care victims require, and there is rehabilitation after hospital treatment.” &nbsp;
Read also: <a href="https://archive.nepalitimes.com/article/nation/Nation-road-kill,621">Road kill</a>, Duncan Maru

Shristi Karki

Highway accidents are no accident in Nepal

<figure><img width="1419" height="630" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110121140/636ce3df9c7e80680e09667ajpeg.jpg" alt=""/><figcaption>FISHING OUT: Armymen try to pull out the bus that fell into the Madi River in Tanahu in 2013. Photo: PAWAN PAUDEL</figcaption></figure>At 5AM on 12 December 2019, residents of Khadichaur of Sindhupalchok district woke up to a loud crash. A bus had careened off a hairpin bend and plunged 500m down the mountain, killing 17 and wounding 18 passengers.They were pilgrims on the way back from the Kalinchok shrine. A little over a year later, the tragedy has become part of the deadly statistics of <a href="https://www.nepalitimes.com/latest/how-covid-19-saves-lives-in-nepal/" target="_blank" rel="noopener noreferrer">Nepal’s highway accidents</a> in which an average of seven people die every day.“There was a pile of bodies, some with their limbs severed. I had never before seen such a horrendous sight,” recalls Mithu Mijar. “All we could do was help lift the bodies and place them in ambulances.”Tara Bahadur Karki is still traumatised by the sight, and cannot walk past the site without recalling that fateful day: “The entire slope was covered with bodies and there were more under the bus. After a while, we lost count, as we kept pulling them out of the wreckage.”https://www.youtube.com/watch?v=bqRS60ctCj4 <figure><img width="1500" height="844" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110121140/636ce3e29c7e80680e09667bjpeg.jpg" alt=""><figcaption> </figcaption></figure>Most of the accidents are preventable, and the causes are mainly poor road condition and reckless driving. The <a href="https://www.nepalitimes.com/here-now/its-an-emergency-nepal-needs-to-improve-trauma-care/" target="_blank" rel="noopener noreferrer">pandemic of highway accidents</a> kills as many Nepalis every year as all the natural disasters combined. In fact they are so common that most Nepalis are desensitised by the numbers. From July 2014-July 2019, there were a total of 54,000 road accidents in Nepal resulting in 12,000 deaths of people mostly in the age group 15-40 years. This number <a href="https://www.nepalitimes.com/latest/how-covid-19-saves-lives-in-nepal/" target="_blank" rel="noopener noreferrer">went down sharply during the Covid-19 lockdown</a>. Highway fatalities declined by half to less than 700 in March-August 2020, compared to the same period the previous year. By the Dasain-Tihar festival in November 2020, with restrictions removed, the number of deaths on the roads again spiked to 242 after falling to 52 in May. <figure><img width="1263" height="752" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110121140/636ce3e49c7e80680e09667cjpeg.jpg" alt=""><figcaption> </figcaption></figure>“In developing country like ours we have fewer accidents but more casualties because of our mass transport. But we often forget about those wounded, they are sentenced to a life of economic hardships and trauma beyond our imaginations,” says former Superintendent of Police Jagat Man Shrestha.On average, 40 people are injured on roads across the country each day.In 2019, there were nearly 13,000 highway and road accidents in which 2,736 people lost their lives and 10,731 were seriously injured. Those who survive often have a <a href="https://www.nepalitimes.com/here-now/injured-use-internet-to-reach-physiotherapists/?preview_nonce=aefd82ecbe" target="_blank" rel="noopener noreferrer">traumatic brain and spinal cord injuries</a>, requiring long-term or life-long rehabilitative care. <figure><img width="1636" height="942" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110121140/636ce3e79c7e80680e09667djpeg.jpg" alt=""><figcaption> </figcaption></figure>Journalist Gajendra Budathoki was on his way home one rainy night when the blinding headlight of an oncoming bus from the wrong side at Bhadrakali turn caused his motorcyle to skid off the road. A spinal cord injury has paralysed him from the waist down. “I would never go faster than 50km/hour and my friends used to poke fun at me for being slower than a bicycle but now I’m forced to leave the rest of my life bound on a wheelchair,” he laments.According to the WHO Global Status on Road Safety 2018, only 8 in 100,000 people die of highway and road accidents in developed countries, but the number soars to 27.5 in low-income nations like Nepal.A Ministry of Physical Infrastructure and Transport study has found that 76% of <a href="https://www.nepalitimes.com/here-now/the-other-global-pandemic-road-fatalities/" target="_blank" rel="noopener noreferrer">highway accidents</a> are caused by drivers who do not follow traffic rules, or are speeding.“Tipper truck drivers get Rs1,000 per trip so they try to make as many roundtrips as possible. I have seen them make five per night, driving even as they doze off at the wheels. If they don’t kill people, who will?” asks the chief of Lalitpur Metropolitan Police Sitaram Hachhethu.Traffic police have now deployed speed guns to check speeding at the accident-prone Satdobato-Gwarko road. They penalise up to 100 commuters a day, many of them in motorcycles that are going at 90km/hour in the road with a speed limit of 50km/hour.  Road maintenance or lack thereof is another major cause of traffic accidents. Local governments need to wait for the budget to maintain road safety while the Department of Roads is unable to add crash barriers on highways.“Our roads are narrow, bad, and frankly not the kind we should have built,” accepts Arjun Thapa, head of the Department. “Priority on road construction without proper infrastructure planning is to blame.”Roads are synonymous with development in Nepal. Every election, politicians promise highways to boost their vote banks. There are <a href="https://archive.nepalitimes.com/article/nation/accident-prone-Mugling-Narayangadi-highway,3828" target="_blank" rel="noopener noreferrer">excavators clawing away at the mountains</a> all over the country. <figure><img width="1500" height="1000" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110121140/636ce3ea9c7e80680e09667ejpeg.jpg" alt=""><figcaption> </figcaption></figure>Says road safety analyst Kamal Panday: “Well-constructed roads prevent accidents, but we have made ours ignoring technical and engineering aspects because new roads bring in votes, and maintenance doesn’t.”All automobiles are subjected to mechanical inspection tests every six months, those that fail are not allowed on the streets. But testing centres across the country are not functional as vehicles are certified based on manual (visual) inspection alone.The design of vehicles can also factor in crucial life and death situations. For example, tipper truck drivers have blind spots on the sides which prevent them from seeing motorcyclists. Moreover, the bumpers of these heavy load vehicles is 1.5m above the ground making them lethal in a collision. Many countries including China, Brazil and Japan have now added 360degree cameras for tipper drivers.“Our tippers are not fit for highway and city traffic, their only purpose is to carry raw material from mines to construction site,” says Namraj Ghimire of the Department of Transport Management. <figure><img width="1536" height="850" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110121140/636ce3ed9c7e80680e09667fjpeg.jpg" alt=""><figcaption> </figcaption></figure>An important aspect when it comes to traumatic road traffic accidents is the transportation of the wounded to the hospitals without further aggravating their condition. “We have seen many cases of careless handling leading to unnecessary damage to the spine resulting into deaths,” says Raju Dhakal of the Spinal Injury Rehabilitation Centre in Sangha.The traffic police and the Department of Transport Management are responsible for implementing rules and regulations. The Department of Roads has to build safe infrastructure. But when asked, they all pass the blame to each other. Traffic police complain that they do not have enough human resources. The Department of Roads states that most roads in Nepal are now under the purview of local governments. The Transport Service Department simply does not bother about vehicular inspections. <figure><img width="1400" height="1050" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110121140/636ce3f09c7e80680e096680jpeg.jpg" alt=""><figcaption> </figcaption></figure>It is therefore up to the public to make their voice heard, and make government agencies feel more responsible, says activist Anandaraj Joshi, who used to be a truck driver in Western Nepal. “Civil society, media and investigators must continue to pursue this issue, start a discourse to wake up the uncaring state and together eradicate this calamity from its roots,” Joshi says.There is a consensus among experts that the implementation of road engineering suited to the geography of the place and mechanical knowledge among drivers is crucial to reducing road accidents. Similarly, traffic education goes a long way in preventing road fatalities and must start at homes and schools.Says former SP Jagat Man Shrestha: “Traffic enforcement gives us a quick result but it will be temporary. To prevent as many road accidents as possible, we must revamp our education system and upgrade engineering.”

Anita Bhetwal

Nepal’s other pandemic: road fatalities

From stone spouts to cast-iron mains, Nepal’s water system and its struggle to provide safe water tells a larger story of power, disease, dependency — and lessons for the future. From 1823 to 1891, the Nepali state made just two notable interventions in Kathmandu’s drinking water system. The first was when Prime Minister Bhimsen Thapa commissioned a stone pout (hiti) to tap groundwater within the valley’s traditional supply system. The second came nearly 70 years later with Nepal’s first industrial-era water system, the Bir Water Works in 1891 under Prime Minister Bir Shumsher Rana. Linking these two milestones was the spectre of cholera. From the 19th century on there were seven global cholera pandemics. <a href="https://www.sciencedirect.com/science/article/pii/S0264410X19309995#bb0325" target="_blank">Originating in Asia</a>, the disease reached Europe and the Americas, the Vibrio cholera bacillus breeding in poor sanitation wherever it found it. The first wave erupted in 1817, followed by others in 1829, 1852, 1863, 1881, 1889 and, finally, in 1961, the seventh pandemic which still lingers on. London, the epicentre of the Industrial Revolution, was repeatedly stricken. In Britain ‘miasma’ foul air was blamed. &nbsp;In Nepal, cholera was seen as divine damnation. By the late 19th century, as Nepal’s relationship with Britain deepened, the Bir Water Works was inaugurated in 1891 as a defence against cholera. Whether cholera also shaped Bhimsen Thapa’s decision in 1823 is less clear. Contemporary records note the commissioning of Sundhara, but do not refer to the cholera epidemic raging at the time. The silence itself is telling: Nepal’s elites were ruling in the shadow of the disease. Bhimsen Thapa first resided in Thapathali Palace, which was built in 1802 by Nain Singh Thapa, father of Mathabarsingh Thapa, who would briefly become prime minister in the 1840s. In 1806, Bhimsen Thapa moved to Bagh Durbar, a new complex on the western edge of Tundikhel. Historians are vague about the water supply in the residences of the nobility, but wells and water hauled from rivers, ponds, canals, and other sources were likely the primary sources. A small hiti north of Bagh Durbar, near today’s Sun Dhara, may have supplied the palace. In 1823, Bhimsen Thapa had it enlarged, making it the last and largest state-built hiti in Kathmandu. Even as Bhimsen Thapa was involved in palace intrigues and border conflicts, Britain was engineering pipelines. By the late 18th century, Sir Thomas Simpson had invented the bell-and-spigot joint, making long-distance pipes viable. Fluid dynamics, dealing with pumps, pipes, and filters, was becoming a foundational discipline. In Kathmandu, the scourge continued. Cholera struck Kathmandu repeatedly, in 1862, 1867, 1872, 1874 and 1875. The 1872 epidemic, <a href="https://nepalitimes.com/news/kathmandu-in-the-time-of-cholera" target="_blank">according to historian Tom Robertson</a>, claimed between 200 and 250 lives a day. On average, cholera killed between 1,200 and 1,500 people annually in Kathmandu Valley, an enormous toll for its small population. The summer of 1885 was especially calamitous: a cholera epidemic ravaged Kathmandu and its periphery from the beginning of June until late August. The disease even breached the royal palace, reportedly killing 23 people, mostly young girls. Records show that 909 people received treatment at the British Residency dispensary, and estimates suggest that as many as 10,000 people perished in a city of 50,000. In November that year, Bir Shumsher seized power in a coup. He inherited not only a premiership but a Valley ridden with disease. Cholera was endemic, and it was accompanied by typhoid, smallpox, goitre, syphilis, and chronic dyspepsia. The The British Residency dispensary at Lainchaur was inadequate. “In a poor country like ours, wealth means health,” Bir Shumsher remarked, an unusually pragmatic admission that epidemics were not divine punishment but structural afflictions of urban life. He soon pledged to expand health care. In 1889, he opened Bir Hospital and staffed it with Indian doctors to treat cholera, typhoid, smallpox, and other prevalent illnesses. PIPED WATER Bir Shumsher also recognised the need for safe drinking water. Between 1866 and 1872, he had served as Nepal’s ambassador in Calcutta, and he must have seen water mains already in operation there, and a filtration plant inaugurated in 1870. Madras had installed such a system as early as 1800, Bombay constructed the Vihar and Tulsi reservoirs in the mid-19th century. In Kathmandu British Residency personalities such as George Gimlette must have urged Bir’s government to quicken the construction of the hospital and water system, yet the archival traces of such exchanges still await historical scrutiny. By the late 19th century, the British had developed a technological ecosystem for water supply, intakes, pipes, fittings, reservoirs, and trained engineers. Bir Shumsher appealed to the British Government in India for engineering assistance. A British engineer named Mr Feigneur surveyed Kathmandu to prepare maps, and estimated the volume of water that could be brought from the Rudramati River. In 1889, a more experienced engineer, Lockhart Matthew Sinclair arrived. He was a Scotsman educated at Wellington College and the Royal Indian Engineering College, with prior experience in constructing waterworks in Jubbulpore and the Viceregal Palace in Shimla. Appointed State Engineer of Nepal (1889–1892), Sinclair reviewed Feigneur’s plans, updated them, and chose the Bishnumati River as the source of the city’s drinking water. Sinclair’s design included a reservoir at Panipokhari, at 1,330m elevation and 30m above &nbsp;Tundikhel, thereby enabling gravity-fed distribution in pipes. With a capacity of 7,327 cubic metres, the reservoir could store nine days of supply.&nbsp; The system was designed to serve about 70,000 residents through both private connections and public standpipes. The reservoir was a single-compartment tank with an arched brick roof covered in earth and turf. Its brick walls were bonded with lime mortar and aggregate, and its floor was dressed with fly stone. Work on the valley’s water supply began in 1888, three years after Bir Shumsher seized power. The following year, Bir Hospital and the Bir Water Works took shape. The project involved some 40km of imported cast-iron pipes, weighing 1.866 million kg and inscribed with the marks of Scottish foundries ‘Ally and McLean’ and ‘Glasgow’. Construction required 620,000 man-days of labour and cost over Rs600,000. Transport costs inflated prices: <a href="https://commons-nepal.com/the-first-kaldhara-in-the-four-cities-of-the-valley/" target="_blank">a load of cement</a> costing Rs10 in Calcutta was worth Rs33 by the time it reached Kathmandu. Bir Water Works was inaugurated in September 1891, six years after the cholera epidemic. Water flowed out of 131 taps, including eight in Lainchaur, six in the royal palace, eleven in the prime minister’s palace, sixteen around Tundikhel, thirteen in Thapathali, seven in Thamel, and two in Naxal. The system’s designation, the term ‘works’ , echoes the Chelsea, Calcutta, and Glasgow Water Works, underlining its industrial pedigree. Water was also supplied to Phora Durbar, Bir Shumsher’s palace of music and dance whose fountains sprayed rose-scented water in a display of opulence. The <a href="https://commons-nepal.com/the-first-kaldhara-in-" target="_blank">Bir Dhara Works</a> was more than an engineering scheme: it was Nepal’s first modern public-health intervention. Safer drinking water curbed waterborne disease, and the number of cholera outbreaks declined, but were not eliminated.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260103020144_d5c22de54c0eaab680a166c5a7482839fdc09b60679109021d0504252a810254.png" data-media-id="editor_4" data-image-id="20260103020144_d5c22de54c0eaab680a166c5a7482839fdc09b60679109021d0504252a810254" data-rendition-name="original" width="865" height="535" loading="lazy" alt="Cholera and drinking water in Kathmandu"> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260103020144_a46075b6d759585df56a2bb8e5a07d85de7d9a69406165c32784fe30012c9971.jpg" data-media-id="editor_5" data-image-id="20260103020144_a46075b6d759585df56a2bb8e5a07d85de7d9a69406165c32784fe30012c9971" data-rendition-name="original" width="2791" height="3859" loading="lazy" alt="Cholera and drinking water in Kathmandu"> </figure>  “Now we have water to fight cholera, and I believe cholera will no longer prevail. After four years of piped water, the benefits have been greater than expected,” Bir Shumsher said in a proclamation. Despite this, the prevalence of poor sanitation, open defecation, cramped housing, and malnutrition meant that typhoid, smallpox, and dyspepsia remained endemic. The Bir Dhara system marked Kathmandu’s transition from reliance on wells, rivers, springs, and hiti to piped water, operating for several decades and laying the foundation for the expansion of drinking water services across the country in the late twentieth century. <a href="https://commons-nepal.com/the-first-kaldhara-in-the-four-cities-of-the-valley/" target="_blank">Extensions followed in Patan</a> under Chandra Shumsher, and Bhim Shumsher later added the Tri Bhim Dhara. Piped water systems were subsequently constructed in towns such as Kirtipur, Bhaktapur, Dhankuta, Pokhara, Dhulikhel, and Jajarkot which itself saw a deadly cholera outbreak in 2009.&nbsp; CHOLERA METAPHOR In 1933, Nepal’s first water bureaucracy, the Pani Goswara, was established, formalising state involvement in urban water supply. Yet even till the late 20th century, households continue to rely on a mix of sources, including public water networks, private vendors, rooftop storage tanks, borewells, wells, hiti, and household filtration. The lack of reliable water supply places disproportionate financial, physical, and psychological burdens on low-income households, underscoring how decades of infrastructure expansion have not translated into universal, reliable service. during challenges in governance, investment priorities, and regulation. Bir Shumsher also attempted to introduce <a href="https://www.ukaalo.com/news/cholera-in-kathmandu-1958/" target="_blank">basic hygiene measures</a>, such as pit latrines with squatting slabs. However, there is no record of these facilities being built in his palaces, later built palaces, or elsewhere. Sanitation conditions remained poor for both the elite and the general population. Open defecation or the use of crude pit latrines without proper waste disposal was common. With no drainage or sewer systems, human waste accumulated near homes, contributing to the spread of waterborne diseases. In 2019, Nepal declared itself ‘open defecation free’, a policy milestone, but this achievement masks the persistence of deeper problems. Urban areas generate some 867 million litres of wastewater daily, yet only 7% of it is treated before being discharged. Sewage flows untreated into rivers and streams, spreading cholera, typhoid, dysentery, and other diseases, particularly among children and vulnerable communities. Safe disposal of faecal sludge continues to be a major struggle for many communities and local governments. Besides Jajarkot, Godavari in Kathmandu Valley had a localised outbreak in 2024. This year, Birganj was struck by a cholera outbreak caused by a lethal combination of unreliable water supply, groundwater overpumping, poor drainage and hygiene, and unsafe waste disposal. And Nepal’s peacekeepers deployed after the earthquake in Haiti in 2010 were blamed for spreading cholera that ultimately killed 30,000 people in the Caribbean nation. The Bir Water Works was more than a reservoir and pipes. It was Nepal’s first brush with modernity, mediated through engineering and haunted by cholera. More than 134 years on, cholera remains a threat and a reminder of Nepal’s challenges in water and sanitation governance. The issue is not merely ensuring access to safe water but also building public trust that quality essential services can be delivered equitably, sustainably, and with resilience. Ajaya Dixit is a Kathmandu-based researcher exploring Nepal’s water history since the mid-eighteenth century to inform ethical water and river management in a changing climate.

Life in a time of cholera

As someone born and raised in Patan, I knew that the city was rich in art, architecture and intangible heritage. But I never realised just how rich, and how little I knew about its hidden treasures until this book. Yala Mhasika/Exploring Lalitpur/Lalitpurko Chinari is published by the Lalitpur Chamber of Commerce &amp; Industry and introduces the city to the world, as well as to its own inhabitants. Lalitpur is popularly known as Patan, probably because of the pastures for livestock in its outskirts. Its original name in Nepal Bhasa is Yala, and is a blend of urban and rural, old and new.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260101120152_700fb4c7b27d78813f69347846403c492cd1d54e2f62e4ec097013714c4a2022.jpg" data-media-id="editor_0" data-image-id="20260101120152_700fb4c7b27d78813f69347846403c492cd1d54e2f62e4ec097013714c4a2022" data-rendition-name="original" width="2000" height="1333" loading="lazy" alt="Exploring Lalitpur book review"> <figcaption>Patan Dhoka</figcaption> </figure>  Like other kingdoms in the valley of Swoniga, the dense urban cluster of houses, temples, monasteries were situated along the higher ground, while the farmlands were on the slopes leading to the rivers below. This unique townscape combined an urban lifestyle within a distinctly agriculture-based rural setting. The fertile soil, replenished by organic nutrients washed down from the streets above, as well as Kathmandu’s location on the ancient trade route between India and Tibet, provided the Valley’s kingdoms with prosperity – and thus the flourishing of art and culture over centuries. Most of Yala’s residents were farmers, traders, or artisans. Chinese visitors who came to Nepal in the 6th century saw that there were more traders than farmers, and more temples than houses. An entire street is inhabited by the descendants of Lhasa traders. Arniko is supposed to have been born in Yala.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260101120152_0fb490355fac9b8252c9abfbf5ef1bbac844b29103744a421eb6ef6dbc77dff7.jpg" data-media-id="editor_1" data-image-id="20260101120152_0fb490355fac9b8252c9abfbf5ef1bbac844b29103744a421eb6ef6dbc77dff7" data-rendition-name="original" width="2000" height="1332" loading="lazy" alt="Exploring Lalitpur book review"> <figcaption>Kwonti area which houses five-storey Kumbeshwar temple dedicated to Shiva and Baglamukhi temple dedicated to Dasa Mahavidya shakti peeth.</figcaption> </figure>  Nepal exported goods and even minted coins for Tibet, and had a virtual monopoly of the major trans-Himalayan trade routes. This prosperity was reflected in monuments and shrines like the Kwa Baha Golden Temple. More so than the other three kingdoms of Swoniga, architecture flourished in Yala making it the centre for metal, stone and wood craft. The name Lalitpur means ‘city of fine art’ but with its sense of community, it might as well be a city of fine living. Legend also has it that the name Lalitpur comes from a farmer called Lalit who helped bring the rain god Karunamaya from Assam when the Valley was suffering a prolonged drought. Lalit’s shoulder beam stands to this day in Jhatapol. Disasters, invasion and <a href="https://nepalitimes.com/here-now/life-in-a-time-of-cholera">epidemics</a> were a recurring theme in Patan.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260101120152_b33b1024cb7a46f49fea35ecc9afa2740895907059d7a43c8bd6c463b1be05e7.jpg" data-media-id="editor_3" data-image-id="20260101120152_b33b1024cb7a46f49fea35ecc9afa2740895907059d7a43c8bd6c463b1be05e7" data-rendition-name="original" width="2000" height="1333" loading="lazy" alt="Exploring Lalitpur book review"> <figcaption>Ajima of Haugal Tole which is the oldest stone scripture in Nepal with the Gaja Laxmi in Chyasal.</figcaption> </figure>  The book was put together by the heritage expert team of Rosha Bajracharya, Sunil Pandey and Anil Chitrakar and provides a socio-economic and political history of Patan – how it was always food surplus, thanks to sustainable farming until recently. Ground and drone images by Photo Venture Nepal in the book give us a rare new perspective on Patan. There is an entire chapter on the chariot festival of Karunamaya (Machhindranath), a community-managed festival with Barahi carpenters assembling the woodwork, vine engineers Yamva weaving rope and rattan for the 25m tall chariot, and Ghaku drivers controlling the speed and brakes as the structure rolls through narrow streets in the annual festival.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260101120152_d27b23aeb4548b0b64ab8ed20f40baa331060498c6b5443e2cb999b876c670af.jpg" data-media-id="editor_4" data-image-id="20260101120152_d27b23aeb4548b0b64ab8ed20f40baa331060498c6b5443e2cb999b876c670af" data-rendition-name="original" width="2000" height="1333" loading="lazy" alt="Exploring Lalitpur book review"> <figcaption>Te Bahal in Patan which houses Karunamaya six months a year.</figcaption> </figure>  WALKING, WORSHIPPING The book can help in exploring Patan along five routes starting in Patan Dhoka, Pulchok, Shankhamul, Mahaboudha and Lagankhel with maps and details of the baha and bahil, shrines, ponds, open spaces, dhyochenn, courtyards and phalcha along the way. Because of its coffee-table size and heft, however, the guidebook is not practical to carry around. And despite detailed descriptions of the past and present of each site, readers are left wanting to know more about those places. It is proof of Patan’s vast treasures that even this book barely scratches the surface.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260101120152_31a597b7dc1bcc9f67b4f6a66b8c1c0e0a9406727389699e6aed9ac6c3c50901.jpg" data-media-id="editor_5" data-image-id="20260101120152_31a597b7dc1bcc9f67b4f6a66b8c1c0e0a9406727389699e6aed9ac6c3c50901" data-rendition-name="original" width="2000" height="1332" loading="lazy" alt="Exploring Lalitpur book review"> <figcaption>Patukodom where visitors can view what remains of the ancient Kirant palace.</figcaption> </figure>  Some of the lesser-known must-visit sites include Patukodom which is all that remains of a palace of the original Kirat inhabitants of Patan. An archaeological dig here would surely unearth hitherto unknown facets of pre-Newa Patan. Then there are the slightly out of the way shrines like Mahabouha, a replica of a temple in Bodhgaya which houses 3,341 terracotta Buddhas with 90 big statues and which took 35 years and four generations to complete.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260101120152_ffb657dc254f707dc1755f6f13b1ef67bb7183b6573da9678c54482129fb3878.jpg" data-media-id="editor_6" data-image-id="20260101120152_ffb657dc254f707dc1755f6f13b1ef67bb7183b6573da9678c54482129fb3878" data-rendition-name="original" width="2000" height="1333" loading="lazy" alt="Exploring Lalitpur book review"> <figcaption>Mahaboudha is a replica of a temple in Bodhgaya.</figcaption> </figure>  In a recent Patan by Night heritage walk, we learnt that Pim Bahal was the labour of love of a lakhe demon (now popularised as masked dancer) who had fallen for a local girl, and he dug the pond so she would not have to walk to a faraway spout to collect water. Nearby is the Charumati Chaitya, built by the daughter of Emperor Ashoka when she visited the Valley in the 3rd century BCE to spread Buddhism in Nepal. Interestingly, if Kathmandu is a city of temples, Patan is the centre of monasteries which represent a unique Tantric melding of Buddhist and Hindu forms. Examples are: the Tadham Cuka with relocated Licchavi-era chaityas symbolic of the four major events in Buddha’s life, Ajima of Haugal Tole which is the oldest stone scripture in Nepal with the Gaja Laxmi in Chyasal, and Bignantak Ganesa temple which is a manifestation of Shiva mingled with Vajrayana Buddhism.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260101120152_17a500e77f06b9881f684329e41d3482f6f6a639ffb929d8bb44e5af7934c61c.jpg" data-media-id="editor_7" data-image-id="20260101120152_17a500e77f06b9881f684329e41d3482f6f6a639ffb929d8bb44e5af7934c61c" data-rendition-name="original" width="2000" height="1333" loading="lazy" alt="Exploring Lalitpur book review"> <figcaption>Bignantak Ganesa temple.</figcaption> </figure>  &nbsp;Besides spatial descriptions, the book also explains the temporal by curating a detailed cultural calendar of Lalitpur with dates and places of jatra, rituals, devotional dances and festivals that weave the agricultural cycle with the zodiac.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260101120152_b8e1cc03653fea85dec84a7abee4fd594c35c6ad553769f37905eb5b38774e08.jpg" data-media-id="editor_8" data-image-id="20260101120152_b8e1cc03653fea85dec84a7abee4fd594c35c6ad553769f37905eb5b38774e08" data-rendition-name="original" width="2000" height="1125" loading="lazy" alt="Exploring Lalitpur book review"> <figcaption>Mipwa Lakhe of Patan which create fire in mid aid during performance.</figcaption> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260101120152_442e10bff842214e8c7522ebf6e63663599768db73bb57d999deff9de1b59375.jpg" data-media-id="editor_9" data-image-id="20260101120152_442e10bff842214e8c7522ebf6e63663599768db73bb57d999deff9de1b59375" data-rendition-name="original" width="2000" height="1333" loading="lazy" alt="Exploring Lalitpur book review"> <figcaption>Gan pyakhan or Astamatrika dance which is performed in Patan Darbar Squre during Dasain. </figcaption> </figure>  The very last chapter is dedicated to water and nature, what sustains lives and civilisations, and how Lalitpur continues to be the city it is because of the water supply system our ancestors left behind which function still, despite encroachment and pollution. ‘In the history of the world cities have been built, they thrived for some time and then became archaeological sites because they were not able to maintain the quality of air, water, and its soil,’ the authors write. ‘This led these cities to depopulate and ultimately die and are only referred to in history books. Lalitpur is not going to make the same mistake.’ &nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260104080132_3f403388d57da82b499d6c489a8f095002bf69f11e515e92fa96fb5ca3af69e9.jpg" data-media-id="editor_10" data-image-id="20260104080132_3f403388d57da82b499d6c489a8f095002bf69f11e515e92fa96fb5ca3af69e9" data-rendition-name="original" width="1136" height="702" loading="lazy" alt="Exploring Lalitpur"> </figure>

YALA

Nepal has made dramatic progress in expanding health services, yet millions of people still do not fully benefit from their Constitution-ensured right to basic medical service. Many of those deprived of accessible and affordable healthcare are in remote far-flung areas of the country, but increasingly they are also among the urban poor who have migrated to the cities and live in the margins. In both areas there are gaps in service quality, health workforce availability, and governance capacity. Out of pocket expenses for medical treatment of a family member can push families into absolute poverty and debt. The 2025 WHO–World Bank Global Monitoring Report on Universal Health Coverage underlines this challenge -- financial hardship from health spending remains a major barrier to equity, even where medical coverage has improved. In Nepal, rising demand for better and more affordable healthcare and workforce shortages due to outmigration of medical personnel and other factors mean that the government is unable to bridge these gaps through public provision alone. Well-governed and accountable public-private partnerships (PPPs) aligned with national priorities offer <a href="https://archive.nepalitimes.com/article/nation/Crowding-it-out,1003" target="_blank">a practical pathway from policy commitment to real-world impact</a>. The experience of the non-profit Nyaya Health Nepal (NHN) in partnership with the Sudurpaschim Province is an example of where this has worked well. Through <a href="https://nepalitimes.com/banner/altruistic-healthcare-models-in-nepal" target="_blank">public ownership and non-profit management</a>, <a href="https://www.youtube.com/watch?v=CJzWlnYd0ZM&amp;t=17s" target="_blank">Bayalpata Hospital</a> in Achham and <a href="https://nepalitimes.com/news/unique-hospital-handover-in-dolakha" target="_blank">Charikot Hospital in Dolakha</a> strengthened service delivery, supply chains, health workforce management, and digital health systems, while keeping all services free at the point of care.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251231101244_b59dabd4604a24426a55fe91c0e5866b5029858bdb4c4028c331557aeb5408ae.jpg" data-media-id="editor_4" data-image-id="20251231101244_b59dabd4604a24426a55fe91c0e5866b5029858bdb4c4028c331557aeb5408ae" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="Bayalpata"> <figcaption>Bayalpata hospital in Achham.</figcaption> </figure>  NHN managed Charikot from 2016-2020 and handed it over to Bagmati Province, and Bayalpata was handed over to Sudurpachim after 17 years in August 2025. These partnerships reduced out-of-pocket spending, improved trust in public facilities, and directly addressed financial concerns of citizens. The WHO–World Bank Global Monitoring Report emphasised that universal health coverage requires strengthening primary health care, providing free services at the point of care, and protecting families from financial hardship. Public–nonprofit partnerships like NHN and others in Nepal provide a model to directly address these challenges. By improving access to quality care, supporting local health workers, and keeping services free, these partnerships help reduce health costs for families, build trust in local health facilities, and narrow the gap between rural and urban health services, <a href="https://www.youtube.com/watch?v=xJdxLD0hBqo&amp;t=3s" target="_blank">turning </a><a href="https://www.youtube.com/watch?v=xJdxLD0hBqo&amp;t=3s" target="_blank">policy commitments into real improvements for communities.</a> The experience of <a href="https://nepalitimes.com/banner/state-of-the-art-rural-hospital" target="_blank">Bayalpata and Charikot hospitals</a> show that effective PPPs are governance-driven, not market-led. Clear agreements, transparent data sharing, performance-based management, and strong government oversight guaranteed that public institutions were strengthened rather than sidelined. Bayalpata and Charikot successfully transitioned leadership and full management to Sudurpaschim and Bagmati provincial governments, proving that public-private partnerships can build lasting government capacity, not dependency.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251231101244_a8821faa2059498bbd3318386a1bea25b7cfe7a36600c2e2ce250e97caed51e8.jpg" data-media-id="editor_8" data-image-id="20251231101244_a8821faa2059498bbd3318386a1bea25b7cfe7a36600c2e2ce250e97caed51e8" data-rendition-name="original" width="1570" height="940" loading="lazy" alt="Charikot hospital"> <figcaption>Charikot hospital in Dolakha.</figcaption> </figure>  This model combined facility-level operational flexibility with public stewardship, and tackled long-standing weaknesses in Nepal’s health system, from workforce retention to evidence-based decision-making. Scaling such models through a national, gap-focused partnership framework is now an urgent opportunity. Replicating Bayalpata model partnerships in selected hospitals and primary health care centers could rapidly advance the three pillars of universal healthcare: equitable access, quality services, and financial risk protection. Institutionalising public-private partnerships within the Ministry of Health and Population and &nbsp;linking it to national health insurance reforms could help fulfil the promise of Article 35 of the Constitution guaranteeing basic healthcare to all citizens. For development partners and donors, this could represent a high-impact, evidence-informed investment aligned with the WHO–World Bank call to reduce financial hardship while strengthening healthcare systems. If Nepal is serious about leaving no one behind, strategic public–non-profit partnerships must move from the margins to the mainstream of health system reform. By <a href="https://nepalitimes.com/opinion/is-free-health-care-possible-in-nepal" target="_blank">scaling the NHN model</a> at Bayalpata and Charikot nationwide, Nepal can build a resilient, equitable health system where every community regardless of location or income has access to quality care, financial protection, and the opportunity to succeed. Investing in well-governed PPP models is not only essential to protect the health of the Nepali people but also to safeguard the country’s economic stability and long-term resilience. &nbsp; Srijana Devkota is Director of Program and Partnerships at <a href="https://nyayahealthnepal.org/" target="_blank">Nyaya Health Nepal</a> (NHN). <a href="https://www.youtube.com/watch?v=xJdxLD0hBqo&amp;t=3s" target="_blank">Watch a video of Bayalpata Hospital.</a> <div class="embed-block"><iframe width="560" height="315" src="https://www.youtube.com/embed/xJdxLD0hBqo?si=_gSoClqwmI-ecSxh" 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>

A healthier, wealthier Nepal

For daring to demand democracy, the Rana regime hanged activist Shukra Raj Shastri at midnight on 24 January 1941 by the side of the road at Teku. Across town in Siphal, Dharma Bhakta Mathema was also hanged. Four days later, Dasrath Chand and Gangalal Shrestha were executed by firing squad. These four young revolutionaries were members of the underground Nepal Praja Parishad that led the anti-Rana revolution with plans to assassinate key figures of the dynasty. The four martyrs sacrificed their lives for an unfulfilled cause. Monuments were put up in their honour (Shahid Gate) and their names glorified by the Shah monarchy that itself went on to ban political parties and persecute democracy activists. In 1950, the newly-formed Nepal National Congress launched an armed uprising against Rana rule after King Tribhuvan sought refuge at the Indian embassy to flee from the Rana regime. In 1951, the Ranas, Nepali Congress and King Tribhuvan signed a tripartite agreement that brought an end to 104 years of Rana rule.&nbsp; Thus began contemporary Nepal’s cycles of unfinished revolutions. Some 75 years later, on a sunny September morning, Nepal’s young and hopeful took to the streets demanding an end to the nation’s corrupt polity, envisioning a better democracy. They organised through digital platforms, played songs, danced, and chanted slogans. A few hours later, commandos fired on the protesters, massacring dozens. Over 8 and 9 September 2025, the government was overthrown, constitutional bodies were literally reduced to ashes, and 74 Nepalis were martyred.&nbsp; Nepal’s periodic revolutions have been ignited by anger against rulers, they have begun with great promise, spread with enthusiastic popular support despite rulers trying to crush them — but ultimately they have always fallen short of the expectations of citizens demanding reform. Through decades of dissent, Nepal’s periodic revolutions have remained incomplete, with the nation caught up in a cyclical search for stability.&nbsp; In 1960, king Mahendra staged a coup and overthrew an elected government led by prime minister B P Koirala -- a royal revolution against democracy. Mahendra is reported to have famously said to Koirala: “Nepal is not big enough for the two of us.” For the next 30 years Nepal resembled a one-party state under the absolute monarchy of the Panchayat. Elected leaders languished in jail or exile, political parties were banned, and the press controlled. This was the most frigid period of the Cold War, with Nepal’s neighbours India and China at war. Geopolitics was bound to have an impact. “After the 1816 Sugauli Treaty with British India, external forces magnified internal power struggles as outsiders played divide and rule,” explains editor and political analyst Rajendra Dahal. “Movements did not reach a logical conclusion because domestic politicians were forced to compromise.” Indeed, the departure of the British from India in 1947 meant that the days of the Anglophile Rana regime were numbered. Successive prime ministers sought patronage in Delhi, and the monarchy tried to counterbalance it with a policy of equidistance with China. The neighbours showed a keen strategic interest in Nepal’s domestic politics. “The Panchayat system did not deliver what it promised,” says Santosh Sharma Poudel of Nepal Institute of Policy and Research. “Nepalis suffered administrative and governance failure, politics was centralised in Kathmandu, leaving out the rest of Nepal.” With mainstream political parties and leaders were &nbsp;underground between 1961 till 1990, student activists became proxies for political parties. As pressure for change grew, a student-led pro-democracy movement spread across Nepal in 1979. In response, King Birendra announced a referendum to allow Nepalis to choose between the status quo and a ‘reformed’ Panchayat &nbsp;system.&nbsp; The Panchayat won by a slim margin with questions about the legitimacy of the plebiscite. The reforms never materialised and it would be another decade before street anger boiled over again. As the People’s Movement for democracy spread, king Birendra again relented, unbanning political parties and Nepal became a constitutional monarchy. Inspired by Mao Zedong, a faction of Nepal’s Communists felt that western-style parliamentary democracy was too slow to end a feudalist monarchy. They launched an armed struggle in 1996, and the war lasted ten years (editorial, page 2). “If the democratic government post-1990 had performed better, and brought real reform, the Maoists would not have a reason to launch a revolution,” says Poudel. After nearly a decade of bloodshed that left 17,000 dead and thousands still missing, the Maoists joined forces with the democratic parties that they had been fighting, to pressure king Gyanendra through street protests in 2006 to restore democracy. In 2008, an elected Constituent Assembly abolished the monarchy. &nbsp;Recalls Rajendra Dahal: “The second people’s movement did not aim to abolish the monarchy. In fact, the reinstated parliament even granted equal rights for royal daughters to be crowned queen. But eventually, the monarchy no longer fit the political framework that the parties envisioned.” It took two elections over the next eight years to draft a new Constitution that reflected Nepal’s socio-cultural and geographic diversity and met the demands of the Maoists. The new federal Constitution was finally promulgated in 2015, but failed to satisfy India and the aspirations of the Madhes communities for autonomy. The state’s effort to crush the Madhes movement cost 45 lives. The promise of the new Constitution was squandered over the next decade with rotating leadership of the NC, UML and the Maoists — all of whom had forgotten the sacrifices made in the name of revolution. Cronyism and corruption was the order of the day. And it was this never-ending cycle of political opportunism and malgovernance that brought Nepal’s youth to the streets on 8 September.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260101120128_bc50f6370ff80a6758199ea7ba9f4c214656a9322a8d2ba1c97e6cdfb88f7f62.jpg" data-media-id="editor_0" data-image-id="20260101120128_bc50f6370ff80a6758199ea7ba9f4c214656a9322a8d2ba1c97e6cdfb88f7f62" data-rendition-name="original" width="3372" height="1371" loading="lazy" alt="timeline"> </figure>  1951 Revolution against the &nbsp;Rana regime 1960 King Mahendra's coup, jails B P Koirala and launches the partyless Panchayat system 1979 Student protests for democracy, King Birendra announces referendum&nbsp; 1980 Continuation of the partyless Panchayat system narrowly wins plebiscite&nbsp; 1990 People’s Movement I 1996 Maoists launch armed struggle&nbsp; 2000 Royal Massacre 2005 King Gyanendra's military-backed coup&nbsp; 2006 Comprehensive Peace Accord and Parliament restored 2008 Monarchy is abolished 2015 Madhes Movement, New Constitution promulgated 2017 First 3-tier election under federal system 2022 Second elections under federal Constitution&nbsp; 2025 GenZ protests BRK ALLIANCE “The socio-political change sought in all these movements never matched the people’s expectations, because the central issue of clean and efficient government never materialised,” says Poudel. The post-September political landscape has injected new personalities and alliances still relatively new to politics, as evidenced by the new electoral partnership of the BRK — Balen Shah, Rabi Lamichhane, and Kulman Ghising (page 1).&nbsp; These leaders are not without flaws, but they have become the effective flag-bearers of the GenZ movement, hoping to represent Nepalis disillusioned by decades of democratic decay. The March election will pit them against the legacy parties. There is already criticism that BRK is behaving just like male-dominated opportunists of old parties. The troika is resembling the triumvirate of Oli, Deuba and Dahal and its culture of patronage and quid-pro-quo power-sharing between alpha males. Will this also be another unfinished revolution? Says political scientist Sucheta Pyakuryal: &nbsp;“The kind of destruction that happened after the revolution should have been followed by a ground-breaking shift in Nepal’s political ecosystem, but that did not happen. Today the situation is a lot grimmer because we have players who have learned how to use the democratic facade to sound ‘equitable’ and ‘accountable’. But look closely and you see how the same political chauvinism, cronyism and nepotism still continue.”&nbsp;