<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?

original

674x448

610x380

500x500

400x266

400x240

400x203

301x200

1250x600

1084x550

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

Nepal’s only international aviation gateway, at Kathmandu airport, will cut night-time operation hours to allow construction of taxiways, and airlines have been told to curtail flights. This is expected to lead to more than normal chaos during the height of peak autumn and spring tourist seasons at an airport that is congested even at the best of times. The airport will close from 10PM to 8AM from 8 November-31 March 2025. The taxiways will now connect to the thresholds at both ends of the runway, making the airport more efficient in handling higher frequencies of landings and takeoffs. The parallel taxiway extension will allow international flights to land every 4 minutes instead of the current every 7 minutes. At present planes have to wait to land until a plane taking off backtracks along the runway.&nbsp; Kathmandu is Nepal’s only airport with international operations, and it has only one runway that is only one way in from the south over the mountains. With the taxiway improvement, the airport will be able to handle 42 aircraft landings and takeoffs per hour — double the current capacity.&nbsp; The Civil Aviation Authority of Nepal (CAAN) has been trying to entice international airlines to also start flying to and from the other two international airports at Pokhara and Bhairawa (Lumbini) by slashing landing and handling charges. But so far only Nepal Airlines operates a weekly flight to Bhairawa from Kuala Lumpur.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241018161016_046569e53d1d66cd445cc66c697c0ef724810aec9f54bdf827481e3cd6b80c32.jpg" data-media-id="editor_0" data-image-id="20241018161016_046569e53d1d66cd445cc66c697c0ef724810aec9f54bdf827481e3cd6b80c32" data-rendition-name="original" width="2356" height="1134" loading="lazy" alt="Kathmandu airport expansion"> <figcaption>Kathmandu Airport Expansion plan with extension of taxiways to the thresholds of runways 02 and 20 that will limit airport operations from 8 November 2024 - 31 March 2025. Areas in blue are existing structures, including the international terminal which in future will be the domestic airport, and the new international terminal near the north end of the runway,</figcaption> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241018121028_6e17cc2ee87c1b02d78cb54905825b7aa15299b7a00f5eddb01a59579ab85c1a.jpg" data-media-id="editor_1" data-image-id="20241018121028_6e17cc2ee87c1b02d78cb54905825b7aa15299b7a00f5eddb01a59579ab85c1a" data-rendition-name="original" width="1353" height="1328" loading="lazy" alt="Kathmandu airport NT"> </figure>  CAAN has reportedly told international airlines to cut their flight frequency to Kathmandu citing the shorter operation hours and has told budget airlines to shift some of their flights to Pokhara or Bhairawa, or face cuts. Many airlines currently operate regular flights to and from Kathmandu between 10PM and 8AM: Air Arabia to Sharjah, Fly Dubai to Dubai, Jazeera Airways to Kuwait, Cathay Pacific to Hong Kong, Singapore Airlines, several Nepal Airlines flights, and one of four daily flights by Qatar Airways to Doha. Jazeera Airways, FlyDubai, and Thai AirAsia have applied and got permission from CAAN to begin regular flights to Bhairawa’s Gautam Buddha International Airport. Starting 9 November, FlyDubai will start making a stopover in Bhairawa before flying on to Kathmandu. Immigration, customs and security are all fully functional in Bhairawa. In Kathmandu, the next phase of the airport upgrade includes converting the current international terminal for domestic operations, the construction of a new international terminal where the domestic departure area is now, as well as moving the hangars and the Nepal Army Air Wing to the eastern side of the runway. The apron area will also double its parking space for widebody jets. This is part of a Airport Capacity Enhancement Project that was initially funded through a $80 million loan from the Asian Development Bank (ADB), and the entire masterplan is expected to cost $800 million. This project is the latest upgrade to Nepal’s only international airport since it saw its first flight in 1949. The current international and domestic terminals are too small to handle the current annual traffic volume of 8.5 million passengers a year that is growing at 20% a year.

Kathmandu airport to cut flight hours

As Kathmandu becomes more congested and polluted, and with remote online work becoming the norm, many professional Nepalis are planning to retire in Pokhara, or move there.&nbsp; With its stunning mountain panorama, balmy winters and proximity to a profusion of wilderness areas, builders are responding to this demand with new townhouses, housing development and apartments. One such block of flats is the 10-storey <a href="https://sungavaapartment.com/">Sungava Apartment</a> located at Phulbari above the Seti River, near the point where it flows into and under Pokhara. The imposing structure near Manipal Hospital is almost complete, and on a recent visit the site was strewn with huge boulders unearthed while digging the foundation.&nbsp; The Seti brought down these boulders during a gigantic flood that geologists estimate happened 800 years ago when a chunk of Annapurna IV broke off and ploughed into the glacier below. Today, Sungava (means ‘orchid’) sits safely on a high terrace, 100m above the blue-green Seti and commands a view of Dhaulagiri, Annapurna South, Machapuchre, Annapurna III and IV.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2024102411104_5f8fc736c86ea3c08d7bef43bb727081d3cc1a2caa55ae2b441717e6044de7e9.jpg" data-media-id="editor_1" data-image-id="2024102411104_5f8fc736c86ea3c08d7bef43bb727081d3cc1a2caa55ae2b441717e6044de7e9" data-rendition-name="original" width="2016" height="1512" loading="lazy" alt="High living below the Himalaya NT"> </figure>  The soil here is conglomerate that has solidified like concrete, and the boulders were extracted by heavy earthmovers. It is intriguing to think that these metamorphic rocks as big as cars, rounded by glacial grinding, were once a part of a much higher Annapurna IV. Even for those with little interest in geology, Sungava is an ideal place to contemplate the tectonic forces that pushed these peaks into the sky to be sculpted into delicate shapes by wind, snow, earthquake and avalanche over millions of years. The view of the Himalayan panorama from Sungava’s many balconies are breathtaking when not obscured by clouds, or the haze that drifts in from across the southern border. On most days, just watching the towering pyramid of Machapuchre (Tamu name: कतासुँ क्लिको) play hide and seek with the clouds is mesmerising. There are rocks aplenty at Phulbari, and it is probably the flowers that grew along the flat terraces e that gave the place its flowery name. The boulders will hopefully be turned into a rock garden while landscaping. An nearby restaurant complex is making the best use of the stones in its design, using flat rocks as outdoor benches and tables. Sungava was designed by the husband-wife architect team of Deepak Sherchan and Jyoti Joshi of <a href="https://thedarkmermaidamarbshrestha.blogspot.com/2013/12/creative-builders-collaborative-cbc.html">Creative Builders Collaborative (CBC)</a>, which also built Heritage Plaza, Indreni Apartment and numerous other projects in Nepal. Sadbhavana retains CBC’s trademark Newari-style masonry and here it borrows from the orange brickwork of the old town of Pokhara, integrating it with modern design elements. A few of those heritage houses are still standing in Ganesh Tole and Ram Krishna Tole in Pokhara’s old quarter.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2024102411108_5eb64a4885961b6d30781cefeb1e8a313da313ac5227c7a66b60f0c7d48d6fab.jpg" data-media-id="editor_3" data-image-id="2024102411108_5eb64a4885961b6d30781cefeb1e8a313da313ac5227c7a66b60f0c7d48d6fab" data-rendition-name="original" width="1362" height="595" loading="lazy" alt="High living below the Himalaya NT"> </figure>  About 400m from the apartment past a bend on the river, and down below three tiers of terraces in the canyon is a suspension bridge. Below it, the Seti is still swollen with post-monsoon flow as it tumbles away in a hurry to head down south.&nbsp; Back at the apartment, it is quiet, far away from the hubbub of Lakeside a 15 minute drive away, and in the lap of greenery. There are 52 units at Sungava and it already has a close-knit prospective community of professionals, including doctors, publishers, engineers, and businesspeople from the renewable energy and IT sectors.&nbsp; Some residents say they opted for a second home in Pokhara to make it a ‘base camp’ to explore the Annapurnas with its many hiking trails made newly accessible with new roads. With the NRN citizenship law, overseas Nepalis can now also buy the flats. &nbsp; The floor plans include options for north and south-facing 3-bedroom apartments with verandas, and the facility has underground parking has EV charging, heated pool, sauna and gym. There are still some unsold apartments with panoramic views of the mountains and one can imagine oneself at the kitchen with its huge window, humming a ditty while preparing breakfast: “खाना पकाउँ हिमाल हेरेर...”

High living below the Himalaya

When the United Nations held its Summit of the Future at its headquarters in New York in September, many world leaders, including Nepal’s Prime Minister K P Oli, highlighted the effect of climate breakdown in increasing the frequency and intensity of natural disasters. What did not get as much attention was the long term impact of the climate crisis on food production. In fact, heat stress, weather extremes and the consequences on rain-fed agriculture is already being felt worldwide, undermining the chances of the <a href="https://unstats.un.org/sdgs/">UN’s Sustainable Development Goals (SDGs)</a> being met by 2030.&nbsp; The SDG’s 17 targets commit countries like Nepal to reduce poverty and inequality, end malnutrition, protect the natural environment, and ensure that citizens all enjoy health, justice and prosperity without leaving anyone behind.&nbsp; However, besides the impact of climate breakdown on agricultural production, in Nepal the area under cultivation is impacted by urban expansion, falling productivity and the need for expensive inputs like fertiliser and pesticides.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241019041052_626413c5baf4dae407ac9579231b41daeb51510aa636b75aeb7489d94cca6a62.jpg" data-media-id="editor_1" data-image-id="20241019041052_626413c5baf4dae407ac9579231b41daeb51510aa636b75aeb7489d94cca6a62" data-rendition-name="original" width="999" height="1500" loading="lazy" alt="urban agriculture in Kathmandu"> <figcaption>Kathmandu's urban sprawl is eating into its fertile cultivable lands. Photo: TAYLOR MASON</figcaption> </figure>  Now, a new study led by Nepali researcher Prajal Pradhan at the University of Groningen in The Netherlands looks at how urban agriculture may offer a solution to falling food production and meeting SDG targets. The researchers evaluated 1,450 publications exploring the contributions of urban agriculture with both positive and negative effects, and published their findings in the journal Cells Report Sustainability. Urban agriculture can help achieve 17 SDGs, positively influencing 81 targets. However, it could also undermine 51 goals.&nbsp; Read also: <a href="https://nepalitimes.com/here-now/the-vanishing-land">The vanishing land</a>, Taylor Mason “Urban agriculture offers immense potential for sustainable development, but realising this potential depends crucially on adopting practices that minimise its adverse effects while maximising its benefits,” Pradhan explains. Urban agriculture can substantially enhance urban food security, provide employment to the urban poor, serve as ground water recharge in built-up areas, and preserve open spaces that can serve as safe havens during disasters like earthquakes. However, it also presents problems like the potential health risks from contamination and the need for expensive inputs. &nbsp; “Urban agriculture plays a definitive role in advancing the SDGs, but achieving this requires tailored, context-specific solutions that address the unique challenges of different regions,” says Yuanchao Hu of Wuhan University in China and who is a researcher at the Potsdam Institute for Climate Impact Research. “But it needs equitable access and rigorous management of environmental risks.”&nbsp; Rapid urbanisation is eating into Nepal’s most fertile agricultural land, which means farming in remaining open spaces inside cities can be a viable alternative, especially as food prices rise.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241019041052_7b7c9413086226fbdc630d45acf772cfa1ced77a8970b9056ec5ec7e5226fdf8.jpg" data-media-id="editor_3" data-image-id="20241019041052_7b7c9413086226fbdc630d45acf772cfa1ced77a8970b9056ec5ec7e5226fdf8" data-rendition-name="original" width="1500" height="999" loading="lazy" alt="urban agriculture in Kathmandu"> <figcaption>A vegetable patch in between new houses in Thimi. Photo: TAYLOR MASON</figcaption> </figure>  “The conversion of Nepal’s most fertile land into cities is a severe problem,” Pradhan told Nepali Times. “Crop cultivation, horticulture, agroforestry, beekeeping, livestock rearing, or aquaculture can all be farming activities within and around cities.”&nbsp; The study makes recommendations for sustainable practices that build on the positive aspects of urban agriculture while mitigating the downsides, thereby promoting more resilient cities in future. Research shows that urban agriculture has been helping many countries attain SDG targets by enhancing food security and biodiversity while helping education and preservation of open spaces.&nbsp; Indeed, many farmers from the hinterland who have settled in Kathmandu Valley or other urban areas of the country have been practicing urban agriculture, leasing neighbourhood patches or cultivating roof gardens both out of necessity because of inflation and falling income to grow their own food, and also as a fulfilling hobby. Saurav Dhakal, a sustainability advocate with Story Cycle and now research fellow at the Asian Institute of Technology in Thailand, says there are socio-economic and environmental benefits of urban agriculture. “It provides benefits to all urban dwellers, regardless of their income status,” says Dhakal, “families get fresh food, and there are many other benefits like water retention, heat regulation and biodiversity. These are all public goods, so special government incentives may be needed.” It is not unusual to see vegetable patches and even paddy fields within inner city Kathmandu where an older generation of farmers are using available fertile land and <a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/rooftop-gardens-kathmandu,1415">roof gardens to produce fresh, nutritious food </a>to reduce their dependence on food items that have to be bought after being trucked in from large distances.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2024101905100_1291ce98dbbb8caed8702ac4b1d469b3e13016d7ecaaf3bfd5f91c974d3c0c77.jpg" data-media-id="editor_5" data-image-id="2024101905100_1291ce98dbbb8caed8702ac4b1d469b3e13016d7ecaaf3bfd5f91c974d3c0c77" data-rendition-name="original" width="1500" height="999" loading="lazy" alt="urban agriculture in Kathmandu"> <figcaption>An older generation of farmers are using any available fertile land to continue farming but it is getting more and more difficult. Photo: TAYLOR MASON </figcaption> </figure>  Nepal’s urban population grew rapidly from only 3.6% in 1991 to 25% today. There is large outmigration from the mountains to peri-urban areas of the Tarai, to Kathmandu Valley and Pokhara, with many young men then moving abroad for work. Kathmandu Valley’s population has swelled to nearly 3 million, and is growing at 6.5% a year. Dilip Shrestha, 71, used to work for Nepal Food Corporation, so he knew firsthand about inflation, shortages and vegetables with pesticide residue. So, when he designed his new house in Kathmandu, he built a spacious roof where he grows cucumber, ginger, garlic, coriander, onions, tomatoes, chili, beans, okra, pumpkin and lettuce. His family eats healthier, and he has reduced dependence on the market.&nbsp; The co-author of the Cell Reports Sustainability journal article, Daya Raj Subedi who is a PhD candidate at Beijing Forestry University, says urban agriculture also promotes inclusion and psycho-social wellbeing.&nbsp; He says, “A crucial finding of the study is the identification of opportunities and challenges associated with urban agriculture, it can promote sustainable transformation of society.” In Banepa, 55-year-old Bijaya Manandhar in her lifetime has watched the fertile farms of her neighbourhood that used to supply vegetables to Kathmandu, now completely built up with no open space left. The pandemic lockdown prompted her to turn to the family’s <a href="https://nepalitimes.com/banner/rooftop-agriculture-on-the-roof-of-the-world">ancestral livelihood by growing food</a> not on terrace farms, but on the roof terrace. Manandhar is now a part of <a href="https://nepalitimes.com/banner/rooftop-agriculture-on-the-roof-of-the-world%5C%5C">कौसी खेती र करेसाबारी क्रान्ती</a> (Rooftop Farming and Garden Revolution) which has an online membership of 52,000, and awards annual prizes to women who excel in urban agriculture.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241019041052_7257f5def8f823f35a799fa6f6825e153f2ffa406ac11325d4fe74049b79e96d.jpg" data-media-id="editor_8" data-image-id="20241019041052_7257f5def8f823f35a799fa6f6825e153f2ffa406ac11325d4fe74049b79e96d" data-rendition-name="original" width="1600" height="736" loading="lazy" alt="urban agriculture in Kathmandu"> <figcaption>Rooftop farming is gaining popularity as a form of urban agriculture. </figcaption> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241019041052_beff1a4494ce896dd8fd383ee1f518e5448bcf7ea8bb138255391c7bcb9769ed.jpg" data-media-id="editor_9" data-image-id="20241019041052_beff1a4494ce896dd8fd383ee1f518e5448bcf7ea8bb138255391c7bcb9769ed" data-rendition-name="original" width="4000" height="3000" loading="lazy" alt="urban agriculture in Kathmandu"> </figure>  Pradhan says the challenge now is to upscale such examples of successful urban agricultural practices so they support Neal’s efforts to meet SDG targets. He adds, “Crop cultivation around cities can be protected by land use plans and regulations. Promoting community-based agriculture, including rooftop gardens, requires community engagement and public-private partnerships across the food value chain.”&nbsp; Such support would accelerate the popularity of existing rooftop farming and community gardens in Kathmandu Valley, or kitchen garden initiatives in Pokhara, and building on traditional farming practices that are preserved and integrated into urban settings like in Bhaktapur and Banepa. In Lalitpur, the Women Entrepreneurship Facilitation Center promotes urban farming enhancing both sustainability and empowerment.&nbsp; Another co-author of the report, Yuanchao Hu from China says followup research of the team will aim to identify good practices in local urban agriculture practices. He adds, “There are examples of urban agriculture that optimise sustainability, ensuring that it remains a viable solution for cities globally while countries try to meet SDG targets.” Prajal Pradhan, Daya Raj Subedi, Kshitij Dahal, Yuanchao Hu, Prakriti Gurung, Sijal Pokharel, Sagar Kafle, Biplav Khatri, Sudeeksha Basyal, Monika Gurung, and Aruna Joshi. Urban Agriculture matters for sustainable development. Cell Reports Sustainability, 1:100217, 2024. [DOI: 10.1016/j.crsus.2024.100217] Prajal Pradhan (<a href="mailto:p.pradhan@rug.nl">p.pradhan@rug.nl</a>) This article is brought to you by <a href="https://nepalitimes.com/" target="_blank">Nepali Times</a>, in collaboration with <a href="https://inpsjapan.com/en/" target="_blank">INPS Japan</a> and <a href="https://sgi-peace.org/" target="_blank">Soka Gakkai International</a>, in consultative status with UN ECOSOC.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20240630110640_30c3782f9c09219bf1c249b51483a3cfb7a53a06d117d2aebd23ca7080d12758.jpg" data-media-id="editor_14" data-image-id="20240630110640_30c3782f9c09219bf1c249b51483a3cfb7a53a06d117d2aebd23ca7080d12758" data-rendition-name="original" width="680" height="103" loading="lazy" alt="SDG logo"> </figure>

Back to the land in the cities

The 700-year-old Lakshmi Narasingha temple in Bhaktapur houses a rare half-lion and half-human incarnation of Lord Vishnu carrying the Goddess Lakshmi. The temple was destroyed in the 1934 mega earthquake that killed 10,000 people and destroyed many monuments in Kathmandu Valley. It was rebuilt by a German project in the 1980s, but as a single-storey structure instead of its original two-tier pagoda design.&nbsp; With new findings from in-depth research, Bhaktapur municipality began re-restoring the temple in 2021, preserving its original architecture.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241017131016_2fae38cce543ad7b1f6de632feb3e212e08ed1acedd747830e949d7b8e878f18.jpg" data-media-id="editor_0" data-image-id="20241017131016_2fae38cce543ad7b1f6de632feb3e212e08ed1acedd747830e949d7b8e878f18" data-rendition-name="original" width="2048" height="1365" loading="lazy" alt="In with the old in Nepal NT"> </figure>  “Our temples and heritage sites hold deep meaning. It is disheartening to witness how often they lose their original elements, whether by design or accident,” explains Kumar Chawal of the Consumer Committee of Bhaktapur. “There is a need to preserve our architecture and protect its historical value for future generations. Otherwise, we risk losing a vital part of our identity.” The Laksmi Narsingha restoration is similar to the Bhai Dega temple in Patan Darbar Square which also collapsed in 1934, but was rebuilt with a Moghul-style dome by the Rana government at the time. Only two months before the 2015 earthquake, heritage conservationists had started to rebuild Bhai Dega as the original three-tier based on early photographs. But priorities shifted when four other temples in the square were brought down by the 7.8M earthquake on 25 April 2015.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241017131016_697ea707d9ad163be5de5f2efbf5b70d3cab771adcc22f0fae6bf937c6cb0130.jpg" data-media-id="editor_1" data-image-id="20241017131016_697ea707d9ad163be5de5f2efbf5b70d3cab771adcc22f0fae6bf937c6cb0130" data-rendition-name="original" width="2048" height="1365" loading="lazy" alt="In with the old in Nepal NT"> </figure>  This showed how damage to monuments in Kathmandu Valley spanned from one earthquake to the next. Bhai Dega restoration remains half-complete to this day because money for its restoration ran out.&nbsp; Whereas Bhai Dega restoration was done by the Kathmandu Valley Preservation Trust with grants from western embassies and international foundations, in Bhaktapur it is the municipality itself that allocated the Rs30.7 million needed to restore the Lakshmi Narasingha temple. The expected date of completion is early 2025. The municipality and local communities are focusing on two main aspects: preserving the past and promoting localisation. The restoration team has designed a blueprint for the temple by using historical photographs and insights from older generations.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241017131016_182882fdc393c99e70d1d0490319e415229563666c4934e3a582426ebf00ca30.jpg" data-media-id="editor_2" data-image-id="20241017131016_182882fdc393c99e70d1d0490319e415229563666c4934e3a582426ebf00ca30" data-rendition-name="original" width="1200" height="560" loading="lazy" alt="In with the old in Nepal NT"> </figure>  “At first, the Lakshmi Narasingha temple had only one entrance, but during the demolition process, we uncovered the foundations of four doors. Now, we are restoring all of them. This is an example of how our ancient structures have changed over time, often without our knowledge,” says Chawal. “Constructing temples is not like building houses. They carry historical and spiritual values, which is why they hold a special place in our hearts,” he adds. By replicating ancient design elements and rebuilding the temple as accurately as possible to its original form, the team has stayed true to Bhaktapur’s soul. But the restoration also revived ancient techniques that were in danger of being forgotten, generating employment for woodcarvers, masons, and contractors. The community of Bhaktapur’s Gahiti neighbourhood near the famous Nyatapola Temple has also set aside specific days for locals to volunteer in the reconstruction work. This has encouraged young people to take pride in ownership of their heritage. Families have also supported the effort by donating funds for bells, the temple pinnacle, and other structural features to the temple.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241017131016_db850ec0c084cdbe54f65bee92dad2ad8122d20fd60ec87ec086fbb9d2f72bd6.jpg" data-media-id="editor_3" data-image-id="20241017131016_db850ec0c084cdbe54f65bee92dad2ad8122d20fd60ec87ec086fbb9d2f72bd6" data-rendition-name="original" width="2048" height="1365" loading="lazy" alt="In with the old in Nepal NT"> </figure>  “I feel at peace knowing I have contributed my sweat to restoring this temple,” said one volunteer. “It is our duty to preserve our temples and heritage. The Nyatapola area will look magical once this temple is completed.” Community mobilisation is a long-standing tradition in Bhaktapur. In the past, locals have actively participated in the restoration of other temples in the city, such as Bhairav and Nyatapola fostering a strong sense of ownership. This collective engagement has not only been crucial in preserving the city's historical monuments but also in strengthening the bond between local communities and their heritage, says officials at the municipality. While securing funding is essential, and the municipality showed it values heritage conservation, the Lakshmi Narasingha restoration is proof that active involvement and sense of responsibility of the local community is as important, if not more. Local involvement also means that the monuments will be cared for into the future, When locals take ownership of these efforts, the restored monuments are not only protected in the present but are also cared for in the future.

womens-health