Coronavirus cases are surging in the mountainous nation of Nepal. Video / Agencia EFE / AP
The Covid-19 crisis engulfing the mountainous nation of Nepal probably started somewhere like the border town of Birgunj.
Known as the "Gateway to Nepal", bustling Birgunj is a main link between the capital Kathmandu and Kolkata, India's third largest city with 14 million residents.
The two countries share an open border; no passports are needed and citizens of each country walk or drive freely across the frontier every day.
It's likely that a few weeks ago, the new and more contagious Indian variant of Covid-19 hitched a ride over the border and sunk its spike proteins into the nation of 30 million.
"One of my best friends has Covid; my relatives in Kathmandu have Covid; almost every household has one or two people with Covid," Sydneysider Shamim Anwar, whose parents live in Birgunj, told news.com.au.
His mum and dad have so far not tested positive, but Anwar fears it's only a matter of time.
"By population, the situation is worse than India. Most people I know in Nepal have Covid. It's devastating."
Nepalese paramedics treat a Covid-19 patient outside an emergency ward of a government run hospital in Kathmandu, Nepal. Photo / AP
Nepal 'staring into the abyss'
On Sunday, Nepal recorded 8777 new cases of coronavirus. That might not seem much when compared to India's 400,000 daily infections, but India's 1.3 billion inhabitants is far more than its Himalayan neighbour's 29 million.
ICU beds have run out, oxygen is running out and the Prime Minister's time may soon be up too, with leader KP Sharma Oli facing a no-confidence motion in the country's parliament today.
He has been compared to Emperor Nero, of "fiddling when Rome burned".
Earlier in the crisis he recommended the Nepalese gargle with guava leaves to ward off infection. It didn't work.
In March, fewer than 100 people a day were being diagnosed in Nepal. In late April, daily cases broke the 1000 mark. The current seven-day rolling average is 8100. Bodies are being cremated en masse.
"Nepal is staring into the Covid abyss, with cases skyrocketing by 1200 per cent in weeks," thundered the Indian Express newspaper.
"Experts believe that this is just the tip of the iceberg, as the high positivity rate shows that Nepal isn't detecting nearly enough cases," the paper reported.
Around 500 kilometres to the west of Birgunj is Nepalgunj. Another border town, it's now the country's second Covid-19 epicentre outside Kathmandu.
"The hospital is overloaded, we are treating patients at each and every corner of the building," said Badri Chapagain, a doctor at the hospital.
Nepalese army personnel in PPE suits salute to pay tribute to Covid-19 victims before cremating their bodies near Pashupatinath temple in Kathmandu, Nepal. Photo / AP
'Cases were hidden'
India's recent state elections saw massive rallies, thronging with people. A large religious festival also took place, which many Nepalese people also attended. Both are thought to have been the ideal conditions to spread the virus.
Nepal took steps to limit border crossing, but as it did so, tens of thousands of Nepalis working in India rushed home, likely bringing Covid-19 with them.
"When it came to Nepal, they couldn't control it," said Anwar.
"At first the cases in Nepal were all hidden, the main media didn't cover it. But when people were dying every day, people began posting about it on social media."
The crisis has been exacerbated due to several factors.
Nepal's healthcare system is weak, with 1595 intensive care beds and 480 ventilators. According to World Bank data, it has just 0.7 physicians per 100,000 people. That's fewer than India's 0.9 per cent.
On May 8, 22 of the country's health districts had bed shortages, according to Nepal's Health Emergency Operation Centre.
Nepalese workers wearing personal protective suits place the body of a Covid-19 victim on a funeral pyre for cremation on the banks of Bagmati river in Kathmandu, Nepal. Photo / AP
Red tape not helping already stretched health system
To critics, the government in Kathmandu has seemed to hinder more than help.
They point to a diktat from the health ministry which ordered hospitals to ask for official permission before they could refill their already small number of oxygen tanks, creating more red tape in the midst of a crisis.
Local media have reported that several hospitals have now called patients' families asking them to take them home as they cannot supply them with oxygen. Four major hospitals have told the government they will be unable to admit patients if the supply of oxygen is interrupted.
"The government hospitals are without beds. The private hospitals, where beds are available, have not been able to provide services due to the lack of oxygen due to the government's decision," the Association of Private Health Institution of Nepal told the Kathmandu Post.
A lockdown is now in place in the capital.
Anwar is doing what he can, from Sydney, to help Nepal. Through Himani Kosh, the Australian arm of the Himani Trust, a charity set up by a former Nepali princess, he has started a GoFundMe page. He is hoping to raise $50,000 to pay for food, medicine, equipment an oxygen.
A lack of vaccinations has also hit Nepal hard. Just 7.2 per cent of the population have had a jab, mostly AstraZeneca vials produced in India. But that country's own crisis has led it to stop exporting the shots so it can ramp up its own vaccination drive.
The situation in Nepal is in stark contrast to nearby Bhutan which also neighbours India. The nation of 800,000 vaccinated 93 per cent of its citizens in a little over two weeks in April. By the time India stopped shipping vaccines, Bhutan was done.
Yesterday, it reported just 15 cases of Covid-19; it has seen one single death throughout the entire pandemic.
"Bhutan has been well managed but you look at Nepal and it's having issues getting the vaccine from India," said Anwar.
A Covid-19 patient receives oxygen on the corridor of the emergency ward of a hospital in Kathmandu, Nepal. Photo / AP
PM is 'Nero fiddling while Rome burns'
Ahead of Monday's no-confidence vote in the Kathmandu parliament, PM Oli was getting a drubbing.
An opinion piece in The Kathmandu Post mocked his schedule.
"He is a busy man. He starts his day as early as eight or nine at times.
"(But) he is too busy to pay attention to the raging coronavirus pandemic that on Thursday claimed 54 lives."
Some local analysts have said a feud between factions in the ruling coalition has taken his mind off the crisis at hand.
"This could lead to further escalation of the political crisis, thereby putting the pandemic crisis out of focus," stated the editorial.
Others were even more caustic.
"Prime Minister Oli can be compared with Nero, the fifth Roman emperor who earned notoriety for fiddling when Rome burned ... for his indifference towards people's plight," said Rajendra Maharjan, a political commentator.
"He is not a bit worried even though people are dying for a lack of beds and oxygen."
Nepalis desperately need a government focused on the virus that is gripping the nation, not infighting.
For Anwar, he just wants to help his parents, and others, from contracting Covid-19 in a country not equipped to deal with their health needs should they fall ill.
"It's really painful knowing my friends and family have got or are getting Covid.
"It's emotionally and psychologically painful and stressful right now. I just try to help them with whatever means I can."
