Political Ideology
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Following his release, with Indian independence imminent, B. P. Koirala set about trying to bring change to Nepal. In 1947 he founded from India the socialist Nepali National Congress, which in 1950 became the Nepali Congress Party. He was imprisoned in Nepal in 1947-1948 after returning to his home city in Biratnagar to lead a labor demonstration. A year later he was arrested again, but was soon released after a 27-day hunger strike, popular protests, and the intervention of Indian Prime Minister Jawaharlal Nehru.

Koirala led the armed revolution of 1951 which overthrew Nepal's 104-year old Rana regime. The last Rana prime minister was dismissed in October 1951 when the Rana-Congress coalition cabinet (in which Koirala served for nine months as the Home minister) broke apart. Koirala then concentrated on the developing Nepali political structure. King Mahendra responded with a new constitution enabling free parliamentary elections to take place in 1959. Only a fragmented parliament was expected, but Koirala's Nepali Congress scored a landslide, taking more than two-thirds of the seats in the lower house. After several weeks of significant hesitation, Mahendra asked Koirala to form a government, which took office in May 1959.

Koirala led his country's delegation to the United Nations and made carefully poised visits to China and India, then increasingly at odds over territorial disputes. Yet, he was in trouble at home almost from the beginning. His land reform measures, especially the revision of the tenancy laws so easily passed by parliament, deeply offended the landed aristocracy which had long dominated the army. King Mahendra, on 15 December 1960, suspended the constitution, dissolved parliament, dismissed the cabinet, imposed direct rule, and for good measure imprisoned Koirala and his closest government colleagues. Many of them were released after few months, but Koirala, though he was suffering from throat cancer, was kept imprisoned without trial until 1968. In 1968 then the Prime Minister Surya Bahadur Thapa, who led the liberal group in the Rastriya Panchayat, played a significant role in releasing B.P.Koirala from prison. later in June Mr. Thapa had to resign due to pressure from the hardliner in releasing Mr. koirala from prison. Then he was finally left on a self exile to live in Banaras.

King Birendra, educated in England and the United States, succeeded his father in 1972, and the political climate was believed to be gradually improving. Koirala, however, was arrested immediately upon his return from exile in 1976 and charged with the capital offense of attempting armed revolution. Finally, in March 1978he was finally cleared of all treason and sedition charges. 1981, then he was enabled to travel to the United States for medical treatment. Then the Prime Minister Surya Bahadur Thapa convinced the king to allow Mr. B.P.Koirala to proceed to USA for treatment as per recommendation from the royal physican Dr. M.R. Pandey. Then the His majesty's Government of Nepal beared a portion of his medical treatment in USA, while the rest were arranged by his nephew Shail Updhaya, Dr. Shukdev Shah, family and friends.

After returning from a further medical visit to the United States, he had a series of audiences with King Birendra, as he tried for a "national reconciliation." During the student demonstrations in 1979, he was under house arrest. However, he welcomed King Birendra's call for national referendum on the question of political system for Nepal. The referendum results were announced to be in favor of retaining the political system led by the king. B.P.Koirala was the first leader to welcome the result of the national referendum and accepted the people verdict and claimed that the referendum was fair and free. However, owing to differences in the electoral process to seek membership of class organization as mandatory, Koirala demanded a boycott of the 1981 elections. Despite obviously failing health and political strength, Koirala could still draw a great popular support. He addressed one of Nepal's largest public meetings in recent years in Kathmandu's Ratna Park in January 1982. He died on July 21, 1982 in Kathmandu. An estimated half a million people attended his funeral.