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

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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

As dusk fell over Kathmandu, the thunderstorm continued unabated. It had been raining continuously for 18 hours, and the forecast said it would keep raining at least till 8am on Sunday. The Bagmati roared through Chobhar Gorge in awesome rapids – the only drainage outlet for the entire Kathmandu Valley. By evening, 120mm of rain had fallen in 18 hours, more than the average for the whole of October.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251004161016_99ad9098124bec91da71ac42bbe889981fe64dda2dd3012b8bb289cf78ba4c54.jpg" data-media-id="editor_0" data-image-id="20251004161016_99ad9098124bec91da71ac42bbe889981fe64dda2dd3012b8bb289cf78ba4c54" data-rendition-name="original" width="2048" height="1365" loading="lazy" alt="Kathmandu floods 2025"> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251004161016_59b97f3a3b2af91d3876b298963b3e68395c8b388aba6d9972c9bde1f668608d.jpg" data-media-id="editor_1" data-image-id="20251004161016_59b97f3a3b2af91d3876b298963b3e68395c8b388aba6d9972c9bde1f668608d" data-rendition-name="original" width="2048" height="1365" loading="lazy" alt="Kathmandu floods 2025"> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251004161016_1715f4d6ff1ee87302b697d3c95df36486bea71ed279852ef606c8f5dc68439b.jpg" data-media-id="editor_2" data-image-id="20251004161016_1715f4d6ff1ee87302b697d3c95df36486bea71ed279852ef606c8f5dc68439b" data-rendition-name="original" width="2048" height="1365" loading="lazy" alt="Kathmandu floods 2025"> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251004161016_ecd3dec69270afbd5a5c71dfa71780b6f8982984a95f3fbb83f23ee594451224.jpg" data-media-id="editor_3" data-image-id="20251004161016_ecd3dec69270afbd5a5c71dfa71780b6f8982984a95f3fbb83f23ee594451224" data-rendition-name="original" width="2048" height="1365" loading="lazy" alt="Kathmandu floods 2025"> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251004161016_53e47ae222c9f4397bcdad6d8021a711a5671fd45373fb3df2ed5c6413d58359.jpg" data-media-id="editor_4" data-image-id="20251004161016_53e47ae222c9f4397bcdad6d8021a711a5671fd45373fb3df2ed5c6413d58359" data-rendition-name="original" width="2048" height="1365" loading="lazy" alt="Kathmandu floods 2025"> </figure>  Settlements along the banks of Bagmati and Vishnumati in Kathmandu have been evacuated and affected families will be temporarily sheltered in schools across the capital.&nbsp; Bagmati Province has set up a Unified Command Team for disaster management while the Home Ministry has instructed CDO and security personnel to be on duty 24/7.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251004171048_7e5d10f8e0042190e54e6db6cddbd51ed9d6d9dbc0cdb087d7af3207c9eaa2d0.jpg" data-media-id="editor_5" data-image-id="20251004171048_7e5d10f8e0042190e54e6db6cddbd51ed9d6d9dbc0cdb087d7af3207c9eaa2d0" data-rendition-name="original" width="1600" height="888" loading="lazy" alt="heavy rain in Kathmandu"> <figcaption>Friday's satellite precipitation forecast for Sunday morning at 0600 showing heavy rainfall along the Chure Hills and Madhes Province south of Kathmandu. </figcaption> </figure>  The torrential rain has obstructed several highways as well as caused infrastructure damage, but no human casualties have been reported so far. Many had feared a repeat of the deadly flashfloods on 28 September 2024 in which 200 people were killed and half of Nepal's hydropower generation capacity siped out. The government has declared 5 and 6 October as a public holiday to prevent people from travelling during the Dasain festival, and to reduce risk. All highways in and out of Kathmandu closed till Monday. Flood-prone river corridor roads in Kathmandu have been closed after 6PM on Saturday. Meanwhile, all domestic flights were suspended from Kathmandu and other airports from 2PM Saturday, and most inbound international flights were diverted from 3PM onwards. Rerouted flights started arriving in kathmandu late Saturday as the core of the storm system moved east.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251004151056_bad029b05dbfda622986270a798edc6efcc2791ff34f53b9d1283554ac72c39a.jpg" data-media-id="editor_6" data-image-id="20251004151056_bad029b05dbfda622986270a798edc6efcc2791ff34f53b9d1283554ac72c39a" data-rendition-name="original" width="2048" height="1365" loading="lazy" alt="heavy rainfall in Kathmandu 2025"> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251004151052_9e740929c7ef0899b0f397195695b873bba45b089bb1e11cf37dbe125d0cd60d.jpg" data-media-id="editor_7" data-image-id="20251004151052_9e740929c7ef0899b0f397195695b873bba45b089bb1e11cf37dbe125d0cd60d" data-rendition-name="original" width="2048" height="1363" loading="lazy" alt="heavy rain in Kathmandu 2025"> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251004151056_2b75c2ea57df76dae1c470f0e460720b7d258868258789729e491ab93cb41ebd.jpg" data-media-id="editor_8" data-image-id="20251004151056_2b75c2ea57df76dae1c470f0e460720b7d258868258789729e491ab93cb41ebd" data-rendition-name="original" width="2048" height="1365" loading="lazy" alt="heavy rainfall in Kathmandu 2025"> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251004151056_6c045ac30e50710bcf3ca7b6ca4ac9c45e8d8881ed39f522779c860b0d3f15c3.jpg" data-media-id="editor_9" data-image-id="20251004151056_6c045ac30e50710bcf3ca7b6ca4ac9c45e8d8881ed39f522779c860b0d3f15c3" data-rendition-name="original" width="2048" height="1365" loading="lazy" alt="heavy rainfall in Kathmandu 2025"> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251004151052_9ef160b8403764495b86159661cc9a11d9d7d3b848686a631e5ec8cff0c4c38f.jpg" data-media-id="editor_10" data-image-id="20251004151052_9ef160b8403764495b86159661cc9a11d9d7d3b848686a631e5ec8cff0c4c38f" data-rendition-name="original" width="2048" height="1365" loading="lazy" alt="heavy rain in Kathmandu 2025"> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251004151052_e5825bcc6666e5235d9db2d4854a19cd6536335ebaf4cd65413acc601ceee3b5.jpg" data-media-id="editor_11" data-image-id="20251004151052_e5825bcc6666e5235d9db2d4854a19cd6536335ebaf4cd65413acc601ceee3b5" data-rendition-name="original" width="2048" height="1365" loading="lazy" alt="heavy rain in Kathmandu 2025"> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251004151056_097077400e96f571f4418cd7b57c082045d86dd9035c31c5acd7ede2bfc54349.jpg" data-media-id="editor_12" data-image-id="20251004151056_097077400e96f571f4418cd7b57c082045d86dd9035c31c5acd7ede2bfc54349" data-rendition-name="original" width="2048" height="1365" loading="lazy" alt="heavy rainfall in Kathmandu 2025"> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251004151056_30a4da8f384f6fe1a862e775124ae08ccf51c1db60e71e7e2d683e0f25f33546.jpg" data-media-id="editor_13" data-image-id="20251004151056_30a4da8f384f6fe1a862e775124ae08ccf51c1db60e71e7e2d683e0f25f33546" data-rendition-name="original" width="2048" height="1365" loading="lazy" alt="heavy rainfall in Kathmandu 2025"> </figure>  Madhes, Bagmati and Kosi provinces are the worst hit with Maheshpur in Rautahat district recording 270mm of rain as of 3PM on Saturday. Similarly, Gaur received 243.6mm, Kalaiya in Bara 200.6mm and Birganj 221.4mm. The Department of Meteorology did not blame climate change, but said the unusually heavy precipitation at a time when the monsoon is supposed to have ended was caused by the head-on collision between moisture-laden westerlies with the retreating monsoon.

More dark clouds over Nepal

Kathmandu: A Reader, the latest publication from Martin Chautari, is an anthology of anthropological essays exploring Kathmandu through various lenses across the 21st century. This compilation is edited by Benjamin Linder and attempts to bring modern discourses on Kathmandu and its urbanity together, in a single volume. The book is divided into three sections: the physical form of the city, the imprints it bears from past political upheavals, and the complexity in the lives of its people. The book examines these diverse aspects, leaving readers who have just witnessed the momentous events of September with anxiety, and perhaps a greater understanding of Kathmandu’s context. Urban planning expert Biresh Shah’s discourse on the Valley’s urban sprawl and its landmarks is insightful, but also prophetic when he warns about seismic risk.&nbsp; Jan Brunson’s chapter on female mobility in Kathmandu via scooters is more optimistic, suggesting small-scale, daily-life movements in Kathmandu transform the city for its various demographics — in this case young women.&nbsp; Linder himself contributes with a discourse on the toponymy of Thamel, close-reading Kathmandu’s tourist hub through the usage and understanding of its name over the ages. MYTHBUSTERS The book is a collage of pieces held together by a thread that runs through the chapters of a vibrant, bustling image of the Valley. One common theme is Linder’s attempt to expand on common understandings and urban myths about Kathmandu. Readers who have spent time in the city will relate to the many anecdotes. for example, Niels Gutschow bringing up the lack of open spaces, or Mark Liechty mentioning restaurants in Kathmandu being melting pots of cultures and castes.&nbsp; The essays here further extend these urban legends by giving historical and anthropological contexts. In-migration and the rise in land prices have led to shrinking open spaces, the creation of cosmopolitan food outlets, and even hubs for sex workers. The Bagmati cleanliness campaign extends to a past understanding of the Bagmati Civilisation. Urban myths become puzzles to be solved by connecting the various threads of discussion across the book. The sections in Kathmandu: A Reader are all by experts in their various fields and present a holistic, well-rounded picture. Yet, it is obvious there is still more ground to cover, more themes to explore — perhaps by more Nepali scholars.&nbsp; In his introduction, Linder admits that due to practical reasons, ‘many wonderful works were left on the cutting room floor’. That is a pity. Indeed, there could have been more discourse on the changing ethnic composition of Kathmandu. A close-read into the lives of people termed as ‘outsiders’ but forming a growing slice of the population would be important to also chart future trends. &nbsp; The religious importance of Kathmandu as a unique civilisational alloy forged by melding the Hindu and Buddhist faiths can be explored more too. One can imagine a future edition including an examination of the post-Covid era Kathmandu valley.&nbsp; This need to broaden the ethnographic literature on Kathmandu becomes more apparent because 11 out of the 15 essays here are written by non-Nepali scholars, including the entire section focusing on urban cultural politics. Linder explains in his introduction that this was largely due to the community of academics in Nepali urban studies being fairly small. Kathmandu: A Reader then becomes even more integral as a gateway for new authors looking to work in the space of urban research on the Valley — undergraduates in the humanities for future theses and research ideas.&nbsp; In a time when Kathmandu is littered with new exam coaching centres for medical and engineering students, an anthology like this helps remind young scholars that there is plenty of scope for qualitative research in the social sciences. Sabin Ninglekhu’s discourse on the sukumbasi and aesthetics in Kathmandu are reminders that stories and academic journeys can be inspired from one’s surroundings. Kathmandu: A Reader has a good balance between academic and lighter readings, and is almost encyclopaedic in nature. There is even content about Kathmandu’s gangsters and scooty girls — allowing readers to venture deeper into their milieu.&nbsp; Kshitiz Pratap Shah is a recent graduate in English from Ashoka University.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251002051016_c8ce28ecfd0dde4986023822b3d40360ead97d29b7f186f6494d8da67021c5a5.jpg" data-media-id="editor_0" data-image-id="20251002051016_c8ce28ecfd0dde4986023822b3d40360ead97d29b7f186f6494d8da67021c5a5" data-rendition-name="original" width="1136" height="702" loading="lazy" alt="Kathmanu a reader"> </figure>

A reader for Kathmandu

Following the <a href="https://nepalitimes.com/news/nepal-s-8-september-massacre">uprising of 8-9 September</a>, the Nepal Army commenced a series of consultations concerning the transition process, during which the potential reinstatement of the monarchy was reportedly under consideration.&nbsp; However, former King Gyanendra Shah declined to pursue this option without a consensus among the political parties. This information was conveyed by Madhav Kumar Nepal, a former Prime Minister and a notable critic of the monarchy, in a newspaper article. The former king, for his part, delivered his annual Dasain message to the nation on 28 September. He emphasised, among other points, that the younger generation constitutes the foundation of the nation’s future.&nbsp; ‘Only the patriotic spirit, energy, and innovative thinking inherent in them can guide the nation toward strength, prosperity, and self-reliance. Let us reflect upon ourselves in the mirror of our country,’ he said. ‘Our political endeavours have often focused on destruction. Now, our initiatives should aim not at ruin but at improvement.’ Seventeen years <a href="https://nepalitimes.com/news/the-ghost-of-monarchy-returns-to-haunt-nepal">after Nepal abolished its monarchy</a> and became a federal secular democratic republic, the monarchy still influences the country’s political scene, mainly because of the persistent weaknesses of democratic institutions. Throughout much of its modern history, Nepal’s political landscape was controlled by the monarchy. During the partyless Panchayat system (1960-1990), the palace was consistently criticised for its authoritarian rule. However, it presented itself as the defender of national unity and sovereignty, especially against Indian influence. The 1990 People’s Movement transitioned Nepal into a constitutional monarchy. However, this period was marred by persistent instability, including the outbreak of a Maoist insurgency in 1996 and a royal palace massacre five years later.&nbsp; By 2005, when <a href="https://nepalitimes.com/here-now/tell-me-what-the-common-man-is-thinking">the new king, Gyanendra</a>, assumed full control, detaining politicians and restricting press freedoms, the monarchy’s legitimacy was already under scrutiny. The mass movement of 2006 resulted in the end of royal rule, leading to the official abolition of the 240-year-old Shah dynasty in 2008. Supporters of a republic saw this as the outcome of years of activism. In contrast, royalists viewed it as the sudden dismantling of an institution they believed had united Nepal. The new political framework aimed to promote stability, prosperity, and inclusion. However, Nepal has seen over 14 different governments in 17 years. Divided by factionalism, political parties have often focused on overthrowing rivals instead of effective governance. Widespread corruption persists. Infrastructure projects frequently face delays. Millions of young Nepalis leave the country to find jobs, resulting in the loss of many of the nation’s most talented individuals. The common belief that politicians amass wealth while ordinary citizens struggle has caused deep disillusionment. This serious situation led <a href="https://nepalitimes.com/news/international-spotlight-on-nepal">Nepal’s Generation Z to protest</a> in the streets. Within this broader context, for many, the monarchy has reemerged as a symbol of stability. To some, the king signifies unity that goes beyond partisan divisions. To others, the last Hindu monarch represents cultural continuity amid secular and federalist upheavals. <a href="https://nepalitimes.com/news/nepal-s-deja-vu-on-black-friday">Royalist demonstrations in Kathmandu</a> have mobilised tens of thousands. However, electoral support remains limited. The leading pro-monarchy party, the Rastriya Prajatantra Party (RPP), secured merely about 6 percent of the vote in the 2022 elections.&nbsp; Major political parties remain steadfast in their commitment to republicanism, and Nepal’s younger, globally connected population broadly <a href="https://nepalitimes.com/opinion/a-new-dawn-for-democracy-in-nepal">identifies with democracy</a>, despite frustrations with its shortcomings. Remembrances of King Gyanendra’s authoritarian rule serve as strong reminders of why the monarchy was abolished. However, this memory is gradually being replaced by more recent events.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251002111020_c018307c7b7dda363d04be3d65f01d132c81c62bae7ed2aa1ea235a12719b251.jpg" data-media-id="editor_6" data-image-id="20251002111020_c018307c7b7dda363d04be3d65f01d132c81c62bae7ed2aa1ea235a12719b251" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="monarchy in Nepal"> <figcaption>Photo: SAROJ BAIZU</figcaption> </figure>  PUBLIC IMPATIENCE Amid dissatisfaction with political parties, a question has emerged about whether the country needs an institution that can enforce discipline. As a result, calls for the reinstatement of the king are not just about Mr Gyanendra Shah, but also reflect a broader desire for government that is stable, accountable, and respectful. The influence of the monarchy extends into regional affairs. <a href="https://nepalitimes.com/here-now/america-nepal-and-the-royal-coup-qedzifz9">During the Cold War</a>, the palace adeptly balanced relations between India and China, positioning itself as the guardian of Nepal’s sovereignty.&nbsp; It also carefully navigated pressures from the United States and the Soviet Union. Today, as Nepal faces pressures from New Delhi, Beijing and Washington, some royalists perceive the monarchy as a safeguard against external interference. The <a href="https://archive.nepalitimes.com/article/editorial/autopsy-of-a-blockade%20,2863">2015 blockade imposed by India</a> impacted Nepal’s economy and led the country to seek closer comprehensive relations with China. As a result, India has adopted a more cautious approach toward Nepal’s republican leadership.&nbsp; China is viewed as supportive of centralised authority, in contrast to Nepal’s democratic institutions. There are perceptions that the United States, previously supportive of the monarchy, may once again consider it a stable partner. Officially, India, China, the broader international community, and major donors continue to support <a href="https://nepalitimes.com/here-now/the-story-so-far">Nepal’s post-2006 political order</a>. At the same time, they observe ongoing discussions among Nepalis about the possibility of a constitutional monarchy within a democratic framework. Following the recent unrest, some Nepalis believe that restoring the monarchy could create uncertainty for India and China, given Nepal’s complex political landscape. Others suggest that worries about perceived Western influence on the interim government through international NGOs might trigger serious soul-searching in New Delhi and Beijing. Despite its limited mandate to hold elections on March 5, 2026, t<a href="https://nepalitimes.com/news/nepal-pm-set-to-expand-her-cabinet">he interim government</a>, led by former Chief Justice <a href="https://nepalitimes.com/news/madam-prime-minister-of-nepal">Sushila Karki</a>, has an opportunity to start rebuilding public trust. Although the new government continues to enjoy popularity, there is evident public impatience regarding its delays in investigating corruption and misconduct by the previous leadership, as well as the incidents of killings, looting, and arson during the protests.&nbsp; The nation has been further unsettled by whispers of an impending and potentially more significant political upheaval prior to the upcoming elections. Republicans believe that demonstrating the effectiveness of democracy is the best way to mitigate calls for a monarchy. However, if the leadership fails to address key issues such as corruption, unemployment, and institutional strengthening, it could further boost the monarchy’s influence – and potentially lead to its comeback. Sanjay Upadhya is the author oand analyst based in the Unoited States. Originally posted <a href="http://originally%20published%20at%20https//www.linkedin.com/pulse/why-monarchy-still-sways-nepals-republic-sanjay-upadhya-pe4xe" target="_blank">here.</a>

Why the monarchy still sways Nepal’s republic

One is an archipelago, the other is landlocked. But the Philippines and Nepal have a lot in common: both are disaster-prone, their economies dependent on overseas migrant workers, both went though Maoist insurrections that failed to replace a feudal order dominated by political dynasties. And both countries suffer from rampant corruption. Twelve days after <a href="https://nepalitimes.com/news/nepal-s-new-normal" target="_blank">deadly protests toppled Nepal’s government</a> tens of thousands of Filipinos, many of them youth, also poured out into the streets demanding transparency and better government. Cars were set on fire, and more than 200 people were arrested, nearly half of them minors. The ‘Trillion Peso March Against Corruption’ was fuelled by <a href="https://www.nytimes.com/2025/09/21/world/asia/manila-philippines-rally-protest.html" target="_blank">anger over embezzlement</a> by politicians and their <a href="https://pcij.org/2025/08/31/5-reveals-from-the-flood-control-data/" target="_blank">crony contractors</a> estimated to top $17 billion in flood control infrastructure that were either never completed, or non-existent.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025100411108_85daed60ed5599f53235312e5b33703244bbac8640dbaf5161f90e5abe83f7eb.png" data-media-id="editor_3" data-image-id="2025100411108_85daed60ed5599f53235312e5b33703244bbac8640dbaf5161f90e5abe83f7eb" data-rendition-name="original" width="2326" height="1366" loading="lazy" alt="Phillipines anti-corruption protests"> </figure>  “We learnt from Nepal and <a href="https://www.nytimes.com/2025/09/30/world/anime-protests-flag-moldova-nepal-indonesia-gaza.html" target="_blank">Indonesia</a> how to deploy social media as a tool to spread information, we are digital natives and well connected within the country and across borders,” said <a href="https://www.linkedin.com/in/yuri-lemana-68322b183/?originalSubdomain=ph" target="_blank">Yuri Lemana</a> of the <a href="https://www.facebook.com/FOIYouthPH/" target="_blank">Youth Alliance for Freedom of Information</a>, and a part of the GenZ protests.&nbsp; “The system has failed us, unemployment is on the rise, there are shrinking opportunities for youth, and we face environmental threats. There is a realisation that our future is at stake,” Lemana added. Online groups started highlighting bribery and kickbacks in July after President Ferdinand (Bongbong) Marcos Jr himself brought up corruption in the infrastructure budget in his annual address to the nation, and launched a probe.&nbsp; The protests gained traction after powerful visuals of <a href="https://nepalitimes.com/news/international-spotlight-on-nepal" target="_blank">rallies in Indonesia and Nepal</a> circulated on digital platforms. Filipino journalists also exposed the <a href="https://www.youtube.com/watch?v=-f0MFz3vmfE" target="_blank">high-flying lifestyle of contractors</a> involved in siphoning off the infrastructure budget.&nbsp; As in Nepal, the youth protests were joined in by various radical groups. In Manila they reportedly included supporters of ex-president Rodrigo Duterte who is currently on trial at the <a href="https://www.icc-cpi.int/philippines/duterte" target="_blank">International Criminal Court (ICC)</a> in the Hague for extrajudicial killings during his ‘war on drugs’ 2011-2019. Duterte still has a lot of support, especially in the Filipino diaspora, for being tough on crime. Duterte was allied with Marcos in the 2022 elections, and his daughter Sara Duterte is currently vice-president. But the two families had a massive falling out, and the Supreme Court annulled the Lower House’s attempt to impeach the vice-president. This week in Manila, a remarkably well-informed Grab driver replayed TikTok videos of Kathmandu’s burning Parliament building to a passenger from Nepal. After his garment factory was driven out of business by cheap Chinese imports, he started driving a ride-hailing cab and was livid with successive governments not providing opportunities to ordinary people like him. Traffic was gridlocked because of flooded streets, and the driver vented out his anger: “Look at this. The streets are always flooded because of corruption. We should have done here what you did in Nepal.” Even before the protests, Senate President Francis Escudero and House Speaker Martin Romualdez had both resigned over the 'Floodgate Scandal'. Romualdez is Marcos’ cousin and is now said to be in Madrid, where his every movement is being tracked by Filipino diaspora in social media posts. The Independent Commission for Infrastructure has issued subpoenas to probe corruption in flood control projects. As in Nepal and Indonesia, much of the anger was over the offspring of politicians extravagantly flaunting their ill-gotten wealth on Instagram and TikTok. In the Philippines, the outrage is also over political clans passing on electoral seats to offspring. The 21 September protests were centred around Rizal Park and the EDSA Intersection in Manila — both symbolic for previous people’s movements against the Spanish colonialists and the 1986 uprising against the dictatorship of Ferdinand Marcos (father of the present president). “People here had seen what happened in Nepal, and were asking why we weren’t as angry as people there? Why not show our anger, too?” said one reporter who covered the protests. But, he added: “Let’s not be naive. It may have started with youth anger, but there were also people who were paid to infiltrate and instigate. We were also wary that things should not get out of hand like in Nepal.”  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025100411104_2c02ece56d29b2d8222433572d75c2dcc9bc2f3425d277a0056f393b521eecd0.png" data-media-id="editor_10" data-image-id="2025100411104_2c02ece56d29b2d8222433572d75c2dcc9bc2f3425d277a0056f393b521eecd0" data-rendition-name="original" width="1550" height="996" loading="lazy" alt="Phillipines youth protests"> <figcaption>An Instagram post of the protests in Manila with a comment relating it to the Nepal unrest two weeks earlier.</figcaption> </figure>  Seventy percent of Filipinos are Millennials and GenZ of voting age, and they were impatient with a rigged electoral system. In a clear parallel to what happened in Kathmandu two weeks earlier, radical groups, political rivals, and the general public furious with the system all joined in the protests. Catholic priests, people from all generations and professions had participated in the EDSA Uprising against Marcos in 1986. This time, it was the youth who took the lead. Joseph Francisco Ortega of the <a href="https://www.facebook.com/nationalyouthcommission/" target="_blank">Philippine National Youth Commission</a> said he understands the frustration among the youth that fuelled the unrest. The discontent is also because despite there being young legislators, they are either party-affiliated or scions of political dynasties. “If we can convince young politicians to do the right thing, then we have won half the battle,” Ortega said. “If we want to rebuild quickly and for the long term, we have to change the system from within. There is a constructive way to do this, while exercising the right to non-violent protest.” CROSS-POLLINATION The <a href="https://www.youtube.com/watch?v=6w8monPKdrc" target="_blank">violence in Manila streets</a> on 21 September was nowhere near the scale of what happened in Kathmandu on 8-9 September, but both transcended GenZ to be an outlet for pan-generational rage much like 1986 in the Philippines.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251004111012_e9cf9abfa8e35f3c074506dfdf94a262b5b311da6863cc2ec7bc3458a983df71.jpg" data-media-id="editor_13" data-image-id="20251004111012_e9cf9abfa8e35f3c074506dfdf94a262b5b311da6863cc2ec7bc3458a983df71" data-rendition-name="original" width="6566" height="4377" loading="lazy" alt="Nepal GenZ protests"> <figcaption>Angry crowd torched Parliament building among others during the 8-9 September GenZ protests in Nepal. Photo: AMIT MACHAMASI</figcaption> </figure>  “With due respect to the youth, it is not about age but about technology,” explained journalist Malou Mangahas of the <a href="https://www.facebook.com/R2KRN/" target="_blank">Right To Know, Right Now Coalition</a> who participated in the 1986 uprising against Marcos. “We were all young and angry once. We are older, but still angry, and demanding good governance, transparency and accountability.” Just like in Nepal, young Filipinos rallying against corruption were also wary of infiltration, and it was clear from the anti-Marcos graffiti who the instigators of violence were. The GenZ were mainly wearing white while the pro-Duterte crowd <a href="https://www.youtube.com/watch?v=6w8monPKdrc" target="_blank">are seen in videos</a> in black.&nbsp; The minors seem to have just joined in the melee from their street-side settlements. Rights groups have called for their release, accusing police of rough interrogation and ‘red-tagging’ as Communist provocateurs. Much of the transboundary cross-pollination of anti-government protests across Asia last month used gaming characters, memes, and anime personas like the manga cartoon One Piece flag depicting a grinning skull in a straw hat which became an icon of youth protests.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025100411100_2d09f075663678fe92d4e4dcc631ee6ad1aa8a99996f4c4a3649e4bf4d85132f.png" data-media-id="editor_16" data-image-id="2025100411100_2d09f075663678fe92d4e4dcc631ee6ad1aa8a99996f4c4a3649e4bf4d85132f" data-rendition-name="original" width="810" height="1208" loading="lazy" alt="One Piece"> <figcaption>The One Piece Flag flying during protests in Manila on 21 September. Photo:  CYBERNETICBOYLOL / WIKIPEDIA</figcaption> </figure>  Yuri Lemana adapted a saying of gaming character <a href="https://www.warhammer.com/en-WW/shop/mechanicum-archmagos-prime-2024?srsltid=AfmBOorpYg8Zk5G5WiPUS9SXTampX969gMw79sP7ZzkE1G6H5pICR4PW" target="_blank">Archmagos Cortiko</a> in <a href="https://start-warhammer.com/" target="_blank">Warhammer 40,000</a>: “Prayer has its power, but fury also has its uses. If the government tries to hide things from us, we will find a way. Fury will find a way.” Kunda Dixit is the Publisher of Nepali Times, and was a foreign correspondent based in Manila in the early 1990s.

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More dark clouds over Nepal

A reader for Kathmandu

Why the monarchy still sways Nepal’s republic

Nepal GenZs inspired Filipinos