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According to the Birgunj Metropolitan City’s Health Division, at least 71 cases of cholera have been confirmed since Friday, with over 200 patients currently receiving treatment for diarrhea and suspected cholera in various hospitals across the city. Two deaths have been reported among patients suffering from severe diarrhea, though cholera infection has not been confirmed in those cases.

Medical experts suspect the outbreak is linked to contamination of drinking water pipelines with sewage. Samples from 11 affected locations have been collected and sent to the National Public Health Laboratory in Teku, Kathmandu, with test results expected soon.

Hospitals in Birgunj, particularly Narayani Hospital, are struggling to cope with the rising patient load. “Due to a shortage of hospital beds, we have been forced to treat patients on the floors and verandas,” said Dr Uday Narayan Singh, spokesperson for Narayani Hospital. 

The outbreak has particularly affected Birgunj Metropolitan City-11, 12, 13, and 16. With community-level spread confirmed, the municipality has ordered all schools in the city to remain closed for two days (Sunday and Monday) as a precautionary measure.

Minister for Water Supply Pradeep Yadav, who visited Narayani Hospital and other affected areas, acknowledged that sewage contamination in water pipelines may have triggered the outbreak. “Water samples from affected areas have been sent to Kathmandu for testing. Only after the results arrive can we confirm the exact cause,” Yadav said. He assured that the government is fully sensitive to the crisis and that teams with water purification materials, including chlorine solutions such as Piyush, have already been dispatched to Birgunj.

Mayor of Birgunj metropolitan city, Rajesh Man Singh, said the city office has also mobilized local health teams for door-to-door awareness campaigns, water sampling, and immediate intervention since Friday night when the first cluster of cases emerged in Murlitol of ward 12. “Strict monitoring is underway at marketplaces to ensure hygiene in the transport and sale of fish, meat, sekuwa and other animal products.” As part of the campaign, authorities have begun inspecting vendors, who display food items openly, sell products in unhygienic conditions or neglect sanitation standards, with actions being taken against violators.

Officials confirmed that this is the first major cholera outbreak in Parsa district in the past decade. Cholera, caused by the bacterium Vibrio cholerae, spreads through contaminated food and water. Symptoms include acute diarrhea, vomiting, abdominal pain, sunken eyes, dehydration, muscle cramps, and in severe cases, fever.

With patient numbers still rising, health authorities warn that the situation could worsen unless water sources are secured and mass preventive measures are enforced immediately.

The Madhes Provincial Government has supplied medicines and health materials to Narayani Hospital in Birgunj for the treatment of cholera patients. On Sunday, Dr Bipan Kumar Jha, Chief of the Health Division at the Ministry of Health and Population, Madhes Province, and Public Health Officer Santosh Thakur handed over the medicines and supplies to Dr Chumanlal Das, Medical Superintendent of Narayani Hospital. The provincial government has provided 17 types of medicines and materials needed for the treatment of diarrhea and cholera patients through the Parsa District Health Office, Thakur said. He added that the provincial government is committed to controlling the cholera outbreak in Birgunj and is prepared to provide additional medicines and supplies if required.

Meanwhile, Home Minister Ramesh Lekhak has directed security agencies to remain on high alert to support efforts in containing a cholera outbreak that has spread across Birgunj. During a meeting of the Central Security Committee on Sunday, Minister Lekhak instructed the Nepali Army, Nepal Police and the Armed Police Force to remain ready for mobilization if required. “The minister has also instructed preparations to deploy medical teams, including doctors, should the situation worsen,” said Ministry spokesperson and Joint-secretary Anand Kafle after the meeting. 

Environmentalist Ujjwal Upadhyay says the cholera outbreak in Birgunj is a direct impact of climate change. Taking to Facebook, he explained that reduced monsoon rainfall and recurring droughts have dried up water sources, creating an acute shortage of drinking water. As a result, local residents have become dependent on unsafe alternatives, such as jar water that is often not quality-tested. When water quantity declines at the source, the concentration of pathogens increases, making the water more contaminated and heightening the risk of infectious diseases.

According to the World Health Organization (WHO), every individual requires at least 100 liters of safe water per day. When supply falls below this level, the likelihood of waterborne diseases rises sharply.

As tube wells began to dry up one after another, the municipality started supplying water through new PVC pipelines, many of which run alongside sewerage canals. During times of acute shortage, people broke open these pipelines to access water but never repaired them afterward, leaving the system highly vulnerable to contamination.

While open defecation has nearly ended in the city, the lack of safe water has compounded the problem. “The bigger question,” Upadhyay stresses, “is who should bear responsibility and provide compensation for such climate-induced losses and damages caused by the excessive carbon emissions of major powers?”

In recent years, words like “sugar” and “pressure” have become part of our everyday conversation. These terms refer to two chronic conditions: diabetes and high blood pressure (hypertension). Once considered the problems of the elderly or the wealthy, they have now become common across all age groups and social classes, posing a serious threat to the health and well-being of millions.

According to the WHO STEPS Survey (2019/20), about one in four Nepalis aged 15 to 69 has high blood pressure, while nearly six percent live with diabetes. Experts believe these numbers are likely higher today due to changes in lifestyle, diet, and increasing urbanization. Perhaps even more worrying is the fact that many individuals remain unaware of their condition until it leads to severe complications such as heart attacks, strokes, or kidney failure.

The changing face of health in Nepal

Nepal has experienced rapid social and economic transformation in recent decades. While infectious diseases and maternal health once dominated public health priorities, a new challenge is emerging: non-communicable diseases (NCDs). Diabetes and hypertension now account for a significant portion of the disease burden. This shift is largely driven by lifestyle changes. Traditional Nepali life involved walking long distances, manual labor, and eating simple, fresh food prepared at home. Today, many people spend most of their time sitting at desks, in vehicles, or glued to digital screens. Physical activity has decreased, and diets have shifted toward high-calorie, processed foods laden with salt, sugar, and unhealthy fats.

Urbanization has brought many conveniences but also new risks. Fast food outlets, sugary drinks, and packaged snacks have become common even in smaller towns. Stress levels have increased as people juggle work, family, and economic challenges. All of these factors contribute to rising rates of obesity, diabetes, and hypertension often affecting people at younger ages than before.

Why are diabetes and high blood pressure dangerous?

Both diabetes and high blood pressure are often called “silent killers” because they typically cause no obvious symptoms in their early stages. Many people feel perfectly fine while the disease silently damages their organs. Diabetes, characterized by high blood sugar levels, can damage blood vessels, nerves, kidneys, eyes, and the heart. Uncontrolled diabetes increases the risk of heart disease, kidney failure, blindness, and amputations.

High blood pressure strains the heart and arteries, increasing the risk of stroke, heart attack, kidney disease, and cognitive decline. Alarmingly, these two conditions often occur together -about two-thirds of people with Type 2 diabetes also have hypertension. The combination of these diseases significantly raises the chance of severe health events and premature death. This dual burden places a heavy strain on individuals, families, and the health system.

The human and economic cost

Living with diabetes or high blood pressure requires lifelong management. Patients need regular doctor visits, medications, blood tests, and lifestyle adjustments. For many Nepali families, especially those in rural areas or with low incomes, the costs of treatment and travel to health facilities are substantial. Moreover, when these diseases lead to complications—such as strokes, heart failure, or kidney failure patients often need hospital stays and expensive procedures. Many lose their ability to work, and their families face income loss and increased care responsibilities. This creates a vicious cycle where illness leads to poverty, which in turn worsens health outcomes.

Early detection: The key to saving lives

Because these conditions develop silently, early detection is critical. Regular screening for blood pressure and blood sugar should be part of routine health care for adults, especially after the age of 35. Unfortunately, many Nepalis do not have easy access to these tests, and awareness remains low. Community health workers and local health posts can play a vital role in educating people and providing screening services. Schools and workplaces are also ideal settings for awareness campaigns and health checks.

Simple steps to prevention and control

The good news is that diabetes and hypertension are mostly preventable and manageable with simple lifestyle choices. Everyone can take steps to protect their health:

• Eat fresh, homemade meals: Limit salt, sugar, and processed foods. Increase fruits, vegetables, and whole grains.
• Stay physically active: Aim for at least 30 minutes of moderate exercise daily. Walking, cycling, yoga, or household work all count.
• Avoid tobacco and limit alcohol: Both increase the risk of these diseases and worsen complications.
• Maintain a healthy weight: Even modest weight loss can improve blood pressure and blood sugar.
• Manage stress: Practices like meditation, spending time with family, or enjoying hobbies can help.
• Regular health checks: Don’t wait for symptoms-check your blood pressure and blood sugar regularly.

What must the government do?

Individual effort alone is not enough. To address the growing NCD burden, Nepal’s health system needs strengthening:

• Expand screening and treatment services in all health facilities, including rural clinics.
• Ensure affordable access to essential medicines for diabetes and hypertension.
• Train health workers to detect and counsel patients effectively.
• Run nationwide awareness campaigns in multiple languages and formats.
• Regulate unhealthy food marketing and consider taxing sugary drinks and junk food.
• Promote physical activity programs in schools, workplaces, and communities.

Nepal has demonstrated remarkable success in tackling infectious diseases and improving maternal health. Similar political will and community engagement can help turn the tide on diabetes and hypertension.

Real stories, real impact

Consider the story of Ramesh, a 52-year-old businessman in Kathmandu. He never thought much about his health until he experienced sudden chest pain and was diagnosed with a heart attack. Tests revealed he had uncontrolled diabetes and hypertension both undiagnosed until then. After months of treatment and lifestyle changes, Ramesh now actively manages his health and advocates for others to get regular checkups. Stories like his are increasingly common. They highlight the urgent need for early detection and prevention across Nepal.

Our collective responsibility

Diabetes and high blood pressure may not cause sudden outbreaks or emergency situations, but their effects are just as devastating. These diseases steal lives slowly and silently, causing suffering for individuals and hardship for families. The good news is that with awareness, commitment, and coordinated action, we can prevent many cases and manage existing ones better. Everyone—individuals, families, healthcare workers, and policymakers—must come together to build a healthier Nepal. We have the knowledge and tools; now is the time to act. Let’s take control of our health before these silent killers take control of our lives.

On a long flight to Kathmandu, the man next to me said, “So, you are a professor—what do you teach?” I smiled. If only academic life were that simple. Teaching is only one part of what I do. Many imagine professors spending most of their time in classrooms. The truth is far broader: we supervise students, review research papers, write proposals, organize conferences, design new courses, serve on committees and sometimes travel across continents to share ideas. Being an academic is not just a job. It is a way of living and learning. Teaching, research and service are woven together, each influencing the others. A student’s question might spark a research idea. Writing a paper might change how I teach. Organizing a conference might lead to collaborations that last years. The philosopher Martin Heidegger called this “worldhood.” 

Our actions don’t exist as isolated tasks, but as parts of a larger, meaningful whole. Reviewing a paper, mentoring a student, preparing a lecture or attending a conference are all connected threads in the same fabric of academic life. Each gains significance from its connection to the others. Our work flows together in a daily rhythm that shapes our identity as academics. Some days are smooth; others are a blur of deadlines, meetings and rejections. But the rewards are real: a student finally grasping a difficult idea, a paper being accepted, a collaboration taking root. Guiding students is among the most satisfying parts of my job.

Watching them grow, thinking critically and discovering new things is deeply rewarding. Every discussion, assignment and piece of feedback is an investment in the next generation—not just in their knowledge, but in their ability to question, explore and contribute to the world. Research is another core pillar. Writing papers, reading others’ work and debating ideas with colleagues all feed into a global conversation. When I attend a conference—whether in Asia, Europe or Africa—I’m not just presenting my work; I’m listening, exchanging perspectives and finding new questions to explore. 

Often, the most important moments happen outside formal sessions: a conversation over coffee, a hallway debate, a chance meeting that sparks an unexpected project. Travel is not just about sightseeing, but also about connecting ideas and people. Each trip adds new threads to the academic fabric—perspectives from different cultures, insights from other disciplines and friendships that outlast any single project.

Academic life is always forward-looking: the next paper to write, the next course to design, the next student to mentor. Our work builds on the knowledge of those before us, and future scholars will build on ours. A lecture is never just a lecture; it’s part of a long chain of learning. A research paper is part of an ongoing conversation. Mentoring a student helps shape the future of our academic community.

Yes, there are challenges—funding struggles, heavy workloads, administrative tangles—but the rewards outweigh them. The freedom to explore ideas, the joy of learning continuously and the chance to inspire others make this life fulfilling. Back in Norway, I still think about my recent guest lecture at Madan Bhandari University of Science and Technology (MBUST) in Nepal.

I noticed how eager students were to explore ways to relate their research to their own community’s challenges. Seeing them connect academic concepts to real-world problems reminded me of the true purpose of teaching: helping students think critically, apply knowledge, and make a difference in the communities they care about. So, when people ask what I do, I find it hard to give a short answer. Being a professor is not a list of duties. 

It is curiosity, dedication and connection. It is the privilege of being part of a community of thinkers and learners. Each lecture, paper, and conversation add to a larger journey. Academia is not just a career. It is a calling—one that shapes how we live, think and relate to the world. For those of us who have chosen it, the journey is filled with challenges, discoveries and every so often, moments that make it all worthwhile.

A few months ago, a shocking incident unfolded in Balkot. A seemingly ordinary family was devastated when Milan Acharya murdered his father and brother in their sleep. He later admitted to the killings, attributing his action to stress and depression. Acharya claimed he did it to “free them,” revealing a deeply troubled state of mind.

Some months later, Lila Raj Giri murdered his seven-year-old daughter and five-year-old nephew in Bharatpur. He attacked the two children with a sickle before turning the weapon on himself. Giri was found in a critical condition and rushed to the hospital. A former soldier, authorities suspect Giri committed the murder due to a mental health crisis.

Similar tragedies continue to emerge across the country. In one recent case, a woman named Durbi from Morang district died after her husband, Babudhan Satar, attacked her in a domestic dispute. A neighbor who tried to intervene was also injured.
Not long after, Rajendra Rai murdered his wife Manisha and her four family members at Dhodlekhani village of Bhojpur. The incident followed months of conflict between Rai and his in-laws, who didn’t approve of marriage between him and their daughter. 

The above- mentioned cases are not random or isolated. In recent months, Nepal has witnessed a disturbing rise in violent crimes committed within families. These chilling cases reveal more than just crime; they point toward a larger, more complex social and psychological crisis.

As Lawrence R Samuel notes in The Psychology of Murder: “The taking of another person’s life was often the outcome of a strong emotion linked to a particular event and a close relationship.” Mental health struggles, unresolved conflicts, societal pressure, caste discrimination, and a lack of support systems may all be contributing factors. Yet the big question remains: Why are people committing these acts—and why do they seem unafraid of the legal consequences?

Is it a failure of the legal system? Or are we neglecting the mental health crisis quietly growing inside homes? The normalization—or even the increasing frequency—of such domestic tragedies demands more than just punishment.

Looking in the traditional Nepali society, it places a strong emphasis on family honor, obedience to elders, rigid gender roles, and social hierarchy. While these norms have historically maintained social cohesion, they often suppress individual emotions and discourage open conversations about mental health. The stigma around seeking help—especially for men or those facing emotional distress—can lead to bottled-up anger, isolation, and unresolved conflict within families. In cases where individuals challenge these norms (such as through love marriages or defying parental authority), tensions can escalate, sometimes with tragic consequences.

Psychiatrist Dr Rika Rijal explains, “In psychiatry, extreme domestic violence within families often emerges from severe depression with psychotic features, psychotic illnesses, unresolved trauma, or overwhelming stress. Individuals in such states may not perceive reality accurately. They might experience overwhelming guilt, or distorted beliefs that drive them toward harming loved ones.” Emotional isolation, personality issues, or long-standing family tensions can further compound the risk.

According to Dr Rijal, depression is not always quiet sadness— it can appear as anger, agitation, and irritability. “In some cases, unresolved trauma or feelings of helplessness may become so unbearable that the person externalizes their inner turmoil in destructive ways.” 

Within homes, this can tragically manifest as violence against family members—those closest and most vulnerable.

In the case of Acharya, the statement to “free” his family reflects a possible altruistic delusion, says Dr Rijal. “In such a state, the person falsely believes they are protecting loved ones. Sometimes, individuals extend their suicidal ideation outward, thinking that death is a form of relief not just for themselves but also for their family.” 

Such a thought process does not arise from cruelty but from a profoundly disordered perception of reality. Psychiatrists suggest that families and communities may also help and examine them carefully. There are different warning signs that includes withdrawal and social isolation, expressions of hopelessness or being a burden, sudden aggression, irritability, or erratic behaviour, talking about “ending suffering” or showing preoccupation with death, noticeable decline in daily functioning, such as neglecting hygiene, school, or work, use of substance etc. Recognizing these signs early can provide families and communities with a chance to intervene before crises escalate.

Nepal does have mental health resources, though they remain limited and underutilized. While psychiatric services at any hospital and NGOs like Transcultural Psychosocial Organization (TPO), KOSHISH, and CMC Nepal offer community-based psychosocial support, they are not widely accessible to those in need.

Dr Rijal says, stigma around mental illness, lack of mental health literacy, and geographical barriers prevent many at-risk individuals from accessing these services. She stresses strengthening community awareness and creating accessible mental health support could prevent such tragedies in the future.

According to Nepal Police, property and financial disputes, such as the division of family property or disagreements over land ownership, often spark deep-rooted tensions within households. These conflicts can escalate into family feuds, leading to strained relationships between spouses and even incidents of domestic violence. Officials say that in many cases, individuals involved may suffer from mental health issues like depression or more severe conditions such as psychosis, which further complicate the situation. 

Additionally, societal pressures—especially the emphasis on family honor—can intensify these challenges, with love affairs or inter-caste marriages often viewed as a threat to social respect. The situation is frequently worsened by the use of drugs and alcohol, which can fuel aggressive behavior and impair judgment, making peaceful resolution even more difficult. Lack of education and awareness also lead to these incidents and violence against women and dowry are some of the reasons behind these.