<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

Many of us former Nepal Peace Corps volunteers (PCVs) would agree that our time in Nepal changed in significant but very different ways our perspectives on life if not the future paths we chose to follow. Of no one was this truer than Dorothy Mierow. Dorothy was born in 1920, in Colorado Springs. Her father Charles C Mierow was a classics scholar and Latin professor, who served for ten years as president of Colorado College.&nbsp; Dorothy developed an interest in animals as a child, graduated with a BA degree in natural history from Carlton College in 1942, a Master’s in biology from the University of Pittsburgh, and another Master’s in geography from the University of Minnesota.&nbsp; As a young woman, Dorothy traveled with her father throughout Europe, including a visit to ancient Greek ruins, and took a Magellan Tour by cruise ship around the world in 1958.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025071901074_0bad133ab22aada319e74bbad95d563e191371db291c08f373839fbd15440262.jpg" data-media-id="editor_0" data-image-id="2025071901074_0bad133ab22aada319e74bbad95d563e191371db291c08f373839fbd15440262" data-rendition-name="original" width="903" height="1178" loading="lazy" alt="How the Peace Corps changed a volunteer's life"> <figcaption>HOME AWAY FROM HOME: Dorothy Mierow as a college student in her native Colorado.</figcaption> </figure>  She was a college teacher during much of the 1940s, also teaching at a girls’ school in Hawaii. Then back to her native Colorado in 1953, where she became a curator and later director of the Colorado College Natural History Museum. She taught geography classes, and in her free time, Dorothy climbed 22 of Colorado’s 14,000-foot peaks. Traveling in India in 1960, Dorothy decided to spend two weeks in Nepal. In late 1961, she filled out an application to join the Peace Corps and specified that she wanted to go to Nepal, ‘because I admired the people so much when my father and I were there on our trip’.&nbsp; Dorothy reached Kathmandu in September 1962 as the first group of American Peace Corps volunteers in Nepal. She stood out from the others: one of the few women in that group, surely the oldest at age 41, a world traveler, and a woman who already had established a professional career.&nbsp; One doubts if Dorothy had had a husband and children whether she would ever have gone to work and spend much of the rest of her life in Nepal.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025071901078_68e84ade1ffb0f6c83c7f8fa5c1e7315b5f6c543217f96cde012e4d86f171515.jpg" data-media-id="editor_1" data-image-id="2025071901078_68e84ade1ffb0f6c83c7f8fa5c1e7315b5f6c543217f96cde012e4d86f171515" data-rendition-name="original" width="1259" height="910" loading="lazy" alt="How th Peace Corps changed a volunteer's life NT"> <figcaption>Pokhara Bazar in 1962.</figcaption> </figure>  The Peace Corps assigned Dorothy to teach geography at Tri-Chandra College. After the school closed in the winter due to lack of heating, USAID and the College of Education asked Dorothy to help train general science teachers.&nbsp; She taught for two months and became involved in a textbook-writing project, commenting: ‘I would like the children to know something about public health, conservation (the trees are going fast and so is the soil), and learn the names of some of their common birds, trees, and flowers. They are more impressed with electricity, airplanes, and cell structure.’ When a new college opened in Pokhara in 1963, Dorothy was transferred there and lived with a Nepali family. The college boasted 30 students and no permanent buildings.&nbsp; In October 1963, Dorothy wrote: ‘Pokhara is a town of almost 5,000 people … We are in a fertile valley surrounded by foothills … There is a small Mission Hospital … a Leper Hospital and Tibetan Refugee Camp started by the Red Cross and now run by the Swiss. With winter approaching, more Tibetans are appearing in town, often with pack horses or donkeys. Some have been carrying large boxes of powdered milk,donated (by USAID) to the camp from the airport … There is no electricity, and the transportation problems make many items scarce and expensive. I am really a sort of a museum. The landlord brings all kinds of people in to see how I live and count my shoes and dresses. They express amazement at my books, pictures, tin oven, Nepali dolls from Kathmandu, screened food shelves and curtained closet.’ The standard term for Peace Corps volunteers was two years, but Dorothy extended her term and was still at Prithvi Narayan College at the end of 1965, when she wrote that she had 20 Geography students in the first-year class and 6 in the second year preparing for the IA Examination. The college enrollment was 125 students, and the foundation for a new science building was being excavated.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025071901074_c6a80e5e0db0c705b2f8733c6d30dc0386fe3abbd2238ea9d947b7d746f94a29.jpg" data-media-id="editor_2" data-image-id="2025071901074_c6a80e5e0db0c705b2f8733c6d30dc0386fe3abbd2238ea9d947b7d746f94a29" data-rendition-name="original" width="902" height="605" loading="lazy" alt="How the Peace Corps changed a volunteer's life"> <figcaption>Mierow and friends at Phewa Lake.</figcaption> </figure>  Dorothy noted that she ate one meal a day at the (Shining Mission) Hospital but otherwise lived on dal-bhat, momo, and potato curry at local shops. However, she had developed a new passion: to build what she initially called the Pokhara Museum of the Himalaya. In commendable Peace Corps fashion, Dorothy always worked with Nepalis and respected the culture. ‘The greatest joy and satisfaction I have had has been from the building of a Museum-Library in memory of my parents … It has been possible to feel like a wealthy benefactor with the money saved by father for the family’s education and now available for the education of others… (Father) would have loved to be in on the founding of a new college and be able to plan a library. Several hundred of the books to be in the museum-library came from his collection and were carefully selected to be of use for students in Nepal…’&nbsp; ‘The museum part is to satisfy my own inclinations and was thought of when I found how little diversion there was for the people of Pokhara… It is part of the University requirements for the college that it should have a geography and biology museum. The museum building is small but adequate.&nbsp; I have tried to design it in harmony with Nepalese architecture and decorate it with some of the art of the best artists or woodcarvers… Posts holding up the porch roof are carved by Cottage Industries to represent different peoples of Nepal in typical costumes. The door was carved by a local wood carver and has typical birds of Nepal around it. Inside are 10 roof-support carvings designed by the retired Director of the National Museum in Kathmandu, Mr. C.M. Maskey.&nbsp; They were carved by the best wood carvers in Patan very skilfully. The building has three rooms: the library, the exhibition room, and a smaller workroom which can be used by our newly formed Woman’s Club as well as other groups or classes.’  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025071901074_03d3359c65389d30a0134e9a4862778994121e7e833b7d28b18e06e36fc76ff8.jpg" data-media-id="editor_3" data-image-id="2025071901074_03d3359c65389d30a0134e9a4862778994121e7e833b7d28b18e06e36fc76ff8" data-rendition-name="original" width="629" height="599" loading="lazy" alt="How the Peace Corps changed a volunteer's life"> <figcaption>Mierow with local women in Pokhara in 1969.</figcaption> </figure>  Dorothy promoted her project to influential Nepalis connected with organisations whose support she solicited: The Department of Archaeology, the Department of Agriculture, the Godavari Botanical Gardens; Tribhuvan University’s Science and Education Department, Nature Conservation Society.&nbsp; The museum was opened officially in early 1967. The Annapurna Natural History Museum, the building Dorothy designed and had constructed, is still open and features some exhibits which she created many years ago.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025071901074_54326a8a0685e980e782378076de2f5cd02d2426e9b0d94eed972d3dbe83af26.jpg" data-media-id="editor_4" data-image-id="2025071901074_54326a8a0685e980e782378076de2f5cd02d2426e9b0d94eed972d3dbe83af26" data-rendition-name="original" width="1333" height="1000" loading="lazy" alt="How the Peace Corps changed a volunteer's life"> <figcaption>The Annapurna Natural History Museum.</figcaption> </figure>  Dorothy returned to America in 1967, but she longed for Nepal. In the spring of 1969, she again tried to enroll as a Peace Corps volunteer but was told that as she had spent more than four years, she would not be eligible for another assignment. Undeterred, she persuaded the college in Pokhara to invite her to return as a teacher.&nbsp; UNICEF and the Forestry Department sponsored Dorothy to prepare charts on trees, birds, animals and flowers in colour for distribution to the schools of Nepal. Dorothy, back in the Peace Corps, returned to Pokhara and the Museum in 1972. She formed a friendship with her former geography student from Sikles, Chandra Prasad Gurung, and in 1974, she brought Chandra to America, where he enrolled in Colorado College and studied cultural anthropology.&nbsp; Chandra subsequently earned his PhD in geography from the University of Hawaii and returned to Pokhara to become director of the Annapurna Conservation Area Project. Gurung actively promoted ecotourism, landscape conservation, and biodiversity conservation in Nepal. His life was cut short along with those of 23 other Nepalis and foreigners who perished in a helicopter crash near Taplejung in September 2006.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025071901074_322d3c3ac6f1b08ffa07c44a19998b937a7db9eb43527f7539cf6481e1546314.jpg" data-media-id="editor_5" data-image-id="2025071901074_322d3c3ac6f1b08ffa07c44a19998b937a7db9eb43527f7539cf6481e1546314" data-rendition-name="original" width="2500" height="1000" loading="lazy" alt="How the Peace Corps changed a volunteer's life"> <figcaption>Mierow's four books on Nepal and its biodiversity. </figcaption> </figure>  Dorothy worked with several well-known Nepalis to publish her paintings and photos in beautifully illustrated books. She and Hemanta Mishra of the National Parks and Wildlife Service wrote Wild Animals of Nepal (Ratna Pustak Bhandar, 1976). More than 400 photos Dorothy took on treks to the Everest region, Gosaikunda, Muktinath, Jumla and Rara Lake, as well as travels in the Tarai, appeared in Himalayan Flowers and Trees (Sahayogi Prakashan, 1978).&nbsp; The botanist Tirtha Bahadur Shrestha identified the species. Dorothy and Kesar Lall published This Beautiful Nepal (Sahayogi Press, 1981). Birds of the Central Himalayas (1988) contained Dorothy’s paintings of 250 species of birds found along the areas of the Kali Gandaki River, Pokhara, Chitwan and the central Tarai. Dorothy summed up her life and work in Nepal in Thirty Years in Pokhara (Pilgrims Book House, 1997). Dorothy returned to Pokhara and her adopted Gurung family several times during the 1980s and 1990s to celebrate festivals and meet old friends. Her final years were spent at her mountain cottage in Green Mountain Falls north of Colorado Springs. She died at the age of 79 in August, 2000. Nepal gave new meaning and purpose to Dorothy Mierow’s life. Daniel W Edwards was a Peace Corps volunteer in 1966 and is the author of several books on Nepal. The author thanks Special Collections, Tutt Library, Colorado College.

How the Peace Corps changed a volunteer’s life

· On the night of 15 May, two glacial lakes burst in Tharka in Humla and the debris flow washed away homes and bridges.&nbsp; · Last week, a slurry surge on the Kali Gandaki in Upper Mustang caused at least Rs15 million in damage, and was traced to a melting glacier. · Dozens are feared dead after <a href="https://nepalitimes.com/news/rasuwa-flood-likely-a-glof">an expanding glacial lake in Tibet overflowed</a>, sweeping down into Nepal and damaging four hydropower plants generating 230MW, nearly 8% of the country’s total grid supply.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250718060748_45225dc707c1e9c2968ca8dbf6e564e01e4eb6e2ff254fb8eb940cf62cdd910b.jpg" data-media-id="editor_1" data-image-id="20250718060748_45225dc707c1e9c2968ca8dbf6e564e01e4eb6e2ff254fb8eb940cf62cdd910b" data-rendition-name="original" width="2667" height="1500" loading="lazy" alt="Rasuwa flood"> <figcaption>Miteri friendship bridge connecting Nepal and China was swept away in the Rasuwa flood. Photo: PRAKASH CHANDRA TIMILSENA / NPL</figcaption> </figure>  And those are just in the past month. Climate scientists say Himalayan glacial lake outbursts are becoming more frequent and destructive, and a warning for Nepal not to put all its eggs in the hydropower basket.&nbsp; <a href="https://nepalitimes.com/editorial/when-it-rains-it-pours-ksqprbu3">Record precipitation last September</a> unleashed floods that killed 200 people, and temporarily slashed Nepal’s total generation capacity of 3,000MW by nearly half. The <a href="https://nepalitimes.com/banner/nepal-valley-suffers-quadruple-disaster">Melamchi flood of 2021</a> caused by <a href="https://nepalitimes.com/multimedia/the-not-so-permanent-frost">permafrost melting</a> on a glacier upstream nearly destroyed a $800 million water supply scheme, Nepal’s largest infrastructure project which four years later still has not resumed full operation. The <a href="https://nepalitimes.com/news/sikkim-flood-is-warning-to-nepal">glacial lake overflow in Sikkim</a> caused by record rainfall in September 2023 that destroyed the $1.2 billion Chungthung Dam and caused catastrophic damage to infrastructure on the Teesta River. This was a warning to the cascade of hydropower plants on the Arun and Marsyangdi river basins.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250718060736_6f61797a6be308321e3bae26e55d2f64cba4b9e5eb262adacb9e92fb5f3c6152.jpg" data-media-id="editor_6" data-image-id="20250718060736_6f61797a6be308321e3bae26e55d2f64cba4b9e5eb262adacb9e92fb5f3c6152" data-rendition-name="original" width="919" height="549" loading="lazy" alt="hydro disasters and hydropower plants"> </figure>  Nepal has set a target of generating an additional 28,500MW by 2035 -- out of the feasible 48,000MW -- but how viable is an energy strategy that is exposed to heightened risk due to climate breakdown? &nbsp; “As extreme weather events increase, we must design and build infrastructures respecting river flow and topography,” says former Energy Secretary Dwarika Nath Dhungel. “We must make the best use of our water resources, but not by letting excavators loose everywhere mining riverbeds and building haphazardly where we shouldn’t.”&nbsp; Although no project can be disaster-proof, <a href="https://nepalitimes.com/banner/climate-smarter-himalayan-infrastructure">climate smart design</a> can minimise damage from flash floods and landslides. Recent disasters have driven up insurance premiums for energy projects in Nepal, and smaller ones cannot even afford them. The 456MW Upper Tamakosi hydroelectric project which is still not fully functional after the September floods has claimed insurance worth Rs1.8 billion. The alternative to high risk high investment hydropower projects is <a href="https://nepalitimes.com/here-now/what-s-cooking-in-nepal-besides-politics">energy diversification</a> to other renewables such as solar, wind or biogas. Nepal gets annual sunlight of 300 days with 6-7 hours on average to total 50,000 terawatt-hours (TWh) per year.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250718060744_4acd452b4117180ca9bb5d3be839ff46dfd5464e4d507f5ad3704cef6253bc48.jpg" data-media-id="editor_9" data-image-id="20250718060744_4acd452b4117180ca9bb5d3be839ff46dfd5464e4d507f5ad3704cef6253bc48" data-rendition-name="original" width="1080" height="720" loading="lazy" alt="solar power"> <figcaption>Farmers in Tarai using solar powered water pump. Photo: GHAMPOWER</figcaption> </figure>  The Solar and Wind Energy Resource Assessment (SWERA) calculates that Nepal could source 3,000MW from wind energy alone, considering 10% of the area with more than 300W/m2 wind power density. <a href="https://nepalitimes.com/opinion/people-power/decentralising-power-in-nepal">Solar energy</a> stations are cheaper and quicker to build, and would be an ideal alternative to reliance on hydropower.&nbsp; “There has been some investment in solar power, especially from the state sector,” says water expert Madhukar Upadhyay. “But there is an issue of land acquisition since the arrays need a lot of space. It is comparatively easier to get a permit to put up a hydropower plant on a river.” As for biogas, there is simply no incentive to build on past success with household level plants to <a href="https://nepalitimes.com/here-now/more-bullshit">promote industrial-scale production</a>. Scaling up biogas by integrating it with urban biodegradable waste would still be a viable alternative to LPG.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250718060744_715d44afd5eb4ba8dafa209b0ad0f19400665797b5f078f5636821e600f96684.jpg" data-media-id="editor_12" data-image-id="20250718060744_715d44afd5eb4ba8dafa209b0ad0f19400665797b5f078f5636821e600f96684" data-rendition-name="original" width="1419" height="954" loading="lazy" alt="windmill"> <figcaption>A wind mill in Hapsikot in Nawalpur. Photo: WINPOWER NEPAL</figcaption> </figure>  Nepal’s public sphere is buzzing with excitement over the discovery of potentially 430 billion cubic metres of methane gas beneath Dailekh district that, if properly harnessed, would meet the country’s energy demand for the next 50 years. Even though a feasibility study is awaited, politicians from the prime minister down see this as a petro bonanza that will make Nepal rich. But drilling, storage and distribution of CNG in the country’s current kleptocratic state make that unlikely. If Nepal was to get rich solely on its hydro-energy potential, it could have done so in the past 50 years. Says Dhungel: “This is not exactly a new discovery, but it is premature to celebrate until its extraction is proven to be cost effective. And let us hope it does not get <a href="https://nepalitimes.com/news/balance-of-power">tangled in geopolitics</a>, since China is involved in the prospecting and drilling, which could make India uneasy.”&nbsp; The country suffers from the Dutch Disease curse even before its resource is fully exploited. And the same cronyism, corruption and rent-seeking structure cannot deliver the riches we expect from Dailekh’s methane discovery. Now, <a href="https://nepalitimes.com/here-now/right-climate-for-nepal-s-energy-transition">with hydropower in jeopardy</a>, Nepal’s planners will have to evolve a new strategy for energy security into the future. But first, governance needs to be cleaned up with long-term strategic planning that takes climate risk into account. For example, do we need to mine fossil gas when there are renewable options? Will Dailekh take Nepal away from its climate commitments? Says Madhukar Upadhyay: “Nepal has always been resource rich and management poor. And the larger the resource, the bigger our management incapacity. It is a societal malaise.”&nbsp;

Nepal’s Resource Curse

चौतारा rest stops have long been an integral part of scenic touristic town of <a href="https://nepalitimes.com/news/pokhara-six-decades-ago">Pokhara </a>but are now rarely seen as the city bursts at the seams. They say inhabitants of Pokhara saw a plane before they saw cars. Indeed, the grass airfield was built in the 1950s, while the Kathmandu highway 20 years later. Before roads, people walked to get around, pausing to rest or even nap under the shade of banyan-pipal trees. <a href="https://nepalitimes.com/here-now/pokhara-s-desperation-and-hope">Pokhara airport’</a>s ‘terminal’ in those days was a shady chautara where passengers waited for their flights. The chautara bore silent witness to daily life, whether it was travellers seeking a brief respite from the summer heat or villagers gathering for a chat in the mornings and evenings. But with the roads came vehicles, and then houses started filling up spaces, even farmlands. Pokhara began transforming from a serene village to a <a href="https://nepalitimes.com/news/pokhara-comes-alive-at-night">bustling city</a>.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250719010724_d101fa482441ce67afdf5bc4e4547b334e7662c1cf0a20e9d31a0e8dff66f04b.jpg" data-media-id="editor_3" data-image-id="20250719010724_d101fa482441ce67afdf5bc4e4547b334e7662c1cf0a20e9d31a0e8dff66f04b" data-rendition-name="original" width="2147" height="1581" loading="lazy" alt="Trees of life and living NT"> <figcaption>Photo: DURGA RANA MAGAR</figcaption> </figure>  The banyan-pipal trees were chopped down to make way for wider intersections and buildings. The once-iconic rest stops that carried Pokhara’s identity had all but vanished. “Building chautara was once considered a religious duty, which is why so many of them were constructed across Pokhara,” says archivist Sunil Ulak. <a href="https://archive.nepalitimes.com/news.php?id=10927">Ekai Kawaguchi</a>, a Japanese Buddhist monk, who visited Nepal 120 years ago en route to Tibet, documented <a href="https://nepalitimes.com/banner/no-visitors-in-pokhara-to-admire-view">the landscape of Pokhara</a> and its surroundings. In his book, Three Years in Tibet, he reflects on the natural beauty of the town and its shady trees. A chautara used to be surrounded by ponds, where shepherds would bring their cattle to drink from while they took a nap under the shade. The gentle rustling of leaves in the cool breeze lent a soothing melody as did the chirping of birds, while the insects took refuge in the branches and leaves. Read also: <a href="https://nepalitimes.com/here-now/pokhara-800-years-ago">Pokhara 800 years ago</a>, Kunda Dixit This ‘nature’s breeze’, as botanist Kalyan Panta puts it, is now history due to <a href="https://nepalitimes.com/banner/cost-of-living-in-a-big-city">haphazard urbanisation</a>. “When the wind strikes against one leaf, it creates a domino effect and other leaves start waving as well,” he explains. There were 632 chautara in the city until 1977, and by 2000 the number had fallen to 278. But in some wards the number of trees fell from 55 in 1984 to only five now.&nbsp; The gradual loss of these resting places has meant habitat <a href="https://nepalitimes.com/banner/between-existence-and-extinction-in-nepal">destruction of birds and insects</a>, it has also damaged the environment and natural beauty of the city.&nbsp; Researcher Jagannath Adhikari’s study showed that infrastructure projects ignored the environment, and concluded that that urbanisation in Pokhara was unsustainable.&nbsp; The destruction continues to this day. Recently, old chaurata in wards 6, 13 and 14 were cleared to make way for a sacrificial ritual. In fact, ward 6 got a permit from the local government to clear its remaining trees.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250719010724_cee1d4faf8376e7ba18b9c7012ea4215b7c3fbf7e0983b0c97005df5567d6de0.jpg" data-media-id="editor_9" data-image-id="20250719010724_cee1d4faf8376e7ba18b9c7012ea4215b7c3fbf7e0983b0c97005df5567d6de0" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="Trees of life and living NT"> <figcaption>Photo: DURGA RANA MAGAR</figcaption> </figure>  But in wards 13 and 14, the Human Service Foundation cut down some 33 trees for which it is in a dispute with the metropolitan city as there is no unclear jurisdiction regarding who gives the permit. The Kaski Division Forest Office is currently investigating the matter. Elsewhere in ward 19, the ward office had launched ‘मेरो रूख, म काट्छु’ campaign due to an alleged chaos caused by monkeys in the area. The decision was rescinded after an all-around opposition.&nbsp; To be sure, there are policies in place to protect trees such as the Gandaki Province Forestry Act, 2080, and the Regulations, 2081. The province government also introduced an act in 2019 per which no tree, including pipal, silk cotton and other <a href="https://nepalitimes.com/opinion/suburban-tales/trees-trees?%2F">trees of natural and historical importance</a> shall be damaged, eroded or removed. But the local government, responsible for implementing the Act, is doing the opposite. “If this rapid rate of tree felling continues, neither trees nor chautara will survive for the future generation,” conservationist Ram Bahadur Poudel tells us, adding that old trees are being cleared under the pretext of pruning branches. Interestingly, Ulak notes that Pokhara-8 was called सिमलचौर in the past because there were so many majestic silk cotton trees, but there are very few left, if any, and hence altering the identity of a place. With modernisation, people have questioned the significance of chautara in this day and age. But they still have relevance. Urban centres in Pokhara and Kathmandu are much hotter than the outskirts because of the <a href="https://nepalitimes.com/news/in-the-heat-of-the-moment-5xcycyot">urban heat island effect</a>. Says archivist Ulak: “While their original purpose was to provide rest, today they continue to play a crucial role in regulating temperature, beautifying the city, and preserving our environment.”

Trees of life and living

Nepalis are living longer than ever. By 2028, the country is set to join the ranks of other <a href="https://nepalitimes.com/news/nepals-demographic-window-is-closing">ageing societies</a> around the world, and by 2054, 1 out of every 7 people in Nepal will be over 65. Life expectancy at birth has risen dramatically from just 55 in 1990 to 71 today, &nbsp;thanks to improvements in public health and access. But as more people live longer, the country must also prepare for a parallel rise in age-related illnesses and the complex social and medical needs that come with an <a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/need-to-prepare-for-ageing-society,3624">ageing population</a>. Extended families have always acted as a safety net for <a href="https://nepalitimes.com/news/home-sweet-home-for-older-nepalis">the elderly</a>, with children and grandchildren shouldering most caregiving duties. But with more than 1,600 <a href="https://nepalitimes.com/banner/migration-not-a-wish-but-necessity-for-nepalis">Nepalis migrating </a>every day, older parents are left behind with no one to care for them. <a href="https://nepalitimes.com/editorial/the-new-equaliser">Remittances</a> from migrating youth, which account for nearly a third of Nepal’s GDP, have kept the economy afloat. But money sent home cannot make up for the chronic departure of kin and caregivers, who are often the first to catch the signs and symptoms of disease in elders. In rural areas where over 85% of Nepal’s elderly live, the absence of this daily vigilance means early signs of illness often go unnoticed until they become debilitating. As a result, chronic conditions like hypertension, diabetes, and depression are left unmanaged.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250720130748_213f2c65f2638872e9ac0550a7ac251e4960c3726dc5c76215962a23ba71dff1.jpg" data-media-id="editor_5" data-image-id="20250720130748_213f2c65f2638872e9ac0550a7ac251e4960c3726dc5c76215962a23ba71dff1" data-rendition-name="original" width="1064" height="701" loading="lazy" alt="Smart ageing is Nepal’s next frontier"> </figure>  Geriatric medicine is largely absent from medical curricula and there is no national plan in place to manage cognitive decline, memory loss and confusion. These are often mistaken for signs of normal ageing, instead of <a href="https://archive.nepalitimes.com/article/nation/dementia-brings-new-problem-that-families-have-little%20knowledge-of,2151">dementia</a>, delaying care until it is too late. The same pattern plays out with strokes, osteoarthritis, and vision problems — conditions that could be managed early but are instead allowed to spiral into <a href="https://nepalitimes.com/opinion/comment/changing-disability-to-this-ability-h68f6sq2">disability</a>. Nepal is not ready for an older future. It needs a strategy for ‘smart ageing’ where the focus is not adding years to life, but enhancing years lived through the intelligent application of policy, infrastructure, and crucially, <a href="https://nepalitimes.com/opinion/comment/tech-and-transition-in-nepal">technology</a>. Many models of smart ageing, however, are sculpted around modern societies where independent living in later life is the norm. Furthermore, eroding traditional family care and an underdeveloped formal care system means there is a large gap that can’t simply be filled by copy-pasting from foreign models. Nepal must shape its own version of smart ageing. The <a href="https://nepalitimes.com/news/healthcare-moving-from-hospitals-to-homes?%2F">tech boom</a> has led to homegrown digital healthcare apps such as Hamro Doctor, Cura Health, Jeevee and Health Yaad Ayo which offer teleconsultations, online appointments, and at-home test bookings. As <a href="https://nepalitimes.com/review/nepal-s-new-digital-landscape">smartphones and internet access</a> extend to the most rural fringes of the Nepali countryside, geography is no longer a barrier to the use of these digital tools. What limits their use is the lack of digital proficiency among the older generation. Others find the idea of turning to a device instead of a familiar, reassuring face unfathomable. That is why <a href="https://nepalitimes.com/opinion/addressing-nepals-digital-divide?ref=blog.togglecorp.com">digital literacy</a> efforts must be paired with guided human support to build trust alongside technical skill. Such a model of community-led digital mediation is already gaining traction elsewhere. In the UK, ‘digital health ambassadors’—often young people or even schoolchildren—are trained to co-design and advocate for online platforms that resonate with peers who might otherwise feel excluded from automated health services. A Nepali version could engage cohorts of nursing students, tech-savvy youngsters and returnee migrants to assist elders in navigating digital health platforms and troubleshooting problems, and most of all, normalising the idea of health apps being a reliable recourse.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250720130748_fcb94ab76e76b5574189757e88d76fccad4e115e78dd9eae92a3bd4c882c3431.png" data-media-id="editor_12" data-image-id="20250720130748_fcb94ab76e76b5574189757e88d76fccad4e115e78dd9eae92a3bd4c882c3431" data-rendition-name="original" width="2246" height="1590" loading="lazy" alt="Smart ageing is Nepal’s next frontier"> </figure>  Nepal’s own network of Female Community Health Volunteers (FCHVs), whose credibility is rooted in long-standing relationships across rural communities, could be similarly upskilled, their roles in <a href="https://nepalitimes.com/here-now/target-2030-for-maternal-and-newborn-health">maternal and child health </a>expanded and repurposed to also include geriatric tech support. However, there is a limit to how much older adults can adapt to new technologies. So, Nepal should simultaneously invest in passive technologies—tools that monitor and act for the elderly, instead of demanding active use. That is where wearables and in-home smart health devices collectively known as 'gerontechnology' come in. Picture an 82-year-old in far-flung Rolpa, away from the facilities of an urban hospital. Installed in her home are low-cost motion sensors that monitor prolonged inactivity or signs of a fall, instantly triggering alerts to the nearest health post when necessary. On her wrist, a wearable bracelet continuously tracks her sleep, vital signs, oxygen saturation, and glucose levels. This data is encrypted and synced to a digital dashboard accessible by health staff at the local post. If the system flags an acute risk—such as a potential stroke or hypoglycemia—a nearby health worker is dispatched immediately to her home. If her readings over time indicate a trend toward a <a href="https://nepalitimes.com/news/why-do-so-many-nepalis-have-high-blood-pressure">chronic condition</a> like diabetes, community health volunteers step in. They help schedule a virtual consultation with an endocrinologist in Butwal. Based on the advice received, she gets a prescription and picks up her medication from the local community pharmacy, along with a smart dispenser to ensure she sticks to her treatment plan without missing doses. This is not as far-fetched as it may sound. Many of the individual devices forming this connected medical system called an Internet of Medical Things (IoMT) already exist in Nepal as imported commercial products. What is missing is a stronger framework for <a href="https://nepalitimes.com/business/public-health-partnership">public-private collaboration</a>: one where health tech companies continue developing locally adapted tools, and the government actively integrates these innovations into public health delivery. <a href="https://nepalitimes.com/opinion/people-power/nepal-as-an-ai-power-bank">Nepal’s tech ecosystem</a> is maturing, but policymaking must evolve in tandem, especially when it affects an older generation largely resistant to change. The backlash against the recent mandate requiring National Identity Cards for accessing social security benefits revealed the pitfalls of imposing top-down reforms without adequate preparation or support for seniors. For Nepalis to age well, community caregivers, doctors, innovators, and above all, the state, must step in where families have stepped away. The goal is not to replicate traditional care, but to build a coordinated system of support that connects everyone through technology. The future is older for Nepal, let us be wiser too. The writers are pursuing their undergraduate studies in biomedical engineering at the Hong Kong Polytechnic University.