A case study using 2019 pre-monsoon snow and stream chemistry in the Khumbu region, Nepal.

This case study provides a framework for future monitoring and evidence for human source pollution in the Khumbu region, Nepal. We analyzed the chemical composition (major ions, major/trace elements, black carbon, and stable water isotopes) of pre-monsoon stream water (4300-5250 m) and snow (5200-6665 m) samples collected from Mt. Everest, Mt. Lobuche, and the Imja Valley during the 2019 pre-monsoon season, in addition to a shallow ice core recovered from the Khumbu Glacier (5300 m). In agreement with previous work, pre-monsoon aerosol deposition is dominated by dust originating from western sources and less frequently by transport from southerly air mass sources as demonstrated by evidence of one of the strongest recorded pre-monsoon events emanating from the Bay of Bengal, Cyclone Fani. Elevated concentrations of human-sourced metals (e.g., Pb, Bi, As) are found in surface snow and stream chemistry collected in the Khumbu region. As the most comprehensive case study of environmental chemistry in the Khumbu region, this research offers sufficient evidence for increased monitoring in this watershed and surrounding areas.

Polythermal structure of a Himalayan debris-covered glacier revealed by borehole thermometry.

Runoff from high-elevation debris-covered glaciers represents a crucial water supply for millions of people in the Hindu Kush-Himalaya region, where peak water has already passed in places. Knowledge of glacier thermal regime is essential for predicting dynamic and geometric responses to mass balance change and determining subsurface drainage pathways, which ultimately influence proglacial discharge and hence downstream water availability. Yet, deep internal ice temperatures of these glaciers are unknown, making projections of their future response to climate change highly uncertain. Here, we show that the lower part of the ablation area of Khumbu Glacier, a high-elevation debris-covered glacier in Nepal, may contain ~56% temperate ice, with much of the colder shallow ice near to the melting-point temperature (within 0.8 °C). From boreholes drilled in the glacier's ablation area, we measured a minimum ice temperature of -3.3 °C, and even the coldest ice we measured was 2 °C warmer than the mean annual air temperature. Our results indicate that high-elevation Himalayan glaciers are vulnerable to even minor atmospheric warming.

Non-surgical interventions for pelvic organ prolapse in rural Nepal: a prospective monitoring and evaluation study.

OBJECTIVES: Pelvic organ prolapse (POP) is a major cause of morbidity in Nepal, particularly affecting women in the rural communities. Women with POP in Nepal may suffer from symptoms for decades. At present, the Government of Nepal advocates surgical intervention but access to surgical care is inadequate. This report evaluated the feasibility of a non-surgical public health programme in rural Nepal, and describes risk factors associated with POP in this setting. DESIGN: Prospective monitoring and evaluation study of a new public health programme. SETTING: Baglung district, rural Nepal. PARTICIPANTS: Women with gynaecological symptoms of POP. MAIN OUTCOME MEASURES: Risk factors for disease progression were assessed using Fisher's exact test, Pearson's χ(2)-test and logistic regression analysis. RESULTS: Of the 74 women included in this analysis, 70.8% were diagnosed with stage 2 POP or greater. The majority of women did not have any further children following the onset of POP symptoms (63.5%). Duration of symptoms ranged from 2 months to 60 years, with 73.4% of women suffering for over 5 years and 28.4% suffering for over 20 years. Univariate analyses identified age at screening, age at onset of symptoms, the duration of symptoms and an associated rectocele as factors associated with increasing POP severity (p < 0.05). Kegel exercises were taught to 25 (33.8%) women with POP and ring pessaries were offered to 47 (63.5%) women with POP. CONCLUSIONS: Non-surgical interventions may provide an opportunity to address the significant burden of POP in rural Nepal.