<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.”

Sonia Awale

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It’s an Emergency

Although smallpox is now ‘unfamiliar to the world today’ historian Elizabeth Fenn has written that it was ‘a misery commonplace in years gone by.’For centuries, the smallpox virus and the gruesome death and destruction it caused upended people's lives around the world and in Nepal. In this History of Disease series in Nepali Times in the past month I have recounted how smallpox traveled and killed in Europe and America, became a terrible test for survival for children in South Asia, and  struck down both royals and regular citizens in Nepal in the 19th century.We have seen how people devised inoculation and vaccination to fight the disease, and how vaccines and strong surveillance helped eradicate the disease around the world and in Nepal in the 1970s, but only 'by the slimmest of margins'.Several things about the history of the disease deserve special emphasis. As much as any influential king or prime minister, we sometimes forget that smallpox and other diseases shaped the course of human events.Part I: <a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/banner/big-story-of-small-pox-in-nepal/" target="_blank" rel="noopener noreferrer">Big story of smallpox in Nepal</a>Part II: <a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/opinion/the-smallpox-virus-in-british-india/" target="_blank" rel="noopener noreferrer">The smallpox virus in British India</a>Part III: <a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/opinion/smallpox-politics-and-power-in-kathmandu/" target="_blank" rel="noopener noreferrer">Smallpox, politics and power in Kathmandu</a>Part IV: <a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/opinion/how-nepal-eradicated-the-smallpox-virus/" target="_blank" rel="noopener noreferrer">How Nepal eradicated the smallpox virus</a><figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022112916110/63861ea39c7e80680e0ccdd9jpeg.jpg" alt="" width="1500" height="1001"/><figcaption>Photo: MANISH PAUDEL</figcaption></figure>Viruses such as measles, influenza, hepatitis, polio, rabies, and HIV – as well as non-viral diseases such as cholera, TB, syphilis, and malaria – remade not just individual lives, but also physical, economic, and political landscapes.The fury of smallpox reminds us of the inescapable power of nature. Despite all our efforts, humans are part of nature, and life is fragile.We are living beings made up of cells and nutrients, subject to the rules of geography and biology, death and disease. This reality held true in the past, and holds true today, as much as we hope otherwise. Smallpox may have been chased away, but COVID-19 stands at the doorstep.Each disease has its own characteristics, its own biological personality, its own way of spreading through society and attacking human bodies. <a href="https://www.nepalitimes.com/here-now/the-mosquito-that-changed-nepals-history/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/here-now/the-mosquito-that-changed-nepals-history/&amp;source=gmail&amp;ust=1590041413347000&amp;usg=AFQjCNEvpoGS7wd8yELy9-vJ0LG1oby5kw">Malaria moved via mosquitoes</a> which liked warm weather, <a href="https://www.nepalitimes.com/latest/kathmandu-in-the-time-of-cholera/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/latest/kathmandu-in-the-time-of-cholera/&amp;source=gmail&amp;ust=1590041413347000&amp;usg=AFQjCNGDo4ZWCamW139FFTuqWLpgRZuSoQ">cholera through germs in water</a>, and syphilis through sex. Due to these differences, each disease left its own unique imprint on history.<a href="https://www.nepalitimes.com/banner/big-story-of-small-pox-in-nepal/" target="_blank" rel="noopener noreferrer" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/banner/big-story-of-small-pox-in-nepal/&amp;source=gmail&amp;ust=1590041413347000&amp;usg=AFQjCNF3MVYYqp8ZY4QHWix_z0-R_ABxUA">Big story of small pox in Nepal</a>, Tom RobertsonSmallpox spread through the air, moved easily from person to person, caused searing pain, and, if it did not kill, left behind disfigured, broken human bodies. In Nepal, if it had struck older people, not children, or if it had not left its victim's faces scarred and their eyes damaged, it might have brought less terror.On the other hand, if it had had a reservoir in animals (as many viruses do) it would have been much harder to eliminate, and we might still be facing its burning fevers and excruciating rashes today. Small pox’s particular biology shaped history in a particular way.Nature is not just a passive stage on which we humans act out our dramas as we wish. Instead, it is an actor in every drama, sometimes in the background, sometimes centerstage, but often coming and going at its own will, not ours.<a href="https://www.nepalitimes.com/opinion/the-smallpox-virus-in-british-india/">The smallpox virus in Nepal</a>, Tom RobertsonLooking back, if we recount the stories just of kings and queens and their political chess matches, we overlook some of history's main drivers and its most important stories. In fact, if we overlook disease history we will not understand the stories of kings and queens as well as we think. Can we really tell the history of Rana Bahadur, Girvana, Bimsen Thapa, and Bir Shumshere -- much less the stories of ordinary people around the country -- without understanding the central role of disease?Looking forward, we would do well not to forget nature's power to completely take over the course of events. Smallpox also reminds us that, even though humans share the same biology, diseases often affect some subsets of society more than others, particularly those with less money and power. In other words, biological forces may be universal but they play out in social landscapes as complex and uneven as Nepal's dadakada.In the Americas, smallpox even more than guns, gave Europeans a huge advantage over the indigenous people who had never encountered the disease before, and thus lacked immunity. <a href="https://www.nepalitimes.com/opinion/the-smallpox-virus-in-british-india/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/opinion/the-smallpox-virus-in-british-india/&amp;source=gmail&amp;ust=1590041413347000&amp;usg=AFQjCNHRE-p56xptgt9wTBUUjoc05RxNwA">In colonial India, smallpox and ideas about how to treat it divided the British from Indians</a> more than it brought them together.<a href="https://www.nepalitimes.com/banner/big-story-of-small-pox-in-nepal/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/banner/big-story-of-small-pox-in-nepal/&amp;source=gmail&amp;ust=1590041413347000&amp;usg=AFQjCNF3MVYYqp8ZY4QHWix_z0-R_ABxUA">In Nepal, smallpox preyed upon both rich and poor</a>, powerful and powerless alike. But as the 19th century Newar song 'Sitalamaaju Mye' reminds us, it divided Gorkha conquerors and Newar families. <a href="https://www.nepalitimes.com/opinion/smallpox-politics-and-power-in-kathmandu/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/opinion/smallpox-politics-and-power-in-kathmandu/&amp;source=gmail&amp;ust=1590041413347000&amp;usg=AFQjCNFFHANLUtlK0myrUwhb4qdFGZg4Pg">Smallpox shaped power struggles between Bhimsen Thapa and his political rivals</a>, and later, in the effort at eradication, altered relations between government health workers and individuals from impoverished ethnic minorities.<a href="https://www.nepalitimes.com/opinion/smallpox-politics-and-power-in-kathmandu/">Smallpox, politics and power in Kathmandu</a>, Tom Robertson No doubt, smallpox also shaped gender relations in ways we need more historical research on. Just as differences between diseases mattered in the course of history, so, too, did social differences.<a href="https://www.nepalitimes.com/opinion/how-nepal-eradicated-the-smallpox-virus/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/opinion/how-nepal-eradicated-the-smallpox-virus/&amp;source=gmail&amp;ust=1590041413347000&amp;usg=AFQjCNGC0hhwCb-vpWbsy8-oT_gcbRcM6Q">Nepal's successful effort to eradicate smallpox in the 1960s and 1970s</a> seems particularly relevant to us today. Nepal's last case in 1975 shows what it took to banish a complex disease in challenging circumstances: sustained governmental focus and coordination, adequate long-term funding, scientific knowledge, talented and dedicated staff, careful record keeping, program flexibility and adaptation to local culture and conditions, and dogged surveillance.Yet even at this moment of seeming human control, nature's power was on display. Smallpox eradication happened only with help from nature. Compared to malaria and polio, smallpox was relatively easy to control. It was so intense that it was easy to spot, and that intensity also made it difficult for contagious victims to move around infecting others. Smallpox did not strike a person twice. And unlike other viruses, it proved very susceptible to a vaccine. This history suggests some of the special challenges that COVID-19 poses.Here, too, social difference mattered. Nepal's eradication campaign shows the enormous challenge of protecting individual rights in moments of public health crisis. In Nepal and other South Asian countries, government personnel sometimes used violence to force citizens to get vaccinated. Some health workers grew so convinced of their righteousness -- the 'purity of purpose' in one man's self-description -- that they felt comfortable steamrolling the wishes of others, often people from socially marginalised groups with little say in society to begin with.<a style="background-color: #ffffff; font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/opinion/how-nepal-eradicated-the-smallpox-virus/" target="_blank" rel="noopener noreferrer">How Nepal eradicated the smallpox virus</a>, Tom RobertsonSuch coercion probably could have been avoided through more nimble policies, more extensive training, and better public education. Problems often sprouted, the historian David Arnold noted, when doctors and other health workers didn't understand how ordinary people saw the world and quickly dismissed their concerns as backward or superstitious -- when, as he put it, the medical system had grown ‘culturally and politically distant from the lives of its subjects’.In the end, the history of smallpox shows the fragility of life, but also the power of human perseverance. Smallpox struck down one of every three it infected. It stole beautiful children from their mothers and fathers. It stole sight from survivors. In some places, it wiped out entire families and laid waste to whole villages. It was deadly, ruthless, and horrific. It sometimes brought out the worst in human nature.But it also often spurred great ingenuity, compassion, togetherness, and resilience. In the face of disease, humans have found surprising ways to support each other, learn from the past, endure the suffering of the present, and find hope again in the future.This is the fifth article in the <a href="https://www.nepalitimes.com/opinion/big-story-of-small-pox-in-nepal/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/opinion/big-story-of-small-pox-in-nepal/&amp;source=gmail&amp;ust=1590041413347000&amp;usg=AFQjCNHAaHCW0Y2UQjeFfh0UQoUPVtsqbA">series </a>History of Disease. The next column will deal with danger of dengue in Nepal. <a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/how-chitwan-was-opened,4159" data-saferedirecturl="https://www.google.com/url?q=https://archive.nepalitimes.com/article/Nepali-Times-Buzz/how-chitwan-was-opened,4159&amp;source=gmail&amp;ust=1590041413347000&amp;usg=AFQjCNEcTfdhSI0N9Tqo_qgoyZnrHCccug">Tom Robertson</a>, PhD, is researching the environmental history of Kathmandu Valley.Read other articles on smallpox in Tom Robertson’s History of Disease series in <a href="https://www.nepalitimes.com/opinion/how-nepal-eradicated-the-smallpox-virus/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/opinion/how-nepal-eradicated-the-smallpox-virus/&amp;source=gmail&amp;ust=1590041413347000&amp;usg=AFQjCNGC0hhwCb-vpWbsy8-oT_gcbRcM6Q">Nepali Times</a>.

Tom Robertson

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Viruses past, present and future

Shantanu Dhakal wakes up to a cold misty dawn, dons his college uniform and fastens his tie, tightening it carefully so as not to dislodge the tracheostomy tube protruding from his throat.
Gingerly, he brushes his teeth, mindful not to hurt the wound on his left cheek, where a bullet tore through during the GenZ protests on 8 September in the highway town of Itahari in eastern Nepal.&nbsp;
Dhakal, 18, came home from college that day three months ago and then took the bus to Itahari to join some friends who were protesting in front of the sub-metropolitan city office. It was mid-afternoon, and the crowd was chanting anti-corruption slogans and holding up placards.
Like most young Nepalis, Dhakal and his friends had been angered by videos on social media of the offspring of Nepal’s rich and powerful flaunting their lavish lifestyles.&nbsp;
"That was the trigger for me to join the protest, it opened my eyes to just how widespread nepotism and corruption was," Dhakal told Nepali Times.&nbsp;
The police arrested a few students, angering the crowd even more. They massed at the gate of a nearby police station to demand their friends be released. &nbsp;
Dhakal was standing across the street from the police station when the first shots rang out. The crowd scattered. As he ran for cover, there was a searing pain in his left jaw. Blood was streaming and it took some time for him to realise he had been shot.&nbsp;
“I was bleeding profusely and couldn’t speak. My vision blurred, there was a ringing in my ears,” Dhakal recalls. “I collected myself and continued to run, fearing that I would be shot a second time.”
Dhakal collapsed some distance away, and a fellow protestor took him to a nearby hospital, where doctors bandaged his jaw. He was referred to Birat Medical Teaching Hospital, where surgeons immediately performed an emergency operation. &nbsp;
The bullet had torn through his left jaw, shattering the bone, teeth, and soft tissue. Blood had rushed into his throat, obstructing the airway so doctors first performed a tracheostomy, installing a tube in his throat to help him keep breathing. A week later, the doctors reconstructed his jaw with metallic plates, grafting skin from his chest and transplanting it to the lower left side of his face.&nbsp;
Dhakal spent three weeks in hospital before being discharged. But the relief of being home was marred by disturbing thoughts. He says, “Just sitting there doing nothing began to take a toll on my mental health.” &nbsp;
Since he was always interested in content creation and <a href="https://www.youtube.com/@docsbyshantanu">producing short documentaries</a>, he decided to document online his near-death experience and post-protest life.&nbsp;
Shantanu Dhakal’s Instagram and TikTok <a href="https://www.instagram.com/shantanu__dhakal/">posts are simple, short videos</a> every other day about his treatment process, dressing his wound and cleaning his tracheostomy tube, attending events with others injured during the protests, and scenes from everyday life in his family farm.&nbsp;
The comment section has Nepalis and people from around the world reaching out to ask how he is doing and keeping his spirits up. Dhakal now has a caring social media community, and he uses the platforms to keep in touch with other injured protestors across the country.&nbsp;
Life is returning to a new normal. This week, he returned to college to resume classes after more than two months and is making up for lost time. He has adjusted to speaking and eating with the tube, although the pain never quite goes away.&nbsp;
“I can eat mostly fine, but it is still difficult to speak,” he says. Soon, he will go to hospital for his fortnightly follow-up, and doctors will determine when his tracheostomy tube can be removed.
Like other young Nepalis, Dhakal is now even more politically engaged and actively reads the news of the interim government installed after the GenZ protests.&nbsp;
With the 5 March elections only three months away, young Nepalis like Dhakal hope that the elections will throw out the old and bring in the new. He is among the more than 800,000 new voters who have registered.&nbsp;
“The most important thing is that we have stable government,” he says. “As far as candidates go, an ideal one for me would be a person who prioritises health and education. But if the candidates in my constituency are not up to mark, I may not vote.”
Dhakal along with other injured protesters and relatives of those killed met &nbsp;Energy Minister Kulman Ghising, who has launched his own Ujyalo Nepal Party, and he is cautiously optimistic about the work of the current leadership. &nbsp;
It is a different story in Kathmandu, where Prime Minister Sushila Karki is struggling to manage the expectations of various youth collectives while trying to convince the old parties to participate in elections.&nbsp;
While the UML and NC are actively trying to delegitimise Karki’s government as they prepare to hold their respective general conventions, they are also preparing to give out tickets for elections.&nbsp;
Self-proclaimed GenZ leaders who used Discord to elect Karki prime minister are putting up their own conditions for the polls, even demanding her resignation for failing to meet their demands. This is in sharp contrast to the feelings of many of those injured during the protests who want elections so the nation can heal, and move on.

A new normal

This is the 76th episode of Diaspora Diaries, a Nepali Times series in collaboration with Migration Lab providing a platform to share experiences of living, working and studying abroad. We did not have a whole lot, but did not grow up in scarcity either. When I was in Grade 7, my father migrated to Malaysia but returned just after 18 days and was heavily in debt. It is the interest and not the principal from loan sharks that ruins borrowers. As we grew up, family expenses rose and my father migrated again to Qatar, determined to make it work this time. I used to watch him via IMO in buildings under construction eating rice out of plastic bags. There was no AC, no oven, no shade. Those images are etched into my memory.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251208081244_3f46ccdd1fab8f85ccce9fc8bec677cb7466a1b9556f36d0f92d19c6478369b6.jpg" data-media-id="editor_0" data-image-id="20251208081244_3f46ccdd1fab8f85ccce9fc8bec677cb7466a1b9556f36d0f92d19c6478369b6" data-rendition-name="original" width="600" height="800" loading="lazy" alt="Diaspora Diaries 76"> <figcaption>Family picture from 2014 sent to Anil's father who was working in Qatar.</figcaption> </figure>  After Grade 10, I was encouraged to take up computers in +2 as I was a bright student. I did not have access to a computer, and the 30 minutes we got weekly at the computer lab was just not enough. My parents could not afford to buy a computer, but a friend had both a desktop and laptop at home.&nbsp; I did his homework in exchange for using his computer. When my father in Qatar, found out he bought me a laptop. Today, a decade later, I am still using it. Maybe I valued the computer more because it was bought with my father’s sweat. The laptop reminds me of how he toiled overseas.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251208081240_2b3dc0b903d0b01caf875b5f50c22053aa28097b405cf14f36c6324a93f5dfef.jpg" data-media-id="editor_1" data-image-id="20251208081240_2b3dc0b903d0b01caf875b5f50c22053aa28097b405cf14f36c6324a93f5dfef" data-rendition-name="original" width="1200" height="1600" loading="lazy" alt="Diaspora Diaries 76"> <figcaption>Anil still uses the laptop his father bought him ten years ago.</figcaption> </figure>  The money he sent home did help with household expenses. My mother did tailoring, although the income was not stable. After my father returned from Qatar, we he bought a three-wheeler which he still uses in Makwanpur. After completing Grade 12, I came to college in Kathmandu to study IT. It cost Rs20,000 a month in tuition, rent and food just to survive. I could not complete my bachelor’s. Although my father kept saying, “Don’t worry, I am here,” he just did not have the money to pay for me. So, I took up a data entry job which helped cover living expenses. The pandemic meant my father could not earn money from his auto-rickshaw. We had no savings and had outstanding loans. Migration was the only way to get us out of the rut. I told my father that both of us should go abroad to earn some money. He could return earlier and I would stay on.&nbsp; My father agreed, and I visited recruiting agencies with both our passports. After reviewing our CVs, they said it was easy to find jobs for my father but not for me, given my educational background and my experience in software. “How can we send you for jobs as a cleaner or security guard?” they asked. I finally found a job in Romania, and decided to have my father stay back because going to Europe would have doubled the cost. My mother and sister came to see me off at Kathmandu airport. It felt just like my father leaving for Qatar many years ago. Perhaps some day, my brother would also leave in a similar manner, I thought.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251208081240_c1a00b70223f048e994e1cab7c0e6cd6944c4a2f3f7740b0a8e76921da9d23f0.jpg" data-media-id="editor_2" data-image-id="20251208081240_c1a00b70223f048e994e1cab7c0e6cd6944c4a2f3f7740b0a8e76921da9d23f0" data-rendition-name="original" width="1200" height="1600" loading="lazy" alt="Diaspora Diaries 76"> <figcaption>Anil's sister hugging him at the airport before he left for Romania.</figcaption> </figure>  In Romania, I work in a factory making car seat belts. It is not physically demanding and it is indoors. Even though I did not share it with my family, the initial period was difficult as I had no experience standing and working for so many hours at a time. Once, when I was tired at work, I wondered how my father managed in Qatar in a much more physically taxing job. Here I was not carrying heavy loads, my work was not outdoors. I was so emotional, I wrote a ghazal in my head. The words “खाडीको तातो घाम” kept repeating in my head. After work, I jotted down the verse in my diary:&nbsp; बुवा, तपाई जस्तो बन्न म सक्दै सक्दिनँ Father, I cannot become like you कति गाह्रो छ, म भन्नै सक्दिनँ I cannot imagine how hard it is म मान्छे हेर्दा मात्रै ठूलो I only look like a grown man बानी अझै बच्चै छ But I am still childish किनकि जता त्यतै जान मन लाग्छ I feel like roaming around जे देख्यो त्यो खान मन लाग्छ Eat whatever I see. न पैसा बच्छ I cannot save. न खाएको कुरा सबै पच्छ The food doesn’t agree with me&nbsp; कहिले काहीँ त मलाई म्याकडोनाल्डको बर्गर पनि पच्दैन Not even a burger at McDonalds तर प्लास्टिकमा पोको परेको त्यो चिसो भात But how did my father eat that cold rice खाडीको त्यो तातो घाममा सेक्दै खाँदा मेरो बुवालाई कसरी पच्छ? Under the hot Gulf sun? मेरो पेटले यस्तो पचाउन सक्दै सक्दैन I would not be able to eat that. बुवा, तपाई जस्तो बन्न म सक्दै सक्दिनँ Father, I cannot be like you. कति गाह्रो छ, म भन्नै सक्दिनँ I cannot say how difficult it is.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251208081240_51eb68a130750f1c79ab1046406a5b940c780ebd87cfff5ff6861d3287bd69c0.jpg" data-media-id="editor_3" data-image-id="20251208081240_51eb68a130750f1c79ab1046406a5b940c780ebd87cfff5ff6861d3287bd69c0" data-rendition-name="original" width="1200" height="1600" loading="lazy" alt="Diaspora Diaries 76"> <figcaption>Anil Gole's diary entry of his ghazal compares his migration with his father’s journey.</figcaption> </figure>  I posted it online, and it went viral. But more importantly, people found the words relatable and engaging. My sister first saw it on Tiktok and shared it with my mother. It moved them to tears while my father kept watching it on repeat, deep in thought. Even though my birth father decided to leave my mother when I was less than a year old, my step father never made me feel the absence of anything. My friend from Grade 6 in Makwanpur, Sharan, introduced me to ghazal. He was six years older because he had to pause his studies during the Maoist conflict. He worked in a brick factory in Kathmandu, saved money, and returned to school. He was very talented and we became friends through the school children’s club.&nbsp; Sharan and I spent most of our time together, sharing meals to save money and even skipping classes. One day, in Grade 9 when our teacher was absent, he wrote a ghazal on the spot and explained the form, the rhyme, the meter. I listened half-heartedly as it was not of interest. We left it at that. Shortly after, Sharan was diagnosed with leukemia and he could not finish exam. Because he was a sharp student, the teachers decided to not hold him back. He died just before Grade 10. I cried. I do not have any pictures of Sharan. He had small ears, and I used to tease him that people with small ears do not live long. That still haunts me. <div class="embed-block"><div style="max-width: 56vh;"><div style="left: 0; width: 100%; height: 0; position: relative; padding-bottom: 177.7778%;"><iframe src="https://cdn.iframe.ly/api/iframe?url=https%3A%2F%2Fyoutube.com%2Fshorts%2FLpizGQWTbMs%3Ffeature%3Dshare&key=87ca3314a9fa775b5c3a7726100694b0" style="top: 0; left: 0; width: 100%; height: 100%; position: absolute; border: 0;" allowfullscreen scrolling="no" allow="accelerometer *; clipboard-write *; encrypted-media *; gyroscope *; picture-in-picture *; web-share *;"></iframe></div></div></div> At the school assembly at the start of the new year, we were asked to share a talent. I did not know what to do, but I wrote a ghazal just as Sharan had taught me and dedicated it to him. Halfway through, I started crying and the principal took me to his office and calmed me down.&nbsp; I do not write much poetry except a few posts on social media here and there. But a video of me reciting went viral on TikTok and that encouraged me to write more. That made me feel validated, and I began writing more about real life experiences. It has been three years in Romania. My brother will also be joining me soon. Things have improved for us financially, but we are not where we want to be. We will get there. When we do, I will resume my studies. I’m interested in programming, especially back-end development and working with databases. It is on hold right now.&nbsp; I do not have big dreams, I just want to make sure my parents get what they deserve. It is okay if I get delayed if my parents are able to access what they had scarified for us when they were of my age. For now, my family is my priority.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251208081240_9e8d3cad3b505d3ec5adcea94ed05b2ea9de1d2cd8507335eec86c2659a11b34.jpg" data-media-id="editor_5" data-image-id="20251208081240_9e8d3cad3b505d3ec5adcea94ed05b2ea9de1d2cd8507335eec86c2659a11b34" data-rendition-name="original" width="2016" height="1512" loading="lazy" alt="Diaspora Diaries 76"> <figcaption>Anil's family.</figcaption> </figure>

My father’s son

International Mountain Day on 11 December should inspire celebration, not cynicism. It follows &nbsp;a small but rare diplomatic win: the agreement at COP30 in Belém to hold a dedicated global dialogue on mountains in 2026, and to include mountain-specific indicators in the new climate adaptation framework.&nbsp;
A welcome shift, certainly. But the old narrative lingers — mountains are fragile, disaster-prone, eternally vulnerable. But the uncomfortable truth is that safe and environment-friendly development in the mountains is simply too expensive than anyone wants to admit.
To build a kilometre of two-lane highway in the Tarai costs Rs200 million. That same kilometre on a Himalayan slope with retaining walls, drainage, bioengineering, and landslide protection costs more than Rs1 billion. Add tunnels, viaducts or highways designed for minimum 80km/h speeds and that figure can easily triple.
This pattern repeats across all sectors. A 50MW run-of-river hydropower plant that costs $80 million in low-ling valleys costs four times more in the mountains. The headrace tunnels have to be longer, desanding basins must trap the silt, the access roads cost more than the entire project. And there is no way to prevent the scheme from being washed away by a glacial collapse flood.
Nepal's annual road budget is only Rs150 billion. It is scattered thinly across 753 municipalities, most of them perched on steep, unstable slopes. When resources are inadequate and political cycles are short, the incentives for corruption are predictable &nbsp;— shaving a mountain flank at 70 degrees instead of 45, taking a shortcut on drainage canals, skimping on asphalt thickness, or skipping the Gabion.
In high Nepal, the bulldozer is the engineer. We hang on the prayer that the monsoon will be merciful. July arrives, and reality returns. Mountains fall on roads, flash floods wash away swathes of expensive highways.
The entrance to the Siddhababa Tunnel in Palpa collapses yet again. The Nagdhunga Tunnel faces another landslide delay. The Melamchi headworks go under — again. Each failure costs more to repair than proper engineering would have cost when that infrastructure was built.
We are not just paying once. We the taxpayers are signing up for a subscription to disaster. The real fragility of Nepal’s mountains is of governance, not geology.
This is what the international climate conversation habitually misses. Mountain communities are repeatedly told to ‘respect nature’ and avoid linear infrastructure, often by the same countries proudly announcing new expressways and airports in their own countries.
Mountain people are not anti-development. They want what everyone else wants: electricity that does not flicker, roads that survive the monsoon, schools their children can reach in winter. What they lack is not aspiration, it is the budget required to build things safely that is not stolen by politicians and their crony contractors.
If the world truly wants to protect the Himalaya, Andes or Alps, and the billions who rely on them for water, the answer is not more romantic slogans about fragility of the mountains. It is concessional, patient financing that narrows the gap between cheap and dangerous versus expensive and resilient. And it is transparent government that spends that money wisely.
This means money for tunnels instead of unstable surface cuts. Money for bioengineered slopes instead of naked bulldozer scars. Money for hydropower built for 1-in-100-year floods, not 1-in-25-year budgets.&nbsp;
This is not charity. Mountain infrastructure safeguards global water, carbon, energy and biodiversity systems. It is a global public good, and should be financed as such.&nbsp;
In Syangja, small investments under the Climate Adaptive Equitable Water Management Practices have restored nine community ponds, protected recharge zones and increased dry-season spring flow by about a third. All of this for less than the cost of repairing a single kilometre of poorly built hillside road after the next landslide.
Our experience from the Subnational Governance Programme (SNGP) in some districts of mountains and plains show that when municipalities receive practical guidance backed by scientific research, they can scale these solutions with modest, targeted budgets. Local governments are not the problem — they are the missing link. &nbsp;
The tragedy is not technical incapacity; it is chronic under-financing of the most cost-intensive terrain on earth. Lets stop romanticising mountain poverty on 11 December, International Mountain Day. Let us retire the language of fragility that excuses inaction.
Mountains are not pleading for sympathy. They are demanding fairness: that the true cost of safe development in the world’s steepest geographies be acknowledged and shared. Until that bill is paid, the monsoon will continue to do the accounting, one landslide, one road, one abandoned promise at a time.
Ngamindra Dahal is a water and climate adaptation practitioner based at the Nepal Water Conservation Foundation, Kathmandu.

The Himalaya is not fragile

The second season of the Nepal Premier League (NPL) is a prettier and more mature product. The Tribhuvan University International Cricket Stadium has new flood lights, colourful seats, and more of them from which fans watch not just sixers soaring into the evening sky but also spectacular sunsets over the mountains.&nbsp; Tuesday’s match was a double header with matches 20 and 21 of the season. The early game was Chitwan Rhinos vs Janakpur Bolts, and in the evening Karnali Yaks played Pokhara Avengers. These were teams towards the bottom of the table, with plenty to play for.&nbsp; Things looked fluorescent with the high-vis vests of security, bright pink jerseys of the Bolts, vivid orange Rhinos and the neon green inDrive logo. Security is tight, and between buying tickets and getting to seats viewers are patted down four times, their ticket stubbed twice. The seats are divided into zones, set out by fan base, and they are full and loud throughout.&nbsp; The biggest name in NPL 1.0 last year was probably Shikhar Dhawan, but the second season has brought in internationals who have played at the highest levels: Jason Roy, Faf du Plessis, Imran Tahir, Wayne Parnell, Sohail Tanvir, Martin Guptill. &nbsp; Although they are now in the 35-40 age range and well past their athletic prime, they have been valuable as sources of experience and technique for young Nepali teammates who are preparing for the T20 World Cup in February. They are seeing firsthand the work that goes into being an international level professional.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251205041256_e96211da042ec3043940f2feca4cd59dd00351af41a4ca029169871f69f51957.jpg" data-media-id="editor_0" data-image-id="20251205041256_e96211da042ec3043940f2feca4cd59dd00351af41a4ca029169871f69f51957" data-rendition-name="original" width="1366" height="911" loading="lazy" alt="Cricket carnival NT"> <figcaption>Photos: SUMAN NEPALI</figcaption> </figure>  NPL 2.0 is also much more commercial. Boundary ropes and zones have logos on them, KFC and Asian Paints have their anamorphic logos designed for angle on the field, there is an electric vehicle on display, and the digital scoreboard shows ads in between balls and action on the field.&nbsp; Sponsors and advertisers have allowed the organisers to pull out all the stops to put up the month-long tournament. Maybe the next season will be broadcast with virtual advertising with digital overlay.&nbsp; Cricket is a much faster and more dynamic game in person with the whole field in view, while still being relaxing to watch due to its stop start nature, the winter sun and enchanting sunset views.&nbsp; In the morning game Janakpur bowled first. The defending champions had a defence failure with five losses out of five. They could not break the opening partnership of the Rhinos, who were cruising at about nine runs an over.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251205041256_280bea0db1d097c88d478f5ba7197b5e2faa05623ebf9c0438af46d85bdb891e.jpg" data-media-id="editor_1" data-image-id="20251205041256_280bea0db1d097c88d478f5ba7197b5e2faa05623ebf9c0438af46d85bdb891e" data-rendition-name="original" width="1366" height="911" loading="lazy" alt="Cricket carnival NT"> </figure>  Thirteen overs into the Rhinos’ inning, they are 109 for zero. English batsman David Malan, 38, is on 59 off 42, and his opening partner Arjun Saud, 22 from Dhangadi, is on 50 off 37. The message from the dug out is clear: there are wickets in hand, so hit some sixes.&nbsp; Namibian leg spinner Nicol Loftie-Eaton was bowling for the Bolts, and the batsman went after him. They got off twice, with Rupesh Singh losing an easy catch in the sun, and then putting down a much harder chance running to his left.&nbsp; American Sanjay Krishnamurthi took a fantastic catch diving forward in the very next ball. The rest of Chitwan’s batting order got out regularly while still scoring at a decent clip. The Rhinos ended up posting 174, a big score of course, but not the 200+ that their strong start suggested.&nbsp; In the last over, young left-handed national team batsman Kushal Malla lofted a six on the off-side. The ball scored a direct hit on a cheerleader’s face, she crumpled to the ground, and was rushed on a stretcher to an ambulance. Meanwhile, Mr Gaida, the one-horned Chitwan mascot, stole the show as he roamed the boundary, swaying to the wide mix of DJ songs. The crowd cheered.&nbsp;  <figure> <video controls src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251206071236_63033e071dcdf7e9c6382f889e72f438318faed63d9a3c52d4ba6c10a6e357f6.mp4" alt="" width="100%" height="100%"></video> <figcaption>Mr Gaida, the one-horned Chitwan mascot, stole the show as he roamed the boundary, swaying to the wide mix of DJ songs. Vidoe: VISHAD RAJ ONTA</figcaption> </figure>  As the Bolts started batting, popular Irish commentator Andrew Leonard came down from the press box to check on cheerleaders. Three cheerleaders were reduced to one, but a male breakdancer had joined her.&nbsp; Janakpur were never in any real trouble as they chased. Young Pakistani all-rounder Maaz Sadaqat’s 63 off 30, and Anil Sah’s 61 of 36 propelled the Bolts to the target with two and a half overs to spare.&nbsp; At dusk, the floodlights come on, adding to the atmosphere. There is smoggy Kathmandu below and Langtang glowing pink on the horizon as the second match began.&nbsp; Karnali Yaks captain Sompal Kami won the toss and chose to bowl, but Adam Rossington’s 108 off 58 and Jason Roy’s 46 of 34 meant that Pokhara set up a target of 202. &nbsp; The Yaks started well, and were still very much in the game at over 10 with 95/3. But they lost wickets and slowed down. The pressure of the rising run rate got to the batting order, and soon they were all out for 167.&nbsp; In between innings and games, there is plenty for viewers to do in the carnival-like atmosphere outside. Asian Paints offers free face-painting. Ncell has a stall where viewers can pick up free new sims and play against a bowling machine to win t-shirts. KFC is the only food option around. Red Bulls are Rs150 per can. “Why do you think they’re dancing so hard out there?” asks the vendor of the caffeine-rich energy drink. “Red Bull.”&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025120412128_06edd8e6713c1e76c39364d3efb8ea54d4f7c3d8d2bf0d90933c993fdcfeba74.jpg" data-media-id="editor_3" data-image-id="2025120412128_06edd8e6713c1e76c39364d3efb8ea54d4f7c3d8d2bf0d90933c993fdcfeba74" data-rendition-name="original" width="934" height="656" loading="lazy" alt="NPL fixtures NT"> </figure>  <h2>Starting a new innings</h2> Tek Raj Kharel had just dropped off his inDrive customer near Zone 3 and had been following the tournament, watching games in between rides. He thinks the NPL is more than a game, it is a carnival. “This festival is more for women than men,” says Kharel. How so? “They go to be seen on the digital screen and take selfies, and the men go to see the women.”&nbsp; This week both male and female fans on the stands were certainly dancing hard, and they did not seem to care much about which team was winning. They cheered both when batsmen hit boundaries, and when a wicket fell. They were there to have fun, cricket was just an excuse. A pair of friends were not having as much fun, and were obviously not too much into cricket. The youngsters exited early, with one telling the other to never invite him to something as boring again. Many other couples seemed to be on dates.&nbsp; There were also many dads with their young kids, both generations enjoying themselves. There are not too many other events in Nepal that the family can go to like this.&nbsp; “Any match you watch here is pretty entertaining,” says an older fan. “I didn’t really know much about cricket before but now it has become a habit.”&nbsp; Thanks to new Youth and Sports minister, 26-year old Bablu Gupta, at the end of day’s games, fans get a free ride on shuttle buses to Kalanki, Swayambhu, Bhaktapur and elsewhere in the Valley.&nbsp; There is a lot that is very good with the NPL, and not much that is bad. A few things need quick fixes.&nbsp; While the stadium itself is all right, outside where the stalls are, the ground is dusty and resembles a construction site with litter everywhere. There are no actual bathrooms. Siddhartha Bank has set up a few small makeshift steel sheds, where fans stand shoulder to shoulder to relieve themselves. &nbsp; The pricing system has to be rethought. Tickets started at Rs300 last year, and the stadium was packed. Tickets cost Rs500 now, and on weekdays many seats are empty. A new system where tickets get discounted depending on booking time would improve the atmosphere with bigger crowds. &nbsp; Even so, the NPL is a breath of fresh air in post-GenZ protest Nepal with the hope that the country is starting a new innings.&nbsp; Tickets on Khalti.