On February 5, 2026, during an election campaign, a vehicle associated with the Rastriya Swatantra Party struck a four-year-old girl. She later died from her injuries. This was not just a tragic moment during a political campaign. It was a reflection of a deeper, systemic failure; a failure that continues to take lives across Nepal every day. Now, with a clear electoral mandate and the power to govern, this leadership has a choice: to treat this as an isolated incident, or to recognize it for what it is: a preventable death, and a call to act. I am an emergency physician who unfortunately sees injured children at work all the time. During my specialty training in emergency medicine in the United States, I worked at one of the busiest trauma centers in the country. On any given shift, we treated victims of car crashes, gun violence, falls, and other severe injuries. Trauma was routine, but some moments never leave you. One rainy evening, we received an overhead message: 'Peds versus auto arriving in 3 minutes.' It was a five-year-old girl, hit in front of her home. When I entered the room, it was immediately clear she had no chance of survival. My role was limited to pronouncing her dead on arrival. What followed, walking down a quiet hallway to tell her parents, is something no training prepares you for. That was eight years ago. Recently, during the election campaign, I watched a video from Rautahat that brought all of it back. An election campaign vehicle, driving recklessly, ran over a young girl crossing the street. She was reportedly four years old. This time, I didn't just hear about it. I saw it. When I saw the video, it took me a while to process what had happened. What haunts me most is not just the moment of impact, but what comes after for her parents. They will live not only with her absence, but with that image, replaying in their minds for years. Before this becomes just another headline, we need to name the truth clearly: This was not an accident. And neither was the bus crash in Baitadi a few days later that killed 13 people. And neither was the bus crash in Dhading that killed 18 people in February. Neither was the bus crash in Gorkha that killed 7 pilgrims in March. And neither are the daily hit-and-run deaths across the Terai. And neither was the death of my own Vinaju (brother-in-law), struck by a speeding vehicle in front of his home in Terai. It is possible that almost everyone in Nepal is connected to the tragedy of a roadside fatality either directly or indirectly. Over the past decade, much of my work in Nepal has focused on trauma care: how to save lives after injury occurs. We have trained community responders, built systems, and shown that lives can be saved even in resource-limited settings. But these are downstream solutions. What is killing people in Nepal is not fate. It is not bad luck. It is systemic failure: unsafe roads, weak enforcement, normalised reckless driving, poor urban planning, lack of pedestrian protection, and ultimately, a failure of governance. We must stop calling these deaths 'accidents'. They are preventable. Now, Nepal has voted. A new generation of leaders has been given a mandate, many of them young, many of them promising change, accountability, and a break from the past. This is a moment of hope. But hope alone will not save lives. Every day, an estimated seven people die on Nepal's roads. That number is likely an underestimate. These deaths continue quietly, without headlines, without outrage, without sustained action. The election is over. The real test begins now. Will this new leadership treat road safety as a public health priority? Will they invest in prevention, not just hospitals, but safer streets? Will they enforce laws equally, even when it is politically inconvenient? Will they protect pedestrians, children, and communities over power and speed? Because the truth is simple: A child crossing the street should matter more than a political convoy. As an emergency physician, I have treated both victims and the drivers who caused these injuries. Our duty is to preserve life without judgement. But the system's duty is different; it is to prevent these tragedies from happening in the first place. This is where leadership and policy matter, and this is where the new government will be judged ultimately. Today it is someone else's child. Tomorrow, it could be yours. These deaths do not discriminate. They will reach every community unless we act. Nepal has chosen new leadership. Now, that leadership must choose whether to act. These are not accidents. They are failures we have tolerated. And now, with a clear mandate and a new generation in power, there is no excuse left. Dr Kharel is an emergency medicine specialist and Assistant Professor at Brown University in the USA. He has a Masters in Public Health from Harvard University. He was born in Gulmi, Nepal. He is the founder of non-profit organization HAPSA Nepal (www.hapsaglobe.org), that works to strengthen community based emergency and trauma care in Nepal.