Field School

Planetary Health 2025

Lumbini to Lo Manthang (L2L) — Planetary health across the Himalaya

14 May – 7 June, 2025 Lumbini to Lo Mangthang, Nepal

Program Overview

The 2025 L2L Field School was an interdisciplinary, field-based learning experience designed for undergraduate students from diverse academic backgrounds, including environment, engineering, humanities, and health sciences. The program brought together 17 participants: 7 from Nepal, 7 students from Duke University, USA, and 3 students from member universities of the Himalayan University Consortium (HUC) (China and India).

The three-week journey from the Terai lowlands to the high arid Himalayan region of Nepal provided an excellent natural laboratory to explore the effects of global change on human health and well-being. Students were empowered to learn about a range of interlinked issues: climate change and health, land use and disasters, environment and spirituality, gender, caste and inequalities — all components of Planetary Health.

Fig. Study map of the transect from Lumbini to Lomanthang

Itinerary

  1. 01

    Lumbini 100 masl

    The starting point of the journey and the birthplace of the Buddha, in the hot, flood-prone Terai region.
  2. 02

    Mid-Hill Regions ~1,000 masl

    Students explored health institutions and the oldest town of the Mid-hill settlement of Tansen, as well as the touristic town of Pokhara and its surrounding nature conservation areas and community health contexts.
  3. 03

    Himalayan landscape — culture, climate, health, biodiversity ~3,500 masl

    Students learned how global change is impacting biodiversity in this home of blue sheep, pallas cats, and the elusive snow leopard. Covered: Marpha, Lupra, Muktinath, Kagbeni, Ghami, and Lo Manthang.
  4. 04

    On-foot experience — Lupra → Muktinath → Kagbeni 3,000 → 3,800 → 2,600 masl

    Students trekked up from Lupra to the Muktinath Hindu pilgrimage site and down to Kagbeni, assessing the Lupra and Jyong Khola watershed health — places that have recently experienced severe flood events.
  5. 05

    Tibetan Plateau 3,500 – 3,800 masl

    Students concluded the field school at the Tibetan Plateau in the rain shadow of the Annapurna range, where 3,000-year-old villages (Dhye and Sam Dzong) are being relocated due to climate change.

Learning Objectives

01
Ecosystems

Interactions between communities and environmental change.

02
Disaster Risk

Identify climate risk factors and pathways to sustainable solutions.

03
Health

Environmental drivers of disease burden and psychosocial resilience.

04
Restoration

Sustainable land and ecosystem regeneration practices in the field.

05
Development

Migration, tourism, urbanisation, and changing food systems.

06
Local Knowledge

Indigenous, religious, and ethnic framings of disaster and solutions.

07
Community Engagement

Direct engagement with youth, women's groups, religious leaders, entrepreneurs, and policy makers.

Cross-cutting themes

Sustainability Community resilience Systems thinking Equity and inclusion

Methodology

The field school used the “Doughnut of Social and Planetary Boundaries” framework to anchor the transdisciplinary concept of Planetary Health. The inner ring represents the social foundation (Raworth, 2017; DEAL, 2025) and the outer ring is the ecological ceiling of planetary boundaries (Rockström et al., 2009).

For each of the field school visits, students created a perceptual model to illustrate how each site balances human well-being and ecological sustainability — using the Cambridge Doughnut’s online Doughnut Creator and rating each dimension on a Likert scale from 0–10 (0 = well within the safe space, 5 = boundary, 10 = severe shortfall or overshoot).

Methodology illustration
Fig. Perceptual model of Lumbini, Nepal based on student perceptions.

References

From the Field

Photographs by participants of the 2025 Planetary Health Field School — a visual record of landscapes, communities, and encounters documented by students as they traversed one of Earth's most dramatic climate transitions, capturing what they understand about planetary health.

Sam Dzong lies along the ancient trade route between Tibet and South Asia in Nepal’s storied Upper Mustang district. Situated at an elevation of 4100 m, the village lies north of the 8000m high Annapurna Range, and just below the Tibetan Plateau. Over time, worsening water quality made agriculture and long-term habitation unsustainable. This, and the pull of development has led to the entire community relocating to the purpose built village of Namashung in the next valley. The cause of abandonment is visible in the stream that feeds Sam Dzong. Mineral rich sediment has contaminated the water, rendering cultivation nearly impossible. A makeshift irrigation pipe has been built to bypass the worst of it; enough to grow crops on a small scale, but not enough to sustain a community. Only one field is tended by Chewang Tashi Lama, who still returns to Sam Dzong to grow crops and maintain his family’s home. All across Nepal, farmers and herdsmen relate stories of high intensity precipitation events separated by periods of quiescence. In the past, steady, long-lasting rainfalls would saturate the soil, counterintuitively helping more water get absorbed. The water that gets absorbed feeds the groundwater system, which in turn feeds the mountain springs that are the lifeline for communities in these arid environments. With the current climate crisis, as the groundwater system becomes less vigorous, more minerals and salts are entrained in the waning flow, and when that groundwater emerges as a trickle of a spring, the water quickly begins to evaporate creating a slightly salty tasting ‘mineral water’ that might have the effect of increasing hypertension amongst the people that rely on it for drinking, a more concentrated brine toxic to any crops. The case of Old Sam Dzong demonstrates the human costs of climate change. Water scarcity, soil degradation, and shifting weather patterns continue to displace communities in high-altitude Himalaya today.
Sam Dzong lies along the ancient trade route between Tibet and South Asia in Nepal’s storied Upper Mustang district. Situated at an elevation of 4100 m, the village lies north of the 8000m high Annapurna Range, and just below the Tibetan Plateau. Over time, worsening water quality made agriculture and long-term habitation unsustainable. This, and the pull of development has led to the entire community relocating to the purpose built village of Namashung in the next valley. The cause of abandonment is visible in the stream that feeds Sam Dzong. Mineral rich sediment has contaminated the water, rendering cultivation nearly impossible. A makeshift irrigation pipe has been built to bypass the worst of it; enough to grow crops on a small scale, but not enough to sustain a community. Only one field is tended by Chewang Tashi Lama, who still returns to Sam Dzong to grow crops and maintain his family’s home. All across Nepal, farmers and herdsmen relate stories of high intensity precipitation events separated by periods of quiescence. In the past, steady, long-lasting rainfalls would saturate the soil, counterintuitively helping more water get absorbed. The water that gets absorbed feeds the groundwater system, which in turn feeds the mountain springs that are the lifeline for communities in these arid environments. With the current climate crisis, as the groundwater system becomes less vigorous, more minerals and salts are entrained in the waning flow, and when that groundwater emerges as a trickle of a spring, the water quickly begins to evaporate creating a slightly salty tasting ‘mineral water’ that might have the effect of increasing hypertension amongst the people that rely on it for drinking, a more concentrated brine toxic to any crops. The case of Old Sam Dzong demonstrates the human costs of climate change. Water scarcity, soil degradation, and shifting weather patterns continue to displace communities in high-altitude Himalaya today. © Photo by Rinchen Tamang, text by Hannah Yoon, Rincin Tamang and Tom White.
For over twenty years, Gajendra Sahani and Baile Sahani have made their home in Beni, a quiet town where the rivers meet the hills. Originally from Nawalparasi, close to the Indian border, they have built a life far from where they first began. Each year, when the seasons turn, they set off on familiar paths to Marpha and nearby villages in Mustang, carrying with them the flavours of the plains peanuts, mangoes, and fruits that rarely reach these mountain valleys. Their fruits bring a taste of the lowlands to the mountains. Baile rolled up her sleeves to reveal the tattoos etched onto her arms. One side carries her husband's name, the other her mother-in-law's. Marks of a life shaped early; she was only twelve when she married. The ink, faded but firm, spoke of years gone by, of customs carried through generations. Even now, despite their age, they return to their fields in the Terai during the rainy season to plant seeds, hoping for a good harvest. While their son works as a labourer in the Middle Eastern Gulf, they quietly continue their simple trade in the hills, holding on to the life they’ve built over decades in the villages around the Mustang region.
For over twenty years, Gajendra Sahani and Baile Sahani have made their home in Beni, a quiet town where the rivers meet the hills. Originally from Nawalparasi, close to the Indian border, they have built a life far from where they first began. Each year, when the seasons turn, they set off on familiar paths to Marpha and nearby villages in Mustang, carrying with them the flavours of the plains peanuts, mangoes, and fruits that rarely reach these mountain valleys. Their fruits bring a taste of the lowlands to the mountains. Baile rolled up her sleeves to reveal the tattoos etched onto her arms. One side carries her husband's name, the other her mother-in-law's. Marks of a life shaped early; she was only twelve when she married. The ink, faded but firm, spoke of years gone by, of customs carried through generations. Even now, despite their age, they return to their fields in the Terai during the rainy season to plant seeds, hoping for a good harvest. While their son works as a labourer in the Middle Eastern Gulf, they quietly continue their simple trade in the hills, holding on to the life they’ve built over decades in the villages around the Mustang region. © Photos and text by Rinchen Tamang
The Seti River Valley is a lush, green expanse sitting just outside Pokhara in Nepal's Gandaki Province. The river flows into Lake Phewa at the city's northern edge, but it carries more than water. During storms, sediment gathers in the valley and flows into the lake, where it settles permanently, slowly filling the lakebed from the northwest. The consequences are serious: reduced lake capacity is limiting irrigation in nearby farmland, while sediment prevents oxygenation of lakebed flora, shrinking fish populations and harming overall biodiversity. Though sedimentation is a natural process, it has been significantly accelerated by road construction in the upper valley and by increasingly concentrated monsoon rainfall driven by climate change. In addition, the construction is a contributing factor in multiple landslides. Several solutions are being employed to slow the flow. Agricultural terraces, primarily built for hillside farming, double as barriers that reduce erosion and allow groundwater recharge. Rainwater pipes channel water downhill in a more controlled, less erosive way. Closer to the lake, dams along the Seti River catch sediment. Some of this is collected and sold as construction material. These measures have had some success, but sediment is still accumulating at an alarming rate. Without more ambitious intervention, Lake Phewa - a body of water central to Pokhara's ecology, agriculture and identity - faces a troubled future.
The Seti River Valley is a lush, green expanse sitting just outside Pokhara in Nepal's Gandaki Province. The river flows into Lake Phewa at the city's northern edge, but it carries more than water. During storms, sediment gathers in the valley and flows into the lake, where it settles permanently, slowly filling the lakebed from the northwest. The consequences are serious: reduced lake capacity is limiting irrigation in nearby farmland, while sediment prevents oxygenation of lakebed flora, shrinking fish populations and harming overall biodiversity. Though sedimentation is a natural process, it has been significantly accelerated by road construction in the upper valley and by increasingly concentrated monsoon rainfall driven by climate change. In addition, the construction is a contributing factor in multiple landslides. Several solutions are being employed to slow the flow. Agricultural terraces, primarily built for hillside farming, double as barriers that reduce erosion and allow groundwater recharge. Rainwater pipes channel water downhill in a more controlled, less erosive way. Closer to the lake, dams along the Seti River catch sediment. Some of this is collected and sold as construction material. These measures have had some success, but sediment is still accumulating at an alarming rate. Without more ambitious intervention, Lake Phewa - a body of water central to Pokhara's ecology, agriculture and identity - faces a troubled future. © Photo and text by Nikhil Sethi
An elderly woman in Lo Manthang demonstrates the traditional art of weaving leg warmers from yak wool in Lo Manthang, the walled capital of Upper Mustang. Lo Manthang sits in a Himalayan rain shadow shaped by wind-swept plateaus, deep eroded canyons and minimal rainfall. Founded by Ame Pal and encircled by mud-brick walls built to defend against bandits and rival kingdoms, it was once an independent kingdom. Its extreme isolation has helped preserve Tibetan Buddhist culture, language, customs and daily life. Yet that same isolation has become a growing challenge. With the closure of Tibetan trade routes around 1959, the community shifted from a thriving trade hub to a fragile agro-pastoral economy. Today, springs are drying, pastures are shrinking, and snow leopards - driven by a shrinking prey base - increasingly descend into villages to prey on livestock, creating both economic and social strain. The woman's hands, deftly working yak wool into a traditional garment, represent something larger: a living thread connecting Lo Manthang's people to their heritage. Supporting indigenous crafts such as weaving, beading and painting offers not only a potential option for sustainable livelihoods, but a means of cultural preservation, making tradition a source of both pride and prosperity for future generations.
An elderly woman in Lo Manthang demonstrates the traditional art of weaving leg warmers from yak wool in Lo Manthang, the walled capital of Upper Mustang. Lo Manthang sits in a Himalayan rain shadow shaped by wind-swept plateaus, deep eroded canyons and minimal rainfall. Founded by Ame Pal and encircled by mud-brick walls built to defend against bandits and rival kingdoms, it was once an independent kingdom. Its extreme isolation has helped preserve Tibetan Buddhist culture, language, customs and daily life. Yet that same isolation has become a growing challenge. With the closure of Tibetan trade routes around 1959, the community shifted from a thriving trade hub to a fragile agro-pastoral economy. Today, springs are drying, pastures are shrinking, and snow leopards - driven by a shrinking prey base - increasingly descend into villages to prey on livestock, creating both economic and social strain. The woman's hands, deftly working yak wool into a traditional garment, represent something larger: a living thread connecting Lo Manthang's people to their heritage. Supporting indigenous crafts such as weaving, beading and painting offers not only a potential option for sustainable livelihoods, but a means of cultural preservation, making tradition a source of both pride and prosperity for future generations. © Photo and text by Celeus Baral
At the confluence of the Kali Gandaki and Jhong Khola in Kagbeni lies a sacred site where locals perform rituals of ancestral remembrance. Beneath its spiritual calm, however, lies a painful memory. In 2023, unprecedented rainfall triggered a devastating flood, inundating the village, destroying 35 homes and wiping out livestock. No lives were lost, but the emotional, economic and cultural damage was immense. Former mayor Phenchok Tseptan recalls how the rising waters were initially underestimated, and now any amount of rainfall is enough to awaken fear and sleepless nights. Increased risk from a changing climate do not only impact ecosystems, it affects people's lives, beliefs and sense of safety.
At the confluence of the Kali Gandaki and Jhong Khola in Kagbeni lies a sacred site where locals perform rituals of ancestral remembrance. Beneath its spiritual calm, however, lies a painful memory. In 2023, unprecedented rainfall triggered a devastating flood, inundating the village, destroying 35 homes and wiping out livestock. No lives were lost, but the emotional, economic and cultural damage was immense. Former mayor Phenchok Tseptan recalls how the rising waters were initially underestimated, and now any amount of rainfall is enough to awaken fear and sleepless nights. Increased risk from a changing climate do not only impact ecosystems, it affects people's lives, beliefs and sense of safety. © Photo and text by Anek Rajbhandari
Lubra lies nestled along a flood prone tributary just a couple of kilometres from the main passage of the Kali Gandaki Corridor, an ancient trade and pilgrimage route in the Nepali Himalayas. Lubra is one of the few villages in the world where all residents practice Bon, an animist tradition predating Tibetan Buddhism. The Lama believes road construction throughout Mustang has disturbed the mountain deities. He narrows his eyes as he speaks. "The spirits of the mountains are not happy; the building of the road is a wound upon the land." Meanwhile, reduced snowfall - in parts of Mustang it has not snowed for three years - is causing medicinal herbs to grow scarcer, disrupting the practice of traditional medicine. The pressures of a changing climate, economic development and shifting societal norms form a complex convergence of factors with the potential to disrupt life in villages such as this. The Lama address the possibility of out migration with a simple question: "Where would we go?"
Lubra lies nestled along a flood prone tributary just a couple of kilometres from the main passage of the Kali Gandaki Corridor, an ancient trade and pilgrimage route in the Nepali Himalayas. Lubra is one of the few villages in the world where all residents practice Bon, an animist tradition predating Tibetan Buddhism. The Lama believes road construction throughout Mustang has disturbed the mountain deities. He narrows his eyes as he speaks. "The spirits of the mountains are not happy; the building of the road is a wound upon the land." Meanwhile, reduced snowfall - in parts of Mustang it has not snowed for three years - is causing medicinal herbs to grow scarcer, disrupting the practice of traditional medicine. The pressures of a changing climate, economic development and shifting societal norms form a complex convergence of factors with the potential to disrupt life in villages such as this. The Lama address the possibility of out migration with a simple question: "Where would we go?" © Photo and text by Anek Rajbhandari
The Lo Manthang Health Post is a small government facility providing free healthcare in the ancient capital of Upper Mustang, high on the Tibetan Plateau near Nepal's border with China. Staffed by a small team headed by Urmila Jethara originally from the Bajhang, a Himalayan region of Nepal far to the west of Mustang. The clinic sees up to 10 to 15 patients a day, mostly for persistent coughs, hypertension, diarrhoea and gastritis. The challenges facing the clinic are considerable. Recruiting and retaining staff in such a remote posting is an ongoing struggle. Urmila has stayed in her post since 2022, an unusually long time for such a remote posting. For emergencies - including pregnancy complications, strokes or heart attacks - an ambulance can take five to ten hours to arrive, and another five to ten hours to reach the nearest hospital. Helicopter evacuation is the fastest option, but also the most expensive. Many residents of Lo Manthang place their trust in Amchi medicine, a holistic healing tradition using medicinal herbs, stones and natural remedies. Amchi practitioner Sonam Wangyal Gurung reports a recent rise in mental health disorders, diabetes and hypertension, conditions that rarely present at the government clinic. Patients often only seek help after symptoms have significantly worsened. Any meaningful improvement in healthcare access in this region must recognise both traditional and modern medicine have their place in providing essential, holistic care.
The Lo Manthang Health Post is a small government facility providing free healthcare in the ancient capital of Upper Mustang, high on the Tibetan Plateau near Nepal's border with China. Staffed by a small team headed by Urmila Jethara originally from the Bajhang, a Himalayan region of Nepal far to the west of Mustang. The clinic sees up to 10 to 15 patients a day, mostly for persistent coughs, hypertension, diarrhoea and gastritis. The challenges facing the clinic are considerable. Recruiting and retaining staff in such a remote posting is an ongoing struggle. Urmila has stayed in her post since 2022, an unusually long time for such a remote posting. For emergencies - including pregnancy complications, strokes or heart attacks - an ambulance can take five to ten hours to arrive, and another five to ten hours to reach the nearest hospital. Helicopter evacuation is the fastest option, but also the most expensive. Many residents of Lo Manthang place their trust in Amchi medicine, a holistic healing tradition using medicinal herbs, stones and natural remedies. Amchi practitioner Sonam Wangyal Gurung reports a recent rise in mental health disorders, diabetes and hypertension, conditions that rarely present at the government clinic. Patients often only seek help after symptoms have significantly worsened. Any meaningful improvement in healthcare access in this region must recognise both traditional and modern medicine have their place in providing essential, holistic care. © Photo and text by Navya Kancharla
Agriculture lies at the heart of Nepal’s rural economy, sustaining livelihoods, shaping cultural traditions, and anchoring food security. Yet across the country, from the fertile Terai plains to the arid trans-Himalayan plateau, farming systems are under mounting pressure from climate change. In the Terai, rice and wheat cultivation benefit from fertile soils and irrigation fed systems. Wetland ecosystems such as the Jagdishpur Reservoir exemplifies the tight link between agriculture and ecology: its waters irrigate fields while sustaining migratory birds. Yet fertilizer and pesticide runoff are degrading water quality, undermining both biodiversity and human health. Erratic monsoon rains also disrupt planting cycles, leaving farmers uncertain about yields. For the people who live here, the socio-economic factors that affect health throughout much of Nepal’s population are also present, with women’s health particularly affected by a lack of neo-natal care, malnutrition and the practice of child marriage.
Agriculture lies at the heart of Nepal’s rural economy, sustaining livelihoods, shaping cultural traditions, and anchoring food security. Yet across the country, from the fertile Terai plains to the arid trans-Himalayan plateau, farming systems are under mounting pressure from climate change. In the Terai, rice and wheat cultivation benefit from fertile soils and irrigation fed systems. Wetland ecosystems such as the Jagdishpur Reservoir exemplifies the tight link between agriculture and ecology: its waters irrigate fields while sustaining migratory birds. Yet fertilizer and pesticide runoff are degrading water quality, undermining both biodiversity and human health. Erratic monsoon rains also disrupt planting cycles, leaving farmers uncertain about yields. For the people who live here, the socio-economic factors that affect health throughout much of Nepal’s population are also present, with women’s health particularly affected by a lack of neo-natal care, malnutrition and the practice of child marriage. © Photo by Chloe Young, text by Bishwas Dhungana
Muktinath, situated at 3,800 metres in Nepal's Mustang region, is one of the world's highest sacred complexes - a rare site of shared reverence between Hindus and Buddhists. To Hindus it is an ancient seat of Vishnu; to Buddhists, an abode of Avalokiteśvara, the bodhisattva of compassion. The temple's 108 spring-fed water spouts, where pilgrims bathe to cleanse themselves of sin and suffering, bind spiritual pursuit to the fragile high-altitude ecosystem that sustains them. Muktinath is also regarded as embodying all five elements earth, water, fire, air and sky in a cosmology that is inseparable from the landscape itself, pointing to a deep entanglement of faith and place At ~3,800 m, stepping beneath 108 gushes of near-freezing water triggers sympathetic spikes: tachycardia, rapid breathing, peripheral vasoconstriction. This ritual immersion in glacial waters at altitude functions as something close to hormesis: a controlled stressor embraced for moral and bodily renewal alike. Pilgrimage, at its core, is an act of radical attentiveness. In an era of climate disruption, that attentiveness may matter more than ever.
Muktinath, situated at 3,800 metres in Nepal's Mustang region, is one of the world's highest sacred complexes - a rare site of shared reverence between Hindus and Buddhists. To Hindus it is an ancient seat of Vishnu; to Buddhists, an abode of Avalokiteśvara, the bodhisattva of compassion. The temple's 108 spring-fed water spouts, where pilgrims bathe to cleanse themselves of sin and suffering, bind spiritual pursuit to the fragile high-altitude ecosystem that sustains them. Muktinath is also regarded as embodying all five elements earth, water, fire, air and sky in a cosmology that is inseparable from the landscape itself, pointing to a deep entanglement of faith and place At ~3,800 m, stepping beneath 108 gushes of near-freezing water triggers sympathetic spikes: tachycardia, rapid breathing, peripheral vasoconstriction. This ritual immersion in glacial waters at altitude functions as something close to hormesis: a controlled stressor embraced for moral and bodily renewal alike. Pilgrimage, at its core, is an act of radical attentiveness. In an era of climate disruption, that attentiveness may matter more than ever. © Photo by Navya Kancharla, text by Kyle Abrahm and Ojaswee Karki
Maheswar Tandulkar walks along an irrigation trench on an urban farm, situated on public lands along the banks of the highly polluted Bagmati River in Kathmandu. The farmers live locally and practice substance farming as well as growing crops for sale. They pay no rent and have no ownership of the land. In September 2024, the Bagmati River flooded after intense monsoon rains, inundating the farms and covering the land with debris. The farmers funded the recovery themselves to prepare for the following year’s planting and harvest. Maheswar Tandulkar claims to have spent 30 000 rupees (200 USD) himself. The water for irrigation comes from wells and public sewers and is carried out 15 days in the month.
Maheswar Tandulkar walks along an irrigation trench on an urban farm, situated on public lands along the banks of the highly polluted Bagmati River in Kathmandu. The farmers live locally and practice substance farming as well as growing crops for sale. They pay no rent and have no ownership of the land. In September 2024, the Bagmati River flooded after intense monsoon rains, inundating the farms and covering the land with debris. The farmers funded the recovery themselves to prepare for the following year’s planting and harvest. Maheswar Tandulkar claims to have spent 30 000 rupees (200 USD) himself. The water for irrigation comes from wells and public sewers and is carried out 15 days in the month. © Photo by Saniya Bhusal, text by Tom White
Devotees make offerings during the Rato Machindranath Jatra, one of Nepal's most ancient festivals. The festival traces its roots to the reign of King Narendra Deva in the 6th century, when a 12-year drought gripped the Kathmandu Valley. Legend holds that the sage Gorakhnath, angered by a lack of respect, had subdued the nine Nagas responsible for bringing rain. Only the summoning of Machindranath from Assam in northeast India broke the curse. The rains returned. Each year, as the dry season gives way to the monsoon, chariots are pulled through Lalitpur and Kathmandu to honour that deliverance. The festival's enduring power lies in what it remembers: that human wellbeing depends on natural cycles, and that their disruption carries consequences. Today, Kathmandu regularly ranks among the world's most polluted cities, its air during the dry season reaching hazardous levels. Air pollution can contribute to a host of health problems, including pneumonia, bronchitis, conjunctivitis, and skin allergies in the short term, and more severe conditions such as stroke, heart disease, lung cancer, and kidney disease over time. With its deep-rooted connection to natural cycles - and their disruption - the Rato Machindranath Jatra festival offers a poignant lesson, reminding us of the enduring bond between humans and the environment
Devotees make offerings during the Rato Machindranath Jatra, one of Nepal's most ancient festivals. The festival traces its roots to the reign of King Narendra Deva in the 6th century, when a 12-year drought gripped the Kathmandu Valley. Legend holds that the sage Gorakhnath, angered by a lack of respect, had subdued the nine Nagas responsible for bringing rain. Only the summoning of Machindranath from Assam in northeast India broke the curse. The rains returned. Each year, as the dry season gives way to the monsoon, chariots are pulled through Lalitpur and Kathmandu to honour that deliverance. The festival's enduring power lies in what it remembers: that human wellbeing depends on natural cycles, and that their disruption carries consequences. Today, Kathmandu regularly ranks among the world's most polluted cities, its air during the dry season reaching hazardous levels. Air pollution can contribute to a host of health problems, including pneumonia, bronchitis, conjunctivitis, and skin allergies in the short term, and more severe conditions such as stroke, heart disease, lung cancer, and kidney disease over time. With its deep-rooted connection to natural cycles - and their disruption - the Rato Machindranath Jatra festival offers a poignant lesson, reminding us of the enduring bond between humans and the environment © Photo by Pratistha Kattel, text by Tom White
A decommissioned COVID-19 swab collection vehicle sits on the edge of a busy waste management site in Kathmandu. Kathmandu collects and sorts waste across the city before transporting it to landfills on the valley's outskirts. Limited landfill capacity has historically caused backlogs, though recent infrastructure improvements have helped ease the strain. Waste management was a central plank of Balendra Shah's campaign when he stood for mayor in 2022. He was the first independent candidate to win the office. Upon taking office, Shah prioritised resolving Kathmandu's chronic waste accumulation, which had led to over a month of disruptions prior to his inauguration. Shah was elected as Nepal’s Prime Minister in 2026 following an election triggered by series of protests by predominantly young “Gen Z” Nepalis and the resignation of Prime Minister K. P. Sharma Oli.
A decommissioned COVID-19 swab collection vehicle sits on the edge of a busy waste management site in Kathmandu. Kathmandu collects and sorts waste across the city before transporting it to landfills on the valley's outskirts. Limited landfill capacity has historically caused backlogs, though recent infrastructure improvements have helped ease the strain. Waste management was a central plank of Balendra Shah's campaign when he stood for mayor in 2022. He was the first independent candidate to win the office. Upon taking office, Shah prioritised resolving Kathmandu's chronic waste accumulation, which had led to over a month of disruptions prior to his inauguration. Shah was elected as Nepal’s Prime Minister in 2026 following an election triggered by series of protests by predominantly young “Gen Z” Nepalis and the resignation of Prime Minister K. P. Sharma Oli. © Photo and text by Nikhil Sethi
In the early morning light near Palpa Durbar, a town in Nepal's middle hills, Mangal Sahi skillfully butchers chicken and buffalo meat at his shop. A lifelong resident of Palpa, he reflects on how much the city has changed; how land prices have soared, the familiar winter fog has vanished, and air pollution has worsened due to an increase in forest fires. He says he has also noticed a rise in health issues such as dengue and diarrhoea compared to the past. Many residents of Palpa lack reliable mains water, though the municipality supplies water every 3-4 days, which residents must store and ration. This is potentially a health concern, as standing water can harbour diseas
In the early morning light near Palpa Durbar, a town in Nepal's middle hills, Mangal Sahi skillfully butchers chicken and buffalo meat at his shop. A lifelong resident of Palpa, he reflects on how much the city has changed; how land prices have soared, the familiar winter fog has vanished, and air pollution has worsened due to an increase in forest fires. He says he has also noticed a rise in health issues such as dengue and diarrhoea compared to the past. Many residents of Palpa lack reliable mains water, though the municipality supplies water every 3-4 days, which residents must store and ration. This is potentially a health concern, as standing water can harbour diseas © Photo and text by Alex Pradhan
Two women in traditional dress rinse teacups in a mountain stream in Namashung, Upper Mustang, Nepal. life in remote Himalayan communities such as Namashung relies on natural systems for resources such as clean flowing water. This reliance is woven into the most basic routines of domestic life of these villages and the gendered labour of the women within them. As climate change alters precipitation patterns, threatens glacial water sources, and increases the unpredictability of mountain streams, it is communities like this who will feel the most immediate effects of a disrupted water supply.
Two women in traditional dress rinse teacups in a mountain stream in Namashung, Upper Mustang, Nepal. life in remote Himalayan communities such as Namashung relies on natural systems for resources such as clean flowing water. This reliance is woven into the most basic routines of domestic life of these villages and the gendered labour of the women within them. As climate change alters precipitation patterns, threatens glacial water sources, and increases the unpredictability of mountain streams, it is communities like this who will feel the most immediate effects of a disrupted water supply. © Photo and text by Pia Visari

Mapping Climate Migration

A storymap by photojournalist Tom White, one of the faculty of the Field School: Planetary Health 2025, tracing the climate migration of Sam Dzong — one of the Himalaya's oldest villages, relocated to a new site (often referred to as Namashung) due to glacial retreat and drought that made the land uninhabitable.

View storymap →

About the Team

Main funding institutions

Duke University — Nicholas School of the Environment Duke University — Nicholas School of the Environment

Local institutional partners

Institute of Himalayan Risk Reduction (IHRR) Institute of Himalayan Risk Reduction (IHRR)
Forum for Energy and Environment Development (FEED) Forum for Energy and Environment Development (FEED)
Karmaflights Karmaflights

For more information