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Eight long years have passed since Nepal embarked on the journey of crafting a new federal democratic constitution through the Constituent Assembly (CA), a vision held dear by the people since the 1950s.

As per the constitution's mandate, we have seen two rounds of elections for a three-tier government—federal, provincial, and local— with even parties from the Madhes region embracing the constitution, albeit with initial reservations. Today, there is hardly any prominent political force opposing it outright, though many still harbor reservations.

Yet, despite these advancements, the constitution has fallen short of delivering the much-needed political stability. Over the past eight tumultuous years, we have witnessed six governments led by three different leaders—KP Sharma Oli, Sher Bahadur Deuba and Pushpa Kamal Dahal. There was a glimmer of hope when CPN-UML and CPN (Maoist Center) united in 2018, but that optimism was shattered with their subsequent split.

During this period, the parliament faced dissolution twice, and the ruling alliances underwent frequent changes. Provincial assemblies fared no better. Thanks to the electoral system adopted by the constitution, the chances of a single party securing a majority are nearly nonexistent, and the sustainability of such a majority is uncertain. Parties have become engrossed in safeguarding their interests, leaving the people's agenda in the dust. Ideological positions were abandoned as parties displayed a willingness to form alliances with anyone, anytime. 

In these eight years, parties made systematic efforts to control the judiciary and parliament, undermining the crucial separation of powers principle. The constitutional bodies suffered politicization and paralysis.

The constitution has also failed to ignite the economic prosperity and development it promised. Frequent changes in government, a growing economic crisis, corruption, job scarcity, and poor governance have fueled frustration among citizens.

The disillusionment has driven many youths to seek education and employment abroad, with approximately 2,000 leaving Nepal daily. Those remaining in the country are increasingly losing hope for their careers. Opportunistic royalist and anti-federal forces are meanwhile attempting to capitalize on this discontent.

Constitutional expert Radheshyam Adhikari says that the people's growing frustration is not a reflection of the constitution's failure but rather the ineptitude of those in power. 

“Obviously, people are frustrated because of the working style of the rulers who have failed to deliver. Rule of law has been undermined and economic issues remain unaddressed,” he says. “A constitution is just a tool, not a solution. It is the political parties who must mend their ways.” 

Adhikari adds while there are flaws in the constitution, it can always be redressed after thorough and objective analysis, underscoring that there is no alternative to this constitution.

Another constitutional expert, Nilambar Acharya, shares a similar sentiment. He sees no reason to blame the constitution for the country's current state. 

“Weaknesses and loopholes can be amended, but the constitution itself is not at fault. It's the actors and parties that have made mistakes,” he says. 

The 2015 constitution was a result of compromise among major political players, including Nepali Congress, CPN-UML and CPN (Maoist Center), and various ethnic groups. Madhes-based parties initially disowned the charter, leading to the first amendment to partially address their concerns. Eventually, most Madhes-based parties abandoned their original agenda to join the government.

After eight years, one would expect the constitution and federal structure to have strengthened. However, doubts are emerging about the constitution's sustainability and core principles. Even within major parties, voices are growing in favor of scrapping the federal structure.

Secularism faces more threats than ever, with major parties wavering in their commitment. Pro-Hindu forces are pushing for a return to a Hindu state, and social harmony and religious tolerance are under strain. Recent incidents in Dharan and Lahan serve as examples, where tensions flared. The only way to quell anti-constitution sentiments is through effective governance and action from political parties.

Despite these challenges, it is high time to review the constitution and assess the performance of political parties. This doesn't mean the constitution must be discarded; rather, parties need to course-correct immediately. The constitution was a step toward progress, but the journey requires the right guidance and determination to succeed.

Autism Spectrum Disorder, a neurodivergent condition that impacts social interaction, affects an estimated 250,000-300,000 people in Nepal, with 60,000-90,000 people classified as severely affected. Autism Spectrum Disorder, or ASD, has been thought to predominantly affect males, with a male-female diagnosis ratio of 4:1. However, recent studies have proposed  that this ratio is closer to 3:1, with a considerable population of females being diagnosed late or undiagnosed.

To understand the cause behind poor diagnoses, it is essential to understand the early days of autism research. The term ‘autism’ was coined by the Swiss psychiatrist Eugen Bleuler in 1911 and was used to describe a set of schizophrenia symptoms that involved withdrawal from the external world and increased focus on oneself. 

Later, in the 1940s, researchers Leo Kanner and Hans Asperger used the term to describe a group of children who displayed similar social and communication difficulties but did not fit the profile of schizophrenia. These two  researchers played a crucial role in highlighting autism as a separate developmental disorder. However, these studies were performed with a sample size unrepresentative of autism as a whole. 

The first study (1943) had a sample of 11 children: three girls and eight boys. The  following study was entirely composed of boys. Male-centric research is not just a problem of the past. The current ascertainment bias towards males is 15:1, with males being 15 times more likely to be chosen in a study for autism than females. As most of the existing data focuses on autism in boys, the measures used to define and diagnose autism are also more applicable to male behavior, leaving many girls with late or no diagnosis that can affect them for the rest of their lives.  

To tackle this issue, a recent study analyzed autistic behavior in a sample of both boys and girls. After careful evaluation, they created a list of ASD symptoms that varied from gender to gender. However, there were limitations to the study. Although the focus of the study was to search for symptoms in girls without intellectual disabilities, the ratio of diagnosed boys to girls was an astounding 11:1. They discovered that:  

● Girls were better at adjusting their behavior to fit social contexts.  

● Girls exhibit fewer patterns of similarity concerning restricted, repetitive behavior. 

● Girls were more aware of social conventions and codes of conduct and more influenced by peer pressure. 

● Girls have stronger communication skills. 

● Girls develop significantly fewer routines in specific interests. 

● Girls were less distressed in noisy, crowded places. 

● Girls had fewer non-verbal communication issues compared to boys. 

While this is just the result of one study, it proposes that autism presents itself slightly differently in girls than boys, with girls having fewer social hindrances and lacking the stereotypical repetitive behavior that currently characterizes autistic behavior. These differences are unaccounted for in diagnostic manuals, further hindering a clinician's ability to make a sound diagnosis.  

Diagnosing autism isn’t as easy as putting a patient into an MRI machine. Clinicians must refer to the DSM-5, the diagnosis and statistical manual, to confirm if their patient checks  the boxes for autism. As mentioned earlier, the DSM and most other checklists are based on male-centered studies and are more applicable to men than women. For example, one of the possible requirements for autistic behavior is, as stated: “Stereotyped or repetitive motor  movements, use of objects, or speech (e.g., simple motor stereotypes, lining up toys or flipping objects, echolalia, idiosyncratic phrases).” Some of these behaviors, such as hand wringing, rocking, and restrictive repetitive movements, appear more in boys than girls.

Here’s another example. “Highly restricted, fixated interests that are abnormal in intensity or focus (e.g., strong attachment to or preoccupation with unusual objects, excessively circumscribed or perseverative interests).” The “restrictive, repetitive patterns of behavior and interest” described often present differently in girls, with girls engaging seemingly ordinary interests like animals, celebrities, or a specific TV show. These interests usually reach a near obsessive level, but they are not “stereotypical” autistic traits, so they often go overlooked. None of these differences are acknowledged by the DSM, as the criteria for ASD show no  variance in gender.  

One final factor in the underdiagnosis of girls is a behavior known as camouflaging. Camouflaging refers to masking social impairment or behaviors to fit society’s standards. Due to gender expectations, women feel more pressure than men to conform to societal norms; therefore, females are more likely to engage in camouflaging behavior. Camouflaging, or masking, can occur in girls as young as 7-8, making it harder for parents to notice and report irregularities in their child’s behavior if they have not already been diagnosed. 

Dr Amit Jha, a doctor at Kanti’s child and adolescent psychiatric unit, observed that family members sometimes normalize symptoms of autism in girls, accounting for a girl’s social withdrawal to being “shy.” Ignoring autism symptoms early on can lead to late diagnosis, which is detrimental to a child’s  health in numerous ways. As mentioned earlier, behaviors like camouflaging can arise and delay  a diagnosis for even longer.  

So what is the importance of an early diagnosis? Younger minds have a higher level of  brain plasticity, or the brain's ability to adapt and change. Therefore, the sooner autism is diagnosed and cared for, the more effective treatment will be. Sita Koirala (name changed) pushed her family to seek a diagnosis for her two-year-old sister after she started developing signs of autism. After much resistance from her family, they booked an appointment, only to be told she was fine. 

As time passed and her symptoms worsened, they booked another consultation and finally got an official autism diagnosis. Now, her sister is receiving treatment and slowly improving her communication and social skills. However, it’s hard not to wonder if further intervention could have occurred if she had been diagnosed correctly the first time around and how a delayed  diagnosis impacted her lifelong development. 

All this new research raises the question of why autism presents differently in females. Dr Supekar and Dr Menon from Stanford School of Medicine sought the answer with a brain  mapping study. His research found discrepancies between the male and female motor cortex, supplementary motor cortex, and a portion of the cerebellum, brain areas responsible for motor function. Dr Supekar hypothesized that these differences could account for the disparity in typical symptoms of autism, such as hand flapping and repetitive behaviors. Another doctor in  the study, Dr Menon, adds: “Girls and boys with autism differ in their clinical and neurobiological characteristics, and their brains are patterned in ways that contribute differently  to behavioral impairments.” 

At the end of the study, Dr Supekar concludes: “The discovery of gender differences in both behavioral and brain measures suggests that clinicians may want to  focus diagnosis and treatments for autistic girls differently than boys.” While this is just a single  study and cannot be used to draw definitive conclusions, it is a promising explanation as to why  autism presents itself differently in male and female brains. 

To put it simply, the existing measures of autism could have a higher validity for boys than girls, resulting in missed and late diagnoses. While part of the ratio between diagnosed  boys and girls with autism is due to biological differences, the global ratio is likely 3:1 rather than the current accepted ratio of 4:1.  The children missed during diagnosis fall into a group that doesn’t show stereotypical autistic traits and risk spending their whole life struggling with an undiagnosed condition.

It should also be noted that while the 4:1 ratio is a global statistic—and there is not  enough data collected in Nepal to create a country-wide metric—it is safe to assume that the ratio of diagnosed girls to boys is even higher due to Nepal’s already gender-biased culture. Mental health is still an emerging field in Nepal. Therefore, if this issue can be addressed sooner  rather than later, the gap can be closed through further research, awareness, and capacity building. To treat our girls and boys equally, their conditions need to be looked at differently. Every stakeholder, from government to clinicians to family members, can help ensure every girl gets the treatment she deserves.

Many youths in Nepal are exploring foreign employment prospects. Two primary factors are mainly behind this: Limited job opportunities in Nepal and inadequate appreciation for work.

In Nepal, the mindset of giving due respect to all types of professions, devoid of any hierarchy or discrimination, is generally lacking. No job should be considered superior or inferior. This perspective is closely tied to the issue of compensation and salary. Salaries must be substantial enough to sustain a satisfactory standard of living.

In contrast, foreign nations where Nepalis work have dignity of work. 

Conversely, the scarcity of employment opportunities is largely associated with the nation’s economic circumstances. 

Addressing these crucial issues, including fostering a culture of respect for all professions and enhancing economic growth to generate more job opportunities, necessitates collective efforts. Without resolution of these key challenges, the trend of youths seeking employment abroad is likely to persist and potentially increase.

The author is spokesperson at Foreign Employment Board

The world’s attention will turn to New York this week as the 78th UN General Assembly takes center stage. Yet, it's notable that several prominent world leaders have chosen to bypass this crucial gathering, citing their busy schedules.

Indian Prime Minister Narendra Modi, Chinese President Xi Jinping, UK Prime Minister Rishi Sunak, and French President Emmanuel Macron are conspicuously absent from the inaugural session of UNGA. Experts say this glaring absence of key leaders, responsible for addressing pressing global issues such as climate change, the Russia-Ukraine conflict, food crises, and achieving the Sustainable Development Goals (SDGs), underscores the waning influence of the UN as a multilateral platform.

However, UN Secretary-General Antonio Guterres maintains a resolute focus on action rather than attendance. He emphasizes that what truly matters is what gets accomplished, especially in revitalizing the lagging SDGs. This year, alongside the customary speeches by heads of state and government, there are five high-level summits slated to tackle the burning issues plaguing our world.

According to the UN, the Climate Action Summit, set for Sept 23, aims to amplify ambitions and hold countries accountable to their international commitments under the 2015 Paris Agreement, particularly in reducing global warming. The summit's key priorities include a global shift to renewable energy, development of sustainable and resilient infrastructure and cities, promoting sustainable agriculture, responsible forest and ocean management, resilience and adaptation to climate impacts, and aligning public and private finance with a net-zero economy.

On the same day, the UN will host the first high-level meeting on universal health coverage, aptly tagged “Moving together to Build a Healthier World”. This meeting is touted as the most significant political gathering ever held on this crucial subject. With over half of the world’s population lacking access to essential health services, and nearly 100m people pushed into extreme poverty due to health costs annually, this event is a pivotal opportunity to secure political commitment from global leaders to prioritize and invest in universal health coverage for all. All nations have pledged to work toward achieving universal health coverage by 2030, encompassing financial risk protection, high-quality healthcare services, and access to safe, effective, quality, and affordable essential medicines and vaccines.

On Sept 24 and 25, the SDG summit will take center stage, marking the first such event since the adoption of the SDG agenda in 2015. Despite some progress toward achieving the 17 sustainable development goals, challenges like climate change and financing gaps have hindered overall progress. Small Island Developing States, least developed countries, and landlocked developing countries are falling behind on their SDG targets. To bridge this gap, significant investments, primarily in developing countries, will be a focal point of this year's discussions. The UN estimates that annual investments ranging from $5trn to $7trn across all sectors are needed to realize the SDGs.

From Nepal, a high-powered delegation led by Prime Minister Pushpa Kamal Dahal, accompanied by Foreign Minister NP Saud and Foreign Secretary Bharat Raj Paudyal, is attending the 78th UNGA. Prime Minister Dahal’s primary objective for this visit is to garner international support to conclude Nepal's long-drawn-out transitional justice process. Before embarking on his journey to New York, Dahal made efforts to advance a bill related to transitional justice that had been languishing in the Legislation Committee of Parliament. Although the specifics of international support are not fully disclosed, it's evident that Dahal seeks some flexibility in the bill to allow for amnesty in addressing human rights issues.

Dahal has held talks with the UN Secretary-General Guterres, covering a broad spectrum of issues. These discussions touched on pressing global concerns, from climate change to sustainable development goals, and emphasized various aspects of Nepal-UN cooperation, including peace efforts. Guterres expressed gratitude to Nepal for its active engagement with the United Nations, especially its substantial contribution to peacekeeping. The two leaders also delved into shared concerns related to climate change, challenges faced by Landlocked Developing Countries (LLDCs), and the crucial role of the government's leadership in Nepal’s journey toward graduation from Least Developed Country (LDC) to developing country, according to the UN spokesperson.

Nepal’s key priorities 

• Climate change: Loss and damage, climate finance 
• UN peacekeeping 
• LDC graduation 
• Rights of land-locked countries 
• SDGs