One July afternoon in Gaur, after weeks of drought, the long-awaited rain finally arrived. Children were splashing in puddles, laughing and dancing with their friends. But while rain in the plains brings relief, fear settles in when it pours in the mountains to the north for too long. That is when the floods are unleashed. Madhes Province suffered a prolonged drought in June and July — wells went dry, paddy fields were desiccated, and parts of the Tarai suffered a cholera outbreak because of contaminated water. When the monsoon rains finally came last week, it <a href="https://nepalitimes.com/news/more-dark-clouds-over-nepal?amp=1">arrived with a vengeance</a>. Aside from the physical scars of droughts and floods, these weather extremes also leave scars that are less visible: in the minds and mental well-being of residents here. Gaur is the capital of Rautahat district, close to the border with India. It is <a href="https://nepalitimes.com/banner/nepal-tarai-learns-from-past-floods">prone to chronic floods</a> because it is astride the confluence of two rivers: the Bagmati and the Lalbakaiya. People here still remember the devastating floods of August 2017 when 70% of Rautahat was under water as both rivers overflowed their banks. Weather extremes caused by climate change combined with poorly engineered road embankments, blocked drainage basins, sand mining along rivers, and settlements along floodplains have increased the death and destruction. Floods are also exacerbated by flood control levees across the border in India and improper sluice gates that disrupt the rivers’ natural drainage. This causes floodwaters to back up, submerging settlements on the Nepal side. This past week, Rautahat received up to 330mm of rain in 24 hours — the highest in Nepal. Gaur was once again completely inundated. As before, people found themselves alone with little to no external support at the time of crisis. SURVIVAL MODE Aside from the physical impacts of floods, people suffer anxiety spikes, their decision-making falters as the brain enters survival mode. Fight, flight, or freeze becomes the norm, often leaving people unable to decide what to do when clarity is most needed. Nighttime floods are especially perilous: with power out and darkness setting in, one’s own village becomes a maze. While a few community buildings serve as temporary shelters, reaching them is often impossible. “At such times, you don’t even know where to get out from or how to escape,” a woman from Rajdevi told us. “There’s only my father-in-law at home, so we face the dilemma of whether he should focus on saving our belongings or the people and on top of that, we don’t know how to swim.” For generations, communities have relied on men’s decision-making even during disasters. But with most men away for work, villages are left predominantly with women and elderly men. This makes floods are as much a social crisis as a natural one, especially in a society where roles and responsibilities are gendered. Women face heightened stress managing childcare, domestic duties, household suppression and food scarcity, compounded by gender-based violence which is prevalent in the region.  <figure><img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251010081028_d453cb955b1574a1376ce5cb0f7055c0e210a1e6a70f1cad0ca7306842a006fe.jpg" data-media-id="editor_2" data-image-id="20251010081028_d453cb955b1574a1376ce5cb0f7055c0e210a1e6a70f1cad0ca7306842a006fe" data-rendition-name="original" width="1500" height="1125" loading="lazy" alt="Flooded with memories of floods NT NT"><figcaption>Passengers board the only available boat to cross the Bagmati River; a second operates only when the water level rises.</figcaption></figure>  As for men, they feel intense pressure to provide and protect their family. When they cannot do that in situations like a flood, feelings of guilt, shame and failure can emerge, affecting their well-being. Those who survive face nights with or without shelter, swarmed by mosquitoes and struggling with food scarcity. “We survive on one day’s worth of roti for days when the flood comes, there are no vegetables, no firewood or gas to cook,” the woman added. For many families, daily subsistence is already fragile, and floods only deepen hunger and hardship, heightening stress, anxiety, and psychological trauma, especially among caregivers and children. Malnutrition further intensifies emotional strain and long-term mental health risks. Marginalised communities, particularly Dalits, bear the heaviest burden yet are often the most neglected. During the 2017 floods, around 40 Dalit families were displaced from their settlements, some forced to live under open skies. Some 15% of Rautahat’s population of 700,000 is Dalit. Many were excluded from relief distributions or discouraged from sharing shelters with other communities due to entrenched caste-based discrimination. For these families, floods are not just a disaster but an emotional scar. Dalit women face double discrimination because of caste and gender, fostering a deep sense of abandonment, helplessness, shame, and isolation. In Rautahat, where most families live off the land, the flood undos years of labour and livelihood. When fertile fields or blooming crops submerge and fish ponds are washed away, families lose not only their income but their sense of stability. Agriculture here is more than an occupation, it is tied to identity, dignity, and hope. Repeated crop failure, mounting debt, and uncertainty about the next harvest often lead to anxiety, sleeplessness, and hopelessness, which are silent stressors of Nepal’s agricultural belt. During these crises, villagers rely heavily on family, neighbours, and the limited boats available to cross rivers. Local government responses have often been delayed, and with roads cut off, help arrives late, if at all. That delay breeds distrust and helplessness, deepening the psychological toll long after the waters recede. The people of Gaur and across Rautahat do not have the capacity to deal with aftermath mental issues from the flood as access to such care remains limited. Most cases are often referred outside the district to Kathmandu and Birganj or even across the border to Patna and Delhi. Locals do not trust existing mental health units, they also feel unheard and unsupported. The government provides free psychiatric medicines but they should focus on establishing competent, well equipped mental health institutions with an adequate number of professionals for regular access and strong continuity of care for effective recovery. As floods continue to test the resilience of Rautahat’s people, the need for proper anticipatory action grows ever more urgent. Preventing loss of life and property must go hand in hand with protecting the community’s mental well-being. From a psychosocial perspective, expanding initiatives like giving Psychosocial First Aid training and projects like Sajag Samaj, an anticipatory action project launched in April 2025 can make a real difference. They help communities prepare before disaster strikes, fostering coping skills, awareness, and collective resilience. At the same time, the government and local authorities must strengthen mental health support within disaster response plans, build infrastructures that reduce flood risks and safeguard livelihoods, and ensure that disaster relief is inclusive reaching Dalits, women, and other marginalised groups who are too often left behind. Anek Rajbhandari is program and communication intern at the Institute of Himalayan Risk Reduction.

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Flooded with memories of floods

Phewa Lake in Pokhara used to be much bigger, but it has been shrinking because of the sediment brought down from the surrounding mountains as well as human encroachment. The slopes above the lake used to be heavily denuded, and there was severe soil erosion because Pokhara Valley gets one of the highest annual rainfall in Nepal. To trap the silt, small dams were constructed across streams that flowed into the lake, but the Community Forestry Program restored the catchment’s lush vegetation reducing sedimentation. However, there is now a new danger: extreme weather caused by climate breakdown. And it was here exactly 10 years ago on 28 July 2015 that torrential rain over two days killed over 30 people in Kaski district. Thirteen of them were swept away in a flashflood on the Harpan Khola. But a month later, there was such heavy rain that even the thickly forested mountain above could not prevent a landslide that killed more people. Teacher at the local school, Arjun BK, lost several of his students in that disaster. The tragedy was so traumatic that it left a deep emotional wound that he carries to this day, a decade later. Returning to the classroom to see the empty desks became too unbearable. “That’s why I quit my job as a teacher”, BK told us as he showed us around the village which still bears scars of that landslide and flood ten years ago. Teaching, once a source of joy, became a source of anxiety, grief and frustration. BK showed signs of post-traumatic stress: he would find himself angry, would be cross with his students. Aware of his declining mental health, BK made the difficult decision to leave his job. BK’s struggle also exposed an aspect of climate breakdown that has not got as much attention: how climate change induced disasters are affecting the mental health of survivors. He then founded Koshish Kaski, an organisation working on mental health awareness and care. Koshish Kaski is a satellite organisation of Koshish Nepal, which is the country’s first mental health organization. BK’s symptoms aligned with post-traumatic stress disorder (PTSD): negative thoughts, irritability, difficulty in emotion regulation and avoidance of places that reminded him of the trauma.&nbsp; “I realised these symptoms were not only affecting my mental well-being, but also compromised my ability to teach effectively, so I quit on time,” says BK, while admitting that not everyone has the wisdom to recognise the wounds, nor the privilege to quit their jobs.&nbsp; Many continue teaching while silently struggling, and this can profoundly impact the student’s growth in the process. Arjun BK’s neice Devi Sunar survived the disaster ten years ago, and recalls how her farming community along the Haadi Khola struggled with trauma, fear and sleepless nights. Sunar herself has noticed that the once-predictable weather pattern in the mountains has changed, the monsoons are erratic, springs have dried up, and it is hotter than before. This has led to a decline in harvests – adding to crop loss due to raids by monkeys and wild boar. All this have placed psychological and economic strain on farmers like Devi Sunar.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250728110724_c61b3f30d270385f2def34c7a41ef1e7b049b520038a45c90b77c209c4f75265.jpg" data-media-id="editor_0" data-image-id="20250728110724_c61b3f30d270385f2def34c7a41ef1e7b049b520038a45c90b77c209c4f75265" data-rendition-name="original" width="1420" height="716" loading="lazy" alt="climate disasters in Nepal"> <figcaption>The site of the flashflood 10 yeas later. Photo: KAREN SUDMEIRE</figcaption> </figure>  Studies have found that women are more susceptible to anxiety and depression, and this is corroborated by Arjun BK’s own findings at Koshish Kaski. Climate-related disasters and crop loss add to gender discrimination at home and work. The stress, he found, can disrupt hormonal balance leading to irregular menstrual cycles and poor general health.&nbsp; Along with women, ethnic and ‘lower’ caste groups are more affected by climate-related disasters. Indeed, most of the lives lost in the 2015 disaster were from marginalised groups. In Nepal, these communities are more vulnerable because they live in riskier terrain, have limited access to resources, and heavy dependence on the natural environment for subsistence agriculture. To the north of Pokhara in the Trans-Himalayan Mustang district, farmers say winter rain and snow have failed for the past three years. This is critical since the region’s apple orchards need snow to moisten the soil in spring, as well as control pests.&nbsp; In Kagbeni at the confluence of the Kali Gandaki and Jhong Khola, there are still signs of the devastating debris flow that came down in August 2023, washing away 35 homes, a monastery, livestock and infrastructure.&nbsp; “Luckily, no human lives were lost because there was warning from upstream communities,” recalls Kagbeni Mayor Phenchok Tseptan.&nbsp; Although that flood was likely caused by a landslide lake outbrust upstream, local people suffer anxiety and spend sleepless nights even if there is a light drizzle as it brings back memories of that terrifying day.&nbsp; Because of the lack of awareness and societal taboo about mental health, few in Nepal link climate-related disasters like the ones in Kaski and Mustang to post-traumatic stress or generalised anxiety disorder. And as the Harpan Khola tragedy shows, the impact can be felt even a decade or more later. Arjun BK is a rare survivor of a disaster who not only spoke up about his condition, but also chose to do something about it and help others suffering silently. In recent years, mental health awareness has reached many communities across Nepal and the government has announced plans to establish outpatient mental health units in hospitals.&nbsp; Teachers in schools are also being trained to recognise and care for those who struggle silently with mental health issues – especially after climate-induced disasters. Better early-warning systems to reduce the impact would be a way to prevent trauma, anxiety and stress in the first place.&nbsp; Anek Rajbhandari is a graduate of New York University in Abu Dhabi and has a background in Psychology. The article is a part of author's involvement in Lumbini to LoManthang project by Duke University (Planetlab), IHRR, HUC, FEED and Karmaflight.

The unseen wounds of climate disasters

Orange, yellow and brown. Sama Bajracharya fills the canvas with colours, her forehead creased in concentration and a smile playing at her lips. Sama is 47 and has <a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/A-for-autism,270">autism</a>, a neurological and developmental disorder that affects how people interact with others, communicate, learn, and behave. It took years for Sama’s parents to come in terms with and understand her challenges.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20240416110452_d76000000456e391ebecd6304ca0352da0df367a097a24fba40845620bd0167e.jpg" data-media-id="editor_1" data-image-id="20240416110452_d76000000456e391ebecd6304ca0352da0df367a097a24fba40845620bd0167e" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="Autism awarness with art"> <figcaption>A colourful painting by Sama Bajracharya.</figcaption> </figure>  It was not until a teacher identified her difficulties – an inability to follow lessons, recognise letters and play with other students. She often withdrew and remained isolated. Her parents took her to a doctor who diagnosed her with autism. Because not much was known about the condition at the time, her parents held onto the hope that she would be cured. For 18 years, her mother Ratna Shova Bajracharya took her to traditional healers, dya majus and ayurvedic hospitals. “I did everything that I could, I just wanted to see her live like everyone else happy,” says Ratna Shova.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20240416110456_3783e96dfaeb643383995c2bb37ef189a55c704889ea55ef769842526f132a3f.jpg" data-media-id="editor_2" data-image-id="20240416110456_3783e96dfaeb643383995c2bb37ef189a55c704889ea55ef769842526f132a3f" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="Autism awarness with art"> <figcaption>Sama with her mother Ratna Shova.</figcaption> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20240416110456_a9006224a4e882de540cfc8ad3f9bb298c2b4fb66eaa8f2b48e4b83f68630126.jpg" data-media-id="editor_3" data-image-id="20240416110456_a9006224a4e882de540cfc8ad3f9bb298c2b4fb66eaa8f2b48e4b83f68630126" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="Autism awarness with art"> <figcaption>Sama with her sister Nima walking towards a bus station.</figcaption> </figure>  Upon learning there was no cure from a specialist, Ratna had to adjust their lives to accommodate Sama’s needs. This was not easy as sometimes Sama would exhibit aggressive behaviour including self-harm, throwing objects, breaking mirrors and threatening to jump off the window. A turning point came in 2005 when Sama met Sarita Dangol during an art event for people with autism. A senior artist, Sarita started mentoring Sama in arts and crafts. Art became a form of therapy for Sama, promoting mental and physical stability. Read also: <a href="https://nepalitimes.com/multimedia/the-art-of-healing">The art of healing</a>, Sewa Bhattarai Seeing the impact arts had on her, Sarita along with Sunila Bajracharya co-founded Mikha - The Creative Begins in 2022 to help empower other individuals like Sama by providing them a platform to explore and grow through art.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20240416110456_da249677323f0b78b936809ea68be00dd17f6530c1f8028723d318c71faafb8e.jpg" data-media-id="editor_5" data-image-id="20240416110456_da249677323f0b78b936809ea68be00dd17f6530c1f8028723d318c71faafb8e" data-rendition-name="original" width="1500" height="1015" loading="lazy" alt="Autism awarness with art"> <figcaption>Sama likes knitting.</figcaption> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20240416110456_1dc69dfe3b36b094726ca5ee1fd63f5754a623d4ab8efc8d52e6b5b86a1945f9.jpg" data-media-id="editor_6" data-image-id="20240416110456_1dc69dfe3b36b094726ca5ee1fd63f5754a623d4ab8efc8d52e6b5b86a1945f9" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="Autism awarness with art"> <figcaption>Sama hugs her knitting mentor after her art classes.</figcaption> </figure>  Mikha has become a source of joy for Sama, she excitedly attends classes with her classmates Sabha and Ritu both of whom have been diagnosed with down syndrome. In 2023, Sama participated in the International Disability Dance and Art Festival in Delhi and showcased her artistic and dancing talents, instilling a sense of confidence in her.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20240416110456_8c1556b05170bbe7cbb2f2a1959e26fe3ccfb294c3a86f4fc9b84ba225ccbffb.jpg" data-media-id="editor_7" data-image-id="20240416110456_8c1556b05170bbe7cbb2f2a1959e26fe3ccfb294c3a86f4fc9b84ba225ccbffb" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="Autism awarness with art"> <figcaption>Sama with her friends Sabha and Ritu during their art class.</figcaption> </figure>  Read also: <a href="https://nepalitimes.com/here-now/the-mental-scars-of-violence">The mental scars of violence</a>, Sewa Bhattarai According to the 2021 Census, there are 4,886 individuals with autism in Nepal, out of 647,744 people surveyed. This is 0.8% of the sample population. In 2019, the Autism Care Nepal Society (ACNS estimated) that some 300,000 children were living with autism in Nepal. There has been a <a href="https://nepalitimes.com/here-now/why-are-autism-cases-rising-in-nepal">worrying increase in autism among younger Nepalis</a>, partly due to increased awareness and diagnosis of the condition. Management and support systems, however, are sorely lacking.&nbsp;

Autism awareness with art

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221114111148/63721d9c9c7e80680e0bd4f9jpeg.jpg" alt="" width="1006" height="640"/><figcaption>Anjana Rajbhandary with Sloane, a Labrador Retriever mix she adopted recently. Photo courtesy of: ANJANA RAJBHANDARY</figcaption></figure>Last year, when I was still struggling with <a href="https://www.nepalitimes.com/opinion/coping-with-anxiety-in-new-lockdown/" target="_blank" rel="noopener noreferrer">pandemic-induced anxiety</a>, my best friend Shailu suggested I get a puppy. Shailu herself is mom to two golden doodles and told me how having pets has made her much happier.According to <a href="https://www.psychologytoday.com/us/blog/the-right-balance/201804/how-dogs-drive-emotional-well-being">Psychology Today</a>, dogs help people be present in the moment. When you are playing with or walking your dog, that is what you are doing because you need to pay attention to your puppy, preventing your mind from wandering into the senseless territory.Spending time with a dog can significantly lessen one’s negative emotions because they make you feel loved. Plenty of studies have proven that canines make people happier. But how do you make the right choice when choosing a dog?“Do your research! Don’t get a dog just because you like the way they look,” says Serena, an animal care worker with over 20 years of experience. She strongly recommends opting for a dog that best fits your lifestyle which dictates whether you can give the dog the level of activity it needs.“If you are an active person, get a high-energy dog but if you are a homebody, better to choose the one that needs fewer walks and is fine lounging around with you,” she adds.Read also: <a href="https://www.nepalitimes.com/review/adventures-of-a-kathmandu-street-dog/" target="_blank" rel="noopener noreferrer">Adventures of a Kathmandu street dog</a>, Nepali Times<a href="https://www.instagram.com/dog_father_pranav/">Pranav R. Joshi</a>, a veterinarian with 14 years of experience strongly recommends adopting a dog for mental health benefits. “Dogs radiate an energy towards people that automatically helps because no matter how tired you are, even if it is for 5 minutes, it can positively impact your mental health,” he explains.When you come home tired from work and do not feel like talking to anyone, dogs act as a bridge. They bring families together because even if they don’t talk to each other, they will talk about their furry friends. Experts also encourage teaching children to take care of pets to instill a sense of responsibility from a young age.Having a dog also makes it easier to start conversations, they give you something to talk about. And even if conversations start with dogs, it encourages people to bond with others over time. <a href="https://www.nytimes.com/2018/02/27/well/family/dog-date-men-women-love-dating-relationships.html">Studies</a> have found that single men are more likely to meet women if they have a dog with them. So, your little best friend might even help you find love.“Dogs help people become more sociable and improve relationships,” adds Joshi who has been running <a href="https://www.facebook.com/vetforyourpet">Vet for your Pet</a> clinic since 2009.Andréa Schneider started <a href="https://www.facebook.com/DreasDogsitting/">Drea’s Dogsitting LLC</a> in 2019 because of her love for animals, she wanted to spend every day doing it. “Socialising your puppy from an early age is an investment in happiness and peace for years to come,” she says, adding that the business has allowed her to know more people from her community. Such a practice also helps shape the dog’s personality from an early age.Read also: <a href="https://www.nepalitimes.com/here-now/angel-meets-an-angel/">Angel meets an angel</a>, Sonia Awale<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221114111148/63721d9e9c7e80680e0bd4fajpeg.jpg" alt="" width="1920" height="1280"><figcaption> </figcaption></figure>Another animal lover is Lisa Huey who has been volunteering for the non-profit <a href="https://lolin.org/">Love of Labs</a> since 2020 and has fostered five dogs since. Fostering and adopting older dogs is not common in Nepal, but she is a strong advocate and as such is against leaving pets outside to sleep or keeping them in a cage for too long.“How you treat the dog is how the dog will age,” she says. “Dogs age like people. We have to feed them a healthy diet and keep them active, and as they get older, they need supplements for their health issues. You should treat your dog like a family member.”Dogs are intelligent beings but training them can be time-consuming as they need time and practice to learn and retain commands. Imagine someone speaking to you in a foreign language you do not understand. It is the same for dogs so one must be patient.We adopted Sloane, a Labrador Retriever mix, and couldn’t be happier. Having her has immensely helped my<a href="https://www.nepalitimes.com/opinion/readjusting-to-life-post-covid/" target="_blank" rel="noopener noreferrer"> mental and physical health</a> since we need to give her plenty of exercise to keep her healthy, labs tend to put weight on quickly. She is good with strangers, very playful, and has high energy, so she keeps us plenty busy.People with pets, in particular dogs, are happier because they provide companionship as well as a sense of security. They are a great addition to your life, they add structure to your day. They make you more responsible because they depend on you for their welfare.In short, dogs make you a better person or bring about your best version.Read more: <a href="https://www.nepalitimes.com/latest/microchipping-nepals-dogs/">Microchipping Nepal's dogs</a>, Aria ParasaiAnjana Rajbhandary writes this fortnightly Nepali Times column Life Time about mental health, physical health and socio-cultural issues.

Anjana Rajbhandary

Canine therapy

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221114111144/63721c239c7e80680e0bd47ajpeg.jpg" alt="" width="3000" height="2000"/><figcaption>Illustration: FREEPIK</figcaption></figure>Three years ago, when people went to get a manicure, it was a manicure. Today it is called 'self-care'. Earlier, taking a bath used to be a relaxing way to end a stressful day. Today a soak is also 'self-care'.This is not a diss on <a href="https://www.nepalitimes.com/banner/beauty-parlour-defies-lockdown-to-reopen/">beauty salons</a> of which there are now too many to count in Kathmandu, but self-care is much more than that. Self-care is a common terminology in the field of psychology and is often used to see how patients are <a href="https://www.nepalitimes.com/latest/the-other-pandemic-mental-health/">taking care of themselves</a> physically, mentally, and emotionally.Self-care is also subjective, what one person needs in their life is not the same for others. Before the pandemic, it was limited to taking proactive actions such as eating healthy, staying active, taking your medications as prescribed, and speaking with a therapist. They were intended to slowly change one’s habits so one could become happier and healthier.Navigating the global market that is saturated with products geared towards self-care without ruffling a few feathers is tricky. Last summer, one of my mentors asked me what I thought of the present-day definition of self-care. Both of us have experience with non-profits where we worked with children and adults. Every program we worked on was geared towards improving people's lives, but before the pandemic, we did not ever think of suggesting that a manicure could be self-care.Shainna Ali, Ph.D., LMHC, NCC, tells Psychology Today, 'Self-care is a continuous process of proactively considering and tending to your needs and maintaining your wellness.' She describes it as a holistic practice. A great example of self-care is a physical activity that you incorporate into your life because of the bodily and mental benefits. It is not a one-and-done act, you must stay consistent.The oversaturated market has found a <a href="https://www.nepalitimes.com/here-now/dalits-disasters-and-discrimination/">vulnerable</a> niche, I admit I have myself fallen for it. After all, they deploy some of the cleverest tactics, promoting buying products to reward themselves 'because we deserve it'.Of course, it is lovely to own a bathroom filled with <a href="http://archive.nepalitimes.com/news.php?id=15716#.Yk2Sc9NBz0s">skincare products</a> and scented candles, but soon enough you will find the true meaning of self-care lost amid the piles of online shopping receipts. Go ahead and get yourself that amazing bubble bath, but you cannot buy self-care.We have confused the real meaning of self-care as the <a href="https://www.nepalitimes.com/latest/covid-19-affecting-food-security-in-nepal-wfp/">Covid scare</a> fades. I love having a vanity filled with luxurious skincare products, but that is not exactly self-care for me. That is more of an indulgence, which we all deserve from time to time. People actually need to self-reflect and analyse what they need in their lives.Read also: <a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/Caring-essence-of-nursing,2273">Caring is the essence of nursing</a>, Anjana RajbhandaryDuring the pandemic, a lot of people <a href="https://www.nepalitimes.com/latest/half-of-nepalis-lost-jobs-in-past-month/">lost jobs</a> and had to take care of sick family members. Many reported <a href="https://www.nepalitimes.com/latest/the-other-pandemic-mental-health/">feeling depressed and hopeless</a>. Soon, the value of mental well-being started to take precedence and people started indulging in self-care. So the term came to mean immediate gratification, but it does not guarantee a long-term solution.One of my friends is a working mother but the distraction of home life affected her ability to work efficiently. Then she took up running, just an hour every day, as an act of self-care. It gave her time away from the household chaos but it also improved her fitness level. Eventually, she was happier with a better ability to handle the stress.Another friend justified eating a whole box of cookies as an act of self-care. When the concept is blurred like this, people can define it in any way they want, even to their own detriment. Her choice of self-care ended with weight gain and lowered self-esteem.No amount of rubbing lavender lotion on the skin is going to fill the void left by <a href="https://www.nepalitimes.com/opinion/coping-with-covid-fomo/">pandemic-induced loneliness</a>. A bubble bath is not going to make up for it either, humans need family and friends.It has been two years, and what started as a movement to <a href="https://archive.nepalitimes.com/article/nation/diabetes-in-south-asia,3018">take care of physical</a> and mental health during the pandemic has taken a turn. Self-care has become a staple in the world of marketing -- synonymous with promoting <a href="https://www.nepalitimes.com/opinion/decarbonise-now/">consumerism</a>.If it makes you happy, go for it, but when did buying myself a pair of jeans become self-care? It will not help if you do not have a supportive environment around you. At most, self-care achieves the temporary well-being of your mind.At the end of the day, you have to do what works for you. If practicing an act of kindness is helping you, go for it. But engaging in <a href="https://www.nepalitimes.com/here-now/make-sure-bicycling-is-not-injurious-to-health/">physical activity</a> and eating ice cream every day cannot fall under the same category. The results of the two choices are vastly different.Before we jump on the 'self-care' bandwagon, let us ask ourselves if our choice of self-care is indeed improving our lives or just an excuse to do whatever we want.Anjana Rajbhandary writes this fortnightly Nepali Times column Life Time about mental health, physical health and socio-cultural issues.Read more: <a href="https://www.nepalitimes.com/opinion/the-female-social-anatomy/">The female social anatomy</a>, Anjana Rajbhandary

You can’t buy self-care

<figure><img width="3700" height="1900" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221114101116/637208159c7e80680e0b54cajpeg.jpg" alt=""/><figcaption></figcaption></figure>The coronavirus disease is one of the most well-documented health crises of recent times, with its correlation to almost every sector in society -- including the <a href="https://www.nepalitimes.com/here-now/post-pandemic-mental-health-epidemic/" target="_blank" rel="noopener noreferrer">mental cost</a> of prolonged lockdowns and the stress during the pandemic. Studies have linked a higher prevalence of anxiety, depression, post-traumatic stress disorder (PTSD), hypochondria, obsessive disorders and psychotic symptoms among the general population in the last two years.But for the first time, <a href="https://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0262958&amp;fbclid=IwAR3GhEvU6qnCjQuwR-HEye8Jk3foYOofrmAgpLCgHZEhjm9r_2PWAOpZCBE" target="_blank" rel="noopener noreferrer">a new study</a> squarely links the rise in suicide ideation with the pandemic in Nepal. Police records also show a spike in suicides and self-harm cases in the past two years.Suicide cases had been rising even before the pandemic with 5,509 in 2018 and 5,898 in 2019. However, it jumped to 6,968 during the first year of the pandemic in 2020 — putting the <a href="https://www.nepalitimes.com/banner/nepal-sees-spike-in-suicides-during-pandemic/" target="_blank" rel="noopener noreferrer">suicide rate</a> at 23.9 per 100,000 population.‘The yearly increase in the suicide rate from 2019 to 2020 is 16%, which is more than threefold higher than a yearly increase in the suicide rate from 2018 to 2019 (5%),’ states the paper published on PLOS ONE last month.Titled ‘Association between COVID-19 pandemic and the suicide rates in Nepal’ and conducted by Binod Acharya, Keshav Subedi, Pramod Acharya and Shweta Ghimire, research analysed a total of 24,350 suicides in four years from July 2017 to June 2021 based on Nepal Police data.It investigated changing <a href="https://www.nepalitimes.com/latest/the-other-pandemic-mental-health/" target="_blank" rel="noopener noreferrer">suicide rates</a> in Nepal during the Covid-19 pandemic period (April 2020 to June 2021), compared to the pre-pandemic period (July 2017 to March 2020), adjusted for seasonality and long-term trends in the suicide rate.Males had a higher suicide rate (26.9 per 100,000) than females (16.5 per 100,000), but suicide rates went down over the last two years among males, but was sustained for a longer duration among females. <img width="542" height="600" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221114101116/637208189c7e80680e0b54cbjpeg.jpg" alt=""><img width="533" height="600" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221114101116/6372081b9c7e80680e0b54ccjpeg.jpg" alt="">For example, all the pandemic months except April and May of 2020 and February and March of 2021 had a significantly higher suicide rate compared to the same months in 2019. In comparison to the same month in 2019, July 2020 (just after the first lockdown) had the highest increase in the suicide rate with an increment of 55%.Researchers have pointed out limited or lack of economic resources, public health infrastructure and awareness about mental health as leading factors for the increase in suicides in Nepal during the pandemic.Nepal is one of the countries with highest suicides rates in the world according to the World Health Organization (WHO). The 2021 Nepal Health Research Council (NHRC)’s National Mental Health Survey found the prevalence of suicidality (current suicidal thoughts, lifetime suicidal attempt and future likelihood of suicidal thoughts) at a high of 7.2% among Nepalis. During the study period of this latest survey, the highest proportion of the suicides were observed in Bagmati province (5,709; 23.4%), followed by Province 1 (5,161; 21.2%), Lumbini (4,757; 19.5%), Madhes (3,053; 12.5%), Gandaki (2,369; 9.7%), Sudurpaschim (2,176; 8.9%), and Karnali (1,125, 4.6%).But Sudurpaschim and Karnali provinces, two of the provinces with the lowest Human Development Index (HDI), had the highest increase in suicide rates associated with the Covid-19 pandemic.‘Sudarpaschim and Karnali regions are also known to have a historically high proportion of seasonal <a href="https://www.nepalitimes.com/here-now/in-the-minds-of-nepals-migrant-workers/" target="_blank" rel="noopener noreferrer">migrant workers</a> in India. People in this region could have experienced additional distress as their migrant family members lost their jobs in India because of the business closure and lockdown,’ states the study.Alternatively, Province 1 which has the highest HDI and relatively low poverty rate among seven provinces has had consistently high pre-Covid-19 suicide rates, but had the smallest increase during the pandemic.Official data shows that Nepal registered an early increase in the suicide rate and mental health problems during the pandemic. Many factors come into play: lack of financial stimulus packages in the beginning, irresponsible media reportage about the virus, conflicting messages by authorities and the s<a href="https://www.nepalitimes.com/here-now/nepal-health-workers-battle-covid-19-but-also-stigma/" target="_blank" rel="noopener noreferrer">ocial stigma of being infected</a> all added to the psychological stress in the public.Restrictions during the pandemic also meant that mental health patients were unable to get timely consultation and medication, further aggravating their condition. ‘Public health interventions to the pandemic, especially the severe ones like lockdowns and business closure, should incorporate economic safety nets and mental health service delivery mechanisms catered to geographic, socio-economic differences and needs,’ recommend the researchers. <img width="1500" height="1000" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221114101116/6372081d9c7e80680e0b54cdjpeg.jpg" alt="">Suicides are preventable and treatment of mental health disorders can save lives. A comprehensive suicide surveillance system to maintain detailed suicide and attempt statistics within the jurisdiction of public health agencies rather than just the law-enforcement agencies can be a start.Addressing the underlying cause of <a href="https://www.nepalitimes.com/opinion/coping-with-anxiety-in-new-lockdown/" target="_blank" rel="noopener noreferrer">mental health problems</a> is still the most effective way to prevent suicides. This requires increased awareness and education through various platforms including social media, mass communication and school curriculum, which will in turn also help reduce the stigma associated with psychological disorders. Besides consultation and medication, family support plays a crucial role in healing people with trauma, depression or psychosis. Telemedicine, in particular, has been essential in preventing self-harm during the pandemic but these services need to be scaled up to cover the whole country.The paper concludes: ‘The Covid-19 pandemic is associated with an increased suicide rate in Nepal. The findings may inform policymakers in designing appropriate public health responses to the pandemic that are considerate of the potential impact on mental health and suicide.’Do not shy away from seeking help. If you, or anyone you know, would like to speak to a trained mental health professional, please contact:TUTH Suicide Hotline: 9840021600Transcultural Psychosocial Organisation-Nepal Crisis Hotline: 1660 0102005Mental Health Helpline Nepal: 1660 0133666Centre for Mental Health and Counselling Nepal Toll-free: 16600185080, Hotline: 1145Koshish Toll-free helpline: 166001-22322 (Bagmati Province)Patan Hospital Helpline: 9813476123National Suicide Prevention helpline operated by Mental Hospital Lagankhel and TPO: 1166

Suicides: a pandemic within a pandemic

<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110161148/636d1dac9c7e80680e0af3cejpeg.jpg" alt="" width="1024" height="443"/>This summer, I finally reached my weight goal after struggling for over two decades.<a style="font-size: 15px; letter-spacing: 0.01em;" href="http://archive.nepalitimes.com/regular-columns/all-in-mind/love-yourself-and-have-a-healthier-attitude,532" target="_blank" rel="noopener noreferrer">I gained over 20 kgs in high school</a> in three months. It was a shock to me and my family, and ever since I have tried to lose weight. It did not just affect my self-esteem but also my health.‘Moti’ became synonymous with my name.‘How could you let yourself get so fat?’ people asked me.They made fun of me when I was at my heaviest, and they continue to criticise me as I work towards being healthier.I had tried everything possible to <a href="https://archive.nepalitimes.com/article/nation/slim-dreams-of%20women,3658" target="_blank" rel="noopener noreferrer">lose weight</a> quickly, but as easy as it is to gain weight, it is as difficult to lose it. So when I finally managed to do it, I shared it on my social media, only to be met with backlash.‘You looked better before.’‘I would never deprive myself of food.’‘Are you okay? We are worried about you.’‘You have an eating disorder.’In college, I did not live a healthy lifestyle. Partying, overindulging in food and alcohol, and barely sleeping did not help matters. I wanted to be healthy, but I was not doing anything to change my bad habits.I am at a healthy weight now, and it is a result of daily exercise and a more nutritious diet of protein and vegetables. I stopped eating <a href="https://www.nepalitimes.com/banner/nepalis-binge-on-junk-foods-the-west-rejected/" target="_blank" rel="noopener noreferrer">processed food</a> and cut down my alcohol consumption. I never deprived myself of food, I only stopped overeating.It is considered rude to comment when people gain a few extra kgs. But when someone loses a little weight, everybody thinks they have the right to comment on your body because it is coming from a place of ‘concern.’But how did I gain all the weight in the first place? I was 17, living in Italy. I was having pizza and gelato every day but never exercised. I could not walk half a mile without having to rest or catch my breath. I once even sprained both my ankles because I fell while walking.When <a href="https://www.nepalitimes.com/here-now/omicron-may-not-be-as-risky-but-take-care/" target="_blank" rel="noopener noreferrer">Covid</a> forced us all into lockdown, I decided to make it happen, achieve my weight goals.It was not easy, the most challenging part was being disciplined. But after three months of consistency and daily exercise without giving up, I noticed that I had lost weight and did not have the stomach issues I used to. It took time, but I started to enjoy healthier foods, I began to feel better and happier, and I was not always hungry like I used to be.It takes work, but people are quick to judge and call it deprivation. Many tried to school me when I tried to stick to my diet. When I shared my little victories, they called me vain because I felt the need to lose weight, and some even told me I had an eating disorder. I felt attacked. Instead of support, I was called shallow.Most of these people did not even know me or the amount of work I was putting into this. Much of the reproach also comes from individuals who are not happy with themselves so they take it out on others. There is no polite way to put it, it is just the truth.But for the first time in years, I am happy with how I look and feel, I have been waiting for years to experience this. I can walk for miles. I no longer have to worry about having stomachache when eating out.This is the <a href="https://www.nepalitimes.com/opinion/we-are-what-we-eat/" target="_blank" rel="noopener noreferrer">healthiest relationship I have ever had with food</a>. I enjoy eating, I cook a lot, and food has become a positive part of my life.I am just shocked and disheartened by people’s reactions. I did not expect everyone to help me in my process, but I also did not think I would receive this much hate or people would think they have the right to tell me how I should look.We hate it when someone comments on our body, so what makes it acceptable to comment on others? People will always have opinions, but why be so cruel?So, if you do not have any words of encouragement or something positive to say, it is better to say nothing at all.We have the right to love our bodies. After 20 years of struggling with my weight, I finally feel healthy. I am happy with how far I have come. I am proud of myself, and I will not let anyone shame me for my body.Anjana Rajbhandary writes this fortnightly Nepali Times column Life Time about mental health, physical health and socio-cultural issues.

Too fat or too thin, but never quite right

<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110161124/636d17e79c7e80680e0ac791jpeg.jpg" alt="" width="4096" height="2730"/>Children and young people across the world could feel the <a href="https://www.nepalitimes.com/here-now/post-pandemic-mental-health-epidemic/" target="_blank" rel="noopener noreferrer">impact of Covid-19 on their mental health</a> for many years even after the worst effects of the pandemic are gone, a new UNICEF report warns.The annual <a href="https://www.unicef.org/reports/state-worlds-children-2021" target="_blank" rel="noopener noreferrer">State of the World’s Children 2021: On My Mind </a>this year focuses on promoting, protecting and caring for children's mental health and is a comprehensive look at how children, adolescents and caregivers will be affected for many years into the future.Early findings from UNICEF and Gallup’s survey Changing Childhood Project previewed in the report show that one in five respondents aged 15–24 admitted to feeling depressed and losing interest in things. The survey interviewed approximately 20,000 children and adolescents from 21 countries as well as 40 and older.One-third of respondents of a Chinese online survey last year cited in the report reported feeling scared or anxious.“With nationwide lockdowns and pandemic-related movement restrictions, children have spent indelible years of their lives away from family, friends, classrooms, play – key elements of childhood itself,” said UNICEF Executive Director Henrietta Fore. “The impact is significant, and it is just the tip of the iceberg.”According to the Institute of Health Metrics and Evaluation (IHME)’s 2019 Global Burden of Disease Study, more than one in seven adolescents aged 10–19 globally is estimated to live with a <a href="https://www.nepalitimes.com/opinion/coping-with-anxiety-in-new-lockdown/" target="_blank" rel="noopener noreferrer">diagnosed mental disorder</a>, some of which include depression, anxiety, schizophrenia, ADHD, autism, and eating disorders.WHO’s 2019 Global Health Estimates show that almost 46,000 adolescents die from suicide each year.Here in Nepal, community respondents say that <a href="https://www.nepalitimes.com/latest/tackling-nepals-mental-health-pandemic/" target="_blank" rel="noopener noreferrer">mental health is among the primary concerns</a> of children and adolescents. Nepal Police data shows that 8% of those who died by suicide nationwide in the last five years were minors. Some 20% of suicide ideation and calls to psychological helplines across Nepal are associated with violence, and 25% with economic deprivation.Statistics show a <a href="https://www.nepalitimes.com/latest/in-nepal-lockdown-a-domestic-violence-spike/" target="_blank" rel="noopener noreferrer">direct correlation</a> between the lockdown and incidents of gender-based violence, sexual violence, and violence against children in Nepal. There have been 7,141 reported deaths due to <a href="https://www.nepalitimes.com/banner/nepal-sees-spike-in-suicides-during-pandemic/" target="_blank" rel="noopener noreferrer">suicides nationwide in the last 12 months</a>, up from 6,252 the year before.Additionally, recent surveys reveal that a significant number of households with children <a href="https://www.nepalitimes.com/latest/1-in-5-nepal-families-lack-food/" target="_blank" rel="noopener noreferrer">experienced economic and livelihood losses</a> during the 2020 lockdown, and the economic fallout continued into the 2021 lockdown as households experienced<a href="https://www.nepalitimes.com/latest/half-of-nepalis-lost-jobs-in-past-month/" target="_blank" rel="noopener noreferrer"> job losses</a>, with little to no support from the government.At least one in every seven children globally has been directly affected by lockdowns. More than 1.6 billion children have <a href="https://www.nepalitimes.com/latest/covid-19-cancels-regions-gains-in-education/" target="_blank" rel="noopener noreferrer">lost access to education </a>during the pandemic, and the disruption to routines, recreation, as well as impact on family income and health has left young people with exacerbated mental health issues.Mental health issues cause long-term harm to children and young people’s education, life outcomes, and earning capacity. Indeed, a new analysis by the London School of Economics indicates that mental disorders leading to disability or death among young people cost economies nearly $390 billion annually.Despite the epidemic of mental health crisis among young people who are dealing with unaddressed psychological disorders, it doesn’t attract the investment from governments it deserves, and there were significant gaps between mental health needs and funding even before the pandemic.Indeed, the UNICEF report found that only about 2% of government health budgets are allocated to mental health spending globally.The report also notes that genetics, environmental factors including parenting, schooling and relationships, exposure to violence or abuse, discrimination, poverty, as well as humanitarian and health crises have an impact on children’s mental health.And while caregivers, safe school environments, and positive peer relationships can help reduce the risk of mental disorders, the stigma surrounding mental health and lack of funding prevent children from accessing required mental health resources.The report has called on world governments as well as the public and private sector to commit to addressing the <a href="https://archive.nepalitimes.com/article/nation/stigma-and-silence-mental-health-nepal,3486" target="_blank" rel="noopener noreferrer">stigma surrounding mental health</a>; promoting mental health for children, adolescents and caregivers; taking experiences of children and young people seriously, and identifying and caring for vulnerable groups with psychological conditions.Said Fore: “Mental health is a part of physical health, we cannot afford to continue to view it as otherwise. For far too long, in rich and poor countries alike, we have seen too little understanding and too little investment in a critical element of maximising every child’s potential. This needs to change.

The other pandemic: mental health

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110141148/636d01669c7e80680e0a3628jpeg.jpg" alt="" width="1500" height="1000"/><figcaption>Photo: MONIKA DEUPALA</figcaption></figure>A53-years-old laboratory assistant at a reputed hospital in Kathmandu recently bought aluminium phosphide tablets and ingested three of them. He started vomiting immediately, and had to be rushed into emergency.Because of his poor cardiopulmonary status and low mentation, he was intubated and transferred to the ICU. But that did not save the patient, who died a few hours later. The reason for self-poisoning was later found to be marital discord.Aluminum phosphide is a pesticide that is widely available across the Subcontinent because farmers use it as a fumigant to protect stored grain from insects and rodents. But increasingly more people are using this lethal inorganic compound for <a href="https://www.nepalitimes.com/latest/suicide-watch/">suicide attempts. </a>Aluminium phosphide releases the highly toxic phosphine gas in the presence of moisture. When ingested, therefore, it reacts with the contents of the stomach, releases phosphine and leads to serious multi-organ damage to the heart, brain, kidney and lungs. Since there is no specific antidote, the <a href="http://archive.nepalitimes.com/news.php?id=17916#.YTrBPZ0zZPZ">death rate is very high. </a>A recent large study involving 4,148 patients conducted by the <a href="https://centrepsp.org/">Centre for Pesticide Suicide Prevention</a> at the University of Edinburgh in collaboration with Nepal Public Health Foundation revealed that aluminium phosphide accounted for 61% of all pesticide self-poisoning fatalities in hospitals. In the same study, of the 2,535 pesticide deaths, 300 were caused by aluminium phosphide.There has been a sharp rise in suicide deaths since the Covid-19 pandemic with widespread societal impact of lockdowns and economic difficulties on mental health of individuals. According to the Nepal Police, there were <a href="https://www.nepalitimes.com/here-now/nepals-suicide-rate-vastly-underestimated/">7,141 reported deaths due to suicides</a> nationwide in the last 12 months -- up from 6,252 the year before. Many more make attempts to end their lives.Mental health doctors in Nepal report an increase in patients suffering anxiety, depression, post-traumatic stress disorder, hypochondria, obsessive disorders and psychotic symptoms in the population in the past two years. Subsequent studies have drawn a direct correlation between the pandemic and a spike in mental health problems due to job loss as well as increased domestic and sexual abuse during the lockdowns.<a style="background-color: #ffffff; font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/here-now/suicide-by-pesticide-in-nepal/" target="_blank" rel="noopener noreferrer">Pesticide ingestion</a> is the second most common method for suicide in Nepal as they are cheaper, do not need prescription, and are easily available in agro-vet shops. Most farming families also have pesticides readily available in their homes.Deaths by suicide due to pesticide ingestion are preventable, and there are evidence-based cost-effective interventions such as bans on hazardous agro-chemicals or limiting access to them.Sri Lanka and Bangladesh have clear data on how strict bans on just a few of the pesticides commonly used for self-harm can bring down the rate of suicides rapidly and without affecting agriculture output as the government replaces them with non-lethal agrochemicals.Back in the 1990s, Sri Lanka had one of the highest suicide rates in the world with 57 deaths per 100,000 population. Twenty years after it banned the pesticides Monocrotophos and Methamidophos in 1995, suicide deaths fell by a remarkable 70% to 17 deaths per 100,000 people. That is 93,000 lives saved at $50 per person.Similarly, after Bangladeshi banned 21 Highly Hazardous Pesticides (HHPs) suicide by pesticide ingestion fell dramatically from 6.3 per 100,000 population in 1996 to 2.2 in 2014.This is proof that legislation and strict regulations work. The good news is that in August 2019, Nepal’s Pesticide Registration Board banned eight hazardous chemicals in Nepal including aluminium phosphide and dichlorvos.This means that the production or import of the 3g tablet of aluminium phosphide which also goes by its trade name Celphos, Quickphos, Alphos, are restricted in Nepal. All remaining stockpiles after two years of phase-out period will be deposited in a government-built warehouse not to be sold anymore.But given that a past government ban on ‘dirty dozen’ pesticides has been ignored by farmers, often unaware of just how harmful they are to human health and nature, they have continued to use them in vegetable patches in Kathmandu Valley. Bans alone are not the answer, they also have to be enforced with punitive action for infringement.What we have seen from case studies elsewhere is also that after every ban on a hazardous pesticide, some new brand always comes up. The government must therefore replace HHPs with less toxic chemicals so that when people do ingest them they are not as lethal. Lack of accessibility to hazardous chemicals also means that people have to choose a more difficult method of suicide, which in turn discourages many and prevents more deaths.Apart from regulation, farmers need to be educated on how to use pesticides responsibly and about their handling that includes using personal protective gear, gloves, masks and visors. Something as simple as marking the pesticide bottle or packet with red, yellow or green to indicate how lethal they are also saves lives.Rakesh Ghimire is an assistant professor at the Tribhuvan University Teaching Hospital in Kathmandu, and was a national principal investigator of the study ‘Intentional Pesticide Poisoning and Pesticides.’<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110141148/636d01699c7e80680e0a3629jpeg.jpg" alt="" width="89" height="103">Do not shy away from seeking help. If you, or anyone you know, would like to speak to a trained mental health professional, contact:TUTH Suicide Hotline: 9840021600Transcultural Psychosocial Organisation-Nepal Crisis Hotline: 1660 0102005Mental Health Helpline Nepal: 1660 0133666Centre for Mental Health and Counselling Nepal Toll-free: 16600185080, Hotline: 1145Koshish Toll-free helpline: 166001-22322 (Bagmati Province)Patan Hospital Helpline: 9813476123National Suicide Prevention helpline: 1166

Breaking the pesticide-suicide link

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110141124/636cfc2c9c7e80680e0a0b73jpeg.jpg" alt="" width="1500" height="1000"/><figcaption>Photo: MONIKA DEUPALA</figcaption></figure><ul><li>Two years ago after going through a bad relationship, a 36-year-old Kathmandu-based doctor started getting suicidal thoughts. During the long months of lockdown, he would be on the rooftop and imagine jumping off to end it all. But before long he realised that he was causing self-harm, and sought help. He was diagnosed with depression, eight months into treatment he is rid of suicidal thoughts and is back to his outgoing ways.</li> <li>The bubbly young woman used to be the life of every party, but few of her friends and relatives realised what was going on inside her mind. As the pandemic hit, she started having violent thoughts about harming others and herself. The 22-year-old tried to deal with it herself, but two months ago she sought help from a mental health doctor. She was diagnosed with Obsessive Compulsive Disorder (OCD) and started treatment. Looking back, she advises others to also seek professional help in time.</li> <li>The young woman felt worthless, lacked confidence, avoided crowds and had self-inflicted cuts on her arm. Her inability to come in terms with her sexuality aggravated her sense of insecurity. When the pandemic foiled her plans, she blamed everything on herself, she felt irritated and uncertain, stopped attending virtual classes and her eating habits changed. She finally sought help for her depression and she is now under regular psychiatric counselling and medications. Grounding exercises in particular have helped her overcome self-harm and feelings of inadequacy. “I am okay now,” she says.</li></ul>As the pandemic turns lives upside down, there has also been a global <a href="https://www.nepalitimes.com/here-now/post-pandemic-mental-health-epidemic/" target="_blank" rel="noopener noreferrer">outbreak of mental health disorders</a>, and Nepal has reported a rise in suicides. However, as these cases show, professional counselling and medication can save lives.Recoveries rarely make news, only suicides do.“Most of my patients who attempted suicide have gone on to lead normal lives after they get treatment, and oftentimes they look back to their mental health crisis as nothing more than a lapse of judgment,” says psychiatrist and researcher Rishav Koirala.There has been a sharp rise in <a href="https://www.nepalitimes.com/latest/have-suicides-increased-during-nepal-lockdown/" target="_blank" rel="noopener noreferrer">suicides in Nepal</a> since the Covid-19 pandemic in March 2020 and subsequent lockdowns. Nepal Police data shows that in the last 12 months, there have been 7,141 reported deaths due to suicides nationwide, up from 6,252 the year before.Do not shy away from seeking help. If you, or anyone you know, would like to speak to a trained mental health professional, please contact:TUTH Suicide Hotline: 9840021600Transcultural Psychosocial Organisation-Nepal Crisis Hotline: 1660 0102005Mental Health Helpline Nepal: 1660 0133666Centre for Mental Health and Counselling Nepal Toll-free: 16600185080, Hotline: 1145Koshish Toll-free helpline: 166001-22322 (Bagmati Province)Patan Hospital Helpline: 9813476123National Suicide Prevention helpline operated by Mental Hospital Lagankhel and TPO: 1166<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110141124/636cfc2e9c7e80680e0a0b74jpeg.jpg" alt="" width="640" height="475"><figcaption> </figcaption></figure>In a survey last year, <a href="http://www.tponepal.org" target="_blank" rel="noopener noreferrer">Transcultural Psychosocial Organisation (TPO) Nepal</a> which works with mental health compared five years of suicide data for March-July to see if there was any change during the lockdowns in 2020 and 2021.The results are revealing: suicides have been increasing steadily at an average rate of 8.5% every year, but it spurted to 19.4% in the first four months of the lockdown. Researchers also conducted key informant interviews across Nepal, who reported witnessing an increase in <a href="https://www.nepalitimes.com/latest/suicide-watch/" target="_blank" rel="noopener noreferrer">suicidal behaviours</a> in the community as well as health facilities.“We now have both quantitative and qualitative evidence that mental health problems have increased following the pandemic,” says TPO Nepal’s executive director Kamal Gautam. “And given that the majority of suicides are caused by psychological problems, we can say that Covid-19 has significantly contributed to its increase.”Mental health professionals have long been warning of an epidemic of psychological disorders following the Covid-19 crisis. They have reported an increase in anxiety, depression, post-traumatic stress disorder (PTSD), hypochondria, obsessive disorders and psychotic symptoms among the general population in the last two years.Economic collapse, job loss and slashed income due to the pandemic as well as <a href="https://www.nepalitimes.com/latest/in-nepal-lockdown-a-domestic-violence-spike/" target="_blank" rel="noopener noreferrer">increased domestic and sexual violence</a> and added workload during the lockdowns have all acted as contributing factors. In addition, those afflicted do not have normal social interactions that used to be a safety valve during more normal times.Moreover, many patients on treatment and medication have relapsed due to the limited access to health services, counselling and psychotropic drugs during the pandemic, and in many cases because of Covid phobia.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110141124/636cfc319c7e80680e0a0b75jpeg.jpg" alt="" width="1052" height="690"><figcaption> </figcaption></figure>Up to 80% of suicides have mental health disorders as an underlying cause. A significant portion of cases are also a result of impulsive behaviour.Experts agree that the official <a href="https://www.nepalitimes.com/here-now/nepals-suicide-rate-vastly-underestimated/" target="_blank" rel="noopener noreferrer">numbers on suicides are vastly underestimated</a> due to a lack of suicide registry. Official figures are based solely on police data and post-mortems, and because of stigma associated with mental health, many families also often refrain from revealing the actual cause of death.Official records also do not take into account <a href="https://www.nepalitimes.com/here-now/in-the-minds-of-nepals-migrant-workers/" target="_blank" rel="noopener noreferrer">suicides of Nepali migrant workers overseas</a>, mainly Malaysia and South Korea. Similarly, suicides among those in the LGBTIQ community who have lost their limited sources of livelihood during the pandemic have been largely neglected.“Reported cases alone are not conclusive, but given that we now have a year and a half long trend and data, we have seen a significant increase in mental health disorders, and can assume that pandemic has played a crucial part in the rise in the number of suicides,” adds Rishav Koirala.<a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.who.int/news-room/fact-sheets/detail/suicide" target="_blank" rel="noopener noreferrer">More than 700,000 people die by suicide</a> every year around the world, that is one in every 100 deaths -- more than HIV, malaria, breast cancer, or war and homicide. And for every suicide, there are many more who make attempts to end their lives.Nepal is among the countries with the highest suicide rates in the world and consistently ranks within the WHO’s top 10 list. The Nepal Health Research Council (NHRC)’s <a href="http://nhrc.gov.np/wp-content/uploads/2020/09/Factsheet-Adults-1.pdf" target="_blank" rel="noopener noreferrer">National Mental Health Survey</a> published earlier this year found the prevalence of suicidality (current suicidal thoughts, lifetime suicidal attempt and future likelihood of suicidal thoughts) to be high at 7.2% among Nepalis.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110141124/636cfc339c7e80680e0a0b76jpeg.jpg" alt="" width="1464" height="752"><figcaption> </figcaption></figure>The first of its kind survey in Nepal interviewed 15,088 participants and was carried out before <a href="https://www.nepalitimes.com/opinion/coping-with-anxiety-in-new-lockdown/" target="_blank" rel="noopener noreferrer">the pandemic</a> from January 2019 to January 2020. The study revealed that 10% of Nepal’s adult population had mental health problems in their lifetime with 4.3% experiencing some disorders at present.Mood disorders and neurotic and stress-related disorders were among the most common <a href="https://www.nepalitimes.com/latest/tackling-nepals-mental-health-pandemic/" target="_blank" rel="noopener noreferrer">psychological problems among Nepalis</a>. The prevalence of lifetime disorders was found the highest in Province 1 (13.9%), in the age group 40-49 years (13.3%) and among males (12.4%). As for current disorders, Bagmati scored the highest (5.9%) as well as those in the age group 40-49 years (6.3%) and females (5.1%).These figures correlate with Nepal’s suicide data of the past five years. Despite fewer attempts, men accounted for 57% of total suicides, against 43% of women. Among minors, however, more girls died by suicide, which experts ascribe to possible victimisation and a higher prevalence of borderline personality disorder among younger females.Suicide deaths are also disproportionately distributed across Nepal with Province 1 recording 65 deaths per 100,000 populations. Lumbini and Gandaki follow closely with 58 and 52 per 100,000 respectively. Traditionally neglected by the state and economically disadvantaged Karnali, Far West and Province 2 regions have lower suicide rates.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110141124/636cfc369c7e80680e0a0b77jpeg.jpg" alt="" width="2287" height="1816"><figcaption> </figcaption></figure>More people are dying of suicides in urban centres such as Kathmandu Valley and Ilam district, which reported 32 and 38 suicide deaths respectively per 100,000 populations last year against Rautahat’s 18 and Humla’s 6.This is in direct contrast with the global trends where 77% of suicides occur in low and middle-income countries. Unemployment and poor economic condition have long been associated with a high risk of suicides, but only up to a certain point, as proven by recent data. Japan, <a href="https://www.nepalitimes.com/here-now/dead-end-of-the-korean-dream/" target="_blank" rel="noopener noreferrer">South Korea</a> and Hungary with their higher per capita GDPs have some of the highest suicide rates in the world.“Poorer nations have weaker education and health systems, which translates into delayed or even lack of diagnosis but poverty is not a sole factor for suicides,” says Kamal Gautam. “Suicide is complex and there are multiple factors at play which means a linear approach to prevention would be incomplete, it needs an integrated approach.”Addressing underlying mental health disorders is the most effective way to prevent suicides. This means increased awareness and education about psychological disorders, which in turn can help <a href="https://www.nepalitimes.com/here-now/all-in-the-family/" target="_blank" rel="noopener noreferrer">reduce societal stigma</a>. An introduction to and discussion on mental health in the school curriculum can further sensitise the public.In addition to medication and counselling, societal structure and family dynamics is an important support system for individuals suffering from psychosis, trauma and depression. Telemedicine in particular has been essential in preventing self-harm during the pandemic-induced restrictions but mental health services need to be scaled up across the country.On the other hand, a strict regulation must be implemented on the <a href="https://www.nepalitimes.com/here-now/suicide-by-pesticide-in-nepal/" target="_blank" rel="noopener noreferrer">availability of pesticides</a>, an easy means of suicide for many. Access to alcoholic products must also be supervised with Nepalis known to self-medicate to cope with stress and trauma, in turn increasing the risk of self-harm and suicide.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110141124/636cfc399c7e80680e0a0b78jpeg.jpg" alt="" width="1280" height="853"><figcaption> </figcaption></figure>But most of all, analysing suicide attempts can be a powerful tool for prevention. On average, there are six attempts behind every suicide. Up to 80% of people with suicidal ideation reveal their intention to either a family member, friends or their doctors within a month before their attempt.“We forget that even before the pandemic suicide rates were very high in Nepal and while the pandemic might have added to the problem, the figures alone don’t mean anything if we fail to also study suicide attempts to find a stronger link between the prevalence and the contributing factors,” says Rabi Shakya, psychiatrist and director of Patan Academy of Health Sciences.He adds: “Historically, there have been more suicides after than during the crisis due to the long-term socioeconomic impacts. So we must start preparing for the pandemic of mental health problems including suicides post-Covid. Our health care workers must be trained and fanned out across the country.”Nepalis are not new to mental health problems induced by a crisis. The 10-year-long Maoist insurgency killed 17,000 people but many more continue to suffer from <a href="https://www.nepalitimes.com/here-now/the-mental-scars-of-violence/" target="_blank" rel="noopener noreferrer">PTSD, depression, anxiety and distress</a>. A 2017 report published in the journal Lancet found as high as <a href="https://archive.nepalitimes.com/article/nation/stigma-and-silence-mental-health-nepal,3486" target="_blank" rel="noopener noreferrer">37.5% of the general public</a> had some form of psychological disorder.The <a href="https://www.nepalitimes.com/here-now/its-all-in-the-mind/" target="_blank" rel="noopener noreferrer">2015 earthquake</a> further added to Nepal’s epidemic of mental disorders. Survivors who had narrow escapes or lost family members reported increased panic attacks, anxiety and trauma.But <a href="https://archive.nepalitimes.com/article/editorial/the-republic-of-insomnia,3311" target="_blank" rel="noopener noreferrer">conflicts, disasters</a> and pandemics have shined a light on mental health with an increased national and foreign investment in prevention and management. With larger chunks of the population impacted, there is now more acceptance and the field is starting to get the priority it warrants.Says Rishav Koirala, WHO focal person for mental health post-2015 earthquake: “The best way to prevent suicides is to address underlying psychological disorders and crises, despite adding to the burden has helped normalise them because many more people can now relate and understand that they are treatable.”

Sonia Awale

Nepal sees spike in suicides during pandemic

Jazz as healing music

Already trying to balance youth demands with legal provisions in the Constitution, Prime Minister Sushila Karki’s interim government faced yet another challenge over Dasain: a receding monsoon dumped unseasonal rain unleashing floods and landslides that killed at least 60, mostly in eastern Nepal.&nbsp; The government was rated positively for its early warning and the ‘visibility’ of its disaster response, with many comparing it to the inaction of the NC-UML coalition during last year’s floods.&nbsp; Government agencies and police proactively closed off hazardous sections of highways as Kathmandu was marooned from the rest of the country in the peak holiday season. Stranded passengers were taken care of, with police, army and local governments in Ilam coordinating rescue and relief efforts. Many of the problems were structural and inherited from decades of neglect and corruption in highway contracts. Shoddy bridges and encroachment of settlements along river banks have increased risk from more frequent extreme weather caused by climate breakdown. With Dasain over Tihar around the corner and the worst of the disaster behind, the Karki administration is trying to balance the separate demands of GenZ movers and shakers who installed her in office with constitutional provisions. It has not helped that the badly-mauled political parties are spoiling for a fight, and the three top leaders show little signs of stepping down. “Nepal’s movement did not happen in a democratic vacuum, so this government walks a very fine line in political legitimacy," says Bidushi Dhungel of the National Democratic Institute in Nepal. "In this fragile space, whatever the work done — or not done— by the interim government within its limited mandate, it may open up avenues for further dissent from old and new actors. They are &nbsp;caught between a rock and a hard place.” Civil society activists issued a statement on Wednesday calling on the main political parties to heed the writing on the wall and reform themselves. Signed by professor Krishna Khanal and former ambassador Keshab Mathema, the statement said: 'The main leaders of the main parties should say sorry, and voluntarily resign ... they must respect public sentiments and work to reform and transform their parties to be more accountable to the public, or risk being irrelevant.'&nbsp; Complicating matters further are the sometimes contradictory demands of various GenZ factions on punishing those responsible for the carnage and rampage of 8-9 September, Constitution and elections. Karki faces calls to immediately detain former PM KP Oli and Home Minister Ramesh Lekhak for their involvement in the massacre outside Parliament. Under pressure from GenZ delegates, Home Minister Om Aryal fired off a letter to the police to arrest Oli and Lekhak. But later at a confrontational midnight meeting at the prime minister’s residence in Baluwatar, all four security chiefs advised Karki that arresting the UML and NC ex-ministers could unleash violent confrontation on the streets. The interim government is in a bind. It has formed a committee headed by Gauri Bahadur Karki to investigate the killings last month as well as the arson and vandalism that followed. The question is: should it wait for the committee to submit its report before punishing perpetrators, or let police arrest those who can easily be identified in social media posts setting fire to Singha Darbar, the Supreme Court and other sites.&nbsp; GenZ’s Sudan Gurung faction has gone beyond its original demand to submit an 8-point ultimatum that includes the sacking of the Chief Justice and officials of the anti-corruption bureau.&nbsp; The Prime Minister is caught in the crossfire between managing the expectations of a movement that appointed her, and working within the framework of her interim government’s mandate and Constitution. But it is not just the government that faces challenges. The lack of clear consensus among youth factions and their outspoken collectives is surfacing.&nbsp; &nbsp;“This has been a leaderless and decentralised movement, and the traditional variables typically seen in a political revolt seem missing here," notes political scientist Sucheta Pyakuryal. “There is no organised structure, nor any ideological pull factor, therefore a big question is how much bargaining power does a movement like this have, and how sustainable will it be.” GenZ leaders seem to be in two main camps. Demands like the one for a directly elected prime minister, and the constitutional processes that can make for such an outcome, have emerged as a major point dividing the movement.&nbsp; Nepalis both within and outside the youth movement are watching Hami Nepal’s Sudan Gurung closely — especially after his recent interview with Al-Jazeera during which he expressed his interest to run for Prime Minister and seemed to not accept a win by political parties in the March elections.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251009201044_fcba7e92bb9a8812fd0ad4e9770d6f4d4189972de5229f91e9a832a26e388901.jpg" data-media-id="editor_0" data-image-id="20251009201044_fcba7e92bb9a8812fd0ad4e9770d6f4d4189972de5229f91e9a832a26e388901" data-rendition-name="original" width="2916" height="1000" loading="lazy" alt="One month on NT"> <figcaption>GROUND ZERO: The destroyed centre of Nepal's government with Singha Darbar (in green scaffolding), the Attorney General's Office, Supreme Court, and in the distance, Parliament building. Also seen are the nearly finished new Parliament Complex and the new Supreme Court buildings. Drone shot taken on Thursday morning. Photo: SUMAN NEPALI</figcaption> </figure>  Gurung’s participation in the NDRRMA’s disaster management meeting and manner of his interaction with officials at the event was met with both bouquets and brickbats. Interestingly, some of the criticism was youth activists themselves. &nbsp;“There's a lot of self-involvement and self-importance that seems to be guiding a fragmented young leadership, as opposed to constructively engaging in how to concretise reforms,” says Dhungel. “There seems to be very little stocktaking of what's happened in the past, and what's happened in other countries to try identify where lapses could be before they occur."&nbsp; In the absence of unified positions and level-headed leadership, the youth who spearheaded post-protest negotiations, as well as the GenZ movement in general, risk losing public goodwill already dented by the destruction of state property on 9 September. This also leaves an opening for political parties which are on the defensive and licking their wounds to capitalise on youth discord.&nbsp; Says Pyakuryal: “Post revolution, the political landscape becomes extremely unpredictable and therefore there is a risk of co-optation from several Machiavellian political actors including political parties, monarchists, as well as other forces, and that is concerning.” The immediate and visible transformation that Nepal’s youth expect will not manifest right away, and while there is a need for long-term political planning, the caretaker government must also undertake measures that have a palpable impact on the daily life of citizens. &nbsp;&nbsp; “While youth frustrations must be addressed urgently, statecraft isn’t just about fulfilling short-term goals,”says Pyakuryal. &nbsp; Many, including the youth themselves, now see the need for GenZ to have a more united stance and to move beyond making demands that the interim government cannot fulfil and start mobilising for elections — even by forming its own party.&nbsp; A strong showing in elections can enable them to enact the changes they want to strengthen Nepal’s democracy, and make future governments more accountable.&nbsp; This week, the Election Commission announced 16 November as the deadline to register new parties for the 5 March polls.&nbsp; Youth representatives have said that they want to be active participants in the political process, particularly in national-level politics. The Constitution defines ‘youth’ as being between the ages of 16-40. In the 2022 elections, the Election Commission stated that over 41% of locally-elected representatives were from ages 21-40 years.&nbsp; If young Nepalis are to contest the election outside the banner of mainstream parties, this leaves electoral aspirants little more than a month to decide whether to form a loose coalition with existing parties, a separate political party, or to contest elections independently. “This is first of a kind movement, where political language is digital, not ideological, where organising is done through online platforms and where there is no one leader spearheading the movement,”says Pyakuryal. “I don’t know if ‘anti-corruption’ or ‘political reform’ have a strong enough ideological pull to band people together in the long run.” Indeed, the RSP was formed only four months before the 2022 elections and cashed in on anti-incumbent and anti-corruption sentiments of voters — mainly driven by social media. But controversy and strife within their party means it has largely lost its public trust.&nbsp; Nepal’s September Uprising and its aftermath have shown that a majority of young people are entirely disillusioned with establishment parties and politicians, even using ‘ex-political parties’ as a phrase of reference. Any new young political figures that emerge from this movement and this election will have to work with mainstream parties in a multiparty democracy.&nbsp; &nbsp;“The reality of politics is that change is not possible without engaging with existing political institutions and actors,” says Dhungel. “To say that they do not want to engage, negotiate, or identify allies or proactively seek out input from at least the reform-minded individuals within each of those outfits is political naivety, and may lead to a lack of institutionalised reform.” However, Dhungel notes that the youth leadership would have more agency if they are clear not just on what they want to change, but about whether they are interested in active politics or civic engagement. “The window of opportunity that is fast closing is to really negotiate hard and push for internal reforms within political parties and across the electoral system,” she adds. Pyakurel also adds: “GenZ are smart and politically mature, I hope they see these loopholes. I am optimistic about the direction they take.”

One month on

<a href="https://nepalitimes.com/here-now/waiting-for-bipin-joshi" target="_blank">Nepali student Bipin Joshi</a>, who was taken captive by Hamas on 7 October 2023, was not on the list of those freed following the end of the bombardment and fighting in Gaza.&nbsp; On Monday morning, the Israeli military notified Bipin's family and Nepal’s ambassador to Israel Dhan Prasad Pandit, that there is no evidence of him still being alive. However, Nepal's Foreign Ministry is yet to be notified by Israel's government of Bipin's status. The news came three days after a US-brokered ceasefire between Israel and Hamas came into effect, and hostage and prisoner exchanges by the two sides started Monday morning.&nbsp; Almost 2,000 Palestinians held in Israeli prisions are expected to be released by Israel in exchange for the hostages during the next phase of the peace deal between the two parties, and the bodies of deceased hostages remaining in Gaza are also expected to be returned.&nbsp; Bipin Joshi was among a group of Nepalis who had arrived in Israel in 2023 just weeks before 7 October 2023 as part of a ‘learn and earn’ program to work and earn in kibbutz farms there.&nbsp; Along with other students Joshi had been working on a farm in Kibbutz Alumim in southern Israel near Gaza. <a href="https://nepalitimes.com/here-now/war-in-israel-earthquake-and-grief-in-nepal">Ten Nepali students were killed </a>while taking cover in shelters near their farms in two separate attacks by Hamas fighters.&nbsp; Joshi’s colleagues, fellow Nepalis who survived the attack, recall gunmen lobbing two grenades into the bunker that they had taken cover in. Bipin hurled one of the grenades out, they say, but the other one exploded, killing and injuring Nepalis inside. &nbsp;&nbsp;&nbsp;&nbsp; Shortly after, Bipin was captured by Hamas along with a Thai national and led away into Gaza. CCTV footage showed Bipin alive and at a hospital in Gaza on the day of the attack itself after he was taken hostage.&nbsp; Thirty-one Thai citizens, who like Nepalis worked in farms in Israel, were taken hostage during the Hamas attack, the highest number of foreign captives in October 2023.&nbsp; <a href="https://nepalitimes.com/news/deft-diplomacy-freed-thai-hostages">Deft Thai diplomatic engagement</a> with officials from Iran, Egypt, and Qatar brought about the release of 23 of its nationals in 2023. Five more Thai nationals were released earlier this year.&nbsp; In August, Joshi’s family visited Israel at the invitation of the government and urged the international community to push for his return. Bipin’s mother Padma and sister Pushpa have been at the United Nations to lobby for his release.&nbsp; His family last week also released a video clip of Bipin briefly speaking on camera, reportedly obtained by Israel and said to be filmed in November 2023, around a month after he was taken captive. Joshi looks healthy in that video.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251013091028_d551c7f88204c52217152fb5db655bb5a5f8bf2cff1e6a055326ebf64453ff9f.png" data-media-id="editor_3" data-image-id="20251013091028_d551c7f88204c52217152fb5db655bb5a5f8bf2cff1e6a055326ebf64453ff9f" data-rendition-name="original" width="2848" height="1528" loading="lazy" alt="Bipin Joshi NT"> </figure>  More than 67,000 Palestinians have been killed during the last two years of the genocide in Gaza. About 1,200 people were killed during the Hamas attack on 7 October 2023, while more than 251, including Bipin Joshi, were taken as captives.&nbsp; This is the third ceasefire implemented in Gaza since 7 October 2023 after previous ones in November 2023 and January 2025. This 20-point deal facilitated by intermediaries US, Qatar, Turkey, and Egypt included terms for Hamas to give up its arms, and for a devastated Gaza to be governed by a Palestinian body of independent technocrats, while Israeli troops will withdraw in stages from Gaza.&nbsp; Hamas has agreed to relinquish control of Gaza, but has rejected the demand for disarmament, saying the group will demobilise but is prepared to resume fighting if Israel breaches the ceasefire.&nbsp; Following the ceasefire, Palestinians in Gaza have begun long journeys back to homes reduced to rubble by Israel’s two-year assault on the strip. The flow of humanitarian aid in the city has also increased following the peace deal.&nbsp; Israel's closure of humanitarian corridors in the past months had blocked the entry of food and medicine into Gaza, causing widespread famine. The United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) has said that the restriction of aid into the beseiged city has left as many as <a href="https://www.unrwa.org/newsroom/news-releases/gaza-unrwa%E2%80%99s-lancet-study-reveals-alarming-surge-child-malnutrition">54,600 children acutely malnourished</a>.&nbsp; Meanwhile, US president Donald Trump landed in Israel on Monday as hostages were being released, and world leaders are expected to head to Egypt for an international summit to discuss the next steps in Gaza, Israel, and West Asia.&nbsp;

Nepali hostage in Gaza not alive: Israel

7:30pm Tuesday, 9 September.&nbsp; I was driving my daughter back from a relative’s house in Baneswar where she had taken refuge after a curfew was declared the previous day while she was in school. She was riding pillion on the back of my moped. We drove past Parliament <a href="https://nepalitimes.com/news/nepal-s-8-september-massacre">where 19 people had been killed by police </a>the previous day. We passed Thapathali, where the Kantipur highrise was on fire. The sky had gone dark, and the stinging smoke made it hard to breathe. A gas cylinder exploded, and the crowd dispersed briefly. The blast provided a moment to escape the raging mob. By myself I may not have been so scared, but my daughter’s safety made me more afraid. I had never been this frightened in my journalism career, even while covering the Maoist insurgency 20 years ago. At the Tripureswor intersection there were more angry crowds. The further we got from the epicentre of the GenZ demonstration, the more elderly the protesters looked. Many were muscular gentlemen with tattooed arms. Prime Minister K P Oli had just <a href="https://nepalitimes.com/news/kathmandu-burns-despite-pm-resignation">resigned</a>, but the crowd was still chanting “के पी चोर, देश छोड”. Soon, we were surrounded by an enraged mob. &nbsp;My survival instinct took over, and I started shouting “के पी चोर” and my plucky daughter screamed from behind “देश छोड”. Father and daughter waved at the &nbsp;protesters, and gave them a thumbs up. &nbsp;We finally got home, scared and smelling of burning rubber and smoke.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251007031028_c5c04095cdb6f0b24cdc2cc60bf627f49c15e0cf9b509ad149df35a2e73e1d3f.jpg" data-media-id="editor_2" data-image-id="20251007031028_c5c04095cdb6f0b24cdc2cc60bf627f49c15e0cf9b509ad149df35a2e73e1d3f" data-rendition-name="original" width="1200" height="1600" loading="lazy" alt="Reporter's diary of 8-9 September"> <figcaption>A building in Baneswar was damaged by protesters. </figcaption> </figure>  ARSON AND LOOTING I was born in the remote mountains of western Nepal in Rukum, the district that was the stronghold of the Maoist guerrillas after they launched an armed struggle in 1996. I moved to Kathmandu for higher studies, and as a student witnessed the popular uprising of 2006 against Gyanendra’s absolute monarchy. I have covered violence and chaos. I have been caught in the crossfire between the rebels and state security. I covered the violent <a href="https://nepalitimes.com/here-now/nepal-s-historic-youth-dissensus">street protests</a> of the 2006 People’s Movement that ended the war, the Madhes movement and the Indian blockade of 2015.&nbsp; But never was I more scared than during the 30-minute drive home through the city with my daughter at the back of my moped.&nbsp; Last month’s protests were initially led by youth groups which had loosely banded together as GenZ to protest corruption and impunity. On 8 September, I drove to the Mandala in my trusty moped to cover the rally, some protesters were in school uniform. There was singing and chanting. Just before noon, a slightly older group of protesters peeled off from the sit-in in front of Everest Hotel, broke through the half-hearted police cordon and moved towards the intersection outside Parliament. Most of the original young demonstrators remained at the sit-in, while the grownup protesters who were clearly not a part of the GenZ, started to break the perimeter wall of the Parliament complex. The young protesters looked a bit confused about what to do next as they also neared the Parliament gates. Violence was not a part of their plan, and the infiltration had begun in earnest. A group of organised older rioters broke through the western wall, even as police were concentrated along the main south gate. These agitators seemed focused on a single mission: to burn down the Parliament building, and they went about it purposefully.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251007031032_1fcd474774c8e110e833485cf54a7e63e8c8388ec78c2b4d3ae6e830c203c183.jpg" data-media-id="editor_4" data-image-id="20251007031032_1fcd474774c8e110e833485cf54a7e63e8c8388ec78c2b4d3ae6e830c203c183" data-rendition-name="original" width="1280" height="960" loading="lazy" alt="Reporter's diary of 8-9 September NT"> <figcaption>Blood seen in Baneswar.</figcaption> </figure>  Too late, the police used water cannons to disperse those by the south gate. I went closer, my press card dangling from my neck. A tear gas canister whizzed past my head. I was not able to see clearly, and backed away to safety. The police opened fire at point blank range, killing 19 protesters. Hundreds of injured were carried to the nearby Civil Hospital. There are many video clips on social media of task force police kneeling, taking aim with SLR rifles and shooting, they show protesters being hit and falling. The riot police fled, and the Armed Police Force and Nepal Army soldiers came out, but remained close to the trucks that had transported them to the intersection. Seeing that the security forces were not stopping them, the crowd then went on an arson rampage — it became a free-for-all as government buildings were set on fire one after another. Most of the arsonists were not GenZ, they were in the mid-30s, and I heard many shouting slogans for the<a href="https://nepalitimes.com/opinion/why-the-monarchy-still-sways-nepal-s-republic"> restoration of the monarchy</a>. Others were there simply to vandalise and loot. After having chased the police away from the Parliament building, they posted pictures and videos, having the run of the premises, instigating new arrivals to continue with the arson, and also brandishing looted automatic weapons. A curfew was declared, but this did not stop the rampage throughout that evening and into the night. Unable to return home, I spent the night in a friend’s office, and returned to the Parliament area the next morning. The black asphalt was dyed red with blood. Shoes, slippers and pieces of clothing littered the street. The next day, 9 September the much-feared and expected revenge attacks ignited. There was hope that the Army would be able to protect government buildings and provide public security, but the arson, vandalism and looting went unchecked — even when the seats of government were set on fire. The military did make an appearance, but only after 10pm to enforce the curfew, but by then the mob had already gone home.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251007031032_578cfa7c9e56f6ffcf1ca9b148e114a87b5332268cf97720584b70906823c074.jpg" data-media-id="editor_6" data-image-id="20251007031032_578cfa7c9e56f6ffcf1ca9b148e114a87b5332268cf97720584b70906823c074" data-rendition-name="original" width="1200" height="1600" loading="lazy" alt="Reporter's diary of 8-9 September NT"> <figcaption>A protester receiving treatment at Civil Hospital.</figcaption> </figure>  That was the moment I asked myself: Where have the students gone? Has the GenZ movement been hijacked? I could not see any of the GenZ-ers anywhere on 9 September. It was around midday of 9 September that millennials, including from groups like Hami Nepal came forward to the media, claiming to speak for the GenZ. They claimed to have led the protests. Others claiming to be GenZ said they were for the restoration of the monarchy, but they did not look the age.&nbsp; Mobs were out of control, burning down the prime minister’s office, the Supreme Court, the CIAA and the official and private residences of ministers. Within 27 hours Nepal became a country without a government, and leaders without homes. Important official documents went up in flames with the buildings that housed them. PM Oli resigned, too late to save the day. The Army occupied itself airlifting ministers from their official residences. Former prime minister Sher Bahadur Deuba and his wife foreign minister Arzu Rana Deuba were dragged out, beaten up and their home set on fire. They were rescued and taken to an army base. It became hard to tell over the next few days if the Army was providing them security, or keeping them incommunicado in detention. The Army was negotiating with GenZ as well as pro-monarchists at its headquarters, but moved the talks to President Ram Chandra Paudel’s office on 11 September.&nbsp; Former chief justice Sushila Karki was nominated interim head of government by GenZ delegates voting on Discord, and <a href="https://nepalitimes.com/news/march-to-5-march">mandated to hold elections</a> on 5 March.&nbsp; Will that happen? Things are too fluid at the moment. And my mind is still reeling from the fear and panic of that moped ride with my daughter through rampaging mobs. Did all that really happen in front of my eyes, or was it just a nightmare?&nbsp; Bhadra Sharma is a reporter for The New York Times based in Kathmandu.