The mystery of the severed hands

On the fourth day of our cycling trip to Lo Manthang in Upper Mustang, we spent the night in a town called Gheling (3,570m), nestled amidst barren, eroded badlands. The fascinating discovery of a severed human hand at Gheling gompa (monastery) added a breath of mystery to our exploits. My three companions, Khashing, Diwas, and Shayeet, after a cup of shucha and salted butter tea (pocha in Tibetan), took a stroll through the village and dropped by a gompa. I stayed back at the lodge since I’d developed a mild headache and felt too burnt out after the grueling climb of Syangmochen La (pass) at 3,850m; the bleak wind at gale speed threatened to hurl me off my bike, further fueling my misery.  Sonam, the hostess, and Chhiring, her three-year-old son, kept me company as I huddled before the iron stove with a large kettle in the dining room. While I chatted with the lady, Chirring kept eyeing me with a mischievous look but stayed withdrawn and bashful.  Dried yak and chyangra (domesticated mountain goat) droppings are fuel for firing iron stoves throughout the Upper Mustang. Even in prewinter November, the weather at night dropped to minus three to four degrees.  The room doubled as a kitchen and a dining space with painted wooden tables and benches with woolen rugs spread over the top. As a few thangka scrolls hung on the walls, a framed photo of His Holiness, the 14th Dalai Lama, looked on solemnly.  My friends showed up as I sampled a glass of uwa rakshi (naked barley liquor). The heat from the stove and the drink managed to take the chill off me. My ears pricked when they recounted the sensational happening.  Kunga, a teenage lama (monk), showed my friends around the monastery. They learned he sought ordination into Lama Hood (monkhood) and worked and studied there.  The young monk fetched a bundle swathed in vermillion cloth and unwrapped it. What my friends saw left them baffled. He held a shriveled, hacked-off human right hand, which Kunga claimed dated back over 500 years. The hand still had a gold ring on the ring finger. “This hand belonged to the thief who entered the gompa and tried to steal ancient artifacts. The custodian of the monastery caught him red-handed, chopped off his right hand, and turned him over to the authorities. At Tsarang, too, the royal palace holds one,” said Kunga.  The monk even allowed them to touch it but forbade them to take pictures. Every monastery in Lower and Upper Mustang prohibits photography. It felt genuine, Shayeet swore, and the rest nodded in agreement. Sonam stood by the story. It was apparently local folklore in Gheling. I decided I’d not let the opportunity to see it myself slip at Mustang Raja’s (King) palace in Tsarang.  The next day, we left Gheling and hit the road to Tasarang (3,588m). The morning was crisp but there was no sign of wind. We knew we would face the blast after 11 am though. At a foothill, we ran into a string of horses—regular sightings in Mustang—nibbling on a patch of grass.  At sundown, we arrived in Tsarang, built in the 13th century by the first King of Lo, Chhyogel Ame Pal Sangpo. All four of us were fit to drop as we had to tackle the 4,020m high Nyi La pass with the howling, biting wind that furiously lashed at us. As darkness approached, we called it a day. We struck for the white Dzong (fortress) the next day, the palace of the late King of Mustang, Jigme Palbar Bista.  Standing high on a sandstone cliff and ringed by a thicket of poplar and wild willow, the five-story structure looked formidable but rundown, almost falling apart—tall crumbling walls in ruins stood close by. The site looked deserted. There was no one around and a sign read closed to visitors. My hopes to see the shriveled hands were quashed. We ran into a middle-aged monk heading towards the town, thumbing his prayer beads as we prepared to leave. He seemed very forthcoming and told us the fort still housed the king’s armory, a gallery, and the royal chambers, but they were all in dilapidated states. One room held the chopped-off human hands. After the 2015 earthquake, visitors got barred for safety reasons.  The story at Tsarang differed from Gheling’s though. Going by the local lore, the king ordered to chop off the right hand of the main builder of the palace so he could not erect another of his masterpieces. As we hit the trail, the matter of the severed hands remained vague and shrouded in profound mystery. Watch the video footage on chopped-off hands at Gheling and Tsarang uploaded on Instagram by Magnus Ronningen, a Norwegian adventurer and journalist: https://www.instagram.com/p/BJSQGAmAf61/

What do Nepal elections mean for India-Nepal relations?

Nepal is an important neighbor of India and holds special significance in its foreign policy due to centuries-old geographic, historical, cultural, and economic ties. Not only do the two countries have an open border and free movement of people, but they also have close bonds through marriages and familial relations, also sometimes referred to as Roti-Beti ka Rishta. The India-Nepal Treaty of Peace and Friendship of 1950 is the foundation of the special ties. So, whenever there is an election in the neighborhood, it becomes of strategic importance for India to look into the country’s domestic politics and its results to maintain good relations with the government. The article will highlight how recent Nepal elections will set the future of India-Nepal relations. The transition from monarchy to democracy Nepal was ruled by a succession of hereditary rulers for most of its history. In Nepal, numerous governments have been formed, and many have failed. Since the restoration of democracy in 1990, there have been three elections: in 1991, 1996, and 1999. Nepal has always desired to transition from a monarchy to a democratic government and change its founding principles to conduct a new society. Nepal had seen several popular democratic movements, and on 28 May 2008, the newly elected Constituent Assembly said that Nepal was now a federal democratic republic. It got rid of the monarchy, which had been in place for 240 years. Nepal today has a president as head of state and a prime minister heading the government. It has experienced two systems: monarchy (from the country’s unification in 1768 until 2006) and republican democracy (from 2007 to the present). Election fever in 2022 On Sunday, Nov 20, approximately 18m eligible voters cast their ballots in Nepal to elect new federal and provincial legislatures, the country’s second election since the constitution was promulgated in 2015. The 165 members of the 275-member federal House of Representative will be elected through the first-past-the-post (FPTP) system, with the remaining 110 seats filled using a proportional representation system (PR). A total of 330 seats in the seven provincial houses will be decided directly, with proportional representation filling the remaining 220 seats. In the past Nepal’s leaders had made collective promises of ‘stable government, democratic consolidation, economic prosperity, and corruption-free governance’. but none of them could keep their promises, especially for India, which plays a decisive role in Nepal’s internal politics. The current government, Prime Minister Sher Bahadur Deuba of Nepali Congress (NC), has deep strategic relations with India and shares a common good. But, in the past, under the leadership of the Communist Party of Nepal-Unified Marxist Leninist (CPN-UML) of former Prime Minister KP Sharma Oli, the ties between the two countries became fractious. Oli hopes to return to power after the election and he has promised to bring Kalapani, Lipulekh, and Limpiadhura, a disputed territory between Nepal and India, under Nepal’s control. The border issue has emerged as a major bone of contention between Nepal and India. India, China and the US nexus China and India aren’t the only countries waiting with bated breath for the results of Nepal's elections. In its fierce competition with China in the region, the US cares just as much about who comes out on top. To fight against China’s Belt and Road Initiative, worth billions of dollars, and also in the Indo-Pacific. China, meanwhile, has been working to become a significant player in Nepal since 2006. It is doing so by increasing its investments in many different areas. So China is looking for a government in Kathmandu that is cooperative and willing to work for its interests. Beijing’s increasingly close ties with Kathmandu has annoyed New Delhi no end. Tensions between India and Nepal grew with the Oli government signing of a trade and transit treaty with China in 2016. President Xi Jinping visited Nepal in Oct 2019. All these major activities have a strategic role in forming future relations between India and Nepal. Challenges for India Internal security is a big issue for India. The border between India and Nepal is almost open and only lightly policed, which terrorist and insurgent groups from the North Eastern part of India use to their advantage by, for example, sending trained cadres and fake Indian currency. India’s reputation for taking too long to finish projects has made the trust gap between India and Nepal grow over time. Nepal has had a long history of political instability, including a 10-year violent insurgency, which has hurt the country’s growth and economy. Some Nepali ethnic groups don't like India because they think that it meddles too much in Nepal’s internal affairs. Nepal and China have diplomatic ties, and the latter’s influence in Nepal is growing. It means that India has less power in Nepal than it used to. So, to overcome China’s growing influence, India will need to start narrowing the communication gap with Nepal, as well as give momentum to stalled projects. Conclusion Elections in Nepal may have significant geopolitical implications for India and other neighboring nations. No matter which political party comes to power. India should provide an alternative narrative for India-Nepal relations, considering the long-standing people-to-people ties and cultural connection between the two nations. It should concentrate on realizing the unrealized potential of hydropower cooperation, mainly due to divergent perceptions. It should maintain its policy of non-interference in Nepal’s internal affairs. India cannot afford to overlook the need for a stable and secure Nepal, given its immense strategic significance. Misuse of an open border by internal and external forces affects both countries, and both are responsible for border management and regulation. All of these significant challenges and their resolutions will propel India-Nepal relations to new heights. The author is the Director of Research in the Indo-Pacific Consortium at Raisina House, New Delhi. Views expressed are personal

Mind Matters | Grieving a pet’s loss

Query

I’m a 29-year-old bartender and recently my pet dog of 12 years passed away. Dealing with the death of a loved one is generally difficult. But I feel like I’m falling deep into this sorrow, so much so that I don’t see myself feeling better, ever. I don’t know what to do to deal with this loss. Should I be seeking professional help? I can’t seem to think straight. I’m writing to let my emotions out and, in the process, maybe I can find some answers.—A pet lover Answered by Dristy Moktan, psychosocial counselor, Happy Minds I’m really very sorry to hear about your loss. Losing a pet can be a harrowing experience. It must be even more difficult since you both were together for 12 years. But I want to tell you that how you feel is a normal reaction, given the situation. The fact that you realize how you feel is the first step towards acceptance. What I understand when you say you are diving deep into your sorrow is that you are in the depression phase of your grief. It’s a very difficult phase and your concerns are valid. One thing I really appreciate is that you are aware of your emotional state. To some extent, it’s okay to feel this immense grief. But, on the other hand, you do need to work on getting out of it so that it will not last a long time. You can do that by finding closure. Everyone has a different way of doing that but there are a few things I would like you to try.  When there is a death in the family, our culture always gives us one last time to say goodbye to our loved ones through a funeral. It can be the same with your pet. It does not have to be exactly like that or even a big event. You can arrange a small memorial for your pet, and say a few words in memory of your dog. It can be extremely comforting and can give you a sense of peace.  If you aren’t up for that, then create an album, or try journaling, remembering the good times you have had with your pet. Sometimes recalling happy memories can help you heal or at least get started on that journey. Know that you gave your dog a loving home, you cherished it, and that it lived a happy life with you by its side. It can be difficult but you always knew this was inevitable, didn’t you? So try cherishing the memories you had.  Another thing you can do is talk to someone with whom you feel the most comfortable. Share your feelings, and cry if you feel like it, but don’t compartmentalize your emotions. Shutting off your emotions will push you deeper into the grieving state. It’s even better if you know someone who has lost a pet too. That way you can feel like you are not alone. Having a support group always helps as you will be going through the grieving process along with others by your side.  If you find my suggestions aren’t helpful, I would advise you to go for counseling. A trained professional will be a better option to guide you through your grieving process. 

Preventing antimicrobial resistance together

Antimicrobial resistance (AMR) is a global health and development threat. It is everywhere. It can affect anyone, of any age, in any country. It is a threat to humans, animals, plants and the environment. Antimicrobials—including antibiotics, antivirals, antifungals and antiparasitics—are medicines used to prevent and treat infections in humans, animals and plants. Microorganisms that develop antimicrobial resistance are also referred to as ‘superbugs’. Antimicrobial resistance occurs when bacteria, viruses, fungi and parasites change over time and no longer respond to existing medicines. Medicines become ineffective leading to treatment failure, increasing the risk of disease spread, severe illness and death. The magnitude of the problem is reflected in the fact that in 2019, nearly 5m human deaths worldwide were associated with bacterial AMR, of which 1.3m human deaths were directly attributable to bacterial AMR. Though the emergence of resistance in microorganisms occurs naturally over time, its amplification and spread are the result of human behavior. Antimicrobial resistant organisms are found in people, animals, food, plants and the environment (in water, soil and air). They can spread from person to person, between people and animals, from food of animal origin. The main drivers of antimicrobial resistance include the misuse and overuse of antimicrobials; lack of access to clean water, sanitation and hygiene (WASH) for both humans and animals; poor infection and disease prevention and control in health-care facilities and farms; poor access to quality, affordable medicines, vaccines and diagnostics; lack of awareness and knowledge; and lack of enforcement of legislation. WHO has declared that AMR is one of the top 10 global public health threats facing humanity. Many of the medical breakthroughs of the last century could be lost through the spread of antimicrobial resistance. Previously curable infectious diseases may become untreatable and spread throughout the world. This has already started to happen. A growing number of infections—such as pneumonia, tuberculosis, gonorrhea, and food borne diseases such as salmonellosis—are becoming harder to treat as the antibiotics used to treat them become less effective. Older and cheaper antibiotics like penicillin, tetracycline and ciprofloxacin have been effective in the past, but now all of the 82m cases of gonorrhea detected each year are resistant to one or all of these. The last effective drug, ceftriaxone, already indicates increasing gonococcal resistance. Antibiotic resistant Mycobacterium tuberculosis strains are threatening progress in containing the global tuberculosis epidemic. Antimalarial drug resistance is another serious cause for concern. Parasite resistance to artemisinin—the core compound of the best available medicines to treat malaria has been reported. HIV drug resistance (HIVDR) poses the risk of compromising the effectiveness of antiretroviral therapy (ART) in reducing HIV incidence and HIV-associated morbidity and mortality. In Nepal, national surveillance shows that around 80 percent of typhoidal salmonellae (the bacteria causing typhoid fever) is now resistant to ciprofloxacin which used to be the treatment choice for typhoid fever. Approximately half of the hospital acquired infections are multidrug resistant. The cost of AMR to the economy is significant. In addition to death and disability, prolonged illness leads to higher medical costs due to longer hospital stays, and the need for more expensive medicines. Left unchecked, in the next decade, AMR could result in a global GDP shortfall of $3.4trn annually and push 24m more people into extreme poverty. The WHO South-East Asia Region of which Nepal is the member state is likely the most at-risk part of the world. As recent history demonstrates––given the ease and frequency with which people now travel, AMR is a global problem, requiring efforts from all nations and many sectors. Combating the complexities of AMR requires a multisectoral One Health approach. Multiple sectors and stakeholders engaged in human, terrestrial and aquatic animal and plant health, food and feed production and the environment need to communicate and work together in the design and implementation of programmes, policies, legislation and research to attain better public health outcomes. Together they need to focus on:

  • Improving awareness and understanding of antimicrobial resistance through effective communication, education and training in the appropriate use and prescription of antimicrobials in human health, animal health and agricultural practice. It includes making antimicrobial resistance a core component of professional education, in the health, veterinary and agricultural sectors.
  • Strengthening surveillance and research across human, animal, plant, food, and environment sectors in efforts to tackle antimicrobial resistance (AMR).
  • Strengthening policies and implementation of infection prevention and control measures through effective sanitation, hygiene and infection prevention measures. Infections can be prevented by washing hands regularly, preparing food hygienically, avoiding close contact with sick people, practicing safe sex, and keeping vaccinations up to date. Good husbandry practices, biosecurity, sanitation, hygiene, vaccination and other infection prevention measures are essential to reduce the need for antimicrobials in animals and antimicrobial pesticides in plants.
  • Optimize the use of antimicrobial medicines in human and animal health through effective and enforceable regulation and governance for licensing, distribution, use and quality assurance of antimicrobial medicines in human and animal health and appropriate use of antimicrobial agents in agriculture.
  • Ensure sustainable investment in countering antimicrobial resistance and increase investment in new medicines, diagnostic tools, vaccines and other interventions.
As a WHO member state, Nepal endorsed the global action plan to tackle AMR during the 68th World Health Assembly. The same year during the WHO South East Asia Regional Committee Meeting in Timor Leste, member states passed a key resolution for steadfast political commitment and multisectoral coordination for AMR control. The Ministry of Health and Population in Nepal has drafted a National Action Plan (NAP) to contain AMR. This plan provides the necessary framework for action. WHO remains committed to supporting the Government of Nepal in its implementation. The author is the WHO Representative to Nepal