One July afternoon in Gaur, after weeks of drought, the long-awaited rain finally arrived. Children were splashing in puddles, laughing and dancing with their friends. But while rain in the plains brings relief, fear settles in when it pours in the mountains to the north for too long. That is when the floods are unleashed. Madhes Province suffered a prolonged drought in June and July — wells went dry, paddy fields were desiccated, and parts of the Tarai suffered a cholera outbreak because of contaminated water. When the monsoon rains finally came last week, it <a href="https://nepalitimes.com/news/more-dark-clouds-over-nepal?amp=1">arrived with a vengeance</a>. Aside from the physical scars of droughts and floods, these weather extremes also leave scars that are less visible: in the minds and mental well-being of residents here. Gaur is the capital of Rautahat district, close to the border with India. It is <a href="https://nepalitimes.com/banner/nepal-tarai-learns-from-past-floods">prone to chronic floods</a> because it is astride the confluence of two rivers: the Bagmati and the Lalbakaiya. People here still remember the devastating floods of August 2017 when 70% of Rautahat was under water as both rivers overflowed their banks. Weather extremes caused by climate change combined with poorly engineered road embankments, blocked drainage basins, sand mining along rivers, and settlements along floodplains have increased the death and destruction. Floods are also exacerbated by flood control levees across the border in India and improper sluice gates that disrupt the rivers’ natural drainage. This causes floodwaters to back up, submerging settlements on the Nepal side. This past week, Rautahat received up to 330mm of rain in 24 hours — the highest in Nepal. Gaur was once again completely inundated. As before, people found themselves alone with little to no external support at the time of crisis. SURVIVAL MODE Aside from the physical impacts of floods, people suffer anxiety spikes, their decision-making falters as the brain enters survival mode. Fight, flight, or freeze becomes the norm, often leaving people unable to decide what to do when clarity is most needed. Nighttime floods are especially perilous: with power out and darkness setting in, one’s own village becomes a maze. While a few community buildings serve as temporary shelters, reaching them is often impossible. “At such times, you don’t even know where to get out from or how to escape,” a woman from Rajdevi told us. “There’s only my father-in-law at home, so we face the dilemma of whether he should focus on saving our belongings or the people and on top of that, we don’t know how to swim.” For generations, communities have relied on men’s decision-making even during disasters. But with most men away for work, villages are left predominantly with women and elderly men. This makes floods are as much a social crisis as a natural one, especially in a society where roles and responsibilities are gendered. Women face heightened stress managing childcare, domestic duties, household suppression and food scarcity, compounded by gender-based violence which is prevalent in the region.  <figure><img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251010081028_d453cb955b1574a1376ce5cb0f7055c0e210a1e6a70f1cad0ca7306842a006fe.jpg" data-media-id="editor_2" data-image-id="20251010081028_d453cb955b1574a1376ce5cb0f7055c0e210a1e6a70f1cad0ca7306842a006fe" data-rendition-name="original" width="1500" height="1125" loading="lazy" alt="Flooded with memories of floods NT NT"><figcaption>Passengers board the only available boat to cross the Bagmati River; a second operates only when the water level rises.</figcaption></figure>  As for men, they feel intense pressure to provide and protect their family. When they cannot do that in situations like a flood, feelings of guilt, shame and failure can emerge, affecting their well-being. Those who survive face nights with or without shelter, swarmed by mosquitoes and struggling with food scarcity. “We survive on one day’s worth of roti for days when the flood comes, there are no vegetables, no firewood or gas to cook,” the woman added. For many families, daily subsistence is already fragile, and floods only deepen hunger and hardship, heightening stress, anxiety, and psychological trauma, especially among caregivers and children. Malnutrition further intensifies emotional strain and long-term mental health risks. Marginalised communities, particularly Dalits, bear the heaviest burden yet are often the most neglected. During the 2017 floods, around 40 Dalit families were displaced from their settlements, some forced to live under open skies. Some 15% of Rautahat’s population of 700,000 is Dalit. Many were excluded from relief distributions or discouraged from sharing shelters with other communities due to entrenched caste-based discrimination. For these families, floods are not just a disaster but an emotional scar. Dalit women face double discrimination because of caste and gender, fostering a deep sense of abandonment, helplessness, shame, and isolation. In Rautahat, where most families live off the land, the flood undos years of labour and livelihood. When fertile fields or blooming crops submerge and fish ponds are washed away, families lose not only their income but their sense of stability. Agriculture here is more than an occupation, it is tied to identity, dignity, and hope. Repeated crop failure, mounting debt, and uncertainty about the next harvest often lead to anxiety, sleeplessness, and hopelessness, which are silent stressors of Nepal’s agricultural belt. During these crises, villagers rely heavily on family, neighbours, and the limited boats available to cross rivers. Local government responses have often been delayed, and with roads cut off, help arrives late, if at all. That delay breeds distrust and helplessness, deepening the psychological toll long after the waters recede. The people of Gaur and across Rautahat do not have the capacity to deal with aftermath mental issues from the flood as access to such care remains limited. Most cases are often referred outside the district to Kathmandu and Birganj or even across the border to Patna and Delhi. Locals do not trust existing mental health units, they also feel unheard and unsupported. The government provides free psychiatric medicines but they should focus on establishing competent, well equipped mental health institutions with an adequate number of professionals for regular access and strong continuity of care for effective recovery. As floods continue to test the resilience of Rautahat’s people, the need for proper anticipatory action grows ever more urgent. Preventing loss of life and property must go hand in hand with protecting the community’s mental well-being. From a psychosocial perspective, expanding initiatives like giving Psychosocial First Aid training and projects like Sajag Samaj, an anticipatory action project launched in April 2025 can make a real difference. They help communities prepare before disaster strikes, fostering coping skills, awareness, and collective resilience. At the same time, the government and local authorities must strengthen mental health support within disaster response plans, build infrastructures that reduce flood risks and safeguard livelihoods, and ensure that disaster relief is inclusive reaching Dalits, women, and other marginalised groups who are too often left behind. Anek Rajbhandari is program and communication intern at the Institute of Himalayan Risk Reduction.

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Flooded with memories of floods

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

Sonia Awale

Injured use Internet to get rehab care

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109101132/636b73eb9c7e80680e062365jpeg.jpg" alt="" width="1500" height="911"/><figcaption>Photo: NATIONAL TRAUMA CENTRE</figcaption></figure>Speeding along a narrow winding mountain road in Dhading, a heavily intoxicated truck driver lost control of the <a href="https://www.nepalitimes.com/banner/nepals-deadly-roads-take-their-toll/" target="_blank" rel="noopener">vehicle</a> and it overturned, killing seven and severely injuring 34 passengers hitching a ride.This was a mass trauma incident that required immediate attention, but <a href="http://nationaltraumacenter.gov.np/" target="_blank" rel="noopener">Nepal’s only trauma care centre</a> was located in Kathmandu, 90km away via bumpy roads jammed with traffic.Read also: <a href="https://www.nepalitimes.com/?p=40249&amp;preview_nonce=aefd82ecbe&amp;preview=true" target="_blank" rel="noopener">injured use Internet to reach physiotherapists in Nepal</a>, Sonia AwaleMost passengers from the truck accident were taken to nearby hospitals in Dhading, but the 21 most critical patients were airlifted or driven in ambulances to the National Trauma Centre in Kathmandu.“It had already taken a while to bring the patients to the Trauma Centre, so we had to act quickly once they were here,’’ recalls Pramod Yadav, acting medical superintendent at the facility.The standard protocol for trauma care is the triage system -- determining the priority of treatment based on the severity of injury. Doctors at the National Trauma Centre quickly designated yellow, green and red codes to patients to ensure that those in critical condition were taken care of first, and fast.Read also: <a href="https://archive.nepalitimes.com/article/nation/accident-prone-Mugling-Narayangadi-highway,3828" target="_blank" rel="noopener">Unblocking an artery</a>, Sanjeev SharmaOn-call doctors were contacted and began assessing the patient’s injuries. But without a functioning MRI and a faulty CT machine, some had to be sent to private clinics and later returned to the hospital.This is a recurring event for patients seeking immediate care at the government-run Trauma Centre where patients in critical condition have to be moved about from one facility to another for tests.“We cannot afford an MRI machine, it is very expensive to repair our CT machines, we have limited trolley beds and only 11 ICU beds when we need more than 50,” says Yadav. “We are requesting the government for Rs420 million to become a real trauma centre, especially since we are the only one in the country.”There were 60,000 severe trauma injuries in Nepal in the last year, a 3,000 increase from the previous year, and a whopping 27,000 over the year before that. Like with all government-run medical centres, the Trauma Centre lacks resources, is under-staffed, and is incapable of handling this exponential increase.“In the last two, three years, falls, physical assault, <a href="https://www.nepalitimes.com/banner/nepals-deadly-roads-take-their-toll/" target="_blank" rel="noopener">road traffic accidents</a>, sports injuries and <a href="https://archive.nepalitimes.com/article/nation/burning-in-the-aftermath,3757" target="_blank" rel="noopener">burns</a> have been the leading causes of trauma,” lists  Siddhartha Dhungana, the Medical Record Officer at the National Trauma Centre. “Head injuries and multi-organ failures have been the highest causes of death in these cases.”Most hospitals in Nepal, like the National Trauma Centre, follow the World Health Organisation’s trauma protocol. During a trauma case, medical personnel are contacted as soon as possible, patients are screened, their needs are identified and necessary care is given.Although the government has not developed a standard care protocol for trauma like it has for cancer patients, private hospitals have implemented and refined their own systems based on WHO guidelines.<a href="http://archive.nepalitimes.com/article/nation/politics-behind-epidemic-of-hospital-vandalism,3578" target="_blank" rel="noopener">Om Hospital</a>’s Continuing Medical Education Program is at the forefront of teaching trauma care to new doctors and providing courses on improved techniques to existing doctors.“We make sure that the ABCs of trauma care are followed strictly and that blood is readily available be it from our blood bank or staff-chain blood donors,” says Binod Adhikari of Om, which handles dozens of cases every day and has systems in place to coordinate between doctors, nurses and critical care anesthesiologists to provide emergency care to patients.<h2>Ambulance chasers</h2><figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109101132/636b73ee9c7e80680e062366jpeg.jpg" alt="" width="1500" height="1125"><figcaption> </figcaption></figure>Most of Nepal's ambulances are just jeeps with stretchers, with no life-support systems or medical attendants. It was only in 2011 that Nepal’s first emergency medical service was established. Supported by the Patan Academy of Health Sciences and the Stanford University School of Medicine, Nepal Ambulance Service (NAS) has since trained more than 100 emergency medical technicians (EMTs) and ambulance drivers and operates the <a href="http://archive.nepalitimes.com/news.php?id=18888#.XjvhpTIzaUk" target="_blank" rel="noopener">'Dial 102' service</a>. NAS operates mainly in Kathmandu Valley, Pokhara, Chitwan, Butwal and Bhairawa.“Before this, only few private hospitals had ambulances and they were used mainly for patient transfer rather than pre-hospital care,” says Hari Khadka, a paramedic at <a href="https://www.grandehospital.com/" target="_blank" rel="noopener">Grande International Hospital</a> and a member of the first EMT batch of NAS. “Ten years ago, there was simply no concept of pre-hospital care or paramedics in Nepal.”Now, many hospitals have their own EMS systems with mostly Type 3 ambulances that have first aid kits and basic medical supplies. <a href="https://www.nrcs.org/" target="_blank" rel="noopener">Nepal Red Cross Society</a> (NRCS) operates 283 ambulances nationwide. Although not every ambulance carries a paramedic, every driver has received first aid training.“We have five Type 2 ambulances and a paramedic in each vehicle,” says Bipul Neupane of NRCS. “We send these ambulances to patients who need basic life support systems.”But for patients needing critical care in remote areas, there is no recourse but expensive helicopter medical evacuation.Like Type 1 ambulances, some of these helicopters can have doctors, ventilators, advanced life support, and EMTs.“EMS has helped save many lives in Nepal but it isn’t always the best option considering the geography of Nepal and the condition of the roads,” says Sanjaya Karki, Head of the Emergency Department at <a href="https://www.nepalmediciti.com/" target="_blank" rel="noopener">Nepal Mediciti Hospital</a>. “Helicopter Emergency Medical Services ensure that we can get to critical patients as quickly as possible and provide the best pre-hospital care.”

It’s an emergency: Nepal needs to improve trauma care

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110714118/636903cc9c7e80680e037ce4jpeg.jpg" alt="" width="1400" height="932"/><figcaption>File Photo: Shreejana Shrestha</figcaption></figure>When 44 girls were rescued from sexual abuse and torture in a children’s home in <a href="http://archive.nepalitimes.com/article/nation/Nepali-children-rescued-from-India,3618" target="_blank" rel="noopener">Muzaffarpur</a> in Bihar in May, it made headlines in India. What went unnoticed was that seven of children were Nepali.The shelter run by Seva Sankalp Evam Vikas Samiti was raided after reports of abuse, and its head Brajesh Thakur arrested. After trying several times, <a href="http://archive.nepalitimes.com/article/nation/Nepali-children-rescued-from-India,3618" target="_blank" rel="noopener">Shailaja CM</a> of the child charity <a href="https://www.chorachori.org.uk/" target="_blank" rel="noopener">Chora Chori</a> was finally able to bring home to Nepal the three girls and four boys.Now, safe in the Chora Chori shelter in Kathmandu the children are being treated for psychological trauma. They have difficulty in communicating because of their mental scars, are fearful of strangers, and the staff are still working to build trust with them.“Some of the children were quite sullen, and their silence made communication difficult,” says Anila Dangol, counsellor at Chora Chori, which has been rescuing many Nepali children trafficked to India.Dongol and Shailu Rajbhandari have been trying out a new way of rehabilitating the children with <a href="https://www.theraplay.org/" target="_blank" rel="noopener">theraplay</a>, after being trained by British therapist Debbie Mintz.Theraplay imitates the earliest intimate interactions between mother and child, trying to re-build emotional bonds with affection.Says Mintz: “Many children who are traumatised will have missed this nurture, which is an important part of growing up. Without it, they have no history of a trustful and loving relationship with an adult.That makes them unwilling to form social bonds, and they become emotionally insecure.”This method involves treating older children as though they were much younger, and giving them complete attention and affection in guided, hour-long sessions. It usually involves a lot of games with massages, a non-threatening way of encouraging healthy physical contact. The sessions usually involve fun games and storytelling where the therapist begins a story and the child ends it.Many of the <a href="http://archive.nepalitimes.com/news.php?id=2876#.W3VbK84zbIU" target="_blank" rel="noopener">abused children</a> feel threatened by any kind of physical contact. In such cases, the therapist invites the child to touch them first, and maybe use objects like feathers instead of direct contact. At Chora Chori, the theraplay method was applied to 15 children, including children rescued from Muzaffarpur and <a href="http://archive.nepalitimes.com/article/nation/bal-mandir-rape-allegations,1495" target="_blank" rel="noopener">other victims of sexual abuse</a>.The goal is for the children to be able to establish healthy, nurturing relationships with people. Though this therapy is often used for children with trauma, especially in case of adoption, it is now increasingly used on the elderly.“A child who has been denied healthy relationships, bonds with the therapist. They need love, care, and trust, without which they cannot function as healthy adults,” Mintz explains.Since privacy is critical in theraplay, its intimate nature also raises concerns about higher risk of child abuse. But Mintz believes it is no different from any other therapy session where you leave the therapist and child alone in a room, and trust is key.It is too early to say whether this approach will help the rescued children grow up to be emotionally secure adults, but for now Shailu Rajbhandari says it has worked wonders with children at Chora Chori.She adds: “Many of the children came up with stories about their own past after a single session, some talked of abuses while some recalled being forced to work. After the therapy, it was much easier to communicate with children who had been defensive or excessively introverted before.”Some 300 cases of human trafficking are reported to the police every year, but child welfare workers believe the number is much higher. An estimate by the National Human Rights Commission (NHRC) estimates that every year 23,000 <a href="http://archive.nepalitimes.com/article/nation/epicentre-trafficking-migration,3256" target="_blank" rel="noopener">Nepalis become victims of trafficking</a>, and half of them are children. Some end up being taken across the border to India where <a href="http://archive.nepalitimes.com/article/nation/runaway-boys-brought-home-to-%20Nepal,2950" target="_blank" rel="noopener">police regularly round up unaccompanied children from railway stations and the streets and hand them over to shelters</a> like the one in Muzzafurpur that was raided.Says Shailaja CM: “Conditions of many children’s homes in India are deplorable. Not only are many of them lacking in basic facilities, abuse is also rampant.”

Nurturing rescued children with nature

<figure><img width="1400" height="932" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110714114/636902db9c7e80680e037c8bjpeg.jpg" alt=""/><figcaption>Source: The Lancet</figcaption></figure>The debilitating effects of mental health diseases and the <a href="http://archive.nepalitimes.com/news.php?id=14138#.W2MFj9Uza70" target="_blank" rel="noopener">social stigma associated with them</a> are not limited to patients: the lives of family members also change irrevocably. Family support can also be an important source of strength and even help in the healing process, say psychiatrists, patients and their relatives.Reshma Magar from Sindhuli, brought her 35-year-old son to a mental health clinic in Kathmandu after he displayed symptoms like severe headaches, mouth fizzing, and haphazard running around. As a mother, she was constantly worried he might hurt himself.“We have the Sun Kosi River nearby and I would think: what if he jumped?” says Magar, who has to tie him up in the hospital bed to contain his violent behavior. “I would be crying and the nurses here would console me.”Read also: <a href="https://www.nepalitimes.com/?p=10647&amp;preview=true" target="_blank" rel="noopener">Raising children can be therapy</a>, Ketan DulalNabina and Samira Pradhan shared similar hardships. Their brother, 40, started showing erratic behaviour after his wife left him, taking their daughter with her. He throws things around, does not eat, and their 71—year-old mother has to look after him.“It is very hard,” Nabina says, “mother herself has health issues and because of our brother’s state, violence in the home remains a constant danger.”Sufferers of psychotic mental illnesses are generally unaware they have a problem. In <a href="http://archive.nepalitimes.com/article/nation/stigma-and-silence-mental-health-nepal,3486" target="_blank" rel="noopener">schizophrenia</a>, a severe psychotic disease, patients have a distorted sense of reality − hallucinations, extreme paranoia, hearing voices − that their mind infers as truth. They resist help, and family members have a difficult job coaxing them to seek and continue medical treatment.Beyond this, the emotional trauma of having a suffering relative is a constant feature of life for the Magar and Pradhan families, which makes each day frightening and unpredictable.Read also: <a href="https://www.nepalitimes.com/?p=10641&amp;preview=true" target="_blank" rel="noopener">Addicted to the joystick</a> , Suprasanna AryalResearch has shown that patients suffering from psychosis have various structural and functional abnormalities in the brain. Schizophrenia patients have dysfunctions in their neurotransmitter systems, metabolic pathways and certain structures in the brain regulating motor activity.Traditionally Nepali society, which did not have coping mechanisms, regarded mental disorder as a curse, and there is strong social stigma and ostracisation of both the patients and their families. Derogatory labels for <a href="http://archive.nepalitimes.com/article/Nepali-Times-Buzz/overcoming-depression,2164" target="_blank" rel="noopener">‘crazy’ people like ‘dimag khuskeko’ or ‘pagal’</a> are still widely used.However, now that science has shown that the causes are mostly chemical imbalances, there is treatment says Basudev Karki of Lagankhel Mental Hospital: “Medicine now has treatment for mental diseases, just like for physical ailments. Problems of the mind also need medical care and treatment and there is nothing wrong in that. Instilling this understanding will help address stigma for patients.”Read also: <a href="https://www.nepalitimes.com/?p=10601&amp;preview=true" target="_blank" rel="noopener">Ashna comes out of black</a>, Sewa Bhattarai <img width="670" height="585" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110714114/636902de9c7e80680e037c8cjpeg.jpg" alt="">However, Karki cautions that medical interventions alone sometimes do not suffice because the triggers may be a combination of biological, psychological and social factors. For example, there was a <a href="http://archive.nepalitimes.com/article/editorial/the-republic-of-insomnia,3311" target="_blank" rel="noopener">surge in mental disorders in Nepali society</a> during <a href="http://archive.nepalitimes.com/article/nation/psychological-scars-of-maoist-conflict-on-young-survivors-take-longer-to-heal,1519" target="_blank" rel="noopener">the conflict</a> and after <a href="https://www.nepalitimes.com/here-now/its-all-in-the-mind/" target="_blank" rel="noopener">the earthquake</a> and Blockade. Out-migration and family separation pushes people into another class of mental illness, like neuroses, such as <a href="http://archive.nepalitimes.com/regular-columns/all-in-mind/the-silent-scream-depression-is-common-but-only-few-get-treatment,588" target="_blank" rel="noopener">depression</a> and anxieties in which, unlike psychosis, the patients preserve a sense of reality.Following hospital treatment it is up to family to provide psychological support for patients, to think positively and maintain a healthy lifestyle. They must protect patients from extreme stress due to social factors, such as unemployment or financial trouble.Muna Tamang shows extraordinary determination this week as she sits beside the hospital bed of her 24-year-old daughter who is suffering from psychosis. “As long as she can live and heal, I have decided that we will do anything for her treatment, even if we have to take loans,” Tamang told us.Read also: <a href="https://www.nepalitimes.com/here-now/its-all-in-the-mind/" target="_blank" rel="noopener">It's all in the mind</a>, Sonia AwaleNepal’s mental health facilities are mostly based in cities, but even here there aren’t enough trained specialists to deal with what is a national mental health epidemic. Up to one-third of Nepal’s population suffers from some form of mental illness, according to one study. (See chart)One group, The Transcultural Psychosocial Organistaiton (TPO) is working to remedy the urban-rural mental health gap, by training doctors and health workers at the local level with Female Community Health Workers.“We do not just want to make these services available, but to also ensure people reach out to them, and refer patients to seek help in facilities,” says Kamal Gautam at the TPO.Such efforts have helped remove stigma, and empowered patients and families to receive treatment and care. But Nepal still has a long way to go. With greater state investment, access to mental health services and proper therapy, family members can be even more involved in helping patients and reducing their stigma.Some names have been changed.

All in the family

<img width="1078" height="516" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221107121148/6368f1379c7e80680e035a1cjpeg.jpg" alt=""/>A chhuchi girl Muna (<a href="https://www.imdb.com/name/nm8619216/?ref_=nv_sr_1" target="_blank" rel="noopener">Shristi Shrestha</a>) in Dharan meets a pulpuleko dude Ved (<a href="https://www.imdb.com/name/nm4641795/?ref_=nv_sr_1" target="_blank" rel="noopener">Vinay Shrestha</a>) from America. He has all the money to host luxurious pool parties and she has no money for milk in her morning tea. Will they ever click?It seems unlikely: he tears her kurta as he shoves past her and she splashes paint at him. But the director <a href="https://www.imdb.com/name/nm4531129/" target="_blank" rel="noopener">Naresh KC</a>  manages to bring the two together to create sizzling, sparkling chemistry. The transition from spitfire to flames (from sandwich me to sketch me to sandwich chhaina? back again) is entirely believable. Along the way we also learn why the girl is so stubborn, and why the guy so callous. Vinay is a convincing insensitive brat, Shristi credibly essays a struggling small-town girl in flowery kurtas and plaited hairdos, but it's her sister who brings the eastern flavor with her on-point accent.Not that the movie is not without flaws. The editing, especially in the first half, is not that great, it jumps abruptly from a girl doing the shradha funeral ritual to a bikini party to a dream sequence with a monster. And the shock value of that gimmicky bikini party song on Nepali screen is a whole another story (was it really necessary to imitate wannabe South Asian rap videos? Kathale magekai ho?).There are some tropes that could have worked until the 90s, but not today. For example, when Ved loses access to his money and is forced to do Muna's bidding, the audience comes up with a thousand reasonable things he could have done to solve it. Some plot twists are reminiscent of Korean melodramas. Sushma Karki's gold-digger character is not just over the top, but the entire subplot is annoying.What is refreshing, however, is movie’s approach to real world issues instead of taking the masala Bollywood route that most of Kollywood is fond of. In his first film <a href="https://www.imdb.com/title/tt3552320/?ref_=fn_al_tt_1" target="_blank" rel="noopener">Dying Candle</a>, the director had explored complicated family dynamics with an absent, benevolent father and a problematic mother. This time he reverses it with a romanticised, absent mother and a difficult father. This movie calls itself a tribute to Van Gogh, and Van Gogh's strong bond with his supportive brother finds itself reflected in Jukhuri and Thupri, that was also at the centre of Dying Candle.Animation plays a refreshingly large role, perhaps for the first time in Nepali cinema. A CGI-rendered monster haunts Muna in her dreams and spills over into her paintings. It is a symbol of issues that we cannot run away from how we must slay our own demons. The attempt to tackle deep seated emotional trauma is laudable, but not entirely satisfactory -- and this is the movie's biggest flaw. One wishes the writer had worked harder to make the reconciliation more plausible.Still, Van Gogh is a rare treat to movie-going eyes. Starry Night swirls everywhere: from the title credits to Vinay's shirt to songs. A blue train chugs behind Shristi in a red dress and parasol, bringing Bridges across the Seine at Asnieres to life. A field of post-impressionist sunflowers wave in the wind. A couple takes a mid day Siesta after Millet on a haystack to Sukmit Gurung's Pal Pal Timrai Samjhana Ma. Giving new meaning to old songs is something of a favourite for KC. Having used the classic Kehi Mitho Baat Gara to great effect in Dying Candle, he does it again with the mushy favourite Gahiro Gahiro Sagar Jastai. The movie's original songs are also delightful, especially the soulful Sanjh Paryo.Though this movie is wanting in a lot of ways, it is watchable for venturing into new territories. It captures Nepali filmdom at a time it is just beginning to flex its wings, so this is not yet time to compare the fledgling industry with the world cinema. But there are some things this movie does as well as any other: deliver an emotional punch, especially on its central theme--the redemptive power of love.https://www.youtube.com/watch?v=YpcXJBdB4xo

Romeo & Muna

<h2>The conflict and earthquake added to Nepal’s hidden epidemic of mental disorder</h2><figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110710114/6368ca479c7e80680e02f2fejpeg.jpg" alt="" width="1400" height="1050"/><figcaption>MEMORIES: Nani Maiya Prajapati was serving lunch to her husband, daughter, son-in law and two grandchildren when the earthquake struck three years ago. She survived, but the rest of her family did not. The 2015 tragedy left mental scars on thousands of survivors like her that will take time to heal. ROJITA ADHIKARI</figcaption></figure><a href="http://archive.nepalitimes.com/article/nation/stigma-and-silence-mental-health-nepal,3486">One-third of Nepalis</a> were already suffering some form of psychiatric disorder, but mental health experts say the numbers <a href="http://archive.nepalitimes.com/article/nation/psychological-scars-of-maoist-conflict-on-young-survivors-take-longer-to-heal,1519">went up significantly during the Maoist conflict</a> and rose again after the <a href="http://archive.nepalitimes.com/blogs/kundadixit/2015/05/27/a-month-that-felt-like-a-year/">2015 earthquake</a>.<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110710114/6368ca4a9c7e80680e02f2ffjpeg.jpg" alt="" width="130" height="101">Besides existing psychological disorders in the general population, there are now torture victims, child soldiers, combatants with post-traumatic stress disorders (PTSD), <a href="http://archive.nepalitimes.com/article/nation/Mental-cost-of-migration,3159">mistreated migrant workers</a>, and lately earthquake survivors who had narrow escapes or lost family members.Read Also: <a href="https://www.nepalitimes.com/?p=4261&amp;preview=true">Time heals</a>, Prabin DhungelArun Bhattarai was lying down for a nap that Saturday three years ago when a deep underground rumble followed by a big jolt woke him up. His house in Dhading collapsed, and his family became earthquake refugees in Kathmandu. Bhattarai, now 46, suffered from insomnia and anxiety attacks for months afterwards. The trauma drove him to drink, but today after treatment he has beaten his alcoholism.“A lot of people suffered from anxiety, <a href="http://archive.nepalitimes.com/article/editorial/the-republic-of-insomnia,3311">post-traumatic stress disorder</a> and depression following trauma and bereavement during the earthquake, some even attempted suicide,” says mental health specialist Kapil Dev Upadhyay. “The disaster aggravated the psychosocial condition of many patients who were already recovering.”<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110710114/6368ca4b9c7e80680e02f300jpeg.jpg" alt="" width="500" height="715"><figcaption> </figcaption></figure><a href="https://reliefweb.int/sites/reliefweb.int/files/resources/Hidden-Aftershocks_Summary-Report.pdf">A survey</a> of earthquake-affected districts of Rasuwa, Nuwakot and Makwanpur for the Nepal Red Cross Society, conducted by the group Transcultural Psychosocial Organisation (TPO),  showed that nearly 40% of respondents suffered from <a href="http://archive.nepalitimes.com/regular-columns/all-in-mind/the-silent-scream-depression-is-common-but-only-few-get-treatment,588">depression</a> and anxiety for a year-and-half after the earthquake. Another 22% said they had suicidal thoughts, and a quarter had taken to drinking heavily. More women than men were affected by the symptoms (see chart).Sunita KC was out for a Saturday walk with her husband at Kathmandu Darbar Square when nearby <a href="http://archive.nepalitimes.com/article/nation/Monumental-loss,2215">monuments swayed and collapsed</a> in clouds of dust. The 23-year-old was plagued with nightmares and lost the will to live. She got better after medication, but three years later her symptoms have returned. This week KC was in a clinic in Kathmandu with her family for consultation where she was diagnosed with severe depression.At the Psychiatric Department of Teaching Hospital, Rishav Koirala estimates that every family has at least one member afflicted with some form of mental illness after the earthquake.“In a way, the earthquake was a blessing in disguise because it raised public awareness about mental health and partially removed the <a href="http://archive.nepalitimes.com/news.php?id=14138#.WthaP26FPIU">stigma</a>. The government was also forced to address mental healthcare.”Indeed, the government trained MBBS doctors to provide psychiatric help to survivors in the primary health care systems and district hospitals. Nepal’s Mental Health Policy, adopted in 1997 but rarely implemented, is finally being revised.At an <a href="http://mentalhealthconferencenepal.com/programme/">international conference on mental health in Kathmandu</a> in February, the government pledged to prioritise mental health, increase investment for a mental health focal unit in each provincial health ministry, and to recognise alcohol and substance abuse as mental health problems.“School level psychological education can help change societal attitudes towards mental disorders, and since Nepalis are resilient and family-oriented there is a support system,” says psychiatrist Namrata Pradhan at Model Hospital.Nepal has one of the lowest patients to psychiatrists ratios in the world. In addition, society has entrenched stigma about ‘mad’ people who are often ostracised, often by family members. Even before the earthquake, patients were left to fend for themselves.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110710114/6368ca4d9c7e80680e02f301jpeg.jpg" alt="" width="878" height="516"><figcaption> </figcaption></figure>Rabi Shakya, professor of psychiatry at the Patan Academy of Health Sciences agrees that the public is more aware of mental disorders after the earthquake. “There has been a visible change in terms of awareness and general acceptance level regarding mental health, and as a result patients are coming out and seeking treatment,” he told Nepali Times this week.Post-earthquake studies have shown higher rates of psychiatric disorders, but the major limitation is the lack of a baseline study. The Nepal Health Research Council is now preparing a nationwide mental health survey later this year to help develop a longterm plan to upgrade psychiatric care.Says mental health activist and former patient Jagannath Lamichanne: “We need public awareness and acceptance so that people are comfortable with sharing their experiences, and that can be the most powerful tool for prevention.”Name of patients have been changed.Read also:<a href="http://archive.nepalitimes.com/article/nation/stigma-and-silence-mental-health-nepal,3486">Stigma and silence</a>,  Ketan Dulal<a href="http://archive.nepalitimes.com/article/editorial/the-republic-of-insomnia,3311">The republic of insomnia</a>,  Editorial<a href="http://archive.nepalitimes.com/article/nation/psychological-scars-of-maoist-conflict-on-young-survivors-take-longer-to-heal,1519">Post-conflict stress syndrome</a>,  Taylor Caldwell<a href="http://archive.nepalitimes.com/article/nation/down-and-out,3158">Down and Out</a>,  Smriti Basnet

It’s all in the mind

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110710114/6368ca509c7e80680e02f302jpeg.jpg" alt="" width="1500" height="844"/><figcaption>Pic: Gopen Rai</figcaption></figure>Immediately after <a href="http://archive.nepalitimes.com/blogs/kundadixit/2015/05/27/a-month-that-felt-like-a-year/">the earthquake</a>, there was a <a href="http://archive.nepalitimes.com/article/editorial/the-republic-of-insomnia,3311">sudden surge of patients with mental disorders</a> in Kathmandu’s psychiatric clinics.But since 2016, records at the Nepal Mental Hospital and Bir Hospital show a sharp decrease in the number of patients with post-traumatic stress disorders. Doctors say the reason is that most patients with earthquake-related psychosocial issues received medication, counselling and support from families in the last three years.<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110710114/6368ca539c7e80680e02f303jpeg.jpg" alt="" width="130" height="101">Even so, some survivors still have anxiety attacks during an aftershock or when they hear loud noises. Pukar Gautam was a college student who found himself in the narrow alleys of Patan when the earthquake struck.Read Also: <a href="https://www.nepalitimes.com/?p=4260&amp;preview=true">All in the mind</a>, Sonia Awale“I was terrified and took cover below a sturdy beam,” Gautam remembers. He was traumatised for months afterwards, and even today feels claustrophobic in narrow, crowded alleys.Many traumatised children had to be counselled when schools reopened two months after the earthquake in 2015. They could not concentrate on their studies, had difficulty sleeping and looked distracted.Niroj Mali is a teacher at Chantal Mauduit Academy in Taukhel, and remembers students were still in shock when they came back to school. Instead of regular classes he had the children sing, dance and watch cartoons. “They are doing well now, the earthquake seems like a bad dream,” Mali says.Sandeep Bista, 32, works for the Red Cross and was trapped in a room in Bhaisepati with a visiting aunt when the earthquake struck. He was treated for persistent anxiety, and feels much better now. But his aunt suffers relapses and has to regularly visit the district hospital in Ramechhap.Chief Psychiatrist Lata Shrestha at the Nepal Mental Hospital confirms that the number of patients with psychological trauma has declined to levels before the earthquake. “I have seen more people now seeking psychological help and counselling for trauma and this is a positive side-effect of the earthquake,” she says.Nawal Jha was posted to hospitals in earthquake affected districts and remembers treating many survivors with <a href="http://archive.nepalitimes.com/article/nation/down-and-out,3158">mental disorders</a>. Younger patients who had seen much death and destruction were even <a href="http://archive.nepalitimes.com/regular-columns/all-in-mind/suicide-after-earthquake,496">suicidal</a>, he remembers.Purnima Lama was in a building in Bungamati and suffered a fracture when the house she was in collapsed. She needed medical treatment, but was reluctant to seek psychological counselling. “I was scared <a href="http://archive.nepalitimes.com/article/nation/stigma-and-silence-mental-health-nepal,3486">others would think I was mad</a>,” she says, recalling how a relative was ostracised from her village in Dhading after she was mentally traumatised after a brother was killed during the conflict.Psychiatrist Basu Dev Karki also says societal attitudes towards mental disorders are changing: “People now look at mental health at par with other medical conditions. That is a positive step in ensuring the mental wellbeing of the people.”Some names have been altered.  Read also:<a href="http://archive.nepalitimes.com/article/nation/stigma-and-silence-mental-health-nepal,3486">Stigma and silence</a>,  Ketan Dulal<a href="http://archive.nepalitimes.com/article/editorial/the-republic-of-insomnia,3311">The republic of insomnia</a>,  Editorial<a href="http://archive.nepalitimes.com/article/nation/psychological-scars-of-maoist-conflict-on-young-survivors-take-longer-to-heal,1519">Post-conflict stress syndrome</a>,  Taylor Caldwell<a href="http://archive.nepalitimes.com/article/nation/down-and-out,3158">Down and Out</a>,  Smriti Basnet

Time heals

<a href="https://nepalitimes.com/here-now/waiting-for-bipin-joshi" target="_blank">Nepali student Bipin Joshi</a>, who was taken captive by Hamas on 7 October 2023, was not on the list of those freed following the end of the bombardment and fighting in Gaza.&nbsp; On Monday morning, the Israeli military notified Bipin's family and Nepal’s ambassador to Israel Dhan Prasad Pandit, that there is no evidence of him still being alive. However, Nepal's Foreign Ministry is yet to be notified by Israel's government of Bipin's status. The news came three days after a US-brokered ceasefire between Israel and Hamas came into effect, and hostage and prisoner exchanges by the two sides started Monday morning.&nbsp; Almost 2,000 Palestinians held in Israeli prisions are expected to be released by Israel in exchange for the hostages during the next phase of the peace deal between the two parties, and the bodies of deceased hostages remaining in Gaza are also expected to be returned.&nbsp; Bipin Joshi was among a group of Nepalis who had arrived in Israel in 2023 just weeks before 7 October 2023 as part of a ‘learn and earn’ program to work and earn in kibbutz farms there.&nbsp; Along with other students Joshi had been working on a farm in Kibbutz Alumim in southern Israel near Gaza. <a href="https://nepalitimes.com/here-now/war-in-israel-earthquake-and-grief-in-nepal">Ten Nepali students were killed </a>while taking cover in shelters near their farms in two separate attacks by Hamas fighters.&nbsp; Joshi’s colleagues, fellow Nepalis who survived the attack, recall gunmen lobbing two grenades into the bunker that they had taken cover in. Bipin hurled one of the grenades out, they say, but the other one exploded, killing and injuring Nepalis inside. &nbsp;&nbsp;&nbsp;&nbsp; Shortly after, Bipin was captured by Hamas along with a Thai national and led away into Gaza. CCTV footage showed Bipin alive and at a hospital in Gaza on the day of the attack itself after he was taken hostage.&nbsp; Thirty-one Thai citizens, who like Nepalis worked in farms in Israel, were taken hostage during the Hamas attack, the highest number of foreign captives in October 2023.&nbsp; <a href="https://nepalitimes.com/news/deft-diplomacy-freed-thai-hostages">Deft Thai diplomatic engagement</a> with officials from Iran, Egypt, and Qatar brought about the release of 23 of its nationals in 2023. Five more Thai nationals were released earlier this year.&nbsp; In August, Joshi’s family visited Israel at the invitation of the government and urged the international community to push for his return. Bipin’s mother Padma and sister Pushpa have been at the United Nations to lobby for his release.&nbsp; His family last week also released a video clip of Bipin briefly speaking on camera, reportedly obtained by Israel and said to be filmed in November 2023, around a month after he was taken captive. Joshi looks healthy in that video.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251013091028_d551c7f88204c52217152fb5db655bb5a5f8bf2cff1e6a055326ebf64453ff9f.png" data-media-id="editor_3" data-image-id="20251013091028_d551c7f88204c52217152fb5db655bb5a5f8bf2cff1e6a055326ebf64453ff9f" data-rendition-name="original" width="2848" height="1528" loading="lazy" alt="Bipin Joshi NT"> </figure>  More than 67,000 Palestinians have been killed during the last two years of the genocide in Gaza. About 1,200 people were killed during the Hamas attack on 7 October 2023, while more than 251, including Bipin Joshi, were taken as captives.&nbsp; This is the third ceasefire implemented in Gaza since 7 October 2023 after previous ones in November 2023 and January 2025. This 20-point deal facilitated by intermediaries US, Qatar, Turkey, and Egypt included terms for Hamas to give up its arms, and for a devastated Gaza to be governed by a Palestinian body of independent technocrats, while Israeli troops will withdraw in stages from Gaza.&nbsp; Hamas has agreed to relinquish control of Gaza, but has rejected the demand for disarmament, saying the group will demobilise but is prepared to resume fighting if Israel breaches the ceasefire.&nbsp; Following the ceasefire, Palestinians in Gaza have begun long journeys back to homes reduced to rubble by Israel’s two-year assault on the strip. The flow of humanitarian aid in the city has also increased following the peace deal.&nbsp; Israel's closure of humanitarian corridors in the past months had blocked the entry of food and medicine into Gaza, causing widespread famine. The United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) has said that the restriction of aid into the beseiged city has left as many as <a href="https://www.unrwa.org/newsroom/news-releases/gaza-unrwa%E2%80%99s-lancet-study-reveals-alarming-surge-child-malnutrition">54,600 children acutely malnourished</a>.&nbsp; Meanwhile, US president Donald Trump landed in Israel on Monday as hostages were being released, and world leaders are expected to head to Egypt for an international summit to discuss the next steps in Gaza, Israel, and West Asia.&nbsp;

Nepali hostage in Gaza not alive: Israel

Already trying to balance youth demands with legal provisions in the Constitution, Prime Minister Sushila Karki’s interim government faced yet another challenge over Dasain: a receding monsoon dumped unseasonal rain unleashing floods and landslides that killed at least 60, mostly in eastern Nepal.&nbsp; The government was rated positively for its early warning and the ‘visibility’ of its disaster response, with many comparing it to the inaction of the NC-UML coalition during last year’s floods.&nbsp; Government agencies and police proactively closed off hazardous sections of highways as Kathmandu was marooned from the rest of the country in the peak holiday season. Stranded passengers were taken care of, with police, army and local governments in Ilam coordinating rescue and relief efforts. Many of the problems were structural and inherited from decades of neglect and corruption in highway contracts. Shoddy bridges and encroachment of settlements along river banks have increased risk from more frequent extreme weather caused by climate breakdown. With Dasain over Tihar around the corner and the worst of the disaster behind, the Karki administration is trying to balance the separate demands of GenZ movers and shakers who installed her in office with constitutional provisions. It has not helped that the badly-mauled political parties are spoiling for a fight, and the three top leaders show little signs of stepping down. “Nepal’s movement did not happen in a democratic vacuum, so this government walks a very fine line in political legitimacy," says Bidushi Dhungel of the National Democratic Institute in Nepal. "In this fragile space, whatever the work done — or not done— by the interim government within its limited mandate, it may open up avenues for further dissent from old and new actors. They are &nbsp;caught between a rock and a hard place.” Civil society activists issued a statement on Wednesday calling on the main political parties to heed the writing on the wall and reform themselves. Signed by professor Krishna Khanal and former ambassador Keshab Mathema, the statement said: 'The main leaders of the main parties should say sorry, and voluntarily resign ... they must respect public sentiments and work to reform and transform their parties to be more accountable to the public, or risk being irrelevant.'&nbsp; Complicating matters further are the sometimes contradictory demands of various GenZ factions on punishing those responsible for the carnage and rampage of 8-9 September, Constitution and elections. Karki faces calls to immediately detain former PM KP Oli and Home Minister Ramesh Lekhak for their involvement in the massacre outside Parliament. Under pressure from GenZ delegates, Home Minister Om Aryal fired off a letter to the police to arrest Oli and Lekhak. But later at a confrontational midnight meeting at the prime minister’s residence in Baluwatar, all four security chiefs advised Karki that arresting the UML and NC ex-ministers could unleash violent confrontation on the streets. The interim government is in a bind. It has formed a committee headed by Gauri Bahadur Karki to investigate the killings last month as well as the arson and vandalism that followed. The question is: should it wait for the committee to submit its report before punishing perpetrators, or let police arrest those who can easily be identified in social media posts setting fire to Singha Darbar, the Supreme Court and other sites.&nbsp; GenZ’s Sudan Gurung faction has gone beyond its original demand to submit an 8-point ultimatum that includes the sacking of the Chief Justice and officials of the anti-corruption bureau.&nbsp; The Prime Minister is caught in the crossfire between managing the expectations of a movement that appointed her, and working within the framework of her interim government’s mandate and Constitution. But it is not just the government that faces challenges. The lack of clear consensus among youth factions and their outspoken collectives is surfacing.&nbsp; &nbsp;“This has been a leaderless and decentralised movement, and the traditional variables typically seen in a political revolt seem missing here," notes political scientist Sucheta Pyakuryal. “There is no organised structure, nor any ideological pull factor, therefore a big question is how much bargaining power does a movement like this have, and how sustainable will it be.” GenZ leaders seem to be in two main camps. Demands like the one for a directly elected prime minister, and the constitutional processes that can make for such an outcome, have emerged as a major point dividing the movement.&nbsp; Nepalis both within and outside the youth movement are watching Hami Nepal’s Sudan Gurung closely — especially after his recent interview with Al-Jazeera during which he expressed his interest to run for Prime Minister and seemed to not accept a win by political parties in the March elections.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251009201044_fcba7e92bb9a8812fd0ad4e9770d6f4d4189972de5229f91e9a832a26e388901.jpg" data-media-id="editor_0" data-image-id="20251009201044_fcba7e92bb9a8812fd0ad4e9770d6f4d4189972de5229f91e9a832a26e388901" data-rendition-name="original" width="2916" height="1000" loading="lazy" alt="One month on NT"> <figcaption>GROUND ZERO: The destroyed centre of Nepal's government with Singha Darbar (in green scaffolding), the Attorney General's Office, Supreme Court, and in the distance, Parliament building. Also seen are the nearly finished new Parliament Complex and the new Supreme Court buildings. Drone shot taken on Thursday morning. Photo: SUMAN NEPALI</figcaption> </figure>  Gurung’s participation in the NDRRMA’s disaster management meeting and manner of his interaction with officials at the event was met with both bouquets and brickbats. Interestingly, some of the criticism was youth activists themselves. &nbsp;“There's a lot of self-involvement and self-importance that seems to be guiding a fragmented young leadership, as opposed to constructively engaging in how to concretise reforms,” says Dhungel. “There seems to be very little stocktaking of what's happened in the past, and what's happened in other countries to try identify where lapses could be before they occur."&nbsp; In the absence of unified positions and level-headed leadership, the youth who spearheaded post-protest negotiations, as well as the GenZ movement in general, risk losing public goodwill already dented by the destruction of state property on 9 September. This also leaves an opening for political parties which are on the defensive and licking their wounds to capitalise on youth discord.&nbsp; Says Pyakuryal: “Post revolution, the political landscape becomes extremely unpredictable and therefore there is a risk of co-optation from several Machiavellian political actors including political parties, monarchists, as well as other forces, and that is concerning.” The immediate and visible transformation that Nepal’s youth expect will not manifest right away, and while there is a need for long-term political planning, the caretaker government must also undertake measures that have a palpable impact on the daily life of citizens. &nbsp;&nbsp; “While youth frustrations must be addressed urgently, statecraft isn’t just about fulfilling short-term goals,”says Pyakuryal. &nbsp; Many, including the youth themselves, now see the need for GenZ to have a more united stance and to move beyond making demands that the interim government cannot fulfil and start mobilising for elections — even by forming its own party.&nbsp; A strong showing in elections can enable them to enact the changes they want to strengthen Nepal’s democracy, and make future governments more accountable.&nbsp; This week, the Election Commission announced 16 November as the deadline to register new parties for the 5 March polls.&nbsp; Youth representatives have said that they want to be active participants in the political process, particularly in national-level politics. The Constitution defines ‘youth’ as being between the ages of 16-40. In the 2022 elections, the Election Commission stated that over 41% of locally-elected representatives were from ages 21-40 years.&nbsp; If young Nepalis are to contest the election outside the banner of mainstream parties, this leaves electoral aspirants little more than a month to decide whether to form a loose coalition with existing parties, a separate political party, or to contest elections independently. “This is first of a kind movement, where political language is digital, not ideological, where organising is done through online platforms and where there is no one leader spearheading the movement,”says Pyakuryal. “I don’t know if ‘anti-corruption’ or ‘political reform’ have a strong enough ideological pull to band people together in the long run.” Indeed, the RSP was formed only four months before the 2022 elections and cashed in on anti-incumbent and anti-corruption sentiments of voters — mainly driven by social media. But controversy and strife within their party means it has largely lost its public trust.&nbsp; Nepal’s September Uprising and its aftermath have shown that a majority of young people are entirely disillusioned with establishment parties and politicians, even using ‘ex-political parties’ as a phrase of reference. Any new young political figures that emerge from this movement and this election will have to work with mainstream parties in a multiparty democracy.&nbsp; &nbsp;“The reality of politics is that change is not possible without engaging with existing political institutions and actors,” says Dhungel. “To say that they do not want to engage, negotiate, or identify allies or proactively seek out input from at least the reform-minded individuals within each of those outfits is political naivety, and may lead to a lack of institutionalised reform.” However, Dhungel notes that the youth leadership would have more agency if they are clear not just on what they want to change, but about whether they are interested in active politics or civic engagement. “The window of opportunity that is fast closing is to really negotiate hard and push for internal reforms within political parties and across the electoral system,” she adds. Pyakurel also adds: “GenZ are smart and politically mature, I hope they see these loopholes. I am optimistic about the direction they take.”

One month on

The meeting called by Prime Minister Sushila Karki at Baluwatar on 4 October was supposed to be about completing the interim cabinet with GenZ representatives. But it ended with factions putting up rival demands.
It is ironic that a movement that voted for Karki on Discord is itself marred by discord.
But such jostling was to be expected. This was an amorphous and leaderless group of young Nepalis that was suddenly elevated to fill a national power vacuum, and is now expected to redesign the country from scratch. &nbsp;
At least two camps have emerged within the youth groups. One is led by Sudan Gurung of Hami Nepal with Barsa Raut, Anil Baniya, Purshotam Yadav and Ojaswi Raj Thapa, while the second under Rakshya Bam has Pradeep Gyawali, Aditya Karn, Yujan Rajbhandari and Dheeraj Joshi.
Just like it was at Nepal Army Headquarters on 10 September, there is distrust and dissent within these disparate group. For the sake of stability, and in memory of the 72 who lost their lives last month, Nepalis want these groups to be more united in their stances. &nbsp;
Prime Minister Karki did not attend the Baluwatar meeting last week, wanting the GenZs to first work out their differences. Home Minister Om Prakash Aryal and Finance Minister Rameshore Khanal were present, and entreated the young delegates to cooperate.
Sudan Gurung has demanded the resignation of the Chief Justice and the head of the anti-graft body, the CIAA. However, some even within Gurung’s camp are said to want constitutional provisions to be respected, and do not agree with some of his eight demands.
Rakshya Bam accuses Gurung of trying to do away with the Constitution and issuing arbitrary statements on governance. Her group also issued a statement warning against any attempt to deviate from the values of democratic change.
The conflict between various GenZ groups has exposed the nature and limitations of street revolt, proving that it is always easier to destroy than to rebuild. A revolution can bring rapid and transformative change, but then comes the task of agreeing on new structures and processes — while dealing with the ego and ambition of the protagonists.
TIGHT-ROPE WALK
One year after a similar student-led uprising, Bangladesh is struggling to stabilise the system and preparing for elections while dealing with extremism and geopolitical fallout. Sri Lanka held elections and brought in a new youthful leader, but it has not been smooth sailing.
Prime Minister Karki’s caretaker government is on a tight-rope walk. Moving too fast on arresting the previous prime minister and investigating others for corruption risks igniting renewed street violence, but delaying justice will anger the impatient youth, who want immediate results.&nbsp;
The longer the uncertainty and instability lasts, the more likely it will be for radical forces to take advantage of the fluidity. The communal clashes in Birganj and Janakpur over Dasain, inspired by what is happening across the border, should be a wakeup call. Hate speech and ethnic slurs on social media could be incendiary if left unregulated.
The Prime Minister has said her foremost priority is to ensure free, fair and inclusive elections on 5 March — mindful that various forces are out to sabotage it for their own interests.
Amending the Constitution to meet GenZ demands may have to wait for polls next year, and real change that improves lives, creates jobs and makes the bureaucracy cleaner and more efficient will take longer.
But till then, the interim administration could deliver tangible benefits to people with do-able improvements like speeding up the driving license process, removing middlemen from all levels of the bureaucracy, expeditiously completing highway repairs, controlling food prices.
The youth want immediate course correction, given how the old political parties, politicians and bureaucracy had plundered the state for years. But idealism alone cannot make a state machinery function. Every decision during this sensitive transition must be taken without undermining previous gains.
Factional friction within the GenZ will allow the old leaders in the old parties to regroup and plot revenge. Meanwhile, the three main parties, which fuelled the youth and class rage with their corruption and reckless disregard for the public good for the past three decades, do not seem to have learnt their lessons.&nbsp;
Despite being disgraced, K P Oli of UML, Sher Bahadur Deuba of the Nepali Congress and Pushpa Kamal Dahal of the Maoist Centre, are still not willing to retire. The tragic loss of life and the mayhem that followed does not seem to have opened their eyes to the writing on the wall. They are intent on blaming everyone but themselves.
The Election Commission has already set a deadline for party registration by 16 November. Some in the GenZs want provisions to vote for a directly elected executive head of the country by even changing the Constitution.
There is a lot of confusion about what exactly the mandate of the interim government is, what it can and cannot do. With the dissolution of Parliament, the interim government cannot amend the Constitution, its only mandate is to conduct elections to form a new government that would then work on amendments.&nbsp;
At most, it can pass ordinances but only for the peace and good governance of the country or when there is an immediate need to enact a law.
To make things murkier, Sudan Gurung in a widely-shared interview on Al Jazeera said that he would run for prime minister, and that he would not accept the old parties and their leaders even if they win the elections unless they completely reform their political stance. He is also willing to work with pro-monarchists if they are for the betterment of the country.
Dharan Mayor Harka Sampang has already registered a new party called Shram Sanskriti Party while the likes of Kathmandu Mayor Balen Shah, Energy Minister Kulman Ghising and for RSP Sumana Shrestha are expected to follow another corporate backer for a new party.
All parties, including any new ones representing the youth, must learn from the failures of the newer alternatives such as Sajha, Bibeksheel and more recently RSP. Parties go nowhere without a clear ideology, organisation and a vision and pathway post-elections.
The interim government is made of most capable technocrats and a Prime Minister with zero tolerance for incompetence and who says she has no intention of continuing in the position a minute longer than necessary.&nbsp;
We now have to move beyond destruction to rebuilding, and not be distracted by discord.
Sonia Awale

trauma