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The Indian government on Saturday imposed a 40 percent additional duty on the export of onions ‘to check price rise and improve supplies in the domestic market’, sending distress signals in Nepal and other countries in the neighborhood that have been grappling with rising inflation, food inflation in particular. As per the Nepal Rastra Bank’s annual report released on Aug 18, annual average inflation remained 7.74 percent. 

“This notification shall come into force with immediate effect, and will remain in place till 31 Dec, 2023,” reads the Finance Ministry notification. The export duty comes amid reports that onion prices are likely to rise in September.

Media reports quoted Consumer Affairs Secretary Rohit Kumar Singh as saying that the step is meant to improve the domestic availability of onions and contain the price rise.

The move comes amid the Narendra Modi government’s plans to keep a buffer stock of three lakh tonnes of onions for the 2023-24 season against 2022-23’s buffer stock of 2.51 lakh tonnes.

The Indian government has already imposed restrictions on the export of wheat and rice after reducing import duty on edible oils as part of its effort to provide relief to the people.

The export tax is expected to increase prices in countries like Nepal, which depend on Indian onions that cost around Rs 65 per kg in the Kalimati fruits and vegetable market before the tax surge.

With the government of Nepal already imposing a 13 percent value added tax on onions, the price of onions is almost certain to go further up after the Indian move. 

“As Nepal is dependent on India for onions, the latest export duty hike will increase onion prices in the domestic market also. The hike has taken effect from Saturday night, meaning fresh consignments enter Nepal with a hiked price. We don’t have domestic production, so the onion price in Nepal will include the hiked export tax,” says Binay Shrestha, information officer at Kalimati fruits and vegetable market.

Recent days have also seen tomato prices shoot up in Nepal, with the prevailing scarcity in India pushing tomatoes across the border, as if rising prices of rice and wheat were not enough.

With the rise in the prices of onions, tomatoes, rice and wheat along with petroleum products that fuel transportation, the Nepali kitchens are becoming more and more expensive to run.

The World Health Organization has said that it is currently tracking several Covid-19 “variants of interest,” including EG.5 which is on the rise in several countries. The UN health body said that the EG.5 variant of the coronavirus nicknamed “Eris” is spreading quickly and widely.

“The risk remains of a more dangerous variant emerging that could cause a sudden increase in cases and deaths,” said Director-General Tedros Adhanom Ghebreyesus in Geneva on Aug 9.

What is EG.5?

EG.5 is a sublineage of the omicron variant and has been detected in 51 countries, including the United States, China, South Korea and Japan, according to an initial risk evaluation of the WHO.

EG.5 is a descendent lineage of XBB.1.9.2, which has the same spike amino acid profile as XBB.1.5. It was first reported in Feb 2023 and cases have been increasing steadily.

Globally, there has been a steady increase in the proportion of EG.5 reported. During epidemiological week 29 (17-23 July), the global prevalence of EG.5 was 17.4 percent. This is a notable rise from the data reported four weeks prior (19-25 June 2023), when the global prevalence of EG.5 was 7.6 percent.

Because of its growth advantage and immune escape characteristics, EG.5 may cause a rise in case incidence and become dominant in some countries or even globally, the WHO has warned.

What symptoms does it cause?

The symptoms seem to be the same as those caused by other strains, said Dr Sher Bahadur Pun, Chief of the Clinical Research Unit at Sukraraj Tropical and Infectious Disease Hospital.

Symptoms similar to other variants of coronavirus such as a runny nose, headache, fatigue, and sore throat and sneezing are common. People who are older, have compromised immune systems, or suffer from multiple other conditions are at higher risk for more severe effects which may include lower respiratory disease, chest pain and shortness of breath.

Is Nepal prepared to handle a rise in the number of cases?

Nepal has seen a total of 1,157,462 coronavirus cases as of Aug 15, as per the Ministry of Health and Population. A total of 12,031 deaths have been reported across the country. 

There was a massive rise in the number of coronavirus cases during the spread of the Delta variant. At the time, there was a severe lack of oxygen, hospital beds, human resources, and medical equipment in hospitals and other health facilities. But Nepal has not learnt lessons from the past, said Dr Pun. “If there is a sudden rise in the number of cases, it will be difficult to handle the cases.” 

The government has already scrapped the Covid-19 protocols. As per the protocol international passengers no longer have to carry negative PCR test reports and Covid vaccination certificates. Also the restrictions that were imposed for the prevention of the coronavirus infection have already been lifted.

When there is a rise in the number of cases in foreign countries due to the new variant, it is very likely that the same variant could enter Nepal. “We have to monitor our borders, strengthen our health system and increase surveillance,” said Dr Pun.

Recommendations to prevent the virus

In response to the new variant and rise in the number of cases, the WHO has published various recommendations, which include updating national Covid-19 programs to move towards longer term sustained management of the disease. It has also urged countries around the world to continue collaborative surveillance to detect significant changes in the virus, as well as trends in disease severity and population immunity.

WHO chief Tedros called for all countries to report Covid-19 data, especially on death and severe disease, genetic sequences and vaccine effectiveness.

“Governments should continue to offer vaccination against the disease, especially for the most at-risk groups, and ensure equitable access to vaccines, tests and treatment,” he said during a press conference in Geneva.

The WHO has also added that all countries should deliver optimal clinical care for Covid-19, including access to proven treatments and measures to protect health workers and caregivers.

The coronavirus first emerged in Wuhan, China, in late 2019 and WHO declared the global pandemic the following March. Since then, nearly seven million people have died from Covid-19, and there have been more than 769m confirmed cases worldwide.

What can you do to protect yourself from the new variant?

Vaccination is important for those who are elderly and have weakened immune systems. To prevent oneself from the new variant one must get vaccinated, wear a mask and avoid crowds and poorly ventilated spaces. 

For a sizable number of young students, English is quite hard to crack, as the recently-published results of grade 12 show. Out of 448,837 students, a whopping 109,527 got non-graded (NG), in the words of the National Examination Board (NEB). In plainspeak, almost a quarter of the grade 12 examinees failed their English papers as they could not even score 35 percent.  

It has been years since schools—not only private and boarding schools but community and government schools also—adopted English as a medium of instruction. Many private and boarding schools do not even allow students to communicate in languages other than English on their premises.

Against this backdrop, ApEx talked with students and experts to better understand this below-par performance—not only of individual students, their parents and teachers but of the country’s education system.   

“I attempted all the questions but still failed my English exam. To be frank, I find grammar quite hard. I will now be taking tuitions to improve my grades,” says Aditya Paudel, one of the students.

Paudel is one of the 123,396 students eligible for grade increment exams to be held on Sept 23 and 24. Only after clearing these exams will they be eligible for pursuing college education. 

The experts point out that lack of reading and writing culture among students, lack of patience and lack of government policies are some of the factors that have made English a ‘difficult’ subject for many students. The lack of government policy in orienting both the teachers and students about the topics, teaching materials and methods has hampered English teaching and learning big time.

Lack of patience and motivation among students, lack of infrastructure and lack of access to latest technologies have not helped, either. Old methods of teaching, lack of interest in students, lack of growth opportunities for teachers and workload are some other problems in English teaching and learning.

“Teachers possess scant knowledge on ways to teach the topics/chapters. Orienting teachers on teaching methods will benefit both teachers and students,” says Motikala Subba Dewan, president of Nepal English Language Teachers’ Association. The government should develop a handbook of teaching materials to help with English language teaching.

“Some schools have made it compulsory for the students to speak English on their premises. It is not the right to control the use of the medium. Use of Nepali, mother tongue mediums and English will help students understand the subject matter better,” says Professor Dr Abhi Subedi.

The education institutions should be transformed into centers of learning (in a true sense) and a task-based approach used to improve the command of the language. The experts suggest assigning tasks to students by forming peer groups for positive outcomes. They have some suggestions for teachers too. The teachers should teach properly and complete the courses on time to help students clear their exams, they say. 

These days, students have unfettered access to English via the Internet. If used skillfully, this medium can help students brush up their English. Subject teachers should motivate the students to make use of this medium to polish their English and perform better in their exams, suggest the experts. 

What’s more, the experts suggest improving the English teaching environment for better results. “It should be taught naturally,” says Subedi. 

Prescriptions aside, who will help out the students in need is a moot question.

Tobacco use in Nepal poses a significant public health problem with far-reaching consequences. The affordability of tobacco products has contributed to a persistently high prevalence rate (at around 32 percent) among the population. This has led to increased mortality and morbidity from non-communicable diseases, with an estimated 37,529 tobacco-attributable deaths in 2019 alone. 

What could be the role of an individual, family and society in controlling tobacco consumption? A roundtable discussion organized by the Annapurna Media Network on Tuesday highlighted the need to control tobacco consumption and suggested measures to discourage tobacco use among youths. Excerpts: 

Dr Bhakta Bahadur KC, Chief, Health Promotion and Tobacco Control Section, Ministry of Health and Population

It has been challenging for us to implement the Tobacco Products (Control and Regulatory) Act. The government has not been able to strictly implement restrictions on tobacco consumption in public places. Though we have succeeded in restricting smoking in hotels above two stars, we have not been able to restrict tobacco consumption in smaller hotels and restaurants.

The Ministry of Health had proposed amendments to the Act calling for stricter anti-tobacco law, but the Office of the Prime Minister and Council of Ministers returned the amendment proposal. We are planning to ban the sales of all tobacco products for people below the age of 21, raise the fine amount to Rs 500 for tobacco consumption in public places, increase the pictorial health warning on tobacco packages, and ban or regulate e-cigarettes and vapes. 

Raising the tobacco tax is also a good way to discourage youths from picking up habits like smoking and chewing tobacco. 

Dr Jaya Kumar Gurung, Senior research expert, Nepal Development Research Institute

​​​​​​​

We have a very weak information system to inform the public about no tobacco consumption. Our Act has clarified about the sales and distribution. As per the Act, the government may, if it deems necessary, make provisions of license for sale and distribution of tobacco products. The government can make the provision immediately if it really wants to control and regulate tobacco consumption. 

The Act also states that no person shall be allowed to or to cause to sell and distribute or provide the tobacco products for free to a person below the age of 18 and to pregnant women. But I doubt that shopkeepers are aware of this law. 

Also, the Act bars selling and distribution of tobacco products within 100 meters of educational and health institutions, child welfare homes, child care centers and elderly care homes. This law too has not been implemented. The Act itself has become old and it needs to be updated. Our regulatory body is weak and as a result, the monitoring process is also dismal. 

If we are serious about the control and regulation of tobacco, there must be a designated team to monitor illegal sales and use of tobacco products. As far as raising the tobacco tax is concerned, the government so far has been reluctant to do so. 

Kumar Prasad Dahal, Head, Youth Development Division, Ministry of Youth and Sports 

Many of our youths are addicted to tobacco products. To help prevent the young population from tobacco addiction as well as tobacco-related diseases like cancer, the government has come up with effective laws and policies. 

The Tobacco Act explains that the manufacturers shall print visible text and pictorial warnings about the hazards of tobacco consumption, covering at least 75 percent of their product packets. Manufacturers have adhered to this stipulation, but it is not enough to discourage people from consuming tobacco.  

The government should launch anti-tobacco campaigns targeting vulnerable groups, including teenagers, wage workers and farmers. It should also conduct counseling sessions to make tobacco consumers break their habit. 

Hari Prasad Mainali, Secretary, Forum for Protection of Consumer-Rights Nepal 

The government has not given a serious thought about banning tobacco in Nepal. How will Nepal be if tobacco is banned? Can we ban it? How much can we regulate and control? How is the situation of tobacco consumption in rural areas in Nepal? There are many aspects that need to be weighed and considered if we are to ban or regulate tobacco use in the country.

Tobacco is sold in weekly markets in rural areas, and our anti-tobacco laws say nothing about this. The question we need to ask is how we can control tobacco sales and consumption using the state mechanisms. Public awareness is also very important. 

Many of our youths use tobacco products these days, and those who are non-users are picking up the habit out either out of peer pressure, or because they feel like it is part of the youth culture.

So, we need to reassess our approach and anti-tobacco laws and come up with an effective solution to discourage youths from using tobacco products. 

The price of rice, Nepal’s staple food, is escalating in the domestic market right after India announced a global ban on the export of all varieties of rice, save the Basmati. The move from New Delhi came after Russia announced its withdrawal from the Black Sea Grain Deal in the midst of the Ukraine war, straining a war-hit supply system and aggravating the global food crisis. 

Despite hints that the ban may not apply to Nepal and the government’s assurance that there’s enough stock to last three months after which a new harvest season will begin, panic buying has been going unabated and the traders have been making hay. 

In a very short span of time, traders have raised the prices of different varieties of rice by more than 16 percent in the domestic market.

“When I inquired about the price of a 25 kg rice sack some days ago, the shopkeeper said Rs 2,300. But when I visited the shop the next day, the price had already increased by Rs 200. The shopkeeper said the price would rise further as he was running out of stock. That’s why I bought two sacks of rice,” said Parbati Dahal, a resident of Naya Thimi.

Many more customers like Dahal are opting for panic buying, fearing the unavailability of rice in the market in the coming days. But the government officials say there is no reason to panic. 

“We have food grains for three months at least. The new paddy will be ready in October-November,” says Gajendra Kumar Thakur, director-general at the Department of Commerce, Supplies and Consumer Protection.

In response to increasing complaints from consumers about the price hike, government authorities have a readymade answer: “We have been monitoring the market daily.”

Thakur says it is difficult to immediately find out whether there is black marketeering going on, as people get their foodstuffs from wholesalers, distributors and retailers. 

“We have been collecting data from the market and analyzing them. The reported price hike is under investigation,” adds Thakur.

The department has requested consumers to lodge complaints against price gouging by calling at its two numbers: 5343939 and 5347992.  

India has imposed a ban on the export of non-Basmati rice across the globe despite objections from the international community. The export policy of non-Basmati white rice, semi milled or wholly milled rice, whether or not polished or glazed, is amended from “free to prohibited,” according to a notification from the Directorate General of Foreign Trade.

According to one official, discussions are underway with the Indian government to exempt Nepal from the ban list. 

The Indian rice ban has also affected the prices of Nepali rice. Dev Kumar Shrestha, who runs a rice mill at Lagankhel, Lalitpur, says as this is an off-season for rice production, it is usually normal for the prices to go up during this time. But he does admit that the hike rates have been unreasonable after the Indian ban of rice export.   

“Big traders who are in power and are making huge profits by causing an artificial crisis,” says Shrestha. “When they raise the price, we too have to buy at an increased rate, which has caused the price increase.”   

Shrestha says since India has not banned the export of Basmati rice, high quality rice including long grain, Basmati rice should be easily available. “There is an ample supply of low quality rice, only the middle quality rice varieties are hard to get. Still, there is a panic among consumers.”

Some shopkeepers have stopped ordering rice because they are finding it difficult to sell them due to the price hike. Fanindra Shrestha, a grocer from Buddhanagar, Kathmandu, is one of them. He says the customers who visit his shop return empty handed after hearing the new price list of the rice varieties.  

“I cannot convince them, so I thought it is best not to order more rice because my customers are not going to buy them,” says Fanindra.

When there is a price hike of any goods in the market, it affects the consumers and eventually the supply chain. Those with purchasing power can buy and hoard any amount of goods that are in short supply, whereas the poor consumers cannot afford them. 

Market experts warn this could create an imbalance in the demand and supply, upsetting the market.

Several traders and experts that ApEx spoke with suggest that the government needs to come up with a long-term solution to address the issue, as this is not the first time the country has experienced such a scenario. They say that the government should take the initiative to make Nepal self-reliant when it comes to essential food items including rice. 

“We must increase our domestic rice production,” says Shrestha, the rice mill owner from Lagankhel. “By doing so we will no longer be dependent on foreign countries for rice.”

Health experts have expressed concerns regarding growing  misuse of antibiotics, as it is threatening to outpace the ability of medicines to cure infections. They warn that the misuse of antibiotics could pose a high risk for pandemics of infections. 

Infection with drug resistant microbes increases the morbidity, mortality, length of hospitalization and treatment cost of patients.

The World Health Organization has also warned that if people do not change the way antibiotics are used now, the new antibiotics will suffer the same fate as the current ones and become ineffective. 

What is antimicrobial resistance?

Antimicrobial Resistance (AMR) occurs when bacteria, viruses, fungi and parasites change over time and no longer respond to medicines making infections harder to treat and increasing the risk of disease spread, severe illness and death. 

As a result of drug resistance, antibiotics and other antimicrobial medicines become ineffective and infections become increasingly difficult or impossible to treat. That means the germs are not killed and continue to grow. Resistant infections can be difficult, and sometimes impossible, to treat.

AMR is an urgent global public health threat, killing at least 1.27m people worldwide and associated with nearly five million deaths in 2019, according to the Centers for Disease Control and Prevention of the United States of America.

Antibiotic resistance can affect anyone and will lead to a situation when there are no antibiotics because the antibiotics which we have will not work. It will affect agricultural products and their livestock too as there has been a wide use of antibiotics in livestock as well. 

The WHO has declared AMR among the top 10 global health threats. It can no longer be addressed by single, isolated interventions with limited impact. 

Factors associated with antimicrobial resistance 

Self-medication, unnecessary use, incomplete dose, inadequate awareness, public preferences, economic condition, professional ethics, unavailability of antibiotics prescribers, unclear law/policies, easy accessibility of antibiotics in pharmacies/medical shops and lack of antimicrobial resistance surveillance are some of the factors causing antibiotic resistance in Nepal. 

Similarly, no evidence-based practices for antibiotic prescriptions, unregistered pharmacies, inadequate laboratory facilities for culture and susceptibility, less motivated health workers for service delivery, over-prescription of antibiotics, and patients not finishing the treatment play an important role in causing antibiotic resistance in Nepal. 

“Multiple pregnancies, abortion and unhygienic birthing centers are some of the risk factors for antimicrobial resistance in females as antibiotics are used during pregnancy,” says Dr Bibeka Shrestha, an expert working in antimicrobial resistance. 

A cross-sectional survey with 516 samples of clinicians, private drug dispensers, patients, laboratories, public health centers and livestock and poultry farmers, conducted by KR Rijal and team in 2017, showed that 79 percent of respondents purchased antibiotics directly over the counter.

Section 17 of the Drugs Act states that no person shall sell or distribute such drugs without prescription of a doctor as categorized not to be sold or distributed without such prescription. 

Condition in Nepal 

Nepal experiences an extremely huge burden of infectious diseases such as respiratory tract infections, enteric fever (typhoid, paratyphoid fever), urinary tract infections and other bacterial infections. Researchers have reported a high burden of drug resistant/multidrug resistant bacteria in the country. 

In a research conducted by Dr Anup Bastola and his team in Sukraraj Tropical and Infectious Disease hospital between 2015 and 2019, Salmonella spp and Shigella spp bacteria were mostly resistant to ampicillin/amoxicillin, cotrimoxazole and chloramphenicol. 

In the research Assessment of Antibiotics Use and its Resistance in Nepal conducted by Nepal Health Research Council recently among 1,079 doctors/health workers, only 32 percent of the doctors/health workers have access to laboratory facility for Antibiotic Susceptibility Testing (AST). Among them, only 49 percent recommend antibiotic susceptibility testing before prescribing antibiotics which is a significant reason for influencing rational prescriptions of antibiotics.

Among the 521 pharmacies, the majority of the drug dispensers (43.4 percent) dispense antibiotics without a doctor’s/health worker’s prescription. Azithromycin (24.5 percent), Amoxicillin/Amoxyclav (20.5 percent), Cefixime (14.8 percent), Ciprofloxacin (14.1 percent), and Metronidazole (nine percent) were the most commonly dispensed antibiotics without prescriptions from doctors and health workers.

Of the 2,122 outpatients, 22 percent did not consume a full course of antibiotics. Similarly, about 10 percent and eight percent of the outpatients consume antibiotics as prophylaxis and consume double dose antibiotics for fastest recovery respectively. Around 22 percent of them save residual antibiotics for treating similar symptoms in future. Additionally, around 28 percent of the outpatients mentioned that they buy antibiotics without doctor’s/health worker’s prescriptions.

About 85 percent of health workers/doctors did not prescribe antibiotics by their generic name. Similarly, more than one-third i.e. 37.8 percent of prescribed medicines were antibiotics which is higher than the WHO set standard. 

In a cross-sectional study conducted by Karuna Kayastha and team at International Friendship Children’s Hospital Kathmandu from August 2017 to 2018 in among 1,443 samples that included urine, pus, wound swab, endotracheal tip, catheter tip, and blood were collected from pediatric patients below 15 years  extended-spectrum β-lactamase (ESBL) production in Escherichia coli and Klebsiella species E. coli (n = 79), Klebsiella pneumoniae (n = 18), and Klebsiella oxytoca (n = 6) were isolated from different clinical specimens. Of which, 64 (62.1 percent) exhibited multidrug resistance.

Among the total of 103 bacterial isolates, 62.1 percent (64/103) were found to be multi drug resistant; the highest multidrug resistant strains were detected in K. pneumoniae (88.9 percent; 16/18), followed by E. coli (57 percent; 44/79) and K. oxytoca (50 percent; 3/6)

“Nepal is one of the major contributors to the growing burden of antimicrobial resistance due to widespread use of antibiotics,” says Dr Santosh Dulal, health expert working on antimicrobial resistance.  

According to the National Tuberculosis Control Centre 350 to 450 multidrug resistant tuberculosis are notified annually. 

Multidrug-resistant TB is caused by a TB germ that is resistant to at least isoniazid and rifampin, the two most potent TB drugs. These drugs are used to treat all persons with TB disease, the center says. 

“There must be rational use of antibiotics. The government must train the health workers on prescribing the antibiotics,” says Dr Bastola, communicable, infectious and tropical disease health expert. 

Nepal has a high prevalence of infectious and communicable diseases that contribute to higher morbidity and mortality. The infectious disease with the highest contribution to premature mortality in Nepal in 2019 were lower respiratory infections, diarrheal diseases and typhoid fever as per the Nepal Burden of Disease 2019. “When there is antibiotic resistance then it poses risk on the treatment of these diseases,” says Dr Dulal. 

Though the government has made a national action plan for antimicrobial resistance (2021-2026), it has yet not been endorsed by the government. 

Methods of prevention

Irrational use of antibiotics and illegal import of medicines need to be strictly controlled. Immunization and vaccination program to prevent and surveillance initiatives on antimicrobial use as antimicrobial resistance involving government agencies, medical personnel, veterinarians, livestock producers/farmers is needed. 

Unless the infection prevention is done there remains the risk for antimicrobial resistance. This is why the government must work to prevent infections. 

There is also a need for strict monitoring and regulations to prevent dispensing of antibiotics, (Colistin for animals) or reserve group of antibiotics from pharmacies without prescriptions.

Mind it

• Do not distribute antibiotics and consume it 
• Pay attention on cleanliness and maintain distance with patients 
• Take all the necessary vaccines
• Follow medical advice 
• Only prescribe medicines upon laboratory reports 
• Properly manage hospital waste 
• Surveillance, monitoring and research
• Coordinate at different levels
• Keep AMR on curriculum of schools and colleges
• Strict punishment for violating regulations
• Make treatment guidelines available to clinicians and health workers

Japan is currently facing a significant challenge with its growing elderly population and declining childbirth rates. This demographic shift has led to the decline of extended families, resulting in a demand for caretakers in the Japanese market. A team of Japanese experts recently discussed the shortage of human resources and the increasing elderly population, highlighting the opportunities for Nepalis to address the human resource crisis in Japan. In a discussion organized by Annapurna Media Network on Tuesday, they shed light on the ways Nepalis can apply for semi-skilled worker positions in Japan and economically benefit from these opportunities.

In the interaction, Sanat Neupane, CEO of Annapurna Media Network, shared his perspective on Nepal-Japan relations and the migration of Nepalis seeking employment abroad. He said that Nepal and Japan have a long-standing friendship, and added that the network has been advocating for the healthcare and rights of migrant workers. “Although the ultimate goal is for Nepalis not to have to go abroad for employment, he acknowledged that if they do, Japan should be the preferred destination due to the favorable prospects it offers,” he added.

Given below is the viewpoints of the members of the delegations in their own words:

Shimichi Hotta, Advisor, Blue Sky Japan

There are no extended families in Japan anymore, and the childbirth rate is very low. We have started experiencing a shortage of human resources in Japan to take care of our elderly population. With the decreasing childbirth in the country, the population has decreased in Japan of late. Currently, there are 5,000,000 households in Japan, and about 20 percent of them are families of the elderly population. Unfortunately, the Japanese tradition of extended families has now ended, and the active working population is becoming low. Though we have insurance policies for the elderly population, the time when youths were taking care of the elderly population will not come back.

Social security has been a matter of great concern for our government. There is a high demand for caretakers in our country. To address labor shortages in various industries, the Japanese government has come up with the semi-skilled worker scheme. Under the new conditions, about 60,000 foreign workers will be allowed to enter Japan. Nepalis can cope with any kind of situation and can control their feelings and emotions, which is why there is a demand for Nepali human resources in Japan. 

Go Uehara, CEO, Blue Sky Japan

I am thankful for the opportunity to share about our work here. Our company has been providing employment for 200 Nepalis, and we are eager to offer employment opportunities to more Nepalis. People from across the world have come to Japan to work in the caregiver sector in the elderly care homes. We are focusing on how we can safely take Nepalis to Japan without them being cheated by middlemen. Our commitment is to strengthen their economic status and ensure their stay in Japan is safe.

Naohiro Beppu, General Manager, Planning Division, Medical Corporation Seihoukai

​​​​​​​We have been running nursing homes and hospitals in Japan. I have noticed that Nepalis are close to the pronunciation of the Japanese language, which is crucial for effective communication in elderly care. Nepalis are smart in developing these communication skills. We believe that  Nepalis can benefit a lot. We have already decided to take 12 Nepalis and are eager to recruit more. Currently, we have 2,500 people working with us, and we are looking to add more Nepalis to our team.

Minoru Fujisawa, Trainer/Caregiver specialist, Medical Corporation Seihoukai 

I am responsible for the training component in the company, and I strongly believe in the importance of continuous training for better job performance. In our experience, even Japanese employees may not possess all the required skills in the beginning, but Nepalis have demonstrated better skills, and they are easy to teach. Once they receive proper training, it significantly eases their work and enhances their abilities. With their inherent skills and the added benefits of training, I have full confidence that Nepali caregivers can excel in their roles and achieve remarkable outcomes. 

Yoshiyuki Masuda, General Manager, HR Division, Medical Corporation Eiseikai

I have been involved in running health care institutions, and one of the challenges we face is that elderly people often seek emergency services at a particular health institution but then have to go to other places for further treatment. Many prefer different health institutions for extended hospital stays rather than the one they used for emergency care. Additionally, doctors often recommend physiotherapy treatments for patients, but some patients prefer to stay at home, and they cannot be left alone without proper care. This has created a significant need for caretakers to assist these patients with their daily needs. 

Moreover, nursing care is also in high demand for patients who require specialized attention and support. Health practitioners also visit patients' homes for follow-up care. Due to these factors, there has been a wide demand for caretakers in Japan. Having observed the qualities of Nepali caregivers, I can say that they are smart, dedicated, and honest in their work. Because of these attributes, we have been actively seeking to recruit Nepali caregivers in our health institutions. I have already listed eight Nepalis for the second round of interview.

Akiko Wakata, Chief, HR Division, Medical Corporation Konoikekai

​​​​​​​This is my first visit to Nepal, and I am truly impressed by the Nepalis’ ability to speak Japanese properly. I have observed that they possess excellent caring skills, and those with nursing expertise will find it much easier to adapt to life in Japan. I am eager to provide caregiver certificates to Nepalis who are willing to stay and work in Japan. Currently, I have already listed six Nepalis for interviews, and I am highly interested in increasing the number to 12 or even 18. 

Santosh Poudel, Director, Blue Sky Japan

​​​​​​​To apply for the visa in Japan under this scheme, one must pass the Japanese language test. The test can be taken after completing three months of language classes at any recognized language institution in Nepal. Anyone willing to apply for the caretaker position, can sit for the test, which includes fundamental questions about caretaking. The test format is multiple-choice, and the applicant has the option to take it in either Nepali or Japanese language. The application process is free of cost, and the air ticket will also be provided at no charge. Once selected, you can work for eight hours per day and earn Rs 200,000 per month, along with access to insurance facilities.  Anyone below the age of 60 are eligible to apply for this position. The companies will offer a minimum five-year contract, and the visa should be renewed every year. Also, the applicants can take a certificate within five years of their tenure and then apply for a permanent residence in Japan.

The spread of lumpy skin diseases in cattle has hit farmers across the country. They are facing a triple whammy as the dairy production has decreased, fields remain unploughed and paddy transplantation has not taken place due to widespread infection. 

Lumpy skin disease is caused by the lumpy skin disease virus, which belongs to the genus capripoxvirus, a part of the poxviridae family (smallpox and monkeypox viruses are also part of the same family). It is a contagious vector-borne disease spread by mosquitoes, flies, and ticks.

According to the United Nations Food and Agriculture Organisation (FAO), infected animals shed the virus through oral and nasal secretions which may contaminate common feeding and water troughs. Thus, the disease can either spread through direct contact with the vectors or through contaminated fodder and water.

The incubation period or the time between infection and symptoms is about 28 days, per the FAO. Per some other estimates, the incubation period is 4 to 14 days. 

Some of the symptoms of the disease are nasal and ocular discharge, discharge of mucopurulent (containing mucus and pus) with progression of the disease, fever, swelling of joints, swollen superficial lymph nodes, sharp reduction in milk production and formation of skin nodules all over the body. Damaged skin and hides, fertility problems and death are some of the impacts of the disease along with increased treatment costs.

Morbidity rate of the infection is usually 5–45 percent and mortality rate is usually less than 10 percent, according to the Central Veterinary Laboratory.

Many farmers have complained that the government has not taken effective measures to control the disease.

“I have just returned after burying an ox from one of my relatives because one of my oxen is sick and struggling for life. There is no vaccine at the municipal veterinary,” says Surya Thapa Magar, a farmer from Aiselukharka, Khotang. 

It is a distressing situation for farmers like Magar. At Aiselukharka, there is no household where the cattle infection has not spread. In fact, the disease has reached all 77 districts of the country, infecting around 555,000 and killing at least 21,000 cattle so far, according to the Animal Service Department.

The infection is particularly high in mid-hill and hill regions of Karnali, Lumbini and Koshi provinces. 

The spread of the disease can lead to substantial and severe economic losses, particularly in the dairy industry. The disease leads to reduced milk production as animals become weak as they lose appetite due to mouth ulceration. 

The annual total milk production in Nepal is 2,301,000 metric tonnes. About 40 percent of milk production is contributed by cows and the remaining 60 percent by buffalo. There are about more than 500,000 dairy farmers and 1,700 dairy cooperatives involved in the dairy sector in the country.

A risk assessment study conducted by the United Nations’ Food and Agriculture Organization (FAO) based on information available from 2019 to October 2020 revealed that the economic impact of the disease for South, East and Southeast Asian countries “was estimated to be up to $1.45bn in direct losses of livestock and production”.

According to Nepal Veterinary Council, the mortality rate of the infections in animals is 3.8 percent and there is a loss of Rs 49,135 per animal in the country. Animal deaths resulting from this disease have already caused a loss of NRs 27.22bn.

In the absence of timely treatment, the disease could spread in over 2.5m animals, resulting in the death of 100,000 cows and buffalos, causing a total loss of Rs 1.26trn, per the council. There are over 7.4m cows and more than 5m buffalos in the country.

“It’s a huge economic loss for us. We haven’t been able to plough the field as tractor costs Rs 2,000 per hour, which we cannot afford. On top of that, the production of milk has also decreased,” says Chiranjibi Poudel, a farmer from Halesi, Khotang. 

While the government has expressed its commitment to providing all resources required for the prevention and control of the disease, many farmers say the help has not arrived. In Baitadi district, for instance, vaccines are not available so far. Farmers say they feel helpless watching their cattle die a slow, painful death. 

“The cases of lumpy skin infection are increasing by the day but the district lacks vaccines. We have written to the federal and provincial governments requesting vaccines,” Dr Bishal Pathak, livestock development officer at the Veterinary Hospital and Livestock Service Center. 

Officials, however, claim that the government has imported 737,000 doses of vaccine and supplied them to all seven provinces. The government has allowed importers to import Neethling strains vaccine, which can be administered to pregnant cows and buffaloes. 

Veterinarians say as the disease can easily transmit from one animal to the other, the infected animal should be kept separate from healthy animals. They suggest vector population control, hygienic measures in the farms, awareness campaigns and vaccination as preventive and control measures.

The vaccines are not produced in Nepal; they are imported. The government has allowed importers to import Neethling strains vaccine. The vaccine can also be administered to pregnant cows and buffaloes. The calves born will be resistant to the virus for three months. 

The infected animals should not be administered vaccines. They should only be given vaccines a year after they have been infected with the disease. As the anti-virus resistance is formed in the cattle it is not necessary to vaccinate them immediately after their recovery.

The farmers demand the vaccines be made easily available to prevent infection spread in the healthy cattle. 

It is safe to consume milk from cattle infected by Lumpy Skin Disease, as it is a non-zoonotic disease. 

FAO says that a large portion of the milk in Asia is processed after collection and is either pasteurized or boiled or dried in order to make powdered milk. It ensures that the virus is inactivated or destroyed.

“It is safe to consume milk from the infected cattle but it will be beneficial to drink milk after boiling. However, if the cattle is given antibiotics then the milk should not be consumed from the day when the antibiotic was started and after a week from the day when the antibiotic was stopped in the animal,” the Department of Livestock Services said. 

Symptoms

• Nasal and ocular discharge
• Discharge of mucus and pus with progression of the disease
• Fever
• Swollen joints and superficial lymph nodes
• Sharp reduction in milk production
• Formation of skin nodules all over the body