<figure><img width="800" height="600" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221114101124/63720a059c7e80680e0b5579jpeg.jpg" alt=""/><figcaption>Photo: NEURO HOSPITAL</figcaption></figure>* A 32-year-old female patient was suddenly unable to move one side of her body. She was rushed to Upendra Devkota Memorial National Institute of Neurological and Allied Sciences (Neuro Hospital) where doctors used a new non-invasive treatment to remove a clot that was obstructing the artery supplying blood to her brain. The patient’s mobility was immediately restored and she walked out of the hospital.* A man in his mid-fifties arrived at Neuro hospital five hours after suffering a stroke. He underwent the 15-minute procedure after which he could move all of his limbs freely.The strokes could have been fatal for both patients if they had not been rushed to hospital, and if the new state-of-the-art mechanical thrombectomy procedure was not available.The prevalence of strokes in Nepal has increased 40% in the past decade, and more and more younger people are suffering the condition that could paralyse or kill them. Strokes are the third leading cause of premature deaths in Nepal, and ranks first for disabilities. A person somewhere in Nepal suffers a stroke every 20 seconds. Doctors say a changing lifestyle and <a href="https://www.nepalitimes.com/banner/nepalis-binge-on-junk-foods-the-west-rejected/">dietary habits</a>, including heavier drinking and smoking has led to an increase in <a href="https://www.nepalitimes.com/latest/why-do-so-many-nepalis-have-high-blood-pressure/">hypertension</a>, <a href="https://archive.nepalitimes.com/article/nation/diabetes-in-south-asia,3018">diabetes</a>, high cholesterol — all precursors to strokes. <figure><img width="1201" height="660" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221114101124/63720a089c7e80680e0b557ajpeg.jpg" alt=""><figcaption> </figcaption></figure>Recent studies have also reported that people infected with Covid-19 have an elevated risk of ischemic stroke, adding to the burden of disease. Other risk factors include aging, congenital heart diseases, hormonal changes and pregnancy. Women are comparatively more prone to suffering strokes.Ischemic strokes account for 85% of all cases, where an artery supplying blood to the brain is blocked damaging it. Haemorrhagic stroke, on the other hand, occurs when blood from a ruptured artery collects in the brain.“A stroke is a medical emergency, especially ischemic stroke which can lead to permanent disabilities and even death if it is not treated immediately,” says Subash Phuyal, Nepal’s first interventional neuro-radiologist at the Neuro Hospital in Bansbari.In fact, speed is of the essence to save the life or prevent life-long paralysis of a patient. But patients in Nepal often are not aware of symptoms and get to hospitals too late, where the right treatment may not be available. <figure><img width="4032" height="3024" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221114101124/63720a0b9c7e80680e0b557bjpeg.jpg" alt=""><figcaption> </figcaption></figure>Unlike a heart attack, stroke patients do not feel any pain, making it difficult to identify it. Which is why doctors have come up with the acronym BE FAST (Balance, Eyes, Face drooping, Arm weakness, Slurred speech, and Time) to identify signs of stroke in time.Patients usually experience a sudden problem with their sense of balance, have blurred vision, double vision or loss of sight in one or both eyes. There could be facial drooping, weakness or paralysis on one side of the body, and slurred speech.If a patient gets to hospital within four hours of a stroke, they are immediately given a medicine to dissolve the blood clot obstructing the artery, restoring blood flow to the brain. This treatment is effective in only 10% of patients. Read also: <a href="https://www.nepalitimes.com/banner/new-treatment-offers-hope-for-nepals-leprosy-patients/">New treatment offers hope for Nepal’s leprosy patients</a>, Sonia AwaleHowever, with mechanical thrombectomy, 90% of patients who get to hospital in time can be cured. A small incision is made in the thigh and catheters inserted using an imaging machine in the cath lab. The catheter travels along the major arteries until it retrieves the clot to allow the blood to flow again.In the case of haemorrhagic stroke, surgery to clip the blood vessel is now replaced with a method called endovascular coiling in which the catheter inserts platinum coils to block the aneurysm.This non-invasive mechanical thrombectomy was first devised in 2015, and it was already available at the Neuro Hospital in Kathmandu four years later. Its biplane cath lab has been treating up to 25 patients a month.The hospital’s founder <a href="https://www.nepalitimes.com/here-now/upendra-devkotas-lives/">Upendra </a>Devkota (see box) was determined to introduce the newly-developed endovascular treatment technology in Nepal, but did not live to see it save lives. He died of cancer in 2018. His wife Madhu Devkota completed the dream, and set up an interdisciplinary team for stroke patients. Neuro Hospital is also building a rehabilitation centre for recovering patients who often need physiotherapy.But despite having the most advanced stroke treatment in Nepal, most people are not aware of the danger signs of a stroke. They also do not know that such non-surgical treatment is available in Kathmandu. It is also not widely known that such care is available in the country, and up to half the stroke patients at Neuro Hospital are brought too late for treatment.Nepal’s topography adds to the problem of getting patients to hospital in time. Madhu Devkota suggests the government could provide an air ambulance facility, as it does for complicated maternity cases.Says Subhash Phuyal: “People must know that strokes are preventable, and that advanced treatment is available right here in Nepal. But the most important thing is to get the patient to hospital as quickly as possible.”  <img width="630" height="882" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221114101124/63720a0f9c7e80680e0b557cjpeg.jpg" alt="">Visionary doctorA young and talented doctor at Bir Hospital, Upendra Devkota, was sent on a scholarship to the Glasgow Neuroscience Institute in 1983 to train in neurosurgery. Under the guidance of the renowned Professor Graham Teasdale, Devkota proved himself among the best neurosurgeons in the world and had a bright career ahead of him in the UK.But the Gurkha-native left all that behind to return to Nepal in 1989 to set up the country’s first Neurological Trauma Unit at Bir Hospital. He worked day and night, while also training young neurosurgeons with limited resources.Devkota briefly served as the Health Minister under King Gyanendra in 2005, and a year later started setting up the National Institute of Neurological and Allied Sciences.“Many tried to dissuade us, but despite challenges we were determined to set up an institution dedicated to preventing paralysis and disabilities in Nepal,” says Madhu Devkota. “My husband had foreseen the need for an advanced neurological centre in Nepal. So we thought, if not us, who would? So, we ran with it.”Read also: <a href="https://www.nepalitimes.com/latest/why-do-so-many-nepalis-have-high-blood-pressure/">Why do so many Nepalis have high blood pressure?</a> Sonia Awale

Sonia Awale

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New cure for stroke, but prevention is key

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110151112/636d06f59c7e80680e0a5f92jpeg.jpg" alt="" width="1500" height="1000"/><figcaption>Photo: MONIKA DEUPALA</figcaption></figure>The past year-and-half since the Covid-19 outbreak, Nepal’s limited health resources all had a singular focus. But now that the second wave is waning and the lockdown has been eased, hospitals are once again flooded with patients with <a href="https://archive.nepalitimes.com/article/nation/diabetes-in-south-asia,3018" target="_blank" rel="noopener noreferrer">diabetes</a>, cardiovascular diseases and kidney ailments.Many of these patients had left these conditions untreated, and doctors say nursing them back to health will be more complicated. One of the most common disorders is hypertension or high blood pressure, which has become an epidemic.Hypertension is a silent killer and one of the most common causes of chronic conditions like <a href="http://archive.nepalitimes.com/article/Nepali-Times-Buzz/A-mysterious-rash-of-kidney-failures,3639" target="_blank" rel="noopener noreferrer">kidney damage</a> that are often too costly to treat for the majority of Nepalis. Now, mental stress due to Covid has also added to the problem.“Hypertension makes up for the majority of patients in hospitals these days now that the lockdown has been relaxed,” says cardiologist Prakash Regmi. “Also worrying is that many of these are new patients coming in due to Covid-related stress, a large number of people who had their blood pressure under control previously after treatment are also relapsing.”To be sure, Nepal has been seeing a dramatic rise in hypertension patients even before the pandemic – some of them in their teens and 20s. <a href="https://www.hindawi.com/journals/ijhy/2021/6610649/" target="_blank" rel="noopener noreferrer">A paper published in March</a> in the International Journal of Hypertension, shows that since 2000, the hypertension rate in Nepal has been increasing at 3.5% per decade, and 44.7% of Nepali men will be suffering from hypertension by 2025.The study also found that high blood pressure is disproportionately affecting men, the elderly, those without formal education, and those who reside in urban areas, and seems to be most common in Gandaki Province.Worldwide, an estimated 1.13 billion people have hypertension, and it is responsible for 9.4 million deaths globally every year. In 2015, 1 in 4 men and 1 in 5 women had elevated blood pressure.In Nepal, close to one-third of the adult population has some form of hypertension, but in urban centres the figure is as high as 40%, with 25% in rural areas suffering from it.There is no specific cause of hypertension, but its biggest risk factor is high sodium intake. A survey in 2020 revealed that on average, the mean dietary <a href="https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.13813#:~:text=Overall%2C%20estimated%20mean%20salt%20intake,d%20(SD%20%C2%B1%204.7)." target="_blank" rel="noopener noreferrer">salt intake of a Nepali</a> per day is 13.3 mg. Most of the world consumes double the WHO recommended 5g of daily salt intake, increasing the risk of heart disease and strokes, which kills some 3 million people annually worldwide.“Traditionally Nepalis have a preference for salty food, but now with higher consumption of processed and <a href="https://www.nepalitimes.com/banner/nepalis-binge-on-junk-foods-the-west-rejected/" target="_blank" rel="noopener noreferrer">junk food</a>, our salt intake has grown,” says public health expert Aruna Uprety, adding that the sodium content in packaged foods is often much higher than what companies claim.In May WHO (World Health Organisation) released a new set of <a href="https://www.who.int/news-room/events/detail/2021/05/05/default-calendar/launch-event-who-global-sodium-benchmarks-for-different-food-categories" target="_blank" rel="noopener noreferrer">global benchmarks for sodium levels</a> that will act as a guide for countries and industry to reduce sodium content in more than 60 categories of processed foods, in line with the global target of reducing salt intake by 30% and hypertension by 25%, both by 2025.Another prominent risk factor is mental stress and lack of physical exercise, both of which have been exacerbated with people staying at home for months and under the uncertainty of the pandemic. Family history of hypertension also plays a significant role in an individual developing high blood pressure, as does smoking and drinking alcohol.Undetected hypertension, and non-medication to control it, can lead to other disorders like stroke, heart disease, kidney failure, etc.Despite the huge burden of the disease on public health and the economy, treatment of hypertension is ill-managed. Patients are never diagnosed because often times there are no prior symptoms.And of the 50% who are diagnosed with high blood pressure, half ignore their condition and get no treatment. Of the remaining, 25% do get some kind of treatment but half of them again do not follow-up or take the correct dose of medication.“All in all only about 10% of hypertension patients get proper treatment in Nepal. Lack of proper health monitoring system, as well as misconceptions about life-long medications, hasn’t helped,” says cardiologist Prakash Regmi. “This often leads to a point where treatment is either too expensive, or even unmanageable.”Hypertension is first and foremost a lifestyle disease with strong ties to a possible failure of crucial organs in the human body. Its prevention and control are heavily dependent on an <a href="https://www.nepalitimes.com/banner/junk-food-is-making-nepali-children-shorter/" target="_blank" rel="noopener noreferrer">individual’s choice of diet</a>.A state-sponsored robust awareness campaign to focus on preventive measures and a strong healthcare system are urgently needed to reduce the epidemic of hypertension.Says public health expert Aruna Uprety: “Mandatory blood pressure check-ups for certain age groups at fixed intervals is a good place to start. It goes a long way in reducing the cost of the disease and human lives.”Stages of hypertension<ul style="font-weight: 400;"><li>Normal: Less than 120/80 mm Hg</li> 	<li>Prehypertension (Elevated): Systolic between 120-129 and diastolic less than 80</li> 	<li>Stage 1 (Moderate): Systolic between 130-139 or diastolic between 80-89</li> 	<li>Stage 2 (Severe): Systolic at least 140 or diastolic at least 90 mm Hg</li> 	<li>Hypertensive crisis: Systolic over 180 and/or diastolic over 120</li></ul>Types of hypertension<ul style="font-weight: 400;"><li>Primary or essential: Most common high blood pressure among adults. No specific cause but risk factors include diet, age, physical activity and genetics.</li> 	<li>Secondary: Up to 10% of hypertension is secondary. Most often caused by another medical condition or the use of certain medicines.</li></ul>Risk factors<ul style="font-weight: 400;"><li>High salt/sodium intake</li></ul>WHO recommendation: 5gm/day<ul style="font-weight: 400;"><li>Mental stress</li> 	<li>Lack of physical exercise</li></ul>WHO recommendation: at least 150–300 minutes of moderate-intensity aerobic physical activity<ul style="font-weight: 400;"><li>Family history of high blood pressure</li></ul>

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Why do so many Nepalis have high blood pressure?

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109101132/636b73f19c7e80680e062367jpeg.jpg" alt="" width="1500" height="1016"/><figcaption>Photo : MONIKA DEUPALA</figcaption></figure>Last November, a speeding bus in Argakanchi lost control and tumbled down a mountain, killing 19 and injuring 18 passengers. Three weeks later, another bus careened off a serpentine road in Sindhupalchok, killing 16 and wounding 18.Seven Nepalis die every day in <a href="https://www.nepalitimes.com/banner/nepals-deadly-roads-take-their-toll/" target="_blank" rel="noopener">road and highway accidents</a>. Shocking though that statistic might be, the number of injured is much higher. On average, 40 people are injured on roads across the country each day. Last year, there were nearly 13,000 road accidents in which 2,736 people lost their lives and 10,731 were seriously injured.Read also: <a href="https://www.nepalitimes.com/?p=40237&amp;preview_nonce=7ab9966f81&amp;preview=true" target="_blank" rel="noopener">It’s an emergency: Nepal needs to improve trauma care</a>, Sanghamitra Subba<a href="http://archive.nepalitimes.com/article/Nepali-Times-Buzz/accident-prone-Mugling-Narayangadi-highway,3828" target="_blank" rel="noopener">Highway accidents</a> are now the biggest killer of young men and women in the country. The causes are usually carelessness and speeding, and poorly-maintained roads and vehicles. The number of accidents are rising faster than the increase in the number of vehicles.Those who survive often have traumatic brain and <a href="http://archive.nepalitimes.com/news.php?id=6946" target="_blank" rel="noopener">spinal cord injuries</a>, requiring long-term or life-long rehabilitative care. But the state of rehabilitation in Nepal is nearly non-existent. There is no government rehabilitation centre, and while some private hospitals do offer inpatient physiotherapy, none have dedicated acute rehabilitation units and none employ physical medicine and rehabilitation consultants.“Forget about prioritising it, rehabilitative medicine is not even included in the healthcare system of Nepal,” laments Raju Dhakal, the only physical medicine and rehabilitative doctor registered in Nepal. “Every hospital has a cardiology unit, intensive care unit and even physiotherapy but no rehabilitation unit. This should be integrated in the healthcare system rather than treated as a separate entity.”The <a href="https://www.facebook.com/SpinalNepal/" target="_blank" rel="noopener">Spinal Injury Rehabilitation Centre</a> (SIRC) in Sanga, founded in 2002, is Nepal’s largest inpatient rehabilitation centre and the only one specialised in spinal cord injury. The 51-bed hospital treats patients from all 77 districts and provides inpatient rehab for 300 individuals a year.It also conducts outpatient care, home follow-up visits, community outreach programs, and a residential vocational rehabilitation program to help people with disabilities integrate back into society and to better equip thier families to deal with their special needs.The only other facilities with dedicated inpatient rehabilitation beds are <a href="https://gphospital.org/" target="_blank" rel="noopener">Green Pastures Hospital</a> in Pokhara and the <a href="https://www.hrdcnepal.org/" target="_blank" rel="noopener">Hospital for Rehabilitation and Disabled Children</a> in Kavre.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109101132/636b73f49c7e80680e062368jpeg.jpg" alt="" width="1500" height="1065"><figcaption> </figcaption></figure>“Usually two physical medicine and rehabilitation specialists are needed for every 100,000 people. This means we need 500 specialists in Nepal, and instead we have one,” says Manoj Sivan, associate professor of rehabilitative medicine at Leeds University in the UK, who says the gap in rehabilitative care can be bridged with telemedicine.“Tele-rehabilitation can link the people in the community with specialists to provide necessary interventions remotely, allowing them to the save time and money spent travelling to the centre,” adds Sivan, who was in Nepal last month with a team of researchers to launch a six-month pilot project called Tele-rehabilitation Nepal (TERN) in collaboration with SIRC (above).Unlike <a href="https://archive.nepalitimes.com/article/nation/long-distance-medicine-in-nepal,3521" target="_blank" rel="noopener">other telemedicine consultations</a> where a patient has to visit a health post to connect with doctors based in cities, in tele-rehab a social worker from SIRC visits patients, finds out their needs and then connects them with a specialist team that consists of a physician, physiotherapist, occupational therapist, nurse and  psychologist.Patients with long-term disabilities and their families learn about better management of bladder, bowel and pain, as well as exercise techniques to help mobility.The idea for e-rehab first came to Dhakal when a paraplegic patient from Surkhet visited SIRC and was unable to pay a minimal consultation fee. She had spent Rs45,000 to hire a jeep and had to pay for extended hotel stay for herself and two relatives. “It hit me hard,” Dhakal recalls. “This country’s topography makes accessing healthcare stressful for most Nepalis.”Besides those with <a href="http://archive.nepalitimes.com/article/Nepali-Times-Buzz/paraplegic-ram-bahadur-tamang-travels-from-namo-buddha-to-lumbini,1303" target="_blank" rel="noopener">spinal injuries</a> caused by highway accidents, tele-rehabilitation is useful for those recovering from other medical emergencies like strokes and also for general medicine.The Nepal Government’s 2016 Policy, Strategy, and Ten Year Action Plan on Disability Management plans for every province to have at least one fully equipped rehabilitation centre and established orthotics/prosthetics workshop in the next ten years. SIRC is also working with the Ministry of Health to develop another 100-bed hospital to provide specialised rehabilitation care.Added Dhakal: “Sooner or later the government has to take responsibility and decentralise rehabilitative care. This will allow us to train more people and supervise other centres to decentralise rehab.”<h2>Wheelchair doctor treats patients in wheelchairs</h2>As the only physical medicine and rehabilitation doctor in Nepal, Raju Dhakal (left) has a lot on his plate. His days are packed with back-to-back consultations with rehabilitation patients. The 37-year-old does this with ease as he moves about in his wheelchair greeting patients at Spinal Injury Rehabilitation Centre (SIRC) at Sanga, Kavre.Dhakal himself was diagnosed with poliomyelitis when he was two-and-half years old. Originally from Gorkha, he came to Kathmandu and lived in SOS Children’s Village while undergoing treatment. He started school at age seven, and learned to read and write at the same time as he learned to use crutches.Read also: <a href="https://www.nepalitimes.com/review/new-life-for-khagendra-b-basnyat/" target="_blank" rel="noopener">New life for Khagendra B Basnyat</a>, Sewa BhattaraiWith an MBBS from Kathmandu Medical College, Dhakal went on to receive an MD in Physical Medicine and Rehabilitation in Dhaka.“At daily rotations during my internship, there was one patient that every doctor skipped. He was undergoing rehabilitation after treatment for a spinal injury. No one could do anything for him so he remained there in a corner of that ward,” recalls Dhakal. “This opened my eyes to a gaping hole in medical care in Nepal.”Dhakal went on to become honorary clinical fellow at the Department of Rehabilitative Medicine at the <a href="https://medicine.unimelb.edu.au/research-groups/medicine-and-radiology-research/royal-melbourne-hospital" target="_blank" rel="noopener">Royal Melbourne Hospital</a> in Australia. He trained in Spinal Cord Medicine and Rehabilitation in Ireland, Canada and Switzerland.“In Nepal we are still very focussed on diagnosis and acute treatment. But what about residual paralysis in case of trauma, traumatic brain injuries and spinal injuries?” asks Dhakal. “Long-term rehabilitative care for patients with disabilities is severely lacking. We need more facilities for specialised rehabilitation care.”

Injured use Internet to get rehab care

The Kathmandu Valley has attracted an exceptional number of outstanding and accomplished foreigners over the decades, but few as extraordinary as Marilyn Silverstone (1929-1999).&nbsp; Frances Klatzel’s book A Portrait of Ourselves, Marilyn Silverstone: From Photojournalist to Buddhist Nun, is a fitting and fascinating biographical celebration of this American woman whose life of unusual choices took her, as the title suggests, from an affluent Jewish childhood in Scarsdale, New York to becoming an acclaimed and adventurous Magnum photographer.&nbsp; Roving the world, her camera captured many of the most iconic events of the 20th century, her images were published in Time, Life, Newsweek, Look, National Geographic, Paris Match, Vogue and other magazines. Following the teachings of Dilgo Khyentse Rinpoche, Marilyn Silverstone devoted the last twenty years of her eventful life to living quietly and practising Buddhism in Nepal. Ordained as a Buddhist nun, she took vows in the sanctified Solukhumbu precincts of Thubten Choling with Venerable Trulshik Rinpoche in the spring of 1977. Living in Kathmandu until her death in Shechen Monastery, which she helped create, Marilyn wrote: ‘When I look back over the years, although I did not know it at the time, ending my life as a Buddhist nun was logical and inevitable.’&nbsp; Ani Marilyn was a familiar figure amid the sacred spaces of the Valley, the lanes of Boudha and even Kathmandu’s drawing rooms during my early years in Nepal, a large smiling presence draped in maroon robes, dyed sneakers, slightly whiskered, robust.&nbsp; As a wedding gift she gave Tenzin and I an inscribed copy of her slim volume, Ocean of Life, aptly named for the span of her achievements and expansive embrace – editor, translator, writer, filmmaker, photographer, journalist and Buddhist nun. Marilyn’s nephew wrote: ‘Her legacy was that she was always herself no matter what chapter of her life that she was living.’  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260122100124_70d489c3d161f59668f315ede60cbb213d365357b0a9f2d7aad3b537a14dcb5e.png" data-media-id="editor_0" data-image-id="20260122100124_70d489c3d161f59668f315ede60cbb213d365357b0a9f2d7aad3b537a14dcb5e" data-rendition-name="original" width="1164" height="1600" loading="lazy" alt="Ani Marilyn"> <figcaption>Ani Marilyn as a Tibetan Buddhist nun at Shechen Monastery in Boudha.</figcaption> </figure>  Working with a wide range of impeccable sources, Frances Klatzel has assembled first-hand the personal recollections and unsparing insights from Marilyn’s most intimate friends. One of these, Jane Abell Coon, wrote the Introduction. She was a well-known person in 1980s Kathmandu whose husband Carlton Coon served as American Ambassador to Nepal and she simultaneously as American Ambassador in Bangladesh.&nbsp; The book begins with a rare message from the 14th Dalai Lama and a touching Foreword by Venerable Rabjam Rinpoche. It ends with exquisite excerpts from a Buddhist religious tract that Marilyn had translated from its traditional Tibetan text. Marilyn’s initial trip to India was to photograph Ravi Shankar in 1955, the classical sitar maestro. Increasingly fascinated by ‘the complex and compassionate culture’ of Tibet, her Himalayan archives include images throughout India, Nepal, Sikkim and Bhutan.&nbsp; The first internationally accredited photojournalist to base herself in India, from 1959 Marilyn lived in Bombay then Delhi, with her lifelong partner Frank Moraes, the Goan journalist, writer, commentator and first Indian editor of the Times of India after Independence. INDIAN INFLUENCERS I remember being taken to meet the legendary Frank Moraes in 1973, by then politically exiled in Marilyn’s elegant but chaotic London house, a magnet for South Asian intellectuals. She was not there, but Frank’s son the poet Dom Moraes was slumped desultory on a sagging sofa. My impression of Frank was well-dressed, polite and slightly distracted. Marilyn’s talent for friendship and wide network of Indian influencers and princely connections gave her unique access to historic events, as well as recording refugees, rituals, droughts, floods, famines and funerals. In addition to maharajahs and global leaders, her images portray personal moments, ordinary people, unflinching pain and flashes of joy. She said: ‘In my job, the closer you get to people, the better off you are.’ This book is illustrated with a thrilling trove of pictures of and by Marilyn, many of which reflect the impact of Henri Cartier-Bresson who signed her up as one of the first women to join his prestigious Magnum photo cooperative.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260122100124_6dfdef41da5945aea0a8bbd8c1514af5de2adb36361d4e20c29914c59f2039e0.png" data-media-id="editor_1" data-image-id="20260122100124_6dfdef41da5945aea0a8bbd8c1514af5de2adb36361d4e20c29914c59f2039e0" data-rendition-name="original" width="2124" height="1404" loading="lazy" alt="Ani Marilyn"> </figure>  Her assignments ranged across warzones in Vietnam, the Shah of Iran’s coronation, and Russian tanks rolling into Prague. Marilyn’s 1960s involved constant travel, her Magnum beat was the ‘Far East’, from Pakistan and Bangladesh to China, Korea, and Japan.&nbsp; With a knack at being in the right place at the right time, Marilyn was the only western woman journalist to record the arrival from Lhasa into ‘safety and exile’ of the young Dalai Lama in 1959. She was at Prime Minister Jawaharlal Nehru’s funeral in Delhi, the Chogyal of Sikkim’s marriage to Hope Cooke, and with Jacqueline Kennedy on a small boat at the Lake Palace of Udaipur.&nbsp; Marilyn snapped the Pope giving blessings in Bombay, Mother Teresa attending to the poor, and the Beatles on their way to meet the Maharishi. With Frank, she travelled to Africa and shot Emperor Haile Selassie in Ethiopia, Nigeria’s independence celebrations, and a very old and solar-topied Dr Albert Schweitzer in his jungle hospital in Gabon.&nbsp; A Portrait of Ourselves, Marilyn Silverstone: From Photojournalist to Buddhist Nun, is a highly recommended tribute to an inspirational life, told with discerning honesty and private perceptions by those who knew her best.&nbsp; Her monastic years living in Nepal continued to feature travel, hard work, undiminished curiosity, dogged fights for right, uncompromising support for others, disdain for conformity and battles with ill health, but all with her characteristic good humour. Marilyn leaves us with some sound advice in her own words: “I can say that I did it all. The secret though is just keep walking through life without analysing it too much or clinging to it too much. Just walk on.” &nbsp;&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260122100140_dc0c465e462bd14e92b2a2e79b5349f23fa039bcda81cc02a9a70adbcee35c7b.jpg" data-media-id="editor_2" data-image-id="20260122100140_dc0c465e462bd14e92b2a2e79b5349f23fa039bcda81cc02a9a70adbcee35c7b" data-rendition-name="original" width="1136" height="702" loading="lazy" alt="marilyn silverstone"> </figure>

“Just walk on”

The pale green ice on the top of the lake gleams in the pale January sunlight. The dark waters beneath are visible through the translucent frozen surface. This is Thulagi Glacial Lake at the foot of Mt Manaslu in central Nepal, classified as one of the <a href="https://nepalitimes.com/here-now/danger-nepal-s-glacial-lakes-are-filling-up">most dangerous lakes </a>to appear in the Himalaya due to climate heating.&nbsp; The place is breathtaking not just because of its 4,050m altitude, but the scenery all around. The beauty belies the threat this expanding lake poses downstream along the Marsyangdi Valley. &nbsp; The lake lies at the terminus of the 4.5km long Thulagi Glacier. The local Gurung inhabitants call it Dona Tal. They say it started appearing in the 1960s. Local guide Chandra Bahadur Gurung, 47, has been ferrying trekkers to the spot for about 20 years.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260122100136_a34407fbb58b41554f08d392933ea32360649deaf712e2221686533f81507f58.jpg" data-media-id="editor_1" data-image-id="20260122100136_a34407fbb58b41554f08d392933ea32360649deaf712e2221686533f81507f58" data-rendition-name="original" width="1500" height="1125" loading="lazy" alt="Thulagi glof"> <figcaption>MELTING MOUNTAINS: Thulagi Glacial Lake in Manang has been identified among 47 lakes in Nepal at risk of an outburst flood because of climate breakdown. All photos: DURGA RANA MAGAR</figcaption> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260122100136_4d3c25c9b4f6eaff3e538b36346471c301d38338514bfdfa9ee63ccd77d20489.jpg" data-media-id="editor_2" data-image-id="20260122100136_4d3c25c9b4f6eaff3e538b36346471c301d38338514bfdfa9ee63ccd77d20489" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="Thulagi glof"> <figcaption>Yaks graze below Thulagi Himal (7,059m) and Mt Manaslu (8,163m) along the Dona Khola that drains the lake.</figcaption> </figure>  “Dona used to be small, but it has now grown bigger,” he says, gesturing to how the glacier has receded and shrunk. Trekkers used to be able to go to the other side, but now the glacier is riddled with ponds and boulders falling off the moraine that make it dangerous.&nbsp; Gurung adds rather matter-of-factly: “The lake will burst sooner or later.”&nbsp; Kathmandu-based International Centre for Integrated Mountain Development (ICIMOD) has been studying Thulagi for the past two decades. Topographic maps from the 1960s and early satellite images show the lake being much smaller.&nbsp; When the <a href="https://nepalitimes.com/news/nepal-s-resource-curse">Marsyangdi Hydropower Project</a> project was being built in 1994, the German Institute of Geology and Natural Resources with the Department of Hydrology and Meteorology measured the lake to be already 2km in length. More recent surveys show the lake has increased its size since then to more than 1 sq km. &nbsp; The lake is among 47 <a href="https://nepalitimes.com/here-now/meltpools-in-the-himalaya">dangerous glacial lakes in Nepal and Tibet </a>&nbsp;identified by ICIMOD in 2020 due to its size, the risk of landslides and avalanches, and the gradual collapse of the lake’s ice-core moraine dam.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260122100136_9b9fea3665494614c2d89e4202c735fd642a13552d67ca2be3da5c390320ca9b.jpg" data-media-id="editor_5" data-image-id="20260122100136_9b9fea3665494614c2d89e4202c735fd642a13552d67ca2be3da5c390320ca9b" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="Thulagi glof"> <figcaption>Local guide Chandra Bahadur Gurung has been taking trekkers up to Thulagi Lake for 20 years.</figcaption> </figure>  In 2018 a team of glaciologists led by Umesh K Haritasya <a href="https://www.mdpi.com/2072-4292/10/5/798">published a journal article</a> about the evolution of three glacial lakes including Thulagi, Lower Barun, and Imja. Even back in 1976, Thulagi was twice the size of <a href="https://archive.nepalitimes.com/article/from-nepali-press/Diverting-danger,3172">Imja glacial lake</a> in the Khumbu and six times the size of the Lower Barun. The team measured the lake’s depth at 79m, and calculated that it held 36.1 million m3 of water. Since then, Thulagi has been growing at a slower rate than the other two lakes because it is shielded by shadows of mountains. There is also not as much glacial calving in the narrow valley.&nbsp; Nonetheless, scientists and experts have long warned that a Glacial Lake Outburst Flood (GLOF) from Thulagi poses a big risk to four hydropower projects on the Marsyangdi and settlements like Besisahar and Dumre (map).  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260125130136_eac3ccf38d2f91619825ab977bb21ea3eee84d6e87939721f9a8dbb7f0f22504.jpg" data-media-id="editor_8" data-image-id="20260125130136_eac3ccf38d2f91619825ab977bb21ea3eee84d6e87939721f9a8dbb7f0f22504" data-rendition-name="original" width="2076" height="1444" loading="lazy" alt="Thulagi map"> </figure>  The lake feeds into Dona Khola, a tributary of the Marsyangdi where the 49.9MW Dona Khola hydropower project is being built at a cost of Rs10 billion. Another 42MW Super Dona Khola project is planned on the river. “One of the trigger points that could lead to a glacial lake outburst could be the steep lateral moraine, which might be weakened by rapidly melting permafrost,” says Scott Watson, a University of Leeds researcher who was part of the team that conducted the 2018 study. Locals are already witnessing what Watson describes. They say that it was easy to reach Thulagi’s headwaters even until a few years ago, but that is now dangerous because of ice and rockfalls.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260122100136_217a1951a620e8efe11e5936600be172874976a0c04a1031495cf6687ce8f82c.jpg" data-media-id="editor_9" data-image-id="20260122100136_217a1951a620e8efe11e5936600be172874976a0c04a1031495cf6687ce8f82c" data-rendition-name="original" width="1426" height="1070" loading="lazy" alt="Thulagi glof"> <figcaption>The 50MW Upper Marsyangdi Hydropower Project station in Lamjung. A Thulagi Lake outburst would damage four hydropower projects on the Marsyangdi and its tributaries.</figcaption> </figure>  GLOF WARNING&nbsp; Glaciologist Rijan Bhakta Kayastha has been studying Thulagi since 1994, and was part of a team that discovered that the lake’s terminal moraine was made up of rocky soil on top and ice at its core.&nbsp; In 2020, Kayastha's team published a study that modelled the route of a possible GLOF. They found that if the lake burst, it would take 2.5 hours to reach Dharapani, and 4 hours to reach Bahundanda 39km downstream. The surge would be 13.7m high at Dharapani and 15m by the time it reached Taal, the village most at risk because it is situated only a few metres above the Marsyangdi. ‘Considering the size of the Thulagi glacial lake and its dam, it seems unlikely that a rock fall or avalanche would cause the lake to breach the moraine dam,” concluded the study. “But an earthquake or climate change would require a separate study. At present, there is no immediate or imminent threat of this glacier bursting.” MEMORIES OF 2021 Across Manang valley, residents are haunted by the memories of the <a href="https://nepalitimes.com/banner/himalayan-floods-a-sign-of-worse-to-come">2021 flood on the Marsyangdi</a> that swept away parts of Chame, Dharapani, Naso, and Taal villages.&nbsp; Kamarkali Gurung, grew up on the banks of the Marsyangdi in Dharapani, and had never imagined that the tranquil river she knew could become such a monster. She had saved up to build her own three-story property with 17 rooms.&nbsp; Her family was away that June evening when the flood swept away her hotel. “Not even a spoon remained, everything was gone,” says Kamarkali. “Losing the hotel hurt like losing a loved one. The Marsyangdi flows through my house now, I can never go back.”&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260122100136_925087c286f18a0374f5d2fae5cc528b6e8b5a55e02813e470c49b923b4f193a.jpg" data-media-id="editor_11" data-image-id="20260122100136_925087c286f18a0374f5d2fae5cc528b6e8b5a55e02813e470c49b923b4f193a" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="Thulagi glof"> <figcaption>SURVIVORS: Kamarkali Gurung's hotel was swept away by the 2021 flood on the Marsyangdi. She now operates her hotel from a rented house in Dharapani.</figcaption> </figure>  Surendra Gurung, also a hotelier, was in Dharapani the night of the flood, and can still remember the fear as the river roared towards the village. “I did not know if I would live or die,” he says.&nbsp; Sirantal village was merely 10m above the Marsyangdi, and was completely destroyed by the flood. Thirty-two people were rescued by army helicopters, and most of the families have now relocated to Taal.&nbsp; One of them is Singha Bahadur Gurung who also ran a lodge for 20 years. “We did not have to buy anything except rice, the soil in Sirantal was so fertile,” he remembers.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260122100136_9da9290e59a6d565ae9cb81a850f725ccd937fd658d0adfabccfe4114ec94bed.jpg" data-media-id="editor_12" data-image-id="20260122100136_9da9290e59a6d565ae9cb81a850f725ccd937fd658d0adfabccfe4114ec94bed" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="Thulagi glof"> <figcaption>Singha Bahadur Gurung operated a lodge in Sirantal before the flood swept it away in 2021.</figcaption> </figure>  Marsyangdi now flows through where Singha Gurung’s village used to be. “Ever since the flood, I am terrified every time it rains from June to August,” he says.&nbsp; The 2021 flood was during the monsoon, and was caused by unusually heavy rainfall in the catchment. A GLOF on the Marsyangdi would be much more destructive. Roshni Ghale, 46, runs a hotel in Taal, and escaped with her family to a nearby cave as the flood engulfed nearby homes.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260122100136_7a6b74a4c33b597e2815b035ec5d56ffea35923016518f0fb35bcc4fc925dccd.jpg" data-media-id="editor_13" data-image-id="20260122100136_7a6b74a4c33b597e2815b035ec5d56ffea35923016518f0fb35bcc4fc925dccd" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="Thulagi glof"> <figcaption>Roshni Ghale spent six months after the 2021 flood rebuilding her hotel in Taal. Tourism has steadily picked up in the four years since the flood. </figcaption> </figure>  “We spent the next six months after the flood rebuilding our lives, going to bed hungry many a night,” she recalls. In the four years since, tourism has picked up again, but the<a href="https://nepalitimes.com/news/the-unseen-wounds-of-climate-disasters"> community is still traumatised</a>. In the wake of the floods, the government had begun talks to rehabilitate and repatriate the community, but until now, they have been <a href="https://nepalitimes.com/multimedia/from-one-disaster-to-the-next">empty promises</a>. In any case, the people here, most of them experienced hoteliers whose livelihood depends on tourism, are unwilling to uproot their lives and start over elsewhere.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260122100136_9a13c863422806eefdcd826ed12f9906e2372bd8f60f83c5351652eccf050384.jpg" data-media-id="editor_16" data-image-id="20260122100136_9a13c863422806eefdcd826ed12f9906e2372bd8f60f83c5351652eccf050384" data-rendition-name="original" width="1500" height="844" loading="lazy" alt="Thulagi glof"> <figcaption>Most of the survivors of the 2021 flood on the Marsyangdi from villages like Sirantal have relocated to the upstream village of Taal, which itself was hit by a monsoon flood in 2021.</figcaption> </figure>  DISASTER PREPAREDNESS Even though studies have assessed the risk of GLOFs in Manang and across Nepal, and warned about the damage that such floods could cause, it took until 2021 for early warning systems to be installed on the banks of the Marsyangdi and in the town of Taal.&nbsp; But beyond that, there has been little preparedness. Early warning systems and disaster preparedness are necessary not just along the Marsyangdi but also at and around Thulagi itself, say experts. Locals here are becoming increasingly aware of the risk posed by the expanding lake up the valley, but are reluctant to leave homes and communities that they have lived in for generations. The hydropower projects on the Dona Khola promises jobs, and the local government is upgrading the hiking trail to Thulagi Lake which has become a tourist attraction. “Manang now gets <a href="https://nepalitimes.com/here-now/too-little-snow-too-much-rain">too little snow and too much rain</a>, and the Marsyangdi charts its own course,” says Min Rashi Gurung, chair of Ward-1 of Naso rural municipality, where Thulagi is located. &nbsp; But help may be on the way.Last year, the Green Climate Fund (GCF) approved a $36.1 million grant to help Nepal reduce risk of GLOFs in Thulagi and four other glacial lakes. The project is managed by the government and the United Nations Development Programme (UNDP). The project is set to begin next fiscal year, and will reduce the water level in the four glacial lakes including Thulagi, similar to what was done in Imja and Tso Rolpa, says Dinkar Kayastha at the Department of Hydrology and Meteorology. &nbsp; Centre for Investigative Journalism - Nepal

Hotter Himalaya melts glaciers

This is the 81st episode of Diaspora Diaries, a Nepali Times series in collaboration with Migration Lab providing a platform to share experiences of living, working and studying abroad. I went to Australia in 2008 because everyone was headed there. It was my first time leaving the country and my first job. My college helped me find work as a kitchen helper at a Brisbane restaurant.&nbsp; I did not know that being a kitchen helper meant washing dishes. I was young and did not know how to wash dishes or how to handle the steam, the hot water, and the busy kitchen. The utensils were thrown at the dishwashing station continuously, and water splashed on my face. My shoes and clothes were always wet. It was an on-call job. A couple of days into the job, I was asked to come in when I was at the movies. I refused. They fired me. That was that. I then worked on a farm, picking lemons and oranges. The lemon work was particularly hard because I would get cuts all over my hands. This hustle was not for me.&nbsp; Within a year in Australia, I decided to return to Nepal because the foreign life did not suit me. After spending eight months in Nepal, reality sank in. Nepal was not all that great either. I went back to Australia. On the plane, I befriended a Nepali woman who was homesick and a first time traveler. At the immigration in Australia, the officer noticed my long absence and started interrogating me. He noticed the Nepali woman waiting for me and asked who she was. Without thinking I lied that she was my girlfriend. That seemed to do the trick because he did not want us to be separated. He stamped my passport. She went her way. I went mine.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260127130112_5e7bfa6acc5f94d5f1905537e387c2d4169469679ace2b71de368912f3bd514f.jpg" data-media-id="editor_0" data-image-id="20260127130112_5e7bfa6acc5f94d5f1905537e387c2d4169469679ace2b71de368912f3bd514f" data-rendition-name="original" width="987" height="1004" loading="lazy" alt="DD 81 NT"> </figure>  In Sydney, I again found a dishwashing job at a fine dining restaurant. A Sri Lankan colleague helped me learn the job. The pace at which I had to do the dishes was insane but I got the hang of it in two weeks. I always dreamt of one day wearing the chef’s white coat. It commanded respect, I could tell. In addition to becoming good at my job washing dishes, I also had good language and networking skills so I built good relationships with colleagues. There was a need for a pizza chef at the restaurant. It was expensive to hire someone new, and they asked me if I was up for the job. I said yes even though I knew nothing about making pizzas. My Italian colleagues coached me and before I knew it, I became better than others at the job. Soon, I realised that I did not just want to make pizzas. Whatever I wanted to learn, I just asked seniors to take me under their wings and I would help without pay. They would agree but still pay me. It wasn’t a strategy per se, I genuinely wanted to learn. At some point, a Japanese sous chef in my restaurant and I had coincidentally applied to the same restaurant, and there, under him, I got to learn even more. Working with a Japanese chef is really difficult, but you learn a lot. He would sometimes even hold my hand with tongs dipped in hot water when I screwed something up. I worked in a few restaurants after this and was earning well. When one of my colleagues, a dishwasher, was let go unfairly, I decided to leave because I did not want to be a quiet bystander to this act. I returned to Nepal immediately after this.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2026012719010_f33ba38bb5f86f1d33262fd0d7ccd09ed01f6cc52148ca3d4cd66c434b695730.jpg" data-media-id="editor_1" data-image-id="2026012719010_f33ba38bb5f86f1d33262fd0d7ccd09ed01f6cc52148ca3d4cd66c434b695730" data-rendition-name="original" width="1200" height="1600" loading="lazy" alt="DD 82"> </figure>  I started a restaurant called Ghumti, but it was struggling. The location of the restaurants was not good and it failed. I bought another restaurant in Darbar Marg. I was managing two restaurants when Covid hit. The rent kept piling up, and there was no revenue. I took a huge loss. I gave them up and returned to Chitwan and started making migration plans. I came across a job vacancy for Alba in Qatar by the famous Enrico Crippa. I still remember the heat when I got out of the airport in Doha, it was like entering an oven. Thankfully, I had a Nepali roommate who showed me around and helped me adjust.&nbsp; The hotel was still under construction, but training had started. We worked really hard for the opening and things went well. In 2023, we even won the Best MENA Restaurant award. But at some point in 2024, the international Crippa chain decided to leave.&nbsp; Some colleagues including the head chef left and I suddenly was put in charge. I had some head chef experience from Australia and had previous experience working in high pressure environments, so I stepped up. We had to start from scratch again, this time as Alba in Raffles, Doha.&nbsp; The name of our restaurant comes from the Alba white truffle, which is the best available and is expensive, selling at around 40,000 QAR per kg. We had heard the official announcement that the Michelin was coming to Qatar, and we worked even harder.&nbsp; Michelin inspections are strict, highly secretive and you have no idea you are being investigated. Even then, we were up for the game. We were ‘selected’ which meant we had potential.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2026012719010_bab3a904af69603e9e79f333aeea89b035401c0c8d1750930107f3594ff1f565.jpg" data-media-id="editor_2" data-image-id="2026012719010_bab3a904af69603e9e79f333aeea89b035401c0c8d1750930107f3594ff1f565" data-rendition-name="original" width="1000" height="697" loading="lazy" alt="DD 81"> </figure>  I went to the award ceremony with low expectations. But because they announce the name alphabetically, Alba came first. I was very happy and felt validated. Being recognised as a Michelin one star restaurant is a huge achievement for us. My MD reminded me of a promise I had made of getting a Michelin tattoo if we got the award. I guess I will get it done when I come to Nepal next. My plan is to get a tattoo that captures my journey right from the dishwashing days.&nbsp; I have cooked for Obama, Beckham, Kaka, Trump, 50 Cent, Lindsay Lohan, you name it, because our restaurant is visited by high profile guests. At first, I used to feel the pressure. Now I view all guests as the same. The food you make is the same no matter who is eating it. I love the work. In fact, it does not feel like work. The rush in the kitchen, the atmosphere, the heat, the scent, I live for it. When I am not working, I get bored. It is like an addiction without which I get withdrawals. I want to contribute in introducing Nepali cuisine and ingredients in the worldstage. Nepalis overseas have a lot of potential in the hospitality sector. But my advice to youth is to focus on building a strong base and invest in learning. It is increasingly common for Nepalis to job hop for a salary jump. While other skills like language are also important, it is the hard skills that we really need to focus on. In our field of work, it is the plate that needs to speak.

Sky is the limit

A mighty metal bird, ‘Heron on Hunt’ spreads its wings and unhinges its mouth hungrily. It looks down at ‘The Defending Crab,’ which has windshield wipers for legs and opens its pincers defiantly at the heron, daring it to attack. The crab shell is made of a ceiling fan, the blades of which have been cut up to form the bird’s wings. “The story is that you are what you eat,” says artist <a href="https://taragaonnext.com/events/artist-in-studio-9-metamorphosis-by-saurab-koirala/" target="_blank">Saurab Koirala</a>, whose solo exhibition ‘<a href="https://taragaonnext.com/events/artist-in-studio-9-metamorphosis-by-saurab-koirala/" target="_blank">Metamorphosis</a>’ at <a href="https://taragaonnext.com/events/archiving-for-the-future-an-intersection-of-heritage-and-architecture/" target="_blank">Taragaon Next </a>has sculptures made of material retrieved from garbage warehouses. Koirala was in the studio when protestors ransacked the adjacent Hyatt Hotel on 9 September. The windows of the iconic museum designed by <a href="https://www.archdaily.com/957728/carl-pruscha-an-architect-investigating-overlooked-territories" target="_blank">architect Carl Pruscha</a> in the 1960s were all shattered, but the studio survived. He used the broken glass to make fins for his fish sculptures and wings for insects.  <figure><img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2026012409010_0c6c0f6d69472940e1c623db7bae62235a18ded418066b1c8ecc89485d76dcd4.jpg" data-media-id="editor_4" data-image-id="2026012409010_0c6c0f6d69472940e1c623db7bae62235a18ded418066b1c8ecc89485d76dcd4" data-rendition-name="original" width="1000" height="1500" loading="lazy" alt="Saurab Koirala exhibition Taragaon Next NT"></figure>  Metamorphosis is a reference to the transformation of trash into art, but it is also fitting because many of the repurposed items are of insects: a firefly, a dung beetle, a spider, a dragonfly, a queen ant. The most striking are the pair of praying mantises, the smaller one is black, made of windshield wipers, and the larger grey one is made of a motorcycle silencer, bicycle parts, and a fluorescent tube holder. About the unrealistic size difference, Koirala notes that each piece is made of a component that defines its size. For the larger grey mantis, the defining piece is the silencer that makes up its torso. “The mantises are mating,” Koirala explains. “The female mantis will cannibalise the male afterwards, and the dragonfly witnesses the whole scene.” It is possible to look at each installation and immediately recognise what it is meant to be, but on looking closer we see what the parts are made of, and how. The exhibition is from Koirala’s Taragaon Next residency program sponsored by the Saraf Foundation.  <figure><img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2026012409010_35d47a71c3e357d4cdba166cdcbf37019639c68a3d69a158f19fe97ea48065ea.jpg" data-media-id="editor_5" data-image-id="2026012409010_35d47a71c3e357d4cdba166cdcbf37019639c68a3d69a158f19fe97ea48065ea" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="Saurab Koirala exhibition Taragaon Next NT"></figure>  Koirala thinks of himself as primarily a painter and a caricature artist, and not a sculptor. His mother was a teacher, and would make miniature animals, gods, houses for her students. “Seeing how happy she was doing that made me want to do it too, although she did not want me to be an artist,” Koirala recalls. Some of his mother’s creations are also on display at the exhibition. Koirala got more experience working with 3D models digitally in his work at Incessant Rain animation studio, especially animals. This seems to have given him strong visualisation skills that he has put to use in the art pieces, using minimal bending and cutting. Koirala participated in the WastArt Competition in 2018, where his Danphe sculpture made from colourful coke and soda cans was so striking that it became a part of the permanent collection at the Sagarmatha Next Art Gallery in Syangboche. Koirala worked in the studio in Khumbu, fashioning yaks and bees out of trekking trash.  <figure><img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2026012409010_253578bca93f136dca51102fc03a675cc3a8f47ba0b2d31ae2a4020c2c6e7485.jpg" data-media-id="editor_6" data-image-id="2026012409010_253578bca93f136dca51102fc03a675cc3a8f47ba0b2d31ae2a4020c2c6e7485" data-rendition-name="original" width="1000" height="1500" loading="lazy" alt="Saurab Koirala exhibition Taragaon Next NT"></figure>  “My back hurts,” he grimaces as he opens the doors to the studio, an unassuming shed a short walk from the exhibition which is littered with metal spare parts for future art. He has gone through three whole bicycles with a power saw. Koirala seems to want to alter the scrap as little as possible, and it is uncanny how well some of it fits the pieces. The aerodynamic curved fuel tank of a Bajaj Avenger motorcycle becomes the abdomen of a gigantic queen ant. A mosquito repellent becomes the green body of a spider. A stapler and a coconut turn into a snail. The steel legs of a rolling office chair curve exactly into the legs and paws of a fox in motion. “I did not want the animals to be in static poses. I wanted to capture dynamic movement,” says Koirala. Fittingly, most of the parts he has chosen have come from vehicles: bicycles, motorcycles, scooters, car horns, air filters. While Koirala’s work in his Sagarmatha Next residency was about waste encroaching into nature in the mountains, his work in Metamorphosis is a nostalgic memory of a happy childhood in Biratnagar. ‘There used to be abundant dragonflies in my hometown,’ writes Koirala in his description. “As kids, we would catch them and tie threads to their tails and fly them like kites.” The message about the degradation of nature is more valid than ever. The world is seeing the mass extinction of insects, and uncontrolled urbanisation of polluted Kathmandu Valley means only ants and some spiders survive. Artist in Studio #9: <a href="https://taragaonnext.com/events/artist-in-studio-9-metamorphosis-by-saurab-koirala/" target="_blank">Metamorphosis</a> <a href="https://taragaonnext.com/" target="_blank">Taragaon Next</a> Till 30 January 10AM-5:30PM