<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110161124/636d17de9c7e80680e0ac78djpeg.jpg" alt="" width="1500" height="1000"/><figcaption>Photo: AMIT MACHAMASI</figcaption></figure>A post-graduate student of mechanical engineering Samita Rimal is completing her 14-day quarantine in a hotel in Montreal. Despite being fully vaccinated with VeroCell in Nepal, she now has to take one of the four jabs recognised in Canada.“I wish I had taken J&amp;J before coming here, I just wasted time and money, others like me should really try to find out the exact requirements before leaving Nepal,” says 23-year-old Rimal.Another student preparing to leave for Canada is in a dilemma: should she get a shot of the Johnson &amp; Johnson (J&amp;J) vaccine which is accepted in Canada, or face two weeks of quarantine and further restrictions because the Chinese vaccine VeroCell is not accepted by the Canadian government?“People inoculated with vaccines other than those accepted there are treated as if they are not vaccinated and hence face additional restrictions. I probably won’t be able to attend in-person classes there,” says the 29-year-old.Other students leaving Nepal are also confused because they do not know whether it is safe to mix vaccines accepted in Europe or North America on top of the Covishield or VeroCell vaccines they have taken earlier this year.A year after the first Covid-19 jabs were developed, there are at least 11 different vaccines in use worldwide, and many more are in different phases of trials. Never before has there been as much effort and investment in vaccine development.But this breakthrough in science is not accompanied by a<a href="https://www.nepalitimes.com/opinion/hope-hyperbole-and-hypocrisy-of-covax/"> fair distribution of vaccines</a> around the world,  or within countries. It is usually those with access and reach who are fully vaccinated, and some are even getting <a href="https://www.nepalitimes.com/opinion/to-boost-or-not-to-boost/" target="_blank" rel="noopener noreferrer">booster shots</a> already.<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110161124/636d17e09c7e80680e0ac78ejpeg.jpg" alt="" width="698" height="738">Nepal is currently using three different vaccines: AstraZeneca, VeroCell and J&amp;J. While China is giving Nepal one million doses of its other Covid vaccine Sinovac, the government is set to receive 100,000 doses of Pfizer shots under WHO’s <a href="https://www.who.int/initiatives/act-accelerator/covax" target="_blank" rel="noopener noreferrer">COVAX</a> facility, which requires ultra-cold refrigeration.There are two new jabs under trial in Nepal: a Chinese messenger RNA (mRNA) vaccine, and another developed by Sonafi, a partnership between a French company and UK’s GlaxoSmithKline.Of these only AstraZeneca and J&amp;J are widely accepted in Europe, the US, and the Gulf, which means Nepali students and migrant workers have to bear expensive hotel quarantine costs while missing out on university or work.On the other hand, even as thousands of people get vaccinated each day, the vaccination drive has been <a href="https://www.nepalitimes.com/opinion/giving-all-nepalis-a-shot-at-the-covid-vaccine/" target="_blank" rel="noopener noreferrer">concentrated in the urban centres</a>. This is why it is not surprising that even as half of Kathmandu Valley residents is fully vaccinated, only 22% of Nepal’s total population has been inoculated.Nepalis in the hinterland were already least prioritised by the state, for health, education and basic needs, but extreme climate events due to global warming has <a href="https://www.nepalitimes.com/here-now/at-the-covid-19-frontlines-in-rural-nepal/" target="_blank" rel="noopener noreferrer">added to the pre-existing challenges</a>.“This week in a village in Kailali we met isolated pockets of Tharus and Dalits, most of them unvaccinated,” says epidemiologist Lhamo Yangchen Sherpa. “Because of flash floods, they had no access to healthcare, market or schools, the streets were all flooded and the river had swelled.”Indeed, as Sherpa argues in her <a href="https://www.nepalitimes.com/opinion/giving-all-nepalis-a-shot-at-the-covid-vaccine/" target="_blank" rel="noopener noreferrer">guest editorial</a>, this monsoon rural Nepal was hit by triple disasters: historical state neglect, <a href="https://www.nepalitimes.com/here-now/aid-pours-into-nepal-but-where-be-vaccines/" target="_blank" rel="noopener noreferrer">international apathy</a> with rich countries stockpiling vaccines, and <a href="https://www.nepalitimes.com/editorial/a-flood-of-recrimination/" target="_blank" rel="noopener noreferrer">climate change</a>.  All of this has further magnified the coronavirus crisis in the region least equipped with healthcare infrastructure, and vaccine inequity.Elsewhere in Kathmandu, there is a false sense of security among people who think they are immune against Covid-19 with increasing vaccine coverage. The declining number of daily news cases and deaths have added to the complacency. However, many Kathmandu hospitals still report full ICUs -- mostly occupied but by referral <a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/latest/rural-nepal-fights-back-covid-19/" target="_blank" rel="noopener noreferrer">patients from outside the Valley.</a><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110161124/636d17e39c7e80680e0ac78fjpeg.jpg" alt="" width="650" height="327">The misinterpretation of the recent sero-prevalence study conducted by WHO and the Health Ministry has added to the misconception. The sample survey found that 67% of Nepalis have natural immunity against the virus.But virologists say the test used does not reveal the concentration of neutralising antibodies that fend off the virus in an individual. It does not detect memory T-cells either, which provide crucial immunity against foreign organisms in the body.After six months of Nepal’s vaccination drive, about half of those who had been inoculated have started registering a decline in the level of antibodies. However, this does not always translate into individuals getting infected, as they might still have immunity afforded by memory T-cells.“Given our vaccination coverage and natural immunity mostly against the Delta variant, we can say that there might not be an immediate large-scale surge unless there is a new strain,” says pulmonary specialist at Kathmandu’s HAMS hospital Raju Pangeni. “But we also know that even those vaccinated are not fully protected against the Delta variant which transmits much faster in enclosed spaces.”With the Dasain festival starting this week, people are now leaving for their hometowns, and<a href="https://www.nepalitimes.com/latest/dasain-crowd-unmasked/" target="_blank" rel="noopener noreferrer"> market places are crowded</a>. Parties, meetings and seminars are being held in enclosed spaces, and unvaccinated students are <a href="https://www.nepalitimes.com/editorial/two-schools-of-thought/" target="_blank" rel="noopener noreferrer">packed into classes</a> for lessons before the holidays begin.During Dasain, children and the elderly are at the most risk of infection. While children are entirely unvaccinated, senior citizens even if fully inoculated have weaker antibody responses. This means the mobile younger population that have been vaccinated and hence are asymptomatic even if infected pose severe risks to the vulnerable groups.“We must perform our rituals this Dasain keeping in mind the consequences of our actions, if we are not careful we will be jeopardising the health of our children and parents,” says Sherpa, who works with IPAS Nepal.Experts have now shifted their focus to the post Dasain-Tihar festival season, and upcoming winter months when coronaviruses thrive. Children, elderly, people with co-morbidities, and immune-compromised individuals are at the higher risk.Says Raju Pangeni: “Our priority now must be to vaccinate children across Nepal after the holidays. At the same time, we must also promote influenza vaccines in order to avoid the double whammy of Covid and flu.”

Sonia Awale

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The jabs and jabnots

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110161124/636d17b19c7e80680e0ac780jpeg.jpg" alt="" width="856" height="571"/><figcaption>Kathmandu's Dasain shopping crowd this week. Photo: AMIT MACHAMASI</figcaption></figure>Nearly half of Kathmandu Valley’s population is fully vaccinated against Covid-19, but the national average is only a little over 20%. In essence, this is a microcosm of <a href="https://www.nepalitimes.com/opinion/hope-hyperbole-and-hypocrisy-of-covax/" target="_blank" rel="noopener noreferrer">vaccine inequity seen globally</a> – but it also reflects Nepal’s in-built socioeconomic inequalities.In Asia and Africa, a majority of the population including health workers and the elderly are yet to receive even their first dose. But the US, France, Germany, and Israel are already <a href="https://www.nepalitimes.com/opinion/to-boost-or-not-to-boost/" target="_blank" rel="noopener noreferrer">providing booster shots</a> to their vulnerable populations.On one hand, this is a stark reminder that Nepal is not on the priority of wealthy nations. Just as it was not during the <a href="https://www.nepalitimes.com/banner/the-real-cost-of-nepals-second-wave/" target="_blank" rel="noopener noreferrer">devastating second wave in May</a> when, despite the prime minister and the president calling on foreign governments for vaccine shipments, <a href="https://www.nepalitimes.com/here-now/aid-pours-into-nepal-but-where-be-vaccines/" target="_blank" rel="noopener noreferrer">the response was tepid</a>.On the other hand, the imbalance in vaccine distribution within Nepal is a reflection of long-standing inequities in healthcare services, education, drinking water, and food that predate Covid-19.Despite a federal Constitution that has devolved decisions and delivery of basic services to local governments, it is still Kathmandu that holds the purse strings and power. Isolated and beyond the state’s reach even at the best of times, Nepal’s hinterland this year has been cut off by <a href="https://www.nepalitimes.com/banner/still-chasing-the-melamchi-mirage/" target="_blank" rel="noopener noreferrer">destructive floods blamed on the climate crisis</a>.A village in Kailali with 200 Tharu and Dalit families has been marooned by floods for the past month, where the submerged roads block access to even the rudimentary healthcare available.It is not surprising, therefore, that very few in this village are inoculated. In fact, those who need to be vaccinated the most now face a triple whammy: historical state neglect, international apathy, and now <a href="https://www.nepalitimes.com/opinion/mountainous-regions-face-catastrophic-impacts-without-urgent-climate-action/" target="_blank" rel="noopener noreferrer">climate-induced extreme weather</a>.This in turn has set off a vicious cycle, and the poor are getting poorer. The official death toll from Covid-19 in Nepal is nearly 12,000, but the ‘excess deaths’ that were not counted in remote villages across the country is probably several times higher.An estimated <a href="https://www.nepalitimes.com/banner/helping-nepals-covid-orphans/" target="_blank" rel="noopener noreferrer">1,200 children have become orphans</a> because of the death of one or both parents due to Covid-19. Many of them do not have support for food, healthcare, and education – setting a stage for intergenerational inequity.In Kathmandu and urban centres, on the other hand, there is complacency and false sense of security as <a href="https://www.nepalitimes.com/latest/too-early-for-nepal-to-let-its-guard-down/" target="_blank" rel="noopener noreferrer">the festive season approaches</a>. Unvaccinated children have also started <a href="https://www.nepalitimes.com/editorial/two-schools-of-thought/" target="_blank" rel="noopener noreferrer">attending in-person schools</a>. The Health Ministry’s recent seroprevalence study has revealed that 67% of people have SARS-CoV-2 antibodies, and therefore have natural immunity against the virus. This, combined with half of the valley’s targeted demography being vaccinated on paper, makes a case for a fully immune population.But that is not the case. There is now growing proof that antibodies provided by vaccines wane over time, which means many of us who were vaccinated earlier this year have weaker protection than we think. Only those newly infected with the virus might have sufficient antibodies to fight off the next infection.It is not as important to know what portion of the population has antibodies as to how much of it they have. Vaccinated individuals are less susceptible to hospitalisation, severe symptoms, and death, but they can still be contagious, especially as the <a href="https://www.nepalitimes.com/here-now/delta-variants-wake-up-call-for-nepal/" target="_blank" rel="noopener noreferrer">more virulent Delta variant</a> continues to circulate in the region.The Dasain shopping spree has started, and there are throngs of <a href="https://www.nepalitimes.com/latest/dasain-crowd-unmasked/" target="_blank" rel="noopener noreferrer">shoppers in Asan and other bazar streets</a>. Many have stopped wearing masks, or use them inappropriately. The situation will be worse when Kathmandu residents travel to their hometowns this week. They will be visiting elderly parents and grandparents, exposing vulnerable elderly relatives with lower immunity to the virus.The government is bringing in 100,000 doses of Pfizer vaccines after the festivals, with plans for 10 million more by March. But provincial and district hospitals must have deep refrigeration equipment in place, and make necessary collaboration with private hospitals.To make sure that each Nepali child, even those in remote Karnali, gets <a href="https://www.nepalitimes.com/banner/once-nepal-gets-vaccines-they-need-to-be-fairly-distributed/" target="_blank" rel="noopener noreferrer">a shot at the Covid-19 vaccine</a>, our expansive network of community healthcare workers must be mobilised and, where required, administer vaccines at the household level.Lhamo Yangchen Sherpa is an epidemiologist and a senior research monitoring and evaluation advisor at IPAS Nepal.

Giving all Nepalis a shot at the Covid vaccine

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110141148/636d01119c7e80680e0a360ejpeg.jpg" alt="" width="1313" height="882"/><figcaption>Photo: UNICEF NEPAL</figcaption></figure>In terms of <a href="https://www.nepalitimes.com/opinion/hope-hyperbole-and-hypocrisy-of-covax/" target="_blank" rel="noopener noreferrer">global vaccine equity</a>, the answer to the question of whether it is ethical for rich countries to boost with a third dose of  Covid-19 vaccine, seems like a no brainer.But ethics aside, it has been pointed out that no one is safe until everyone is safe. It is in the public health interest of rich countries to ensure that as many people around the world are vaccinated to <a href="https://www.nepalitimes.com/banner/vaccines-variants-and-a-third-wave/" target="_blank" rel="noopener noreferrer">prevent new variants and spikes</a>.The graph below starkly illustrates the big gap between the jab and jab-nots – showing the wide chasm between rich and poor countries in terms of the proportion of the population which has got even the first dose.Booster vaccination is a moot point for low-income countries because at the moment the option is limited to high- income countries, where some research has shown waning antibody presence and the authorities in the US are advising a third dose eight months after the second one.As of now there is only scant data to show that boosting will help real-life protection in the general population. Clearly the vast majority of the people who received the full dose of approved  vaccines, including the Chinese VeroCell here in Nepal, already have adequate <a href="https://www.nepalitimes.com/banner/behind-the-masks/" target="_blank" rel="noopener noreferrer">protection against severe</a> (as opposed to mild or moderate infections) Covid-19 disease with the present vaccine schedule.Crucially, a strong international drive to vaccinate the unvaccinated could potentially save many more lives than would boost the already vaccinated.But this is a very wily virus which almost overnight changed the rules of the game by mutating into the <a style="letter-spacing: 0.01em;" href="https://www.nepalitimes.com/here-now/delta-variants-wake-up-call-for-nepal/" target="_blank" rel="noopener noreferrer">highly infectious Delta variant</a>. We need look no further than what happened in neighbouring India earlier this year as this variant ripped through the unvaccinated population regardless of herd immunity that was thought to be widespread.Delta surged across the open border into Nepal, where it overwhelmed the country’s inadequate and inequitable health care system. There is credible data to suggest that there might have been 3-5 million excess deaths in India during the second wave.<a href="https://covid19.healthdata.org/nepal?view=cumulative-deaths&amp;tab=trend" data-saferedirecturl="https://www.google.com/url?q=https://covid19.healthdata.org/nepal?view%3Dcumulative-deaths%26tab%3Dtrend&amp;source=gmail&amp;ust=1630901105986000&amp;usg=AFQjCNGVkeZeMBLFWPxAOLd86V8RWL22gQ">Estimates for Nepal</a> by the <a href="http://www.healthdata.org/covid" data-saferedirecturl="https://www.google.com/url?q=http://www.healthdata.org/covid&amp;source=gmail&amp;ust=1630901105986000&amp;usg=AFQjCNG9rCQIZqojh5um31-iM7GlGaMZPA">Institute of Health Metrics and Evaluation</a> of the University of Washington in Seattle show that although the official cumulative deaths due to Covid-19 as of this week was nearing 11,000, the real figure with excess mortality is closer to 40,000.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110141148/636d01159c7e80680e0a360fjpeg.jpg" alt="" width="1774" height="1118"><figcaption> </figcaption></figure>It is among the vast number of the unvaccinated that the virus has a greater chance of randomly mutating and becoming a variant (from alpha to omega and now the mu variant in South America) and potentially spreading worldwide.Every time the virus replicates, its likelihood of mutation increases. The novel coronavirus, unlike the other SARS-CoV-1 from 2003 may not be as keen on killing people as it is in perpetuating infections by replicating as much as possible .After India, the Delta virus affected the UK population in a widespread manner, but there was one huge difference -- in Britain it infected many who had already been vaccinated, even though the severity of the illness was significantly lower in this subset.Hence, as these variants generally develop in the unvaccinated population and some (there are 15 variants at present) turn out like the Delta variant, it would be in the enlightened self-interest of the richer countries to have as much of the world vaccinated as possible so that random mutations and variants will be substantially limited, and will not reach their shores.But such enlightened self-interest seems to be lacking in high-income countries, especially because there are <a href="https://www.nepalitimes.com/editorial/no-vax-ask-for-mask/" target="_blank" rel="noopener noreferrer">not enough vaccines to go around</a>, and rich nations perceive an immediate benefit from boosting.Israel is already giving third jabs and France, UK and the US are strongly considering boosters. Boosting may be a good idea if the Covid-19 vaccine supply was plentiful. But currently the supply is limited and more than half the world’s population has not received even a single dose of the vaccine.Sadly, many in low and middle income countries are waiting for doses through the COVAX facility and drug manufacturers like Serum Institute of India scramble to fulfill previous contracts while grappling with the Delta virus at home.What is even more unconscionable is that many rich countries are throwing away expiring vaccines. And now with new orders for booster vaccination programs from high income countries, the developing world will have to wait even longer to have their contracts filled.With booster doses planned for the rich world, it may indeed be a zero sum game for the world if the supply of the approved Covid-19 vaccines is not dramatically increased. The good news is that Serum Institute of India, where Nepal sourced its first lot of Astra Zeneca Covishield vaccine until the pandemic took a turn for the worse in India, has greatly increased its production capacity.Given the experience of the past nearly two years, most high income countries are likely to ignore ethical considerations regarding vaccine equity and booster doses.Many institutions in the West that deal with global health may be embarrassed about not being able to persuade their governments to put their money where their mouth is and do the right thing.So far, their pleas for <a href="https://www.nepalitimes.com/opinion/global-solidarity-needs-intensive-care-in-pandemic-battle/" target="_blank" rel="noopener noreferrer">vaccine equity</a> have generally been ignored – even though they know an effective global vaccination drive would ultimately benefit them by reducing the risk of new variants emerging.In practice, if the production of vaccines revs up and COVAX is able to ship more vaccines to poor countries, regardless of boosting or no boosting by the richer countries, millions of people in the Global South will benefit.In the meantime, we have to continue to mask up, avoid crowds and sanitise, because the vaccine per se <a href="https://www.nepalitimes.com/opinion/dying-to-get-vaccinated/" target="_blank" rel="noopener noreferrer">will not stop transmission</a>.The other bit of good news is that the Nepal Health Research Council in conjunction with other local collaborators is  sequencing (identifying the molecular structure) of Covid-19 virus samples from various parts of Nepal.The Sanger Center, the world’s premier genomic institute based outside Cambridge in the UK, will validate the results from Nepal and enhance our capacity building in molecular medicine.This should help us in promptly identifying variants of Covid-19 so Nepal can deal with future infectious disease outbreaks in a scientific and orderly manner. <a href="https://www.nepalitimes.com/banner/how-nepal-must-prepare-for-3rd-covid-wave/" target="_blank" rel="noopener noreferrer">Covid-19</a> has emphasised the additional significance of sequencing even for other rampant diseases like  tuberculosis and typhoid in South Asia.Buddha Basnyat is a physician and clinical researcher at Patan Academy of Health Sciences and a <a href="https://www.nepalitimes.com/opinion/what-is-novel-about-the-novel-coronavirus/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/opinion/what-is-novel-about-the-novel-coronavirus/&amp;source=gmail&amp;ust=1630901105986000&amp;usg=AFQjCNH6pJWJpOhLqwh7C7o4x6py0843Jg">frequent health columnist</a> for Nepali Times.

Buddha Basnyat

To boost or not to boost

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110151120/636d08aa9c7e80680e0a602ejpeg.jpg" alt="" width="1500" height="1000"/><figcaption></figcaption></figure>The Covid-19 pandemic has now killed more people than the devastating 2015 earthquake. Officially, over 9,700 Nepalis have died due to the coronavirus in the past year and a half, but the<a href="https://www.nepalitimes.com/latest/nepal-covid-19-impact-worse-than-official-figures/" target="_blank" rel="noopener noreferrer"> real figure</a> is said to be at least three times more.At a glance, it seems that densely populated urban centres with the most infections have <a href="https://www.nepalitimes.com/editorial/the-covid-tsunami/" target="_blank" rel="noopener noreferrer">recorded the highest fatalities</a>. But analysing the available government data shows that the fatality rate among infected patients is higher in <a href="https://www.nepalitimes.com/latest/rural-nepal-fights-back-covid-19/" target="_blank" rel="noopener noreferrer">remote areas of the country</a>.In Bagmati province, of every 1,000 Covid patients, 11.9 individuals have lost their lives, but it is 21.1 in Karnali Province. District-wise, Kathmandu saw 9.1 deaths per 1,000 cases while Mustang recorded a whopping 111.9 fatalities per 1,000.Public health experts blame limited health care facilities in rural Nepal including ICUs, ventilators, drugs and oxygen for Covid-19 treatment for this huge discrepancy. They also have notably fewer doctors, nurses and other paramedics.“A majority of coronavirus patients recover but most of those who died did not survive because of the <a href="https://www.nepalitimes.com/latest/why-is-there-still-an-oxygen-shortage/" target="_blank" rel="noopener noreferrer">lack of medical oxygen</a> and this is also largely due to uneven distribution of health infrastructure,” says Bijay Acharya of the Massachusetts General Hospital, also associated with the US Nepal Health Foundation.He adds: “In many places, patients have died on their way to hospitals or while being moved from one to another. Many more people in the villages have likely passed away unable to access the treatment.”Binita Adhikari, a public health specialist affiliated with the Health Nepal Foundation and the Johns Hopkins Bloomberg School of Public Health agrees. “The fatality rate is high in remote Nepal also because many people who need treatment never reached the hospital. The Covid-19 outcome depends on how soon a person is diagnosed, hospitalised and receives treatment,” she says.The fact that the entire<a href="https://www.nepalitimes.com/here-now/at-the-covid-19-frontlines-in-rural-nepal/" target="_blank" rel="noopener noreferrer"> Karnali Province</a> has only two functional laboratories for Covid-19 testing (Karnali Academy of Health Sciences in Jumla and Surkhet’s Provincial Hospital) means that official figures for total cases in the region are largely under-counted. And this could also have made the fatality rate among confirmed cases higher.<a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/latest/nepals-local-governments-lead-from-the-front/" target="_blank" rel="noopener noreferrer">Poor road infrastructure</a> and having to travel distance, sometimes several days, for diagnosis or to access hospital care also adds to the casualties. This also means additional expenses for the poor.The annual per capita income of people in Karnali is $606, which is nearly half of the national average, and a third of the population there is living below the poverty line. The region’s Human Development Index (HDI) at 0.538 is also much lower than the rest of the country.Even within Karnali Province, the poorest and the most disadvantaged have been disproportionately affected. The coronavirus mortality in Karnali stands at 2.1%, but in remote Dolpo, the figure rises to 7.01%. There is just one ventilator here at the district hospital, but even that is non-functional in a lack of skilled human resources to operate it. There are only two beds with oxygen.Similarly, the fatality rates in Mugu, Humla, Rukum East and Salyan were 6.1%, 5.15%, 4.86% and 4.07%, all much higher than the national average of 1.5%. These are also some of Nepal’s most economically and socially disadvantaged districts. Dolpo’s HDI is 0.4 and Mugu’s 0.39.“It is very likely the total number of people infected and dying of the pandemic in the region is much higher than reported. Much of this is due to continued lack of testing and contact tracing,” says epidemiologist Lhamu Yangchen Sherpa.Director of Teku Hospital at Kathmandu Anup Bastola agrees: “The high fatality rates in <a href="https://www.nepalitimes.com/latest/in-nepal-virus-climbs-from-plains-to-mountains/" target="_blank" rel="noopener noreferrer">remote districts</a> don’t necessarily mean they have more deaths, but that many of them have not had sufficient testing, which means most of the infected people barring those in critical condition didn’t reach us.”It is however clear that regions with good health infrastructure, economically sound environment, and with higher human development index are better placed to save those infected.While Solu, Bhojpur and Ilam saw districts 5.06%, 4.8% and 4.09% of their Covid patients succumb to the disease, Morang, Chitwan and Kaski reported only 1.02%, 1.25% and 1.52% fatality rates respectively. The figure is even lower for Kathmandu at 0.91%.Province-wise, after Karnali, Lumbini has the highest Covid death rate at 1.77%. This is followed by Gandaki at 1.73%, with the lowest being Bagmati (1.19%).There is also a huge <a href="https://www.nepalitimes.com/banner/once-nepal-gets-vaccines-they-need-to-be-fairly-distributed/" target="_blank" rel="noopener noreferrer">disparity in Nepal’s Covid vaccination drive</a>. Of the 1.42 million Nepalis (4.9% of the total population) who have been fully vaccinated, 55.45% of them are from Bagmati Province alone. Karnali accounts for a mere 3.5% of people who have received either both doses of AstraZeneca Covishield or VeroCell or a single shot J&amp;J vaccine.In other words, 14% of Bagmati residents have been fully inoculated versus 3% of Karnali people. The figure is even lower for Province 1, 2 and Far West where 2.4%, 1.71% and 2.78% of their population have been fully vaccinated.However, some public health experts have argued that the vaccination drive when doses are scarce should not necessarily aim right now for equity, but focus on high-risk, crowded cities with mobile populations, and regions along the Indian border.Says Bijay Acharya: “Age alone shouldn’t factor into who gets the vaccine first, economic status and social background should also be taken into account to ensure those other than the affluent also benefit. Areas with a high risk of infection and marginalised communities with poor health infrastructure should be equally prioritised.”Nepal government is in a process procure six million dose of Pfizer vaccines for teenages from 12-18 years of age in the next six to nine months' time. Health Ministry is in the final stages of preparing -80 degree Celsius storage facilities in all seven provinces.Translated by Sonia Awale from the <a href="https://www.himalkhabar.com/news/125201" target="_blank" rel="noopener noreferrer">original in Himal Khabar</a>.

Nepal’s uneven Covid-19 deaths

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110151116/636d07d99c7e80680e0a5fe2jpeg.jpg" alt="" width="2048" height="1366"/><figcaption>Photo: MONIKA DEUPALA</figcaption></figure>The world is at a tipping point in the battle to contain the spread of Covid-19. <a href="https://www.nepalitimes.com/opinion/hope-hyperbole-and-hypocrisy-of-covax/" target="_blank" rel="noopener noreferrer">Countries across Asia are struggling to access vaccines</a> while tens of thousands are dying from the disease. Richer countries are sitting on enough doses to vaccinate their populations many times over.Sharing vaccine doses right now is our best shot if we are to prevent further catastrophe in Asia.Recently the G20 countries with 80% of the world's wealth held a global health summit and called for <a href="https://reliefweb.int/sites/reliefweb.int/files/resources/e006598.full_.pdf" target="_blank" rel="noopener noreferrer">sharing of vaccines and production technology</a> between nations.Pharmaceutical companies made commitments to sell cut-price vaccines to lower income countries. Some companies and countries have offered intellectual property waivers or sharing of technologies on Covid-19 vaccines. The United States and Europe offered to share more vaccines and the raw materials for manufacturing. These are all positive moves. Formany parts of Asia, the burning issue now is speed.Countries with vaccine stockpiles need to sell or share their millions of excess doses either directly or via the <a href="https://www.who.int/initiatives/act-accelerator/covax">global COVAX facility</a> to help save lives in countries experiencing record death rates. And they need to do so as quickly as possible.We only need to look at Britain and the United States to see how mass vaccination can help contain the disease. In the United Kingdom, Covid-19 vaccines have so far <a href="https://www.gov.uk/government/news/covid-19-vaccine-surveillance-report-published/">prevented 13,200 deaths and 39,700 hospitalisations</a> according to Public Health England. In the race against new waves, new variants, and new tragedies, we need such good news at a global level too.<a href="https://ourworldindata.org/covid-cases">Eight of the 10 countries</a> in the world that are seeing infections double the fastest are in Asia and the Pacific. Many of these countries, such as Fiji and Timor Leste have low vaccination rates and fragile health systems.Many countries in Asia, including Bangladesh, Sri Lanka and Nepal are down to their last doses, forcing authorities to suspend or scale down their vaccine rollouts. Just 3% of people in India and less than 1% in the Philippines <a href="https://ourworldindata.org/covid-vaccinations">have been fully vaccinated</a>, according to Oxford University's Our World in Data.A majority of Asian and other lower income nations simply cannot compete with richer countries in the race to buy vaccines. Pakistan has ordered enough doses to inoculate only 3% of its population, while the European Union has enough to vaccinate its population 3.5 times over, according to Duke Global Health Innovation Center.It's not just about purchasing power. It's also about the resources needed to distribute and vaccinate. Britain is vaccinating people 13 times faster than Nepal, while the United States is administering more than 2.5 times as many doses per day as India for every 100 people.Even with limited supplies, countries across Asia are rushing to <a href="https://www.nepalitimes.com/latest/vaccines-too-little-too-late-for-nepal/" target="_blank" rel="noopener noreferrer">vaccinate as many people as possible</a>. Every day, millions of <a href="https://www.nepalitimes.com/here-now/protecting-those-who-protect-us-from-covid/" target="_blank" rel="noopener noreferrer">frontline health workers</a>, including Red Cross and Red Crescent volunteers, are risking their own safety to provide lifesaving medical treatment and immunisations. These staff and volunteers needed to be vaccinated as a priority so they can make other people safe. Many critical workers have still not received even a first dose.I am writing this from Malaysia, which has one of the highest Covid-19 infection rates in the world. Intensive care units and hospitals in many countries around Asia are full. Judging from <a href="https://www.nepalitimes.com/banner/we-knew-the-tsunami-was-approaching/" target="_blank" rel="noopener noreferrer">what we've seen in India and Nepal</a>, demand for oxygen will outweigh supply in countries across the continent and many people will die, people who wouldn't die if they were vaccinated.The International Federation of Red Cross and Red Crescent Societies is supporting the vaccine roll out, working with health authorities to run vaccination centres, keeping people safe with clean water, soap and hygiene, and delivering <a href="https://www.nepalitimes.com/here-now/helping-nepalis-breathe-again/" target="_blank" rel="noopener noreferrer">oxygen supplies</a>. It all helps but is a drop in the ocean compared to what is needed to contain Covid-19.The only solution is <a href="https://www.nepalitimes.com/opinion/no-country-is-safe-until-we-are-all-safe/" target="_blank" rel="noopener noreferrer">immediate vaccination</a> to scale at record rates. Scaling up production and sharing intellectual property rights will both make a huge difference in the medium term. In the short term, sharing surplus vaccine doses is one of the fastest ways to save lives. If there ever was a global imperative for the world to act in solidarity, it is now.Alexander Matheou is Asia Pacific Director at the International Federation of Red Cross and Red Crescent Societies.

Global solidarity needs intensive care in pandemic battle

Once Nepal gets vaccines, they need to be fairly distributed

Fenerbahçe Beko won the Turkish Airlines EuroLeague finals in Abu Dhabi, held 23-25 May, defeating Monaco 81-70 in the final. Olympiacos, who defeated Panathinaikos 97-93, finished the series in third place. The Most Valuable Player (MVP) of the final match, Nigel Hayes-Davis from Fenerbahçe Beko, received a prize of 1,000,000 Miles&amp;Smiles from Turkish Airlines’ Chief Commercial Officer Ahmet Olmuştur. The carrier has been the title sponsor of the Turkish Airlines EuroLeague, a top tier tournament, since 2010.

Turkish Basketball

Thousands of Nepali students dreaming of an American education have been forced to look elsewhere as the Trump administration’s visa restrictions make their future uncertain.
The US was long considered a top destination for higher studies, making Nepal the 10th biggest country of origin for international students in America.&nbsp;
However, that number has seen a significant decline with the total for Nepali students now at 16,482. Some 8,000 Nepali students obtained no-objection certificates to study in the US from the Ministry of Education in the past year.&nbsp;
India, Australia, Canada, South Korea, United Kingdom and Japan are the other popular destinations for Nepali students. There are no clear numbers for Nepalis going to India, but a slight decline was noted this year after the deaths of two female students.
The US State Department has issued a circular to its embassies not to issue new visas to applicants until further notice. US Secretary of State Marco Rubio in the directive stated that the department planned to expand the screening of applicants' social media.&nbsp;
While new applicants are barred including those applying for visitor visas, students with scheduled interviews are allowed to proceed.
“Many of our students are affected by the new restrictions, but those who had applied for student visas earlier have got interview dates,” one Kathmandu-based college counsellor told us.
Meanwhile, even foreign students with spotless records already in the US have not been spared, as visa scrutiny intensifies under the new policy. In a move that underscores the growing sense of insecurity, many US colleges advised international students to carry their passports and documents at all times, even when traveling locally.
“Me and my friends did not go home this summer because we were not sure we would be allowed back, so we just went to Niagara Falls,” said a Nepali undergrad in Ohio, who like many interviewed for this report did not want her name used for fear of repercussion.
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Nepali students have adopted a cautious stance, with many choosing not to return home during summer vacation due to fear of visa revocations as well as travel bans. Meanwhile, over 7,000 Nepalis with Temporary Protected Status (TPS) will have to come back to Nepal by 5 August or face deportation. Thirty-seven were flown back to Kathmandu on Omni Air last week.
“The US is one of the most sought-after destinations for higher education, and the ban will definitely impact bright students,” says Narottam Aryal of the King’s College in Kathmandu.
Indeed, Nepali undergraduates admitted into Ivy League colleges for the 2025 academic year have been asked to look for alternatives. The entire Fulbright Foreign Scholarships Board resigned on Wednesday citing interference from the Trump administration on the selection of this year’s cohort. Some Nepali students already on Fulbright scholarships have noted disruptions, delays and even cancellation of stipends.&nbsp;
The student visa restrictions were initially just for foreign students admitted to Harvard University, but it was later extended to all Chinese students and now to all students. Universities like Columbia which actively recruit foreign students, face sharp enrolment declines, threatening their financial stability and diversity.
An Indian female PhD candidate at Columbia University had her visa revoked by the US State Department, and said she was targeted on the basis of her social media posts on Israeli military attacks in Gaza. Social media vetting of political activism has raised concerns about privacy and freedom of expression in a country where such rights were a given.
Many students have been informed via email that their visas have been revoked for getting speeding or parking tickets, but even others with no criminal record have been affected. The fear of deportation looms large amongst international students, including those from Nepal.&nbsp;
For most Nepalis who migrate to the US for education, the journey is a high-stakes investment. They come largely from middle-class families, often rely on a patchwork of scholarships, work-study programs, loans, or even the sale of family assets to afford fees.
Most Nepali students pursue STEM subjects which offer extended Optional Practical Training (OPT) periods that help fund their education. But with the US backsliding on education and humanitarian matters, countries like the UK and Canada are becoming more attractive despite their own recent stricter controls on student visas.&nbsp;
The UK universities saw a 63% rise in Nepali students’ admissions in 2024. Japan is another popular destination with 64,816 Nepali students enrolled as of 2024.
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Already, China, Hong Kong and Malaysia are poised to benefit from the increased scrutiny of US student visas. Several Hong Kong universities are offering unconditional admission to affected students, while Malaysian institutions are targeting previously US-bound Asian students. China and India have 330,000 and 280,000 students respectively in America, but the numbers for China have seen a sharp drop in the past year.
Elsewhere, branch campuses of American institutions such as NYU in Abu Dhabi, Georgetown in Dubai and Northwestern in Doha are getting more admission applications, and universities in the Gulf region are expanding infrastructure to accommodate those who would otherwise have gone to the US.&nbsp;
Even educational institutions in Nepal are hopeful that the US visa restrictions can be an opportunity to at least keep Nepali undergrads in Nepal, and also attract foreign students from the region.&nbsp;
“Many students might choose to complete their undergraduate degree here in Nepal and then move abroad for their Master’s degree later,” says Aryal of King’s College. “There was a need for quality higher education in Nepal anyway in terms of innovation and opportunities, so this could be the time to reduce our dependence on other countries.”
Nepal’s strategic position between India and China makes it sensitive to US policy shifts. India, a key ally, is also under US scrutiny for potential student travel restrictions. Chinese universities are already offering more scholarships to Nepali talent to capitalise on the US retreat.
American universities have challenged student visa restrictions in the courts. A federal court in Boston revoked the blanket ban on Harvard, and the State Department has ordered the resumption of processing student and exchange visitor visas.&nbsp;
Some are still hoping that President Trump will backtrack on the student visa restrictions, just like he has done with many of his more drastic executive orders.
Even so, the visa see-saw and longer-term uncertainties about living in the United States and its education system means students across the world are making alternative plans.
Says Aryal: “Policies of foreign countries change according to their needs, so excessive dependence was never a good idea. We should work to create different opportunities and choices of higher education within Nepal, so students are retained.” &nbsp;

America no longer prime destination for Nepali students

While Nepal was hosting the Sagarmatha Sambaad international climate conference in Kathmandu this month, on Mt Everest it was pretty much business as usual.&nbsp; The signs of climate breakdown are all there: a river now runs through Base Camp in summer, the Khumbu Icefall is more unstable, and there are more &nbsp;frequent avalanches. When expeditions arrived in March, the mountains were bare: it had not snowed since September, but then blizzards dumped unseasonal snow in May. And despite climate worries, such is the pull of Himalayan mountaineering that the Everest Industry showed no signs of slowdown. More than 600 international climbers and their Nepali guides had made it to the summit of the world’s highest mountain. At one point there were an estimated 2,000 people in the tent city on the Khumbu Glacier. All the ropes and ladders on the Icefall came down on Thursday, marking the official end of the spring climbing season, and just in time to avoid a monsoon cyclone approaching from the Bay of Bengal. It has been an action-packed season. One factor could be that Everest fees will go up from September: each foreign climber needs to pay a $15,000 royalty, up from the present $11,000. The cost for a Nepali climber on the South Col route will also go up: from Rs75,000 to Rs150,000.&nbsp; The fee to climb Everest in autumn is $7,500 (up from $5,500), but most climbers still prefer spring. Winter permit fee (December-February) is only $3,750 per person and the mountain is now also open for monsoon (June-August) climbs, when the fee is ever lower at $2,750. The revised rule also makes it mandatory for every two climbers on an 8,000m peak to hire one Nepali mountain guide.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025053004050_67f856fe52714e4bdcf21ae7d45c6f18c82117b9d0a5f73ed1efa04c96de1046.jpg" data-media-id="editor_0" data-image-id="2025053004050_67f856fe52714e4bdcf21ae7d45c6f18c82117b9d0a5f73ed1efa04c96de1046" data-rendition-name="original" width="931" height="732" loading="lazy" alt="The Everest Industry graph 1"> </figure>  In addition, climbers also have to pay for porters and guides, equipment, Base Camp costs, Ice Fall and fixed rope team fees, so climbing Everest does not come cheap. But such is the draw of climbing the world’s highest peak that some say the increased fees will not diminish the crowds next year. The government has tried to spread expeditions out to other seasons and other 8,000ers, but with not much success. Earlier this year, Nepal unilaterally increased the number of 8,000m peaks to 14 by adding six more sub-summits to broaden the choice for climbers. Added were: Yalung Kang (8,505m), Yalung Kang West (8,077m) &nbsp;Kangchenjunga Central (8,473m), Kangchenjunga South (8,476m), Lhotse Middle (8,410m) and Lhotse Shar (8,400m).&nbsp; The announcement could go against the accepted topographic criteria that a stand alone peak has to be at least 300m higher than an adjoining prominence, and at more than 3km isolation from it. The UIAA (Union Internationale des Associations d'Alpinisme) still recognises only 14 mountains as eight-thousanders, and only eight of those are in Nepal, or on the border with China. Nepal’s revised mountaineering regulations also increased the insurance coverage of high-altitude workers to protect porters and high altitude guides who usually take more risks on the mountains. Rescue teams and clean-up campaigners to collect trash and remove bodies of dead climbers up to Camp IV of Mt Everest do not need permits.&nbsp; The Sagarmatha Pollution Control Committee is now using drones to fly down trash in 20kg sacks. Each climber is also required to bring down at least 6kg of waste and not just their own, but this rule is erratically enforced. With five fatalities on Everest and Lhotse, Spring 2025 had a historically low death toll. Another five climbers died on Annapurna, Kangchenjunga and Makalu.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025053004050_38681de22f0fefb6faa12b01755566d09c5064d0ff84e12ccc7b5d68ea9ba38a.jpg" data-media-id="editor_1" data-image-id="2025053004050_38681de22f0fefb6faa12b01755566d09c5064d0ff84e12ccc7b5d68ea9ba38a" data-rendition-name="original" width="665" height="740" loading="lazy" alt="The Everest industry graph 2"> </figure>  Journalist Ben Ayers who ran the Everest Live social media channel from Everest Base Camp with daily updates credited the low death rate to dramatic rescues of climbers from the ‘Death Zone’ by their Nepali guides and longline helievacs — the visuals all uploaded on YouTube.&nbsp; “Ironically, this perception of safety is bringing more and more inexperienced climbers to the mountain, and they need more rescues,” Ayers said in one of his dispatches.&nbsp; American expedition chronicler and summiteer Alan Arnette suspects there is a lot of under-reporting given that the jet stream and storms were lashing Everest even till late in the season. He told us: “I heard a lot about frostbite and rescues that were not made public. It’s become practically impossible to cover the details on Everest. All the teams report nice news, and they don’t talk about bad stuff to avoid hurting businesses.” Although trash on Nepal’s mountains makes headlines, what does not receive as much attention is the climate impact of so many expeditions. The Sagarmatha Sambaad conference sidestepped this issue, which is ironic given that the impact of climate breakdown is most evident on Himalayan peaks and their glaciers.&nbsp; <h2>Need for Speed</h2> The big stories this year have been about speed-running from their home cities to the top of Everest. Ukrainian entrepreneur Andrew Ushakov flew out of JFK on 15 May at 10:15AM Nepal time, and was on the summit 3 days, 23 hours, and 7 minutes later on 19 May at 9:22AM.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250601080640_1c5cc6fc991307861768f07037ed9d30930fb20f35dbb57dc31c9a92a9e1a885.jpg" data-media-id="editor_2" data-image-id="20250601080640_1c5cc6fc991307861768f07037ed9d30930fb20f35dbb57dc31c9a92a9e1a885" data-rendition-name="original" width="1440" height="1800" loading="lazy" alt="The Everest Industry"> <figcaption>Andrew Ushakov at the summt. Photo: ELITE EXPED</figcaption> </figure>  “I could never find the time for the traditional 40-50 days of acclimatisation,” Ushakov explained matter-of-factly. His ‘Everest Sea-to-Summit’ climb was possible because he spent 400 hours in hypoxic sleep tents over the past four years in New York. However, Ushakov did use ropes already fixed, hired four Nepali guides, helicoptered to Base Camp, and used much more oxygen than an average climber. And after the climb, Ushakov was arrested at Kathmandu airport for being in possession of $20,000 of undeclared cash and spent a night in jail and fined $60,000.&nbsp; The other speedsters were Garth Miller, Alastair Cairns, Anthony Stazicker, and Kev Godlington, all former British Army commandos. They left London and summited five days later on 21 May, and flew right back. They also used hypoxic tents to simulate the thin air high on Everest.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250601080644_90c8dd5cc07b4b43f2989b1dc0c0650ab80f10ebb06680c25a6909c519957bd8.jpg" data-media-id="editor_3" data-image-id="20250601080644_90c8dd5cc07b4b43f2989b1dc0c0650ab80f10ebb06680c25a6909c519957bd8" data-rendition-name="original" width="810" height="668" loading="lazy" alt="The Everest Industry "> <figcaption>All four members of the Furtenbach team at the summit. Photo: Sandro Gromen-Hayes</figcaption> </figure>  But more controversial was their use of xenon gas therapy in a German hospital to ramp up the production of oxygen-carrying haemoglobins in their blood. Xenon is banned by the World Anti-Doping Agency for being performance enhancing in sports. Expedition leader Lukas Furtenbach said this rule does not apply to mountaineering, as it is not a regulated sport like swimming. Nepal has no rules about xenon, but the Department of Tourism said it was launching an ‘investigation’ to decide on future policy since it is difficult to ban xenon, but allow oxygen. The controversy has also divided the mountaineering community, with some climbers saying they just want to maximise their chances of survival. Spending less time on the mountain could make climbing safer by reducing avalanche risk. It would also mean less trash on the mountains, but it would reduce the income of Nepal’s expedition industry. It is also unclear how much of the success was due to xenon therapy and whether the ex-special forces were already in good physical shape.&nbsp; The need for speed hides the fact that climbing in the Himalaya is dangerous business, and climbers cannot sprint to the top just by huffing xenon. But ultra-fast climbs could be charged more, and the revenue generated can be used to establish state-of-the-art rescue operations, and increase pay and insurance for guides. Two other speed chasers this season were Swiss-Ecuadorian Karl Egloff and American Tyler Andrews, both on Everest without oxygen. Andrews choppered to Base Camp to catch a weather window, but turned back from 8,500m due to high winds. Heavy snow and wind also forced Egloff to descend from 7,000m. Slow and steady climbers like Anja Blacha from Germany did make it to the summit without oxygen, while Kami Rita Sherpa broke his own record with his 31st Everest summit as he led a 26-strong Indian Army group. There were 468 permits issued for foreign climbers from 48 expeditions to Everest this spring. Nepal’s other eight-thousanders together had only 17 expeditions. Nepal has more than 1,000 peaks above 6,000m, and has opened only 476 of them for climbing.&nbsp;

The Everest Industry

While Nepal marked <a href="https://nepalitimes.com/news/mt-everest-pvt-ltd">Mt Everest</a> Day on 29 May, on the other side of the planet in the US state of Colorado dozens of Nepalis who have climbed the world’s highest peak multiple times were busy working as chefs and Uber drivers. Among them is Nima Doma Sherpa, who climbed Mt Everest in 2019 after her husband Tshering Wangchu was among 16 crushed by an avalanche on <a href="https://nepalitimes.com/banner/on-thin-ice-in-the-khumbu">the Khumbu Icefall</a> five years earlier. A large serac broke off the West Shoulder of <a href="https://nepalitimes.com/news/the-everest-industry">Mt Everest </a>and fell directly on a group of <a href="https://nepalitimes.com/opinion/more-porters-sick-on-everest-trail">porters and guides</a> making their way up the Icefall at 5,800m. Their bodies were flown by helicopter to Khumjung where Tshering Wangchu was born. He was excited about climbing Mt Everest for the first time.&nbsp; In Khumjung, Nima Doma felt like her own life had also ended. This was the kind of news Sherpa wives, mothers and sisters dreaded every <a href="https://nepalitimes.com/here-now/peak-climbing-season-2025-s4abrxny">mountaineering season</a>. She stayed home for more than two years grieving, but ultimately gathered up all her emotional strength to take care of her 6-year-old son and 3-year-old daughter. Nima had grown up in Khumjung hearing <a href="https://nepalitimes.com/review/stories-of-nepal-s-summiteers">tales of adventure on the mountains </a>from their father, Ang Chubi Sherpa who had climbed Everest in 1993. He used to bring her and her sisters and brother European chocolates after every expedition, and used to tell them that the chocolate bars grew on the mountains. “It was only after we got older did we realise that he told us that chocolates grew in the mountains so we would not worry about him putting himself in harm's way,” Nima Doma recalled with a faraway look at her home in Boulder this week. Nima went to the school that <a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/commemorating-edmund-hillary-in-nepal,4145">Edmund Hillary</a> opened in Khumjung till Grade 8, and then dropped out to help in the kitchen and <a href="https://nepalitimes.com/here-now/when-yaks-go-so-does-culture">tend yaks</a>. She was married off to Tshering Wangchu, who was also a high altitude guide. When Tshering went on expeditions, Nima also started working as a porter from Namche to Base Camp. It was perhaps her father’s tales of mountains of chocolates that had always attracted her to <a href="https://nepalitimes.com/here-now/knowing-our-mountains-43v4iyvo">the peaks</a>. After her husband was killed ten years ago this month, being a widow with children was not easy for Nima Doma. But she was not alone: there were at least 200 single mothers in <a href="https://nepalitimes.com/here-now/khumbu-since-1950-jaww4qn0">the Khumbu</a>, and 20 of them just in Khumjung whose husbands had been killed in <a href="https://archive.nepalitimes.com/article/nation/tragic-start-to-himalayan-spring-nepal,3695">mountaineering accidents</a>. Some were not even 20 years old, and had children growing up without fathers. But there were also women in the 50s whose husbands had been killed in the 1980s. Nima found sponsors for her children’s education, and moved to Kathmandu. In the capital, Sherpa widows used to meet to help each other. Some of them had joined the Nepal Mountaineering Association (NMA) training for rock and ice climbing. “I decided that it was no use sitting home and crying anymore, after meeting other single mothers I felt less alone,” remembers Nima, who joined the Juniper Foundation and enrolled in an NMA training camp in Manang. There she climbed Chulu East (6,584m) and met Furadiki Sherpa, whose rope-fixing husband had also been <a href="https://nepalitimes.com/news/on-mt-everest-s-70th-records-and-fatalities">killed on Everest</a> in 2013. They set themselves the goal of climbing Everest one day, and started a fund-raising drive.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250530090544_621be0724b9182c8e3594b2c562a71ec32ac01d985a71d0cf31646de9d51e15a.png" data-media-id="editor_12" data-image-id="20250530090544_621be0724b9182c8e3594b2c562a71ec32ac01d985a71d0cf31646de9d51e15a" data-rendition-name="original" width="2678" height="1274" loading="lazy" alt="Everest summiteers find new life in the US"> </figure>  “We decided we had to overcome society’s stigma of <a href="https://archive.nepalitimes.com/article/nation/widows-personal-happiness-comes-last-in-face-of-social-financial-hardships,1855">widowhood</a> and prove that <a href="https://nepalitimes.com/here-now/remembering-junko-tabei">women could also climb mountains</a>,” Nima said, adding that she was inspired by Nepal’s first woman Everest summiteer Pasang Lhamu Sherpa, who died during her descent in 1993. Nima Doma and Furdiki climbed the technically-difficult Ama Dablam (6,812m) and then arrived at Everest Base Camp in April 2019 as part of their Two Widows Expedition with the motto, ‘So Can We’. While climbing up the Icefall Nima passed the spot where her husband had been killed. It was a jumble of constantly-shifting ice blocks bigger than houses. She closed her eyes and said a prayer. “I remember thinking, this is so difficult and dangerous. This is what my husband had to do to support our family,” Nima Doma said. “I was determined to fulfil my husband’s dream of climbing Chomolungma, and to prove to ourselves that we two women could do it.” It was 23 May 2019 when <a href="https://www.reuters.com/article/world/two-sherpa-widows-scale-everest-and-smash-stigma-idUSKCN1SU0MV/" target="_blank">Nima and Furdiki stepped on the summit</a> and looked over into Tibet, and down at Tengboche Monastery to the south.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250530090544_6b822582b5d88ba5e972db084f184690b40653c6efd9901b2dd082ffba2a263b.png" data-media-id="editor_16" data-image-id="20250530090544_6b822582b5d88ba5e972db084f184690b40653c6efd9901b2dd082ffba2a263b" data-rendition-name="original" width="2700" height="1522" loading="lazy" alt="Everest summiteers find new life in the US"> </figure>  Nima Doma hugged Furdiki, took off her mask and wept. But for the first time in five years, it was not from grief but relief — relief for being free of all the sadness and sacrifices and for fulfilling her husband’s dream. They had found <a href="https://nepalitimes.com/here-now/life-after-death">life after death</a>. “I felt this immense joy to be on top of the world, it was indescribable,” Nima Doma said, “I have wept only twice in my life. Once when my husband died, and once there on top of Everest.” The tears had frozen on Nima Doma’s cheeks, as she and Furdiki headed back down the mountain.

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