<figure><img width="3700" height="1900" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221114101116/637208159c7e80680e0b54cajpeg.jpg" alt=""/><figcaption></figcaption></figure>The coronavirus disease is one of the most well-documented health crises of recent times, with its correlation to almost every sector in society -- including the <a href="https://www.nepalitimes.com/here-now/post-pandemic-mental-health-epidemic/" target="_blank" rel="noopener noreferrer">mental cost</a> of prolonged lockdowns and the stress during the pandemic. Studies have linked a higher prevalence of anxiety, depression, post-traumatic stress disorder (PTSD), hypochondria, obsessive disorders and psychotic symptoms among the general population in the last two years.But for the first time, <a href="https://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0262958&amp;fbclid=IwAR3GhEvU6qnCjQuwR-HEye8Jk3foYOofrmAgpLCgHZEhjm9r_2PWAOpZCBE" target="_blank" rel="noopener noreferrer">a new study</a> squarely links the rise in suicide ideation with the pandemic in Nepal. Police records also show a spike in suicides and self-harm cases in the past two years.Suicide cases had been rising even before the pandemic with 5,509 in 2018 and 5,898 in 2019. However, it jumped to 6,968 during the first year of the pandemic in 2020 — putting the <a href="https://www.nepalitimes.com/banner/nepal-sees-spike-in-suicides-during-pandemic/" target="_blank" rel="noopener noreferrer">suicide rate</a> at 23.9 per 100,000 population.‘The yearly increase in the suicide rate from 2019 to 2020 is 16%, which is more than threefold higher than a yearly increase in the suicide rate from 2018 to 2019 (5%),’ states the paper published on PLOS ONE last month.Titled ‘Association between COVID-19 pandemic and the suicide rates in Nepal’ and conducted by Binod Acharya, Keshav Subedi, Pramod Acharya and Shweta Ghimire, research analysed a total of 24,350 suicides in four years from July 2017 to June 2021 based on Nepal Police data.It investigated changing <a href="https://www.nepalitimes.com/latest/the-other-pandemic-mental-health/" target="_blank" rel="noopener noreferrer">suicide rates</a> in Nepal during the Covid-19 pandemic period (April 2020 to June 2021), compared to the pre-pandemic period (July 2017 to March 2020), adjusted for seasonality and long-term trends in the suicide rate.Males had a higher suicide rate (26.9 per 100,000) than females (16.5 per 100,000), but suicide rates went down over the last two years among males, but was sustained for a longer duration among females. <img width="542" height="600" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221114101116/637208189c7e80680e0b54cbjpeg.jpg" alt=""><img width="533" height="600" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221114101116/6372081b9c7e80680e0b54ccjpeg.jpg" alt="">For example, all the pandemic months except April and May of 2020 and February and March of 2021 had a significantly higher suicide rate compared to the same months in 2019. In comparison to the same month in 2019, July 2020 (just after the first lockdown) had the highest increase in the suicide rate with an increment of 55%.Researchers have pointed out limited or lack of economic resources, public health infrastructure and awareness about mental health as leading factors for the increase in suicides in Nepal during the pandemic.Nepal is one of the countries with highest suicides rates in the world according to the World Health Organization (WHO). The 2021 Nepal Health Research Council (NHRC)’s National Mental Health Survey found the prevalence of suicidality (current suicidal thoughts, lifetime suicidal attempt and future likelihood of suicidal thoughts) at a high of 7.2% among Nepalis. During the study period of this latest survey, the highest proportion of the suicides were observed in Bagmati province (5,709; 23.4%), followed by Province 1 (5,161; 21.2%), Lumbini (4,757; 19.5%), Madhes (3,053; 12.5%), Gandaki (2,369; 9.7%), Sudurpaschim (2,176; 8.9%), and Karnali (1,125, 4.6%).But Sudurpaschim and Karnali provinces, two of the provinces with the lowest Human Development Index (HDI), had the highest increase in suicide rates associated with the Covid-19 pandemic.‘Sudarpaschim and Karnali regions are also known to have a historically high proportion of seasonal <a href="https://www.nepalitimes.com/here-now/in-the-minds-of-nepals-migrant-workers/" target="_blank" rel="noopener noreferrer">migrant workers</a> in India. People in this region could have experienced additional distress as their migrant family members lost their jobs in India because of the business closure and lockdown,’ states the study.Alternatively, Province 1 which has the highest HDI and relatively low poverty rate among seven provinces has had consistently high pre-Covid-19 suicide rates, but had the smallest increase during the pandemic.Official data shows that Nepal registered an early increase in the suicide rate and mental health problems during the pandemic. Many factors come into play: lack of financial stimulus packages in the beginning, irresponsible media reportage about the virus, conflicting messages by authorities and the s<a href="https://www.nepalitimes.com/here-now/nepal-health-workers-battle-covid-19-but-also-stigma/" target="_blank" rel="noopener noreferrer">ocial stigma of being infected</a> all added to the psychological stress in the public.Restrictions during the pandemic also meant that mental health patients were unable to get timely consultation and medication, further aggravating their condition. ‘Public health interventions to the pandemic, especially the severe ones like lockdowns and business closure, should incorporate economic safety nets and mental health service delivery mechanisms catered to geographic, socio-economic differences and needs,’ recommend the researchers. <img width="1500" height="1000" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221114101116/6372081d9c7e80680e0b54cdjpeg.jpg" alt="">Suicides are preventable and treatment of mental health disorders can save lives. A comprehensive suicide surveillance system to maintain detailed suicide and attempt statistics within the jurisdiction of public health agencies rather than just the law-enforcement agencies can be a start.Addressing the underlying cause of <a href="https://www.nepalitimes.com/opinion/coping-with-anxiety-in-new-lockdown/" target="_blank" rel="noopener noreferrer">mental health problems</a> is still the most effective way to prevent suicides. This requires increased awareness and education through various platforms including social media, mass communication and school curriculum, which will in turn also help reduce the stigma associated with psychological disorders. Besides consultation and medication, family support plays a crucial role in healing people with trauma, depression or psychosis. Telemedicine, in particular, has been essential in preventing self-harm during the pandemic but these services need to be scaled up to cover the whole country.The paper concludes: ‘The Covid-19 pandemic is associated with an increased suicide rate in Nepal. The findings may inform policymakers in designing appropriate public health responses to the pandemic that are considerate of the potential impact on mental health and suicide.’Do not shy away from seeking help. If you, or anyone you know, would like to speak to a trained mental health professional, please contact:TUTH Suicide Hotline: 9840021600Transcultural Psychosocial Organisation-Nepal Crisis Hotline: 1660 0102005Mental Health Helpline Nepal: 1660 0133666Centre for Mental Health and Counselling Nepal Toll-free: 16600185080, Hotline: 1145Koshish Toll-free helpline: 166001-22322 (Bagmati Province)Patan Hospital Helpline: 9813476123National Suicide Prevention helpline operated by Mental Hospital Lagankhel and TPO: 1166

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Suicides: a pandemic within a pandemic

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110141124/636cfc2c9c7e80680e0a0b73jpeg.jpg" alt="" width="1500" height="1000"/><figcaption>Photo: MONIKA DEUPALA</figcaption></figure><ul><li>Two years ago after going through a bad relationship, a 36-year-old Kathmandu-based doctor started getting suicidal thoughts. During the long months of lockdown, he would be on the rooftop and imagine jumping off to end it all. But before long he realised that he was causing self-harm, and sought help. He was diagnosed with depression, eight months into treatment he is rid of suicidal thoughts and is back to his outgoing ways.</li> <li>The bubbly young woman used to be the life of every party, but few of her friends and relatives realised what was going on inside her mind. As the pandemic hit, she started having violent thoughts about harming others and herself. The 22-year-old tried to deal with it herself, but two months ago she sought help from a mental health doctor. She was diagnosed with Obsessive Compulsive Disorder (OCD) and started treatment. Looking back, she advises others to also seek professional help in time.</li> <li>The young woman felt worthless, lacked confidence, avoided crowds and had self-inflicted cuts on her arm. Her inability to come in terms with her sexuality aggravated her sense of insecurity. When the pandemic foiled her plans, she blamed everything on herself, she felt irritated and uncertain, stopped attending virtual classes and her eating habits changed. She finally sought help for her depression and she is now under regular psychiatric counselling and medications. Grounding exercises in particular have helped her overcome self-harm and feelings of inadequacy. “I am okay now,” she says.</li></ul>As the pandemic turns lives upside down, there has also been a global <a href="https://www.nepalitimes.com/here-now/post-pandemic-mental-health-epidemic/" target="_blank" rel="noopener noreferrer">outbreak of mental health disorders</a>, and Nepal has reported a rise in suicides. However, as these cases show, professional counselling and medication can save lives.Recoveries rarely make news, only suicides do.“Most of my patients who attempted suicide have gone on to lead normal lives after they get treatment, and oftentimes they look back to their mental health crisis as nothing more than a lapse of judgment,” says psychiatrist and researcher Rishav Koirala.There has been a sharp rise in <a href="https://www.nepalitimes.com/latest/have-suicides-increased-during-nepal-lockdown/" target="_blank" rel="noopener noreferrer">suicides in Nepal</a> since the Covid-19 pandemic in March 2020 and subsequent lockdowns. Nepal Police data shows that in the last 12 months, there have been 7,141 reported deaths due to suicides nationwide, up from 6,252 the year before.Do not shy away from seeking help. If you, or anyone you know, would like to speak to a trained mental health professional, please contact:TUTH Suicide Hotline: 9840021600Transcultural Psychosocial Organisation-Nepal Crisis Hotline: 1660 0102005Mental Health Helpline Nepal: 1660 0133666Centre for Mental Health and Counselling Nepal Toll-free: 16600185080, Hotline: 1145Koshish Toll-free helpline: 166001-22322 (Bagmati Province)Patan Hospital Helpline: 9813476123National Suicide Prevention helpline operated by Mental Hospital Lagankhel and TPO: 1166<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110141124/636cfc2e9c7e80680e0a0b74jpeg.jpg" alt="" width="640" height="475"><figcaption> </figcaption></figure>In a survey last year, <a href="http://www.tponepal.org" target="_blank" rel="noopener noreferrer">Transcultural Psychosocial Organisation (TPO) Nepal</a> which works with mental health compared five years of suicide data for March-July to see if there was any change during the lockdowns in 2020 and 2021.The results are revealing: suicides have been increasing steadily at an average rate of 8.5% every year, but it spurted to 19.4% in the first four months of the lockdown. Researchers also conducted key informant interviews across Nepal, who reported witnessing an increase in <a href="https://www.nepalitimes.com/latest/suicide-watch/" target="_blank" rel="noopener noreferrer">suicidal behaviours</a> in the community as well as health facilities.“We now have both quantitative and qualitative evidence that mental health problems have increased following the pandemic,” says TPO Nepal’s executive director Kamal Gautam. “And given that the majority of suicides are caused by psychological problems, we can say that Covid-19 has significantly contributed to its increase.”Mental health professionals have long been warning of an epidemic of psychological disorders following the Covid-19 crisis. They have reported an increase in anxiety, depression, post-traumatic stress disorder (PTSD), hypochondria, obsessive disorders and psychotic symptoms among the general population in the last two years.Economic collapse, job loss and slashed income due to the pandemic as well as <a href="https://www.nepalitimes.com/latest/in-nepal-lockdown-a-domestic-violence-spike/" target="_blank" rel="noopener noreferrer">increased domestic and sexual violence</a> and added workload during the lockdowns have all acted as contributing factors. In addition, those afflicted do not have normal social interactions that used to be a safety valve during more normal times.Moreover, many patients on treatment and medication have relapsed due to the limited access to health services, counselling and psychotropic drugs during the pandemic, and in many cases because of Covid phobia.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110141124/636cfc319c7e80680e0a0b75jpeg.jpg" alt="" width="1052" height="690"><figcaption> </figcaption></figure>Up to 80% of suicides have mental health disorders as an underlying cause. A significant portion of cases are also a result of impulsive behaviour.Experts agree that the official <a href="https://www.nepalitimes.com/here-now/nepals-suicide-rate-vastly-underestimated/" target="_blank" rel="noopener noreferrer">numbers on suicides are vastly underestimated</a> due to a lack of suicide registry. Official figures are based solely on police data and post-mortems, and because of stigma associated with mental health, many families also often refrain from revealing the actual cause of death.Official records also do not take into account <a href="https://www.nepalitimes.com/here-now/in-the-minds-of-nepals-migrant-workers/" target="_blank" rel="noopener noreferrer">suicides of Nepali migrant workers overseas</a>, mainly Malaysia and South Korea. Similarly, suicides among those in the LGBTIQ community who have lost their limited sources of livelihood during the pandemic have been largely neglected.“Reported cases alone are not conclusive, but given that we now have a year and a half long trend and data, we have seen a significant increase in mental health disorders, and can assume that pandemic has played a crucial part in the rise in the number of suicides,” adds Rishav Koirala.<a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.who.int/news-room/fact-sheets/detail/suicide" target="_blank" rel="noopener noreferrer">More than 700,000 people die by suicide</a> every year around the world, that is one in every 100 deaths -- more than HIV, malaria, breast cancer, or war and homicide. And for every suicide, there are many more who make attempts to end their lives.Nepal is among the countries with the highest suicide rates in the world and consistently ranks within the WHO’s top 10 list. The Nepal Health Research Council (NHRC)’s <a href="http://nhrc.gov.np/wp-content/uploads/2020/09/Factsheet-Adults-1.pdf" target="_blank" rel="noopener noreferrer">National Mental Health Survey</a> published earlier this year found the prevalence of suicidality (current suicidal thoughts, lifetime suicidal attempt and future likelihood of suicidal thoughts) to be high at 7.2% among Nepalis.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110141124/636cfc339c7e80680e0a0b76jpeg.jpg" alt="" width="1464" height="752"><figcaption> </figcaption></figure>The first of its kind survey in Nepal interviewed 15,088 participants and was carried out before <a href="https://www.nepalitimes.com/opinion/coping-with-anxiety-in-new-lockdown/" target="_blank" rel="noopener noreferrer">the pandemic</a> from January 2019 to January 2020. The study revealed that 10% of Nepal’s adult population had mental health problems in their lifetime with 4.3% experiencing some disorders at present.Mood disorders and neurotic and stress-related disorders were among the most common <a href="https://www.nepalitimes.com/latest/tackling-nepals-mental-health-pandemic/" target="_blank" rel="noopener noreferrer">psychological problems among Nepalis</a>. The prevalence of lifetime disorders was found the highest in Province 1 (13.9%), in the age group 40-49 years (13.3%) and among males (12.4%). As for current disorders, Bagmati scored the highest (5.9%) as well as those in the age group 40-49 years (6.3%) and females (5.1%).These figures correlate with Nepal’s suicide data of the past five years. Despite fewer attempts, men accounted for 57% of total suicides, against 43% of women. Among minors, however, more girls died by suicide, which experts ascribe to possible victimisation and a higher prevalence of borderline personality disorder among younger females.Suicide deaths are also disproportionately distributed across Nepal with Province 1 recording 65 deaths per 100,000 populations. Lumbini and Gandaki follow closely with 58 and 52 per 100,000 respectively. Traditionally neglected by the state and economically disadvantaged Karnali, Far West and Province 2 regions have lower suicide rates.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110141124/636cfc369c7e80680e0a0b77jpeg.jpg" alt="" width="2287" height="1816"><figcaption> </figcaption></figure>More people are dying of suicides in urban centres such as Kathmandu Valley and Ilam district, which reported 32 and 38 suicide deaths respectively per 100,000 populations last year against Rautahat’s 18 and Humla’s 6.This is in direct contrast with the global trends where 77% of suicides occur in low and middle-income countries. Unemployment and poor economic condition have long been associated with a high risk of suicides, but only up to a certain point, as proven by recent data. Japan, <a href="https://www.nepalitimes.com/here-now/dead-end-of-the-korean-dream/" target="_blank" rel="noopener noreferrer">South Korea</a> and Hungary with their higher per capita GDPs have some of the highest suicide rates in the world.“Poorer nations have weaker education and health systems, which translates into delayed or even lack of diagnosis but poverty is not a sole factor for suicides,” says Kamal Gautam. “Suicide is complex and there are multiple factors at play which means a linear approach to prevention would be incomplete, it needs an integrated approach.”Addressing underlying mental health disorders is the most effective way to prevent suicides. This means increased awareness and education about psychological disorders, which in turn can help <a href="https://www.nepalitimes.com/here-now/all-in-the-family/" target="_blank" rel="noopener noreferrer">reduce societal stigma</a>. An introduction to and discussion on mental health in the school curriculum can further sensitise the public.In addition to medication and counselling, societal structure and family dynamics is an important support system for individuals suffering from psychosis, trauma and depression. Telemedicine in particular has been essential in preventing self-harm during the pandemic-induced restrictions but mental health services need to be scaled up across the country.On the other hand, a strict regulation must be implemented on the <a href="https://www.nepalitimes.com/here-now/suicide-by-pesticide-in-nepal/" target="_blank" rel="noopener noreferrer">availability of pesticides</a>, an easy means of suicide for many. Access to alcoholic products must also be supervised with Nepalis known to self-medicate to cope with stress and trauma, in turn increasing the risk of self-harm and suicide.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110141124/636cfc399c7e80680e0a0b78jpeg.jpg" alt="" width="1280" height="853"><figcaption> </figcaption></figure>But most of all, analysing suicide attempts can be a powerful tool for prevention. On average, there are six attempts behind every suicide. Up to 80% of people with suicidal ideation reveal their intention to either a family member, friends or their doctors within a month before their attempt.“We forget that even before the pandemic suicide rates were very high in Nepal and while the pandemic might have added to the problem, the figures alone don’t mean anything if we fail to also study suicide attempts to find a stronger link between the prevalence and the contributing factors,” says Rabi Shakya, psychiatrist and director of Patan Academy of Health Sciences.He adds: “Historically, there have been more suicides after than during the crisis due to the long-term socioeconomic impacts. So we must start preparing for the pandemic of mental health problems including suicides post-Covid. Our health care workers must be trained and fanned out across the country.”Nepalis are not new to mental health problems induced by a crisis. The 10-year-long Maoist insurgency killed 17,000 people but many more continue to suffer from <a href="https://www.nepalitimes.com/here-now/the-mental-scars-of-violence/" target="_blank" rel="noopener noreferrer">PTSD, depression, anxiety and distress</a>. A 2017 report published in the journal Lancet found as high as <a href="https://archive.nepalitimes.com/article/nation/stigma-and-silence-mental-health-nepal,3486" target="_blank" rel="noopener noreferrer">37.5% of the general public</a> had some form of psychological disorder.The <a href="https://www.nepalitimes.com/here-now/its-all-in-the-mind/" target="_blank" rel="noopener noreferrer">2015 earthquake</a> further added to Nepal’s epidemic of mental disorders. Survivors who had narrow escapes or lost family members reported increased panic attacks, anxiety and trauma.But <a href="https://archive.nepalitimes.com/article/editorial/the-republic-of-insomnia,3311" target="_blank" rel="noopener noreferrer">conflicts, disasters</a> and pandemics have shined a light on mental health with an increased national and foreign investment in prevention and management. With larger chunks of the population impacted, there is now more acceptance and the field is starting to get the priority it warrants.Says Rishav Koirala, WHO focal person for mental health post-2015 earthquake: “The best way to prevent suicides is to address underlying psychological disorders and crises, despite adding to the burden has helped normalise them because many more people can now relate and understand that they are treatable.”

Sonia Awale

Nepal sees spike in suicides during pandemic

<figure><img width="1500" height="1000" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109101116/636b70369c7e80680e060067jpeg.jpg" alt=""/><figcaption>A customer buys a bottle of pesticide over a counter in Kathmandu. Photo: MONIKA DEUPALA</figcaption></figure>Of the 25,308 <a href="https://archive.nepalitimes.com/article/nation/down-and-out,3158" target="_blank" rel="noopener">suicides</a> recorded by the police in Nepal in the past five years, poisoning was the method of choice of 6,213 and pesticides were the most common form of poison used. Suicide by <a href="http://archive.nepalitimes.com/news.php?id=17916#.XhbkaVUzaUk" target="_blank" rel="noopener">pesticides</a> is the easiest, cheapest and the quickest way to kill oneself in Nepal.A <a href="https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-017-4542-y" target="_blank" rel="noopener">2015 study in Chitwan</a> showed that 90% of all poisoning cases resulted from deliberate ingestion of pesticides. Hospital and forensic data over the years reveal that pesticide self-poisoning kills at least 1,000 people in Nepal annually.“Pesticides are in fact a far greater threat than what police records show. There are many people who make the attempt and survive due to insufficient dose or medical treatment,” says Ravi Shakya, a mental health specialist at Patan Hospital. “If we also count attempted suicides, pesticide is the most preferred method of suicide in Nepal.”Read also: <a href="https://www.nepalitimes.com/here-now/nepals-suicide-rate-vastly-underestimated/" target="_blank" rel="noopener">Nepal's suicide rate vastly underestimated, </a>Sewa BhattaraiShailesh Thapa Chhetri of Nepal Police agrees: “Previously, hanging used to be the most common method of suicide, as people had the easiest access to ropes. Now, access to pesticides is even easier. Almost every household has pesticides, whether to kill cockroaches or to spray in the farms.”Do not shy away from seeking help. If you, or anyone you know, would like to speak to a trained mental health professional, please contact:TUTH Suicide Hotline: 9840021600Transcultural Psychosocial Organization-Nepal Crisis Hotline: 1660 0102005Mental Health Helpline Nepal: 1660 0133666And as the import of pesticides increases, the hazardous chemicals will only be more accessible for self-harm. The Ministry of Agriculture and Livestock Development claims that Nepal’s pesticide consumption is 396g per hectare but research by the Netherlands-based Wageningen University shows it to be <a href="https://www.nepalitimes.com/from-the-nepali-press/banned-pesticides-are-widely-used-in-nepal/" target="_blank" rel="noopener">2.9kg per hectare in vegetable patches</a>. “Pesticides that kill people are readily available in the market, they do not need prescriptions and anyone can buy it,” says Dilli Ram Sharma, former Director General of the Department of Agriculture. “To make matters worse, farmers <a href="https://archive.nepalitimes.com/article/nation/pesticide-laced-vegetables-continue-to-poison,1555" target="_blank" rel="noopener">always go for the most toxic ones</a> that kill all pests at once.”Read also: <a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/latest/suicide-watch/" target="_blank" rel="noopener">Suicide watch</a> <figure><img width="1500" height="844" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109101116/636b70399c7e80680e060068jpeg.jpg" alt=""><figcaption> </figcaption></figure>A <a href="http://www.forensic.gov.np/assets/upload/images/pdf/Trends-of-clinical-toxicology-cases-in-Nepal.pdf" target="_blank" rel="noopener">2014 National Forensic Science Laboratory study</a> that looked at the trends of clinical toxicology cases in Nepal from 2002-2012 showed that of the total poisoning cases due to insecticides, 71% were by ingesting the organophosphorus compounds Metacid (Methyl parathion) and Nuvan (Dichlorovos). Pyrethroid, carbamate and organochlorine were also used. Some of these pesticides are actually banned in Nepal, but available over the counter. A Central Police Forensic Science Laboratory study conducted over the past three years shows organophosphorus compounds and aluminium phosphide as the most common active ingredients in poisoning cases. Data from seven tertiary hospitals across Nepal found Celphos (aluminium phosphide used to kill rodents) as the most common pesticide in those admitted for poisoning. The <a href="https://www.centrepsp.org/" target="_blank" rel="noopener">Centre for Pesticide Suicide Prevention</a> in collaboration with the University of Edinburgh and Nepal Public Health Foundation is collecting three years worth of hospital and forensic data to analyse self-poisoning. Prof Michael Eddleston of the University of Edinburgh is the principal investigator and was recently in Nepal. “I don’t think it’s ever possible to use pesticide safely. You have to make pesticides non-toxic to humans, animals and the environment. We are trying to identify the problematic pesticides that are killing people here and provide that information to the concerned authorities so that they are banned and replaced with safer pesticides,” Eddleston told Nepali Times.The Nepal Public Health Foundation is also organising a two-day national conference (9-10 January) focussed on <a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/rooftop-gardens-kathmandu,1415" target="_blank" rel="noopener">healthy farming</a> and reducing pesticide use.Indeed Bangladesh, Korea and Sri Lanka have shown that removing highly hazardous pesticides from <a href="https://archive.nepalitimes.com/article/nation/heavy-pesticide-use-and-low-consumer-awareness-affecting-public-health,1394" target="_blank" rel="noopener">agricultural practice</a> is key to preventing suicide deaths without affecting agricultural output. The good news is that some of the most toxic pesticides are being banned in Nepal. In 2019, when the Centre for Pesticide Suicide Prevention pinpointed Dichlorvos and 3g tablets of aluminium phosphide as the most common causes of pesticide suicide in Nepal, the Plant Quarantine and Pesticide Management Centre placed a ban on both the pesticides, to be enforced after a grace period of two years for the chemicals already on the market.  Similarly, before Metacid (Methyl parathion) was prohibited in 2006, up to 68% of Nepalis killing themselves were using the chemical. After the ban, this figure came down to 8%.“Prevention is better than cure and that is exactly what pesticide ban does. And this has a double benefit: it reduces suicide death while also bringing down the rampant use of pesticides in agriculture, leading to a decline in pesticide residue,” adds Sharma, who retired after banning the two pesticides.Despite the ban, however, the smuggling of pesticides across the open border with India remains a challenge, and experts call for crossborder cooperation to fight it.  Says Rakesh Ghimire of Teaching Hospital: “Control of pesticides especially in agricultural areas is important, but as important is pesticide information centres and treatment when the poisoning happens.”

Suicide by pesticide in Nepal

Who is accountable for teacher-student relationships?

Of the nearly 19 million eligible voters in next week’s election in Nepal, an estimated 5 million are abroad and cannot cast their ballots. Many others within Nepal must travel to their home districts, and might decide not to because of the cost.
Flights into Kathmandu these days are full of global Nepalis returning just to vote, but almost as many are leaving for overseas jobs. Most of those coming or going are in the 20-40 age group, and a majority want Nepal to see a change in leadership.
Bangladesh held an election this month in which citizens overseas could vote by mail.&nbsp;
“Bangladesh made maximum use of technology not just for campaigning but also for polling itself. We could have also managed this, so people within Nepal did not have to travel to their home districts to vote,” says Mohna Ansari, former head of Nepal’s National Human Rights Commission who was an election observer in Bangladesh.
A 3-day holiday has been declared so people can travel to their home constituencies to cast ballots. Even if there was not enough time to manage ballots for overseas Nepalis, it could have been done for Nepalis within Nepal.
Former Chief Election Commissioner Bhojraj Pokharel reckons that physical voting in countries with a large Nepali diaspora would have been a logistical nightmare, but in the PR system, using electronic voting machines or paper ballot could have been piloted in some places. It is not possible to manage the entire voting process until we introduce the internet voting system.
“First of all, there needs to be political will to bring the policy and be ready to undertake that level of investment and it is not a one-time cost,” Pokharel says. “A government formed by the GenZ could have atr least issed an ordinance ensuring this right, piloted out-of-country voting where possible, which could have built pressure for the future Parliament and the government. It would have given people hope. It is a lost opportunity.”
All major political parties called for voting rights for global Nepalis in their manifestos, but these very leaders blocked legislation allowing it despite a 2017 Supreme Court ruling out of fear that it would be anti-incumbent.&nbsp;
<h2>Why so late?</h2>
Bangladesh delivered election results in just one day, but the final results of Nepal's last local polls in 2022 including that of Kathmandu constituencies took nearly a month.
Acting Chief Election Commissioner Ram Prasad Bhandari said this week that the results of the First-Past-The-Post (FPTP) ballot counting would “likely” be published within 24 hours of the poll closing at 5PM on 5 March. But many are skeptical.
“I wonder if we lack the capacity or know-how to announce results as quickly as possible,” says Mohna Ansari.
Former Chief Election Commissioner Pokharel says manual ballot paper counting in Nepal is inherently slow because of the large numner of political parties and/or candidates on the ballot, the counting mechanism, the political behaviour of the candidates/parties and some managerial issues during counting.
“Our present policy is to count all the ballot papers at the returning officers' officies, located at the district headquarters. It requires collecting ballot boxes safetly first. This takes time, and there have been cases of ballot boxes being damaged or stolen during transport. In a few highly difficult, geographically remote polling centres, we use a helicopter or transport. But sometimes, accommodating the party and candidates' representatives remains challenging,” explains Pokharel. A solution could be counting ballots at the very booths where they are cast.
Another reason for the delay is simply the number of political parties, and the need for each ballot paper to be examined by booth representatives for consensus. In close races, the smallest difference can lead to tense situations, further delaying results, even though counting centres are protected by metal fencing so there is no disruption.
After this, then it is the turn of Proportional Representation (PR) ballots to be counted. Weeks pass by the time the results of candidates and parties are tallied and verified. But the most common delay is because election officers think ballot counting is a nine-to-five job.&nbsp;
“The efficiency of poll station officers is most important, and they are incentivised for this,” says Ansari, adding that counting can even start within an hour after voting closes.
In remote areas, local resources could be mobilised to make counting quicker, but there is a crisis of trust, adds Ansari.&nbsp;
That could be easily solved with electronic voting which the EC implemented in the 2008 polls but discontinued because political parties felt the machines could be hacked or manipulated.

Nepalis Select Who To Elect

On Saturday, Iran retaliated with missile strikes on Abu Dhabi, Dubai, Bahrain and Qatar, a region where there are an estimated 2 million Nepalis working to send money home. In addition, thousands of Nepalis were preparing to board flights to Kathmandu from West Asian cities this weekend to vote in the 5 March election. Many are said to be stranded at various aviation hubs. A Qatar Airways flight from Doha took off just before the air space was closed, while Air Arabia and Kuwait Airways have diverted or cancelled flights. Nepalis in the West Asian region said things were relatively calm where they were, although some heard loud explosions at about noon local time. In Dubai, some thought they were Ramadan fireworks.&nbsp; In Kuwait, nearly 2,000 Nepalis working in the US military base as security guards and cleaners were evacuated before the strikes. In Bahrain where the US Fifth Fleet naval base is located and which was hit by two Iranian missiles, workers contacted by Nepali Times said the situation was under control and the authorities had told everyone to stay indoors and not use highways. The conflict also coincided with the beginning of Nepal’s trekking and mountaineering season, and tourists were either on their way or planning to leave European and North American cities for Himalayan hikes. Most of them transit through Doha, Dubai or Kuwait and all three airports are closed. Turkish Airlines flights via Istanbul are still operating.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260228130212_ab5e132d56da1df6a3fb1b6919648f845a168ad2c51d79f7587fb85a6e913b97.png" data-media-id="editor_0" data-image-id="20260228130212_ab5e132d56da1df6a3fb1b6919648f845a168ad2c51d79f7587fb85a6e913b97" data-rendition-name="original" width="1864" height="826" loading="lazy" alt="Qatar and UAE airspace closed"> <figcaption>Qatar and UAE airspace closed. Credit: Flightradar24</figcaption> </figure>  However, the main impact for the world could be a spike in the price of petroleum products if the strategic Strait of Hormuz is blocked. China relies on Iranian oil for their refineries, and Nepal could be affected indirectly if the economies of its neighbours are hit. Nepal imports all its diesel, petrol, LPG and aviation fuel from India which sources it mainly from the Gulf, and until recently from Russia. Petroleum makes up 25% of the value of all imports, and that is more than Nepal earns from all its exports. Saudi Arabia this year overtook the UAE as the main destination for Nepali workers, with the number now totalling 400,000. There are said to be as many in the UAE, and another 350,000 in Qatar. There are another 100,000 mostly women in Kuwait, and 50,000 each in Oman and Bahrain.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260228130220_d24ae633ff84f283835434becdb2f1351f84c415ce87ca34378bd4e2669661b3.jpg" data-media-id="editor_1" data-image-id="20260228130220_d24ae633ff84f283835434becdb2f1351f84c415ce87ca34378bd4e2669661b3" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="West Asia Iran conflict"> <figcaption>Iran retaliated with missile strikes on Abu Dhabi, Dubai, Bahrain and Qatar on Saturday.</figcaption> </figure>  Nepal receives nearly $11 billion a year in remittances from overseas Nepalis (not counting India) through official channels, although the total is said to be much more. &nbsp;This makes up more than a quarter of Nepal’s GDP equivalent — one of the highest proportions in the world. More than half of the overseas remittances to Nepal comes from its workers in the Gulf, and it is the mainstay of the country’s economy. Nepalis in Saudi Arabia, Qatar and the UAE alone send home more than $3 billion a year, much of that helping support their families back home. An average Nepali worker in the Gulf sends home nearly $2,500 a year, and this is spent mainly for household supplies, children’s education and healthcare. There are also an estimated 7,000 Nepali caregivers and healthcare workers in Israel, and most of them are women. The Nepal Embassy has asked Nepalis in Israel to take caution and move to bomb shelters.

West Asia war and Nepalis

If you did not watch the understated movie उनको स्विटर / (The Woolen Sweater) after it was released in May last year, you missed a major turning point in Nepali cinema. Much-hyped films fall short of expectations, but here is an exquisitely acted and directed production with a strong underlying message of tolerance. What a contrast from formulaic melodramatic Kollywood fare — a love story so simple, cinematography so subtle in capturing the beauty of the monsoon on mountain pastures, and a background folk song accompaniment that evokes the flavour and tenor of multi-ethnic eastern Nepal. Since its release, Unko Sweater received praise in Nepal, but it was in multiplexes across Nepaliphone India where the movie became a rage. Positive reviews spread by word of mouth on social media, where the script, performance and camera work were praised for reflecting a genuine and unsullied rural Nepal. The movie is a layered portrayal of caste, ethnicity, gender and culture with the tender romance between the shy Dharanidhar Kafle (Bipin Karki) and Phool Gurung (Miruna Magar) in which the two, despite being soulmates, have to deal with societal norms and gossip. They do this without rebelling, in their own quiet way. In the first scene in a crowded jeep, people are seen discussing an election. An elderly greying Kafle is headed home, and the rest of the movie has back and forth flashbacks revealing the story of his unspoken affection for Phool. But there is an undercurrent of ethnic rigidity. When Kafle’s brother Dambar elopes with Iksha Limbu, the repercussions are borne by both families. Then Kafle’s uncle is banished for being an outcast.&nbsp; Miruna Magar as Phool, as an ebullient woman, is in contrast to the introverted Kafle, who does not say much but has a melodious singing voice. As the plot thickens, Kafle is shown to be bound by circumstances that pose obstacles to his love for Phool. The storyline delicately shows how life and situations constantly force people to shift direction. Despite underlying differences, the various castes and ethnicities in this fictitious village near the Sikkim border get along because they have to. There is an interdependence between highland farmers and other ethnicities living down the valley that is at the heart of Nepal’s ethnic harmony. Despite taboos about interethnic and intercaste relationships, people still have trust and faith amongst each other. There is no time reference to the story, but it does speak of a nostalgic era decades ago when rural Nepal was not yet connected by roads and phones, when people had no choice but to get along. Things have changed now with outmigration, and education has blurred ethnic lines. A QUIET LOVE Director Nabin Chauhan is not in your face with his message, giving viewers a hint of deep rooted traditional values that still govern society. Each character adds to the storyline, validating the way they behave, pushing the plot forward.&nbsp; There are many emotions that are intricately woven into the plot, and the most prominent, of course, is love. Not the showy, lustful way it is shown in flamboyant formula films, but a quiet bond that does not need words, a silence, a glance and a gesture conveying the universe of love. When Phool asks Kafle what he will do if they cannot be together, he says he will build her a house with a beautiful garden of flowers in the meadows where he herds livestock. He builds it awaiting her return, while Phool knits him a sweater, the symbol of their interwoven love. In screenings of the film in Nepal and India, there has not been a dry eye in the audience. The background score and music by Kobid Bazra and the powerful rendition by Jhuma Limbu of the ‘Kafle’ strike a strong chord. The cinematography by Chintan Rajbhandari does not glamourise Nepal’s rural landscape, it is shown in its raw misty beauty as a constant backdrop. The viewer is uplifted by the notion that love transcends social restrictions and orthodoxies.&nbsp; The ending is left deliberately unfinished, possibly to make way for a sequel which we can only hope will be as compelling as उनको स्विटर. &nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260301060348_42480e8b6934c9a5c518c44c2970748b341bbbf290c2b303b6aa6359d883567b.jpg" data-media-id="editor_0" data-image-id="20260301060348_42480e8b6934c9a5c518c44c2970748b341bbbf290c2b303b6aa6359d883567b" data-rendition-name="original" width="1280" height="560" loading="lazy" alt="Unko Sweater"> </figure>  उनको स्विटर / (The Woolen Sweater) Artmandu Nepal, 2025 Directed by Nabin Chauhan 145 minutes Available now on YouTube <div class="embed-block"><iframe width="560" height="315" src="https://www.youtube.com/embed/lCgtmgiII7M?si=MirwKOwKmxE3jLS6" title="YouTube video player" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share" referrerpolicy="strict-origin-when-cross-origin" allowfullscreen></iframe></div>