<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109121148/636b94279c7e80680e06f1e3jpeg.jpg" alt="" width="2540" height="1426"/><figcaption>Richshaw operator Kancha Lama hardly gets one ride a day. He mostly depends on people distributing free food during the lockdown.</figcaption></figure>After two months in which there were new records of cases and fatalities every day, the second wave of the Covid-19 pandemic <a href="https://www.nepalitimes.com/banner/kathmandu-covid-19-lockdown-relaxed/" target="_blank" rel="noopener noreferrer">appears to be cresting in Nepal</a>, but it has left the economy in ruins with a crisis-ridden government offering no hope to citizens.<a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/banner/we-knew-the-tsunami-was-approaching/" target="_blank" rel="noopener noreferrer">At its peak in mid-May</a>, there were more than 9,000 new infections and up to 250 deaths daily. And that was just the official count, models put the figures at least three times higher. However, the real impact of the pandemic is in the country’s economic meltdown, with more than half the employed losing their jobs.The Covid-induced lockdowns have pushed millions of  Nepalis back below the poverty line, which means they are now <a href="https://www.nepalitimes.com/banner/nepals-epidemic-of-hunger/" target="_blank" rel="noopener noreferrer">unable to access food and water</a>, basic health care and education. This has completely reversed Nepal’s gains in poverty reduction in the past ten years.<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109121148/636b942a9c7e80680e06f1e4jpeg.jpg" alt="" width="225" height="225">Back in March, at the tail end of the first wave, <a href="https://www.nepalitimes.com/latest/covids-collateral-damage/" target="_blank" rel="noopener noreferrer">Himalmedia’s tv magazine Saglo Samaj interviewed</a> farmers, tourist guides, hotel operators and taxi drivers most affected by the lockdowns.This week, the team revisited each of the same people to find out what had become of them. Their stories are a microcosm of a society ravaged by the pandemic, where the poor have got poorer.https://www.youtube.com/watch?v=Yni_6WWbmAo&amp;feature=youtu.beNepalis suffered altogether <a href="https://www.nepalitimes.com/banner/economic-cost-of-5-months-of-nepal-lockdown/" target="_blank" rel="noopener noreferrer">five months of lockdown in 2020</a>, and another nearly two months this year. The restrictions were eased this week, even though the daily number of fatalities and active cases are higher than when the lockdown was imposed on 29 April.The pandemic and the lockdowns have disabled every sector. Some 1.1 million people in the <a href="https://www.nepalitimes.com/latest/nepal-tourism-may-take-5-years-to-recover/" target="_blank" rel="noopener noreferrer">hospitality industry</a> have been directly impacted by the pandemic and more than half of Nepalis lost their jobs in the past month alone.Yet, the government has no clear plans to provide alternative employment opportunities for those who lost their jobs. In fact, it has been too <a href="https://www.nepalitimes.com/banner/court-debates-nepal-pm-olis-future/" target="_blank" rel="noopener noreferrer">preoccupied with a political power struggle for most </a>of the pandemic to plan a real exit strategy. Every response to the crisis has been too little, too late.On Tuesday, even though other districts prepared to relax their lockdown just as Kathmandu did, Nepal saw 4,522 new cases and 41 fatalities. There are a total of 52,648 active infections, 762 of them in ICU and 218 in ventilator support in hospitals across the country.Public health experts are already warning of a possible third wave and urging the government to make preparations for <a href="https://www.nepalitimes.com/latest/nepal-covid-19-impact-worse-than-official-figures/" target="_blank" rel="noopener noreferrer">increased contact tracing</a> and hospital treatment to avoid much devastation.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109121148/636b942b9c7e80680e06f1e5jpeg.jpg" alt="" width="2552" height="1428"><figcaption> </figcaption></figure>MILKED DRYBuffalo milk is the only source of income for farmers in Kamdi village of Banke district in the western Tarai. But many of the dairy farmers were unable to sell their milk during the lockdowns in 2020. Later, they didn’t get a fair price and the Dairy Development Corporation was slow to pay even what they were owed.“The market is closed, there is barely any feed for the cattle. We are working day and night, but for nothing,” says Malati Prasad Yadav, who has 150 buffalos, but little income since the pandemic.The farmers took loans to buy feed and take care of the buffalos, but the second wave has quashed the little hope they had. They were hoping the government would announce a relief package in this year’s budget. But their hopes were dashed.“We are having to pour the milk into the drains, there are no consumers for ghee or cheese. We are running at a loss and there is no telling how long it will last,” says Saroj Pandey of the SJ Dairy in Nepalganj. “The government should boost the morale of farmers and local businesses, subsidise their electricity or promote Nepali goods by stopping import from the third country.”<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109121148/636b942e9c7e80680e06f1e6jpeg.jpg" alt="" width="1500" height="844"><figcaption> </figcaption></figure>TOURISM AND REALISMOne of the hardest-hit sectors is tourism. And while professionals of most fields have had to cope with the challenges brought on by the pandemic, <a href="https://www.nepalitimes.com/latest/where-have-all-the-guides-gone/" target="_blank" rel="noopener noreferrer">tourist guides have been unemployed</a> for more than a year now.Four months ago, tourist guide Shankar Bhattarai had taken up teaching to make a living but was spending all his free time reading up about Nepal’s history and culture to better prepare himself for when the tourists would come back post lockdown. But the second wave killed what was left of <a href="https://www.nepalitimes.com/editorial/survive-revive-thrive/" target="_blank" rel="noopener noreferrer">Nepal’s tourism</a>.He has since given up any hope of normalcy and is constantly worried about debt collectors. Hoping for an alternative for tourists guides like himself, he was further depressed with this year’s budget.“There were provisions only for the big hotels and travel agents, we didn’t find ordinary tour guides like us anywhere in the relief packages,” says Bhattarai, who had been a tourist guide since 2011. “I’ve tried my best to promote Nepal through my work but at our time of need, we have no government support. I now question myself about staying back in Nepal.”<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109121148/636b94309c7e80680e06f1e7jpeg.jpg" alt="" width="2537" height="1425"><figcaption> </figcaption></figure>UNSERVICEABLEBig businesses have their own woes. The three-star Airport Hotel in Kathmandu has seen only a handful of guests in more than a year. The hotel’s original staff of 100 is down to 10, and only 10 of its 62 rooms are kept serviceable.“We are doing much worse than last year, we did survive 15 months somehow, there were some domestic tourists, but then the second wave happened and it destroyed what little we had,” says owner Binayak Shah, adding that he has not been able to pay the monthly instalments on its loan for 17 months.He adds: “I have no income, so how can I pay them? This means sooner or later, the bank is going to blacklist me, and put this hotel up for auction.”<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109121148/636b94339c7e80680e06f1e8jpeg.jpg" alt="" width="2544" height="1420"><figcaption> </figcaption></figure>DOWN AND OUTWhile some worry about paying millions in bank loans, daily wage labourers worry about the next meal. Kancha Lama has been operating a rickshaw in Kathmandu for 38 years, but his <a href="https://www.nepalitimes.com/banner/pandemic-puts-brake-on-kathmandus-rickshaws/" target="_blank" rel="noopener noreferrer">business is down and out</a>. He hardly gets one ride a day, and mostly depends on people distributing free food.“It’s easy for the government to tell us to stay home and eat healthy, where is the money? It doesn’t even allow me to beg on the streets. At least they should distribute rations for people like us,” says Lama. “If I get Covid, at least I will be out of this misery.”Bir Bahadur Lama is in Asan every day, and if it is his lucky day he will get a client or two to carry loads for them. Otherwise, he sits on the temple steps passing the day with other jobless porters. Before the pandemic, they used to carry loads for Asan’s many shops. Sometimes, good samaritans offer them food, but that is rare.“I just wish I did not have to sleep hungry and lockdown would end soon, that is all I wish for,” he says.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109121148/636b94379c7e80680e06f1e9jpeg.jpg" alt="" width="2539" height="1430"><figcaption> </figcaption></figure>TAKEN FOR A RIDEDuring the lockdown last year, a bank took possession of Ganesh Tamang’s taxi which he had bought with Rs500,000 out of savings from years of toil in the Gulf.With no other source of income, he is now back to his village and raises livestock. “I often feel like I was born in a wrong country, to a wrong family, and at the wrong time, it wouldn’t have come to this anywhere else,” he says.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109121148/636b943a9c7e80680e06f1eajpeg.jpg" alt="" width="1500" height="844"><figcaption> </figcaption></figure>Sagar Bohora has a sickly mother at home, and a family of young children dependent on him. But his taxi has broken down because it has not run much for the past year-and-a-half. He needs at least Rs30,000 for repairs, but he has barely enough after paying off the auto loan.“I only ask banks and financial institutions that they give us a few months until after the lockdown so that we can pay our dues, by then we will be able to get up, with or without government help,” says Bohora.<h2>Pandemic makes the poor poorer</h2><figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109121148/636b943c9c7e80680e06f1ebjpeg.jpg" alt="" width="2538" height="1424"><figcaption> </figcaption></figure>There is empirical evidence that the second pandemic wave has <a href="https://www.nepalitimes.com/latest/nepal-prepares-for-economic-fallout-of-pandemic/" target="_blank" rel="noopener noreferrer">further impoverished Nepal’s poor</a>. Even by modest estimates, some 9 million Nepalis have been pushed back below the poverty line due to Covid-19 induced lockdowns. In this week’s Saglo Samaj tv magazine, Shankar Sharma, former ambassador to the US and vice-chairperson of the National Planning Commission spoke to Kanak Mani Dixit. Excerpts:Kanak Mani Dixit: We went back to people we had interviewed four months ago, and found that their situation had further declined. Do they represent the current Nepali society?Shankar Sharma: They are an accurate representation. There are three categories that have been hit the hardest by the pandemic: the first are <a href="https://www.nepalitimes.com/latest/pandemic-offers-chance-to-revive-farming/" target="_blank" rel="noopener noreferrer">subsistence farmers</a> below the poverty line, this also includes disadvantaged groups. The next are people in the informal sector whose livelihood has been endangered with the extended closure of the market. Then there is the hospitality industry and unlike others, they haven’t been able to pick up after the first wave because the impact of the lockdown on the <a href="https://www.nepalitimes.com/banner/tourism-that-treads-lightly-on-the-land/" target="_blank" rel="noopener noreferrer">travel industry</a> is long-term. These businesses had loans and now their debt has accumulated.These impacts are directly reflected in our macroeconomic numbers. Economic growth rate last year was 2% and this year it won’t be more than 1%. Similarly, the World Bank estimates following the pandemic there are now a total 9 million people in Nepal below the poverty line.Would you say that because it is not monetised rural subsistence living is faring better?Back during the Maoist insurgency, some development partners had conducted a study about people who had migrated to the cities due to the violence. They asked people if they would go back to the village once the peace accord was signed, 93% of the respondents said no.One of the main reasons behind this was <a href="https://www.nepalitimes.com/editorial/back-to-the-future-of-farming/" target="_blank" rel="noopener noreferrer">Nepal’s agriculture</a> couldn’t compete with Indian and Chinese produce. This also led to more people migrating abroad. Experts have suggested the concept of contract farming, which is also included in this year’s budget and will do well for the country.But one of our biggest problems is our <a href="https://www.nepalitimes.com/banner/nepals-fake-poor/" target="_blank" rel="noopener noreferrer">inability to identify the poor</a>. The government has developed ID cards for their identification, but 23% of the poor are not on the list but 25% are those who have listed themselves in hopes of getting some relief. As a result, the real poor have been deprived even of their social security fund.What should we do to boost their morale and of the country?The affected people are those in rural Nepal but they also have an advantage of three levels of government. But it is still the responsibility of the central government to provide relief worth at least two months at $1 per day for its people. Unfortunately, there is no mention of this in the budget this year.The Nepal government has also allocated a total of Rs50 billion for training in the last two budgets but hasn’t been able to spend that money. This fund should be used in skill development for Nepalis post lockdown, effective spending of the budget is a must. Similarly, the government should support cottage and small industries so that they don’t close down. If we lack funding, we could use loans and grants we have received from international development partners.Despite the pandemic, there is still talk about Nepal graduating from Least Developed Country (LDC) status to a middle-income country. What will happen now?Following the pandemic, the United Nations has set a new deadline for the LDCs to graduate to lower-middle-income and middle-income countries. The good news is that we have made some progress in our per capita income, and the fact that our economy is now dependent on multiple factors is a positive sign. But what is worrying is that our economic growth is still lower than the average growth of underdeveloped countries. This means we will have to work more on increasing our living standard.It is said that Nepal is not a poor country, but the government just cannot seem to spend its development budget. If they were held more to account by civil society and media during this pandemic that might help? I think that is an appropriate conclusion to make. The government will always play the lead role, but it is important to highlight the importance of civil society and journalists in creating awareness about various programs at the local level such as the <a href="https://www.nepalitimes.com/banner/missing-the-plot-in-nepals-job-scheme/" target="_blank" rel="noopener noreferrer">Prime Minister’s Employment Scheme</a>, which goes a long way in rejuvenating elected representatives in villages and towns.

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The real cost of Nepal’s second wave

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110111124/636cd1d59c7e80680e08f8dajpeg.jpg" alt="" width="2048" height="1536"/><figcaption>21-year-old Tsering Bhuti during a trekking expedition in Manang in 2019.</figcaption></figure>In November 2019, Tsering Bhuti joined Alliance Française to learn French. In her job as a trekking guide, she thought learning a new language was going to be a boost.But the Covid-19 pandemic had other plans for her, denting her ambition, taking away her livelihood, and knocking out Nepal’s trekking industry.“The Visit Nepal campaign would have been a turning point for my career, and I was looking forward to making business connections for the future,” says Bhuti, who has assisted <a href="https://www.nepalitimes.com/latest/nepal-allows-royal-himalayan-expedition/" target="_blank" rel="noopener noreferrer" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/latest/nepal-allows-royal-himalayan-expedition/&amp;source=gmail&amp;ust=1610334109257000&amp;usg=AFQjCNEuL4__xvBKJiRogSOt_TLmHDPzUQ">expeditions</a> on Annapurna and Manaslu trekking circuit.But she has not given up all hope. “Maybe this break will give me more time to prepare to be a better guide. I will train for mountaineering now,” she adds.Bhuti is just one of thousands of trekking and mountaineering guides in Nepal who have been unemployed for over a year now. Although regular international flights restarted in October, and <a href="https://www.nepalitimes.com/latest/nepal-open-for-trekking-from-17-october/" target="_blank" rel="noopener noreferrer" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/latest/nepal-open-for-trekking-from-17-october/&amp;source=gmail&amp;ust=1610334109257000&amp;usg=AFQjCNFV5-8XwAWlS_YplQR0aU2DzP4Kdw">trekking resumed in October</a>, the number of tourists visiting Nepal slumped from over 1.1 million in 2019 to fewer than 230,000 last year.There was a slim hope that things would pick up in the 2021 spring climbing season, but with many countries going through a third wave of coronavirus, airline and expedition bookings are seeing cancellations.The impact of the global pandemic has been seen on all sectors of Nepal’s economy, but none more so than in tourism. The industry used to directly employ 1 million Nepalis, and many more who benefited in ancillary sectors.The suspension of travels after the coronavirus pandemic also dealt a blow to the government’s <a href="https://www.nepalitimes.com/latest/lets-call-off-visit-nepal-year-2020/" target="_blank" rel="noopener noreferrer" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/latest/lets-call-off-visit-nepal-year-2020/&amp;source=gmail&amp;ust=1610334109257000&amp;usg=AFQjCNF3MhopsZRAK_Orw9S7_GZyBQvS6Q">Visit Nepal 2020 (VNY 2020) </a>campaign, which had a set target of welcoming two million tourists last year.After being closed for nearly a year, the Nepal Academy of Tourism and Hotel Management (NATHM) in Kathmandu is planning to re-open some of its classes with minimum students so that guides and tourism support staff can use the time to upgrade their skills.“We get numerous calls every single day asking if we are resuming our classes,” says Gyanendra Pandit of NATHM. “It’s time to get back into action.”Last year, NATHM registered 300 students for tourist guides and 800 for trekking guide training courses which had to be suspended after running for a few weeks as the country went into lockdown.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110111124/636cd1d99c7e80680e08f8dbjpeg.jpg" alt="" width="1754" height="1316"><figcaption>The Everest Region is looking for a modest revival of trekking this spring. Photo: Pooja Rijal/Nepali Times Archive</figcaption></figure>When Visit Nepal year began in early January 2020, travel agents, guides, porters were all upbeat in the expectation of more business. But just as trekkers and tourists started arriving for the spring season, flights to and from Kathmandu were stopped in March.“Tourism is largely run by the private sector in Nepal with very little help from the government. This unforeseen crisis has made us think about how we conduct tourism in this country,” says Sarita Lama of the Trekking Agencies Association of Nepal. “This year our revenue is zero. Many trekking and travel agencies have closed indefinitely, as they were unable to pay rents and their employees."Nepal’s tourism sector brought in over $700 million in 2019, and contributed 8% equivalent to the country’s GDP. Indeed, tourism experts say pandemic has given the industry time to <a href="https://www.nepalitimes.com/opinion/nepals-tourism-now-has-to-re-start-from-zero/" target="_blank" rel="noopener noreferrer" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/opinion/nepals-tourism-now-has-to-re-start-from-zero/&amp;source=gmail&amp;ust=1610334109257000&amp;usg=AFQjCNGFY7vFfsXrkcvgLsdT3lHwmOS6IA">rethink the whole business model.</a>The former CEO of Nepal Tourism Board <a href="https://www.nepalitimes.com/here-now/survive-2020-revive-in-2021-and-thrive-in-2022/" target="_blank" rel="noopener noreferrer" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/here-now/survive-2020-revive-in-2021-and-thrive-in-2022/&amp;source=gmail&amp;ust=1610334109257000&amp;usg=AFQjCNGdAsBiez2_LE7vGptE5zv4Y8yryA">Deepak Raj Joshi</a> agrees that the Covid-19 crisis has given Nepal some breathing space and to look for ways to <a href="https://www.nepalitimes.com/editorial/survive-revive-thrive/" target="_blank" rel="noopener noreferrer" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/editorial/survive-revive-thrive/&amp;source=gmail&amp;ust=1610334109257000&amp;usg=AFQjCNH6DE8NgNaUn6XoOlo2ZeHPWomcUw">make tourism more sustainable</a> and for its benefits to be more equitably distributed within the country.“We should use this pandemic as an opportunity to work towards improvement of facilities along trekking trails and upgrading skills of porters and guides so they can earn more when trekking resumes,” Joshi says.There are also sightseeing tour guides who has lost their jobs in the past year. Kedar Tamang has been a guide taking visitors to tourist attractions around Nepal for the past 25 years. He says he hasn’t seen any crisis as dismal as the past year.“As a tour guide, our responsibility has been to portray a good image of Nepal to the outside world by sharing our culture, history and heritage,” says Tamang. “Out of 4,500 registered tour guides, not even one person has found another job for a year now.”The dire emergency has forced some in the business to adapt to the new environment and create new opportunities in domestic tourism, and to do advance online promotion for a time when visitors can return to Nepal.Manish Shrestha of Enroute Nepal says, “Most of the travel agents have shifted online and have made us rethink our business model. That’s how we are now adapting and adjusting to the new normal.”But for most porters and trekking guides, this is not an option. There is also a lot of competition to guide the few Nepali trekking goops that are venturing out along the trails.Ang Kingka Sherpa, a certified <a href="https://www.nepalitimes.com/banner/hiking-in-the-himalaya-during-covid-19/" target="_blank" rel="noopener noreferrer" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/banner/hiking-in-the-himalaya-during-covid-19/&amp;source=gmail&amp;ust=1610334109257000&amp;usg=AFQjCNEi_4EHUq3yaelGq3kc1dXNmb6sUw">trekking</a> guide has been out of a job since the beginning of the lockdown. The 31-year-old has worked his way up the career ladder from being a porter.“Being a guide or a porter is not just my job, it is also my passion. I do not think I can do anything else for a living,” says Sherpa, who has difficulty providing for his family after losing his income, and exhausting his savings.But he has not lost all hope. He is confident tourists will come back to Nepal: “April-May still might hold promise. Let’s see how things go.”Read also:<a href="https://www.nepalitimes.com/latest/nepal-allows-royal-himalayan-expedition/" target="_blank" rel="noopener noreferrer" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/latest/nepal-allows-royal-himalayan-expedition/&amp;source=gmail&amp;ust=1610334109257000&amp;usg=AFQjCNEuL4__xvBKJiRogSOt_TLmHDPzUQ">Survive, revive, thrive</a>, Editorial<a href="https://www.nepalitimes.com/latest/nepal-allows-royal-himalayan-expedition/" target="_blank" rel="noopener noreferrer" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/latest/nepal-allows-royal-himalayan-expedition/&amp;source=gmail&amp;ust=1610334109257000&amp;usg=AFQjCNEuL4__xvBKJiRogSOt_TLmHDPzUQ">Nepal allows 'royal' himalayan expedition</a>, Nepali Times

Where have all the guides gone?

From stone spouts to cast-iron mains, Nepal’s water system and its struggle to provide safe water tells a larger story of power, disease, dependency — and lessons for the future. From 1823 to 1891, the Nepali state made just two notable interventions in Kathmandu’s drinking water system. The first was when Prime Minister Bhimsen Thapa commissioned a stone pout (hiti) to tap groundwater within the valley’s traditional supply system. The second came nearly 70 years later with Nepal’s first industrial-era water system, the Bir Water Works in 1891 under Prime Minister Bir Shumsher Rana. Linking these two milestones was the spectre of cholera. From the 19th century on there were seven global cholera pandemics. <a href="https://www.sciencedirect.com/science/article/pii/S0264410X19309995#bb0325" target="_blank">Originating in Asia</a>, the disease reached Europe and the Americas, the Vibrio cholera bacillus breeding in poor sanitation wherever it found it. The first wave erupted in 1817, followed by others in 1829, 1852, 1863, 1881, 1889 and, finally, in 1961, the seventh pandemic which still lingers on. London, the epicentre of the Industrial Revolution, was repeatedly stricken. In Britain ‘miasma’ foul air was blamed. &nbsp;In Nepal, cholera was seen as divine damnation. By the late 19th century, as Nepal’s relationship with Britain deepened, the Bir Water Works was inaugurated in 1891 as a defence against cholera. Whether cholera also shaped Bhimsen Thapa’s decision in 1823 is less clear. Contemporary records note the commissioning of Sundhara, but do not refer to the cholera epidemic raging at the time. The silence itself is telling: Nepal’s elites were ruling in the shadow of the disease. Bhimsen Thapa first resided in Thapathali Palace, which was built in 1802 by Nain Singh Thapa, father of Mathabarsingh Thapa, who would briefly become prime minister in the 1840s. In 1806, Bhimsen Thapa moved to Bagh Durbar, a new complex on the western edge of Tundikhel. Historians are vague about the water supply in the residences of the nobility, but wells and water hauled from rivers, ponds, canals, and other sources were likely the primary sources. A small hiti north of Bagh Durbar, near today’s Sun Dhara, may have supplied the palace. In 1823, Bhimsen Thapa had it enlarged, making it the last and largest state-built hiti in Kathmandu. Even as Bhimsen Thapa was involved in palace intrigues and border conflicts, Britain was engineering pipelines. By the late 18th century, Sir Thomas Simpson had invented the bell-and-spigot joint, making long-distance pipes viable. Fluid dynamics, dealing with pumps, pipes, and filters, was becoming a foundational discipline. In Kathmandu, the scourge continued. Cholera struck Kathmandu repeatedly, in 1862, 1867, 1872, 1874 and 1875. The 1872 epidemic, <a href="https://nepalitimes.com/news/kathmandu-in-the-time-of-cholera" target="_blank">according to historian Tom Robertson</a>, claimed between 200 and 250 lives a day. On average, cholera killed between 1,200 and 1,500 people annually in Kathmandu Valley, an enormous toll for its small population. The summer of 1885 was especially calamitous: a cholera epidemic ravaged Kathmandu and its periphery from the beginning of June until late August. The disease even breached the royal palace, reportedly killing 23 people, mostly young girls. Records show that 909 people received treatment at the British Residency dispensary, and estimates suggest that as many as 10,000 people perished in a city of 50,000. In November that year, Bir Shumsher seized power in a coup. He inherited not only a premiership but a Valley ridden with disease. Cholera was endemic, and it was accompanied by typhoid, smallpox, goitre, syphilis, and chronic dyspepsia. The The British Residency dispensary at Lainchaur was inadequate. “In a poor country like ours, wealth means health,” Bir Shumsher remarked, an unusually pragmatic admission that epidemics were not divine punishment but structural afflictions of urban life. He soon pledged to expand health care. In 1889, he opened Bir Hospital and staffed it with Indian doctors to treat cholera, typhoid, smallpox, and other prevalent illnesses. PIPED WATER Bir Shumsher also recognised the need for safe drinking water. Between 1866 and 1872, he had served as Nepal’s ambassador in Calcutta, and he must have seen water mains already in operation there, and a filtration plant inaugurated in 1870. Madras had installed such a system as early as 1800, Bombay constructed the Vihar and Tulsi reservoirs in the mid-19th century. In Kathmandu British Residency personalities such as George Gimlette must have urged Bir’s government to quicken the construction of the hospital and water system, yet the archival traces of such exchanges still await historical scrutiny. By the late 19th century, the British had developed a technological ecosystem for water supply, intakes, pipes, fittings, reservoirs, and trained engineers. Bir Shumsher appealed to the British Government in India for engineering assistance. A British engineer named Mr Feigneur surveyed Kathmandu to prepare maps, and estimated the volume of water that could be brought from the Rudramati River. In 1889, a more experienced engineer, Lockhart Matthew Sinclair arrived. He was a Scotsman educated at Wellington College and the Royal Indian Engineering College, with prior experience in constructing waterworks in Jubbulpore and the Viceregal Palace in Shimla. Appointed State Engineer of Nepal (1889–1892), Sinclair reviewed Feigneur’s plans, updated them, and chose the Bishnumati River as the source of the city’s drinking water. Sinclair’s design included a reservoir at Panipokhari, at 1,330m elevation and 30m above &nbsp;Tundikhel, thereby enabling gravity-fed distribution in pipes. With a capacity of 7,327 cubic metres, the reservoir could store nine days of supply.&nbsp; The system was designed to serve about 70,000 residents through both private connections and public standpipes. The reservoir was a single-compartment tank with an arched brick roof covered in earth and turf. Its brick walls were bonded with lime mortar and aggregate, and its floor was dressed with fly stone. Work on the valley’s water supply began in 1888, three years after Bir Shumsher seized power. The following year, Bir Hospital and the Bir Water Works took shape. The project involved some 40km of imported cast-iron pipes, weighing 1.866 million kg and inscribed with the marks of Scottish foundries ‘Ally and McLean’ and ‘Glasgow’. Construction required 620,000 man-days of labour and cost over Rs600,000. Transport costs inflated prices: <a href="https://commons-nepal.com/the-first-kaldhara-in-the-four-cities-of-the-valley/" target="_blank">a load of cement</a> costing Rs10 in Calcutta was worth Rs33 by the time it reached Kathmandu. Bir Water Works was inaugurated in September 1891, six years after the cholera epidemic. Water flowed out of 131 taps, including eight in Lainchaur, six in the royal palace, eleven in the prime minister’s palace, sixteen around Tundikhel, thirteen in Thapathali, seven in Thamel, and two in Naxal. The system’s designation, the term ‘works’ , echoes the Chelsea, Calcutta, and Glasgow Water Works, underlining its industrial pedigree. Water was also supplied to Phora Durbar, Bir Shumsher’s palace of music and dance whose fountains sprayed rose-scented water in a display of opulence. The <a href="https://commons-nepal.com/the-first-kaldhara-in-" target="_blank">Bir Dhara Works</a> was more than an engineering scheme: it was Nepal’s first modern public-health intervention. Safer drinking water curbed waterborne disease, and the number of cholera outbreaks declined, but were not eliminated.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260103020144_d5c22de54c0eaab680a166c5a7482839fdc09b60679109021d0504252a810254.png" data-media-id="editor_4" data-image-id="20260103020144_d5c22de54c0eaab680a166c5a7482839fdc09b60679109021d0504252a810254" data-rendition-name="original" width="865" height="535" loading="lazy" alt="Cholera and drinking water in Kathmandu"> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260103020144_a46075b6d759585df56a2bb8e5a07d85de7d9a69406165c32784fe30012c9971.jpg" data-media-id="editor_5" data-image-id="20260103020144_a46075b6d759585df56a2bb8e5a07d85de7d9a69406165c32784fe30012c9971" data-rendition-name="original" width="2791" height="3859" loading="lazy" alt="Cholera and drinking water in Kathmandu"> </figure>  “Now we have water to fight cholera, and I believe cholera will no longer prevail. After four years of piped water, the benefits have been greater than expected,” Bir Shumsher said in a proclamation. Despite this, the prevalence of poor sanitation, open defecation, cramped housing, and malnutrition meant that typhoid, smallpox, and dyspepsia remained endemic. The Bir Dhara system marked Kathmandu’s transition from reliance on wells, rivers, springs, and hiti to piped water, operating for several decades and laying the foundation for the expansion of drinking water services across the country in the late twentieth century. <a href="https://commons-nepal.com/the-first-kaldhara-in-the-four-cities-of-the-valley/" target="_blank">Extensions followed in Patan</a> under Chandra Shumsher, and Bhim Shumsher later added the Tri Bhim Dhara. Piped water systems were subsequently constructed in towns such as Kirtipur, Bhaktapur, Dhankuta, Pokhara, Dhulikhel, and Jajarkot which itself saw a deadly cholera outbreak in 2009.&nbsp; CHOLERA METAPHOR In 1933, Nepal’s first water bureaucracy, the Pani Goswara, was established, formalising state involvement in urban water supply. Yet even till the late 20th century, households continue to rely on a mix of sources, including public water networks, private vendors, rooftop storage tanks, borewells, wells, hiti, and household filtration. The lack of reliable water supply places disproportionate financial, physical, and psychological burdens on low-income households, underscoring how decades of infrastructure expansion have not translated into universal, reliable service. during challenges in governance, investment priorities, and regulation. Bir Shumsher also attempted to introduce <a href="https://www.ukaalo.com/news/cholera-in-kathmandu-1958/" target="_blank">basic hygiene measures</a>, such as pit latrines with squatting slabs. However, there is no record of these facilities being built in his palaces, later built palaces, or elsewhere. Sanitation conditions remained poor for both the elite and the general population. Open defecation or the use of crude pit latrines without proper waste disposal was common. With no drainage or sewer systems, human waste accumulated near homes, contributing to the spread of waterborne diseases. In 2019, Nepal declared itself ‘open defecation free’, a policy milestone, but this achievement masks the persistence of deeper problems. Urban areas generate some 867 million litres of wastewater daily, yet only 7% of it is treated before being discharged. Sewage flows untreated into rivers and streams, spreading cholera, typhoid, dysentery, and other diseases, particularly among children and vulnerable communities. Safe disposal of faecal sludge continues to be a major struggle for many communities and local governments. Besides Jajarkot, Godavari in Kathmandu Valley had a localised outbreak in 2024. This year, Birganj was struck by a cholera outbreak caused by a lethal combination of unreliable water supply, groundwater overpumping, poor drainage and hygiene, and unsafe waste disposal. And Nepal’s peacekeepers deployed after the earthquake in Haiti in 2010 were blamed for spreading cholera that ultimately killed 30,000 people in the Caribbean nation. The Bir Water Works was more than a reservoir and pipes. It was Nepal’s first brush with modernity, mediated through engineering and haunted by cholera. More than 134 years on, cholera remains a threat and a reminder of Nepal’s challenges in water and sanitation governance. The issue is not merely ensuring access to safe water but also building public trust that quality essential services can be delivered equitably, sustainably, and with resilience. Ajaya Dixit is a Kathmandu-based researcher exploring Nepal’s water history since the mid-eighteenth century to inform ethical water and river management in a changing climate.

Life in a time of cholera

As someone born and raised in Patan, I knew that the city was rich in art, architecture and intangible heritage. But I never realised just how rich, and how little I knew about its hidden treasures until this book. Yala Mhasika/Exploring Lalitpur/Lalitpurko Chinari is published by the Lalitpur Chamber of Commerce &amp; Industry and introduces the city to the world, as well as to its own inhabitants. Lalitpur is popularly known as Patan, probably because of the pastures for livestock in its outskirts. Its original name in Nepal Bhasa is Yala, and is a blend of urban and rural, old and new.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260101120152_700fb4c7b27d78813f69347846403c492cd1d54e2f62e4ec097013714c4a2022.jpg" data-media-id="editor_0" data-image-id="20260101120152_700fb4c7b27d78813f69347846403c492cd1d54e2f62e4ec097013714c4a2022" data-rendition-name="original" width="2000" height="1333" loading="lazy" alt="Exploring Lalitpur book review"> <figcaption>Patan Dhoka</figcaption> </figure>  Like other kingdoms in the valley of Swoniga, the dense urban cluster of houses, temples, monasteries were situated along the higher ground, while the farmlands were on the slopes leading to the rivers below. This unique townscape combined an urban lifestyle within a distinctly agriculture-based rural setting. The fertile soil, replenished by organic nutrients washed down from the streets above, as well as Kathmandu’s location on the ancient trade route between India and Tibet, provided the Valley’s kingdoms with prosperity – and thus the flourishing of art and culture over centuries. Most of Yala’s residents were farmers, traders, or artisans. Chinese visitors who came to Nepal in the 6th century saw that there were more traders than farmers, and more temples than houses. An entire street is inhabited by the descendants of Lhasa traders. Arniko is supposed to have been born in Yala.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260101120152_0fb490355fac9b8252c9abfbf5ef1bbac844b29103744a421eb6ef6dbc77dff7.jpg" data-media-id="editor_1" data-image-id="20260101120152_0fb490355fac9b8252c9abfbf5ef1bbac844b29103744a421eb6ef6dbc77dff7" data-rendition-name="original" width="2000" height="1332" loading="lazy" alt="Exploring Lalitpur book review"> <figcaption>Kwonti area which houses five-storey Kumbeshwar temple dedicated to Shiva and Baglamukhi temple dedicated to Dasa Mahavidya shakti peeth.</figcaption> </figure>  Nepal exported goods and even minted coins for Tibet, and had a virtual monopoly of the major trans-Himalayan trade routes. This prosperity was reflected in monuments and shrines like the Kwa Baha Golden Temple. More so than the other three kingdoms of Swoniga, architecture flourished in Yala making it the centre for metal, stone and wood craft. The name Lalitpur means ‘city of fine art’ but with its sense of community, it might as well be a city of fine living. Legend also has it that the name Lalitpur comes from a farmer called Lalit who helped bring the rain god Karunamaya from Assam when the Valley was suffering a prolonged drought. Lalit’s shoulder beam stands to this day in Jhatapol. Disasters, invasion and <a href="https://nepalitimes.com/here-now/life-in-a-time-of-cholera">epidemics</a> were a recurring theme in Patan.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260101120152_b33b1024cb7a46f49fea35ecc9afa2740895907059d7a43c8bd6c463b1be05e7.jpg" data-media-id="editor_3" data-image-id="20260101120152_b33b1024cb7a46f49fea35ecc9afa2740895907059d7a43c8bd6c463b1be05e7" data-rendition-name="original" width="2000" height="1333" loading="lazy" alt="Exploring Lalitpur book review"> <figcaption>Ajima of Haugal Tole which is the oldest stone scripture in Nepal with the Gaja Laxmi in Chyasal.</figcaption> </figure>  The book was put together by the heritage expert team of Rosha Bajracharya, Sunil Pandey and Anil Chitrakar and provides a socio-economic and political history of Patan – how it was always food surplus, thanks to sustainable farming until recently. Ground and drone images by Photo Venture Nepal in the book give us a rare new perspective on Patan. There is an entire chapter on the chariot festival of Karunamaya (Machhindranath), a community-managed festival with Barahi carpenters assembling the woodwork, vine engineers Yamva weaving rope and rattan for the 25m tall chariot, and Ghaku drivers controlling the speed and brakes as the structure rolls through narrow streets in the annual festival.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260101120152_d27b23aeb4548b0b64ab8ed20f40baa331060498c6b5443e2cb999b876c670af.jpg" data-media-id="editor_4" data-image-id="20260101120152_d27b23aeb4548b0b64ab8ed20f40baa331060498c6b5443e2cb999b876c670af" data-rendition-name="original" width="2000" height="1333" loading="lazy" alt="Exploring Lalitpur book review"> <figcaption>Te Bahal in Patan which houses Karunamaya six months a year.</figcaption> </figure>  WALKING, WORSHIPPING The book can help in exploring Patan along five routes starting in Patan Dhoka, Pulchok, Shankhamul, Mahaboudha and Lagankhel with maps and details of the baha and bahil, shrines, ponds, open spaces, dhyochenn, courtyards and phalcha along the way. Because of its coffee-table size and heft, however, the guidebook is not practical to carry around. And despite detailed descriptions of the past and present of each site, readers are left wanting to know more about those places. It is proof of Patan’s vast treasures that even this book barely scratches the surface.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260101120152_31a597b7dc1bcc9f67b4f6a66b8c1c0e0a9406727389699e6aed9ac6c3c50901.jpg" data-media-id="editor_5" data-image-id="20260101120152_31a597b7dc1bcc9f67b4f6a66b8c1c0e0a9406727389699e6aed9ac6c3c50901" data-rendition-name="original" width="2000" height="1332" loading="lazy" alt="Exploring Lalitpur book review"> <figcaption>Patukodom where visitors can view what remains of the ancient Kirant palace.</figcaption> </figure>  Some of the lesser-known must-visit sites include Patukodom which is all that remains of a palace of the original Kirat inhabitants of Patan. An archaeological dig here would surely unearth hitherto unknown facets of pre-Newa Patan. Then there are the slightly out of the way shrines like Mahabouha, a replica of a temple in Bodhgaya which houses 3,341 terracotta Buddhas with 90 big statues and which took 35 years and four generations to complete.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260101120152_ffb657dc254f707dc1755f6f13b1ef67bb7183b6573da9678c54482129fb3878.jpg" data-media-id="editor_6" data-image-id="20260101120152_ffb657dc254f707dc1755f6f13b1ef67bb7183b6573da9678c54482129fb3878" data-rendition-name="original" width="2000" height="1333" loading="lazy" alt="Exploring Lalitpur book review"> <figcaption>Mahaboudha is a replica of a temple in Bodhgaya.</figcaption> </figure>  In a recent Patan by Night heritage walk, we learnt that Pim Bahal was the labour of love of a lakhe demon (now popularised as masked dancer) who had fallen for a local girl, and he dug the pond so she would not have to walk to a faraway spout to collect water. Nearby is the Charumati Chaitya, built by the daughter of Emperor Ashoka when she visited the Valley in the 3rd century BCE to spread Buddhism in Nepal. Interestingly, if Kathmandu is a city of temples, Patan is the centre of monasteries which represent a unique Tantric melding of Buddhist and Hindu forms. Examples are: the Tadham Cuka with relocated Licchavi-era chaityas symbolic of the four major events in Buddha’s life, Ajima of Haugal Tole which is the oldest stone scripture in Nepal with the Gaja Laxmi in Chyasal, and Bignantak Ganesa temple which is a manifestation of Shiva mingled with Vajrayana Buddhism.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260101120152_17a500e77f06b9881f684329e41d3482f6f6a639ffb929d8bb44e5af7934c61c.jpg" data-media-id="editor_7" data-image-id="20260101120152_17a500e77f06b9881f684329e41d3482f6f6a639ffb929d8bb44e5af7934c61c" data-rendition-name="original" width="2000" height="1333" loading="lazy" alt="Exploring Lalitpur book review"> <figcaption>Bignantak Ganesa temple.</figcaption> </figure>  &nbsp;Besides spatial descriptions, the book also explains the temporal by curating a detailed cultural calendar of Lalitpur with dates and places of jatra, rituals, devotional dances and festivals that weave the agricultural cycle with the zodiac.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260101120152_b8e1cc03653fea85dec84a7abee4fd594c35c6ad553769f37905eb5b38774e08.jpg" data-media-id="editor_8" data-image-id="20260101120152_b8e1cc03653fea85dec84a7abee4fd594c35c6ad553769f37905eb5b38774e08" data-rendition-name="original" width="2000" height="1125" loading="lazy" alt="Exploring Lalitpur book review"> <figcaption>Mipwa Lakhe of Patan which create fire in mid aid during performance.</figcaption> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260101120152_442e10bff842214e8c7522ebf6e63663599768db73bb57d999deff9de1b59375.jpg" data-media-id="editor_9" data-image-id="20260101120152_442e10bff842214e8c7522ebf6e63663599768db73bb57d999deff9de1b59375" data-rendition-name="original" width="2000" height="1333" loading="lazy" alt="Exploring Lalitpur book review"> <figcaption>Gan pyakhan or Astamatrika dance which is performed in Patan Darbar Squre during Dasain. </figcaption> </figure>  The very last chapter is dedicated to water and nature, what sustains lives and civilisations, and how Lalitpur continues to be the city it is because of the water supply system our ancestors left behind which function still, despite encroachment and pollution. ‘In the history of the world cities have been built, they thrived for some time and then became archaeological sites because they were not able to maintain the quality of air, water, and its soil,’ the authors write. ‘This led these cities to depopulate and ultimately die and are only referred to in history books. Lalitpur is not going to make the same mistake.’ &nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260104080132_3f403388d57da82b499d6c489a8f095002bf69f11e515e92fa96fb5ca3af69e9.jpg" data-media-id="editor_10" data-image-id="20260104080132_3f403388d57da82b499d6c489a8f095002bf69f11e515e92fa96fb5ca3af69e9" data-rendition-name="original" width="1136" height="702" loading="lazy" alt="Exploring Lalitpur"> </figure>

YALA

Nepal has made dramatic progress in expanding health services, yet millions of people still do not fully benefit from their Constitution-ensured right to basic medical service. Many of those deprived of accessible and affordable healthcare are in remote far-flung areas of the country, but increasingly they are also among the urban poor who have migrated to the cities and live in the margins. In both areas there are gaps in service quality, health workforce availability, and governance capacity. Out of pocket expenses for medical treatment of a family member can push families into absolute poverty and debt. The 2025 WHO–World Bank Global Monitoring Report on Universal Health Coverage underlines this challenge -- financial hardship from health spending remains a major barrier to equity, even where medical coverage has improved. In Nepal, rising demand for better and more affordable healthcare and workforce shortages due to outmigration of medical personnel and other factors mean that the government is unable to bridge these gaps through public provision alone. Well-governed and accountable public-private partnerships (PPPs) aligned with national priorities offer <a href="https://archive.nepalitimes.com/article/nation/Crowding-it-out,1003" target="_blank">a practical pathway from policy commitment to real-world impact</a>. The experience of the non-profit Nyaya Health Nepal (NHN) in partnership with the Sudurpaschim Province is an example of where this has worked well. Through <a href="https://nepalitimes.com/banner/altruistic-healthcare-models-in-nepal" target="_blank">public ownership and non-profit management</a>, <a href="https://www.youtube.com/watch?v=CJzWlnYd0ZM&amp;t=17s" target="_blank">Bayalpata Hospital</a> in Achham and <a href="https://nepalitimes.com/news/unique-hospital-handover-in-dolakha" target="_blank">Charikot Hospital in Dolakha</a> strengthened service delivery, supply chains, health workforce management, and digital health systems, while keeping all services free at the point of care.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251231101244_b59dabd4604a24426a55fe91c0e5866b5029858bdb4c4028c331557aeb5408ae.jpg" data-media-id="editor_4" data-image-id="20251231101244_b59dabd4604a24426a55fe91c0e5866b5029858bdb4c4028c331557aeb5408ae" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="Bayalpata"> <figcaption>Bayalpata hospital in Achham.</figcaption> </figure>  NHN managed Charikot from 2016-2020 and handed it over to Bagmati Province, and Bayalpata was handed over to Sudurpachim after 17 years in August 2025. These partnerships reduced out-of-pocket spending, improved trust in public facilities, and directly addressed financial concerns of citizens. The WHO–World Bank Global Monitoring Report emphasised that universal health coverage requires strengthening primary health care, providing free services at the point of care, and protecting families from financial hardship. Public–nonprofit partnerships like NHN and others in Nepal provide a model to directly address these challenges. By improving access to quality care, supporting local health workers, and keeping services free, these partnerships help reduce health costs for families, build trust in local health facilities, and narrow the gap between rural and urban health services, <a href="https://www.youtube.com/watch?v=xJdxLD0hBqo&amp;t=3s" target="_blank">turning </a><a href="https://www.youtube.com/watch?v=xJdxLD0hBqo&amp;t=3s" target="_blank">policy commitments into real improvements for communities.</a> The experience of <a href="https://nepalitimes.com/banner/state-of-the-art-rural-hospital" target="_blank">Bayalpata and Charikot hospitals</a> show that effective PPPs are governance-driven, not market-led. Clear agreements, transparent data sharing, performance-based management, and strong government oversight guaranteed that public institutions were strengthened rather than sidelined. Bayalpata and Charikot successfully transitioned leadership and full management to Sudurpaschim and Bagmati provincial governments, proving that public-private partnerships can build lasting government capacity, not dependency.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251231101244_a8821faa2059498bbd3318386a1bea25b7cfe7a36600c2e2ce250e97caed51e8.jpg" data-media-id="editor_8" data-image-id="20251231101244_a8821faa2059498bbd3318386a1bea25b7cfe7a36600c2e2ce250e97caed51e8" data-rendition-name="original" width="1570" height="940" loading="lazy" alt="Charikot hospital"> <figcaption>Charikot hospital in Dolakha.</figcaption> </figure>  This model combined facility-level operational flexibility with public stewardship, and tackled long-standing weaknesses in Nepal’s health system, from workforce retention to evidence-based decision-making. Scaling such models through a national, gap-focused partnership framework is now an urgent opportunity. Replicating Bayalpata model partnerships in selected hospitals and primary health care centers could rapidly advance the three pillars of universal healthcare: equitable access, quality services, and financial risk protection. Institutionalising public-private partnerships within the Ministry of Health and Population and &nbsp;linking it to national health insurance reforms could help fulfil the promise of Article 35 of the Constitution guaranteeing basic healthcare to all citizens. For development partners and donors, this could represent a high-impact, evidence-informed investment aligned with the WHO–World Bank call to reduce financial hardship while strengthening healthcare systems. If Nepal is serious about leaving no one behind, strategic public–non-profit partnerships must move from the margins to the mainstream of health system reform. By <a href="https://nepalitimes.com/opinion/is-free-health-care-possible-in-nepal" target="_blank">scaling the NHN model</a> at Bayalpata and Charikot nationwide, Nepal can build a resilient, equitable health system where every community regardless of location or income has access to quality care, financial protection, and the opportunity to succeed. Investing in well-governed PPP models is not only essential to protect the health of the Nepali people but also to safeguard the country’s economic stability and long-term resilience. &nbsp; Srijana Devkota is Director of Program and Partnerships at <a href="https://nyayahealthnepal.org/" target="_blank">Nyaya Health Nepal</a> (NHN). <a href="https://www.youtube.com/watch?v=xJdxLD0hBqo&amp;t=3s" target="_blank">Watch a video of Bayalpata Hospital.</a> <div class="embed-block"><iframe width="560" height="315" src="https://www.youtube.com/embed/xJdxLD0hBqo?si=_gSoClqwmI-ecSxh" 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>

A healthier, wealthier Nepal

For daring to demand democracy, the Rana regime hanged activist Shukra Raj Shastri at midnight on 24 January 1941 by the side of the road at Teku. Across town in Siphal, Dharma Bhakta Mathema was also hanged. Four days later, Dasrath Chand and Gangalal Shrestha were executed by firing squad. These four young revolutionaries were members of the underground Nepal Praja Parishad that led the anti-Rana revolution with plans to assassinate key figures of the dynasty. The four martyrs sacrificed their lives for an unfulfilled cause. Monuments were put up in their honour (Shahid Gate) and their names glorified by the Shah monarchy that itself went on to ban political parties and persecute democracy activists. In 1950, the newly-formed Nepal National Congress launched an armed uprising against Rana rule after King Tribhuvan sought refuge at the Indian embassy to flee from the Rana regime. In 1951, the Ranas, Nepali Congress and King Tribhuvan signed a tripartite agreement that brought an end to 104 years of Rana rule.&nbsp; Thus began contemporary Nepal’s cycles of unfinished revolutions. Some 75 years later, on a sunny September morning, Nepal’s young and hopeful took to the streets demanding an end to the nation’s corrupt polity, envisioning a better democracy. They organised through digital platforms, played songs, danced, and chanted slogans. A few hours later, commandos fired on the protesters, massacring dozens. Over 8 and 9 September 2025, the government was overthrown, constitutional bodies were literally reduced to ashes, and 74 Nepalis were martyred.&nbsp; Nepal’s periodic revolutions have been ignited by anger against rulers, they have begun with great promise, spread with enthusiastic popular support despite rulers trying to crush them — but ultimately they have always fallen short of the expectations of citizens demanding reform. Through decades of dissent, Nepal’s periodic revolutions have remained incomplete, with the nation caught up in a cyclical search for stability.&nbsp; In 1960, king Mahendra staged a coup and overthrew an elected government led by prime minister B P Koirala -- a royal revolution against democracy. Mahendra is reported to have famously said to Koirala: “Nepal is not big enough for the two of us.” For the next 30 years Nepal resembled a one-party state under the absolute monarchy of the Panchayat. Elected leaders languished in jail or exile, political parties were banned, and the press controlled. This was the most frigid period of the Cold War, with Nepal’s neighbours India and China at war. Geopolitics was bound to have an impact. “After the 1816 Sugauli Treaty with British India, external forces magnified internal power struggles as outsiders played divide and rule,” explains editor and political analyst Rajendra Dahal. “Movements did not reach a logical conclusion because domestic politicians were forced to compromise.” Indeed, the departure of the British from India in 1947 meant that the days of the Anglophile Rana regime were numbered. Successive prime ministers sought patronage in Delhi, and the monarchy tried to counterbalance it with a policy of equidistance with China. The neighbours showed a keen strategic interest in Nepal’s domestic politics. “The Panchayat system did not deliver what it promised,” says Santosh Sharma Poudel of Nepal Institute of Policy and Research. “Nepalis suffered administrative and governance failure, politics was centralised in Kathmandu, leaving out the rest of Nepal.” With mainstream political parties and leaders were &nbsp;underground between 1961 till 1990, student activists became proxies for political parties. As pressure for change grew, a student-led pro-democracy movement spread across Nepal in 1979. In response, King Birendra announced a referendum to allow Nepalis to choose between the status quo and a ‘reformed’ Panchayat &nbsp;system.&nbsp; The Panchayat won by a slim margin with questions about the legitimacy of the plebiscite. The reforms never materialised and it would be another decade before street anger boiled over again. As the People’s Movement for democracy spread, king Birendra again relented, unbanning political parties and Nepal became a constitutional monarchy. Inspired by Mao Zedong, a faction of Nepal’s Communists felt that western-style parliamentary democracy was too slow to end a feudalist monarchy. They launched an armed struggle in 1996, and the war lasted ten years (editorial, page 2). “If the democratic government post-1990 had performed better, and brought real reform, the Maoists would not have a reason to launch a revolution,” says Poudel. After nearly a decade of bloodshed that left 17,000 dead and thousands still missing, the Maoists joined forces with the democratic parties that they had been fighting, to pressure king Gyanendra through street protests in 2006 to restore democracy. In 2008, an elected Constituent Assembly abolished the monarchy. &nbsp;Recalls Rajendra Dahal: “The second people’s movement did not aim to abolish the monarchy. In fact, the reinstated parliament even granted equal rights for royal daughters to be crowned queen. But eventually, the monarchy no longer fit the political framework that the parties envisioned.” It took two elections over the next eight years to draft a new Constitution that reflected Nepal’s socio-cultural and geographic diversity and met the demands of the Maoists. The new federal Constitution was finally promulgated in 2015, but failed to satisfy India and the aspirations of the Madhes communities for autonomy. The state’s effort to crush the Madhes movement cost 45 lives. The promise of the new Constitution was squandered over the next decade with rotating leadership of the NC, UML and the Maoists — all of whom had forgotten the sacrifices made in the name of revolution. Cronyism and corruption was the order of the day. And it was this never-ending cycle of political opportunism and malgovernance that brought Nepal’s youth to the streets on 8 September.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260101120128_bc50f6370ff80a6758199ea7ba9f4c214656a9322a8d2ba1c97e6cdfb88f7f62.jpg" data-media-id="editor_0" data-image-id="20260101120128_bc50f6370ff80a6758199ea7ba9f4c214656a9322a8d2ba1c97e6cdfb88f7f62" data-rendition-name="original" width="3372" height="1371" loading="lazy" alt="timeline"> </figure>  1951 Revolution against the &nbsp;Rana regime 1960 King Mahendra's coup, jails B P Koirala and launches the partyless Panchayat system 1979 Student protests for democracy, King Birendra announces referendum&nbsp; 1980 Continuation of the partyless Panchayat system narrowly wins plebiscite&nbsp; 1990 People’s Movement I 1996 Maoists launch armed struggle&nbsp; 2000 Royal Massacre 2005 King Gyanendra's military-backed coup&nbsp; 2006 Comprehensive Peace Accord and Parliament restored 2008 Monarchy is abolished 2015 Madhes Movement, New Constitution promulgated 2017 First 3-tier election under federal system 2022 Second elections under federal Constitution&nbsp; 2025 GenZ protests BRK ALLIANCE “The socio-political change sought in all these movements never matched the people’s expectations, because the central issue of clean and efficient government never materialised,” says Poudel. The post-September political landscape has injected new personalities and alliances still relatively new to politics, as evidenced by the new electoral partnership of the BRK — Balen Shah, Rabi Lamichhane, and Kulman Ghising (page 1).&nbsp; These leaders are not without flaws, but they have become the effective flag-bearers of the GenZ movement, hoping to represent Nepalis disillusioned by decades of democratic decay. The March election will pit them against the legacy parties. There is already criticism that BRK is behaving just like male-dominated opportunists of old parties. The troika is resembling the triumvirate of Oli, Deuba and Dahal and its culture of patronage and quid-pro-quo power-sharing between alpha males. Will this also be another unfinished revolution? Says political scientist Sucheta Pyakuryal: &nbsp;“The kind of destruction that happened after the revolution should have been followed by a ground-breaking shift in Nepal’s political ecosystem, but that did not happen. Today the situation is a lot grimmer because we have players who have learned how to use the democratic facade to sound ‘equitable’ and ‘accountable’. But look closely and you see how the same political chauvinism, cronyism and nepotism still continue.”&nbsp;

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