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.
There is no way to sugarcoat this – Nepal is being hammered by Covid-19. Just as in its giant neighbour, places such as the capital Kathmandu and cities bordering India have run out of intensive-care hospital beds and oxygen, extra cremation sites have been set up on the banks of rivers and fewer than 5% of people have been vaccinated, with no new jabs in sight.
Globally there are signs that some countries are taking policy decisions that will advance sustainable development post-Covid-19, including the United States under the new Biden administration, but as a non-expert I feel pretty confident to say the evidence is inconclusive that the world will be on a greener path.
So given how hard it seems to be for rich countries to turn that corner, it seems unlikely that a ‘developing’ country like Nepal could make it happen. Although it was progressing before the pandemic, the challenges were enormous and included climate change (evidenced by melting glaciers) high unemployment that was sending more and more young people abroad to find work, and stalled progress in terms of mother and child health after decades of impressive results.
Roads lead to development: they link remote places with markets, hospitals and schools, says one side of the argument. Roads ruin the unique nature of untouched places, reducing an already too homogeneous world to sameness, retorts the other side.
Warning shots fired into the air by police to control mobs were responsible for two deaths being probed by United Nations human rights experts, according to the Government of Nepal.
Both Rafikul Alam of Jhapa and Suraj Kumar Pandey of Kapilvastu were “unfortunate” victims of police attempts to control mobs, wrote the Permanent Mission of Nepal to the UN in Geneva in a response to the experts, also known as special rapporteurs, on 10 February.
Advocates for women were excited late in 2020 when they heard that changes were coming to Nepal’s rape law, which has long been criticized as ineffective. For example, youth activists who had met with the attorney general and other lawmakers were energized and excited by the process, as reported on my podcast, Nepal Now.
But when the ordinance containing the revisions was signed by the president, not all of the rumoured improvements were there. Left out was removal of the statute of limitations that says a rape charge must be filed within one year and broadening of the scope of victims of rape to include men, boys and persons of other genders.
To its credit, the Nepali media has written regularly about successive governments’ lack of action on transitional justice since the Comprehensive Peace Accord was signed in 2006. Reporting has focused on the legal framework, which in 2015 Nepal’s Supreme Court ruled must be revised because it granted amnesty for the most serious crimes of the conflict.
In the civil war, from 1996 to 2006, the state and Maoists combined to kill 17,000 Nepalis, torturing and disappearing thousands more.
The Nepal Government has denied that a joint team from the Nepal Army and Chitwan National Park destroyed homes belonging to landless Chepang people on 18 July 2020.
The operation “removed 8 Katha of maize crop, 9 wooden towers and 2 sheds from the area (but) the operation team has not destroyed any of those 8 HHs [households] Iiving there and any of their property,” says a letter to United Nations (UN) human rights experts dated 21 December.
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.
Just over a year ago President Bidya Bhandari of Nepal launched a new group, Baliyo (strong or mighty) Nepal, created to tackle the persistent malnutrition in the country that stubbornly refuses to be beaten.
Almost immediately a backlash hit. Local media reported that the group was a creation of the Chaudhary Group, one of whose companies makes Wai Wai instant noodles, a type of junk food that can be found in virtually every village of the country. One paper quoted a Chaudhary official saying that Baliyo Nepal would ‘improve’ Wai Wai to feed it to malnourished kids.