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Life and Death in Pashupatinath: Elders Find a Home on the Banks of Kathmandu's Bagmati

By Dave Baldridge

For more information about Pashupitinath Briddhashram and how to contribute, visit

Executive Director

American Association for International Aging




"At the end of our lives, we will not be judged by how many diplomas we have received, how much money we have made or how many great things we have done. We will be judged by 'I was hungry and you gave me to eat. I was naked and you clothed me. I was homeless and you took me in'."

--Mother Theresa


Monday, November 7, 2005,

It’s our first day in Kathmandu and we are leaving Nepal’s only government-sponsored senior citizens home. Charles Englebert, our Colorado-based Himalayan mountain bike guide-to-be for the next two weeks, suddenly looks away, tears in his eyes. His voice is choked, so we save our questions, not wanting to intrude.

Back in the U.S. a month later, we learn more of the story by email from Charles’ brother, Kevin:

When guiding in Nepal in 2004, Charles discovered an older man living (or rather dying) under a bridge. The man could not see due to infection in his eyes and he could not walk due to a crushed hip sustained in some sort of accident. He was starving and freezing. Charles estimates the man had only a few more days before he would have died.

For several days, Charles brought food and water to him, nursing him back to strength and trying to convince him to get some care. The man was reluctant to seek help. Eventually, however, he agreed to move into the shelter. The cab ride from the bridge to the shelter was unpleasant, as the old man had not bathed or had adequate toiletries for quite some time--truly a desperate situation. Charles felt that he had done all he could, and this last act was probably a lifesaver.




One year later, while on our trip, Charles returned to the same shelter to find out if the elderly man, named Dona Badu, had survived. He has, and is thriving! His sight is back, his hip has healed, he is almost completely mobile, and he has made many new friends at the shelter. Dona Badu cried when he saw Charles, and told him that he “had brought him back from the dead.” He proclaimed “all these people are my friends,” pointing to the many people he has met at the shelter.

One year later, while on our trip, Charles returned to the same shelter to find out if the elderly man, named Dona Badu, had survived. He has, and is thriving! His sight is back, his hip has healed, he is almost completely mobile, and he has made many new friends at the shelter. Dona Badu cried when he saw Charles, and told him that he “had brought him back from the dead.” He proclaimed “all these people are my friends,” pointing to the many people he has met at the shelter.

The temple at Pashupatinath, built in the sixth century B.C., is reportedly the largest and holiest of all Hindu temples. Pashu means living beings, and Pati means master. Lord Pashupatinath, the protector of animals, is one of the forms of Lord Shiva.

It is said that Shiva, the Hindu god of creation, appeared in the bank of the Holy Bagmati River centuries ago and the Temple of Lord Pashupatinath was erected here to secure the holy site. Hindus have worshipped here for at least 1,500 years.

The Siddhi Shaligram Briddhashram (Home for the Elderly) lies 4.8 kilometers northeast of the heart of the city, surrounded by the Pashupatinath Hindu temple grounds. According to a local newspaper, the temple—a World Heritage Site--is “a famous pilgrimage for Hindu pilgrims from around the world, but also an abode for frolicking monkeys and sadhu santas with tangled hairs who come from across the Indian subcontinent.”

Through the complex, the Bagmati River flows quietly past the ghats where ghutiyars cremate human remains daily, dumping the ashes into the river where they flow downstream, eventually to the sacred Ganges. For Hindu faithful, to die and be cremated means release from the cycle of repeated birth and death.

On one particular day, floating on her back, a woman, wearing a brilliant red dress and carrying an urn under one arm, is chanting. Nearby, two Ramanandi sadhus (ascetic pilgrims), themselves elders with faces painted brightly behind long tangled beards—are posing for tourists. They pay scarce attention to the woman who, apparently in the midst of her own personal epiphany, exits the water, still chanting, her eyes cast upward to a hazy, polluted sky.


A few yards across the river, the Briddhashram houses some 180 destitute Nepali elders. Founded by Mother Theresa’s Missionaries of Charity, the order still supports some sisters who, along with intermittent volunteers, operate one wing there. According to, the English-speaking sisters need help each morning “changing and cleaning sheets, helping residents wash, clipping nails, scrubbing pots, etc.”

The rest of the center—the only home for seniors supported by the monarchy—is run by the government. In order to gain admission, elders endure a lengthy and hectic process of verification from the District Administration Offices, Municipalities or Village Development Committees, and sometimes the Social Welfare Council.


As we stroll through the grounds, a few elders look at us curiously. They are eating their noon meal of rice, scooped from bowls with their fingers. They sit on concrete ledges around a garden that they tend. In the middle of the garden, a miniature Shiva temple presides over bell and datura flowers the elders have planted around it.

Sustained mostly by donations that provide just over $200/person—the average annual income for a Nepalese citizen—the Briddhashram residents consider themselves some of the most fortunate elders in all of Nepal. In truth, they are. Briddhashram residents represent close to one in every 7,000 Nepalese elders. They are keenly aware that they survive daily against enormous odds.

Western perceptions of the Briddhashram sometimes reflect a different perspective. One Australian visitor found residents “living in very basic and cramped living conditions . . .so dark that we stumbled along walkways. We were amazed to see that parts of the accommodation included open air porches that must have been extremely cold in winter.”

Briddhashram residents are less critical. One elder told a reporter, “I am very happy here. They give us food, clothing and take care of us, which is all we need because after all we are going to die one day.” Another--an 80-year-old who has lived in shelters since 1946--said, “Our daily routine is so simple and peaceful. We are served good food and then we go for prayers in the morning and in the evening. It’s better to live here on the lap of Lord Pashupatinath than at my son’s house which is filled with hatred.”

“There are very few options for the elders in Nepal, a caregiver told the Kathmandu Post: “In the absence of a center providing good old age care, they live as a liability and a headache for their families. Even at this, Nepal’s flagship senior home, “many elders . . . simply . . . have nowhere else to go.”


Given such overwhelming in-your-face levels of need, Pashupatinath Briddhashram employees and volunteers get high marks from residents and supervisors alike. “Our staff members here work day in and day out,” says office chief Arjun Prasad Gautam. “They start working from as early as six a.m. ‘til eight p.m.” But it’s not enough to stem the overwhelming, unrelenting need apparent in the eyes of elders and children everywhere in Kathmandu. Nepal’s entire working class population, not just the elderly, find themselves in crisis.

Landlocked by Pakistan, India, Tibet, and China, Nepal is among the poorest and least developed countries in the world, with nearly half of its population living below the poverty line. Subsistence agriculture is the mainstay of the economy, providing a livelihood for more than 80% of the population.


In general, the forces driving Nepalese quality of life are out of control. These include an autocratic monarchy, lack of an industrialized infrastructure, a fertility rate of 4.19 children per woman, one of the highest infant mortality rates in the world (nearly 67/1,000), and a population of which only 45.2 percent over the age of15 are literate. A Nepal Multiple Indicator Survey by Community Information and Epidemiological Technologies (CIET) indicated that only two percent of Nepalese women over the age of 61 could read or write a simple letter.

The only official Hindu state in the world, Nepal is home to nearly 28 million people and 50 ethnic groups speaking 25 different languages. These minorities—including Newars, Gurungs, Magars, Tamangs, and Sherpas—coexist more or less peacefully. Not so Nepal’s political entities--the Maoists and the ruling monarchy. Nepal’s ongoing political crisis—with Maoists controlling large chunks of the Nepalese countryside—contributes to health problems as well as the simmering potential for civil war. Often, Nepal’s estimated 1? million elders aren’t able to navigate the ongoing conflict effectively.

The Kathmandu Post reported in 2002 that “an increasing number of elderly have left their homes following their children’s enlistment in Maoist militant groups.” A U.S. Department of State report on human rights practices states that up to 200,000 persons have been displaced since the start of the insurgency, and that in 2003 alone 38,000 Nepalese of all ages left their villages out of fear.


Seventy-nine-year-old Kirtiman Thami reportedly left his home after his only surviving son joined the Maoists. “Before his enlistment, the Maoists harassed us,” he said. “After his enlistment, I had no choice but to leave.” After wandering and begging for weeks, Thami finally gained admission to the Briddhashram.

The Post reported that an elder in tears said, “Many families have disintegrated and several thousand are displaced due to the conflicting demands of both the security forces and the Maoists. Most people of my generation have left the village. There is no work and no safety there.”

If safety is ever to come to Nepalese elderly—whether they are lost in the busy streets of Kathmandu or eking out subsistence livings in remote villages--it is seemingly unlikely to happen in the near future without dramatic political and economic reforms.

Whether or not the Nepalese government has the political will to enact broad reforms remains to be seen. Based on the government’s health care track record, the world shouldn’t hold its breath. Now in its second long-term health plan and soon to begin its tenth five-year health plan, the poorest nation in Asia continues to issue optimistic reports and establish enthusiastic goals. This despite the fact that Nepal spends only 3.7 percent of its annual budget on health care.

That translates to about $3/person (including donor funding), whereas the World Bank estimates that $12/person is needed for basic health care in a developing nation (the U.S. government spends $4,000/person annually). Nepal’s investment in health is the lowest of any country in Asia. The result, as assessed by the Nepal Health Economics Association (NHEA) is that “a large segment of the population is still denied access to adequate health care.”

In Nepal, even the concept of adequate health care stumbles against the nation’s shambles of a public health infrastructure. More than a third of Nepal’s citizens lack access to safe drinking water (UNICEF1994) or adequate sanitation. The British Medical Journal estimated in 2004 that 72% of Nepal’s human waste was not disposed of properly. That same year, a Water for Nepal Health (NEHWA) spokesperson said that contaminated water and unhygienic conditions causes 80% of all diseases. NEHWA also noted that less than 30% of Nepal’s citizens wash their hands in safe water before meals, resulting in high rates of diarrhea, dysentery, worms, and cholera.

The resulting health statistics are grim. Recent diarrhea occurs in 15% of children, and in one hospital, gastroenteritis has been responsible for 63% of fatalities. Stunted growth due to malnutrition affects 47% of kids under age five.

The lives of Nepali elders, too—even apart from health considerations--remain especially difficult. A Nepal Community Based Action Group (NIPAN) study in 2001 revealed that “A majority of the elderly persons in poverty-stricken rural areas work five to ten hours and elderly women up to 16 hours a day to make a living. Elders or women from poor families work as porters or farm wage earner(s), while some are involved in breaking stones, sewing shoes and dresses as far as allowed by their physical capacity irrespective of gender and caste.”

The 2001 study pointed out that, with the emergence of financial difficulty in the family, “there seems to be wide disparity in the care provided for elders.” The report also stated that “elderly persons from all kinds of families list food, clothing, accommodation and health services” as their basic needs.

There currently exists little or no data reflecting a systematic assessment of Nepali elders’ health status or their needs. NGO recommendations for improving their lives consistently involve considerations of familial responsibility, inheritance, labor force issues, and long-term care. While these are all familiar to America’s aging network, locally they lack coherent, organized support from other Nepalese advocates or the government. The government continues to endure strong criticism for its continuing inability to coordinate initiatives with NGOs or other potential sources of help.

In retrospect, the images of Pashupatinath continue to burn through the jumble of images, smells, and sounds that linger in a Westerner’s mind after a Third World visit. The continued existence of the center, like that of the towering Himalayas a hundred miles away, perhaps poses more questions than it answers.

For more information about the Pashutpatinath Briddhashram and how you can make a donation, contact:

American Association for International Aging (AAIA)
4220 Indian Springs, NE, Albuquerque, NM 87109
Tel: 505/232-9908 or 505/239-4793


A 59-year-old Cherokee, Dave Baldridge hopes “to give back something to the Nepali elders who changed my world view of aging in poverty.” A long-time board member of the American Society on Aging, Baldridge, executive director of the American Association for International Aging, also consults for the CDC’s Native Diabetes Wellness Program in Albuquerque, NM.

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