A REPORT OF SEMINAR

ON
POLITICAL INSTABILITY AND ITS EFFECT ON
PREVENTION, TREATMENT AND CONTROL OF COVID-19
IN NEPAL

SUBMITTED BY:
BPH 3RD YEAR, 6TH SEMESTER, 10TH BATCH

SUBMITTED IN PARTIAL FULLFILLMENT OF THE

REQUIREMENTS IN THE SUBJECT OF HEALTH SERVICE
MANAGEMENT IN NEPAL (COURSE CODE: PSD 306.1-
HSMN) FOR DEGREE OF BACHELOR OF PUBLIC HEALTH

SUBMITTED TO -
DEPARTMENT OF PUBLIC HEALTH
KARNALI COLLEGE OF HEALTH SCIENCE
PURBANCHAL UNIVERSITY
2021
 RECOMMENDATION LETTER

This is to recommend that the practical skill report entitled “POLITICAL INSTABILITY
AND ITS EFFECT ON PREVENTION, TREATMENT AND CONTROL OF COVID-
19 IN NEPAL” carried out by 6th semester for the partial fulfillment of requirement of the
6th semester of Bachelor of Public Health. This project was conducted under Mr. Ram Sharan
Pyakhurel’s supervision. The approach and methodologies to present the subject is very
refined. We would like to recommend keeping this term paper presentation report for
evaluation.

………………….

Mrs. Sushma Neupane

HOD, Faculty of Public Health

Karnali College of Health Science, Kathmandu

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 APPROVAL SHEET

It is certified that this report entitled “POLITICAL INSTABILITY AND ITS EFFECT
ON PREVENTION, TREATMENT AND CONTROL OF COVID-19 IN NEPAL”
prepared by BPH 6th semester under our guidance and supervision as a partial fulfillment of
the requirement for the degree of Bachelor of Public Health from Karnali College of Health
Science of Purbanchal University

………………… ..….……………

Mr. Ram Sharan Pyakhurel External Examiner

Lecturer

…………………

Mrs. Sushma Neupane

HOD, Faculty of public health

Karnali College of Health Science

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 ACKNOWLEDGEMENT

This report is submitted as a partial fulfillment of requirement for the term paper presentation
of Health Service Management in Nepal for the 6 th semester of Bachelor of Public health at
the Faculty of Public Health, Purbanchal University of Nepal.

We wish to express our sincere thanks to our supervisor, Mr. Ram Sharan Pyakhurel for all
his help and valuable guidance and support during the work with this report. We would also
take a time to thank our HOD, Faculty of Public Health, Mrs. Sushma Neupane without
whose guidance it would not have been possible to bring us to this topic.

We express our enormous thanks to our guest speakers of the seminar Dr. Uddhav Pyakhurel
and Dr. Indra Adhikari for providing us the valuable information in political stability,
COVID-19 and mental health.

We would also like to give our sincere gratitude to all the participants for their presence and
their valuable time in seminar. We are also thankful to Siddhartha Foodland for providing us
the venue to conduct the seminar and all their valuable help. We would also like to thank the
administration of Karnali College of Health Science for providing us the necessary logistic
facility.

We wish to take this opportunity to express gratitude to our parents and all family members

for their support, kindness and encouragement . We would also like to thank our parents for
their motivation and support.

We would like to express our great appreciation and enormous thanks to all those persons
without whom this accomplishment would have not been possible.

BPH 6th Semester

Karnali College of Health Science
Gaushala, Kathmandu

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 ABBREVIATION

COVID-19: Novel Corona Virus Disease

GoN: Government of Nepal
PCR: Polymerase Chain Reaction
RDT: Rapid Diagnostic Test
WHO: World Health Organization
VAT: Value Added Tax

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 LITERATURE REVIEW
Kritika Poudel and Pramod Subedi published an article “Impact of COVID-19 pandemic on
socioeconomic and mental health aspects in Nepal on July 10, 2020. According to Poudel et
al. With the recent increase in COVID-19 cases in Nepal, public health concerns are
growing. Nepal is under some forms of lockdown to combat the pandemic, encouraging
people to practice social distancing in order to reduce interactions between people,
potentially reducing the risk of new infection; however, this has had an impact on people's
overall physical, mental, social, and spiritual health. The published articles on the
psychosocial effects of COVID-19 and other outbreaks were reviewed as the methodology of
the article. Barkur et al., 2020; Flaxman et al., 2020 Lockdown is considered to be an
effective measure in slowing the spread of coronavirus around the globe it has increased fear,
anxiety, depression, panic attacks, psycho-motor excitement, suicidal deaths, and a general
decrease in overall wellbeing. According to Poudel and Subedi COVID-19 has caused impact
on trade and tourism, agriculture, education, media sectors, health and also to the vulnerable
people. Poudel et al., Subedi et al., while many countries provide sophisticated health safety
nets and relief funds to their citizens, some developing countries face unique challenges in
responding to the pandemic due to vulnerable populations and limited resources and the
effect can be observed in socio-economic and mental health in the Nepalese society.

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 EXECUTIVE SUMMARY

Coronavirus disease (COVID-19) is an infectious disease caused by a newly discovered

coronavirus. When an infected person coughs or sneezes, the COVID-19 virus spreads
primarily through droplets of saliva or discharge from the nose, so it is important to perform
respiratory etiquettes like covering the mouth and nose while sneezing. Nepal's development
and economic growth have been severely hampered by frequent changes in government.
There is no sign of political stability in Nepal, even after the constitution was promulgated.
The political instability has also hampered the prevention, treatment and control of the
COVID-19. The poor governance in the country has halt the ability to take the proper
decision regarding the virus.

The objective of the seminar was to know about the political instability and its effect on
prevention, treatment and control of COVID-19 in Nepal and the effect of COVID-19 in th
mental health. The seminar was conducted on 2nd March, 2021, Tuesday inn Siddhartha
Foodland, Old Baneshwor, Kathmandu.

Dr. Uddhab Pyakhurel presented his speech on political instability in Nepal. He believes that
the rise in disease and pandemic is caused due to the globalization and connectivity and
tourism. He believes that stability is a mindset. The political instability is viewed as change
in leadership and governance but actual view is change in system than the governance and
leadership. The underutilization of the PCR test, focus on globalization, tax removal hotel
and lodging rather than poverty and treatment of COVID-19 is the problems of Nepal for
prevention, treatment and control of COVID-19.

Dr. Indra Adhikari reviewed the socio-psychological effect of COVID-19. She said that the
lack of institutionalization is the limitation of Nepal. There is lack of division of work
between the authorities of in federal system and poor planning and implementation of policy
and programs. The lockdown had created the economic and emergency crisis and family
separation increasing the mental health issues. The Women had to face domestic violence
and victimization at household. They also had to face the violence in coping mechanism like
isolation ward creating both physical and mental problems among women.

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 Table of Contents

RECOMMENDATION LETTER.........................................................................................ii
APPROVAL SHEET.............................................................................................................iii
ACKNOWLEDGEMENT.....................................................................................................iv
ABBREVIATION....................................................................................................................v
LITERATURE REVIEW......................................................................................................vi
EXECUTIVE SUMMARY...................................................................................................vii
CHAPTER I.............................................................................................................................9
INTRODUCTION...........................................................................................................................9
1.1 Background......................................................................................................................9
1.2 Objective..............................................................................................................................10
1.3 Introduction of Dr. Uddhab Pyakhurel.............................................................................10
1.4 Introduction of Dr. Indra Adhikari...................................................................................11
CHAPTER II..........................................................................................................................12
METHODOLOGY........................................................................................................................12
2.1 Seminar Topic:....................................................................................................................12
2.2 Seminar Date:......................................................................................................................12
2.3 Seminar Venue....................................................................................................................12
2.3 Guest Speakers:.............................................................................................................12
2.4 Methods................................................................................................................................12
CHAPTER III........................................................................................................................13
FINDING.......................................................................................................................................13
CHAPTER IV........................................................................................................................17
CONCLUSION..............................................................................................................................17
REFRENCE...........................................................................................................................18
ANNEX...................................................................................................................................19

viii
 CHAPTER I
INTRODUCTION

1.1 Background

Coronavirus disease (COVID-19) is an infectious disease caused by a newly discovered

coronavirus. The majority of people infected with the COVID-19 virus will have mild to
moderate respiratory symptoms and will recover without attempting any special treatment. Older
adults, as well as those with underlying medical conditions such as cardiovascular disease,
diabetes, chronic respiratory disease, and cancer, are at a higher risk of developing serious
illness. When an infected person coughs or sneezes, the COVID-19 virus spreads primarily
through droplets of saliva or discharge from the nose, so it is important to perform respiratory
etiquettes like covering the mouth and nose while sneezing. The ways to prevent the spread of
COVID-19 is by maintaining physical distance, wearing a mask while in public, cleaning the
hands and maintaining good sanitation of the environment around us. In addition to these
methods to prevent the spread of virus, the safe and effective vaccine have been developed
around the world and many people have been vaccinated to prevent the disease.

Nepal's development and economic growth have been severely hampered by frequent changes in
government. There is no sign of political stability in Nepal, even after the constitution was
promulgated. The national political arena is still dominated by the game of government collapse
and formation. The political instability has also hampered the prevention, treatment and control
of the COVID-19. The poor governance in the country has halt the ability to take the proper
decision regarding the virus. Due to this the country had to face the long mismanaged lockdown
for the long period of time causing economic crisis, our country relied on the RDT test instead of
PCR test for the long period of time which was not reliable, poor isolation and quarantine service
and now due to the political instability the country is facing the problem regarding the
distribution of vaccination. The political instability in Nepal has hampered the capacity of the
country to properly manage the virus and prevent the spread of the corona virus. The political
instability in the country has caused poor governance and socio-economic development of the
country which, directly or indirectly, affects the prevention treatment and control of the COVID-
19.

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1.2 Objective
1.2.1 General Objective:

 To know about Political instability and its effect on prevention, treatment and control of
COVID-19 in Nepal

1.2.2 Specific Objective:

 To get aware about the current situation of political instability in the country.
 To understand about the political instability in relation with overall health sector
 To be aware about the effect of political instability in prevention of COVID-19 in Nepal.
 To be aware about the effect of political instability in treatment of COVID-19 in Nepal.
 To know about the effect of political instability in control of COVID-19 in Nepal.
 To understand about the effect of COVID-19 on mental health, especially on women.

1.3 Introduction of Dr. Uddhab Pyakhurel

Dr. Uddhab Pd. Pyakhurel Ph.D. from Jawaharlal Nehru University, New Delhi, is Head of
the department of Development Studies, School of Arts, Kathmandu University, Nepal. He is
also associated with various democracy forums i.e., South Asian Dialogues on Ecological
Democracy (SADED), Vasudhaiva Kutumbakam (VK), and Network Institute for Global
Democratization (NIGD). He often contributes articles to journals and local newspapers on
poverty, people’s participation, social inclusion/exclusion, state restructuring, micro- credit,
gender, conflict, identity, democracy, election, Nepal’s foreign relations and other socio-
political issues.
In addition, he is the author of a book Maoist Movement in Nepal: A Sociological
perspective (New Delhi: Adroit Publishers, 2007); co-author of three books- Nepal-India
Open Border: Problems and Prospects (New Delhi: Vij Books, 2016), Dalit Representation in
National Politics of Nepal (Kathmandu: NNDSWO 2012) and State of Conflict and
Democratic Movement in Nepal (New Delhi: Vij 2013); and editor of a Monograph titled
Higher Education in Nepal: Inclusive Policy Guidelines ( Lalitpur: School of Arts,
Kathmandu University & SNV- Nepal, 2014). “A Quarter Millenium of Nepal’s Foreign
Policy: Continuity and Changes (in Takashi Inoguchi (ed.) the SAGE Handbook of Asian
Foreign Policy.

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 London: Sage SAGE Publications Ltd, 2020), “BRI, Nepal’s Expectation, and Limitation of
Nepal- China Border Relations (Issues & Studies, Vol. 55 No. 02, September, 2019),
“Teaching Sociology in Nepal: Revisiting the Contemporary Concerns” (in Ravi Kumar et.
al. (eds.), and Sociology and Social Anthropology. Histories and Practices. Delhi: Orient
Blackswan Private Limited, 2018), amongst others are book chapters and research articles
published by the author.

1.4 Introduction of Dr. Indra Adhikari

Dr. Indra Adhikari, a PhD in Civil-Military Relations from Jawaharlal Nehru University
(JNU), New Delhi, India has completed a Master Degree in Political Science from Tribhuvan
University-Kathmandu, and M.Phil. in International Relations from JNU. Dr. Adhikari, who
served as Acting Executive Director (while being appointed as Deputy Executive Director)
for a government think-tank under the Ministry of Foreign Affairs--Institute of Foreign
Affairs (IFA).
She also had worked as a Consultant Researcher at Policy Research Institute (a Think-Tank
under the Office of the Prime Minister), and as an Associate Research Fellow at Nepal
Centre for Contemporary Studies. Securing several fellowships i.e. SAARC Fellow of Indian
Council for Cultural Relations (ICCR) India, from 2004-2011, SAARC Research Fellow at
Institute for Defense Studies and Analysis, New Delhi, and Harka Gurung Senior Research
Fellow at Social Inclusion Research Fund, SNV-Nepal, she has published dozens of research
articles in edited books, monographs and journals.
She contributes op-ed articles on security, foreign policy and diplomacy, internal and
international politics and socio-political issues including gender in the Kathmandu based
newspapers and magazines. She has authored a book-- Military and Democracy in Nepal
(Routledge, 2015) and co-authored other two books.

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 CHAPTER II
METHODOLOGY
2.1 Seminar Topic:
Political instability and its effect on prevention, treatment and control of COVID-19 in
Nepal
2.2 Seminar Date:
2nd March, 2021, Tuesday
2.3 Seminar Venue:
Siddhartha Foodland, Old Baneshwor, Kathmandu
2.3 Guest Speakers:
Dr. Uddhab Pyakhurel
Dr. Indra Adhikari

2.4 Methods:
Lecture
Panel Discussion

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 CHAPTER III
FINDING
The speech delivered by the guest speaker in the seminar on the topic Political Instability and its
effect on prevention, treatment and control of COVID-19 in Nepal are as follows:

Dr. Uddhab Pyakhurel

Dr. Uddhab Pyakhurel presented his words and messages on political instability in Nepal in
relation to COVID-19. The case rate of developed countries is way more than the cases in the
developing countries like Nepal. According to his point of view the rise in COVID-19 spread and
pandemic is the result of globalization. While, the benefit of globalization is argued to be
connection, import and export it has negative effect on the general people and the effect include
westernization and import of everything and lack of export from Nepal. Connectivity and
tourism also gave rise to pandemic. He believes that lack of connectivity could have prevented
the spread of disease and if there was no connectivity then the disease would have been limited
to Wuhan, China. Dr. Pyakhurel said that the disease spread in Nepal was comparatively less
than other developed countries due to the lack of developmental activities in Nepal.
The developed and advanced technology are used most in the developed countries and also virus
survives the most on those machines and technologies made of “Steel” leading to spread of the
virus. But in the context of Nepal, people do not rely on such machines and can manage to
survive without interaction to factors causing the spread of the disease. In Nepal, there are 26
PCR machine for the test of COVID-19 but there is underutilization of those machines and in the
initial phase only RDT test were performed which is not reliable. The rise of cases in Nepal is
also observed due to the entrance of poor people who went to labor work and lack of isolation
and treatment of such people. Thus, the rise of pandemic is due to following reasons:

 Connectivity
 Lack of utilization of PCR
 Sustainable life
 Budget on import of PCR although present in Nepal, RDT test and Mobile PCR (which is not
very reliable)

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According to Dr. Pyakhurel the socio-political perspective on health is that main problem of
Nepal being poverty, political leaders and other peoples are focused for self- development. This
is directly related with the poverty and prevention, treatment and control of COVID-19. There is
lack of commitment of the government relating to the constitution. It is the duty and
responsibility of GoN to provide “Maulik Hak” at highest possible level to all individuals of
Nepal which includes food, health, etc. It is necessary to increase awareness among people
regarding their health and rights. The government says, there is lack of money, but Dr. Pyakhurel
argues that the government has enough money from Tax, VAT, aids, etc. which is enough to
provide all facilities to everyone for the prevention, treatment and control of COVID-19. He
believes that poor governance and management and corruption is the reason for the lack of
money and budget.

Dr. Pyakhurel believes that instability and stability is the mindset. Pokitical instability is
generally viewed as change in government and leadership but the actual view of political
instability is the change in the system. The change in the system with the same government is
also considered as instability. In the current system, more focus is given to hotels, tax removal
and giving benefits to richer ones but should actually be dealt with poor people, farmers, poverty.
Dr. Pyakhurel said that “We are not poor and our health system is better since we are better at
survival even without interaction”. To conclude, Dr. Pyakhurel said that focus should be shift to
our ancient view than globalization and Nepal should not follow the indicators of the developed
countries.

Dr. Indra Adhikari

Dr. Indra Adhikari presented her speech regarding the political decision regarding COVID-19
and its psychological effect. Dr. Adhikari is also COVID-19 researcher at policy level. She said
that the limitation of developing countries like Nepal is the lack of institutionalization than the
political instability. There was no initiation on prevention, treatment and control of COVID-19 in
Nepal, till the 4th month of the rise of novel corona virus in Wuhan, China and the initiative was
taken only after the warning from WHO. There is lack of division of work between the
authorities in the federal system. This has led to poor policy, programs which is developed as per
the understanding in the upper level and are implemented by the local government which has
created the gap in the system and planning and implementation of the programs.

14
The cabinet meeting for the prevention, treatment and control of COVID-19 was held on 9 th of
Chaitra and the implementation of the lockdown was started form 11th of Chaitra, leaving only 2
days. This created the problem like lack of compatibility to the decision made by the
government. The complete and sudden stop of social interaction caused the rise in psycho-
sociological problems. The lack of engagement and movement caused the crisis of the day-to-
day essential supplies including the insufficiency of soap and sanitizer. The psychological
problem was generated due to the speed of policy implementation leading to family separation.
The problem also raised from the incomplete information, since, the information was only
provided regarding the symptoms and prevention of COVID-19 but not regarding the treatment
and control of the disease. The problems faced due to the incompatible decision made by the
government are as follows:

 Psychological effect
 Emergency crisis
 Lack of information
 Poverty

The effect of COVID-19 can be observed in all the sector including education, tourism,
agriculture, business, etc. All the economic activities were completely stopped and people were
forced to stay in the same place which caused the rise in mental health issues like depression and
the suicide cases were also increased during the period of lockdown. The health workers like
doctors, nurse and others also had to face the mental health issues due to the bars and
discrimination society had created and also due to the exposure to COVID-19, increasing the risk
of getting the disease and affecting their health. The COVID-19 has created the impact to poor
and informal sector creating the crisis trauma. Dr. Adkhikari argues that our society has not been
able to internalize the psychological problem as the disease. She said that the mental health
issues and psychological problems are referred as personal problem and there is lack of
acknowledgement psycho-social and ecological issues. Due to this people, who have faced
mental health issues cannot be open about their problems and do not seek any kind of help or
treatment which worsens their situation of mental health problems.

15
Dr. Adhikari spoke about the problems that women had to face due to the COVID-19 and their
mental health issues. There has been the division of work of male and female in our society.
Male have always been considered as the bread winner of the family. When the male members of
the family couldn’t provide with the necessary supplies women couldn’t fulfil the needs of the
family leading to domestic violence and victimization at household. Dr. Adhikari said that 80%
of women work in informal sector and around 95% of them, due to the lockdown, had to lose
their job which increased their dependency, others who didn’t lose their job had to manage the
household and also work from home which increased frustration and mental health problems.
The coping mechanism like isolation ward weren’t women friendly and had to face the violence
even by the security personnel. Dr. Adhikari said that migrant women couldn’t receive incentives
due to lack of the official documents. These women couldn’t receive all the facilities they needed
as they didn’t had any official documents like citizenship and also had to face the discrimination.
Pregnant women and children were the vulnerable group and had to face many issues and
couldn’t receive the treatment they needed due to COVID-19.

To conclude, Dr. Adhikari said that poor involvement of women, poor recognition of work of
women, increased ego of male when they couldn’t provide the supplies, alcohol activity,
violence in community and economic crisis increased the violence against women and increased
the mental health issues among women.

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 CHAPTER IV
CONCLUSION

The political instability has also hampered the prevention, treatment and control of the COVID-
19. The poor governance in the country has halt the ability to take the proper decision regarding
the virus. Political instability is the change in system rather than change in governance and
leadership. There are total of 26 PCR machines in Nepal, but there is underutilization of those
machine and Nepal relied on RDT test on initial phase which is not reliable. Globalization,
connectivity and tourism is the major cause of rise and pandemic of the disease and focus should
be shift to poverty, farmers and treatment of COVID-19 than the tax removal globalization. The
rise of COVID-19 pandemic has caused the rise to economic crisis, family separation, lack of
social interaction and movement leading to the mental health issues. Women have been affected
to more extent due to the COVID-19 as there was increase in domestic violence and
victimization at the household and community level leading to physical and mental health
problems.

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 REFRENCE

 Coronavirus. World Health Organization

https://www.who.int/health-topics/coronavirus#tab=tab_1

 Bhattarai KD. Nepal's Unending Political Instability. – The Diplomat. for The Diplomat;
2020
https://thediplomat.com/2016/07/nepals-unending-political-instability/

 Kritika Poudel PS. Impact of COVID-19 pandemic on socioeconomic and mental health
aspects in Nepal - Kritika Poudel, Pramod Subedi, 2020. SAGE Journals
https://journals.sagepub.com/doi/full/10.1177/0020764020942247

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ANNEX

Banner for seminar on Political instability and its effect on prevention, treatment and control of
COVID-19 in Nepal

Certificate of participation for the participants

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Dr. Uddhab Pyakhurel presenting his speech

Dr. Indra Adhikari presenting her speech

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Organizing team of seminar

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