what is the nepali meaning of biography

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Nepali To English Dictionary

Biography meaning in nepali, meaning of "biography".

Other word with "Biography"

• autobiography, writing about oneself ,
• autobiography, writing about oneself, writing in first person ,
• to write a biography
• मायाँ लाग्दो

English Nepali Dictionary | अंग्रेज़ी नेपाली शब्दकोश

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biography - Meaning in nepali

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Definitions and Meaning of biography in English

Biography noun.

life history , life story , life , life

What is another word for biography ?

Sentences with the word biography

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What is biography meaning in nepali.

Other languages: biography meaning in Hindi

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What is biography meaning in Nepali, biography translation in Nepali, biography definition, pronunciations and examples of biography in Nepali.

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• Contemporary Nepali dictionary : meanings in Nepali

• English-Nepali.com : English-Nepali dictionary

• Nepali-English glossary , Cornell University (2004)

• NepalResearch : Nepali & Sherpa dictionaries ( Sherpa is closed to Tibetan )

• Nepali-English dictionary & Nepali-German dictionary [PDF] (Latin & Nepali characters)

• Practical dictionary of Modern Nepali by Ruth Schmidt (1993)

• Comparative and etymological dictionary of the Nepali language by Ralph Turner (1931)

• Shorter English-Nepali dictionary by T. Warren (1944)

→ Devanagari keyboard to type a text with the Devanagari script

• YouTube : common phrases & alphabet (videos)

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• Nepali, a beginner's primer , conversation and grammar , by Banu Oja & Shambhu Oja (2004)

• Nepalgo : Nepali course & vocabulary by topics

• Nepalese Linguistics : online journal about the languages of Nepal, published by the Linguistic society of Nepal

• The sounds of the English language and Nepali Language by Rajan Kumar Kandel, in Anusheelan research journal (2010)

• The effects of English in the Nepali hinterlands : career gains and identity loss , by Ashok Raj Khati, in Nelta (2013)

• Why English is not a foreign language in Nepal by Ram Ashish Giri, in Journal of world languages (2014)

• Motion events in Nepali by Krishna Parajuli, thesis (2021)

• Négociation des ressources langagières dans les échanges conversationnels népali-anglais by Julian Vasseur, thesis (2021)

• Nepali lessons for teach yourself Nepali by Netra Prasad Paudyal (2014)

• Basic course in Nepali spoken by Tika Karki & Chij Shrestha

• Descriptive grammar of Nepali by Jayaraj Acharya (1991)

• Course in Nepali by David Matthews (1998)

• Colloquial Nepali : learning guide by George Gordon Rogers (1950) (Latin alphabet)

• Grammar of the Népalese language by James Alexander Ayton (1820)

• books & papers about the Nepali language: Google books | Internet archive | Wikipedia

• Kantipur : news in Nepali & English

• BBC : news in Nepali

• NepaliSong : Nepali songs to listen

• Text from the Nepali translated version of Alice's adventures in Wonderland (Lewis Carroll), annoted corpus, by Netra Prasad Paudyal (2014)

• In search of the oldest Nepalese manuscript by Kengo Harimoto, in Rivista degli studi orientali (2011)

• WordProject : translation of the Bible into Nepali

सबै व्यक्ति हरू जन्मजात स्वतन्त्र हुन ती सबैको समान अधिकार र महत्व छ। निजहरूमा विचार शक्ति र सद्धिचार भएकोले निजहरूले आपसमा भातृत्वको भावना बाट व्यवहार गर्नु पर्छ।

→ First article in different languages

→ Universal Declaration of Human Rights : bilingual text, in Nepali, Hindi, English & other languages

→ Nepal : maps, symbols, heritage & documents

→ Hindi & Sanskrit language

→ Tibetan language & Sherpa (Tibetic language)

Nepalese Culture

Core concepts.

• Companionship
• Interdependence
• Dependability

Nepal is a landlocked, mountainous country located between India and Tibet. It is well known for the impressive Himalayan range and deep valleys that shape the landscape. Nepalis have a reputation for being dependable and resilient people who can withstand difficult conditions. This was recently exemplified in the stoic national response following the devastating earthquake of 2015. Nepalis often exhibit patience and calmness, and are generally not overly dramatic people. Their tolerance has enabled many different faiths and ethnicities to coexist quite harmoniously. Much of Nepal’s culture is deeply steeped in tradition and religion. However, new values and ideas are being introduced to the general population in light of a new democratic political order.

Nepalis are generally deeply loyal to their citizenship and culture. They are very proud that their country has never been colonised, seeing this as a key distinguishing fact between them and India. The Gurkhas (Nepali soldiers) continue to be highly admired for their role in this regard1. Nepalis understand the worth and beauty of their land. The culture is enigmatic with many religious customs, rituals, festivals, processions and local secrets. Yet, people also share a sense of sadness regarding the widespread poverty and mismanagement of their country. Indeed, poverty is an undeniable social issue. This, coupled with an unstable political situation, means the primary ambition of most Nepalis is generally to secure a stable future for their family.

Nepal is largely underdeveloped with limited social services and public infrastructure. There are very few urban centres outside of the capital city of Kathmandu. An estimated 83% of the population live in rural areas (2011). The geographical isolation that the mountains create has generally led many villages to be secluded from outside influence, meaning many have retained quite a distinct cultural identity. Tribal and nomadic practices continue in many places. The diversity of customs and values between regions means Nepal cannot be broadly generalised. However, typically it can be observed that the more remotely situated a community is, the more visibly traditional their cultural practices will be. Meanwhile, those regions with access to better education are likely to have diverged from some aspects of traditional social customs. Kathmandu in particular is becoming very outward looking, drawing influence from across the globe. Recent cosmopolitan transformation is visible in fashion as traditional Nepali attire is now usually only worn in rural areas.

Social Hierarchies

Nepali culture is quite hierarchical and there is significant stratification between the poorest and the most powerful of society. People mostly accept these differences in social status as the natural order and defer to those who are older or who they perceive to have a high reputation. However, a person’s status and background is not always immediately evident in Nepal. For example, one may find that a fruit seller has a degree in business. As it can be difficult to assume someone’s status from their appearance, Nepalis commonly ask about one’s age, profession, education and family background to determine the correct level of respect to be shown. Westerners often find that they are deferred to a lot and treated with high regard as (relatively speaking) they are considered to be very wealthy in Nepal. Land ownership is also a common measure of status. However, one’s family reputation and status ( ijat ) is generally thought to be more important than material wealth. People are not expected to be respected because of their money, but rather their virtue. There is also a preference shown towards those who are educated or speak English. This being said, many Nepalis are gradually becoming more materialistic and money focused.

The Nepali awareness of status is also heavily influenced by the Hindu caste system . Although often classified under one term, the ‘caste’ system actually represents multiple overlapping systems of stratification. The ‘ varna ’ system divides society into four broad categories (varna) that are sometimes described as clusters of castes. These are the Brahmins, Kshatriyas, Vaishyas and Sudras. Each varna is considered to indicate a different level of ‘purity’ – with the Brahmins being the holiest/purest in Hinduism. Within each varna, there are more specific ‘ thar ’ categories that specify the social community one is born into and are often referred to in terms of vocation/employment. They are allocated and stratified into the varna system depending on the person’s social status. For example, occupations considered ‘dirty’ – such as cleaning or handling cow leather – are situated within the lower varna class of Sudra.

One’s caste traditionally determined the person’s line of work, position in the social hierarchy and defined ideas of self-worth. Despite it becoming illegal to discriminate on the basis of caste in 1962, the influence of this social stratification has remained. Some Nepalis may socialise and marry within their caste while others may even ostracise those belonging to subordinate castes. For example, they may not accept offers of food from someone of a low caste, believing it to be ‘impure’. Nevertheless, as Nepal modernises, the social constraints of the caste system are fading. In Kathmandu, for instance, where castes mix on a daily basis, the concern regarding others’ castes is diminishing. The younger generation is also particularly liberal and open towards all castes. One of the main agendas of the incoming government has been to recognise all castes.

Ethnic Demographic

People’s social distinction, be it their caste or ethnicity , plays a big role in informing their personal identity in Nepal. For example, many Nepalis use the name of their ethnic group or caste as their surname. An individual’s ethnicity is different from their caste. While one’s caste is usually indicative of occupation and family status, ethnic groups commonly share a distinctive language, ancestral home, religious tradition or form of social organisation.

The government has identified between 50 and 60 Nepali ethnicities (2011). Many of these are indigenous to Nepal and have origins as the original inhabitants of a certain region (e.g. the Tharu and Tamang people). Other ethnicities in Nepal, while not native, are often historical inhabitants of the areas. Some of the biggest ethnicities are the Brahmin-Chhetri, Magars and Newars.

The ethnic makeup of Nepal reflects the historical migratory patterns into the country from the North and South. Broadly, the castes and ethnicities can be broken down into two main groups: Tibeto-Burmans and Indo-Aryans. This differentiation between the two is not so much socially distinctive, but often visible in hereditary features that suggest distant ancestry. Indo-Aryans typically have similar appearances to their Indian neighbours in the South, whilst Tibeto-Burmans generally resemble Mongol or Tibetan people. Indo-Aryans are more populous and have come to dominate Nepal socially, politically and economically, while Tibeto-Burmans traditionally inhabit the mountains at very high altitudes. However, with increasing urban and overseas migration, the geographic differentiation between ethnicities is reducing.

Nepalis with foreign ancestry may have retained certain cultural influences that relate to their ancestral background. For example, those from India commonly follow Hinduism, whilst Tibeto-Burmans are generally Buddhist. However, these labels purely serve as a helpful way to categorise the origins of Nepal's ethnic diversity and don’t necessarily reflect Nepali people’s personal identity. People are unlikely to describe themselves as ‘Tibeto-Burman’ or ‘Indo-Aryan’. Every individual ethnicity has developed a strong and distinctive cultural identity. They often share a common language, belief or form of social organisation unique to their ethnic group.

Collectivism

Nepali culture is very collectivistic. Families may combine their assets in order for all members to be economically secure, and close friends perform favours for one another on a regular basis. This interdependence has been largely driven by necessity, as the government cannot always be relied upon to provide support. Instead, Nepalis tend to be deeply reliant on and loyal to their family and social group. It’s common for people to forfeit their own aspirations for the betterment of their entire family unit. For example, one person may work in very difficult conditions whilst sending remittances back to others. In rural areas and at high altitudes especially, people depend on their community for survival, and basic assets are shared communally. Village elders are often the authority figures of these communities. Those who are urban, educated and internationally exposed may be more individualistic in their outlook. However, given the underdeveloped status of Nepal, economic independence is still difficult to attain.

Friendship and Company

Most friendships have a strong significance and substance to people in Nepal. They are approached quite earnestly and are not usually shallow relationships that come and go quickly. There is a sense of graciousness that comes with sharing in another’s company; people are constantly “humbled” to meet others, have a guest or gain a new friend. Once the growth of a friendship begins, so too does an expectation of loyalty and reliability. People often reach out to friends for personal favours and support and may expect to be granted certain privileges (such as job opportunities) on the basis of the relationship.

Generally, Nepalis feel most comfortable when they are accompanied in whatever they do. They love companionship and are known to strike up conversation for little reason other than to talk. This aspect of Nepali culture makes it feel very warm and inclusive. People rarely go anywhere alone ( eklai ), particularly women. Those who are travelling alone can expect to be questioned out of curiosity as to why; solo travellers are usually sent off with a blessing and so are accompanied by the wishes and prayers of their family.

Purity and Fatalism

A deep moral and ethical awareness is interlaced into daily life in Nepal. This is influenced by religious values and beliefs, as well as cultural ideas of purity. They are deeply entrenched and ritualised in people’s diet and personal practice. Almost any action, object, job or person can be categorised as particularly ‘pure’ or ‘impure’. Nepalis can be quite reserved in their behaviour, acting modestly in accord with what is considered to be appropriate behaviour within these cultural guidelines.

The fundamental importance religion holds in many Nepalis’ lives also influences their approach to problem solving. It is common for people to take a fatalistic attitude, assuming the cause of problems to be the result of a god or spirit’s work. For example, witches are sometimes thought to be the cause of bad luck. This fatalism does not necessarily mean people are passive, waiting for things to occur at the will of a god. Nepalis generally work very hard until the point that they can do no more – from there, “what will be will be”. However, misfortunes are often attributed to an individual’s behaviour; for instance, bad health is commonly perceived to result from bad karma. Therefore, Nepalis are known to be quite stoic and tolerant in difficult situations as this explanation of problems can make them feel as if they somewhat deserve to suffer.

_____________________

1 The Nepali military played a famous role in fighting the British off.2 See the statistics on the side of this page for a list of different ethnic groups in Nepal.

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• The Culture Of Nepal

• Nepal is situated in the Himalayas and is a country that houses multiple cultures and ethnicities.
• 123 languages are spoken in Nepal.
• Though volleyball is the national sport, football (soccer) is the most popular.
• The population of Nepal is mostly Hindu, with the next most-practiced religion being Buddhism
• A lot of performance and art in Nepal is inspired from Hindu religious mythology.

Nepal is a sovereign state in South Asia , situated in the Himalayas. This landlocked country has a population of approximately 29 million people in 2020 and borders China and India. The country’s capital and largest city is Kathmandu. The country has a rich, multi-ethnic and multi-dimensional culture based on ancient traditions and social customs. The Nepalese culture is closely related to the culture of the more massive Indian Sub-continent and is influenced by the cultures of India and Tibet.

Ethnicity, Language, And Religion

Nepal is a multiethnic and multicultural country that came into existence through the progressive, political merging of smaller kingdoms and principalities such as Videha, Mustang, Limbuwan, and Madhesh. The northern part of the country is inhabited by Limbu, Rai, and Mongolian people while the Sherpa, Magar, Gurung and Lama people inhabit the western and central regions. 

There are approximately 123 languages spoken in Nepal. The major language is Nepali, spoken by 44.6% of the population as mother tongue. Other main languages include Maithili, Tamang, Tharu, and Bhojpuri. There are two main religions in Nepal; Buddhism and Hinduism. However, some Nepalese practice a unique combination of the two religions. The majority of the population, 80%, are Hindu while 11% practice Buddhism. Islam is practiced by about 3.2% of the population. Christians are \bout 1% of the population.

Nepalese cuisine is comprised of a variety of cuisines from the different ethnicities of the country and has been influenced by Asian culture. In most instances, a meal is never complete without a sizeable amount of rice. Rice is mainly served with daal, a spiced lentil soup, and vegetable curry called tarkari. 

Meals are eaten twice a day; late morning and early evening. Mostly, the meals also include “achar” which pickled vegetables or fruit. Rice may also be supplemented with flatbread known as “roti.” Traditionally, people eat from their individual plates using their hands and while seated on the floor.

Nepalese Traditional Clothing

Each of the ethnic groups in Nepal has its own traditional clothing. However, most of these follow the same pattern. Men’s traditional clothes are referred to as “Daura Suruwal.” Daura is a double-breasted shirt while Suruwal are simple baggy trousers that fit tightly at the ankle. Other items of clothing include jackets and a vest. The combination of a jacket and Daura Suruwal is considered informal traditional wear. A Daura does not have buttons or clasps and is often held in its place by four ties, two close to the waist and two near the shoulders. The national hat is called “Dhaka topi” and is often worn by the men.

The traditional outfit for the women is called “Kurta Suruwal.” It consists of a long blouse, sleeveless or short-sleeved and usually extending below the hips, light baggy pants, and a large scarf. The clothing is loose and usually brightly coloured and with patterns. The scarf is also long and matches with the rest of the outfit. It is draped over the body.

Literature, Art, And Craft

Nepalese literature dates back to the 19th century with the adaptation of the Hindu “Ramayan” by the Bhanubhakta Acharya for the Nepali readership. The development of literature in the country has been hampered by the heavy government censorship and control, forcing most authors and poets to seek publication outside the country. Several Nepali authors have been actively writing innovative Nepali literature since the Democratic revolution of 1991. Some of these authors include Khagendra Sangraula, Yuyutsu Sharma, Narayan Wagle, and Toya Gurung.

Much of Nepalese art is considered religious. The Newar people are responsible for most of the examples of the traditional art and architecture of Nepal. They are known for craftsmanship, Paubha painting, and sculpture. The Newari create a caste-bronze statue of Hindu and Buddhist deities.

Performance Arts

Performance art also focuses on religious themes drawn from Hindu epics. Political satire is also very common as well as comedic forms. Nepal has a rich musical heritage with several distinctive vocal styles and instruments. Music is popular across all age groups and has become a marker of identity, especially among the younger generation. The older generation prefers folk songs and religious music while the younger generation is attracted to western and experimental film music. Performance art such as music and dancing is a very important part of festivals and celebrations. The end of the plowing season is often marked by songs, shouts, and dances.

Several sports are played in Nepal, both at the national and international levels. The most popular sport in the country is football (known in the US and Canada as soccer), followed by cricket. The Nepalese national cricket team has even participated in the World Cup and other international competitions. However, the national sport of Nepal is volleyball. 

The sport with the most tournaments in Nepal is football, and they are held across the country. The Nepal football national team won gold in the 2016 South Asia Games. According to the 2018 FIFA ranking, Nepal holds position 165.

Life In Society

Nepal is a multi-ethnic society with a rich culture and religious practices. Visitors are required to embrace native customs while visiting certain places such as temples. Like the locals, they must put on a respectable dress with no leather, remove their shoes, and ask for permission before entering the Hindu temple. Nepalis are generally friendly. However, public display of affection is not appreciated. 

Superstition still rules the country. Interestingly, praising a baby’s appearance or walking on spilled rice brings bad luck. Red chillies are almost everywhere and are believed to drive away the evil spirit. The family is very important in Nepalese culture. Like much of the world, for a very long time, women were honored as mothers and had little access to education and political power. Men were the heads of their respective families and were required to provide for them. While there has been progress for the rights of women in recent decades, this progress has been slow to reach the regions outside of the urban centres.

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• Culture of Nepal

Culture Name

Alternative name, orientation.

Identification. Nepal is named for the Kathmandu Valley, where the nation's founder established a capital in the late eighteenth century. Nepali culture represents a fusion of Indo-Aryan and Tibeto-Mongolian influences, the result of a long history of migration, conquest, and trade.

Location and Geography. Nepal is a roughly rectangular country with an area of 147,181 square miles (381,200 square kilometers). To the south, west, and east it is bordered by Indian states; to the north lies Tibet. Nepal is home to the Himalayan Mountains, including Mount Everest. From the summit of Everest, the topography plunges to just above sea level at the Gangetic Plain on the southern border. This drop divides the country into three horizontal zones: the high mountains, the lush central hills, and the flat, arid Terai region in the south. Fast-moving, snow-fed rivers cut through the hills and mountains from north to south, carving deep valleys and steep ridges. The rugged topography has created numerous ecological niches to which different ethnic groups have adapted. Although trade has brought distinct ethnic groups into contact, the geography has created diversity in language and subsistence practices. The result is a country with over thirty-six ethnic groups and over fifty languages.

Demography. The population in 1997 was just over 22.6 million. Although infant mortality rates are extremely high, fertility rates are higher. High birth rates in rural areas have led to land shortages, forcing immigration to the Terai, where farmland is more plentiful, and to urban areas, where jobs are available. Migration into cities has led to over-crowding and pollution. The Kathmandu Valley has a population of approximately 700,000.

Linguistic Affiliation. After conquering much of the territory that constitutes modern Nepal, King Prithvi Narayan Shah (1743–1775) established Gorkhali (Nepali) as the national language. Nepali is an Indo-European language derived from Sanskrit with which it shares and most residents speak at least some Nepali, which is the medium of government, education, and most radio and television broadcasts. For many people Nepali is secondary to the language of their ethnic group or region. This situation puts certain groups at a disadvantage in terms of education and civil service positions. Since the institution of a multiparty democracy in 1990, linguistic issues have emerged as hotly debated topics.

Symbolism. The culture has many symbols from Hindu and Buddhist sources. Auspicious signs, including the ancient Hindu swastika and Shiva's trident, decorate buses, trucks, and walls. Other significant symbols are the emblems (tree, plow, sun) used to designate political parties.

Prominent among symbols for the nation as a whole are the national flower and bird, the rhododendron and danfe; the flag; the plumed crown worn by the kings; and the crossed kukhris (curved knives) of the Gurkhas, mercenary regiments that have fought for the British Army in a number of wars. Images of the current monarch and the royal family are displayed in many homes and places of business. In nationalistic rhetoric the metaphor of a garden with many different kinds of flowers is used to symbolize national unity amid cultural diversity.

History and Ethnic Relations

The birth of the nation is dated to Prithvi Narayan Shah's conquest of the Kathmandu Valley kingdoms in 1768. The expansionist reigns of Shah and his successors carved out a territory twice the size of modern Nepal. However, territorial clashes with the Chinese in the late eighteenth century and the British in the early nineteenth century pushed the borders back to their current configuration.

National Identity. To unify a geographically and culturally divided land, Shah perpetuated the culture and language of high-caste Hindus and instituted a social hierarchy in which non-Hindus as well as Hindus were ranked according to caste-based principles. Caste laws were further articulated in the National Code of 1854.

By privileging the language and culture of high-caste Hindus, the state has marginalized non-Hindu and low-caste groups. Resentment in recent years has led to the organization of ethnopolitical parties, agitation for minority rights, and talk about the formation of a separate state for Mongolian ethnic groups.

Despite ethnic unrest, Nepalis have a strong sense of national identity and pride. Sacred Hindu and Buddhist sites and the spectacular mountains draw tourists and pilgrims and give citizens a sense of importance in the world. Other natural resources, such as rivers and flora and fauna are a source of national pride.

Hindu castes and Buddhist and animist ethnic groups were historically collapsed into a single caste hierarchy. At the top are high-caste Hindus. Below them are alcohol-drinking ( matwali ) castes, which include Mongolian ethnic groups. At the bottom are untouchable Hindu castes that have traditionally performed occupations considered defiling by higher castes. The Newars of the Kathmandu Valley have a caste system that has been absorbed into the national caste hierarchy.

Historically, members of the highest castes have owned the majority of land and enjoyed the greatest political and economic privileges. Members of lower castes have been excluded from political representation and economic opportunities. The untouchable castes were not permitted to own land, and their civil liberties were circumscribed by law. Caste discrimination is officially illegal but has not disappeared. In 1991, 80 percent of positions in the civil service, army, and police were occupied by members of the two highest castes.

Urbanism, Architecture, and the Use of Space

Nepal historically was one of the least urbanized countries in the world, but urbanization is accelerating, especially in the capital, and urban sprawl and pollution have become serious problems. Kathmandu and the neighboring cities of Patan and Bhaktapur are known for pagoda-style and shikhara temples, Buddhist stupas, palaces, and multistory brick houses with elaborately carved wooden door frames and screened windows. Although the largest and most famous buildings are well maintained, many smaller temples and older residential buildings are falling into disrepair.

At the height of British rule in India, the Rana rulers incorporated Western architectural styles into palaces and public buildings. Rana palaces convey a sense of grandeur and clear separation from the peasantry. The current king's palace's scale and fortress-like quality illustrate the distance between king and commoner.

Rural architecture is generally very simple, reflecting the building styles of different caste and ethnic groups, the materials available, and the climate. Rural houses generally have one or two stories and are made of mud brick with a thatched roof. Village houses tend to be clustered in river valleys or along ridge tops.

Food and Economy

Food in Daily Life. Many Nepalis do not feel that they have eaten a real meal unless it has included a sizable helping of rice. Most residents eat a large rice meal twice a day, usually at midmorning and in the early evening. Rice generally is served with dal, a lentil dish, and tarkari, a cooked vegetable. Often, the meal includes a pickle achar, made of a fruit or vegetable. In poorer and higher-altitude areas, where rice is scarce, the staple is dhiro, a thick mush made of corn or millet. In areas where wheat is plentiful, rice may be supplemented by flat bread, roti. Most families eat from individual plates while seated on the floor. Though some urbanites use Western utensils, it is more common to eat with the hands.

Conventions regarding eating and drinking are tied to caste. Orthodox high-caste Hindus are strictly vegetarian and do not drink alcohol. Other castes may drink alcohol and eat pork and even beef. Traditionally, caste rules also dictate who may eat with or accept food from whom. Members of the higher castes were particularly reluctant to eat food prepared by strangers. Consequently, eating out has not been a major part of the culture. However, caste rules are relaxing to suit the modern world, and the tourist economy is making restaurants a common feature of urban life.

Food Customs at Ceremonial Occasions. At weddings and other important life-cycle events, feasts are generally hosted by the families directly involved, and numerous guests are invited. At such occasions, it is customary to seat guests on woven grass mats on the ground outside one's home, often in lines separating castes and honoring people of high status. Food is served on leaf plates, which can be easily disposed of. These customs, however, like most others, vary by caste-ethnic groups, and are changing rapidly to suit modern tastes.

Basic Economy. The large majority of the people are subsistence farmers who grow rice, maize, millet, barley, wheat, and vegetables. At low altitudes, agriculture is the principal means of subsistence, while at higher altitudes agropastoralism prevails. Many households maintain chickens and goats. However, few families own more than a small number of cows, water buffalo, or yaks because the mountainous topography does not provide grazing land for large animals.

Nepal is one of the poorest countries in the world. This poverty can be attributed to scarce natural resources, a difficult terrain, landlocked geography, and a weak infrastructure but also to feudal land tenure systems, government corruption, and the ineffectiveness of development efforts. Foreign aid rarely goes to the neediest sectors of the population but is concentrate in urban areas, providing jobs for the urban middle class. The name of the national currency is rupee.

Land Tenure and Property. Historically, a handful of landlords held most agricultural land. Civil servants often were paid in land grants, governing their land on an absentee basis and collecting taxes from tenant-farming peasants. Since the 1950s, efforts have been made to protect the rights of tenants, but without the redistribution of land.

Overpopulation has exacerbated land shortages. Nearly every acre of arable land has been farmed intensively. Deforestation for wood and animal fodder has created serious erosion.

Commercial Activities. The majority of commercial activity takes place at small, family-owned shops or in the stalls of sidewalk vendors. With the exception of locally grown fruits and vegetables, many products are imported from India and, to a lesser extent, China and the West. Jute, sugar, cigarettes, beer, matches, shoes, chemicals, cement, and bricks are produced locally. Carpet and garment manufacturing has increased significantly, providing foreign exchange. Since the late 1950s, tourism has increased rapidly; trekking, mountaineering, white-water rafting, and canoeing have drawn tourists from the West and other parts of Asia. The tourism industry has sparked the commercial production of crafts and souvenirs and created a number of service positions, such as trekking guides and porters. Tourism also has fueled the black market, where drugs are sold and foreign currency is exchanged.

Major Industries. There was no industrial development until the middle of the twentieth century. Much of earliest industrial development was accomplished with the help of private entrepreneurs from India and foreign aid from the Soviet Union, China, and the West. Early development focused on the use of jute, sugar, and tea; modern industries include the manufacturing of brick, tile, and construction materials; paper making; grain processing; vegetable oil extraction; sugar refining; and the brewing of beer.

Trade. Nepal is heavily dependent on trade from India and China. The large majority of imported goods pass through India. Transportation of goods is limited by the terrain. Although roads connect many major commercial centers, in much of the country goods are transported by porters and pack animals. The few roads are difficult to maintain and subject to landslides and flooding. Railroads in the southern flatlands connect many Terai cities to commercial centers in India but do not extend into the hills. Nepal's export goods include carpets, clothing, leather goods, jute, and grain. Tourism is another primary export commodity. Imports include gold, machinery and equipment, petroleum products, and fertilizers.

Division of Labor. Historically, caste was loosely correlated with occupational specialization. Tailors, smiths, and cobblers were the lowest, untouchable castes, and priests and warriors were the two highest Hindu castes. However, the large majority of people are farmers, an occupation that is not caste-specific.

Social Stratification

Classes and Castes. Historically, caste and class status paralleled each other, with the highest castes having the most land, capital, and political influence. The lowest castes could not own property or receive an education. Although caste distinctions are no longer supported by law, caste relations have shaped present-day social stratification: Untouchables continue to be the poorest sector of society, while the upper castes tend to be wealthy and politically dominant. While land is still the principal measure of wealth, some castes that specialize in trade and commerce have fared better under modern capitalism than have landowning castes. Changes in the economic and political system have opened some opportunities for members of historically disadvantaged castes.

Political Life

Government. The Shah dynasty has ruled the country since its unification, except during the Rana period from the mid-nineteenth to the mid-twentieth century. During the Rana administration, the Shah monarchs were stripped of power and the country was ruled by a series of prime ministers from the Rana noble family. In 1950, the Shah kings were restored to the throne and a constitutional monarchy was established that eventually took the form of the panchayat system. Under this system, political parties were illegal and the country was governed by local and national assemblies controlled by the palace. In 1990, the Movement for the Restoration of Democracy (People's Movement) initiated a series of popular demonstrations for democratic reforms, eventually forcing the king to abolish the panchayat system and institute a multiparty democracy.

The country is divided administratively into fourteen zones and seventy-five districts. Local and district-level administers answer to national ministries that are guided by policies set by a bicameral legislature made up of a House of Representatives and a National Council. The majority party in the House of Representatives appoints the prime minister. The executive branch consists of the king and the Council of Ministers.

Leadership and Political Officials. The government is plagued by corruption, and officials often rely on bribes to supplement their income. It is widely believed that influence and employment in government are achieved through personal and family connections. The king is viewed with ambivalence. He and his family have been criticized for corruption and political repression, but photos of the royal family are a popular symbol of national identity and many people think of the king as the living embodiment of the nation and an avatar of the god Vishnu.

Social Problems and Control. International attention has focused on the plight of girls who have been lured or abducted from villages to work as prostitutes in Indian cities and child laborers in carpet factories. Prostitution has increased the spread of AIDS. Foreign boycotts of Nepali carpets have helped curb the use of child labor but have not addressed the larger social problems that force children to become family wage earners.

Military Activity. The military is small and poorly equipped. Its primary purpose is to reinforce the police in maintaining domestic stability. Some Royal Nepal Army personnel have served in United Nations peacekeeping forces. A number of Nepalis, particularly of the hill ethnic groups, have served in Gurkha regiments. To many villagers, service in the British Army represents a significant economic opportunity, and in some areas soldiers' remittances support the local economy.

Nongovernmental Organizations and Other Associations

Aid organizations are involved in health care, family planning, community development, literacy, women's rights, and economic development for low castes and tribal groups. However, many projects are initiated without an understanding of the physical and cultural environment and serve the interests of foreign companies and local elites.

Gender Roles and Statuses

Division of Labor by Gender. Only men plow, while fetching water is generally considered women's work. Women cook, care for children, wash clothes, and collect firewood and fodder. Men perform the heavier agricultural tasks and often engage in trade, portering, and other work outside the village. Both men and women perform physically demanding labor, but women tend to work longer hours, have less free time, and die younger. In urban areas, men are far more likely to work outside the home. Increasingly, educational opportunities are available to both men and women, and there are women in professional positions. Women also frequently work in family businesses as shopkeepers and seamstresses.

Children and older people are a valuable source of household labor. In rural families, young children collect firewood, mind animals, and watch younger children. Older people may serve on village councils. In urban areas and larger towns, children attend school; rural children may or may not, depending on the proximity of schools, the availability of teachers, and the work required of them at home.

The Relative Status of Women and Men. Women often describe themselves as "the lower caste" in relation to men and generally occupy a subordinate social position. However, the freedoms and opportunities available to women vary widely by ethnic group and caste. Women of the highest castes have their public mobility constrained, for their reputation is critical to family and caste honor. Women of lower castes and classes often play a larger wage-earning role, have greater mobility, and are more outspoken around men. Gender roles are slowly shifting in urban areas, where greater numbers of women are receiving an education and joining the work force.

Marriage, Family, and Kinship

Hindu castes do not generally approve of cross-cousin marriage, which is preferred among some Mongolian ethnic groups. Among some groups, a brideprice substitutes for a dowry. In others, clan exogamy is an important feature of marriages. Until recently, polygyny was legal and relatively common. Now it is illegal and found only in the older generation and in remote areas. Child marriages were considered especially auspicious, and while they continue to be practiced in rural areas, they are now prohibited by law. Love marriage is gaining in popularity in the cities, where romantic films and music inform popular sentiment and the economy offers younger people economic independence from the extended family.

Domestic Unit. Among landholding Hindu castes, a high value is placed on joint family arrangements in which the sons of a household, along with their parents, wives, and children, live together, sharing resources and expenses. Within the household, the old have authority over the young, and men over women. Typically, new daughters-in-law occupy the lowest position. Until a new bride has produced children, she is subject to the hardest work and often the harshest criticism in her husband's household. Older women, often wield a great deal of influence within the household.

The emphasis in joint families is on filial loyalty and agnatic solidarity over individualism. In urban areas, an increasing number of couples are opting for nuclear family arrangements.

Inheritance. Fathers are legally obligated to leave equal portions of land to each son. Daughters do not inherit paternal property unless they remain unmarried past age thirty-five. Although ideally sons manage their father's land together as part of a joint family, familial land tends to be divided, with holdings diminishing in every generation.

Kin Groups. Patrilineal kin groups form the nucleus of households, function as corporate units, and determine inheritance patterns. A man belongs permanently to the kinship group of his father, while a woman changes membership from her natal kin group to the kin group of her husband at the time of marriage. Because family connections are critical in providing access to political influence and economic opportunities, marriage alliances are planned carefully to expand kinship networks and strengthen social ties. Although women join the husband's household, they maintain emotional ties and contact with their families. If a woman is mistreated in her husband's household, she may escape to her father's house or receive support from her male kin. Consequently, women often prefer to marry men from the same villages.

Socialization

Infant Care. Infants are carried on the mothers' back, held by a shawl tied tightly across her chest. Babies are breast-fed on demand, and sleep with their mothers until they are displaced by a new baby or are old enough to share a bed with siblings. Infants and small children often wear amulets and bracelets to protect them from supernatural forces. Parents sometimes line a baby's eyes with kohl to prevent eye infections.

Child Rearing and Education. Mothers are the primary providers of child care, but children also are cared for and socialized by older siblings, cousins, and grandparents. Often children as young as five or six mind younger children. Neighbors are entitled to cuddle, instruct, and discipline children, who are in turn expected to obey and defer to senior members of the family and community. Children address their elders by using the honorific form of Nepali, while adults speak to children using more familiar language. Because authority in households depends on seniority, the relative ages of siblings is important and children are often addressed by birth order.

Certain household rituals mark key stages in child's development, including the first taste of rice and the first haircut. When a girl reaches puberty, she goes through a period of seclusion in which she is prohibited from seeing male family members. Although she may receive special foods and is not expected to work, the experience is an acknowledgment of the pollution associated with female sexuality and reproductivity.

From an early age, children are expected to contribute labor to the household. The law entitles both girls and boys to schooling; however, if a family needs help at home or cannot spare the money for uniforms, books, and school fees, only the sons are sent to school. It is believed that education is wasted on girls, who will marry and take their wage-earning abilities to another household. Boys marry and stay at home, and their education is considered a wise investment.

The customary greeting is to press one's palms together in front of the chest and say namaste ("I greet the god within you"). Men in urban areas have adopted the custom of shaking hands. In the mainstream culture, physical contact between the sexes is not appropriate in public. Although men may be openly affectionate with men and women with women, even married couples do not demonstrate physical affection in public. Some ethnic groups permit more open contact between the sexes.

Hospitality is essential. Guests are always offered food and are not permitted to help with food preparation or cleaning after a meal. It is polite to eat with only the right hand; the hand used to eat food must not touch anything else until it has been thoroughly washed, for saliva is considered defiling. When drinking from a common water vessel, people do not touch the rim to their lips. It is insulting to hit someone with a shoe or sandal, point the soles of one's feet at someone, and step over a person.

Religious Beliefs. Eighty-six percent of Nepalis are Hindus, 8 percent are Buddhists, 4 percent are Muslims, and just over 1 percent are Christians. On a day-to-day level, Hindus practice their religion by "doing puja, " making offerings and prayers to particular deities. While certain days and occasions are designated as auspicious, this form of worship can be performed at any time.

Buddhism is practiced in the Theravadan form. There are two primary Buddhist traditions: the Buddhism of Tibetan refugees and high-altitude ethnic groups with cultural roots in Tibet and the Tantric form practiced by Newars.

There is a strong animistic and shamanic tradition. Belief in ghosts, spirits, and witchcraft is widespread, especially in rural areas. Spiteful witches, hungry ghosts, and angry spirits are thought to inflict illness and misfortune. Shamans mediate between the human and supernatural realms to discover the cause of illness and recommend treatment.

Religious Practitioners. Many forms of Hindu worship do not require the mediation of a priest. At key rites of passage such as weddings and funerals, Brahmin priests read Vedic scriptures and ensure the correct performance of rituals. At temples, priests care for religious icons, which are believed to contain the essence of the deities they represent. They are responsible for ensuring the purity of the temple and overseeing elaborate pujas.

Buddhist monasteries train young initiates in philosophy and meditation. Lay followers gain religious merit by making financial contributions to monasteries, where religious rites are performed on behalf of the general population. Within Buddhism there is a clerical hierarchy, with highly esteemed lamas occupying the positions of greatest influence. Monks and nuns of all ranks shave their heads, wear maroon robes, and embrace a life of celibacy and religious observance.

Rituals and Holy Places. Nepal occupies a special place in both Hindu and Buddhist traditions. According to Hindu mythology, the Himalayas are the abode of the gods, and are specifically associated with Shiva, one of the three principal Hindu deities. Pashupatinath, a large Shiva temple in Kathmandu, is among the holiest sites in Nepal and attracts Hindu pilgrims from all over South Asia. Pashupatinath is only one of thousands of temples and shrines scattered throughout Nepal, however. In the Kathmandu Valley alone, there are hundreds of such shrines, large and small, in which the major gods and goddesses of the Hindu pantheon, as well as local and minor divinities, are worshiped. Many of these shrines are constructed near rivers or at the base of pipal trees, which are themselves considered sacred. For Buddhists, Nepal is significant as the birthplace of Lord Buddha. It is also home to a number of important Buddhist monasteries and supas, including Boudha and Swayambhu, whose domeshaped architecture and painted all-seeing eyes have become symbols of the Kathamandu Valley.

Death and the Afterlife. Hindus and Buddhists believe in reincarnation. An individual's meritorious actions in life will grant him or her a higher rebirth. In both religions the immediate goal is to live virtuously in order to move progressively through higher births and higher states of consciousness. Ultimately, the goal is to attain enlightenment, stopping the cycle of rebirth.

In the Hindu tradition, the dead are cremated, preferably on the banks of a river. It is customary for a son to perform the funeral rites. Some Buddhists also cremate bodies. Others perform what are called "sky burials," in which corpses are cut up and left at sacred sites for vultures to carry away.

Medicine and Health Care

Infant mortality is high, respiratory and intestinal diseases are endemic, and malnutrition is widespread in a country where life expectancy is fifty-seven years. Contributing to this situation are poverty, poor hygiene, and lack of health care. There are hospitals only in urban areas, and they are poorly equipped and unhygienic. Rural health clinics often lack personnel, equipment, and medicines. Western biomedical practices have social prestige, but many poor people cannot afford this type of health care. Many people consult shamans and other religious practitioners. Others look to Ayurvedic medicine, in which illness is thought to be caused by imbalances in the bodily humors. Treatment involves correcting these imbalances, principally through diet. Nepalis combine Ayurvedic, shamanic, biomedical, and other systems.

Although health conditions are poor, malaria has been eradicated. Development efforts have focused on immunization, birth control, and basic medical care. However, the success of all such projects seems to correlate with the education levels of women, which are extremely low.

The Arts and Humanities

Graphic Arts. Much of Nepali art is religious. Newari artisans create cast-bronze statuary of Buddhist and Hindu deities as well as intricately painted tangkas that describe Buddhist cosmology. The creation and contemplation of such art constitutes a religious act.

Performance Arts. Dramatic productions often focus on religious themes drawn from Hindu epics, although political satire and other comedic forms are also popular. There is a rich musical heritage, with a number of distinctive instruments and vocal styles, and music has become an marker of identity for the younger generation. Older people prefer folk and religious music; younger people, especially in urban areas, are attracted to romantic and experimental film music as well as fusions of Western and Asian genres.

The State of the Physical and Social Sciences

Universities are underfunded, faculties are poorly paid, and library resources are meager. Nepalis accord less respect to degrees from universities than to degrees obtained abroad and many scholars seek opportunities to study overseas or in India. Despite these limitations, some fine scholarship has emerged, particularly in the social sciences. In the post-1990 period, political reforms have permitted a more open and critical intellectual environment.

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Home » Culture in Nepal, Art, Cuisine, Religion and Tradition

Culture in Nepal, Art, Cuisine, Religion and Tradition

Nepal's culture is greatly influenced by its music , architecture, religion and literature. Your first sight of Nepal may leave you speechless, the great quantities of temples, churches, monasteries and other religious buildings, the hurly-burly in the streets and the number of people and animals socializing on every corner of the narrow cobble-stone lanes.

Nepal has about thirty-six different ethnic groups and multiple religions and languages. Its music is similarly varied, with pop, religious, classical and folk music being popular. Musical genres from Tibet and Hindustan have greatly influenced Nepalese music. Usually, women, even of the musician castes, do not play music except for specific situations, such as at the traditional all-female wedding parties.

The architecture in Nepal is another art that has become an important part of the country’s culture. Nepal’s architecture can be divided into three broad groups: the stupa style, the pagoda style, and the shikhara style.

Nepal is constitutionally a Hindu kingdom with legal provisions of no prejudice against other religions. The Hindu inhabitants in the country has been constantly over 80 percent since the 1950s. The second largest religion of Nepal is Buddhism, it is practiced by about 11 percent, while Islam comprises of about 4.2 percent of the population. The Kirat religion makes up nearly 3.6 percent of the population.

Nepal has many customs and beliefs that might be difficult to understand and not so easy to obey but this is the way of life to them and you should respect it when you are in their territory.

Do not feel offended if any Nepalese hesitates to shake hands with you because it hasn’t been very long since the western traditions were introduced to them. Most Nepalese greet one another by a “Namaste”, a common act done by putting the palms together in a prayer like gesture.

It is customary to eat and deal with food with your right hand. They use their left hand to wash themselves after being to the toilet. Note that most Nepalese eat with their hands, forks and spoons are not very common.

Note that men and woman should always dress appropriately. Men should not walk or trek bare-chested, shorts are acceptable but it’s recommended to rather wear long pants. Women are recommended to wear long skirts that cover the ankles, because exposure of a woman’s legs can draw unnecessary attention.

Showing affection between men and woman in public is not acceptable. So avoid kissing, hugging, cuddling or even holding hands in public.

Related Page

South east ridge.

One of the most daunting mountains you can ever attempt to climb is that of Mount Everest – the highest mountain in the world. There are several routes that one can take up Everest but the most popular two are the South East Ridge, that starts off in Nepal, and the North East Ridge, which begins on the Tibetan side of the Mountain.

Near the sheltered valley of Kathmandu you will find at a height of 2285 meters a pilgrimage site called Champadevi. This site makes up one of the many one-day hiking routes that you can take starting off at Kathmandu.

• 3 Other destinations
• 4.1.1 Elevation zones
• 4.1.2 River basins
• 4.2.1 Karnali-Seti-Bheri
• 4.2.2 Rapti and Gandaki
• 4.2.3 Emergence of Shah Dynasty from Gorkha
• 4.2.4 Kathmandu Valley (Bagmati)
• 4.2.5 Koshi
• 4.3.1 Hindu groups
• 4.3.2 Newar
• 4.3.3 Indigenous peoples
• 4.3.4 Religion
• 4.4 Climate
• 4.5 Tourist information
• 5.1.1 Visas
• 5.1.2 Entry points
• 5.2 By plane
• 5.3 By road
• 5.5 By train
• 6.1 By plane
• 6.3 By taxi
• 6.4 By motorbike
• 6.5 By bicycle
• 6.6 By road
• 6.7 On foot and navigation
• 9.1.1 Annapurna region treks
• 9.1.2 Everest region treks
• 9.1.3 Trekking peaks
• 9.1.4 Langtang region treks
• 9.1.5 Pro-poor rural treks
• 9.1.6 'Ethno-tourism' or cultural treks
• 9.1.7 Remote treks
• 9.1.8 Social responsibility and responsible travel
• 9.2 Rafting and kayaking
• 9.3 Mountain biking
• 9.4 Motorcycling
• 9.5 Canyoning
• 9.6 Jungle safari
• 9.7 Trance parties
• 14.1 Thangka painting
• 15.1 Volunteering
• 16 Stay safe
• 17 Stay healthy
• 19.1 Mobile phones
• 19.2 Electricity

Nepal ( Nepali : नेपाल) is a landlocked country in the Himalayas in South Asia . It has eight of the world's 10 highest peaks, including Mount Everest , the world's tallest, on the border with Tibet , as well as Lumbini , the birthplace of Gautama Buddha, the founder of Buddhism.

Regions [ edit ]

Nepal is divided into 7 provinces and 77 districts for administrative purposes, but Wikivoyage uses the divisions below, based on the country's elevation, which are more useful for travellers. From north to south:

Cities [ edit ]

• 27.71 85.32 1 Kathmandu — capital and cultural centre of Nepal, with its Hanumandhoka Durbar Square and the stupas at Boudhanath and Swayambhunath .
• 27.672222 85.427778 2 Bhaktapur — a well-preserved historical city, centre of pilgrimage and Nepali pottery-making; no motorized vehicles allowed.
• 26.483333 87.283333 3 Biratnagar — an important agricultural and industrial center and a center for politics in eastern Nepal, also the 2nd largest city in Nepal.
• 26.712222 85.921667 4 Janakpur — a historical religious centre and home to the 500-year old Janaki Temple.
• 27.804444 86.71 5 Namche Bazaar — a Sherpa settlement in the Solu Khumbu region popular with trekkers.
• 28.05 81.616667 6 Nepalgunj — the main hub for the Mid- and Far-Western Development Region; Bardiya National Park and Banke National Park are close by.
• 27.6833 85.3333 7 Patan — beautiful, historic Patan Durbar Square was designated as a World Heritage Site by UNESCO in 1979.
• 28.209722 83.985278 8 Pokhara — picturesque lake-side town fast becoming the destination of choice for travellers due to the scenery, adventure sports, dining, hotels and live music scene.

Other destinations [ edit ]

Locked between the snow peaks of the Himalayas and the seething Ganges plain, Nepal has long been home to wandering ascetics and tantric yogis. Consequently, the country has a wealth of sacred sites and natural wonders:

• 28.596111 83.820278 1 Annapurna — Popular trekking region of Nepal with the world-famous Annapurna Circuit .
• 27.5 84.333333 2 Chitwan National Park — World Heritage site with tigers, rhinos and jungle animals.
• 27.683333 85.116667 3 Daman — Tiny village in the mountains offering panoramic views of the Himalayas; especially stunning at sunrise and sunset.
• 27.1941 86.624 4 Haleshi (Tibetan: Maratika ) — The site of a mountain cave where Padmasambhava attained a state beyond life and death.
• 27.4814 83.275829 5 Lumbini — The sacred site of the Buddha Shakyamuni's birth.
• 27.816667 86.716667 6 Mount Everest — The tallest peak of the world in the Khumbu region.
• 27.718333 85.518056 7 Nagarkot — A hill station one hour from Kathmandu offering excellent views of the Himalayan Range.
• 27.6 85.266667 8 Parping — The site of several sacred caves associated with Padmasambhava, the founder of Tibetan Buddhism.
• 28.331051 84.109866 9 Tangting — A beautiful and undiscovered traditional Gurung village with a stunning view of the Annapurna range.

Understand [ edit ]

Geography [ edit ], elevation zones [ edit ].

Nepal has been divided into elevation zones, south to north:

• Outer Terai - Level plains, a cultural and linguistic extension of northern India. Nepali is spoken less than Awadhi and Bhojpuri dialects related to Hindi and Maithili . Lumbini ( Lord Buddha's birthplace ) and Janakpur (Hindu Goddess Sita's birthplace) are in this zone. Other cities -- Dhangadhi, Nepalgunj , Bhairahawa , Butwal, Birgunj , Janakpur and Biratnagar -- are transportation hubs and border towns more than travel destinations. Nevertheless, the Terai may offer opportunities for intimate exposure to traditional Indian culture that have become less available in India itself.
• Siwalik Range or Churia Hills - the outermost and lowest range of foothills, about 600 m (2,000 ft) high. Extends across the country east to west but with significant gaps and many subranges. Poor soils and no agriculture to speak of. No developed tourist destinations, however the forests are wild and the sparse population of primitive hunters and gatherers is unique.

• Inner Terai - large valleys between the Siwaliks and higher foothills to the north. The Dang and Deukhuri valleys in the Mid West are the largest, offering opportunities to experience Tharu art and culture. Chitwan south of Kathmandu is another of these valleys, known for Chitwan National Park , a World Heritage Site where tigers, rhinos, crocodiles, deer and birds can be observed. Originally these valleys were malarial and lightly populated by Tharus who had evolved resistance and developed architectural and behavioral adaptations limiting exposure to the most dangerous nocturnal mosquitoes. Suppression of mosquitoes with DDT in the 1960s opened these valleys to settlers from the hills who cleared forests and displaced and exploited Tharus. Nevertheless, more remote parts of these valleys still have a Garden of Eden quality - forests broken by indefinite fields, lazy rivers, fascinating aboriginal peoples.
• Mahabharat Range - a prominent foothill range continuous across the country from east to west except for narrow transecting canyons, with elevations ascending up to 3,000 m (10,000 ft). Steep southern slopes are a no-man's land between lowland and Pahari (hill) cultures and languages, which begin along the crest and gentler northern slopes. Given clear skies, there are panoramic views of the high himalaya from almost anywhere on the crest. Underdeveloped as a tourist venue compared to India's 'Hill Stations', nevertheless Daman and Tansen are attractive destinations.
• Middle Hills - Valleys north of the Mahabharat Range and hills up to about 2,000 m (6,500 ft). are mainly inhabited by Hindus of the Bahun (priestly Brahmin) and Chhetri (warriors and rulers) castes who speak Nepali as their first language. Higher where it becomes too cold to grow rice, populations are largely Magar , Gurung , Tamang , Rai or Limbu , the hill tribes from which the British recruited Gurkha soldiers while the soldiers' families grew crops suited to temperate climates. Men in these ethnic groups also work as porters or may be herders moving their flocks into the high mountains in summer and the lower valleys in winter. Trekking through the hills is unremittingly scenic with streams and terraced fields, picturesque villages, a variety of ethnic groups with distinctive costumes, and views of the high Himalayas from high points.

• Valleys - Kathmandu and to the west Pokhara occupy large valleys in the hills. The Kathmandu Valley was urbanized long before the first Europeans reached the scene and has historic neighbourhoods, temple complexes, pagodas, Buddhist stupas, palaces and bazaars. Its natives are predominantly Newar farmers, traders, craftsmen and civil servants. Newar culture is an interesting synthesis of Hindu and Buddhist elements. Unfortunately a range of hills north of this valley limit views of the Himalaya. Pokhara has fewer urban points of interest but outstanding views of the nearby Annapurna Himalaya . Pokhara's Newar population is confined to bazaars. Elsewhere upper caste Hindus dominate, whose ancestors probably were Khas peoples from far western Nepal. Both valleys offer excellent opportunities to experience Nepal without strenuous trekking. Narrower valleys along streams and rivers are important rice-growing centres in the hills. There is a limited amount of this land and most of it is owned by upper caste Hindus.
• Lekhs - Snow occasionally falls and lasts days or weeks in the winter above 3,000 m(10,000ft), but melts in summer below about 5,500 m (18,000 ft). Treeline is about 4,000 m (13,000 ft). This zone is used for summer pastures but not year-round habitation.

• North of the lekhs, the snowy high Himalayas rise abruptly along a fault zone to peaks over 6,700 m (22,000 ft) and even over 8,000 m (26,000 ft). Himalaya means 'abode of snow', which is uninhabited. Valleys among the peaks are inhabited, especially along trade routes where rice from the lowlands was traded for salt from the Tibetan Plateau along with other goods. Trade has diminished since China annexed Tibet in the 1950s but catering to trekkers and climbers has become an economic engine. People living along these routes have Tibetan affinities but usually speak fluent Nepali.
• Trans-Himalaya - Peaks in this region north of the highest Himalayas in central and western Nepal are lower and gentler, mostly around 6,000 m (20,000 ft). Valleys below 5,000 m (17,000 ft). are inhabited by people who are essentially Tibetan and have adapted to living at much higher elevations than other Nepalis. Roads have not yet penetrated this far and travel is expensive by air or arduous on foot. Nevertheless, it is a unique opportunity to experience a very significant and attractive culture in spectacular surroundings.

River basins [ edit ]

These are also important geographic divisions. The Mahabharat Range is a major hydrologic barrier in Nepal and other parts of the Himalaya. South-flowing rivers converge in candelabra shapes to break through this range in a few narrow gorges. Travel is usually easier within these candelabra drainage systems than between them, so high divides between river systems became historically important political, linguistic and cultural boundaries.

History [ edit ]

Karnali-seti-bheri [ edit ].

The Karnali system in the far west is the birthplace of Pahari ('hill') culture. It was settled by people called the Khas , speaking an Indo-European language called Khaskura ('Khas talk') that was related to other north Indian languages and all claiming descent from classical Sanskrit .

East of the Karnali proper, along a major tributary called the Bheri and further east in another basin called the Rapti lived a Tibeto-Burman people called Kham . Khas and Kham people seem to have been allies and probably intermarried to create the synthesis of aryan and mongoloid features that especially characterizes the second-highest Chhetri (Kshatriya) caste. It appears that Khas kings recruited Kham men as guards and soldiers. Khas and Kham territories in the far west were subdivided into small kingdoms called the Baisi , literally '22' as they were counted.

Nepal has one of the world's highest birthrates because Hindu women usually marry by their early teens, causing their entire reproductive potential to be utilized. Furthermore, men who can afford it often take multiple wives. This may trace back to Khas culture, explaining relentless Khas colonization eastward as finite amounts of land suitable for rice cultivation were inevitably outstripped by high birthrates.

Rapti and Gandaki [ edit ]

The Rapti river system east of the Karnali-Bheri had few lowlands suitable for growing rice and extensive highlands that were not attractive for Khas settlement but were a barrier to migration. However the Rapti's upper tributaries rose somewhat south of the Himalaya. Between these tributaries and the Dhaulagiri range of the Himalaya, a large east–west valley called Dhorpatan branching off the upper Bheri provided a detour eastward, over an easy pass called Jaljala into the Gandaki river system further east. The Gandaki is said to have seven major tributaries, most rising in or beyond the high Himalaya. They merge to cut through the Mahabharat and Siwalik ranges. In this basin elevations were generally lower and rainfall was higher compared to the Karnali-Bheri and Rapti basins. There was great potential for rice cultivation, the agricultural base of the Khas way of life. A collection of small principalities called the Chaubisi developed. Chaubisi literally means '24', as these kingdoms were counted. Not all were Khas kindoms. Some were Magar, a large indigenous hill tribe people related to the Kham. Other kingdoms were Gurung and Tamang. Several Gandaki tributaries rose in the trans-Himalayan region where inhabitants and rulers became increasingly Tibetanized to the north.

Emergence of Shah Dynasty from Gorkha [ edit ]

Within the Chaubisi kingdoms of the Gandaki basin, Gorkha was a small valley east of Pokhara ruled by a Khas family now called Shah, an honorific title that may have come later, however any earlier name seems to be forgotten. In 1743 AD Prithvi Narayan Shah became the ruler of Gorkha after his father Nara Bhupal Shah died. Prithvi Narayan already had a reputation as a hotheaded upstart. Resolving to modernize Gorkha's army, he was bringing modern arms from India when customs officers demanded inspection and payment of duties. Prithvi Narayan refused and attacked the officers, killing several before escaping with his arms and men. He also visited Benares to study the situation of local rulers and the growing encroachment of British interests. Prithvi concluded that invasion was a chronic danger to rulers on the plains of northern India, whereas the hills were more defensible and offered more scope to carve out a lasting empire.

Kathmandu Valley (Bagmati) [ edit ]

Prithvi Narayan must have been a charismatic figure, for he recruited, equipped and trained a formidable army and persuaded his subjects to underwrite all this from his ascension to the throne until his death in 1775. Through conquest and treaty, he consolidated several Chaubisi kingdoms. As his domain expanded, Khaskura became known as Gorkhali , i.e. the language of the Gorkha kingdom. Then he moved east into the next river basin, the Bagmati which drains the Kathmandu Valley that held three small but prosperous urban kingdoms. Like the Rapti, the Bagmati rises somewhat south of the Himalaya. Unlike the Rapti basin, this valley had once held a large lake and the remaining alluvial soil was exceptionally fertile. Between the agricultural abundance, local crafts, and extensive trade with Tibet, the cities were prosperous. Prithvi Narayan encircled the valley, cutting off trade and restricting ordinary activities, even farming and getting water. With a combination of stealth, brutality and intimidation he prevailed and deposed the local kings in 1769, making Kathmandu his new capital. This was the high point of Prithvi Narayan's career, however he continued consolidating the Kathmandu Valley with the Chaubisi and Baisi federations to the west until his death in 1775. Gorkhali was re-dubbed Nepali as 'Nepal' came to mean not only the urbanized Kathmandu Valley, but all lands ruled by the Shahs.

Koshi [ edit ]

Prithvi Narayan's heirs, Pratap Singh, Rana Bahadur and Girvan Yuddha continued expansion of their kingdom into the Koshi river basin east of the Bagmati system. Like the Gandaki, the Koshi traditionally has seven major tributaries descending from the Himalaya before joining forces to break through the Mahabharat and Siwalik ranges. Ranges drained by Koshi tributaries include Mount Everest and its neighbouring peaks, as well as the western side of the Kangchenjunga massif. Kangchenjunga and a high ridge to the south are the watershed between the Koshi and Tista basins as well as the border between Nepal and the former kingdom Sikkim that India annexed in 1975.

Caste, ethnicity, religion and languages [ edit ]

The caste and ethnic groups of Nepal according to the 2001 census are classified into five main categories:

• Castes originating from Hindu groups
• The ethnic groups or Janajati

Hindu groups [ edit ]

According to one theory, Hindu castes migrated from India to Nepal after the 11th century due to Muslim invasion. Another theory says that present day Hindu hill castes come from the Buddhist/Hindu population of the ancient Khas kingdom (present day Mid-western and Far-western Nepal). The traditional Hindu caste system is based on the four Varna Vyavastha "the class system" of Brahmin (Bahun) priests, scholars and advisors; Kshatriya (Chhetri) rulers and warriors, Vaishya (merchants); Shudra (farmers and menial occupations not considered polluting). Below the Shudra Dalit perform 'polluting' work such as tanning and cleaning latrines. However, the middle Vaishya and Shudra are underrepresented in the hills, apparently because they did not have compelling reason to leave the plains while Muslim invaders tried to eliminate previous elites. Dalits seem to have accompanied the upper castes into the hills because they were bound by longstanding patronage arrangements. However, the absence of Vaishya people in the Hindu hill population supports the second theory.

Traditional caste rules govern who can eat with whom, especially when boiled rice is served, and who can accept water from whom. Until the 1950s these rules were enforced by law.

Dalits are subject to caste-based discrimination and so called ‘untouchability’ in social, economic, educational, political and religious areas. The National Dalit Commission (2002) categorized 28 cultural groups as Dalits. Some argue that the use of the term Dalit will never ever help to abolish caste-based untouchability. (Literally, 'Dalit' translates to 'suppressed' in Nepali.) There are suggestions that the term should not be used because it not only breeds inferiority but is also insulting.

Newar [ edit ]

Newars, the indigenous people of the Kathmandu valley, follow both Hinduism and Buddhism. According to the 2001 census they can be classified into 40 distinct cultural groups, but all speak a common language called Nepal bhasa (Newa bhaaya). Newars use prevailing lingua francas to communicate outside their community: Nepali in the hills and Maithili, Bhojpuri and Awadhi in the Terai.

Indigenous peoples [ edit ]

The ethnic groups of the hills, Tarai and mountain areas are grouped as Janajati. According to the National Foundation for Development of Indigenous Nationalities (NFDIN), ethnic groups are those “who have their own mother tongue and traditional customs, a distinct cultural identity, a distinct social structure and written or oral history all of their own". 61 Adibasi Janajatis have been recognised by the Nepal Government. Five are from the mountain regions, 20 from the Hills, 7 from inner Terai and 11 from the Terai region. A Janajati is a community who has its own mother tongue and traditional culture and yet does not fall under the conventional fourfold Varna of the Hindu system or the Hindu hierarchical caste structure according to the Nepal Federation of Indigenous Nationalities [dead link] . Many of these ethnic groups are Hinduized to some degree, although Hindu practices supplement rather than replace more ancient beliefs and practices. Unlike the Hindus, many indigenous nationalities of Nepal such as the Sherpa people as well as the people of Muslim & Christian faiths, have a culture of eating beef.

Other caste and ethnic groups included in the ‘other’ category are Sikhs, Christians, Bengalis and Marawadis.

Different indigenous nationalities are in different stages of development. Some indigenous nationalities are nomads, e.g. Raute, and some are forest dwellers, e.g. Chepang and Bankaria. Most of the indigenous nationalities rely on agriculture and pastoralism and very few are cosmopolitan, e.g. Newar.

Religion [ edit ]

The census of 2011 listed 10 religions: Hindu, Buddhist, Islam, Kiranti, Christian, Jain, Sikh, Prakriti, Bon and Bahai. Hindus comprise 81%, Buddhists about 9% with the other religions making up the rest.

Climate [ edit ]

Nepal has a monsoonal climate with four main seasons - though traditionally a year was categorized into six distinct climate periods: Basanta (spring), Grishma (early summer), Barkha (summer monsoon), Sharad (early autumn), Hemanta (late autumn) and Shishir (winter).

Below is a general guide to conditions at different seasons:

• Heavy monsoonal rains from June to September - the rains are generally lighter high in the Himalayas than in Kathmandu, though the mountain peaks are often not visible due to clouds. In the Kathmandu Valley & Pokhara - monsoon rains typically consist of an hour or two of rain every two or three days. The rains clean the air, streets, & cool the air. If you come, bring an umbrella, expect lower lodging prices & fewer tourists.
• Clear and cool weather from October to December - after the monsoon, there is little dust in the air so this is the best season to visit the hilly and mountainous regions.
• Cold from January to March , with the temperature in Kathmandu often dropping as low as 0°C (32°F) at night, with extreme cold at high elevations. It is possible to trek in places like the Everest region during the winter, but it is extremely cold and snow fall may prevent going above 4,000-4,500 m (13,000-15,000 feet). The Jomosom trek is a reasonable alternative, staying below 3,000 m (10,000 feet) with expected minimum temperatures about -10°C (14°F) (and much better chances of avoiding heavy snow.)
• Dry and warm weather from April to June - there is an abundance of blooming flowers in the Himalayas at this time, with rhododendrons, in particular, adding a splash of colour to the landscape. Terai temperatures may reach or exceed 40°C (104°F) while Kathmandu temperatures are about 30°C (86°F). This is the best time to undertake mountain expeditions.

The recording of temperatures and rainfall of the major locations across Nepal was started in 1962 and their averages provide a reference point for analysing the climate trend.

Tourist information [ edit ]

• Nepal Tourism website

Get in [ edit ]

Entry requirements [ edit ], visas [ edit ].

Visas are free for all tourists who come from a South Asian Association for Regional Cooperation ( SAARC ) country (except Afghanistan), so nationals of Bangladesh, Bhutan, India, the Maldives, Pakistan and Sri Lanka may stay in Nepal indefinitely without a visa.

Nationals of Nigeria, Ghana, Zimbabwe, Cameroon, Eswatini, Somalia, Liberia, Ethiopia, Iraq, Palestine and Afghanistan are required to obtain visas before arrival .

Tourist Visas are available on arrival for citizens of many countries at Kathmandu airport and designated frontier posts (see below) and cost:

• US$30 for 15 days
• US$50 for 30 days
• US$125 for 90 days

Tourist visas can be granted for a maximum of 150 days in a visa year.

You can also pay this on arrival in other convertible currencies such as euros, pounds sterling, Chinese reminbi and Australian dollars, although US dollars are always preferred and some smaller entry points (like Birgunj) may only accept US dollars, and Kodari only accepts US dollars and Chinese reminbi.

All tourist visas are the "multiple entry" type and allow multiple entries and exits during the period of validity.

Volunteering while on a tourist visa without permission is strictly prohibited .

More details are available on the official website of Nepal Immigration

Visa Application

Visas can be applied for on line: https://online.nepalimmigration.gov.np/tourist-visa [dead link] , but as the online application form requires information about the intended place of stay in Nepal that is difficult to acquire (such as ward number, municipality, district etc.), it generally more convenient to complete the visa application after arrival.

To extend your tourist visa, visit the Nepal Immigration Office in Kathmandu or Pokhara with your passport and another photo, and pay US$2 for every day past your visa you want to stay, up to the maximum of 150 days per year.

Cash payment is recommended (non-USDs are also accepted, but expect the exchange rate not to be the best). Visa and Mastercard payments are also available—they are coded as cash advances on the credit card. A US$1 fee is added in addition to the required visa payment amount if paying with credit card.

Entry points [ edit ]

• Tribhuvan International Airport, Kathmandu
• Kakarbitta , Jhapa (Eastern Nepal) - closed for non-Indian/Nepali nationals as of October 2023.
• ImmiBirganj, Parsa (Central Nepal)
• Kodari , Sindhupalchowk (Northern Border)
• Belahia, Bhairahawa (Rupandehi, Western Nepal)
• Jamunaha, Nepalgunj (Banke, Mid Western Nepal)
• Trinagar Bhansar (Mohana), Dhangadhi (Kailali, Far Western Nepal)
• Gaddachauki, Mahendranagar (Kanchanpur, Far Western Nepal)

By plane [ edit ]

Kathmandu's Tribhuvan International Airport ( KTM  IATA ) is the only international airport in Nepal. Although Nepal is a popular tourist destination, most flights from anywhere will stop on the way in either Asia or the Middle East. Because of this, expect long travel times if you're coming from Europe or North America.

With the more stable political situation, more airlines are offering flights to Nepal. Some are listed in the Kathmandu city article .

By road [ edit ]

Many travellers ride from India on Royal Enfield motorcycles. Foreigners have to pay customs at the borders but most don't bother. Crossing the border requires you to pay a daily toll of Rs120 and a transport permit of Rs50 (one time), the police can ask you for these two documents any time during your ride. Selling the bike in Nepal is easy as other travellers are looking for bikes to ride back to India. If you're coming from India you'll find driving in Nepal a lot less chaotic. The roads are amazing and the new east–west highway under construction with support from the Japanese will open up new destinations for those interested in exploring Nepal by motor-bike.

Please check before hiring a motorbike on the current state of fuel. In late 2009 there were problems with fuel supply which can leave riders stranded. Bike hire should cost around Rs500 a day (Pulsar, Hero Honda, scooter) unless you are hiring an Royal Enfield.

Rental companies are also notorious for trying to charge tourists large amounts of money for 'damage' that may not have done by you on returning the bike. Therefore, make sure a thorough damage assessment is carried out before departing and, if the hirer tries to scam you on return, go to the local police.

The best route to explore Nepal by road on motorcycle, is to enter from the border crossing of Banbasa- Mahendra Nagar, just after the border crossing, the Mahendra Highway (made with collaboration from India) is amazing to ride on.

By bus [ edit ]

There are five border crossings open to tourists.

From India:

• Bahraich-Nepalganj from Lucknow
• Banbassa-Mahendrenagar from Delhi
• Panitanki - Kakarbhitta from Siliguri , Darjeeling - closed for non-Indian/Nepali nationals as of October 2023.
• Raxaul - Birganj from Patna , Kolkata
• Sunauli - Bhairawa from Varanasi

From China:

• Kyirong (or Kyirong Zhen) which is 25 km from the Nepal border. It has a decent two-star hotel, and the Tamang Sherpa Restaurant across the street from the hotel (May 2018). The road to the border is very windy (40-45 minutes by car), but it is paved and in good condition. The road on the Nepal side is terrible. To Kathmandu, it will take 6 to 7 hours driving time, not including stopping for lunch and the 8-10 checkpoints. During the monsoon season (Jun-Aug), the road can be closed for hours or days because of rockslides and mudslides.
• The crossing at Zhangmu to Kodari was closed after an earthquake in 2015, and has not been reopened for tourists (as of May 2018).

By train [ edit ]

Cargo and passenger trains operate between Sirsiya in southern Nepal, and the Indian town of Raxaul. However, except for Indians, foreigners are not allowed to cross the border with it. The internal train network is limited to a few kilometres of train network in Janakpur .

Get around [ edit ]

There are a number of domestic airlines in Nepal such as Yeti Air, Tara Air and Nepal Airlines that offer frequent flights to many destinations around the country. Destinations to and from Kathmandu include places like Biratnagar, Nepalganj , Lukla, Pokhara , Simikot, Jomsom, Janakpur and Bharatpur . To arrange flights from outside Nepal, there are a number of on-line booking agents who can make bookings, take payment (credit/debit cards/PayPal) and then send e-tickets. If you are buying tickets while in Nepal or if you are flying at short notice, it is necessary to be flexible on flight times and dates as the planes often get fully booked in advance. Cancellations and delays due to severe weather conditions do occur. If you have time, just board the next plane.

• Micro bus – They are 10-12 seaters with very fast and popular service. It has almost replaced local bus service given its fast service. However, apart from previous few routes, Micro Bus has come up with many other alternate routes and now has good coverage. The fare is more expensive than local buses. Tourists should be aware that microbuses are often driven with great speed and very little care and have unfortunately been the cause of a large percentage of the road accidents in Nepal. Use microbuses with caution.
• Tempo – These come in two types. One is a three-wheeled electric or propane powered micro-bus for 10-13 passengers. They run in different routes around Kathmandu and cost Rs5-12. The other type is a newer Toyota van running the same routes at a higher price and a bit faster and safer. Be prepared for a crowd.
• Local bus – Although the system can be confusing, they are cheap. They can be crowded at times both with people and domestic animals such as goats, ducks etc. Some buses will not depart until full to a certain quota.
• Tourist bus – Book a few days ahead at a Kathmandu or Pokhara travel agent (or your hotel will book for you). A few steps above local buses (no goats, everyone gets a seat) but not much safer. "Adhikari Travels" is the most reliable company and has trips between Kathmndu, Chitwan, Lumbini and Pokhara.

By taxi [ edit ]

• Rickshaw – Good for short trips if you don't have much luggage and don't mind being bounced around a bit. Bargain before you get in, and don't be afraid to walk away and try another.
• Taxi – There are two types of taxi: "private", which pretty much run from the airport to upmarket hotels and "10 Rupee", which don't leave until they are full. When haggling for a fare remember that taxi drivers have been hit hard by the petrol crisis sometimes queuing up overnight to get 5 litres of petrol at twice the market price. So be sympathetic but don't get ripped off. Offer to pay 'meter plus tip', 10% is more than enough. Taxis may charge passengers more than usual during periods of low fuel availability.
• Driver – It's quite easy to rent a car with a driver in Nepal; however, you'll need to haggle to get a reasonable price. If you come in summer, it is recommended to take a car with air-conditioning. Car rental without a driver in Nepal is almost unheard of, as is renting a car in India and taking it across the border.

By motorbike [ edit ]

Firstly, custom or classic motorbikes in form 350 cc and 500 cc Royal Enfield bikes are available for rent including lessons, repairs and tours. Furthermore, local motorbikes are another choice and can be rented in the Thamel area of Kathmandu.

Nepalese law requires the driver to wear a helmet when riding a motorcycle or scooter.

With the petrol crisis, motorcycle rental has become a costly choice, depending on availability 1 litre of petrol costs Rs120-250 on top of the rental fee (Rs300-800).

When renting a motorbike or scooter, it should be remembered that vehicles are rarely insured. The hirer is liable for any damage caused to the vehicle. It is not advisable to leave your passport as a deposit when renting a vehicle.

By bicycle [ edit ]

You can also rent a bicycle to travel around Kathmandu at a very reasonable price (Rs500-5,000) according to the condition or quality of bicycle and the rental period.

Nepal has left-hand traffic. There is little awareness of pedestrians' rights. Roads are often narrow and in poor condition. Rains and landslides affect the condition of the already poor road network, increasing the risk of road accidents. Avoid using local buses, especially those that are overloaded and in poor condition. Travelling after dark increases the risk of serious road accidents.

An international driving licence is required to drive a car. This card must be carried when driving, as well as all documents relating to the car. Traffic accidents involving a foreigner are almost invariably considered to be caused by a foreigner. Claims for damages in such accidents are often high.

Fuel shortages can sometimes occur, which may throw your driving-related plans into chaos.

On foot and navigation [ edit ]

Although motor roads are penetrating further into the hinterlands, many destinations can only be reached on foot (or by helicopter). See the section on #Trekking below.

For reliable maps, GPS navigation , comprehensive trails and map information, consult OpenStreetMap , which is also used by this travel guide and by many mobile Apps like OsmAnd or Mapy.cz . Or just download the according GPX or KML files for trails on OpenStreetMap through Waymarked Trails . (Note, you just need to change the OpenStreetMap relation ID of the trail to download its GPX or KML files through the same link.)

Talk [ edit ]

The great biological and cultural diversity of present-day Nepal is matched by its linguistic diversity. Nepal boasts a variety of living languages many of which are remnants of the traditional Asiatic cultural amalgamation in the region, it has an impressively large number for a country with such a small land mass. Nepal has more distinct and individual languages in one country than the whole of the European community.

The official language of Nepal is Nepali . It's related to Hindi, Punjabi, and other Indo-Aryan languages, and is normally written with the Devanagari script (as is Hindi), originated from Sanskrit. While most Nepalis speak at least some Nepali, a large percentage of the population has as their mother tongue another language, such as Tharu around Chitwan, Newari in the Kathmandu Valley, and Sherpa in the Everest area.

Although Nepal was never a British colony, English is somewhat widespread among educated Nepalis. Nevertheless, learning even a few words of Nepali is fun and useful, especially outside of the tourist district and while trekking (porters often speak very little English and the inquisitive children in the tea houses are delighted to hear a few words of Nepali from their house guests). As Asian languages go, Nepali has to be one of the easiest to learn, and the traveller making the effort isn't likely to make worse blunders than many natives with a different first language. The locals are also happy to help with your burgeoning language skills.

See: Nepali phrasebook

A disturbingly large number of Nepal's mother tongues are severely endangered and will likely cease to be living languages within a generation.

See: Tamang phrasebook|Thami phrasebook|Majhi phrasebook

See [ edit ]

• Mount Everest , the highest mountain in the world is probably Nepal's most famous sight, and much of the country consists of very high mountains.

There are four UNESCO World Heritage Sites in Nepal:

• The Kathmandu Valley , obviously including the capital but also the cities of Bhaktapur and Patan .
• Sagarmatha National Park .
• Chitwan National Park.
• Lumbini , the birthplace of Buddha.

Do [ edit ]

Trekking [ edit ].

Beginning in March 2023, travelers who trek in remote regions must hire a government-licensed guide or join a group . This rule was implemented because of the cost of search-and-rescue operations for trekkers who get lost.

101,320 trekkers visited Nepal in 2007. Of that number, 60,237 (59.4%) visited Annapurna area while those visiting the Everest and Langtang regions accounted for 26,511 (26.5%) and 8,165 (8.1%) respectively.

"Tea-house trekking" is the easiest way to trek as it doesn't require support. Tea houses have developed into somewhat rustic full-scale tourist lodges with showers, pizza, pasta and beer. The day's hikes are between lodge-filled settlements or villages: there's no need to take tents, food, water or beer. All those things, plus luxuries such as apple pie, can be purchased along the way. Physical requirements range from easy to strenuous.

Facilities available in remote areas are less extensive than in the more popular areas thus these areas are often visited in organised groups, with guide, porters and full support. Manaslu , Kanchenjunga , Dolpo , Mustang and Humla require Restricted Area Permits , requiring a minimum of two foreign trekkers plus a registered/qualified guide. Progress is being made however, and tea-houses are becoming more available in all of these areas. Before setting out on any trek, make sure you find out what the current facilities are in that area, as they are changing every year.

Annapurna region treks [ edit ]

Annapurna - North of Pokhara , from lush middle hills into high mountains.

• Annapurna Circuit : A 2-3 week trek around the Annapurna mountains, leads up the Marsyangdi river to Dharapani, Chame, Manang, over Thorung La (5,400 m) to the Hindu temples at Muktinath and (possibly) ending at Jomsom. Down the Kali Gandaki on the Jomsom trail (the last week of the Annapurna Circuit which is done by itself in the opposite direction). Known as the "Apple Pie Trek" partly for crossing the apple growing region of Nepal, and partly for being one of the easier treks, enjoying Gurung and Thakali hospitality. Up through spring rhododendron blooms to Poon Hill for a dawn Himalayan vista. Another shorter but spectacular mini-circuit is the Nayapul-Ghandruk-Ghorepani-PoonHill-Nayapul route.
• Annapurna Sanctuary : A trek up into the very heart of the range provides an awesome 360 degree high mountain skyline.

Everest region treks [ edit ]

Everest lies in the region known as Khumbu - To get here, take a bus to Jiri or fly to Lukla then hike up to Namche Bazzar , capital of the Sherpa lands at the foot of Everest. Main "teahouse trek" regions, in each of these areas there are a number of trail options, there is plenty of scope for short treks of less than a week to much longer if you have time and wanderlust.

• Everest Base Camp Trek : Lukla to EBC, stunning scenery, wonderful Sherpa people. The most popular trek is up to Everest Base Camp and an ascent of Kalar Patar. Visit the Buddhist Tengboche monastery for the Mani Rimdu festival in November.
• The 'Classic Everest Base Camp Trek': Jiri to EBC
• Gokyo: Lukla to the sacred lakes of Gokyo. Explore the Gokyo valley with its sacred lakes and stupendous views of four 8,000 m peaks. Or a circuit of the region crossing the high passes or Cho La and Renjo La.
• Numbur Cheese Circuit : Trek through the largest cheese producing area, via the sacred lakes of Jata Pokhari and Panch Pokhari to Numburchuili base camp.
• Island Peak Trek in the Everest region takes in some of the most spectacular scenery in the Himalayas. See 'Regions' - Khumbu
• Pikey Cultural Trail
• Dudh Kunda Cultural Trail

Trekking peaks [ edit ]

Trekking peaks require a qualified "climbing guide", permits and deposits to cover camp waste disposal:

• Island Peak Trek - The Island Peak trek in the Khumbu region takes in some of the most spectacular scenery in the Himalayas.
• Mera Peak climbing - Enjoy panoramic views of Mt Everest (8,848 m; 29,030 ft), Cho-Oyu (8,201 m; 26,910 ft), Lhotse (8,516 m; 27,940 ft), Makalu (8463 m; 27,770 ft), Kangchenjunga (8,586 m; 28,170 ft), Nuptse (7,855 m; 25,770 ft), and Chamlang (7,319 m; 24,010 ft).

Langtang region treks [ edit ]

• Helambu Langtang Trek . A short taxi ride from Thamel to the roadhead at Shivapuri leads to a trail through the middle-hills countryside of Helambu. Either circle around and return to Kathmandu or cross the pass to the sacred lake at Gosainkhund, descend and then hike up the Langtang valley beneath mountains that form the border with Tibet. Descend back to catch a bus on a rough road through Trisuli to Kathmandu. If you don't fancy the long shaky bus ride (>8 hours) from/to Syabrubesi, Dhunche or Thulo Barku, you can get a 4x4 pickup for about Rs90,000 to/from Kathmandu.
• Langtang Valley Trek
• Tamang Heritage Trail

Pro-poor rural treks [ edit ]

Tourism is a dynamic sector of economy and accepting it as a vehicle of poverty reduction is a relatively new concept in Nepal. Nepal is a predominantly rural society, with 85% of the population living in the countryside. Naturally, Nepal's rich culture and ethnic diversity are best experienced in its village communities. You can engage in local activities, learn how to cook local cuisine or take part in agricultural activities like kitchen gardening, etc.

In the rural Nepal context, pro-poor tourism means expanding employment and small enterprise opportunities especially pro-indigenous peoples, youth and pro-women. Pro-poor initiatives in Nepal include the UNDP-TRPAP [dead link] and ILO-EMPLED projects.

• Chepang Heritage Trail
• Pathibhara Trail
• Limbu Cultural Trail
• Dudhkunda Cultural Trail
• The Guerrilla Trek
• Numbur Cheese Circuit
• Indigenous Peoples Trail

Trekking on the Indigenous Peoples Trail and the Numbur Cheese Circuit is a means for Nepali as well as foreign visitors to experience the rural and traditional Nepali way of life, and for the local community to participate in and benefit directly from tourism. You'll feel better knowing that your visit is genuinely helping your hosts. And if you want to simply lie on a beach, well, the Majhi Fishing Experience on the Sun Kosi in Ramechhap features one of the best beaches in Nepal.

'Ethno-tourism' or cultural treks [ edit ]

Ethno-tourism is increasingly popular in Nepal and is designed to maximize social and economic benefits to the local communities and minimize negative impacts to cultural heritage and the environment. Ethno-tourism is a specialized type of cultural tourism and can be defined as any excursion which focuses on the works of humans rather than nature, and attempts to give the tourist an understanding of the lifestyles of local people.

• Numbur Cheese Circuit in the Everest Region
• Indigenous Peoples Trail in Ramechhap
• Majhi Fishing Experience on the Sun Koshi
• The Guerrilla Trek in Mid-Western Nepal
• Helambu Trek in Langtang
• Tamang Heritage Trail in Langtang
• Chepang Heritage Trail in Chitwan

Remote treks [ edit ]

Other more remote regions will require a bit more planning and probably local assistance, not least as the required permits are only issued via Nepali guides/agents. Camping is required on one or more nights.

• Kanchenjunga - far eastern Nepal, accessible via Taplejung (from Kathmandu 40min by plane, 40hrs by bus), a strenuous trek through sparsely populated country to the third highest mountain.
• Dolpa - Upper Dolpa in northwestern Nepal beyond the highest Himalaya is the remote Land of the Bon, almost as Tibetan as Nepali. Lower Dolpa is more accessible and can me reached by plane.
• Manaslu Trek - Unspoiled trails through remote villages and over the Larkya La, a remote pass at 5,100m, to circuit an 8,000m mountain. The Manaslu massif rises above the old kingdom of Gorkha close to the Tibetan border about halfway between Kathmandu and Pokhara and will be close at hand for the last half of the circuit.

Social responsibility and responsible travel [ edit ]

Nepal is one of the poorest countries in the world and hiring a local company will benefit the local economy, however the involvement of travel agents in Kathmandu must be approached with caution. The numbers of travel, trekking and rafting agencies registered in 2007 were 1,078, 872 and 94 respectively. The rapid growth in tourism in Nepal coupled with the absence of a self-regulating code of conduct has helped to grow unhealthy competition among travel agents with regular undercutting in tariffs. Such undesirable actions take away benefits not only from trekking guides and porters but also from others engaged in supplying goods and providing services to the tourists. By paying lower tariffs tourists may save money but directly at the expense of local communities. Try to use 'socially responsible' tour operators that promote proper porter treatment and cultural and environmental sensitivity among their clients in line with the UN-WTO Sustainable Tourism Criteria [dead link] .

• Organised group trekking or independent trekking?

While organized groups from " western tour operators " from overseas drain the operational profit out of the country, organized groups hire a larger amount of local workforce from porters to guides. With local tour operators, most of the operational profit remains in the country. Groups are more likely to go remote areas, and rely as much as possible on local resources to minimize transport cost and hire maximum local porters.

In comparison, individual travellers are concentrated on the main trails with lodges and usually a lower budget. These trekkers usually use simpler lodges with lower costs. They may venture less often into remote areas, as that would mean more expense or very basic local services which most try to avoid. They generally spend less than organized travellers on same trails simply because they often have more restricted budgets.

Safety and comfort are higher with organized tours. There is a full range of choice for any demand, just be sure to think about what trekking means for you. For the hard core trekkers, no porter will ever carry, while for others, to carry a 15-18 kg backpack might be more than they would want.

• Keep working conditions and wages in mind when selecting a trekking company. For visitors from the west, hiring guides and porters is affordable and an extra few dollars can make a big impact in the life of a guide or porter. In order to feed themselves and their families, porters take on the job of carrying heavy loads to high elevations. Some of the problems porters face are underpayment, inadequate clothing and gear, being forced to carry excess weight, insufficient food provision and poor sleeping facilities. Sometimes these issues leave porters open to illness and neglect on the mountain. Nowadays most companies care better due to past awareness campaigns to their staff, however, some backpackers employ (illegally) porters and guides and there continue to be reports that some tourists pay less than the going rate.
• There are a number of websites that facilitate direct contact with recommended trekking guides and porters. By law this is not permitted, as foreigners on tourist visa are not allowed to employ any kind of workforce, but only legal registered companies as use in most countries around the globe. So unless you want to break the law, do not employ yourself any kind of porters or guides and ensure to hire only through legal companies, in case of an accident it may bring severe problems to have employed illegally staff.
• Adequate clothing is made available for protection in bad weather and at altitude. This should include adequate footwear, hat, gloves, windproof jacket and trousers, sunglasses, and access to a blanket and pad above the snowline.
• Leaders and trekkers provide the same standard of medical care for porters they would expect themselves.
• Porters must not be paid off because of illness without the leader or trekkers being informed.
• Sick porters are never sent down alone, but rather with someone who speaks their language.
• Sufficient funds are provided to sick porters to cover the cost of their land rescue and treatment.
• All trekking porters should have provision for security, personal protective equipment including shoes and clothes, depending on the weather.

Rafting and kayaking [ edit ]

Rafting trips of 1 to 10 days on many rivers and for all levels of experience leave from Kathmandu and Pokhara . For detailed itineraries visit the Nepal Association of Rafting Agents . The main rivers for rafting are:

• Bhote Koshi
• Kali Gandaki
• Marshyangdhi

Many companies offer Learn to Kayak Clinics on the Trisuli river, an ideal spot to take your first steps into the world of whitewater. GRG's Adventure Kayaking is one of the companies that specialise in kayaking in Kathmandu. Nepal is one of the best places in the world for whitewater adventures.

Mountain biking [ edit ]

Mountain biking in Nepal is fun and at times challenging event. There are many popular biking routes:

• The Scar Road from Kathmandu starts from Balaju towards Kakani to Shivapuri ending in Budhanilkantha in northern Kathmandu.
• Kathmandu to Dhulikhel starts from Koteshwor in Kathmandu to Bhaktapur to Banepa to Dhulikhel. You can also continue from Dhulikhel to Namobuddha to Panauti to Banepa.
• The Back Door to Kathmandu starts from Panauti and heads to Lakuri Bhanjyang and then to Lubhu in Lalitpur ending near Patan.
• Dhulikhel to the Tibetan Border starts in Dhulikhel and follows the Araniko Highway with a night stay on the way.
• The Rajpath from Kathmandu starts from Kalanki in Kathmandu and follows the Prithvi Highway up to Naubise. Then Tribhuwan Highway route is taken with overnight stay in Daman. From there, ride downhill to Hetauda, with the option of heading towards Narayangarh or the Indian border.
• Hetauda to Narayangarh and Mugling starts from Hetauda and heads along the Mahendra Highway to Narayangarh. You could take a detour to Sauraha near from Taandi.
• Kathmandu to Pokhara starts from Kathmandu and traverses through Naubise, Mugling to Pokhara.
• Pokhara to Sarangkot and Naudanda starts from Lakeside Pokhara and heads towards Sarangkot and from there towards Naudanda. From there, ride downhill towards the highway.

The best time to go for biking is between mid October and late March, when the atmosphere is clear the climate is temperate: warm during the days and cool during the night. Biking in other times of the year is also possible but great care should be taken while biking during the monsoon season (June to September) as the roads are slippery. Biking can be done independently or can be organized through biking companies of Nepal.

You can rent mountain bikes of almost any quality, but remember that if you're going on a longer or harder ride, at least your own saddle would be a good option to bring. In late 2009 the daily rental costs ranged from US$3 for a simple bike to US$30 for a western bikes with suspension.

Motorcycling [ edit ]

Nepal's geography and climate makes for some of the best motorcycling roads in the world. The traffic is a little chaotic, but not aggressive, and the speeds are low. Be aware that you need an international driving licence in Nepal, even though you might never be stopped by the police as a tourist on a bike.

Perhaps the best and most original way to explore the country is by motorcycle. Kathmandu should be avoided by beginners, but the rest of Nepal is simply amazing. Hearts and Tears Motorcycle Club, Wild Experience Tours & Blazing Trails Tours are the better known Names in the industry. They specialize in motorcycle touring and have a great collection of custom bikes. They are professional set-ups with imported safety equipment, structured training and well organized group tours.

Canyoning [ edit ]

Since 2007 that the Nepal Canyoning Association was founded, a lot of canyons (khola in Nepali) have been equipped for organized descents. The 2011 IRC (International Canyoning Rendezvous) took place in the Marshyangdi River valley in the Annapurna region. There are at least 30 canyons where private companies organize excursions for descents. The Nepali canyons offer breathtaking views of the valleys and rice fields below and various combinations of difficulty and water level. Most canyons can only be accessed on foot from the nearby roads, through paths used by the locals for agriculture purposes or accessing their homes. In 2011, one of the longest and most difficult canyons in the world was equipped in an expedition by the "Himalayan Canyon Team" in the Chamje Khola.

Jungle safari [ edit ]

Chitwan National Park offers elephant rides, jungle canoeing, nature walks and bird watching, as well as more adventurous tiger and rhino-viewing. There are also many other less visited parks including Bardiya and Shuklaphanta National Park .

Trance parties [ edit ]

"The Last Resort", near the Tibetan border, has frequent Full Moon trance parties, lasting 2-3 days. Watch for posters and check music shops. Pokhara has started featuring its own brand of Full Moon raves and interesting Western takes on Nepali festivals.

Buy [ edit ]

Money [ edit ].

Nepalese rupees are the local currency, denoted by the symbol " ₨ " or " Rs " (ISO code: NPR ).

Coins of Nepal come in denominations of 1 and 2 rupees. Banknotes of Nepal come in denominations of 5, 10, 20, 50, 100, 500 and 1,000 rupees.

Although Indian currency is also accepted in Nepal (at an official exchange rate of 1.60 Nepalese rupees to 1 Indian rupee), the 500 and 1,000 rupees notes are not accepted, as are 200, 500 and 2,000 rupees notes. Carrying 500 Indian rupee notes is illegal in Nepal.

There are banks in Kathmandu , Pokhara , Chitwan , Nepalgunj , Janakpur , Lumbini and in several other major cities that will allow you to retrieve cash from ATM or credit cards. You may be charged a service fee, depending on your bank. There are many ATMs in those cities that are open around the clock.

Keep all currency exchange and ATM receipts as they are required at the airport bank to convert back to your original currency. If you don't have them, they will refuse to convert your currency but they will suggest going to the Duty Free shop upstairs, even though it isn't a licensed money changer. Traveller's cheques may be useful outside of the major cities.

Eat [ edit ]

The Nepali national meal is daal-bhaat-tarkaari . It is spiced lentils poured over boiled rice, and served with tarkari: vegetables cooked with spices. This is served in most Nepalese homes and teahouses, two meals a day at about 10:00 and 19:00 or 20:00 If rice is scarce the grain part may be cornmeal mush called aata, barley, or sukkha roti (whole wheat 'tortillas'). The meal may be accompanied by dahi (yogurt) and a small helping of ultra-spicy fresh chutney or achaar (pickle). Traditionally this meal is eaten with the right hand. Curried meat, goat or chicken, is an occasional luxury, and freshwater fish is often available near lakes and rivers. Because Hindus hold cattle to be sacred, beef is not part of traditional Nepali cuisine, but can still be obtained for a high price in some expensive restaurants although the price is high mainly because it is imported from India. Buffalo and yak are eaten by some but considered too cow-like by others. Pork is eaten by some tribes, but not by upper-caste Hindus. As in India, there are some communities and tribes that are vegetarian.

Outside the main morning and evening meals, a variety of snacks may be available. Tea, made with milk and sugar is certainly a pick-me-up. Corn may be heated and partially popped, although it really isn't popcorn. This is called "kha-jaa", meaning "eat and run" Rice may be heated and crushed into "chiura" resembling uncooked oatmeal that can be eaten with yogurt, hot milk and sugar, or other flavourings. Fritters called 'pakora' and turnovers called "samosa" can sometimes be found, as can sweets made from sugar, milk, fried batter, sugar cane juice, etc. Be sure such delicacies are either freshly cooked or have been protected from flies. Otherwise flies land in the human waste that is everywhere in the streets, then on your food, and so you become a walking medical textbook of gastrological conditions.

Because of the multi-ethnic nature of Nepali society, differing degrees of adherence to Hindu dietary norms, and the extreme range of climates and micro-climates throughout the country, different ethnic communities often have their own specialties.

Newars, an ethnic group originally living in the Kathmandu Valley, are connoisseurs of great foods who lament that feasting is their downfall, whereas sexual indulgence is said to be the downfall of Pahari Chhetri. In the fertile Kathmandu and Pokhara valleys this cuisine often includes a greater variety of foodstuffs, particularly vegetables, than what are available in most of the hills. As such, Newari cuisine is quite distinct and diverse relatively compared to the other indigenous regional cuisines of Nepal, so watch out for Newari restaurants. Some of them even come with cultural shows: a good way to enjoy good food while having a crash-course in Nepalese culture.

The cuisine of the Terai lowlands is almost the same as in adjacent parts of India. Locally-grown tropical fruits are sold alongside subtropical and temperate temperate crops from the hills. In addition to bananas ('kera') and papayas ('mewa') familiar to travellers, jackfruit ('katar') is a local delicacy.

Some dishes, particularly in the Himalayan region, are Tibetan in origin and not at all spicy. Some dishes to look for include momos , a meat or vegetable filled dumpling, which is similar to Chinese pot-stickers. Momos has become very popular in past few decades. Momos can be found almost everywhere in Kathmandu and other towns in Nepal, whether it be a big hotel or a small restaurant. Other dishes like Tibetan Bread and Honey a puffy fried bread with heavy raw honey that's great for breakfast. Up in the Himalayan mountains, potatoes are the staple of the Sherpa people. Try the local dish of potato pancakes ( rikikul ). They are delicious eaten straight off the griddle and covered with dzo (female yak) butter or cheese.

Pizza, Mexican, Thai and Chinese food and Middle-Eastern food can all be found in the tourist districts of Kathmandu , Pokhara and Chitwan . If you are on a budget, eating local dishes will save money.

Many small restaurants are not prepared to cook several different dishes; try to stick with one or two dishes or you will find yourself waiting as the cook tries to make one after another on a one-burner stove in those small restaurants.

As far as possible, eat only Nepali village products. If you take only village product foods, it will help them economically.

Drink [ edit ]

• Raksi is a clear liquid, similar to tequila in alcohol content. It is usually brewed "in house", resulting in a variation in its taste and strength. This is by far the least expensive drink in the country. It is often served on special occasions in small, ceramic cups (Salinchha in Newar language) that hold less than a shot. It works well as a mixer in fruit juice or seltzer. It may appear on menus as "Nepali wine".
• Jaand (Nepali) or chyaang (Tibetan) is a cloudy, moderately alcoholic drink sometimes called "Nepali beer". Mostly it is made from rice, specially in Newari culture. While weaker than raksi, it will still have quite an effect. This is often offered to guests in Nepali homes, and is diluted with water. For your safety, ask guests if the water has been sanitized before drinking this beverage.
• Beer production in Nepal is a growing industry. Some local beers are now also exported, and the quality of beer has reached to international standards International brands are popular in the urban areas. Everest and Gorkha are two popular local brands.
• Cocktails can pretty much only be found in Kathmandu and Pokhara 's tourist areas. There you can get watered-down "two for one drinks" at a variety of pubs, restaurants and sports bars.

Although not as internationally famous as Indian brands, Nepal does in fact have a large organic tea industry. Most plantations are in the east of the country and the type of tea grown is very similar to that produced in neighbouring Darjeeling . Well known varieties are Dhankuta, Illam, Jhapa, Terathhum and Panchthar (all named after their growing regions). Over 70% of Nepal's tea is exported and the tea you see for sale in Thamel, while they serve as token mementos, are merely the scrapings from the bottom of the barrel.

• Milk tea is boiled milk with added tea, with or without sugar.
• Chai is tea with added milk and also sometimes containing ginger and spices such as cardamom.
• Suja is salty tea made with milk and butter - only available in areas inhabited by Tibetans, Sherpas and a few other Himalayan people.
• Herbal teas are mostly made from wild flowers from the Solu Khumbu region. In Kathmandu, these teas are generally only served in high class establishments or those run by Sherpas from the Solu Khumbu.

Sleep [ edit ]

Budget accommodation in Nepal ranges from around Rs250 to around Rs750 for a double. The prices you are told at first are not fixed so you should haggle. Especially if you want to stay for a longer period, you can get a large discount. Cheaper rooms usually do not have sheets, blankets, towels, or anything else besides a bed and a door. Most budget hotels and guesthouses have a wide range of rooms, so be sure to see what you are getting, even if you have stayed there before. Usual price for three-star equivalent hotel (AC, bathroom, Internet access and satellite TV in the room) is around Rs1,500 for a double, a bit more in Kathmandu. Accommodations might easily be the cheapest part of your budget in Nepal.

However, if you prefer luxurious accommodation, the best hotels equal approximately to four star hotels in western countries (unlimited access to swimming pool or whirlpool, no power outages, room service, very good restaurant and buffet breakfasts). Expect the price being much higher (circa US$50 for a double or US$100 for an apartment, even more in Kathmandu). In these hotels, all prices are usually fixed. In Kathmandu, some luxurious hotels require going through security check when entering.

Learn [ edit ]

Thangka painting [ edit ].

• Tsering Art School , offers a Thangka painting course. A minimum study period of 3 months a year for 3 years is recommended. Due to the sacred nature of this art form, those who wish to study here must have taken refuge in the Buddha, Dharma and Sangha, and be Buddhist. There are no boarding facilities offered at the Tsering Art School for foreign students. The school fees are Rs1,600 per month. Basic drawing and painting implements are required and can be purchased in Nepal. For study enquiries and enrolments contact the school administrator, Miss Lobsang Dolma by email on: [email protected]

Work [ edit ]

Volunteering [ edit ].

Visitors to Nepal should be aware that it is illegal to do volunteering "work" on a tourist Visa. In order to volunteer legally, the organization who will engage you must obtain for you a non-tourist visa.

Unfortunately, volunteer tourism has mostly become more profitable than real tourism. Foreign operators and Nepali agents have found an inexhaustible supply of well-meaning but naive people who will pay sometimes even big amounts to "volunteer" in Thamel, Lakeside and Chitwan. See Volunteer travel#Be wary .

Teaching English is a popular project for volunteers and is often combined with courses in computer literacy or health and physical education. The Nepali school system, which many children only attend for a few years, requires English fluency so there is always a demand for native English speakers of all ages, races and nationalities. There have been few prerequisites for teaching beyond fluency in English. Be aware that many schools, especially private ones, charge families higher fees if "foreign teachers present" and often locally available English teachers may not be able to find work because of the number of foreign mostly illegally engaged foreign volunteers, many of whom may be illegally employed.

If you want to teach, a school may request and obtain a non tourist visa for you so you can teach legally.

There are many options for finding volunteer opportunities. Several international volunteer organizations, will find you a project, room and boarding, either at the school or with a local family for a fee. This "fee" can range from US$500-2000 depending on the type and length of program. Often only little of that money will go to the school and host family, often they are too poor even to support a volunteer, so the bulk often goes to the agency.

Some organisations will provide language and culture lessons as well as general teaching supplies and support. Once you make a deposit on a particular program there may be limited options for change. Programs can last from two weeks to five months if made in tourist visa, but keep in mind a regular, legal work and a longer stay may be more rewarding for both you and the school, as it can take several weeks to get into the swing of things. Above all, examine carefully how your money is spent and who really benefits.

An alternative to paid placement is to find a local, grassroots program, or to contact schools directly in Kathmandu when you arrive. Local hostels and restaurants usually have bulletin boards full of often doubtful requests for volunteers. More and more local groups are placing ads on the web as well. These programs are more likely to charge only for room and board, but you will need to do some research to find out the specifics of each group and what, if any, support you will receive. Waiting until you arrive also lets you get to know the areas you can volunteer in and allows you to shop around for a situation that best suits you. These placements tend to be longer term (3-5 months), but this is always negotiable with a specific school or project.

Always check if your engagement does not take away work of other people and that your volunteer work is done legally and that the community profits from the deal. Report to police or other serious NGO/INGO any kind of misuse. Always demand written receipts with complete organisation address, stamp and signatures. This helps to prevent siphoning off precious development funds, which generally tend to not reach the intended beneficiaries most of time. Estimates go from 85-95% for funds spent on "logistics", "office expenses", "allowances", vehicles and so forth.

Stay safe [ edit ]

Sometimes, there are strikes ("bandas") and demonstrations to contend with. Some businesses close, but many allowances are usually made for tourists, who are widely respected. Ask about strikes at your hotel or read the English language Nepali newspapers.

The Maoist insurgency ended in 2006 after they signed comprehensive peace agreement with the government, in which they agreed to become a mainstream political party and participate in elections. The government is in the hand of Nepali Congress as it wins the election of 2014. Due to the change in government the tourists are now much more safer than before. The trekking routes and other tourist destinations are safe for travel. If your country has an embassy or consulate in Nepal, let them know your whereabouts & plans, and at least listen seriously to any cautionary advice they offer.

It is not unheard of for Maoist "tax collectors" to collect "revolutionary taxes" from trekkers. They may approach you as a large group. Even though this is effectively extortion, it is not always an unfriendly encounter and should not assume the worst. They will usually provide a receipt for the tax and claim that it will provide you with security and safe passage within the area that you are in. It is best to defer to your guide and if your guide suggests that you pay the tax, accept the recommendation. You can negotiate and haggle, or refuse outright, and they will either press harder, threaten you or leave you alone entirely. This has become progressively rarer since the Maoist insurgency ended in 2006 (especially on the trek to the Everest basecamp) but is still imposed in some areas.

Nepal's cities are safer than most, and even pickpockets are rare. It's relatively safe for women and solo travellers as compared to many other South Asian countries. Nevertheless, don't flash cash or make ostentatious displays of wealth. It is advised to take trekking guide when trekking to a Himalayan region.

Be cautious with the public transport. Roads are narrow, steep, winding & frequently crowded. Domestic flights with a private company are safer than the roads. Flying risks are greatest before & during the monsoon season when the mountains are usually clouded over.

If you should be seriously injured or sick where there are no roads or airports available, medical evacuation by helicopter may be your last best chance. If there is no firm guarantee that the bill will be paid, companies offering these services may demur, so look into insurance covering medical evacuations. You might ask if your embassy or consulate guarantees payment.

Stay healthy [ edit ]

• Water that you can drink without fear of becoming ill is rare because of a lack of water treatment facilities and sewage treatment. It is safest to assume that water is unsafe for drinking without being chemically treated or boiled, which is one reason to stick to tea or bottled water. It may be possible to buy filtered, treated water in cities and many villages. The Annapurna Conservation Area Project (ACAP) has installed a number of safe water stations along the Annapurna Circuit where water may be purchased for a reasonable cost.
• When trekking carry iodine or other chemical means of treating water and be sure to follow directions, i.e. don't drink the water before the specified time interval to ensure that resistant cysts are deactivated. In trailside teashops, although glasses may be washed in questionable water, tea is made by pouring boiling water through tea dust into your glass. The chances of disease-causing organisms surviving that are small but not zero.
• Brush teeth with prepared drinking water and avoid water entering the mouth when showering.
• Salads , especially in the wet season, should be treated as suspect. Some restaurants wash salad greens with lightly iodized water to make it safe.
• Wash hands regularly and especially before eating. Carry hand sanitizer and use it regularly.
• Thoroughly wash fruit and vegetables for raw consumption using boiled and filtered water. Also consider peeling them.
• Look for freshly-cooked food and avoid anything that has been cooked and then left sitting around without refrigeration (which can expose you to a buildup of bacterial toxins), or without protection from flies (which can transfer disease organisms and parasite eggs to the food).
• Also see the Travellers' diarrhea article.
• Get vaccinated and consider prophylactic treatment. You may be exposed to typhoid, cholera, hepatitis malaria and possibly even rabies. Read the article on Tropical diseases and review travel plans with your health care provider.
• Practice safe sex or do without. Nepali women are sought after in India and the Middle East and so there is human trafficking. Victims may be allowed to return home when health issues become a liability, then continue 'working' as long as possible. The incidence of STDs is rising and the government has not always been proactive about treatment and promoting awareness. Unless your Nepali is extremely fluent, your chances of finding out about a prospective partner's sexual history are slim.

• Altitude sickness Permanent snow lines are between 5,500 m and 5,800 m (18,000 ft and 19,000 ft), so base camps and passes in the Himalaya are usually higher than Mount Blanc or Mount Whitney. This puts even experienced mountain climbers at risk of altitude-related medical conditions that can be life-threatening. Risks can be minimized by choosing routes that don't go high, such as Pokhara-Jomosom, or routes and trekking companies where gamow bags or other treatment are available, and by sleeping not more than 300 m (1,000 ft) higher per day. According to the "climb high, sleep low" mantra, it is good to take daytime conditioning hikes that push acclimation, then to return to a more reasonable elevation at night.
• Hypothermia is a risk, especially if you are trekking in spring, autumn or winter to avoid heat at low elevations. When it is a comfortable 30°C (85°F) in the Terai, it is likely to be in the teens Fahrenheit or -10°C (14°F) at that base camp or high pass. Either be prepared to hike and sleep in these temperatures (and make sure your comrades, guides and porters are equally prepared), or choose a trek that doesn't go high. For example, at 3,000m (10,000ft) expect daytime temperatures in the 40s Fahrenheit or 5 to 10°C.
• Rabies - Dogs are not vaccinated and catch this fatal disease from other dogs or wild animals with some regularity. All mammals are potentially vulnerable. Dogs are considered ritually polluting and are widely abused, so it can be impossible to know whether a dog bit you because it is paranoid about people or because it is rabid. You should be vaccinated against rabies before going to Nepal, but this is not absolute protection. Be on the lookout for mammals acting disoriented or hostile and stay as far away as possible. Do not pet dogs, cats or pigs no matter how cute. Keep a distance from monkeys, especially in places like the Monkey Temple (Swayambunath) in Kathmandu. If bitten or exposed to saliva, seek medical attention. You may need an extended series of injections that provides a higher level of protection than routine vaccination.
• Snakebite - The risk is greatest in warm weather and at elevations below 1,500 m (5,000 ft). Poisonous snakes are fairly common and cause thousands of deaths annually. Local people may be able to differentiate poisonous and non-poisonous species. Cobras raise their bodies in the air and spread their hoods when annoyed; itinerant snake charmers are likely to have specimens for your edification. Vipers have triangular heads and may have thick bodies like venomous snakes in North America. Kraits may be the most dangerous due to innocuous appearance and extremely potent neurotoxin venom. Kraits are strangely passive in daylight but become active at night, especially around dwellings where they hunt rodents. Krait bites may be initially painless, causing only numbness. However without proper antivenin numbness can progress to deadly paralysis, even with bites from small, seemingly harmless specimens. Wearing proper shoes and trousers rather than sandals and shorts provides some protection. Watch where you put your feet and hands, and use a torch when walking outside at night. Sleeping on elevated beds and on second stories helps protect against nocturnal kraits.

Respect [ edit ]

Greet people with a warm Namaste (or "Namaskar" formal version - to an older or high-status person) with palms together, fingers up. It is used in place of hello or goodbye. Don't say it more than once per person, per day. The least watered down definition of the word: 'The divine in me salutes the divine in you.'

Show respect to elders.

Say Thank you: Dhanyabaad /'ðɅnjɅbɑ:d/ (Dhan-ya-baad)

Feet are considered dirty. Don't point the bottoms of your feet at people or religious icons. Do not to step over a person who may be seated or lying on the ground. Be sensitive to when it is proper to remove your hat or shoes. It is proper to take off your shoes before entering a residential house.

The left hand is considered unclean because it is used to wash after defecating. Many Nepali hotel & guest House toilets have bidet attachments, like a kitchen sink sprayer, for this purpose in lieu of toilet paper. It is considered insulting to touch anyone with the left hand. It is proper to poke someone, take and give something with the right hand.

Circumambulate Buddhist shrines and temples, chortens, stupas, mani walls, monasteries etc. in a clockwise direction. Hindu shrines and temples have no such practice.

When haggling over prices, smile, laugh and be friendly. Be prepared to allow a reasonable profit. Don't be a miser or insult fine craftsmanship, it's much better to lament that you are too poor to afford such princely quality.

Many Hindu temples do not allow non-Hindus inside certain parts of the temple complex. Be aware & respectful of this fact, as these are places of worship, not tourist attractions.

Being a non-Hindu makes you moderately ' impure to some strict Hindus. Avoid touching containers of water; let someone pour it into your drinking container. Likewise avoid touching food that others will be eating. Make sure you are invited before entering someone's house. You may only be welcome on the outer porch, or in the yard. Shoes are routinely left on the front porch or in a specific area near the front door.

Wash hands before and after eating. Touch food only with the right hand if you're not left-handed.

Connect [ edit ]

Internet connectivity is increasing rapidly, and obviously its availability is most widespread in Kathmandu (especially in Thamel and around the Boudha Stupa in Boudhanath) or Pokhara . In those two cities, most hotels and lodges will have free Internet connection with Wi-Fi. So will many restaurants. More and more villages will have Internet available at some lodges, usually with Wi-Fi. For example, in 2013, Wi-Fi was available in lodges in Jomsom and Muktinath. In the more remote villages, however, there may only be the occasional Internet cafe that is available. For example, Chame (on the Annapurna circuit) has an Internet cafe with secured Wi-Fi for Rs15 per minute. Even more remote villages may have Internet via satellite connection, but it is quite pricey at over Rs100 per minute.

Mail can be received at many guesthouses or at Everest Postal Care, opposite Fire & Ice on Tridevi Marg. Phone calls are best made from any of the international phone offices in Kathmandu . Voice over Internet (VOI) is usually Rs1-2/min. Mobile phones are the best optionsee below).

Mobile phones [ edit ]

There are two main mobile operators in Nepal. Government run NTC (Nepal Telecom Company) and private Ncell (previously called Spice Mobile and Mero Mobile).

Both operators allow tourists to buy SIM cards for about Rs200 in Kathmandu and most major towns. You will need to bring a passport photo, fill in a form and have your passport and visa page photocopied.

Ncell SIMs - can be bought from many stores, but are best bought from official stores in Birgunj or Kathmandu. Micro SIMs can be cut for free if you need.

NTC SIMs - NTC SIMs can be bought from their official offices and mobile stores across the country. They do not publish their coverage maps. However they do have superior remote coverage to Ncell, particularly on the Annapurna, everest and other trekking route.

Electricity [ edit ]

In Nepal, various types of electric plugs and sockets are common.

The most common plug types to be found on devices are C (Europlug), F ("Schuko"), G (UK), D and M.

Sockets mostly accept multiple types of plugs. Most modern wall sockets will accept types A, B, C, E, F, G, I and D. Some will additionally support type M. Note that the European plugs (types C, E and F) will typically sit rather loosely in these "universal sockets", so it can be advisable to use an adapter.

Occasionally you may also see older sockets which only support types D and M. However, at least one "modern" socket will usually be present in a room.

Adapters can be purchased inexpensively in Kathmandu for around ₨100, and some have fuses built in. Try shopping in Thamel or the Kumari Arcade in Kathmandu.

Electricity on treks can be scarce. In remote parts there may only be solar powered electricity. Expect to pay Rs100-200 per hour to charge devices on many tea-house treks, including the Everest base camp trek.

If you have devices that will need regular recharging, you may wish to purchase in advance a small solar panel and battery pack.

Go next [ edit ]

• Mount Kailash - in Tibet, a short distance beyond the North West corner of Nepal. Hindu and Buddhist cosmology describes the cosmos as a central mountain, Mount Meru, surrounded by the earth's continents and seas, then by the rest of the universe. Cambodia's Angkor Wat temple complex is an architectural representation of this schema. As geographical knowledge developed, Mount Kailash was proclaimed the physical manifestation of Mount Meru. It is the hydrological hub of the subcontinent. The Karnali, Sutlej Indus and Brahmaputra rivers all begin near this mountain. Hindus and Buddhists gain religious merit by circumambulating the mountain.

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How a high-flying Hong Kong lawyer turned wellness coach found her true path, helped by months of silent meditation in solitary Himalayan retreats

• 'I call myself a common person, but I'm leading an uncommon path,' says May Lim, who quit her job and moved to Nepal in search of the meaning of life
• Engaging in meditation and spiritual practice daily helped her finally feel that she was being true to herself and able to relieve the tension of others

Over 20 years ago, May Lim was living the high life. Having graduated from Cambridge University with first-class honours in commercial law, she was a respected lawyer who had worked at some of Hong Kong's biggest companies.

Outside work, she was often seen at beauty salons and shopping centres, or driving around in her Mercedes-Benz convertible.

But eventually she quit her job, sold the car and left everything behind to move to Nepal, the birthplace of Buddha - in search of the meaning of life. Now, she has dedicated her life to the world of healing.

Do you have questions about the biggest topics and trends from around the world? Get the answers with SCMP Knowledge , our new platform of curated content with explainers, FAQs, analyses and infographics brought to you by our award-winning team.

"I've always wanted to know the truth," Lim says. "In my mind, there is more to life than what we understand life is ... So from a very young age, I was already asking, what is the truth? Why am I here? What is life? Do I exist?"

The lawyer, who began her career at global law firm Linklaters, had always been Buddhist due to her family's influence, but it was in 2000 that she felt an overwhelming need to search for something more beyond her life in Hong Kong. She had just experienced a difficult break-up, and was still reeling from the effects of her mother's death in 1997.

"I wanted to break free from this cycle of endless suffering," she says.

So Lim jetted off to Nepal, hoping to find solace in the Himalayas.

"It was a very deep calling that was undeniable," she says. "Even with all this seemingly outer material success [and] with a lot of potential at the time, it was not enough."

Banker turned Buddhist nun on hostage-taking that changed her life

Lim's visit to Nepal changed her world forever. After serendipitously meeting a stranger in Durbar Square, in Kathmandu, that stranger took her to the Jamchen Lhakhang Monastery in the city, where she met the man who would become her first guru, Chogye Trichen Rinpoche.

During their brief meeting, he gave her a picture of a Buddha, which symbolised his wish for her to live a long life. As she was leaving the monastery, she was overcome with emotion. She knew that the person she had met would become one of "the masters of her life".

"I had goosebumps, I had tears running down my eyes," she says. "I ran back in and I grabbed onto his feet, and I said, 'Rinpoche, I don't know who you are, but I know you're my teacher.'"

That day, she also met Chokyi Nyima Rinpoche, who would become her second guru after her first guru died.

After that trip, Lim returned to Hong Kong for three years before she decided to quit her job as Yahoo Asia's corporate counsel for Greater China. She returned to Nepal for a longer stay.

There, she began studying Buddhist philosophy and Tibetan, and also practised meditation. She embarked on several solitary retreats - first for one month, then two stints of three months each - during which she did not have any contact with the outside world, and spent most of her time reciting mantras. Across seven months in solitude, Lim recited about 2 million of them.

Each time, she stayed in a guest room with an attached bathroom, and had a cook and attendant deliver meals.

A big takeaway from her time in solitude was that her feelings and reactions all related back to the mind.

"I could sit there [alone] and suddenly I would be angry," Lim says. "Where did that anger come from? You can't blame anyone, right? Sometimes when you're out in the world, when you're upset about something, you blame someone.

"[But] I realised it was my perception. It was my memory that was making me angry. It was all me," she adds. "My perception is dependent upon my past experiences ... and the seeds that I have planted in myself."

Meditation: a Silicon Valley executive's secret to success

For Lim, engaging in meditation and spiritual practice daily meant that she finally felt that she was being true to herself.

"To a lot of people, if you look at me from the eyes of worldly life, I'm very weird or eccentric," she says. "If there is a norm, I don't really quite fit, so I call myself [a] common person, but I'm leading an uncommon path.

"Not a lot of people can really understand that, and I think it's been a struggle for me to be me. But I am who I am."

After two fruitful years in Nepal, Lim returned to Hong Kong for her family. Wanting to be a dutiful daughter and to incorporate what she had learned into her life, she went back to being a lawyer - "to normalise my abnormality", she says.

She was a full-time lawyer, including a stint as chief legal counsel at the luxury goods company Richemont, until 2015.

"I was trying to conform, just to do the right thing, so to speak," she says. But she suffered from burnout in the corporate world, given its high demands and toxicity.

"It was a very aggressive environment in my days, especially as an Asian woman, a Chinese woman in a French company," she says, noting how she experienced a frozen shoulder due to the stress. "Because of all that ... to take care of myself, I woke up one morning and I said, I need to resign. I cannot continue. This is too much."

What's the macrobiotic diet loved by Hollywood celebs, from Madonna to Gwyneth?

After quitting her job, Lim had a series of adventures while still working as a part-time lawyer.

She went to Amsterdam in the Netherlands to get a macrobiotic chef certificate; the major principles of macrobiotic diets are to reduce animal products, eat locally grown foods that are in season, and to eat in moderation.

She dissected a cadaver in Germany to learn more about the human body. She also got her yoga teacher certification after a friend asked for lessons.

When Lim returned to Hong Kong in 2017, she officially launched "Heal with May" and became a well-being coach.

Aside from leading private and group yoga and meditation classes, she also delivers talks and has a number of private clients, whom she helps with navigating stress and achieving harmony and balance.

In a high-pressure city like Hong Kong, many people don't realise that they are stressed, Lim says.

"It's almost like we are addicted to the stress, and then it makes us very grumpy and aggressive."

When people face continuous stress and pressure that is left unaddressed, it can lead to an amygdala hijack - an overwhelming emotional response disproportionate to the circumstance - that triggers the fight-or-flight response, Lim says.

"If you're on that mode all the time without a break, so you're shaking all the time, you will break down," she says.

In her sessions, she helps clients - including executives, senior partners at law firms and even Hong Kong actress Chingmy Yau - release tension and "return to neutral" through breathwork .

"Breathing is the best tool to help calm us down very quickly," she says. "A lot of my work is also quite science-based. It's very much based on the nervous system, and how we can activate our vagus nerve to then calm down the system to bring more balance and harmony."

Lim has three stress-relieving tips that can be easily employed in daily life.

First, she recommends sitting in silence for a few minutes before you start your day, to focus on breathing, set your day with an intention, to "remember your why" and to achieve peace of mind.

Like many others, she also recommends exercising or daily movement, though it should be tailored to your abilities and desires. "Sitting is the new smoking," she says.

The final tip she has is to practise gratitude , daily.

"I believe that we have the power to self-heal," she says. "We just don't give it enough time and space."

Like what you read? Follow SCMP Lifestyle on Facebook , Twitter and Instagram . You can also sign up for our eNewsletter here .

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This article originally appeared on the South China Morning Post (www.scmp.com), the leading news media reporting on China and Asia.

Copyright (c) 2024. South China Morning Post Publishers Ltd. All rights reserved.

• Open access
• Published: 27 May 2024

Patients’ satisfaction with cancer pain treatment at adult oncologic centers in Northern Ethiopia; a multi-center cross-sectional study

• Molla Amsalu 1 ,
• Henos Enyew Ashagrie 2 ,
• Amare Belete Getahun 2 &
• Yophtahe Woldegerima Berhe   ORCID: orcid.org/0000-0002-0988-7723 2  

BMC Cancer volume  24 , Article number:  647 ( 2024 ) Cite this article

79 Accesses

Metrics details

Patient satisfaction is an important indicator of the quality of healthcare. Pain is one of the most common symptoms among cancer patients that needs optimal treatment; rather, it compromises the quality of life of patients.

To assess the levels and associated factors of satisfaction with cancer pain treatment among adult patients at cancer centers found in Northern Ethiopia in 2023.

After obtaining ethical approval, a multi-center cross-sectional study was conducted at four cancer care centers in northern Ethiopia. The data were collected using an interviewer-administered structured questionnaire that included the Lubeck Medication Satisfaction Questionnaire (LMSQ). The severity of pain was assessed by a numerical rating scale from 0 to 10 with a pain score of 0 = no pain, 1–3 = mild pain, 4–6 = moderate pain, and 7–10 = severe pain Binary logistic regression analysis was employed, and the strength of association was described in an adjusted odds ratio with a 95% confidence interval.

A total of 397 cancer patients participated in this study, with a response rate of 98.3%. We found that 70.3% of patients were satisfied with their cancer pain treatment. Being married (AOR = 5.6, CI = 2.6–12, P  < 0.001) and being single (never married) (AOR = 3.5, CI = 1.3–9.7, P  = 0.017) as compared to divorced, receiving adequate pain management (AOR = 2.4, CI = 1.1–5.3, P  = 0.03) as compared to those who didn’t receive it, and having lower pain severity (AOR = 2.6, CI = 1.5–4.8, P  < 0.001) as compared to those who had higher level of pain severity were found to be associated with satisfaction with cancer pain treatment.

The majority of cancer patients were satisfied with cancer pain treatment. Being married, being single (never married), lower pain severity, and receiving adequate pain management were found to be associated with satisfaction with cancer pain treatment. It would be better to enhance the use of multimodal analgesia in combination with strong opioids to ensure adequate pain management and lower pain severity scores.

Peer Review reports

Introduction

Pain is defined as an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage [ 1 ]. The prevalence of pain in cancer patients is 44.5-66%. with the prevalence of moderate to severe pain ranging from 30 to 38%, and it can persist in 5-10% of cancer survivors [ 2 ]. Using the World Health Organization’s (WHO) cancer pain management guidelines can effectively reduce cancer-related pain in 70-90% of patients [ 3 , 4 ]. Compared to traditional pain states, the mechanism of cancer-related pain is less understood; however, cancer-specific mechanisms, inflammatory, and neuropathic processes have been identified [ 5 ]. Uncontrolled pain can negatively affect patients’ daily lives, emotional health, social relationships, and adherence to cancer treatment [ 6 ]. Patients with moderate to severe pain have a higher fatigue score, a loss of appetite, and financial difficulties [ 7 ]. Patients fear the pain caused by cancer more than dying from the disease since pain affects their physical and mental aspects of life [ 8 ]. A meta-analysis of 30 studies stated that pain was found to be a significant prognostic factor for short-term survival in cancer patients [ 9 ]. Many cancer patients have a very poor prognosis. However, adequate pain treatment prevents suffering and improves their quality of life. Although the WHO suggested non-opioids for mild pain, weak opioids for moderate pain, and strong opioids for severe pain, pain treatment is not yet adequate in one-third of cancer patients [ 10 ].

Patient satisfaction with pain management is a valuable measure of treatment effectiveness and outcome. It could be used to evaluate the quality of care [ 11 , 12 , 13 ]. Patient satisfaction affects treatment compliance and adherence [ 12 ]. Studies have reported that 60-76% of patients were satisfied with pain treatment, and a variety of factors were found associated with levels of satisfaction [ 3 , 14 , 15 , 16 ]. Studies conducted in Ethiopia reported the prevalence of pain ranging from 59.9 to 93.4% [ 17 , 18 ]. These studies indicate that cancer pain is inadequately treated. Assessment of pain treatment satisfaction can help identify appropriate treatment modalities and further its effectiveness. We conducted this study since there was limited research-based evidence on cancer pain management in low-income countries like Ethiopia. Our research questions were: how satisfied are adult cancer patients with pain treatment, and what are the factors associated with the satisfaction of adult cancer patients with pain treatment?

Methodology

Study design, area, period, and population.

A multi-center cross-sectional study was conducted at four cancer care centers in Amhara National Regional State, Northern Ethiopia from March to May 2023. Those cancer care centers were found in the University of Gondar Comprehensive Specialized Hospital (UoGCSH), Felege-Hiwot Comprehensive Specialized Hospital (FHCSH), Tibebe-Ghion Comprehensive Specialised Hospital (TGCSH) and Dessie Comprehensive Specialized Hospital (DCSH). We selected these centers as they were the only institutions providing oncologic care in the region during the study period.

The UoGCSH had 28 beds in its adult oncology ward and serves 450 cancer patients every month. Three specialist oncologists and 12 nurses provide services in the ward. The FHCSH had 22 beds and provides services for 325 cancer patients every month. Two specialist oncologists, two oncologic nurses, and 7 comprehensive nurses provide services. The TGCSH had eight beds and serves 300 cancer patients every month. There were three specialist oncologists and four oncologic nurses at the care center. The cancer care center at DCSH had 10 beds. It serves 350 cancer patients every month. There was one specialist oncologist, three oncologic nurses, and three comprehensive nurses.

All cancer patients who attended those cancer care centers were the source population, and adult (18+) cancer patients who were prescribed pain treatment for a minimum of one month were the study population. Unconscious patients, patients with psychiatric problems, patients with advanced cancer who were unable to cooperate, and patients with oncologic emergencies were excluded from this study.

Variables and operational definitions

The outcome variable was patient satisfaction with cancer pain treatment, which was measured by the Lubeck Medication Satisfaction Questionnaire. The independent variables were sociodemographic (age, sex, marital status, monthly income, and level of education), clinical (site of tumor, stage of cancer, metastasis), cancer treatment (surgery, chemotherapy, radiotherapy), level of pain, and analgesia (type of analgesia, severity of pain, adequacy of pain treatment, adjuvant analgesic).

• Patient satisfaction

perceptions of the patients regarding the outcome of pain management and the extent to which it meets their needs and expectations. It was measured by a 4-point Likert scale (1 = strongly disagree, 2 = disagree, 3 = agree, 4 = strongly agree) using the LMSQ which has 18 items within 6 subscales that have 3 items in each (effectivity, practicality, side-effects, daily life, healthcare providers, and overall satisfaction) [ 19 ]. Final categorization was done by dichotomizing into satisfied and dissatisfied by using the demarcation threshold formula.

\((\frac{\text{T}\text{o}\text{t}\text{a}\text{l}\,\,\text{h}\text{i}\text{g}\text{h}\text{e}\text{s}\text{t}\,\,\text{s}\text{c}\text{o}\text{r}\text{e} - \text{T}\text{o}\text{t}\text{a}\text{l}\,\, \text{l}\text{o}\text{w}\text{e}\text{s}\text{t}\,\, \text{s}\text{c}\text{o}\text{r}\text{e} }{2}\) ) + Total lowest score [ 20 ]. The highest patient satisfaction score was 70 and the lowest satisfaction score was 26. A score < 48 was classified as dissatisfied, and a score ≥ 48 was classified as satisfied.

The Numeric rating scale (NRS) is a validated pain intensity assessment tool that helps to give patients a subjective feeling of pain with a numerical value between 0 and 10, in which 0 = no pain, 1–3 = mild pain, 4–6 = moderate pain, 7–10 = severe pain [ 21 ].

The Adequacy of cancer pain treatment was measured by calculating the Pain Management Index (PMI) according to the recommendations of the WHO pain management guideline [ 22 ]. The PMI was calculated by considering the prescribed most potent analgesic agent and the worst pain reported in the last 24 h [ 23 ]. The prescribed analgesics were scored as follows: 0 = no analgesia, 1 = non-opioid analgesia, 2 = weak opioids, and 3 = strong opioids. The PMI was calculated by subtracting the reported NRS value from the type of most potent analgesics administered. The calculated values of PMI ranged from − 3 (no analgesia therapy for a patient with severe pain) to + 3 (strong opioid for a patient with no pain). Patients with a positive PMI value were considered to be receiving adequate analgesia, whereas those with a negative PMI value were considered to be receiving inadequate analgesia.

Sample size determination and sampling technique

A single population proportion formula was used to determine the sample size by considering 50% satisfaction with cancer pain treatment and a 5% margin of error at a 95% confidence interval (CI). A non-probability (consecutive) sampling technique was employed to attain a sample size within two months of data collection period. After adjusting the proportional allocation for each center and adding 5% none response, a total of 404 study participants were included in the study: 128 from the University of Gondar Comprehensive Specialized Hospital, 99 from Dessie Comprehensive Specialized Hospital, 92 from Felege Hiwot Comprehensive Specialized Hospital, and 85 from Tibebe Ghion Comprehensive Specialized Hospital.

Data collection, processing, and analysis

Ethical approval.

was obtained from the Ethical Review Committee of the School of Medicine at the University of Gondar ( Reference number: CMHS/SM/06/01/4097/2015) . Data were collected using an interviewer-administered structured questionnaire and chart review during outpatient and inpatient hospital visits by four trained data collectors (one for every center). Written informed consent was obtained from each participant after detailed explanations about the study. Informed consent with a fingerprint signature was obtained from patients who could not read or write after detailed explanations by the data collectors as approved by the Ethical Review Committee of the School of Medicine, at the University of Gondar.

Questions to assess the severity of pain and pain relief were taken from the American Pain Society patient outcome questionnaire [ 24 ]. Patients were asked to report the worst and least pain in the past 24 h and the current pain by using a numeric rating scale from 0 to 10, with a pain score of 0 = no pain, 1–3 = mild pain, 4–6 = moderate pain, 7–10 = severe pain.

The Pain Management Index (PMI) based on WHO guidelines, was used to quantify pain management by measuring the adequacy of cancer pain treatment [ 25 ]. The following scores were given (0 = no analgesia, 1 = non-opioid analgesia, 2 = weak opioid 3 = strong opioid). Pain Management Index was calculated by subtracting self-reported pain level from the type of analgesia administered and ranges from − 3 (no analgesic therapy for a patient with severe pain) to + 3 (strong opioid for a patient with no pain). The level of pain was defined as 0 with no pain, 1 for mild pain, 2 for moderate pain, and 3 for severe pain. Patients with negative PMI scores received inadequate analgesia.

The pain treatment satisfaction was measured by the Lübeck Medication Satisfaction Questionnaire (LMSQ) consisting of 18 items [ 19 ]. Lübeck Medication Satisfaction Questionnaire (LMSQ) has six subclasses each consisting of equally waited and similar context of three items. The subclass includes satisfaction with the effectiveness of pain medication, satisfaction with the practicality or form of pain medication, satisfaction with the side effect profile of pain medication, satisfaction with daily life after receiving pain treatment, satisfaction with healthcare providers, and overall satisfaction. Satisfaction was expressed by a four-point Likert scale (4 = Strongly Agree, 3 = Agree, 2 = Disagree, 1 = Strongly Disagree). The side effect subclass was phrased negatively, marked with Asterix, and reverse-scored in STATA before data analysis.

Data were collected with an interviewer-administered questionnaire. The reliability of the questionnaire was assessed by using 40 pretested participants and the reliability coefficient (Cronbach’s alpha value) of the questionnaire was 91.2%. The collected data was checked for completeness, accuracy, and clarity by the investigators. The cleaned and coded data were entered in Epi-data software version 4.6 and exported to STATA version 17. The Shapiro-Wilk test, variance inflation factor, and Hosmer-Lemeshow test were used to assess distribution, multicollinearity, and model fitness, respectively. Descriptive, Chi-square and binary logistic regression analyses were performed to investigate the associations between the independent and dependent variables. The independent variables with a p-value < 0.2 in the bivariable binary logistic regression were fitted to the final multivariable binary logistic regression analysis. Variables with p-value < 0.05 in the final analysis were considered to have a statistically significant association. The strength of associations was described in adjusted odds ratio (AOR) at a 95% confidence interval.

Sociodemographic and clinical characteristics

A total of 397 patients were involved in this study (response rate of 98.3%). Of the participants, 224 (56.4%) were female, and over half were from rural areas ( n  = 210, 52.9%). The median (IQR) age was 48 (38–59) years [Table  1 ]. The most common type of cancer was gastrointestinal cancer 114 (28.7%). Most of the study participants, 213 (63.7%), were diagnosed with stage II to III cancer. The majority of the participants were taking chemotherapy alone (292 (73.6%)) [Table  2 ]. Over 90% of patients reported pain; 42.3% reported mild pain, 39.8% reported moderate pain, and 10.1% reported severe pain. Pain treatment adequacy was assessed by self-reports from study participants following pain management guidelines, and 17.1% of patients responded to having inadequate pain treatment. The majority of patients, 132 (33.3%), were prescribed combinations of non-opioid and weak opioid analgesics for cancer pain treatment. Only 34 (8.6%) cancer patients used either strong opioids alone or in combination with non-opioid analgesics.

Patients’ satisfaction with cancer pain treatment and correlation among the subscales

Most participants strongly agree (243, (61.2%)) with item LMSQ18 in the “overall satisfaction” subscale and strongly disagree (206, (51.9%)) for item LMSQ2 in the “side-effect” subscale respectively [Table  3 ]. The highest satisfaction score was observed in the side-effect subscale, with a median (IQR) of 10 (9–11) [Table  4 ].

Two hundred and seventy-nine (70.3%) cancer patients were found to be satisfied with cancer pain treatment (CI = 65.6−74.6%). The highest satisfaction rate was observed in the “side-effects” subscale, to which 343 (86.4%) responded satisfied [Fig.  1 ]. A Spearman’s correlation test revealed that there were correlations among the subscales of LMSQ; and the strongest positive correlation was observed between effectivity and healthcare workers subscale (r s = 0.7, p  < 0.0001). The correlation among the subscales is illustrated in a heatmap [Fig.  2 ].

Patient satisfaction with cancer pain treatment with each LMSQ subclass, n  = 397

A heatmap showing the Spearman correlation of each subclass of pain treatment satisfaction, n  = 397

Factors associated with patient satisfaction with cancer pain treatment

In the bivariable binary logistic regression analysis, marital status, stage of cancer, types of cancer treatment, severity of pain in the last 24 h, current pain severity, types of analgesics, and pain management index met the threshold of P-value < 0.2 to be included into the final multivariable binary logistic regression analysis. In the final analysis, marital status, current pain severity, and pain management index were significantly associated with patient satisfaction (P-value < 0.05). Married and single cancer patients had higher odds of being satisfied with cancer pain treatment compared to divorced patients (AOR = 5.6, CI, 2.6–12.0, P  < 0.001), (AOR = 3.5, CI = 1.3–9.7, P  = 0.017), respectively. The odds of being satisfied with cancer pain treatment among patients who received adequate pain management were more than two times greater than those who received inadequate pain management (AOR = 2.4, CI = 1.1–5.3, P  = 0.03). Patients who reported a lesser severity of current pain were nearly three times more likely to be satisfied with cancer pain treatment (AOR = 2.6, CI = 1.5–4.8, P  < 0.001) [Table  5 ].

The objective of the present study was to assess patients’ satisfaction with cancer pain treatment at adult oncologic centers. Our study revealed that most cancer patients (70.3%) have been satisfied with cancer pain treatment. This is consistent with studies done by Kaggwa et al. and Mazzotta et al. [ 16 , 26 ]. Whereas, it is a higher rate of satisfaction compared to other studies that reported 33.0% [ 27 ] and 47.7% [ 28 ] of satisfaction. The differences might be possibly explained by the use of different pain and satisfaction assessment tools, the greater inclusion (about 70%) of patients with advanced stages of cancer, the duration of cancer pain treatment, and the adequacy of pain management. In the current study, only 19.6% of patients have been diagnosed with stage IV cancer: patients should take treatment at least for a month, and over 80% of patients have received adequate pain management according to PMI. However, some studies have reported higher rates of satisfaction with cancer pain treatment [ 15 , 29 ]. The possible reason for the discrepancy might be the greater (over 40%) use of strong opioid analgesics in the previous studies. Strong opioids were prescribed only for 8.6% of patients in our study. Due to the complex pathophysiology, cancer pain involves multiple pain pathways. Hence, multimodal analgesia in combination with strong opioids is vital in cancer pain management [ 30 ]. Furthermore, the use of epidural analgesia could be another reason for higher rates of satisfaction [ 29 ].

Regarding satisfaction with subscales of LMSQ, about 80% of patients were satisfied with the information provided by the healthcare providers [ 27 ]. In our study; 67.8% of patients were satisfied with the education provided by healthcare providers about their disease and treatment. In contrast, a higher proportion of participants were satisfied with information provision in a study conducted by Kharel et al. [ 29 ]. Furthermore, we observed the lowest satisfaction rate in the daily life subscale. About 48% of cancer patients were not satisfied with their daily lives after receiving analgesic treatment for cancer pain.

Married and single (never married) cancer patients were found to have higher odds of being satisfied with cancer pain treatment as compared to divorced cancer patients. These findings could be explained by the presence of better social support from family or loved ones. Better social support can enhance positive coping mechanisms, increase a sense of well-being, and decrease anxiety and depression. It also improves a sense of societal vitality and results in higher patient’ satisfaction [ 31 , 32 ].

Patients who had a lower pain score were satisfied compared to those who reported a higher pain score, and this is supported by multiple previous studies [ 16 , 26 , 27 , 29 , 33 , 34 ]. This could be explained by the negative impacts of pain on physical function, sleep, mood, and wellbeing [ 35 ]. Moreover, higher pain severity scores could increase financial expenses because of unnecessary or avoidable emergency department visits; and has a consequence of dissatisfaction [ 23 ]. On the contrary, there are studies that state pain severity does not affect patients’ satisfaction [ 36 , 37 ].

Positive PMI scores were significantly associated with cancer pain treatment satisfaction. Patients who received adequate pain management were highly likely to be satisfied with cancer pain treatment. This finding is similar to that of a study done in Taiwan [ 38 ]. However, a study conducted by Kaggwa et al. has denied any association between PMI scores and cancer pain satisfaction [ 16 ].

Satisfaction with healthcare workers and effectivity of analgesics

This study showed that there was a moderately positive correlation between satisfaction with healthcare workers and satisfaction with patients’ perceived effectiveness of analgesics. This might be explained by a positive relationship between healthcare professionals and patients receiving cancer pain treatment. Healthcare providers who provide health education regarding the effectiveness of analgesics may improve patients’ adherence to the prescribed analgesic agent and improve patients’ perceived satisfaction with the effectiveness of analgesics. A systematic review showed that the hope and positivity of healthcare professionals were important for patients to cope with cancer and increase satisfaction with care [ 39 ]. Increased patient satisfaction with care provided by healthcare workers may change attitude of patients who accepted cancer pain as God’s wisdom or punishment and create a positive attitude toward the effectiveness of analgesics [ 40 ]. Another study supported this finding and stated that healthcare providers who deliver health education regarding the prevention of drug addiction, side effects of analgesics, timing, and dosage of analgesics improve patient attitude and cancer pain treatment [ 41 ].

Correlation of each subclass of cancer pain treatment satisfaction

A Spearman correlation was run to assess the correlation of each subclass of LMSQ using the total sample. There was strong positive correlation (r s = 0.5–0.64) between most of LMSQ subclass at p  < 0.01.

A cross-sectional study stated that the effectiveness of analgesic, efficacy of medication and patient healthcare provider communication were associated with patient satisfaction [ 42 ]. In this study, 58.2% of patients were satisfied with the practicability of analgesic medications. Comparable to this study, a cross-sectional study stated that patients who were prescribed convenient, fast-acting medications were more satisfied [ 43 ]. Another study stated that 100% of patients who received sufficient information on analgesic treatment and 97.9% of patients who received sufficient information about the side effects of analgesic treatment were satisfied with cancer pain management [ 44 ]. Patients who were satisfied with their pain levels reported statistically lower mean pain scores (2.26 ± 1.70) compared to those not satisfied (4.68 ± 2.07) or not sure (4.21 ± 2.21) [ 27 ]. This may be explained by the impact of pain on daily activity. Patients who report a lower average pain score may have a lower impact of pain on physical activity compared to those who report a higher mean pain score. Another study also supports this evidence and states that patients who reported a severe pain score and lower quality of life had lower satisfaction with the treatment received [ 45 ].

As a secondary outcome, only 16% of patients were diagnosed to have stage I cancer. This finding could indirectly indicate that there were delays in cancer diagnosis at earlier stage. Further studies may be required to underpin this finding.

In this study, baseline pain before analgesic treatment was not assessed and documented. As a cross-sectional study, we could not draw a cause-and-effect conclusion. Since questions that were used to measure oncologic pain treatment satisfaction were self-reported, answers to each question might not be trustful. The expectation and opinion of the interviewer also might affect the result of the study. These could be potential limitations of the study.

Conclusions

Despite the fact that most cancer patients reported moderate to severe pain, there was a high rate of satisfaction with cancer pain treatment. It would be better if hospitals, healthcare professionals, and administrators took measures to enhance the use of multimodal analgesia in combination with strong opioids to ensure adequate pain management, lower pain severity scores, and better daily life. We also urge the arrangement of better social support mechanisms for cancer patients, the improvement of information provision, and the deployment of professionals who have trained in pain management discipline at cancer care centres.

Data availability

Data and materials used in this study are available and can be presented by the corresponding author upon reasonable request.

Abbreviations

Adjusted Odds Ratio

Crude Odds Ratio

Confidence Interval

Dessie Compressive and Specialized Hospital

Felege-Hiwot Compressive and Specialized Hospital

Inter-quartile Range

Lubeck Medication Satisfaction Questionnaire

Numerical Rating Scale

Pain Management Index

Standard Deviation

Tibebe-Ghion Compressive and Specialized Hospital

University of Gondar Compressive and Specialized Hospital

World health organization

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Acknowledgements

We would like to acknowledge the University of Gondar Comprehensive Specialized Hospital, Tibebe-Ghion Comprehensive Specialized Hospital, Felege-Hiwot Comprehensive Specialized Hospital, Dessie Comprehensive Specialized Hospital. We would also want to acknowledge Ludwig Matrisch from the Department of Rheumatology and Clinical Immunology, Universität zu Lübeck, 23562 Lübeck, Germany for supporting us on the utilization of the Lübeck Medication Satisfaction Questionnaire (LMSQ) [email protected],

This study was supported by University of Gondar and Debre Birhan University with no conflict of interest. The support did not include publication charges.

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‘’M.A. has conceptualized the study and objectives; and developed the proposal. Y.W.B., H.E.A., and A.B.G. criticized the proposal. All authors had participated in the data management and statistical analyses. Y.W.B, M.A., and H.E.A. have prepared the final manuscript. All authors read and approved the final manuscript.‘’.

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Amsalu, M., Ashagrie, H.E., Getahun, A.B. et al. Patients’ satisfaction with cancer pain treatment at adult oncologic centers in Northern Ethiopia; a multi-center cross-sectional study. BMC Cancer 24 , 647 (2024). https://doi.org/10.1186/s12885-024-12359-7

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Received : 17 October 2023

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DOI : https://doi.org/10.1186/s12885-024-12359-7

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