<figure><img width="2000" height="1333" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110161148/636d1dca9c7e80680e0af3d8jpeg.jpg" alt=""/><figcaption>Photo: MONIKA DEUPALA</figcaption></figure>After watching the Netflix drama<a href="https://www.netflix.com/title/81004536"> </a><a href="https://www.netflix.com/title/81004536">Bombay Begums</a> recently, I was encouraged to see that mainstream cinema has started giving space to a female character going through menopause and experiencing hot flashes. This is probably a first in the Subcontinent's cinema.The series did not captivate me as much as this rare portrayal of a woman during menopausal transition in a s<a href="https://www.nepalitimes.com/here-now/saving-one-nepali-mother-at-a-time/" target="_blank" rel="noopener noreferrer">ociety that is so steeped in </a>patriarchy, and an issue that even women in Nepal do not want to address. The same kind of <a href="https://www.nepalitimes.com/opinion/tipping-point-on-menstrual-banishment-in-nepal/">taboos that dictate menstruation</a> also affect menopause, the two biological events that bookend the life of women.The general assumption is that this is not something that should be talked about openly, and the prevailing misconception is that women’s health consists only of <a href="https://www.nepalitimes.com/here-now/nepal-far-from-hitting-contraceptive-target/">pregnancies and contraception</a>. Health after menopause is either ignored or dismissed. This is prevalent not only in the public, but also among us health workers who have limited knowledge on the matter. We need a fundamental change in how we view women’s health to understand menopause better.Women today are living much longer than their mothers and grandmothers. Assuming most women have menopause between 45-50 years, they still have a considerable number of years left to live, which makes understanding menopause even more essential. Menopause is a natural biological process, and not a ‘disease’ or ‘sickness’ that some health workers and drug companies try to make it out to be. It is much like <a href="https://www.nepalitimes.com/here-now/menstruation-is-not-private-business-it-is-everyones-business/">menstruation or menarche</a> where girls experience pain only to disappear with time, with only a few needing medical treatment. <a style="background-color: #ffffff; font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/editorial/that-time-of-the-month/" target="_blank" rel="noopener noreferrer">Much of this</a> is managed with a few simple home remedies. I used to carry a hot water bag and my mother used to make me soup with garlic and fenugreek to relieve the pain. Once in a while, I also needed a painkiller but not often. When I was 48, I started getting irregular menstruation and within a year, my periods stopped completely. I did not have other health problems like palpitation, dizziness, night sweats, hot flashes headaches and irritability, often described by many pre-menopausal or menopausal women. There is no way to predict who will and who will not experience such symptoms. But this can be avoided or reduced by adopting <a href="https://www.nepalitimes.com/opinion/living-to-eat/" target="_blank" rel="noopener noreferrer">healthy eating habits</a> and exercises while still in our prime.This is explained in detail in Our Bodies, Ourselves: Menopause, a book I was gifted some time back. Given that it dealt with a matter largely untouched in this part of the world, the book's message was a pleasant surprise.It was eye-opening in a lot of ways. I learned about various mental and physical health issues associated with menopause, and how detrimental it is not talking opening about it.Menopause can be highly stressful for those going through it. In addition to physical discomfort, women get skin spots, gain weight and develop wrinkles. But one must accept these changes, be prepared and still strive to lead a healthy life without giving too much importance to appearances.  <img width="400" height="497" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110161148/636d1dcd9c7e80680e0af3d9jpeg.jpg" alt="">Our body transforms with age, and everyone starts losing bone mass after the age of 35. Bone loss in women increases after menopause. This book has important tips on how to slow down this process: consume foods high in calcium and vitamin D, sunbathe and exercise daily. Whole grain, green leafy vegetables, lentils and fruits should make up a large chunk of the daily diet. Say <a href="https://www.nepalitimes.com/opinion/we-are-what-we-eat/" target="_blank" rel="noopener noreferrer">no to junk and processed foods</a>, carbonated drinks, extra sugar and fatty items which may give her osteoporosis later in life.For optimum health during menopause and after, a woman should also avoid smoking which interferes with the way bones absorb calcium and weaken our bones.Every woman has to go through menopause, but it is largely up to us to be prepared and make the experience as less painful as possible, physically as well as mentally. This book succeeds in sending the message across. Although written by a medical doctor, <a href="https://www.ourbodiesourselves.org/publications/menopause/" target="_blank" rel="noopener noreferrer">Our Bodies, Ourselves: Menopause </a>is an easy read. The author has interviewed many women to document the myriad of experiences they have had and hence is very relatable. Some health workers consider menopause as a disease and have developed ways to treat it. Here in Nepal too, there is now hormone therapy for women who have undergone menopause. The book argues that it is unnecessary, and instead has negative impacts on women’s bodies. By emphasising that menopause is a natural process and that most women have a relatively easy time with the transition, this book tells you that the hormonal changes of menopause affect each woman differently, they just need to work out how best to manage those changes. And while every woman is unique, <a href="http://archive.nepalitimes.com/article/nation/we-are-what-we-eat-aruna-uprety,3954" target="_blank" rel="noopener noreferrer">attention to diet and lifestyle</a> can do wonders in relieving discomfort as well as help with estrogen deficiency. The author combines trustworthy medical information based on the best available evidence with thoughtful analysis of the social, cultural, and political forces affecting our health. Inspired by this read, I have decided to write a book on menopause in Nepali so that all women, young and old across the country (as well as men) are educated about this transition and are prepared with the necessary tools to tackle it. Aruna Uprety is a public health expert and the author of the book Khana Khanu Bho?

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Talking about life after menopause

<figure><img width="640" height="494" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110141128/636cfc959c7e80680e0a0b98jpeg.jpg" alt=""/><figcaption>All photos and infographics courtesy of: MERCY CORPS</figcaption></figure>The news of Covid infections in Karnali do not readily reach the capital. But remote districts in this far-flung region have some of the highest coronavirus fatality rates in the country.There are multiple factors involved: <a href="https://www.nepalitimes.com/editorial/pandemic-of-poverty/">poverty,</a> limited health and transport infrastructure, shortage of medical staff, lack of testing, and family members returning from India. People in the remote mountains of this historically neglected region now also have to survive on limited food.A recent survey in outback communities of Karnali province shows that the most serious socio-economic impact of the pandemic has been on <a href="https://www.nepalitimes.com/latest/quarter-of-nepalis-still-hungry-during-pandemic/">access to food</a> – a full one-third of households surveyed reported <a href="https://www.nepalitimes.com/latest/1-in-5-nepal-families-lack-food/">not having enough food.</a> Another 19% said they were even heavier in debt, and 14% lost their livelihood.To be sure, the Karnali has suffered <a href="https://www.nepalitimes.com/latest/the-pandemic-of-hunger/">chronic food insecurity</a> even before the pandemic, and almost every household has at least one member working in cities or in India. But the Covid crisis has made it worse. The survey was conducted among 395 people across 21 Karnali municipalities by USAID BHAKARI program implemented by the global humanitarian aid group Mercy Corps with an aim to improve food security in the region. Ten per cent of those polled were people with disabilities. <img width="640" height="283" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110141128/636cfc989c7e80680e0a0b99jpeg.jpg" alt="">Some 78% of those surveyed said they had to change their diet and as high as 90% reported not having money to buy food, 38% switched to cheaper food items while 16% of the households resorted to prioritising children over adults with limited meals. Another 14% said they reduced the size of meal portions, 13% reduced the number of meals per day.  These figures may lead to a long-term impact on the physical and mental growth of children. The coronavirus crisis and subsequent lockdowns have pushed millions of Nepalis back below the poverty line leading to an <a href="https://www.nepalitimes.com/editorial/hunger-for-governance/">epidemic of childhood malnutrition.</a> “The impact of drought and the second wave are significant in the vulnerable communities in Karnali province, further increasing the food crisis in the region. We have reached a critical point,” says Yugdeep Thapa of Mercy Corps.  Women and people with disabilities in particular have faced added challenges in the past 18 months since the outbreak of Covid-19. Of the total women surveyed, 67% are not getting access to <a href="https://www.nepalitimes.com/here-now/ensuring-menstrual-hygiene-during-nepal-lockdown/">hygiene</a> products ranging from soap and sanitisers to menstrual pads.<a href="https://www.nepalitimes.com/latest/a-little-help-goes-a-long-way-in-home-isolation/"> Limited access to health services</a> due to lockdown-induced restrictions meant that 45% of the women couldn’t visit a health post or hospitals for reproductive health services. There have been a slew of reports about an <a href="https://www.nepalitimes.com/latest/in-nepal-lockdown-a-domestic-violence-spike/">increase in domestic and sexual violence</a> across the country during the pandemic, with women and children in closer contact with their abusers for a longer period. The Mercy Corps study confirms this, with one-third of the women reporting an unsafe environment at home due to domestic violence. Another 28% said they had faced increased violence and abuse in the household. While telemedicine has been an effective tool to receive medical consultation regarding coronavirus and other health problems, here in the mountains of Karnali Province, a majority of families have had no knowledge of such services with 24% of women unaware of the general Covid related helpline.Last winter’s drought added to the food insecurity. A quarter of those polled said they lost their entire year's harvest, and 89% said they were looking for work to sustain their livelihoods. Some 44% of respondents said they were farmers, 17% were daily wage earners and 21% had family members working abroad. <img width="550" height="980" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110141128/636cfc9b9c7e80680e0a0b9ajpeg.jpg" alt="">The contribution of <a href="https://www.nepalitimes.com/latest/more-remittance-more-than-remittance/">remittance to household income is likely to increase</a> as job losses have pushed a further 15% of people to migrate to India, many of them after returning home due to the Covid lockdowns there in 2020 and this year. Those who couldn’t afford <a href="https://www.nepalitimes.com/business/remittances-from-nepali-workers-rise/">foreign employment</a> sold their livestock or property to feed their children during the pandemic. In fact, 57% of the respondents in the study said they had to sell livestock or borrow money. Less than 1% of those surveyed had a year's worth of food stock, 42% had enough food to last only three months at most. <img width="640" height="272" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110141128/636cfc9d9c7e80680e0a0b9bjpeg.jpg" alt="">Half of the participants in the survey have not received any social security allowance to tide them over the long months of the coronavirus crisis. Those who did spent it mostly on food, health care and education.On the disaster front, 62% of the respondents had little to no information on preparedness even as the <a href="https://www.nepalitimes.com/latest/monsoon-hits-nepal-with-a-bang/">annual monsoon flooding season</a> was approaching at the time of the survey. But among those who accessed some news, did it mostly via radio and mobile phones which local governments could use to disseminate essential information in the future. <img width="640" height="530" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110141128/636cfca09c7e80680e0a0b9cjpeg.jpg" alt="">Read Also:<a href="https://www.nepalitimes.com/latest/covid-19-affecting-food-security-in-nepal-wfp/"> Covid-19 affecting food security in Nepal</a>

Karnali’s Covid blues

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109141112/636ba77e9c7e80680e073787jpeg.jpg" alt="" width="1728" height="1296"/><figcaption>A woman gets Sayana Press suring the lockdown. Photo: IPAS NEPAL</figcaption></figure>For the past two decades, Basanti Paudel, 41, of Nawalpur had always used Depo-Provera to <a href="https://www.nepalitimes.com/banner/no-conceivable-reason-for-unwanted-pregnancies/" target="_blank" rel="noopener noreferrer">prevent unwanted pregnancies</a>  Then last year, she was given a new choice: Sayana Press.<a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/here-now/nepal-far-from-hitting-contraceptive-target/" target="_blank" rel="noopener noreferrer">Sayana Press</a>, a successor to Depo-Provera, was introduced last year in  Nawalparasi and Sindhuli and is a better option because it has a smaller dosage, comes with a small needle, can be stored at room temperature and is injected sub-cutaneously just under the skin rather than in the muscles, making it less painful. Sayana can also be self-injected at home and lasts for three months just like Depo-Provera.Basanti Paudel immediately took to the new contraceptive. “It is a much better, but I worry about its availability during the lockdown, and that I may have to go back to using Depo-Provera,” she says.Pabitra Acharya, 42, of the same neighbourhood also started using Sayana Press after her husband who was working in India came back home following Covid-19 pandemic. She would also like to continue using the injection but is also worried about its availability.“Once we decide on the contraceptive best for us, we should be able to access it each time. Using different methods affects our health,” Acharya says.Both women were at the Rajahar Health Post in Nawalpur this week to express their concern about availability. At the health post, Dev Bahadur Dahal  Nawalpur assured them that they would not have to go back to using Depo Provera.“The drug used in Sayana Press and Depo-Provera is the same, the only difference is the dose, which is 30% lower. We thought why not go for an option that has lower drug but is just as effective and not as painful,” says Lhamo Y Sherpa of Ipas Nepal, adding that depending on the results in the two districts, the new contraceptive would be scaled up to the rest of the country.<a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/banner/implant-service-providers-take-contraception-to-nepals-poor/" target="_blank" rel="noopener noreferrer">Nepal’s contraceptive prevalence</a> rate at 53% is a dramatic improvement from 20 years ago, but it is still a long way from the government’s target of 75% contraceptive prevalence by 2030.Furthermore, the use of modern family planning methods has plateaued since 2006 <a href="https://www.nepalitimes.com/here-now/migrating-males-and-population-decline/" target="_blank" rel="noopener noreferrer">due to labour migration</a>. But the <a href="https://www.nepalitimes.com/here-now/workers-return-to-jobless-nepal/" target="_blank" rel="noopener noreferrer">return of hundreds of thousands of migrant workers from India</a> and the Gulf following the Covid-19 pandemic is leading to an increase in the demand of contraceptives. Which is why there is a <a href="https://www.nepalitimes.com/here-now/baby-boom-expected-after-lockdown/" target="_blank" rel="noopener noreferrer">fear of shortages</a>  and also a break in the supply chain because of the lockdowns.According to the Nepal Demographic and Health Survey (NDHS) 2016, there is a 24% unmet need for family planning in Nepal — a quarter of women who need contraceptives are not using them.Sayana Press offers a new and easy to use contraceptive that can help meet the country’s unmet needs for family planning. It also gives women agency, especially because their husbands often refuse to use condoms.The new birth control device is already popular with women in Nawalparasi and Sindhuli districts and very few users have complained of side effects normally associated with contraceptives. In fact, users have reported fewer reproductive health complications.“For 20 years, I never got my periods regularly, once I did not have them for two years, and had to resort to medications to force my period,” says Basanti Paudel. “Since using Sayana, it has become more regular. It evevn seems to have brought down my blood pressure, and I don’t have nausea anymore.”Dilmaya Pariyar, 29, has been using contraceptives for 12 years and once every three months she needed to go to a health post to get a Depo-Provera injection, which was always followed by a week of pain in her arms, preventing her from working.“With Sayana Press, I haven’t had any pains. In fact, this has been the most suitable contraceptive for me so far,” she says. The other advantage is that Sayana Press can be injected at home with some basic training.There are some women who have complained of excessive bleeding for up to seven days after switching to Sayana Press, but according to a survey, the new contraceptive appears to have been well accepted in the trials which are conducted by the reproductive health agency Ipas Nepal and the Ministry of Health and Population (MoH) with financial support from the UK’s Department for International Development (DFID). Sayana Press is already used in 40 European countries.Of 1,112 women from 17-49 years of age who participated in the Ipas Nepal comparative study, 12% said they preferred Sayana Press to Depo-Provera. Participants also found the fact that it was self-injectible quite appealing.Says Bhim Singha Tinkaro, head of Family Welfare Division in the Health Ministry: “Given the positive results so far, Sayana Press can now be expanded to other parts of the country, and the ministry is expected to make a decision soon.”

New contraceptive for increased lockdown demand

<figure><img width="931" height="620" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110914118/636ba68f9c7e80680e07372djpeg.jpg" alt=""/><figcaption>All photos: VSO</figcaption></figure>Despite <a href="https://www.nepalitimes.com/banner/kathmandu-valley-back-to-lockdown/" target="_blank" rel="noopener noreferrer">restrictions on gatherings</a>,  women across Nepal mark Tij this week, the festival of women, on Friday. Increasingly, Tij songs are less about lamenting gender justice and more about striving for equality.One manifestation of entrenched patriarchy in Nepal is menstrual taboo, an extreme form of which is chhaupadi, the practice in parts of Nepal of the <a href="http://archive.nepalitimes.com/article/nation/women-speaking-out-against-chaupadi,3518" target="_blank" rel="noopener noreferrer">monthly banishment</a> of women to an outhouse during their periods.In a country where period stigma is still prevalent young women, adolescent girls are facing extra barriers under lockdown to maintain their period in a safe and dignified way.During the pandemic girls are mostly confined to the household, and during their periods are forbidden to touch communal objects in the household. Added to this, the economic crisis hitting these communities is leaving young women and girls unable to afford period products.Under a unique <a href="https://www.vsointernational.org/our-work/inclusive-education/system-strengthening/sisters-for-sisters" data-saferedirecturl="https://www.google.com/url?q=https://www.vsointernational.org/our-work/inclusive-education/system-strengthening/sisters-for-sisters&amp;source=gmail&amp;ust=1597908281944000&amp;usg=AFQjCNE0R0d69AjenpkQ1LnCoIEncENunQ">Sisters for Sisters' Education</a> started by the UK-based VSO (Volunteer Service Overseas), big girls in rural Nepal who were already mentoring younger ones have stepped in during the lockdown to guide them about using and accessing period products.<a href="https://www.nepalitimes.com/?p=21465&amp;preview=true" target="_blank" rel="noopener noreferrer">Nepal’s superwomen beat superstition</a>, Aruna Upreti <figure><img width="932" height="620" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110914118/636ba6919c7e80680e07372ejpeg.jpg" alt=""><figcaption>Muni Kumari Gupta is a ‘Big Sister’ who has been mentoring 11 little sisters in her community in a village in Parsa, the district in Nepal hardest hit by the Covid-19 pandemic. “These days we are all living in a fear of the coronavirus,” Muni Kumari says, “ever since the first case was found in our village, there has been more fear.”</figcaption></figure>Muni Kumari Gupta is a ‘Big Sister’ who has been mentoring 11 little sisters in her community in a village in Parsa, the district in Nepal hardest hit by the Covid-19 pandemic.“These days we are all living in a fear of the coronavirus,” Muni Kumari says, “ever since the first case was found in our village, there has been more fear.”Because the lockdown has been re-imposed in Parsa, Muni Kumari keeps in touch with her little ‘sisters’ through the mobile phone telling them to wear masks, maintain distance and keep elderly relatives safe.<a href="https://www.nepalitimes.com/banner/communicating-to-remove-menstrual-taboo/" target="_blank" rel="noopener noreferrer">Communicating to remote menstrual taboo</a>, Sewa BhattaraiWhen the lockdown eased for a few weeks in July, she visited the homes of her ‘sisters’ to coach them in school lessons. Most schools in Parsa had been converted into quarantine centres for returnees from abroad, and had been closed.Muni Kumari herself takes classes through the radio and joins her ‘sisters’ to learn English through the remote radio classes.“It has been very difficult to communicate properly with girls and their families. I was allowed to visit a few families near my home so that I could teach them how to wash hands and use a face mask properly,” says Muni Kumari, who had been trained in making reusable sanitary pads, and she shares this skill with family members and girls in the community.“During the lockdown, we were unable to buy sanitary pads at the shops. Therefore, the skills helped us to make our pads at home,” she adds.<a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/pad-power-nepal,4147">Pad Power</a>, Ziyu LinAnjali Patel is now in Grade 10, and is thankful that she has her ‘Big Sister’, Muni Kumari Gupta to help her navigate the dangers of the pandemic, the shortages of everything during the lockdown, and setbacks to education because of the closure of schools.“My Big Sister is the closest person I can share my problems with,” says Anjali, “she lives nearby and is always available to guide us and the other small sisters. She helps me with my studies, and tells me how to stay safe during the pandemic.”When Anjali was 10, her parents made her do household chores so she missed school a lot. Her parents also did not find school to be that important for a girl child. It was Muni Kumari who convinced her parents that Anjali should get an education.<a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/removing-menstrual-shame,4148" target="_blank" rel="noopener noreferrer">Removing menstrual shame</a>, Clara Hare-Grogg <img width="933" height="620" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110914118/636ba6949c7e80680e07372fjpeg.jpg" alt=""><img width="931" height="619" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110914118/636ba6969c7e80680e073730jpeg.jpg" alt="">Anjali Patel is at home listening to a remote classroom on the radio, and helping her nephews with school lessons.After the lockdown started in March, Anjali found it difficult because she could not meet her mentor face-to-face. But Muni Kumari called her on the phone and gave her confidence, instructing her how to protect herself and the family against the virus.The Sister for Sisters program is supported by UK Aid through VSO and has distributed sanitary hygiene packs to nearly 1,200 families in Surkhet, Lamjung, Dhading and Parsa districts of Nepal. The kits include soap, towel, toothbrush, reusable sanitary pad, underwear, nail cutter, hygiene kit bag and liquid chlorine. The project is implemented by Global Action Nepal and Aasaman Nepal. Nitu Gupta is also a ‘Big Sister’ for 13 smaller girls in an adjoining village in Parsa district. As elsewhere in Nepal, the young girls cannot go to school, their families are in a precarious economic situation, and there is the need to protect themselves from the spread of the coronavirus.<a href="https://www.nepalitimes.com/editorial/that-time-of-the-month/" target="_blank" rel="noopener noreferrer">That time of the month</a>, EditorialNitu was already helping to educate her 13 ‘sisters’ before the lockdown, and she has been carrying on that work to make up for the closure of schools.  “During the lockdown, our economic situation became much more difficult, and the girls were mentally affected because there have been suicides in the community,” Nitu says.Sisters for Sisters helped girls like Nitu with remote training through radio to stay safe during the pandemic. She kept in touch with the girls under her care, teaching them to wash hands frequently. <a href="https://www.nepalitimes.com/here-now/menstruation-is-not-private-business-it-is-everyones-business/" target="_blank" rel="noopener noreferrer">“Menstruation is not a private business, it’s everyone’s business”</a>, Reeti KC <figure><img width="932" height="620" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110914118/636ba6999c7e80680e073731jpeg.jpg" alt=""><figcaption>Nitu Gupta is another mentor in the Sister for Sisters project, raising awareness about Covid-19 and supporting the education of girls who are out of school in Bahubari of Parsa district. Here she is handing over a hygiene kit to the mother of one of her little 'sisters'.</figcaption></figure>She adds, “The most challenging has been the lack of access to reading materials and menstrual products during the lockdown. But we have been able to provide the families with hygiene kits. This has helped the girls stay clean and comfortable.” Joya Parvin,18, is also a ‘Big Sister’ with 13 younger girls under her charge, but during the lockdown she has only been able to keep in touch with four of them who live nearby. She says the biggest challenge for the girls in her group is accessing menstrual products, soap and sanitser and masks.When she first became a ‘Big Sister’ her main role was to convince parents from her Muslim community to send their daughters to school. But now that schools are closed, he mentoring is different – to make sure the girls keep up with their studies through radio, and have the necessary support to maintain hygience and stay safe.<a href="https://archive.nepalitimes.com/regular-columns/GUEST-COLUMN/blood-sisters-menstruation,839" target="_blank" rel="noopener noreferrer">Blood sisters</a>, Sangita Thebe-Limbu <figure><img width="930" height="620" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110914118/636ba69b9c7e80680e073732jpeg.jpg" alt=""><figcaption>Joya Pravin showing the little 'sisters' under the charge how to make their own sanitary napkins.</figcaption></figure>One of the little ‘sisters’ in the group that Joya mentors is Rami Khatun, and she says she was seized with panic when Parsa became a coronavirus hotspot in July. “But she gave us tips on how to stay safe, and when the shops ran out of sanitary pads, Joya taught us how to make our own,” says Rami.Rami spends her lockdown days at home helping with chores, and taking care of her nephews. Even though the schools are closed, Joya used to visit when the lockdown was eased. But now that are restrictions of movement, she calls frequently and Rami listens to the radio program to improve her English.Read also: <a href="https://www.nepalitimes.com/opinion/tipping-point-on-menstrual-banishment-in-nepal/">Tipping point on menstrual banishment in Nepal</a>, Marty Logan

Ensuring menstrual hygiene during Nepal lockdown

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108141124/636a58c19c7e80680e054852jpeg.jpg" alt="" width="1400" height="933"/><figcaption>WELCOME TO THE WORLD: A child sleeps in a hammock while its parents work in a workshop making idols for the Dasain festival in Kupondol. Photo: GOPEN RAI</figcaption></figure>Giving birth is a life or death issue in Nepal. Even though the maternal mortality rate dropped from 1,000 per 100,000 live births 40 years ago to 239 today, inadequate birthing facilities is still a problem. But attention is now also shifting to preventing pregnancies.There is a big <a href="https://www.nepalitimes.com/banner/implant-service-providers-take-contraception-to-nepals-poor/">unmet need for contraceptives</a>: nearly a quarter of women surveyed nationwide in 2016 said they were not using birth control, even if they need it. Social stigma, patriarchy, ignorance and lack of access were reasons.Nepal’s contraceptive prevalence rate is 52%, but in remote Bajura it is only 34%. Although progress is being made, we are still a long way from the government’s target of raising the rate to 75% by 2030.Read also: <a href="https://www.nepalitimes.com/?p=33714&amp;preview_nonce=033aa12640&amp;preview=true" target="_blank" rel="noopener">Nepal far from hitting contraceptive target,</a> Sewa BhattaraiAs our reports in this edition from Bajura and Chitwan show, there are cultural hurdles. With <a style="background-color: #ffffff; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/here-now/migrating-males-and-population-decline/" target="_blank" rel="noopener">husbands away working for long periods</a>, their wives are reluctant to use contraceptives because of what others will say. The result: women suffer unwanted pregnancies, <a style="background-color: #ffffff; letter-spacing: 0.01em;" href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/globe-rallies-to-aid-nepals-women,3841" target="_blank" rel="noopener">unsafe abortions</a> and ultimately struggle to take care of large families.Almost every woman who visited a hospital in Bajura on a busy day last month had the same story: their husbands were away and they did not use birth control. Some were suffering from botched abortions.More than 800 abortion cases were registered in Bajura last year. Just one hospital in Achham terminated more than 600 pregnancies in one year. Meanwhile, Nepal’s total fertility rate has dropped from 6 in 1960 to near-replacement level at 2.05 today, and the country’s population growth rate is also down from 2.5% in 1990 to 1.1% today. Surveys in Province 2 and Far-western Province have shown a clear correlation between unwanted pregnancies, child marriage and fertility in regions with entrenched patriarchy.Among Nepalis, 21% use injectable contraceptives, 10% are on pills, 10% use condoms, 8% have IUDs and only 3% have implants. Depo-Provera was among the most used injectables, but it was difficult to administer and painful. Now, the government, with donor support, is field-testing in Nawalpur and Sindhuli a lower-dose injectable called Sayana Press, which could make contraceptives more accessible to women.Interventions like these, the government hopes, will reduce unwanted pregnancies, thus preventing unsafe abortions and reducing the number of women who have to take care of larger families.<a href="https://archive.nepalitimes.com/regular-columns/Comment/mothers-in-Nepal-still-dying-at-childbirth,1007" target="_blank" rel="noopener">Complications during pregnancy or at childbirth</a> are the leading causes of death among girls aged 15-19 in low-income countries like Nepal. Unwanted pregnancies also hamper women’s education and economic independence, and impact their family life, fuelling an intergenerational cycle of poverty and poor health.Read also: <a style="background-color: #ffffff; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/banner/implant-service-providers-take-contraception-to-nepals-poor/" target="_blank" rel="noopener">Implant service providers take contraception to Nepal's poor</a>, Rojita Adhikari

Born in Nepal

https://youtu.be/VaSUaALct0oParvati Thapa, 39, looks lost as she wanders into the district hospital in this isolated northwestern corner of Nepal. She and her husband have walked a whole day to get here, and they just found out she is 19 weeks pregnant.Thapa already has three children, and after they were born she lost four sons one after another. After her menstruation stopped, she suspected menopause but now knows she is pregnant for the eighth time.“My husband is away for months at a time, tending cattle in the mountains. Why should I use <a href="https://www.nepalitimes.com/banner/implant-service-providers-take-contraception-to-nepals-poor/" target="_blank" rel="noopener">family planning</a> when we meet so rarely?” asks Thapa, who looks much older than her age.Read also: <a href="https://www.nepalitimes.com/?p=33648&amp;preview_nonce=5c7e9df60a&amp;preview=true" target="_blank" rel="noopener">Born in Nepal</a>, Sewa Bhattarai<a href="https://www.nepalitimes.com/?p=33648&amp;preview_nonce=5c7e9df60a&amp;preview=true" target="_blank" rel="noopener"> </a>Like most women in the remote mountains, Thapa has never used contraceptives. <a style="background-color: #ffffff; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/here-now/migrating-males-and-population-decline/" target="_blank" rel="noopener">Doing so carries a stigma for married women with migrant husbands</a>, and there are misconceptions about the different methods available. The result is that women suffer unwanted pregnancies, <a style="background-color: #ffffff; letter-spacing: 0.01em;" href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/globe-rallies-to-aid-nepals-women,3841" target="_blank" rel="noopener">unsafe abortions</a> and end up with large families they are  unable to take care of.Nepal’s contraceptive prevalence rate is 53%, but in Bajura it is only 34%. Although this is a dramatic improvement from 20 years ago, it is still a long way from the government’s target of 75% contraceptive prevalence by 2030. The fact that the use of modern family planning methods has plateaued since 2006 points to futher deterrences.“The family planning rate is really low in Bajura because a lot of the men migrate to India for work,” says nurse Dhankala Khadka at Bajura District Hospital. “If the husband is away and the wife wants to use birth control, she is often questioned about fidelity and may be ostracised by her community. Even husbands do not support them.”<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108141124/636a58de9c7e80680e054862jpeg.jpg" alt="" width="1400" height="970"/><figcaption>Parvati Thapa went to Bajura district hospital suspecting menopause, but found out it was her eighth pregnancy. Photo: MONIKA DEUPALA</figcaption></figure>Almost every woman who visited nurse Khadka on a busy day last month had the same story: their husbands were away and they did not use birth control.There were 804 abortions in Bajura in the past year, which Rohit Giri of Bajura District Hospital says is very high: “Most who come to us are married women with children, and the abortions are due to the lack of birth control, which leads to unwanted pregnancies.”<a style="background-color: #ffffff; letter-spacing: 0.15px;" href="https://www.nepalitimes.com/banner/this-is-how-to-upgrade-nepals-rural-health/" target="_blank" rel="noopener">In Bayalpata Hospital</a> in neighbouring Achham district, the story is much the same — it performed 660 abortions in the past year. Bhawana Rawal, 33, has had two abortions at the hospital in the past five years and admits she does not used birth control.Read also: <a href="https://www.nepalitimes.com/here-now/migrating-males-and-population-decline/" target="_blank" rel="noopener">Migrating males and population decline</a>, Om Astha Rai“I already have two children, and do not need any more, but I got pregnant twice by accident,” she says. “I still do not want to use contraceptives in future.” Rawal did try a Depo-Provera injection once but says it made her bleed too much. Other women have the same complaint. For those who do not want to use a permanent contraception, many felt pills were a hassle to acquire and take every day, and IUDs hurt.“Unwanted pregnancies often lead to anaemia because women lose so much blood,” says Kalawati Setthi, a nurse at Bayalpata Hospital. Nearly 40% of women in Far-western Nepal were found in a survey to be anaemic — most of them pregnant and <a href="https://www.nepalitimes.com/banner/back-to-the-nipple-in-nepal/" target="_blank" rel="noopener">breastfeeding</a>.The government has put up posters in rural hospitals to encourage contraceptive use but at this rate, it is unlikely that the target of 75% contraceptive use will be reached.<h2>Demand, but no supply</h2>According to the Nepal Demographic and Health Survey (NDHS) 2016, there is a 24% unmet need for family planning in Nepal — a quarter of women who need contraceptives are not using them. A report by Population Services international (PSI) Nepal found that unmarried youth aged 15-24 and married women aged 20-24 are the groups that use contraceptives the least.Married women like Parvati Thapa at a clinic in Bajura last month (left), normally tended to use contraceptives after their first child, and exposure to information about family planning through health workers and current users of family planning, as well as talking about it with husbands or relatives.Unmarried youth were likely to discuss family planning only with their sexual partners and most used condoms over other methods, which were bought and kept by the male partner. In contrast, married women visited health facilities themselves and chose the type of method they wanted.Unmarried youth, especially adolescents, had a higher unmet need and were more vulnerable to stigma associated with family planning. The report argues that the term ‘family planning’ only applies to married women and their plan to have children, whereas there are many contraceptive users who have no intention of having children, or use contraceptives to prevent sexually-transmitted diseases (STDs).Read also: <a href="https://www.nepalitimes.com/banner/child-marriage-in-nepal-eloped-at-13-mother-by-17/" target="_blank" rel="noopener">Child marriage in Nepal, eloped at 13, mother by 17</a>, Sewa BhattaraiWhen a woman goes to a public health facility for contraceptives, a register is filled out, which includes a column for ‘husband’s name’, which is another deterrent for unmarried women. Though the husband’s name is optional, there is no column for the wife’s name when it comes to male contraceptives like condoms or a vasectomy.A report by the UN Population Fund (UNFPA) about sexual and reproductive health says complications in pregnancy and childbirth are the leading cause of death among girls aged 15-19 in low-income countries like Nepal. Unwanted pregnancies also hamper women’s education and economic independence, and impact their family life, fuelling an intergenerational cycle of poverty and poor health.<h2>More choice for family planning</h2><figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108141124/636a58e19c7e80680e054863jpeg.jpg" alt="" width="1400" height="1029"><figcaption> </figcaption></figure>Although Nepal’s contraceptive prevalence rate has increased dramatically, from 7% in 1981 to nearly 60% today, social taboos, patriarchy and unavailability mean that many women still do not have access to birth control.It usually falls on women to take the initiative, since many men refuse to use condoms or get a vasectomy. Popular contraceptives used to be the pill or Depo-Provera, an injectable that needs refrigeration and must be taken at a clinic, but the dosage is high and the injection painful.Now, women like Shanti Adhikari, 43, in Chitwan, (pictured, right) who have always used Depo-provera for short-term contraception, have a new choice: Sayana Press.Read also: <a style="background-color: #ffffff; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/banner/implant-service-providers-take-contraception-to-nepals-poor/" target="_blank" rel="noopener">Implant service providers take contraception to Nepal's poor</a>, Rojita Adhikari<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108141124/636a58e49c7e80680e054864jpeg.jpg" alt="" width="524" height="531">Adhikari’s husband, who works as a security guard in India, will be coming home for Dasain, so she is at the health post in Nawalpur for her Depo-Provera progesterone hormone injection, which prevents pregnancy for three months.But auxiliary nurse midwife Sharada Rimal (pictured, left) tells her about Sayana Press. Its advantages over Depo-Provera are that it comes with its own small needle, the dosage is much smaller, it is less painful and can be self-injected.“Everyone in my neighbourhood comes to this health post for contraceptives, but no one told me about this new injection. The needle looks much smaller, I think I will go with this one,” says Adhikari, 43, as Rimal proceeded to inject her in the thigh.Sayana Press, a successor to Depo-Provera, is being launched in Nepal in two districts: Nawalpur and Sindhuli, by the reproductive health agency Ipas Nepal in coordination with the UK’s Department for International Development (DFID) and the Ministry of Health and Population (MoH). The drug has already been tried and approved, and is available for use in 40 European countries.What sets Sayana apart from Depo-Provera is the smaller dosage (104 mg compared to 150), it comes with its own needle, it can be stored at room temperature and is injected sub-cutaneously (just under the skin), rather than in the muscles like <a href="https://archive.nepalitimes.com/article/from-nepali-press/Ftnp-the-curse-of-the-contraceptive,493" target="_blank" rel="noopener">Depo-Provera</a>.Injectable contraceptives are the most popular reversible contraceptive among women, for a variety of reasons. Adhikari says she does not like pills because she has to remember to take them every day, and, because of her age, she wants to be discreet about using them.While most other methods, like IUCDs, implants, condoms and pills, are visible and can be discovered by others, an injection leaves no traces. 52% married couples use contraceptives in Nepal: 8.9% use injectables, 4.6% are on pills, 4.2% use condoms, 1.4% use IUDs and only 3.3% use implants. 9.8% use other traditional methods. Some have gone for permanent contraception, with 14.7% preferring female Sterilization and 5.5% male Sterilization.“Depo-Provera has been in use for 50 years, but it was so popular and effective not much further research was done on it,” explains Lhamo Yangchen Sherpa of Ipas. “But WHO studies found that a much lower dosage was enough.”<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108141124/636a58e69c7e80680e054865jpeg.jpg" alt="" width="478" height="531">Health workers like Rimal confirm that Sayana Press is much easier to inject, more portable and less painful. Though it is self-injectable in some countries, in Nepal, where it has been undergoing trials in 14 health facilities of Nawalpur and Sindhuli since 5 September, it will only be administered by health professionals.Bhim Singh Tinkari of the MoH Family Welfare Division says that since 7% of pregnant women still die from unsafe abortions, making contraceptives easily accessible can save lives. Binod Bindu Sharma of the MoH links contraceptives to women’s choice and empowerment. “The availability of contraceptives is important for women’s rights, since it lets women choose when and how many children to have,” says Sharma, adding that the ministry is making Sayana Press available for free in health facilities.Lisa Honan, head of DFID Nepal, links contraceptives with women’s economic potential, adding that the country can make better use of women in the workforce if they have better choices of contraceptives. “DFID is committed to providing Sayana in any volume in Nepal until 2022 through UNFPA (the UN Population Fund), and would help Nepal scale it up all over the country if the results of the feasibility study are positive.”

Nepal far from hitting contraceptive target

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

Turkish Basketball

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

America no longer prime destination for Nepali students

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

The Everest Industry

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

womens-health