When a deadly debris flow on the night of 12 July swept two intercity buses into the Trisuli River along the Mugling highway, it took more than an hour for rescue to arrive as shocked survivors groped in the darkness. One bus had left Kathmandu for Gaur with 36 passengers the previous evening. The other was heading to the capital from Birganj, carrying 26 passengers.&nbsp; Three passengers managed to escape from broken windows and climb back up to the road in pouring rain. They then sought help from vehicles stuck on either side of the landslide to get themselves to the hospital.&nbsp; Security forces and the Chitwan District Administration Office reached the site soon after they were notified. A team from the Armed Police Force’s Disaster Management Training School (DMTS) in Kurintar arrived soon after. The Nepal Army division in Bharatpur was notified at 4:30AM, and a Quick Response Team (QRT) was immediately dispatched. Nepal Army divers arrived in the morning. Read also: <a href="https://nepalitimes.com/opinion/managing-the-monsoon">Managing the monsoon</a>, Ngamindra Dahal In the fortnight since the tragedy, up to 500 trained rescuers have been working to find the buses (pictured). So far, the bodies of 25 passengers have been recovered, two from downstream in India. A 12-member team from the Indian National Disaster Response Force also arrived to help in the search. “Search and rescue operations in an accident like this typically last for 10 days,” says Khimananda Bhushal of the District Administration Office in Chitwan. “But we have to keep going until we locate the buses.”&nbsp; Rescuers have used rafts, anchors, air and water drones, as well as magnets to search for the missing buses and the remaining passengers. The Indian team is said to have sonar for the underwater search.&nbsp; “We have dedicated units for disaster response in our security forces, we have enough trained manpower to respond to most disasters,” says Bharat Mani Pandey, former joint secretary of the NDRRMA (National Disaster Risk Reduction and Management Authority).&nbsp; The Nepal Police has 1,250 personnel while the Nepal Army has more than 1,200 members assigned for disaster risk reduction and management. There are 2,500 others in the APF with disaster management training. All districts have District Disaster Management Committees.&nbsp; <h2>Water</h2>  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20240725120744_85a258a01d47c487c753ca6433a3b168b2f45f0391c039252de7aef0cecc1c5f.jpg" data-media-id="editor_1" data-image-id="20240725120744_85a258a01d47c487c753ca6433a3b168b2f45f0391c039252de7aef0cecc1c5f" data-rendition-name="original" width="3600" height="2410" loading="lazy" alt="101, 102, 103"> <figcaption>Photo: RSS(Photo: Shristi Karki)</figcaption> </figure>  So far this monsoon, 133 people have died in floods, landslides and drownings and 147 others people have sustained injuries. Seven people across the country are missing.&nbsp; Many of the <a href="https://nepalitimes.com/here-now/highway-accidents-are-no-accident-in-nepal">highway fatalities</a> are a combination of bad roads that are not built to be safe during monsoon rains. The road network has expanded, there are more hospitals with trauma care and ambulances, but Emergency Medical Technicians (EMT) are still not available in much of Nepal. Most ambulances are actually just ordinary vans to trasnport the injured to hospitals, with no specialised emergency care equipment. Much of Nepal’s pre-hospital emergency care is dependent on bystanders and passersby who self-mobilise to get injured people to hospital after accidents, especially on Nepal’s rural highways where ambulances and EMTs cannot reach on time. But even though well-intentioned, such first responders are rarely trained in emergency care and protocols. In many cases, improper handling of the injured does more harm than good.&nbsp; <h2>Roads</h2>  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20240725120744_27952fa8765f1b0178c1b42e7968084bad8538d40d082e4af787408d9ecab6be.jpg" data-media-id="editor_3" data-image-id="20240725120744_27952fa8765f1b0178c1b42e7968084bad8538d40d082e4af787408d9ecab6be" data-rendition-name="original" width="1500" height="845" loading="lazy" alt="101, 102, 103"> <figcaption>Photo: RSS(Photo: sher bahadur shing)</figcaption> </figure>  <a href="https://nepalitimes.com/multimedia/nepal-s-other-pandemic-road-fatalities">Road Traffic Accidents (RTAs) take more lives annually in Nepal than</a> floods, landslides, plane crashes, and other accidents and ‘natural’ disasters put together. There have been 21,287 road mishaps in Nepal so far in 2024, resulting in 2,198 fatalities and 5,713 serious injuries.&nbsp; The Nepal Ambulance Guidelines 2021 defines an ambulance as ‘a vehicle to transport patients that include ambulance equipment, sirens, GPS, a trained driver and an EMT’.&nbsp; But there are only 705 ambulances equipped with GPS across the country, and only 81 offically approved. Ambulances have to be certified as Type A Advanced Life Support (ALS) ambulances, or Type B Basic Life Support (BLS) ambulances. There are 119 trained EMTs and 929 trained ambulance drivers certified by Nepal’s National Health Training Center. Meanwhile, there are 30 trained dispatchers who work out of 11 ambulance dispatch centres across the country. These dispatchers respond to 102, the emergency number for ambulance services in Nepal.&nbsp; Read also: <a href="https://nepalitimes.com/news/roadkill">ROADKILL</a>, Sonia Awale The Nepal Red Cross Society (NRCS) operates 242 Type A, 60 Type, and 182 Type C ambulances across Nepal. Type C is essentially a normal transport vehicle. And while accessibility, technology, and skilled human resources were always a challenge for Nepal and its relatively basic pre-hospital services, this was made glaringly obvious during the 2015 earthquake, says Bal Krishna Sedai, deputy director of the NRCS. “We realised that Nepal’s pre-hospital care system was in no way prepared to handle mass casualty events,” Sedai explains.&nbsp; Ambulances are a 24-hour service, but Nepal’s laws state that no individual can work for more than eight hours. This means each ambulance would need three EMTs and three drivers and that is near impossible because of budget constraints. “The government has been unable to allocate enough human resources to sustain pre-hospital care,” adds Sedai. Read also: <a href="https://nepalitimes.com/here-now/nepal-s-air-ambulance-saves-mothers">Nepal's air ambulance save mothers</a> Nepal’s topography hinders first responders from getting to accident or disaster sites on time, even though they are ideally supposed to be there within 15 minutes in the Tarai, and within 30 minutes in the mountains.&nbsp; Says Sedai: “We urgently need to map where ambulances need to be stationed across the country in order to provide effective service, and this must take into account Nepal’s geography and population density.” <h2>Quakes</h2>  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20240725120744_2159d1a80ac5d0310f5d69041ed8e341124e86b4487262b529549aed63ac9dd2.jpg" data-media-id="editor_7" data-image-id="20240725120744_2159d1a80ac5d0310f5d69041ed8e341124e86b4487262b529549aed63ac9dd2" data-rendition-name="original" width="1500" height="1125" loading="lazy" alt="101, 102, 103"> </figure>  Disaster response and management is perhaps most critical in times of mega-disasters like earthquakes that Nepal is prone to. Himalayan seismologists have warned that <a href="https://nepalitimes.com/opinion/comment/learning-from-jajarkot-what-we-didnt-after-2015-695vpzle">2015 was not the Big One</a>, and neither was the Jajarkot earthquake last November. Yet, the country remains unprepared. Among others, it lacks modern equipment for <a href="https://archive.nepalitimes.com/article/nation/Search-locate-%20rescue-in-collapsed-concrete-houses,3676">search and rescue from reinforced concrete buildings</a>. In the <a href="https://nepalitimes.com/here-now/jajarkot-one-month-after-the-earthquake">aftermath of the Jajarkot earthquake</a>, 915 Nepal Army, 853 Nepal Police, and 35 APF personnel had been deployed for search, rescue, and relief by the 10th day after the disaster. “A mega quake in western Nepal will impact the whole country, including northern India. This is a level of disaster the whole country needs to be prepared for, not just western Nepal,” Surya Narayan Shrestha of the National Society for Earthquake Technology (NSET) <a href="https://nepalitimes.com/opinion/comment/turkey-and-nepal-face-similar-seismic-risks">wrote in Nepali Times last year</a>. “Given how disaster-prone we know Nepal is, we must seriously put our efforts and money into reducing the risks.”&nbsp; While ambulance services have been integrated to operate under the 102-dispatch system across Nepal following the National Ambulance Guidelines 2021, experts say that Nepal needs an integrated emergency response system. At present, emergency numbers 100, 101, 102, and 103 puts people in touch with the police, fire services, ambulance services, and traffic police respectively. Former NDRRMA Joint Secretary Bharat Mani Pandey coordinated an 11-member task force earlier this year that included members from key ministries as well as security forces to develop an integrated emergency information system so they do not have to dial different numbers for police, ambulance, or fire. &nbsp; “We found that police is the most contacted agency even when people are in need of ambulance or fire rescue services,” says Pandey. “We must have a command centre that incorporates different emergency service providers into an integrated response system.”&nbsp; <h2>Fire</h2>  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20240725120744_6c338449143818aa97b9e6cfbe391104cfa2f19f532df508bd373106393fd3e5.jpg" data-media-id="editor_12" data-image-id="20240725120744_6c338449143818aa97b9e6cfbe391104cfa2f19f532df508bd373106393fd3e5" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="101, 102, 103"> <figcaption>Photo: BIJAYABAR PRADHAN(Photo: Shristi Karki)</figcaption> </figure>  Fire support services are in an even woeful state, especially given the <a href="https://nepalitimes.com/editorial/smoke-screen">record-breaking wildfires</a> threatening settlements this year. There are only 211 fire brigades in Nepal, which means one fire engine per 110,254 people across the country. More than 1,100 people have died in <a href="https://nepalitimes.com/opinion/borderlines/going-up-in-smoke">forest fires</a> and household fires in the last decade.&nbsp; “Our fire response system is very weak to put it bluntly,” admits Sundar Sharma at the NDRRMA. “211 fire brigades is not nearly enough, and we do not have enough trained firefighters and first responders.”&nbsp; ---- As it is, <a href="https://nepalitimes.com/here-now/it-s-an-emergency-nepal-needs-to-improve-trauma-care">trauma care and infrastructure are inaccessible</a> to a large number of Nepalis. Tertiary hospitals that specialise in trauma and critical care are largely centralised in urban areas, and the rescue, ambulance, and medevac fees are unaffordable for most. There is also limited clarity and knowledge of which hospitals and health institutions are primary, secondary, or tertiary, which is crucial for emergency responders and medical professionals to direct trauma patients to relevant hospitals on a case-by-case basis. That way, first responders can triage survivors of accidents and disasters. “There is a weak link in our life-saving mechanisms between accident sites and hospitals, and we do not have enough trained emergency responders,” <a href="https://nepalitimes.com/here-now/injured-use-internet-to-get-rehab-care">Raju Dhakal of the Spinal Injury Rehabilitation Centre in Sanga</a> told Nepali Times, citing a spate of highway mishaps killed more than two dozen people and injured many more within a week last year. He added: “Even not-critical injuries become life-threatening because police and rescuers do not reach accident sites on time, or are not trained in handling spine or head injuries.” &nbsp;&nbsp;

Shristi Karki

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100, 101, 102

Nearly 24,000 people died on Nepal’s roads in the last 10 years. In comparison, 17,000 people were killed in the 10 years of the Maoist armed conflict. Covid killed about 12,000 Nepalis.
Nepal’s highways are deadlier than war or pestilence.&nbsp;
Numbers are numbing. But although this epidemic of fatalities is now one of the biggest causes of death nationwide, it gets scant attention from governments, the public and media.
Nepalis have come to accept death on roads as a part of life. All three levels of government shirk from responsibility, <a href="https://nepalitimes.com/here-now/highway-accidents-are-no-accident-in-nepal">calling them ‘accidents’</a>. And road mortality has become so commonplace that the mainstream press buries the news.The relentless slaughter on our roads is the result of political disinterest, governance malfunction, and public apathy. Nepalis are not dying on roads, they are being killed.
“Road traffic accidents are getting more frequent and there is a direct correlation with the failure of national governance,” says transport expert Chandra B Shrestha. “Local and provincial governments have neither the capacity, nor clarity of their roles. Budgets are poured into building substandard roads.”
Shrestha analysed the tragedy this month on the Chandragiri road that killed a doctor, his parents and two children. Only his wife, a physician, survived because she got out of the car to put a rock behind the wheel of their hatchback that stalled on a steep section.
He says the incline was too steep, the rough surface did not allow it to gather enough speed for the gradient, and the thick dust did not provide adequate traction for the tyres.
Most of the euphemistically called ‘roads’ in Nepal are similar <a href="https://nepalitimes.com/editorial/dying-to-travel">death traps</a>. They are not wide enough, do not have the required radius on excessively steep curves, no attention is paid to drainage, and houses are allowed to be built without the required set-back.
“There is no design or planning to begin with, there is a total absence of any engineering,” says Shrestha. “This should be criminal. These are not accidents, but almost deliberate deaths.”&nbsp;
And like all crimes, the perpetrators can be tracked by following the money. Inevitably, it leads to corruption linked to infrastructure budgets to build roads regardless of priority or quality for kickbacks or votes. And when a bus falls off a road, there is <a href="https://archive.nepalitimes.com/article/nation/traffic-accidents-continue-to-increase-worryingly-in-Nepal,2799">no political will </a>to investigate the root cause in the political economy and lack of accountability.&nbsp;
Apart from faulty highway engineering and absence of safety features, the other factors in <a href="https://archive.nepalitimes.com/article/nation/Nation-road-kill,621">road fatalities</a> include driver negligence, carelessness, over-speeding, overloading, and lack of maintenance of vehicles.&nbsp;
Two-wheelers, which used to be confined to cities, have now added a new challenge to highway safety. Motorcycles are involved in 68% of road traffic accidents in Nepal.
“Young people over-speeding in their heavy 600cc bikes are a danger to themselves and others. Moreover, we have found a notable increase in youths driving under substance abuse,” says DIG of Police Bhim Prasad Dhakal, explaining that strict monitoring of drinking and driving has led to an increase in drug use.
Highway deaths make news, but injuries are a major cause of physical disability in Nepal. The numbers are shocking: just last year more than 30,000 people were injured in road crashes. Nearly 6,000 of them had severe spinal or brain trauma needing complicated surgery, rehabilitation and lifelong care.
As Nepal’s road network expands, and with inadequate attention to highway safety as well as lack of timely treatment of trauma victims and rehabilitation, it will be the <a href="https://archive.nepalitimes.com/article/editorial/cartel-carnage-highway,3233">poorest Nepalis who will pay the price</a>. And they are the section of society already marginalised and excluded by governments, the public and the media.
“Road crashes perpetuate the vicious cycle of poverty,” says Raju Dhakal of the Spinal Injury Rehabilitation Centre in Sanga. “From expensive medical bills to rehabilitation to lost years of productivity, it represents a huge loss for the nation. Our health system needs to be revamped, and investment is needed for preventive, curative, palliative and rehabilitative care.”
<h2>The main cause of highway deaths: corruption</h2>
The epidemic of fatalities and injuries on Nepal’s highways are no accident, they are a criminal offence
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It is ironic that for something that is considered a vote bank, there is no accountability when it comes to the maintenance of roads to ensure their safety. All 77 districts in Nepal are now connected to the road network but bad roads are a given in this country.&nbsp;
Under federalism, <a href="https://nepalitimes.com/news/federal-express">true devolution of power is yet to be exercised</a> but heavy earth-movers are clawing through the mountains in a misguided notion of ‘development’. A fatalistic society accepts road ‘accidents’ as a price to be paid.&nbsp;
This is one case where corruption kills, yet rarely is power held to account, or wrongdoing punished.&nbsp;
“Road maintenance is not sexy or attractive enough, there is no political or monetary incentive, and there is no budget allocated either for road maintenance,” says transport expert Chandra B Shrestha.
Shrestha was a district transport planning adviser in the 1990s, and says Nepal expanded its road network but left sustainability out of the equation. “Asset maintenance is not even an afterthought,” he says. “What this means is that our roads are non-functional and not cost-effective, among other things.”
Every 14 deaths per 100,000 are caused by road fatalities, which is now the <a href="https://www.nepjol.info/index.php/HPROSPECT/article/view/5666/4664">third biggest cause of death in the 15-29 age group</a>. Three times more men die on the roads than women.
Last year alone, there were nearly 2,500 fatalities on the country’s highways and streets. Yet, the 79 who died in two tragic aviation mishaps in 2023 got vastly more attention in the public sphere.&nbsp;
Every year in Nepal, highways take more lives than floods, landslides, lightning strikes and other disasters put together. An average of 7 people die every day on the roads, and 19 were killed in three separate bus and car crashes in a 24-hour period last week.
As per the UN’s Sustainable Development Goals, Nepal was committed to halving road traffic deaths and injuries by 2020 and providing safe, affordable, accessible, and sustainable transport systems by 2030. We missed the first target. The second is not likely to be met.
Twelve people lost their lives when an over-speeding bus plunged into the Rapti River in Dang in the evening of 12 January. The very next day, a jeep travelling to Dhorpatan in Baglung overturned and killed two. This was followed by the private car that fell 500m from the road on Chandragiri, killing five passengers including two children.&nbsp;
And this is not even the peak season for highway fatalities, which <a href="https://nepalitimes.com/news/deadly-dasain-on-nepal-s-highways">sees a spike during the Dasain-Tihar festival </a>or during the monsoon. In the last 10 years, there have been a total of 137,395 highway and road crashes in Nepal. A majority of these took place in Kathmandu, and in the Tarai where straighter stretches of road tend to lead to overspeeding. Gandaki and Kosi Provinces are next because of their wider network of mountain roads. &nbsp;
Nepal’s topography and weather are contributory factors, making roads difficult to build and maintain. In addition to being substandard, switchbacks wrap around mountain or roads that follow narrow gorges, traverse treacherous cliffs. During the monsoon, entire sections of arterial highways such as Mugling-Narayanghat are in a permanent state of disrepair.
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The fact that vehicles are regularly falling down mountains on the same section of highways over and over means <a href="https://nepalitimes.com/here-now/the-other-global-pandemic-road-fatalities">lessons are never learnt</a>, no one is accountable. We do not take corrective actions when there are cost-effective solutions readily available.
“Driver carelessness on poorly built and maintained roads is the biggest cause of accidents. So our licensing system must be improved to allow only the qualified people to drive, even then we have to differentiate between heavy and light vehicle licensing,” says DIG Bhim Prasad Dhakal.
He adds: “Equally important are regular tests of public vehicles, better signage, as well as monitoring and patrolling where even the traffic police have areas to improve on.”&nbsp;
Traffic police has introduced time card for long-distance drivers and vehicle owners need to employ two drivers on such routes. New roads like the Midhill Highway are better engineered, have improved signage and guardrails.
Still, because roads with poor safety features are being built all over Nepal, the country needs trauma centres along every stretch of highway and ambulances with emergency equipment pre-positioned at health posts. The government has mandated one trauma centre in each province, and even though more are required even that target has not been met.
“Management of crash sites is of utmost importance, but first responders are often untrained locals who add to the severity of the injuries or even cause the wounded to die during rescue due to mishandling,” says Raju Dhakal of the Spinal Injury Rehabilitation Centre (SIRC) in Sanga.&nbsp;
Trained trauma teams are often too late to arrive, and most victims and their families cannot afford long-term rehabilitation.
A four-month pregnant 20-year-old woman sustained brain injury after a motorbike hit her on the Sindhuli Highway last year. She lost her baby, and her husband had to quit his job to look after her 24/7 after being trained at the Sanga centre.
Many patients that receive rehabilitation therapy at SIRC after highway mishaps are paralysed and require a caretaker round-the-clock. If the person is the sole support, their families become destitute as well. Many children drop out of school, and end up in the streets.&nbsp;
The public must refuse to accept Nepal’s <a href="https://archive.nepalitimes.com/page/maps-showing-increase-in-road-accident-fatality-rates#google_vignette">poor road safety record</a>. There should be rallies and sit-in’s outside government offices just like there are for other crimes to push the government to take this life-or-death issue more seriously.&nbsp;
Given that road accidents are the biggest killers of children in the 9-15 age group, traffic rules and discipline should be taught in school. Pillion riders should refuse to get on two-wheelers if there is no helmet available for them, cars and bikes should be restricted on pedestrian streets.
Some surveys have also found that using local vehicles reduces accidents. But more often than not, the older less conditioned buses and jeeps operate on rural roads.
The use of CCTVs on highways and major junctions as well as dashcams on public vehicles can help in post-accident investigation and deter reckless driving in the very first place.
“Most of all, it is the government that has the biggest responsibility here,” says Raju Dhakal of the Spinal Injury Rehabilitation Centre in Sanga. “It must seriously revamp everything from licensing, making vehicle tests mandatory, stricter traffic patrolling and actually holding culprits accountable.”
He adds: “The fact that most of the cost for treatment and rehabilitation of road traffic accidents is borne out of pocket by patients’ families has left the government off the hook. The public should refuse to accept this anymore.” &nbsp;

Sonia Awale

ROADKILL

<figure><img width="1217" height="626" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20230208140216/63e3a0f09c7e80680e0d705ejpeg.jpg" alt=""/><figcaption>Armymen try to pull out the bus that fell into the Madi River in Tanahu in 2013. Photo: PAWAN PAUDEL/NEPALI TIMES ARCHIVE</figcaption></figure>The question everyone has been asking after the <a href="https://www.nepalitimes.com/banner/pokhara-bound-flight-crashes-in-nepal/" target="_blank" rel="noopener noreferrer">tragic crash of the Yeti Airlines flight</a> in Pokhara on 15 January is why airline accidents are so frequent in Nepal. 
The answer may lie in the question itself. It is a mistake to call them ‘accidents’ — which are unfortunate incidents that happen unintentionally. The fact is that most deadly air crashes in Nepal over the past 60 years have been found by investigation committees to have been caused by negligence, carelessness, over-confidence, or not following rules. This means they should not have occurred. Lives need not have been lost.
As <a href="https://www.nepalitimes.com/banner/how-to-make-nepal-skies-safer/" target="_blank" rel="noopener noreferrer">we reported in last week’s edition</a> of this paper, 92% of the fatal crashes since 1962 happened when airworthy planes flew into mountains obscured by clouds. Despite strict rules about flights maintaining visual at all times in the mountains, planes kept being operated in no-go weather en route or at destination airports.
The Pokhara crash did not follow this pattern. Early clues point to possible lapses in the pre-landing cockpit procedure during a checkout flight for the co-pilot. We will have to wait for the investigation report to know what went so horribly wrong in those final moments. 
But that will be too late and of no comfort to the relatives of those who died. Entire families perished in the Seti Gorge that Sunday morning. The dead included promising surgeons, musicians, scientists, entrepreneurs, journalists. Besides the unbearable individual tragedies, this was an incalculable loss to the whole nation. 
There are many factors that contribute to our inability to learn from past mistakes. It may sound deterministic, but at a deeper cultural level there is a tendency to blame ‘accidents’ on ‘fate’ — factors beyond human control. But most crashes could have been avoided if rules were followed.
In many aspects of modern life, Nepalis have not come to terms with the rapid advance of modern technology, and the conventions that must be followed in operating them. It is manifested in the carelessness in handling electric wires, LPG cylinders, and how building codes are flouted. 
Earthquakes in Nepal cannot be called ‘natural’ disasters. As we saw in 2015, it is not earthquakes that kill people, but <a href="https://www.nepalitimes.com/banner/in-a-disastrous-state/" target="_blank" rel="noopener noreferrer">poorly designed houses</a>, and owners knowingly using sub-standard materials to cut costs.
Also, look at the way we drive. There were more than 4,000 road traffic ‘accidents’ in Nepal last year, resulting in nearly 2,800 fatalities and at least 5,000 people with serious injuries. Ironically, this figure would possibly be much higher if the roads were properly built and maintained, because that would encourage over-speeding.
The Covid-19 lockdowns in 2020 paradoxically <a href="https://www.nepalitimes.com/here-now/nepals-other-pandemic-road-fatalities/" target="_blank" rel="noopener noreferrer">saved thousands of lives</a> that may have otherwise been lost on roads and highways. There is an <a href="https://archive.nepalitimes.com/article/nation/Nation-road-kill,621" target="_blank" rel="noopener noreferrer">epidemic of what are called ‘road traffic accidents’</a>, and it has become the number one cause of disease burden among young Nepalis. 
A week after the Pokhara air crash, four people were killed and 15 injured when a jeep plunged into a gorge in Surkhet. On 11 December, 11 died when a bus veered off the road in Jajarkot. On 12 October, a passenger bus plunged down a mountain in Mugu, killing most of the 40 people on board.   
Ninety-four people lost their lives in air crashes in Nepal in the past 12 months, but during that same period the number of people killed on roads was nearly <a href="https://www.nepalitimes.com/banner/nepals-deadly-roads-take-their-toll/" target="_blank" rel="noopener noreferrer">30 times higher</a>. Bus and jeep crashes have become so routine that they do not even make it to the front pages of newspapers anymore. Each is reported as a separate event, not as a trend showing the sharp increase in road and highway fatalities in Nepal year-on-year.
News is defined as whatever is negative, or out of the ordinary. It is the nature of the news ‘business’ that aviation disasters get more priority. People who travel by air tend to be better off, there is more international interest because foreigners may be involved, or the aircraft type is in operation all over the world. 
Policy decisions and rules save lives. Proof of this is the dramatic drop in fatalities in Kathmandu Valley after the crackdown on driving under the influence. Time cards to control speeding along highways have also been effective. Better maintenance of roads and their safety features could prevent many road mishaps.
As with other disasters, it is <a href="https://archive.nepalitimes.com/article/editorial/cartel-carnage-highway,3233" target="_blank" rel="noopener noreferrer">the poorest Nepalis who are most vulnerable</a> to dangerous roads, and this is a criminal lack of responsibility on the part of the state. We expect the new coalition government with a crop of young technocrats in the various ministries to swing into action to ensure the safety of the travelling public.

Dying to travel

<figure><img width="800" height="464" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110161124/636d184e9c7e80680e0ac7bajpeg.jpg" alt=""/><figcaption>Photos: ACHYUTRAJ BHANDARI</figcaption></figure>The death toll in a bus plunge in Mugu has reached 32. Twenty-four people died on the spot and eight more during rescue and treatment. The rest, 11 passengers airlifted by helicopters for <a href="https://www.nepalitimes.com/here-now/its-an-emergency-nepal-needs-to-improve-trauma-care/" target="_blank" rel="noopener noreferrer">treatment</a> in Nepalganj, are in critical condition.The overloaded bus lost control and plunged down a steep slope near Rara Lake at about 12:30PM on Tuesday. Initial investigation points to brake failure as the cause of the accident. Most of the 43 passengers were travelling from Nepalganj to Mugu’s Gamgadhi to celebrate Dasain with their families.Also on Tuesday, a passenger bus from Dhangadi to Bajura also fell off the highway, injuring 16. On Monday, another jeep careened off the road and fell off a cliff killing at least eight. It was carrying passengers from Kathmandu travelling to Ghandruk to celebrate Dasain holidays.Nearly 50 people have died on <a href="http://archive.nepalitimes.com/article/nation/lack-of-trauma-centres-along-nepal’s-highways-worsened-fatality-rate,1383" target="_blank" rel="noopener noreferrer">Nepal’s highways</a> in the last two days. The causes range from overloading because of the festival, negligence of drivers, mechanical failure, over-speeding, poor road condition because of a very wet monsoon, and an increasing number of unregulated private vehicles.<a style="font-size: 15px; letter-spacing: 0.01em;" href="https://archive.nepalitimes.com/article/nation/traffic-accidents-continue-to-increase-worryingly-in-Nepal,2799" target="_blank" rel="noopener noreferrer">Road Traffic Accidents</a> (RTA) in Nepal’s highways are so commonplace that most Nepalis are desensitied by the numbers. An average of seven individuals die in road accidents a day in Nepal and 40 are injured. In fact, <a href="https://www.nepalitimes.com/here-now/nepals-other-pandemic-road-fatalities/" target="_blank" rel="noopener noreferrer">more people die on Nepal's highways every year </a>than in all natural disasters combined.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 more often than not have traumatic brain and spinal cord injuries, requiring long-term or life-long rehabilitative care.The total accidents had come down in 2020-2021 because of the pandemic and lockdowns, but is rising again as things get back to normal. <img width="1205" height="741" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110161124/636d18509c7e80680e0ac7bbjpeg.jpg" alt="">According to the <a href="https://www.who.int/publications/i/item/9789241565684">WHO Global Status on Road Safety 2018</a>, only 8 in 100,000 people die of highway and road accidents in developed countries, but the ratio is 27.5 in low-income nations like Nepal.Most of the accidents in Nepal can be prevented by just maintaining the roads and avoiding reckless driving. According to the Ministry of Physical Infrastructure and Transport study, 76% of highway accidents are caused by drivers who do not follow traffic rules or are speeding.To control over-speeding and reckless driving, traffic police at the accident-prone Satdobato-Gwarko road have now deployed speed guns. They penalise up to 100 commuters a day, many of them in motorcycles that are going at 90km/hour on the road with a speed limit of 50km/hour.   <img width="1040" height="556" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110161124/636d18539c7e80680e0ac7bcjpeg.jpg" alt="">A parliamentary committee that had studied RTAs in Nepal two years ago and concluded it as the ninth biggest killer in the country has also given directives to mitigate the problem. But the state of Nepal’s accident-prone roads remains the same. Adding to the challenge are <a href="https://www.nepalitimes.com/latest/monsoon-hits-nepal-with-a-bang/" target="_blank" rel="noopener noreferrer">floods and landslides during monsoon</a>,  made more frequent and destructive by <a href="https://www.nepalitimes.com/latest/nepal-doubles-its-carbon-footprint/" target="_blank" rel="noopener noreferrer">climate change</a>. Sections of major highways have been washed off, cutting off parts of remote Nepal from the rest of the country. Several accidents here don’t even make it to the news or after many days.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. <figure><img width="1001" height="546" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110161124/636d18559c7e80680e0ac7bdjpeg.jpg" alt=""><figcaption>Relatives of those injured or casualties at the Mugu District Hospital in Gamgadi on Wednesday. Photo: NRIPENDRA MALLA </figcaption></figure><a style="font-size: 15px; letter-spacing: 0.01em;" href="https://archive.nepalitimes.com/page/maps-showing-increase-in-road-accident-fatality-rates" target="_blank" rel="noopener noreferrer">Available studies</a> reveal that in the last decade, the death rate due to traffic accidents has increased by a whopping 142% and accidents by 178%. Nepal is far from meeting the target set by the United Nations General Assembly to halve the number of<a href="https://www.nepalitimes.com/here-now/the-other-global-pandemic-road-fatalities/" target="_blank" rel="noopener noreferrer"> road fatalities and injuries </a>by 2030.Last year’s annual report by the Office of the Auditor General (OAG) found that road traffic accidents in Nepal have increased by an annual average of 7% in 2017-18, 22% in 2018-19 and 17% in 2019-20.  <img width="1636" height="942" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110161124/636d18589c7e80680e0ac7bejpeg.jpg" alt="">The<a href="https://www.nepalitimes.com/latest/how-covid-19-saves-lives-in-nepal/" target="_blank" rel="noopener noreferrer"> slight dip in 2019-20</a> is attributed to five months of Covid-19 lockdown when road fatalities declined by half to less than 700 in March-August 2020, compared to the same period last year. Ironically, hundreds of lives may have been saved by the pandemic.But by the <a href="https://www.nepalitimes.com/latest/this-years-dangerous-dasain/" target="_blank" rel="noopener noreferrer">Dasain-Tihar festival in November 2020</a>, with restrictions removed, the number of deaths on the roads again spiked to 242 after falling to 52 in May, much like this year.For a country where roads are synonymous with development, more people lose their lives on the highways than by infectious diseases. The reason is the focus on quantity over quality, bad engineering and lack of maintenance.

Deadly Dasain on Nepal’s highways

<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

<figure><img width="1419" height="630" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110915118/636bb51a9c7e80680e07bbe3jpeg.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>The Covid-19 crisis has dominated news bulletins in Nepal for the last six months, and in the past week the headlines are about rising cases and fatalities. But what is missing from the news is that the pandemic has also helped save lives.Police statistics show that about 1,400 people were killed in Nepal in road traffic accidents between March-August 2019. This year, the figure dropped to 707 in the same period. Meanwhile, 390 people have died with Covid-19 across the country since the lockdowns began. In those six months last year, more than 5,000 people were seriously injured in highway accidents. This year, the number of wounded was down to 1,978 between March-August. Because of the pandemic, there are therefore far fewer trauma patients in hospitals, and many of them have been saved from lifelong physical disabilities.Besides lives saved in road traffic accidents studies have shown that improved air quality in the cities of north India during the lockdown has saved many thousands of lives.The <a href="https://energyandcleanair.org/wp/wp-content/uploads/2020/04/CREA-Europe-COVID-impacts.pdf" data-saferedirecturl="https://www.google.com/url?q=https://energyandcleanair.org/wp/wp-content/uploads/2020/04/CREA-Europe-COVID-impacts.pdf&amp;source=gmail&amp;ust=1600526831303000&amp;usg=AFQjCNEaep49FFrKVnsBp1buzFoFhtJbtQ">Centre for Research on Energy and Clean Air (CREA)</a> estimates that improved air quality since Covid-19 has saved 15,000 lives in 12 of India’s big cities. In New Delhi alone, 4,600 people who may have died of acute respiratory distress have lived because of the cleaner air. A similar study in Nepal is not available, but since Kathmandu Valley’s air quality at certain times of day is as bad as New Delhi, and much of the suspended particulates from north India is carried by prevailing winds into Nepal in winter, there could also be a correlation here between improved health and better air quality during the lockdown. <img width="1402" height="780" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110915118/636bb51d9c7e80680e07bbe4jpeg.jpg" alt="">To be sure, the pandemic has led to other hardships, often adding to unnecessary fatalities. Many more women have died this year than in 2019 during the lockdown because they have not been able to get to hospital for delivery. Child mortality is similarly up 30% compared to pre-lockdown months because of delayed vaccinations, and parents unable to get sick children to hospital in time. Patients with chronic ailments have also been deprived of treatment. Jobs losses have increased hunger and susceptibility to disease.The dramatic drop in highway fatalities, however, reveals just how dangerous Nepal’s roads are, and has provided the government an opportunity to take concrete steps to improve road safety even as the government decided to allow long-distance buses to resume their services this week.The fact that 707 people were killed on Nepal’s roads even despite an almost complete ban on vehicular traffic in cities as well as on inter-district highways between March till August this year shows just goes on to show how deadly Nepal’s highways are. A paper in the <a href="https://injuryprevention.bmj.com/content/early/2020/02/18/injuryprev-2019-043309" data-saferedirecturl="https://www.google.com/url?q=https://injuryprevention.bmj.com/content/early/2020/02/18/injuryprev-2019-043309&amp;source=gmail&amp;ust=1600526831303000&amp;usg=AFQjCNFw67kURQsjGTpdjwgy0yMJObRYPg">British Medical Journal</a> shows that even before the pandemic in 2017, transport injuries killed more young people in Nepal than from tuberculosis, malaria and HIV combined. Seven Nepalis died every day in road and highway accidents in Nepal before the lockdowns, and on average, 40 people were injured. Last year, there were nearly 13,000 road accidents in which 2,736 people lost their lives and 10,731 were seriously injured.But at the same time, Covid-19 has seen rapid spread in the past weeks. Nepal registered the highest number of confirmed coronavirus cases on Friday with 2,020 new cases out of 11,158 PCR tests conducted across the country, Kathmandu Valley alone accounted for 859 positive SARS-CoV-2 cases, also the highest so far. But the last 24 hours also saw 871 people returning home after a successful treatment, bringing the total recoveries to 43,820 and the recovery rate to 71%, up from 55% in August. Nepal now has 17,383 active cases.While the government has decided to further relax the lockdown by allowing domestic airlines to operate, hotels and restaurants to reopen and intercity bus services to resume, the odd-even rule for vehicles is still in force. <figure><img width="640" height="480" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110915118/636bb51f9c7e80680e07bbe5jpeg.jpg" alt=""><figcaption>Wreckage of the bus accident in Dhankuta in 2016 that killed 15 people, including ex-Minister of State for Finance Hari Khewa.</figcaption></figure>This could help contain the spread of Covid-19 somewhat, but it will keep traffic accidents and fatalities low -- especially during the monsoon when roads are even more treacherous in the mountains with additional risk of landslides and flash floods.  Highway accidents are now among the biggest killer in Nepal, right after heart diseases, diabetes, tuberculosis and renal ailments. Age-adjusted death rate at 21% is among some of the highest in the world.The cause of accidents in Nepal is usually carelessness and speeding, and poorly-maintained roads and vehicles. The number of accidents is rising faster than the increase in the number of vehicles.Those who survive often have traumatic brain and spinal cord injuries, requiring long-term or life-long expensive rehabilitative care, available in only few institutions in Nepal and in limited capacity.

How Covid-19 saves lives in Nepal

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109101136/636b74e99c7e80680e0623bcjpeg.jpg" alt="" width="3600" height="2400"/><figcaption>Nepali students on their way to the quarantine centre in Bhaktapur after landing in Kathmandu Airport on Sunday morning. Photo: RSS</figcaption></figure>The global public health crisis caused by <a href="https://www.nepalitimes.com/banner/why-nepal-must-watch-about-coronavirus-but-not-panic/">the 2019 novel coronavirus </a>has  hospitalised tens of thousands and killed hundreds of people, wrecked tourism in the Asia-Pacific region, impacted civil aviation and slowed down the world economy.An <a href="https://www.theguardian.com/global-development/2020/feb/07/coronavirus-chinese-rage-death-whistleblower-doctor-li-wenliang">attempt by the Chinese authorities to suppress</a> first reports from Wuhan is blamed for the initial rise in case load, and its dissemination across China and the world. But it is also China’s willingness to quarantine a whole province that is stopping its spread.The epidemic has also exposed the challenges to containment in <a href="v">the age of social media</a>. Rumours and conspiracy theories resulting in stigmatisation and xenophobia have become the norm in a global village interconnected instantaneously by internet-based apps.The media’s habit of magnifying the negative is now exacerbated by the split-second reach of individual posts, click-baits, fake news, and the chain-reaction through shares and likes over web platforms.Till Wednesday, 2,012 people had died from <a href="https://www.nepalitimes.com/latest/a-nepali-in-beijing-during-coronavirus-scare/">the Wuhan virus</a>, and 75,227 are hospitalised. These statistics are constantly updated in the media, with countries where it has spread shaded ominously on a world map – giving the impression that it has spread globally.Yet there are very few mentions anywhere that nearly 15,000 infected people have made full recovery, or that the fatality rate for the virus is a low 2%. Even though no one has yet died in the United States from this virus strain, there is saturation coverage in the media that likens the epidemic to the one in the Hollywood thriller Contagion. Few compare Covid-19 to the common flu that killed nearly 35,000 people in the United States last winter.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109101136/636b74eb9c7e80680e0623bdjpeg.jpg" alt="" width="1800" height="1291"><figcaption> </figcaption></figure>The psychology of terror, irrationality of panic, and fear of diseases without cure are not new. What is new this time is mobile communication which allows panic about the virus to go viral.In Nepal, too, the media was obsessed with the plight of 182 students trapped in Hubei province. The issue was politicised by those opposed to Prime Minister Oli’s government – both within his NCP and without. Media gave prominence to tearful parents, highlighted a letter to the prime minister about his callousness and disregard. Under pressure already for non-performance, the government found <a href="https://www.nepalitimes.com/latest/nepalis-from-hubei-quarantined-in-bhaktapur/">the evacuation of the students to a quarantine camp</a> in Bhaktapur a convenient way to show-case action.If only the government reacted with similar efficiency to other, much more serious, national emergencies like Nepal’s unacceptably high maternal mortality rate. Although there has been a steep drop in the number of women who die in childbirth from 900 per 100,000 in 1990 to 239 today, Nepal has <a href="https://www.nepalitimes.com/banner/federalism-leaves-nepals-medical-sector-ailing/">missed the target</a> of reducing that number to 125 this year. It does not look like we will hit the SDG goal of 75 by 2030, either.<a href="https://www.nepalitimes.com/here-now/who-will-save-nepals-poor-new-mothers/">More than 1,200 women die</a> in child birth every year in Nepal, that is three every day. Most of these are easily preventable either by ensuring proper nutrition, enforcing the ban on <a href="https://www.nepalitimes.com/banner/child-marriage-in-nepal-eloped-at-13-mother-by-17/">child marriage</a>, ensuring access to ultrasound machines to detect complications in time, and encouraging institutional delivery.As Buddha Basnyat of the Patan Academy of Health Sciences (PAHS) comments, it is only political will that is stopping Nepal from adopting the game-changer drug Tranexamic acid (TXA) in the treatment of post-partum haemorrhage, (PPH) the most common cause of maternal death. There is a huge 44% <a href="https://www.nepalitimes.com/here-now/nepal-far-from-hitting-contraceptive-target/">unmet need for contraceptives</a>, which is leading to unwanted pregnancies and preventing a further drop in Nepal’s total fertility rate.<a href="https://www.nepalitimes.com/banner/tb/">Tuberculosis</a> kills 6,000 people in Nepal every year, and every other Nepali is a carrier of the bacillus, which means half the population should actually be quarantined. Yet the health system is supremely unconcerned, and the public is not aware of the risk.There were 2,736 fatalities in <a href="https://www.nepalitimes.com/banner/nepals-deadly-roads-take-their-toll/">road traffic accidents</a> in Nepal last year. Yet, even though the coronavirus has not killed anyone and there has been only one suspected case, Nepalis are hoarding supplies of masks and hand sanitisers. Meanwhile, vehicles continued to be driven recklessly over precarious roads. Where is the outrage?<a href="https://www.nepalitimes.com/here-now/air-pollution-is-more-dangerous-than-smoking/">Air pollution</a> in Kathmandu Valley, Chitwan and the Tarai is so bad that it is making many people die prematurely, reducing our lifespans by 3.5 years. Where is the peoples’ anger at having their lives cut short? It is ironic that residents of Kharipati are more worried about Nepali students from Wuhan being quarantined in their neighbourhood, than about the toxic fumes emitted by dozens of brick kilns nearby.To be sure, we cannot afford to be complacent when it comes to new epidemics like <a href="v">Covid-19</a>. However, it is the neglect of easily preventable diseases that kills more people in Nepal -- most often poor people in rural communities. We need a robust health system that prioritises primary health care, trains medical professionals, and builds a well-equipped infrastructure to handle future epidemics.But that does not make it into the news.Sonia Awale

When panic goes viral

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109101132/636b73f19c7e80680e062367jpeg.jpg" alt="" width="1500" height="1016"/><figcaption>Photo : MONIKA DEUPALA</figcaption></figure>Last November, a speeding bus in Argakanchi lost control and tumbled down a mountain, killing 19 and injuring 18 passengers. Three weeks later, another bus careened off a serpentine road in Sindhupalchok, killing 16 and wounding 18.Seven Nepalis die every day in <a href="https://www.nepalitimes.com/banner/nepals-deadly-roads-take-their-toll/" target="_blank" rel="noopener">road and highway accidents</a>. Shocking though that statistic might be, the number of injured is much higher. On average, 40 people are injured on roads across the country each day. Last year, there were nearly 13,000 road accidents in which 2,736 people lost their lives and 10,731 were seriously injured.Read also: <a href="https://www.nepalitimes.com/?p=40237&amp;preview_nonce=7ab9966f81&amp;preview=true" target="_blank" rel="noopener">It’s an emergency: Nepal needs to improve trauma care</a>, Sanghamitra Subba<a href="http://archive.nepalitimes.com/article/Nepali-Times-Buzz/accident-prone-Mugling-Narayangadi-highway,3828" target="_blank" rel="noopener">Highway accidents</a> are now the biggest killer of young men and women in the country. The causes are usually carelessness and speeding, and poorly-maintained roads and vehicles. The number of accidents are rising faster than the increase in the number of vehicles.Those who survive often have traumatic brain and <a href="http://archive.nepalitimes.com/news.php?id=6946" target="_blank" rel="noopener">spinal cord injuries</a>, requiring long-term or life-long rehabilitative care. But the state of rehabilitation in Nepal is nearly non-existent. There is no government rehabilitation centre, and while some private hospitals do offer inpatient physiotherapy, none have dedicated acute rehabilitation units and none employ physical medicine and rehabilitation consultants.“Forget about prioritising it, rehabilitative medicine is not even included in the healthcare system of Nepal,” laments Raju Dhakal, the only physical medicine and rehabilitative doctor registered in Nepal. “Every hospital has a cardiology unit, intensive care unit and even physiotherapy but no rehabilitation unit. This should be integrated in the healthcare system rather than treated as a separate entity.”The <a href="https://www.facebook.com/SpinalNepal/" target="_blank" rel="noopener">Spinal Injury Rehabilitation Centre</a> (SIRC) in Sanga, founded in 2002, is Nepal’s largest inpatient rehabilitation centre and the only one specialised in spinal cord injury. The 51-bed hospital treats patients from all 77 districts and provides inpatient rehab for 300 individuals a year.It also conducts outpatient care, home follow-up visits, community outreach programs, and a residential vocational rehabilitation program to help people with disabilities integrate back into society and to better equip thier families to deal with their special needs.The only other facilities with dedicated inpatient rehabilitation beds are <a href="https://gphospital.org/" target="_blank" rel="noopener">Green Pastures Hospital</a> in Pokhara and the <a href="https://www.hrdcnepal.org/" target="_blank" rel="noopener">Hospital for Rehabilitation and Disabled Children</a> in Kavre.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109101132/636b73f49c7e80680e062368jpeg.jpg" alt="" width="1500" height="1065"><figcaption> </figcaption></figure>“Usually two physical medicine and rehabilitation specialists are needed for every 100,000 people. This means we need 500 specialists in Nepal, and instead we have one,” says Manoj Sivan, associate professor of rehabilitative medicine at Leeds University in the UK, who says the gap in rehabilitative care can be bridged with telemedicine.“Tele-rehabilitation can link the people in the community with specialists to provide necessary interventions remotely, allowing them to the save time and money spent travelling to the centre,” adds Sivan, who was in Nepal last month with a team of researchers to launch a six-month pilot project called Tele-rehabilitation Nepal (TERN) in collaboration with SIRC (above).Unlike <a href="https://archive.nepalitimes.com/article/nation/long-distance-medicine-in-nepal,3521" target="_blank" rel="noopener">other telemedicine consultations</a> where a patient has to visit a health post to connect with doctors based in cities, in tele-rehab a social worker from SIRC visits patients, finds out their needs and then connects them with a specialist team that consists of a physician, physiotherapist, occupational therapist, nurse and  psychologist.Patients with long-term disabilities and their families learn about better management of bladder, bowel and pain, as well as exercise techniques to help mobility.The idea for e-rehab first came to Dhakal when a paraplegic patient from Surkhet visited SIRC and was unable to pay a minimal consultation fee. She had spent Rs45,000 to hire a jeep and had to pay for extended hotel stay for herself and two relatives. “It hit me hard,” Dhakal recalls. “This country’s topography makes accessing healthcare stressful for most Nepalis.”Besides those with <a href="http://archive.nepalitimes.com/article/Nepali-Times-Buzz/paraplegic-ram-bahadur-tamang-travels-from-namo-buddha-to-lumbini,1303" target="_blank" rel="noopener">spinal injuries</a> caused by highway accidents, tele-rehabilitation is useful for those recovering from other medical emergencies like strokes and also for general medicine.The Nepal Government’s 2016 Policy, Strategy, and Ten Year Action Plan on Disability Management plans for every province to have at least one fully equipped rehabilitation centre and established orthotics/prosthetics workshop in the next ten years. SIRC is also working with the Ministry of Health to develop another 100-bed hospital to provide specialised rehabilitation care.Added Dhakal: “Sooner or later the government has to take responsibility and decentralise rehabilitative care. This will allow us to train more people and supervise other centres to decentralise rehab.”<h2>Wheelchair doctor treats patients in wheelchairs</h2>As the only physical medicine and rehabilitation doctor in Nepal, Raju Dhakal (left) has a lot on his plate. His days are packed with back-to-back consultations with rehabilitation patients. The 37-year-old does this with ease as he moves about in his wheelchair greeting patients at Spinal Injury Rehabilitation Centre (SIRC) at Sanga, Kavre.Dhakal himself was diagnosed with poliomyelitis when he was two-and-half years old. Originally from Gorkha, he came to Kathmandu and lived in SOS Children’s Village while undergoing treatment. He started school at age seven, and learned to read and write at the same time as he learned to use crutches.Read also: <a href="https://www.nepalitimes.com/review/new-life-for-khagendra-b-basnyat/" target="_blank" rel="noopener">New life for Khagendra B Basnyat</a>, Sewa BhattaraiWith an MBBS from Kathmandu Medical College, Dhakal went on to receive an MD in Physical Medicine and Rehabilitation in Dhaka.“At daily rotations during my internship, there was one patient that every doctor skipped. He was undergoing rehabilitation after treatment for a spinal injury. No one could do anything for him so he remained there in a corner of that ward,” recalls Dhakal. “This opened my eyes to a gaping hole in medical care in Nepal.”Dhakal went on to become honorary clinical fellow at the Department of Rehabilitative Medicine at the <a href="https://medicine.unimelb.edu.au/research-groups/medicine-and-radiology-research/royal-melbourne-hospital" target="_blank" rel="noopener">Royal Melbourne Hospital</a> in Australia. He trained in Spinal Cord Medicine and Rehabilitation in Ireland, Canada and Switzerland.“In Nepal we are still very focussed on diagnosis and acute treatment. But what about residual paralysis in case of trauma, traumatic brain injuries and spinal injuries?” asks Dhakal. “Long-term rehabilitative care for patients with disabilities is severely lacking. We need more facilities for specialised rehabilitation care.”

Injured use Internet to get rehab care

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109101132/636b73eb9c7e80680e062365jpeg.jpg" alt="" width="1500" height="911"/><figcaption>Photo: NATIONAL TRAUMA CENTRE</figcaption></figure>Speeding along a narrow winding mountain road in Dhading, a heavily intoxicated truck driver lost control of the <a href="https://www.nepalitimes.com/banner/nepals-deadly-roads-take-their-toll/" target="_blank" rel="noopener">vehicle</a> and it overturned, killing seven and severely injuring 34 passengers hitching a ride.This was a mass trauma incident that required immediate attention, but <a href="http://nationaltraumacenter.gov.np/" target="_blank" rel="noopener">Nepal’s only trauma care centre</a> was located in Kathmandu, 90km away via bumpy roads jammed with traffic.Read also: <a href="https://www.nepalitimes.com/?p=40249&amp;preview_nonce=aefd82ecbe&amp;preview=true" target="_blank" rel="noopener">injured use Internet to reach physiotherapists in Nepal</a>, Sonia AwaleMost passengers from the truck accident were taken to nearby hospitals in Dhading, but the 21 most critical patients were airlifted or driven in ambulances to the National Trauma Centre in Kathmandu.“It had already taken a while to bring the patients to the Trauma Centre, so we had to act quickly once they were here,’’ recalls Pramod Yadav, acting medical superintendent at the facility.The standard protocol for trauma care is the triage system -- determining the priority of treatment based on the severity of injury. Doctors at the National Trauma Centre quickly designated yellow, green and red codes to patients to ensure that those in critical condition were taken care of first, and fast.Read also: <a href="https://archive.nepalitimes.com/article/nation/accident-prone-Mugling-Narayangadi-highway,3828" target="_blank" rel="noopener">Unblocking an artery</a>, Sanjeev SharmaOn-call doctors were contacted and began assessing the patient’s injuries. But without a functioning MRI and a faulty CT machine, some had to be sent to private clinics and later returned to the hospital.This is a recurring event for patients seeking immediate care at the government-run Trauma Centre where patients in critical condition have to be moved about from one facility to another for tests.“We cannot afford an MRI machine, it is very expensive to repair our CT machines, we have limited trolley beds and only 11 ICU beds when we need more than 50,” says Yadav. “We are requesting the government for Rs420 million to become a real trauma centre, especially since we are the only one in the country.”There were 60,000 severe trauma injuries in Nepal in the last year, a 3,000 increase from the previous year, and a whopping 27,000 over the year before that. Like with all government-run medical centres, the Trauma Centre lacks resources, is under-staffed, and is incapable of handling this exponential increase.“In the last two, three years, falls, physical assault, <a href="https://www.nepalitimes.com/banner/nepals-deadly-roads-take-their-toll/" target="_blank" rel="noopener">road traffic accidents</a>, sports injuries and <a href="https://archive.nepalitimes.com/article/nation/burning-in-the-aftermath,3757" target="_blank" rel="noopener">burns</a> have been the leading causes of trauma,” lists  Siddhartha Dhungana, the Medical Record Officer at the National Trauma Centre. “Head injuries and multi-organ failures have been the highest causes of death in these cases.”Most hospitals in Nepal, like the National Trauma Centre, follow the World Health Organisation’s trauma protocol. During a trauma case, medical personnel are contacted as soon as possible, patients are screened, their needs are identified and necessary care is given.Although the government has not developed a standard care protocol for trauma like it has for cancer patients, private hospitals have implemented and refined their own systems based on WHO guidelines.<a href="http://archive.nepalitimes.com/article/nation/politics-behind-epidemic-of-hospital-vandalism,3578" target="_blank" rel="noopener">Om Hospital</a>’s Continuing Medical Education Program is at the forefront of teaching trauma care to new doctors and providing courses on improved techniques to existing doctors.“We make sure that the ABCs of trauma care are followed strictly and that blood is readily available be it from our blood bank or staff-chain blood donors,” says Binod Adhikari of Om, which handles dozens of cases every day and has systems in place to coordinate between doctors, nurses and critical care anesthesiologists to provide emergency care to patients.<h2>Ambulance chasers</h2><figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109101132/636b73ee9c7e80680e062366jpeg.jpg" alt="" width="1500" height="1125"><figcaption> </figcaption></figure>Most of Nepal's ambulances are just jeeps with stretchers, with no life-support systems or medical attendants. It was only in 2011 that Nepal’s first emergency medical service was established. Supported by the Patan Academy of Health Sciences and the Stanford University School of Medicine, Nepal Ambulance Service (NAS) has since trained more than 100 emergency medical technicians (EMTs) and ambulance drivers and operates the <a href="http://archive.nepalitimes.com/news.php?id=18888#.XjvhpTIzaUk" target="_blank" rel="noopener">'Dial 102' service</a>. NAS operates mainly in Kathmandu Valley, Pokhara, Chitwan, Butwal and Bhairawa.“Before this, only few private hospitals had ambulances and they were used mainly for patient transfer rather than pre-hospital care,” says Hari Khadka, a paramedic at <a href="https://www.grandehospital.com/" target="_blank" rel="noopener">Grande International Hospital</a> and a member of the first EMT batch of NAS. “Ten years ago, there was simply no concept of pre-hospital care or paramedics in Nepal.”Now, many hospitals have their own EMS systems with mostly Type 3 ambulances that have first aid kits and basic medical supplies. <a href="https://www.nrcs.org/" target="_blank" rel="noopener">Nepal Red Cross Society</a> (NRCS) operates 283 ambulances nationwide. Although not every ambulance carries a paramedic, every driver has received first aid training.“We have five Type 2 ambulances and a paramedic in each vehicle,” says Bipul Neupane of NRCS. “We send these ambulances to patients who need basic life support systems.”But for patients needing critical care in remote areas, there is no recourse but expensive helicopter medical evacuation.Like Type 1 ambulances, some of these helicopters can have doctors, ventilators, advanced life support, and EMTs.“EMS has helped save many lives in Nepal but it isn’t always the best option considering the geography of Nepal and the condition of the roads,” says Sanjaya Karki, Head of the Emergency Department at <a href="https://www.nepalmediciti.com/" target="_blank" rel="noopener">Nepal Mediciti Hospital</a>. “Helicopter Emergency Medical Services ensure that we can get to critical patients as quickly as possible and provide the best pre-hospital care.”

It’s an emergency: Nepal needs to improve trauma care

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110815110/636a61059c7e80680e056eadjpeg.jpg" alt="" width="1500" height="1012"/><figcaption>Photo: KUNDA DIXIT</figcaption></figure>The first thing one notices these days while travelling by road in the Tarai are hundreds of cattle blocking the East-West Highway, mainly at intersections like Atariya or Kohalpur.The ‘cow emergency’ hit the headlines in September, when 24 cows were found dead below the highway in Surkhet and hundreds of others were wandering in the jungles. Police investigation revealed that the cattle were being transported from Nepalganj to Dailekh as part of an effort by the municipality to reduce the population of street livestock.Read also:<a href="https://www.nepalitimes.com/?p=35036&amp;preview=true" target="_blank" rel="noopener">Creatures of culture</a><a href="https://www.nepalitimes.com/?p=35062&amp;preview=true" target="_blank" rel="noopener">In an animal farm,</a> EditorialWhat few people know is that dozens of cattle had died earlier this year when Sukla Phanta Municipality near Dhangadi spent Rs5.5 million to round up cattle and put them in shelters, where most of them died of starvation and lack of care.There is no estimate of the number of cattle on the <a href="https://www.nepalitimes.com/banner/east-west-city/" target="_blank" rel="noopener">highways near border towns of the western Tarai</a>, but on a recent trip reporters counted hundreds just on the stretch between Dhangadi and Atariya. Locals said there were a lot more street cattle previously, and the numbers had actually gone down.https://www.youtube.com/watch?v=hF0y09GnNVwLocal officials said the main reason for the cattle crisis was the ban on beef in north Indian states, especially after the election of high priest and Hindu nationalist politician <a href="https://archive.nepalitimes.com/article/nation/saffron-surge-politics,3619" target="_blank" rel="noopener">Yogi Adityanath</a> as Chief Minister of Uttar Pradesh in 2017. Media reports of lynchings by religious extremists of Muslim traders suspected to be transporting cows put a stop to the unofficial ‘export’ of cattle from Nepal to India.Read also:<a href="https://www.nepalitimes.com/?p=35133&amp;preview=true" target="_blank" rel="noopener">Saving Nepal's last wild dogs,</a> Yadav Ghimirey<a href="https://www.nepalitimes.com/?p=35155&amp;preview=true" target="_blank" rel="noopener">A dog with altitude,</a> Sonam Choeyki LamaThere used to be a thriving crossborder trade in aged oxen and cows that had stopped giving milk. But sensitivity about cow slaughter in India after the rise of the BJP, as well as the new border fence on the India-Bangladesh border, has meant that the cattle are abandoned on the streets.<a href="https://www.nepalitimes.com/here-now/rana-regime-restored-in-nepalganj/" target="_blank" rel="noopener">Nepalganj Mayor Dhawal Rana</a> thought he had solved the problem by finding communities in the mountains willing to take the cows, however the transporter contracted to take the cattle to Dailekh let the cattle loose in the jungle near Surkhet in September.https://www.youtube.com/watch?v=45vQlWqfPW8https://www.youtube.com/watch?v=gD4iyOyafOcThere are other factors at play: increased <a href="http://archive.nepalitimes.com/article/nation/productivity-empowerment-and%20job-with-mechanization-and-cooperative-in-agriculture,2378" target="_blank" rel="noopener">mechanisation of agriculture</a> and the use of threshing machines, disc ploughs and the replacement of ox carts with tractors means that bulls are no longer in high demand in the Tarai.“Ten years ago I sold my bulls for Rs50,000 — now there are no buyers. I can’t even pay someone to take the bulls away,” says Biru Ram Chaudhari of Lalitpur village of Kailali.Read also:<a href="https://www.nepalitimes.com/opinion/guy-jatra/">Guy Jatra</a>, The Ass<a href="https://www.nepalitimes.com/opinion/kathmandu-traffic-faqs/">Kathmandu traffic FAQs</a>, The AssThe <a href="https://www.nepalitimes.com/here-now/nepal-and-malaysia-rewrite-rules-for-migrant-labour/" target="_blank" rel="noopener">outmigration of Nepali youth</a> to India, the Gulf and Malaysia has meant that <a href="https://nepalitimes.atavist.com/back-to-the-land" target="_blank" rel="noopener">agriculture</a> in general has seen a downturn, and there are fewer households keeping water buffalos and cattle at home. The urban expansion of Dhangadi and Nepalganj municipalities has also forced households to abandon home dairies.The stray cattle are now grazing in jungles by the highways, munching away at the undergrowth. Forests planted for flood control have also been affected. Sugarcane and paddy farmers have lost their entire crops as the cattle move through the fertile farms of the western Tarai.Says local farmer Gayadin Chaudhari: “It used to be <a href="https://www.nepalitimes.com/here-now/how-humans-can-live-with-wild-elephants/" target="_blank" rel="noopener">elephants and wild animals</a> that destroyed our crops, now it is the cattle. In Mohanpur they lost 8 bigha (1.5 hectares) of sugarcane to stray cows.”In Attariya, police say there has been an increase in highway accidents and fatalities because of collisions of vehicles with stray cows at night. They say the only solution is to tag cows so that they can be traced back to their owners, who will then be forced to be more responsible.

Kunda Dixit

Waiting till the cows come home

Nepal’s only international aviation gateway, at Kathmandu airport, will cut night-time operation hours to allow construction of taxiways, and airlines have been told to curtail flights. This is expected to lead to more than normal chaos during the height of peak autumn and spring tourist seasons at an airport that is congested even at the best of times. The airport will close from 10PM to 8AM from 8 November-31 March 2025. The taxiways will now connect to the thresholds at both ends of the runway, making the airport more efficient in handling higher frequencies of landings and takeoffs. The parallel taxiway extension will allow international flights to land every 4 minutes instead of the current every 7 minutes. At present planes have to wait to land until a plane taking off backtracks along the runway.&nbsp; Kathmandu is Nepal’s only airport with international operations, and it has only one runway that is only one way in from the south over the mountains. With the taxiway improvement, the airport will be able to handle 42 aircraft landings and takeoffs per hour — double the current capacity.&nbsp; The Civil Aviation Authority of Nepal (CAAN) has been trying to entice international airlines to also start flying to and from the other two international airports at Pokhara and Bhairawa (Lumbini) by slashing landing and handling charges. But so far only Nepal Airlines operates a weekly flight to Bhairawa from Kuala Lumpur.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241018161016_046569e53d1d66cd445cc66c697c0ef724810aec9f54bdf827481e3cd6b80c32.jpg" data-media-id="editor_0" data-image-id="20241018161016_046569e53d1d66cd445cc66c697c0ef724810aec9f54bdf827481e3cd6b80c32" data-rendition-name="original" width="2356" height="1134" loading="lazy" alt="Kathmandu airport expansion"> <figcaption>Kathmandu Airport Expansion plan with extension of taxiways to the thresholds of runways 02 and 20 that will limit airport operations from 8 November 2024 - 31 March 2025. Areas in blue are existing structures, including the international terminal which in future will be the domestic airport, and the new international terminal near the north end of the runway,</figcaption> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241018121028_6e17cc2ee87c1b02d78cb54905825b7aa15299b7a00f5eddb01a59579ab85c1a.jpg" data-media-id="editor_1" data-image-id="20241018121028_6e17cc2ee87c1b02d78cb54905825b7aa15299b7a00f5eddb01a59579ab85c1a" data-rendition-name="original" width="1353" height="1328" loading="lazy" alt="Kathmandu airport NT"> </figure>  CAAN has reportedly told international airlines to cut their flight frequency to Kathmandu citing the shorter operation hours and has told budget airlines to shift some of their flights to Pokhara or Bhairawa, or face cuts. Many airlines currently operate regular flights to and from Kathmandu between 10PM and 8AM: Air Arabia to Sharjah, Fly Dubai to Dubai, Jazeera Airways to Kuwait, Cathay Pacific to Hong Kong, Singapore Airlines, several Nepal Airlines flights, and one of four daily flights by Qatar Airways to Doha. Jazeera Airways, FlyDubai, and Thai AirAsia have applied and got permission from CAAN to begin regular flights to Bhairawa’s Gautam Buddha International Airport. Starting 9 November, FlyDubai will start making a stopover in Bhairawa before flying on to Kathmandu. Immigration, customs and security are all fully functional in Bhairawa. In Kathmandu, the next phase of the airport upgrade includes converting the current international terminal for domestic operations, the construction of a new international terminal where the domestic departure area is now, as well as moving the hangars and the Nepal Army Air Wing to the eastern side of the runway. The apron area will also double its parking space for widebody jets. This is part of a Airport Capacity Enhancement Project that was initially funded through a $80 million loan from the Asian Development Bank (ADB), and the entire masterplan is expected to cost $800 million. This project is the latest upgrade to Nepal’s only international airport since it saw its first flight in 1949. The current international and domestic terminals are too small to handle the current annual traffic volume of 8.5 million passengers a year that is growing at 20% a year.

Kathmandu airport to cut flight hours

As Kathmandu becomes more congested and polluted, and with remote online work becoming the norm, many professional Nepalis are planning to retire in Pokhara, or move there.&nbsp; With its stunning mountain panorama, balmy winters and proximity to a profusion of wilderness areas, builders are responding to this demand with new townhouses, housing development and apartments. One such block of flats is the 10-storey <a href="https://sungavaapartment.com/">Sungava Apartment</a> located at Phulbari above the Seti River, near the point where it flows into and under Pokhara. The imposing structure near Manipal Hospital is almost complete, and on a recent visit the site was strewn with huge boulders unearthed while digging the foundation.&nbsp; The Seti brought down these boulders during a gigantic flood that geologists estimate happened 800 years ago when a chunk of Annapurna IV broke off and ploughed into the glacier below. Today, Sungava (means ‘orchid’) sits safely on a high terrace, 100m above the blue-green Seti and commands a view of Dhaulagiri, Annapurna South, Machapuchre, Annapurna III and IV.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2024102411104_5f8fc736c86ea3c08d7bef43bb727081d3cc1a2caa55ae2b441717e6044de7e9.jpg" data-media-id="editor_1" data-image-id="2024102411104_5f8fc736c86ea3c08d7bef43bb727081d3cc1a2caa55ae2b441717e6044de7e9" data-rendition-name="original" width="2016" height="1512" loading="lazy" alt="High living below the Himalaya NT"> </figure>  The soil here is conglomerate that has solidified like concrete, and the boulders were extracted by heavy earthmovers. It is intriguing to think that these metamorphic rocks as big as cars, rounded by glacial grinding, were once a part of a much higher Annapurna IV. Even for those with little interest in geology, Sungava is an ideal place to contemplate the tectonic forces that pushed these peaks into the sky to be sculpted into delicate shapes by wind, snow, earthquake and avalanche over millions of years. The view of the Himalayan panorama from Sungava’s many balconies are breathtaking when not obscured by clouds, or the haze that drifts in from across the southern border. On most days, just watching the towering pyramid of Machapuchre (Tamu name: कतासुँ क्लिको) play hide and seek with the clouds is mesmerising. There are rocks aplenty at Phulbari, and it is probably the flowers that grew along the flat terraces e that gave the place its flowery name. The boulders will hopefully be turned into a rock garden while landscaping. An nearby restaurant complex is making the best use of the stones in its design, using flat rocks as outdoor benches and tables. Sungava was designed by the husband-wife architect team of Deepak Sherchan and Jyoti Joshi of <a href="https://thedarkmermaidamarbshrestha.blogspot.com/2013/12/creative-builders-collaborative-cbc.html">Creative Builders Collaborative (CBC)</a>, which also built Heritage Plaza, Indreni Apartment and numerous other projects in Nepal. Sadbhavana retains CBC’s trademark Newari-style masonry and here it borrows from the orange brickwork of the old town of Pokhara, integrating it with modern design elements. A few of those heritage houses are still standing in Ganesh Tole and Ram Krishna Tole in Pokhara’s old quarter.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2024102411108_5eb64a4885961b6d30781cefeb1e8a313da313ac5227c7a66b60f0c7d48d6fab.jpg" data-media-id="editor_3" data-image-id="2024102411108_5eb64a4885961b6d30781cefeb1e8a313da313ac5227c7a66b60f0c7d48d6fab" data-rendition-name="original" width="1362" height="595" loading="lazy" alt="High living below the Himalaya NT"> </figure>  About 400m from the apartment past a bend on the river, and down below three tiers of terraces in the canyon is a suspension bridge. Below it, the Seti is still swollen with post-monsoon flow as it tumbles away in a hurry to head down south.&nbsp; Back at the apartment, it is quiet, far away from the hubbub of Lakeside a 15 minute drive away, and in the lap of greenery. There are 52 units at Sungava and it already has a close-knit prospective community of professionals, including doctors, publishers, engineers, and businesspeople from the renewable energy and IT sectors.&nbsp; Some residents say they opted for a second home in Pokhara to make it a ‘base camp’ to explore the Annapurnas with its many hiking trails made newly accessible with new roads. With the NRN citizenship law, overseas Nepalis can now also buy the flats. &nbsp; The floor plans include options for north and south-facing 3-bedroom apartments with verandas, and the facility has underground parking has EV charging, heated pool, sauna and gym. There are still some unsold apartments with panoramic views of the mountains and one can imagine oneself at the kitchen with its huge window, humming a ditty while preparing breakfast: “खाना पकाउँ हिमाल हेरेर...”

High living below the Himalaya

When the United Nations held its Summit of the Future at its headquarters in New York in September, many world leaders, including Nepal’s Prime Minister K P Oli, highlighted the effect of climate breakdown in increasing the frequency and intensity of natural disasters. What did not get as much attention was the long term impact of the climate crisis on food production. In fact, heat stress, weather extremes and the consequences on rain-fed agriculture is already being felt worldwide, undermining the chances of the <a href="https://unstats.un.org/sdgs/">UN’s Sustainable Development Goals (SDGs)</a> being met by 2030.&nbsp; The SDG’s 17 targets commit countries like Nepal to reduce poverty and inequality, end malnutrition, protect the natural environment, and ensure that citizens all enjoy health, justice and prosperity without leaving anyone behind.&nbsp; However, besides the impact of climate breakdown on agricultural production, in Nepal the area under cultivation is impacted by urban expansion, falling productivity and the need for expensive inputs like fertiliser and pesticides.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241019041052_626413c5baf4dae407ac9579231b41daeb51510aa636b75aeb7489d94cca6a62.jpg" data-media-id="editor_1" data-image-id="20241019041052_626413c5baf4dae407ac9579231b41daeb51510aa636b75aeb7489d94cca6a62" data-rendition-name="original" width="999" height="1500" loading="lazy" alt="urban agriculture in Kathmandu"> <figcaption>Kathmandu's urban sprawl is eating into its fertile cultivable lands. Photo: TAYLOR MASON</figcaption> </figure>  Now, a new study led by Nepali researcher Prajal Pradhan at the University of Groningen in The Netherlands looks at how urban agriculture may offer a solution to falling food production and meeting SDG targets. The researchers evaluated 1,450 publications exploring the contributions of urban agriculture with both positive and negative effects, and published their findings in the journal Cells Report Sustainability. Urban agriculture can help achieve 17 SDGs, positively influencing 81 targets. However, it could also undermine 51 goals.&nbsp; Read also: <a href="https://nepalitimes.com/here-now/the-vanishing-land">The vanishing land</a>, Taylor Mason “Urban agriculture offers immense potential for sustainable development, but realising this potential depends crucially on adopting practices that minimise its adverse effects while maximising its benefits,” Pradhan explains. Urban agriculture can substantially enhance urban food security, provide employment to the urban poor, serve as ground water recharge in built-up areas, and preserve open spaces that can serve as safe havens during disasters like earthquakes. However, it also presents problems like the potential health risks from contamination and the need for expensive inputs. &nbsp; “Urban agriculture plays a definitive role in advancing the SDGs, but achieving this requires tailored, context-specific solutions that address the unique challenges of different regions,” says Yuanchao Hu of Wuhan University in China and who is a researcher at the Potsdam Institute for Climate Impact Research. “But it needs equitable access and rigorous management of environmental risks.”&nbsp; Rapid urbanisation is eating into Nepal’s most fertile agricultural land, which means farming in remaining open spaces inside cities can be a viable alternative, especially as food prices rise.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241019041052_7b7c9413086226fbdc630d45acf772cfa1ced77a8970b9056ec5ec7e5226fdf8.jpg" data-media-id="editor_3" data-image-id="20241019041052_7b7c9413086226fbdc630d45acf772cfa1ced77a8970b9056ec5ec7e5226fdf8" data-rendition-name="original" width="1500" height="999" loading="lazy" alt="urban agriculture in Kathmandu"> <figcaption>A vegetable patch in between new houses in Thimi. Photo: TAYLOR MASON</figcaption> </figure>  “The conversion of Nepal’s most fertile land into cities is a severe problem,” Pradhan told Nepali Times. “Crop cultivation, horticulture, agroforestry, beekeeping, livestock rearing, or aquaculture can all be farming activities within and around cities.”&nbsp; The study makes recommendations for sustainable practices that build on the positive aspects of urban agriculture while mitigating the downsides, thereby promoting more resilient cities in future. Research shows that urban agriculture has been helping many countries attain SDG targets by enhancing food security and biodiversity while helping education and preservation of open spaces.&nbsp; Indeed, many farmers from the hinterland who have settled in Kathmandu Valley or other urban areas of the country have been practicing urban agriculture, leasing neighbourhood patches or cultivating roof gardens both out of necessity because of inflation and falling income to grow their own food, and also as a fulfilling hobby. Saurav Dhakal, a sustainability advocate with Story Cycle and now research fellow at the Asian Institute of Technology in Thailand, says there are socio-economic and environmental benefits of urban agriculture. “It provides benefits to all urban dwellers, regardless of their income status,” says Dhakal, “families get fresh food, and there are many other benefits like water retention, heat regulation and biodiversity. These are all public goods, so special government incentives may be needed.” It is not unusual to see vegetable patches and even paddy fields within inner city Kathmandu where an older generation of farmers are using available fertile land and <a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/rooftop-gardens-kathmandu,1415">roof gardens to produce fresh, nutritious food </a>to reduce their dependence on food items that have to be bought after being trucked in from large distances.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2024101905100_1291ce98dbbb8caed8702ac4b1d469b3e13016d7ecaaf3bfd5f91c974d3c0c77.jpg" data-media-id="editor_5" data-image-id="2024101905100_1291ce98dbbb8caed8702ac4b1d469b3e13016d7ecaaf3bfd5f91c974d3c0c77" data-rendition-name="original" width="1500" height="999" loading="lazy" alt="urban agriculture in Kathmandu"> <figcaption>An older generation of farmers are using any available fertile land to continue farming but it is getting more and more difficult. Photo: TAYLOR MASON </figcaption> </figure>  Nepal’s urban population grew rapidly from only 3.6% in 1991 to 25% today. There is large outmigration from the mountains to peri-urban areas of the Tarai, to Kathmandu Valley and Pokhara, with many young men then moving abroad for work. Kathmandu Valley’s population has swelled to nearly 3 million, and is growing at 6.5% a year. Dilip Shrestha, 71, used to work for Nepal Food Corporation, so he knew firsthand about inflation, shortages and vegetables with pesticide residue. So, when he designed his new house in Kathmandu, he built a spacious roof where he grows cucumber, ginger, garlic, coriander, onions, tomatoes, chili, beans, okra, pumpkin and lettuce. His family eats healthier, and he has reduced dependence on the market.&nbsp; The co-author of the Cell Reports Sustainability journal article, Daya Raj Subedi who is a PhD candidate at Beijing Forestry University, says urban agriculture also promotes inclusion and psycho-social wellbeing.&nbsp; He says, “A crucial finding of the study is the identification of opportunities and challenges associated with urban agriculture, it can promote sustainable transformation of society.” In Banepa, 55-year-old Bijaya Manandhar in her lifetime has watched the fertile farms of her neighbourhood that used to supply vegetables to Kathmandu, now completely built up with no open space left. The pandemic lockdown prompted her to turn to the family’s <a href="https://nepalitimes.com/banner/rooftop-agriculture-on-the-roof-of-the-world">ancestral livelihood by growing food</a> not on terrace farms, but on the roof terrace. Manandhar is now a part of <a href="https://nepalitimes.com/banner/rooftop-agriculture-on-the-roof-of-the-world%5C%5C">कौसी खेती र करेसाबारी क्रान्ती</a> (Rooftop Farming and Garden Revolution) which has an online membership of 52,000, and awards annual prizes to women who excel in urban agriculture.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241019041052_7257f5def8f823f35a799fa6f6825e153f2ffa406ac11325d4fe74049b79e96d.jpg" data-media-id="editor_8" data-image-id="20241019041052_7257f5def8f823f35a799fa6f6825e153f2ffa406ac11325d4fe74049b79e96d" data-rendition-name="original" width="1600" height="736" loading="lazy" alt="urban agriculture in Kathmandu"> <figcaption>Rooftop farming is gaining popularity as a form of urban agriculture. </figcaption> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241019041052_beff1a4494ce896dd8fd383ee1f518e5448bcf7ea8bb138255391c7bcb9769ed.jpg" data-media-id="editor_9" data-image-id="20241019041052_beff1a4494ce896dd8fd383ee1f518e5448bcf7ea8bb138255391c7bcb9769ed" data-rendition-name="original" width="4000" height="3000" loading="lazy" alt="urban agriculture in Kathmandu"> </figure>  Pradhan says the challenge now is to upscale such examples of successful urban agricultural practices so they support Neal’s efforts to meet SDG targets. He adds, “Crop cultivation around cities can be protected by land use plans and regulations. Promoting community-based agriculture, including rooftop gardens, requires community engagement and public-private partnerships across the food value chain.”&nbsp; Such support would accelerate the popularity of existing rooftop farming and community gardens in Kathmandu Valley, or kitchen garden initiatives in Pokhara, and building on traditional farming practices that are preserved and integrated into urban settings like in Bhaktapur and Banepa. In Lalitpur, the Women Entrepreneurship Facilitation Center promotes urban farming enhancing both sustainability and empowerment.&nbsp; Another co-author of the report, Yuanchao Hu from China says followup research of the team will aim to identify good practices in local urban agriculture practices. He adds, “There are examples of urban agriculture that optimise sustainability, ensuring that it remains a viable solution for cities globally while countries try to meet SDG targets.” Prajal Pradhan, Daya Raj Subedi, Kshitij Dahal, Yuanchao Hu, Prakriti Gurung, Sijal Pokharel, Sagar Kafle, Biplav Khatri, Sudeeksha Basyal, Monika Gurung, and Aruna Joshi. Urban Agriculture matters for sustainable development. Cell Reports Sustainability, 1:100217, 2024. [DOI: 10.1016/j.crsus.2024.100217] Prajal Pradhan (<a href="mailto:p.pradhan@rug.nl">p.pradhan@rug.nl</a>) This article is brought to you by <a href="https://nepalitimes.com/" target="_blank">Nepali Times</a>, in collaboration with <a href="https://inpsjapan.com/en/" target="_blank">INPS Japan</a> and <a href="https://sgi-peace.org/" target="_blank">Soka Gakkai International</a>, in consultative status with UN ECOSOC.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20240630110640_30c3782f9c09219bf1c249b51483a3cfb7a53a06d117d2aebd23ca7080d12758.jpg" data-media-id="editor_14" data-image-id="20240630110640_30c3782f9c09219bf1c249b51483a3cfb7a53a06d117d2aebd23ca7080d12758" data-rendition-name="original" width="680" height="103" loading="lazy" alt="SDG logo"> </figure>

Back to the land in the cities

The 700-year-old Lakshmi Narasingha temple in Bhaktapur houses a rare half-lion and half-human incarnation of Lord Vishnu carrying the Goddess Lakshmi. The temple was destroyed in the 1934 mega earthquake that killed 10,000 people and destroyed many monuments in Kathmandu Valley. It was rebuilt by a German project in the 1980s, but as a single-storey structure instead of its original two-tier pagoda design.&nbsp; With new findings from in-depth research, Bhaktapur municipality began re-restoring the temple in 2021, preserving its original architecture.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241017131016_2fae38cce543ad7b1f6de632feb3e212e08ed1acedd747830e949d7b8e878f18.jpg" data-media-id="editor_0" data-image-id="20241017131016_2fae38cce543ad7b1f6de632feb3e212e08ed1acedd747830e949d7b8e878f18" data-rendition-name="original" width="2048" height="1365" loading="lazy" alt="In with the old in Nepal NT"> </figure>  “Our temples and heritage sites hold deep meaning. It is disheartening to witness how often they lose their original elements, whether by design or accident,” explains Kumar Chawal of the Consumer Committee of Bhaktapur. “There is a need to preserve our architecture and protect its historical value for future generations. Otherwise, we risk losing a vital part of our identity.” The Laksmi Narsingha restoration is similar to the Bhai Dega temple in Patan Darbar Square which also collapsed in 1934, but was rebuilt with a Moghul-style dome by the Rana government at the time. Only two months before the 2015 earthquake, heritage conservationists had started to rebuild Bhai Dega as the original three-tier based on early photographs. But priorities shifted when four other temples in the square were brought down by the 7.8M earthquake on 25 April 2015.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241017131016_697ea707d9ad163be5de5f2efbf5b70d3cab771adcc22f0fae6bf937c6cb0130.jpg" data-media-id="editor_1" data-image-id="20241017131016_697ea707d9ad163be5de5f2efbf5b70d3cab771adcc22f0fae6bf937c6cb0130" data-rendition-name="original" width="2048" height="1365" loading="lazy" alt="In with the old in Nepal NT"> </figure>  This showed how damage to monuments in Kathmandu Valley spanned from one earthquake to the next. Bhai Dega restoration remains half-complete to this day because money for its restoration ran out.&nbsp; Whereas Bhai Dega restoration was done by the Kathmandu Valley Preservation Trust with grants from western embassies and international foundations, in Bhaktapur it is the municipality itself that allocated the Rs30.7 million needed to restore the Lakshmi Narasingha temple. The expected date of completion is early 2025. The municipality and local communities are focusing on two main aspects: preserving the past and promoting localisation. The restoration team has designed a blueprint for the temple by using historical photographs and insights from older generations.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241017131016_182882fdc393c99e70d1d0490319e415229563666c4934e3a582426ebf00ca30.jpg" data-media-id="editor_2" data-image-id="20241017131016_182882fdc393c99e70d1d0490319e415229563666c4934e3a582426ebf00ca30" data-rendition-name="original" width="1200" height="560" loading="lazy" alt="In with the old in Nepal NT"> </figure>  “At first, the Lakshmi Narasingha temple had only one entrance, but during the demolition process, we uncovered the foundations of four doors. Now, we are restoring all of them. This is an example of how our ancient structures have changed over time, often without our knowledge,” says Chawal. “Constructing temples is not like building houses. They carry historical and spiritual values, which is why they hold a special place in our hearts,” he adds. By replicating ancient design elements and rebuilding the temple as accurately as possible to its original form, the team has stayed true to Bhaktapur’s soul. But the restoration also revived ancient techniques that were in danger of being forgotten, generating employment for woodcarvers, masons, and contractors. The community of Bhaktapur’s Gahiti neighbourhood near the famous Nyatapola Temple has also set aside specific days for locals to volunteer in the reconstruction work. This has encouraged young people to take pride in ownership of their heritage. Families have also supported the effort by donating funds for bells, the temple pinnacle, and other structural features to the temple.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241017131016_db850ec0c084cdbe54f65bee92dad2ad8122d20fd60ec87ec086fbb9d2f72bd6.jpg" data-media-id="editor_3" data-image-id="20241017131016_db850ec0c084cdbe54f65bee92dad2ad8122d20fd60ec87ec086fbb9d2f72bd6" data-rendition-name="original" width="2048" height="1365" loading="lazy" alt="In with the old in Nepal NT"> </figure>  “I feel at peace knowing I have contributed my sweat to restoring this temple,” said one volunteer. “It is our duty to preserve our temples and heritage. The Nyatapola area will look magical once this temple is completed.” Community mobilisation is a long-standing tradition in Bhaktapur. In the past, locals have actively participated in the restoration of other temples in the city, such as Bhairav and Nyatapola fostering a strong sense of ownership. This collective engagement has not only been crucial in preserving the city's historical monuments but also in strengthening the bond between local communities and their heritage, says officials at the municipality. While securing funding is essential, and the municipality showed it values heritage conservation, the Lakshmi Narasingha restoration is proof that active involvement and sense of responsibility of the local community is as important, if not more. Local involvement also means that the monuments will be cared for into the future, When locals take ownership of these efforts, the restored monuments are not only protected in the present but are also cared for in the future.

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