National Integration in Nepal

Occasional Papers in Sociology and Anthropology - Volume 3, 199

Living the golden dreams: the gulf and Nepalese women

"Nepalese migration for work is a centuries-old practice, although during the past two decades the dynamics of this phenomenon have shifted dramatically. These changes have occurred in tandem with democratization and the liberalization of Nepalese migration policy since 1990, and with the increasing integration of Nepal into the global cash economy. One major change has been in the destinations of migrant workers. Whereas Nepalese migrants once primarily traveled to India or mercenary postings with the British or Indian armies, today Nepalese migrants travel all over the world for work. The Arab states of the Persian Gulf – Kuwait, Bahrain, Oman, Qatar, the Kingdom of Saudi Arabia, United Arab Emirates (UAE) and Iraq – have become some of the most important destinations for Nepalese migrants. In UAE alone, for example, it is estimated that there are 150,000 Nepalis. Another major change in the migration phenomenon is related to the demographics of Nepalese migrant workers, particularly gender representation. Although traditionally women were not heavily involved in migration, today it is estimated that around 30% of Nepalese migrant workers are female (although official data, which omit undocumented workers, put this figure much lower). Among women migrant workers, approximately 80% end up doing some form of domestic work in private households – as housemaids, cooks, cleaners, caretakers, etc. While for many domestic workers in the Gulf, migration has provided good opportunities for cash income that are simply not available in Nepal today, many female migrants also become victims of exploitation and abuse. Migrants sometimes become victims of trafficking during the travel process, especially when they go undocumented using informal channels. Additionally, migrant women, especially those engaged in domestic work, often face exploitation and abuse in the workplace. Female domestic workers are especially at risk due to the informal and isolated nature of their work and because of the lack of appropriate legal protections for informal sector workers in destination countries. The issue of how to better assist female migrant domestic workers, to ensure both their safety and their livelihoods, is a topic of serious debate. Often, the issue has been raised in the aftermath of serious cases of abuse (such as the mysterious death of Kani Sherpa in Kuwait in 1998), leading to rushed government reactions such as bans and age restrictions on women migrating to work. These responses have been criticized for violating women’s rights, unduly hurting young women, and driving more women migrants underground, which further increases their vulnerability to abuse. A number of alternative strategies have been implemented and/ or proposed by various stakeholders, including preventative measures and other actions to be undertaken by the government, NGO sector, and private sector involved in the migration process.

Study of drug utilization pattern and adverse drug reactions of psychotropic drugs in psychiatric inpatient department of tertiary care hospital

Background: Mental disorders are now widely recognized as a major contributor to the global burden of disease. The drug use in psychiatric illness is a complex process and because of this the optimal benefits of drug therapy in patient care is not achieved. This often leads to increased cost of medical care, drug resistance, adverse effects and patient mortality. Hence, this study is undertaken to study the drug utilization pattern and adverse drug reactions of psychotropic drugs in psychiatric inpatient department of a tertiary care hospital.Methods: A prospective, observational study was undertaken from 1st February 2015 to 31st July 2016. A total of 250 prescriptions were analysed. Defined daily dose of the drugs were calculated. ADR’s were recorded in the format of the National Pharmacovigilance Programme of India (PvPI).Results: In 250 prescriptions most, common drug prescribed was antipsychotics (48.5%). Total drug utilization in terms of DDD/100 bed days was 669. The total number of adverse drug reactions observed was 8%. Antipsychotics were the most common class of psychotropic drugs causing ADR’s.Conclusions: In conclusion, it has been found that the psychotropic drugs used in our psychiatry department was rational and was based on clinical knowledge, expertise and the guidelines available in the field of psychiatric practice

Study to assess knowledge, attitude and practice regarding swine flu vaccine amongst medical students

Background: Due to recurrent outbreak and associated high mortality of swine flu there is panic amongst medical students also because of higher risk of getting infected. Vaccination for swine flu is the best preventive measure. So this study was undertaken. The aim of the present study was to assess the knowledge, attitude and practice regarding swine flu vaccine amongst medical students of government medical college and provide data to improve awareness about swine flu vaccineMethods: This was a cross sectional observational study carried out amongst 250 medical students during period of April-June 2015. A pre designed and pre tested, multiple choice questionnaires was used to assess KAP regarding swine flu vaccine and descriptive analysis was done.Results: Knowledge of participants regarding Swine flu vaccine was high as the mean score of correct answers marked was 152.5. But Only 21.8% participants had knowledge about cost of vaccine and 33.2% about the adverse drug reactions to the vaccine. Internet was the most common source of information amongst participants. Attitude of participants toward vaccination was favourable (mean score -128.4) but attitude for vaccination during pregnancy (30.8%) and with other vaccines (32.8%) was unfavourable. Only 30(12%) candidates have taken the vaccine which shows very poor practice.Conclusions: This study shows high knowledge, favourable attitude but poor practice towards Swine flu vaccination amongst medical students. So there is need to increase awareness for vaccination of swine flu amongst medical students by continuous health education and also need to increase the availability of vaccine in government hospitals

Migration health research and policy in south and south-east Asia: mapping the gaps and advancing a collaborative agenda

Migrant health has been the subject of various international agreements in recent years. In parallel, there has been a growth in academic research in this area. However, this increase in focus at international level has not necessarily strengthened the capacity to drive evidence-informed national policy and action in many low- and middle-income countries. The Migration Health South Asia (MiHSA) network aims to challenge some of the barriers to progress in the region. Examples include the bias towards institutions in high-income countries for research funding and agenda-setting and the overall lack of policy-focused research in the region. MiHSA will engage researchers, funders and policy-makers in collectively identifying the most pressing, yet feasible, research questions that could help strengthen migrant and refugee health relevant to the region’s national contexts. In addition, policies and provisions for different migrant populations in the region will be reviewed from the health and rights perspectives, to identify opportunities to strategically align research agendas with the questions being asked by policy-makers. The convergence of migration policy with other areas such as health and labour at global level has created a growing imperative for policy-makers in the region to engage in cross-sector dialogue to align priorities and coordinate responses. Such responses must go beyond narrow public health interventions and embrace rights-based approaches to address the complex patterns of migration in the region, as well as migrants’ precarity, vulnerabilities and agency

Carbamazepine induced toxic epidermal necrolysis in a patient of seizure disorder

Toxic epidermal necrolysis (TEN), also known as Lyell's syndrome, is a widespread life-threatening mucocutaneous disease where there is extensive detachment of the skin and mucous membrane. Many factors are involved in the aetiology of TEN, the most common being the adverse drug reactions. Here we report a case of TEN in a 12 year old female child who presented with fever and blisters all over her body after taking carbamazepine for uncontrolled generalised tonic-clonic seizure. This case has been reported to highlight the importance of using carbamazepine cautiously as this case shows the “probable” association between carbamazepine and TEN, which is a life threatening condition