<figure><img width="2048" height="1364" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022111015118/636d05fb9c7e80680e0a5f3ajpeg.jpg" alt=""/><figcaption>Photo: MONIKA DEUPALA</figcaption></figure>There is breaking news every other day: the United States donates 2 million Moderna shots to Bangladesh and Pakistan. Denmark announces 250,000 AstraZeneca doses to Bhutan. Japan pledges surplus AZ vaccines to Sri Lanka and the Pacific Islands.Nepal is never in the news, even though <a href="https://www.nepalitimes.com/here-now/lonely-wait-of-nepals-elderly-for-2nd-doses/" target="_blank" rel="noopener noreferrer">1.4 million people still wait for their second doses</a> of Covishield AZ vaccines and another 20 million people need to be inoculated before a possible third wave this year. So far, Nepal has only been gifted or bought vaccines from India, China or the COVAX initiative. It has not even got 1 million vaccines from Serum Institute India that it paid for, and <a href="https://www.nepalitimes.com/editorial/no-vax-ask-for-mask/" target="_blank" rel="noopener noreferrer">all other promises from western countries were never kept</a>.  Nepal’s vaccine diplomacy has failed miserably. And the only silver lining is that there are four million doses of the Chinese Sinopharm VeroCell starting next week to immediately inoculate its above 55 population.Nepal is still recording an excess of 2,000 new cases a day and is seeing a slight daily increase following the <a href="https://www.nepalitimes.com/banner/kathmandu-covid-19-lockdown-relaxed/" target="_blank" rel="noopener noreferrer">relaxation in travel restrictions</a>. Everyone, the public and the government, seem to have forgotten that the real peak during the first wave last year took place only after the lockdown was eased.“The third wave is already on its way, our figures are going up and we must assume we will be hit by new variants,” says Buddha Basnyat, a physician at Patan Academy of Health Sciences (PAHS). “We must vaccinate as many people as quickly as possible, if not we will get more difficult variants that are potentially resistant to the vaccines.”In other news, the Oxford Vaccine Group which developed the AstraZeneca (AZ) vaccine has found that administering two doses 44-45 weeks produced the highest antibody boost. This news, announced by <a href="https://www.nepalitimes.com/opinion/im-sad-vaccines-are-delayed-in-nepal/" target="_blank" rel="noopener noreferrer">Andrew Pollard</a>, one of the developers of the AZ, is glad tidings for countries like Nepal where people above 65 are waiting for their second doses.Pollard said antibody levels remained elevated for close to a year with <a href="https://www.thehindu.com/sci-tech/health/ten-month-gap-between-astrazeneca-doses-sees-highest-antibody-boost-oxford-study/article35019890.ece" target="_blank" rel="noopener noreferrer">a ten-month gap between AZ doses</a>, as well as antibody levels twice that after the second dose among volunteers who were administered a third booster dose, pointing to a long-term, possibly life long immunity, also against variants.“This is great news for the elderly, many of whom are panicking, unable to get their second dose in the recommended time frame. The additional time the study has afforded us shouldn’t lead to complacency in our effort to procure vaccines,” says Sher Bahadur Pun, an epidemiologist at Sukraraj Tropical and Infectious Disease Hospital. <figure><img width="950" height="633" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022111015118/636d05fe9c7e80680e0a5f3bjpeg.jpg" alt=""><figcaption> </figcaption></figure>Norway, Czech Republic and Denmark have unused AZ shots they want to donate to Nepal, but have been forced to go through <a href="https://www.nepalitimes.com/opinion/hope-hyperbole-and-hypocrisy-of-covax/" target="_blank" rel="noopener noreferrer">COVAX, which is unlikely to deliver</a> the doses before the end of 2021.On 1 July, Denmark announced that it would donate 250,000 vaccines to Bhutan. However, it is understood that these grants still need to be facilitated by the EU. Also in the news this week is the result of a new modelling study published in the European Centre for Disease Prevention and Control’s medical journal Eurosurveillance that further strengthens the link between <a href="https://www.nepalitimes.com/banner/despite-doubts-nepal-sticks-with-astrazeneca-jabs/" target="_blank" rel="noopener noreferrer">AZ vaccines and a rare blood clot</a>.The study models four months of a vaccine distribution strategy in France from May 2021 and concludes that using AZ on the entire adult population would avert 10 deaths from Covid among 18-39-year-olds. However, it would be associated with 21 deaths from blood clots in the same age group over the same time period. In other words, <a href="https://www.irishexaminer.com/news/arid-40328123.html?type=amp" target="_blank" rel="noopener noreferrer">clot risk to younger people from the AZ vaccine</a> is twice as high as Covid death risk. But public health experts in Nepal maintain that the benefit of mass vaccination still far outweighs the risk. “Similar studies in the context of the South Asian population are needed but as it is, transmission risk of Covid is much higher than the individual risk of blood clots here,” says epidemiologist Lhamo Yangchen Sherpa.Buddha Basnyat of PAHS concurs: “The UK with over half of its population fully vaccinated is now being hit by the <a href="https://www.nepalitimes.com/latest/covids-regional-threat-needs-regional-response/" target="_blank" rel="noopener noreferrer">delta variant</a>, although it has been largely spared from severity due to the mass inoculation. Nepal being mostly unvaccinated is unprotected both from transmission and severity. This should show us where our priority should lie.”The European Centre for Disease Prevention and Control finding about clot risk therefore could indirectly be a blessing in disguise for countries like Nepal by further freeing up AZ stockpiles in Europe, as well as Korea and Japan.Even so, blood clot risk has prompted leaders including Germany’s Angela Markel to opt for Moderna as a booster shot to her first dose of AZ jab.Several EU nations including Germany have said mix-and-match doses are safe for Covid prevention, which according to new findings also point to <a href="https://www.bbc.com/news/health-57636356" target="_blank" rel="noopener noreferrer">a better immune response</a>. This could also offer much-needed flexibility when vaccine supplies are uneven or limited.“We need to introduce mixing and matching also in Nepal in the face of more virulent delta variants, particularly for the elderly who are at the higher risk of developing severity from an infection, instead of waiting endlessly for Covishield,” says Basnyat.At a time when Nepal is yet to recover from a <a href="https://www.nepalitimes.com/banner/the-real-cost-of-nepals-second-wave/" target="_blank" rel="noopener noreferrer">devastating second surge</a>, only an equitable vaccination strategy will prevent an even more deadly third wave. But a mere 2.6% of Nepal’s population has been fully vaccinated, and less than 9% has received a single dose of either Covishield or VeroCell shots.  <figure><img width="1594" height="898" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022111015118/636d06009c7e80680e0a5f3cjpeg.jpg" alt=""><figcaption> </figcaption></figure>And even the doses are unevenly distributed within the country. More than half the first dose of VeroCell was distributed in Bagmati province, according to the government’s own figures. Moreover, 97% of the booster jabs of VeroCell were used only in Bagmati Province. “We are seeing a similar kind of disparity in vaccination that we saw in testing, concentrated in urban centres and in particular Kathmandu,” notes epidemiologist Lhamo Yanghen Sherpa. “The excuse for using most of the doses in Kathmandu is that people elsewhere refused to inoculate. If that’s the case what is the government and others doing to dispel vaccine myths?” Virologist Sher Bahadur Pun says the government should immediately deploy its 60,000 or so <a href="https://www.nepalitimes.com/latest/enlisting-female-health-volunteers-to-fight-covid-19/" target="_blank" rel="noopener noreferrer">female community volunteers</a> and healthcare workers who have historically done such effective work in non-Covid childhood vaccination drives.He adds, “They are spread across the country and are best placed to communicate the significance of vaccines and increase vaccination uptakes at  local levels.”

Sonia Awale

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Vaccines too little, too late for Nepal?

<figure><img width="720" height="960" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109121152/636b95289c7e80680e06f23fjpeg.jpg" alt=""/><figcaption>Migrant workers, including Nepalis, in Kuwait after being vaccinated. A Nepali worker gets his jab (right). Source: Ram Bahadur Basnet</figcaption></figure><img width="720" height="960" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109121152/636b952b9c7e80680e06f240jpeg.jpg" alt="">In February 2020, Nepali migrant worker Min from Sindhupalchok was excited to visit Nepal after completing two years working in Kuwait. More than a year later, he is still here, due to a Covid-19 travel ban by Kuwait.  He could have returned by taking an indirect route via the UAE since there were no direct flights from Nepal. But since quarantining in the UAE was too costly, he decided to wait for travel restrictions in Kuwait to be lifted. “Now it looks like new rules regarding mandatory vaccination in Kuwait will further delay my return,” says Min.Another worker in Kuwait is Lila from Chitwan. He had spent 15 years there, but has been stuck ever since he came home for a break. Lila’s employer in Kuwait is getting impatient.Stories of stranded migrants are common, but with new vaccination requirements by destination countries, the situation has only become even more uncertain. “From 1 August, Kuwait will allow entry of non-citizens <a href="https://www.khaleejtimes.com/coronavirus-pandemic/covid-19-kuwait-to-allow-fully-vaccinated-non-citizens-entry-from-august-1" data-saferedirecturl="https://www.google.com/url?q=https://www.khaleejtimes.com/coronavirus-pandemic/covid-19-kuwait-to-allow-fully-vaccinated-non-citizens-entry-from-august-1&amp;source=gmail&amp;ust=1625121388603000&amp;usg=AFQjCNGRqFuLUOQyHv8xigeCvXBJcBO4MA">only if they are fully vaccinated</a> by one of the four vaccines: Pfizer BioNTech, Oxford/AstraZeneca, Moderna and Johnson &amp; Johnson,” says Nepal’s ambassador to Kuwait, Durga Bhandari. None of these vaccines are currently available in Nepal, and other countries that send workers to the Gulf also face the same problem. Saudi Arabia is also set to impose similar vaccination requirements from 1 August. Until then, those who are not vaccinated have to undergo quarantine for a week. While Qatar is allowing Nepali passengers with mandatory institutional quarantine, there has been no announcement regarding vaccines yet. Nepal is currently banned <a href="https://www.hindustantimes.com/business/uae-ban-on-flights-from-india-pakistan-and-12-other-countries-to-continue-101624791232360.html" data-saferedirecturl="https://www.google.com/url?q=https://www.hindustantimes.com/business/uae-ban-on-flights-from-india-pakistan-and-12-other-countries-to-continue-101624791232360.html&amp;source=gmail&amp;ust=1625121388603000&amp;usg=AFQjCNGNiLYfuDmDxMx29zavs0qeaH_35w">by the UAE</a> and <a href="https://www.arabianbusiness.com/culture-society/463675-bahrain-to-ban-travellers-from-india-pakistan-sri-lanka-bangladesh-nepal" data-saferedirecturl="https://www.google.com/url?q=https://www.arabianbusiness.com/culture-society/463675-bahrain-to-ban-travellers-from-india-pakistan-sri-lanka-bangladesh-nepal&amp;source=gmail&amp;ust=1625121388603000&amp;usg=AFQjCNEAlpu8KOlC-kc1Zsa4tH4PqRrmLg">Bahrain</a> for public health reasons. The UAE has approved Sinopharm, Pfizer, Sputnik V and Oxford-AstraZeneca, and has imposed double vaccination mandate to South Africa, Nigeria and India, which will likely be applied to Nepalis as well once the ban is lifted, according to UAE-based travel entrepreneur Krishna Bhusal. As the Gulf countries ramp up their vaccination drives and set ambitious targets for universal vaccination, they have started to <a href="https://gulfnews.com/world/gulf/saudi/saudi-arabia-bans-access-to-shopping-malls-for-unvaccinated-1.79888953" data-saferedirecturl="https://www.google.com/url?q=https://gulfnews.com/world/gulf/saudi/saudi-arabia-bans-access-to-shopping-malls-for-unvaccinated-1.79888953&amp;source=gmail&amp;ust=1625121388604000&amp;usg=AFQjCNGatchZ14YZDxeTeuO6gYsybD3TyQ">require proof of full vaccination</a> for all activities including workplace visits, public events, restaurants and malls. Nepal, on the other hand, is bearing the brunt of the global vaccine inequality with a dismal vaccination rate of 2.6%. It is uncertain when outgoing migrants will get their turn, and as they wait, how many will lose lucrative opportunities or have visas or contracts expire. “Even without these flight bans and the new vaccination requirements, it has been difficult for workers with expensive quarantine and testing costs,” says labour recruiter Saroj Pokharel.  <figure><img width="1280" height="720" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109121152/636b952d9c7e80680e06f241jpeg.jpg" alt=""><figcaption> </figcaption></figure>It can cost from $800-$2,000 for institutional quarantine in Qatar depending on the standard of facilities, and many employers are reluctant to cover these expenses which get passed down to workers.  “The only way out is widespread vaccination, but at the rate we are progressing, I do not see the foreign employment sector recovering anytime soon,” Pokharel says. Quarantine costs are about $1,000 in Saudi Arabia as well. “Employers <a href="https://www.facebook.com/nepalembassysaudiarabia/photos/pcb.4383977018335352/4383976668335387/" data-saferedirecturl="https://www.google.com/url?q=https://www.facebook.com/nepalembassysaudiarabia/photos/pcb.4383977018335352/4383976668335387/&amp;source=gmail&amp;ust=1625121388604000&amp;usg=AFQjCNEmtN1gYwebB1uttNn6azamjkR9Ew">are required to foot the bill</a> and have to commit in writing in the job demand approval letter that they will bear the costs of quarantine. The Saudi authorities will also notify employers regarding this rule,”  says Nepali Labour Attaché Prem Upadhaya at the Consulate in Jeddah. However, given that workers are desperate it is likely that they will pay for it covertly, no matter how high the cost, or how inconvenient.  The rules on quarantine and vaccines do not just involve Nepali workers, and other countries face the same problem. In response, <a href="https://www.khaleejtimes.com/coronavirus-pandemic/covid-overseas-filipino-workers-now-priority-for-vaccinations-in-philippines" data-saferedirecturl="https://www.google.com/url?q=https://www.khaleejtimes.com/coronavirus-pandemic/covid-overseas-filipino-workers-now-priority-for-vaccinations-in-philippines&amp;source=gmail&amp;ust=1625121388604000&amp;usg=AFQjCNHnyJI2Ct6KhHvrodMix3HHdQo45A">the Philippines</a> has put its overseas contract workers in the ‘essential’ category alongside health staff which moves them up in the vaccination priority list.  <a href="https://www.thedailystar.net/bangladesh/news/migrant-get-pfizer-moderna-vaccines-2119989" data-saferedirecturl="https://www.google.com/url?q=https://www.thedailystar.net/bangladesh/news/migrant-get-pfizer-moderna-vaccines-2119989&amp;source=gmail&amp;ust=1625121388604000&amp;usg=AFQjCNELsJNafXsHgtlEvgStbVvrBX2UQQ">Bangladesh</a> will prioritise workers heading to Kuwait and Saudi Arabia for the Pfizer vaccines that it received as part of the global COVAX initiative. It is set to receive 2 million doses of the <a href="https://www.newagebd.net/article/142013/bangladesh-to-get-25m-doses-of-moderna-covid-vaccine-from-usa-soon" data-saferedirecturl="https://www.google.com/url?q=https://www.newagebd.net/article/142013/bangladesh-to-get-25m-doses-of-moderna-covid-vaccine-from-usa-soon&amp;source=gmail&amp;ust=1625121388604000&amp;usg=AFQjCNFbi4BS2QNvFQRAy-CH1Y9JsT1W0Q">Moderna vaccine</a> from the United States through COVAX. The country also has a scheme to reimburse quarantine costs of workers to Saudi Arabia.  In Pakistan, Saudi-bound expats <a href="https://edition.cnn.com/2021/06/28/asia/pakistan-expatriates-vaccination-center-intl-hnk/index.html" data-saferedirecturl="https://www.google.com/url?q=https://edition.cnn.com/2021/06/28/asia/pakistan-expatriates-vaccination-center-intl-hnk/index.html&amp;source=gmail&amp;ust=1625121388604000&amp;usg=AFQjCNFJRRpihnsIY9ucUrvaWzFkopcjsw">broke into a vaccination centre</a> in Islamabad after fears that the AstraZaneca vaccines would run out. Prime Minister Imran Khan has asked Saudi Arabia and other countries to accept the WHO-approved Chinese vaccine with which Pakistan is inoculating its population.  <a href="https://www.dailynews.lk/2021/06/28/local/252607/slbfe-arrange-covid-jabs-free-foreign-job-seekers" data-saferedirecturl="https://www.google.com/url?q=https://www.dailynews.lk/2021/06/28/local/252607/slbfe-arrange-covid-jabs-free-foreign-job-seekers&amp;source=gmail&amp;ust=1625121388604000&amp;usg=AFQjCNHjFonIPKoFSEU0CaUMXKxyigNsCA">Sri Lanka</a> has also announced free vaccines for those with confirmed overseas jobs, but is also dependent on the Sinopharm Chinese vaccine, which is not accepted by key destination countries.  In <a href="https://telanganatoday.com/relief-for-nris-as-saudi-approves-covishield" data-saferedirecturl="https://www.google.com/url?q=https://telanganatoday.com/relief-for-nris-as-saudi-approves-covishield&amp;source=gmail&amp;ust=1625121388604000&amp;usg=AFQjCNExwn7EkYkTzX80oqjEd5UFS0uLTw">India</a>, many migrant workers are stranded because their vaccine certificates refer to Covishield, and not Oxford AstraZeneca. However, Saudi Arabia finally recognised Covishield as equivalent to AstraZeneca after diplomatic dialogue. Vaccination camps have been set up for outgoing students and workers, although <a href="https://www.thehindu.com/news/cities/Tiruchirapalli/vaccination-camp-for-people-with-plans-to-go-abroad/article34889852.ece" data-saferedirecturl="https://www.google.com/url?q=https://www.thehindu.com/news/cities/Tiruchirapalli/vaccination-camp-for-people-with-plans-to-go-abroad/article34889852.ece&amp;source=gmail&amp;ust=1625121388604000&amp;usg=AFQjCNHEBvKQtQVlQtUD1cKoW-dlOYF1RA">demand far outweighs supply</a>. In Nepal, however, there is growing frustration with the lack of progress in sourcing vaccines. Says Sujit Shrestha of NAFEA (Nepal Association of Foreign Employment Agencies): “We need a way out because there is demand in these countries for Nepali workers. The government should get vaccines and prioritise outgoing workers, or coordinate with destination countries to provide quarantine and vaccines for workers. For many Nepali families, foreign employment is the only source of income.” After a few months of slow and uneven recovery of emigration, the second wave impacted both new and current Nepali workers. But even with cases falling and limited flights allowed, there is uncertainty because of the vaccines.  It is not just about whether Nepal can inoculate outgoing workers soon, but also whether the vaccination provided is accepted by the destination country.  Saudi Arabia has a demand for 40,000 Nepali workers that are waiting to be filled. In Kuwait, employers are struggling with labour shortages. This is in addition to thousands stranded in Nepal while on holiday like Min and Lila, who are at risk of losing their jobs overseas. Says Kuwait-based Nepali Ram Bahadur Basnet: “If flights normalise and the issue of vaccinations gets sorted out, Nepalis will be able to find attractive opportunities here.”  Some names have been changed. Additional reporting by Hom Nath Giri.

Upasana Khadka

Job-seekers now also jab-seekers

<figure><img width="1236" height="856" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109111148/636b85a09c7e80680e067804jpeg.jpg" alt=""/><figcaption>Photo: AMIT MACHAMASI</figcaption></figure><h2>1. Oxygen</h2> To save lives, Nepal’s most urgent need now is oxygen. Not just cylinders, but oxygen generators, concentrators and liquid oxygen. Most infected people are not succumbing to Covid-19, they are <a href="https://www.nepalitimes.com/here-now/helping-nepalis-breathe-again/" target="_blank" rel="noopener noreferrer">dying because of low oxygen saturation</a> in the blood, and lack of hospital beds -- patients who need not have died of coronavirus. Dire as the situation is in the cities, Nepal’s pandemic has now <a href="https://www.nepalitimes.com/editorial/nepals-humanitarian-emergency/" target="_blank" rel="noopener noreferrer">infiltrated the remotest villages</a> where there is no hospital care and no oxygen. The virus is preying on people already suffering malnutrition, previous ailments, and decades of structural state neglect. In Rolpa, Humla and other remote districts, between 80-90% of PCR tests are coming back positive, and it takes a week to get results. Patients are either not isolating, or not following precautions.Kathmandu's doctor-to-patient ratio is 1:850, but in rural Nepal it is one doctor for every 15,000 people, and hospitals and medical staff there <a href="https://www.nepalitimes.com/here-now/at-the-covid-19-frontlines-in-rural-nepal/" target="_blank" rel="noopener noreferrer">are already overstretched</a>.Close to 60% of all swabs collected nationwide are from Bagmati Province, with nearly half of them in Kathmandu Valley, says epidemiologist Lhamu Yangchen Sherpa. She adds: “There just aren’t enough tests and contact tracing is minimal, official total cases and fatalities are grossly underestimated.” <figure><img width="1497" height="746" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109111148/636b85a39c7e80680e067805jpeg.jpg" alt=""><figcaption> </figcaption></figure><figure><img width="984" height="519" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109111148/636b85a69c7e80680e067806jpeg.jpg" alt=""><figcaption> </figcaption></figure>Hospitals in Kathmandu Valley with roof helipads have multiple daily rescue flights, but even these facilities are <a href="https://www.nepalitimes.com/banner/we-knew-the-tsunami-was-approaching/" target="_blank" rel="noopener noreferrer">at breaking point</a> with patients being turned away. Understaffed and under-equipped hospitals in the districts do not stand a chance. Even where hospitals exist, many families avoid them for fear of being infected and take wrong medication from pharmacies.Case in point are recent deaths due to misdiagnosis across the country. <a href="https://www.nepalitimes.com/banner/a-shot-in-the-arm-for-vaccines-in-nepal/" target="_blank" rel="noopener noreferrer">Typhoid disease</a> simulates Covid-19 with similar symptoms, and the widespread Widal test is known to give false positives.“Covid patients are being prescribed antibiotics to fight typhoid, only to turn critically ill in a few days’ time,” says Buddha Basnyat of Patan Academy of Health Sciences. “This is the reason behind some of the latest Covid fatalities.” <figure><img width="1280" height="720" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109111148/636b85a89c7e80680e067807jpeg.jpg" alt=""><figcaption> </figcaption></figure>As in India, Nepal is beginning to see a slight bending of the curve for new infections, but health experts expect the fatality rate to remain high for some more time.  There were 190 Covid deaths in the past 24 hours and 6,543 recoveries. Of the total 8,305 new cases on Thursday, Kathmandu Valley accounts for 3,232 infections. 7,814 people are undergoing treatment in hospitals with 1,748 in ICU and 492 in ventilator support. “After the relentless patient pressure of the past month, we have seen a decline in those requiring admissions,” says virologist at Teku hospital Sher Bahadur Pun. “The virus has now infected a majority of people in the cities, and this combined with the lockdown means we may be getting to the halfway mark of the second wave.” <h2>2. Vaccines</h2> A prolonged lockdown is not the answer. If it was, the <a href="https://www.nepalitimes.com/latest/covid-19-numbers-slightly-down-in-nepal/" target="_blank" rel="noopener noreferrer">reduction in the number of cases and the positivity rate</a> this week would have been steeper. Even while the government tries to increase oxygen supply to hospitals, the only long-term strategy is to vaccinate at least 70% of Nepal’s eligible population.Doctors report a marked difference between the recovery of people who are vaccinated against those who are not. Says virologist Pun at Teku Hospital: “Except for a few rare cases, all patients in critical condition and those dying are the ones who for one reason or another had not been vaccinated.”But Nepal has run out of its vaccine stock, leaving 1.4 million people still waiting for their second dose of AstraZeneca Covishield in a lurch, after India banned its export, and the COVAX Facility could not supply its remaining 1.8 million vaccines to Nepal because of the global supply bottleneck.  <figure><img width="1440" height="1080" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109111148/636b85ac9c7e80680e067808jpeg.jpg" alt=""><figcaption> </figcaption></figure>The Nepal government and pressure groups in Nepal and the United States <a href="https://www.nepalitimes.com/here-now/nepal-needs-urgent-american-vaccine-support/" target="_blank" rel="noopener noreferrer">have strongly urged the Biden administration</a> to immediately rush some of its AstraZeneca doses to Nepal.Meanwhile, the UK, the US and Canada have authorised vaccines for use in children and adolescents, sparking outrage in the global public health community for prioritising an age group that is rarely critically affected by Covid-19. The World Health Organisation’s director-general Tedros Adhanom Ghebreyesus has urged rich countries to instead donate doses to the <a href="https://www.nepalitimes.com/latest/unicef-urges-g7-to-dispatch-vaccines/" target="_blank" rel="noopener noreferrer">COVAX Facility</a> for poorer states that have barely covered health workers and the most vulnerable groups. Speaking at the British Parliament last week, noted vaccinologist and the principal researcher of Oxford University’s AstraZeneca vaccine, Andrew Pollard, called the decision to inoculate children in wealthy nations ahead of high-risk groups in poorer countries “morally wrong.” Pollard has worked extensively in the region, leading research into the burden and transmission of typhoid in Nepal, Bangladesh and Malawi, and the impact of typhoid vaccine in these areas. He also runs surveillance for invasive bacterial diseases, and studies the impact of pneumococcal vaccines in children in Nepal.In Nepal, vaccination will grind to a halt this week after the current campaign to inoculate 300,000 people in the 18-59 age group with their second dose of the Chinese VeroCell ends.  <figure><img width="960" height="640" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109111148/636b85af9c7e80680e067809jpeg.jpg" alt=""><figcaption> </figcaption></figure><img width="960" height="640" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109111148/636b85b29c7e80680e06780ajpeg.jpg" alt=""><img width="960" height="639" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109111148/636b85b49c7e80680e06780bjpeg.jpg" alt="">Although <a href="https://www.nepalitimes.com/here-now/nepal-is-a-priority-for-vaccine-shipments/" target="_blank" rel="noopener noreferrer">Foreign Minister Pradeep Gyawali says</a> the government is in “final negotiations” for 2 million doses of Sinopharm VeroCell vaccines by June, there is no movement at the Ministry of Health. Ongoing talks to procure 8 million doses of <a href="https://www.nepalitimes.com/opinion/vaccine-geo-politics-and-sputnik-v/" target="_blank" rel="noopener noreferrer">the Sputnik V</a> have hit a production capacity snag in Russia. “We can implement lockdowns only for so long, the only exit strategy is vaccines. Science delivered, now our politicians must do the same,” says Buddha Basnyat, a physical at the Patan Academy of Health Sciences. “The Nepal government must procure vaccines using every diplomatic channel possible, and rich countries must realise that they are not safe until countries like Nepal are also vaccinated.” Activists have been trying to convince <a href="https://www.nepalitimes.com/latest/leading-public-figures-call-on-uk-government-for-oxygen-for-nepal/" target="_blank" rel="noopener noreferrer">the US government and Europeans</a> that Nepal has a lot of experience in successful vaccination campaigns against polio, smallpox, measles. It has over 50,000 female community health volunteers (FCHVs) reaching children with vaccines every year.  <figure><img width="1024" height="768" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109111148/636b85b79c7e80680e06780cjpeg.jpg" alt=""><figcaption> </figcaption></figure><img width="2048" height="943" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109111148/636b85ba9c7e80680e06780djpeg.jpg" alt=""><img width="1920" height="864" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109111148/636b85bd9c7e80680e06780ejpeg.jpg" alt="">Similarly, Nepal’s health system has amassed vast experience in maintaining the vaccine cold chain even in the remote mountains. It also has trained human resource overseeing DOTS (Directly Observed Therapy, Short-course) for tuberculosis management all over the country who can lend a hand in equitable distribution of vaccines in <a href="https://www.nepalitimes.com/latest/rural-nepal-fights-back-covid-19/" target="_blank" rel="noopener noreferrer">rural Nepal</a>.Says epidemiologist Lhamo Yangchen Sherpa: “It’s not too late, we can still use existing resources like FCHVs to better mobilise vaccination, conduct contact tracing, dispel any remaining vaccine hesitancy, and use public health professionals in prevention.”

It’s an Emergency

<figure><img width="1280" height="854" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022111012110/636cd9ef9c7e80680e092ecejpeg.jpg" alt=""/><figcaption>Thousands of revellers thronged to Kathmandu's Darbar Square on Sunday to celebrate Phau Purnima ignoring warnings of a possible second Covid-19 wave and despite hazardous smoke haze that has shrouded the country for days. Photos: MONIKA DEUPALA and AMIT MACHAMASI</figcaption></figure>After a year of living in the shadow of the Covid-19 pandemic, Nepalis were bracing themselves for a second wave from India, when they were hit by an unexpected disaster: <a href="https://www.nepalitimes.com/latest/wildfires-in-nepal-cause-air-quality-to-plummet/" target="_blank" rel="noopener noreferrer">wildfires that have shrouded the country</a> in a pall of smoke for days.The two crises have converged with the suspension of Nepal’s Covid-19 vaccination drive after India <a href="https://www.nepalitimes.com/banner/despite-doubts-nepal-sticks-with-astrazeneca-jabs/" target="_blank" rel="noopener noreferrer">banned the export of the AstraZeneca Covishield doses</a>. Two days after the Ministry of Health warned citizens about wearing masks, washing hands and avoiding crowds to defend themselves against a coronavirus surge, it issued another statement on Saturday telling people to stay indoors to avoid the <a href="https://www.nepalitimes.com/banner/nepal-is-going-up-in-smoke/" target="_blank" rel="noopener noreferrer">hazardous haze</a>, and not to venture out unless urgent.It did not look like people in Kathmandu were paying attention to either warning. Thousands of revellers thronged to Kathmandu’s Darbar Square on Sunday dancing and singing, spraying water and smearing colour on each other to celebrate the festival of colours, Phau Purnima. “It depends on us whether there will be another lockdown. Do we continue to mask up and maintain physical distance or start crowding and ignore safety measures?” warns Buddha Basnyat of the Patan Academy of Health Sciences. “Nepal usually tracks India in health trends, so we have to be prepared.” <figure><img width="1280" height="852" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022111012110/636cd9f29c7e80680e092ecfjpeg.jpg" alt=""><figcaption></figcaption></figure><img width="640" height="427" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022111012110/636cd9f59c7e80680e092ed0jpeg.jpg" alt=""><img width="640" height="427" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022111012110/636cd9f99c7e80680e092ed1jpeg.jpg" alt=""><figure><img width="1280" height="854" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022111012110/636cd9fc9c7e80680e092ed2jpeg.jpg" alt=""><figcaption>Public gatherings in light of vaccine shortage can have disastrous results.</figcaption></figure>Despite the government ban on public gatherings following the <a href="https://www.nepalitimes.com/editorial/its-not-over-yet/" target="_blank" rel="noopener noreferrer">second wave in neighbouring India</a>, there have been political rallies and public gathering with people behaving as if the pandemic is over. Kathmandu’s bars, restaurants and malls are packed to the brim. Offices and schools have reopened, and there is little physical distancing.On Saturday, with 62,714 new Covid-19 cases, India registered the highest daily rise in 2021 with Maharashtra, Chandigarh, Punjab, Goa, Puducherry, Chhattisgarh, Madhya Pradesh and Haryana recording the highest positivity rates. Bihar state neighbouring India is also seeing a surge as workers travel back.Anticipating another lockdown like last year, <a href="https://www.nepalitimes.com/latest/nepalis-still-stuck-in-no-mans-land/" target="_blank" rel="noopener noreferrer">Nepali migrants from India</a> have also started returning home. Checkpoints in Karnali, Far-West and Province 2 are overwhelmed with a steady rise in positive cases among returnees, who are being asked to self-isolate at homes.“We now have a year-long experience of managing Covid-19 and it is time to learn from our previous mistakes and limitations,” says Sher Bahadur Pun, a virologist at Teku Hospital.Sameer Dixit of Centre for Molecular Dynamics Nepal agrees. “While the second wave in India has been limited to fewer states so far and hasn’t resulted in as high a mortality rate as the first time, local governments here must take charge: monitor returnees, their tests and quarantines,” he says.Despite being <a href="https://www.nepalitimes.com/banner/nepal-fights-infodemic-to-push-vaccine/" target="_blank" rel="noopener noreferrer">one of the first Asian countries to start a Covid-19 vaccination drive</a> in late January, Nepal now has only about 500,000 doses of AstraZeneca Covishield vaccine in stock, just sufficient for second doses starting 20 April for those who had inoculated in the first phase.Following the Indian ban on the export of Covishield vaccine before domestic demand is met, Nepal is yet to receive another million doses it purchased from Serum Institute of India. The ban has also delayed the next batch of Covishield shots under <a href="https://www.nepalitimes.com/opinion/glimmers-of-hope-for-nepal-on-vaccine/" target="_blank" rel="noopener noreferrer">the COVAX initiative</a>, which is not expected until May.A Nepal Airlines plane is finally flying to Beijing on Monday to bring back 800,000 doses of the Sinopharm vaccine gifted by China, but it will not be sufficient to begin the next phase of vaccination targeted at the age group 55-64.But if it comes down to it, experts are recommending vaccinating as many individuals in the risk group as possible, even if that means bypassing the second dose for those already inoculated with the first. <figure><img width="3200" height="1970" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022111012110/636cd9ff9c7e80680e092ed3jpeg.jpg" alt=""><figcaption>Tourists take part in Phau Purnima revelry at lakeside in Pokhara despite fears of a second wave, and even though Pokhara has been shrouded in smoke for the past three days. Photo: KRISHNA MANI BARAL</figcaption></figure>So far, <a href="https://www.nepalitimes.com/latest/1-6-million-vaccinated-20-million-to-go/" target="_blank" rel="noopener noreferrer">Nepal has inoculated 1.6 million people</a> and needs to vaccinate 20 million more under its target to immunise 70% of its population. For this alone, the government needs to look into other certified vaccines in the market such as Russian Sputnik V, Bharat Biotech’s Covaxin and Chinese vaccines.With governments failing to ensure supply, it has become crucial to get the private sector involved to meet demand. The Ministry of Health earlier this month approved letting private companies import vaccines so that those with the resource and willingness can immunise themselves, this is said to involve India’s Covaxin and <a href="https://www.nepalitimes.com/latest/sputnik-v-vaccine-mystery-in-nepal/" target="_blank" rel="noopener noreferrer">the Russian Sputnik</a>.

Thick haze adds to Nepal Covid-19 woes

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022111011114/636cccff9c7e80680e08bc51jpeg.jpg" alt="" width="960" height="640"/><figcaption>Nepal took delivery of one million doses of Covishield vaccine ordered from the Serum Institute of India, on Sunday. Photo: AMIT MACHAMASI</figcaption></figure>Amidst the pandemic, Covid-19 vaccines have become a means for countries to exert influence over others. This has seen global powers flex their manufacturing prowess to reap geopolitical gains.As a landlocked country perched between China and India, the world’s two most populous countries and the largest global vaccine manufacturers, Nepal has <a href="https://www.nepalitimes.com/opinion/glimmers-of-hope-for-nepal-on-vaccine/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/opinion/glimmers-of-hope-for-nepal-on-vaccine/&amp;source=gmail&amp;ust=1613969755600000&amp;usg=AFQjCNFMX8c41M-XBr18zmXA9q450CrOjw">benefited from them. </a>Attempts by both Beijing and Delhi to distribute vaccines to Nepal signify the Himalayan state’s growing strategic value to both.India made the first move. In January, New Delhi <a href="https://www.reuters.com/article/us-health-coronavirus-nepal-vaccine-idUSKBN29W0VJ" data-saferedirecturl="https://www.google.com/url?q=https://www.reuters.com/article/us-health-coronavirus-nepal-vaccine-idUSKBN29W0VJ&amp;source=gmail&amp;ust=1613969755600000&amp;usg=AFQjCNHvA5Q2Hq3IlOSW_YRiVLKoHZsimg">pledged to inoculate</a> Nepal’s frontline workers before any other country, and promptly dispatched one million doses of the Covishield vaccine manufactured by its <a href="https://www.seruminstitute.com/" data-saferedirecturl="https://www.google.com/url?q=https://www.seruminstitute.com/&amp;source=gmail&amp;ust=1613969755600000&amp;usg=AFQjCNFeCK6lMJ0mEMwnhe5ZlUkRhkq83g">Serum Institute of India.</a>“Nepal is getting the vaccines within a week after India rolled out its vaccination drive, which signifies the friendship between India and Nepal and the importance India attaches to Nepal,” India’s ambassador to Nepal Vinay Mohan Kwatra said, as the <a href="https://www.nepalitimes.com/latest/jabs-and-jab-nots/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/latest/jabs-and-jab-nots/&amp;source=gmail&amp;ust=1613969755600000&amp;usg=AFQjCNFGat2xjZpiPoxjEjZIquz-r4fqSw">first shipment of the Oxford AstraZeneca vaccine arrived at Kathmandu airport.</a><figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022111011114/636ccd029c7e80680e08bc52jpeg.jpg" alt="" width="2839" height="2092"><figcaption> </figcaption></figure>Such rosy optics masked recent complications in relations between the two neighbours. India’s ties with Nepal have been strained in recent years by the Kalapani border <a href="https://www.brookings.edu/blog/up-front/2020/06/11/interpreting-the-india-nepal-border-dispute/" data-saferedirecturl="https://www.google.com/url?q=https://www.brookings.edu/blog/up-front/2020/06/11/interpreting-the-india-nepal-border-dispute/&amp;source=gmail&amp;ust=1613969755600000&amp;usg=AFQjCNHENUQx_suOCbeya69_G1M1t9-8ZQ">dispute</a>. In May 2020, India’s Defence Ministry opened a new 80 km-long road in the Himalaya to the Chinese border that passed through territory claimed by Nepal. In response, Kathmandu changed its own official map, and set up new border posts.There had been concerns in New Delhi that Nepal has become increasingly ‘Sinified’, especially since its six-month blockade of the border in 2015. China was the architect of the alliance of Nepal’s Maoist and UML parties, which swept the 2017 elections and united to form the Nepal Communist Party (NCP).Since 2018, Prime Minister K P Oli has signed off on numerous projects that are part of Beijing’s Belt and Road Initiative. The NCP and the Chinese Communist Party forged fraternal ties, with various workshops on ‘Xi Jinping Thought’ held in Kathmandu.After infighting among members of the Maoist coalition, Oli was forced to dissolve Parliament in December, presenting an opportunity for New Delhi to jostle for influence. While India will need to present more robust measures of support to Nepal than vaccines to cement its influence, India has a head start in the case of vaccine diplomacy.Evidently, Beijing has grown increasingly frustrated with the NCP leadership, and has voiced its displeasure by not opening its two border checkpoints, citing the pandemic. <a href="https://www.nepalitimes.com/banner/chinese-tourist-influx-to-nepal-in-2020/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/banner/chinese-tourist-influx-to-nepal-in-2020/&amp;source=gmail&amp;ust=1613969755600000&amp;usg=AFQjCNGmlmUxbFQO-w3a9zFkseqhfdPvxg">China’s Ambassador in Nepal Hou Yanqi</a> failed after repeated attempts to get the NCP leadership to <a href="https://www.nepalitimes.com/latest/is-china-now-micro-managing-nepal-politics/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/latest/is-china-now-micro-managing-nepal-politics/&amp;source=gmail&amp;ust=1613969755600000&amp;usg=AFQjCNFWPcQGwn4P8cJlsujB-h5uxm4tew">patch up their differences</a>, Beijing sent its <a href="https://www.nepalitimes.com/latest/is-china-now-micro-managing-nepal-politics/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/latest/is-china-now-micro-managing-nepal-politics/&amp;source=gmail&amp;ust=1613969755600000&amp;usg=AFQjCNFWPcQGwn4P8cJlsujB-h5uxm4tew">Army Chief Wei Wengfe</a> to Kathmandu in November just after India’s <a href="https://www.nepalitimes.com/latest/indias-multi-pronged-line-to-right-nepal-ties/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/latest/indias-multi-pronged-line-to-right-nepal-ties/&amp;source=gmail&amp;ust=1613969755600000&amp;usg=AFQjCNHLEaB38PgM99Dyx6gKRNEM6v1gSg">Chief of Army Staff M M Navarane</a> himself paid a visit to Nepal.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022111011114/636ccd069c7e80680e08bc53jpeg.jpg" alt="" width="1500" height="1080"><figcaption> </figcaption></figure>Not to be outdone in vaccine geopolitics, Chinese Foreign Minister Wang Yi called Foreign Minister Pradeep Gyawali on 5 February, and <a href="https://www.fmprc.gov.cn/mfa_eng/zxxx_662805/t1852133.shtml" data-saferedirecturl="https://www.google.com/url?q=https://www.fmprc.gov.cn/mfa_eng/zxxx_662805/t1852133.shtml&amp;source=gmail&amp;ust=1613969755600000&amp;usg=AFQjCNGy-kYDmw6qDY0hOU4alm8LtlGWKw">pledged </a>500,000 doses of its Sinopharm vaccine. After a long delay, the Chinese vaccine finally got approval from Nepal’s Department of Drug Administration last week for emergency use.The delay in the approval process for the Sinopharm vaccine, which has not been approved by the WHO yet, appears to have miffed Beijing. The Indian media played up supposed pressure by the Chinese Embassy in Kathmandu to fast-track the approval process.Beyond the Himalaya, vaccine geopolitics is playing out elsewhere in South Asia. Attempts by China to distribute vaccines to Bangladesh were thwarted after the government there refused to contribute to the development costs of the Sinopharm vaccine.After India donated two million doses of Covishield to Bangladesh, Dhaka struck a deal to <a href="https://www.thehindubusinessline.com/news/bangladesh-to-buy-indian-covid-19-vaccines-after-china-asks-to-share-vaccine-trials-cost-report/article33648633.ece" data-saferedirecturl="https://www.google.com/url?q=https://www.thehindubusinessline.com/news/bangladesh-to-buy-indian-covid-19-vaccines-after-china-asks-to-share-vaccine-trials-cost-report/article33648633.ece&amp;source=gmail&amp;ust=1613969755600000&amp;usg=AFQjCNG9b3i3OdybiKzX5Vufug5v02OGGw">purchase 30 million</a> doses of the vaccine for the country, snubbing Beijing. Chinese state media accused <a href="https://www.globaltimes.cn/page/202101/1214041.shtml" data-saferedirecturl="https://www.google.com/url?q=https://www.globaltimes.cn/page/202101/1214041.shtml&amp;source=gmail&amp;ust=1613969755600000&amp;usg=AFQjCNEoix9h2tMalRVwO7rZWBx2DMco2w">Delhi of meddling</a> with its  attempt to distribute vaccines in Bangladesh.China’s closest ally in the region, Pakistan, became the first country to receive donated shipments of China’s Sinopharm vaccine, with Beijing <a href="https://thediplomat.com/2021/02/china-gifts-pakistan-1-2-million-covid-19-vaccine-doses/" data-saferedirecturl="https://www.google.com/url?q=https://thediplomat.com/2021/02/china-gifts-pakistan-1-2-million-covid-19-vaccine-doses/&amp;source=gmail&amp;ust=1613969755600000&amp;usg=AFQjCNGfbpJhrMSFm9ugwe0zMnssbFpZbw">pledging to send over</a> 1.2 million doses to Islamabad.Along with Nepal and Bangladesh, New Delhi also gifted Covishield to Afghanistan, Sri Lanka, Bhutan, Seychelles, Mauritius and Burma as part of its ‘Neighbourhood First’ policy.Nepal also took delivery of <a href="https://www.nepalitimes.com/latest/nepal-braces-for-new-wave-with-vaccine-drive/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/latest/nepal-braces-for-new-wave-with-vaccine-drive/&amp;source=gmail&amp;ust=1613969755600000&amp;usg=AFQjCNFOkIKOTq_lBwSlRkb9icdh4NEBhA">1 million more Covishield vaccines</a> that it ordered from the Serum Institute of India on Sunday, and another 2.2 million doses purchased by Britain under the <a href="https://www.who.int/initiatives/act-accelerator/covax" data-saferedirecturl="https://www.google.com/url?q=https://www.who.int/initiatives/act-accelerator/covax&amp;source=gmail&amp;ust=1613969755600000&amp;usg=AFQjCNFCmy6JvaMqdagVd7fzazTMUZePEA">WHO’s GAVI-COVAX initiative</a> are arriving next week.China has made strategic gains in the region in recent years to India’s detriment. Through its Belt and Road Initiative, China has poured investment into Sri Lanka, Pakistan, Nepal and the Maldives. Funded by Chinese money, massive ports, highways and other infrastructure projects have been built. With its muddled bureaucracy and weaker spending power, Delhi had not been able to keep up with Beijing’s soft power expansion.Now, India is using vaccines as the vanguard of its response. The Serum Institute has <a href="https://www.nytimes.com/2021/02/11/world/asia/vaccine-diplomacy-india-china.html" data-saferedirecturl="https://www.google.com/url?q=https://www.nytimes.com/2021/02/11/world/asia/vaccine-diplomacy-india-china.html&amp;source=gmail&amp;ust=1613969755600000&amp;usg=AFQjCNE0Xe33J3K0BozaLao6fO5i6bcnag">been producing</a> vaccine supplies at a much faster rate than the Indian government’s inoculation program can distribute them, making it easy for Delhi to send them abroad without suffering political backlash at home.This has given India a new edge for its soft power ambitions in the South Asian and Indian Ocean regions. Given that most of the developing world will not be vaccinated <a href="https://www.eiu.com/n/85-poor-countries-will-not-have-access-to-coronavirus-vaccines/" data-saferedirecturl="https://www.google.com/url?q=https://www.eiu.com/n/85-poor-countries-will-not-have-access-to-coronavirus-vaccines/&amp;source=gmail&amp;ust=1613969755600000&amp;usg=AFQjCNFRvEEUYnAtYJl-4suTFC2JfUJFhQ">until 2023</a>, demand for vaccines will only rise. While China’s manufacturing prowess means that it is likely to keep up with demand, regional resistance to its largely un-trialed vaccines will complicate efforts to gain approval by government agencies.What happens in Nepal over the coming months will be a microcosm of regional vaccine geopolitics. The erosion of Chinese influence with its inability to keep the NCP together, gives an opening for New Delhi to reassert itself in Kathmandu.While China may have promised Nepal its continued support to help <a href="https://www.nepalitimes.com/here-now/when-will-nepals-covid-vaccine-turn-come/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/here-now/when-will-nepals-covid-vaccine-turn-come/&amp;source=gmail&amp;ust=1613969755600000&amp;usg=AFQjCNHVHDy7dKQmiyzWk-iPKWg82NOhBw">overcome the pandemic</a>, its assistance may not be needed or welcomed if India already fulfils this role.

South Asia’s vaccine geopolitics

India and Pakistan are twins separated at birth. Tensions between them have been at a hair trigger ever since independence and has erupted into full scale conflict at least four times in the past 80 years.
The 22 April terrorist attack in Kashmir that killed 25 Indian tourists and a Nepali citizen, threatens to escalate tension between the two nuclear-armed nations. India has squarely blamed Pakistan for the attacks, and Prime Minister Narendra Modi has given his military “operational freedom” to respond. Pakistan has said it has credible intelligence of an Indian military strike and its officials have promised a “full spectrum” response — a code for a <a href="https://nepalitimes.com/editorial/thinking-the-thinkable">nuclear retaliation</a>.
For Nepal, the killing of its national in the Pahalgam attack comes as another stark reminder that in conflicts from Afghanistan to Iraq, from <a href="https://nepalitimes.com/opinion/how-to-agree-an-armistice-in-ukraine">Ukraine</a> to Israel, <a href="https://nepalitimes.com/news/10-nepalis-from-one-town-fighting-in-ukraine">Nepalis are getting caught in the crossfire</a>. The last time full-scale fighting broke out between <a href="https://nepalitimes.com/opinion/peacemongers-at-india-pakistan-border">India and Pakistan</a> on Kargil in 1999, at least 22<a href="https://nepalitimes.com/here-now/india-s-trial-by-fire-for-soldiers-from-nepal?%27%5C%22="> Nepalis fighting for the Indian Army</a> were killed in action.
Three of Nepal’s immediate neighbours (China, India, Pakistan) have nuclear weapons, and they do not have good relations. With China supplying weapons, <a href="https://nepalitimes.com/editorial/war-and-warming">missile technology</a> and other support to Pakistan, this triangular friction could set off a regional conflagration.&nbsp;
<a href="https://www.nature.com/articles/s43016-022-00573-0" target="_blank">Research at Rutgers University</a> has calculated that even a week-long tactical nuclear exchange between India and Pakistan would throw up so much smoke and debris into the atmosphere that it would block out the sun for years, and lead to a collapse of the <a href="https://nepalitimes.com/news/grow-nourish-sustain-together-world-food-day">global food system</a>. This does not take into account the radioactive fallout that prevailing winds would blow up to <a href="https://nepalitimes.com/here-now/lives-on-the-line-in-the-himalaya">the Himalaya</a>, contaminating glaciers that are the sources of <a href="https://nepalitimes.com/here-now/saving-what-is-left-of-himalayan-rivers">Asia’s main rivers</a>.
The impact of <a href="https://nepalitimes.com/news/climate-breakdown-linked-to-thame-flood">climate breakdown </a>on High Asia was already ringing alarm bells about its <a href="https://nepalitimes.com/news/himalayan-icecap-melting-faster-than-thought">shrinking ice cap</a> reducing the dry season flow of water downstream. Water was going to be the next strategic commodity, geopolitical experts warned, and the next wars in Asia would be over water.
That water war is already happening. India retaliated to the Kashmir attack by suspending the <a href="https://www.nytimes.com/2025/04/24/world/asia/india-pakistan-indus-waters-treaty.html" target="_blank">Indus Waters Treaty</a> of 1960 mediated by the World Bank that has withstood at least three wars between India and Pakistan. The treaty gives India control over the three eastern tributaries of the Indus (<a href="https://en.wikipedia.org/wiki/Beas_River" target="_blank">Beas</a>, <a href="https://en.wikipedia.org/wiki/Ravi_River" target="_blank">Ravi</a> and <a href="https://en.wikipedia.org/wiki/Sutlej" target="_blank">Sutlej</a>), while Pakistan got water from the Indus and two of its western tributaries (<a href="https://en.wikipedia.org/wiki/Indus_River" target="_blank">Indus</a>, <a href="https://en.wikipedia.org/wiki/Chenab_River" target="_blank">Chenab</a> and <a href="https://en.wikipedia.org/wiki/Jhelum_River" target="_blank">Jhelum</a>.
Pakistan was assured of 70% of the annual flow, and India could use a reasonable amount of water for<a href="https://archive.nepalitimes.com/news.php?id=15231"> irrigation and hydropower</a>. &nbsp;Within days of its threat, India stopped water flowing down to Pakistan from the Chenab river and is reportedly preparing to do the same on the Jhelum.
The sabre-rattling has reached a crescendo. Besides threats and counter-threats there are also symbolic drills, with the Indian Air Force practicing landing on an expressway in Uttar Pradesh by its Rafale, Su-30 and Jaguar fighter jets to demonstrate ‘operational readiness’. In response Pakistan test-fired its Abdali ballistic missile that can carry a nuclear warhead and has a range of 450km.&nbsp;
The danger is that with ultra-nationalist rhetoric and the beating the war drums by both sides, India’s government and Pakistan’s military may have to ‘do something’ to appease domestic public opinion. But any tactical strike, an artillery exchange, or territorial incursion could quickly escalate out of control.
Expecting an Indian retaliation for the Pahalgam killings, Pakistan is using<a href="https://nepalitimes.com/opinion/interfaith-collaboration-for-nuclear-disarmament"> nuclear deterrence </a>and warning of “catastrophic consequences”. The two neighbours came close to a nuclear exchange in 2019 after an attack on the Indian military in Kashmir, and prompt international intervention led by the United States cooled tensions.&nbsp;
This time, the <a href="https://nepalitimes.com/news/trump-shock-wave-hits-nepal">Trump administration</a> is too distracted and not as engaged. Pakistan has denied it was responsible for the terrorist attack and called on Washington to stop a possible Indian retaliation. India and Pakistan have stopped overflights by each other’s airlines, and some international carriers have even stopped flying over Pakistan fearing an air war.
Washington, Beijing, the UN and the EU have all urged restraint. Iran, which has good relations with both India and Pakistan has sent its foreign minister to urge both countries not to go into a tit-for-tat war. Iran has its own nuclear flashpoint to worry about with tensions in Israel, &nbsp;Yemen and Syria.
India and Pakistan both share similar problems of joblessness, <a href="https://nepalitimes.com/here-now/why-nepal-s-poverty-rate-is-stuck">poverty </a>and <a href="https://nepalitimes.com/here-now/climate-change-new-threat-to-nepal-s-rhinos">environmental threats</a>. Neither side needs the threat of a senseless war, and we in the neighbourhood do not need it either.&nbsp;
Kunda Dixit
This Editorial 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.

Nukes in the neighbourhood

The streets of Patan are alive this month with lavender jacaranda trees under rain-washed skies as <a href="https://nepalitimes.com/banner/the-red-god-rises-again-in-patan">the chariot of Rato Matsyendranath</a> is pulled across town. This is the festival of the rain god, and inevitably the heavens opened up and pre-monsoon showers pelted the chariot as it started being pulled in Pulchok last week. Thousands of devotees, onlookers and the chariot procession organisers thronged the streets on the first day last week. The rhythmic cymbals and drums exuded a vibrant energy as the enormous four wheels turned and the chariot lurched.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025051007050_81df97744db16f732a419dc1f1579d235ce3df37642b078f50b83bd4bd026688.jpg" data-media-id="editor_1" data-image-id="2025051007050_81df97744db16f732a419dc1f1579d235ce3df37642b078f50b83bd4bd026688" data-rendition-name="original" width="1000" height="1503" loading="lazy" alt="Divine chariot"> </figure>  The<a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/Red-rain-god,3141"> red rain god</a> has Hindu and Buddhist antecedents, alternatively called Bungadya and<a href="https://nepalitimes.com/here-now/kathmandu-s-gravity-defying-chariot-festival"> Karunamaya</a> — reflecting Kathmandu Valley’s syncretic mixture of the two religions.&nbsp; “Bungadya is a profoundly <a href="https://nepalitimes.com/opinion/12-full-opinion/marketing-the-intangible">intangible form of heritage</a>,” explains heritage expert Monalisa Maharjan. “It embodies traditional knowledge,<a href="https://nepalitimes.com/multimedia/reviving-nepal-s-craft"> artisanal skills passed down through generations</a>. Local communities and specific families have specified roles in being custodians of the heritage, ensuring their survival over the centuries.” There are many legends and stories about this annual tradition. Lichhavi king Narendra Dev is supposed to have brought Rato Matsyendranath from Assam to Kathmandu Valley to convince Guru Gorakhnath to lift a spell that created a two-year drought in Kathmandu.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250510050520_347a9a398f8a9abc4a7fb4e2774fde8264cccbdce8bdab23851ab3f0e73c3e8a.jpg" data-media-id="editor_6" data-image-id="20250510050520_347a9a398f8a9abc4a7fb4e2774fde8264cccbdce8bdab23851ab3f0e73c3e8a" data-rendition-name="original" width="1503" height="1000" loading="lazy" alt="Divine chariot"> </figure>  Matsyendranath was Gorakhnath’s mentor, and upon seeing him, the serpents were released, unleashing the rains. The chariot festival honours the return of this life-giving rain. The deity is seen as an icon for thriving agriculture, t<a href="https://nepalitimes.com/here-now/before-the-next-monsoon">he arrival of monsoon</a> showers, and the welfare of the community. Read also: <a href="https://nepalitimes.com/opinion/the-reign-of-the-god-of-rain">The reign of the god of rain</a>, Vidhu Prakash Kayastha Till this day, the Rato Matsyendranath festival is no ordinary celebration. Patan does not sleep for a month as the chariot is pulled through various neighbourhoods. It unfolds at a state level with the president (formerly the king) attending the climax of the Bhoto Jatra in Jawalakhel later this month.&nbsp; The intergenerational transmission of tradition is unique in the world, and the reason the festival is one of the most vibrant cultural expressions that thrives despite inroads of modernity. The other unique aspect is that it is a transnational festival, binding Patan with Guwahati in the Indian state of Assam.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025051005058_8bc685ada13045d863b28e3eed91c931da2b510714586af6fd7eb5d1e298a24a.jpg" data-media-id="editor_9" data-image-id="2025051005058_8bc685ada13045d863b28e3eed91c931da2b510714586af6fd7eb5d1e298a24a" data-rendition-name="original" width="1000" height="1503" loading="lazy" alt="Divine chariot"> </figure>  “Unlike Nepal, where the deity commands grandeur and devotion, many in Assam are unaware of Rato Matsyendranath,” says Khagen Sharma of Gauhati University, which convened <a href="https://nepalitimes.com/news/nepal-assam-connection-revived">a symposium in February in Guwahati on the rain god</a>. Attending was a delegation led by Lalitpur Mayor Chiribabu Maharjan, organisers of the festival, and builders of the chariot. After the symposium, a committee was formed to explore and revive the tradition in Assam as well. Although the team had planned to visit Nepal this month, logistical challenges delayed the trip. Still, there are plans to build a Guru Matsyendranath statue in Assam to reestablish regular worship practices in the Guwahati shrine.&nbsp; The vines used to build the chariot in Patan are sourced from the jungles of Assam. But Sharma notes that in recent years unclear regulations have blocked the official import of the vines, although they are still brought to Nepal informally. The <a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/makers-of-machhindranath,2204">chariot making</a> has also had a taste of modernisation in recent times. In the past, even a single nail or piece of steel was avoided. But over time, the wooden structure, particularly the shaft between the wheels, has been replaced with bronze. When that too proved unstable, metal clamps were introduced, which have become a pragmatic compromise.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250510050524_b2a819a5791612f14c81d30fc393dbd3f99f0c64b90a9110e8b0855d944bfa93.jpg" data-media-id="editor_12" data-image-id="20250510050524_b2a819a5791612f14c81d30fc393dbd3f99f0c64b90a9110e8b0855d944bfa93" data-rendition-name="original" width="1500" height="998" loading="lazy" alt="Divine chariot"> </figure>  Another welcome change is the focus on safety. Builders climbing the chariot’s tower now wear harnesses and there are efforts in crowd control. The most visible change in recent years has been the involvement of Patan’s enthusiastic youth in the festival — the tradition is now passing to a new generation. Says Matsyendranath expert Vidhu Kayastha: “There is more energy, the young people in red t-shirts this year were very organised, these modern touches aren’t diluting our culture, they’re keeping it alive in new forms.” He adds, “We are <a href="https://nepalitimes.com/here-now/searching-for-a-homeland-away-from-home">reconnecting with our roots</a>, we have more resources, more awareness than ever before. We must not be swept away by western values that may not serve us, and in some ways, cause more harm than good. We must revive our own culture.”&nbsp;

Divine chariot

In 2025, two seemingly disconnected acts of violence shattered the illusion of stability in the region. In March, <a href="https://www.ft.com/content/16f7f947-1e96-4206-9844-891378adc683" target="_blank">militants hijacked a passenger train</a> near the Bolan Pass in Balochistan, executing soldiers in cold blood. A month later, <a href="https://www.nytimes.com/2025/04/22/world/asia/kashmir-terrorist-attack.html" target="_blank">gunmen in Kashmir’s</a> Pahalgam Valley massacred tourists. 
In both Islamabad and New Delhi, <a href="https://www.aljazeera.com/news/2025/4/25/were-cursed-kashmiris-under-attack-across-india-after-pahalgam-killings" target="_blank">the reaction was reflexive:</a> condemn the violence, <a href="https://www.economist.com/asia/2025/04/22/india-and-pakistan-could-come-to-blows-over-kashmir" target="_blank">blame external enemies</a>, declare the situation contained. But South Asia’s leaders are not fighting terrorists alone. They are fighting the consequences of their own betrayals.
Across <a href="https://www.bbc.com/news/world-asia-26272897" target="_blank">Balochistan</a>, <a href="https://www.bbc.com/news/world-south-asia-11693674" target="_blank">Kashmir</a>, <a href="https://www.crisisgroup.org/asia/south-asia/india/346-finding-way-out-festering-conflict-indias-manipur" target="_blank">Manipur</a>, and beyond, decades of <a href="https://www.amnesty.org/en/projects/enforced-disappearance-in-south-asia/" target="_blank">enforced disappearances</a>, broken promises, and brute militarisation have hollowed out the social contracts meant to hold these nations together. The grievances that drove rebellions from the 1940s through the 1990s – demands for dignity, recognition, and political agency – were never meaningfully addressed. They were buried beneath asphalt and propaganda, paved over by development projects and security checkpoints.
States may claim victory. But their victories are mirages, dissolving the moment anyone looks too closely. South Asia’s unfinished wars are not relics of a violent past. They are live ammunition, loaded into the future.
<a href="https://www.theguardian.com/world/2025/mar/24/he-only-wanted-revenge-the-bloody-insurgency-in-balochistan-gaining-lethal-momentum" target="_blank">Balochistan</a> has been at war with Pakistan for most of its modern history. Rich in gas, minerals, and coastline, the province has been plundered for decades under the language of national development. 
Projects like the <a href="https://eastasiaforum.org/2020/11/26/pakistans-three-evils-cpec-and-good-governance/" target="_blank">China-Pakistan Economic Corridor (CPEC)</a> promise progress but deliver exclusion: minerals are mined, ports are secured, but Baloch homes are raided. 
The insurgency endures not because of foreign conspiracies, as Islamabad endlessly insists, but because the Pakistani state remains incapable of seeing its <a href="https://thebalochistanpost.net/2025/01/enforced-disappearances-in-balochistan-in-december-2024-tbp-report/" target="_blank">Baloch citizens</a> as anything other than a security problem to be managed.
In <a href="https://www.forbes.com/sites/ranisingh/2016/07/12/kashmir-in-the-worlds-most-militarized-zone-violence-after-years-of-comparative-calm/" target="_blank">Kashmir</a>, the Indian government claims to have <a href="https://www.nytimes.com/2023/03/08/world/asia/kashmir-village-defense-committees.html" target="_blank">“normalised” the valley</a> after revoking its autonomy in 2019. It <a href="https://www.cfr.org/global-conflict-tracker/conflict/conflict-between-india-and-pakistan" target="_blank">looks a lot like occupation</a>. Soldiers outnumber local leaders, dissent is criminalised, internet shutdowns suffocate public life. Tourism campaigns and investment summits cannot erase a generation raised under curfew and surveillance.
<a href="https://www.bbc.com/news/world-asia-india-66260730" target="_blank">Manipur’s descent into ethnic bloodshed</a> in 2023 exposed another fault line Delhi prefers to ignore. Long-simmering tensions between the Meitei and Kuki communities erupted into violence that shattered any illusions of northeastern integration. The central government’s delayed, politicised response made clear what many Manipuris had always suspected: they are citizens of India only when convenient.
Even the <a href="https://msf.org.au/rohingya-worlds-largest-stateless-population" target="_blank">Rohingya, stateless and exiled from Myanmar</a>, find themselves entangled in South Asia’s ethnonationalist calculus. Fleeing genocide, they are criminalised anew in Bangladesh and India – trapped between the countries that reject them and the memories that refuse to let them go.
South Asia’s states have excelled at suppressing rebellion. But failed at extinguishing the reasons rebellions rise in the first place. And the wars South Asia tries to forget at home have found new life abroad.
Across <a href="https://www.abc.net.au/news/2024-06-17/modis-indian-government-accused-of-spying-silencing-critics/103974414" target="_blank">Canada, Australia, Britain, and the United States</a>, diasporic communities have become memory-keepers and, increasingly, <a href="https://www.business-standard.com/world-news/khalistan-supporters-hold-protest-outside-indian-consulate-in-vancouver-123092600087_1.html" target="_blank">the agitators</a> for the struggles their home states would rather erase.
Khalistan flags fly outside Indian consulates in Vancouver and <a href="https://www.tribuneindia.com/news/punjab/perturbed-over-waving-of-khalistani-flags-at-an-event-in-melbourne-india-warns-australia-of-khalistan-separatists-and-their-links-with-terror-groups-458320/" target="_blank">Melbourne</a>. Tamil activists march through London, demanding accountability for the <a href="https://www.aljazeera.com/news/2024/5/19/grim-reminder-sri-lankas-tamils-mark-15-years-since-end-of-civil-war" target="_blank">massacres in Mullivaikkal</a>. Kashmiri protests in Washington and New York refuse to let India’s crackdown slip into diplomatic amnesia.
For host countries, these movements pose uncomfortable questions. Freedom of expression collides with fears of extremism. Clashes erupt between communities carrying wounds that their new homelands.
Meanwhile, South Asian states pursue their adversaries across borders. India faces allegations of <a href="https://www.nbcnews.com/news/world/canada-says-india-home-minister-ordered-campaign-against-sikh-activist-rcna177972" target="_blank">targeting Sikh activists for assassination in Canada</a> and the <a href="https://www.npr.org/2024/10/27/g-s1-29561/sikh-separatist-assassination-india" target="_blank">United States</a>. Pakistan continues to court Kashmiri separatists abroad while crushing Baloch dissent at home. <a href="https://apnews.com/article/sri-lanka-tamils-civil-war-dead-5b372b0bba567837c5a4d94250040e7d" target="_blank">Sri Lanka</a> lobbies furiously to brand Tamil diaspora organisations as fronts for terrorism, even as it stonewalls investigations into its own wartime atrocities.
The old insurgencies have not been defeated. They have been globalised. South Asia’s governments have long mistaken silence for stability.
In Punjab, India broke the back of the <a href="https://www.cnn.com/2023/10/06/india/india-canada-sikh-khalistan-analysis-intl-hnk/index.html" target="_blank">Khalistan insurgency</a> through brute force. The fields grew green again, the trains ran on time. But the wounds were never closed, the <a href="https://www.dw.com/en/why-is-indias-khalistan-separatist-movement-on-the-rise/a-65081729" target="_blank">movement’s heart beats</a> not in Amritsar but in Brampton and Surrey.
In Sri Lanka, the <a href="https://www.academia.edu/4738983/The_Man_Who_Destroyed_Eelam" target="_blank">military crushed the Tamil Tigers</a> with <a href="https://www.newyorker.com/magazine/2011/01/17/death-of-the-tiger" target="_blank">overwhelming brutality in 2009</a>. <a href="https://www.scmp.com/week-asia/politics/article/3264148/we-want-our-children-back-sri-lankan-families-still-demanding-justice-their-missing-loved-ones" target="_blank">Tamil families still search for their missing</a>, still mourn their dead – and still organise across the diaspora for justice that remains undelivered.
In Kashmir, Delhi boasts of new <a href="https://www.aljazeera.com/opinions/2023/2/4/kashmir-is-bleeding-its-economy" target="_blank">highways and investment corridors</a>, showcasing the region as a trophy of unity. But when the visitors leave and the cameras are packed away, <a href="https://harvardlawreview.org/print/vol-134/from-domicile-to-dominion-indias-settler-colonial-agenda-in-kashmir/" target="_blank">the checkpoints, the raids, and the quiet despair remain.</a>
Victory parades fade. Grievance endures. Suppressing insurgency may end battles. It does not end the ideas that fueled them. In a region where <a href="https://www.nytimes.com/2025/04/23/world/asia/kashmir-attack-india-pakistan.html" target="_blank">history is rarely past</a>, and memory is rarely voluntary, states that rule through repression are only ever buying time. And often, not very much.
South Asia’s unfinished wars are not accidents. They are the inevitable consequences of states that confuse conquest with consent, and erasure with reconciliation. They cannot legislate memory out of existence.
Every <a href="https://www.bbc.com/news/articles/c15qyyzz89lo" target="_blank">disappeared son in Balochistan</a>, every <a href="https://medium.com/the-wvoice/the-half-widows-in-kashmir-fef80c6b88e9" target="_blank">half-widow in Kashmir</a>, every <a href="https://www.doctorswithoutborders.org/what-we-do/focus/rohingya-refugee-crisis" target="_blank">refugee child born stateless in a Rohingya camp</a> carries forward the memory of betrayal – a memory that outlives soldiers, politicians, and peace accords alike.
The region’s future will not be decided by GDP figures or infrastructure projects alone. It will be decided by whether its governments can summon the political courage to face the truths they have long suppressed – or whether they will continue down a path <a href="https://theconversation.com/india-is-using-the-g20-summit-to-further-its-settler-colonial-ambitions-in-kashmir-205166" target="_blank">where forgetting is demanded</a>, and rebellion becomes inevitable.
Shyam Tekwani is a professor at the Daniel K. Inouye Asia-Pacific Center for Security Studies in Hawaii. This <a href="https://dkiapcss.edu/nexus_articles/ghosts-at-the-border-south-asias-unfinished-wars/" target="_blank">article</a> was originally published on <a href="https://dkiapcss.edu/security-nexus/" target="_blank">DKI APCSS Security Nexus.</a> The views expressed in this article are those of the author and do not reflect the official policy or position of DKI APCSS, the Department of Defense, or the US Government. The appearance of external hyperlinks does not constitute endorsement by the United States Department of Defense (DoD) of the linked websites, or the information, products, or services contained therein. DoD does not exercise any editorial, security, or other control over the information you may find at these sites.

Balochistan to Kashmir

Most Nepalis thought they had seen the last of it after <a href="https://nepalitimes.com/news/11-56-25-april-2015-wkc9q2an">the 25 April 7.8 magnitude </a>earthquake ten years ago. But the Himalaya had more surprises in store. On 12 May, another 7.3 magnitude tremor that some said was an aftershock, but was strong enough to itself be a major earthquake, struck Dolakha.&nbsp; Not many people had heard of Singati till then — a cluster of houses by the Tama Kosi River along a narrow gorge that is the roadhead to Rolwaling Valley.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250508110520_57b6e316656851f71eca56ca6f98d9bbcc820c1a00d62af3c990725b4361244d.jpg" data-media-id="editor_1" data-image-id="20250508110520_57b6e316656851f71eca56ca6f98d9bbcc820c1a00d62af3c990725b4361244d" data-rendition-name="original" width="1000" height="1500" loading="lazy" alt="Climate magnifies earthquake risk in Nepal village NT"> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250508110520_016534fb2b6a79957402281cda768efb83a146786377e39e11df3e251d37159e.jpg" data-media-id="editor_2" data-image-id="20250508110520_016534fb2b6a79957402281cda768efb83a146786377e39e11df3e251d37159e" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="Climate magnifies earthquake risk in Nepal village NT"> </figure>  It was here that dozens were killed on 25 April in the first earthquake. Hundreds of <a href="https://archive.nepalitimes.com/article/nation/Singati-rising-from-rubble-rebuilding,3703">Singati survivors</a> had lined up for food and relief supplies in the morning of 12 May when the second earthquake triggered a rock slide that buried a nearby camp. At least 50 people were killed. &nbsp; Three hours later, a US Marine Corps UH-1Y Venom helicopter landed in a nearby cornfield to pick up the wounded, and flew off. The aircraft lost contact with air traffic control in Kathmandu and its wreckage was located high on Kalinchok four days later. Six American servicemen, two Nepal Army soldiers, and five wounded civilians from Singati were killed. Today, Singati bears little physical scar of the multiple tragedies that struck the town ten years ago. Most <a href="https://nepalitimes.com/multimedia/bungamati-builds-back">houses have been rebuilt</a> as urban-style concrete structures, and Singati has become an economic hub on the road leading up to several hydropower plants and a<a href="https://nepalitimes.com/banner/off-the-beaten-trek-in-nepal"> popular trekking destination</a>.&nbsp; The town looks less like a village and more like a suburb of the Dolakha district headquarter of Charikot, 47km away.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250508110520_196f341d1df1403ba133e5dfeb837eec20d7cbcb4c8c56b17cc5598810de5df2.jpg" data-media-id="editor_6" data-image-id="20250508110520_196f341d1df1403ba133e5dfeb837eec20d7cbcb4c8c56b17cc5598810de5df2" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="Climate magnifies earthquake risk in Nepal village NT"> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250508110524_ae66c4a92430f67db51b5e11e017059eedfbac4cb18c8e073f2a50cca1fe904e.jpg" data-media-id="editor_7" data-image-id="20250508110524_ae66c4a92430f67db51b5e11e017059eedfbac4cb18c8e073f2a50cca1fe904e" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="Climate magnifies earthquake risk in Nepal village NT"> </figure>  “The demand for construction material, cement, iron rods and bricks peaked after the earthquakes,” says Suresh Khadka, who owns a hardware business here and now supplies material to the 456MW Upper Tama Kosi hydropower project that is undergoing repairs after it was damaged by a landslide last year. The demand for cement boomed since most residents believe, not necessarily correctly, that <a href="https://nepalitimes.com/banner/in-a-disastrous-state">cement houses are safer</a>. Although Khadka did well selling construction material after the earthquake, he worries that most new structures do not follow seismic-resistant building codes.&nbsp; The construction boom financed by bank loans has in turn forced many from Singati to <a href="https://nepalitimes.com/banner/making-overseas-migration-better">migrate overseas for work</a> so they can service their debt.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250508110524_50caa4530bd5ff9120cf7ab70a62173846d337ef448ff8bac339f3faa375a9e2.jpg" data-media-id="editor_10" data-image-id="20250508110524_50caa4530bd5ff9120cf7ab70a62173846d337ef448ff8bac339f3faa375a9e2" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="Climate magnifies earthquake risk in Nepal village NT"> <figcaption>Suresh Khadka</figcaption> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250508110520_ef8b7d3993fc3b5df852bbf952feb3fbabc96d6883b0d5eb74ee5c60f4123b83.jpg" data-media-id="editor_11" data-image-id="20250508110520_ef8b7d3993fc3b5df852bbf952feb3fbabc96d6883b0d5eb74ee5c60f4123b83" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="Climate magnifies earthquake risk in Nepal village NT"> <figcaption>Phu Doma Sherpa (right)</figcaption> </figure>  “My family had no choice but to borrow money to rebuild our home since the government compensation was not enough, and ten years later we are still paying off the loan,” says Phu Doma Sherpa, 60. Because of the shortage of qualified masons and proper seismic engineering, <a href="https://nepalitimes.com/here-now/structural-problems">many of the buildings are of questionable building standards </a>and the traditional architecture has been abandoned, admits Kul Bahadur Budathoki, deputy chair of the municipality. “But these buildings were more expensive than what the government grants could cover, many people here are heavily in debt and the men have <a href="https://nepalitimes.com/here-now/every-day-is-closer-to-pay-day">migrated to the Gulf to pay their loans</a>,” Budathoki says.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250508110520_32f89e97b7e757fc9286c0bbb671f48ea8d4468e9634fa646d7247c650ad8480.jpg" data-media-id="editor_14" data-image-id="20250508110520_32f89e97b7e757fc9286c0bbb671f48ea8d4468e9634fa646d7247c650ad8480" data-rendition-name="original" width="1501" height="1079" loading="lazy" alt="Climate magnifies earthquake risk in Nepal village NT"> <figcaption>Kul Bahadur Budathoki</figcaption> </figure>  Singati is in a multi-hazard zone. The <a href="https://archive.nepalitimes.com/article/nation/Singati,3091">12 May 2015 earthquake </a>could have led to the collapse of Nepal’s largest glacial lake, <a href="https://nepalitimes.com/here-now/stairway-to-heaven">Tso Rolpa</a>, upstream. Due to global warming, the glacier has turned into an expanding lake 3.5km long, and its collapse would have unleashed a catastrophic Himalayan tsunami down the Tama Kosi Valley, with Singati directly in its path. Singati has literally risen from the ashes of 2015, with its residents beginning to recover from the trauma and financial toll. But it is not out of danger as <a href="https://nepalitimes.com/news/climate-breakdown-linked-to-thame-flood">climate breakdown </a>magnifies the risk from future earthquakes.

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