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 The number of tourists traveling to Pokhara by air has increased by 32 percent this year, accord­ing to Bhola Prasad Guragain, the chief of Civil Aviation Office in Pokhara.He informs that compared to last year, this year the tour­ist number has increased by 141,671. “The numbers of both domestic and foreign tourists have increased,” he says. “In 2016-17, there were 139,477 foreign tourists. In the next fiscal, there were 175,024 foreign tourists who flew to Pokhara.”

While last year 411,536 domestic and foreign tour­ists traveled by air to and fro from Pokhara, the number increased to 553,207 this year. There are direct flights from Pokhara to Kathmandu, Bhair­ahawa, Chitwan and Jomsom. Right now Buddha Air, Yeti Airlines, Simrik Air, Nepal Airlines and Tara Airlines col­lectively undertake 20 flights a day.

With the start of the tourist season, airlines are preparing to increase flights. Gautam Baral, station manager of Bud­dha Air at Pokhara, says they are planning for up to 14 flights a day on Pokhara-Kathmandu route from the end of August.

“Right now, there are eight flights a day,” he says. “Advance flight bookings during the tourist season has increased by 50 percent, which is why we are planning for 12-14 flights every day.”

He further informs that start­ing August 26, the airplane would be kept in Pokhara at night so that 7 am flights can be arranged for travelers. Yeti Airlines is also preparing for 12-13 flights every day, accord­ing to Guragain of the Civil Aviation Office.

Bikash Baral, station man­ager of Simrik Airlines in Pokhara, informs that they are adding five flights for the tourist season. “Right now, there are only two flights,” he says. Guragain also informs that Makalu Air is planning for charter flights from Pokhara. Additionally, Shree Airlines is also thinking of new flights to Pokhara.

 The new criminal code and the proposed legislation on protection of rights to privacy pose a grave risk to press freedom and freedom of expression in Nepal. Article 17 of the new constitution guarantees every individual freedom of expression and opinion. Likewise, Article 19 says that no punitive action can be taken against a media house for “publishing, broadcasting or printing any news item, feature, editorial, article, information or other material”. Yet some provisions in the new code and legislation seem intended to take away these constitutionally-guaranteed freedoms and to reduce transparency and accountability of public office-holders. For instance the new code makes it a criminal offense to listen to or record a conversation between two people or to photograph people without their consent. The violator of this provision will be liable for a year of jail and/or Rs 10,000. Likewise, the proposed bill says the educational qualification, criminal background, character and political affiliation of public office-holders cannot be scrutinized without express consent. The violators of this law will get three years of jail and/or be fined Rs 30,000.

The government says that such a law had become vital to protect every person’s right to privacy under Article 27 of the constitution. But as the citations of the new constitution above suggest, the exaggerated concern on privacy, and neglect of other freedoms, is not in keeping with the spirit of the new constitution.

The new provisions will make it impossible for journalists to write critically about the functioning of public office-bear­ers and to do investigative stories. This in a country consis­tently ranked as one of the most corrupt and lawless.

But the drafters and enforcers of these laws stoutly defend them. “I think the curbs on press freedom and freedom of expression have been exaggerated,” says Radheshyam Adhikari, a member of the National Assembly, the federal upper house. “Reading the newspapers you feel that media personnel think they will be swiftly jailed for writing a critical report about the government. That is not the case.”

The offense has to be first established in a court of law, Adhikari points out. “So far as investigative journalism is concerned, you do it at personal risk. But if the journalist in question is honest and somehow manages to establish the truth in public, then he or she has nothing to fear. Look at what happened with Watergate!”

The two cases cited above are in many ways emblematic of mental health patients in Nepal, where one in three people will develop some kind of psychi­atric problem in their lifetime. But according to Health Research and Social Development Forum, over 90 percent of those who need mental health services in Nepal don’t get it. “Most of my patients are either scared of being judged when people find out about their problems. They typically come for help only when the problem gets out of their hands,” says Dr Krishangi Basnet, a practicing psychiatrist in Kathmandu. “Even though the situ­ation has improved of late, it is still far from satisfactory.”

Acceptance, understanding and support of family and friends are crucial in dealing with mental health problems. But these can be hard to get with mental illness stigmatized.

According to psychiatrists, they mostly see cases of anxiety and mood disorders in Nepal. In anxi­ety disorders, an individual comes to associate fear or anxiety with certain objects or situations. Most people with anxiety disorder will try to avoid exposure to whatever trig­gers their anxiety. Likewise, mood disorders are known as affective disorders or depressive disorders, where patients undergo significant mood changes, generally involving mania or depression.

Missing beds

The multi-sectoral action plan for the prevention and control of non-communicable diseases (2014-2020) estimates that 18 percent NCDs in Nepal are related to mental health. The World Health Organi­zation’s 2012 global suicide survey ranked Nepal seventh, with depres­sion being the major suicide trigger. Yet Nepal is far from fulfilling the needs of its mental illness sufferers.

Even though the costs to individ­uals, families and the society due to mental disorders are staggering, less than one percent of our annual health budget goes to mental health and only two percent medical and nursing training is dedicated to it. At present, there are only 50 psychiat­ric clinics and 12 counseling centers in Nepal and most psychiatric wards are staffed and run by nursing staff without specialized training in men­tal health (See first box). Moreover, there is no mental health division in Ministry of Health (although one is planned) and there are only a handful professional organizations working on mental health.

“Since mental health problems are often intangible, it is a little dif­ficult to allocate budget for it,” says Bir Bhadra Joshi, assistant executive at the Department of Health and Population. “But with many NGOs working on it, we believe we are better placed to deal with it now than we were even a decade ago.”

But it is hard to do away with entrenched prejudice. The civ­il code of Nepal (which is in the process of being amended) still uses derogatory words like ‘mad’, ‘insane’, ‘person with broken mind’ to describe those with mental health problems.

Constitutionally challenged

The constitution of Nepal (Arti­cle 25 of fundamental rights) guarantees the right to health and healthcare to all Nepali citizens. The World Health Organization too clearly states that health is a state of complete physical, mental and social well-being. But Nepal has been slow to act, as the focus is still predominantly on physical health, even though evidence continues to mount that mental problems also lead to many physical health com­plications. So awareness is vital. But it is not enough.

“Public education about men­tal health problems and treat­ment options need to go hand-in-hand with improvements in mental health services,” says Kamal Gautam, the deputy execu­tive manager of the Transcultural Psychosocial Organization, an NGO that works with the government. “We need many more trained psy­chiatrists and treatment centers.”

But how do you first diagnose you have a problem?

It is impossible to make a cer­tain diagnosis. But if certain signs (See second box) appear within a short span of time, they may offer tell-tale clues. If you or someone you know has been showing these signs for more than two weeks, con­sider consulting a therapist as soon as possible.

Two tales

I was 20 and studying medicine at the time. I had severe anxiety due to family issues, which in turn led to depression. I had to temporarily drop out of medical school in the final year. But in spite of being a medical student, I couldn’t seek the help that I needed. It took me over three years to overcome the dis­ease. I dealt with it on my own because I was in denial and didn’t want people to know. I fought alone and won. I am now 40 and work as a neurosur­geon because the brain fas­cinates me. I had to waste three years of my life because I could not get help. Again, I was able to overcome depression on my own but I also realize there might be others who may not be as lucky.

—A 40-year-old male neurosurgeon

I grew up seeing my dad scream at my mom all the time. I could sense dad’s withdraw­al from reality and his sinking into fantasy and delusion even though I was only 10 at the time. My dad, a teacher, was someone everyone looked up to. This slow fragmentation in his thinking made our lives difficult. It took us around two years to figure out he was men­tally ill and another year to diag­nose him with schizo­phrenia, which is a chronic mental disorder involv­ing abnormal social behavior and delusions. After years of parental dis­putes, I too started having mental health problems. But I was in denial. After numer­ous failed suicide attempts, at the age of 17, I acknowledged the severity of my depression and anxiety, and sought medical help.

—A 19-year-old female student

No. of medical personnel in mental health in Nepal (per 100,000 people)
-0.22 psychiatrists
-0.06 psychologists
-1.5 psychiatric beds
-0.04 counseling centers

To consult one, please contact:

- TUTH Suicide Hotline: 9840021600

- Transcultural Psychosocial Organization-Nepal Crisis Hotline: 1660 0102005

- Mental Health Helpline Nepal: 1660 0133666

Of late there has been no shortage of voices linking higher taxes with the supposed failure of the federal formula. It is true that taxes have been increased (and their scopes widened) across the board, from properties to small businesses. Even cattle and bicycles are now being taxed. Land and property taxes were minimal under the old unitary dispensation, with most people paying no more than Rs 100. But under the new consolidated taxes, the same taxes have jumped to an average of well above Rs 1,000.Kathmandu municipality has introduced a spate of new levies and jacked up old ones. It will charge Rs 500 for a person to prove, on paper, that he is alive. To be liable for a naturalized citizenship, the recommendation forum will set you back by Rs 10,000. In Dhangari sub-municipality of Kailali district, you will have to pay an annual tax of Rs 15 if you own a bicycle; crossing a local river on a boat there will incur you Rs 25 a trip. In Godavari municipality of the same district a chatpate seller will have to fork out Rs 20 and an ice-cream seller Rs 30 a day.

Perhaps one reason for such widespread skepticism of the new tax regimen is that people are just not used to hearing of ironsmiths and fruit sellers paying taxes. In time, they might sound pretty normal. But in the view of political analyst Shyam Shrestha there is another, more important reason for this skepticism. “Neither the central government nor the local level governments have bothered to explain the ratio­nale for these levies,” he says.

He has a point. These taxes will help pay for social security and basic health and education needs of the locals, a duty of the local bodies under the new constitution. “How can the local bodies guarantee these services without raising taxes?” Shrestha asks. But Shrestha says elected representatives have thus far been unable to credibly assure the people that their money will be well spent.

“If you can assure them that all their basic needs will be taken care of, who will oppose higher taxes?” he asks.

Notably, three years after the promulgation of the new constitution, the all-important National Natural Resources and Fiscal Commission it envisioned to work out taxes and division of spoils among different tiers of the government is yet to get a complete shape (See: HERE). Perhaps the political masters of the country were never sold on federalism.