Pratik Rimal
Kathmandu, March 27
There’s a disappointing side to the widely appreciated story of the government's road expansion drive in the Kathmandu Valley, untold and unheard so far: the laborers who have been working hard to to make the government's road widening drive a success haven't been paid their wages. This has made it quite difficult for them to eke out a living.
These poor laborers haven't got their wages because the contractors hired by different community groups to carry out the demolition of houses and buildings on the sides of the roads haven't been paid. The community groups haven't been able to pay the contractors because they themselves are yet to get paid by the Kathmandu Valley Town Development Committee (KVTDC). And the KVTDC hasn't paid the community groups because the Ministry of Finance (MoF) is yet to relase the funds.
“It is very difficult because I have a family of five to feed,” Krishna Pun, a laborer at Chabahil said. Pun, his wife and their elder son were all working to demolish houses at Chabahil. “We go to the contractor and he says he doesn’t have money, and that he’d inform us as soon as he has the cash. We’ve been waiting for a month, but there’s no money, and we are living on credit,” said a distressed Pun, who has to collect altogether a sum of Rs. 50,000. Another laborer at New Baneshwor shared the same plight.
The scene of KVTDC is also troubling. Members of the 30-concerned committees elected by it to assist the road expansion drive throng its premises demanding their shares. Following assurances from the MoF it had assured the community groups to pay them as soon as they complete their assignements. However, months down the line, it has nothing to give to the community group except narrating that the MoF has been mum.
“The road expansion drive was not given on tender. It was handed to community groups, and for this reason, it has been successful,” Indra Kumar Chamling, one of the members of 30-community groups said. Though their contribution has made the drive a success and completed their assignements with six months, they are left high and dry. “We bought construction materials on credit by promising that we'd repay them immediately after we complete our work. Now, shopkeepers are claiming the dues. And we don’t have money to pay them because KVTDC hasn’t paid us,” Chamling said, claiming that his group is at the receiving end of around four million rupees from KVTDC.
What concerns stakeholders is the silence of MoF. So far, the MoF has neither reimbursed the community groups, nor has said that it does not have money to pay. Tiwari and Chamling both say that the ministry frustrates them. “If they didn’t have money, why did they start the drive, and if they have the money, why aren’t they paying back our labor,” Chamling queried.
A higher source said that when the government started the move, MoF had shown the money that it never had. “When the government started the drive, they actually didn’t have money. Yet, they assured elected community groups that once they complete their job, they’d be paid back,” a source who preferred anonymity said.
Dr. Bhai Kaji Tiwari, Town Controller at KVTDC repeatedly consoles the community group’s representative with the same refrain, “We don’t have money because the Ministry isn’t paying us.” Tiwari added that so far, there has been no response from MoF. "When we reach them, we are told that there's no minister and secretary. What they are doing is very irresponsible," Tiwari said.
FEAR OF A HIATUS
So far, the drive has succeeded in expanding 22 kilometers of roads. If the government falters to its words, Tiwari fears that the road expansion drive could come to a halt. Although few people had created a scene on house demolitions, the larger number of Kathmandu dwellers who owned a house had readily renounced a part of their property to appreciate the government’s move. “So far, the move has been successful because people had willingly participated. Community groups had raised money from houses with promises to repay them. It's painful to see that the ‘promised’ words are not happening,” Tiwari said adding, “People could lose their faith on government, and the expansion could stop abruptly,” Chamling cautioned.
KVTDC had initially asked Rs. 110.65 million rupees to FM. Since FM declined the offer, the former had asked for Rs. 50 millions on Tuesday. “That way, we can continue the drive. Otherwise, it soon will wind up,” Tiwari warned. The FM could not be reached for its version despite numerous attempts.
HEALTH AILMENTS
Shova Baral, 23 is a resident of Chabahel. Allergic to dust pollution since her childhood, Baral, these days, is finding it difficult to bear the demolition drive. Although she has fully covered herself, Baral still finds it difficult, especially because of the season. "The temperature's so hot, and I'm sweating within. Yet, I need to cover my hands because I am allergic to dust. The bustling traffic, honking horns, ever-flowing dust and the hot Sun. How do you escape it," Baral argued. Baral is not the only one to suffer from the 'praised' demolition drive. Amrit Shakya of Jorpati and his friends too share the same troubles.
Udita Khanal, a resident doctor at Tribhuwan University Teaching Hospital said that people living close to demolition and those passing the demolished area are likely to suffer from various forms of skin and eye allergies. "Moreover, the pollution could also heighten chronic cases like asthama and atopy," Khanal said.
DRAINAGE WOES LIKELY TO OCCUR
As the sweltering heat of summer will soon welcome rainy season, experts on drainage system worry of a flooded valley if construction wastes are not cleared sooner. "Our drainage system are not designed systematically and do not adhere to standard norms. Unless we flush them with jet pipes, there could be blockades in the coming days," Birendra Man Pradhan, an expert said, adding that since the debris is higher this time, the frequency of flushing must happen more often.
About Me
- Pratik Rimal
- Kathmandu, Nepal
- Ever since I first started to write my first poem and article, I've loved to write. I continue to learn to write. In doing so, I let my feelings, thoughts, and emotions run wild and let people know what I intend to say, what I want to say. For me, writing is a creative expression to express what we never can say by speaking... Your readings and feedback are always important to me. Therefore, I wish that you'd write to me. My email address: pratik.rimal@hotmail.com Cell: +977-98511-42610
Thursday, March 29, 2012
Tuesday, March 20, 2012
Music has the power to change
Defenders of Metal concluded 'Metal Mayhem IV' with mayhem. The show however was put to a stop after locals complained of noise at 9:30 PM. In the concert, Pratik Rimal had the opportunity to interact with Mark Barney Greenway, lead singer of Napalm Death, a British band, for a few minutes before they geared up to rock the crowd.
TNP: Your musical journey of 32 years. How does it feel?
Mark: Well, to be honest, it was very uninteresting. There have been a lot of changes in the band line. It was a hurried start. We were young and had our spirits too high, it had resulted in differences.
TNP: It is easy to form a band, but harder to stick together. What keeps you going?
Mark: That is true. However, not everything is easy; everyone has his or her own differences. What matters is how you respond to that. I have been in the band for 20 years and as far as I know, there have been a lot of differences to sort out. To keep going, it is very important that everyone work together, have a common goal and a common way to achieve it.
TNP: People say music is free from all forms of religious and political messages. However, you address a variety of 'anarchist concerns' in tradition of ‘anarcho punk movement’ with themes like anti-racism, feminism, anti-militarism and anti-capitalism.
Mark: I would not like to call it 'anti' because I am speaking my mind, and everyone has the right to differ. What we sing is not against religion and other issues. It rather is about a country's failure to address issues like women empowerment, discrimination, social stigmas and oppression.
TNP: You were initially influenced by anarcho punk movement. Has the band's theme evolved over time, or do you still sing on the same theme?
Mark: Yeah, we still sing the same genre and our theme has not changed. See, the fact is music has the power to change. It helps you to understand religion and humanity which is often forgotten because of power, and men do anything for power. Music can change that, and that's what we sing for, and that’s why we sing.
TNP: Your song, 'You Suffer' holds a Guinness World Record for the shortest song (micro song) of 1.3 seconds. What actually is a micro song?
Mark: Yes we do, but it was not deliberate. We have always been spontaneous with what we do, be it lyrics or our music. The term, 'micro song' is just lame and there’s nothing called a micro song.
TNP: How do you see Napalm Death 30 years ago, and now?
Mark: There have been differences. When I look at the yesteryears, I see how we've improved with what we do, what we sing, and the music we bring to our audience. Right now, we feel great, but we make sure to take a day at a time. We have also matured by experience, and have gained better understanding of what a good music is.
TNP: Did you self-learn music or were you taught?
Mark: No one taught us what we play. We just learnt over time.
TNP: What has music taught you?
Mark: Well, music has taught me to be myself. In its journey of 30 years, band members have changed, but it has never changed me. It also has taught me that what one does in the long run counts, and it is important that one should not be corruptive. That's what matters at the end of the day.
Monday, March 19, 2012
We love music as much as we love death –ARSAMES
Formed in 2002 AD, ARSAMES is an Iranian death metal band that sings about Persian history, mythology, folklores and literature. Consequently, the five men band call themselves ‘ancient death metal’. "People tend to quickly forget history, and it is good to remind them time and again," Armin Ghauforian, band manager of Arsames said. The band likes to infuse the essence of ‘extremism’ in their music which they love as much as they love death. Pratik Rimal had the opportunity to know more about the band:
Usually death metal bands name themselves with darker and devilish imagery. Your band's name comes from one of the Persian kings during the Achaemenid dynasty.
Death metal has come to be a broad genre these days and so has the names. Death metal does not just confine to death growl music. Nowadays, it also includes history, mythologies, and literatures. Therefore, it is natural for bands to choose a familiar name, and that is how we chose Arsames. Moreover, our band's name goes well with the lyrics we make, and that counts. However, newer bands are coming, and they are starting to choose awkward names.
Why are you are called as illegal and considered ‘satanic’ by the Iranian government?
We try to wipe out the theme of being called ‘satanic’ because we love and are passionate for music. In a sense, we are illegal because the Iranian government has banned us to promote our albums, or have concerts in Iran. We practice in basements. The government has not just banned us, it has banned every metal band, and sometimes rock bands too, share the brunt. For all these reasons, we travel abroad. Nonetheless, there are many underground heavy metal bands in Iran. Since we cannot promote ourselves from any media in Iran, we go online and connect with other underground metal bands.
Your debut song was ‘Adiposere’ in 2005 A.D. How was the record received in Iran and elsewhere across the world?
We would not like to call it a debut. It was more of a demo song. Nonetheless, it was our first death metal song. Because of the government's ban, we used to share it on MySpace. We now use Facebook to promote our videos and songs. We continue to receive good feedback from our audience.
How do you feel to be called as the Iron Maiden of Iran?
Iron Maiden was our earlier influence, and because of the melody, we were called so. Persia has its own unique melody and we try to use them in our songs. However, nowadays, we are completely death metals.
One of your major themes is of Persian history and mythology. You describe your music as ‘ancient death metal'. Why have you selected Persian history and mythology? How do you define ‘ancient death metal’?
Persia is rich in history, and we have so much to choose from its literature, mythology and folklores. It talks from the early human civilization to everything and anything up to modern age. We share Persian history not just because we are Iranian, but also to share what we know. We are a part of world culture.
In July 2011, you released your album, Persian Death Metal Tribute to Warriors of Metal. How was it received?
It is good to know that since our initial days, we have been receiving good feedback from our audience. The album was an appreciation to all the bands that we have listened, to reach where we are now. Like the demo song, we received good reviews and it was encouraging.
Why do you prioritize Persian history and mythology? By prioritizing it, what do you intend to say?
We are a global citizen, and we all share parts of our history. People tend to forget history quickly, and it is good to recall them time and often. However, yes, we are proud to have our roots from a rich culture.
What are your influences?
Our earlier influences on heavy metals were Iron Maiden, Metallica, Judas Priest and various other metal bands.
How did you go into Death metal?
Tape trading culture was very difficult in Iran because we had to hide it from the police. If they caught us, there would be hassles. Our relatives, who lived abroad, would send us tapes, and we would share it. That is how we got into the genre.
Do you have any songs about the Iranian revolution?
We have a lot to talk about apart from our political system, and we do not deal with political themes. That is not our priority. We focus on music and by its help, we try to show a different face of Iran. We are global and just like any other person.
Who plays what instrument?
Morteza Sharami and Ahmad Tokalou are on guitars, Ali Madarshahi on vocals, Saeed Shariat on drums and Saeed Makari on bass guitars.
What is music to Arsames?
Music is more than entertainment for us. It is something that releases you from reality and focus. It also takes you to a different dream, imagination and creativity. It also helps you to meditate, and there is meditation in death metal too. It also has been our asylum. Music has pulled us together and it has been with us in both good and bad times. We have felt close with it and are continually intrigued by its world.
What are your future plans?
We are optimistic to be global, and we will make out. We are also working on our next album, and it will be an eye catchy one.
IMPACTS OF TV ADS ON CHILDREN
PRATIK RIMAL
Do your children stay glued to the television set, and seldom hear what you say? Every time a difficulty arises, they seem to take a melodramatic stance which you know, is not workable. More often, they complain and argue to have something they see, inside the square television set—loads of junk foods, cosmetic products, toys, and others.
Bhawani Karki, 15, an eighth grader at Davis School, Nilo Pul, shares, “I usually watch reality shows and live programs.” She also watches soap operas if she gets free time. “There’s little time after I complete my school’s assignments. I usually finish my homework at 10 PM, and then, it’s time to sleep,” Karki shares. But she sometimes watches ‘serials’ after completing her assignments for about an hour or half.
“I am not interested on advertisements,” Karki shares. When inquired if she brought things that were displayed on ads, she shares that she has never felt like buying an item just because they are aired on television channels. “The claims advertisements make are doubtful, and I don’t trust them,” Karki shares, adding, “I buy things when I need them, and, not get influenced by adverts.”
Yadav Raj KC, 45 of Pharping is a father of three children. “My daughter usually watches films. Since she and her elder brother have grown up to some extent, they do not demand things shown in advertisements, but my youngest son does,” KC adds. He is worried how his son is in love with junk foods and toys shown in cartoon channels like Cartoon Network, and Nickelodeon.
“If I can afford to purchase, I think over it again to see its utility before I buy it,” KC shares, adding how parents are sandwiched between love for their children and their materialistic lifestyle. “We love our children, and they love toys, candies, clothes, shoes, gadgets and countless number of products shown on television. They make a fuss over an item, and we do not like to see them cry. So, I often buy what my children ask for,” Ambika Thapa, 35, shares.
"Nepal and India closely share its values, beliefs, cultures and traditions with each other. Likewise, Indian and Nepali television channels share and reflect same ads, a factor that could reinforce a child’s vulnerability," Sanjeev Pokharel, an anthropologist, opines, "Awareness is the key to fight back with the negative impacts of advertisements."
Furthermore, unethical practices of concerned stakeholders (producers, distributors, weak state policy, and inability of people to filter content, and media) too have their roles in misleading the masses by the advertisements, Pokharel opines. “Awareness doesn’t just restrict to formal education. It also has to do with a person’s exposure level, and their critical thought processing ability,” Pokharel adds, “If we can develop ad awareness, we can safeguard ourselves from the fraudulent behaviors of advertisements.” Pokharel further adds, “A section of the conscious class can only shield from ad impacts, while the general masses, those who are less conscious are highly at risk of being misled,” Pokharel shares.
AD EFFECTS:
Advertisements are visually appealing, and its impacts can be reflected on a person’s lifestyle and consuming pattern. “Junk food and cosmetic products top the list,” Pokharel shares. “While it bankrupts you financially, it also ruins one’s health,” Pokharel adds. However, an ad’s effect isn’t limited only to economy. It also affects the human psychology, and especially, child psychology.
“A basic factor that reflects the effects of advertisements is personality,” Archana Baral, a hypnotherapist shares. “Fair skin children will generally be loved and appreciated by everyone. Such acts result in higher self-esteem. However, "dark skins" tend to have a lower level of self esteem because they are ‘dark’ and not ‘fair’.” Baral adds, "Such incidents increase feeling of negativity amongst children, despite the love and care given by their parents and elders.
By the time a child turns three, s/he starts to learn language, and picks up everything they hear. When a child is too much exposed to television and its advertisements, it results in mature expression, Baral shares. “Such ‘skipped’ growth highly affects a child, and sometimes, could result in regrets in their later life,” Baral adds.
“Moreover, excess view of commercials could alter a child’s growth and could reshape it into those shown in advertisements,” Baral shares, adding, such views can dull a child’s creativity. The age between eight and 14 is considered fertile for creativity.
SOLUTION:
Baral opines that limited exposure to television and its contents, and especially advertisements, could help prevent its impacts. Furthermore, he shares that, parents too should play an important role to help their children get engaged on various other activities besides the tele and other media alike. “Apart from doing so, parents must also show what’s true and what’s false in any form of media content."
Do your children stay glued to the television set, and seldom hear what you say? Every time a difficulty arises, they seem to take a melodramatic stance which you know, is not workable. More often, they complain and argue to have something they see, inside the square television set—loads of junk foods, cosmetic products, toys, and others.
Bhawani Karki, 15, an eighth grader at Davis School, Nilo Pul, shares, “I usually watch reality shows and live programs.” She also watches soap operas if she gets free time. “There’s little time after I complete my school’s assignments. I usually finish my homework at 10 PM, and then, it’s time to sleep,” Karki shares. But she sometimes watches ‘serials’ after completing her assignments for about an hour or half.
“I am not interested on advertisements,” Karki shares. When inquired if she brought things that were displayed on ads, she shares that she has never felt like buying an item just because they are aired on television channels. “The claims advertisements make are doubtful, and I don’t trust them,” Karki shares, adding, “I buy things when I need them, and, not get influenced by adverts.”
Yadav Raj KC, 45 of Pharping is a father of three children. “My daughter usually watches films. Since she and her elder brother have grown up to some extent, they do not demand things shown in advertisements, but my youngest son does,” KC adds. He is worried how his son is in love with junk foods and toys shown in cartoon channels like Cartoon Network, and Nickelodeon.
“If I can afford to purchase, I think over it again to see its utility before I buy it,” KC shares, adding how parents are sandwiched between love for their children and their materialistic lifestyle. “We love our children, and they love toys, candies, clothes, shoes, gadgets and countless number of products shown on television. They make a fuss over an item, and we do not like to see them cry. So, I often buy what my children ask for,” Ambika Thapa, 35, shares.
"Nepal and India closely share its values, beliefs, cultures and traditions with each other. Likewise, Indian and Nepali television channels share and reflect same ads, a factor that could reinforce a child’s vulnerability," Sanjeev Pokharel, an anthropologist, opines, "Awareness is the key to fight back with the negative impacts of advertisements."
Furthermore, unethical practices of concerned stakeholders (producers, distributors, weak state policy, and inability of people to filter content, and media) too have their roles in misleading the masses by the advertisements, Pokharel opines. “Awareness doesn’t just restrict to formal education. It also has to do with a person’s exposure level, and their critical thought processing ability,” Pokharel adds, “If we can develop ad awareness, we can safeguard ourselves from the fraudulent behaviors of advertisements.” Pokharel further adds, “A section of the conscious class can only shield from ad impacts, while the general masses, those who are less conscious are highly at risk of being misled,” Pokharel shares.
AD EFFECTS:
Advertisements are visually appealing, and its impacts can be reflected on a person’s lifestyle and consuming pattern. “Junk food and cosmetic products top the list,” Pokharel shares. “While it bankrupts you financially, it also ruins one’s health,” Pokharel adds. However, an ad’s effect isn’t limited only to economy. It also affects the human psychology, and especially, child psychology.
“A basic factor that reflects the effects of advertisements is personality,” Archana Baral, a hypnotherapist shares. “Fair skin children will generally be loved and appreciated by everyone. Such acts result in higher self-esteem. However, "dark skins" tend to have a lower level of self esteem because they are ‘dark’ and not ‘fair’.” Baral adds, "Such incidents increase feeling of negativity amongst children, despite the love and care given by their parents and elders.
By the time a child turns three, s/he starts to learn language, and picks up everything they hear. When a child is too much exposed to television and its advertisements, it results in mature expression, Baral shares. “Such ‘skipped’ growth highly affects a child, and sometimes, could result in regrets in their later life,” Baral adds.
“Moreover, excess view of commercials could alter a child’s growth and could reshape it into those shown in advertisements,” Baral shares, adding, such views can dull a child’s creativity. The age between eight and 14 is considered fertile for creativity.
SOLUTION:
Baral opines that limited exposure to television and its contents, and especially advertisements, could help prevent its impacts. Furthermore, he shares that, parents too should play an important role to help their children get engaged on various other activities besides the tele and other media alike. “Apart from doing so, parents must also show what’s true and what’s false in any form of media content."
KIDNEY TURNS KILLER
Pratik Rimal/TNP
Kathmandu, March 8
There are around 10,000 known kidney patients in Nepal. However, only 10 per cent of them are undergoing treatment because of the high costs.
It is believed that around 500 million people around the world have some form of renal diseases. One out of every 10 people suffers from some kidney ailments. “You might look fit from the outside, but you never know if you have renal diseases," Dr. Rishi Raj Kafle, Executive Director of National Kidney Center (NKC) said.
In order to mark the World Kidney Day, NKC organized a free kidney checkup at Chettrapati Hospital. Out of the 317 people who came to take a free test, 30 were found to have some sort of problems related to kidney. "Kidney diseases have no symptoms, and that's why it's even more threatening," Kafle said, adding, "By the time a patient encounters symptoms, they are critical."
A vast majority of the country's population still lag behind on regular medical checkups. As a result, they are unlikely to know what is going inside their bodies. “Moreover, with no symptoms to cast doubts about renal ailments, every individual must have regular screening of blood and urine,” Kafle asserted.
Prevention, way better than Cure
"You don't know when you suffer, and prevention here, is much better than cure." Kafle shared. However, very few people care to do so. They usually turn up for treatment at critical stages. "At such final stages, all we can do is prolong a patient's life; ease their sufferings through dialysis," Kafle added.
Bimal Baral, administrative officer at NKC said that, given the high costs involved, precautions should be taken earlier. "When you go into treatment for kidney failures, it means dialysis, and it's very expensive," Baral said, adding, that even the wealthiest cannot afford the treatment for long due to high costs involved. "A patient spends around Rs. 30,000 a week," Baral shared.
A woman from Dhading is undergoing treatment at NKC. She has been receiving dialysis treatment for the last three years. The costs have already pushed her family towards the depths of poverty. "In three years, I've spent around three million rupees," the woman, who seeks anonymity shares. Tears fill her eyes when she recalls what her husband, a government school teacher at Pokhara, faces every day. "It is so hard to manage money. Until now, I've been taking help from every relative, but how long will they support?" she laments. "This treatment will ruin a family," the woman shares in tears, adding, how she can neither die, nor afford the treatment any longer.
Dr. Sudha Khakurel of KIST Medical College said that renal failures could be prevented in three stages. "The first is primary prevention. Here, we ask people to live a healthy life, control their weight, and exercise," Khakurel said, adding, kidney failures can be easily cured at this stage.
"In secondary stage, kidney slowly starts to get damaged. Here, it is important that people control their sugar level, blood pressure and do regular screenings of urine."
The final prevention is only to prolong life. "It is called tertiary prevention. At this stage, we can only work to save further damage of the kidney," Khakurel said.
AWARENESS IS THE KEY
Another way of prevention is awareness, Khakurel said. "It is important that we aware people of all ages start from the younger ones," Khakurel said, adding, "It is important that schools, colleges, and other private or government institutions inform and educate everyone regarding renal diseases and their prevention," Khakurel said.
Khakurel sees awareness and healthy lifestyles as the key to stay away from renal diseases. However, Khakurel adds that, few myths have also barred timely identification of the disease. "When one sees a swollen ankle, people blame the cold weather, and facial puffiness with a snake's bite," Khakurel said about possible symptoms of renal diseases. "Other symptoms are frothy urine, red urine, backache, and poor urinary stream," Khakurel said.
What seems interesting is that anyone can suffer from diseases related to kidney. However, Khakurel sees some categories as high-risk people. "People suffering from diabetes, high blood pressure, obesity and those above 40 are at high risk," he said. Apart from that, family history of kidney ailments, diabetes or hypertension too could contribute to renal diseases in the long run, Khakurel explained.
The 2012 Campaign will focus on the positive outcome of kidney transplantation and the life-saving aspect of organ donation. The slogan for this year's campaign is Donate - Kidneys for Life - Receive.
Some striking figures:
- Recent reports from the United States estimate that nearly half a million patients in the United States were treated for end-stage renal disease (ESRD) in 2004 and by 2010 this figure is expected to increase by approximately 40%.
- The cumulative global cost for dialysis and transplantation over the next decade is predicted to exceed US$ 1 trillion. This economic burden could strain healthcare budgets in developed countries. For lower income countries it is impossible to meet such costs.
- The economic burden for developing countries is particularly severe, partly because Chronic Kidney Diseases (CKD) generally occurs at a younger age. For example, in Guatemala, 40% of patients receiving renal replacement therapy (RRT) are under 40. In China, the economy will lose US$558 billion over the next decade due to effects on death and disability attributable to chronic cardiovascular and renal disease. For more information please see the diagram
- The number of people with renal replacement therapy has increased from 26,000 in 1990 to 1.5 million in 2000 and is expected to rise to 2.5 million by 2010.
- In Europe, it is estimated that screening for urinary protein loss exceeding 50 mg/day costs 7,000 Euros per life year gained, according to the PREVEND study, which is largely cost-effective.
- More than 80% of individuals receiving RRT live in the developed world because in developing countries it is largely unaffordable. In countries such as India and Pakistan, less than 10% of all patients who need it receive any kind of renal replacement therapy. In many African countries there is little or no access to RRT, meaning many people simply die.
- Chronic Kidney diseases are not curable, the patient needs care for the rest of his life
- If CKD are not detected early enough, the patient will suffer from kidney failure which requires Renal Replacement Therapy (dialysis or transplantation), which is extremely costly and weighs heavily on healthcare budgets.
8 Golden Rules
Kidney diseases are silent killers, which will largely affect your quality of life. There are however several easy ways to reduce the risk of developing kidney disease.
1. Keeping fit and active
2. Keep regular control of your blood sugar level
3. Monitor your blood pressure
4. Eat healthy and keep your weight in check
5. Maintain a healthy fluid intake
6. Do not smoke
7. Do not take over-the-counter pills on a regular basis
8. Check your kidney function if you have one or more of the 'high risk' factors
( Credit: Worldkidneyday.com)
Kathmandu, March 8
There are around 10,000 known kidney patients in Nepal. However, only 10 per cent of them are undergoing treatment because of the high costs.
It is believed that around 500 million people around the world have some form of renal diseases. One out of every 10 people suffers from some kidney ailments. “You might look fit from the outside, but you never know if you have renal diseases," Dr. Rishi Raj Kafle, Executive Director of National Kidney Center (NKC) said.
In order to mark the World Kidney Day, NKC organized a free kidney checkup at Chettrapati Hospital. Out of the 317 people who came to take a free test, 30 were found to have some sort of problems related to kidney. "Kidney diseases have no symptoms, and that's why it's even more threatening," Kafle said, adding, "By the time a patient encounters symptoms, they are critical."
A vast majority of the country's population still lag behind on regular medical checkups. As a result, they are unlikely to know what is going inside their bodies. “Moreover, with no symptoms to cast doubts about renal ailments, every individual must have regular screening of blood and urine,” Kafle asserted.
Prevention, way better than Cure
"You don't know when you suffer, and prevention here, is much better than cure." Kafle shared. However, very few people care to do so. They usually turn up for treatment at critical stages. "At such final stages, all we can do is prolong a patient's life; ease their sufferings through dialysis," Kafle added.
Bimal Baral, administrative officer at NKC said that, given the high costs involved, precautions should be taken earlier. "When you go into treatment for kidney failures, it means dialysis, and it's very expensive," Baral said, adding, that even the wealthiest cannot afford the treatment for long due to high costs involved. "A patient spends around Rs. 30,000 a week," Baral shared.
A woman from Dhading is undergoing treatment at NKC. She has been receiving dialysis treatment for the last three years. The costs have already pushed her family towards the depths of poverty. "In three years, I've spent around three million rupees," the woman, who seeks anonymity shares. Tears fill her eyes when she recalls what her husband, a government school teacher at Pokhara, faces every day. "It is so hard to manage money. Until now, I've been taking help from every relative, but how long will they support?" she laments. "This treatment will ruin a family," the woman shares in tears, adding, how she can neither die, nor afford the treatment any longer.
Dr. Sudha Khakurel of KIST Medical College said that renal failures could be prevented in three stages. "The first is primary prevention. Here, we ask people to live a healthy life, control their weight, and exercise," Khakurel said, adding, kidney failures can be easily cured at this stage.
"In secondary stage, kidney slowly starts to get damaged. Here, it is important that people control their sugar level, blood pressure and do regular screenings of urine."
The final prevention is only to prolong life. "It is called tertiary prevention. At this stage, we can only work to save further damage of the kidney," Khakurel said.
AWARENESS IS THE KEY
Another way of prevention is awareness, Khakurel said. "It is important that we aware people of all ages start from the younger ones," Khakurel said, adding, "It is important that schools, colleges, and other private or government institutions inform and educate everyone regarding renal diseases and their prevention," Khakurel said.
Khakurel sees awareness and healthy lifestyles as the key to stay away from renal diseases. However, Khakurel adds that, few myths have also barred timely identification of the disease. "When one sees a swollen ankle, people blame the cold weather, and facial puffiness with a snake's bite," Khakurel said about possible symptoms of renal diseases. "Other symptoms are frothy urine, red urine, backache, and poor urinary stream," Khakurel said.
What seems interesting is that anyone can suffer from diseases related to kidney. However, Khakurel sees some categories as high-risk people. "People suffering from diabetes, high blood pressure, obesity and those above 40 are at high risk," he said. Apart from that, family history of kidney ailments, diabetes or hypertension too could contribute to renal diseases in the long run, Khakurel explained.
The 2012 Campaign will focus on the positive outcome of kidney transplantation and the life-saving aspect of organ donation. The slogan for this year's campaign is Donate - Kidneys for Life - Receive.
Some striking figures:
- Recent reports from the United States estimate that nearly half a million patients in the United States were treated for end-stage renal disease (ESRD) in 2004 and by 2010 this figure is expected to increase by approximately 40%.
- The cumulative global cost for dialysis and transplantation over the next decade is predicted to exceed US$ 1 trillion. This economic burden could strain healthcare budgets in developed countries. For lower income countries it is impossible to meet such costs.
- The economic burden for developing countries is particularly severe, partly because Chronic Kidney Diseases (CKD) generally occurs at a younger age. For example, in Guatemala, 40% of patients receiving renal replacement therapy (RRT) are under 40. In China, the economy will lose US$558 billion over the next decade due to effects on death and disability attributable to chronic cardiovascular and renal disease. For more information please see the diagram
- The number of people with renal replacement therapy has increased from 26,000 in 1990 to 1.5 million in 2000 and is expected to rise to 2.5 million by 2010.
- In Europe, it is estimated that screening for urinary protein loss exceeding 50 mg/day costs 7,000 Euros per life year gained, according to the PREVEND study, which is largely cost-effective.
- More than 80% of individuals receiving RRT live in the developed world because in developing countries it is largely unaffordable. In countries such as India and Pakistan, less than 10% of all patients who need it receive any kind of renal replacement therapy. In many African countries there is little or no access to RRT, meaning many people simply die.
- Chronic Kidney diseases are not curable, the patient needs care for the rest of his life
- If CKD are not detected early enough, the patient will suffer from kidney failure which requires Renal Replacement Therapy (dialysis or transplantation), which is extremely costly and weighs heavily on healthcare budgets.
8 Golden Rules
Kidney diseases are silent killers, which will largely affect your quality of life. There are however several easy ways to reduce the risk of developing kidney disease.
1. Keeping fit and active
2. Keep regular control of your blood sugar level
3. Monitor your blood pressure
4. Eat healthy and keep your weight in check
5. Maintain a healthy fluid intake
6. Do not smoke
7. Do not take over-the-counter pills on a regular basis
8. Check your kidney function if you have one or more of the 'high risk' factors
( Credit: Worldkidneyday.com)
Foreseen Fire Kills Six
Pratik Rimal
Kalimati, March 4
10:00 PM, load-shedding ends at Kalimati area. A short-circuit causes a small fire at the mid section of Kalimati’s vegetable market. Within minutes, the small fire spreads wild leaving six dead and one injured.
Six people were charred to death while a woman sustained injuries after a short-circuit at the mid section of the vegetable market at 10:00 PM on Saturday. Guards, locals and police personnel at the site speak of horror on how a single spark spread to an uncontrollable wild-fire within five minutes.
An armed police personnel who seeks anonymity said how he could not rescue a boy who was later charred to death. “The fire was too big and had completely engulfed him. We were helpless spectators of this horror; could only watch this poor kid burn to death”. “Later, only his bones were found,” the police said. The boy was later identified as Om Kumar Shah, 15 of Birgunj.
In an attempt to cease fire, fire brigades from Nepal Army, Nepal Police, Armed Police and Juddha Barun Yantra had come to the rescue. However, by the time the extinguishers arrived, the fire was uncontrollable. “At one point, the fire brigades backed due to the growing flames,” a guard within the market area said. “While the fire extinguishers were on their way, we tried to control the fire, but we couldn’t,” another guard adds.
Officers at the market are puzzled as how the fire broke out. What further looks confusing is how a small fire could spread in such a short span of time to collapse the buildings and tons of groceries. “We have no clue of how the short-circuit occurred, and how it triggered such a catastrophe,” Binay Shrestha, Chief Planning Officer at the market said, adding that, the fire was under control only after 3:00 AM and investigation was on the way.
The guards at the market had foreseen such a calamity. It has come to surface that the guards had warned and requested the management to remove dry bamboos, plastic-shades and crates within the market area. However the management turned their blind eyes despite such 50 repetitive requests.
“If only they had considered the warning, such magnitude of ill fate wouldn’t have occured,” Bimala Karki, and other guards at the market said. “No one listened, now see what has happened,” other guards echo. However, Shrestha blames the vendors for their carelessness, but admits of having learnt a valuable lesson.
"We repeatedly held discussions with stakeholders and vendors to caution them about such probable occurrences, but the businessmen were, and still are, too concerned on money making," Shrestha said, blaming how their recklessness caused such an irreplaceable disaster. She said that they were estimating the cost of damage, and are working to clear the debris as soon as possible. Girija Prasad Gupta, president of Terai Fruit and Vegetable Association estimates a damage of more than a billion rupees. "Everything's gone, and the building too has cracked and burnt in many places," Gupta elaborates on his estimation.
With the damage, speculations are rife amongst consumers of food shortage and probable price hike. While some consumers keep their cool, others are too worried about the price hike. "I'm sure they'll hike the price by evening," Amrita Sharma, a local at Kalimati said. What Sharma opines stands true to what vegetable vendors have to say. Rabin Khadka and other agro entrepreneurs have lined their trucks loaded with vegetables and fruits at Balkhu. These businessmen have no place to unload their groceries, and in turn, have asked farmers not to load more trucks for the time being. The en-route trucks will arrive in the valley till today, but after that, it won't," Khadka said, adding that the prices could escalate twice the sum. "With what we have, we can only supply 10 per cent of the population for today. After that, we cannot," Khadka said.
"We have cleared the wastes, and we’ll start unloading trucks from tomorrow," Shrestha said, adding that the work wouldn’t have been successful without the help of Nepal Police, Army, Armed Police Force, and employees. A total of around 300 people had worked throughout the day to clear the night’s damage.
While clearing the wreckage is important to meet the feared food shortage, building the damaged infrastructure too is a priority. "The buildings can collapse anytime, and another fatality could occur," Khadka said.
The deceased include Hira Bahadur Pun, his two daughters, Shanti (16), Neera (14) and son Neerajan (12), Shah and one unidentified person. Pun's wife, Hikka is undergoing treatment at the Military Hospital, Chauni. Pun sustained burns injury. "She sustained 18 per cent burn injury, and as of now, is out of danger," Brig. Gen. Dr. Bachchu Ram K.C., commandant at the hospital said. Pun sustained injuries on her stomach, her right thigh and shoulders.
Nandan Kumar Datta, minister of Agriculture and Cooperatives expressed his shock, and disbelief to the incident. “I cannot express the shock I got this morning. Even now, it's difficult to breathe, I just cannot imagine what it was like when the fire was uncontrollable,” Datta said, assuring the victims with appropriate compensations.
HOW THE FIRE WENT WILD
A short-circuit triggered a small fire at the mid portion of the market. It slowly crept to sacks and dry bamboos. Within a few minutes, the fire started to grow. Later, two gas cylinders burst to exhume liquefied petroleum gas across the passage—only to result in uncontrolled fire.
Kalimati, March 4
10:00 PM, load-shedding ends at Kalimati area. A short-circuit causes a small fire at the mid section of Kalimati’s vegetable market. Within minutes, the small fire spreads wild leaving six dead and one injured.
Six people were charred to death while a woman sustained injuries after a short-circuit at the mid section of the vegetable market at 10:00 PM on Saturday. Guards, locals and police personnel at the site speak of horror on how a single spark spread to an uncontrollable wild-fire within five minutes.
An armed police personnel who seeks anonymity said how he could not rescue a boy who was later charred to death. “The fire was too big and had completely engulfed him. We were helpless spectators of this horror; could only watch this poor kid burn to death”. “Later, only his bones were found,” the police said. The boy was later identified as Om Kumar Shah, 15 of Birgunj.
In an attempt to cease fire, fire brigades from Nepal Army, Nepal Police, Armed Police and Juddha Barun Yantra had come to the rescue. However, by the time the extinguishers arrived, the fire was uncontrollable. “At one point, the fire brigades backed due to the growing flames,” a guard within the market area said. “While the fire extinguishers were on their way, we tried to control the fire, but we couldn’t,” another guard adds.
Officers at the market are puzzled as how the fire broke out. What further looks confusing is how a small fire could spread in such a short span of time to collapse the buildings and tons of groceries. “We have no clue of how the short-circuit occurred, and how it triggered such a catastrophe,” Binay Shrestha, Chief Planning Officer at the market said, adding that, the fire was under control only after 3:00 AM and investigation was on the way.
The guards at the market had foreseen such a calamity. It has come to surface that the guards had warned and requested the management to remove dry bamboos, plastic-shades and crates within the market area. However the management turned their blind eyes despite such 50 repetitive requests.
“If only they had considered the warning, such magnitude of ill fate wouldn’t have occured,” Bimala Karki, and other guards at the market said. “No one listened, now see what has happened,” other guards echo. However, Shrestha blames the vendors for their carelessness, but admits of having learnt a valuable lesson.
"We repeatedly held discussions with stakeholders and vendors to caution them about such probable occurrences, but the businessmen were, and still are, too concerned on money making," Shrestha said, blaming how their recklessness caused such an irreplaceable disaster. She said that they were estimating the cost of damage, and are working to clear the debris as soon as possible. Girija Prasad Gupta, president of Terai Fruit and Vegetable Association estimates a damage of more than a billion rupees. "Everything's gone, and the building too has cracked and burnt in many places," Gupta elaborates on his estimation.
With the damage, speculations are rife amongst consumers of food shortage and probable price hike. While some consumers keep their cool, others are too worried about the price hike. "I'm sure they'll hike the price by evening," Amrita Sharma, a local at Kalimati said. What Sharma opines stands true to what vegetable vendors have to say. Rabin Khadka and other agro entrepreneurs have lined their trucks loaded with vegetables and fruits at Balkhu. These businessmen have no place to unload their groceries, and in turn, have asked farmers not to load more trucks for the time being. The en-route trucks will arrive in the valley till today, but after that, it won't," Khadka said, adding that the prices could escalate twice the sum. "With what we have, we can only supply 10 per cent of the population for today. After that, we cannot," Khadka said.
"We have cleared the wastes, and we’ll start unloading trucks from tomorrow," Shrestha said, adding that the work wouldn’t have been successful without the help of Nepal Police, Army, Armed Police Force, and employees. A total of around 300 people had worked throughout the day to clear the night’s damage.
While clearing the wreckage is important to meet the feared food shortage, building the damaged infrastructure too is a priority. "The buildings can collapse anytime, and another fatality could occur," Khadka said.
The deceased include Hira Bahadur Pun, his two daughters, Shanti (16), Neera (14) and son Neerajan (12), Shah and one unidentified person. Pun's wife, Hikka is undergoing treatment at the Military Hospital, Chauni. Pun sustained burns injury. "She sustained 18 per cent burn injury, and as of now, is out of danger," Brig. Gen. Dr. Bachchu Ram K.C., commandant at the hospital said. Pun sustained injuries on her stomach, her right thigh and shoulders.
Nandan Kumar Datta, minister of Agriculture and Cooperatives expressed his shock, and disbelief to the incident. “I cannot express the shock I got this morning. Even now, it's difficult to breathe, I just cannot imagine what it was like when the fire was uncontrollable,” Datta said, assuring the victims with appropriate compensations.
HOW THE FIRE WENT WILD
A short-circuit triggered a small fire at the mid portion of the market. It slowly crept to sacks and dry bamboos. Within a few minutes, the fire started to grow. Later, two gas cylinders burst to exhume liquefied petroleum gas across the passage—only to result in uncontrolled fire.
A NEPALI NURSE WITH NIGHTINGALE'S HEART
Prabha Sharma used to read books on Florence Nightingale, an English nurse who helped soldiers of the Crimean war (October 1853 – February 1856) when she was young. Sharma was so much influenced by the life of the Lady with the Lamp that she decided her to pursue a career in nursing. However, Sharma's parents turned down her request to become a nurse. "Girls in my family weren't allowed to work. Becoming a nurse was very difficult for me," says Sharma with a smile as she goes down memory lane.
As the saying goes, hope shines brightest in the darkest of times. A small ray of light did shine for Sharma when her schoolteacher filled her form for nursing and asked her elder brother to sign it as Sharma's guardian. “I wanted to stand on my own feet,” Sharma shares. With her brother’s signature on the application, Sharma’s journey to become a nurse started. She has now spent four decades in the profession and continues to cherish her decision to become a nurse.
After passing her PCL in nursing in 1970 from Bir Hospital under government’s scholarship, Sharma started working at the hospital as a Staff Nurse. “I got a chance to work at Bir, while some of my batch mates were sent to different hospitals across the country,” Sharma shares.
During her stay at the hospital, Sharma received training in intensive care from Japanese nurses, and later qualified for a German scholarship scheme for nurses. In Germnay, too, she received training in ICU and Coronary Care Unit (CCU). “Four medical practitioners, Dhananjay Prasad Rimal, Dr. Pushkar Raj Satal, Nirmala Joshi, a technician named Gangalal Shrestha and I went to West Germany,” Sharma shares, adding that from there, she and Nirmala went to Veniceburg University to receive training in hemodialysis.
Although both could have become the country’s first nurses trained in hemodialysis, Joshi never stepped into the field. So, Sharma became the country’s first nurse trained in dialysis service. After completing her training, Sharma worked in Germany for two years.
Sharma was still in Germany when her mother died back in Nepal. She had already lost her father at the tender age of 12. Her mother's death was too much to bear with. So, she chose not to come back to Nepal, and instead went to the UK where she worked at St. Mary’s Hospital in Paddington, London for two years. Thus, she became the first registered Nepali nurse in the UK.
Sharma’s eyes well up with tears when she talks about her mother's demise. She wipes her tears and says, “I just did not feel like coming back to Kathmandu. Instead, I went to the UK and later, to the United States.” After staying for two years in the States, Sharma returned home and rejoined Bir Hospital.
Bir Begins dialysis service in Nepal
A decade after Sharma received her training in hemodailysis, Bir Hospital started dialysis at the joint initiative of Dr. Rishi Kumar Kafle and Sharma on Sept. 29, 1988. However, the hospital treated only clean cases (those who were not positive of tuberculosis and hepatitis).
On April 8, 1997, Sharma collaborated with Dr. Kafle to start the Healthcare Foundation-Nepal, (HECAF-N) a non-profit and non-governmental organization to treat clean as well as positive cases of dialysis. “During the last years of my stay at Bir, a patient came for dialysis. However, his blood test showed that he had TB. Since Bir didn't treat positive cases (it still doesn't), he was left to die. Then we thought of starting the National Kidney Center (NKC) under HECAF-N,” Sharma shares.
Since its establishment, HECAF-N has been training nurses in dialysis treatment. It has also helped start dialysis service at the Military Hospital, Teaching Hospital, Nepal Medical College, and a few hospitals at Nepalgunj, Pokhara and Bharatpur.
As the saying goes, hope shines brightest in the darkest of times. A small ray of light did shine for Sharma when her schoolteacher filled her form for nursing and asked her elder brother to sign it as Sharma's guardian. “I wanted to stand on my own feet,” Sharma shares. With her brother’s signature on the application, Sharma’s journey to become a nurse started. She has now spent four decades in the profession and continues to cherish her decision to become a nurse.
After passing her PCL in nursing in 1970 from Bir Hospital under government’s scholarship, Sharma started working at the hospital as a Staff Nurse. “I got a chance to work at Bir, while some of my batch mates were sent to different hospitals across the country,” Sharma shares.
During her stay at the hospital, Sharma received training in intensive care from Japanese nurses, and later qualified for a German scholarship scheme for nurses. In Germnay, too, she received training in ICU and Coronary Care Unit (CCU). “Four medical practitioners, Dhananjay Prasad Rimal, Dr. Pushkar Raj Satal, Nirmala Joshi, a technician named Gangalal Shrestha and I went to West Germany,” Sharma shares, adding that from there, she and Nirmala went to Veniceburg University to receive training in hemodialysis.
Although both could have become the country’s first nurses trained in hemodialysis, Joshi never stepped into the field. So, Sharma became the country’s first nurse trained in dialysis service. After completing her training, Sharma worked in Germany for two years.
Sharma was still in Germany when her mother died back in Nepal. She had already lost her father at the tender age of 12. Her mother's death was too much to bear with. So, she chose not to come back to Nepal, and instead went to the UK where she worked at St. Mary’s Hospital in Paddington, London for two years. Thus, she became the first registered Nepali nurse in the UK.
Sharma’s eyes well up with tears when she talks about her mother's demise. She wipes her tears and says, “I just did not feel like coming back to Kathmandu. Instead, I went to the UK and later, to the United States.” After staying for two years in the States, Sharma returned home and rejoined Bir Hospital.
Bir Begins dialysis service in Nepal
A decade after Sharma received her training in hemodailysis, Bir Hospital started dialysis at the joint initiative of Dr. Rishi Kumar Kafle and Sharma on Sept. 29, 1988. However, the hospital treated only clean cases (those who were not positive of tuberculosis and hepatitis).
On April 8, 1997, Sharma collaborated with Dr. Kafle to start the Healthcare Foundation-Nepal, (HECAF-N) a non-profit and non-governmental organization to treat clean as well as positive cases of dialysis. “During the last years of my stay at Bir, a patient came for dialysis. However, his blood test showed that he had TB. Since Bir didn't treat positive cases (it still doesn't), he was left to die. Then we thought of starting the National Kidney Center (NKC) under HECAF-N,” Sharma shares.
Since its establishment, HECAF-N has been training nurses in dialysis treatment. It has also helped start dialysis service at the Military Hospital, Teaching Hospital, Nepal Medical College, and a few hospitals at Nepalgunj, Pokhara and Bharatpur.
Qualities of a nurse: Benevolence personified
PRATIK RIMAL
Groping his left hand across the wall for a support, an old man panted and walked at a pace that seemed like eternity to reach his room, a few doors away from where he stood. “Excuse me, let me help you”, a nurse, clad in complete white dress at Om Hospital, Chabahil, gently said with a smile. Upon hearing the voice, he turned his head with a feeling of relief. Careful not to hurt the patient, she gently, but firmly held him and led him to his ward.
Menaka Adhikari has spent 30 years of her life in nursing profession. An assistant matron at Om Hospital and Research Center, Chabahil, Menaka passed her PCL in 2028 BS, and since then, has been in the profession. “I worked for 19 years at Bir Hospital, and have been working at Om Hospital since its establishment 12 years ago,” Adhikari shares.
Being involved in the profession for such a long time, she shares what it takes to be a good nurse, and what qualities budding nurses need to possess if they are to succeed. “A nurse should be polite,” Adhikari says, adding, “If they are not polite, they’ll cast a negative impression on the patient and their attendants. Such polite nurses should also have a smiling face, as it can win a person’s heart. “When you smile, it gives a feeling of assurance that everything will be alright. And this will boost the willpower and confidence of the patients,” Adhikari shares. However, she clarifies that it is not always easy to smile because nurses too have mood swings and conflicting emotions.
Other qualities that a nurse needs to possess are punctuality, tidiness and flexibility of time. If a nurse isn’t punctual or tidy, she would disappoint the patients and the service she is supposed to cater loses value. “A nurse should also be flexible. When they are asked to attend on duty at specific wards all of a sudden, they should make it on time,” Adhikrai adds.
Sharmila Lamichhane, a nurse at Deluxe Ward of the hospital shared what she learnt at her curriculum and was taught at the hospital itself. “A nurse should be tactful, disciplined, confident, hardworking and patient.”
“We get different patients and face difficult circumstances. I think we should have the tact, confidence and patience to gently, but firmly assure patients and their visitors that what we’re doing is for their own good,” Lamichhane adds.
“The nurses here are more polite and friendly than in other hospitals,” Raman Chettri, 43, a visitor of a patient at room 110 of the hospital opines.
Beena Bhattarai, a PCL pass out from Sushma Koirala Memorial Nursing College, Old Baneshwor, further adds the qualities a nurse should have. “Since we see deaths and serious injuries every day, we need to be emotionally strong,” She also regards communication skills, attentiveness to details as other qualities a nurse should acquire. “We deal with different patients and their visitors. Regardless of the number, we have to be able to attentively listen to the details they give, and reply in simple and clear language,” Bhattarai opines, adding that they should also possess the knack for problem solving.
What Adhikari, Lamichhane, and Bhattarai highlight are qualities that not only nurse, but all people need to possess. These qualities are universal human virtues that people must continually work and rework to pursue. Indeed, people need to be polite, but confident of what they speak. They also need to value time and thus be punctual. Patience is a human virtue which helps one to endure difficulties with tactfulness.
Groping his left hand across the wall for a support, an old man panted and walked at a pace that seemed like eternity to reach his room, a few doors away from where he stood. “Excuse me, let me help you”, a nurse, clad in complete white dress at Om Hospital, Chabahil, gently said with a smile. Upon hearing the voice, he turned his head with a feeling of relief. Careful not to hurt the patient, she gently, but firmly held him and led him to his ward.
Menaka Adhikari has spent 30 years of her life in nursing profession. An assistant matron at Om Hospital and Research Center, Chabahil, Menaka passed her PCL in 2028 BS, and since then, has been in the profession. “I worked for 19 years at Bir Hospital, and have been working at Om Hospital since its establishment 12 years ago,” Adhikari shares.
Being involved in the profession for such a long time, she shares what it takes to be a good nurse, and what qualities budding nurses need to possess if they are to succeed. “A nurse should be polite,” Adhikari says, adding, “If they are not polite, they’ll cast a negative impression on the patient and their attendants. Such polite nurses should also have a smiling face, as it can win a person’s heart. “When you smile, it gives a feeling of assurance that everything will be alright. And this will boost the willpower and confidence of the patients,” Adhikari shares. However, she clarifies that it is not always easy to smile because nurses too have mood swings and conflicting emotions.
Other qualities that a nurse needs to possess are punctuality, tidiness and flexibility of time. If a nurse isn’t punctual or tidy, she would disappoint the patients and the service she is supposed to cater loses value. “A nurse should also be flexible. When they are asked to attend on duty at specific wards all of a sudden, they should make it on time,” Adhikrai adds.
Sharmila Lamichhane, a nurse at Deluxe Ward of the hospital shared what she learnt at her curriculum and was taught at the hospital itself. “A nurse should be tactful, disciplined, confident, hardworking and patient.”
“We get different patients and face difficult circumstances. I think we should have the tact, confidence and patience to gently, but firmly assure patients and their visitors that what we’re doing is for their own good,” Lamichhane adds.
“The nurses here are more polite and friendly than in other hospitals,” Raman Chettri, 43, a visitor of a patient at room 110 of the hospital opines.
Beena Bhattarai, a PCL pass out from Sushma Koirala Memorial Nursing College, Old Baneshwor, further adds the qualities a nurse should have. “Since we see deaths and serious injuries every day, we need to be emotionally strong,” She also regards communication skills, attentiveness to details as other qualities a nurse should acquire. “We deal with different patients and their visitors. Regardless of the number, we have to be able to attentively listen to the details they give, and reply in simple and clear language,” Bhattarai opines, adding that they should also possess the knack for problem solving.
What Adhikari, Lamichhane, and Bhattarai highlight are qualities that not only nurse, but all people need to possess. These qualities are universal human virtues that people must continually work and rework to pursue. Indeed, people need to be polite, but confident of what they speak. They also need to value time and thus be punctual. Patience is a human virtue which helps one to endure difficulties with tactfulness.
KATHMANDU'S EMERGING SEX TOY MARKET
PRATIK RIMAL
The sex toy market in the capital has witnessed a steady growth over the past few years. The reason is the conservative Nepali society is gradually becoming liberal about sex. More and more people are opening up about sex, and sex related issues. And they no more hesitate to experiment if it enhances their sexual pleasure.
The number of people flying abroad for education or employment has been on a constant rise for the past many years. This has brought in not only brought remittance but also western cultures. "Increasing access to the media, Western culture and the rapidly changing socio-cultural and economic dynamics too have contributed to a change in the sexual behavior of Nepalis," said Sanjeev Pokharel, an anthropologist.
However, such changes were hardly noticeable when The Condom House and Sweet Secret were established three and five years ago, respectively. Yubaraj Neupane, proprietor of Condom House shared that his business was disappointing in the first year because very few people would enter his store. "Nepalis were not used to a public display of sexual items. Also, many would look down upon the shop as sex and sex-related issues were still a taboo for them," he said, "but things have changed over the past couple of years."
Each country has its own social and cultural beliefs. While these beliefs have their own value, they hold an individual back from trying something new, or say, doing something out of the blue and thus, learn through experiments. As a country opens up, it slowly breaks away with the social, cultural beliefs that are more restrictions than rules and Nepal is not an exception. "Things have really changed in Nepal over the past few years," Neupane shared.
"One of my friends is getting married. I am going to gift him condoms," Ayush Shrestha (name changed), a customer at the store shared. Shrestha, who himself buys condoms knows the importance of safe sex. "People should be open about sex with their partners. If you're open, you can be helped. If you are not, you are likely to get into one or the other problem," Shrestha said.
CONDOMS AND THEIR USE
There are many types of condoms in the market and one should know the kind of condoms to use on different occasions with different persons. Confused? Let truth be told: condoms are not as simple as they seem to be, and ignorance, here, is not a bliss.
Condoms aren't used only to prevent pregnancy or sexually transmitted diseases including HIV/AIDS. They also enhance the sexual pleasure, according to Neupane. "If the female partner is a virgin, one should use light, thin and lubricated condoms without dots," Neupane said. One should use such condoms because the girl's genital is yet to open and using dotted condoms could injure her during intercourse.
If it’s a woman who's already been pregnant, once or twice, the male partner should use extra dotted condoms with lubricant because the woman's genital has already eased and relaxed. Using dotted condoms will heighten her sexual pleasure.
If it is a prostitute, one should use plain, lubricated and dot less condom. Since prostitutes do it more for money than pleasure, it's likely that her genital is dry. Using a dotted condom could cause friction and tear it.
SEX TOYS
Sex toys are objects or devices that are primarily used to facilitate human sexual pleasure. Many popular sex toys are designed to resemble human genitals and may be vibrating or non-vibrating. A range of sex toys can be found in the market. Varying in the degree of features, male sex toys cost from Rs. 1500 to Rs. 25,000 while, for females, the price of sex toys ranges from Rs. 2800 to Rs. 8000.
Sex toys are sometimes seen as catalysts for sex, and are totally harmless if used properly. Neupane said that for sanitation, one should use condoms while playing with sex toys. "If they carelessly use and put it away, and then use it again, they could get infected," Neupane said, adding that sex toys were not for sharing. "No one should share sex toys," Neupane added.
BUSINESS
Neupane and Manjit Poudel, CEO of Sweet Secrets, started their business with an investment of around Rs. 800,000 and Rs 2.5 mill respectively. With little sales in the first year, Neupane doubted if he had taken the right decision. However, things have changed now. Neupane's business has been growing at a steady rate. People of all age groups come to his store to buy condoms. "Customers range from teenagers starting from 16 to as old as 70," Neupane said, "But sex toys business is yet to grow into a good business."
However, when Paudel introduced sex toys and condoms in the market five years ago, the response he got from people was that of appreciation. Nevertheless, Paudel did have some doubts on how the audience would view their shop. "We had apprehensions. But the feedback we got was startling," Paudel shared, adding, that more than 90 per cent of the people appreciated their work.
Paudel also says that sex toys are already a good business. He sells more than 100 sex toys a month. "Sixty percent of the buyers are males, while the remaining 40 per cent are females," Paudel informed.
The Condom House displays a range of condoms and sex toys for both men and women. The shop sees around 100 customers a day on an average. "People don't just come to buy condoms or sex toys. They also come for information regarding condoms and safe sex and ways to enhance sexual pleasure," Neupane said.
According to Neupane, the price of condoms ranges from a rupee to Rs. 700 per piece. "We do not have a condom manufacturing industry here, and therefore import from abroad," Neuapne said, adding that the store imports condoms from India, Japan, London, China, Malaysia, and Korea.
The sex toy market in the capital has witnessed a steady growth over the past few years. The reason is the conservative Nepali society is gradually becoming liberal about sex. More and more people are opening up about sex, and sex related issues. And they no more hesitate to experiment if it enhances their sexual pleasure.
The number of people flying abroad for education or employment has been on a constant rise for the past many years. This has brought in not only brought remittance but also western cultures. "Increasing access to the media, Western culture and the rapidly changing socio-cultural and economic dynamics too have contributed to a change in the sexual behavior of Nepalis," said Sanjeev Pokharel, an anthropologist.
However, such changes were hardly noticeable when The Condom House and Sweet Secret were established three and five years ago, respectively. Yubaraj Neupane, proprietor of Condom House shared that his business was disappointing in the first year because very few people would enter his store. "Nepalis were not used to a public display of sexual items. Also, many would look down upon the shop as sex and sex-related issues were still a taboo for them," he said, "but things have changed over the past couple of years."
Each country has its own social and cultural beliefs. While these beliefs have their own value, they hold an individual back from trying something new, or say, doing something out of the blue and thus, learn through experiments. As a country opens up, it slowly breaks away with the social, cultural beliefs that are more restrictions than rules and Nepal is not an exception. "Things have really changed in Nepal over the past few years," Neupane shared.
"One of my friends is getting married. I am going to gift him condoms," Ayush Shrestha (name changed), a customer at the store shared. Shrestha, who himself buys condoms knows the importance of safe sex. "People should be open about sex with their partners. If you're open, you can be helped. If you are not, you are likely to get into one or the other problem," Shrestha said.
CONDOMS AND THEIR USE
There are many types of condoms in the market and one should know the kind of condoms to use on different occasions with different persons. Confused? Let truth be told: condoms are not as simple as they seem to be, and ignorance, here, is not a bliss.
Condoms aren't used only to prevent pregnancy or sexually transmitted diseases including HIV/AIDS. They also enhance the sexual pleasure, according to Neupane. "If the female partner is a virgin, one should use light, thin and lubricated condoms without dots," Neupane said. One should use such condoms because the girl's genital is yet to open and using dotted condoms could injure her during intercourse.
If it’s a woman who's already been pregnant, once or twice, the male partner should use extra dotted condoms with lubricant because the woman's genital has already eased and relaxed. Using dotted condoms will heighten her sexual pleasure.
If it is a prostitute, one should use plain, lubricated and dot less condom. Since prostitutes do it more for money than pleasure, it's likely that her genital is dry. Using a dotted condom could cause friction and tear it.
SEX TOYS
Sex toys are objects or devices that are primarily used to facilitate human sexual pleasure. Many popular sex toys are designed to resemble human genitals and may be vibrating or non-vibrating. A range of sex toys can be found in the market. Varying in the degree of features, male sex toys cost from Rs. 1500 to Rs. 25,000 while, for females, the price of sex toys ranges from Rs. 2800 to Rs. 8000.
Sex toys are sometimes seen as catalysts for sex, and are totally harmless if used properly. Neupane said that for sanitation, one should use condoms while playing with sex toys. "If they carelessly use and put it away, and then use it again, they could get infected," Neupane said, adding that sex toys were not for sharing. "No one should share sex toys," Neupane added.
BUSINESS
Neupane and Manjit Poudel, CEO of Sweet Secrets, started their business with an investment of around Rs. 800,000 and Rs 2.5 mill respectively. With little sales in the first year, Neupane doubted if he had taken the right decision. However, things have changed now. Neupane's business has been growing at a steady rate. People of all age groups come to his store to buy condoms. "Customers range from teenagers starting from 16 to as old as 70," Neupane said, "But sex toys business is yet to grow into a good business."
However, when Paudel introduced sex toys and condoms in the market five years ago, the response he got from people was that of appreciation. Nevertheless, Paudel did have some doubts on how the audience would view their shop. "We had apprehensions. But the feedback we got was startling," Paudel shared, adding, that more than 90 per cent of the people appreciated their work.
Paudel also says that sex toys are already a good business. He sells more than 100 sex toys a month. "Sixty percent of the buyers are males, while the remaining 40 per cent are females," Paudel informed.
The Condom House displays a range of condoms and sex toys for both men and women. The shop sees around 100 customers a day on an average. "People don't just come to buy condoms or sex toys. They also come for information regarding condoms and safe sex and ways to enhance sexual pleasure," Neupane said.
According to Neupane, the price of condoms ranges from a rupee to Rs. 700 per piece. "We do not have a condom manufacturing industry here, and therefore import from abroad," Neuapne said, adding that the store imports condoms from India, Japan, London, China, Malaysia, and Korea.
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