I’ve been reading about social determinants of health for some years now, but I had to see this phenomenon in practice before I truly ‘got it’.
It’s one thing to understand an issue or fact intellectually, another to experience it first-hand. That’s been made clear to me twice recently concerning health care here in Nepal and what are sometimes called ‘social determinants of health.’
One of my current projects is reporting about malnutrition during Covid-19. I contacted the Nutrition Home close to Kathmandu hoping to speak to the guardian of a child who had been admitted because they were malnourished.
Child marriage has risen in many countries since the world started locking down earlier this year. In fact, the UN Population Fund (UNFPA) is predicting that if conditions don’t change, the pandemic will contribute to an additional 13 million marriages of children (mostly under 18) in the next decade.
The causes of child marriage are many and complex — economic, social and cultural. In Nepal, girls are often seen as a burden: raised by their parents only to be sent away to live with their husband’s family, and on top of that a girl is usually expected to carry with her a dowry for the groom’s family, which can amount to a huge amount of cash and goods, big enough to put her family in debt for many years.
Below is the article I wrote for Nepali Times after visiting Bayalpata Hospital in Nepal’s Achham district. Achham is often described as “remote” but we drove there easily in 9 hours from a main city, paved roads all the way, and jolted by fewer potholes than you’ll suffer driving in Kathmandu.
Watching this movie reminded me of a review I once read of ‘London Calling’, by The Clash. “Makes you feel like beating up a used-car salesman,” it said.
I don’t know why the reviewer chose a used-car salesman, but the album did generate that kind of fist-clenching energy that made you want to rush outside and start sweeping aside the rotten, old establishment.
I felt something similar watching Inside job: disgust at what Wall Street and its White House cronies got away with – and continue to get away with – and a wonder that it looks like nothing will change as a result.