Submit your Article

Around mid-May this year, the Centers for Disease Control and Prevention in the United States eased its mask-wearing guidelines. Those who were fully vaccinated didn’t have to wear masks anymore when in company of other fully-vaccinated people. Most Nepalis, living in Nepal, took off their masks after receiving the second dose of vaccine because “America said you could”.

But medical and public health experts ApEx spoke to unanimously insist that Nepalis must wear masks and wear them properly—not under the chin, below the nose, or dangling by their ear—at least until 70 percent of the population is vaccinated. Currently, the rate stands at less than four and nine percent for double and single dose vaccination respectively. Wearing a mask, thus, isn’t an option. It’s mandatory.

What we also need to understand is that America, where masks aren’t compulsory in outdoor settings, has high vaccination rates and their vaccines have higher efficacy—Pfizer (95 percent) and Moderna (94.1 percent)—than the ones we have received in Nepal (Covishield at 70 percent, VeroCell at 50 to 79 percent and Johnson & Johnson at 66.3 percent).

Dr Binjwala Shrestha of the Department of Community Medicine and Public Health, Tribhuvan University Teaching Hospital (TUTH), says we can’t be careless because Covid-19 cases are on the rise. The figures of daily new infections we hear of are a result of undertesting and underreporting. The data also doesn’t include the results of rapid antigen tests, many of which are positive. The actual figure is much higher, says Dr Shrestha, and you never know who is infected. Masks, she adds, remain the first-line of defense against this deadly virus.

The coronavirus, according to dental surgeon Dr Neil Pande, is 600 times smaller than the width of a hair strand, which makes it highly transmissible. Dr Pande, from the start of the pandemic, has been trying to raise awareness on the importance of proper masking and ventilation to control the spread. Unfortunately, no one is listening and people, he says, are appallingly careless, more so now that the lockdown has been eased and gatherings and celebrations seem to be in full swing.

“The most basic thing we can do is wear a mask, even if and especially if you are vaccinated because you could still be transmitting the virus,” says Dr Pande. Many people seem to have the very concept of vaccine wrong. They think being vaccinated means you are shielded against the virus. But the virus can enter your system and you can infect other people. What it won’t be able to do is replicate and lead to disease and its potential complications. 

Vaccination no excuse

But that doesn’t mean vaccinated people are safe. Not yet, say experts. Dr Bidesh Bista, pulmonologist, Civil Service Hospital of Nepal, says there have been cases of vaccinated individuals getting infected and developing pneumonia. The common perception that if you have been vaccinated, you won’t have severe complications even if you are infected isn’t necessarily true. There have been many cases, worldwide, of people dying of covid complications even after receiving both the vaccine doses.

Dr Samir Kumar Adhikari, joint spokesperson, Ministry of Health and Population, says we can break the chain of infection and be safe only if everybody takes the required precautions. Nepalis, he says, seem to be in a hurry to take off their masks when in fact, now, more than ever, is when everyone needs to be vigilant.

“People look at what’s happening in America, they saw packed Euro Cup stadiums and think they are safe here as well, that the coronavirus threat has been mitigated. That’s not true,” says Dr Adhikari. Our circumstances, he says, are different. We have our own conditions and limitations and our actions should reflect that.

Dr Navindra Raj Bista, assistant professor, Anesthesia and Critical Care, TUTH agrees with Dr Adhikari and adds that our social culture puts us at grave risk. As horrifying as it may sound, our society has never been keen on hygiene. Regular hand washing isn’t an ingrained habit and consciously doing so takes effort—that not a lot of people are inclined to make. Spitting on the sidewalk from steps of stores and while walking and on the road out of buses and cars is also common. The condition of our public transport too ensures close contact among people, making virus transmission easy and likely.

With so much stacked against us, it would be a sin not to do the least we can to keep ourselves safe. Dr Shrestha believes we are committing a social crime of sorts every time we choose to go out without a mask or lower it because “our ears hurt”. Various studies have shown that masks can reduce the risk of infection by 95 percent (when everyone is masked and practicing social distancing measures). 

‘Vaccines are here’

On the streets of Pulchowk and Sanepa in Lalitpur, ApEx questioned several people who weren’t wearing a mask. With mocking smiles and often rolling their eyes, they asked why they should wear one when “the vaccines are already here”. Other responses were “Are masks of any use?”, “You are wearing one, why should I?”, and “We don’t think we have to anymore.”

Some, like Dr Shrestha said, claimed their ears hurt and that masks were suffocating. Others said they simply didn’t feel like wearing one. The people questioned had either not received the second dose of the vaccine or hadn’t been vaccinated at all. When requested for a quick photo, accompanied by the whipping out of a cell phone, every one of them pulled up their masks or fished one out of their pockets.

It basically boils down to people’s attitude, says Dr Shrestha. The ones who are vaccinated think they are safe and are reckless. The fact that they could still transmit the virus and endanger the lives of those around them isn’t of much concern to them. Lack of awareness isn’t the problem here. Rather, it’s the absence of integrity and accountability. Educated people and those belonging to the upper echelons of the society too have a couldn’t-care-less mindset.

Even those who are wearing masks are doing it all wrong. From loosely fitted masks and just covering the mouth to using disposable masks for days and stuffing them in our pockets, we simply aren’t taking it as seriously as we ought to.

Dr Pande stresses the need to wear a properly fitted mask—one that feels snug around the chin and nose, to ensure it is clean, and not to pull it down to the chin and then back up again. Dr Adhikari says a lot of people are wearing the same surgical mask for days on end when a disposable mask should only be worn for four to five hours and then replaced. Dr Bista adds the focus should be on wearing a mask the right way.

Imminent third wave

Experts agree that the best option is a tightly fitted surgical mask but a three-layered cloth mask works as well. N95 masks, they say, are good but not necessary and neither is doubling up if your mask fits well.

“The whole idea of wearing a cloth mask over a surgical mask is so that air doesn’t leak out and you aren’t taking in unfiltered air,” says Dr Bista. A properly worn mask, he adds, won’t fog your glasses either. If that’s been happening then you aren’t putting the mask on correctly. Dr Pande, on the other hand, shares a trick to check if your mask is protective as it should be: Simply hold it up to sunlight. If light filters through, the mask isn’t good enough.

Experts believe the pre-pandemic lifestyle we seem to be following now makes a third wave imminent in Nepal. We have all witnessed the medical catastrophe Covid-19 can bring about—the second wave had us running from hospital to hospital in search of an ICU bed and buying oxygen cylinders in the black market—and the scenario is likely to repeat unless we change our ways. A good place to start would be wearing a mask and doing so properly, irrespective of our vaccination status.

The precious plant that has brought riches to many villages in Nepal’s highlands.

Thousands of people in western Nepal trek up to highlands (as high as 5,000 meters) to gather yarsagumba with the hope of making millions of rupees. But this year was unlike any other before. The harvest season has just come to an end leaving behind collectors with grim faces.

On the one hand they had to work around Covid-19-related restrictions and on the other it was also difficult to find yarsagumba.

Those who trek up for yarsagumba live under precarious conditions for a month or two every year with their families. They roam around to collect the precious plant, generally found at an altitude of 3,000-5,000 meters, and which is believed to possess aphrodisiac qualities.

With more and more people venturing into the wilderness to gather yarsagumba to meet its insatiable demand, its very existence has been threatened. Thus the International Union for Nature Conservation (IUCN) placed it under the ‘vulnerable’ Red List in 2020.

The locals, who call this fungal plant kira (insect), have also been frustrated in recent years due to growing competition and declining availability.

Take, for example, the people in Maikot village of Rukum district in western Nepal who depended on yarsagumba found in Pupal Valley, located between Rukum and Dolpa districts, for their livelihood.

The plant is no longer easily available, feels Bharat Kumar Pun, an active member of the local yarsagumba management committee. “In the past few years, the number of hands picking yarsagumba has grown alarmingly,” he says. “The number of yarsagumba plants has decreased alarmingly though.”

“A decade ago, we used to collect up to 150 kg of the plant,” recalls Pun. “It is difficult to collect 50 kg now.”

Whereas a single person used to collect hundreds of pieces in the past, you can hardly collect 15-30 pieces a day now, adds Pun. “We didn’t know the reasons earlier, but now we have heard about the impact of climate change. That seems real and logical.”

I had visited Pupal during the 2016 harvesting season and couldn’t find a single piece in a day. The situation is pretty much the same, say locals.

Around 2,500 people from the local villages went to Pupal to harvest yarsagumba last year. This year, due to covid-related restrictions, only locals were permitted to collect the plant. Each collector was charged Rs 2,000. 

Profitable no more

Twenty-five-year-old Sushit Pun Magar was one of those who managed to get a permit. But her excitement was short-lived, as she could hardly find six or seven pieces of yarsagumba in the first couple of days. A piece of yarsagumba generally sells between Rs 300 to Rs 1,200, depending on its quality.

Realizing that it was a waste of time, she instead decided to run a temporary hotel for other collectors instead. She earned just Rs 3,200 selling the pieces she collected but made much more by dispensing dal bhat, the staple Nepali diet. “Cooking and serving dal bhat was easier and more profitable,” she says.

Encouraged by the profits yarsagumba brought, many people in Maikot even quit their traditional income sources such as agriculture, livestock, and weaving. They used to trek to the highlands for two months and sustain their livelihood year-round from the income. But many of them are now planning to get back to their old ways.

Some like Aita Man Pun, 41, of Maikot, have even migrated to other cities seeking employment. Now based in Nawalparasi, he has not gone to pick yarsagumba for three years.

“It has become difficult to find good pieces,” he says. “Earning enough from it has thus become hard. It was our major source of income, but we failed to protect it.”

He recalls how his sister, Mayamani, used to make big profits by collecting yarsagumba. She alone collected 1,500-1,900 pieces every season. “People were honest back then. There was no looting even when you dried all the collected fungus in the open,” he recalls.

Mayamani now lives in Japan, while their younger brother has also quit the yarsa hunt out of frustration.

Besides issues like haphazard camping, littering, dust, smoke, and grazing of sheep and horses, Pun reckons climate change too might be responsible for the plant’s decline. He has seen soil quality degrade. 

Here comes climate change

Though locals have heard about climate change, they don’t know how it manifests locally. Biodiversity researcher Uttam Babu Shrestha also suspects the role of climate change on the decline in Yarsagumba volumes as the plant is sensitive to changing temperature. “But there has been no field-based scientific study to make a definite claim.”

But there are enough studies to prove that climate change in the Himalayas has impacted hydrology, agriculture, and ecosystems and resulted in altitudinal shifts of vegetation communities. Thus its impact on the availability of yarsagumba can’t be ruled out.

“A modeling-based study suggested that a 1-degree increase in temperature reduces the production of yarsagumba by 64 percent,” says Shrestha.

Shrestha stresses the need for a proper study of its ecology and the natural rate of reproduction. “We also need to work with local communities and build formal and informal institutions that can regulate detrimental harvesting practices,” he adds.

Shrestha is disappointed that even though the government, including local municipalities, collect high taxes from harvesters and traders, it does not invest in proper study and research on yarsagumba or on the security of harvesters.

A 2018 research titled ‘The demise of caterpillar fungus in the Himalayan region due to climate change and overharvesting’, an analysis of multiple evidence-based approaches using data spanning nearly two decades and four countries, revealed that caterpillar fungus production is declining through much of the Himalayan range.

“While collectors increasingly attribute the decline in caterpillar fungus to overharvesting, habitat and production modeling suggests that climate change is also likely playing a role,” Kelly A Hopping from the Department of Earth System Science, Stanford University, and Stephen M Chignell, from Department of Ecosystem Science and Sustainability, Colorado State University, write in their report.

“Significant winter drying trends in Nepal may be shifting the timing of snowmelt and reducing moisture availability needed to promote fungal fruiting, thus potentially contributing to the decreasing production,” the report reads. 

Not a priority

The government started issuing permits to harvest and collect yarsagumba in 2006. Before that, it was a free-for-all. For export, traders must seek the permission of the Department of Forests, the Department of Commerce, and the District Forest Office by paying certain taxes.

After China's Tibet, Nepal is the second-largest supplier of this expensive plant to global markets. The fungus is mostly found in Dolpa, Rukum, Bajhang, and Darchula districts.

The Ministry of Forests and Environment (MoFE) agrees that there have not been enough studies to understand the impact of climate change on yarsagumba.

The ministry issues directives in terms of managerial tasks, including yarsagumba collection, waste management, and social problems, according to Buddhi Sagar Poudel, its spokesperson. “We have collection-based protocols but we lack scientific protocols.”

But he promises that the issue “will feature in our to-do list and we will soon conduct macro-level studies.” 

Yarsagumba fact file

Yarsagumba, also known as caterpillar fungus or Himalayan Viagra, goes by the scientific name of Ophiocordyceps sinensis. The finger-shaped fungus that sprouts above the soil and is two to five centimeters long is believed to have aphrodisiac qualities. It is usually golden in color, soft to touch, and tastes like a dairy product. Besides its aphrodisiac qualities, people believe that it can treat cancer and other lungs, kidneys, and stomach related diseases. Though this precious plant is sold across the world, China is its biggest market.

“My ears hurt”, “It fogs my glasses” and “I can’t breathe”—These are the three most common excuses Nepalis give for not wearing a mask. “I’m fully-vaccinated” makes it to the top five, though this isn’t as common an answer considering that less than four percent of the total population has received the second dose so far.

Only one or two out of every 10 people on the street are seen wearing a mask properly. By properly we mean not strapped on the chin, with the top of the mask on the upper lip, or dangling from an ear. We counted, on the sidewalk in Jawalakhel, Lalitpur, in front of St Xavier’s School, on the stretch between Hotel Himalaya and Nabil Bank in Kupondole, Lalitpur, and the the road that leads to Dillibazaar from Maitidevi, Kathmandu.

Evidence suggests wearing a mask or a face covering can reduce the risk of transmitting coronavirus. Experts say that people still have to wear a mask, whether or not they have been vaccinated because we still fall in a high-risk zone with over 27,000 active cases and daily new infections rising steadily. Nepal reported 1,223 new coronavirus cases on Sunday, 1,642 on Monday, and 2,202 s on Tuesday.

According to WHO representative to Nepal Dr Rajesh Sambhajirao Pandav, Covid-19 vaccines have proven to be safe, effective and life-saving. But like all vaccines, they do not fully protect everyone vaccinated. “We do not yet know how well they can prevent people from transmitting the virus to others,” he adds.

Dr Samir Kumar Adhikari, joint spokesperson at the Ministry of Health and Population, says many people are either layering mask upon mask or using the same surgical mask for days. A tightly fitted surgical mask or a cotton one with three layers will suffice, he adds. But it’s absolutely crucial to wear one.

However, mask-wearing isn’t a replacement for other measures to reduce the spread of Covid-19. It works best in combination with measures like handwashing, staying at least six-feet apart from other people, and ventilation of indoor spaces.

 “We urge everyone to continue to strictly adhere to public, health and social measures including the use of masks, physical distancing and proper hand and respiratory hygiene,” says Dr Pandav.

Read the full write-up here.

The Karnali province government has formulated a policy to mainstream the endangered Raute community.

Under the policy formulated by the Ministry of Social Development, members of the community shall be provided a place to settle permanently and issued citizenship certificates. The government shall also take measures to preserve their culture by helping transcribe their language.

 The policy comes amid reports that the Rautes’ language, religion, culture, and traditional livelihood are disappearing. Rautes spend most of their time building and demolishing temporary settlements due to their nomadic lifestyle.

Reports also show that they live in unsanitary conditions and children are deprived of education as traditional beliefs forbid doing so. The community suffers from high birth and mortality rates, and malnutrition.

The main objectives of the policy are to build an egalitarian society for the community by protecting the identity and human rights of the community, which has a long history.

According to the latest census, 618 Rautes live in Nepal. As of now, 143 people, including 68 children, from 44 families live a nomadic life in different districts of Karnali. Hunting and making wooden goods and exchanging them for food is their main source of livelihood.

The policy, which identifies education, health, and livelihood as the basic needs of the community, underscores the need to end all forms of violence and discrimination, including gender discrimination and sexual harassment, perpetrated by non-Rautes on Rautes.

Similarly, a museum to portray Raute identity will be established. The ministry has presented the policy to the Social Development Committee and the Provincial Planning Commission.

According to Krishna Prasad Kapri, secretary at the ministry, the policy will ensure the right of Raute children to receive an education. The policy proposes the formation of a steering committee under the chairmanship of the Minister of Social Development to implement the programs laid out in the policy, provide guidance to officials for the mainstreaming of the Raute community, coordinate internal and external cooperation, manage budget, and monitor work related to the Raute community.

The committee shall have secretaries from the Office of the Chief Minister and Council of Ministers, Ministry of Economic Affairs and Planning, Ministry of Social Development, Ministry of Land Management, Agriculture and Cooperatives, and Ministry of Physical Infrastructure as members. The chief of the Social Development Division shall work as a member-secretary.