Brokering justice: global indigenous rights and struggles over hydropower in Nepal

This article explores the dynamics of brokerage at the intersection between the justice conceptions enshrined in global norms and the notions of justice asserted in specific socio-environmental struggles. Using the case of a small hydropower project in Nepal, we trace the attempts of an indigenous activist to enrol villagers in his campaign against the background of villagers’ everyday negotiations with the hydropower company. The study shows how global norms, such as indigenous peoples’ rights, may fail to gain traction on the ground or even become sources of injustice in particular contexts

Menstrual hygiene management among women and adolescent girls in the aftermath of the earthquake in Nepal.

BACKGROUND: Menstrual hygiene management (MHM) is an essential aspect of hygiene for women and adolescent girls between menarche and menopause. Despite being an important issue concerning women and girls in the menstruating age group MHM is often overlooked in post-disaster responses. Further, there is limited evidence of menstrual hygiene management in humanitarian settings. This study aims to describe the experiences and perceptions of women and adolescent girls on menstrual hygiene management in post-earthquake Nepal. METHODS: A mixed methods study was carried out among the earthquake affected women and adolescent girls in three villages of Sindhupalchowk district of Nepal. Data was collected using a semi-structured questionnaire that captured experiences and perceptions of respondents on menstrual hygiene management in the aftermath of the Nepal earthquake. Quantitative data were triangulated with in-depth interview regarding respondent's personal experiences of menstrual hygiene management. RESULTS: Menstrual hygiene was rated as the sixth highest overall need and perceived as an immediate need by 18.8% of the respondents. There were 42.8% women & girls who menstruated within first week of the earthquake. Reusable sanitary cloth were used by about 66.7% of the respondents before the earthquake and remained a popular method (76.1%) post-earthquake. None of the respondents reported receiving menstrual adsorbents as relief materials in the first month following the earthquake. Disposable pads (77.8%) were preferred by respondents as they were perceived to be clean and convenient to use. Most respondents (73.5%) felt that reusable sanitary pads were a sustainable choice. Women who were in the age group of 15-34 years (OR = 3.14; CI = (1.07-9.20), did not go to school (OR = 9.68; CI = 2.16-43.33), married (OR = 2.99; CI = 1.22-7.31) and previously used reusable sanitary cloth (OR = 5.82; CI = 2.33-14.55) were more likely to use the reusable sanitary cloth. CONCLUSIONS: In the immediate aftermath of the earthquake, women and girls completely depended on the use of locally available resources as adsorbents during menstruation. Immediate relief activities by humanitarian agencies, lacked MHM activities. Understanding the previous practice and using local resources, the reusable sanitary cloth is a way to address the menstrual hygiene needs in the post-disaster situations in Nepal

Stressors Among Psychiatric Out-patients with Suicide Attempt Attending Tertiary Care Hospital in Eastern Nepal

Life changes could act as a stressor causing physiological arousal and enhance susceptibility for suicidal behavior. Suicide victims have experienced more changes in living conditions, work problems and object losses than normal controls. Objective of this study was to assess common stressors and stress level among psychiatric out-patients with suicide attempt. It was a descriptive study conducted with purposive sampling in a tertiary care hospital among suicide attempt cases visiting out-patient department of psychiatry. Calculated sample size of 113 cases were enrolled within 1 year period. Stressor factor (stressors, its type-acute or ongoing etc.) was explored and documented in a semi-structured Proforma in all subjects. Stress level was measured with Perceived Stress Scale (PSS). Demographic variables were recorded in a semi-structured proforma. Majority of the subjects were female, married and literate, with the commonest age group of 20- 29 and <20 years. Most subjects were homemakers, urban dwellers, Hindu and, were from low socioeconomic status and joint family. Among the patients; 86 (76.1%) had chronic on-going stressor, 23 (20.4%) acute stressor within 1 month and 4 (3.5%) did not reveal any stressor. Common stressor revealed were: economic (22.12%), marital (21.23%), relationship issue (20.35%), physical and mental illness (17.69%), substance use (13.27%), parental issue (6.19%), physical violence (6.19%), and loss or death of close ones (5.30%). Perceived Stress Scale showed 39% with high, 36% moderate and 21% low stress level within past 1 month. Management of suicide cases, hence, integrally involves stress management

Mass vaccination with a new, less expensive oral cholera vaccine using public health infrastructure in India: the Odisha model.

The substantial morbidity and mortality associated with recent cholera outbreaks in Haiti and Zimbabwe, as well as with cholera endemicity in countries throughout Asia and Africa, make a compelling case for supplementary cholera control measures in addition to existing interventions. Clinical trials conducted in Kolkata, India, have led to World Health Organization (WHO)-prequalification of Shanchol, an oral cholera vaccine (OCV) with a demonstrated 65% efficacy at 5 years post-vaccination. However, before this vaccine is widely used in endemic areas or in areas at risk of outbreaks, as recommended by the WHO, policymakers will require empirical evidence on its implementation and delivery costs in public health programs. The objective of the present report is to describe the organization, vaccine coverage, and delivery costs of mass vaccination with a new, less expensive OCV (Shanchol) using existing public health infrastructure in Odisha, India, as a model.All healthy, non-pregnant residents aged 1 year and above residing in selected villages of the Satyabadi block (Puri district, Odisha, India) were invited to participate in a mass vaccination campaign using two doses of OCV. Prior to the campaign, a de jure census, micro-planning for vaccination and social mobilization activities were implemented. Vaccine coverage for each dose was ascertained as a percentage of the censused population. The direct vaccine delivery costs were estimated by reviewing project expenditure records and by interviewing key personnel.The mass vaccination was conducted during May and June, 2011, in two phases. In each phase, two vaccine doses were given 14 days apart. Sixty-two vaccination booths, staffed by 395 health workers/volunteers, were established in the community. For the censused population, 31,552 persons (61% of the target population) received the first dose and 23,751 (46%) of these completed their second dose, with a drop-out rate of 25% between the two doses. Higher coverage was observed among females and among 6-17 year-olds. Vaccine cost at market price (about US$1.85/dose) was the costliest item. The vaccine delivery cost was$0.49 per dose or $1.13 per fully vaccinated person.This is the first undertaken project to collect empirical evidence on the use of Shanchol within a mass vaccination campaign using existing public health program resources. Our findings suggest that mass vaccination is feasible but requires detailed micro-planning. The vaccine and delivery cost is affordable for resource poor countries. Given that the vaccine is now WHO pre-qualified, evidence from this study should encourage oral cholera vaccine use in countries where cholera remains a public health problem

Interrogating quality: minority language, education and imageries of competence in Nepal

Quality education is increasingly considered essential for human development. However, the mainstream approach to quality as a neutral technology often ignores deeply embedded issues of power relations. This article interrogates the taken-for-granted idea of ‘quality education’ by exploring the ways in which students navigate the assumption of quality education in two mother-tongue schools in Nepal. Drawing on the concept of language ideology, this article shows that the perceived social prestige associated with a language choice is closely intertwined with the discourse of quality education in Nepal. In this context, the students secure ‘imageries of competence’ by repeatedly drawing attention to more acceptable indicators of ‘quality’ such as high examination scores, English proficiency and continuation of higher studies. This article foregrounds the power relations embedded in the perception of quality education and intends to be of wider analytical relevance to other socially heterogeneous contexts beyond Nepal

Simultaneous identities: ethnicity and nationalism in mother tongue education in Nepal *

The scholarly works on ethnicity and nationalism have been highly dominated by binary frameworks. In addition, the normative preference for civic consciousness and the concerns of national disintegration often separate the notions of ethnicity and nationalism. This article suggests that the notions of ethnicity and nationalism cannot be understood exclusively as a choice between maintaining the integrity of the nation and completely rejecting it. Drawing on fieldwork in mother tongue schools in Nepal, the article draws attention to the ways in which school actors discursively positioned ethnic identity as imperative to national identity, the one that bolsters the notion of Nepali nationhood. By paying close attention to the everyday context within which discourses of nationalism are situated, this article argues for an analytical necessity to approach ethnicity and nationalism in relation to each other to appreciate the process of symbolic negotiations in public spaces