<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221114091156/6372030d9c7e80680e0b27e9jpeg.jpg" alt="" width="1378" height="919"/><figcaption>Photos: AMIT MACHAMASI</figcaption></figure>Be it by naïveté, misplaced optimism, or a great faith in the healing powers of Himalayan air and turmeric, no one in Nepal had expected that we would be in the global epicentre of the Covid-19 surge fuelled by the <a href="https://www.nepalitimes.com/here-now/delta-variants-wake-up-call-for-nepal/" target="_blank" rel="noopener noreferrer">Delta variant in the spring of 2021</a>.Our miscalculation and gross lack of preparation cost thousands of lives and left so many Nepalis bereaved during this Dasain and Tihar. Shortly after <a href="https://www.nepalitimes.com/banner/we-knew-the-tsunami-was-approaching/" target="_blank" rel="noopener noreferrer">the Indian wave began in March</a>, Nepal recorded the highest number of Covid cases per capita, and the worst viral transmission rates on the planet. While the world focused on India, Nepal's health system was overwhelmed in a matter of days.Remember how we <a href="https://www.nepalitimes.com/here-now/helping-nepalis-breathe-again/" target="_blank" rel="noopener noreferrer">desperately searched for oxygen cylinders</a>, when every ICU bed was occupied and ventilators were in short supply? Remember rural communities where the situation was even worse, and so many Nepalis died without any medical attention? And there was the black market that forced many to pay exorbitant rates for life-saving oxygen, masks, and even paracetamol.We cannot afford to forget these terrible and deadly months. If we do, and do not prepare for the next wave, we will be bound to repeat them. With <a href="https://www.nepalitimes.com/latest/nepal-on-high-alert-for-omicron/" target="_blank" rel="noopener noreferrer">the Omicron variant </a>now spreading like wildfire across the globe, let us remind ourselves that Nepal experiences a surge in Covid cases a few months after the rest of the world. The Delta variant (which has been proven to be less transmissible than Omicron) took more lives in just a few months than the 2015 earthquakes.The current low case numbers in Nepal are not going to last. Repeating our mistakes of under-preparedness and apathy has the potential to kill thousands of more Nepalis in the coming months.While preliminary data shows that the Omicron variant is <a href="https://www.nepalitimes.com/here-now/omicron-may-not-be-as-risky-but-take-care/" target="_blank" rel="noopener noreferrer">less likely to hospitalise infected individuals</a> than Delta did, we need to take into account that this new variant spreads at a much faster rate. The relief we may feel from a smaller percentage of Covid patients needing life-saving care is cancelled out by there being an exponentially higher number of total infections.Our medical facilities will still be overwhelmed, leading to unnecessary loss of life on a large scale. In short, Omicron is <a href="https://www.nepalitimes.com/latest/nepal-has-all-the-conditions-for-an-omicron-surge/" target="_blank" rel="noopener noreferrer">not to be underestimated</a>, especially for densely populated communities in Nepal.<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221114091156/637203109c7e80680e0b27eajpeg.jpg" alt="" width="1221" height="814">We still have some time to prepare. Policy makers and individuals alike have important roles to play in the critical next weeks and months. We cannot squander this opportunity to save lives. National and local governments need time to act now on these critical areas:<ol><li><a href="https://www.nepalitimes.com/latest/all-vaccines-prevent-severe-covid/" target="_blank" rel="noopener noreferrer">Vaccinate Aggressively</a>: There are varying statistics on the percentage of Nepalis vaccinated, but no more than 40% of the population have been fully vaccinated. Booster shots are now necessary to adequately protect a population, so we still have a very long way to go.</li></ol>The good news is that even if we cannot fully vaccinate and provide boosters for the entire population, clinical experience shows that <a href="https://www.nepalitimes.com/banner/vaccines-variants-and-a-third-wave/" target="_blank" rel="noopener noreferrer">vaccinated individuals</a> have less need for Covid-19 hospitalisations and are much less likely to die from the Omicron variant. Decision makers can make our limited vaccine supply go further by prioritising vaccines for densely populated cities and in areas where Delta infection was low, as people in these areas are less likely to have natural immunity.<ol start="2"><li>Border Control: The devastating wave of the Delta variant in Nepal began a few weeks after it had taken hold in India. This was largely attributed to a spillage of the virus through the open southern border. We can support municipalities along the border to help contain the Omicron by strict health desks to screen individuals crossing the border. This will require increased funding and other resources.</li></ol><ol start="3"><li>Isolation and Quarantine Centres: Delta spread from India and urban areas into the countryside because we could not properly accommodate and care for infected patients in quarantine and isolation centres. There is time to re-establish these facilities before the next wave hits, and train frontline health workers and local governments based on guidelines that already exist. Again, as the variants (and our knowledge about them) evolve, we need to remain agile and empower our managers and healthcare workers to address the changing ground situation.</li></ol><ol start="4"><li>Oxygen Supply: During and after the Delta wave last year, the Ministry of Health and Population made commendable efforts to expand oxygen plant availability in the country, with support from international aid groups. These new plants need to be brought online and tested in the coming months, and MoHP must accelerate its efforts to meet its own requirement of having an oxygen plant at every 100 bed-hospital in the country.</li></ol><ol start="5"><li>Using Female Community Health Volunteers: FCHVs have been a key for many of Nepal’s remarkable gains in public health, including reducing maternal mortality rates. This network of local health workers was not fully deployed during the last Covid wave. We can use FCHVs to disseminate public health information, vaccine knowledge, and to play a frontline role in enforcing community guidelines to reduce local transmission of the virus, and to care for the infected. These volunteers and other community-based health workers need to be adequately compensated, and equipped with materials, protective equipment, and training.</li></ol>Properly mobilising and empowering FCHVs is the fastest and most efficient way to support rural communities that lack other options for advanced care. This will have a ripple effect across the national health system, and may be a key factor in avoiding another total collapse. All of these steps depend on implementation by the government and private healthcare system. We commend recent steps taken by the health department to test Nepalis returning from India, and to establish quarantine centres along the border.<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221114091156/637203139c7e80680e0b27ebjpeg.jpg" alt="" width="856" height="571">As individuals, we must <a href="https://www.nepalitimes.com/here-now/living-with-covid-in-2022/" target="_blank" rel="noopener noreferrer">continue to take responsibility</a> for protecting our loved ones by following public health guidelines for another few months at least. History shows we will not know for certain that Omicron has arrived in Nepal until after the variant is endemic in the population. These proactive measures can slow the spread, starting now:<ol><li>Mask up in all public places and when in close contact with members of at-risk populations. Doubling up on masks is a good idea, given the extremely contagious nature of Omicron.</li></ol><ol start="2"><li>Avoid touching the face with fingers, and frequently wash hands - at least 20 seconds with soap and water.</li></ol><ol start="3"><li>Avoid all public gatherings. If not, maintain social distance of at least 1m.</li></ol><ol start="4"><li>Support the local government by following protocols and encouraging elected officials to take proactive measures to protect the community. Volunteer to spread awareness or set up facilities if you can, and be ready to support your community when the next wave arrives. We Nepali are great at using ‘source-force’ to get things done - now is a great time to use your connections and networks to encourage people in positions of influence to take proactive steps to prepare for Omicron.</li></ol>In the age of Covid, it’ is every country and every community for itself. Delta taught us in Nepal not to trust promises of international aid to save us from the pandemic. We are on our own, and we only have each other to get through this.The Delta wave, like <a href="https://www.nepalitimes.com/banner/rebuilding-five-years-after-2015-quake/" target="_blank" rel="noopener noreferrer">the 2015 earthquakes</a>, also taught us that when the going gets tough, Nepalis come together and achieve miracles. Remember the community groups that blossomed across the country to create isolation centres, distribute food and supplies, and invented improvised oxygen concentrators.Remember the FCHVs and community members who risked their lives to travel into every corner of the country to deliver vaccines to the most vulnerable citizens.  This time, we have an opportunity to harness this grit and compassion when it is needed most - before the disaster strikes.Ramu Kharel is an emergency medicine physician at Brown University and has worked extensively in the frontlines of Covid-19. He runs a non-profit organisation HAPSA in Nepal that is working on Covid response.Ben Ayers is an American citizen based in Nepal for over 20 years.

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Omicron is coming to Nepal, be prepared

When the <a href="https://www.nepalitimes.com/banner/we-knew-the-tsunami-was-approaching/">second wave of the Delta variant ravaged Nepal</a> in April-May this year, <a href="https://www.nepalitimes.com/banner/nepals-life-or-death-o2-quest/" target="_blank" rel="noopener noreferrer">hospitals ran out of oxygen and ICU beds</a>. The <a href="https://www.nepalitimes.com/here-now/aid-pours-into-nepal-but-where-be-vaccines/" target="_blank" rel="noopener noreferrer">international community rushed</a> oxygen plants and ventilators, but many of the critical life-saving machines are lying idle in government hospitals around the country.  Besides the hundreds of donated ventilators, the government also bought the machines, but <a href="https://www.nepalitimes.com/latest/rural-nepal-fights-back-covid-19/">state-run hospitals</a> do not have the anaesthesiologists <a href="https://www.nepalitimes.com/banner/nepals-doctors-are-like-soldiers-fighting-a-war/" target="_blank" rel="noopener noreferrer">trained</a> to run it nor the critical care wards to put them in.  The district hospital in Sandhikharka of Arghakhanchi bought a ventilator six months ago, it has never been turned on even though there were critically-ill Covid-19 patients who needed respiratory support.  Even though the second wave <a href="https://www.nepalitimes.com/latest/as-covid-19-crests-nepal-eases-restrictions/" target="_blank" rel="noopener noreferrer">appears to have subsided</a>, the positivity rate among those being tested is still hovering at 10%, and there is a weekly rolling average of 320 patients in ICU and 120 in ventilators in government and private hospitals around the country. “Only two days ago, we had a Covid patient who had to be put on a ventilator. But we had to send them to Butwal since we didn’t have anyone who knew how to use it,” says Rajendra GC, medical superintendent of the hospital. The Seti Provincial Hospital in Nepalganj has 11 ventilators, but not all of them can be used at the same time because of the lack of dedicated space and trained personnel.“If the ventilators stop working, we won’t be able to treat the patients until a technician from Kathmandu comes to fix them,” says hospital manager Ved Prakash Joshi. <img width="1978" height="1156" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110161124/636d17eb9c7e80680e0ac792jpeg.jpg" alt=""/><img width="1440" height="905" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110161124/636d17ee9c7e80680e0ac793jpeg.jpg" alt="">In the district hospital in remote Bajhang district, a medical officer was the only person with some level of training in critical care. He was transferred recently, and it is hospital chief Sandip Okheda who has had to handle emergency cases based on only a few days of training to operate ventilators.Ventilators are essential for <a href="https://www.nepalitimes.com/here-now/at-the-covid-19-frontlines-in-rural-nepal/" target="_blank" rel="noopener noreferrer">patients needing critical care</a> and are used for breathing problems that can accompany various health conditions. In severe Covid patients, the virus damages the lungs, causing the oxygen level to drop and making it harder for the person to breathe. Ventilator tubes are intubated to push air into the lungs, and the procedure is regarded as the last resort for many patients.Before the pandemic, government hospitals across the country had only 500 ventilators, which meant there was a critical shortage during the second wave when many of the patients admitted to the ICU needed life support. At the height of the pandemic in April-May, there were 11,000 new confirmed cases daily and up to 240 people were dying every day, <a href="https://www.nepalitimes.com/latest/nepal-nears-10k-daily-cases/" target="_blank" rel="noopener noreferrer">hospitals were overwhelmed</a>.  The public health emergency led national and international aid agencies as well as Nepali migrant workers in the Gulf to <a href="https://www.nepalitimes.com/here-now/nepals-diaspora-comes-to-the-rescue/" target="_blank" rel="noopener noreferrer">rush in with the help</a>. The government reportedly added 1,000 ventilators after the pandemic, and some government hospitals ordered their own, although there is no count of the exact number.  There are currently 329 Covid patients getting treatment in ICUs across the country and an additional 112 in ventilator support, many of them referral patients from outside Kathmandu Valley.  Each patient on a breathing machine requires multiple doctors and nurses to care for them and operate it properly. In many district hospitals, that is not the case and as a result, patients needing ventilator support have lost their lives. <img width="301" height="459" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110161124/636d17f19c7e80680e0ac794jpeg.jpg" alt="">“My own relatives died because the hospitals did not have ventilators and intensive care units,” says epidemiologist Anup Subedi. “Having ventilators alone is not enough, hospitals must be equipped, and the staff trained in intensive care.” <img width="800" height="451" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110161124/636d17f29c7e80680e0ac795jpeg.jpg" alt="">According to critical care specialist Manoj Kumar Yadav, operating a ventilator requires a pulmonologist, anaesthesiologist and intensive care specialist. Professionals with 3-4 years of training through fellowship or a graduate of internal medicine or anaesthesia are considered proficient. Meanwhile, doctors with an MD in anaesthesia and medicine as well as nurses can be trained in critical care to fill the gap.A recent study conducted at Teaching Hospital in Kathmandu has shown that of all the diseases, Covid patients require ventilators the most. It also found that 84% of the 95 Covid-19 patients in the hospital who were on ventilator support have died.“The same study also points out that although the lack of skilled manpower is not directly responsible for the death of patients on ventilators, round-the-clock care is required for those on breathing support or complications may arise,” adds Yadav.Officials at the Health Ministry admit that the inability of the government to recruit permanent doctors and specialists has adversely affected the healthcare services across the country. This is a critical gap, and leaves Nepal at high risk in case there is a third wave.The Ministry of Health spokesperson Krishna Prasad Paudel has the usual vague promise, without mentioning actual actions taken: “We will train our human resource and make sure that at least the ventilators in storage are up and running soon."

Donated ventilators gather dust in Nepal

<figure><img width="2400" height="1600" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110131116/636cebac9c7e80680e09ad1ejpeg.jpg" alt=""/><figcaption></figcaption></figure>Amidst a dramatic surge in Covid-19 infections in Nepal, Prime Minister K P Oli has announced that all big government and private hospitals and medical colleges will be turned into Covid-19 treatment centres. Wearing a surgical mask in his televised address to the nation on Monday, Oli said hospitals like Bir and the Tri-Chandra Army Hospital in Kathmandu and other big private hospitals in the country would serve only people with Covid-19 infections, while smaller hospitals would be designated for non-Covid-19 patients.   He added that the Nepal Army would be adding 1,000 beds for coronavirus patients in each province as well as in Kathmandu Valley, which has been recording half of all new daily infections nationwide in the past week. Bigger hospitals will be setting up their own oxygen plants, Oli said.  The prime minister’s address appears to have been prompted after widespread criticism that his government had ‘surrendered’ to the second wave that has seen a dramatic increase in daily case load and fatalities in the past month. The daily new Covid-19 cases on Saturday, Sunday and Monday were the highest so far in the pandemic with  5,763, 7,211 and 7,448 testing positive. On Monday, there were 37 fatalities in the past 24 hours, bringing the total tally for Covid-19 deaths to 3,362. Altogether 2,021 people recovered from the disease on Monday, with the number of active cases reaching over 50,000 nationwide. Nepal’s Ministry of Health has said that the Covid-19 spread in the country is not just out of control, but that the proportion of those infected who are seriously ill has also gone up. The Ministry’s statistics show that the number of patients needing ICU and ventilator care has increased rapidly in the past two weeks. Of those patients who needed hospital treatment, 17% were serious enough to need intensive care. The number of active cases in Nepal as of Monday is 54,041, of which 50,171 have mild symptoms and are in home isolation. But there are 3,869 Covid-19 patients in private and government hospitals, of which 578 are in ICU, and of them 141 are on ventilator support. Most of the seriously ill are in Bagmati Province, where Kathmandu Valley is located. Of those hospitalised, 22% in the province are seriously ill, and there are 320 patients in ICU and 88 on ventilators. In Province 2, 26% of those in hospital need intensive care, and the proportion is 33% in Karnali Province. However, only 5% of patients in hospitals in Gandaki Province and 6% in Far-West Province need to be in ICU. <figure><img width="1200" height="621" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110131116/636cebaf9c7e80680e09ad1fjpeg.jpg" alt=""><figcaption>A patient at an isolation ward in Nepalganj. Photo: UMA MAGAR</figcaption></figure>The Ministry of Health warned over the weekend that hospitals were full, and that the pandemic had gone “out of control”, asking people to strictly observe precautions. The government is advising people not to come to hospital unless their oxygen levels drop below 92, but most Nepalis do not have oximeters at home and do not go to hospital until it is too late.This has prompted local municipalities and wards to set up their own isolation centres, and even oxygen-equipped spaces for those needing treatment.In Nepalganj, Bheri Hospital and other hospitals are full, and infected health personnel are forced to treat Covid-19 patients because there has been no backup support from the central government. Nepalganj has therefore converted its training centre into its own isolation and treatment centre with 50 oxygen equipped beds. “We are trying to do what we can, and already the centre has ten patients who need oxygen,” says Nepalganj mayor Dhawal Shumshere Rana, who has spent Rs2 million of the city’s own budget to set it up and staff it with doctors and nurses who work in three shifts. Patients are provided free food and ambulance service. “it was much cheaper to cover the training centre, and we could bring the isolation ward into operation within a week, and we hope this will provide some respite to the overwhelmed hospitals,” Rana says. “We now want to add another centre with 100 beds. We want to make sure no one has to die because they could not get oxygen, or a hospital bed.”Banke district on the Indian border is finding 400 new Covid-19 cases every day, and about a third of them need hospital admission. The new isolation centres are designed to take the pressure off the district’s hospitals which are treating patients from all over Karnali and Far-western Province. Only those needing ICU and ventilators will be sent to hospitals, Rana says.<a href="https://www.nepalitimes.com/latest/our-health-system-cant-contain-the-pandemic/" target="_blank" rel="noopener noreferrer" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/latest/our-health-system-cant-contain-the-pandemic/&amp;source=gmail&amp;ust=1620125152099000&amp;usg=AFQjCNEFm7L2FXwPP4VPNvvbKh_wensRNg">Health Minister Hridayesh Tripathi</a> told Nepali Times last week that his government would be adding 1,000 hospital beds in Kathmandu to deal with the rush at hospitals in the capital. “Our health system cannot sustain this level of infections,” he said.In Kathmandu, the Social Welfare Council that regulates the activities of non-profit local and international voluntary organisations on Sunday issued a directive requiring them to set aside from 5-20% of their annual budget for Covid-19 related relief.The Council’s Durga Bhattarai said non-profits with main annual budgets up to Rs50 million need to spend 20% of it on helping with the national coronavirus effort, while those with budgets above Rs500 Millie have to set aside 5%. It says the revenue will be used to buy oxygen cylinders, ICU equipment and ventilators, as well as relief for returnee workers from overseas.With more than 25 of Nepal’s 77 districts under some form of lockdown, local governments have been told to enforce the restrictions more strictly, allowing only essential services, medical emergencies and funerals.Government spokesperson Parvat Gurung said the Cabinet on Sunday decided tis suspend all domestic flights from Monday midnight, and all international flights from Wednesday midnight. However, international airlines serving Kathmandu had not been officially notified of the decision.The Cabinet decision on Monday also said that as per the ‘air bubble’ agreement with India, there would be two weekly flights in both directions between Kathmandu and Delhi, but all passengers would have to spend ten days in hotel quarantine in Kathmandu and it would be strictly enforced.Speaking in English at the end of his address, Oli said: "We are of the view that vaccines and critical care medicines are global goods and everyone should have access to it."

Nepal designates more hospitals for Covid-19 treatment

<figure><img width="2400" height="1600" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109111140/636b83899c7e80680e067741jpeg.jpg" alt=""/><figcaption></figcaption></figure>Amidst a dramatic surge in Covid-19 infections in Nepal, Prime Minister K P Oli has announced that all big government and private hospitals and medical colleges will be turned into Covid-19 treatment centres. Wearing a surgical mask in his televised address to the nation on Monday, Oli said hospitals like Bir and the Tri-Chandra Army Hospital in Kathmandu and other big private hospitals in the country would serve only people with Covid-19 infections, while smaller hospitals would be designated for non-Covid-19 patients.   He added that the Nepal Army would be adding 1,000 beds for coronavirus patients in each province as well as in Kathmandu Valley, which has been recording half of all new daily infections nationwide in the past week. Bigger hospitals will be setting up their own oxygen plants, Oli said.  The prime minister’s address appears to have been prompted after widespread criticism that his government had ‘surrendered’ to the second wave that has seen a dramatic increase in daily case load and fatalities in the past month. The daily new Covid-19 cases on Saturday, Sunday and Monday were the highest so far in the pandemic with  5,763, 7,211 and 7,448 testing positive. On Monday, there were 37 fatalities in the past 24 hours, bringing the total tally for Covid-19 deaths to 3,362. Altogether 2,021 people recovered from the disease on Monday, with the number of active cases reaching over 50,000 nationwide. Nepal’s Ministry of Health has said that the Covid-19 spread in the country is not just out of control, but that the proportion of those infected who are seriously ill has also gone up. The Ministry’s statistics show that the number of patients needing ICU and ventilator care has increased rapidly in the past two weeks. Of those patients who needed hospital treatment, 17% were serious enough to need intensive care. The number of active cases in Nepal as of Monday is 54,041, of which 50,171 have mild symptoms and are in home isolation. But there are 3,869 Covid-19 patients in private and government hospitals, of which 578 are in ICU, and of them 141 are on ventilator support. Most of the seriously ill are in Bagmati Province, where Kathmandu Valley is located. Of those hospitalised, 22% in the province are seriously ill, and there are 320 patients in ICU and 88 on ventilators. In Province 2, 26% of those in hospital need intensive care, and the proportion is 33% in Karnali Province. However, only 5% of patients in hospitals in Gandaki Province and 6% in Far-West Province need to be in ICU. <figure><img width="1200" height="621" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109111140/636b838d9c7e80680e067742jpeg.jpg" alt=""><figcaption>A patient at an isolation ward in Nepalganj. Photo: UMA MAGAR</figcaption></figure>The Ministry of Health warned over the weekend that hospitals were full, and that the pandemic had gone “out of control”, asking people to strictly observe precautions. The government is advising people not to come to hospital unless their oxygen levels drop below 92, but most Nepalis do not have oximeters at home and do not go to hospital until it is too late.This has prompted local municipalities and wards to set up their own isolation centres, and even oxygen-equipped spaces for those needing treatment.In Nepalganj, Bheri Hospital and other hospitals are full, and infected health personnel are forced to treat Covid-19 patients because there has been no backup support from the central government. Nepalganj has therefore converted its training centre into its own isolation and treatment centre with 50 oxygen equipped beds. “We are trying to do what we can, and already the centre has ten patients who need oxygen,” says Nepalganj mayor Dhawal Shumshere Rana, who has spent Rs2 million of the city’s own budget to set it up and staff it with doctors and nurses who work in three shifts. Patients are provided free food and ambulance service. “it was much cheaper to cover the training centre, and we could bring the isolation ward into operation within a week, and we hope this will provide some respite to the overwhelmed hospitals,” Rana says. “We now want to add another centre with 100 beds. We want to make sure no one has to die because they could not get oxygen, or a hospital bed.”Banke district on the Indian border is finding 400 new Covid-19 cases every day, and about a third of them need hospital admission. The new isolation centres are designed to take the pressure off the district’s hospitals which are treating patients from all over Karnali and Far-western Province. Only those needing ICU and ventilators will be sent to hospitals, Rana says.<a href="https://www.nepalitimes.com/latest/our-health-system-cant-contain-the-pandemic/" target="_blank" rel="noopener noreferrer" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/latest/our-health-system-cant-contain-the-pandemic/&amp;source=gmail&amp;ust=1620125152099000&amp;usg=AFQjCNEFm7L2FXwPP4VPNvvbKh_wensRNg">Health Minister Hridayesh Tripathi</a> told Nepali Times last week that his government would be adding 1,000 hospital beds in Kathmandu to deal with the rush at hospitals in the capital. “Our health system cannot sustain this level of infections,” he said.In Kathmandu, the Social Welfare Council that regulates the activities of non-profit local and international voluntary organisations on Sunday issued a directive requiring them to set aside from 5-20% of their annual budget for Covid-19 related relief.The Council’s Durga Bhattarai said non-profits with main annual budgets up to Rs50 million need to spend 20% of it on helping with the national coronavirus effort, while those with budgets above Rs500 Millie have to set aside 5%. It says the revenue will be used to buy oxygen cylinders, ICU equipment and ventilators, as well as relief for returnee workers from overseas.With more than 25 of Nepal’s 77 districts under some form of lockdown, local governments have been told to enforce the restrictions more strictly, allowing only essential services, medical emergencies and funerals.Government spokesperson Parvat Gurung said the Cabinet on Sunday decided tis suspend all domestic flights from Monday midnight, and all international flights from Wednesday midnight. However, international airlines serving Kathmandu had not been officially notified of the decision.The Cabinet decision on Monday also said that as per the ‘air bubble’ agreement with India, there would be two weekly flights in both directions between Kathmandu and Delhi, but all passengers would have to spend ten days in hotel quarantine in Kathmandu and it would be strictly enforced.Speaking in English at the end of his address, Oli said: "We are of the view that vaccines and critical care medicines are global goods and everyone should have access to it."

<figure><img width="1050" height="626" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110911110/636b7a779c7e80680e064761jpeg.jpg" alt=""/><figcaption>Nepalis crossing the border into the country through the Gauriphanta checkpost in Dhangadi, Far Western Nepal. Photos: DINESH KHABAR</figcaption></figure>A week before Nepal declared a <a href="https://www.nepalitimes.com/latest/nepal-covid-19-lockdown-extended-till-7-april/" target="_blank" rel="noopener">nationwide lockdown</a> to prevent imported COVID-19 cases, close to half a million Nepali migrant workers from India crossed the border into the country without any screening.  Another 1.5 million people left Kathmandu Valley for their home districts as the government announced that all long-distance buses would stop plying after 6AM on 17 March.Tens of thousands of Nepali workers driven out of their jobs in Indian cities are still trapped across the border in India – prevented from returning to their own country as the government tries to decide where to quarantine them.Darchula police records show that 128, 022 people entered Nepal before the border was sealed, there now hundreds camping out on the banks of the Mahakali River. Health desks at border checkpoints were equipped only with thermometers. <a href="https://www.nepalitimes.com/latest/enlisting-female-health-volunteers-to-fight-covid-19/">Enlisting female health volunteers to fight COVID-19</a>, Ramu Sapkota and Mukesh Pokhrel“It is easier to track people travelling by air, since they are fewer and the airport has the equipment for thermal screening,” says Sher Bahadur Pun, infectious disease specialist at the Sukraraj Tropical and Infectious Disease Hospital in Kathmandu. “Local governments should not waste any time to track down such individuals and place them under quarantine immediately.”But that is easier said than done. The Health Ministry has not even been able to carry out contact tracing of the four Nepalis who flew into Kathmandu from the Gulf and Europe in March who have tested positive for coronavirus. Local governments in rural Nepal have no record of people who have come home, and are just starting to collect information of recent returnees.  <img width="640" height="295" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110911110/636b7a799c7e80680e064762jpeg.jpg" alt="">“If anyone is infected here, it is going to be a disaster. All we have are thermometers,” says Padam Giri, mayor of the Budhinanda municipality in Bajura, one of the remotest districts in northwestern Nepal. Four individuals who returned to Sunchhahari from India recently have been placed in isolation. Of the 46 people who arrived in Bajura from Mahendranagar after the lockdown, 16 are currently in quarantine at the district headquarters in Martadi.Adds vice-chair of the Sunchhahari Rural Municipality in Rolpa Pabitra Gharti Magar: “So far no one has shown any symptoms, but if anyone did, we do not even have test kits.” The mountainous districts of western Nepal are considered to be the most vulnerable because every family has at least one worker in India who has now returned. It was also western Nepal which was worst hit in Nepal by the HIV/AIDS epidemic in the 1990s as migrant males brought the disease home and spread it to their wives.<a href="https://www.nepalitimes.com/here-now/nepali-workers-overseas-toil-through-the-pandemic/">Nepali workers overseas toil through the pandemic</a>, Upasana KhadkaMahendra Bahadur Shah, chair of the Barekot Rural Municipality in Jajarkot admits that they failed to keep records of people returning from India because they did not initially take the pandemic seriously. Many migrant workers who entered Nepal though the Gaidachauki checkpoint before it was closed are from Bajhang, Doti, Baitadi and Dadeldhura districts.Historically neglected by the central government in Kathmandu, western Nepal has chronic suffered food shortages and epidemics. People from the region make up the highest number of returnees. Even though only one case of the novel coronavirus has been confirmed in the region and is in hospital in Dhangadi, public health experts say the virus is out there. <img width="640" height="372" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110911110/636b7a7b9c7e80680e064763jpeg.jpg" alt="">“Hundreds of thousands of people have returned to western Nepal from Maharastra, Delhi and Bihar, which are the hardest-hit COVID-19 states in India. The one case in Dhangadi is only the tip of the iceberg,” says Bikash Gauchan, medical director at Bayalpata Hospital in Achham.Bayalpata has set up a fever clinic, and 10 isolation beds have been added. The hospital has a stock of 20 precious personal protection equipment, and is producing masks locally for staff. Municipalities, district police offices and hospitals are all on red alert for a possible outbreak of COVID-19 in the region. Adds Gauchan: “We have a few ventilators in the entire western Nepal, and a limited stock of oxygen. We will not be able to do anything if the situation is to turn for worse, but if we contact traced and isolated possibly infected people we might be able to buy some time.” Back in Kathmandu, Sher Bahadur Pun at the Teku hospital says the returnees might have already had extensive interaction with their family members and hence need to be isolated and placed under home quarantine."Even if only one person is infected, who may or may not have a symptom, there is a high chance that the pandemic will spread across the village where there is a lack of reliable healthcare services and people are not aware that they need visit the doctor even if they have a slight fever,” Pun says.Among the general public, there is now a sense of panic, and migrant returnees are being stigmatised, turning villagers against each other. Even people who die of other causes are rumoured to have died of the coronavirus. Public health experts want greater public awareness, physical distancing and expanding the so far limited testing for COVID-19.Warns Pun: “If the coronavirus has entered the country unchecked through the border, then we could have a ticking time bomb in our hands.”

Returnees may be taking coronavirus to rural Nepal

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

Life in a time of cholera

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

YALA

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

Nepal’s incomplete revolutions

One of the few Newa towns situated outside Kathmandu Valley, Panauti still evokes the feeling of a place frozen in time.&nbsp; Largely untouched by haphazard urbanisation, this town 32km east of Kathmandu used to be a kingdom revered for the sacred confluence of the Punyamati and Rosi rivers.&nbsp; The Bramhayani temple is the site of a 12 yearly Makar Mela which is attended by devotees from as far away as India.&nbsp; Panauti’s crumbling monuments were restored in the 1990s by the French government. Temples, resting places, traditional homes were rebuilt and locals trained to revive their craft. Panauti and France marked 50 years of cooperation in September.&nbsp; However, the priceless murals on the temple walls are fading and need urgent restitution. Now, these crumbling wall paintings are meticulously documented in the Wall Paintings of Panauti and Their Context.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260106090116_31f6acf06ef879037fec8274b85153eab4468566abf71616490679bf8468b85d.jpg" data-media-id="editor_0" data-image-id="20260106090116_31f6acf06ef879037fec8274b85153eab4468566abf71616490679bf8468b85d" data-rendition-name="original" width="1596" height="1074" loading="lazy" alt="Panauti murals"> </figure>  In his foreword, French researcher Gérard Toffin writes about some of the earliest wall paintings from the Malla period in Kathmandu, including a 17th century mural depicting the procession of Rato Machhindranath which has since been restored.&nbsp; Several other pieces still exist but in a pitiful state, defaced by scratches. ‘They were painted on a plaster coating made of soil, husks, or limestone, which were applied to the bricks making up the walls,’ Toffin notes.&nbsp; The book delves into the cult of Asta Matrika among Newa of all castes and classes, the first of which is Bramhayani. These all-pervading deities are linked to Shaktism which focuses on the importance of the female principle and together, combine the forces of life, sex and fertility with that of death and eros. The deities are painted on the wall, carved on the stone or moulded into metallic statues.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260106090120_836efd2b0a569d8ec0fb2c6651a29b8f2dd8f8f75b72e27bb86b0bfc0ad8461f.jpg" data-media-id="editor_1" data-image-id="20260106090120_836efd2b0a569d8ec0fb2c6651a29b8f2dd8f8f75b72e27bb86b0bfc0ad8461f" data-rendition-name="original" width="1074" height="1434" loading="lazy" alt="Panauti murals"> </figure>  Riddhi Baba Pradhan, former director general of the Department of Archaeology who oversaw the restoration of Panauti 30 years ago, writes that a colourful wall painting depicting Buddha's past life at the Chabahil Chaitya built or restored during the reign of Lichhavi king Vrisdev in the 3rd century might be the earliest mural in Nepal. As for Panauti, a fragment from a 400-year-old scroll which illustrates a scene of Triveni Ghat with Dalinchok Hill in the background is likely the oldest. But that relic is currently at the Virginia Museum of Fine Arts in the United States.&nbsp; Pradhan recalls first encountering wall paintings inside Bramhayani temple which were deteriorated by smoke, leaky roof, dust, vermilion, sprinkles of animal blood and lack of maintenance. The team led by chemist Bhimvar Singh Thapa treated the wall paintings and some of the details were recovered including the paintings of Astamatrika and Asta Bhairav on the east, west and southern walls.&nbsp; PAINTINGS ARE NOT VISIBLE The murals were painted during the reign of the last Malla King of Bhaktapur Ranjit Malla and Queen Viswalaxmi Devi 300 years ago. But 40 years after the restoration, Pradhan notes that the murals are again in poor condition: ‘The paintings are not visible, the plaster is severely damaged and the surface has peeled off … electrical wires hang haphazardly inside the temple.’ The second lot of murals at Ghat Sattal are thought to have been commissioned during the late Malla period or the beginning of the Shah dynasty. Exterior walls depict incarnations of Lord Vishnu as well as Sesh Narayan, Ganesh, a scene of Samundra Manthan, of angels Maya, Moha, Ganga. Their attributes, dresses, ornaments, facial expressions, body postures are all skilfully represented but in a deteriorated condition.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260106090116_88d06703ae23a271905d81f35056d41df92cbbc4b9966fac3f34821659e585a8.jpg" data-media-id="editor_2" data-image-id="20260106090116_88d06703ae23a271905d81f35056d41df92cbbc4b9966fac3f34821659e585a8" data-rendition-name="original" width="588" height="862" loading="lazy" alt="Panauti murals "> </figure>  The wall paintings of Bramhayani Dyochhen are 90% degraded even though they were restored and repaired 40 years ago by the Panauti Integrated Project. Compared to other artefacts, wall paintings are more delicate to external factors, and if not preserved an important part of Nepal’s heritage will be lost.&nbsp; Furthermore, most of the wall paintings in Nepal are temperas, and not frescos. Tempera is painted with water-soluble mineral or vegetable pigments fixed with glue on the cow dung clay plaster on the brick walls. While Nepal’s focus has been on the repatriation of stolen artefacts from abroad, religious and cultural objects within the country like the Panauti murals need urgent attention.&nbsp; This slim publication by Panauti Municipality is an important call to begin the work before it is too late.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260101120124_d0efa1e57b2710a206beb37c7e934ac34e694afc278985934eac2fc52124a92c.jpg" data-media-id="editor_3" data-image-id="20260101120124_d0efa1e57b2710a206beb37c7e934ac34e694afc278985934eac2fc52124a92c" data-rendition-name="original" width="1136" height="702" loading="lazy" alt="Wall Paintings of Panauti"> </figure>

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YALA

Nepal’s incomplete revolutions

Saving Panauti's murals