What really changed the course of the recurring smallpox epidemics in Nepal? Access to vaccines. In 1816, having faced military defeat and losing parts of our land in the Anglo-Nepal war, the Nepali government requested the British government for vaccines to control smallpox after King Girvana Bikram Shah died from it

At the onset of the COVID-19 pandemic last year, most Nepalis did not know what was happening.

They were many non-believers, including our politicians, who had no idea about how infectious a global pandemic could be, and how its spread would affect the economy and society at large. Delving into our history, several pandemics have paralysed the nation; unfortunately, those lessons are rarely considered in taking the right actions.

The earliest recorded pandemic (first typhoid epidemic) was in 430 BC in Greece. In 165 AD, there was the Antonin plague (first smallpox epidemic); in 1350, the Black Death (second bubonic plague); in 1817, the cholera pandemic; and in 1918, the Spanish flu. Nepal has been hit by smallpox epidemics time and again throughout history. One of the earliest records of smallpox was in 1735 AD when King Bhaskar Malla was ruling Kantipur. The epidemic lasted for two years and accounted for 18,714 deaths.

The kingdom was also struck by a famine at the same time, and a priest suggested the king pacify the gods by organising a big feast for the hungry citizens, believing it would ward off the virus. Instead, the epidemic spread even more viciously after.

The king and his two wives isolated themselves away from the city in Kindol Bihar, near Swayambhu.

After six months of isolation, the 22-year-old king became restless. Upon the advice of a farmer who told the king that the epidemic had subsided, the king in excitement is said to have immediately galloped to his palace. While living with his concubines, he contracted the disease and died soon after. In the same year, the Living Goddess, Kumari, also succumbed to the disease.

In 1762, during the time of King Pratap Malla, no epidemic was reported in Kathmandu, but in Bhaktapur smallpox erupted, and King Jagat Prakash Malla died. There is a "thyasphu"

(historical record) indicating the widespread of smallpox in 1761.

In 1799, a severe smallpox epidemic swept the valley, and the queen of King Rana Bahadur Shah got infected. He paid homage to the Goddess of smallpox, Sitala Devi, at Swayambhu, and donated money for her speedy recovery.

The queen recovered but with severe scars that disfigured her face.

Unable to accept her lost beauty, she committed suicide.

The king was so enraged that he destroyed the temple, took back the donation and forbade the worship of the Goddess. The king in his frenzy of rage also ordered a sizable population to be deported out of the valley, thinking they were the super spreaders. The deportees were driven from Kathmandu and Bhaktapur to Dolakha and across the Tama Koshi River.

Many died of cold and hunger along the way.

Newar settlements in towns outside the valley can be traced to this forced relocation. Forced relocation then was carried out under the strict orders of the king, but even today, haphazard policies have resulted in similar mass exoduses of people from the cities. In 2020, the call for an immediate lockdown in Nepal and India led to a mass exodus of people to the villages, and Nepali migrant workers in India rushed back home. Many lives were lost during this state of confusion. Some died from hunger and exhaustion while walking to their villages while others died in the quarantine centres along the border towns. The first population census of Nepal in 1856 also collected data of houses depopulated as a result of epidemics. In Patan 2,000 houses and in Bhaktapur 500 houses were depopulated as a result of smallpox. Depopulation must have occurred due to whole families dying or being forced out to prevent its spread. Similarly, today, landlords in Kathmandu are evicting COVID-positive tenants, and many are returning to their villages for fear of hardships during the lockdown. Depopulation also occurred when epidemics spread in the rural areas. Hari Ram, an Indian explorer, travelled through the Everest region in 1885 to secretly gather information for India's survey.

His report noted that "an outbreak of virulent smallpox carried off a large number of the inhabitants out of Khumbu." In a similar manner, COVID-19 has spread beyond the city to the trekking routes and villages today.

So, what really changed the course of the recurring smallpox epidemics in Nepal? Access to vaccines. In 1816, having faced military defeat and losing parts of our land in the Anglo-Nepal war, the Nepali government requested the British government for vaccines to control smallpox after King Girvana Bikram Shah died from it. He was the son of King Rana Bahadur Shah.

Talk of Karma hitting back for all his misdeeds during the previous pandemic!

Vaccination was a humanitarian gesture, used as a diplomatic strategy for greater British influence.

Smallpox occurred worldwide, but Nepal, like India, experienced the more virulent form of the variola virus –variola major – which had a high mortality rate.

Here again, it's amazing how history repeats itself with India and Nepal being victims of the more virulent COVID-19 double mutant variant.

From the initial vaccination drive in 1816, when a few citizens were vaccinated, to 1966, when the WHO launched a global smallpox eradication strategy, the country made much progress in vaccinating the entire population. The last case of smallpox was recorded in 1975, and in 1977, Nepal was declared smallpox-free.

Today we face a bigger battle to control COVID-19 and vaccinate the entire population. We are trapped in the politics of vaccine grants and purchase. Vaccine politics is at its peak with India unable to deliver more doses. As in 1816, when the British made political and diplomatic inroads, the Chinese vaccine grants could take a similar path today. With the government unable to handle the pandemic properly, the harsh outcomes of COV- ID-19 in Nepal are only starting to unfold.

Sakya is Executive Director, KGH Hotels

A version of this article appears in the print on June 2, 2021, of The Himalayan Times.