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Dr Kamana Neupane is a 30-year-old dentist currently practicing at Kantipur Dental College Teaching Hospital and Research Centre. She serves as a consultant periodontist at the teaching hospital, where she shares her expertise with aspiring dental professionals. She obtained her Bachelor of Dental Surgery (BDS) degree from Chitwan Medical College. She followed that up with a Master of Dental Surgery (MDS) degree from Kantipur Dental College, affiliated to Kathmandu University. 

In addition to her clinical practice, Dr Neupane is an active member of several professional organizations, including the Nepalese Society of Periodontology and Oral Implantology, Nepal Association of Dental Research, and the Nepal Medical Association. She strives to provide the highest quality dental care to her patients while actively contributing to the advancement of dental research and education in Nepal. Rastrika Shakya from ApEx spoke to Dr Neupane about her experience and roles in the field of dentistry.

What do you think about the current state of dental care in Nepal? 

In our region, particularly in the southeastern area, there’s a noticeable lack of awareness about oral health. Many people believe that as we age, our teeth naturally become weaker and see it as normal, which is a misconception. This leads to a general unawareness and lack of motivation regarding oral health. Regular checkups for oral health aren’t common. Most people only visit a dentist when they have severe issues. If people understood the importance of good oral hygiene and made regular visits to the dentist, oral health problems would decrease. Just like we prioritize taking care of other parts of our body, it’s crucial to prioritize our oral health too.

In urban areas, there’s some regard for oral health but in remote areas, there’s very little awareness. For many, oral health care and treatment seem like luxuries rather than necessities. It’s unrealistic to expect people in remote areas to prioritize dental health when they’re struggling to meet their basic needs. However, we can make a positive impact with proper education, awareness, and motivation. 

What are some practices for maintaining good oral hygiene? Are there any habits or behaviors that negatively impact oral health?

Brush your teeth every morning and night, right after meals, using a soft-bristled toothbrush and toothpaste with fluoride. Don’t forget about dental floss as it’s crucial for cleaning the spaces between your teeth and removing any leftover food. Also, make sure to rinse your mouth, teeth, and tongue thoroughly. It’s all about keeping your entire mouth clean and healthy. However, maintaining good dental hygiene isn’t the only factor in oral health. Some bad habits can negatively impact our oral health. Smoking, drinking alcohol, and using substances like cocaine, heroin, and tobacco can directly weaken our gums and teeth. Habits such as teeth grinding and breathing through the mouth can also cause problems. Studies have shown that individuals who smoke or abuse substances are four times more likely to experience gum problems than non-smokers. 

What are the key steps you take when a patient comes to your clinic for treatment?

We conduct a comprehensive assessment of their physical and mental well-being. We carefully evaluate their orientation and overall fitness to ensure they are in a condition conducive to receiving treatment. We delve into their medical history to gain insight into the reasons behind their visit and the specific issues they are facing. We take into account their overall health status, recognizing that certain medical conditions can significantly impact oral health. For instance, we are mindful that conditions like diabetes can manifest in oral symptoms such as loose teeth, despite diligent oral hygiene practices.

Then we conduct a thorough examination of the patient’s mouth, often using X-rays, CT scans, and sometimes blood tests for more complex cases. This helps us diagnose any problems. We prioritize treatment based on the patient’s immediate needs, such as relieving pain or addressing swelling. Then we address any underlying issues that the patient might not have been aware of. We take the time to thoroughly explain the patient’s condition, discussing the contributing factors and potential treatment options. By empowering patients with knowledge about their oral health, we enable them to make informed decisions and actively participate in their treatment journey.

Are there any community outreach programs or public health initiatives you’re involved in to promote dental health awareness and education in Nepal?

We actively engage in oral health campaigns within local schools, recognizing the receptivity of young minds to educational initiatives. Through these campaigns, we want to impart fundamental knowledge about maintaining oral hygiene to children. We emphasize the importance of regular brushing and demonstrate proper brushing techniques tailored to their age and understanding. Our commitment to promoting oral health extends beyond the classroom. We also conduct checkups and treatment camps in rural areas. These camps serve as crucial outreach initiatives, providing much-needed dental services to underserved communities. We also take the opportunity to educate attendees about the significance of oral hygiene practices. We aim to instill good oral hygiene habits from a young age and ensure that everyone has access to essential dental services and knowledge.

How do you stay updated on the latest advancements and techniques in dentistry? 

In our field, we rely on international journals to stay updated with the latest advancements. These have articles containing new research, processes, and advancements in dentistry. Researchers share their findings, fill gaps in knowledge, and present results while comparing their work with previous techniques. As a periodontist, I’m part of the periodontal society in Nepal which comprises all Nepali periodontists. We organize three conferences annually. During these conferences, we host national speakers who present on various topics, including postgraduate students sharing their cases and outcomes. We invite international speakers to share insights into developments in their respective countries. These conferences serve as platforms for exchanging information and updating ourselves on the latest trends and practices in periodontology. We also actively participate in international conferences where we can engage with the global dental community, exchange knowledge, and learn about advancements from around the world.

What are your views on the future of dentistry?

When comparing Nepali dentistry with international standards, we find ourselves lagging significantly. Our technologies and practices are outdated, primarily due to affordability constraints. Many Nepali patients struggle to afford advanced dental treatments available in more developed countries. Additionally, the availability of advanced dental equipment and materials in the market is limited in Nepal.

Despite these challenges, there is hope for improvement in the future. With ongoing advancements in technology and increasing awareness, we aspire to bridge the gap and reach the same level as international standards soon. It will require concerted efforts from both the government and the dental community to enhance infrastructure, increase affordability, and improve access to modern dental technologies and practices.

Nepal’s strategic location between two major powers, India and China, makes it a crucial player in the geopolitical dynamics of the region and beyond. The country’s location between the two rising, competing and conflicting powers of Asia (China and India) makes it important for Western powers to strike a strategic balancing act in the region. In this situation, Nepal’s strategic location between two of the emerging countries of Asia makes it imperative for the US to launch a regional maneuver. 

In addition, the US and India maintain strategic relationships in the Asia-Pacific region and Quadrilateral Security Dialogue (QUAD). Global power is shifting toward the Asia-Pacific region with strategic bipolarity between the US and China creating several implications for the global order. These developments indicate that the US-led ‘unipolar world’ may not last last long, making way for a multipolar world with China as one of the power centers. 
In recent years, increased cooperation between India and the US through Washington, DC-led projects like the Millennium Challenge Corporation (MCC) is being seen as a counter to China’s BRI in Nepal. China’s debt-based approach to BRI raises concern about the impact of it on the stability and sovereignty of recipient nations, including Nepal. At the same time, MCC has made significant progress within a short span of time, particularly in Nepal’s energy sector, whereas none of the Chinese projects that Nepal signed under BRI in 2017 have materialized/progressed. 

The US believes China’s BRI project is not just an economic initiative but also a geopolitical one and is part of China’s border strategy to expand as well as deepen its global influence. It believes that one of the primary goals of BRI is to export Chinese development and influence, particularly in the developing world. The US-China bipolar strategic rivalry shows that both powers are in a race to influence each other’s ‘regions’. In this situation, the US strategic entry into Nepal and intense rivalry between BRI and MCC projects are reflective of these two countries’ growing competition in world politics.

China views a growing American role in Nepal’s development in recent years as a threat to its presence in the region. Historically, Nepal’s strategic location has shaped Beijing’s delicate balancing act. 

On its part, Nepal presents a range of opportunities for both India and the US, including ensuring stability and security, facilitating economic growth and promoting democratic values. Both countries have also collaborated on advancing Nepal’s legal system, protecting human rights, promoting gender equality and countering Chinese misinformation. Thus, strategic cooperation between India and the US has fostered sufficient trust to see no significant opposition from India regarding the US-led diplomatic efforts in Nepal. All in all, shared interests of India and the US in Nepal provide a strong foundation for cooperation and coordination between the parties involved. 

China has come up with three new initiatives—Global Security Initiative (GSI), Global Development Initiative (GDI) and Global Civilizational Initiative (GCI), which, per Chinese officials, fall under the BRI umbrella. These initiatives, according to the officials, aim to eliminate the root cause of international conflicts, encourage joint international efforts to bring more stability, improve global security governance and promote durable peace and development in the world. But Nepal has reportedly conveyed its unwillingness to join GSI due to risks of data security, unequal distribution of benefits, looming economic dependence, transparency and debt risks. China’s BRI was also seen optimistically initially, but there has been no progress in the past five years even after signing of an MoU with the strategic community seeing a risky amount of debt and a way for Beijing to use its debt leverage to pursue ambitious strategic plans in Nepal. Though 35 projects were originally identified under BRI, Nepal later brought them down to nine. Still, no government in Nepal has committed to moving ahead with these projects due to “concerns over unclear financial terms of Chinese loans”. 

According to diplomats, the Nepal-US relationship is entering a new phase. The US has three distinct interests in Nepal: Political, economic and strategic/military. In terms of strategy, Nepal’s geopolitical location as a gateway for emerging global powers India and China has shaped US interest in Nepal. Different aid programs and a series of high-level visits in recent years are a clear-enough indication of increasing American engagement in Nepal.
Given this context, Nepal must pragmatically balance competing objectives of India, China and the US to advance national interest and priorities. But our governments have largely failed to take timely decisions and initiatives for national development as well as economic upliftment.

The US’ shifting policy toward Nepal is understood as part of the current global power transition. In Nepal, the US-China rivalry has become more visible over the last few years, presenting a great challenge of taking both MCC and BRI together, and balancing the interest of prevailing superpower and emerging superpowers.

Views are personal

Russian citizens residing or visiting Nepal will have the opportunity to vote in the upcoming Russian presidential election, scheduled from March 15 to 17. The Russian Embassy in Nepal has confirmed that polling stations will be set up in Pokhara and Kathmandu to facilitate voting.

Alexander Ivasev, the representative of the Russian Embassy overseeing the polling stations in Pokhara and Kathmandu, assured that the voting process would be accessible for Russian citizens in Nepal.

Polling will take place in Pokhara on March 15 and in Kathmandu on March 17, accommodating both residents and tourists. This arrangement aims to ensure that Russian nationals, including approximately 200 permanent residents in Nepal, can participate in the election. The polling station in Pokhara will be located at Hotel Barahi, while the one in Kathmandu will be at the embassy.

Voting hours in Pokhara will be from 8 am to 12 pm, and voters must present their passports to cast their votes.

The election features four candidates, including the incumbent president, Vladimir Putin, who is running as an independent candidate for a fifth term. Other candidates include Vladislav Davankot of the New People’s Party, Leonid Slutsky of the Nationalist Liberal Democratic Party, and Nikolai Kharitolov of the Communist Party.

The only negative connotation you can find in the Nepali language about potatoes is, “s/he eats aalu (potato) in the final exam”. As the shape of a potato resembles zero, it’s popularly termed as ‘potato grade’ in our society. Aside from this, the potato holds an all-time favorite status in Nepali society, as implied by the phrase “s/he is just like a potato,” meaning one can fit anywhere, just like a potato goes well with any vegetable.

While browsing the online version of Annapurna Post, I suddenly noticed a detailed story about ‘Tharu aalu’ from Tikapur in Kailali. I had never heard of a potato species named after the Tharu indigenous community. So, I read through the entire story. According to the report, this species of potato is exclusively cultivated by the Tharu community and is considered indigenous.

Potatoes entered Nepal 176 years ago, introduced by British naturalist Sir Joseph Dalton Hooker in Taplejung during an ecological expedition in eastern Nepal from October to December of 1848. Sir Hooker was accompanied by Brian H. Hodgson, a naturalist and ethnologist who later became a British resident in Kathmandu. Potatoes then spread across Nepal and became a national favorite.

The per capita consumption of potatoes in Nepal is 75 kg, which is one of the highest in Asia, with almost 90 percent of potatoes consumed by Nepalis being cultivated in Nepal, while only 10 to 12 percent is imported.

Potatoes, scientifically known as Solanum tuberosum, are believed to have originated in the Andes Mountains of South America, particularly in present-day Peru and Bolivia. These early potatoes were smaller and had a wide range of shapes and colors, quite different from the standardized varieties we know today.

Potatoes quickly adapted to the diverse agro-climatic conditions of Nepal, making them a vital crop across different regions of the country. Their adaptability and ease of cultivation made them especially appealing to Nepali farmers.

Potatoes became more than just a crop; they were a solution to food security issues. In a nation with a complex geography, ranging from the lowlands of the Tarai to the towering Himalayas, having a reliable source of sustenance was crucial. Potatoes provided this reliability, as they could be grown at various altitudes and in different soil conditions.

Potatoes have left an indelible mark on Nepali cuisine, being a key ingredient in a variety of dishes, including aalu chop, aalu ko achar (potato salad), and often served with sel roti and puri. The adaptability of potatoes allows them to be incorporated into both vegetarian and non-vegetarian dishes, making them an essential part of Nepali gastronomy.

The aalu dum is a ubiquitous dish that features potatoes simmered in a flavorful tomato-based gravy. Variations abound, with some adding peas or cauliflower. It’s a staple enjoyed year-round.

Aalu sadheko is a spicy potato salad that is popular in Kathmandu Valley. It’s a delightful twist on the classic potato salad. Boiled potatoes are tossed with a tangy dressing of chilies, ginger, garlic, and herbs. Perfect for any occasion.

Mustang aalu, on the other hand, is a deep-fried and fiery delicacy. This crispy potato snack is a specialty of the Mustang region. Packed with red chilies, timur pepper (or substitutes), and other spices, it’s a guaranteed crowd-pleaser. It’s best enjoyed during colder months.

Baglung, Gulmi, and Palpa regions offer chukainu, a refreshing yogurt-based potato curried salad. Chopped potatoes are combined with vegetables, herbs, and a creamy yogurt dressing, making it a light and healthy option. Tempering with fenugreek seeds is very important.

Sherpa communities in the high Himalayas have their own potato delicacy – rildok. Mashed potatoes are mixed with nettles or other wild greens, offering a unique taste and essential nutrients during the harsh winters.

Malekhu is popular for its aalu chop. This dish features deep-fried potato wedges tossed in a spicy and tangy sauce. While its exact origin is unclear, it’s a popular street food enjoyed across Nepal.

Thicheko aalu, that’s a local delicacy in Pokhara, literally translates to ‘pressed potatoes.’ This dish involves flattening boiled potatoes and pan-frying them until crispy. It’s a simple yet flavorful snack.

Originating from the Madhesh and popular nationwide, aalu bhujuri is a simple and delicious item made from potatoes. Just thinly slice the potatoes and fry them in hot oil with seed spices like cumin or fennel. Cook until brown. Add salt, grated garlic, chili, and turmeric, and cook for a while.

This is just a taste of the many potato dishes that grace Nepali tables. Each region and community has its take on this versatile ingredient, reflecting the rich heritage of Nepali cuisine. So, next time you’re looking for a potato dish with a twist, consider exploring the culinary delights of Nepal.

The author is a UK-based R&D chef