<figure><img width="1236" height="856" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109111148/636b85a09c7e80680e067804jpeg.jpg" alt=""/><figcaption>Photo: AMIT MACHAMASI</figcaption></figure><h2>1. Oxygen</h2> To save lives, Nepal’s most urgent need now is oxygen. Not just cylinders, but oxygen generators, concentrators and liquid oxygen. Most infected people are not succumbing to Covid-19, they are <a href="https://www.nepalitimes.com/here-now/helping-nepalis-breathe-again/" target="_blank" rel="noopener noreferrer">dying because of low oxygen saturation</a> in the blood, and lack of hospital beds -- patients who need not have died of coronavirus. Dire as the situation is in the cities, Nepal’s pandemic has now <a href="https://www.nepalitimes.com/editorial/nepals-humanitarian-emergency/" target="_blank" rel="noopener noreferrer">infiltrated the remotest villages</a> where there is no hospital care and no oxygen. The virus is preying on people already suffering malnutrition, previous ailments, and decades of structural state neglect. In Rolpa, Humla and other remote districts, between 80-90% of PCR tests are coming back positive, and it takes a week to get results. Patients are either not isolating, or not following precautions.Kathmandu's doctor-to-patient ratio is 1:850, but in rural Nepal it is one doctor for every 15,000 people, and hospitals and medical staff there <a href="https://www.nepalitimes.com/here-now/at-the-covid-19-frontlines-in-rural-nepal/" target="_blank" rel="noopener noreferrer">are already overstretched</a>.Close to 60% of all swabs collected nationwide are from Bagmati Province, with nearly half of them in Kathmandu Valley, says epidemiologist Lhamu Yangchen Sherpa. She adds: “There just aren’t enough tests and contact tracing is minimal, official total cases and fatalities are grossly underestimated.” <figure><img width="1497" height="746" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109111148/636b85a39c7e80680e067805jpeg.jpg" alt=""><figcaption> </figcaption></figure><figure><img width="984" height="519" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109111148/636b85a69c7e80680e067806jpeg.jpg" alt=""><figcaption> </figcaption></figure>Hospitals in Kathmandu Valley with roof helipads have multiple daily rescue flights, but even these facilities are <a href="https://www.nepalitimes.com/banner/we-knew-the-tsunami-was-approaching/" target="_blank" rel="noopener noreferrer">at breaking point</a> with patients being turned away. Understaffed and under-equipped hospitals in the districts do not stand a chance. Even where hospitals exist, many families avoid them for fear of being infected and take wrong medication from pharmacies.Case in point are recent deaths due to misdiagnosis across the country. <a href="https://www.nepalitimes.com/banner/a-shot-in-the-arm-for-vaccines-in-nepal/" target="_blank" rel="noopener noreferrer">Typhoid disease</a> simulates Covid-19 with similar symptoms, and the widespread Widal test is known to give false positives.“Covid patients are being prescribed antibiotics to fight typhoid, only to turn critically ill in a few days’ time,” says Buddha Basnyat of Patan Academy of Health Sciences. “This is the reason behind some of the latest Covid fatalities.” <figure><img width="1280" height="720" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109111148/636b85a89c7e80680e067807jpeg.jpg" alt=""><figcaption> </figcaption></figure>As in India, Nepal is beginning to see a slight bending of the curve for new infections, but health experts expect the fatality rate to remain high for some more time.  There were 190 Covid deaths in the past 24 hours and 6,543 recoveries. Of the total 8,305 new cases on Thursday, Kathmandu Valley accounts for 3,232 infections. 7,814 people are undergoing treatment in hospitals with 1,748 in ICU and 492 in ventilator support. “After the relentless patient pressure of the past month, we have seen a decline in those requiring admissions,” says virologist at Teku hospital Sher Bahadur Pun. “The virus has now infected a majority of people in the cities, and this combined with the lockdown means we may be getting to the halfway mark of the second wave.” <h2>2. Vaccines</h2> A prolonged lockdown is not the answer. If it was, the <a href="https://www.nepalitimes.com/latest/covid-19-numbers-slightly-down-in-nepal/" target="_blank" rel="noopener noreferrer">reduction in the number of cases and the positivity rate</a> this week would have been steeper. Even while the government tries to increase oxygen supply to hospitals, the only long-term strategy is to vaccinate at least 70% of Nepal’s eligible population.Doctors report a marked difference between the recovery of people who are vaccinated against those who are not. Says virologist Pun at Teku Hospital: “Except for a few rare cases, all patients in critical condition and those dying are the ones who for one reason or another had not been vaccinated.”But Nepal has run out of its vaccine stock, leaving 1.4 million people still waiting for their second dose of AstraZeneca Covishield in a lurch, after India banned its export, and the COVAX Facility could not supply its remaining 1.8 million vaccines to Nepal because of the global supply bottleneck.  <figure><img width="1440" height="1080" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109111148/636b85ac9c7e80680e067808jpeg.jpg" alt=""><figcaption> </figcaption></figure>The Nepal government and pressure groups in Nepal and the United States <a href="https://www.nepalitimes.com/here-now/nepal-needs-urgent-american-vaccine-support/" target="_blank" rel="noopener noreferrer">have strongly urged the Biden administration</a> to immediately rush some of its AstraZeneca doses to Nepal.Meanwhile, the UK, the US and Canada have authorised vaccines for use in children and adolescents, sparking outrage in the global public health community for prioritising an age group that is rarely critically affected by Covid-19. The World Health Organisation’s director-general Tedros Adhanom Ghebreyesus has urged rich countries to instead donate doses to the <a href="https://www.nepalitimes.com/latest/unicef-urges-g7-to-dispatch-vaccines/" target="_blank" rel="noopener noreferrer">COVAX Facility</a> for poorer states that have barely covered health workers and the most vulnerable groups. Speaking at the British Parliament last week, noted vaccinologist and the principal researcher of Oxford University’s AstraZeneca vaccine, Andrew Pollard, called the decision to inoculate children in wealthy nations ahead of high-risk groups in poorer countries “morally wrong.” Pollard has worked extensively in the region, leading research into the burden and transmission of typhoid in Nepal, Bangladesh and Malawi, and the impact of typhoid vaccine in these areas. He also runs surveillance for invasive bacterial diseases, and studies the impact of pneumococcal vaccines in children in Nepal.In Nepal, vaccination will grind to a halt this week after the current campaign to inoculate 300,000 people in the 18-59 age group with their second dose of the Chinese VeroCell ends.  <figure><img width="960" height="640" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109111148/636b85af9c7e80680e067809jpeg.jpg" alt=""><figcaption> </figcaption></figure><img width="960" height="640" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109111148/636b85b29c7e80680e06780ajpeg.jpg" alt=""><img width="960" height="639" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109111148/636b85b49c7e80680e06780bjpeg.jpg" alt="">Although <a href="https://www.nepalitimes.com/here-now/nepal-is-a-priority-for-vaccine-shipments/" target="_blank" rel="noopener noreferrer">Foreign Minister Pradeep Gyawali says</a> the government is in “final negotiations” for 2 million doses of Sinopharm VeroCell vaccines by June, there is no movement at the Ministry of Health. Ongoing talks to procure 8 million doses of <a href="https://www.nepalitimes.com/opinion/vaccine-geo-politics-and-sputnik-v/" target="_blank" rel="noopener noreferrer">the Sputnik V</a> have hit a production capacity snag in Russia. “We can implement lockdowns only for so long, the only exit strategy is vaccines. Science delivered, now our politicians must do the same,” says Buddha Basnyat, a physical at the Patan Academy of Health Sciences. “The Nepal government must procure vaccines using every diplomatic channel possible, and rich countries must realise that they are not safe until countries like Nepal are also vaccinated.” Activists have been trying to convince <a href="https://www.nepalitimes.com/latest/leading-public-figures-call-on-uk-government-for-oxygen-for-nepal/" target="_blank" rel="noopener noreferrer">the US government and Europeans</a> that Nepal has a lot of experience in successful vaccination campaigns against polio, smallpox, measles. It has over 50,000 female community health volunteers (FCHVs) reaching children with vaccines every year.  <figure><img width="1024" height="768" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109111148/636b85b79c7e80680e06780cjpeg.jpg" alt=""><figcaption> </figcaption></figure><img width="2048" height="943" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109111148/636b85ba9c7e80680e06780djpeg.jpg" alt=""><img width="1920" height="864" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109111148/636b85bd9c7e80680e06780ejpeg.jpg" alt="">Similarly, Nepal’s health system has amassed vast experience in maintaining the vaccine cold chain even in the remote mountains. It also has trained human resource overseeing DOTS (Directly Observed Therapy, Short-course) for tuberculosis management all over the country who can lend a hand in equitable distribution of vaccines in <a href="https://www.nepalitimes.com/latest/rural-nepal-fights-back-covid-19/" target="_blank" rel="noopener noreferrer">rural Nepal</a>.Says epidemiologist Lhamo Yangchen Sherpa: “It’s not too late, we can still use existing resources like FCHVs to better mobilise vaccination, conduct contact tracing, dispel any remaining vaccine hesitancy, and use public health professionals in prevention.”

Sonia Awale

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It’s an Emergency

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109101152/636b79289c7e80680e0646e7jpeg.jpg" alt="" width="960" height="640"/><figcaption>A quarantine zone at Nepal Army's headquarters in Tundikhel. Photo: BIKRAM RAI</figcaption></figure>By now the novel coronavirus pandemic has affected every corner of the globe. If it has not brought disease, it has at least brought the <a style="background-color: #ffffff; font-size: 16px; letter-spacing: 0.15px;" href="https://www.nepalitimes.com/editorial/fear-goes-viral/" target="_blank" rel="noopener">fear of infection</a>. Cities, and indeed entire countries, are in lockdown. Fortress Europe has raised its walls higher. Airlines are grounded. Nepal has banned trunk international routes from Friday night. Even countries with excellent public health facilities and emergency preparedness plans are overwhelmed.Nepal is now <a href="https://www.nepalitimes.com/opinion/global-thinking-and-local-action-on-coronavirus/" target="_blank" rel="noopener">so closely intertwined with globalisation</a> through migration, tourism and trade that its <a href="https://www.nepalitimes.com/here-now/nepals-economy-already-weak-takes-direct-hit/" target="_blank" rel="noopener">already-fragile economy has been badly hit</a> even before a full-blown health emergency hits. Ironically, less-developed countries seem to have a built-in resilience that comes from being crisis-prone -- since they are lower down in the economic ladder, they have a shorter distance to fall.Read also: <a href="https://www.nepalitimes.com/editorial/poor-health-makes-nepalis-poorer/" target="_blank" rel="noopener">Poor health makes Nepalis poorer</a>, EditorialDespite Nepal’s surprisingly <a href="https://www.nepalitimes.com/banner/born-in-nepal/" target="_blank" rel="noopener">dramatic improvements in mother-child survival </a>over the past two decades, <a href="https://www.nepalitimes.com/editorial/poor-health/" target="_blank" rel="noopener">the public health system here is in crisis</a>. State-of-the-art modern hospitals in the city, while reducing the need for Nepalis to go abroad for treatment, are out of reach of a majority of the population. Government health facilities are more affordable, but for the most part medical care there is not up to mark.Nepalis are still afflicted by easily preventable water-borne diseases like <a href="https://archive.nepalitimes.com/news.php?id=16988#.XnMUhagzbSF" target="_blank" rel="noopener">typhoid and diarrhoea</a>, vector-borne infections like malaria, encephalitis or dengue, and illnesses like <a href="https://www.nepalitimes.com/banner/nepal-tb-cases-grossly-underestimated/" target="_blank" rel="noopener">tuberculosis </a>and acute respiratory infections that spread through breathing. Great inroads have been made in reducing the impact of communicable diseases in the past decades through awareness programs, vaccinations and safer drinking water, but children in <a href="https://www.nepalitimes.com/banner/this-is-how-to-upgrade-nepals-rural-health/" target="_blank" rel="noopener">remoter parts of Nepal</a> are still dying of simple infections.Read also: <a href="https://www.nepalitimes.com/banner/a-shot-in-the-arm-for-vaccines-in-nepal/" target="_blank" rel="noopener">A shot in the arm for vaccines in Nepal</a>, Sonia AwaleOn top of this, urbanising Nepal now also has the added burden of <a href="https://www.nepalitimes.com/editorial/poor-health/" target="_blank" rel="noopener">non-communicable afflictions</a> like diabetes, cardio-vascular ailments and renal disease. As families move from the districts to the cities, changes in diet and more sedentary habits have given rise to an epidemic of lifestyle-related diseases. This is compounded by genetic susceptibility among South Asians for diabetes and heart disease.For example, a study by the BPKIHS in Dharan showed that while the national average for <a href="https://archive.nepalitimes.com/article/nation/diabetes-in-south-asia,3018" target="_blank" rel="noopener">Type 2 diabetes </a>prevalence is 8.1% of the population, the incidence in Dharan was 14%, while it was only 1% in Taplejung. The prime minister’s own second kidney transplant this month showed that <a href="https://archive.nepalitimes.com/article/editorial/health-tip-editorial,4032" target="_blank" rel="noopener">ignoring risk factors and not diagnosing non-communicable diseases</a> can lead to a huge health burden for families and the state. A small percentage of Nepalis have health insurance, so many middle income families fall below the poverty line due to medical expenses. Many Nepali migrant workers have been forced to seek jobs abroad to pay back debts incurred during hospitalisation of family members.Last summer’s explosion of dengue in Kathmandu Valley was <a href="https://www.nepalitimes.com/banner/mosquitoes-move-up-mountains-as-the-earth-warms/" target="_blank" rel="noopener">blamed on climate change</a>. But it was actually a perfect storm of crowded and squalid living conditions, poor drainage, greater mobility of people, and a particularly wet monsoon. None of these factors have been addressed, so we are staring at a recurrence of dengue this year even while we cope with <a href="https://www.nepalitimes.com/banner/why-nepal-must-watch-about-coronavirus-but-not-panic/" target="_blank" rel="noopener">a possible COVID-19 outbreak</a>.Public health has not been a national priority for successive governments in Nepal. Even if it has, it is only in paper and has not really been translated into <a href="https://www.nepalitimes.com/opinion/is-free-health-care-possible-in-nepal/" target="_blank" rel="noopener">accessible and affordable healthcare</a> for the general public. Governance failure has contributed to this state of affairs, but there is also the virus of corruption that has afflicted the entire government healthcare system. A politico-business nexus has also infected <a href="http://archive.nepalitimes.com/news.php?id=19560" target="_blank" rel="noopener">medical education</a>, putting it out of reach of deserving poorer students.Read also: <a href="https://www.nepalitimes.com/editorial/when-panic-goes-viral/" target="_blank" rel="noopener">When panic goes viral</a>, EditorialInto this mix, we now have the coronavirus scare. Officially, Nepal has just one case in which the patient recovered and has been discharged. The government has tested about 500 people, and all have been negative. Experts have confirmed that the tests are credible, and proper protocols are in place. But not enough tests have been done to determine if there are more people out there with the virus.At $75 per test, the kits are expensive. This is where international help would be needed, and if the case rate rises the country will also need help with containment and mitigation. Nepal has been lucky so far that there is no indication of community transmission yet. But our luck could turn any day.

This is a test

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108151120/636a66739c7e80680e059980jpeg.jpg" alt="" width="1500" height="1000"/><figcaption>Photo : BIKRAM RAI</figcaption></figure>There used to be a time when the main public health threat in Nepal was from infectious diseases like <a href="https://www.nepalitimes.com/here-now/the-mosquito-that-changed-nepals-history/" target="_blank" rel="noopener">malaria</a>, encephalitis, <a href="https://www.nepalitimes.com/banner/tb/" target="_blank" rel="noopener">TB</a> and typhoid. Whether vector-borne or transmitted through contaminated air or water, the most cost-effective way to address them was through prevention. Communication was the first line of defence against communicable diseases.Things have changed. Awareness has grown because literacy rates are up. Most Nepalis now suffer from non-communicable ailments like cardiovascular diseases, <a href="https://archive.nepalitimes.com/article/nation/diabetes-in-south-asia,3018">diabetes</a>, <a href="http://archive.nepalitimes.com/article/Nepali-Times-Buzz/A-mysterious-rash-of-kidney-failures,3639" target="_blank" rel="noopener">renal failure</a> and malignancies. These need treatment in medical facilities at a time when the over-commercialisation of hospitals has made healthcare unaffordable for a majority of the population. In fact, <a href="https://www.nepalitimes.com/editorial/poor-health/" target="_blank" rel="noopener">poor health</a> is making Nepalis poorer.Read also:<a href="https://www.nepalitimes.com/opinion/is-free-health-care-possible-in-nepal/" target="_blank" rel="noopener">Is free health care possible in Nepal?</a>, S P Kalaunee<a style="background-color: #ffffff; font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/?p=37821&amp;preview_nonce=9ce6a7c55d&amp;preview=true" target="_blank" rel="noopener">Federalism leaves Nepal’s medical sector ailing,</a> Sewa BhattaraiAlso, communicable diseases have not been completely overcome. Diarrhoeal dehydration and other water-carried infections are still major killers. One of the reasons Nepal’s progress in reducing child mortality has stalled is because of the state’s failure to ensure adequate and safe drinking water in remote regions. In this paper we have also reported on <a href="https://www.nepalitimes.com/banner/nearly-half-of-nepali-children-still-malnourished/" target="_blank" rel="noopener">stunting and wasting among children</a> due to malnutrition.In addition, <a href="https://www.nepalitimes.com/here-now/air-pollution-is-more-dangerous-than-smoking/" target="_blank" rel="noopener">worsening air pollution</a> has caused an epidemic of chronic obstructive pulmonary disease (COPD), which has led to lung infections in all age brackets and causing terminal pneumonia and other complications in the elderly. At current levels of PM2.5 concentration in the air, studies show, the average lifespan of city dwellers in Nepal could be reduced by up to four years.Read also:<a href="https://www.nepalitimes.com/here-now/nepal-is-a-microcosm-of-all-of-the-changes-in-world-health/" target="_blank" rel="noopener">"Nepal is a microcosm of all of the change in world health"</a><a href="https://www.nepalitimes.com/editorial/poor-health/" target="_blank" rel="noopener">Poor health</a>, EditorialNepal’s burden of non-communicable diseases and injuries has doubled in the last 25 years, with nearly 15% caused by <a href="https://www.nepalitimes.com/banner/nepals-deadly-roads-take-their-toll/" target="_blank" rel="noopener">road traffic accidents</a> or natural disasters. Traffic accidents are now the second biggest killer of young Nepalis. Just in the past three weeks, 90 people have been killed on highways due to poor road condition or carelessness.A vivid indication of the threat of non-communicable diseases is today’s prevalence of diabetes. South Asians are genetically more susceptible to cardiovascular diseases and diabetes, but there are now new risk factors caused by increasing rural to urban migration. While the world prevalence average for both types of diabetes is 8%, research has shown that 14% of people in Dharan suffer from the disease. Taplejung, from where many have migrated to Dharan, has a rate of only 1%. The reason is clear: increased intake of carbohydrates and a more sedentary lifestyle when people move to cities.To meet these challenges, Nepal desperately needs <a href="https://www.nepalitimes.com/opinion/is-free-health-care-possible-in-nepal/" target="_blank" rel="noopener">affordable and accessible medical care</a>. At the moment, hospital treatment is neither. The poor in remote, underserved areas of the country are disproportionately vulnerable. As our report from Bajura shows, the problem is further complicated because confusion over federalism, budget and jurisdiction has left most rural government hospitals underfunded and underserved. It is imperative that the government act quickly to resolve the retention crisis caused by medical staff getting themselves transferred out of their jobs in remote areas.Read also: <a href="https://archive.nepalitimes.com/article/nation/national-health-insurance-not-as-easy,4028" target="_blank" rel="noopener">A national health insurance is not as easy as it looks</a>, Sonia Awale<a href="https://www.nepalitimes.com/banner/this-is-how-to-upgrade-nepals-rural-health/" target="_blank" rel="noopener">This is how to upgrade Nepal's rural health</a>, Sewa BhattaraiA survey last year showed that half of all <a href="https://archive.nepalitimes.com/article/nation/national-health-insurance-not-as-easy,4028" target="_blank" rel="noopener">medical expenditure of Nepalis families</a> is out-of-pocket, and 60% of that is for treatment of non-communicable diseases and injuries. The federal government allocates only about 10% of its budget to health care, and the focus is still on communicable diseases. Donor priority is also not on non-communicable diseases and injuries. A study of government hospitals by the Nick Simons Institute shows a huge unmet need in remote areas for basic surgery like caesarean sections and orthopaedics.One bright spot ahead is the success of pilot insurance schemes being tried out in various parts of the country. In a <a href="https://www.nepalitimes.com/opinion/is-free-health-care-possible-in-nepal/" target="_blank" rel="noopener">commentary this week</a>, S P Kalaunee of Nyaya Health, an NGO that helps the government manage hospitals in Achham and Dolakha, presents a proven 60:25:15 formula of health insurance. In this arrangement, non-profits, the private sector and all three levels of government can make medical care affordable to all Nepalis, if upscaled. Under the scheme, 60% of the cost of care comes from insurance, provincial governments pay 25% and municipalities take care of the remaining 15%.Parts of the scheme are being tried out in <a href="https://www.nepalitimes.com/banner/this-is-how-to-upgrade-nepals-rural-health/" target="_blank" rel="noopener">Bayalpata Hospital in Achham</a> (which last week <a href="https://www.nepalitimes.com/banner/bayalpata-hospital-in-nepal-wins-global-design-award/" target="_blank" rel="noopener">won the Global Architecture Festival award</a> in Amsterdam for its design). Insurance reimbursement covers the cost of insurance-covered care, the local government allocates funds required for basic and emergency healthcare, and the provincial government pays for managing the cost of referrals beyond insurance coverage. Internationally, this has become an issue with 12 December marked as Universal Health Coverage Day.Nepal’s constitution now guarantees basic and emergency healthcare as fundamental rights of citizens, and puts the responsibility on to the state. The government  can no longer keep passing the buck on providing universal insurance for its citizens.<h2>10 years ago this week</h2>Nepali Times <a href="http://archive.nepalitimes.com/issue/480" target="_blank" rel="noopener">issue #480 of 11-17 December 2009</a> carried an <a href="http://archive.nepalitimes.com/news.php?id=16572#.XfId7ZMzaUk" target="_blank" rel="noopener">interview on page 1 with Baburam Bhattarai</a>, who was then vice-chair of the Maoist party.  Excerpts:‘From the very beginning, we have said that the basis of the federal system should be nationality. In Marxist terms, nationality means a common language, geography, economy and psychological make-up. A group of people that shares these qualities is called a nationality.<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108151120/636a66769c7e80680e059981jpeg.jpg" alt="" width="392" height="600">On this basis we have proposed to constitute federal autonomous units in Nepal and we also practised this during the People’s War. Since the very beginning we have been consistent that federalism should be along the lines of nationality.’

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POOR HEALTH MAKES NEPALIS POORER

https://www.youtube.com/watch?v=qYrj1Et-9PkSir Jeremy Farrar is a British medical doctor and researcher with 30 years of experience in tropical and infectious diseases. In 2013, he was appointed director of the Wellcome Trust, one of the biggest global charities working in medical research. Nepali Times caught up with Farrar this week in Kathmandu, a place he visits often. Excerpts from the conversation:Nepali Times: What explains your interest in Nepal?Jeremy Farrar: I first came to Nepal in about 1989 or 1990. Since then, I have been working mostly on infectious diseases but increasingly on non-infectious diseases. I spent 18 years in Vietnam and moved back to London 6 years ago. I'm interested in where there are inequitable challenges of health, which I can see getting worse than better, and I think science as part of society can make a difference, and all of that is true in Nepal.You were with Oxford University collaborating with Patan Hospital.Most of my work was based on typhoid in Vietnam and Dr Buddha Basnyat of Patan Hospital quite rightly termed South Asia as the ‘capital of typhoid’. The burden of typhoid in this part of the world is massive. So in 2004 I came here and started a partnership that has been ongoing for the last 15 years. It started with typhoid, but now it has branched out to include other infections particularly important in Nepal.Since you started coming to Nepal how has the health situation here changed?In some ways Nepal is a microcosm of all of the changes that are happening in low and low-middle-income countries. <a href="http://archive.nepalitimes.com/news.php?id=12158#.Xa_yEZIzbIU" target="_blank" rel="noopener">Nepal is still struggling with the burden of infectious diseases </a>but it is now also having to deal with the double whammy of infectious diseases that have not disappeared and the increasing burden posed by non-communicable diseases. The real problem for countries such as Nepal is dealing with both at the same time, and those require quite different public health measures, and require governments to make informed, evidence-based policy decisions.Read also:  <a href="http://archive.nepalitimes.com/news.php?id=17306#.Xa_yFZIzbIU" target="_blank" rel="noopener">Myadhe joro aka typhoid fever</a>, Buddha Basnyat<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108141156/636a60b19c7e80680e056e92jpeg.jpg" alt="" width="1500" height="1000"/><figcaption>Photo: Sonia Awale</figcaption></figure>We just suffered an unprecedented dengue epidemic in Kathmandu.  Dengue is the infectious disease of the 21st century because it is driven by all of the changes we are going to see: environment change, climate change, urbanisation, travel and movement of people and therefore vectors. <a href="https://www.nepalitimes.com/banner/mosquitoes-move-up-mountains-as-the-earth-warms/" target="_blank" rel="noopener">Cities like Kathmandu are perfect breeding grounds</a> for the Aedes mosquito. Kathmandu's climate is changing, the city is growing exponentially in a haphazard way and the mosquito loves highly dense populations of people. If you put together environmental and climate change and the mosquitoes gradually spreading further north from India into the Tarai and increasingly into Nepal, it's inevitable that Kathmandu and the lower lands of Nepal will suffer from dengue outbreaks.Read also: <a href="https://www.nepalitimes.com/here-now/climate-health-emergency/" target="_blank" rel="noopener">Climate-health emergency,</a> Sonia AwaleOn top of these, we still have TB and leprosy.In my professional career of 35 years I have never been more optimistic about <a href="https://www.nepalitimes.com/banner/nepal-tb-cases-grossly-underestimated/" target="_blank" rel="noopener">tuberculosis</a>. If you take the big three infectious diseases of the world (TB, HIV, malaria), in 30 years HIV has gone from being a death sentence in a few week after diagnosis to a difficult disease but one you can manage long term. In the last 20 years there has been amazing progress in malaria with insecticide-laced bed nets and the Chinese herbal drug called Artimisinin, the most important malaria drug ever invented.TB has not made that much progress. We are still using a diagnostic test invented in the 19th century. There has been no new tuberculosis drug since the last 40 years. We have not really understood how it transfers from one person to another. But that is being transformed. With the coming of a new pipeline of drugs that are now being used in South Asia and sub-Saharan Africa, the treatment period will shorten, making it much easier. But perhaps more important than that, for the first time there is the possibility of a tuberculosis vaccine that will prevent infection and disease. We have to make sure that it gets developed properly, then manufactured and made accessible in an equitable way at a price that is affordable for everybody.Read also: <a href="https://www.nepalitimes.com/banner/tb/" target="_blank" rel="noopener">TB</a>, Sonia Awale<a style="background-color: #ffffff; font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/banner/for-nepal-a-game-changer-in-tb-control/" target="_blank" rel="noopener">For Nepal, a game-changer in TB control</a>, Buddha Basnyat and Maxine CawsWellcome Trust is also involved with snakebite research. What are the real problems tackling this?Snakebite is the biggest disease nobody has heard of. It affects mostly impoverished people in rural communities who have no political voice. <a href="https://www.nepalitimes.com/here-now/snakebite-is-treatable-no-one-need-die-from-it/" target="_blank" rel="noopener">Snakebite treatment</a> is still using 19th century or early 20th century interventions, which are expensive to produce, difficult to access and not available to those who really need them. If people are bitten in low or low-middle income countries, chances are they will never get treated. We are interested in bringing in technologies that have been used in cancer and infectious diseases to produce a treatment that counteracts the snake venom.Read also: <a href="https://www.nepalitimes.com/banner/hisss/" target="_blank" rel="noopener">Hiss</a>, Sonia AwaleIs mental health an area you are working on?In addition to funding discovery science, we have a small number of focused areas, where there has been little progress in the past. Mental health is the next one we are launching. Mental health has not attracted much investment or young people interested in working on it, and it's often placed into different parts of the health system with separate hospitals. Mental health still caries enormous stigma everywhere in the world. So we've not had the investment in science, public health and in clinical care of people, and we haven't had the advances in prevention and treatment. This is not only a health issue but also of social justice and economy. Working in collaboration with various partners we are trying to transform mental health from being an issue of stigma and no progress to one that people are willing to talk about, that becomes a normal part of society and where we make scientific and health progress that will reduce the burden of this massive problem.

“Nepal is a microcosm of all of the changes in world health”

Typhoid is just another part of Nepal’s adventure tourism package<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221104141144/6365176d9c7e80680e02c277jpeg.jpg" alt="" width="800" height="1203"/>There is never a good moment to contract typhoid, and I’ve had it three times in Nepal. With a two-week incubation period, many different strains, and highly contagious through shit and spit, I never did work out where I picked it up each time.The first was on a 1985 recce, a trek that turned out to be the nascence of the <a href="http://archive.nepalitimes.com/article/Nepali-Times-Buzz/annapurna-base-camp,3697">Annapurna</a> Conservation Area Project (ACAP). It is humbling to find that you cannot put one foot in front of another, especially when hiking with super-scientists Roger Payne (whales), Iain Douglas Hamilton (elephants) and Bruce Bunting (WWFUS).We had been despatched on our mission by Nepali conservationist Hemanta Mishra who went on with others to push through the ground-breaking ACAP idea. Nepal’s conservation areas and especially Annapurna are still cited as a world model of how a nationally protected park managed by local communities can become self-supporting through tourism.Iain and I were climbing the Landrung hill through sunny terraced fields when the fever hit. One minute I was fine, and the next I was shuddering with sweat and dazed with weakness. Every step was an effort and the afternoon sun sheered into my eyes.“If this was Kenya I would suspect bilharzia or yellow fever,” Iain declared unhelpfully. He supported me safely home, peering with puzzled concern through heavy horn-rimmed glasses. Despite a variety of antibiotics the fever lasted 16 days, debilitating limbs, sapping the soul, the mind teetering on the edge of delirium. It took me weeks to find the strength to walk across my tiny garden, and many months before I recovered normal energy levels.Nearly ten years later I caught a lighter bout in Kathmandu and lay shivering in our Maharajganj house trying to get better quicker by enforced rest, gripped by the first Poldark video series about glamorous smugglers along the Cornish coast. It was 1994 and I needed to regain my strength fast as I was due in Kyrgyzstan -- tourism colleague Oliver Bennett of Deloittes was relying on me for a government tourism marketing strategy.Oliver was an old school consultant, always dressing as though in his native city of London -- to my certain knowledge wearing pinstriped suits on every mountain, lake and beach assignments.The shortage of fuel in post-Soviet Kyrgyzstan meant the Bishkek airport was closed. Instead, battling weakness, I flew to Tashkent and was driven 12 hours through breathtakingly remote country by a couple of nuclear physicists who needed to make a buck – the economy was a shambles and I never met a single Kyrgyz who did not long to be back in the USSR.Nurturing my strength and thanks to Oliver’s protection, I managed to struggle through. Part of our brief was ecotourism training sessions with the budding Kyrgyz private sector. Emerging from the Soviet system, they had trouble with the concept of capitalism, enquiring with all seriousness whether their companies were permitted to make a profit.Exploring the historic Silk Route attractions of Kyrgyzstan, the hooves of Genghis Khan’s invaders could be readily imagined hammering across the open grasslands. We sampled Issikul Lake mineral treatments, formerly reserved for the communist elite, pummelled by fierce ladies in white coats with strong fingers.In woodland dachas, as guests of friendly mountaineers trying to start adventure travel businesses, we drank vodka in fragrant saunas.We marvelled at ancient engraved marker stones and discussed snow leopard viewing with Elburz mountain smugglers. I galloped knee to knee down a verdant valley with the gallant EBRD client Khalid after milking mares with yurt-dwelling nomads. At the evening feast Oliver, squatting in his crumpled suit, had to cope with the prized sheep’s eyes. I was disdained having asked one brightly clad nomad lady how long her child had been riding horses -- since birth, of course.By the third attack I thought I was getting used to typhoid. This time was in <a href="http://archive.nepalitimes.com/article/Nepali-Times-Buzz/Mustang-in-march,2108">Mustang</a> with a group of down-under friends on a 2008 circuit of the trans-Himalayan high spots around Lo Manthang. We had hoped to circumambulate Mount Kailash so it was a compromise, defeated by the fluctuating vagaries of Tibetan visa policy.They were an experienced bunch, and loved the rugged walking and splashed ochres of Mustang’s grandiose scenery (photo, left). We had happily negotiated sheer drops to view prehistoric paintings, explored ancient stupas within a cliff-face cave, avoided charging thar on a steep hillside, and even glimpsed a pair of snow leopards on a distant ridge – or so the excited horsemen assured us.I was zigzagging up the dusty trail to Tsarang, having linked arms to cross the flooded river in our boots, and couldn’t understand why my unwilling feet suddenly had no energy. Highland Doctor Jamie was waiting for me at the top. “I’m all right,” I protested.“No you’re not.” Jamie’s Scottish lilt was emphatic. “Looks like typhoid to me and we can’t risk waiting for a helicopter.” For the next three days back to <a href="http://archive.nepalitimes.com/article/Nepali-Times-Buzz/going-to-jomsom-in-the-off-season,3878">Jomosom</a> he followed my pony closely as I swayed precariously in the saddle, helping me stagger into my tent at night. Haggard, dusty and sweat stained I remember little of the flight to Kathmandu, and this time was hospitalised on a drip, and instructed to stay in bed for days. I did not demur, and can confirm first hand that compulsory rest is the best road to recovery.Read also:<a href="http://archive.nepalitimes.com/article/Nepali-Times-Buzz/annapurna-base-camp,3697">Fully booked in the sanctuary</a> ,  Shreejana Shrestha<a href="http://archive.nepalitimes.com/article/Nepali-Times-Buzz/Mustang-in-march,2108">Mustang in March</a>,  Cynthia Choo and Kenji Kwok

Lisa Choegyal

Infectious enthusiasm for travel

The daily 10-hour curfew at Tribhuvan International Airport from 8 November that will last five months has affected tourism during Nepal’s peak season, with some hotels and trekking agencies here reporting cancellations into spring next year. The reduced hours at Nepal’s main aviation gateway till 31 March means that a third of all flights have been cut. This has also caused ticket prices to surge by up to eight times of normal fares. For example a Kathmandu-Delhi ticket that used to cost Rs12,000 is now listed at Rs50,000, and even then seats are not available.&nbsp; “Especially if they are here to trek, change in flight dates can cause tourists to miss their connections,” says Jagan Timilsina, who runs a trail running and outdoor education business. &nbsp; Pokhara is feeling the brunt as hotels report last-minute cancellations for November because of flight disorders. Some hoteliers also say although there have been some cancelled trips, most itineraries have been rescheduled.&nbsp; Hari Prasad Sharma Gaire of the local chapter of the Hotel Association of Nepal says the Kathmandu airport closure should have been timed for the off-season. He told us: “Starting construction during the peak tourist season was a mistake and will cause the tourism industry to lose a lot of business. The upgrade could have been spread out over a longer time but closed for fewer hours at night so that disruption was minimal.”&nbsp; Nearly a third of the 1.2 million tourists who visit Nepal annually come to Pokhara, which is also the gateway to Mustang, the Annapurna treks and pilgrimage tourism to Muktinath. Located by scenic lakes with a range of adventure sports like hot air ballooning, paragliding, canyoning, bungee and ziplines, Pokhara is also popular among diaspora Nepalis. “Besides its own attractions, Pokhara is really the hub for central Nepal, and we have been trying to get visitors to extend their stay here,” says Timilsina, who started out as a trekking porter and rose up the ranks to be an expedition guide and entrepreneur. &nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2024111603114_0e071ce63ea9b0a9a7ee76f8c3cea0ff08c6767c41dd09f6bc4413d2db067a60.jpg" data-media-id="editor_0" data-image-id="2024111603114_0e071ce63ea9b0a9a7ee76f8c3cea0ff08c6767c41dd09f6bc4413d2db067a60" data-rendition-name="original" width="3500" height="2333" loading="lazy" alt="Pokhara's tourism woes NT"> <figcaption>Tourist arrivals in Pokhara have slumped since the disruptions at Kathmandu airport due to upgrading work. Photo: KRISHNA MANI BARAL/NEPALI TIMES ARCHIVE</figcaption> </figure>  Even without the Kathmandu airport closure affecting tourist arrivals, Pokhara was already suffering from a decline due to many factors like the poor state of the Prithvi Highway, the shortage of luxury accommodation for high-end tourists, and the reluctance of international airlines to start direct flights to Pokhara despite an expensive new airport that was inaugurated two years ago.&nbsp; “There was a lot of initial excitement on the construction of the international airport,” says Timilsina, “but it hasn’t delivered as expected due to politics. People have invested in nearby businesses, and have faced losses.” India has blocked direct flights from its cities to Pokhara because the facility was built by a Chinese company. Although tourists and pilgrims from India hit record levels this year, the poor state of the highways and the Indian bus accident on the highway to Kathmandu in July that killed 27 pilgrims from Maharashtra state dampened arrival figures. Gaire says, “While tourist arrivals to Pokhara are now approaching pre-Covid levels, we haven’t seen the improvement we were expecting. We need a better marketing strategy. What are our embassies abroad doing?”&nbsp; Indeed, Pokhara used to be a favourite destination for Chinese tourists. There was a boom in arrivals from China before Covid, especially after a popular Chinese tv serial was shot on location here. But arrivals from China have not really recovered since the pandemic because of the economic slowdown there. Promoting Pokhara airport to handle direct flights from Chengdu or Kunming could revive Chinese arrivals.&nbsp; Nepal’s Civil Aviation Authority (CAAN) has used the Kathmandu airport closure as an excuse to arm-twist international airlines to start flying to Bhairawa, which has barely been in operation for two years since it was inaugurated. So far, Fly Dubai, Thai AirAsia, Jazeera and Qatar are flying to Bhairawa, but most use it as a hop before flying on to Kathmandu, which does not reduce congestion at Kathmandu.&nbsp; An ideal situation could have been to get Pokhara to run to full capacity while Kathmandu is partially out of action. Pokhara entrepreneurs are puzzled why the CAAN and the national government have not taken more interest in promoting Pokhara as an alternative to reduce the congestion in Kathmandu. Nepal’s football team that was flying to Dushanbe this week couldn’t get tickets via Delhi, and took a domestic flight to Bhadrapur, crossed over to Bagdogra and flew on to Delhi to catch their flight to Tajikistan.

Pokhara’s tourism woes

An excerpt of a conversation between an anthropologist and linguist Mark Turin, PhD and Lava Deo Awasthi, PhD, the first Chairperson of the Language Commission of Nepal. Nepali Times: What is the role of Nepal’s Language Commission and when was it formed? Lava Deo Awasthi: The Constitution of Nepal (2015) created a Language Commission (LC) with the following four core mandates: (a) to develop eligibility criteria for gaining status as an official language and offer recommendations to the Government of Nepal about the official language(s) in each province; (b) to offer recommendations to the Government about measures to be taken for the conservation, promotion, and development of languages; (c) to suggest possible ways of using mother tongues in education by assessing their stage of development; and, (d) to conduct studies, carry out research and perform monitoring functions about the response to the constitutional provisions for the federalisation of languages in Nepal. The Commission was founded in 2016 and I was appointed as the Chairperson of the Commission in September of the same year by the Cabinet of Ministers. What in your own professional and educational background helped to prepare you for the role? I have worked with the Government of Nepal for about 30 years, alongside holding teaching appointments at universities in Nepal. Prior to assuming the role of the Chairperson of the Commission, I served as permanent Secretary to the Government of Nepal and worked as the Chief Administrator of the Central Development Region. I was appointed as Director General of the Department of Education and completed my assignments as Joint Secretary at the Planning, Monitoring and Educational Administration Divisions of the Ministry of Education.&nbsp; In addition, I have taught courses as a visiting professor at Tribhuvan University and Kathmandu University for more than three decades. Later, I also started supervising MPhil and PhD students at the Far Western University in Mahendranagar, Kanchanpur. My PhD project from the Danish University of Education was dedicated to making sense of Nepal’s social construct and commitment to multilingualism, exploring the persistence of monolingual school practices in the face of constitutional promises and state commitments to multilingualism. I conducted a survey of Nepal’s languages and carried out a qualitative study of the Tharu language in the district of Bardia. I analysed language policy statements and explored classroom pedagogies in schools. I documented how teachers showed a tendency to resist change and maintain the status quo because they were not consulted when new educational language policies were introduced. Teachers also exhibited a deeply-held adherence to the Gurukul education system which appears to have been harnessed as a way to resist newer pedagogical ideologies imported from the West. Recognising how engrained these rich traditions of knowledge transmission are, I wanted to know how students’ engagement in the learning process appeared to have dwindled, creating a gap between children’s home languages and the language(s) of the school. Whilst statutory provisions for education in the mother tongue were oriented towards promotion, classroom pedagogies remained resolutely monolingual and exclusionary. The result was that multilingual education policies that had been introduced in Nepal did not result in meaningful changes in classroom practices. My research was also a reflection of childhood traumas I had experienced at the earliest stage of formal education. My home language, Baitadeli, has a strong oral tradition and no written literature. English is my fifth language in terms of exposure and competence, and my home district of Baitadi is well-known for its loyalty to the local language. I had to drop out of school after completing my sixth grade. Staying at home, I received much attention from my family and had much greater exposure to my native language, culture and environment. My overall impression is that dropping out of school had a surprisingly positive impact on my life. The opportunity offered a surprising dividend for me as I gained mastery in my mother tongue and received extensive exposure to folk literature and Indigenous knowledge and survival skills, cultivating my interest in language, culture, literature and local cosmologies.&nbsp; Now that I reflect on it, I appreciate how language has always played a key role in my life. I grew up in a multilingual environment: brought up with Baitadeli, Hindi, Sanskrit, Nepali and English. Language played a major part in my decision to leave school and my later success is closely linked to my competence in several languages. It was rewarding to be at home with my family as I deepened my understanding of native language and culture, which in turn helped me to harness and refine my art of living. Languages matter so much to me because they are both software and hardware. Later, when I was in secondary school, I realised that my command of my home language contributed significantly to enhancing my Nepali and English. I used my mother tongue as a form of linguistic capital to strengthen my competence in both English and Nepali.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2024111811110_5400ba54792bf9e4854e1c1effde8bf09804e99647f23513700b450cc49adc4a.jpg" data-media-id="editor_0" data-image-id="2024111811110_5400ba54792bf9e4854e1c1effde8bf09804e99647f23513700b450cc49adc4a" data-rendition-name="original" width="1000" height="1500" loading="lazy" alt="Dr Lava Deo Awasthi"> </figure>  In your term as the Commission’s first Chairperson, what were your strategic goals and objectives? My first strategic goal was to create an environment conducive to implementing the provisions of the Constitution of Nepal in relation to language. My priority was to prepare a detailed action plan for my six-year tenure in consultation with language stakeholders, including language experts, professionals, activists, Indigenous community members and representatives of relevant national and local-level institutions. The Commission formed a body of high-level advisors to ensure that the Chairperson’s work was well-informed and credible. The advisors to the committee had highly visible professional and social reputations in Nepal and had much experience in the field of language conservation, promotion, research and development. Another strategy we adopted was to establish close institutional linkages with federal, provincial, and local level governments for collecting opinions and disseminating information widely.&nbsp; What critical issues did you have to consider while discharging your duty? When Nepal’s new Constitution was drafted, a number of concerns could not be adequately addressed. These related to the conservation of languages, the recognition of official languages at the provincial level, and the use of mother tongues at federal, provincial, and local levels. These unresolved issues and matters pertaining to the federalizsation of Nepal’s languages were passed on to the Language Commission to address and resolve.&nbsp; Regarding the recommendations for official languages, a five-year timeline had been set by the Constitution. With great effort, we succeeded in having all provinces agree to recognise their official languages as per the recommendations of the Commission.&nbsp; What were your greatest achievements during your term? One of the greatest achievements was that we succeeded in setting a language agenda at all levels. Nepal’s language communities and other stakeholders expressed the view that this was the first time their languages were recognised and their voices heard by the state. People participated in debates and discussed issues relating to language that in all likelihood had never before happened in their lifetimes, at least not in ways that were supported by the state. We encouraged people to speak in their own language(s) and provided translators during plenary sessions and group discussions. Another major achievement was developing criteria for the status planning of languages at federal, provincial, and local levels, and to recommend 11 province-level official languages, in addition to the Nepali language. Similarly, a notable achievement was recognising Indigenous languages spoken by smaller communities, all of whom faced ongoing marginalisation and high levels of endangerment. The Commission identified 9 new languages that had not been reported in the 2011 census, and provided a framework for recognising official languages within a municipality. The commission emphasised the need for documentation and digitisation of languages for developing corpora and archives at national and sub-national levels.&nbsp; Languages of historical importance as well as classical languages were given recognition for their protection, growth, and development. Recommendations were made for the conservation, promotion and development of Nepal’s marginalised languages that are threatened by majority languages and for those languages that hold particular power at local and global levels. Recommendations were also made for how best to safeguard Nepal’s languages from the ever-growing spread of English and other powerful, globalising languages.&nbsp; A further important aspect of the Commission’s work was to emphasise mother tongue medium instruction in schools across the nation. Recognising the role of language in children’s cognitive, socio-emotional and academic development, the Commission suggested strategies for linking schools with ward-level language clusters for use in the classroom. The importance of nurturing and respecting a child’s first language was reiterated in the Commission’s recommendations for children’s learning and all-round development. By the end of my term, a remarkable change could be observed in terms of building trust within and across Nepal’s diverse language communities. A network of language groups and stakeholders across the country proved to be a powerful way of bringing all language communities under one roof for a collective review of and response to the process of federalising language policy. The many language stakeholders across Nepal appreciated the opportunity to work within a coordinated framework, and—feeling empowered by this—seemed genuinely enthusiastic about the initiatives taken by the Commission.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2024111811114_b45297fdd2fedf17bdb6313e495a1062c0d87f1a19fa5349f871f220b75f93ab.jpg" data-media-id="editor_1" data-image-id="2024111811114_b45297fdd2fedf17bdb6313e495a1062c0d87f1a19fa5349f871f220b75f93ab" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="Dr Lava Deo Awasthi NT"> </figure>  What were the most significant challenges for you as Chairperson? One of the major challenges was winning people’s trust in advocating for the mission of the Language Commission. I faced considerable resistance as I sought to emphasise the use of native languages in families and communities. While the Commission advocated for multilingualism and promoted linguistic diversity, the prevailing policy circles and central level institutions had been deeply influenced by a one-language discourse and ideology of Nepali only. The spread of English also poses a huge threat to Nepal’s languages. However, people in power do not seem to see this as a problem. They tend to abandon their own languages in preference for English. The way that Nepal’s municipalities are increasingly introducing English as a medium of instruction at the earliest stage of a child’s school-based education has proven to be detrimental to their cognitive development, socio-emotional wellbeing and academic success. Most of Nepal’s elites have been heavily influenced by the spread of English and remain unaware about its impact on their home languages as well as on the inter-generational transmission of Indigenous languages in the country. I wish that we could have produced more compelling evidence to show the consequences of making poor policy choices for our children’s education. Demystification calls for a collective response. To make change happen across this entire, complex and federalising country was daunting work and left like a race against time. I feel that I could have done more to offer concrete examples in favour of using the mother tongue as a medium of children’s education at the earliest stages of a child’s education. What do you see the Language Commission achieving in the next 5-10 years? The Language Commission will have to ensure that all of its key recommendations are implemented at all levels of government. In 10 years’ time, all seven of Nepal’s provinces will have their official languages in place. These languages will also be recognised as languages of federal business, alongside Nepali. I anticipate that all official languages in the federal and provincial systems will have a national portal for inter-language corpora using machine translation to fulfil their federal, provincial and local level language functions, and that all languages spoken in Nepal will be represented through a digital database in the national archive. The Office of Statistics will monitor the status of Nepal’s languages over time. By the end of the next decade, each municipality in the country will have recognised one or two official languages at the local level, based on speech populations. Other local languages will have received community-level legal recognition and official status to fulfil their functional roles. Languages that are highly endangered or at risk will be entitled to receive state grants for enhancing local level capabilities to encourage families and young learners to speak the language. Incentive schemes will be introduced in municipalities that promote language within the family and at home. Inter-generational transmission of languages will have received welcome and timely attention across Nepal. It is my hope that all schools—public and private—will have introduced mother tongue medium instruction at the earliest stage of school education, at least up to class five. Nepali, English and other national as well as classical and foreign languages will be taught as subjects. The existing policy of English medium education at the early stage of education will be abolished. The Government of Nepal will be held accountable if the number of speakers of any language decreases or if local communities face language loss and greater endangerment. Under the aegis of the Language Commission, a Centre for Language Research and Innovation will be created with world-class facilities for language documentation and archiving in collaboration with Tribhuvan University’s Central Department of Linguistics and other relevant institutions. Harnessing the vastness of Nepal’s linguistic diversity, the Language Commission will morph into a centre of excellence for national and international communities to engage in collaborative language research, to share experiences and document best practices at in service of global linguistic diversity and Nepal’s many Indigenous languages.

Languages are both software and hardware

Turkish Airlines has introduced a new amenity kit collection designed in collaboration with French fashion house Lanvin for international business class passengers on flights more than five hours. It consists of five pieces designed for sustainability and elegance. Bags are reusable and will consist of Lanvin cosmetic products like hand and body lotions and lip balm. Eye masks and socks are made from recycled materials, earplugs are packaged in paper and the toothbrush is bamboo.

Turkish amenity kit

Earlier this month, Nepal received Rs1.6 billion from the World Bank as part of its <a href="https://nepalitimes.com/news/will-nepal-ever-be-paid-for-saving-trees">Forest Carbon Partnership Facility (FCPF)</a>, rewarding the country for increasing its carbon sink capacity. Nepal is the first in South Asia to benefit from this facility, and it is specifically to recompense the country for increasing forest cover in 13 Tarai districts between 2018-2024. “We are also trying to get another Rs13 billion from the facility while also preparing for free market-based carbon trading in the international market,” says Nabaraj Pudasaini of the REDD (Reducing Emissions from Deforestation and Forest Degradation in Developing Countries) Implementation Centre. Big emitters of greenhouse gases are under pressure to reduce their carbon emissions, and many have signed agreements to do so by investing in decarbonisation projects in developing countries. Countries that emit more than a specified amount of carbon would be able to buy emission rights from countries that emit less. Nepal is internationally known for its community forestry program which has been largely credited for <a href="https://nepalitimes.com/banner/tree-mendous">increasing tree cover to over 45%</a> in less than three decades. But this achievement had not been adequately recognised or rewarded internationally before. Forests, especially in the tropics, absorb and store large amounts of carbon while releasing oxygen in a process known as photosynthesis. <a href="https://www.fao.org/forest-resources-assessment/en/">Preventing deforestation</a> and increasing canopy cover is considered a much more achievable goal than reducing emission in the scale necessary to limit global average temperature to 1.5°C above pre-industrial levels. COP11 in Montreal in 2005 first proposed reducing carbon emissions by improving forest quality by halting degradation. By 2015, a new mechanism of financial assistance was created to help less developed countries with sustainable management of forests <a href="https://www.un-redd.org/">(called REDD+)</a>. Under this new mechanism, countries receive aid based on their efforts to prevent forest degradation and increase carbon sink, and in 2021 the World Bank was entrusted with implementing it. Nepal’s FCPF receipt this month was calculated on the basis of 2.4 million tons of carbon stored at a rate of $5 per ton. In the second phase, Nepal will receive more than Rs4 billion within the next year for storing an additional 7 million tons of carbon. Eighty per cent of this amount obtained from carbon trading needs to be spent on local beneficiaries and indigenous communities.&nbsp; But carbon trading is not easy, Nepal needs to prove that protected forests will not be destroyed in future.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241121091132_c8a381c9a95aa86fec558951650d97bb87914741f01766982ba2b086af001f16.jpg" data-media-id="editor_4" data-image-id="20241121091132_c8a381c9a95aa86fec558951650d97bb87914741f01766982ba2b086af001f16" data-rendition-name="original" width="1500" height="999" loading="lazy" alt="Greenbacks for greenery NT "> <figcaption>Photo: KUNDA DIXIT</figcaption> </figure>  Explains carbon trading expert Yugan Manandhar. “Forests should be handed over to the community and shown that they are managed sustainably. Proving this will be particularly challenging; forest encroachment and degradation is rife in the Tarai.” <a href="https://nepalitimes.com/multimedia/nepal-is-going-up-in-smoke">Deliberate forest fires</a> have also added to the challenge because they increase carbon emissions and reduce the sink capacity of forests. The basis for the amount that Nepal received was set five years ago by calculating the carbon reserves of forests in the 13 Tarai districts. In the meantime, sustainable forest management, tree plantation, forest destruction and erosion control were prioritised to increase carbon reserves in those forests. Nepal is signing another carbon trading agreement during the ongoing Baku climate conference. The <a href="https://www.leafcoalition.org/">Lowering Emissions by Accelerating Forest finance (LEAF Coalition) </a>proposes to sell the carbon stored in the forests of Bagmati, Gandaki and Lumbini provinces. For this, Nepal signed the letter of intent three years ago at COP26 in Glasgow. The target is to store 70 million tons of carbon in 32 million hectares of forest in the three provinces per which Nepal will receive Rs13 billion in four years at $10 per ton with provisions to increase the rate if various conditions are met. However, the agreement in itself doesn’t guarantee the amount. According to the targets set by Nepal, forest degradation should be stopped and carbon reserves increased by protecting tree cover. Preparations are also underway for clean air carbon trade because it has offset fossil fuel use by introducing 30,000 electric vehicles. Nepal has been selected for the first round to receive $40 million within one and a half years through the Clean Air System of the World Bank. Given that most of Nepal’s energy mix is from biomass, replacing them with electric stoves can significantly improve health by reducing indoor pollution as well as strengthen the country’s capacity for carbon trade. “Nepal's goal now is to sell carbon in the free market where carbon credits are bought and sold based on supply and demand in an open and transparent manner,” adds Pudasaini of the REDD Implementation Centre. “Nepal can now set its own price and bargain with interested buyer countries and organisations.” Lately, India has been discussing setting up a carbon market. Nepal has exported Rs12.72 billion worth of electricity to India so far this fiscal year, which can be traded under Nepal’s carbon market. “Carbon trading can create significant economic benefits for Nepal, which will help reinvest in development and environmental protection projects,” says Manandhar. “But we must prioritise sustainable management of forests, cutting older trees and allowing regrowth as well as promoting electric stoves and electric vehicles.”