Articles and Poems

- Rabindra Mishra

"I’ve become useless to my country - a complete waste. Not only me, I even made my children an utter waste to the nation," a Nepalese doctor, who has been residing and working in Britain for around two decades, once told this scribe. Another in a different occasion said: "I’ve been living in Britain for nearly 20 years, but I could be neither British nor remain a Nepali." And the third said: "After retirement, I want to go to Nepal and provide medical service to the poor free of charge - just for the sake of name." This scribe might have met only around two dozen Nepalese doctors out of around 60 who permanently reside in Britain, however, the remarks made by a few of them, mentioned above, seem to reflect the general feeling, predicament and, above all, the longing for identity among many of them.

Throughout the human history, if mankind has fought, striven and desired for anything that is for "Identity." Initial struggle is for the identity of a community or a nation and then the aim is to achieve an individual identity. It appears that the Nepalese doctors and for that matter the permanently residing Nepalese community in Britain are slowly losing both the identities, while other ethnic communities have established and gradually enhanced theirs. This brief article concentrates mainly on doctors because the writer of these lines believes that this particular professionals could have made more direct contribution to the community than professionals from any other group and they could have also probably achieved more in Nepal than what they have in Britain.

Most of the permanently residing Nepalese doctors in Britain came in 1960’s and 70’s. Many came on government scholarships and shamelessly never returned to the service of the Nepalese government again. In a country like Nepal, medicine is a profession in which both fame and fortune are guaranteed even now. Only a few doctors can argue that they continued staying in Britain because they had job satisfaction. Most of the Nepalese doctors in Britain are General Practitioners (GPs) who have little more to do than refer the patients to specialists and hospitals.

It would be hard to believe them if they talked about job satisfaction which is acquired only through challenging and demanding work. Back in Nepal, there was virtually no competition in the medical profession in the 60’s and 70’s and almost all of those who started their career then are leading a comfortable life and have earned both wealth and respect. Probably that is the most painful fact to accept for many of the Nepalese doctors in Britain, whose fame and, in a way, the fortune, both are absent in Nepal, where their identity matters. In Britain they are like a drop in the ocean. The doctor who said that he had become "a complete waste" to the country had also made the following remark: "In Nepal, people talk about Dr Dixit, Dr Pandey, Dr Baral and everyone knows them, they command respect and exert influence in the society. What about us? Who knows us? What have we done to the nation? And if we talk about the life in Britain, probably many doctors in Nepal are leading a better life than we do here."

It is not late yet and may be it is time to reflect and ponder for the Nepalese doctors in Britain whether they could do something for the nation. When they are criticised for not being of any use to the country, some of them mention about a few small contributions made by the Nepalese Doctor’s Association (NDA) to health projects in Nepal. However, their contribution appears to be just a face-saving measure which could be considered insignificant compared to what they could have done had they been true to the nation.

There is another bitter side to the whole episode. The majority of the second generation of Nepalese, who grew up with their parents in Britain, virtually don’t know anything about Nepaliness and cannot speak their mother tongue. They go to Nepal just for a holiday and at least one of them, who I knew recently, found it "disgusting." His reaction may not reflect the general view but all the young Nepalese I have met say they can’t live in Nepal. Neither the parents nor the children seem to have ever given any attention to the fact that after the first generation how the second generation of Nepalese will identify themselves? Where will they fall back for support if "Paki- bashing" or a wave of hatred against the Asians intensifies? Other ethnic communities like Indians, Bangladeshis, Pakistanis, Sinhalas and Tamils from our region have not only preserved their cultural identity but also made a mark of their own in the British society.

They are equally in touch with their country, culture and the community. Majority of the second generation Indians in the UK are fluent in at least three languages: their mother tongue (e.g. Gujrati, Panjabi, Bangali, Tamil etc.), Hindi and English. They celebrate their festivals with full enthusiasm and fervour. Whereas most of the young Nepalese boys and girls don’t even know how to greet their elders in a traditional manner and give and receive tika. They are more keen to celebrate Christmas and obviously the English new year.

After 10 or 15 years it is impossible to imagine that these Nepalese youths will celebrate Nepalese festivals when they even don’t know the language, let alone the tradition and practices. Have the parents ever thought what the response of their children will be after their generation when somebody asks, "what is your biggest festival and how do you celebrate it?" The answer probably would be, "I think it is called Dashain but I don’t celebrate any more because I don’t know how to celebrate." "What do you celebrate then?" "Christmas," probably will be the answer. If such a paradoxical situation arises, which seems very likely, that will be a most insulting and embarrassing moment for any person with self-respect and dignity and who feels proud about his roots and identity.

It is unfortunate that the Association of the Nepalese in the UK, Yeti, is too divided, misguided and mismanaged to deal with and discuss such issues. The leaders of the association are more keen to celebrate King’s birthday, fax reports about the celebration to the palace and welcome the leaders and ministers from Nepal than to work for the interest of the Nepalese community in Britain. Being British should not mean losing the cultural identity, for the sake of which millions of people around the world must be on war right at this moment while you finish reading this last line.

- Mr Sura Prasad Shrestha

Nepal and the United kingdom have been enjoying best of relations ever since the establishment of diplomatic ties between the two kingdoms more than 180 years ago. Until 1950, one of the cornerstones of Nepal- UK relations was the Gurkha connection. The treaty of Sugauli, which put an end to armed clashes between the country opened up new chapters in bilateral relations by providing for Gurkha recruitment in the regular British army. In fact, attracted by the bravery and warrior like built up of Gurkha soldiers, Britishers decided to recruit Gurkhas into their army, even before the 1814-1816 war between Nepal and British India was over.

Gurkhas have served the British Crown for more than 182 years. During the First World War, the small mountain Kingdom of Nepal supplied 200,000 men to the forces of the British Crown. There were 20,000 recorded Gurkha casualties. In the second world war, 250000 Gurkhas volunteered and forty two British Gurkha battalions were raised. In the war, 7544 Gurkhas were killed in action or died from wounds or diseases; a further 1441 were missing presumed dead. During the Second World war, 23655 were wounded.

Gurkhas won 2,734 decorations for bravery, including 13 Victoria Crosses, the highest decoration of the British Empire. The Gurkhas are always admired by those who have had the privilege to serve with them or command them. Their personal pride, dignity, delight, natural courtesy and sense of humor, apart from their bravery, gallantry and honesty are unparalleled qualities. The British Gurkhas have served and fought gallantly for the crown for nearly two centuries in most areas of the world in which British forces had been engaged. The recent unveiling of a statue of a Gurkha soldier in London by Her Majesty, the Queen of United Kingdom is a glowing tribute to those brave people who sacrificed their lives fighting for freedom and peace in the world.

From the stand point of diplomatic relations, Nepal has the rare privilege of being one of the oldest friends of Britain. Britain had been kind enough to provide Nepal a magnificent building in a very important location like Kensington Palace Gardens to establish the mission on long term lease. The mission which stayed temporarily in 35, Hyde Park Square shifted to this beautiful building at Kensington Palace Gardens on 23 of June 1934.

The others gesture the British government to the then rulers was the annual present of Rs.10 lakh as a mark of appreciations for the help given during the great war. The long and glorious heritage of monarchy and its age old tradition of respect for the wishes of the people are some unique features of our bond of friendship. The exchange of visits of heads of states of Nepal and the United Kingdom has always been instrumental in further nurturing the mutual understanding and friendly ties between the two kingdoms.

There are close links between the royal families as demonstrated by the state visit to Nepal by Her Majesty Queen Elizabeth II and His Royal Highness the Duke of Edinburgh in 1961 and 1986 and the state visit of His late Majesty King Mahendra in 1960 and state visit of His Majesty King Birendra and Her Majesty Queen Aishwarya in 1980. The frequent visits of the Prince and Princess of both countries have also nurtured relations. Apart from the historical visits of Jung Bahadur and Maharaja Chandra Sumsher, no important official visit of head of government was made until Prime Minister Sher Bahadur Deuba’s official visit in 1996.

Some of the problems were raised on this visit regarding the possibility of looking after the Gurkha soldiers to provide equal status in terms of rank, pay, pensions and others family facilities compare to their British compatriots. The prime minister also raised the issues of promoting trade between the two countries and taking advances of the opportunities provided by the Nepalese governments liberal investment policy. The exchange of visit of parliamentarians, judicial personnels, administrators, and academicians are also frequently organised by the foreign officials of the British government which has helped to make these people well informed about the recent developments abroad so as to make them professionally competent. Nepal has undergone a significant political change during the past couple of years and has adopted a multiparty parliamentary system similar to that of the Westminster model.

The bonds of friendship between our two countries has always been strengthened by British explorers, mountaineers and geographers. They have always played a vital and pioneering role in projecting Nepal to the outside world. None- governmental and charitable organisations based in the United Kingdom are also playing an important role in our relations.

Their programmes directed for the uplift of the downtrodden, underprivileged, and depressed people have made tangible achievements in the field of health, education, environmental protection including forest preservation. British economic aid dates back to 1961 when the road from Jogbani to Dharan was build and now it covers various fields like transportation, telecommunication, agriculture, health, education, forest and integrated rural development.

The programme is basically directed towards raising the economic condition of the common people. Britain has also contributed through international agencies like United Nations, World Bank, Asian Development Bank and European Economic Community.

The vast field of economic cooperation through trade which is of mutual benefit to both the countries is one area which appears to be neglected. Only recently, the British government felt it necessary to establish a separate wing within the department of trade to look after export trade in South Asia. There is enough potential in Nepal for export to justify promotion of hydro power projects. Investors and business community in the United Kingdom who are already interested in Nepal formed the Britain-Nepal Chamber of Commerce a few years ago. This organisation has been helpful in sponsoring activities to promote business interest between the two countries by organising trade fairs, exchange of visit of business community and industrialists. It also provides informations on trade promotion and industrial investment policy programmes of Nepal to potential enterpreneurs oand investors of Britain. Being a landlocked country with difficult terrain, Nepal’s development process has always been costly compared to make other Asian countries.

Unless the giant neighbouring country India breaks the bureaucratic legacy inherited from British India, Nepal will not be able to meet the aspirations of its people for better living conditions. Being a colonial power for long years in India, Britain always used to look at Nepal from the stand point of Indian interest. Now it is time for Britain to strengthen its bilateral relations with Nepal and look at it as an important sovereign and a democratic nation. It seems India can play an effective role in sustaining and strengthening democracy and human freedom in Asia and particularly in neighbouring countries. This will create an atmosphere of participation in development for people in the region.

Bilateral relations between Britain and Nepal is one of special significance. So, Britain’s treatment and facilities of Nepal can be equated with other Commonwealth member countries though Nepal is not a member country. Britain is now a member of the European Economic Community. The EEC has laid down several conditions for member countries to provide help to non-member nations. In this regard also Britain has to give special consideration to its bilateral relations with Nepal. Now it is time for the Britain government to demonstrate its special effort to make this country economically strong and politically stable. This will be the best tribute to the bravest of the brave soldiers loved and cherished throughout the world.

(The writer is former Royal Nepalese Ambassador to UK and seasoned bureaucrat of Nepal who had held many most important prestigious posts that including the Chief Election Commissioner)

Refugees: Story to History

- Rajesh Giri
Amsterdam, Netherlands

According to the 1951 UN Convention Relating to the Status of Refugees, signed by 127 nations, a refugee is someone who has left his or her country because of a "well-founded fear" of persecution for reasons of race, religion, nationality, social group or political opinion. As countries started to gain independent, the problem of refugees and statelessness have become a multi- dimensional and world-wide phenomenon. By 1995, there were some 15,340,000 refugees and asylum-seekers world-wide. In this year, the top five largest groups of refugees and asylum-seekers as follows:- (1) Palestinians: 3,286,000, (2) Afghans: 2,328,200, (3) Rwandans: 1,545,000, (4) Bosnians: 905,000, (5) Liberians: 725,000. All of these refugees problem is caused by economic, political and social reasons followed by the civil unrest.

Since 1989, even the tiny South-Asian nation, Bhutan, has surprisingly forced its own citizens out of the country. The kingdom of Bhutan is currently ruled by King Jigme Singe Wangchuk. The official statistics shows that the current population of the country is 600,000. Drukpas (Tibetan descendants) occupy the northern part of Bhutan. They speak Dzongkha (an offshoot of Tibetan) and practice Himalayan Lamaist Buddhism. They form approximately 16-20% of the total population. The king himself belongs to this group. Sharchhops of Indo-Burmese origin constitute around 30-35% of the population, who live in the eastern region. They speak Sharchhopkha language which is similar to the one spoken by the people of Arunachal Pradesh state of India. They also practice Himalayan Lamaist Buddhism. The Nepalese speaking people of Indo-Aryan origin live in the southern Bhutan and form about 50-55% of the population. Since the late 1800s they were migrated from Nepal. They are called Lhotshampas and have dominated the southern part. Until now, they have retained their Nepalese culture, language and religion traditions, which starkly differs from those of the Drukpas.

With the involvement of the British, in 1907, Bhutan established a hereditary monarchy. Since then it is ruled under an absolute monarchy, the king is both head of state and head of government. The judicial system is not independent and there is no written constitution. Other than the ruling feudal components, no one is allowed to become Membership of the National Assembly. The King appoints all the necessary ministers who remain in office at the pleasure of the king. Political parties and activities or forming associations and unions are strictly prohibited. There is no right to freedom of speech, freedom of expression, political rights and free press. There are no social or cultural rights and no right to seek justice.

Nevertheless, by the mid 1900s, the late King Jigme Dorji Wangchuk, the father of the present king, implemented various policies aimed at modernising Bhutan and uplifting it from being an economic backwater. In 1958 Bhutan’s first Citizenship Act was introduced which states: "If any foreigner who has reached the age of majority and is otherwise eligible presents a petition to an official appointed by His Majesty and takes an oath of loyalty according to the rules laid down by the official, he may be enrolled as a Bhutanese national provided that (a) The person is a resident of the kingdom of Bhutan for more than 10 years: and (b) Owns agricultural land within the kingdom." The Act was passed by the National Assembly to grant Bhutanese citizenship to ethnic Nepalese who had been in the country for at least 10 years and owned agricultural land. Before that the Nepalese had all been aliens. Meanwhile, an increasing number of Bhutanese people were exposed to the West. Many of them (both Drukpas and Lhotshampas) travelled abroad and brought back western ideology of political democracy and leadership. Consequently, they began criticising the monarchy as dictatorial and despotic.

While attempting to economically modernise Bhutan, instead of support, opposition was created to the monarchy. As a result, the present King put an end to the economic development programs in 1985. All opposition to the monarchy were suppressed. Quickly, contact with foreign countries was cut off. So far the country has only two (a Bangladeshi and an Indian) embassies. The king also dismantled most media programs and even then television antennas. Most regrettably, the Lhotshampas were identified as a threat to the Drukpa monarchy. He introduced a new Citizenship Act in 1985 and the national census in 1988 which was directed against the majority Lhotshampas. The Citizenship Act in 1985 states: "A person permanently domiciled in Bhutan on or before 31st December, 1958, and whose name is registered in the census registration maintained by the Ministry of Home Affairs shall be deemed a citizen of Bhutan by registration." However, in reality, only the southern Bhutanese (Lhotshampas) were declared "non- nationals," a direct violation of Article 15 of the United Nations Universal Declaration of Human Rights with regard to arbitrary deprivation of nationality. Even the ones who showed all the mandatory certificates could not claim Bhutanese citizenship because the authorities immediately burned their certificates. Against such an inhuman behaviour of the Bhutanese government, not only the Lhotshampas but also the US State Department criticised its act, quote: "In recent years, assimilation has given way to Bhutanization... The (1985) citizenship law retroactively stripped citizenship from Nepalese immigrants who could not document their presence in Bhutan prior to 1958. [This is a] nearly impossible requirements in a country with widespread illiteracy, which only recently adopted administrative procedures."

To be continued….

About the pain in the head

- Dr. Badri Prasad Upadhyay

HEADACHE is a common problem. It is located anywhere in the head but most commonly in the temple or forehead. The size of headache may vary from person to person. But the affected person is in severe pain as a result of scalp vessels being distended and tender during an attack. Some 90% of the population will have had a headache within one year. Migraine is the commonest in the clinical practices. Although migraine affects both young of 20 to 40 age females than males and also occur in children less than 10 years of age with slight male preponderance. Ninety percent of migraine cases are familial disorders which typically presents with paroxysm of unilateral headache but it can spread to both sides of the head. Migraine is often associated with nausea or vomiting.

There are various types of migraines but the classical, common, opthalmoplagic, hemiplagic and basilar migraines are more common. Classical migraine is usually preceded by an aura which may be numbness, tingling sensations around the mouth and lips. There may be epigsatric sensations, flashing of light (teichopsia) or scotomas (an area of blindspot in the field of vision) of various types, followed by a headache. It build unto crescends and lasts 1-2 hours and subsides on its own or by taking anti-migraine medications.

In contrast, common migraines occurs without the preceding aura. The paroxysms of head ache may occur at various times in the same patient while headaches associated vertigo (feelings of an object moving around or itself),slurring of speech points to basilar migraine. An aura is due to spasm of blood vessels of the brain which causes reduction in the blood supply to the brain. This is followed by vasodilation and stretching of nerve endings along the blood, vessels which gives rise to pain. Usually there are no neurological squeal as the blood supply to the brain is not enough compromised, but sometimes it may be complicated by status maigrainosus (headache lasting more than 48 hrs and not responding to conventional anti-migraine medications) and rarely migrainous brain infractions. Headaches which persist for more than 48 hrs or have changed their previous characters must be taken seriously and a doctor must be consulted immediately as headache can be due to various causes such as hypertension, cerebro vascular disease (CVD), cervical spondylosis, anxieties, depressions, respiratory diseases, eye problems and brain tumours.

Physical examinations does not reveal anything except plump, anxious women. There may be a spasm of muscles of the neck. A headache which is complicated by weakness of paralysis of one side of the body is called hemiplagic migraine. Similarly when it is associated with the paralysis of eye muscles - an opthalmoplagic migraine. Both f these conditions recover completely without a residual effect. Migranous headaches become less frequent and less severe as the person gets older. A diagnosis of migraine is unlikely after the age of 40. However some other causes of headaches mentioned, above must be taken into consideration.

The third type. Achronic type of headache (which persists for long period) and affects predominantly males of (20-50) age is called chronic migrainous neuralgia of cluster headache (one attack is immediately followed by other). It is also called alarm clock headache because it recurs during the same period of time. A cluster headache differs from the classical attack of migraine in that it does not have an aura and vomiting is more frequent than a classical one. The character of pain is also aching in nature. It is mainly centred around the eye, occurs mainly in the night and disappears during the day after sleep. The affected eye is red, congested and waters profusely. Some people may get transient cranial nerve palsy or Horner syndrome. The affected person will be in a great agony and may even walk in the night for remedy. Vasodilators like alcohol or GNT (Nitro-glycerine) aggravates the headache. Nitro-glycerine is used to confirm the diagnosis. The attack typically follows within one hour of taking sublingual nitro-glycerine. Remission occurs completely but the headache recurs every year or two. Usually migrainous headache and cluster headache does not co-exist; but there is high incidence of peptic ulcer disease in an "alarm clock" headache. What causes such a terrifying headache is poorly understood but the disintended scalp arteries and increased pulsation with the release of vasoactive peptides have been blamed for pain. Genetic factors are also implicated. Bio-chemical factors like prostaglandin’s and serotonin have also been considered but without much explanation . Some 70% of migraine undergo remission during pregnancy. On the whole, migraine has non-specific symptoms and is based on various exogenous and endogenous trigger factors. On the one hand, anxieties, anger, worry, depression, shock, excitement are some of the endogenous triggers while stopping, bending, travel, holidays, fast foods like - chocolates, cheese, red wines citrus foods, irregular meal habits, and drugs like oral contraceptives and nitrates nifedipine are considered to be exogenous triggers. Similarly TV, noise, intense smells, stress, fatigue, also precipitates an attack of migraine.

Migraine does not occur with menstruation’s but may precede it. Generally it does not response to diureticsor hormonal therapy. It must be treated with the pain killers like non steroid anti-inflammatory drugs – (NSAID) or muscle relaxants and sedatives like diazepamtill the menstruation is over. In general measures one can take are cold compression staying in the darkened room, may relief symptoms. Identify the trigger factors and avoid them. An early treatment must be sought - alcohol must not be taken. Drugs like oral contraceptives; vasodilator’s like GNT nifedipine must be avoided.

Aspirin 600mg, or paracetamol 1 gram must be taken as early as possible to abort an attack. If there is associated vomiting metachlopramide may be given in the injections or tablets or suppositories which reduces nausea and also enhances the effectiveness of Aspirin by increasing its absorptions in the GIT- tract. If the headache is persistent codeine or co-proxamol may be added. Spasms of muscles of neck may be treated with Diazepam. If these drugs fail to relieve, the Ergotamine sublingually, inhalations or suppositories may abort an acute attack . Ergotamine more than 6mg/per week must not be taken. Persons with Ischaemic Heart disease, Peripheral Vascular Disease , and pregnancy should not take Ergotamine preparations. Steroids 20mg , six hourly in tappering doses may be useful in status maigrainosus. Recently, sumitriptan 50-100 mg/day or serotonin receptor agonist has been bade available to abort an acute attack but must be taken as early as possible. It is also safe for the persons with JHD,PVD and pregnancy.

Those who suffers more than two attacks in a month must take any of the following agents as a preventives measures.

a) Beta-Blockers like proprananol (80-160mg) daily
b) Pizotifen 1.5mg nocte.
c) Cyproheptadine which is Ca-channel blocker well as serotonin antagonists mainly       used in children.
d) Verapamil (80-120mg) and Nimodipine can also be used and are mainly useful in        classical but not in common migraine.
e) Antidepressants like Amitriptyline 25mg nocte or regular use of naproxen with          antacid may be useful but be taken at least for 3 months.

In short, although migraines are of complex nature, varying in causes, severity and having various endogenous and exogenous triggers, early treatment and possible preventive measures will completely cure an attack of migraine without a residual effect.

Take Me Home

- Hind Vaidya

Rice planting is followed by wheat and corn planting. My parents had a vegetable plot not far from our house just next to a big house called Niyamchhey where my parents had gone often with me. The people from that house used to call me "bahini". My parents and my friends used to call me as "nani" which is a common name for a girl. There was an old lady at that house. She was very kind to me. She would ask me to stay beside her and would stroke my hair and give me chewra with sugar and sometimes with gelebi. There was a man called Kanchhakaji who used to check my nails and hair. He would not say anything to me but would say to my mum and dad, but, I never knew what. The rice fields and vegetable plot are owned by the people of the Niyamchhey house. Therefore whatever my parents had grown, they had to take 50% in that house. My parents were always busy. They had to store grains, pulses, chillies, hays for whole year. There used to be bundles of garlic bulbs on Buigal. When there was not much to do in the field, there were many community meetings to attend and festivals to celebrate. During December and January, women would keep busy weaving threads out of cotton and lambs wool. They would dye the cotton threads black or blue colour for saree. Skirt like black cotton saree with one inch red border is the identity of farmer women in Patan area. Shawl is made from lambs wool.

Mustard greens were pleated long and dried outside the window. There was a popular newari song about this:

Jhaalee Chhonguu Tuukan Maa.....
Woh-hey Lyaashi Jeetah Maa......
Woh Lyaashi Mabyuusaalaa,
Jaahee Naymakhuu

Means:

          Look that pleats of mustard greens
          through the window,
          and I want the same girl,
          If not...............
          I will starve to die.

When the sun shown in the court yard in front of our house, my dad spread a mat made up of straw and spread a blanket over. Then we sat there. He had a packet of dry roasted brown soya beans. He skinned the soyabeans carefully without splitting the cotyledons and then he hooked them one by one in my hair and I had rows of soyabeans in my hair just like a beads. I used to shake my head to move the beans in my hair. That was a enjoyable moment. Then he used to let me nibble rest of the soyabeans. It was a wonderful memory.