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Dr Prakash Gyawali, a 48-year-old senior consultant orthopedic surgeon, believes you should always be quick to seek medical help when you need it. People, he says, tend to endure pain for longer than necessary. It often puts them at a disadvantage and complicates cases. The doctor who has been working at Nepal Orthopedic Hospital since 2012 specializes in arthroplasty, orthopedic trauma, and accident cases. As the clinical coordinator, he also oversees academic activity at the hospital.

After getting his master’s in surgery in 2007, Dr Gyawali came back home to Nepal to better orthopedic care in the country. He went to rural parts of Nepal as these were places that needed medical care the most. He met Dr Katrin Hagen, a Swiss orthopedic surgeon, when working at a health camp. The two became good friends and she offered him an opportunity to undergo a training course in Switzerland. 

The training allowed him a chance to become well-versed in global orthopedic techniques. He even worked at Clinic Good in St Moritz, Switzerland for a while. He has been associated with Operation Walk, which is a volunteer medical humanitarian organization that provides free joint replacement surgeries at no cost. It’s based in Chicago, USA. 

According to the surgeon, the current methods and procedures for arthroplasty in the Nepal Orthopedic Hospital meet international standards but there is a need to invest in skilled manpower. Acknowledging the high costs associated with both implants and surgeries in arthroplasty, he remains dedicated to serving underprivileged people through collaborations with global organizations. Also, at the hospital, they’ve set up a system where patients are lined up for free implant services and donations from Operation Walk.

Dr Gyawali confesses he has always been a hard worker. He went to a government school and his dad, who ran an auto workshop, wanted him to become a doctor. Despite tough competition and having fewer resources than other boarding school children, Gyawali tried his level best to do well in his studies. “I had to create my own opportunities,” he says.

Now, he believes in creating opportunities for others through his work. There is a scarcity of skilled manpower in dealing with general orthopedic trauma. It isn’t because of a lack of knowledge. There is a lack of exposure, says the doctor. He has been fortunate enough to go abroad and train and that has helped him hone his skills.

However, Dr Gyawali adds he is grateful to Dr Chakra Raj Pandey, a highly regarded orthopedic surgeon in Nepal, for sparking his interest in orthopedics. He says it was Dr Pandey who taught him how to take care of patients and pay meticulous attention to all the little things that a surgeon needs to keep in mind. A mentor, he says, can change the course of your life. Dr Pandey has been that invaluable person in his life.  

As a person, Dr Gyawali is a stickler for discipline. He likes being able to do his job well and fulfill his responsibilities. He likes to plan. He finds he is better able to function at his best that way. He also makes it a point to be on time. In the medical field, discipline and punctuality matter a lot, he says. 

Dr Gyawali has conducted over 200 knee replacement surgeries and they have all gone without a hitch. This has cemented his reputation as a good surgeon and patients specifically ask for him. However, he believes a doctor needs to have the right attitude to provide good healthcare. He says that if a doctor is friendly and positive, the patients get better faster. “Surgery isn’t just about fixing injuries but it’s also about making patients feel comfortable. Some processes go beyond science,” he adds. 

He wants to help others through his services, especially focusing on those who are financially unable to afford healthcare or have deformities. And he wants to extend his services to rural areas of Nepal. He wishes to be able to set up surgical facilities in remote parts of Nepal. 

Another area of focus is arthritis care, he says. The condition is quite common in Nepal. However, the surgery is costly, which is why people often ignore their pain. The condition worsens over time. Dr Gyawali wants to change this so he constantly tries to make people aware of bone health. He has been working on a research paper to figure out how to tackle the situation.

He emphasizes the importance of reducing implant costs, suggesting measures like government-backed insurance policies, tax exemptions on equipment, and promoting collaborations. He believes the government must prioritize the health of its people by investing in dependable and high-quality equipment rather than heavily relying on international funds and charity. “The government must prioritize orthopedic care as the number of patients is rising,” he says.  

Pangolins, also known as ‘scaly anteaters’ are unique mammals, owing to their specialized diet (eating ants and termites) and  external “armor” of overlapping epidermal scales. These creatures are threatened to extinction primarily due to anthropogenic influences. Limited reproductive capacity and lack of sufficient intervention along with growing anthropogenic influence imply that the mammal needs interventions to avoid its extinction.

Pangolin are represented by nine species distributed along tropical and subtropical Asia, and sub-Saharan Africa. All the species of pangolin are listed under appendix I of CITES, indicating the level of threats they are experiencing, primarily due to illegal international trade. Pangolins represent the most trafficked mammals in the world with more than 20 tons of pangolin and their parts trafficked annually.

In Nepal, two species of pangolin are found: ‘Chinese’ and ‘Indian’. Both the species are threatened to extinction as Chinese pangolin is listed as critically endangered while Indian pangolin is listed as endangered on the IUCN red list. A study on the distribution of pangolins shows that the species have been recorded in 61 districts. 

Despite a significant presence of the species in Nepal, what is alarming is the fact that illegal trade in pangolin reportedly grew eight-fold between 2009 and 2015.

A national-level survey of pangolins has been conducted and Pangolin Conservation Action Plan 2018-2022 drafted for the species’ conservation in Nepal.  The action plan has set out four objectives: To enhance the understanding and knowledge on conservation status, ecology and habitat dynamics of pangolin; Curb poaching and control illegal trade in pangolin; Identify and manage priority sites to improve habitat quality for pangolin conservation; and Develop local stewardship for conservation of pangolin. Despite a lack of information to assess effectiveness of the action plan, it would be safe to say that many targets and objectives of the plan have remained unachieved. 

The national survey conducted field verification in the remaining 16 districts, with confirmation made on the basis of the Key Informant Interview and other methods primarily due to limitation of resources. There is a need for field verification of the information thus received. Additionally, as macro-level information is of limited importance at the implementation level, understanding the fine scale conservation biology of species is essential, something which the concerned agencies are yet to realize. Despite growing attention toward pangolins in Nepal, information about the population status of the species is lacking, hindering our ability to carry out conservation interventions such as identification of hotspots for conservation, something which the action plan has stipulated as its third objective.  

Second objective is to curb poaching and control illegal trade in pangolins. Limited information regarding the illegal trade in the species means significant interventions are yet to be made toward the species’ conservation. According to a study conducted by Bishal Sharma, a researcher at the Environment Protection and Study Center (ENPROSC), based on seizure records from district forest offices, a large fraction of confiscation of pangolins and their parts have been made in Kathmandu. This may be an indication of the lack of sufficient personnel to limit trade in other parts of the country primarily due to limited staffing. 

Notably, during a field survey, we made observations of pangolins’ burrows in areas close to the foot trails within the forest and mostly in areas with a moderate level of canopy. Other studies have also observed similar trends, indicating the vulnerability of the species. 

Pangolins were almost unknown nearly two decades ago. However, in the second decade of the 21st century, with growing global concern about the species, awareness is rising in Nepal as well. An increasing number of researchers and conservation biologists working on pangolin conservation and some level of government intervention and media coverage point toward this. 

But growing concerns have also proved to be a curse rather than a boon for the species. Most of the conservation interventions in Nepal are focused on awareness raising, without due understanding of ways to change human behavior toward wildlife. This will amplify threats to the species.

For instance, while visiting a private forest in Dhankuta in 2018, I found a burrow and during interactions, some locals admitted to poaching pangolins for meat. They admitted that local-level exploitation of pangolin had increased after news related to international trade in pangolin started to appear. Similar findings have been reported from other districts in eastern Nepal, where money outweighs the traditional belief in conservation of pangolin. 

On the front of developing local stewardship, limited progress has been made. For example, community-based conservation intervention has been initiated at the Rani community forest in Hetauda of Makwanpur district. Pangolin parks have been established in Hetauda. In 2021, Smriti Dahal, a student at the Department of Environmental Science, Padma Kanya Multiple Campus, Bagbazaar conducted a survey in the area and found that people living near the pangolin parks had better knowledge of the species. Gauri Jaiswal, a student at the Department of Environmental Science, Tri-Chandra Multiple Campus, studied the Rani community forest and found community-based conservation at the forest to be effective. 

However, conservation practices adopted at the forest in question may not be suitable for other pangolin habitats across the country. Furthermore, we have to think about the sustainability of the scheme as pangolins are nocturnal, with a limited scope for connecting them with livelihood through ecotourism and related measures. 

Nonetheless, pangolins are an important element of the ecosystem as they provide ecosystem services by controlling insect populations and excavating burrows, which likely affect soil processes through turnover of organic matter and aeration. Burrows also provide shelter and thermal refugia for a range of commensal taxa. But these ecosystem services are delimited due to anthropogenic influences. Thus, we need to take underpinning action based on the evidence on the field and by connecting conservation action with the socioeconomic and ecological setting of the pangolin and its habitat.

The author is an assistant professor at the Department of Environmental Science, Padma Kanya Multiple Campus

The Mahasamiti meeting of Nepali Congress started on Monday after a six-year hiatus. Although the party’s top decision-making body, which is supposed to meet every two years, last held its meeting in 2018, which came hot on the heels of Congress’ historic electoral drubbing in general elections. 

In these past six years, the party has re-emerged as the largest party, thanks to the electoral alliance with the CPN (Maoist Center) and a few other fringe parties in the 2022 general elections. However, the grand old party is still not out of the woods yet. The party’s popularity is diminishing, intra-party rift is becoming increasingly tense, and the organizational structure is in shambles.  

The electoral alliance in 2022 elections catapulted NC back to the top spot, but many in the party are of the view that they should think about contesting the next general elections without any alliance.     

NC General Secretary Gagan Kumar Thapa and his team is pressing the leadership of Sher Bahadur Deuba to pass a resolution that the party will not forge a pre-poll alliance. However, Deuba and his supporters are not keen about the idea. 

In a direct reference to the Maoist party, in his political document, Thapa states: “The Mahasamiti meeting should make a resolution that the party would not forge a pre-election alliance, and will not create an environment in which the cadres will be forced to vote for other parties.”

The document further states though the prospects of a single party securing a majority are slim under the current electoral system, there can be a post-election alliance to deliver a government on the basis of common minimum program. The grassroots level cadres, according to Thapa, feel that pre-poll alliance is eroding the party’s ideology. 

“Between the 2017 and 2022 elections, our popular votes have shrunken by five percent. This is because NC cadres and supporters did not get the chance to vote for their party,” Thapa told the Mahasamiti meeting. 

Regarding the existing alliance with Maoist, Thapa said that the party should stick to it for the next four years, but come the next general elections, the Nepali Congress should fight alone. 

The faction led by senior leader Shekhar Koirala has a similar position on electoral alliance. 

“When I visit outside Kathmandu, our cadres often ask me, ‘When will we contest the election as a single party?’ Because of the electoral alliance, our vote share has decreased to 27 percent from 34\35 percent,” he said.

The reading of Thapa and Koirala regarding the pre-election alliance is the same, but their ambition to become the next president of the NC prevents them from joining hands to mount pressure on the current leadership. 

NC President Deuba and his supporters do not subscribe to Thapa and Koirala’s views. They believe that the alliance with Maoists helped the Congress become the largest party, and that this partnership could be continued in the future. 

The NC leadership takes the alliance with the Maoists as a compulsion and strategy to keep its main rival, the CPN-UML, out of power. But the local level leaders are not satisfied with the alliance. This was evident when the party members disregarded the NC-Maoist alliance and voted for the UML candidate in the National Assembly elections of Koshi province. The incident has created an environment of distrust between the NC and the Maoist party. 

NC leader Nain Singh Mahar says local level cadres are dead set against pre-poll alliance, mainly with the Maoist party. 

Given the animosity between two parties during the insurgency era, the NC cadres do not want to vote for the Maoist party. During the armed rebellion launched by the Maoists, the rebel force killed scores of NC cadres and confiscated their properties. To this day, the supporters of NC see the Maoists as their enemy. Even when the Maoists decided to join mainstream politics, scores of NC leaders and cadres were against the peace process initiated by former Congress leader Girija Prasad Koirala.

In the 2022 general elections, the NC forged an electoral alliance with the Maoists to defeat the UML. Soon after the elections, the Maoist chairman, Pushpa Kamal Dahal, whose party polled behind the UML in third position, urged the NC to support his prime ministerial bid.

When the NC rejected Dahal’s bid, the Maoist leader went on to join forces with the UML to become prime minister. This led to a bizarre scenario where the NC, despite winning the most number of seats in the House of Representatives, was consigned to the opposition aisle. Deuba’s leadership was heavily criticized at the time. Questions were also raised about alliance politics, particularly when two parties with opposing ideologies come together. 

The Deuba leadership managed to break the Maoist-UML alliance and reform another government under Dahal, but the debate over electoral alliance did not leave the NC. Deuba and his supporters may not want to pass the resolution rejecting the pre-poll alliance, as it could create friction within the current coalition. But this does not mean that the pressure is not off from Deuba. 

If the NC Mahasamiti meeting endorses the resolution, it will surely create a rift in the NC-Maoist coalition. The next general elections are still four years away, and if NC passes such a proposal, there is a high chance that the Maoists will once again join forces with the UML. 

It’s clear that Deuba doesn’t want to scupper his chance to become prime minister as per the deal reached with the Maoist chairman and current prime minister, Dahal. Deuba will try his best not to get the Thapa-proposed resolution passed from the Mahasamiti meeting. 

Vice-President Purna Bahadur Khadka, a leader close to Deuba, in his political document, states that the election alliance has become a compulsion due to the current electoral system. 

“We are forging the electoral alliance to avoid the risks of political instability because under the current system, no party secures the majority numbers required to form a government.” 

Another General Secretary Bishwa Prakash Sharma has taken a middle path stating that it would be too early to decide about the electoral alliance, as the election is four years away.  He nevertheless agrees that alliance politics is damaging the party's reputation among the supporters.

Frustration is also growing among the Congress cadres and supporters because the current coalition government has failed to deliver. Although the NC dominates in all three tiers of government, the party has not taken any notable initiatives to ensure good governance and development. 

According to Thapa, there is not proper coordination and communication between the party and government, a major challenge that all governments have been facing after the restoration of democracy in 1990.  

As the decision of the ongoing Mahasamiti meeting of the NC could impact the national politics, the Maoist and the UML will be closely following the development.

The government of Madhes province has not implemented a single provincial pride project in six years. Instead, it has focused on smaller programs with budgets no more than Rs 1m, but their progress too have been slow and laborious. Many of these projects have had their budgets frozen. The capital spending has never been satisfactory. The provincial government and ministers often make commitments to implement provincial pride projects but the reality is completely different. Their focus is mostly on small projects proposed by their cadres.

The provincial government has proposed a budget of Rs 44.11bn for the fiscal year 2023/24. However, the focus has primarily been on implementing piecemeal programs even though the provincial government has no dearth of resources. The Ministry of Physical Infrastructure Development has the highest budgetary allocation of over Rs 12bn. However, minister Krishna Prasad Yadav’s focus seems to be on implementing small projects proposed by party cadres rather than larger projects that could benefit the whole province. For instance, Hansapur Municipality in Dhanusha has been provided with 25 projects ranging from Rs 1.5m to Rs 2.5m. Pradeep Yadav, who serves as the treasurer of the Madhes Provincial Committee of Nepali Congress, is the mayor of Hansapur. In contrast, neighboring Dhanauji and Aurahi rural municipalities lack programs of even Rs 2m.

Dipendra Thakur, deputy leader of the CPN-UML parliamentary party in the Madhes Province Assembly, criticized ministers for pouring budgets into their constituencies while neglecting pressing needs elsewhere. The Dalit Development Committee, responsible for uplifting the Dalit community, which comprises 18 percent of the province’s population, has been allocated a meager budget of Rs 6.9m.

Ministers have also been accused of overspending in their areas through budget transfers. Minister for Finance Sanjaya Kumar Yadav and Minister for Industry, Commerce, and Tourism Sunita Yadav have been summoned by provincial assembly committees for transferring over Rs 600m in the last month of the previous fiscal year.

Dr Bhogendra Jha, former vice-chairman of the Madhes Province Planning Commission, said that the capital budget is being distributed without considering the priorities of the local people. Similarly, CPN (Maoist Center) assembly member Mala Kumari Karna criticized the chief minister and ministers for implementing budgetary programs only in their constituencies.

Maoist Center leader Bharat Prasad Sah also emphasized the need for the provincial government to focus on provincial pride projects instead of distribution-oriented plans. “The province hasn't implemented a single significant program over the past six years. I served as a minister in the government led by Janata Samajbadi Party (JSP). I, however, couldn’t implement development-oriented programs due to inadequate support,” he added.

Satish Kumar Singh of Janamat Party said party cadres are favored while selecting development programs. “Only those close to the ministers are benefiting from budgetary programs. We had the opportunity to make federalism work, but the government’s actions are making a mockery of it,” he added.

Chief Minister Saroj Kumar Yadav issued a 19-point directive on Jan 22, pledging to uphold financial transparency and good governance. However, the first budget of Chief Minister Yadav has faced criticism for focusing on distributing piecemeal programs to appease cadres rather than prioritizing substantial projects.

According to Minister for Home, Communication, and Law, Mohammad Shamim, projects such as the Ram Janaki Stadium, one electoral constituency-one road, provincial roads, and universities are considered provincial pride projects. However, he acknowledged that these projects are not gaining momentum. “Service delivery of provincial governments have been affected due to obstacles created by the federal government,” he added.