https://www.youtube.com/watch?v=kJLBI7sim0M&amp;feature=youtu.beA revolutionary treatment for open wounds has dramatically reduced the healing period of <a href="http://archive.nepalitimes.com/news.php?id=711#.XSckw-szaUk" target="_blank" rel="noopener">leprosy patients in Nepal</a>, saving them money and prolonged pain. The new procedure has huge implications internationally, as it reduces the medical cost for treating patients with chronic open wounds.The technique, called Leukocyte Platelet Rich Fibrin (LPRF), was <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6089057/" target="_blank" rel="noopener">devised for dental surgery</a> by Nelson Pinto of Chile and has proven to accelerate the healing of tissue. Now, it is also being used to treat hard-to-heal skin lesions of <a href="https://archive.nepalitimes.com/article/nation/diabetes-in-south-asia,3018" target="_blank" rel="noopener">diabetes</a> and leprosy patients.“LPRF has shown miraculous results in the treatment of chronic wounds in Nepal,” says dental surgeon Sushil Koirala who is pushing the new treatment in government hospitals. “It does not need special equipment, is cheap and, so simple even paramedics and nurses can perform it.”<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108131140/636a4f009c7e80680e04fce5jpeg.jpg" alt="" width="1400" height="1050"/><figcaption>SECOND CHANCE: Surgeon Indra Bahadur Napit guides a paramedic during a session of LPRF on a patient with leprosy at Anandaban Hospital. Pic: KUNDA DIXIT</figcaption></figure>There are three specialised leprosy hospitals in Nepal: Ananadaban in Lele, Green Pastures in Pokhara, and Lalgadh in Dhanusa. Anandaban Leprosy Hospital 16 km south of Kathmandu has been trying out LPRF on patients with excellent results.Leprosy is a biblical disease in which bacteria called Mycobacterium leprae damages the patient’s nerves and causes the fingers, toes and limbs to go numb, leading to further injuries. Leprosy is treated with antibiotics, but some patients suffer antigen reaction and need long-term rehabilitation.One of the patients at Anandaban is Phelit Sahi, who was ostracised by her community in Jumla because she had leprosy and had been living in a cave for 25 years. Reporters who had gone to cover a local event in a helicopter found out about her, and flew her to Kathmandu for treatment.Every week, doctors draw 80cc of blood from her and place it in a special centrifuge for 12 minutes. The clear plasma separates from the red corpuscles and is compressed to form a high-density fibrin clot which is applied to her wound.“She is among more than 100 patients that we have treated with LPRF, and we have gained enough experience in this technique to lead the way for the world,” says surgeon Indra Bahadur Napit at Anandaban, who presented his results at WHO in Geneva.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108131140/636a4f039c7e80680e04fce6jpeg.jpg" alt="" width="1400" height="933"><figcaption> </figcaption></figure>Raju Lama was 27 when he was diagnosed with leprosy, but because of late diagnosis, his fingers and toes were deformed, and he had to abandon his job. Doctors recommended amputating his right leg, but became the first patient to get LPRF treatment. He is happy with his “ragat upachar” (blood treatment) and says after several LPRF procedures his wounds are healing much faster.Ram Kumari Sah and her husband from Janakpur have been living with leprosy for decades. She does not feel pain in her hands and legs and often hurts herself. Her lesions become infected and never healed. This week, she was waiting for her turn at the LPRF ward in Anandaban.The hospital’s LPRF pilot study has shown that 97% of the cases healed completely within seven weeks. The results are so encouraging that news of this revolutionary treatment has spread through word of mouth. A dozen patients, currently at Anandaban were referred by hospitals in India. A team of Nepali doctors is also training doctors in Burma, Bangladesh and Nigeria.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108131140/636a4f069c7e80680e04fce7jpeg.jpg" alt="" width="1400" height="1003"><figcaption> </figcaption></figure>The new treatment is expected to add to Nepal’s success in reducing the prevalence of leprosy from 21 cases per 10,000 in the 1980s to less than 1 today. Nepal was officially declared leprosy-free in 2010 when the prevalence rate came down to 0.79%.However, in recent years, the prevalence rate is creeping up again, and was 0.94% in 2018. More than 3,000 new patients are diagnosed with leprosy every year, with most of the cases found in Province 2. Experts say this could be a result of active case finding and may not mean that the prevalence is increasing.Leprosy is curable with multidrug therapy but many do not get treatment on time. The incubation period is five years on average and symptoms may occur within a year, but can also take as long as 30 years to become visible, making the disease difficult to diagnose, and the delay leads to nerve damage and deformities. Leprosy is transmitted through the air during close and frequent contact with untreated cases.“Leprosy can afflict anyone but there is a correlation between the disease and poverty,” explains dermatologist Mahesh Shah. “If one’s immune system is strong, the bugs do not do any damage. But poor hygiene and nutrition increases susceptibiltity. Neglected people from neglected countries suffer from leprosy the most.”<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108131140/636a4f0a9c7e80680e04fce8jpeg.jpg" alt="" width="1400" height="1169"><figcaption> </figcaption></figure>Up to 40% of patients undergoing multidrug treatment develop a reaction, and need long-term hospitalisation. Since the patients are poor, most private hospitals are not interested in treating them. At Anandaban, treatment is free as it is supported by government grants and charities.Since 1% of cases suffer from relapse in Nepal, active door-to-door case finding is important to meet the WHO target of zero leprosy transmission by 2030.Even more daunting is to counter societal stigma and ostracisation of leprosy patients. Family members regard the disease as punishment from the gods, and even some medical interns and nurses refuse to touch patients despite patients being on antibiotics and unable to spread the disease. Nepal’s laws still allow husbands to divorce their wives if they have leprosy.“It is a complicated disease made even more so by stigma and ignorance,” says Napit, “but with LPRF, we now have a powerful weapon in our arsenal. A vaccine would be the final solution, but no one cares about leprosy. All the funding goes for diseases like HIV.”   <h2>Miraculous healing</h2>When Nelson Pinto’s favourite horse broke its leg, he had two options: either put it down or amputate its leg. The Chilean dentist decided on a third option.He drew some blood from the horse, spun it in a centrifuge to separate the autologous fibrin matrix which is rich in platelets, and applied the plasma to the horse’s wound. After a few weeks, the horse was cantering again.Pinto knew about the technique because Leukocyte Platelet Rich Fibrin (LPRF) was developed for dental implant treatment. The surgeon was so convinced that the new process would be useful in treating chronic open wounds that he embarked on a global crusade to spread its use.Pinto convinced fellow-dentist from Nepal, Sushil Koirala, whom he met at an international conference, to adopt the technique. Since then, Koirala has been trying to convince the government and private hospitals to adopt the procedure, but without much success. However, Anandaban Leprosy Hospital in Lalitpur has seen phenomenal improvements in the healing time of lesions among its patients. (See adjoining report above)LPRF is now used to treat diabetic wounds, lesions caused by leprosy, localised <a href="http://archive.nepalitimes.com/article/nation/burning-in-the-aftermath,3757" target="_blank" rel="noopener">burns</a> and surgical wounds, and with this, healing time is often cut in half. It is also being used in cosmetic surgery to remove wrinkles and rejuvenate the skin. The reason why it is so effective, Pinto explained during a trip to Nepal last month, is because it is completely natural and autologous, which means a patient is not receiving any foreign tissues or chemicals.And the treatment is cheap. A similar treatment used in Europe, which involves a kit manufactured by a multinational pharmaceutical company, costs $3,000 per patient. LPRF costs only $30. But it seems as though private hospitals are not interested in this treatment as patients heal so quickly. Many doctors are also not enthusiastic because LPRF can be administered by a paramedic or a nurse.Says Sushil Koirala: “The reason they don’t like it is because there is no money in it. LPRF only uses the patient’s blood and there are no chemicals or equipment involved for multinational companies to make money out of.”Koirala’s Punyaarjan Foundation has donated centrifuge machines to a few hospitals in Nepal including the Sushma Koirala Memorial in Sankhu, Anandaban Leprosy Hospital, Bir Hospital in Kathmandu and to three hospitals in Burma with varying degrees of acceptance.The Bible relates how Jesus Christ miraculously and instantaneously cured ten lepers at the gates of Jerusalem. LPRF may not cure leprosy lesions as quickly, but the procedure is nearly as miraculous.<h2>Life after leprosy</h2><figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108131140/636a4f0d9c7e80680e04fce9jpeg.jpg" alt="" width="1400" height="1050"><figcaption> </figcaption></figure>Kumar Tamang, 47, is putting the final touches on his painting of an elephant with a bejewelled crown and a howdah. He dips his paintbrush on a palate and paints the border bright red. His fingers are numb and deformed by leprosy, yet he has been painting for 25 years. His love for Mithila art is on full display on the walls, pillars and ceiling of Shanti Sewa Griha, a leprosy clinic set up by the German charity, Leprahilfe, in 1992.Nearby, in a dark corner, is 50-year-old Nathuni Barai from Nawalparasi, who also has deformed fingers which he uses deftly to draw intricate patterns on a letter pad. Both Tamang and Barai are former patients at <a href="http://archive.nepalitimes.com/news.php?id=15213#.XSckyeszaUk" target="_blank" rel="noopener">Shanti Sewa Griha,</a> making a livelihood from products that Leprahilfe buys from fundraising. Their families live nearby, and their children attend a school set up by the charity.Now, nearly three decades after the clinic was set up, Shanti Sewa Griha runs a school and orphanage in Budhanilkantha, an organic farm in Sundarijal and a rehabilitation centre near Pashupati.As the number of patients grew, they were trained in painting, tailoring, quilt making, carpentry and jewellery making as a form of livelihood. Bags, uniforms, paintings, stationery and decorative items are sold as souvenirs to raise money for the upkeep of the shelters and to pay former patients.“This is a form of operational therapy which tries to break the vicious circle this disease has formed,” said Marianne Grosspietsch, one of the founders of Leprahilfe. “Our goal is to create hope in Nepal.”In 1974, Grosspietsch adopted a young boy named Puskar Limbu who had leprosy like the rest of his family. She took the boy to her home in Germany, treated his leprosy and sent him to school. Limbu went on to pursue a successful career in graphic design in Germany and is a grandfather himself today.Children of former leprosy patients have also gone on to become nurses and doctors.Kalpana Pariyar (pictured above) was 14 when she was diagnosed with leprosy before there was serious nerve damage to her fingers. She grew up in the shelter and married fellow-patient Krishna Majhi, whom she took care of until he died eight years ago. She now has a college going daughter and an eight-year-old son.“I have spent my entire life here. This is my home, this is where I made my life and found peace,” says Pariyar, looking up from her sewing machine on which she was weaving dhaka fabric.Sonia Awale

Sonia Awale

original

674x448

610x380

500x500

400x266

400x240

400x203

301x200

1250x600

1084x550

New treatment offers hope for Nepal’s leprosy patients

<figure><img width="1400" height="932" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110714114/636902db9c7e80680e037c8bjpeg.jpg" alt=""/><figcaption>Source: The Lancet</figcaption></figure>The debilitating effects of mental health diseases and the <a href="http://archive.nepalitimes.com/news.php?id=14138#.W2MFj9Uza70" target="_blank" rel="noopener">social stigma associated with them</a> are not limited to patients: the lives of family members also change irrevocably. Family support can also be an important source of strength and even help in the healing process, say psychiatrists, patients and their relatives.Reshma Magar from Sindhuli, brought her 35-year-old son to a mental health clinic in Kathmandu after he displayed symptoms like severe headaches, mouth fizzing, and haphazard running around. As a mother, she was constantly worried he might hurt himself.“We have the Sun Kosi River nearby and I would think: what if he jumped?” says Magar, who has to tie him up in the hospital bed to contain his violent behavior. “I would be crying and the nurses here would console me.”Read also: <a href="https://www.nepalitimes.com/?p=10647&amp;preview=true" target="_blank" rel="noopener">Raising children can be therapy</a>, Ketan DulalNabina and Samira Pradhan shared similar hardships. Their brother, 40, started showing erratic behaviour after his wife left him, taking their daughter with her. He throws things around, does not eat, and their 71—year-old mother has to look after him.“It is very hard,” Nabina says, “mother herself has health issues and because of our brother’s state, violence in the home remains a constant danger.”Sufferers of psychotic mental illnesses are generally unaware they have a problem. In <a href="http://archive.nepalitimes.com/article/nation/stigma-and-silence-mental-health-nepal,3486" target="_blank" rel="noopener">schizophrenia</a>, a severe psychotic disease, patients have a distorted sense of reality − hallucinations, extreme paranoia, hearing voices − that their mind infers as truth. They resist help, and family members have a difficult job coaxing them to seek and continue medical treatment.Beyond this, the emotional trauma of having a suffering relative is a constant feature of life for the Magar and Pradhan families, which makes each day frightening and unpredictable.Read also: <a href="https://www.nepalitimes.com/?p=10641&amp;preview=true" target="_blank" rel="noopener">Addicted to the joystick</a> , Suprasanna AryalResearch has shown that patients suffering from psychosis have various structural and functional abnormalities in the brain. Schizophrenia patients have dysfunctions in their neurotransmitter systems, metabolic pathways and certain structures in the brain regulating motor activity.Traditionally Nepali society, which did not have coping mechanisms, regarded mental disorder as a curse, and there is strong social stigma and ostracisation of both the patients and their families. Derogatory labels for <a href="http://archive.nepalitimes.com/article/Nepali-Times-Buzz/overcoming-depression,2164" target="_blank" rel="noopener">‘crazy’ people like ‘dimag khuskeko’ or ‘pagal’</a> are still widely used.However, now that science has shown that the causes are mostly chemical imbalances, there is treatment says Basudev Karki of Lagankhel Mental Hospital: “Medicine now has treatment for mental diseases, just like for physical ailments. Problems of the mind also need medical care and treatment and there is nothing wrong in that. Instilling this understanding will help address stigma for patients.”Read also: <a href="https://www.nepalitimes.com/?p=10601&amp;preview=true" target="_blank" rel="noopener">Ashna comes out of black</a>, Sewa Bhattarai <img width="670" height="585" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110714114/636902de9c7e80680e037c8cjpeg.jpg" alt="">However, Karki cautions that medical interventions alone sometimes do not suffice because the triggers may be a combination of biological, psychological and social factors. For example, there was a <a href="http://archive.nepalitimes.com/article/editorial/the-republic-of-insomnia,3311" target="_blank" rel="noopener">surge in mental disorders in Nepali society</a> during <a href="http://archive.nepalitimes.com/article/nation/psychological-scars-of-maoist-conflict-on-young-survivors-take-longer-to-heal,1519" target="_blank" rel="noopener">the conflict</a> and after <a href="https://www.nepalitimes.com/here-now/its-all-in-the-mind/" target="_blank" rel="noopener">the earthquake</a> and Blockade. Out-migration and family separation pushes people into another class of mental illness, like neuroses, such as <a href="http://archive.nepalitimes.com/regular-columns/all-in-mind/the-silent-scream-depression-is-common-but-only-few-get-treatment,588" target="_blank" rel="noopener">depression</a> and anxieties in which, unlike psychosis, the patients preserve a sense of reality.Following hospital treatment it is up to family to provide psychological support for patients, to think positively and maintain a healthy lifestyle. They must protect patients from extreme stress due to social factors, such as unemployment or financial trouble.Muna Tamang shows extraordinary determination this week as she sits beside the hospital bed of her 24-year-old daughter who is suffering from psychosis. “As long as she can live and heal, I have decided that we will do anything for her treatment, even if we have to take loans,” Tamang told us.Read also: <a href="https://www.nepalitimes.com/here-now/its-all-in-the-mind/" target="_blank" rel="noopener">It's all in the mind</a>, Sonia AwaleNepal’s mental health facilities are mostly based in cities, but even here there aren’t enough trained specialists to deal with what is a national mental health epidemic. Up to one-third of Nepal’s population suffers from some form of mental illness, according to one study. (See chart)One group, The Transcultural Psychosocial Organistaiton (TPO) is working to remedy the urban-rural mental health gap, by training doctors and health workers at the local level with Female Community Health Workers.“We do not just want to make these services available, but to also ensure people reach out to them, and refer patients to seek help in facilities,” says Kamal Gautam at the TPO.Such efforts have helped remove stigma, and empowered patients and families to receive treatment and care. But Nepal still has a long way to go. With greater state investment, access to mental health services and proper therapy, family members can be even more involved in helping patients and reducing their stigma.Some names have been changed.

All in the family

Nepal is known internationally for its successful community forestry programme, and the country has doubled its forest cover to over 45% in the last 25 years.&nbsp; But the opposite is true for densely populated urban centres like Kathmandu Valley which have turned into concrete jungles, with no remaining open spaces. Air pollution is increasing to hazardous levels, and the urban heat bubble means the temperature in the city is 2°C-3°C higher than in the outskirts. But there is a solution with a proven track record from similar densely populated cities in Japan — the ‘Miyawaki Method’ of growing local varieties of trees in any small patch of land in the city and turning them into compact forests. Named after Japanese botanist Akira Miyawaki in the early 1970s, carefully selected native trees and plants grow in tiny plots of land, or even in household backyards. They regenerate degraded urban soil, and help restore some greenery and biodiversity back to sterile city centres. The group Lily Leaves has planted Miyawaki forests in six sites across Kathmandu, and is on a mission to green all the river corridors in the Valley. So far, it has planted more than 17,000 trees belonging to nearly 40 species in patches of land along the Bishnumati and Swayambhu, and is eyeing the UN Park area along the Bagmati. “It is extremely important to connect with nature and greenery in cities,” says Lily Katuwal of Lily Leaves. "Besides restoring nature, these forests also clean air pollution and reduce summer temperatures.” Unlike traditional reforestation where trees of the same species are planted in bulk at a distance of 3-4m, Miyawaki prioritises native varieties best suited to Kathmandu Valley’s microclimate. The saplings are packed densely together, spaced only 60cm apart. After they start growing, native grass and undergrowth also thrive. The most recent plantation was along the banks of the Bagmati in Sanepa where, in addition to camphor and jacaranda which are grown in the area, native species such as kabro (Ficus lacor), kanike (Forget-me-not), parijat (Night-flowering Jasmine or Coral Jasmine), chanp (Plumeria), harro (Ink Nut) and barro (Bahera) were planted. A new site in Kirtipur is being readied for the next plantation. Miyawaki has been carried out elsewhere in various parts of Nepal, primarily in Dhanusha which has seen forest regrowth that has brought back insect, bird, reptile and amphibian life.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260402120428_e70c196852945760d082fc73ee18ea6883d13c16186893c00c10fd0a0ea12105.jpg" data-media-id="editor_0" data-image-id="20260402120428_e70c196852945760d082fc73ee18ea6883d13c16186893c00c10fd0a0ea12105" data-rendition-name="original" width="1201" height="1600" loading="lazy" alt="Planting seeds for a greener Kathmandu"> </figure>  EMPOWERING WOMEN Lily Leaves employs just 17 women, six of whom have hearing disabilities. Many have been neglected or abandoned by their in-laws for various reasons. They have a livelihood and learn new skills so they can also find jobs elsewhere.&nbsp; “We trained them in plantation and other skills including tailoring, as well as jewelry, bag and reusable pad making,” says Katuwal. “They are now experts in planting trees.”&nbsp; Lily Leaves gets support from Pipal Tree International in the UK and Nepal, and hopes that the idea of compact urban forest spreads. This is especially important in areas like Taudaha, which is an important stopover for migratory birds. Once noted for its aquatic and avian biodiversity, Taudaha has become lined with concrete and has turned into a loud picnic spot. Urban expansion has encroached upon what used to be the floodplain of the Dhobi Khola, Bishnumati, Bagmati and Manohara rivers. The open spaces along the river corridors are being turned into green belts haphazardly. For many wards, the concept of green space is to have cement pavements and ornamental hard-to-maintain potted plants instead of allowing urban forests to grow back naturally. “Apartment buildings and housing colonies that are being constructed can include green spaces that can increase the real estate and rent value of property,” Katuwal says. “Engineers designing the buildings can suggest such changes so that we remain connected with nature.” Although Lily Leaves needs to have permission from local ward and municipal councils before implementing any program, it continues to face challenges in ensuring smooth coordination.&nbsp; In one such plantation along the Bishnumati River corridor, for example, a heavy earthmover uprooted young trees that were just beginning to thrive. Despite this setback, Katuwal’s team returned to replant them. The land mafia often covets the last remaining open spaces in Kathmandu, deploying local strongmen to try to take them over. &nbsp;They tear down fences, uproot saplings and loot tools. There is a lack of awareness about the importance of greening the city. But now that the former mayor of Kathmandu Balendra Shah is prime minister, national awareness could translate into more urban forests not just in Kathmandu but also in overcrowded urban centres across Nepal. Says Lily Katuwal: “We just plant the seed in people’s minds. Once people in the neighbourhood see that restoring nature lifts their quality of life and increases land prices, there is support. That is when the power of a good example spreads, and communities build on the idea.” &nbsp;

Planting seeds for a greener Kathmandu

It is only April, and Himalayan expeditions are already making rotations to acclimatise on Annapurna and Dhaulagiri, and will soon be making summit pushes.&nbsp; On Mt Everest, Icefall Doctors are fixing ropes and ladders into the Western Cwm as international climbers arrive at Base Camp. Spring 2026 is going to be the busiest and most crowded so far in the Nepal Himalaya. The main reason is that China has closed expeditions from the north side for eight-thousanders Everest and Cho Oyu, and also Xixapangma.&nbsp; The closure is informal, from what one can make out. The Chinese have not put out any official statement, but there are no permits either. The reason seemingly was the ‘Rising Dragon’ firework display last September by pyrotechnic artist Cai Guo-Qiang near Xigatse.&nbsp; Working with outdoor wear company Arc’teryx, Guo-Qiang set off an impressive sequence of orange and white fireworks that wound up a mountain. The spectacular display was criticised for damaging the fragile ecology of the Tibetan Plateau. But this cannot be the only reason the north side is closed. Experienced Everest blogger Alan Arnette anticipates that about 125 climbers will shift to the Nepal side of the mountains, and expects there to be up to 900 summits this spring — up from the highest spring number so far of 876 climbers on top in 2019.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260404050428_8c31812bf38f699c4faa74f25814a6ddaee397f71a629e549023f29250f05082.jpg" data-media-id="editor_0" data-image-id="20260404050428_8c31812bf38f699c4faa74f25814a6ddaee397f71a629e549023f29250f05082" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="mountaineering"> <figcaption>Photo: KARMA TENZING</figcaption> </figure>  The early Base Camp arrivals are having problems with their first rotations because of heavy snow this season. Unlike previous springs, this year has seen back-to-back blizzards at high altitudes since February. The increased snow load on the slopes have increased avalanche danger right across the mountains.&nbsp; There has been an increase in numbers on Everest despite the West Asia war, flight disruptions, LPG shortage and new regulations. The permit fee has gone up for the first time since 2015 from $11,000 to $15,000 this year.&nbsp; The Tourism Bill passed by Nepal’s Upper House last year would have required climbers to have first summitted a 7,000m peak in Nepal before attempting Everest. However, the Department of Tourism has confirmed that there are no new experience requirements this season. Some want this rule changed to include 7,000m peaks anywhere in the world. That could be one reason people are rushing to climb Everest before the Nepal government changes its mind and enforces the new regulations on prior experience on Everest. “It’s probably going to encourage a lot of people that simply are not ready to go,” reckons Alan Arnette. “Once again, we may see a lot of inexperienced people on the mountain trying to get in before the rule comes into place, if it does.”&nbsp; Arnette has always been sceptical of Everest regulations, and points out many instances where rules have been announced but not implemented over the ten years that he has been tracking them. For example, a helicopter ban to Everest Base Camp was announced last year, but rescinded. A rule requiring climbers to bring down waste was never seriously enforced. Since there is so much money involved for the government and for the operators, any any rule that would reduce revenue is never fully implemented. This year there is another ‘High-Altitude Trash Quota’ rule requiring climbers and guides operating above Camp 2 to collect and bring down at least 2kg of waste from the higher camps.&nbsp; The Nepal government has tried to diversify peaks on offer by reducing the royalty on climbs, but the draw of Everest, Annapurna and other eight-thousanders seems to be too great. Even when the permit fees for some remote peaks like Kangri Shar, Himlung and Api, were reduced to $400, there are few takers.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260402120436_a90cd44858e97086f773aa1fbd592b3434bb07d89cd4a1843b2ca32a84e7c72d.jpg" data-media-id="editor_1" data-image-id="20260402120436_a90cd44858e97086f773aa1fbd592b3434bb07d89cd4a1843b2ca32a84e7c72d" data-rendition-name="original" width="1500" height="1125" loading="lazy" alt="Photo Damien Francois"> <figcaption>Photo: DAMIEN FRANCOIS</figcaption> </figure>  TIME LAPSE Clients and expedition operators have been trying to shorten the time needed to complete an Everest expedition from the city of origin to the top and back. Since Nepal has no rules about spending a certain number of days in acclimatisation, this has allowed some expedition organisers to use new technology.&nbsp; Austrian operator Lukas Furtenbach last May led a group of four British ex-military clients to the summit within a week of leaving London. This climb was scrutinised because the group had practiced breathing xenon gas, a substance that increases the count of red blood cells and is banned in competitive sports. The climbers had also trained for months at home in hypoxic tents, and used supplemental oxygen during the actual climb.&nbsp; The success of that expedition prompted an investigation by Nepal’s Ministry of Culture, Tourism, and Civil Aviation, but there was nothing it could do because the team had taken the xenon in Germany two weeks before their trip. But even if they had administered the gas in Nepal, it would technically not be illegal. Furtenbach is firmly in favour of speed, and of using the gas. “The only reason why we are working with xenon is to make climbing safer, to protect climbers from high altitude sickness,” he says, arguing that the less time climbers spend on the mountains, the less their exposure is to disasters, sickness, and they also generate less trash.&nbsp; His firm, Furtenbach Adventure, offers a three-week Everest South Flash expedition, at a cost of €100,000, using custom oxygen systems. Other expeditions take up to two months.&nbsp; A young American duo of Ryan Mitchell and Justin Sockett got to Everest Base Camp five days ago. They are preparing for an oxygen-free summit attempt.&nbsp; ‘ Being around these mountains for one day has already brought me so much joy. Every time I come back to the Khumbu I feel more familiar and connected,’ posted Mitchell. He and Sockett have since summitted Lobuche East (6,119m) as they continue to acclimatise and wait for the Khumbu Icefall route to be fixed.&nbsp; There are other sans-O2 trips planned this climbing season in Nepal. Norwegian Kristin Harila, the fastest in the world to climb all 14 8,000ers (in 92 days), is attempting the Nuptse, Lhotse, and Everest three-peak climb without supplemental oxygen. American Tyler Andrews and Ecuadorian Karl Egloff are continuing their race to break records in Everest. While Andrews is attempting the Fastest Known Time from Base Camp to the top without oxygen, Egloff is taking it a step further and going for a round trip: from Base Camp to the summit and back in record time.&nbsp; Both Egloff and Andrews had attempted these climbs in 2025 spring, but abandoned around 7,000m due to bad weather.&nbsp; Kami Rita Sherpa wants to extend his all-time record of total Everest summits to 32, while Kenton Cool from England is chasing 20, a non-Nepali record.&nbsp; The first summits of the season will be in late April, or early May depending on weather. Besides Everest, there are a lot of interesting climbs on lesser known peaks.&nbsp; The Japanese trio of Masayuki Takenaka, Tatsuro Sugimoto, and Ryota Nomura, for example, are attempting the unclimbed Jarkya Himal (6,473m) near Manaslu. &nbsp;&nbsp; <h2>Fake rescues</h2>  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260402120436_600c0176e24327fd3dfcfd634e4b871f3e5314aa00eb4885ad137ac6f9c4a3b6.jpg" data-media-id="editor_2" data-image-id="20260402120436_600c0176e24327fd3dfcfd634e4b871f3e5314aa00eb4885ad137ac6f9c4a3b6" data-rendition-name="original" width="800" height="519" loading="lazy" alt="Fake rescues"> </figure>  This year’s spring climbing season has coincided with Nepal’s new government taking action against alleged perpetrators in fake rescues and insurance fraud. The Central Investigation Bureau (CIB) has already arrested more than a dozen trekking agency executives, hospital managers and helicopter company executives for medevac insurance fraud. Climbers are known to fabricate medical emergencies, get flown down from as high as Camp II on Everest, and then submit false insurance claims.&nbsp; Sometimes one flight is made to look like many using fake invoices. Trekking companies are also involved in fake rescues of hikers who just get tired of walking.&nbsp; Too many fake claims could lead to insurer’s losing confidence in the industry, and increased premiums, leading to delayed responses in real accidents.&nbsp; As a result of the scandal, there is now more scrutiny from the government about rescues. Already, helicopter operators have to wait for permission before carrying out rescues while their application is vetted.&nbsp; The worry is that this could cause unnecessary delays when time is of the essence in mountain rescue. Already, medevacs are delayed because of the bureaucracy needing permits to fly to sensitive regions bordering China. Last year, a climber died on Himlung because helicopter rescue took too long while operators ran from door to door in Kathmandu to obtain necessary permits. <h2>Mingma David Sherpa, MP</h2>  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260402120432_05c1600440327f4ae4bcae641b634714951f45702080a88d4e2628587190aa25.jpg" data-media-id="editor_3" data-image-id="20260402120432_05c1600440327f4ae4bcae641b634714951f45702080a88d4e2628587190aa25" data-rendition-name="original" width="960" height="958" loading="lazy" alt="Mingma David Sherpa"> </figure>  Meet Mingma David Sherpa, Nepal’s first mountaineer to be nominated to Parliament. Sherpa is a self-made professional climber from Rolwaling, who rose up from an expedition porter to a record-breaking mountaineer and expedition organiser. As an insider, he is now in a position to streamline laws related to Nepal’s trekking and mountaineering sector. He is co-owner of EliteExped with Nims Purja, and in 2021 the two were part of a team of Nepali climbers to be the first to make it to the top of K2 in winter, the second highest mountain in the world in Pakistan.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260402120432_c4ec586e7a27b09a72e61925a3897d843f864563d9e82a3fd3e25293e22cbe54.png" data-media-id="editor_4" data-image-id="20260402120432_c4ec586e7a27b09a72e61925a3897d843f864563d9e82a3fd3e25293e22cbe54" data-rendition-name="original" width="2082" height="1396" loading="lazy" alt="Mingama David Sherpa"> </figure>  Mingma David was also on Purja’s Project Possible to climb all the 14 eight-thousanders in six months, shattering the previous record of seven years. He was featured in Purja’s documentary 14 Peaks: Nothing is Impossible.&nbsp; At age 30 he became the youngest climber to reach the top of all 14 eight-thousanders for which he was awarded the Piolet d’Or. Mingma David has taken part in dozens of successful rescues of fellow climber, including the highest ever long-line rescue on Dhaulagiri and saving the life of fellow-climber from 8,600m on Everest. <h2>April Fool</h2>  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260402120432_775afff27d4a2889a60730aa25bbc5f8eb8ea343528c8c031a6febbfd74814c4.jpg" data-media-id="editor_5" data-image-id="20260402120432_775afff27d4a2889a60730aa25bbc5f8eb8ea343528c8c031a6febbfd74814c4" data-rendition-name="original" width="1365" height="1820" loading="lazy" alt="Furtenback Adventures"> </figure>  The Austrian expedition outfitting company Furtenbach Adventures spoofed the anticipated crowds on an April First post on social media this week, showing ‘a fully galvanized, weather-resistant steel staircase, complete with a sturdy handrail’ to make the Hillary Step bottleneck on Mt Everest less dangerous.

Nepal Himalaya Spring 2026

The war in West Asia has exposed the fragility of the economic architecture Nepal has built on over two generations. If the conflict continues, growth across developing Asia will slow and prices will rise. For Nepal, this will be felt through higher living costs, weaker economic activity, and growing uncertainty for the millions of families who depend on remittances.&nbsp; Nepal now needs to structurally transform from exporting labour to investing in domestic job creation. &nbsp; The country's current path toward a knowledge economy has a blind spot. A <a href="https://iids.org.np/wp-content/uploads/2025/02/unleashing.pdf" target="_blank">report</a> by the Institute for Integrated Development Studies (IIDS) in Kathmandu shows that IT export companies alone generated 7,228 jobs and income for 66,509 freelancers.&nbsp; We are building digital labour export, not an economy that accumulates institutional knowledge. The Nepali Upwork developer and a migrant construction worker in the Gulf are engaged in the same economic activity, but with different tools. Nepal’s reliance on a <a href="https://data.worldbank.org/indicator/BX.TRF.PWKR.DT.GD.ZS?locations=NP" target="_blank">remittance-driven economy,</a> means the country has failed to create enough <a href="https://www.worldbank.org/en/country/nepal/publication/unlocking-nepal-s-growth-potential" target="_blank">quality jobs</a> at home. For millions of young people, leaving the country is not a choice but a necessity to survive and support families back home. <a href="https://www.worldbank.org/en/country/nepal/publication/unlocking-nepal-s-growth-potential" target="_blank">Remittances</a> have no doubt helped reduce poverty. Thirty years ago, 55% of Nepal’s population lived on less than $2.15 a day, now it is 20% after the absolute poverty line was revised upwards. This progress has come at a cost — &nbsp;an economy that depends more on exporting workers than creating opportunities at home. This development reflects a deeper political failure to create meaningful jobs within the country. Since the democratic transition in 1991, Nepal’s leadership has largely recycled the same faces, with limited progress on job creation or industrial growth.&nbsp; Nepal cannot build a <a href="https://nipore.org/accelerating-nepals-startups/" target="_blank">knowledge economy</a> while its most ambitious people are outbound to Doha and Tokyo. We are also not just losing ‘labour’. We are losing the entrepreneurial risk tolerance of our youth.&nbsp; If the most ambitious 25-year-olds are abroad, who is left to support innovation and entrepreneurship? The same people who are working tirelessly abroad, are our biggest asset for development. Their work ethic and the know-how inurban renewal could well fit into the new RSP government’s mandate of 7% annual growth.&nbsp; The <a href="https://english.biznessnews.com/posts/-nepal%E2%80%99s-it-exports-cross-1-billion-" target="_blank">$1B milestone</a> of IT exports is a celebratory moment for Nepal. However, that cannot lead to a pathway to a $100 billion economy without innovation ecosystems that go beyond individual labour export. Companies like SecurityPal and industry associations such as NASIT have made significant efforts in building such an environment, recently championed by private sector leaders as a &nbsp;<a href="https://www.securitypalhq.com/blog/silicon-peaks" target="_blank">Silicon Peaks</a> model that emphasises a home growth tech cluster. The need to accelerate this transition is even more urgent with the escalating conflict in West Asia. &nbsp;The recent International Labour Organisation (ILO) <a href="https://www.ilo.org/sites/default/files/2026-03/Nepal%20LDC%20Graduation%20Employment%20Impacts%20Report.pdf" target="_blank">report</a> shows that LDC graduation is expected to adversely impact manufacturing with losses of $1 billion by 2030.&nbsp; If manufacturing takes such a large hit from losing trade preferences, then Nepal’s services and IT sectors need to structurally transform and shift from exporting individual talent to building firms. &nbsp; A generation’s frustration has finally forced a shift in Nepal’s political structure, handing the new government a clear mandate to fix failures. But the question still persists: what prevents Nepal from achieving sustained, productivity-driven growth? &nbsp;&nbsp; RSP is in the right place at the right time to put Nepal's economy on a firm footing. At the heart of Nepal’s economic underperformance lies a major development binding constraint: low returns to investment on projects.&nbsp; The government invests like a high-growth economy, with gross capital formation at around <a href="https://data.worldbank.org/indicator/NE.GDI.FTOT.ZS?locations=NP" target="_blank">25–30 percent of GDP</a>. Yet economic growth remains modest. The problem is not how much the country invests, but how little it gets in return. One way to see this is by looking at how much investment is required to generate growth.&nbsp; Nepal needs large amounts of capital to produce relatively small gains in output (graph, below). For instance, in 2024, the ICOR was 8.29, this suggests that Nepal had to invest more than 8 units of capital to produce a one unit of additional economic output.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260406040412_605dc527641d2ff2dc5723ed8bbec946898331d5538a55b9941e32a0725bf811.jpg" data-media-id="editor_9" data-image-id="20260406040412_605dc527641d2ff2dc5723ed8bbec946898331d5538a55b9941e32a0725bf811" data-rendition-name="original" width="1827" height="925" loading="lazy" alt="Economy graph"> <figcaption>Source: Author's calculation based on a Growth Diagnostic simulation</figcaption> </figure>  This reflects a deeper issue in how investment is allocated and executed. Capital is often locked in low-productivity sectors or diluted by delays, inefficiencies, and policy uncertainty.&nbsp; As a result, even high levels of investment fail to translate into sustained growth. Until investment shifts toward productive, firm-building activities, higher spending alone will not deliver results. &nbsp; To reverse this, the government must focus on raising the returns to investment by enabling firms to grow and compete. This requires a shift from managing scarcity to creating an environment where capital can generate consistent and predictable returns. A central priority should be given to attracting and retaining both domestic and foreign private investment. Investors do not just respond to direct incentives, but also to policy stability in the country. Nepal’s economy cannot sustain high growth if its human capital continues to leave the country.&nbsp; The goal should not simply be to create jobs, but to build companies that scale, innovate, and compete beyond Nepal. This requires supporting sectors with strong productivity potential and ensuring that firms can expand without being constrained by infrastructure gaps or regulatory friction. Finally, the state must improve the quality of its own investment. Public spending should focus on lowering the cost of doing business through reliable electricity, efficient logistics, and digital infrastructure.&nbsp; The GenZ movement took two days to bring change. The economic transformation of Nepal might take a generation. The RSP can accelerate this transition, but only if it focuses on building a better investment climate for business and not just feeding the global labour pool. Kailash Raj Pandey is an MPA/ID and MBA candidate at Harvard Kennedy School and MIT Sloan School of Management and a fellow at MIT Kuo Sharper Center for Innovation and Prosperity.&nbsp; Siddhartha Raymajhí is a policy researcher based in Kathmandu.

Creating a firm future for Nepal

Barely a month after the March election, newly elected lawmakers convened for the first session of Parliament on Thursday (picured above).
But the RSP had already hit the ground running in its first week in office. Prime Minister Balendra Shah and his trusted Home Minister Sudan Gurung conducted a slew of high profile arrests. &nbsp;
The former prime minister, home minister and Kathmandu CDO, among others, were detained in connection with the 8 September massacre outside Parliament.&nbsp;
The Cabinet unveiled its 100-point roadmap outlining sweeping institutional, economic and social reforms to ensure better service delivery, and setting deadlines for itself for the first 100 days in office.&nbsp;
Key priorities include strengthening digital governance, removing redundancy across the civil service, investigating assets of high-ranking political and government figures, depoliticising the bureaucracy and universities, as well as broader legal and constitutional reforms.
“The move to hold former leaders accountable sends a powerful signal that impunity is no longer politically untouchable,” says Pukar Malla of Governance Lab at Daayitwa Abhiyan. “On the reform agenda, the direction is right but the timeline is too compressed, 100 days is not enough to transform the system. It is only enough to establish the discipline of transformation.”
The RSP’s decisions have mostly been greeted with enthusiasm by the electorate which gave the party an almost two-thirds majority in Parliament. Nepalis are for the first time in decades genuinely hopeful about the country’s leadership.
“The enthusiasm is real because the pain is real. &nbsp;But people are not just asking for symptoms to be treated. They want the patterns underneath the symptoms to change,” says Malla. "That is where the leadership journey becomes much harder, because structural change is slower, more conflictual, and far less theatrical than headline decisions.”
The RSP’s prompt proactiveness signals a can-do approach designed to placate voters impatient to see immediate change, and also to warn influential figures of the past three decades that anyone can be dragged to jail or put on the immigration no-fly list. The message is also to the bureaucracy to pull its weight, and clean up its act.&nbsp;
But in public discourse, there is also a sense that anyone critical of the government’s decisions can be targeted and trolled. Enthusiasm about the new government &nbsp;seems to outweigh critical and nuanced reasoning about whether ‘Balen Sarkar’ can achieve targets it has given itself within the self-imposed timeframe.&nbsp;
Any concerns about the RSP’s perceived high-handedness or criticism of state overreach tends to be dismissed, branded as noisemaking by mouthpieces of old parties.
Critics say the arrest of Oli, Lekhak others did not follow due process, and displays the very partisanship and vendetta tactics of the legacy parties that the RSP vowed to dismantle.
“The detentions and the plans this government has made for the next 100 days might be necessary, but they seem to be optimised for public spectacle and rather than being deliberative steps for sustained reforms,” says researcher Dovan Rai of Body and Data.
She adds: “K P Oli failed because he put himself above the system, and it seems as though that power has just transferred from one personality to another. What we need is strong institutions, not strongmen that play the role of hero or villain.”
The RSP’s strategy to overhaul the state apparatus is high-stakes, aspirational and at times unquantifiable. The new leaders and the public must recognise that Nepal’s problems cannot be solved in 100 days.
The near two-thirds dominance in Parliament offers the RSP a chance to show results, but it is also an unforgiving majority. Failure is not an option.
Adds Pukar Malla: Political leadership may drive change from above, but civil society and citizen networks have to partner from below.”
The NC and the UML are licking their wounds, and again proved their obsolescence this week by trying to rehabilitate and reinstate old leaders. The UML is on warpath, and missed another opportunity to turn a new leaf by rejecting 36-year-old Suhang Nembang as parliamentary party leader.
People who did not vote for RSP must give the party a chance to deliver on promises. But the party's most effective opposition may have to be its own voters, who must play the check and balance role by insisting on results, and preventing fawning support for populist leaders resulting in authoritarian creep. &nbsp;&nbsp;
“The public now plays a critical role in holding the leadership accountable, it must go beyond small wins,” says Dovan Rai. “Support must not come from opportunism, and criticism must not be based on prejudice.”

stigma

New treatment offers hope for Nepal’s leprosy patients

All in the family

Planting seeds for a greener Kathmandu

Nepal Himalaya Spring 2026

Creating a firm future for Nepal

RSP dos and don’ts