How Nepal is Learning To Cope With the Psychological Toll of Its Missing

Photos of the Rasuwa flood missing line the walls of the Teaching Hospital, Tribhuvan University. Credit: Brandon Kohrt

By Diwash Gahatraj
KATHMANDU, Oct 12 2026 (IPS)

Nearly three decades ago, in the final stretch of Nepal’s civil war, Dr Brandon Kohrt sat with parents whose sons had been conscripted as child soldiers and never returned.

Nobody could tell them what had happened, whether their sons were alive somewhere, whether they were dead, or even where to begin looking. That absence of an answer, Kohrt says, never really left those families. It is the same absence now facing thousands of households across Nepal, after catastrophic floods swept away entire communities.

On August 26, floods and landslides tore down the Bhotekoshi and Trishuli river valleys in Nepal’s Rasuwa district, killing well over a thousand people and leaving thousands more missing, one of the deadliest natural disasters in the country’s recent history.

Kohrt has spent nearly 25 years in Nepal, long enough to watch the country move through this same unresolved grief again and again, first during that war, then after a devastating earthquake, and now, once more, before a wall of missing-persons photographs at Kathmandu’s Teaching Hospital.

Only a small fraction of the recovered bodies have been identified so far. These missing men and women are not just numbers — they add up to a history that stretches back decades in Nepal to that same conflict and the earthquakes that followed it, when entire families waited years for people who never returned. Tracking these disappearances and the psychological toll they leave on families and Nepali society at large has occupied Kohrt ever since.

Kohrt is a professor of psychiatry, global health, and anthropology at George Washington University and has served since 2006 as a technical advisor to the Transcultural Psychosocial Organization Nepal.

Much of his work centres on ambiguous loss, the specific, suspended grief that comes when someone is gone but there’s no body, no confirmation, and nothing to mourn against. The term was coined in the 1970s by Pauline Boss, an American family therapist who began studying it through the wives of US soldiers missing in action in Vietnam, women who couldn’t say for certain whether they were married or widowed.

Boss found the condition wasn’t confined to one culture or one kind of disaster. Researchers have since studied it among families of the disappeared during Argentina’s military dictatorship, families of migrants lost crossing borders in Europe and Africa, and among the families with whom Kohrt sat decades ago. He has worked directly with Boss for over a decade and has applied her framework in Nepal for years before this disaster ever struck.

In the weeks since the floods struck, that gap between the dead and the missing has filled with people. Nepali families search alongside Indian, American, Ukrainian, and Malaysian families thousands of miles away, all waiting on the same uncertain word.

IPS spoke with him about what that grief looks like this time, what’s changed for him after his years of returning to the same wound, and what he’s learned, watching people find ways to keep living without an answer.

Excerpts from the interview follow.

IPS: For readers encountering the term for the first time, what is ambiguous loss?

Kohrt: It’s an important psychological concept, and I want to say at the outset, it is not a mental illness. It’s something anyone can go through. It’s when you still have the psychological sense of someone’s presence in your life, typically a loved one, but there is no physical evidence of either their life or their death. There’s no phone call, no video, nothing to prove they’re still living. But there’s also no body, no proof that they’re deceased.

Nearly every culture has rituals around a body that help us mourn and accept a loss. When there’s no body, we’re stuck in emotional limbo, caught between hope and despair. Some people jump right away to accept their loved one is gone, even without confirmation. Others maintain hope beyond even expectations of reality. We’re all on a different spectrum, and it’s very personal, very individualised. Ambiguous loss is also a real risk factor for what we call complicated grief, a longer, more psychologically difficult kind of mourning, with a higher risk of depression and anxiety.

With 6,145 people still missing in Nepal and only a fraction of recovered remains identified, that state of unresolved uncertainty isn’t abstract. It’s the present condition of thousands of families right now. IPS asked Kohrt how Nepal has faced this same experience before.

IPS: You’ve now worked in Nepal through the Maoist conflict, the 2015 earthquake, and this flood. What connects them?

Kohrt: I first came to Nepal in 1996, right at the start of the civil war. Toward the end of it, I worked with an organisation here, TPO Nepal, on the mental health needs of former child soldiers. Some of those parents never found out what happened to their children. Ambiguous loss was part of the psychosocial reality here even then, decades before this flood, and those families often carried an added burden – communities sometimes treated them with suspicion or blame simply for having a missing relative linked to the conflict, something families searching after this flood aren’t facing in the same way, since so many communities have been affected together.

After the 2015 earthquake, most bodies were recovered, and families were able to do funeral rites, but there are still villages, not far from where this disaster has struck now, where landslides buried people who were never found. This isn’t Nepal’s first experience with this exact kind of unresolved loss in some of these same communities.

IPS: In Nepal specifically, are there rituals that help families cope when there’s no body?

Kohrt: There’s a ritual called Kush Kriya, using grass to essentially perform a substitute funeral when there’s no body. It’s very helpful, but people need to be ready for it. Some may feel like they haven’t exhausted every possible avenue to find their loved one, and they’ll refuse to do it. There’s also a different ritual, Bakal Garne, more like a promise or a wish, maybe to a temple, maybe releasing fish into a river. That one doesn’t require accepting death. You can do a Bakal Garne hoping for your loved one’s safe return or simply hoping to find their body so you can do the cremation you need to do.

Even without an old ritual to lean on, Kohrt says, people still need something to actively do.

IPS: You mentioned people in Nepal are giving DNA samples right now, sometimes more than one, in different countries. What does that process do for a family psychologically?

Brandon Kohrt: Providing a DNA sample has a symbolic meaning that goes beyond its forensic purpose. You’re taking a piece of yourself and giving it in hopes of finding your loved one. Even if the result never confirms anything, the act itself becomes almost another form of ritual. People need to feel active and engaged, rather than passive and helpless.

That instinct, to act rather than wait, is something Kohrt has watched play out across every disaster he’s worked through in Nepal.

IPS: Does arriving at a disaster site feel different to you now than it did 25 years ago, or does something in you brace the same way each time?

Brandon Kohrt: With the earthquake, you could walk through neighbourhoods and see and touch the destruction right in front of you. But with the flood, when I arrived in Nuwakot, I could see some destroyed buildings and others submerged in mud. What you can’t see are all the buildings, bridges, vehicles, and people that were taken by the flood and washed away. This is much more a disaster of absence than a typical disaster of ruins. This will be something much more common with climate change-related disasters, where places gradually and abruptly disappear.

Professionally, the biggest difference is going from being hands-on in the response to being more of a supportive observer. Foreign expertise really isn’t needed anymore; there’s such a strong local Nepali mental health emergency response community now, from psychiatrists to community psychosocial workers.

One colleague, who I first hired at TPO Nepal twenty years ago, is now leading donor coordination and setting out a vision for what’s needed over the next three years. If foreign aid and development is successful, you should get to a point where disaster response is led locally, like we’re seeing in Nepal now.

IPS: You described the photo wall at Teaching Hospital. What does it do to you personally, standing there again?

Kohrt: It was really difficult standing in front of the wall of photos. What is so hard is thinking that behind each photo there are so many family members and friends wondering what happened to this person. Some are holding out hope; some are trying to accept the loss and move toward grief. Each face represents someone who was a sister, a mother, a daughter, a friend, a neighbour, or a coworker to all these other people. For every face we see, there are scores of people suffering.

IPS: Do you find yourself getting better at holding this kind of grief over the years, or does it stay just as hard each time?

Brandon Kohrt: I would say I am better at connecting with grief, acknowledging and sharing in others’ grief. A year after the earthquakes, I was in Nepal when one of my brothers died in the United States. I didn’t make it home in time to see his body before he went to the hospital morgue and was cremated.

I remember how hard it was grieving without having seen his body. That pales in comparison to the ambiguous loss thousands of families in Nepal are experiencing as the search for bodies continues. But it’s something that comes up for me when I talk to grieving families and hear their stories. It cracks open a window to allow the flow of empathy.

IPS: After all these years, what have you learned about how people manage to keep living when there is no answer forthcoming?

Brandon Kohrt: It’s how people move on. People have an incredible ability to carry a lot inside of them – pain, loss, unfulfilled hope, and grief – and keep moving forward in life. A lot of what people went through with the flood will be something they carry with them psychologically, but day-to-day survival requires focusing on taking care of children, caring for elderly relatives, and finding a new place to live. This shouldn’t be confused with recovery or resilience. It’s just getting by, which so many people do after a disaster. What good psychosocial and mental health support does is be available for those moments when some of that pain and grief can surface so that when people are ready, they have that support waiting for them.

IPS UN Bureau Report