Activism as a Moral Practice: Cultural Politics, Place-Making and Indigenous Movements in Nepal.

In this dissertation, I examine the everyday and organized ways in which Dhimal, a historically marginalized indigenous people from Nepal’s easternmost lowlands, enact locally embedded and globally influenced indigenous activism to assert their distinct history, territorial belonging, and political autonomy as they participate in the processes of crafting new directions for the making of a ‘New Nepal’ in the post-April 2006 period. Taking ‘place’ as a central analytic in the study of indigenous politics, I investigate how issues of land and landlessness shape Dhimals’ sense of indigeneity, ethnic history, territorial belonging, and their envisioning of the future as ādivāsi in Nepal. In doing so, my ethnography provides new insights for approaching the relationship between Tarai ādivāsi and the land by focusing on the interplay among land, labor, power relations, state-led geographical imaginings, and the role of malaria in mediating relations among ādivāsi, the state, and other social groups, and shaping Dhimals’ historical agency in resisting the extractive Hindu state. Based on 18 months of ethnographic fieldwork conducted between 2007 and 2009 in Kathmandu, the capital city of Nepal, and Morang district, this dissertation moves beyond the conventional emphasis on the organized and contentious struggles in the study of indigenous politics by focusing on how community-making practices related with marriage, village rituals, and place-making become constitutive practices of Dhimal indigenous activism. By demonstrating the centrality of everyday practices in indigenous politics, this dissertation shows how people, located in specific historical-political contexts, transform the global-national discourses of indigeneity and indigenous rights into locally meaningful and relevant political projects through their embedded everyday practices. This analytical focus on locally embedded practices has important implications for understanding how indigenous activism becomes embodied moral practice enacted by people out of their felt sense of responsibility and duty for the social production of their collective self.PHDAnthropologyUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/100010/1/rjanak_1.pd

Rethinking knowledge production and exchange: perspectives from Nepal

Can we de-centre research exercise, knowledge production and exchange from core areas to the wider community? Uma Pradhan, Nimesh Dhungana, Sara Parker, Janak Rai, Kumud Rana and Sohan Prasad Sha discuss how academic research on Nepal — whether by those based in the country or coming from outside — remains focused on core centres for a variety of institutional and structural reasons, and give examples of how this can be overcome to attempt a more widely-anchored knowledge-gathering and dissemination exercise

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy

Effects of antiplatelet therapy after stroke due to intracerebral haemorrhage (RESTART): a randomised, open-label trial

Background: Antiplatelet therapy reduces the risk of major vascular events for people with occlusive vascular disease, although it might increase the risk of intracranial haemorrhage. Patients surviving the commonest subtype of intracranial haemorrhage, intracerebral haemorrhage, are at risk of both haemorrhagic and occlusive vascular events, but whether antiplatelet therapy can be used safely is unclear. We aimed to estimate the relative and absolute effects of antiplatelet therapy on recurrent intracerebral haemorrhage and whether this risk might exceed any reduction of occlusive vascular events. Methods: The REstart or STop Antithrombotics Randomised Trial (RESTART) was a prospective, randomised, open-label, blinded endpoint, parallel-group trial at 122 hospitals in the UK. We recruited adults (≥18 years) who were taking antithrombotic (antiplatelet or anticoagulant) therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage, discontinued antithrombotic therapy, and survived for 24 h. Computerised randomisation incorporating minimisation allocated participants (1:1) to start or avoid antiplatelet therapy. We followed participants for the primary outcome (recurrent symptomatic intracerebral haemorrhage) for up to 5 years. We analysed data from all randomised participants using Cox proportional hazards regression, adjusted for minimisation covariates. This trial is registered with ISRCTN (number ISRCTN71907627). Findings: Between May 22, 2013, and May 31, 2018, 537 participants were recruited a median of 76 days (IQR 29–146) after intracerebral haemorrhage onset: 268 were assigned to start and 269 (one withdrew) to avoid antiplatelet therapy. Participants were followed for a median of 2·0 years (IQR [1·0– 3·0]; completeness 99·3%). 12 (4%) of 268 participants allocated to antiplatelet therapy had recurrence of intracerebral haemorrhage compared with 23 (9%) of 268 participants allocated to avoid antiplatelet therapy (adjusted hazard ratio 0·51 [95% CI 0·25–1·03]; p=0·060). 18 (7%) participants allocated to antiplatelet therapy experienced major haemorrhagic events compared with 25 (9%) participants allocated to avoid antiplatelet therapy (0·71 [0·39–1·30]; p=0·27), and 39 [15%] participants allocated to antiplatelet therapy had major occlusive vascular events compared with 38 [14%] allocated to avoid antiplatelet therapy (1·02 [0·65–1·60]; p=0·92). Interpretation: These results exclude all but a very modest increase in the risk of recurrent intracerebral haemorrhage with antiplatelet therapy for patients on antithrombotic therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage. The risk of recurrent intracerebral haemorrhage is probably too small to exceed the established benefits of antiplatelet therapy for secondary prevention

Effects of antiplatelet therapy after stroke due to intracerebral haemorrhage (RESTART): a randomised, open-label trial

Background: Antiplatelet therapy reduces the risk of major vascular events for people with occlusive vascular disease, although it might increase the risk of intracranial haemorrhage. Patients surviving the commonest subtype of intracranial haemorrhage, intracerebral haemorrhage, are at risk of both haemorrhagic and occlusive vascular events, but whether antiplatelet therapy can be used safely is unclear. We aimed to estimate the relative and absolute effects of antiplatelet therapy on recurrent intracerebral haemorrhage and whether this risk might exceed any reduction of occlusive vascular events. Methods: The REstart or STop Antithrombotics Randomised Trial (RESTART) was a prospective, randomised, open-label, blinded endpoint, parallel-group trial at 122 hospitals in the UK. We recruited adults (≥18 years) who were taking antithrombotic (antiplatelet or anticoagulant) therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage, discontinued antithrombotic therapy, and survived for 24 h. Computerised randomisation incorporating minimisation allocated participants (1:1) to start or avoid antiplatelet therapy. We followed participants for the primary outcome (recurrent symptomatic intracerebral haemorrhage) for up to 5 years. We analysed data from all randomised participants using Cox proportional hazards regression, adjusted for minimisation covariates. This trial is registered with ISRCTN (number ISRCTN71907627). Findings: Between May 22, 2013, and May 31, 2018, 537 participants were recruited a median of 76 days (IQR 29–146) after intracerebral haemorrhage onset: 268 were assigned to start and 269 (one withdrew) to avoid antiplatelet therapy. Participants were followed for a median of 2·0 years (IQR [1·0– 3·0]; completeness 99·3%). 12 (4%) of 268 participants allocated to antiplatelet therapy had recurrence of intracerebral haemorrhage compared with 23 (9%) of 268 participants allocated to avoid antiplatelet therapy (adjusted hazard ratio 0·51 [95% CI 0·25–1·03]; p=0·060). 18 (7%) participants allocated to antiplatelet therapy experienced major haemorrhagic events compared with 25 (9%) participants allocated to avoid antiplatelet therapy (0·71 [0·39–1·30]; p=0·27), and 39 [15%] participants allocated to antiplatelet therapy had major occlusive vascular events compared with 38 [14%] allocated to avoid antiplatelet therapy (1·02 [0·65–1·60]; p=0·92). Interpretation: These results exclude all but a very modest increase in the risk of recurrent intracerebral haemorrhage with antiplatelet therapy for patients on antithrombotic therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage. The risk of recurrent intracerebral haemorrhage is probably too small to exceed the established benefits of antiplatelet therapy for secondary prevention

Effects of antiplatelet therapy after stroke due to intracerebral haemorrhage (RESTART): a randomised, open-label trial

BACKGROUND: Antiplatelet therapy reduces the risk of major vascular events for people with occlusive vascular disease, although it might increase the risk of intracranial haemorrhage. Patients surviving the commonest subtype of intracranial haemorrhage, intracerebral haemorrhage, are at risk of both haemorrhagic and occlusive vascular events, but whether antiplatelet therapy can be used safely is unclear. We aimed to estimate the relative and absolute effects of antiplatelet therapy on recurrent intracerebral haemorrhage and whether this risk might exceed any reduction of occlusive vascular events. METHODS: The REstart or STop Antithrombotics Randomised Trial (RESTART) was a prospective, randomised, open-label, blinded endpoint, parallel-group trial at 122 hospitals in the UK. We recruited adults (≥18 years) who were taking antithrombotic (antiplatelet or anticoagulant) therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage, discontinued antithrombotic therapy, and survived for 24 h. Computerised randomisation incorporating minimisation allocated participants (1:1) to start or avoid antiplatelet therapy. We followed participants for the primary outcome (recurrent symptomatic intracerebral haemorrhage) for up to 5 years. We analysed data from all randomised participants using Cox proportional hazards regression, adjusted for minimisation covariates. This trial is registered with ISRCTN (number ISRCTN71907627). FINDINGS: Between May 22, 2013, and May 31, 2018, 537 participants were recruited a median of 76 days (IQR 29-146) after intracerebral haemorrhage onset: 268 were assigned to start and 269 (one withdrew) to avoid antiplatelet therapy. Participants were followed for a median of 2·0 years (IQR [1·0- 3·0]; completeness 99·3%). 12 (4%) of 268 participants allocated to antiplatelet therapy had recurrence of intracerebral haemorrhage compared with 23 (9%) of 268 participants allocated to avoid antiplatelet therapy (adjusted hazard ratio 0·51 [95% CI 0·25-1·03]; p=0·060). 18 (7%) participants allocated to antiplatelet therapy experienced major haemorrhagic events compared with 25 (9%) participants allocated to avoid antiplatelet therapy (0·71 [0·39-1·30]; p=0·27), and 39 [15%] participants allocated to antiplatelet therapy had major occlusive vascular events compared with 38 [14%] allocated to avoid antiplatelet therapy (1·02 [0·65-1·60]; p=0·92). INTERPRETATION: These results exclude all but a very modest increase in the risk of recurrent intracerebral haemorrhage with antiplatelet therapy for patients on antithrombotic therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage. The risk of recurrent intracerebral haemorrhage is probably too small to exceed the established benefits of antiplatelet therapy for secondary prevention. FUNDING: British Heart Foundation

"Women are the pillars of Our Culture": Bohna as a resurgent cloth among the Dhimal

Bohna is the traditional ethnic dress woven and worn by Dhimal women. It is an everyday dress which Dhimal women wear it in all kinds of social spaces and events: home, fields, markets, cinema halls, colleges, mela, and other places. In the recent decades, with the resurgence of indigenous political movements and Dhimals' localized social movements for revival of their customary practices, bohna has emerged as a powerful marker of Dhimal indigenous identity. This paper examines the historical, cultural and political embeddedness of bohna in Dhimal society. The paper highlights the creative agency of Dhimal women by showing how weaving and exchange of bohna recreate and connect the embedded relations of affection, exchange and mutual obligations between Dhimal women.DOI: http://dx.doi.org/10.3126/dsaj.v8i0.10724Dhaulagiri Journal of Sociology and Anthropology Vol. 8, 2014; 99-112</p

Malaria, Tarai Adivasi and the Landlord State in the 19th century Nepal: A Historical-Ethnographic Analysis

This paper examines the interplay between malaria, the Tarai Adivasi and the extractive landlord state in the 19th century Nepal by focusing on Dhimal, one indigenous community from the easternmost lowlands. Throughout the 19th century, the Nepali state and its rulers treated the Tarai as a state geography of extraction for land, labor, revenue and political control. The malarial environment of the Tarai, which led to the shortage people (labor force), posed a major challenge to the 19th &nbsp;century extractive landlord state and the landowning elites to materialize the colonizing project in the Tarai. The shortage of labor added pressure on the malaria resistant Tarai Adivasi to reclaim and cultivate land for the state. The paper highlights the need for ethnographically informed social history of malaria in studying the changing relations between the state and the ?div?si communities in the Tarai DOI: http://dx.doi.org/10.3126/dsaj.v7i0.10438 Dhaulagiri Journal of Sociology and Anthropology Vol. 7, 2013; 87-112</p