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In the past decade, 12,000 Nepalis have died in an increasingly brutal civil war that pits a backward-looking monarchy and an abusive military against fanatical Maoist rebels. To help solve the crisis, the rest of the world must convince both sides that there is a third way.

Background Nepal faces a rising burden of noncommunicable diseases (NCDs), yet Gurkha veterans—a population with distinct sociocultural backgrounds, occupational exposures, and post-service lifestyle transitions;remain largely overlooked in NCD research. Their increased susceptibility to sedentary behavior and unhealthy dietary habits may contribute to heightened NCD risks. This study assesses key behavioral (smoking, alcohol use, diet, and physical inactivity) and metabolic (obesity, elevated blood pressure) risk factors and identifies predictors of hypertension among Gurkha veterans. Methods A community-based cross-sectional study was conducted in Palpa district, Lumbini Province, Nepal, in 2019. A multistage sampling technique was employed to determine the sample size, and a total of 189 Gurkha veterans were interviewed for data collection. Data were analyzed using SAS software (Version 9.4). A Bivariate analysis was conducted to assess the statistical associations among NCD risk factors, followed by multivariable logistic regression to identify independent predictors of hypertension while controlling for potential confounders. Results The study revealed a high prevalence of daily alcohol consumption (41.80%), and inadequate fruit intake (89.95%. Likewise, 28.57% of the Gurkha veterans had lower intake of vegetables and 26.98% of them were performing low physical activity of vigorous level. Moreover, 35.98% had overweight and obesity and, nearly half of the participants (47.62%) were hypertensive. Multivariable logistic regression showed that daily alcohol drinkers (AOR: 3.13, 95% CI: 1.56–6.25, p =0.001), those engaging in less than 75 minutes per week of vigorous physical activity (AOR: 4.82, 95% CI: 1.89–12.30, p =0.001), and those with overweight or obese status (AOR: 3.50, 95% CI: 1.70–7.22, p <0.001) had significantly higher odds of having hypertension. Conclusion Alcohol consumption, physical inactivity, and obesity were the strongest predictors of hypertension among ex-Gurkha soldiers. Given the distinct lifestyle transitions and health challenges faced by this population, targeted early screening, at the community level with a continuum of care and health promotion strategies are essential to mitigate the NCD burden among retired Gurkha soldiers.

The burden of adolescent depression is high in low- and middle-income countries (LMICs), yet research into prevention is lacking. Development and validation of models to predict individualized risk of depression among adolescents in LMICs is rare but crucial to ensure appropriate targeting of preventive interventions. We assessed the ability of a model developed in Brazil, a middle-income country, to predict depression in an existing culturally different adolescent cohort from Nepal, a low-income country with a large youth population with high rates of depression. Data were utilized from the longitudinal study of 258 former child soldiers matched with 258 war-affected civilian adolescents in Nepal. Prediction modelling techniques were employed to predict individualized risk of depression at age 18 or older in the Nepali cohort using a penalized logistic regression model. Following a priori exclusions for prior depression and age, 55 child soldiers and 71 war-affected civilians were included in the final analysis. The model was well calibrated, had good overall performance, and achieved good discrimination between depressed and non-depressed individuals with an area under the curve (AUC) of 0.73 (bootstrap-corrected 95% confidence interval 0.62–0.83). The Brazilian model comprising seven matching sociodemographic predictors, was able to stratify individualized risk of depression in a Nepali adolescent cohort. Further testing of the model’s performance in larger socio-culturally diverse samples in other geographical regions should be attempted to test the model’s wider generalizability.

How do non-state armed groups (NSAGs) survive and even thrive in situations where state armed groups (SAGs) collapse, despite the former’s often greater material adversity? We argue that, optimizing under their different constraints, SAGs invest more in technical military training and NSAGs invest more in enhancing soldiers’ intrinsic payoffs from serving their group. Therefore, willingness to contribute to the group should be more positively correlated with years of service in NSAGs than in SAGs. We confirm this hypothesis with lab-in-the-field and qualitative evidence from SAG and NSAG soldiers in Nepal, Ivory Coast, and Kurdistan. Each field study addresses specific inferential weaknesses in the others. Assembled together, these cases reduce concerns about external validity or replicability. Our findings reveal how the basis of NSAG cohesion differs from that of SAGs, with implications for strategies to counter NSAG mobilization.

Unable to attract enough voluntary recruits, many rebel groups rely on force to fill their ranks. Given that the group used force to compel individuals to join, a coerced conscript would be presumed unlikely to be loyal and would be expected to desert at the first opportunity. Yet, groups that have relied on coerced recruitment retain their members just as well as, if not better than, rebel armies that rely on voluntary methods of recruitment. This is a puzzle. How do rebel groups maintain allegiance and prevent desertion, especially if they rely on abduction to staff their ranks? A recruit can be forced to join a rebel group, but continuing to rely on coercion to enforce retention is too costly and not sustainable. These groups must find a way to reduce the costs of retention. The solution to this puzzle rests in the mechanisms of socialization that shape the allegiance of forcibly recruited soldiers. Socialization mechanisms are traced through three outcomes: compliance (or Type 0 socialization), role learning (Type I socialization), and norm internalization (Type II socialization). Integrating socialization theory and a rational choice analysis demonstrates that mechanisms that alter preferences through Type II socialization are effective in retaining recruits; the highest level of retention occurs when several mechanisms work in concert. Illustrative case studies of the Lord’s Resistance Army from Uganda, the Revolutionary United Front in Sierra Leone, the Maoists in Nepal, and the Liberians United for Reconciliation and Democracy (LURD) show that a reliance on child soldiers, group assets (pecuniary and nonpecuniary), organizational structure, and the nature of military contestation shape when different mechanisms are effective or not.

The dynamics of conflict (de)escalation by social movements or political opposition groups have attracted cross-disciplinary interest among social scientists, but there remain several knowledge gaps to be filled. On the one hand, there is already extensive research on the shifts from unarmed expressions of collective grievances to the adoption of violent strategies by oppressed constituencies or 'minorities at risk', as well as on the transition from armed insurgency to negotiations, demobilization, reintegration and conventional politics. However, there is scarce scholarship on the phenomenon of armed groups shifting their conflict-waging strategies from violent to nonviolent means, especially in contexts which cannot be resolved by force but are also 'unripe' for conventional de-escalation methods through negotiation and political integration. This article offers a first attempt to fill this conceptual and empirical gap, by investigating the nature and the drivers of transitions from armed strategies to nonviolent methods of contentious collective action on the part of non-state conflict actors. It focuses in particular on the internal and relational/environmental factors which underpin their decisionmaking process, from a change of leadership and a pragmatic re-evaluation of the goals and means of insurgency, to the search for new local or international allies and the cross-border emulation or diffusion of new repertoires of action. This multilevel analysis draws from past research on various self-determination or revolutionary movements which fit the scope of analysis (i.e. Nepal, Egypt, Palestine, West Papua, East Timor, Mexico and Western Sahara). The article also points to the need for more systematic enquiry on these cases through in-depth comparative empirical analysis.

Public lands including forests and community pastures are still crucial means of local livelihood, social security, and environmental conservation in many developing countries including Nepal. However, these resources are increasingly managed primarily to offset greenhouse gas emissions of developed countries. The new management has exacerbated many local problems: livelihood constriction, social crises, human casualties (deaths and serious injuries), biodiversity degradation, and water scarcity including cryosphere retreating. Drawing data from multiple sources, this study attempted to explain the international political objectives and processes that dispossessed developing societies of public land resources for the benefit of developed countries. It shows that representatives of the developed countries were proactively and strategically involved in agenda formation, solutions negotiations, and decision-making while developing international environmental policies, and succeeded to structure the policies for managing the resources of developing countries for the best benefit of their own countries. The developed countries provided funds and experts, as strategic tools, through international aid agencies to implement the policies of their interest in institutionally weak countries. In Nepal, the aid agencies influenced the thinking of the public and the decisions of the government and other stakeholders through a series of strategic measures. They propagandized false crises, worked with a coalition of powerful international agencies, offered free technical support, and changed national policies proactively to manage the land resources for achieving their missions. Active involvement in policy implementation also helped the agencies to monitor implementation hurdles and apply other tactics to resolve them. Lucrative flash incentives were provided to motivate and get the support of communities, powerful stakeholders, and politicians to implement the policies. Psychosocial pressures were also applied to persuade local communities and their leaders for getting local cooperation in making and practicing new legal institutions (government authority rules or orders, user group rules, and forest management plans) that bind and control local communities for forest protection. The institutions obliged local communities to contribute free labor or cash for developing, modifying, and protecting the forests. These two levels of interventions led to the further development of reinforcing institutions, resource conditions, and social-ecological systems that secured benefits for developed countries and deprived local communities of power to control, produce and access the public land resources in their own backyard for years. This study also showed that international environmental policies and aid agencies have respectively served as institutional weapons and vehicles for materially and institutionally powerful countries to colonize the land resources of weaker countries, without using of physical coercion or deplyment of military forces.

On 25 April 2015, a 7.8-magnitude earthquake struck Nepal. Soon after, the Israel Defense Force (IDF) dispatched a rapid-response team and opened a tertiary field hospital in Kathmandu. There is limited data regarding the spectrum of diseases among rescue teams to disease-stricken areas. The aim of this study was to assess the morbidity among the field-hospital staff during the mission. The rescue team was deployed for a 2-week mission in Kathmandu. Pre-travel vaccinations were given prior to departure. The field-hospital was self-equipped including food and drinking water supply with a self-serving kitchen, yet had a shortage of running water. A Public Healthcare and Infectious-Diseases team was present and active during the entire mission. A survey assessing the morbidities and risk-factors throughout the mission was performed at the last day. One hundred thirty-seven (69%) team members completed the questionnaire. Medical complaints were recorded in 87 of them (64%). The most common symptoms were gastrointestinal (GI) (53% of all responders, 84% of the 87 with symptoms). Respiratory symptoms were recorded in 16% and fever in only 8%. There was no significant difference in the rate or spectrum of morbidity between the medical and the non-medical staff. The Israeli field hospital was a stand-alone facility, yet 53% of its' staff suffered from GI complaints. Prevention of morbidity and specifically of GI complaints upon arrival to a disaster-stricken area in a developing country is difficult. Medical teams in such missions should be acquainted with treating GI complaints.

Our objective was to elucidate how culture influences internal (psychological), external (social), institutional (structural), and health care (medical) processes, which, taken together, create differential risk of comorbidity across contexts. To develop a conceptual model, we conducted qualitative research with 13 female child soldiers in Nepal. Participants gave open‐ended responses to intimate partner violence (IPV) vignettes (marital rape, emotional abuse, violence during pregnancy). Twelve participants (92%) endorsed personal responses (remaining silent, enduring violence, forgiving the husband). Twelve participants endorsed communication with one's husband. Only four participants (31%) sought family support, and three contacted police. Ultimately, 12 participants left the relationship, but the majority (nine) only left after the final IPV experience, which was preceded by prolonged psychological suffering and pregnancy endangerment. In conclusion, comorbidity risks are increased in cultural context that rely on individual or couples‐only behavior, lack external social engagement, have weak law and justice institutions, and have limited health services.

Successfully reintegrating former rebels into civil society is a crucial task in post-conflict countries. In the aftermath of a decade-long conflict (1996-2006) in Nepal, management of arms and armies became a major issue in the domain of post-conflict peacebuilding. \"From Combatants to Peacemakers\" was an initiative to promote peace and harmony among the former ex-combatants and host communities. In this context, this article highlights the role of social dialogue, which proved effective in promoting social harmony, peace, and reconciliation among ex-combatants and community members in Nepal. Also, the article explicates the worth of social dialogue that may be used in other parts of the world to successfully reconcile former antagonist groups into the same communities.