Workers pay the price as virus rampages through country

KATHMANDU • Mr Ram Singh Karki escaped the first wave of the coronavirus pandemic in India by boarding a crowded bus and crossing the border home to Nepal.

Months later, as the rate of new infections fell, he returned to his job in New Delhi at a printing press, which had sustained his family for two decades and helped pay the school fees of his three children.

Then, India was swept by a second wave of infections, and Mr Karki was not as lucky.

He was infected last month and hospitals in New Delhi were overwhelmed. When his oxygen level dropped, his manager arranged for an ambulance to take him back to the border. He crossed into Nepal, carrying with him just the clothes on his back - and the virus.

Nepal is now considering declaring a health emergency as the virus rampages virtually unchecked through the impoverished nation of 30 million people. With the virus carried by returning migrant workers and others, a vicious second wave has stretched the country's medical system beyond its meagre limits.

Nepal has recorded 500,000 Covid-19 cases and 6,000 deaths, numbers that experts believe deeply undercount the toll. Testing remains limited. One figure could indicate the true severity: For weeks now, about 40 per cent of the tests conducted have been positive.

A government in disarray has compounded the trouble. Nepal's embattled Prime Minister K. P. Sharma Oli has been pushing for an election in November after the country's Parliament was dissolved this month, an event that could worsen the spread.

This past week, Nepal's Minister for Health and Population Hridayesh Tripathi said the government was considering declaring a health emergency as infections rise. But such a declaration could be caught up in politics. The move would allow officials to limit people's movements - a level of control that opposition groups worry could be used to quell dissent.

In the meantime, officials in Kathmandu, the capital, have urged people to store food for at least a week and stay home.

The impact is rippling beyond those infected. Remittances from migrant workers have slowed. Tourism and the economy have been damaged.

The United Nations' Development Programme in Nepal resident representative Ayshanie Medagangoda Labe said: "Millions of people continue to feel the increasing pressure not just with the direct health impact of Covid-19, but also with food, jobs, medical bills, kids out of school, payback loans, mental pressure, and much more."

Nepal's close relationship with India and the porous 1,770km border they share helped make it vulnerable. Officials say labourers like Mr Karki, who were forced to return home amid the second wave, brought the virus with them. Villages along the border are some of the worst hit.

Nepal's Health Ministry said about 97 per cent of the cases sent for genome sequencing show the B16172 variant that was first found in India, and which the World Health Organisation has classified as a "variant of global concern".

Mr Oli has called for international aid, although it will not be enough to meet Nepal's needs. China has donated vaccines, oxygen cylinders and ventilators, while the United States and Spain have sent planeloads of medical equipment. But Nepal cannot fight the pandemic without help from India. Already, an Indian vaccine manufacturer has told Nepal it cannot deliver a promised one million doses.

Nepal is also dependent on India for half of its medical equipment needs, according to the Chemical and Medical Suppliers Association of Nepal, but India is keeping just about everything for its own urgent domestic needs.

NYTIMES