<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221114131124/637233e59c7e80680e0c4905jpeg.jpg" alt="" width="760" height="443"/>Monkeypox cases are increasing worldwide and now with India seeing more infections, public health experts have warned that Nepal needs to be vigilant.While the disease does not pose the same degree of threat as Covid-19, officials say it is better to remain cautious. The World Health Organization (WHO) has already declared a health emergency.“Monkeypox symptoms take time to show. If the infection spreads in Nepal, it could be too late by the time it gets identified,” warns Sher Bahadur Pun, infectious disease specialist at Kathmandu’s Teku hospital. Infected people may be reluctant to be tested.Meanwhile, officials say they have already started preparations against monkeypox with increased surveillance at the Nepal-India border area and health workers on high alert.“We have instructed border personnel to check people with visible rashes and send them to dermatologists,” says Sameer Adhikari of the Health Ministry. “Lab personnel have been alerted and health workers have been provided with guidelines.”Monkeypox is not a new disease but is a rare zoonotic infection caused by a virus similar to smallpox but not as severe. The virus was first discovered in monkeys in 1958 and the first human case was identified in 1970. The disease was previously confined to central and West Africa.Monkeypox is primarily transmitted from rats and monkeys, and from one person to another by coming in contact with an infected person’s lesion, by touching a contaminated object or from respiratory droplets. It can also be spread by kissing, hugging, touching, or sex.A person taking care of an infected individual, children, infants, pregnant women and immune-compromised individuals are especially at a high risk of contracting monkeypox.Monkeypox does not yet have a vaccine but some smallpox jabs can prevent the infection, including the ACAM2000 and Jynneos shots. Because smallpox and monkeypox are caused by related viruses, smallpox inoculation is effective for both.Monkeypox is usually a mild condition and symptoms appear within 6 to 13 days and resolve within 3 weeks. Common symptoms include fever, headache, back and muscle ache and swollen lymph nodes and exhaustion. People quickly develop rashes that are contagious till they dry up and burst.Monkeypox is rarely fatal, however, it can be dangerous and cause pneumonia, and skin and eye conditions in some individuals. Previously up to 10% of infected individuals died due to the infection.At least 75 countries have reported monkeypox cases so far with Spain registering the highest at 3,125 followed by the US at 2,316, the UK 2,137, Germany 2,268, France 1,453, Canada 615, the Netherlands 712, Brazil 592 and Portugal 588.Most monkeypox cases do not need medical attention but if fever is too high, certain medicines can be taken. Individuals need to hydrate themselves, have a healthy diet and get good sleep. Scabs should not be scratched, hands should be kept clean and the skin dry.The good news is that many of the safety measures to prevent Covid-19 from transmitting such as masking up, avoiding crowded spaces and sanitising can also keep monkeypox at bay.Translated by Aria Parasai from the <a href="https://www.himalkhabar.com/news/131330?fbclid=IwAR2jdwW01dFzVzjh_nHfRSr2d5sGoj_KyHtVrwAjM8jGJsKWuL4evSLZXco">Nepali original</a> at Himalkhabar.comRead more: <a href="https://www.nepalitimes.com/banner/1-mask-up-2-avoid-crowds-3-get-boosters/">1. Mask Up. 2. Avoid Crowds. 3. Get Boosters</a>, Sonia Awale

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Preparing to prepare for monkeypox

Although smallpox is now ‘unfamiliar to the world today’ historian Elizabeth Fenn has written that it was ‘a misery commonplace in years gone by.’For centuries, the smallpox virus and the gruesome death and destruction it caused upended people's lives around the world and in Nepal. In this History of Disease series in Nepali Times in the past month I have recounted how smallpox traveled and killed in Europe and America, became a terrible test for survival for children in South Asia, and  struck down both royals and regular citizens in Nepal in the 19th century.We have seen how people devised inoculation and vaccination to fight the disease, and how vaccines and strong surveillance helped eradicate the disease around the world and in Nepal in the 1970s, but only 'by the slimmest of margins'.Several things about the history of the disease deserve special emphasis. As much as any influential king or prime minister, we sometimes forget that smallpox and other diseases shaped the course of human events.Part I: <a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/banner/big-story-of-small-pox-in-nepal/" target="_blank" rel="noopener noreferrer">Big story of smallpox in Nepal</a>Part II: <a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/opinion/the-smallpox-virus-in-british-india/" target="_blank" rel="noopener noreferrer">The smallpox virus in British India</a>Part III: <a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/opinion/smallpox-politics-and-power-in-kathmandu/" target="_blank" rel="noopener noreferrer">Smallpox, politics and power in Kathmandu</a>Part IV: <a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/opinion/how-nepal-eradicated-the-smallpox-virus/" target="_blank" rel="noopener noreferrer">How Nepal eradicated the smallpox virus</a><figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022112916110/63861ea39c7e80680e0ccdd9jpeg.jpg" alt="" width="1500" height="1001"/><figcaption>Photo: MANISH PAUDEL</figcaption></figure>Viruses such as measles, influenza, hepatitis, polio, rabies, and HIV – as well as non-viral diseases such as cholera, TB, syphilis, and malaria – remade not just individual lives, but also physical, economic, and political landscapes.The fury of smallpox reminds us of the inescapable power of nature. Despite all our efforts, humans are part of nature, and life is fragile.We are living beings made up of cells and nutrients, subject to the rules of geography and biology, death and disease. This reality held true in the past, and holds true today, as much as we hope otherwise. Smallpox may have been chased away, but COVID-19 stands at the doorstep.Each disease has its own characteristics, its own biological personality, its own way of spreading through society and attacking human bodies. <a href="https://www.nepalitimes.com/here-now/the-mosquito-that-changed-nepals-history/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/here-now/the-mosquito-that-changed-nepals-history/&amp;source=gmail&amp;ust=1590041413347000&amp;usg=AFQjCNEvpoGS7wd8yELy9-vJ0LG1oby5kw">Malaria moved via mosquitoes</a> which liked warm weather, <a href="https://www.nepalitimes.com/latest/kathmandu-in-the-time-of-cholera/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/latest/kathmandu-in-the-time-of-cholera/&amp;source=gmail&amp;ust=1590041413347000&amp;usg=AFQjCNGDo4ZWCamW139FFTuqWLpgRZuSoQ">cholera through germs in water</a>, and syphilis through sex. Due to these differences, each disease left its own unique imprint on history.<a href="https://www.nepalitimes.com/banner/big-story-of-small-pox-in-nepal/" target="_blank" rel="noopener noreferrer" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/banner/big-story-of-small-pox-in-nepal/&amp;source=gmail&amp;ust=1590041413347000&amp;usg=AFQjCNF3MVYYqp8ZY4QHWix_z0-R_ABxUA">Big story of small pox in Nepal</a>, Tom RobertsonSmallpox spread through the air, moved easily from person to person, caused searing pain, and, if it did not kill, left behind disfigured, broken human bodies. In Nepal, if it had struck older people, not children, or if it had not left its victim's faces scarred and their eyes damaged, it might have brought less terror.On the other hand, if it had had a reservoir in animals (as many viruses do) it would have been much harder to eliminate, and we might still be facing its burning fevers and excruciating rashes today. Small pox’s particular biology shaped history in a particular way.Nature is not just a passive stage on which we humans act out our dramas as we wish. Instead, it is an actor in every drama, sometimes in the background, sometimes centerstage, but often coming and going at its own will, not ours.<a href="https://www.nepalitimes.com/opinion/the-smallpox-virus-in-british-india/">The smallpox virus in Nepal</a>, Tom RobertsonLooking back, if we recount the stories just of kings and queens and their political chess matches, we overlook some of history's main drivers and its most important stories. In fact, if we overlook disease history we will not understand the stories of kings and queens as well as we think. Can we really tell the history of Rana Bahadur, Girvana, Bimsen Thapa, and Bir Shumshere -- much less the stories of ordinary people around the country -- without understanding the central role of disease?Looking forward, we would do well not to forget nature's power to completely take over the course of events. Smallpox also reminds us that, even though humans share the same biology, diseases often affect some subsets of society more than others, particularly those with less money and power. In other words, biological forces may be universal but they play out in social landscapes as complex and uneven as Nepal's dadakada.In the Americas, smallpox even more than guns, gave Europeans a huge advantage over the indigenous people who had never encountered the disease before, and thus lacked immunity. <a href="https://www.nepalitimes.com/opinion/the-smallpox-virus-in-british-india/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/opinion/the-smallpox-virus-in-british-india/&amp;source=gmail&amp;ust=1590041413347000&amp;usg=AFQjCNHRE-p56xptgt9wTBUUjoc05RxNwA">In colonial India, smallpox and ideas about how to treat it divided the British from Indians</a> more than it brought them together.<a href="https://www.nepalitimes.com/banner/big-story-of-small-pox-in-nepal/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/banner/big-story-of-small-pox-in-nepal/&amp;source=gmail&amp;ust=1590041413347000&amp;usg=AFQjCNF3MVYYqp8ZY4QHWix_z0-R_ABxUA">In Nepal, smallpox preyed upon both rich and poor</a>, powerful and powerless alike. But as the 19th century Newar song 'Sitalamaaju Mye' reminds us, it divided Gorkha conquerors and Newar families. <a href="https://www.nepalitimes.com/opinion/smallpox-politics-and-power-in-kathmandu/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/opinion/smallpox-politics-and-power-in-kathmandu/&amp;source=gmail&amp;ust=1590041413347000&amp;usg=AFQjCNFFHANLUtlK0myrUwhb4qdFGZg4Pg">Smallpox shaped power struggles between Bhimsen Thapa and his political rivals</a>, and later, in the effort at eradication, altered relations between government health workers and individuals from impoverished ethnic minorities.<a href="https://www.nepalitimes.com/opinion/smallpox-politics-and-power-in-kathmandu/">Smallpox, politics and power in Kathmandu</a>, Tom Robertson No doubt, smallpox also shaped gender relations in ways we need more historical research on. Just as differences between diseases mattered in the course of history, so, too, did social differences.<a href="https://www.nepalitimes.com/opinion/how-nepal-eradicated-the-smallpox-virus/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/opinion/how-nepal-eradicated-the-smallpox-virus/&amp;source=gmail&amp;ust=1590041413347000&amp;usg=AFQjCNGC0hhwCb-vpWbsy8-oT_gcbRcM6Q">Nepal's successful effort to eradicate smallpox in the 1960s and 1970s</a> seems particularly relevant to us today. Nepal's last case in 1975 shows what it took to banish a complex disease in challenging circumstances: sustained governmental focus and coordination, adequate long-term funding, scientific knowledge, talented and dedicated staff, careful record keeping, program flexibility and adaptation to local culture and conditions, and dogged surveillance.Yet even at this moment of seeming human control, nature's power was on display. Smallpox eradication happened only with help from nature. Compared to malaria and polio, smallpox was relatively easy to control. It was so intense that it was easy to spot, and that intensity also made it difficult for contagious victims to move around infecting others. Smallpox did not strike a person twice. And unlike other viruses, it proved very susceptible to a vaccine. This history suggests some of the special challenges that COVID-19 poses.Here, too, social difference mattered. Nepal's eradication campaign shows the enormous challenge of protecting individual rights in moments of public health crisis. In Nepal and other South Asian countries, government personnel sometimes used violence to force citizens to get vaccinated. Some health workers grew so convinced of their righteousness -- the 'purity of purpose' in one man's self-description -- that they felt comfortable steamrolling the wishes of others, often people from socially marginalised groups with little say in society to begin with.<a style="background-color: #ffffff; font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/opinion/how-nepal-eradicated-the-smallpox-virus/" target="_blank" rel="noopener noreferrer">How Nepal eradicated the smallpox virus</a>, Tom RobertsonSuch coercion probably could have been avoided through more nimble policies, more extensive training, and better public education. Problems often sprouted, the historian David Arnold noted, when doctors and other health workers didn't understand how ordinary people saw the world and quickly dismissed their concerns as backward or superstitious -- when, as he put it, the medical system had grown ‘culturally and politically distant from the lives of its subjects’.In the end, the history of smallpox shows the fragility of life, but also the power of human perseverance. Smallpox struck down one of every three it infected. It stole beautiful children from their mothers and fathers. It stole sight from survivors. In some places, it wiped out entire families and laid waste to whole villages. It was deadly, ruthless, and horrific. It sometimes brought out the worst in human nature.But it also often spurred great ingenuity, compassion, togetherness, and resilience. In the face of disease, humans have found surprising ways to support each other, learn from the past, endure the suffering of the present, and find hope again in the future.This is the fifth article in the <a href="https://www.nepalitimes.com/opinion/big-story-of-small-pox-in-nepal/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/opinion/big-story-of-small-pox-in-nepal/&amp;source=gmail&amp;ust=1590041413347000&amp;usg=AFQjCNHAaHCW0Y2UQjeFfh0UQoUPVtsqbA">series </a>History of Disease. The next column will deal with danger of dengue in Nepal. <a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/how-chitwan-was-opened,4159" data-saferedirecturl="https://www.google.com/url?q=https://archive.nepalitimes.com/article/Nepali-Times-Buzz/how-chitwan-was-opened,4159&amp;source=gmail&amp;ust=1590041413347000&amp;usg=AFQjCNEcTfdhSI0N9Tqo_qgoyZnrHCccug">Tom Robertson</a>, PhD, is researching the environmental history of Kathmandu Valley.Read other articles on smallpox in Tom Robertson’s History of Disease series in <a href="https://www.nepalitimes.com/opinion/how-nepal-eradicated-the-smallpox-virus/" data-saferedirecturl="https://www.google.com/url?q=https://www.nepalitimes.com/opinion/how-nepal-eradicated-the-smallpox-virus/&amp;source=gmail&amp;ust=1590041413347000&amp;usg=AFQjCNGC0hhwCb-vpWbsy8-oT_gcbRcM6Q">Nepali Times</a>.

Tom Robertson

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Viruses past, present and future

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109101152/636b78a69c7e80680e0646b2jpeg.jpg" alt="" width="1000" height="763"/><figcaption>Photo: BIKRAM RAI</figcaption></figure>With business coming to a grinding halt globally due to the COVID-19 pandemic, Nepal’s migration and tourism-based economy is being severely impacted.Global stock markets are in freefall, the US has halted trans-Atlantic flights, Italy is in lockdown, India has stopped issuing tourist visas, schools in Japan are closed, Qatar has banned nationals from 14 countries, Saudi Arabia has halted travel to nine countries, and although the virus has stabilised in next-door China, there is a danger there of reverse infection.But as the epidemic spreads, Nepal has officially admitted to only one confirmed case of COVID-19. Public health experts say this does not mean there are no infected people, it just means suspected cases have not been tested yet. They say the country is not prepared to deal with an outbreak.“The situation around the world is getting out of hand, but Nepal has been able to dodge a full-blown health crisis till now,” says Sameer M Dixit, a scientist at the Centre for Molecular Dynamics Nepal. “In an ideal situation the country would be under lockdown, but right now Nepal should stop all direct flights from highly affected countries.”Even though there are no overt signs of a health crisis, Nepal’s economy has already been hit hard and the impact is expected to worsen in the coming months as tourism collapses and air travel is further curtailed.The Asian Development Bank’s ‘<a href="https://www.adb.org/publications/economic-impact-covid19-developing-asia" target="_blank" rel="noopener">COVID-19 Economic Impact Assessment Template</a>’ released this week lays out the best- and worst-case scenarios for countries in the region. For Nepal, the bank predicts a loss of up to $322 million.The tourism sector has been impacted by travel restrictions imposed by Nepal and other countries, and airlines cancelling flights.The government decision late Thursday, after the print edition of this paper had gone to press, decided to revoke visa on arrival at Kathmandu for nationals of all countries. Visitors will still be allowed to enter Nepal but they will require a visa from a Nepali mission abroad and also a Coronavirus-free health certificate. The visa rule be effective 14 March to 30 April for now.The move comes one day after China cancelled all expeditions from its side of Mt Everest. The Nepali government has also cancelled all climbing expedition permits including Mt Everest for the spring season.Read also: <a href="https://www.nepalitimes.com/banner/why-nepal-must-watch-about-coronavirus-but-not-panic/" target="_blank" rel="noopener">Why Nepal must watch Coronavirus, but not panic</a>, Sameer M DixitEven before the government <a href="https://www.nepalitimes.com/latest/lets-call-off-visit-nepal-year-2020/" target="_blank" rel="noopener">called off Visit Nepal Year 2020</a>, the campaign was criticised for lack of international promotion and the money being wasted on domestic extravaganza. Although tourist arrivals saw only a slight drop to 101,400 in February, there was a 80% decrease in visitors from China.Official figures are not yet available for March and April, but the travel industry is reporting widespread cancellations. <a href="https://www.nepalitimes.com/latest/nepal-postpones-international-events-as-fear-of-covid-19-intensifies/" target="_blank" rel="noopener">Many international conferences and sports events have been postponed</a>. Hotel occupancy rates are dropping at what should have been peak season. Trekking and mountaineering expeditions have gone ahead but there has been a 50% decline in the number of clients. There are also reports of cancellations for April.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109101152/636b78a99c7e80680e0646b3jpeg.jpg" alt="" width="981" height="497"><figcaption> </figcaption></figure>“Hotel bookings are down by 60% in the 5-star hotels around Nepal,” Shreejana Rana, President of <a href="https://www.hotelassociationnepal.org.np/" target="_blank" rel="noopener">Hotel Association of Nepal</a>, told Nepali Times. “We had <a href="https://www.nepalitimes.com/banner/chinese-tourist-influx-to-nepal-in-2020/" target="_blank" rel="noopener">expected a surge in bookings </a>after Chinese New Year and during the spring from American and European tourists but that isn’t the case.”The first airlines to cancel flights were the ones operating to Chinese destinations: Himalaya Airlines, Sichuan Airlines and Tibet Airlines. Air China, China Southern and China Eastern are still operating flights, but with reduced frequency and smaller aircraft.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109101152/636b78ab9c7e80680e0646b4jpeg.jpg" alt="" width="4096" height="2730"><figcaption> </figcaption></figure><figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109101152/636b78ae9c7e80680e0646b5jpeg.jpg" alt="" width="3644" height="2429"><figcaption> </figcaption></figure>“The tourism industry is very sensitive. The smallest problem has widespread impact, and it takes a lot of time to recover from it,” says Deepak Raj Joshi, former CEO of <a href="https://www.welcomenepal.com/" target="_blank" rel="noopener">Nepal Tourism Board</a>. “We need to start preparing for the future right away.”The Tourism Ministry is now repurposing <a href="https://www.nepalitimes.com/editorial/the-nepal-brand/" target="_blank" rel="noopener">Visit Nepal Year 2020</a> towards a 2020-2030 ‘Tourism Decade’, and the hotel industry is relying on domestic promotion, encouraging Nepalis to travel to Pokhara and to go trekking during the new-year break in April.Nepal expects about 250 climbers from 24 expeditions on Mt Everest this spring, even though Korean, Japanese and some western expeditions have cancelled. This is half down from last year, when there was a <a href="https://www.nepalitimes.com/banner/most-days-its-not-so-crowded-on-mt-everest/" target="_blank" rel="noopener">notorious traffic jam on the summit</a>. On Wednesday, China closed its side of the mountain due to the COVID-19 scare.“Everest expeditions are starting soon but we are still trying to figure out what to do if the mountaineers catch coronavirus during the trip,” says Sarita Lama of the <a href="https://www.taan.org.np/" target="_blank" rel="noopener">Trekking Agencies’ Association of Nepal (TAAN)</a>. “This is so bad it may take us years to recover from the crisis.” Trek bookings are also at half of last year’s numbers.Nepal’s main source of foreign exchange, its <a href="https://www.nepalitimes.com/opinion/for-nepals-migrant-workers-good-news-in-small-bites/" target="_blank" rel="noopener">two million workers abroad</a>, will also be hit. Qatar this week imposed a ban on workers from 14 countries, including Nepal. Nepal is preventing workers from flying to South Korea.The High-Level Coordination Committee also decided on Thursday to stop issuing labour permits for Nepali migrants seeking to go abroad for work. It is uncertain when the migration ban will be lifted.Read also: <a href="https://www.nepalitimes.com/opinion/labour-mobility/crossborder-virus-and-nepali-migrant-workers/" target="_blank" rel="noopener">Crossborder virus and Nepali migrant workers</a>, Upasana KhadkaNepal’s major infrastructure projects all face delays because of the reliance on Chinese contractors and workers. The start of the epidemic in January coincided with Chinese New Year, which meant that workers at new airport projects in Pokhara, Bhairawa and numerous hydropower plants under construction who had gone home could not return.Even among those who have returned, some have been quarantined, including 70 who work on Pokhara’s new airport. If given the all-clear, they will be released only on 16 March.“Although work has slowed down these past couple of months, we will work night and day to meet the target completion date of July 2021,” Pokhara airport manager Binesh Munakarmi assured Nepali Times.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109101152/636b78b19c7e80680e0646b6jpeg.jpg" alt="" width="3000" height="1688"><figcaption> </figcaption></figure>Construction at Bhairawa airport, which was scheduled to open later this year, is expected to be delayed.“Many of our engineers and workers have not been able to come back to Nepal,” says Bhairawa airport project chief Prabesh Adhikari. “There are about 25 Chinese workers on site and we are trying to move construction forward, but we need the rest to return.”The timely completion of<a href="https://archive.nepalitimes.com/article/nation/reservoirs-of-suspicion/hydropower-geopolitics%20,3991" target="_blank" rel="noopener"> hydropower projects</a>, of which 65 have the involvement of Chinese companies, looks more bleak. Construction at 25 of these under-construction projects have not resumed since Chinese New Year. Workers have not been allowed to travel out of China, and necessary electro-mechanical equipment has also not been dispatched from China to Nepal.“Even if one Chinese engineer is absent, or if one critical piece of equipment does not arrive from China, work stops,” says the <a href="http://www.ippan.org.np/public/page/ippan-committee" target="_blank" rel="noopener">President of the Independent Power Producers’ Association</a> Shailendra Guragain. “If the situation worsens, we may be seeing losses amounting to a billion dollars in our projects.”Read also: <a href="https://www.nepalitimes.com/here-now/the-climate-connection-to-covid-19/" target="_blank" rel="noopener">The climate connection to Covid-19</a>, Rastraraj Bhandari

Nepal’s economy, already weak, takes direct hit

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.