Heart disease

The TU Teaching Hospital has, no matter how authentic its figures are, registered a marked rise in cases of coronary heart disease over the last five years. This has no doubt put the focus on why the number of heart patients is increasing dramatically, especially in the capital. The consumption of unhygienic food, adulterated oil, dirty water, lack of physical exercise are some of the causes attributed to this disease. Heart disease has much to do with a person's life style, and the middle and lower class families are badly affected as they have begun to consume more red meat due to their relative increase in incomes. This apart, the statistical graph has featured young people who have been increasingly turning to smoking and drinking since the country adopted economic liberalization. The most common and widespread cases of heart ailment identified so far are Ischemic heart disease which is growing rapidly among adults, along with rheumatic heart disease in children.

The available data on heart disease provided by the country’s leading hospital underlines that 23 percent of the patients visiting there suffered from heart ailment. Most of the patients were from within the Kathmandu Valley. It detected 5,000 cases of cardiac disease in 1996 and the figure shot up to 20,000 within five years’ time, a conspicuous jump indeed. Of the total number of heart patients detected, 80 percent were men. Uncovering the factors behind the gender disparity might even help in understanding the nature and causes of the disease better. One thing in particular that must be noted is that the sudden rise in heart patients might have been due to better health consciousness among the general public and more people reporting for treatment, besides the establishment of new hospitals with better treatment facilities. The country has actually made remarkable progress in the health sector since the restoration of democracy. The equipment available in the country for treating patients is much more sophisticated compared to what we had five years ago. This also could be one of the main reasons the number of heart patients visiting the hospitals has increased by almost 50 percent since 1996.

We, however, must not ignore that the treatment of cardiac related diseases in the country is still expensive and only a few people can afford the costs at the private hospitals that conduct valve operations, coronary angiography, among other things. A very few hospitals have virtually monopolised the treatment of heart disease and these are beyond the reach of ordinary people. There are hardly any social organizations to support those undergoing surgical treatment. The government cannot tolerate this. It has to open up new heart treatment centres at different state-run hospitals so that the lower income groups too can afford complicated treatment facilities. The government must recognize that the country can never develop until and unless the people of different strata have easy access to proper health services.

City management in Nepal

By Shizu Rana

Housing policy parameters for most Asian cities are framed by federal and provincial governments but they are implemented by provincial and local agencies. The people, who frame them, have belonged to the middle class and for the most part they have been trained conventionally. The policies they frame reflect their class in thinking and the first world biases in their training. Most of them have poor understanding about the socio-economical field situation of poor communities.

There are powerful and political interest groups that affect policy decisions and where policies do not solve their interests, they are in position to subvert them. Their interests and those of the poor are in a conflict. There are organizations that can play a positive role in policy making, but they remain confined to the traditional role, the history has burdened them with. And then, there are those groups that service the needs of the victims of government policies and of those that the establishment of the third world cities.

Broadly speaking, these groups, that determine how a city functions, can be classified as the informal sector communities, NGOs, the formal private sector and government agencies.

Nepal’s history is all about isolation. It was never colonized, and until five decades ago, the country was virtually untouched by the industrial revolution. At that time, it’s government remained essentially feudalistic and the country lacked even the basic infrastructure.

The lack of resources, poor infrastructure, small domestic market, competition from India and no access to the sea represent major constraints to the economic development. By global standard, all but a few of the people of Nepal would be classified as poor. A recent World Bank and UNDP study on poverty estimates the poverty incidence are over 70 percent. For the poorest, the problems are exacerbated by socio-cultural aspects such as ethnic discrimination, gender disparity, and caste system as well as the problems which have undermined the effectiveness of poverty alleviation programmes such as corruption, nepotism and bureaucracy.

While the majority of Nepal’s poor live in the rural areas, urban poverty is apparent throughout Kathmandu and is increasing rapidly with the development efforts. Urban and rural poverty are intimately connected.

There have been several urban planning studies, as well as the existence of other priorities but the fundamental nature of problems are not yet tackled. An extensive reform of urban infrastructure and institutions was recommended but, in preparation for the actual implementation, these recommendations were whittled down to core set objectives which can be more readily realized.

The Kathmandu valley has been the object of technical reports, and projects, so much so that new information reports and proposals are occurring constantly. It will be a herculean task even to collect and study them systematically for the best utilization while practically impossible to implement the various suggestion put forward by such in numerous studies. In spite of this we are putting forward a proposal for the Kathmandu valley simply because we consider the scientific approach is the only approach to identify and solve the various problems of the valley.

Kathmandu was declared a metropolitan city seventy four years after becoming a municipality. Naturally, this adds new responsibilities to a city which is suffering from resource constraints, which has a burgeoning population and faces environmental and sanitation problems.

Urban development is planned in accordance with urban population growth. Therefore, urban infrastructure would be stressed even if there was no migration into the Valley, but migration is a major cause of population growth. The population density has already strained resources and the problem cannot be resolved until economic disparities between the Valley and the rest of the country are reduced. As the World Bank (1993) pointed out, the water supply would be less of an issue if the Valley population were prepared to pay for it. However, they do not even pay the full cost of operating and maintaining the existing facilities and it is believed that they are not prepared to do so in near future.

Indeed, the rapid urbanization and economic change in the Valley has not only burdened local authorities and institutional arrangements. Along with this, legislative gaps, redundancies, confusion of mandates and jurisdictions together with political changes and viability, constitute substantial impediments to the provisions of sustainable management of the Valley’s natural resources and environment.

But still, only the Kathmandu valley’s rich venerable heritage and its religious significance for practising Hindu and Buddhist warrants careful attention in terms of the current state of its sacred rivers and their future prospects. The growing industry, population, and urban activities demand its necessity to keep in pace with the Kathmandu valley’s requirements in terms of water, sanitary, sewerage and other facilities.

There are no other options but to expand the activities to different areas of the valley, which need scientific approach to identify and solve local problems amicably, without creating any further confusion.

The eventual expansion of the urban agglomeration is leading to an environmental inferno. The only way out from this hopeless situation is to evaluate the potential environmental capacities of the Kathmandu valley and their meaningful use.

Lunchbreak idea

By Hitesh Karki

Now it is the turn of Malaysia. One must be thankful to the Ministry of Labour for finding out newer destinations so that we can stuff in a few more dollars in our national coffer. It’s a very well known fact that what we Nepalese suffer from is nothing but herd mentality. One does it and almost immediately everybody follows suit. Examples, in case you need any, are plenty. One invests in Stock and so all of us start doing the same. Well, I don’t think I need to explain all of them. If one starts a school or rather an academy, as is commonly known today, and the very next day, you find an academy right next to the place where you live.

So toying with the idea of an ever increasing manpower companies, one of my friends suggested that we too open one of that kind. And like everyone aspires to be different even though they don’t have any idea how they are going to make it a cut above the rest, we too were determined to make it different.

To begin with, this company won’t be sending a bunch of Tom Dick and Harry abroad where they have to break their bones, quite literally, just to earn a few dollars. We all know what kind of skilled manpower we usually export to the Gulf region. To be eligible, one has to meet the following criteria. Does he have a knack for breaking the bars along the pavements or for burning tyres or throwing stones just like those little Palestine kids that we see everyday on television. Quite obviously, the one who dare the most will be paid more. Unlike the rest for whom they have certain restricted places like the Gulf, ours will be universal. Be it the neighbouring state of our neighbouring country or the WTO summit, far off in the western hemisphere, we will be there. Our business knows no boundaries. Thanks to the last eleven years, we have no dearth of experts in the field of making protests (read vandalism).

We can make an entire city come to a stand still just like that. And thanks to the Gurkha legacy that we carry, we fear no lathi charges or no arrests. We are the bravest of all. Just like those who fought in Burma and Vietnam. Burning vehicles, well that’s as easy as lighting a cigarette with a match stick.

To be in tune with time, we will be hosting a grandiose web site. The clients will be offered with a number of options like what kind of manpower they need and how many of them. The visa and all will have to be borne by the client. In case the client could not afford all the expenses like air fare and accommodation, the charges will be a little more, but anyway we will make sure that their demands be met. As for the manpower, the incentives, overtime and all additional benefits will directly depend on the amount of destruction they make. Anyway, the writing on the wall is very clear: "everyone wants to make money, hook or by crook."

Another thing, we just want to leave no stone unturned, provided we get paid. Even if it means we have to smuggle them like those Chinese people crammed into a cargo ship. For that, all we need is a government support and that’s not difficult to come by. Everybody knows even if the active PAC (which at the moment seems to be running the country more than the government itself) summons them, they will be asked to resign, at the most.

Till then they can relax in their lavish bungalows and cruise around the city because sooner or later they will be back in power and one can bet that they will surely come back with vengeance. Hey, that was just an idea which we were enjoying during one of our lunch breaks! But on second thoughts, do you think the idea is really an exaggeration?

Nepal needs more democracy or less of it ?

The Kathmandu Post and Mercantile Communications conducted a survey on the topic: "On the 11th anniversary of the People’s Movement, do you think Nepal needs more democracy or less democracy?" The survey was done on the Net last week. Of the 951 respondents, 61.2 percent (582) said "Less", 34.8 percent (331) said "More" and 4% (38) said "Don’t Know".

We regret the inconvenience, if any, due to the original names being kept back by some of the respondents.

Nepal needs more democracy because without democracy we cannot expect more development. Without freedom and democratic norms, it is not possible to uplift the people’s socio-economic status. But unfortunately, even the so-called educated people are indifferent to the promotion of democratic culture. Similarly, incompetent and corrupt politicians are at the helm of national affairs. Nepotism, favouritism and corruption are the key stimulants in our democracy. Another thing, a cloud of uncertainty and insecurity looms large over the country, especially after the spate of Maoist bloodbath. In fact, Nepal needs to polish up its democratic exercise.

- Shiva Bhandari

First of all, our leaders of the ruling party and the opposition should be sent back to school to learn the basic principles of democracy. They should be taught that there is indeed a big difference between democracy and mobocracy. They are the ones who are giving democracy a bad name.

- Amitabh Thapa

Democracy cannot be more or less. Due to the behaviour and attitude of our illiterate, uncivilised and myopic leaders, we are disillusioned with the system called democracy. What our country actually needs is a controlled democracy under a competent and dynamic leader who is more than willing to acknowledge his or her mistakes and ready to consult experts before making crucial decisions. Political parties should not cling on to the game of majority.

- Dharmendra

Democracy means different thing to different leaders here. Bigwigs change the definition of democracy to suit their interests. We certainly need more democracy, but not Nepali-style of democracy, manipulated by a handful of immoral and corrupt leaders.

- Ganesh Thapa

Nepal should welcome more democracy, but a democracy led by those who are dedicated to taking care for public welfare. And not the ones who have lust for money, power and fame. The Koirala government has done much to tarnish the image of democracy. If democracy delivers such governance, we do not need it at all. What’s the use of having freedom, when half of the people are dying slow deaths, under poverty, disease, illiteracy and other deprivations.

- Umala

Asking for more democracy is ridiculous. If the mayhem, chaos and confusion in the country is anything to go by, who would want more democracy? We have had enough of that. If there are true leaders in our country, let us try to make up for what we have lost so far and see where we have reached. Have not we seen enough glitters of our precious and prized so called democracy!

- Pardesh Lahure

First of all, what is democracy? Please ask yourself and then, think where is democracy in Nepal? Democracy has been a plaything of the high and the mighty. It does not make a sense to the majority of Nepalis who are struggling to earn two squares of meal a day.

- Ram Jee Aryal

Well, everybody has seen and felt democracy as it is since a decade. So one can easily find out whether the country needs more of democracy or less of it. The so-called followers of democracy have abused the tools of democracy. The post-Jana Andolan era has been marked by frequent Nepal Bandhas, Chakka Jaams, torch rallies and so on. If democracy functions in this way, then we don’t need it any more. What we need is peace and prosperity, even if it is at the cost of democracy.

- Arun

We do not want democracy at all. People are fed up with deteriorating law and order, not to mention bad governance and cancerous corruption. The democracy at the moment is in a seriously trouble because of the irresponsible politicians. Democracy for them means bleed the people white. Today, Nepal needs a force that can stamp out all anti-democratic elements and that can bring back the country from the mouth of a disaster.

- Raju