Category Archives: News

Blood on our hands

During her menstrual days,Swomen spend four days in a shed, outcast from the main household

On Thursday, 19-year-old Tulasi Shahi died of snake bites. Almost seven months earlier, 15-year-old Roshani Tiruwa suffocated to death. And just a month before that, it was 26-year-old Dambara Upadhyay. All of them died under the same circumstance — they succumbed to the so-called Hindu tradition in Nepal that banishes women during menstruation.  

In Hinduism, avatars of some goddesses are seen as manifestation of power. And every time when a woman is mistreated, the conflicted views of mythology versus reality becomes a part of public discourse — while they are worshiped as divine figures, since the ancient times its believers have however relegated women from that pedestal, positioning them as “impure” when nature takes it course every month. And generation after generation, the self-proclaimed custodians of the religion have been using fear as a medium to impose these “traditions” at the cost of women’s lives.

“Our elders think the gods will be angry,” Sunita BK told me while reporting on the issue that plagues hundreds of women in different pockets of Nepal. “The family will have to bear the consequences if we stay in the house during menstruation. We can’t speak against them.”

While many families feared the wrath of the divine deity, which may or may not exist, for many women in villages like Mangalsen, it’s the power of the family patriarchs and such practices that govern their existence.

On a balmy January afternoon in the far-western district of Accham, the 19-year-old spoke of frigid winter nights she had spent in the mud shed since her early teens, adhering to the practice locally known as chaupadi. The tin-thatched structure had paper cardboard that carpeted the dusty floor, no windows for ventilation, and a wooden door without proper locks. It wasn’t even big enough for a five-feet woman to stretch.

The shed is a crammed space with no ventilation or windows. Reports of deaths due to suffocation during chaupadi have surfaced over the past years

Sunita said her mother and mother-in-law followed the same tradition, and the latter said her mother told that it was a part of every woman’s monthly routine, with the elderly from the family ensuring that the religious sanctimony is not broken. And in order to protect something that their dead ancestors passed, people tend to entirely ignore the living, leaving women to die under inhumane conditions — in any religion, it would constitute sinful.

When I visited Accham, almost a full-day drive from the closest airport in Dhangadi, in 2014,  death of 15-year-old Sharmila Bhul from the previous year still lingered in people’s memories. She lived 30 minutes away from Sunita’s village, and had mysteriously died in the shed. She was expelled from the house during her period. It wasn’t a shocking news for many. It was a sorrowful story, but not shocking. It was more or less an ill fate that could have happened to anyone.

It is noteworthy that blinded by faith, people tend to normalize such events, selectively ignoring the injustices faced by women in their community, becoming equally complicit in a criminal behavior disguised in the form of tradition.

It’s been 12 years since Nepal’s Supreme Court outlawed chaupadi. During the past decade, the country has witnessed seasons of political and social changes. Women’s empowerment, along with other catch phrases that are used as yardsticks to measure social progress, have become a part of the local lexicon, even in villages of districts as far as Accham. Nepal is hailed for reducing maternal mortality, improving women’s access to finance, and securing political representation, as female leaders hold the positions that once were held by key male players only. They have been elected as the chief justice, speaker of the house, and also the country’s first female president.

And while these developments paint a rosy picture of a poor but progressive country, the society still hasn’t forgotten to deem women “impure” during menstruation. However, it should be noted that this is not only rural Nepal’s problem. Archaic traditions as such are silently practiced in urban pockets like the capital, Kathmandu. In my neighborhood, men from the so-called upper caste Brahmin family still don’t touch women while they bleed, and even in my Newari household, women don’t enter the kitchen or the worship room during menstruation. The only difference is that women die in villages, but in cities we kill their dignity by giving them an “untouchable” status.

While the problem exists, it is important that we look forward seeking solutions. Yes, there have been policy interventions, but that doesn’t guarantee a social transformation. And this is where the members of the community should step forward. In villages like Mangalsen, I met men like Kamal Rawal, a 22-year-old journalist who has taken a stand against the practise, starting from his household. In Ridikot, the village where Sharmila died, locals are challenging this culture, destroying one shed at a time. Rights organizations have also been vocal in raising awareness.

But when I asked Sunita about all of this — the political representation, the progressive attitude, including her neighboring village — she smiled at first, and then shrugged. The teenager, and a mother of a child, said all of that is so distant from her everyday life. They mean little to her as long as she has to brave the weather, wild animals and worry about perverted men barging in the sheds at night, and spend five days in the shed every month during her menstrual cycle.

“I hope the situation will change soon,” she said.

But the underlying question is: How soon will it change?

One after another, women are dying in similar situations. And from where Nepal stands today, even one death is too many. Every death is equally shocking because it’s untimely, unnatural — it can be passed as murder — and something that is undoubtedly preventable. And let’s not wait until another death, or series of stories splashed across international media outlets to enrage us about what’s happening in our backyards.

It’s now beyond time for family patriarchs, community crusaders, and political leaders to shun this practice and shatter the sheds in every corner of the country. For centuries, society has banished women for bleeding, but its members should now collectively accept that they are to blame for each death — they are the ones with blood on their hands.

 

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Promoting education in rural China, one girl at a time

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Photo: EGRC

To understand her philanthropy, Tien Ching says one needs to dig into her past.

When she was 13, Tien used to study at an elite junior high school with daughters of Chinese leaders and dreamt of becoming a journalist when the Cultural Revolution started in 1966. For a seventh grader, not being able to continue her education during those tumultuous years, Tien says, seemed like the final chapter of her unwritten book.

In the following years, Tien’s life story traversed from western China’s Gansu Province to Beijing and then Vancouver, but she never had a chance to continue her education.

But 37 years later, the teenager who had quietly packed her dreams had an epiphany – to provide girls in rural China a chance of higher education, something she didn’t have.

In 2005, Tien set up a charity and called it Educating Girls of Rural China (EGRC). It was the beginning of a mission that now has a cohort of 400 career women from Gansu and other provinces.

Go Girls
Tien was 17 when her mother, a pediatrician, moved to Gansu for work. She followed her and ended up toiling long hours at a chemical fertilizer factory.

“It was a no brainer,” she says, reflecting on the struggles. “I felt I couldn’t be there. There was no hope.”

She heard harrowing stories from her mother, who travelled to remote parts of the province, about girls as young as 13 already married, some with children. They were devoid of any educational opportunities or career-oriented future.

“I was always determined to get out of there, continue my education,” she says explaining a “complicated story” of returning to Beijing eight years later.

However, complications in her residency status meant she couldn’t sit for the university entrance exam in Beijing. Later, she married the son of a family friend living in Canada and emigrated there in 1983. But, family responsibilities meant she made a “conscious decision” not to pursue higher education.

But years later, while watching her daughter perform at a UNICEF fundraising event for girls’ education — it was called Go Girls — her thoughts travelled back to Gansu.

“That evening I remembered the girls in Gansu and my life there,” she says pensively. “I thought of the meaning of opportunity … if they had chances, the girls there would be as smart as my daughter.”

Like a goddess

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Photo: Li Fangxia

For many young women, whose lives Tien has transformed, she is more than a “sponsor” supporting their college tuition – she’s a mentor, friend and part of their family now.

Li Fangxia, who graduated from Northwest A&F University in Shaanxi Province with an EGRC scholarship, says Tien “gave us the life we had never imagined.”

“Every time I meet her, I feel empowered,” Li says. “She’s like a goddess.”

Coming from a family weighed by financial problems, Li says she was always expected to be the helping hand in the farms. Also, her brother’s education was a priority; their parents couldn’t afford her university fees too.

In parts of rural China, sons are still given preferential treatment while women are discouraged from higher education, obligated to help the family. Li says she had “given up.”

This is when the 25-year-old heard about Tien’s charity and applied. After an application and an interview, her request was approved.

“I am the first girl in the countryside to go to university and work in Beijing,” Li says. “Other girls, they gave up studies and married very early.”

And in that process, women like Li are also helping shift traditional attitudes and emboldening other women in her village of Quan’erwan – she helps her family financially, pays her brother’s university tuition and is an ambassador for pushing girls’ education.

“I am a good example,” Li says with pride. “They may now rethink that girls deserve to go to college and they can do anything that boys can, even better.”

Seeds of success

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Photo: EGRC

When Tien talks about her past, she still sounds emotional. She is in her 60s and not “bitter anymore” but says a sense of regret still hangs in her subconsciousness – until she sees one of her graduates.

“When I look at these girls, I see them fulfilling something I didn’t have the opportunity to finish: education,” says Tien, who is busy attending networking events in Beijing and also shared her story at TEDx talk program. “Mostly, I see change in them and that encourages me. I see a part of myself in them.”

In these 11 years, Tien’s philanthropy has become an integral part of many success stories. The 6,000 yuan (865 US dollars) yearly scholarship to individuals from her charity goes beyond its monetary value, providing important life lessons to the beneficiaries.

The women Tien helped have gone to become teachers, entrepreneurs, and more so independent thinkers and leaders, in China and Canada.

“I want to help China generate the next generation of female leaders,” Tien says. “I want them to make them dream bigger. When I see my girls, I see that in them.”

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After the earthquake

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(Two year update: People still living in temporary shelters, delays in rebuilding, concerns over heritage reconstruction

A year is a long time, and in Nepal, the length of the year since the April 25, 2015, earthquake is relative: it depends who you ask.

For the government, it’s been quite a short year: it hasn’t been able to accomplish much of the reconstruction work.

But for the earthquake survivors, it’s been one of the longest years. The quake swallowed their houses, shattered their livelihoods, and a year later, they’re still struggling to pick up the pieces.

It’s been 366 days since the 7.8-magnitude earthquake shattered parts of Nepal, including the capital Kathmandu. It was 11:56 a.m. when the ground shook – it was first a thud and then a thunderous roar that echoed from beneath.

It was violent and lasted almost a minute. It was so violent that I couldn’t reach for the door. My heart pounded, legs trembled, and my thoughts froze. And when it stopped, my surroundings had changed in a matter of seconds.

The street outside my house had cracked, and though many of our houses survived the tremor, just a few meters away, a neighbor’s two-story house had collapsed entirely.

And just an hour later, as I clutched my notebook and ran uncomfortably in my flip-flops while still in shock, in Kathmandu Durbar Square, the city’s century-old palatial courtyard, I witnessed history was erased, almost. Several historic monuments and temples were levelled – and people were buried inside.

The chaos and the commotion in my hometown that day — and the powerful aftershock on May 12 — seemed as if a doomsday prediction had finally come true.

While Kathmandu and its surrounding areas, including Bhaktapur, Sankhu, Bungmati and Harisiddhi, suffered incomprehensible damage, tiny hamlets outside the city were entirely hammered.

In Sindhupalchowk, the district with the highest casualties, I witnessed death, destruction and despair. The scale of the seismic shift was devastating.

“There are no houses left in my village,” Sujan, one of the waiters who worked at my friend’s restaurant, told me hours after the earthquake, as he was making desperate phone calls to his family members in Sindhupalchowk.

Upon visiting the district five days later, I could see what Sujan meant: settlements in Sindhupalchowk were obliterated.  Schools, hospitals, and houses were smashed by the quake.

This is where I met Uddhav. The 28-year-old was trying to see a doctor in a makeshift medical camp in the district headquarters of Chautara on a sweltering May afternoon.

The drive to his small village through a snaking dirt road was striking – it was a stark paradox between nature’s beauty versus the power of its devastation.

The view of the snow-capped Himalayas, rolling hills and gushing rivers was eclipsed by flattened villages and collapsed homes. Uddhav’s village was one of them.

Sitting on his hard bed with no mattress, under a temporary tent house, he told his story without  any visible emotions.

“I’ve lost everything,” he said, his eyes fixated on the ground.

The earthquake not only injured him but also killed his wife and two children. His two-story house was now nothing but a mountain of rubble.

“I need to be strong – I can’t show my tears to my mother,” he said, as his grieving mother sat beside him and wept profusely.

It had been more than a week after the quake when I visited Sindhupalchowk, and survivors like Uddhav were desperately looking for help – water, food, tarpaulin sheets, tents. Anything.

And while local and international non-profits, and most importantly, volunteers from communities across Nepal mobilized to deliver assistance, the government was slow to react. The red tape made humanitarian assistance entangled in bureaucratic web with little sense of urgency.

“It seems like we are invisible,” Laxmi Gole told me last year. She was infuriated and were among the locals blocking part of the road in Sindhupalchowk that led to the district headquarters in Chautara.

It’s been a year and many earthquake survivors still haven’t received much from the state.  Thousands of people like Uddhav have given up hope that the government or the representatives they elected and sent to Kathmandu would act on their behalf.

Most survivors still live in temporary shelters where they braved the monsoon rains, frigid winter and the stormy spring early this year. They feel ignored by the government.

A US$4.1 billion pledge by the international community has more or less turned into a fairytale fantasy. The country’s National Reconstruction Authority, responsible to lead the reconstruction efforts, was buried in a bureaucratic dillydally and was dormant until a few months ago. The Prime Minister Disaster Fund Relief, along with local and international aid organizations, raised millions of dollars in the aftermath of the quake, but the ones who need it the most seem to be entirely out of the equation. Alhough the survivors whose houses were destroyed were to receive Rs. 200,000 from the state, it was not until last week that they received Rs. 50,000 as the first installment – that too, only 641 of the thousands of survivors.

The promulgation of the new constitution in September was seen as an answer to many of Nepal’s problems but it further plunged the country into crisis. And as much as the government hailed the controversial constitution as inclusive, many ethnic groups and women felt alienated. As a result, the southern plains burned, unsatisfied India imposed an economic blockade — it denies the accusations though — and the country’s ailing economy slumped further while the government watched from a distance, indulging in inconclusive talks with the agitating parties and failing to address the issue.

At least 55 people, including civilians and security personnel, died between August and September – it was believed to be the most violent protests since the end of the bloody Maoist conflict a decade ago.

Up in the hills, as winter approached, people were dying, too. By late December, at least 22 people had died. They were able to survive the seismic shake but succumbed to the state’s apathy.

Come spring, the situation has not changed much.

Far from home, as I sit to read an avalanche of articles, many reporters have picked up stories where they left a year ago. And even amid the most encouraging stories, there was agony.

Al Jazeera’s 101 East team — I was a part of last year’s film — also revisited Uddhav and his village. And though there were signs of early progress, life was perilous for many.

Hundreds of men like Uddhav, who already had debt since before the quake days, have taken out additional loans and are now drowned in debt. Many are considering going to the Middle East or Malaysia for foreign employment despite the risks. Almost 1,500 Nepalis leave for foreign employment every day to feed their families back home, and while many return with considerable sum of money and stories of hardship in a foreign land, the unfortunate ones come back in coffins.

And yet, they are determined to leave – just like Uddhav, who told me while visiting Kathmandu months after the quake, that given a chance, he would leave despite his injuries.

Uddhav’s story is indicative of the government’s lethargic reaction to cope with the country’s biggest natural disaster since the 1934 earthquake.

“There’s nothing left,” Uddhav told me.

After what seemed to be the longest year for many survivors, they still have nothing left but hollow promises from the state.

And as leaders release balloons and light candles in Kathmandu to remember the dead at the first year anniversary of the quake that killed nearly 9,000 people, they seem to be less concerned about the living.

Those balloons will deflate and the candles burn out, and no one will remember what the leaders did to mark the earthquake anniversary. But people will never forget that they were forgotten when they needed their government the most.

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Nepal’s Integrity Idol

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At a time when Nepal’s political leaders are throwing chairs and vandalising parliament property, and people disregard civil servants, one man has won the reputation as the country’s first Integrity Idol.

Gyan Mani Nepal, a district education official from the eastern district of Panchthar, didn’t have to woo people by singing or dancing to win public votes. But his honesty and commitment to reform his district’s education sector made him a winner.

“I haven’t done anything different, I’ve just done things differently,” Nepal said in a speech after he was declared the winner.

Nepal gained the maximum number of votes and was chosen among 303 nominees.

Here’s my story. 

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Nepal’s Health Innovations

Despite political turmoil and power struggle in the center, surprisingly Nepal has been progressive in reforming parts of  its health sector. The country is on track for achieving the targets for the United Nations Millennium Development Goals – reduce under-five mortality by two-thirds and maternal mortality ratio by three-quarters between 1990 and 2015. While improved government policies have helped to materialize these goals, the community’s role should also be underscored. For them, these targets are much more than reducing the numbers and getting a “pass/fail” remark on the global report card – every mother and newborn saved, like for everyone else, is a story of joy and celebration, a memory that will live with their generations to come.

During the past two weeks, I have had a chance to learn about some of the researches that have helped save thousands of lives and the programs followed thereafter, which have been a basis for formulating national health policies. The policies that led to national programs have massively helped reducing neonatal, child and maternal mortality in Nepal.  Meanwhile, it was also interesting to see how the ongoing researches are incorporating innovative and easy solutions that could further help save more mothers and newborns.

The following innovations and success stories listed below were highlighted in an event during the visit of Dr. Rajiv Shah, Administrator of the United States Agency for International Development (USAID). The first high-level US official to visit Nepal since 2002, Shah was in the country to award the Government of Nepal, Ministry of Health and Population, for its Chlorhexidine Program.

Chlorhexidine Cord Care Program

In 2011, Nepal’s Ministry of Health and Population became a global pioneer to scale up the use of Chlorhexidine for newborn cord care at national level through the Chlorhexidine Navi Care Program and other partners. For this significant march toward improved neonatal health care, the program has been awarded one of the Grand Prizes of USAID’s 2013 Science and Technology Pioneers Prize that commemorates the use of science, technology and innovation to solve development challenges.

A majority of Nepal’s population, especially in remote parts of the nation, still prefer traditional remedies for cord care to modern-day medicines. The latest Demographic and Health Survey estimates more than 41 percent of babies had materials such as mustard oil, turmeric, ash etc. used in their umbilical cord.

Such practices may contribute to Nepal’s neonatal mortality rate of 33 deaths per 1,000 live births. With about two-third of deliveries conducted at home, mostly in unhygienic conditions, newborns are vulnerable to neonatal infections, which is a leading cause of neonatal deaths in Nepal.

But Chlorhexidine, locally known as Navi Malam, is an antiseptic gel that reduces bacterial colonization on the skin and umbilical stump of newborns.

A pooled analysis of three randomized controlled trials of use of Chlorhexidine immediately after cord cutting done in Nepal, Bangladesh and Pakistan shows that the application of  Chlorhexidine reduces neonatal mortality by 23 percent and reduces serious infections by 68 percent.

The intervention that has reached 41 of the 75 districts started as a pilot project in 2009 using the antiseptic manufactured by a Nepali company, Lomus Pharmaceuticals, along with technical support through USAID and Nepal Family Health Program/JSI. Female Community Health Volunteers, the backbone of Nepal’s public health system, are the main channel to counsel pregnant women and distribute Chlorhexidine tube during the eighth month of pregnancy.

When the program is scaled up and implemented nationally through the public health system, Lomus estimates Nepal would require about 800,000 tubes annually – one for each birth. Currently, the pharmaceutical company produces around 20,000 tubes per day, which cost Rs. 18 (approximately $0.18) apiece.

Since 2009 Lomus has delivered more than 775,000 tubes within Nepal. The company has also exported 240,000 tubes to countries like Nigeria, Madagascar and Liberia within the last two years.

One-cent test for pre-eclampsia/eclampsia

At a time when most public health facilities are lacking standardized testing tools for pre-eclampsia and eclampsia, Jhpiego is in a developing phase to innovate and improve the screening of the disease, which is the leading cause of maternal mortality in Nepal. Though it can be detected early during antenatal visits to a health facility, about 50 percent of women do not fulfil this routine.

This new technique to test pre-eclampsia and eclampsia involves a device (currently a dropper) to dispense a color-changing reagent on paper. Similar to a pregnancy test kit, a pregnant woman urinates on the paper and finds out the result instantaneously. While yellow signifies a negative result, green is a warning that they should visit the health facility.

In this developmental phase, Jhpiego, an affiliate of John Hopkins University in the US, is also training the Female Community Health Volunteers who take this testing to the would-be mothers.

The Maternal Mortality and Morbidity Study 2009 suggests that 21 percent of deaths are attributed to eclampsia.

In course of time, with results from the research that would meet the Gold Standard, Jhpiego plans to develop a standardized design for manufacturing, get a regulatory approval and conduct nationwide pilot studies.

The cost of this innovation would drastically bring down the testing cost. The current retail price for manufacturing and distribution is estimated between $4 to $5 per device for 500 tests; high quality dipsticks cost between  25 cents to 40 cents per test.

GIS Mapping System

A work-in-progress digital mapping of Nepal’s health system is said to be the most advanced in South Asia.

The highly interactive map will also provide scientific data on roads, locations of health services and workers in relationship with population and health service centers.

According to the Ministry of Health and Population, GIS has been incepted and is in the process of institutionalization in the health system. This adoption is also reinforced by e-health, Health GIS and need for integration of information systems.

The Health Facility Mapping Survey has been carried out in 57 districts with technical and financial support from World Health Organization and further processing for remaining 18 districts started in 2013 with the assistance of SAIPAL with support from USAID.

Once compiled the entire database can be linked and accessed according to the user requirement, without the need of studying data table or reports, making GIS the ultimate tool for decision makers in analyzing data by visual means. It would help in answering key questions related to the health sector that would further improve and enhance the country’s health system.

Regarded as Nepal’s “Health Atlas,” the project, once completed, will have the most cutting-edge, geo-enabled data on infrastructure, location and equipment of all health facilities in the region to improve data for decision-making.

Nepal Nutrition Intervention Project – Sarlahi (NNIPS)

For the past 25 years, NNIPS, which is being carried out by Johns Hopkins University (JHU) Bloomberg School of Public Health in collaboration with the Nepal Netra Jyoti Sangh, has been a leader in researching life-saving innovations.

The years of collaborative work, conducting large community trials in the Sarlahi district of Nepal, have contributed significantly to the establishment of programs responsible for reducing maternal, child, and neonatal deaths.

From the vitamin A revolution to umbilical cord cleansing with Chlorhexidine, NNIPS has produced noteworthy health discoveries that have become the basis for establishment of new national health policies and the launching of programs both nationally and globally.

In Nepal, during the 1990s, 2 to 8 percent of preschool-aged Nepali children experienced severe vitamin A deficiency, with a much larger percentage experiencing moderate and sub-clinical deficiencies and the concomitant health and mortality risks associated with them.

During NNIPS’ first large study conducted from 1989 through 1991, it was demonstrated that with periodic high-dose vitamin A supplementation a 30 percent reduction in child mortality in children between six months to five years of age can be achieved. Encouraged by this and similar results from large trials in India and Africa, the Government of Nepal initiated the Nepal National Vitamin A Program in 1993.

The vitamin A campaign now reaches nearly 1 billion children in over 50 countries around the world.

The results of NNIPS’ randomized controlled community trial of umbilical cord cleansing with Chlorhexidine on neonatal mortality and infection in Sarlahi have showed that if applied within 24 hours of birth, chlorhexidine can produce a 34 percent reduction in neonatal mortality.

This research result encouraged the government to implement the Nepal National Chlorhexidine Navi Care Program in 2011.  This program, that has the potential to save thousands of lives in Nepal, has now been expanded to 41 districts, with all 75 districts to be eventually included.  Many African and Asian countries have either already started or are interested in starting their own national Chlorhexidine cord care programs as well.

Female Community Health Volunteers

Dressed in their blue saree uniform patterned with concentric circles, a striking uniform that makes them stand out, Nepal’s cadre of 52,000 Female Community Health Volunteers have been an instrumental force in promoting safer motherhood and institutional deliveries, encouraging contraceptive use among women and men and administering various government-led health campaigns to effectively using a timer to diagnose respiratory illness in children.

The Government of Nepal started the program in 1988 with support from USAID, UNICEF, UNFPA and local non-governmental organizations. In its 25 years now, these women have been play a key role in helping in strengthen the country’s health system from a grassroots level on a voluntary basis. – what started as a community-based project is a public health sector’s national pride now.

During these years, the FCHVs have also played an integral role in scaling up innovations that have put Nepal in the global spotlight. They are at the forefront of promoting the use of Chlorhexidine to prevent umbilical cord infection in newborn, one of the major causes of neonatal deaths in Nepal.

They are also responsible for promoting community-based health interventions, which include distribution of Oral Rehydration Salt for diarrhoea, Vitamin A and pneumonia treatment, have helped to reduce under-fiver mortality by more than 50 percent in the last 15 years.

Along with the responsibilities, being an FCHV also comes with a reputation – they’re the trusted members who are well recognized in their communities, which motivates most of them to continue doing what they’re doing best.

(The following write-up is partially extracted  from a special USAID publication for Dr. Rajiv Shah’s visit to Nepal. With inputs from Alok Thapa for GIS and NNIPS, editing by Jane Silcock, and design by Swapnil Acharya.)

 

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Nepal’s Female Community Health Volunteers

Kulsum Darji from Banke district is one of the 52,000 Female Community Health Volunteers who have helped relentlessly in improving the country's  key health indicators.

Kulsum Darji from Banke district is one of the 52,000 Female Community Health Volunteers who have helped relentlessly in improving the country’s key health indicators.

They are the unsung heroes of Nepal’s health sector.

In the last two decades, these women have supported in improving the country’s health standards from a community level – a cadre of 52,0000 Female Community Health Volunteers (FCHV) have actively aided in bettering the lives of mothers and children across the country’s 75 districts.

In its 25 years now, the Government of Nepal started the FCHV program in 1988 with support from international development agencies like USAID, UNICEF and UNFPA along with local non-government organizations. The main objective then was to have a representative from the community who would work for their community.

After more than two decades, these Female Community Health Volunteers work on the very principle of serving their community. However, their roles have expanded over the years – they’re not only health promoters but in some cases also health providers. From counseling young girls on sexual health to would-be-mothers on safer motherhood and healthy nutrition and contraceptives to treating and referring cases of pneumonia and acute respiratory infections to local health facilities, the FCHVs have played a vital role in saving lives.

What started as a community-based program is now a national pride.

Speaking at an event commemorating the silver jubilee anniversary, Minister for Health & Population Vidyadhar Mallik said the FCHVs have “helped the country in achieving the United Nations Millennium Development Goals and out Nepal in the global map of success.”

According to Dr. Kiran Regmi, Director of the Family Health Division that administers this program, FCHVs have contributed from the grassroots level and are working actively in places that are cut off from health facilities. She also credits them for helping the country to reduce the maternal, infant and under-five mortality rate.

According to Nepal Demographic and Health Survey 2011, infant mortality has declined by 42 percent and under-five mortality by 54 percent over the last 15 years. The maternal mortality rate has also seen a drastic slowdown between 1996 and 2006, from 539 to 281 deaths per 100,000 births.

This progress has made Nepal one of the few countries that are “on track” to meet the Millennium Development Goals of reducing maternal and child mortality, as per the MDG Progress Report 2013.

However, as goals are being achieved, the grim realities of deaths and despair are still prevalent across the country – far many women are still dying of causes that are preventable, and still one in 22 babies die before the age of one, and one in every 19 children before their fifth birthday.

With FCHVs mobilized across the country, and by banking on this trusted cadre in the community, with more information and education, Nepal can set a post-2015 goal in not only decreasing maternal and child mortality but also other sectors.

For a majority of FCHVs, it’s the impact of their work they see in their community that motivates them to continue their voluntary service. The respect and recognition they have in society further pushes them to do what they’re doing.

In course of time, these women have emerged not only as homemakers but also one of the pillars in strengthening the country’s health system; they’ve also inspired and encouraged another generation of women through their work alongside. And that’s what sets them apart.

STORY:  South China Morning Post

VIDEO: Nepal’s Female Community Health Volunteers: Saving lives, empowering women

Photo feature: Republica The Week E-paper (Page 8 and 9) 

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Nepal Votes

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I am one of the 12,147,885 eligible, registered voters who have voted or are in the process to vote  in today’s election in Nepal.

The second general election after the bloody Maoist conflict ended in 2006 will elect members of the country’s Constitution Assembly that will draft Nepal’s pending constitution writing process.

Following the end of the decade-long insurgency, the Maoists swept a popular victory in Nepal’s landmark election in 2008. It was supposedly a dawn of a “new Nepal” — the country’s 240-year-old monarchy was replaced by a republic status, the war had ended and Nepalis became more hopeful.

However, the years that followed made Nepalis frustrated with their elected members. Same old stories of corruption and inept leaders regained freshness. The deadline for the constitution writing process came to a dead-end, the Constitution Assembly was dissolved, a new election government under the country’s Chief Justice formed and today’s election date was decided.

As I walked to vote today, the streets looked deserted – vehicular movement has been stopped until midnight. But as I approached my designated polling booth, I could see people queuing — it was particularly good to see young people and the elderly walk to the polling station to elect their leaders.

“Aaunai paryo ni,” said a woman standing next to me in the women’s queue in the balmy morning sun. She said she had to come. While she wanted to exercise her right to vote, she didn’t seem enthusiastic about what difference the candidates would make.

As the Maoist party candidate from Kathmandu’s constituency 4, made rounds in the polling line at Ved Vidyashram, flashing a smile and saying Namaste with his palms clasped, people there, including me, returned the courtesy. But after he left, the same woman remarked: “Do you think he will remember us after the elections?”

After the Maoists came into mainstream politics and won by a majority, people had high hopes, but the party and its leaders failed to deliver.

From Reuters:

Five governments – two of them headed by the Maoist party – have come and gone as politicians wrangled over the structure of the proposed new republic and how it should be governed.

Economic growth in Nepal, where nearly a quarter of its 27 million people live below the poverty line, has hovered around 3.5 percent over the past 10 years, much lower than the pace achieved by China and India on its doorstep, forcing many people to seek work abroad.

Much of the ire for the drift is directed against Prachanda, the 58-year-old Maoist revolutionary whose party, riding a wave of hope in a war-weary nation, won the largest number of seats in the first constituent assembly that also functioned as the parliament.

As Nepalis are voting today, along with enthusiasm, there is also some scepticism. With one of the Maoist faction (Communist Party of Nepal-Maoist) leading the 33 party alliance boycotting the election, the future of Nepal’s politics is far from any predictions, discussed a group of men in the line where I stood.

“No one is going to get a majority, the votes will divide and so will the country,” a man said.

From TIME:

“No party is going to get a simple majority even this time. It’s just going to be a repeat of 2008,” Surendra K.C., a Kathmandu-based independent political analyst, tells TIME. “Moreover the offshoot of the Maoist party, staying out of the elections, is going to be a problem. If this continues another Maoist insurgency cannot be ruled out.”

However, people are still in the mood to vote, to bring change. Reports in local media claim significant people have left capital Kathmandu to go vote in their districts.

I met a man last week at Nepalgunj airport who was waiting for his flight to Jumla in west Nepal. A development worker by profession, he said he had taken a two-day break from work to fly from Kathmandu just to vote.  He had come to cast his ballot in the 2008 election, and he surely did want to exercise his rights this time too, he said.

I was headed to Jumla too, and so we talked about his village and the politics. He told me he had been in touch with his family and friends and been following Jumla’s politics and added it would be hard to predict who would win.

When I arrived at the main market square in Jumla, I saw cadres from Nepali Congress in full swing, but bystanders watching them and also discussing politics, seemed disillusioned. They said all they wanted was someone who would represent their problems and become their voice in the national politics.

In recent times, Nepalis seemed to have lost faith in their leaders, especially the elderly honchos who are deemed to be the foundation of the party’s ideologies. Out of utter frustration, a new breed of young leaders have sprouted or gained prominence lately. Young leaders like Gagan Thapa, whom a Facebook friend claimed to be Nepal’s Garack Thabama (referring his charismatic personality to US President Barack Obama), and Ujjwal Thapa, an activist turned politician this election season, have much dominated social media and young minds.

In 2012, when I spoke to Ujwal during a political activism demanding the constitution, he said he wanted to tap into the country’s young population and make them think and act, and not just talk.

From The Washington Post:

Highlighting the differences between the mainstream parties and his independent campaign, 36-year-old Ujwal Thapa said he is running to change his neighborhood and does not make big promises to voters.

“Not being able to fulfill their promises has given politicians a bad name,” said Thapa, who graduated from Bennington College in Vermont and has picked for his election symbol a dog, a term associated by many Nepalis with incapable politicians.

“We want to change the perception,” he said. “We want people to think our leaders should be like dogs — but loyal like dogs, honest like dogs and protector like dogs.”

In his article today, local English daily Republica’s editor-in-chief Kosmos Biswokarma writes that the country is in a “transformational stage” and by choosing the right candidates Nepalis have a choice to make the right change.

An editorial in the same newspaper states that “the road ahead is tricky,” but expresses hope meanwhile.

From Republica:

As we saw during the last CA, the longer the process drags on, the lesser the chance of meaningful compromise on important constitutional matters. Five, there must be discussion on important affairs within the CA halls. The whole assembly should be in a position to own up the final document; constitution making is not the prerogative of top leaders.

We still believe Nepalis are capable of charting their own future. What is needed is commitment to hold steadfast to one’s political ideals and to revisit and avoid past mistakes.

Another editorial in The Kathmandu Post resonates similar sentiments:

As Nepalis go to the ballot a second time, the political parties must take stock of their actions in the last CA. Public trust in the political parties was at a stratospheric high in 2008. Now, disenchantment is rife. But the fact that people have decided to give the parties a second chance displays the faith they still have in the parties.

As the poll stations close at 5 pm today, and the votes counted, we will be tracking the process and counting the days that could change the country’s future. We have seen the country go through a drastic political transition and have had expectations of equally drastic socio-economic and political transformations that would take the country forward. But time and again, our leaders have failed to live up to their promises making the path to progress still a remote thought.

With this election, people have given the leaders yet another chance to deliver everything — and even more — that they had failed previously. It’s now time for them to act wisely.

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Remembering an icon

It’s been three days since the country lost one of its music legends — Fatteman Rajbhandari. But when I tuned into a tribute program on Kantipur Television tonight, he was singing with the same panache, striking every musical note that I have been hearing since childhood.

We lived in a conjoined house; he was my grandfather’s younger brother, my father’s uncle. And since he lived in the house next door, I called him “uta baa” meaning the grandfather next door. And for all of my siblings and cousins, for family members of my generation, he became “uta baa.”

Music has been in the family. While my grandfather chose the tabala, his younger brother, Fatteman, ventured into singing, both of the brothers defying what their father did: business. While my grandfather made his way to the army, his younger brother pursued music.

As a child, I remember sitting on uta baa’s lap and playing the harmonium — that’s the only vivid memory I have of those days. Maybe because the harmonium was such a fascinating musical instrument. I remember playing with the keys and more than that putting my fingers on the small circular holes in the front of that instrument, enjoying the puffed air that came out of it. While growing up, for the rest of the time, until last year when I was home for the holidays, I heard him practising his vocals early in the morning. To be honest, it did get annoying at times — listening to him sing at the crack of dawn when all I wanted was some sleep after a late night out. But I couldn’t have asked for a better way to start my day.

For all of us in the family, if I may say so, he was more than a singer — I think personal relationships always weighed in more than his profession. Growing up, I heard stories not about the legendary singer but of a strict father, a mischievous brother, and an adventurous uncle who went on an excursion to Bombay with my father and uncle. He never imposed the grandeur of his professional success and status in the family. As I heard many of his contemporaries and colleagues describe him as modest and devoid of an aura of a celebrity during his funeral, I can’t agree more. In the family, around the neighborhood, he was just yet another man doing his everyday stuff, singing included.

Having achieved so much, he never acted like this man who is undoubtedly in the list of Nepal’s finest. He certainly didn’t act like the modern-day celebrities who crave for publicity and thrive on their stardom. He didn’t need to because he was more than a celebrity — he was an icon.

At his funeral on Tuesday morning, the sensational singer was resting peacefully. It had been a painful week — his upper body had swollen to the extent that he couldn’t breath; his face was puffed making him almost unrecognizable.

But the last morning that we would ever see him, it seemed he had re-emerged to his true form — the swelling had subdued and it was the same face that we were used to seeing. And as we kept staring at his body, one of his songs played in the background: “Marna Baru Garho Hunna/ Timro Maya Marnai Sakinna (It would be easy to die than to let go of your love).”

This timeless classic that made him a national icon was the soundtrack to his funeral. Though emotions ran high and tears trickled down, we all knew that though he’s not with us physically, he will always be alive in his songs — his voice would keep echoing through those eternal songs about love, life and heartaches.

That moment, amid all the grief and sorrow, seemed like an immaculate ending.

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Child labor in Nepal

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Child labor in Nepal is an open secret. From the capital’s public transports to the numerous highway hotels, and trekking routes across the Himalayan trails, it’s difficult to miss children at work. According to the National Child Labor report, an estimated 1.6 million children are in the country’s workforce — three-fourth of them are children under 14, and most of them are girls.

For this particular story, I met children who are working, and some of them rescued from forced labor  — some had run away from their homes in search of a better life, others were working to support their families, and in some instances forced to be the ones who would bring additional income to the family.

While parents send off their children, many businesses that thrive of cheap labor readily recruit these children. There is in fact a demand and supply chain that fuels child labor — poverty is undeniably the biggest push factor. Many children end up in the country’s carpet, brick and garment industries working under excruciating conditions, often exploited physically and even sexually.

An estimated 172,000 children, according to a rapid assessment by international non-profit World Education in collaboration with Plan Nepal, are working as domestic child workers, 56 percent of them are below the age of 14. This trend though a serious issue is often overlooked. Employers argue that they’re providing a better life and education, as well as a salary, in exchange for the household chores.

As the country aims to eliminate hazardous forms of child labor by 2016 and all other forms of child labor by 2020, the challenge lies in the heart of the problem: poverty. Until and unless poverty persists, experts say problems as such will find a place in society.

For more insight on Nepal’s child labor, here’s my story for CNN: No life for a child: The grim reality of Nepal’s child laborers 

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Pushing the limit

Last month I travelled to Pokhara for a series of stories — being a freelancer or a reporter in general, you always want to bring home a bag full of stories when you travel.

Before leaving for Pokhara, all I had were a series of interviews for this particular story I’m currently working. But meanwhile I just thought I would get hold of more sources for the Gurkha story I was working on — little did I know then that this would in fact turn out to be a full-fledged multimedia story and a string of stories for three media outlets.

When I first saw these young Nepali men training to prepare for the British Gurkha recruitment camp, I thought the story would have more impact visually. As they trained in the rain and under the scorching summer sun, pushing their limits, I was in fact pushing my limit too.

With a DSLR camera — the only equipment I had — I ran along with them in the rain and the sun, capturing their rigorous regiment. One of my friends travelling with me offered to help, which was a great relief during interviews.

Two days of shooting, a hard disk that ran out of space and almost three hours of footage, I wrapped up the Gurkha story and started working on the other one I was originally there for.

Being a freelancer, though its flexible, there is always this fear of not finding a home for your story. But you have to try to convince your editors, you have to be persistent in pushing your story. And I’m glad that I’m at a point where I can comfortably do that. But this doesn’t mean, it’s easy. I still have to pitch and persuade my editors. However, the process becomes a bit easier in the long run.

For the Gurkha story, I sent out e-mails and got rejected. Despite that I continued my e-mail pointing out different angles. When one publication didn’t work, I looked for another. My editor there in fact suggested to take a different angle, which actually worked for the best.

But it wasn’t just the text I was trying to get published. I had worked on a video and I had to get it out there. Honestly, I did persuade my editor and finally convinced the multimedia team to go through my video — it worked out well.

While working on a Gurkha story, I also came across a British colonel who had been living in Nepal for more than three decades. A permanent Nepali resident, he had given up his British citizenship and was waiting to become a Nepali national. I thought it would be a good profile and then pitched it to two more outlets.

The first two passed the idea but the foreign editor from the South China Morning Post called me and said it would make an interesting story. And the rest is out there.

At times, being a freelancer does makes me a bit lazy. But it’s at times when I start working on stories as such and see the potentials they have, they keep me on the go.

It’s exactly been a year since I’ve worked on some multimedia project — last time it was my final project for grad school. Though it was daunting, I thoroughly enjoyed the one-man project, and with the Gurkha story too, I’ve enjoyed working on them and also learned a lot while working.

Here’s the list — one story, multiple mediums.

The National: The Gurkhas of the British Army

The National: Training to be Gurkhas [VIDEO]

South China Morning Post: Retired British Gurkha, 88, stateless in Nepal as he waits for citizenship

Republica The Week: I will be a Gurkha [PHOTO FEATURE Pages 8-9]

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