In 1966, the <a href="https://www.who.int/news-room/detail/13-12-2019-who-commemorates-the-40th-anniversary-of-smallpox-eradication" target="_blank" rel="noopener noreferrer">World Health Organization (WHO)</a> launched a worldwide campaign to eradicate smallpox. The aim was ‘zeropox’ -- not just control of the disease, but its complete elimination.After an aggressive campaign run by Nepal's autocratic government, the country saw its last case ever in 1975. The program should be celebrated. But what should also not be forgotten is that it sometimes resorted to heavy handed methods. Balancing public safety and individual rights was not easy.Historically, smallpox had been one of the world's biggest and most terrifying killers. <a href="https://www.nepalitimes.com/opinion/the-smallpox-virus-in-british-india/" target="_blank" rel="noopener noreferrer">In South Asia, the disease attacked young adults and children</a>, those born since the previous epidemic, leaving many disfigured or blind. In Nepal in the 19th  century, smallpox left few communities unscathed, and <a href="https://www.nepalitimes.com/opinion/smallpox-politics-and-power-in-kathmandu/" target="_blank" rel="noopener noreferrer">even killed a king</a>.In 1966, smallpox still plagued 31 countries, annually infecting 10-15 million people and killing 2 million. Two areas caused the most concern: the horn of Africa and South Asia, including Nepal.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 V: <a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/banner/viruses-past-present-and-future/" target="_blank" rel="noopener noreferrer">Viruses past, present and future</a>		
							<figure><img width="1282" height="1386" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022112916110/63861ea09c7e80680e0ccdd8jpeg.jpg" alt=""/><figcaption>Smallpox vaccination statue outside the World Health Organization headquarter entrance in Geneva.</figcaption></figure>Nepal, a WHO official wrote in the early 1960s, ‘must be considered as one of the areas most highly endemic for smallpox in South East Asia’. In 1958, a wave of smallpox hit Kathmandu. A 1965 survey revealed that <a href="https://www.nepalitimes.com/opinion/big-story-of-small-pox-in-nepal/" target="_blank" rel="noopener noreferrer">16% of the Valley's total population had struggled with the virus at some point in their lives</a>. Those were the ones the disease hadn't killed.Each year a few imported cases appeared in the western hills. Don Messerschmidt describes a late 1963 outbreak along the hulakibato in Lamjung, but the main problem areas were the Kathmandu Valley and the Tarai, particularly the eastern plains because of heavy cross-border movement.<a href="https://www.who.int/features/2010/smallpox/en/" target="_blank" rel="noopener noreferrer">WHO and the Nepal government launched a pilot program</a> in 1962 in Kathmandu Valley using new freeze dried vaccine, an improved version of the one Edward Jenner had devised in the 1790s, but got disappointing results.After two and a half years, only 30% of Valley residents were protected. WHO blamed ‘administrative problems and the religious and mundane objections of some sections of the population to vaccination’.In 1966, the program expanded countrywide, with new commitment and revised procedures, including better record keeping to prevent double counting. In 1971 the program started month-long mass vaccination campaigns. Each year for four straight years, several thousand temporary staff vaccinated 6 million Nepalis. Between 1967 and 1975, 39 million Nepalis got vaccinated or re-vaccinated.Another new strategy proved a game changer: aggressive surveillance and containment. Previously, officials had prioritised vaccinations. They had not traced and mapped infections, and thus did not know how many people had the virus and where. In 1971, a WHO official later wrote, ‘vigorous surveillance became the rule’.Surveillance meant routine house-to-house searches. Instead of waiting for cases to be reported, program workers went looking for them. Containment meant vaccinating and revaccinating the entire population near a newly discovered case. This was erring on the safe side by casting a broad net. The program also intensified tracing, detecting infection origins in a remarkable 95% of cases.The aggressive surveillance and containment methods delivered results. ‘It appeared that transmission had been interrupted,’ a WHO official noted later. Nepal had devised ‘a new and surprisingly effective tactic’.But then came a setback: ‘a tidal wave’ of new cases with nearly 2,000 new infections in 240 separate outbreaks. Three of every four of these cases were imports from Uttar Pradesh and Bihar in India where smallpox proved particularly recalcitrant. Of Nepal's 12 million population at the time, 90% lived within 100km of these Indian states.The program responded with more vaccination campaigns, surveillance, and containment, making steady progress. To address outbreaks in Morang the Nepal smallpox program in 1975 initiated a ‘watchdog’ system, a tactic recently devised in India. Staff were posted at the houses of infected people to ensure that they did not leave and that no unvaccinated person entered. Cash rewards were given to citizens and staff reporting new cases.In April 1975, Nepal saw its last case. A disease that had plagued Nepalis for centuries was gone. Looking back, WHO officials saw the surveillance and containment program as the key.‘The shift in strategy in 1971, laying great emphasis on surveillance-containment, was largely responsible for the success of the Smallpox Eradication Programme in Nepal,’ wrote the program's director in a 1977 wrap up report. ‘It is possible that transmission would have been interrupted earlier if the watchguard system had been adopted during 1974.’In many ways Nepal's eradication of smallpox was a heroic victory. The global smallpox program's director applauded Nepal's ‘remarkable accomplishments’. This narrative is not inaccurate but it is not the whole story.To begin with, smallpox eradication owed a great deal to biology. Compared to other diseases, smallpox was simply easier to eradicate. It was easy to see and diagnose (no asymptomatic infections) and did not re-infect people once gone. The disease's painful symptoms prevented movement, slowing transmission. Moreover, the vaccine was easy to administer and extremely effective. There was no virus reservoir among animals re-injecting the disease into human society again and again.Diseases like malaria and polio had far more natural advantages, and have proven much harder to eradicate globally.‘Without the particular characteristics of smallpox and the smallpox vaccine,’ historian Randall Packard has observed, ‘the disease would have been much more difficult to conquer, and the campaign would, in all likelihood, have failed. As it was, it only succeeded by the thinnest of margins.’One particular challenge was how to handle Nepalis who resisted vaccination. In the eastern Tarai, many people, particularly indigenous groups, held what a WHO report described as 'religious objections to vaccination’.WHO said this area became 'the scene of many problems of containment’. In Kathmandu, some Newar groups used to 'strongly object' to vaccination. In Kailali, some Tharus 'resisted vaccination for religious reasons'.Historian Susan Heydon notes that program workers often unjustifiably dismissed the concerns of Nepalis who resisted vaccination. Those who hesitated, she notes, were blamed as superstitious, derided as ‘backward and uneducated’.Instead, she faults the WHO program itself for not doing enough to educate the general population about the benefits of vaccination. She also notes that the program often administered vaccinations during hours next to impossible for ordinary working people.Eradication program workers also occasionally used unnecessary coercion. Coerced vaccinations were not common worldwide or in South Asia. But as historian Packard notes, there was a ‘tendency for aid workers to view themselves as somehow empowered to do whatever it takes to fulfill their mission, and to disregard local customs and laws’. In India and Bangladesh, historian Paul Greenough discovered that 'heavy-handed methods were sometimes relied upon'. On one occasion in Bihar in 1975, for example, health officials accompanied by police arrived at a tribal person's house by jeep at midnight, broke down the door, held down family members, and forcibly vaccinated them. Mandatory vaccinations and re-vaccinations as part of broad containment efforts sometimes sparked 'chaos' in villages.'Encounters with government vaccinators,' Greenough observes, were 'never about immunisation alone.' Religious, caste, and gender dynamics shaped interactions, as did ill will from previous health campaigns.One American health worker in India later recalled how a sense of unbridled self-righteousness led him to mistreat people. 'One of the rules was that everybody gets vaccinated. I was awful in my conviction of purity of purpose -- in breaking down doors and vaccinating crying women, etc.' To a large degree, the ends seemed to justify the means.Official reports, Greenough writes, often dismissed resistance and underreported coercion. He wishes there had been much more training for healthworkers and broader,more careful education for the public.In Nepal, one foreign smallpox fieldworker described how health workers sometimes had to search for Nepalis hiding from them in fear:‘... a good natured room to room search of houses with flashlights, accompanied by the village leader, would detect adults and children hiding under beds, in chests, large wicker baskets, and even in large clay storage vessels. However, the search was done as a game of hide and seek, with laughter after people were found and vaccinated, such as in one particular case where lifting the cover of a large wicker basket revealed two children hiding inside.’This may have been seemed like a game to health workers, but probably not to those Nepali men, women, and children with unknown government strangers searching for them. They seemed terrified.In the name of containing smallpox, a global health problem and an old scourge in Nepal, in the late 1960s and 1970s Nepal's government had tremendous authority to monitor and search Nepal's population. Maintaining public safety certainly justifies strong action, but the unnecessary infringement of individual rights and liberties must also be avoided as well.  This is the third in a <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=1588753218027000&amp;usg=AFQjCNEp4BFSGiWvId09CsLCgnF31j8F-w">series of articles</a> about the history of disease in Nepal. The fifth installment will look at what Nepal can learn from past epidemics in dealing with this one.  <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=1588753218027000&amp;usg=AFQjCNGtSUyejPwwFFhYdaZjZohWFJUIQw">Tom Robertson</a>, PhD, is researching the environmental history of Kathmandu Valley.

Tom Robertson

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How Nepal eradicated the smallpox virus

<figure><img width="1138" height="822" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022112916110/63861e9a9c7e80680e0ccdd6jpeg.jpg" alt=""/><figcaption>A woman in Kathmandu carrying her child infected by small pox in 1964. Photo: WHO</figcaption></figure>The smallpox virus plagued Nepali communities throughout the 19th and early 20th centuries. As historian Susan Heydon has written about in a recent essay called ‘Death of the King’, smallpox destroyed families rich and poor alike, with tremendous personal and political consequences. In the late 1790s, <a href="https://www.nepalitimes.com/opinion/big-story-of-small-pox-in-nepal/">smallpox erupted in Kathmandu Valley</a>. Little is known about the outbreak, but at the time the Valley's cities were still recovering from Prithvi Narayan Shah's conquest three decades earlier. Kathmandu's population lived and worked on streets that one British visitor described as ‘excessively narrow, and nearly as filthy as those of Benares'.In 1799, King Rana Bahadur's favorite wife, Kantivati, came down with smallpox, igniting a series of events that reshaped court politics. Seeing his wife gravely ill, Rana Bahadur dedicated himself to prayers for her, and even abdicated the throne in favour of his two-year old son, Girvana. His efforts were to no avail: Kantivati succumbed to the disease. Rana Bahadur, distraught and furious, desecrates and destroys the temple of Hariti Ma (known to Hindus as Sitala) at Swayambhu.Rana Bahadur also orders children with the disease removed outside the Valley, all the way across the Tama Kosi in the East or the Marsyandi in the West. Because of the Valley's demographics, these were Newar children. A traditional Newar song recounts what happens. Called 'Sitalamaaju Mye', the song is addressed to 'Mother Sitala,' the smallpox goddess. Part I: <a 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 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 IV: <a href="https://www.nepalitimes.com/opinion/how-nepal-eradicated-the-smallpox-virus/" target="_blank" rel="noopener noreferrer">How Nepal eradicated the smallpox virus</a>Part V: <a href="https://www.nepalitimes.com/banner/viruses-past-present-and-future/" target="_blank" rel="noopener noreferrer">Viruses past, present and future</a>'Oh Mother Sitala,' the first line goes, 'behold the piteous state of your people! The children were driven out of the country, surrounded by soldiers.' The song describes the stages of the disease, which touched most Nepali families at one point or another, through its appeal to three different deities. ‘We pray to Mother Kachala, who brings forth the smallpox blisters, to Mother Sitala, who fills them with water, and to Mother Bachala, who carries off the afflicted.’Parents faced heartbreaking difficulties. 'They led them away, carrying one child on the back, one child under the arm and dragging along a third child.' After a week, the families reach the Tama Kosi. There, a child dies. Unable to say goodbye the proper way, the devastated parents throw the body into the river. One of the legacies of these distant events, the 'Sitalamaaju Mye' song appears to use the tragic expulsion of families to symbolise the mistreatment and dukha Newars faced since the takeover of the Valley by the Shah regime in the 1770s. Observers this month have noted that the song speaks to the hardships faced by many Nepali migrant laborers, displaced from their worksites by Covid-19, trying to return to village homes.Rana Bahadur ends up in exile in India, and takes along with him a young Bhimsen Thapa. He returns to power in 1804, but is killed in 1806, opening the door for Thapa to seize power and go on to become one of the most important rulers in Nepal's early history.Smallpox struck again in 1816, and again shapes the power struggles in Nepal's tumultuous Darbar. Bhimsen Thapa still held power, but King Girvana, now 21, was a clear threat.The disease appeared first in the west of the country but found its way to Kathmandu by July. As historian Vikram Hasrat has documented, ‘Smallpox became so virulent in the country that hundreds and thousands of men, women and children, old and young, were swept away. The rivers, tanks, and canals were crowded with dead and dying; and in the streets a man had scarcely room to walk and the dogs dragged away the neglected and putrefied corpses and vultures died with surfeit of human flesh.’Fear gripped the palace. King Girvana had not contracted the disease as a child. He also had young children. Officials requested vaccinations from the British, who had been trying to spread the new practice in India for over a decade.As historian Heydon has documented, the <a href="https://www.nepalitimes.com/opinion/the-smallpox-virus-in-british-india/">British sensed possible political advantage</a>: ‘It would not only be an act of humanity to introduce the Vaccination,’ the British resident Edward Gardner wrote his superiors in India on July 17, ‘but be a desirable object, perhaps to have the Raja and the Officers of the Court inoculated by us.’The British organised vaccinations around the Valley, beginning in Banepa. It is hard to say how many people actually got vaccinated. But one thing we do know: the king was not among them.  <figure><img width="1376" height="980" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022112916110/63861e9d9c7e80680e0ccdd7jpeg.jpg" alt=""><figcaption> </figcaption></figure>The exact reasons why are lost to history, but not the consequences. In late October, both of the king's children showed fever and then rash. One perished on 2 November. Gardner passed along news of the king's family to Calcutta: ‘His youngest son a child under two years of age I am sorry to add died this morning of that distemper and his eldest &amp; only remaining male child has also taken the disease.’ Two weeks later, on 18 November, Gardner learned that 'the Raja had unfortunately taken the smallpox'. He died two days later. The resident reported the event: ‘Alarming symptoms it seems made their appearances during the night which continuing unabated, the Raja was according to the usual custom in this country conveyed early in the morning to the temple at Pusputhnath, where he breathed his last about 11 o’clock am. As was Hindu custom, preparations were underway quickly for his funeral.’ Girvana's senior queen, Siddhi Rajya Laxmi, threw herself on her husband's funeral pyre, as tradition demanded.Gardner regretted the missed chance to prevent the king's death. ‘Many opportunities have unaccountably been neglected for him receiving the vaccination.’ It's hard to know why. There was, however, as historian <a href="https://www.nepalitimes.com/review/the-rest-is-history-for-john-whelpton/">John Whelpton</a> notes, 'speculation about foul play'. The young prince Rajendra recovered and was placed under the regency of <a href="https://www.nepalitimes.com/banner/turning-a-shrine-into-a-temple-of-learning/">Tripura Sundari, a longtime ally of Bhimsen Thapa</a>. Girvana's death and Tripura Sundari's installation as the young king's regent helped <a href="http://archive.nepalitimes.com/blogs/kundadixit/2014/01/05/the-pashmina-war/">Bhimsen Thapa</a> retain his grip on power, a grip he would not yield for another two decades.  Over the next century and a half, as Heydon shows, smallpox showed itself routinely in Nepal. Every spring communities would make prayers to ward off the disease. <a href="https://www.nepalitimes.com/latest/kathmandu-in-the-time-of-cholera/">But periodically epidemics raged</a>. One observer in east Nepal in 1885, for instance, noted that a wave of smallpox had ‘carried off a large number of the inhabitants of Khumbu’.<a href="https://www.nepalitimes.com/here-now/nepal-is-a-microcosm-of-all-of-the-changes-in-world-health/">“Nepal is a microcosm of all of the changes in world health”,</a> Nepali TimesVaccination use was sporadic, and government efforts weak. At mid-century, the Kathmandu-based <a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/pencilling-in-kathmandu-rajman-singh-chitrakar,3379">British doctor Henry Oldfield</a> noted that Jang Bahadur Rana held ‘great faith’ in vaccination and had his children and other royal children inoculated, but did little else. In the 1920s, British journalist <a href="http://archive.nepalitimes.com/news.php?id=3351#.XqwdhS8w0Wo">Perceval Landon</a> noted, 'Vaccination is not compulsory but it is free to those who choose to avail themselves.' Several reasons explain why Nepalis did not use vaccination. Some people, particularly some Newars and Tarai groups, disliked the vaccine. But a far greater problem was that the Rana governments did little to make it widely available or to promote it. They never set up a health system to promote sound practices across Nepal. In contrast, in India by the early 20th century, the British campaign to spread vaccination had found its legs. Millions of ordinary Indians in Madras and other parts of the country started getting vaccines. In 1947 alone, the year the British left India, 21.3 million Indians received vaccinations or re-vaccinations.Nepalis who studied or traveled in India and those who served in the British Army noticed how little health service the Rana regime provided their countrymen. Smallpox was one of many diseases and ailments that modern medicine could help with. The Ranas' lack of concern about the people's health and welfare helped fuel the growing movement to drive them from power. After the 1951 revolution, successive Nepal governments tried to set up a modern health care system in the towns and villages. They implemented disease control programs, including <a href="https://www.nepalitimes.com/here-now/the-mosquito-that-changed-nepals-history/">a nationwide malaria eradication effort</a>, launched in 1959 with the help of the US and the WHO. A smallpox campaign for the Kathmandu Valley was launched in 1961 and became a nationwide eradication program in 1966.  After tormenting Nepalis for centuries and sometimes shaping their politics, smallpox was finally eradicated from Nepal in 1975. It is a tremendous success story -- a story of strong bureaucratic organisation, impressive scientific work, and tenacious implementation. But it is also a story of occasional heavy handedness by a government given unprecedented powers in the effort to maintain public health. This is the third in a <a href="https://www.nepalitimes.com/opinion/big-story-of-small-pox-in-nepal/">series of articles</a> about the history of disease in Nepal. The fourth installment will explore the eradication campaign in the 1960s against smallpox. <a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/how-chitwan-was-opened,4159">Tom Robertson</a>, PhD, is researching the environmental history of Kathmandu Valley.

Smallpox, politics and power in Kathmandu

<figure><img width="1016" height="1280" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109121124/636b8dd59c7e80680e06b36djpeg.jpg" alt=""/><figcaption>Irish-born painter Thomas Hickey's painting in 1806 of three queens of Mysore where the royal woman on the right is pulling up her sari to spread awareness about small-pox vaccination. Photo: PRIVATE COLLECTION</figcaption></figure>The first record of smallpox in South Asia was in the 7th century, although the virus was probably widespread on the Subcontinent a millennia before that. In late 19th century India, for which we have the first reliable statistics, smallpox struck down more than 100,000 people a year, more in epidemic years. In some parts of north India, few escaped it. In Nepal, smallpox generally hit in the spring. ‘Transmission reached a peak during April and May,’ a 1977 WHO report notes, ‘and thereafter fell off rapidly as the monsoon increased relative humidity and hampered population movement.’Smallpox generally attacked children, and older people who hadn't already contracted the disease. ‘Since smallpox erupted epidemically roughly every five to seven years in most parts of India,’ historian of medicine David Arnold explains, ‘its principal victims were children born since the previous epidemic.’Smallpox was ‘the inevitable bridge which every child has to cross before entering into life,’ noted Sir Sayyid Ahmad Khan in India in 1879. ‘Recovery from the disease is considered second birth.’Part I: <a 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 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 href="https://www.nepalitimes.com/opinion/how-nepal-eradicated-the-smallpox-virus/" target="_blank" rel="noopener noreferrer">How Nepal eradicated the smallpox virus</a>Part V: <a href="https://www.nepalitimes.com/banner/viruses-past-present-and-future/" target="_blank" rel="noopener noreferrer">Viruses past, present and future</a>‘It has become quite a saying among the agricultural and even wealthier classes,’ a British planter in the 1860s noted, ‘never to count children as permanent members of the family until they have been attacked with and recovered from smallpox.’Symptoms did not show during the virus's two-week incubation period. Those infected felt fine, and some even travelled, taking the disease with them, although they were not yet contagious.But after two weeks, the first of smallpox's horrific symptoms hit: intense fever, often with splitting headaches, body aches, and vomiting. Children often broke into convulsions. After a couple days, the patient might feel better for a day or two, and even rejoin normal life. But by this point contagious, they risked passing along the infection. Then came a red rash, at first on the tongue but soon all over the body, even on the palms of the hands and the soles of the feet, causing tremendous pain.By the fifth day, fluid started accumulating in the now bigger and bluish pockmarks. Fever deepened. Eyelids, lips, and nose grew swollen. The afflicted person had trouble swallowing. They might fall into delirium. Lesions could form on the eyes. The patient could be hard to recognise. A dreadful smell was common, as were secondary infections. <figure><img width="930" height="758" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109121124/636b8dd79c7e80680e06b36ejpeg.jpg" alt=""><figcaption> </figcaption></figure>At two weeks, scabs formed. They ‘encrust most of the body’, historian Fenn writes. The pain was awful, ‘any movement excruciating.’ The itching could be unbearable. Death, if it was to visit, normally arrived by this point. The disease also tore apart the lungs, heart, and liver. Smallpox consumed its human hosts ‘as a fire consumes its fuel, leaving spent bodies, dead or immune, behind,’ writes Fenn. In Nepal, as in much of north India, people thought of smallpox in religious terms, as a visitation by the goddess Sitala, ‘the cool one’. This understanding of disease came with its own remedy: ‘Smallpox was conceptualised,’ historian Arnold writes, ‘not as a disease but rather as a form of divine possession, and the burning fever and pustules that marked her entry into the body demanded ritual rather than therapeutic responses.’  Sufferers showed respect and honour to Sitala with the proper prayers and offerings. 'Oh Mother Sitala,' 19th century Newaris used to sing, 'do not afflict us! Deliver the people, we beg you a thousand times!'In addition to prayers to Sitala, some South Asians, including Nepalis, used inoculation to head off the disease. They intentionally give their children mild cases of smallpox, hoping that death would not result. Once recovered, the patient would have life-long immunity. Inoculation carried risks and did not work as well as the vaccine developed from cowpox by Edward Jenner in the 1790s, especially after it was improved during the mid 19th century. But inoculation did save many people from death. Otherwise, smallpox killed one in three of those who got it.As early as 1802, and for much of the nineteenth century, the British tried to introduce Jenner's vaccine into its Indian colony. But they ran into lots of obstacles, many of their own creation, so it took until the early 20th before vaccinations became common.What happened? For starters, until the 1850s, the British vaccine was not as effective as they thought, especially in India's heat. Vaccination required person to person contact. Vaccination also cost more than the British wanted to pay, so they did not build the necessary health and education infrastructure. In addition, cultural gaps surrounding the belief in Sitala, which the British tried to crush instead of to accommodate, also interfered. Many resisted vaccination. ‘To some Hindus,' Arnold explains, 'recourse to any form of prophylaxis or treatment was impious, likely to provoke the goddess and further imperil the child in whose body she currently resided.’ Ultimately, he emphasises, the big problem was that the British administration and medical system in India was‘culturally and politically distant from the lives of its subjects’. But by the early 20th, the British had improved the vaccine and its delivery, done a better job of explaining its benefits, and begun to meet with more success. In the decade after 1935, for instance, each year roughly 4.3 million people in Madras alone, almost 10% of the population, received vaccinations.Just as in India, the smallpox virus periodically ravaged Nepal, causing tremendous suffering, killing many, and leaving behind scarring and blindness. It affected all levels of society, even Nepal's royal family on several occasions in the 19th century.  This is the second in a <a href="https://www.nepalitimes.com/opinion/big-story-of-small-pox-in-nepal/" target="_blank" rel="noopener noreferrer">series of articles</a> about the history of disease in Nepal. Forthcoming columns will explore the role of smallpox in Kathmandu’s power struggles in the 19th century, and its eradication campaign in the 1960s. Tom Robertson, PhD, is researching the environmental history of Kathmandu Valley.

The smallpox virus in British India

When we think of Nepal's history, mostly political events jump to mind: the expansion of the Gorkhali state, Jang Bahadur's takeover, or the 'People's War’. We rarely think about disease. But diseases have shaped the course of history in the Himalaya in many unexpected and important ways. Perhaps no disease did so more than malaria, which plagued low hill valleys and especially Tarai forests for centuries. Its near complete eradication in the 1960s has altered the lives of almost every Nepali in one way or another. Viruses somewhat similar to the coronavirus have also touched the lives of countless Nepalis, and shaped larger events. Measles, influenza, hepatitis, <a style="letter-spacing: 0.01em;" href="https://www.nepalitimes.com/banner/polio-hunt/" target="_blank" rel="noopener noreferrer">polio</a>, and rabies have killed or maimed thousands. In 1918, the <a style="letter-spacing: 0.01em;" href="https://www.nepalitimes.com/opinion/remembering-a-pandemic-100-years-ago/" target="_blank" rel="noopener noreferrer">Spanish Influenza</a> cut down 12-18 million Indians, and probably tens of thousands of Nepalis. In some districts in north India, 1 in 10 died. Near Agra, 1 in 7 died. More recently, 50,000 Nepalis now live with HIV, many others have been lost to this virus which first appeared three decades ago.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>Part V: <a href="https://www.nepalitimes.com/banner/viruses-past-present-and-future/" target="_blank" rel="noopener noreferrer">Viruses past, present and future</a> <figure><img width="2048" height="1393" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109121120/636b8d9e9c7e80680e06b359jpeg.jpg" alt=""/><figcaption>Health worker administering a small pox vaccine on a person in Sanischare of Jhapa. Photo: BETH PRENTICE AND BOB FRANK</figcaption></figure>Before COVID-19, perhaps the most feared virus in Nepali history was smallpox. Until its eradication in the mid 1970s, smallpox (biphar in Nepali, chechak in Hindi) regularly terrorised Nepali towns and villages. It struck mostly children, causing excruciating pain, killing many, and leaving survivors permanently disfigured. Every year saw new cases, but every five or ten years, a broader epidemic would tear through communities, particularly dense settlements such as Kathmandu and avenues of trade and communication, such as Nepal's postal routes. A large outbreak hit Kathmandu in 1958, and a pockmark survey in 1965 showed that 16% of the Valley's population had contracted smallpox at some time in their lives. And they were the survivors -- the virus killed roughly one of every three it afflicted.Unlike diseases like cholera that hit the poor in greater numbers, smallpox was an equal opportunity killer. It struck down both raja and raiti. Several times it invaded Nepal's royal palace.The last case of smallpox in Nepal appeared in 1975. The disease, historian <a href="https://www.colorado.edu/history/elizabeth-fenn" target="_blank" rel="noopener noreferrer">Elizabeth Fenn</a> has written, is ‘a misery commonplace in years gone by but unfamiliar to the world today'. <a href="https://www.nepalitimes.com/latest/kathmandu-in-the-time-of-cholera/">Kathmandu in the time of Cholera</a>, Tom RobertsonViruses like smallpox and COVID-19 originate in animals before spreading to humans. Coronavirus developed in bats, but no one knows where smallpox came from. Today, experts believe that as many as 100 million types of viruses exist in animals worldwide, waiting to jump to humans under the right conditions. Once in the human body, viruses become tiny engines of infection of simple but deadly design, little bits of genetic coding packaged in a protein that hijack the body's cells, transforming them into ‘virus producing factories', as historian of medicine Frank Swowden has put it. The virus then reproduces exponentially, killing its host cells and, unless checked, overwhelming the body's defenses.  All diseases have different characteristics and personalities. Their origins, methods of transmission, symptoms, and social impact vary widely. Smallpox spread easily. It moved not by bite of flea or mosquito but from human to human contact, normally through droplets coughed or sneezed into the air. Because the disease caused open sores in a patient's mouth and throat, a single sneeze or cough could launch thousands of infected particles into the air. The virus could also spread through beds and items of clothing. If you lived in a house with a relative suffering from smallpox, and if you had never had the disease before, you had a 50-50 chance of getting it. There was no cure.<a href="https://www.nepalitimes.com/here-now/the-mosquito-that-changed-nepals-history/">The insect that changed Nepal's history</a>, Tom Robertson <figure><img width="2300" height="2728" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109121120/636b8da19c7e80680e06b35ajpeg.jpg" alt=""><figcaption> </figcaption></figure>Smallpox was horrific. Perhaps only bubonic plague and cholera sparked more terror. It left survivors badly pockmarked and often blind. Historically, smallpox caused three-quarters of all blindness in India. Smallpox, an Indian observer noted in 1879, ‘touches the keenest of human susceptibilities; for there are thousands in this country who, though spared by it from death, still have traces of its violence in the deep marks on the face or the loss of an eye’.Around the world, the smallpox virus wrought havoc and dramatic social change. In Europe, it ripped through the dense, disorganised cities and towns of the 17th and 18th  centuries. Half of Europe's population carried scars from the disease. Smallpox afflicted rich and poor alike. It killed England's Queen Mary and Prince William, ending the house of Stuart.In the Americas, smallpox spurred even more devastation and turmoil. Because indigenous groups had no previous exposure and therefore no immunity, they died in much higher rates than Europeans. Whole communities were wiped out. <a href="https://www.nepalitimes.com/here-now/nepal-is-a-microcosm-of-all-of-the-changes-in-world-health/">“Nepal is a microcosm of all of the changes in world health”,</a> Nepali Times  <figure><img width="1278" height="716" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109121120/636b8da59c7e80680e06b35bjpeg.jpg" alt=""><figcaption> </figcaption></figure>The massive waves of death cleared the way for European settlement and spurred the import of slaves from Africa, many of whom had immunities from childhood. Smallpox acted as an ‘unwitting instrument of empire,’ according to Fenn.In its tragic wake, smallpox also prompted important public health innovations. In many parts of Asia, including India and Nepal, people for centuries used variolation -- inoculation using live virus -- to block the disease. A string infected from a mild case of the disease would be rubbed under the skin, thus actually giving the person the disease. Some would perish, but most survived, thereby gaining immunity from future outbreaks.A less risky and more broadly effective vaccine was developed in Britain in the 1790s. A country doctor named Edward Jenner, noticing that milkmaids never contracted smallpox, discovered that intentionally giving humans cowpox -- a virus related to smallpox -- could create immunity to the disease without inoculation's painful symptoms and risk of death. Jenner predicted that vaccines like his could one day eradicate smallpox from the planet. ‘The annihilation of the smallpox, the most dreadful scourge of the human species,' he wrote in 1801, 'must be the final result of this practice.’That prophecy became reality in the 1970s -- but only after a century of misguided British efforts in colonial India, and only after a complicated and controversial global eradication campaign in the 1960s and 1970s that only succeeded, as one historian of medicine put it, ‘by the thinnest of margins’. Coronavirus differs from smallpox in important ways. Nonetheless, revisiting smallpox's history in the Himalaya can help us better understand the interconnected social, medical, and political landscapes in which we live. This is the first in a <a href="https://www.nepalitimes.com/opinion/big-story-of-small-pox-in-nepal/" target="_blank" rel="noopener noreferrer">series of articles</a> about the history of disease in Nepal. Forthcoming columns will explore British attempts to spread vaccination in India and the role of smallpox in Kathmandu’s power struggles in the 19th century, and its eradication campaign in the 1960s. <a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/how-chitwan-was-opened,4159" target="_blank" rel="noopener noreferrer">Tom Robertson</a>, PhD, is researching the environmental history of Kathmandu Valley.

Big story of small pox in Nepal

Architecture can be a powerful agent of change, shaping not just spaces but the way people live, connect, and experience the world.&nbsp; For Nepal, which is <a href="https://nepalitimes.com/banner/natures-fragile-gift-to-nepal">gifted by nature</a> and rich in <a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/ambassador-fund-cultural-preservation-nepal,2092">cultural heritage</a>, &nbsp;reviving rural architecture with modern amenities could hold the key to more <a href="https://nepalitimes.com/here-now/what-sustainable-tourism-means-in-practice">sustainable tourism </a>that benefits local people more. “<a href="https://nepalitimes.com/banner/bayalpata-hospital-in-nepal-wins-global-design-award">Design and architecture</a> are amazing tools to create a unique experience for visitors,” says Spanish architect Tomeu Esteva of Esteva i Esteva Architecture Studio. “Difficult destinations have beautiful hotels with design and comfort.” Esteva was in Kathmandu with his colleagues at an event organised by the Spanish Honorary Consulate at Dwarika’s Hotel last week to showcase buildings which Nepali architects can adapt with local material and design inputs.&nbsp; Rural architecture holds a unique significance: it is more than a shelter and must reflect <a href="https://nepalitimes.com/here-now/inking-an-idenity">local identity, culture</a> and <a href="https://nepalitimes.com/here-now/saving-humla-from-heritage-loss">heritage</a>. An area’s natural and cultural harmony can be upset by <a href="https://nepalitimes.com/here-now/protecting-protected-areas-from-infrastructure?fbclid=IwAR1wK0MDFlFST_2EYb3f54LS4-fPt6rYfLG1DJ1JaQsU3w8-ezyXIxGOqzk">poorly planned development</a>, speakers at the event said, but the environment can be improved and revitalised by well-integrated structures.&nbsp; Another Spanish architect, Belen Moneo, has designed hotels at elevations of 3,700m in her home country Spain that supply natural spring water spas. “<a href="https://nepalitimes.com/banner/lost-in-reconstruction">Creativity in construction</a> must be encouraged. Rural architecture always shows possibilities of what we can do better,” Moneo explains, adding that designs must enhance <a href="https://nepalitimes.com/opinion/the-healing-power-of-nature">the beauty of nature</a> and give a natural feel at a time when steel, glass and cement dominate <a href="https://nepalitimes.com/here-now/rebuilding-kathmandu-after-the-1934-quake">urban design</a>.&nbsp; This is why the <a href="https://nepalitimes.com/here-now/weaving-nature-into-craft">use of natural products</a> such as bamboo, local timber, straw and rammed earth are in demand from customers who want a fresh eco-friendly look encouraged in construction of rural architectural structures. The demand for boutique hotels has increased world over, with &nbsp;more and more tourists favouring aesthetics, experience and comfort over price. While creativity is an important part of <a href="https://nepalitimes.com/here-now/architecture-for-mountains">construction and architecture</a>, incentives to build and use <a href="https://archive.nepalitimes.com/article/nation/Building,370">rural construction materials</a> still remain minimal, and Moneo emphasises the significance of design and execution.&nbsp; Esteva helped design the Vana Retreat in Dehradun that kept the natural environment in focus, with the structure giving an elaborate aesthetic experience to visitors. Another example is Hotel Las Mercedes in the Dominican Republic which was designed and constructed by Moneo and the company she co-founded Moneo Brock, respecting and revaluing the traditional architecture of the area. Hotels providing such experience could attract tourists and revenue. The Spanish ambassador to Nepal Juan Antonio March Pujol said, “The role of architecture and architects in developing tourism is crucial, not only in urban areas but rural settings as well.”&nbsp; The concept of rural boutique hotels gained traction in Spain during the 1990s, particularly in regions like Majorca with economic and environmental sustainability as the main focus. In Nepal <a href="https://nepalitimes.com/opinion/12-full-opinion/guiding-nepal-s-tourism-industry">the tourism industry</a> directly employs about 1 million people, and makes up about 8% of the country’s GDP. In Nepal, the stone homes of <a href="https://nepalitimes.com/news/reviving-himalayan-vulture-and-culture">Mustang and Manang</a>, bamboo and mud structures of <a href="https://nepalitimes.com/here-now/the-tarai-s-shrinking-forests">the Tarai</a>, and the Kathmandu Valley’s terra cotta tile skylines, graceful temples, and tranquil bahal courtyards are all examples of <a href="https://nepalitimes.com/here-now/nepal-s-traditional-seismic-resistant-designs">Nepal’s traditional architecture</a>.&nbsp; Nepali architect Sarosh Pradhan has been working for the past eight years on the Brakka Village project in Manang Valley north of <a href="https://nepalitimes.com/banner/municipalities-want-to-manage-annapurna">the Annapurnas</a>. Other examples of this kind of rural architecture for high-end tourism are the Shinta Mani Hotel in Mustang and Khumbu Lodge below <a href="https://nepalitimes.com/news/mt-everest-pvt-ltd">Mt Everest</a>. Says Pradhan, “There are places in Nepal that radiate purity and embrace simplicity. Creating projects in such settings require deep reflection and thoughtful planning.”  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250421030444_a07a23f6b60fa89c0f35b9dc1aaf19937da4881e6bfb2e1858f3c27dff91729f.jpg" data-media-id="editor_19" data-image-id="20250421030444_a07a23f6b60fa89c0f35b9dc1aaf19937da4881e6bfb2e1858f3c27dff91729f" data-rendition-name="original" width="4608" height="2184" loading="lazy" alt="A new architecture for Nepal's tourism"> </figure>  Rural architecture is not easy, and sometimes more expensive. Inflation, energy efficiency, <a href="https://nepalitimes.com/here-now/those-who-stay">the climate crisis</a>, and <a href="https://nepalitimes.com/banner/cost-of-living-in-a-big-city">increased costs of living</a> pose obstacles to sustainable rural architecture. Read also: <a href="https://nepalitimes.com/here-now/forgotten-international-starchitects-in-nepal">Forgotten international starchitects in Nepal</a>, Anne Feenstra and Varun S Bapu Esteva says faith and trust between client and architect is necessary for any project to be successful. He adds that architects must practice being humble, the process of designing always involves learning and not imposing their ideas on clients. Nepal is uniquely positioned for the growth of <a href="https://nepalitimes.com/banner/hiking-up-the-benefits-of-tourism">rural tourism</a> because of its stunning countryside as well as its internationally renowned traditions in holistic wellness. Creating infrastructure that is small, thoughtfully planned and that respects both tradition and contemporary hospitality standards is crucial. “Projects in Nepal can be made cost effective by using materials from houses that have been brought down,” says Esteva. “Pilot projects involving <a href="https://nepalitimes.com/banner/local-government-by-the-people-for-the-people-of-the-people">local people </a>and simple designing also helps the process.” <a href="https://nepalitimes.com/banner/vacant-homes-become-homestays-in-nepal">The growth of homestays in Nepal</a> is a step in the right direction, but they are still a bit too rustic for the international traveller who also wants comfort and is willing to pay extra for it. Upgrading the facilities in homestays and ensuring that the <a href="https://nepalitimes.com/here-now/an-archive-of-nepali-heritage">architectural heritage</a> of the locality is preserved using locally sourced building material could allow owners to charge more. Says Sangita Shrestha of Dwarika’s Hotel, “Our effort is to build upon rural architecture by empowering local communities and using what is available locally. We can fine tune and encourage indigenous design and training.” The vision goes beyond just boosting the economy, it is about building a future where tourism helps villages grow in a healthy and lasting way. Instead of using up resources, it gives back to the land and the people. It supports local communities by<a href="https://nepalitimes.com/opinion/staying-in-nepal-to-create-jobs"> creating jobs</a>, improving infrastructure, and protecting natural beauty. When done right, tourism can be a tool for <a href="https://nepalitimes.com/editorial/progress-and-or-preservation">preserving culture and nature</a>, not harming them. Architects must therefore see their work as more than just designing buildings, they also need to care deeply about people and places, especially in rural areas that can benefit the most.&nbsp; With global interest in sustainable and off-the-beaten-path travel increasing, Nepal stands at the cusp of a <a href="https://nepalitimes.com/news/missing-out-on-nepal-s-tourism-potential">tourism transformation</a> that values community-driven, eco-conscious hospitality. A mix of modern ideas and traditional knowledge could transform rural tourism in Nepal. Says Shrestha, “Young architects should spend time with <a href="https://nepalitimes.com/latest/the-unsung-heroes-of-conservation">local and indigenous communities</a>, listen to their stories, and learn from their <a href="https://nepalitimes.com/banner/life-and-livelihood-in-remote-nepal">ways of living</a>. These communities have deep knowledge about the land, materials, and climate. If this wisdom is used in new designs, it can help create tourism spaces that truly benefit everyone.” &nbsp;

A new architecture for Nepal's tourism

Extract from an addendum to Nepal's Two Wars, Chapter 2 in the updated edition of Essays on Nepal: Past and Present by Sam Cowan, a retired British Army general with a long association with the Gurkhas. The book was first published in 2018, and republished earlier this month by FinePrint exclusively on Amazon. The addendum details a one-to-one conversation the author had in the <a href="https://archive.nepalitimes.com/news.php?id=8884">Royal Palace </a>with the <a href="https://archive.nepalitimes.com/news.php?id=8371">King Gyanendra</a> in November 2002 just after he had taken his initial steps on the road that ultimately led to <a href="https://archive.nepalitimes.com/news.php?id=14681">the abolition of the monarchy</a> in Nepal in 2008. In the early evening of September 16, 2002, in my role as Colonel Commandant of the Brigade of Gurkhas, I had my second and last official audience with King Gyanendra to give him an update on the Brigade’s activities over the previous 12 months. I had some 6 or 7 such audiences with <a href="https://nepalitimes.com/here-now/preserving-king-birendra-s-family-home">King Birendra</a>.&nbsp; These were official affairs with the British ambassador of the day present, along with key <a href="https://archive.nepalitimes.com/news.php?id=12233">palace officials</a> and a representative from Nepal's Foreign Ministry. The two monarchs were very different in character and temperament, but both treated me with the utmost civility and made the audiences as relaxed and easy for me as possible.&nbsp; It is, however, worth recording that when the official business had been covered, King Birendra, with a twinkle in his eye, often ended by asking, “Now General, what’s the gossip in London?” The second audience with <a href="https://archive.nepalitimes.com/news.php?id=8026">King Gyanendra </a>was my last official act in uniform. We came back to Kathmandu in the first week of November (after treks) to stay for a few nights with our Defence Attaché before heading back to the UK. Waiting for me was a message from the Palace saying that King Gyanendra would like to meet me informally: <a href="https://archive.nepalitimes.com/news.php?id=6933">no uniform</a> and no ambassador.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250421080420_f9046f9882d4481781d14f2b64f18c7fbbea62562e1d74e3465de6d01fb43750.jpg" data-media-id="editor_7" data-image-id="20250421080420_f9046f9882d4481781d14f2b64f18c7fbbea62562e1d74e3465de6d01fb43750" data-rendition-name="original" width="1750" height="2406" loading="lazy" alt="Gyanendra crowned page 1"> <figcaption>Nepali Times Special Edition of 6-14 June 2001 with enthronement of Gyanendra. </figcaption> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250421080424_21333d6ae21828eb47fe3f849438d215fe2804460d47bb2896ef4aee4e895ad2.jpg" data-media-id="editor_8" data-image-id="20250421080424_21333d6ae21828eb47fe3f849438d215fe2804460d47bb2896ef4aee4e895ad2" data-rendition-name="original" width="1500" height="1857" loading="lazy" alt="Royal massacre"> <figcaption>Nepali Times 22-29 June 2001 covering the royal massacre after which Gyanendra became king. </figcaption> </figure>  Although I had no idea what the purpose of the meeting might be, events in Kathmandu since I last saw the king put me on edge. On October 4, 2002, Gyanendra had dismissed Prime Minister Sher Bahadur Deuba, allegedly for failing to hold <a href="https://nepalitimes.com/news/what-goes-on-in-nepal-s-elections">elections</a>. He had put in place a new prime minister and a cabinet personally selected by him. When I heard the news on my travels, the people I met were generally supportive of the king’s actions. There was a general view that something had to be done, the country was going nowhere, and the king deserved his chance, not least to solve<a href="https://nepalitimes.com/latest/14-years-after-conflict-no-closure-in-nepal"> the Maoist </a>problem. Back in Kathmandu, views were not so sanguine. The chosen prime minister, Lokendra Bahadur Chand, was a relic from <a href="https://nepalitimes.com/here-now/mob-movement-and-mayhem">the Panchayat period</a> whose party had failed to win a single seat in the last elections held in 1999. Some of the chosen cabinet ministers had, to put it mildly, dubious reputations, and others had no record of proven competence in any field. There was a fear that the king’s real motive in dismissing <a href="https://nepalitimes.com/editorial/deubas-denouement">Deuba</a> was to start to reverse the democratic gains made since 1990. I informed <a href="https://nepalitimes.com/news/nepal-britain-mark-centenary-of-1923-treaty">the British ambassador</a> about the invitation. He was strongly against accepting it, which was probably the clinching reason for my decision to do the polite thing and accept it. On the evening of November 7, 2002, I presented myself at the royal palace, alone and in civilian attire.&nbsp; As in the past, the Military Secretary, Major General Vivek Shah, met and escorted me into the presence of the monarch. This time, however, he was politely asked to leave the room and shut the door behind him. King Gyanendra greeted me warmly and invited me to sit down.&nbsp; Read also:<a href="https://nepalitimes.com/news/the-ghost-of-monarchy-returns-to-haunt-nepal"> The ghost of monarchy returns to haunt Nepal</a>, Shristi Karki  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250421080424_e382af945d0ad2a04ae41fabe5393f793dd10f54cb1220f111c7c9e7423eb558.jpg" data-media-id="editor_15" data-image-id="20250421080424_e382af945d0ad2a04ae41fabe5393f793dd10f54cb1220f111c7c9e7423eb558" data-rendition-name="original" width="1000" height="993" loading="lazy" alt="Gyanendra coup"> <figcaption>Nepali Times 4-10 February 2005 after king Gyanendra's coup imposed media censorship. anendra became king. </figcaption> </figure>  I had wondered, and to be truthful, had worried, not just about the purpose of the meeting, but about how the conversation might start and develop. I reduced my resolve to two points: be polite but speak candidly. The latter resolve was quickly put to the test with the king’s opening words: “Sam, [in previous meetings it had been ‘General’, you walk the highways and byways of this land more than most, tell me what the common man is thinking?” &nbsp;“Your Majesty, I have no idea what they are thinking, but they are waiting.” “Waiting?” “Yes, Your Majesty, they are waiting to see whether what you did some weeks ago in appointing your own prime minister and cabinet ministers is going to make any difference to their lives or whether it is just going to be more Kathmandu hot air.” “Everything is going to be difficult and is going to take time, a lot of time.” “Your Majesty, time is the one thing you don’t have. You must act quickly and decisively to take advantage of the opportunity you have created. Everyone knows that you have appointed these new ministers. Why don’t you get them in here one by one and tell them that they have three months to deliver a programme in their area of responsibility that is going to make a difference to people’s lives? Most will fail to do so. Sack them! It will be a powerful signal of your strong intent to deliver real change.” I can express the opening of our conversation in this way because just about every word is still etched in my mind. The king’s response to my last quoted words was to challenge me to give an example of something that could be delivered quickly. I can give a verbatim record of what I said in response to this unexpected challenge: “Health posts, Your Majesty, there is no shortage of them throughout the country as building them has been one of the sources of local corruption, but very few have any medicine to issue at present or have skilled people to assess and meet medical needs. Your Majesty, children are dying for lack of a few pills. Given the right priority, over a period, say of six months, every health post could be fully stocked with medicine and manned with trained people. This is something I could help to lead for you as I know it would have strong international backing. At last, people would know that you mean business.” As I warmed to the theme, I could see no sign of the king having any enthusiasm for the idea, and I quickly disengaged as it dawned on me, as it had clearly dawned on the king, that the reason for the deficiencies in health posts was to prevent any Maoist combatant from gaining access to any <a href="https://nepalitimes.com/opinion/tech-away/nepal-s-health-tech-industry-is-here-to-stay">medical support</a>, and if this meant people suffering, so be it. The subject of the Maoist insurgency inevitably came up, and I took the opportunity to elaborate on what is written in the final four paragraphs of the article above. I advised King Gyanendra that, self-evidently, since there were three parties in the conflict—him, the Maoists, and the political parties—it was imperative that he form an alliance with one of them, preferably the political parties; otherwise, he would find himself isolated, as the other two parties would inevitably, at some stage, form their own alliance. However, it quickly became apparent that the king’s mind was on a totally different track. On the Maoists, he told me that he had channels open to them, but he was scathing about the political party leaders. He made it clear that they would be waiting for a very long time before he gave any power back to them, and that is a polite way of expressing the actual words he used, but “crawling through the door” is a phrase which has stuck in my mind.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250421080424_5403455ff6168f0d202a96cb53edea69136d74d59b989cfcc7cc4a1d57672cb5.jpg" data-media-id="editor_17" data-image-id="20250421080424_5403455ff6168f0d202a96cb53edea69136d74d59b989cfcc7cc4a1d57672cb5" data-rendition-name="original" width="2000" height="1317" loading="lazy" alt="fall of monarchy"> <figcaption>Nepali Times 28 April-3 May 2005 with cover image by Ajay Joshi of jubilant protesters after street demonstrations sidelined king Gyanendra, paving the way for a ceasfire and restoration of democracy. </figcaption> </figure>  As the conversation developed, it became ever clearer that King Gyanendra had decided to go in alone, relying on the misleading assurances he was constantly receiving from <a href="https://archive.nepalitimes.com/news.php?id=14954">the army</a>, and no doubt his close advisers, that the Maoists could and would be quickly defeated militarily, and taken out of the equation. This would obviate the need for him to do any deal with the political parties.&nbsp; Thus, the way would be clear for him to establish a version of his father’s Panchayat system, under a constitution that would be granted to the people by him, their sovereign, as his father and brother had done in 1962 and 1990. As in those constitutions, ultimate power would have remained in the sovereign’s hands. This proposed direction of travel was very clear from what the king said to me. In sum, King Gyanendra was motivated by a desire to emulate his immediate predecessors by granting his people a constitution that would restore his father’s Panchayat system in a modern form and give him a central role in decision-making. What was particularly dispiriting was that beyond this single objective he had no plan worthy of the name, nor demonstrably did he have the people with the skills to implement an appropriate plan even if one had existed. Crucially and depressingly, there was little or no indication from the king that he realised that such a course of action could put Nepal’s monarchy into serious jeopardy, as indeed proved to be the case. <h2>King Twice</h2>  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250420110436_315d519fe3d68d2406ebe1480fed54720fbf21b8907a4da5cde751fdc623d445.jpg" data-media-id="editor_19" data-image-id="20250420110436_315d519fe3d68d2406ebe1480fed54720fbf21b8907a4da5cde751fdc623d445" data-rendition-name="original" width="1302" height="632" loading="lazy" alt="“Tell me what the common man is thinking!”"> </figure>  <a href="https://archive.nepalitimes.com/news.php?id=8371">Gyanendra Bir Bikram Shah has been king twice</a>. In 1950 he was enthroned briefly as a child king (left, above) by the Rana Prime Minister Mohan Shumsher when his grandfather, King Tribhuvan, fled to exile in India. In 2001 he was crowned king again after the massacre in the royal palace in which his brother King Birendra and nine other members of his family were killed by Crown Prince Dipendra.&nbsp; During his second reign, Gyanendra gradually asserted power by sacking Prime Minister Sher Bahadur Deuba in 2002, and then taking full control after the 1 February 2005 coup. He was sidelined after the ceasefire in April 2006, and became a commoner after the Constituent Assembly finally <a href="https://archive.nepalitimes.com/article/from-nepali-press/Ftnp-abolishing,624">abolished the monarchy in 2008</a>. In the past year, Gyanendra has tried to exploit public dissatisfaction with the political parties to restore the monarchy.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250421080432_26ef4a4b0e3cee9fdc6794446702efe16550d293904b4f6dd46fe35d4d10c788.jpg" data-media-id="editor_22" data-image-id="20250421080432_26ef4a4b0e3cee9fdc6794446702efe16550d293904b4f6dd46fe35d4d10c788" data-rendition-name="original" width="1136" height="702" loading="lazy" alt="Essays on Nepal by Sam Cowen"> </figure>

“Tell me what the common man is thinking!”

He had just sat down for lunch after tending the garden at his house in Lagan Tole on 25 April 2015 when the ground began to shake violently. &nbsp; Gautam Nepal, 56 at the time, realised it was an earthquake. He panicked at the thought of his neighbours' multi-storied buildings toppling on top of his modest one-storey house. He rushed out as the high-rises swayed and groaned. “We were used to earthquakes, moderate ones are a regular occurrence in Kathmandu, but I had never felt fear like I felt on that day,” recalls Gautam. “My house proved strong, it did not collapse.”  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250419040440_82a74881218223df70e30eb1759cd3a7c9edbb7728acef83c3f8b397d6e6dfe9.jpg" data-media-id="editor_0" data-image-id="20250419040440_82a74881218223df70e30eb1759cd3a7c9edbb7728acef83c3f8b397d6e6dfe9" data-rendition-name="original" width="1737" height="1000" loading="lazy" alt="Loss of soul and soil NT"> <figcaption>LAGAN TOLE'S TOLL: Lagan Tole photographed by tour guide Neil S Rawlins during his travel to Kathmandu in February 1970.</figcaption> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250419040448_90914720a75b7d31a12bc27f0c0af9484a5e5efc7dd797dc6bcd190fc28ecdcb.jpg" data-media-id="editor_1" data-image-id="20250419040448_90914720a75b7d31a12bc27f0c0af9484a5e5efc7dd797dc6bcd190fc28ecdcb" data-rendition-name="original" width="1500" height="1004" loading="lazy" alt="Loss of soul and soil NT"> <figcaption>Lagan Tole photographed by Neils Gutschow in 1992.</figcaption> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250419040440_9a4dd35b070949949bfe275eff8216dd29f88f74a30b063dc614845226f68f03.jpg" data-media-id="editor_2" data-image-id="20250419040440_9a4dd35b070949949bfe275eff8216dd29f88f74a30b063dc614845226f68f03" data-rendition-name="original" width="1501" height="1000" loading="lazy" alt="Loss of soul and soil NT"> <figcaption>Lagan Tole in 2025.</figcaption> </figure>  Other residents of Lagan who also live in traditional low rise houses had the same fear. Tara Nepali, then 48, was doing the washing that Saturday.&nbsp; She recalls, “When my house began to shake, I could only think about the bigger buildings falling on top of me. I was sure my house would collapse, but to my surprise, it survived, and so did we.”  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250419040440_2b4b1ec427d9aec5980021b97b25ca3164d5f79337f113ba02b1d802f71b7cad.jpg" data-media-id="editor_3" data-image-id="20250419040440_2b4b1ec427d9aec5980021b97b25ca3164d5f79337f113ba02b1d802f71b7cad" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="Loss of soul and soil NT"> <figcaption>Gautam Nepali in front of his one-storey Lagan home, where he had been having lunch just before the earthquake struck 10 years ago.</figcaption> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250419040436_6f8a7057bbd269214712076e13117b665165e03a0351db0e3666aee05e91f63c.jpg" data-media-id="editor_4" data-image-id="20250419040436_6f8a7057bbd269214712076e13117b665165e03a0351db0e3666aee05e91f63c" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="Loss of soul and soil NT"> <figcaption>Tara Nepali in front of her house in Lagan. She was doing the washing during the earthquake in 2015.</figcaption> </figure>  But Buddha Khadgi, 68, was not so lucky. His was one of the few houses in the neighbourhood to be reduced to rubble. His lifelong collection of photographic prints were buried, and so were the traditional Newari musical instruments passed down through generations of his family that he used to give music lessons.&nbsp; “I lost the things that connected me to my roots and my heritage. That was infinitely more heartbreaking than the fact that my house was gone,” says Khadgi, now living in a new cement structure.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250419040436_58f4a8ee4eb740536c69096a4d8c0cd2007fdbcc4ef56551ff460d2ef0ef6f2b.jpg" data-media-id="editor_5" data-image-id="20250419040436_58f4a8ee4eb740536c69096a4d8c0cd2007fdbcc4ef56551ff460d2ef0ef6f2b" data-rendition-name="original" width="2496" height="1671" loading="lazy" alt="Loss of soul and soil NT"> <figcaption>Lagan's Maka Galli some decades ago. Photo: SHREE RAM NEPALI</figcaption> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250419040440_6b2bacaf0a1e93b441aff8093b343836d6de0b44d7b29f9b758209845f675bff.jpg" data-media-id="editor_6" data-image-id="20250419040440_6b2bacaf0a1e93b441aff8093b343836d6de0b44d7b29f9b758209845f675bff" data-rendition-name="original" width="1000" height="1500" loading="lazy" alt="Loss of soul and soil NT"> <figcaption>Lagan's Maka Galli in 2025. The neighbourhood's old Newari houses have been replaced by concrete structures, although the falcha has been rebuilt in traditional style.</figcaption> </figure>  Lagan Tole in Kathmandu's historic heart emerged relatively unscathed from the earthquake in large part because, like in nearby Asan, the buildings are densely packed and lean on each other. But in the years after the earthquake, urban pressure and fear of future quakes have made families tear down their traditional houses with sloping tile roofs and replace them with concrete structures.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250419040440_25983e79dc88388cb370b16f7f631e4c276cfc997ffa1f9ce3701e40c876b355.jpg" data-media-id="editor_7" data-image-id="20250419040440_25983e79dc88388cb370b16f7f631e4c276cfc997ffa1f9ce3701e40c876b355" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="Loss of soul and soil NT"> <figcaption>Glimpses of present-day Lagan.</figcaption> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250419040440_9a6a88df8815352a452895c43840a898d4b6c080b79562383306c0cfe8bcd952.jpg" data-media-id="editor_8" data-image-id="20250419040440_9a6a88df8815352a452895c43840a898d4b6c080b79562383306c0cfe8bcd952" data-rendition-name="original" width="1000" height="1500" loading="lazy" alt="Loss of soul and soil NT"> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250419040440_a348b974bd3a5e76d0bf9b309f98813556d43dd6c361856c67e79c03d4283e69.jpg" data-media-id="editor_9" data-image-id="20250419040440_a348b974bd3a5e76d0bf9b309f98813556d43dd6c361856c67e79c03d4283e69" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="Loss of soul and soil NT"> </figure>  Lagan’s longtime residents, especially the elderly whose families have lived here for generations, say that the neighbourhood with its characterless new tall cement boxes is no longer familiar to them. “We used to say that our houses are not supposed to be taller than temples, the houses of our gods,” says Gautam. “Now, the houses here dwarf the temples and even the chariot of Seto Machindranath.”  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250419040440_88d18ce580abaf9e62fd807403f2e3c9a5bd8972d3b32bdacb97d8991c7fec35.jpg" data-media-id="editor_10" data-image-id="20250419040440_88d18ce580abaf9e62fd807403f2e3c9a5bd8972d3b32bdacb97d8991c7fec35" data-rendition-name="original" width="1041" height="1441" loading="lazy" alt="Loss of soul and soil NT"> <figcaption>The Seto Machindranath procession at Lagan on 10 April 1998, during which the chariot caught fire. Photo: SOCIAL MEDIA</figcaption> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250419040440_c403f91f9a48c14eaaeed2d38a2cb97714416765730b6d12f29487f9b0f47e83.jpg" data-media-id="editor_11" data-image-id="20250419040440_c403f91f9a48c14eaaeed2d38a2cb97714416765730b6d12f29487f9b0f47e83" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="Loss of soul and soil NT"> <figcaption>The Seto Machindranath procession at Lagan earlier this month.</figcaption> </figure>  &nbsp;The old baha courtyards, falcha resting places, and open spaces where Lagan’s residents used to grow vegetables and gather as a community are nearly all gone. And the taller the houses get, residents say they feel less anchored to the soil. Lagan has also lost its soul -- the community spirit is eroding as elderly neighbours rarely venture down to meet each other in the evenings. &nbsp; “This no longer feels like the tole I grew up in,” says a resident. “We are beginning to lose the relationships we had with each other as a community, and with it, the spirit of Lagan.”&nbsp;

Loss of soul and soil

Dealer Cimex has extended warranties on BYD EVs sold in Nepal for 10yrs/200,000km, up from 8yrs/160,000km. Lights, tyre pressure monitors, suspension and ball joints now have 5yr/125,000km warranties, and all other parts now have 7.5yr/187,500km warranties.&nbsp;

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