KATHMANDU- It is now confirmed that no disease outbreak in the world’s history has traveled as far and as rapidly as COVID-19. When the World Health Organization (WHO) announced the crisis as a pandemic on March 11th, there were about one hundred thousand reported cases of infection and in less than a month by April 2nd the number had surpassed one million with more than fifty thousand recorded death cases. Both the speed and the scale of the spread of the outbreak has been beyond imagination.
Many countries have closed their borders, banned international travel, and even imposed lock downs in efforts to reduce furthering the spread of the disease. Practicing social isolation and social distancing has reminded us of how fortunate we are to be living in a digital and technological golden age. However, the value of direct human connection is now more than ever realized as being irreplaceable.

The crisis leads us to reflect on the necessity to potentially rethink how systems and societies function. We must consider the role of the state in providing equitable access to the most basic necessity—that of universal health care. Further, the lack of resilience and preparedness at all levels and the gaps in providing accurate information on a timely basis must be learned from, and not repeated. It’s time to realize the futility of man-made geographical boundaries and walls, social, religious and political divisions, as all of this has remained meaningless in dealing with the crisis.
In the case of Nepal, the country closed its border to curtail the influx of the imported cases from abroad following WHO’s prescription to “isolate, test, treat and trace” as the recipe for dealing with the crisis. Nepal is seen as a fortunate country during this global pandemic with only a few cases identified thus far and only one casualty from coronavirus. The testing however, started only recently and in only limited locations which begs us to think critically and speculate whether the infection has already penetrated deeply and widely in Nepal unknowingly. This leads us to consider potential routes of transmission including a) the infection from Chinese tourists and Nepalese returnees from various parts of China; b) inflow of tourists and Nepalese from other parts of the world (particularly southern Europe) prior to the ban; c) the free, unrestricted flow of people from India and specifically the surge of Nepalese returnees from India upon its lockdown; and d) the exodus of more than half a million people from Kathmandu to other parts of Nepal over the past two weeks.
Asta-Ja International Coordination Council (Asta-Ja ICC) held a video meeting recently with the participation of more than a dozen experts and professionals to reaffirm our commitment to serving Nepal, and to share thoughts on various aspects of the crisis and to discuss how we could make a contribution. We take this opportunity to highlight some concerns and ideas relevant to the current crisis in Nepal considering both immediate needs and broader longer-term perspectives in view of the multi-dimensional nature of the problem.
# The overarching need of the moment is to disregard our differences and unite together to show resilience, solidarity and timely action by all to prevent further transmission and provide best possible medical care for all affected individuals. This is not the time to play a blame game and target particular groups, political parties, the government or the private sector but to unite together on the mission to combat the crisis using recommended approaches by knowledgeable experts and public health institutions. Most importantly, the crisis calls for a challenging role on by the political leadership and government at the national as well as decentralized levels to organize and deliver multi-sectoral response in a coordinated and participatory manner. A key issue for research and documentation for wider learning is how the local leaders, authorities and institutions have organized themselves to respond to the crisis and what has been their experience.
# Health care for all should remain the top priority. Recent news from around the world has shown that everyone is vulnerable to coronavirus and among affected groups the elderly are the most vulnerable.

Same goes with geographic vulnerability as before and after the lockdown, there was considerable mobility from outside and within the country so it’s rightly speculated that the virus must have travelled in most parts of the country. The crisis provides an opportunity to focus on the preparedness of our health care system (considering both quality and coverage aspects) in all parts of the country. There is an ethical call on the part of the private sector hospitals and clinics to play their role while ensuring the safety and well-being of their own staff. In the longer term, the crisis serves as a reminder to reform and reequip an ailing primary health care system to serve the health needs of the people in all parts of the country.
# Food, water, and hygiene: Adequate nutrition is stressed as key to maintaining health and immunity to protect against the coronavirus and this is more so for the elderly, young children, pregnant and lactating women. There are already news about price hikes and artificial shortages in various parts of the country, which require a role for private sector cooperation. Nepal has similar experience and lessons from the 2015 earthquake response (though the context is different) which need to be applied in cooperation with the private sector. Targeting the poorest and food insecure groups with immediate food needs is an expensive but essential requirement, which we trust can be undertaken with internal and external donor support. Similarly, the response to the crisis requires regular handwashing and hygiene, which will raise the consumption of water. In Kathmandu where many poor households depend on tankers for water supply, free water distribution to needy groups until the duration of the crisis would serve as a basic relief.

# Livelihood, employment and food security as broader concerns. In a country where unemployment was a major issue and significant proportion of the population was living below the poverty line, the lockdown has created considerable havoc. Farmers with commercial agricultural production are suffering big losses as they have not been able to transport their produce to the markets and also being unable to purchase necessary agricultural inputs. Many vegetable growers around big cities such as Kathmandu have left their crops unharvested as no market agents are coming to their farms to buy their produce. Likewise, dairy farms are experiencing big shortage of animal feed and veterinary supplies, consequently leading to sick animals. Small businesses and families depending on the tourism sector have been hit particularly hard and it might take many months for them to recover.
There is need to engage constructively with the private sector, internal and external donors and international financial institutions (World Bank and Asian Development Bank) to devise relief measures that are introduced in phases. It would be important to remain vigilant on how such allocations are made and what measures are taken for guarding social welfare schemes against corruption, rent seeking and nepotism as these are well known evils of Nepal’s governance system. The worsening of the economic condition of individuals who were already unemployed and households below the poverty line seems a particular concern which might also cause social unrest among the desperate population groups, especially the youth.
# Time to consider alternate/informal education models.

Globally, about 1.5 billion children or 87% of student population are currently affected by closures and lockdown. Many schools particularly in the private sector, have introduced online schooling but the less-privileged children who go to public schools are denied the opportunity at large. There is considerable role and opportunity for TV and Radio channels to run informal educational programs tailored to the need of various age groups. This is particularly important if the crisis prevails for weeks, which is a likely scenario. Such innovations introduced now can be used for future crises and for the periods when children are on holidays.

A related concern which needs to be guarded against is the risk of rise in drop-outs due to distraction of children into labor or household activities (girls in particular), especially if lockdown measure is extended to several weeks.

# Targeting psycho-social care and mental health. The uncertainty and fear from an emergency crisis inevitably produces anxiety and poses mental health challenges.

Those particularly susceptible include young children, older adults, healthcare workers and providers and those with substance abuse or other mental health problems. How do individuals, households and communities deal with addressing fear and anxiety? What is the role of the media to mitigate fear and anxiety by providing reliable information and disseminating programs that target vulnerable groups? Considerable news has come out in recent weeks from many countries about rising cases of domestic violence as a result of the situation arising from the crisis. Women and children seem to be major victims though the whole family eventually bears the burden. Nepal, where domestic violence has already been a concern, is equally vulnerable to these trends. There are documented approaches and resources available from international institutions (WHO, UNICEF, UNWOMEN, Save the Children) which could be tailored to fit Nepal’s varying contexts. Communication media has an important role and some experience that needs to be tailored to specific groups and scaled up to raise awareness for protecting families from domestic violence.

# Nature and environment protection as the positive outcomes. The change in human behavior brought about by the coronavirus crisis has reduced air pollution levels (as millions of people have deserted cities and there is very little movement), traffic congestion, noise pollution. Nature and environment is experiencing a break especially from the burning of natural fuels and the carbon emission which are benefitting the health and quality of life of the people who remain in the cities. These are positive externalities from the crisis which also convey a lesson for reducing over-urbanization and congestion of which Kathmandu is a burning example. An interesting question is what happens to rural-urban migration when the crisis is over? An equally important question is the experience of the rural areas with respect to environmental and social changes in response to the urban rural migration, especially if it is extended for longer durations and a significant number of people decide to stay back.
#reinforcing transparency, accountability and role of reliable data and information. There is an abundance of information flowing from various formal and informal channels about the potential spread and consequences as well as protection and treatment measures. These include inaccurate and unverified information which is misguiding the people. To avoid this problem, there is need for a capable and credible government-led authority to gather and disseminate accurate and reliable data and information on all aspects related to the crisis. Various media channels need to work together to disseminate credible information to the public on evolving situation across the country as well as preventive and curative measures that are recommended by credible institutions and authorities. Similarly, these challenging times call for a need to enhance transparency and accountability at all levels with respects to processes that involve funds whether they are coming from domestic tax payers, grants from international donors or loan by international financial institutions. These are testing times when we hope the principles of honesty, transparency and accountability will receive due respect by all actors.

Asta-Ja ICC, which is an assembly of scholars and experts affiliated with Asta-Ja, consists of several hundred professionals in 17 countries, reiterates its commitment and readiness to contribute to both immediate and longer-term measures, to building capacity at the local, regional and national level to fight against COVID-19 pandemic, to identify future comprehensive pathway for resilient and sustainable development of post-COVID-19 pandemic Nepal, and for modernization and socio-economic transformation of Nepalese society. In response to COVID-19 pandemic, Asta-Ja ICC is working on documenting lessons learned globally from this pandemic by producing a well-formulated publication to facilitate exchange of ideas and learning within Nepal and outside, positioning itself in providing emergency support for needy, and preparing for a Post-COVID-19 Resilient Nepal Convention.
Based on Press release issued by the ASTA JA dated April 04, 2020.