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

Nepal’s cricket team first beat powerhouse West Indies in two out of three matches in September, the first time it won a match and then a series against a test-playing nation.&nbsp; Then the Rhinos played six qualifiers in Oman for the 2026 T20 World Cup which is being held in India and Sri Lanka from 7 February to 8 March next year. The national team qualified comfortably with two games to spare, and won all six matches anyway. In the three months before the World Cup, cricketers will play the second season of the Nepal Premier League from 17 November to 13 December.&nbsp; After a hugely successful first season, steady upgrades have been made. The flood-lit Tribhuvan University Cricket Ground has been fitted with 15,000 seats, even though this takes away from the festival-like atmosphere of fans on their feet on the grassy slope.&nbsp; Last season, matches began at noon and three in the afternoon. Late-evening matches in winter under flood lights will increase attendance and viewership.&nbsp; There is also now technology that will display how far a six was hit and how fast a ball was bowled. Foreign players who will play in the league include Chris Lynn, D’arcy Short, Ravi Bopara, and Sohail Tanvir, all good ex-international players that people have heard of.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251101031128_9db0830fb65d0743e3d36cc4b4473e61d750789028a130f5dff8a619307b0215.jpg" data-media-id="editor_0" data-image-id="20251101031128_9db0830fb65d0743e3d36cc4b4473e61d750789028a130f5dff8a619307b0215" data-rendition-name="original" width="1365" height="1803" loading="lazy" alt="Nepal cricket"> <figcaption>Aasif Sheikh drives through the covers on his way to 69 off 41 vs Samoa.</figcaption> </figure>  But the most important point of the Nepal Premier League will be to prepare and experiment for the World Cup, which starts less than two months after the NPL ends. Team Nepal will be extra eager to play well, given that the matches are happening in South Asia and Nepali fans can make the trip.&nbsp; Head coach Stuart Law will be watching each NPL match keenly, to gain more insight into how to best use his current starters.&nbsp; As each of the eight teams are only allowed a maximum of four foreign players in their starting eleven, Law and Nepali fans will also be scouting new talent who will be hungry to emerge and prove themselves to earn a place in the World Cup Squad.&nbsp; ALL-ROUNDERS One of the most unusual features of the current Nepali squad is how many all-rounders there are. Kushal Bhurtel, Rohit Paudel, Kushal Malla, Gulshan Jha, and Dipendra Singh Airee are all regular starters, and they all bat and bowl. Opener Aasif Sheikh is also the wicketkeeper.&nbsp; Airee, of course, is also an excellent fielder. In the first five games of the qualifiers, he got a record five runouts with direct hits, and was on a roll with a run in every single game. This depth means that almost always seven players bowl for Nepal, and the wealth of options keeps the opponent batting order guessing, but it may create hesitancy within the team in tough situations against stronger teams.&nbsp; Countries at the top level of the sport tend to have more specialists. Perhaps Stuart Law might want to tell Bhurtel to really focus on his batting, or Airee to hone his bowling, which seems to be their strengths. The team would be better off with them performing one aspect consistently well than being hit or miss with both. &nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251101031128_c30fdbab65736ea728f2f94fa121d2169e4d3627194ce1fe9de26eebdb3fc5b3.jpg" data-media-id="editor_1" data-image-id="20251101031128_c30fdbab65736ea728f2f94fa121d2169e4d3627194ce1fe9de26eebdb3fc5b3" data-rendition-name="original" width="957" height="1269" loading="lazy" alt="Nepal cricket"> <figcaption>Lalit Rajbhansi with tricky left arm spin, 3/13 vs Samoa.</figcaption> </figure>  POWERPLAYS The Nepali team likes batting first. It chased only against Japan, but they struggle to put up really competitive scores of say, above 170 unless two batsmen do really well.&nbsp; In the second match against the West Indies, Aasif Sheikh’s 68 and Sundeep Jora’s 63 set up Nepal at 173/6. Against Samoa, Aasif Sheikh had 69 and Airee had 53, before Lokesh Bam’s fierce 39 off 12 featuring 4 sixes set up 211/4.&nbsp; Besides these games, Nepal tends to score up to 150 batting first. To the experienced teams that Nepal will face at the world cup, this is not at all an intimidating score. One reason is that Nepal just cannot seem to get going in the first six powerplay overs, when there are limited fielders on the boundaries.&nbsp; A solution to this might be to promote Gulshan Jha up the order. Although Jha has also been an excellent batter in the end overs, using him at three or four might help set up a more productive powerplay and bigger scores. He should try it out with the Karnali Yaks.&nbsp; Despite all the controversy that comes with Sandip Lamichhane, and his strange decision to sit out the West Indies series minutes before the first match started, his output with the ball is undeniable.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251101031128_453d54ce627367c537d459c38d260d8aca1d56949c49c8023de582f3e72bb678.jpg" data-media-id="editor_2" data-image-id="20251101031128_453d54ce627367c537d459c38d260d8aca1d56949c49c8023de582f3e72bb678" data-rendition-name="original" width="1499" height="1000" loading="lazy" alt="Nepal cricket"> <figcaption>Nepalis turn out to support the team vs Samoa at Al Ameret Stadium in Oman.</figcaption> </figure>  He took wickets in each of the six qualifiers, most notably five vital ones in the match against Qatar that Nepal won by five runs. Lamichhane also gives away very few runs, which cuts some of the more part-time bowlers some slack.&nbsp; Airee is also economical, and his 3/22 was vital in the one-run win against the UAE. Together with Lamichhane the duo constricted the opposition in the middle overs. Veteran Sompal Kami has not been as productive with the ball, and gave away a lot of runs in the series against the West Indies.&nbsp; This is a weakness, because Kami does not contribute with the bat much. While his experience is valuable to ground the young Nepali team, Stuart Law should look out for fast bowlers during the NPL to help balance out quality spinners.&nbsp; One of the most impressive and professional parts of Nepal’s winning streak has been the attention to detail. The players have been generally excellent in the field, giving away very few runs due to wides or no balls. They had three run outs against the UAE and two against Qatar and Japan and in the first game against the West Indies.&nbsp; The fielders seem much calmer and focused when executing difficult catches, a welcome change from past complacency. This attention to detail makes the difference in narrow games and keeps morale high.&nbsp; The Nepali team has performed well, but besides the narrowly-beaten UAE, all the matches were against teams ranked lower in the world T20 rankings. And the series against the West Indies was against a weakened team. In the world cup, Nepal will be facing much stronger teams and will lack the element of surprise it had in the 2024 World Cup.&nbsp; If Nepal wants to keep improving, it now has to be able to dominate teams like Kuwait and Oman. It also should set up more series with associate nations like Scotland, Ireland, Namibia and The Netherlands. This will help accurately gauge the team’s progress and expose its weaknesses.

Nepal’s prospects at World Cup 2026

Imagine a high-end fair trade tea brand from Nepal that has done everything right, with ethical sourcing practices and international certifications. It has built a loyal base of socially conscious, premium customers in an export market and focuses on quality over quantity. Then one day, a government in the export market introduces a new ‘listing criteria’ that requires exporting a certain amount of tea to at least three countries in the past five years. But this was never a numbers game, it was about a niche market of socially responsible tea lovers.&nbsp; Suddenly, fair trade tea companies are restricted from exporting tea to that country.&nbsp; Pretty unfair for the company, for consumers, for the tea sector. More importantly, for tea farmers and families benefiting from fair standards. The overseas labour industry is facing a similar risk as recruiters, including those that have adopted ethical standards, may soon be barred from finding workers for Malaysia.&nbsp; On 27 October, the Malaysian Ministry of Foreign Affairs sent letters to five countries including Nepal, Bangladesh, Burma, Pakistan and India to ‘rationalise the number of licensed private recruitment agencies permitted to facilitate recruitment and placement of workers to Malaysia’.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251030141040_050274dddc6cf10224b0ad9283eec7b3bc3c0acd650543a808a8ea473ecf40db.jpg" data-media-id="editor_0" data-image-id="20251030141040_050274dddc6cf10224b0ad9283eec7b3bc3c0acd650543a808a8ea473ecf40db" data-rendition-name="original" width="961" height="1135" loading="lazy" alt="Malaysia recruitment"> </figure>  The letter includes 10 criteria for private recruiting agencies including at least five years of operating experience, deployment of 3,000 workers in the past three years of operation, &nbsp;experience sending workers to at least three countries, a 10,000 sq m office maintained for three years, valid licenses and good conduct certificates, five employer testimonials, and operating their own training and accommodation centres. Two conditions stand out as potentially harmful to Nepal’s ethical recruitment movement. First, although the letter cites a minimum of 3,000 workers, it says three years in the heading and five in the body text. A big enough difference to affect a significant number of recruiters from making the cut, but problematic regardless.&nbsp; Second, the requirement to send workers to at least three countries disproportionately impacts responsible recruiters in Nepal and elsewhere. Turning the selection of workers into a numbers game is dehumanising. Responsible &nbsp;recruiters deprioritise volume, focus on quality of jobs even when business sustainability comes under threat as ethical opportunities that do not require workers to pay any feed and ensure greater transparency are difficult to come by. Sending workers is further impacted by a series of external shocks. For example, in the Malaysian context Nepal banned emigration to Malaysia for two years followed by the Covid pandemic, and then Malaysia’s decision to stop the intake of foreign workers for the last two years.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251030141040_b1b88b3ae2e94c6bc077529ac6f2a4e380a385ee9a22219edfed25067c9d25a1.jpg" data-media-id="editor_1" data-image-id="20251030141040_b1b88b3ae2e94c6bc077529ac6f2a4e380a385ee9a22219edfed25067c9d25a1" data-rendition-name="original" width="595" height="841" loading="lazy" alt="Malaysia recruitment"> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251030141040_2cf252908d18aaf09c875002eef2d92ab45897a56b560addd2dc02311725c8a7.jpg" data-media-id="editor_2" data-image-id="20251030141040_2cf252908d18aaf09c875002eef2d92ab45897a56b560addd2dc02311725c8a7" data-rendition-name="original" width="590" height="238" loading="lazy" alt="Malaysia recruitment"> </figure>  Many ethical recruiters have focused on Malaysia because it is a more common labour market for responsible recruitment than other destinations like the Gulf. There is no credible justification to why responsible recruiters well regarded by scores of Malaysia-based multinational companies and with decades of experience should be ‘disqualified’ for not diversifying. Finding jobs for Nepalis in new markets is difficult given fierce competition, challenges &nbsp;identifying companies which follow the employer-pays principle, lack of networks and shortcomings in marketing strategies. These factors hit responsible recruiters harder because profit-motivated employers are often unwilling to cover the costs and fees associated with workers’ recruitment.&nbsp; “The volume of deployment does not determine a recruiter’s capability or the quality of services provided,” says Sujit Shrestha of the Nepal Association of Foreign Employment Agencies (NAFEA). Nepal recently scrapped the licensing renewal requirement that mandated sending at least 100 workers a year as it was impractical. The new Malaysian criteria is similar in nature, he added. The ball is now in Nepal’s court at a time when the interim government does not even have designated heads in the Foreign Ministry and the Ministry of Labour, Employment Employment and Social Security. When rumours about the Malaysian action started circulating, NAFEA had raised the issue, but was assured that this was not an attempt to set up a syndicate.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251030141044_83c8a174ef116603f747d1cd254c4d353e8b855a41fb99feec54e701f5fc4c3f.jpg" data-media-id="editor_3" data-image-id="20251030141044_83c8a174ef116603f747d1cd254c4d353e8b855a41fb99feec54e701f5fc4c3f" data-rendition-name="original" width="3456" height="5184" loading="lazy" alt="Malaysia recruitment"> </figure>  How will governments and recruiters in other origin countries now respond? There is precedence from Bangladesh. Dhaka-based journalist at the Daily Star, Porimol Palma who says, “Earlier, the Malaysian authorities had selected 101 Bangladeshi recruiters unilaterally, despite Bangladesh’s call for a syndicate-free recruitment mechanism.” Between 2022-2024, 450,000 Bangladeshis were recruited under this system with workers paying between $4,500 and $6,000, even though the legal limit was $750. Palma attributes part of the high fees workers had to pay were for commissions or bribes to recruitment syndicates. Adrian Pereira heads the North South Initiative in Malaysia says: “The criteria seems a bit fishy, as they do not appear to address the actual problems in the the recruitment of foreign workers. Some of the criteria seem to encourage a system of monopoly or syndicate rather than a rights-based approach. Every government has the right to set criteria for recruiters, but conventions and ILO (International Labour Organization) standards on recruitment exist. It looks like we’re back to square one.”&nbsp; Whether migrant origin countries including Bangladesh and Nepal accept the terms sent without reservations or push back in good faith remains to be seen. In an ideal world, a collective stance should put workers’ needs and welfare at the centre. How rational is the proposed ‘rationalising strategy’? What aspects of it are promising to curb recruitment abuse and what merits serious reconsideration?&nbsp; Even if the move from the Malaysian side is well-intentioned to address rampant malpractices migrant workers face, Nepal should deliberate on the conditions set, the collateral damage especially on the responsible actors and small but capable recruiters. Alternate options that might serve everyone better before rushing to respond with a chosen list by 15 November. If the proposal is accepted, how would it be done in a transparent and accountable way? It is noteworthy that Indonesia was not listed even though it has the most workers in Malaysia among the 16 countries that send migrants to Malaysia.&nbsp; The Responsible Business Alliance (RBA), the ILO, the International Organization for Migration (IOM), and certification programs like On the Level (OTL) also need to use their leverage to ensure that recruiters, including those they have trained or certified on ethical recruitment principles, are not penalised.&nbsp; This is more than just about protecting the ethical recruitment movement, but raising even more basic questions: Who can legally be a recruiter in Nepal? There are already obligations like hefty security deposit and minimum office requirements. But requirements to have building facilities with ‘accommodations’ or ‘testing centres’ are not among them. There are 1,150 plus players in Nepal’s recruitment sector, with a few hundred engaged in the Malaysian market. A unilateral selection criteria could risk foul play, or lead to unintended, unfavourable consequences. To be sure, overseas recruitment in Nepal is known for ‘settings’, corruption, dog-eat-dog competition, and collusion. The profiteering is out of control, often at the expense of workers. But the solution does not lie in stifling the industry with criteria like deployment volume, building worker accommodations or expanding office floors.&nbsp; The focus should instead be on enforcing rules and laws in both countries that govern the industry, and the Malaysian labour agreement that has not been renewed since October 2023.&nbsp; Meddling in the industry in ways that harms fair competition and ethical actors means workers suffer. The only issue that should be taking precedence is: how will Malaysia’s 10-point criteria and planned arrangement affect migrant workers? We have seen how for identical Malaysia-based jobs, one worker might pay zero while another pays up to Rs400,000, depending on the employer and recruiter. It is unclear if the 10-point selection criteria rewards the responsible employers and recruiters.&nbsp; As a longstanding host country for Nepali migrants, Malaysia deserves credit for nurturing the small but growing ethical recruitment industry here. Export-oriented companies in Malaysia need responsible recruitment partners and have mentored recruiters to strengthen their practices and move away from worker-paid models.&nbsp; The business case for ethical recruitment standards has led many recruiters in Nepal to pivot with many now in various stages of transition from traditional to hybrid or purely ethical practices. This progress needs to be acknowledged and built upon.&nbsp; Large, well-networked recruiters with large physical assets and high volume of workers seem to be the winners of Malaysia’s 10-point criteria after two years of waiting for the Malaysian market to reopen. Responsible recruiters endure long periods of minimal or no deployments that threatens their survival. The letter now sitting on the desk of the interim government in Nepal deepens the concern: rather than just failing to recognise or reward responsible recruiters, does the international recruitment market actually punish them? Upasana Khadka heads Migration Lab, a social enterprise aimed at making migration outcomes better for workers and their families. Labour Mobility is a regular column in Nepali Times.

Who gets to recruit for Malaysia?

With the holidays over and elections only four months away, Nepal’s interim government led by Prime Minister Sushila Karki is trying to get down to brass tacks. But it is not easy.
On Wednesday, Karki held the first three-way meeting between GenZ representatives, political parties and the government. Despite some acrimony, there was near unanimity about creating the environment for elections on 5 March. 
Only the UML is holding out, still not taking responsibility for the 8 September massacre, and calling for the reinstatement of Parliament. GenZ delegates poured their wrath on the unrepentant UML, but were themselves talking at cross purposes on the demand for a directly-elected executive. 
Karki was on the defensive, her exasperation spilling over: “How do we undo the damage done by corruption, exploitation, and discrimination over the last 35 years in a single month?” 
She is reported to have added, “There is a tendency to not allow this government to work, and then turn around to criticise it for not achieving anything. We are trying our best, and will fulfil our goal of elections no matter what.” 
The Wednesday meeting does seem to have turned the attention of old parties towards elections, and spurred the GenZ and others with political ambition to form parties.
With the deadline for party registration looming, several like-minded individuals and collectives are coalescing, or trying to. The Election Commission is already reviewing applications from more than a dozen new political parties. 
Kathmandu Mayor Balen Shah has held talks with RSP members, but his popularity on social media is not matched by public visibility and accessibility. Intriguingly, Shah and his supporters on social media have been publicly asking for the resignation of Home Minister Om Aryal for not arresting members of the UML-NC government for the 8 September killings. Aryal used to be Mayor Shah’s legal adviser.
Sudan Gurung of GenZ, ex-RSP Sumana Shrestha, and Energy Minister Kulman Ghising are all shopping for existing or new political parties to join. 
The RSP with its alternative anti-corruption agenda would be the logical choice, but there is a question mark over the role of its head Rabi Lamichhane, who is back in jail on charges of embezzlement.
LARGER CABINET
This week, Karki expanded her Cabinet for the third time by inducting Sudha Sharma Gautam as Minister for Health and activist Bablu Gupta as the Minister for Youth and Sports. 
Recommended by GenZ members, Gupta, 28, is the youngest Minister in Karki’s team. But, as has become the norm with this electoral government, two other controversial nominations fell through. Khagendra Sunar was dropped as Minister for Labour because of several ongoing criminal charges, including for assault and inflammatory speech. And Ganapati Lal Shrestha for Minister of Land Management declined at the last moment after he was not given the Tourism and Culture portfolio as preferred. 
Critics say there is a lack of due diligence on the part of Karki’s advisers in selecting candidates. Last month, Sangeeta Mishra who was nominated for Health Minister was dropped after it turned out that she was under investigation at the CIAA. However, Kulman Ghising also had complaints filed at the anti-corruption body, but was still given three portfolios. 
Then the nomination of Tashi Lhazom was withdrawn after an online controversy over her citizenship. There was also outrage on social media about Mishra and Lhazom being singled out for their ethnicity and gender.
Internal leaks making her choices prematurely public has made Karki’s team overcautious about Cabinet expansion. It is also distracting her from her main goal — to hold credible elections by striking a balance between the political parties and GenZ groups.
After a preliminary hearing on 16 writ petitions against the House dissolution and appointment of new government, the Supreme Court on Wednesday refused to issue an interim order.
“The formation of the government is unconstitutional, and a government formed unconstitutionally is not allowed to make any decisions, until the final hearing,” stated advocate Surendra Bhandari. 
The UML, still smarting from the September protests, is trying to put a spanner in the works of the election government. The GenZ, meanwhile, still do not have a consensus over fundamental demands prior to elections. Combined, these two factors portend a precarious future.

Future imperfect

A little more than one month into its six-month term, Nepal's interim government recalled ambassadors from 11 countries: China, Japan, Malaysia, Qatar, Saudi Arabia, Israel, Russia, Spain, Germany, the UK, the US, and Japan.&nbsp;
Mostly appointed by previous governments, they have to return to Kathmandu by 6 November. The envoys who were retained, even if they were political appointees, tended to be women or from various ethnic minorities.
The recall has met with criticism back home. Prime Minister Sushila Karki is blamed for borrowing a page out of its predecessors’ playbook. Although it was a symbolically inclusive move in a diplomatic corps dominated by established groups, the government may have got its timing wrong.
On Sunday, however, the Supreme Court issued an interim order against government decision to recall the 11 ambassadors. The court questioned the neccesssity and justification of such a move, concerned that it could affect Nepal's relations with the host countries.&nbsp;
Karki has said <a href="https://nepalitimes.com/news/future-imperfect">her priority is to hold elections in March</a>, and by recalling Nepal’s emissaries from important capitals like Washington, London, Bonn, Tokyo, Abu Dhabi and Kuala Lumpur her government has cut channels of communication and support from development partners and with the international community.&nbsp;
Nepal’s anti-corruption GenZ protest and the devolution of the youth movement into <a href="https://nepalitimes.com/here-now/relocate-reallocate-recover">arson, looting, and violence</a> after the targeted killing of protestors in September put the nation in the international spotlight. And the interest was especially keen in neighbouring New Delhi and Beijing.&nbsp;
The Nepal unrest has sparked similar protests across the world from <a href="https://nepalitimes.com/here-now/nepal-genzs-inspired-filipinos">the Philippines</a> to East Timor, Madagascar and Peru. But there is also worry in India where exposure of #nepokids on social media as well as corruption in high places could instigate copycat youth unrest.
And in China, there is still a lingering memory of the deadly protests in 1989 Tiananmen Square. But the Chinese also suspect that some in the GenZ movement have links to free-Tibet. &nbsp;
Foreign policy experts in Nepal reject conspiracy theories about foreign backing for the GenZ, characterising it as mostly triggered by home-grown outrage over chronic corruption of the governing elite.&nbsp;
Throughout its history Nepal has always had to balance the geo-strategic interests of its neighbours: the British in India and the Chinese Empire, and more recently independent India and Communist China.
When former PM K P Oli resigned, he had <a href="https://nepalitimes.com/opinion/comment/when-xi-meets-modi-and-oli">just returned from a visit to Beijing</a> and was a week away from making an official visit to India. A new Nepali prime minister typically makes the first visit to India, but Oli broke that tradition last year by going to China to sign the Belt and Road Initiative (BRI) framework agreement.
"Oli was China's trusted partner supporting <a href="https://nepalitimes.com/news/china-syndrome">Nepal’s participation in BRI</a> and SCO (Shanghai Cooperation Organization)," says geopolitical analyst Sanjay Upadhya. "Now, some in Beijing are apprehensive that there is external support for the youth protests that contributed to Oli’s sudden departure. It is perceived as a strategic setback for China."
Despite an ongoing dispute with India over a 364 sq km border territory, Nepal is heavily dependent economically on India with which it has an open border.&nbsp;
Rulers in Kathmandu have usually leaned over backwards to be closer to China to counterbalance India’s gravitational pull following a strategy of ‘equidistance’ between the two giant neighbours.&nbsp;
Growing American and Western disinterest in the region is making India and China more assertive towards smaller nations. Educator Dovan Rai says, “China is also becoming more aggressive and trying to show its presence in and around South Asia.”
She adds, “Nepal is an important neighbour for China, especially considering issues it regards as sensitive, like the Dalai Lama and Tibet.”
Indeed, the Chinese are said to be suspicious about the links that the <a href="https://nepalitimes.com/here-now/nepal-s-historic-youth-dissensus">GenZ movement</a> was infiltrated by elements linked with Free Tibet or with US-based interests.&nbsp;
What must have especially raised eyebrows at the Chinese Embassy in Kathmandu was that the Dalai Lama’s office in exile in India congratulated Sushila Karki — the first time in history it has sent such a greeting to a new prime minister of Nepal.&nbsp;
Although Nepal’s two neighbours do not see eye-to-eye, both agree and are worried about instability in Nepal, and if it might trigger a refugee crisis, empower extremist factions, or attract Western interference.&nbsp;
Nepal’s September protests were preceded and succeeded by similar movements in the region and around the world. In light of this global eruption of youth frustration, and desire to lead from the front, the hardline governments of Nepal’s two neighbours are undoubtedly wary of the possibility of similar unrest within their own borders.&nbsp;
‘India advocates democratic legitimacy, while China prioritises control and predictability. Recent upheavals demonstrate that neither democracy nor stability alone suffices for sustainable nationhood,’ Upadhya wrote in a recent blog.
With early elections scheduled for 5 March, <a href="https://nepalitimes.com/news/one-month-later">the main challenge for Karki’s transition government</a> is to maintain dialogue and establish consensus between youth groups, political parties, and other agitating forces to participate in polls — all while ensuring there is no covert external influence.&nbsp;
Indeed, with <a href="https://nepalitimes.com/here-now/nepals-democracy-keeps-doubting-itself">Nepal’s democracy</a> at stake as well as new political forces with competing interests set to battle it out in a new political landscape, experts warn that there could be powers that will want to fish in troubled waters.&nbsp;
Explains Dovan Rai: “Along with soft power, foreign countries including our neighbours could intervene in the online information space to promote their interests in Nepal. Fake narratives and disinformation could be spread &nbsp;through digital platforms. We must be careful and vigilant about our digital space.”

stigma

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Who gets to recruit for Malaysia?

Future imperfect

Neighbourhood watch on Nepal