A few months ago, the new admission process for undergraduate students in medical colleges in Nepal was completed. Immediately after that, news came out that a few dozen senior medical students from a medical college in Kathmandu and the eastern region were suspended. Similarly, a medical school near Kathmandu also issued strict instructions to the concerned students against ragging. Perhaps due to the complaints of ragging that have started happening in schools and colleges recently, the new government (Ministry of Education, Science and Technology) has also issued a Student Safety and Harassment Reporting Form (an online student safety and harassment reporting form that can be submitted).

Have you seen the Hindi film '3 Idiots' starring Aamir Khan? If so, how do senior students harass newcomers in it? It is shown in a flat manner. The sad thing is, that ragging culture in medical colleges has entered Nepal from the southern country. In the past, I had heard sporadically about ragging, physical and sexual abuse in prestigious and expensive residential schools (it would be more appropriate to call them boarding schools) in Nepal. So far, there has been no accident that has resulted in the death of a student, but if necessary steps are not taken in time, the consequences will not take long. Even now, the number of students who suffer mental harassment due to ragging is not small.

Perhaps due to the complaints of ragging that have started happening in schools and colleges recently, the new government has also issued a Student Safety and Harassment Reporting Form. Ragging is a type of abuse or initial immoral ritual seen mainly in educational institutions, in which senior students harass, insult, mentally harass or pressure newcomers (junior) students in various ways. Although it was seen as a means of strengthening mutual relations in the past, it seems to have been replaced as physical, mental and emotional violence over time. MBBS studies are a bit longer than other subjects or technical courses. And, due to the tireless effort and practical classes day and night to acquire skills, there is no alternative to residential studies. And in terms of cost, hostels can be the best option in most cases. But, the problem starts from here, namely ragging.

In addition, there is already high academic pressure on students in medical colleges. On top of that, initial unfair and sometimes inhuman ragging can have a serious mental impact on the victimized student. In Nepal, the problem of ragging is not so serious, i.e. its intensity is less here than in some neighboring countries. However, since this is not a good practice, this issue should be addressed and eliminated in a timely manner. Because nowadays, there are many innovative ways to establish relationships between senior and junior students. Not only that, in recent years, due to the growing awareness of student rights and mental health, institutional and government efforts have increased to stop it. For example, as mentioned above, medical colleges and government agencies have published awareness-raising information on 'zero tolerance'. The Ministry of Education, Science and Technology has clarified this issue further by saying, 'Adopting a policy of zero tolerance against any kind of abuse and exploitation in educational institutions, the concerned students take any kind of harassment or abuse seriously and a special mechanism has been put in place to directly address such complaints and take immediate legal and administrative action.'

Ragging is defined as any act that causes or is likely to cause physical, mental, or emotional harm to a junior student. Ragging can take various forms such as verbal abuse and insults, coercion (inappropriate or forced), physical abuse, mental fear and intimidation, social discrimination (due to caste, creed, place, religion, or place). In the current context, online abuse, behavior that creates discrimination and pressure, and social media-based texts or matter are also considered as ragging.

Why is there so much ragging in medical colleges? One, hierarchical structure, i.e. senior-junior system. Due to the long duration of study and the compulsion to rely on seniors for some things or learning, there has been a tendency for seniors to show authority over juniors in medical education. Second, hostel life, i.e. as mentioned above, medical experience and skill learning do not happen day and night, most of the time you have to stay in the hostel and study. Parents and medical college rich people also expect the same. And, since there is comparatively less monitoring in the hostel, the possibility of ragging is higher. Third, traditional thinking, i.e. some seniors see ragging as a tradition and its continuation as a means of developing relationships. This is a kind of superstition and wrong practice. Fourth, fear and silence. Junior students hesitate to complain for fear of retaliation. Now that complaints can be registered confidentially and securely, there is a possibility of making a difference.

What is the status, existence and seriousness of ragging in Nepal? It is impossible to predict exactly. Whether it is actually low or not reported as much as it is, ragging is generally less in appearance. However, incidents of ragging are increasing every year. According to some reports or mutual conversations with victims, mild level of ragging occurs in Nepal. As the saying goes, ‘Achanoko Peer Khukurile Janaani’ (The pain of a sudden attack is not known), in our analysis, mild can also be serious for the affected. For example, activities such as making seniors re-introduce themselves, making them sing, dance or act, making them do work, teasing, making physical comments, calling them names have been carried out. However, in some cases, it cannot be completely ruled out that serious abuse has not occurred. Having said this, the positive side of the recent times is that rejection of ragging is increasing among the new generation.

Ragging can have very adverse effects on mental, academic, professional and social aspects. Ragging can lead to anxiety, depression, low self-esteem and even suicidal thoughts in the victim. Similarly, its educational impact can cause students to be unable to concentrate on their studies, skip classes or develop fear of the institution and drop out of college. Ragging can also lead to unhealthy relationships between seniors and juniors in the future, which can affect health services. Because in the health sector, over time, juniors or even their own students may be better than them. Students affected by the social effects of ragging can become lonely, while the perpetrator may develop more false confidence.

There is no separate law on ragging in Nepal, but if an incident occurs, punishment is given according to the prevailing law. Beating, threatening and physical abuse are considered serious crimes of ragging and legal action can be taken under criminal law. The concerned universities, medical colleges and regulatory bodies (Medical Education Commission, Nepal Medical Council, Student Council) play an important role in controlling and prohibiting ragging through codes of conduct and guidelines. In this regard, most medical colleges have also adopted a zero-tolerance policy. For this, it is necessary to have monitoring work, a confidential complaint system, a system to make students feel safe (especially newcomers), and counseling facilities immediately after admission to colleges or the start of the academic session. To prevent ragging, it is necessary to have a notice board in public at educational places stating that any kind of ragging is completely prohibited. Awareness programs against ragging should be run especially for senior students and their parents. Students should be given institutional information about their work, duties and rights, consequences of ragging, how to file a complaint, and punishment. Similarly, whether the rules as per the guidelines are being followed or not? There should be a regular and emergency monitoring system in hostels and campuses. For that, the active participation of teachers is necessary. Depending on the seriousness, students involved in ragging can be punished by suspending them for some time, preventing them from taking exams, requiring them to undergo counseling and psychotherapy for behavior improvement, keeping them away from the hostel, alerting their parents, placing them in their care, and even expelling them from the college and taking legal action if it is very serious.

There are serious challenges in the matter of ragging. Due to various reasons and fear of seniors, there are few complaints, incidents are not brought to light as much as they occur, incidents are not reported until they are serious, some colleges take ragging as a normal thing, there is no monitoring by the concerned bodies, even if a complaint is made, the necessary action is not taken, despite having a policy, implementation is weak, and there is a lack of separate laws and legal uniformity regarding this. However, as a solution, strict legal provisions, positive and preventive interactions in colleges, mental health services, strict implementation of policies, immediate and appropriate action against the guilty, and a change in thinking about ragging (ragging is not a tradition but abuse) are necessary.