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Despite being in the midst of the monsoon season, Madhes Province continues to face severe drought, leaving farmers in deep distress. With irrigation facilities available on only 49 percent of the province’s total cultivable land, the impact on agriculture is becoming increasingly dire.

The provincial and federal governments have declared Madhes a drought-affected and crisis-hit area, respectively. However, farmers and local officials report that no substantial action has yet been taken to address the crisis.

According to the Madhes Province Dry Zone Study Report—submitted by the Ministry of Agriculture and Livestock Development to Singha Durbar on July 28—poor management and a lack of maintenance of irrigation infrastructure lie at the heart of the problem. Of more than 1,000 deep tubewells installed since the Panchayat era by both the government and the private sector, over 50 percent are no longer operational.

The Kamala Irrigation Project under the Samruddha Tarai Madhes Irrigation Special Program has also faced major setbacks. In Saptari, Siraha, and Mahottari districts, only 98 out of 236 installed deep tubewells are functional. The remaining 138 are idle due to incomplete infrastructure, such as pump houses and electrification. Additionally, 68 deep tubewells constructed in fiscal year 2024/25 remain nonfunctional because their supporting structures have yet to be built.

Adding to the challenges, 13 deep tubewells in four districts have been rendered unusable due to the theft of key components like transformers and panel board wires. Others are blocked by debris—stones, bricks, and sand—or remain idle due to disputes between local water user committees and farming groups.

Older irrigation systems have also broken down. Under the now-defunct Janakpur Agricultural Development Plan, only 85 of 242 deep tubewells remain functional. Many of the rest—installed between 1984 and 1994—have failed due to issues such as clogged filters, outdated diesel engines, or overall technological obsolescence.

In rural areas, the need for shallow tubewells has become urgent, as surface irrigation systems like canals and dams remain insufficient or unevenly distributed.

Out of Madhes’s total 542,580 hectares of cultivable land, only 52,224 hectares are currently under cultivation this season. Rainfed rice, which relies entirely on monsoon rainfall, has been planted across 362,344 hectares, while Chaite rice covers 20,839 hectares.

Although rivers, canals, and lakes provide some irrigation, the main sources remain underground—primarily shallow and deep tubewells. The Ministry of Land Management, Agriculture and Cooperatives has warned that without urgent upgrades and investments, these systems will continue to fail farmers.

Districts like Saptari, Rautahat, Sarlahi, Bara, and Parsa are served by major canals such as the Koshi Chandra, Bagmati, and Gandak. However, large parts of Siraha and Dhanusha remain dependent on increasingly unreliable underground systems.

As the drought worsens and food insecurity looms, farmers are calling for immediate government intervention—repairs, subsidies, and the construction of new infrastructure. Without such action, Madhes could face a severe agricultural collapse in the coming months.

In Madhes, climate change is reshaping daily life—from dwindling water sources to declining rice yields. Locals say they feel increasingly alienated from the very elements that once sustained them. “Neither the rice feels like ours anymore, nor the water,” many say, as the region struggles with dried-up springs, parched fields, and water scarcity so severe that families must walk miles just to fetch a bucket.

The crisis has intensified to the point that the Madhes government has officially declared the region a drought-hit zone. With no monsoon rains this year, paddy planting has been severely disrupted—deepening the struggles of a region that relies almost entirely on rain-fed agriculture. While the provincial government plans to request relief funds from the federal government, there is still no long-term strategy in place to address the growing water crisis.

“I remember when it used to rain nonstop for two months,” recalls 65-year-old Sumitra Sada from Mahottari district. “Back then, every man, woman, and child would be busy in the fields planting rice. But now the season has come and gone without enough rain. We try to pump underground water through borewells, but whenever we do that, the hand pumps across the village run dry.”

The crisis is not just environmental—it’s cultural. Traditional Madhesi meals, once celebrated for fragrant aged rice, homemade ghee, and fresh backyard vegetables, are disappearing. “Fifteen years ago, we used to store large quantities of aged rice for weddings and rituals,” says 75-year-old Bedananda Jha from Janakpur. “Now the granaries are empty. We’re forced to buy polished, tasteless rice from across the border.”

According to government data, Madhes currently produces 2.77m metric tons of paddy. But to meet national demand and reduce imports, the region would need to expand rice farming by nearly 190,000 hectares. Similar production gaps exist for corn and wheat, posing a serious threat to food security.

The region’s once-abundant water sources—rivers, hand pumps, and wells—are drying up. In places like Birgunj, groundwater levels have dropped so drastically that families must now dig as deep as 400 feet to install a hand pump, at a cost of over Rs 150,000. “Water that once came from 100 feet now requires machines and generators to access,” says local resident Umesh Mandal.

To cope, Birgunj Metropolitan City has begun distributing water through tankers and temporary tanks. But experts warn these are merely short-term fixes. “The water crisis will only deepen unless we invest in groundwater recharge and proper conservation,” says hydrologist Pratap Singh Tatar. “People used to share hand pumps; now each home wants its own. There’s no regulation on irrigation borewells, and water is being over-extracted without recharge.”

Only three percent of Madhes residents use piped water from the national utility, while over 70 percent depend on hand pumps and tubewells. But with groundwater levels falling even in rural areas, the future looks bleak.

Experts also point to the degradation of the Chure hills—once considered the “lifeline” of Madhes. Forests that used to absorb rainwater and replenish underground aquifers are being destroyed due to logging, grazing, and encroachment. As the hills go bald, less water flows down to the plains.

“If we fail to protect Chure, Madhes could turn into a desert,” warns environmentalist Vijaya Singh Danuwar. “Chure is our mother. It traps monsoon clouds and releases water gradually. Without forests, there’s no mechanism to hold or distribute the rain.”

Farmers across Madhes are being pushed to the brink. With unreliable rainfall and limited irrigation, they now spend up to Rs 500 an hour to pump water using fire trucks just to transplant rice seedlings. By early July last year, 45 percent of paddy planting was completed. This year, it’s just 25 percent.

Although irrigation coverage increased slightly to 273,410 hectares in 2023/24, most of it depends on canals, ponds, and borewells—many of which are now failing due to water shortages.

Once known as Nepal’s rice bowl, Madhes now struggles to feed itself. While the total area under cultivation may have grown slightly, yields have declined. Agricultural economist Devendra Gauchan blames climate change: “We’re seeing more droughts, heatwaves, floods, and pest outbreaks—all of which reduce productivity. This region, which once exported rice, now imports it.”

Experts say the water crisis in Madhes is not just a natural disaster, but a human-made one—driven by poor planning, unchecked groundwater extraction, climate change, and government inaction.

“We can’t stop climate change,” says hydrologist Tatar, “but we can minimize its effects. What’s happening in Madhes is a warning. If we don’t act now, the cost tomorrow will be unbearable—for food, for water, and for life itself.”

Members of the Madhes Provincial Assembly have accused the government of allowing middlemen to dominate the fiscal year 2025/26 budget. Lawmakers from both ruling and opposition parties claim the budget was influenced by external forces and is not people-oriented, with excessive manipulation by intermediaries.

The assembly has not held proper discussions on the budget, as six opposition parties have continued to protest, demanding a rewrite. On Monday, lawmakers obstructed the session, forcing its adjournment to Tuesday. In June, a budget meeting was abruptly announced just an hour before it was to be held. After an 11-day break, a session was held on Sunday but again adjourned due to joint protests by Janata Samajwadi Party Nepal (JSPN), CPN (Maoist Center), CPN (Unified Socialist), Nepal Sanghiya Samajbadi Party, Nagarik Unmukti Party, and Rastriya Prajatantra Party (RPP).

“Looking at the budget book, it’s evident that the plans were prepared by middlemen,” said Ram Ashish Yadav, chief whip of JSPN. “This year’s budget is deliberately skewed, impractical, and guided by intermediaries. It offers no direction for the province. One example is a 20-year-old project listed in the red book under the name of the Chief Minister’s father, for which Rs 18m has been allocated.”

The red book for 2025/26 shows that Chief Minister Satish Singh has allocated Rs 18m for an unfinished girls’ hostel initially funded by the Indian Embassy. The project, located at Mahendra Bindeshwari Multiple Campus in Rajbiraj, Saptari, was launched in 2005 under the chairmanship of Singh’s father, Shekhar Kumar Singh. Despite receiving Rs 19.6m from the Indian Embassy, the hostel remains incomplete two decades later.

“This budget lacks priorities, principles, and is entirely unprecedented,” said Ram Saroj Yadav, a Nepali Congress leader in the provincial government. “The Chief Minister publicly promised to exclude projects below Rs 10m, and the Finance Minister pledged not to include those below Rs 5m. Yet, the red book is full of such projects. It contradicts the very commitments made by our leadership. There’s no doubt the budget is influenced by middlemen.”

The provincial government has presented a budget of Rs 46.58bn for 2025/26. Notably, the Ministry of Sports and Social Welfare has allocated Rs 3m across two schemes named after Indian godman Asaram Bapu, who is serving a life sentence in India for raping a minor.

“There are serious disparities in project allocations,” said Sunita Yadav, a CPN (Maoist Center) lawmaker. “If this is truly a provincial budget, all MPs should have ownership. But here, middlemen override the MPs’ recommendations. We demand a complete rewrite of the budget—otherwise, we will not allow the Assembly to function.”

This is not the first controversy surrounding the budget in Madhes. In July last year, the 2024/25 budget was mired in scandal after allegations surfaced that outsiders had obtained a secret Finance Ministry password and inserted unauthorized projects into the red book—ignoring MPs’ recommendations. A parliamentary committee was formed with a pledge to investigate the breach. However, no investigation has taken place, and the individual behind the password leak remains unidentified.

Chief Minister Singh has acknowledged some errors in the budget but denied the involvement of middlemen. “We’ve repeatedly invited opposition parties for dialogue,” he said. “I want to assure the public that this budget is transparent.”

Economic empowerment is a crucial condition for gender equality. While the employment situation of women in Madhes Province has been dire, their participation in the labor force has begun to increase of late.

Rampari Devi (45) never went to school and was married at a young age. After her marriage, she had to rely on others even to fetch goods from the weekly market for nearly 20 years. However, after the male members of the family left for foreign employment, the family’s responsibility fell on Devi’s shoulders. She now has to manage everything, from farming to market activities, alone.

Currently, Devi is cultivating vegetables on about six kattha (approximately 2,000 square meters) of land with her daughters-in-law. She sells the vegetables at the local market herself and her work has significantly contributed to her family’s income.

Until about 15 years ago, Rekhadevi Sah (50) from Dhirapur had not even thought of working in her own fields. Her days were spent doing household chores. But now, Sah has also started farming. “The times were different then. In our society, women were not allowed to go outside the house. When we were newly married, we were even forbidden from laughing or speaking loudly. Times have changed now. We have educated daughters-in-law. Women have also started working in agriculture, business and other sectors,” said Sah. “Madhesi villages are not the same as before. In the past, there was no practice of employing women as laborers in the village, but now both men and women work together.”

Different factors like employment, business property rights and per capita income are considered for economic empowerment. Although women in Madhes are at the bottom of economic empowerment compared to other provinces, they have slowly started to climb the ladder.

Dilkhush Paswan from Matihani in Mahottari had to struggle a lot to go out to work and earn just because she was from the Dalit community. “The biggest problem came from the family itself. If you went out to work or joined women’s groups, they would say you would get spoiled or engage in wrong activities. Some even said they wouldn’t give work if the group included a Dalit woman,” Paswan said, recalling her past. “But after much struggle, I have now been able to do small business in the village. I have also gained respect in the family.”

Paswan has started a small business and is also involved in farming.

Until 10 years ago, it was difficult for women in Madhes to receive equal wages for equal work. There was no practice of involving women in agriculture, animal husbandry or small businesses. However, after the men in the villages started going abroad for jobs, women also started to be accepted as workers. Now, there is equality in wages, says agricultural worker Sangita Sada. “Earlier, they used to give Rs 300 to men and Rs 250 to women for farm work. They would not give us the money, though. Men would go as our guardians and receive the money,” said Sada. “We are paid the same wages as male workers these days.”

Bedanand Jha, who was busy transplanting paddy in his farm, said the number of women is comparatively higher than men in farms these days. “Since most men have started going abroad, women have started taking charge of agriculture,” he said, adding: “If female workers don’t engage in work, agriculture becomes even more difficult.”

Bina Singh, Dhanusha district coordinator of WOREC Nepal, an organization working in the field of women rights, said most of the women in Madhes had to endure violence due to a lack of economic empowerment in the past. “Even today, there is no conducive environment for women and girls to work outside their homes in Madhes. Women, especially from Dalit, Muslim and under-privileged families, are trapped in economic dependence and poverty. But efforts have begun to slowly break all these barriers,” she said. “Now, the trend of educating daughters and involving them in work has started to increase.”

As per the 2021 census, 49 percent, or 3,048,849, of the total population of 6,114,600 in Madhes Province, are women. The literacy rate for women is 54.7 percent, while it is 72.5 percent for men. About 68.7 percent of the cottage enterprises are primarily operated by men and 31.3 percent by women.

Madhes Province has seen a rise in criminal activities in recent months, with several cases highlighting the deteriorating law and order situation.

On June 23, Ritadevi Yadav (50) of Kabilas in Aurahi-4 of Mahottari was killed by her brother-in-law, Jatan Yadav (45). According to the District Police Office, Mahottari, Jatan struck Ritadevi with a spade after a household dispute turned violent.

Earlier, on June 14, Haribhushan Kusbaha, the chief of Ramraja Multiple Campus in Kalaiya, was shot dead at Batara in Adarsha Kotwal-3. Police have arrested five people in connection with the case.

Similarly, on June 8, Raju Yadav of Sakhuwa Mahendranagar in Dhanusha filed a report stating his wife, Ruby (28), was missing. A police investigation later revealed that Raju had murdered Ruby and disposed of her body before filing the missing person report to appear innocent.

Additionally, police arrested Dipendra Ram (22) of Narakatiya in Paroha-8 of Rautahat for the murder of his sister, Tetari Kumari Ram (20), using a bamboo pole on June 23. According to the police, Dipendra attacked his sister during a household dispute.

Statistics from the Madhes Province Police Office show a significant increase in homicides, attempted murders, and other criminal cases over the past few years. Law enforcement officials and social activists attribute most of these crimes to disputes and family feuds.

The Madhes Province Police Office recorded 96 cases of willful murder in 2021/22. The number increased to 106 in 2022/23 and has already reached 101 in the first 11 months of the current fiscal year. Similarly, 271 cases of attempted murder were recorded in 2021/22. This number rose to 252 in 2022/23 and has reached 213 in the first 11 months of the current fiscal year. According to the office, 8,454 criminal cases were recorded in 2021/22. This number increased to 9,844 in 2022/23 and has reached 8,664 in the first 11 months of the current fiscal year.

SP Bhuvaneshwar Tiwari of the District Police Office, Dhanusha, cites deteriorating social values, the negative impacts of foreign employment, and the breakdown of traditional family structures as some of the reasons behind the rising number of criminal cases in Madhes Province. Most of those arrested in criminal cases are in the 19-35 age group.

"The minds of our youth are becoming breeding grounds for criminal thoughts," said Sushil Karna, a youth rights activist. "Even educated young people are unable to find employment. This lack of opportunities, combined with inadequate education and drug addiction, is pushing youth into a quagmire of crime," he said. "The open border with India allows easy access to drugs. Once under the influence of drugs, these youths lose their ability to think rationally, and they don’t hesitate to commit even heinous crimes."

Raju Paswan, a human rights activist, said that the lack of punishment for criminals is a major reason behind the rise in criminal cases. "Criminal tendencies in society have increased significantly, but the strict legal measures needed to discourage this haven’t been implemented," Paswan said. "Even existing laws aren't being effectively enforced."

He added that police often fail to initiate timely investigations and weaken cases due to pressure from political parties and leaders. "These factors have boosted the morale of criminals. To control such criminal activities, it’s necessary to enhance the effectiveness of the law," he emphasized.

Women’s rights activist Subhadra Ale pointed out that political protection often encourages criminals. "In most cases of violence against women, families of victims face pressure from all sides when trying to file a complaint with the police. Village leaders and local politicians often protect criminals without understanding the facts," Ale said. "Attempts are made to settle criminal cases with small amounts of money through community mediation in villages."

Advocate Rajkumar Mahasheth stressed the need for social awareness to control incidents of criminal activities and violence. "The primary causes behind increased rates of criminal activities are poverty and unemployment. Another factor is the decline in moral education in our society," he said. "Youths are trapped in addictions. With the lack of employment opportunities in the country, young people are forced to either go for foreign employment or resort to crime."

The results of the federal and provincial elections show that the political scenario in Madhes has changed. Voters by and large seem to have developed an apparent distrust against the erstwhile dominant Madhes-centric parties and their candidates. The Madhes-based parties, which had been winning the majority of seats in the province by raising Madhesi agendas, didn’t fare well this time. Instead, the CPN-UML—the third-placed party in the province in the 2017 polls—has emerged as the largest party in Madhes. More tellingly, new faces have been elected in 20 of the 32 House of Representatives seats from Madhes. Similarly, the Nepali Congress, which won six seats in 2017, has slightly strengthened its presence this time by winning a seat more. The Janata Samajbadi Party (JSP), meanwhile, put on a weak show, winning six seats despite being a Madhes-centric force. It had won 10 seats in the previous elections. Another Madhes-based party, Loktantrik Samajbadi Party (LSP), did even worse by winning just three seats, which is six fewer than last time. The CPN (Maoist Center) was another big loser, securing just one seat in Madhes. It had won five seats in 2017. The newly formed CPN (Unified Socialist) and Janamat Party won two and one seats respectively, while independent candidates were victorious in three constituencies. Of the three independent candidates, Amresh Kumar Singh was the rebel candidate of the NC in Sarlahi-3. Two other independent candidates—Prabhu Sah (Rautahat-3) and Kiran Sah (Rautahat-2)—won as they were supported by some parties in the ruling coalition. The rise of Janamat Party In the provincial assembly election, the Maoist Center, JSP and LSP won half of the seats that they had won in 2017. Looking at the election results declared so far, the Janamat Party, led by CK Raut, would be key in government formation in Madhes government.. Of the 64 first past the post (FPTP) seats in the assembly, Raut’s party has won seven seats so far and is on track to add a few more. The UML and NC have won 13 seats each, while JSP and LSP have secured nine and seven seats, respectively. The Maoist Center and Unified Socialist have won four seats apiece, while independent candidates have occupied six seats. Since the independent candidates had contested the polls against the official candidates of their parties, there are chances that they might rejoin their parties. “People didn’t show belief in Madhes-based parties who put their agendas on the back burner and forged electoral alliances with the parties that they once opposed. So, the people of Madhes voted for CK Raut’s Janamat Party,” says youth activist Arun Jha. “Janamat Party has won the hearts of people by raising the issues that mattered to them.” Jha believes Janamat Party is the new alternative force in Madhes. The defeat of party boss The central presidents of four parties had contested the election to the House of Representatives from Madhes this time. CK Raut, chairman of Janamat Party, defeated JSP chair Upendra Yadav by a huge margin in Saptari-2. Similarly, LSP leader Mahantha Thakur defeated Tarai Madhesh Loktantrik Party’s chair Brikesh Chandra Lal in Mahottari-3. Unified Socialist chair Madhav Kumar Nepal also won from Rautahat-2. The defeat of senior Madhes-centric leaders signifies a big change, says Dr Surendra Labh, member of the National Planning Commission. “They were defeated because of their own doings. Keeping the people entangled in old issues and failure to bring any basis for socio-economic development is the first reason behind their loss,” he says. “The second reason is that the voters want prosperity and economic development. Since the old leaders were unable to deliver these things, the voters went for new faces.” Women in parliament Two out of three female candidates, who contested the election for the House of Representatives from Madhes Province, were elected this time. Both these candidates—Juli Kumari Mahato (Dhanusha-3) and Jwala Sah (Bara-3)—belong to the UML.  The third woman candidate, Chitra Lekha Yadav was defeated in Siraha-2 by JSP's Raj Kishor Yadav. Similarly, four women have been elected to the Madhes Province Assembly so far. Rani Sharma Tiwari was elected from Mahottari-3 (B), while Surita Sah, a rebel candidate of JSP, was victorious in Mahottari-2 (B). Likewise, Unified Socialist’s Bechi Lungeli and Sharada Thapa won from Sarlahi-1 (B) and Mahottari-1 (A) respectively. All four of these women candidates were elected in 2017 as well. No to politics of caste and identity The election results from Madhes this time also hint at the changing attitude of its voters when it comes to politics of caste and identity. Parties, which used to bank on votes by pandering to minority groups, Dalits and Muslims, were left disappointed. This also suggests the growing number of voters who are socially and politically. The defeat of Upendra Yadav in the region dominated by the Yadav community could be an indication that voters in Madhes want to put casteism behind. “It’s a wake up call for parties that gave up their agendas and focused on casteism,” says Dr Labh. What lies ahead? The Madhes-based politics has its roots in the people’s movement of 1950. Various landlords in the Tarai belt including in Mahottari, Saptari and Morang had supported the movement against the autocratic Rana regime. Gajendra Narayan Singh, Kusheshwar Pathak and Mahindra Raya were some of the Madhesi leaders that participated in the 1950 movement. Madhesi people and leaders also fought actively against the Panchayat regime. Leaders like Ramraja Prasad Singh, Dr Laxmi Narayan Jha, Suryanath Raya Yadav, Saketchandra Mishra and Dilip Chaudhary were victims of enforced disappearance by the state. Though Ramraja Prasad Singh managed to free himself, Durgananda Jha became the first martyr of Madhes origin during the Panchayat regime. Madhes and its people had a political voice in a real sense after the Madhes movement of 2007. The erstwhile Madhesi Janadhikar Forum, led by Yadav, was at the forefront of this movement. The party went on to win 52 seats in the 2008 Constituent Assembly (CA) elections. But soon it split into different factions, and as a result, the position of Madhes in the mainstream politics was weakened. In the 2013 CA elections, Madhes-based parties won only 12 out of 119 seats. Although the Madhes-centric parties did form the government in Madhes Province after the 2017 elections, they left much to be desired for when it came to development, stability and good governance.   Observers say voters have punished the Madhes-based parties for their complacency, for condoning corruption and irregularities. It is an outcome of disrespecting people’s will. If the parties do not learn their lesson, they could be  further weakened in the  next election, observers say. Box Madhes Province Assembly (FPTP seats) CPN-UML: 15 Nepali Congress: 13 JSP: 9 LSP: 7 Janamat: 6 Independents: 6 Maoist Center: 4 CPN (US): 4

Survivors of rape and sexual violence in Dhanusha district are compelled to wait for year on end to get justice from the court of law. Concerned family members and survivors say the District Court, Dhanusha, doesn’t give due priority to their cases despite their repeated pleas. A case in point is the incident in which two sisters, both of the underage, were drugged and raped in Chhireshwarnath Municipality. It took the court nearly four years to hand down its conviction against the perpetrator. That period between the incident and the sentencing was harrowing for the two girls and their parents. The family was not just burdened by debt while fighting the case, they were also constantly threatened and pressured by the community members not to drop the charges and agree to an out-of-court settlement. “The situation in the village reached to the point where we could no longer live there,” the girls’ father tells ApEx over the phone. The family moved to Kathmandu to fight the case and start anew. After moving to the Capital city, the girls’ father started working menial jobs to raise his family. Every now and again, he traveled to Dhanusha for the case hearing. “I cannot describe how much I had to go through to bring this culprit, who ruined the lives of my daughters and my family, to justice,” he says. “At one point, I had thought about giving up because the court was too slow to act. My family was saddled with debt. The only thing that kept him going was my two little daughters.” The case was presented for hearing 31 times before the perpetrator was sentenced to 12 years in prison and ordered to pay Rs 500,000 in compensation. There are scores of cases concerning rape and sexual violence awaiting hearing in Dhanusha. The court records show 92 cases, some of them from three years back, are still under judicial consideration. Bikash Basnet, the district court registrar, says the process of justice delivery has slowed down, as the judges are overwhelmed by cases. “One judge has to decide on over 1,100 cases. Still, we try to prioritize serious cases like rape and sexual violence against girls and women,” says Basnet. He claims that the court has formed a separate department to look into and prioritize pending cases. “We will soon start fast-tracking the cases based on their priority,” he adds. Data at the Madhes Province Police shows 734 rape cases and 217 cases of molestation and sexual violence and were reported in eight districts of the province in the past three years. Advocate Rekha Jha believes the situation of sexual crime in Dhanusha and other districts in Madhes province is far worse than what the records show. “We know and we have seen how when there is a rape incident, there are efforts to hush-up the case, how community members and neighbors try to pressure the victim to keep silence,” says Jha. “This practice is still common, particularly when the perpetrators are related or know the victims.” She adds the stigma surrounding rape and sexual assault encourages the culture of keeping the crime a secret, or negotiating out-of-court settlement. “Survivors of rape and sexual assaults rarely go to the authorities themselves,” she says. “And when they do, our justice system delays the hearing, driving them and their families to mental and financial distress.”

When Chancla Devi went into labor in the middle of the night, she was rushed to Provincial Hospital in Janakpurdham, where she underwent a C-section surgery and gave birth to a baby boy. As the baby was sickly, the doctor suggested that he be kept in the Newborn Intensive Care Unit. “The NICU at the hospital was full at the time,” says Rabindra Sah, the baby’s father. “So Dr Abhaya Mandal told us to take the baby to Naina Hospital at Ramananda Chowk.” Naina Hospital is a privately run facility established by Dr Brijmohan Rajak, who also works at the Provincial Hospital, some 16 months ago. It is registered with the government. “It turned out, the hospital did not have an NICU, and the doctors lied to us,” says Sah, who hails from Sarlahi district. “Days after admitting my baby, they told us he did not survive.” Sah claims his newborn died because Dr Mandal referred his baby to a hospital that is being illegally operated. He says the doctors refused to refer the baby to a proper hospital despite his repeated requests. “They kept telling me that the baby was doing fine when he was not,” says Sah. “They killed my baby and then handed me a bill for Rs 32,000.” Dr Mandal refutes Sah’s allegation. “The baby had a heart condition,” he says. “We did our best to save him.” He did admit that he had referred the baby to Naina Hospital. He, however, says that he had no idea the hospital was not registered with the government. The hospital owner, Dr Rajak, says they are in the process of registering the hospital. There are dozens of unregistered hospitals and pharmacies in Janakpurdham, where people visit on a daily basis. Bijay Jha, director at the Health Directorate under the Social Development Ministry of Madhes Province, says though they don’t have the actual figure on the number of unregistered hospitals and pharmacies in the city, it could be close to 90 percent. “These are privately run facilities. We are still in the process of collecting their details,” says Jha. City Hospital, Nawajiwan Hospital, Tarai Rajdhani Hospital, Dhanusha Hospital and City Hospital Care Nursing Home are some of the hospitals based in Janakpurdham. Likewise, there are dozens of pharmacies and diagnostic centers close. The government has not recognized the majority of these facilities As per the law, to open a health facility with 25 beds or less, the operator must obtain a permit from the local government. The provincial government issues permits for hospitals with more than 25 beds. Saroj Mishra, a social activist in Janakpurdham, says most hospitals, pharmacies and pathology labs running in the city are illegal, and people in the medical profession themselves are behind them. “The government is not doing anything about this because those who own these facilities are politically connected,” he says. “Hospitals and pharmacies are being treated as profit-making businesses, which is unfortunate.”