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Dr Keyoor Gautam, consultant pathologist and founder of Samyak Diagnostics Pvt. Ltd., is driven by his responsibility towards his patients. Samyak Diagnostics was established in 2014 with a motive to make lab visits as convenient as possible. The seed was perhaps planted in 2012 when Gautam served as the head of the Department of Pathology at Grande International Hospital and helped build their laboratory system. Gautam, who did his post graduation in India, says diagnostic centers are well managed there unlike in Nepal. “Not just India, but elsewhere too, labs are efficiently run,” he adds. He felt Nepal lacked proper labs that were efficient and affordable. And his position in Grande was just what he needed to turn his vision of an ideal lab into reality. “But it wasn’t an easy task,” he says, “One of the basics of a good lab is easy flow for staff as well as patients, and I knew nothing about construction to do that.” There were times where he felt he wasn’t ready for the challenge. But what helped him, he says, was a word of advice from a senior. “He asked me to picture everything in my head, starting with how people would enter and move about,” he says, and so he did. Gautam was able to establish one of the most efficient labs in Kathmandu at Grande, but he says that came at a cost. He was barely able to see his family. “I knew I was doing good, but at the same time, it felt like I was not giving enough time to my wife and son,” he adds. Working hard for two years at the same institution, Gautam was skeptical if he could ever get a break. And that was when the concept of Samyak Diagnostics came to him. “I thought maybe with my own lab it would be easier to maintain a work-life balance,” he says, “But it took me another two years to finally get there.” Being a newly established path lab, he needed to be there from opening to closing. During the first couple of years, Gautam was the one to open and lock the lab doors. “I felt I needed to be available for my patients as well as the staff,” he says. Now, Samyak Diagnostics is among the best diagnostics labs in the valley, being the first to have ISO 15189 accreditation, an international standard requirement for quality management systems in medical laboratories. Their popularity grew because of word of mouth. People who visit the lab once recommend it to their family and friends. One of the reasons for that is the excellent service they provide. The staff are friendly and put you at ease from the moment you enter. They also ensure no one has to wait for more than five minutes. You also get informed when your lab results are ready, via SMS and email, saving you the hassle of having to check online or call to ask. Surprisingly, the place is affordable, and some tests are even cheaper than other hospitals and clinics, with special discounts for doctors, those in uniform, and some concessions for everybody else. Also, unlike at other labs, doctors are available for consultation in case patients want to discuss or understand their lab results. When asked how he manages to ensure such a friendly environment at the lab, Gautam says it’s because the employees are happy and content. His employees are his extended family and he says he will do whatever it takes to ensure the workplace is safe for them. “That is one of the reasons why I never started doing Covid-19 tests during the pandemic,” he says. Many people told him to provide covid testing, they told him it was a great opportunity to make a lot of money. But money, though an important aspect of business, has never been the basis of his decisions. Gautam mentions he didn’t want his patients to be scared to visit the lab during the pandemic and neglect their medical routine checkups. Being a stickler for discipline and hard work, Gautam reaches office at 7:00 in the morning and he is there till 4:00 pm. He even pops by for a little while on Saturday, which is his day off. He does this because unless he checks in on his team he feels something is amiss. “The hard work I put in ensures a good night’s sleep. I can sleep well when I know everything is running smoothly,” he says. The ISO 15189 accreditation helps put his mind at ease. There is a system that holds him and his team accountable, leaving absolutely no room for error. “One slip-up and the entire place will be shut down,” he says, adding sometimes things do go wrong, despite their best interests. But there is a system there too to ensure it is rectified. “To err is human but you have to own up to your mistake and correct it. That is what’s important,” he says. Samyak has sample collection centers at Baneshwor and Budhanilkantha. There is also the provision for home collection. It was started after much research on how long a test sample can be stored outside the lab. “While introducing new things, we don’t want to compromise on the service we provide,” he adds. Earlier there were many lab tests that couldn’t be done in Nepal. Samyak changed that. Many labs have followed in its footsteps and, as long as the competition is healthy, Gautam is happy that pathology as a field is evolving and becoming better. Having assisted in establishing quality path labs at Nepal Police Hospital in Panipokhari and the National Public Health Laboratory, Gautam believes good, reliable healthcare is everybody’s right, and he is working relentlessly towards making that happen. Gautam has also consulted for various government projects to establish labs in different parts of the country. It was under his guidance and expertise that the government managed to start six labs in Rukkum where healthcare facilities were limited to a bare minimum. As important as work is for him, Gautam realizes the need to spend time with his family, especially his son. It is what recharges him and makes him happy. He also enjoys sports. These days, he is into tennis, he says. He also hopes to retire when he is 50. “I want to learn Sanskrit after that. You have to invest in yourself too,” he says.

Ravi Thapa*, a 31-year-old with HIV, was admitted at a reputed hospital in Sunsari. One of the nurses threw medicines at him. She was scared to come near him. The doctors too were reluctant to check in on him during their daily rounds. His room was never cleaned—the staff never bothered to empty the trash. His wife complained, but the hospital administration blamed the patient for ‘bringing HIV to the hospital’. Thapa says visiting hospitals is the last thing he wants to do, even if he needs medical attention. Khagendra Khadka, president of the National Association of People Living with HIV/AIDS in Nepal (NAP+N), has been living with HIV for  26 years. Six months ago, he had a dental appointment. “I told the doctors that I have HIV. Perhaps that was my mistake because it delayed my treatment,” he says. He was then told to do a battery of tests that, he believes, was a way of chasing him away. “The treatment went smoothly at another hospital, where they didn’t know about my condition,” he adds. Khadka says this is nothing unusual. He has been in such situations numerous times since he was diagnosed. Anik Rana Magar, an LGBTIQA+ rights activist living with HIV for the past 25 years, says that nurses write ‘HIV positive’ in bright red letters above a patient’s bed. “This makes people stare out of curiosity. It completely violates a patient’s personal space,” she says adding doctors even deny taking on patients with HIV. Shivaram Giri, national coordinator of NAP+N, says the situation is as vexing if not more for those requiring surgeries. “Doctors deliberately push back the date of surgery to a month or so later even in critical situations. They want the patient to seek treatment elsewhere,” he says. Giri shares an incident that happened at the Tribhuvan University Teaching Hospital (TUTH) in Maharajgunj: A person with HIV was taken to the emergency room after an accident. Everyone there, he claims, was scared to be near the patient, causing much chaos and delaying treatment. These are only a few representative cases that show how people with HIV are treated at hospitals. According to data from National Center of AIDS and STD Control (NCASC), there are around 30,000 people currently living with HIV in Nepal. Most of them are migrant workers, drug users, sex workers, and individuals belonging to the LGBTIQA+ community. Majority of them are facing the same problem at every hospital department except at the Antiretroviral Therapy (ART) clinics, says Pinky Gurung, president of Blue Diamond Society (BDS). “Two years ago, we had to lose a friend as Bir Hospital was not willing to admit the patient,” says Gurung. Many hospitals, she adds, have told her to take HIV patients somewhere else. “When someone is in need of immediate medical attention, how do they expect us to run to another hospital?” she questions. Gurung, on several occasions, has found medical professionals openly denying to treat the infected or carry out their surgeries. This, she says, goes against the medical code of ethics passed by the Nepal Medical Council Act 1964 which states that in no circumstance can a doctor refrain from treating a patient. Dr Purnima Shakya, in-charge of ART clinic at Bir Hospital, says this is the outcome of how HIV has been perceived by our society for years. “People link HIV with having multiple sexual partners,” she says. This clouds the mindsets of even those in the medical field. They are much more comfortable working with infections more contagious than HIV. But HIV makes them uncomfortable. “It’s not an excuse but it’s true,” she says. Dr Bhola Rijal, a consultant gynecologist and former director of TUTH, verifies the claim. He says he has seen it happen all too many times. There are, he says, many misconceptions about HIV/AIDS among people in Nepal. “Only those who have worked closely with the infected have a better understanding of this issue,” he adds. Bleak situation  This reality weighs heavily on those living with HIV. As they fear being judged and mocked,  many refrain from testing for HIV, even when there are clear signs of infection, says Samata Bam, program coordinator at Cruise Aids Nepal, an organization that works with/for the infected. “Even if they do get tested, they don’t come for follow-ups. They don’t want to be seen near ART clinics because of societal stigma,” she says. Worse, many don’t seek medical aid even when they are severely ill. “They know it might cost them their lives yet they choose it over the discrimination they know they will face at hospitals,” says Bam. Binod Kumar Gupta, ART counselor from Meeting Targets and Maintaining Epidemic Control (EpiC) Nepal, says it’s already difficult for patients to accept their test result. “Many patients have discontinued their treatment because they would rather be in denial than take lifelong medication,” he says. Terrible treatment from hospital staff pushes them even further from acceptance. This has led to a number of suicides and suicide attempts among people who are unable to adjust with the new reality of being infected by HIV. Despite that, every month there are around 25 new HIV positive results out of the tested 150-200 individuals only at Sukraraj Tropical and Infectious Disease Hospital in Teku, Kathmandu. Manju Adhikari, chief of the ART clinic at the same hospital, informs that only few of the infected people are willing to get treated. In the fiscal year 2021/2022 according to the World AIDS Day 2022 factsheet, published by NCASC, there were a total of 1,365 reactive (may or may not be positive but is certainly not negative) cases out of the 97,455 tested for HIV infections, which is lower in comparison to the past years.  “Even if the statistics show the number of people with HIV is decreasing, there are a lot of cases unaccounted for,” says BDS president Gurung. “The situation was slightly better 10 years back when there was a lot of media support,” says Giri of NAP+N. “That’s not the case anymore. There’s very little reporting and awareness.” Government’s take Dr Samir Kumar Adhikari, deputy spokesperson at the Ministry of Health and Population (MoHP), says that the responsibility of working on anything HIV/AIDS related mostly falls under the jurisdiction of NCASC. And it has, he adds, has been working continuously to make our society friendlier for people living with HIV/AIDS. “Our job is to assist them,” he states. Lok Raj Pandey, senior health education officer at NCASC, says the government body has done its part to spread awareness and ensure a better environment, medically as well as socially for people living with HIV. He, however, denies the HIV infected face discrimination at hospitals. “We have not received such complaints so I can’t say with certainty if that’s what is happening,” he adds. On the other hand, activists and organizations ApEx talked to say they have relentlessly lobbied for the rights of people living with HIV/AIDS. Bam mentions that a bill to secure the rights of people with HIV/AIDS has been submitted in the past, but the government agencies have remained hostile. “There is nothing to protect the rights of people living with HIV till this date,” she adds. Khadka from NAP+N says the government also lacks space for people with HIV to lodge a complaint. “We don’t know where to go with our problems,” he says. He agrees with Bam on the fact that there aren’t any laws or policies that will back up those living with HIV when they face discrimination, not just at the hospitals but also in other sectors. Only a few days back, he says a child from Rautahat was not allowed to attend the school after they found out about his infection. “We had to change his school since there was no policy that could support our case,” he says, “even when the National Child Rights Council (NCRC) was on our side.” Although the government has done its part to provide the infected with free ART services, medications, and counseling, Khadka feels the same effort cannot be seen in terms of raising awareness about HIV/AIDS, especially among medical professionals. Dr Rijal believes that unless the government is willing to advocate about HIV/AIDS all year round, like they do on World AIDS Day, it’s highly unlikely for people living with HIV to get better healthcare in the future. *name changed

Prachanda Raj ‘Anil’ was one of the most prominent Supreme Court judges Nepal has had so far. He was appointed a Supreme Court judge on 9 July 1986. Since then, all his verdicts were guided by the need to provide justice, irrespective of the risks and threats that might bring his way. “My father vowed to provide justice, even if doing so put a price on his head,” says Arun Raj Maskey. Prachanda Raj was indeed fearless. During Nepal’s panchayat regime, he was an official of the then Regional Court. However, he didn’t refrain from delivering verdicts that were against the Panchayat system. He was once presented with a case of an individual against the ruling class. He declared the individual to be innocent and that pitted him firmly against the then autocratic rulers. “My siblings and I were just kids back then, but we still remember the day he announced that verdict,” says Arun. “There are many other incidents, that we cannot quite recall in detail, where we knew his verdicts made him unpopular with the regime,” adds his brother Pawan Raj Maskey. It was the same principle that guided Prachanda Raj while investigating the mysterious death of Madan Bhandari, a political leader of the then Communist Party of Nepal (CPN), in 1993. Currently, his death is an unsolved case, but the Prachanda Raj-led investigation had declared it to have been an unfortunate accident. This announcement had gotten him on the bad books of the then CPN. Pawan remembers the tough days that followed after his father delivered the verdict. He says it was a scary time for the family. “We had to endure a lot of physical, mental, and emotional trauma for quite a while,” he says, adding that there were times when their neighbors alerted them of goons surrounding their house, looking for opportunities to harm them. He recalls the day when some people from the media had come to interview his father and their cameras were vandalized. “We all knew it was the party showing their dismay with the verdict,” he says. After all that he did to provide justice to the innocent, Arun says he is dismayed that the Nepal government didn’t give his father his due. Prachanda Raj was appointed the additional judge of the Supreme Court in 1986. He was, apparently, in line to become the Supreme Court chief justice. Unfortunately, the position was dismissed by former Chief Justice Bishwonath Upadhyaya when he was the chairman of 1990 constitution drafting. “My father was terribly upset about it. He actually never got over it,” says Arun. But that didn’t deter his generous spirit. His sons remember him as a kind and gentle man. He was already ready to help anyone in need. If someone came knocking at their door for monetary help, their father did all that he could to help that person, they say. “We remember him handing away his jewelry if he didn’t have cash when someone asked for financial assistance,” says Pawan. The 91-year-old breathed his last on 5 Dec 2022 in the city he was born in: Kathmandu. He is survived by his wife and five children. Birth: November 1931, Kathmandu Death: 5 Dec 2022, Kathmandu 

Every year, thousands of Nepalis fly to foreign countries in search of jobs. Around 90 percent of them end up in Persian Gulf countries. Ideally, a foreign job aspirant is only supposed to pay only for medical, insurance, and pre-departure orientation training, which amounts to around Rs 8,000. But overseas job recruitment agencies, commonly referred to as manpower agencies in Nepal, have been charging an average of Rs 100,000 from each person. They are openly going against the ‘free visa, free ticket’ policy introduced by the government in 2015. Anushka Nepal of ApEx talks to Umakanta Acharya, director general, Department of Foreign Employment on the matter.  Why aren’t job recruitment agencies following the ‘free visa, free ticket’ policy?  When the policy was made public, many agencies showed their dissatisfaction. There were concerns that they might go out of the business. They didn’t like the fact that the government did not consult them before announcing the policy. One reason could be that dissatisfaction. Also, there is an unhealthy competition among manpower agencies on who gets more demand for workers. They are even paying the employers to bump up the worker demand numbers. Some of them are doing this in order not to run out of business, while others are doing it out of greed. As a result, none of the agencies are willing to follow the rules.  The department should receive many complaints regarding this matter. So, What is the department doing?  Yes, we do get several complaints in this matter. But in most cases, there is not enough proof to support the workers’ claims. Manpower agencies do charge exorbitant fees from their clients, but they issue payment receipts for just Rs 10,000. So, without the document of proof to produce it in the court, we cannot pursue the case. The best we could do is to claim for the money people have paid to manpower agencies, and fine those companies if we have some kind of incriminating evidence. There is no legal provision to shut down the agencies, so they go on with their work even if the department has fined them.  Has the department worked on investigating these issues? If so, why has there not been any significant change in favor of the migrant workers?  We do launch investigations into the complaints we get from aspirant migrant workers. The goal of our investigation is to gather enough proof so that the matter could be taken to the court of law. But, like I said before, we rarely find substantial proof of wrongdoing to pursue the case legally. Secondly, a person will drop the case once the recruitment company promises to return their money. This takes away the reason for our investigation. So we haven’t been able to pursue a case thoroughly. There are aspects of money laundering, human rights violation, and also the breach of policy that needs to be looked into, but all of them do not fall under the jurisdiction of the department. One way this could work is if all the associated departments at the ministry were to collaborate while investigating complaints. It is said that manpower agencies enjoy political patronage that stops them from being held accountable. Is this true?  Yes, it is true. Many successful agency owners have a direct or indirect involvement with politics. In Nepal, we all have witnessed how political influence can help an individual get out of a situation no matter how bad. The same goes for manpower agencies. Even when the department is willing to take action, political parties and their leaders protect manpower agencies and their owners. This has given them the confidence to violate regulations and take part in unlawful activities, because they know the authorities cannot touch them. It is a dangerous power they hold, which affects migrant workers the most.  A former labor minister himself owned a manpower agency. Did it not show a conflict of interest?  Obviously, it shows a conflict of interest. The government should not have appointed him in the first place. I cannot say for certain that he had a direct influence in the policy regarding migrant workers and job recruitment agencies. But what I can tell you is that there are many ways, not visible to the public, through which he could have misused the power to help his business interests. He was the minister before I joined the department, but I have heard some of my colleagues say that they felt unsafe during his tenure, that they were hesitant to open an investigation into the malpractices and irregularities reported in foreign job recruitment agencies. When people from the department themselves are scared of doing their jobs, you can imagine which side the minister leaned heavily on.

Narayan Sigdel, a 35-year-old migrant worker from Nawalparasi, Gandaki province, went to Qatar in 2017. He was working in Al Bayt Stadium until March 2020, when he got deported. Before leaving for Qatar, Sigdel paid Rs 80,000 to take his foreign employment process forward. He says he gave money to Orion Overseas Pvt Ltd, located in New Baneshwor, Kathmandu. “The company took Rs 65,000 while the rest of the money was used for health check-ups, insurance and orientation,” he says.  Ranjan Nepali, 25, wife of Shree Krishna Nepali, 26, from Gorkha, Gandaki province, who died in a road accident in August 2022 in Qatar, says that her husband left home with Rs 120,000. “He told me it was for the application process,” she says. He left for Qatar in 2018.  There are many like Sigdel and Nepali who have paid anywhere between Rs 50,000 to Rs 300,000 to recruitment agencies, although the Nepal government announced the ‘free-visa, free-ticket’ scheme in June 2015. The scheme states that migrant workers will only have to pay for insurance, medical check-up, and pre-departure orientation training, which amounts to Rs 8,000.  The manpower agencies will be allowed to take a maximum of Rs 10,000 only if the employers are reluctant to pay the service charge. The visa and round-trip flight tickets are supposed to be the responsibility of the employers. This policy applies to seven countries: Kuwait, Oman, Qatar, Bahrain, Saudi Arabia, the United Arab Emirates, and Malaysia.  Free-visa, free-ticket—which can also be understood as Employers Pay Model—dates back to 2007, when Nepal signed a Memorandum of Understanding (MoU) with Qatar, which stated workers will not have to pay a single paisa during the recruitment process (excluding fees for health check-ups, insurance and pre-departure orientation). However, in 2010, the government announced that manpower agencies could take Rs 70,000 to Rs 80,000 from the applicants. The 2015 scheme changed that, at least on paper. The ground reality remained the same.  Jeet Bahadur Magar, chairperson, Nepal Manpower Pvt Ltd, a recruitment company, admits that the agencies, including his, have not followed the rule. He claims there is no other way but to take money from migrant workers to run their businesses.  To put this into context, it becomes necessary to understand how the foreign employment process has been going on so far. Most of the manpower agencies are competing amongst themselves on who gets the maximum demand for human resources from employers, be it Nepali or international recruitment agencies. Ideally, the employers are supposed to pay a certain amount of service charge to these companies, and bear the cost of visas and tickets. But instead, manpower establishments have been paying potential clients to get more business in the future. The cash for this dubious transaction comes from the applicant’s pocket.  “Many agencies follow the same method and potential employers only reach out to those companies that pay them for their demands,” says Magar. “No employer will work with companies who will ask for a service charge even though that is the legal process.” Many recruiters are also reluctant to pay for the visas and round-trip flight tickets because of the trend set by Nepali recruitment agencies.  Even though people are aware of the ‘free-visa, free-ticket’ scheme, they have no other option but to pay the amount asked for by the manpower companies, says Maya Kumari Sharma, former ambassador of Nepal to Qatar. “They don’t have good opportunities to work in their own country so there’s nothing they can do but cough up the money somehow,” she says. And indeed, people choose to go abroad after being turned down for jobs in Nepal. Nepali says that her husband left for Qatar when he was 21 years old. He wanted to send money back home. Though she was involved in farming and husbandry, it wasn’t enough to sustain the family. “He was the only breadwinner in the family,” she says. Her husband would not have left her to live alone in Gorkha had he seen any other possibilities for them to make a living, she adds. One of the many reasons why Sharma believes the government hasn’t taken any action is because many of these recruitment agencies have political connections. “Their political affiliation is their shield. So they carry on with their illegal activities while the workers suffer,” she says. Umakanta Acharya, director general, Department of Foreign Employment (DoFE), agrees with Sharma. “Nepal has a longstanding history of political influence in every sector. It’s not just the manpower agencies,” he says. “Even when we have tried to take action, they have been protected by their political clout.”  On the other hand, if the workers were to take legal action, they don’t have substantial evidence. The agencies, out of fear of getting caught, only make vouchers that round off to Rs 10,000, even when the bills are much higher. Magar verifies the claim. “The workers are faced with a take it or leave it situation, with the agencies always safeguarding themselves,” he says.  Acharya adds there are several complaints lodged at the DoFE. But with no substantial evidence to prove that the agencies have taken money amounting to more than what is legally allowed, there is nothing the department can do. “All we can do, that too in a handful of cases, is help the workers get their money back, and fine the manpower agency,” he says. Since there is no legal provision to shut down the company, the cycle continues.  There are other alternatives for the government to look into the works of manpower companies, which the authorities have, so far, conveniently chosen to ignore. “Many manpower company owners have invested in several properties. The investment isn’t justified by the money they should be earning legally,” says Roshan Sedhai, an independent journalist who has reported extensively on the plight of migrant workers. Acharya says it’s the Department of Money Laundering Investigation (DoMLI) that needs to take the necessary actions against the agencies but there’s been nothing but silence on that front.  Hari Thapa, chairperson, National Network of Safe Migration (NNSM), an organization working for Nepali migrant workers, says an elaborate investigation should be launched, failing which a simple inspection at the airport would be enough to open a pandora’s box. Acharya says the DoFE initiated an investigation but nothing came out of it due to lack of substantial evidence.  Acharya believes one of the many reasons behind the failed investigation is different departments working in isolation rather than in collaboration with one another. There are issues of money laundering, breach of government policy, as well as human rights violation, none of which fall under the jurisdiction of the same government office. Unfortunately, until and unless there is one department to look into all the issues, Acharya says, migrant workers will continue to suffer at the hands of these unscrupulous manpower agencies.

The menstrual cup, a reusable feminine hygiene product, has become quite popular in Nepal. Jay Prakash Singh, co-founder of Padshala Nepal, says in the past five years, their customer base has been steadily increasing. The store, which also takes online orders, delivers around 15 cups every day. There are even more people visiting the store. The customers, Singh says, are mostly between 18 to 30 years old.  Dr Bhola Rijal, gynecologist and obstetrician, says most of his patients tell him they started using the cup because their friends or colleagues recommended it to them. “Women who are using menstrual cups seem to advocate for it. It’s become popular through word of mouth,” he says. There are many reasons why period cups are so popular among women, one of them being its efficiency. Women ApEx spoke to say that a menstrual cup saves a lot of hassle. You don’t have to buy multiple packets of sanitary pads each month or worry about proper disposal. Some said it has also made traveling easier. Priyanshu Joshi, a 21-year-old student from Sanepa, Lalitpur, has been using a menstrual cup for almost two months now and says switching to it has been the best decision she has made. Earlier, she had to be hyper aware about leakage and change sanitary pads time and again. Not to mention the discomfort that comes with using sanitary pads. Since switching to the cup, her periods are stress free for at least twelve hours at a stretch. “There are times when I forget I’m on my periods since the menstrual cup is comfortable,” she says. Joshi has also been able to monitor her period flow. “I can check the color and consistency of my period blood. That has helped me understand my period better,” she says. She finds it has also helped tackle the problem of period odor.  Priyanka Neupane, a 20-year-old from Sinamangal, Kathmandu, who is studying to be a CA, has been using a menstrual cup for two years. She says she was nervous at the beginning but since she has always had excessive bleeding in every menstrual cycle, sanitary pads were turning out to be an expensive and unreliable option. She says on days when she doesn’t have cramps, she doesn’t even realize she has her periods. Apart from the physical comfort it brings, Neupane says it has also helped to hide her periods. “Coming from a conservative family, period has always been a big issue,” she says, “But with menstrual cups, no one finds out when it’s ‘that time of the month’ for me.”  Many women still can’t talk freely about menstruation in their homes, let alone protest against the various taboos that come with it. Hima Bista, a women’s rights activist, thinks differently. “Why would you hide it when you should be talking about it openly and breaking the taboos instead?” she asks.  But despite wanting to, it’s not easy for many women to go against norms that their parents and grandparents believe in. They also don’t want to hurt their loved one’s sentiments, especially if they are old and thus rigid in their ways. Aarzoo Nepal, 22, who works at Kantipur Media Group, says it took years of struggle for her family to finally understand that menstruation is a natural process. “These things can’t be rushed,” she says.  Nikki Gautam, 22-year-old who lives in Dhobighat, Lalitpur, says a woman once claimed to feel ill as she assumed Gautam made her tea while on her period. Entering the kitchen, or even touching kitchen utensils for that matter, when on your period is thought to be the harbinger of bad luck. “It’s funny how menstruation is everyone’s problem when in fact it’s not any of their business,” she says. With the menstrual cup, Gautam says, it’s been easy to hide her periods and make it no one’s business but her own.  Anju Thapa GC, owner, Anju Sanitary Pad, a company that makes reusable and eco-friendly sanitary hygiene products, says many women have visited her store in search of menstrual cups, mostly after it was recommended to them by someone they knew. But most of them aren’t comfortable using it immediately after buying it, she says. “Some of my regular customers say they haven’t started using the cup despite buying one a while ago. Many confessed they were scared when using it for the first time,” says GC. However, those who use the cup say it’s really easy once you get the hang of it.  There are certain things that make using menstrual cups difficult. There aren’t good public washrooms, or proper washrooms in most workplaces where women feel comfortable enough to clean their cups. Sushrusha Aryal, 21, who studies at Kathmandu University, has been using a menstrual cup for two years. On days with heavy bleeding, she needs to keep emptying her cup, and that’s always a problem. She always carries sanitary pads to use in case of leakage. “After that, I’m always on the lookout for a place where I can clean up. I almost always have to return home in a rush,” she adds.  There’s also the problem of figuring out which menstrual cup fits the best. Priyanjali Karn, 20, student, St. Xavier’s College, Maitighar, who has been using a menstrual cup since 2020, says she has to use sanitary pads in addition to a menstrual cup on the first two days of her periods. This, she says, might be because the cup is too small for her.  “I bought it immediately after hearing about menstrual cups. As a first time user, I don’t think I knew which size would work for me,” she says. Indeed, women ApEx spoke to claim there isn’t much information on how to choose the right size. They have had to use the hit and trial method to figure out what works. Then there are also women who have bought menstrual cups but are unable to use it as they don’t know how.  “It’s natural to feel the pain or uneasiness when you first try to use it. But greasing the cup can make the insertion smooth,” says Prof Dr Eliza Shrestha, a gynecologic oncologist at Bhaktapur Cancer Hospital. She says the best thing to do is to wet the cup or use a water based lubricant to reduce the pain. “A wet menstrual cup is much easier to insert,” she adds. However, like any other sanitary product, a menstrual cup may cause infection. Dr Shrestha says it’s best to avoid using it if you have a history of allergic reactions or vaginal irritation.  Every woman’s body reacts differently when a foreign object is placed inside. Dr Rijal says he has had patients come to him with problems like increased mood swings and pelvic discomfort after using a menstrual cup. He also recommends proper washing of cups, with a good disinfectant, between uses. “Though I normally recommend a disposable cup, if you take good care of the cup and sterilize it properly, it can be a good sustainable alternative to pads and tampons,” he says. Women ApEx spoke to agree—despite having some drawbacks, the menstrual cup has made their periods so much more convenient, they say.

With the 2022 FIFA World Cup under way, there is an inevitable excitement among football fans. They already have their favorites. Anushka Nepal from ApEx talked to 10 fans to find out which teams are they rooting for.   Puzan Shrestha My elder brother was an England fan. Maybe because of his influence, I also started loving the England team since the 2010 World Cup. This time, there aren’t any elite opponents in our group. So, we’ll easily advance from the group stage. England has a strong squad that can take on any opponents. I do have a little concern with our defender Harry Maguire, as he is known to slip off on many occasions. If he could perform better, I’m sure no team could challenge us to win the World Cup trophy. Shrutee Gautam I have been a Messi supporter since my high school days. Everyone in my class knew that, so you can understand how much I must have talked about him. So, obviously, I am supporting Argentina, which I have done since the 2018 World Cup. I believe he deserves to take the trophy home this time. This is his last World Cup and it is a huge deal, since he is one of the greatest players in the history of football. So, with his last World Cup, I want to see Argentina take the trophy.   Nishant Aryal I am supporting Argentina because of Leo Messi. I have done so since the 2019 World Cup. I follow all of Messi’s games. As this could be the last world cup of the greatest of all time, I am excited to watch Argentina lifting the world cup. Coming to the World Cup, we were among the favorites to win. But the defeat against Saudi Arabia in the first match left us heartbroken. Yet, there is hope that we will qualify. I know the players will fight till the last breath for the glory of their nation and to win the hearts of the fans once again as they did back in Copa America. Ojaswi Khanal I have been watching football since I was a fourth grader. The first time I watched the World Cup was when I was in grade eight. Since then I have been supporting Argentina. I want Argentina to win it because of Messi. As they say football owes Messi a World Cup. He is the greatest of all time and he deserves to win this World Cup for all the things he has given. Although he did win Copa America with this team, winning the World Cup is his dream.  Dikshant Siwakoti  The first international football game I watched was between Brazil and Germany. It ended in a draw, but the two Brazilian players—Ronaldinho and Ronaldo Nazario—stole my heart. So, I started to watch football just for these two players. As I grew up and started understanding football from technical and tactical points of view, I found watching Brazil’s games was even more exciting. I have been a Brazil supporter and these days, I see the reflection of Ronaldinho and Ronaldo in Neymar Jr.  No other team has a better squad depth than Brazil this time. Even our non-starting line-up could beat the other teams. We are confident about this World Cup despite the fact that Neymar picked up an injury in the first game and has been ruled out from the group stage games. We are eager to put the sixth star in our jersey. Roshan Dahal I was 10 years old during the 2010 World Cup. Everyone in my village had their favorite teams but I had none. So, I asked my brother which team I should support and he suggested Argentina. In the quarterfinal match between Germany and Argentina, I was awake till 12:30 am cheering for Argentina. Unfortunately, Germany thrashed Argentina 4-0. The Germans were impressive. From that day, I started following Germany. They lost that World Cup, but won the next one. We don’t have that many experienced players in our squad this time. So, I don’t think we can win the trophy this year. Saurav Karkee I started watching and playing football because of Cristiano Ronaldo. I saw him play for Real Madrid in 2013 and ever since, I have been a huge admirer of his. I have learned a lot after watching him play. I supported Portugal in the 2014 World Cup as well as in the 2016 Euro. Despite being an underdog, Portugal won the Euro. It was Ronaldo’s first-ever international trophy. The World Cup is the only trophy that he lacks. This time, we have a balanced team with a mixture of some young talents and experienced players. It looks good on paper. I think Portugal will play good football and obviously, it is Ronaldo’s last World Cup and every player will try their best to make all the Portuguese fans’ dreams come true.  Paranjaya Nepal Usually, I support the country that has many players from Manchester United. But this time, I am supporting Argentina, because of Messi. He is one of the greatest players of our generation, and possibly, a greatest player ever. I don’t think any player of past or present can beat him. It feels like him not winning a World Cup would be an injustice to the talent he has shown in his previous games. So I want Argentina to win this World Cup.  Kareena Bhattarai I started watching the World Cup from 2010 South Africa because all my family and friends were football enthusiasts. My brother was an Argentina fan and like any other sister, I wanted to support a team that would turn out to be a competitor—such a silly reason right? I then started following Brazil as it had already won five world cups. Even though I started supporting them with no good reason whatsoever, I am now a die-hard Brazil fan. This time too, they are the favorites. Pratha Gautam I am not supporting any team in this World Cup, and I have my reasons. I have always liked Germany, though. I am currently living in Poland, so I do root for Poland during their matches. But I don’t have any particular team that I wish would win the World Cup this year.

Samir Shrestha, 37, wanted to make the world a better place for children. He recalls wanting to work for children’s rights ever since he was old enough to understand its importance. Working with children who have cancer, however, was a spur-of-the-moment decision. It all started when he went on a cycling rally across Bangladesh and India. The rally was a form of demonstration to protect the rights of street children. Seeing those children in vulnerable conditions was heartbreaking. When he came back to Nepal, he started asking around to get a better idea of their situation. “I found out there are many organizations working for children’s rights. There were orphanages and other forms of support,” he says, “But none of them focused on supporting children with cancer.”  This was why he started volunteering at the oncology ward at Kanti Children’s Hospital in Maharajgunj, Kathmandu. Shrestha laments that he didn’t have the needed resources to financially assist these children. But he was a steady source of emotional support, which, for many families, brought a lot of relief. “They would tell me how they were feeling. Being able to talk about their problems lessened it a little,” he says. Growing up without a father since he was 12, Shrestha knew what it was like to lose your sense of belonging. Despite his basic needs being met and his uncle (with whom he lived after moving to Kathmandu) being kind to him, he never really felt at home without his father’s presence. He wanted to give the children he worked with what he never had—a feeling of comfort and belonging. As a regular volunteer, the children would look forward to his visits when he would read to them or help them with their meals. “The hospital would call me quite often as the children would not eat without me,” he reminisces.  Shrestha says what he saw while working at the hospital was traumatic. The children were no doubt going through a lot but watching the parents wait around helplessly was even worse. Sometimes, the doctors used to give them money to go home or eat something, he says. The situation was as bleak as it could get as many didn’t have money to even buy little things like masks and gloves. When faced with such a financial crisis, it was difficult for the parents to be emotionally available for their children. “I realized I had to do something to bridge that gap, provide the support that the parents couldn’t,” he says. So, in August 2006, he established the ‘Dirghajeevi Voluntary Group’ that worked in collaboration with the oncology ward at the Kanti Children’s Hospital until 2015. The NGO was established with just 12 members and they had no outside help. The members invested what they could to start off on the noble venture. Their first priority was to make the oncology ward at the hospital more child-friendly. Shrestha says the space looked like an abandoned corridor. The volunteers wanted to give it a much-needed facelift. As days went by and they continued with the work, people reached out to Shrestha and his team. They wanted to help. However, Shrestha didn’t want to take monetary help. He wanted them to visit the hospital, see what they were doing, and decide for themselves how they could contribute. A lot of foreign sponsors, he says, were happy to hear that. Many pitched in to give the oncology ward a complete makeover. Some scrubbed floors and painted the walls while others put up boards and nameplates to demarcate the space. “We even received cupboards and many other essential things,” says Shrestha. After a decade of working exclusively with children at the hospital, he thought he hadn’t been able to do enough. Something felt amiss, he says. They had built a nice ward for the children and would help the parents when needed but they were unable to provide the emotional support the children desperately needed. When the children went home, they often had no one to support or counsel them, he says. In 2018, with a vision to create a psychologically and psychosocially supportive environment for these children, Shrestha started a daycare center. The Loving Heart Daycare Center, located in Imadol, Lalitpur, is a space that focuses on the mental well-being of children who are cancer survivors. The daycare has everything a child would need to heal from the trauma—from counselors to individual and communal activities. “It’s like a big support group to make these children feel heard, seen, and understood,” adds Shrestha. The establishment does not promise to provide parents with medical or financial assistance. It’s solely for psychological support. The good thing is that there is no membership fee at the daycare center. It’s free. They also have counseling sessions for parents who feel like they need some emotional support too. “It’s difficult to watch your child suffer and not be able to do much about it which is why we also provide psychological guidance to parents as and when needed,” says Shrestha.  Recently, they hosted the ‘First Childhood Cancer Survival Meet’—an event where children who beat cancer and their parents could share their stories with other children cancer patients. The goal was to boost the morale of those currently suffering from cancer and let them know they weren’t alone as well as help parents make sense of things. The first-of-its-kind event was an immense success, says Shrestha. People left feeling unburdened and hopeful. “It was a heartwarming time and we hope to give continuity to our work to be able to make children’s battles with cancer a little less stressful,” he says.