Letter to Bernie Sanders



Dear Bernie,

Two years ago, even before you announced candidacy for the president of United States of America, I lived in a little village of western Nepal, where I shared kitchen with a Peace Corps volunteer from your country. I explained to him why I felt lucky to have been born in Nepal, as ours is a country still in making and our opinions and actions can make a difference in shaping its future. Unlike USA, where a system already in existence is so concrete and rigged that it is impossible for a common man’s voice to be heard.

Rigged in a sense that elections, federal or presidential, cost lots of money and are paid for by the groups with special interests. These groups, who represent the top ten percent of America’s economy, who are worth as much as bottom ninety percent, have such a favorable system in place that they get richer everyday while ordinary people struggle to place decent meals in their plates, let alone affordable healthcare or higher education for their children. Most of the new income goes into the pockets of top one percent. Fifty percent of those that manage to go to colleges come out in heavy debts. Out of three black kids, one has a lifetime chance of getting into prison. Veterans do not get basic health services.

Wall Street that helped create the financial crisis of 2008 was bailed out by taxpayer’s money, because it was ‘too big’ to fail. Only that it emerged through the crisis 8o percent bigger, while millions of Americans lost their jobs and houses. Because Wall Street contributes hefty in election campaigns. So do fracking fossil fuel companies and climate change becomes a nonissue. NRA pays, so they do not talk about gun control. Pharmaceuticals are okay to sell drugs at prices hundreds times higher than production cost. Corporations can outsource works, evade taxes, and underpay. As long as they donate to the super PACs.

I did not believe there was a maikelaal who could challenge such a sophisticated system.

But you proved me wrong. A rare social democrat, you have managed to contest this nomination depending entirely on the money raised through individual donations, from person to person. Who could be voice of a common man, if not you?

At 71, you are the oldest candidate ever to stand in US presidential elections, ironically the one with most progressive, borderline radical, ideas. And this has appealed to the younger population, so much that you have won the majority of votes of people aged 45 or younger, in every state contested. This is a big leap from generation who grew up reading ‘Animal Farm’ in their high schools. Now they have flirted with the idea of socialism.

A Jew that can criticize Israel

Jews are the most persecuted community throughout history. But Israel’s recent responses to Palestinian aggression have been way too disproportionate. Killing hundreds of children in Gaza, destroying schools and hospitals to retaliate misfiring Hamas rockets is not fair. Most US politicians see this as Israel’s right to defend itself, but you call spade a spade. Treating Palestinians right, with respect and dignity is the primary step in attempting to solve this chronic conflict.

Why do I care?

Why do I care if Trump builds walls or Bernie makes bridges?

I see things happening in this world that are beyond my comprehension. Hundreds of girls get kidnapped in Nigeria, we can’t do a thing about it. I don’t understand, why. Why can’t we stop thousands of European fighters, the likes of Big Johh from flocking to Middle East for Jihad, or stop them from coming back with terrorist intents and skills? Why thousands from North Africa embark a treacherous journey to Europe in little boats, to drown, to end up in destitute camps in places they are not welcome, or simply get sent back? Why can’t we make their homelands safer and livable?

Proxy wars between big nations fought in poorer countries, cost hundreds of lives every day, unmourned and unnoticed, while we je suis Charlie in most poignant way, is in itself very poignant. European and American lives should not be worth more than that of a Syrian, or a Rohinga, or a Libiyan.

The burden of world peace lies in the shoulders of world leaders. Now the time has come when these leaders of conflicting interests sit down together and make a commitment on common values, not necessarily democratic, but based on principles of humanity and fairness. And actively pursue those agenda- strategically or militarily. We have to dismantle wrong governments, belligerent groups and radicals, who have thrived on conflicts. Terrorists may hide and run but what about the factories that make weapons?

In response to the recent Orlando shooting, you said it was more of a problem with lack of gun control, than radical Islam. I totally agree. Applying same logic, modern terrorism is more a consequence of easy and perpetual availability of weapons of war than religious fanaticism.

Changes do not come from barrel of guns

My country had a decade long civil war, bloody and devastating at many levels. It was for a change, they said but we live essentially the same life. Same crooked leaders, and same crappy living situation.

We saw Arab spring. From Tunisia to Libiya to Egypt to Syria. These recent conflicts have made lives much more miserable for the people than it was already.

But you have started a revolution in USA, effectively challenged the establishment and proved that voice of a common man can be heard, without hurting a soul. Changes come when educated, young people decide that the existing system is not working and not destroy it by force or conflict but by simply challenging it and forcing it to change. That seems like a very good idea. Lets call it Bernism.

Hillary Clinton would not do very bad as a president herself, now that she has engaged herself in the dialogues of equality and righteousness. But she when it came to the question of minimum wage, she was happy with 12 dollars an hour. You demanded 15. That sums up the difference.

Dr. Chirayu Regmi,

Resident MD, Internal Medicine

(This article was posted in this blog when democratic contest for presidential nominee was still on, was taken down temporarily with hopes of publication in some national daily- that they wanted a fresh article. But they failed to do. And the article is back in its rightful place)




गाजापट्टिको चेकपोष्टमा
हुइङ्केर एउटा गाडी आयो,
बटुवालाई दियो ठक्कर,
भीत्र कोहि करायो- ‘अल्लाह हु अकबर’

त्यो रात भूमध्य सागरको पूर्वीतटमा
स-सम्मान नगर परिक्रमा गर्यो- दुइटा यहुदीको लाशले,
आत्मघाती चालकलाई झन्डा ओढायो, अर्कोतिर हमासले।

न कसैको हित भो, न कसैको जित भो
तर जे भो, राष्ट्रियता सहित भो,
त्यसैले दिवंगत तीनैजनालाई
घोषणा शहिद भो !

मैले कसबलाई शहिद भन्नेहरु देखेको छु,
मैले आत्मबलका खातिर लाश, गन्नेहरु देखेको छु,

शहिद तँ को होस्?

क्याम्बोडियाको म्युजियममा खचाखच भरिएको खोपडी होस्?
कि गुजरातको दंगामा जलाइएको अब्दुल मिंयाको झोपडी होस्?

बिस्फोटमा पड्किएर टुक्रा टुक्रा, जिहादीको शरीर होस्,
कि अरुहरुकै युद्धमा स्वर्ग जाने, गोर्खाली बीर होस्?

अनार्य होस् कि, हिटलरले मारेको?
कि शुभास चन्द्र बोस, कसैले गाएब पारेको?

तँ तुत्सी होस् कि हुतु होस्,
तँ नुएर होस् कि दिन्का होस्
कि त सँधै उत्सर्गमा तल्लिन,
यगोपावितको सिन्का होस्?

सेनाले मारेको माओबादी होस् कि,
माओबादीले मारेको सेना होस्,
या जनता होस्, क्रस फायरमा भेटिएको,
कि मुक्तिनाथ होस्, खम्बामा बाँधेर रेटिएको?

आफैमा आगो सल्काएर,
भुतभुताउदै मर्ने दलाइ लामाका चेला होस् की,
आफ्नै छाती ठोकी हिड्ने, अशुराको मेला होस्?

तँ रोहिंगा होस् कि राष्ट्रहिन,
या राजा बिरेन्द्र, सत्तासीन?
तँ बामियानको बुद्ध होस्?
पेशावर मात्रै होस् कि तँ
वजरिस्थान सुद्ध होस्?

तँ कश्मिर भए,
क्वेटा पनि त होलास,
सिमानाको उता भए तँ,
यता पनि त होलास !

तँ सुन्नी होस् कि सिया होस्?
तँ मुजिब होस् कि जिया होस्?
राजीव गान्धी कि प्रभाकरण,
तँ हामी जस्तै होस् कि,
अलि छुट्टै, असाधारण?

मलाई लाग्छ,
तँ झिल्का होस्,
जसको उज्यालोले निदाई रहेको समाज जाग्छ-
तेरो मृत्युले बाँचेकाहरुलाई-
यथास्थितीको क्रूरता बताउँछ
र परिवर्तनकालागि प्रेरित गर्छ।

त्यहि त हो तात्पर्य?
तैले मरेर फ़ुट्दैन पहाड, बन्दैन बाटो।

सडक दुर्घटनामा परेर मर्नेहरुले यदि,
देशलाई सडक सुरक्षाको प्रेरणा मिल्छ भने,
त्यो पनि शहिद हो।

तर मृत्युसंग अभ्यस्त भैसकेको समाजमा,
बरु गढ़िमाईको राँगो शहिद होला,
तँ शहिद होइनस,
फगत एउटा संख्या होस्, कागजमा एउटा अंक-
मुख्य समाचारको सानो अंश भन्दा बढी तेरो महत्व छैन
शहिद दिवसको भोलिपल्ट बढारिने,
मुर्झाएका मालाहरु भन्दा बढी तेरो मूल्य छैन

जब मृत्यु प्रति सह-अनुभूति हराउदै जान्छ
जब पिना सुक्दै र काग कराउदै जान्छ-
तैले मरेर हुदै हुदैन
सुन्ने कोहि भए बोल बरु,
पढ्ने कोहि भए लेखे हुन्छ-
किनकी आहुतिले हुदैन उज्यालो बिहानीको,
उदयले हुन्छ !

चिरायु रेग्मी

Bad Habit

-Chirayu Regmi


You are my choco-pie

Not so sweet

You are my bye bye-

Couldn’t quite do it

You make the background of all I do,

You are the constant music in my head,

You got me hanging by my neck, baby

Till I drop down dead.

Element of my own desire,

you are my funeral pyre,

Smoking my shoulder blade.

You numb my senses,

And kill my wit,

Baby, you are a bad habit,

I really need to quit.

Okay, now

images (1)

Relaxed, maybe good for blood pressure. But how about life?

How about in your prime, when you are young and strong? You are relaxed with your situation- very much comfortable with it. 8 hours of loadshedding a day, noise, pollution, crappy leadership in the country, mis-judged policies. Hooliganism and anarchy. Injustice. If you are relaxed and do nothing about it. Then your situation is not going to change, you have to speak when you need to, fight when you need to stand up against something. (my)Old saying- it is more difficult to be on the wrong side- they might look intimidating- but they can’t fight. Because righteousness is always a bigger sword.

So don’t shy from confrontations- for there will always be. Problems don’t solve by itself, they need to be nailed down. And you can’t depend on anyone else to solve your problems. You got to do it on your own.

No that takes time too. And effort. I am at a situation where I need all my efforts to be best placed to my studies, so I can specialize early enough, make good money by 40s and then do what I want to do for the rest of my life. Most of the people would end their life at what I want to achieve at forty. But I want more- much more. My dreams don’t end with good house, cars and family. I want to get into politics, I want to write, I want to make the difference that I believe in. For that I need a base- to know that I have done for my family- made enough money to live by comfortably. Because getting into politics is a slow process. It will undermine my existence at first, they will all downplay my capabilities. I might even implode. So it’s a survival strategy- that I earn first. Become filthy rich. I am not going to ignore my family’s needs and put the country first. Yes, I do have big plans for the country. But I don’t believe in sacrifices. I don’t agree with bigger the sacrifice, bigger the difference. I will (okay, say selfishly) do with my personal priorities first. I am not a selfless hero.

Thus, I have to stop procrastinating now. I have been in an intellectual coma for a very long time. I have to come out of it. Be alive. For the time, is passing by. And if I don’t build a foundation for my future now my dreams would never realize. If not for dreams, what is there to keep living?

About love, I have loved. Truly, most wonderfully and most sickeningly. It would not be something entirely missing in my life. Though I miss being in love, I can’t afford time to cajole one. So, I will put that in my ‘in a while list’.

I have a long way to go. And fast. So I need to work hard.

Robert Forst said,

Woods are lovely, dark and deep

But I got promises to keep

Miles to go before I sleep.

Miles to go before I sleep.

I missed You

I missed you for so long,

and so bad 

but I realized 

It was not you that I missed.

Or the lover You were

But I missed the Love 

I was in,

and that Love was,

entirely mine-

You were but, a mirror-

where I could see

reflection of my own affection.


Where you existed in me,

is a vacant space now-

but that doesn’t make you irreplaceable-

For in winters,

a hand needs a glove

and a dove needs a dove.

My old love,



Random things on my mind



The blog is infact, named that. But I have not been quite so random. Let me be.

’14 has been a bad year for aviation industry. Malaysian A380 still missing, another one shot down in Ukraine with all the travelers dead, and as of yesterday- a Taiwanese domestic carrier went down trying to make an emergency landing.

Its been a bad year so far- bad for humanity. And shameful too, for us who are merely spectators of the extreme form of injustice around the world- and can do nothing about it. Not just a common folk like you and me, but the very UN, who is entrusted with such a job.

1. Fall of Muslim brotherhood in Egypt, a military coup- who is passing indiscriminate sentences, prosecuting opponents, free thinkers, including journalists. Devolution of Egypt from the great nation it once was.

2. Hundreds of girls abducted by boko haram in Nigeria, to be raped and enslaved- and we could do nothing about it.

3. ISIL, a sunni militant group, who were once aided arms and otherwise by US, NATO(in Syria, to fight proxy war against Russia/Assad)- surge most of Iraq- with Iraqi government now weak and helpless- as foreign forces that invaded the country to find ‘weapons of mass destruction’ turned it upside down, only not to find it and left- can’t defend its ethnically diverse population- shias, kurds, christians etc. Its terrible to see them lined up and shot in the back. And we can do nothing about it.

4. People of Ukraine kill each other, in ethnic lines- but the conflict is, a mere tug of war between Russia and rest of Europe. Why pay so heavy.

5. Tragic of all is killing of people of Palestine by Israel, most of them commoners- unarmed men, women and children. I can’t even comprehend how such a thing can happen in this ‘modern’ age. But, Israeli airport had to be closed for a couple of hours due to air raids from gaza, makes a bigger news than thousands being killed on the other side.

I abhor international community, the UN, leaders of today for not doing what they can do to save innocent lives around the globe.

Someday, I will make a difference.

p.s- I started meaning to write all the random things I had in mind, but the tone of this post has turned so grave, other petty thoughts don’t even compare. But they are there too, I will post separately.

On Revolutionary Medicine



The life of a single human being is worth a million times more than all the property of the richest man on earth.’ Che Guevara, 1960.

Upon being hit by jet liners in the terrorist attack of 9/11 the Twin Towers of New York City collapsed and turned into rumbles within minutes. Thousands of people were buried inside. Brave American men, fire fighters, first responders along with many civilians volunteered to help, amid lots of smoke, dust and pain.  As a consequence of unprotected exposure to pollutants and trauma, many of those who volunteered developed a variety of respiratory illnesses ranging from pulmonary fibrosis to cancer. Many had psychological terrors like PTSD. When they sought for healthcare in American hospitals, they were denied such, as their insurance did not cover the deliberate exposure of oneself to hazardous conditions. Paying on your own is way too expensive.

As depicted on a documentary called Sicko by Michael Moore, some of these patients sail on speedboats to reach Havana, Cuba, where they receive free checkups, treatment and plenty of medicines to take back home.

Even if we doubt the facts laid by Moore, there is one thing we can all agree upon- though highly sophisticated, the capitalist-styled profitable healthcare system of USA is non universal and thus, a non-existence to many of its own citizens.

Cold war is over. Capitalists have emerged victorious in all but one front- provision of free and high quality essential services to all, like police service for security, emergency responders for fires or any other calamities, health and education. Yes, I deliberately put doctors, teachers, firemen and policemen in the same context, because as much as it is the responsibility of the government for the peace and security of its citizens, it is, for universal health and public education. There can be another discourse on education. This time we talk about health.

Driving around Kathmandu, I see many hoarding boards of private clinics and hospitals. They advertise of services and make promises- like a fairness cream would promise a glow. Such an utter commercialization of health care- it breaks my heart. If you delve in deeper, you can realize the ugliness behind posh medical facade. There are many private hospitals in the city with ‘marketing officers’, whose sole duty is to call ambulance drivers to negotiate commissions for bringing a critically ill patient to them, which is often as high as 4000 rupees. Imagine the size of the bill on discharge.

Poor patients are often denied proper medical care. Every other day some newspaper runs an impromptu piece on how a patient died due to a doctor’s negligence and hospital got vandalized. How government hospitals are understaffed and unclean. And about corruption in purchase of life saving drugs like misoprostol.

But all these examples represent merely the tip of an iceberg. Everything that is wrong with existing health care system is due to chronic lack of vision and planning in making of health care workers, doctors and dispatching them for duty.


Making of a doctor

Despite being a profession underpaid and overworked, exploited and allegedly, mundane- our society fancies in their sons and daughters becoming doctors. With dull economy, a medical job might look more secure than other things, so there are many who want to become doctors- which is not bad at all- so many people signing up for a service oriented profession like this. But there’s a catch- we don’t have proper medical education system in our country. We have just one government medical college providing about 40 undergraduate scholarship seats, and rest of the private or semi private institutions serve the desires of aspiring doctors, but in a very high price. It costs at least 4 million to become a MBBS doctor. The prospect is as grim for post graduation studies. Scholarship seats are so few, an aspiring doctor has to either provide his service elsewhere like USA or Australia or pay as high as 10 million or even more to specialize.

Medical education should be free, and to the deserving students. Because the profession is such- where you work really hard through med school and the whole life; where study and work are lifelong priorities; subduing personal comforts or family life; where you skip meals or sleeps for strangers called patients.

The irony is, society expects doctors to invest like a businessmen and serve like a clergyman. It simply cannot happen.

Prof. Dr. Govinda K.C led a fast unto death against such a system, a part of it. Motive behind was to make post graduation scholarships available and of high standards. But despite medical doctors all over the country striking for several days, it could not bring anything tangible. It is because neither our brotherly organization NMA nor governing body NMC has realized impending failure of the system. Or even if they do, they are too happy to complain with the commissions provided by private colleges. But I am not. I worry for the moment when someone in my family gets ill and needs a sophisticated medical care. USA or Singapore or Delhi is beyond everyone’s reach. We have to improve our system and survive here.


Where does all the health budget go?

Yes, we do get an ample amount of budget for health care. This covers the salaries of government medical staffs, which they receive for attendance at their institution, and their bhattas which they receive for doing everything else. That is okay, in light of meager salary they obtain for such a hard work (which indeed is, if they work as per norms and needs). But a big chunk of it is wasted through a syndicate of NGO/INGOs with collaboration of health bureaucrats especially during June/July, at the closure of fiscal year- in programs and projects hurriedly planned and carelessly executed. Global Fund provides huge financial support to the government to be spent through partner organizations, and they work- mostly on paper and reports. With most of the aid bearing managerial cost of the projects, they fail to bring any tangible change. To improve overall health of the people, to reach the goal of ‘Health for all’ as we signed in Alma Ata in 1978, all this money should instead be used in establishing a proper health education system in the country, so we can have skilled and willing-to-serve human resource. After all, we cannot depend on foreign aids for the health of our people.


How to solve?

A scientific and sufficient health service delivery system, reaching people.

A medical education system to teach, train and produce doctors, nurses and other paramedical staffs.

We have 3600 VDCs in the country. Each VDC has a Health Post, the basic unit of our health organogram. It should have a Health Assistant incharge, with 2 AHWs. Co-existing birthing center should have a staff nurse with 2 ANMs. At next level is a Primary Health Center covering an electoral constituency, which we have 240. Since it provides OPD services to a larger number of and referred cases from Health Posts, in-patient along with 24 hours emergency services, it should have 3 medical officers (doctors) with 2 HA and 5 AHW. Birthing center at this level should have a nurse with Bachelor’s degree, with 2 staff nurses and 5 ANM. PHC will also be overseeing all the community level preventive health programs like immunization, infant care, hygiene etc, rendering NGO led activities redundant. It will be a cost cutting measure in long run.

Each district hospital should be able to treat 80 percent of the cases. After all, it is a health center for the whole district. It should have a double team of consultants (there should be at least two of medicine specialists, gynecologists, surgeons etc) so that one of them can be available all the time; nobody can work 24 hours a day and 365 days a year, thus. It should have a team of 6 medical officers and other paramedical staffs in proportional ratio.

Zonal hospitals should become tertiary centers; teaching hospitals. With ICU, CCU and higher specialists, it should be able to solve 90 percent of the cases. It will have highest flow of the patients, highest concentration of doctors, labs and everything. Since lack of free medical education is a core issue, each of these 14 zonal hospitals will have excellent medical schools, providing 50 scholarship seats for undergraduate studies every year (a total of 700!), to deserving candidates- irrespective of caste, sex, or hometown- but based purely on merit- for we want the best to become doctors and deal with our life and sickness, not the lesser competent.

Such academic centers will not only produce free education to aspiring doctors and nurses but also vacancies for professors- who will now be available at zonal levels. They will mentor post graduate students. With two PG seats in each faculty (including both clinical subjects like medicine, surgery and basic sciences like anatomy, pathology etc)- we will be producing about 30 specialist doctors from every zonal center.  Multiply that with 14 teaching hospitals- we will be providing higher medical education to more than 400 doctors every year, which is a great leap from existing 40. With residents to work round the clock in such hospitals providing meticulous care to patients, service quality will greatly improve and upon graduation they will serve at district hospitals, replacing the consultants who will now become a faculty at zonal teaching hospital. Not only will there be a constant production of medical graduates and specialists, there will be a system of service at all levels, as a clinician and as a teacher- and a timely retirement.


With highly sophisticated zonal centers, we would not need the namesake sub regional hospitals. Regional centers will take care of all unsolved cases. Here, professorships will be awarded to consultants, and higher specialization courses will be offered. It will also be the center for skill based trainings and research- where we will invent and devise ideas to revolutionize medical science, provide something to humanity. There will be government pharmaceuticals producing high quality drugs and these medicines will be provided for free- just like medical care would be.

Further, some highly populated districts can have two or three district-level hospitals of equal stratum and formation, each one of them responsible to zonal centers. Big cities can have a couple more; in addition to specialized centers for trauma, heart, kidney etc. But this new plan will discourage people to cluster around cities, since (availability of) health facility is one of the reasons why people migrate.

One might ask, what will be the role of private hospitals and medical colleges, then? They should be graciously thanked for the service they provided when there was none, and asked to seek business elsewhere, for healthcare is not a business and it should be free, for all.

The system as it is, is already a mess and on the verge of a breakdown. If we really want the state of affairs to improve, we- the people, the doctors, the clients, the stake holders should do more than just lament or charity. We need to work on similar plans and preserve to the realisation.

This whole idea might appear audacious to many. I would like to quote Che again, ‘At the risk of seeming ridiculous, let me say that the true revolutionary is guided by a great feelings of love.’


Dr. Chirayu Regmi

(who is doing his part at a primary health center in Shrigaun, Dang)