COPE NepalCOPE Nepal is a youth-led organization that collects and analyzes information about COVID-19 in Nepal to help coordinate efforts to send resources to Nepalese communities hardest hit by the pandemic.

COVID-19 in Nepal

There is no country that has not felt the effects of the COVID-19 pandemic, Nepal included. The first case of COVID-19 in Nepal was detected on January 23, 2020, and the first case of COVID-19 that was locally transmitted was detected nearly two months later on April 4, 2020. On March 9, 2021, the country’s total COVID-19 case count reached 274,869 and total deaths reached 3,012.

Due to an inadequate healthcare system, COVID-19 is particularly concerning in a developing country such as Nepal. After the detection of the first local transmission, Nepal took significant steps to limit COVID-19 transmission. However, difficulties arose due to cases with unknown origins and overwhelmed quarantine centers. Self-isolation became the only option, which is harder for the Nepalese government to regulate.

The COVID-19 pandemic has also had a negative effect on Nepal’s economy. In the last fiscal year, Nepal’s economy contracted for the first time in 40 years. Tourists were not allowed to climb the country’s famous peaks due to COVID-19 restrictions, hurting an economy that is highly dependent on tourism. Furthermore, as a result of school closures and other factors, child marriage is on the rise in Nepal, threatening to reverse progress made toward keeping girls in school.

COPE Nepal

As Nepalese colleges and universities transitioned to remote learning and many young adults found themselves in a state of uncertainty, they embraced creativity and innovation. COPE Nepal is an organization that formed in response to the COVID-19 pandemic. A group of university students from data analytics, branding and communications backgrounds created COPE Nepal with the goal of collecting, presenting and disseminating data about COVID-19 in visual formats. According to the co-founder of COPE Nepal, Anup Satyal, the COVID-19 lockdown opened up more opportunities to make a meaningful impact in Nepal.

COPE Nepal’s Strategy

COPE Nepal’s strategy consists of four parts which are outlined in the acronym COPE:

  • Coordinate efforts and responses with local government and NGOs
  • Operationalize and allocate resources
  • Personalize the COVID-19 response to each location
  • Evaluate strategies and results on a daily basis

COPE Nepal has published a total of four reports showing the progression of COVID-19 in Nepal in a way that is easily understood by policymakers and average people. These reports are also easily accessible on the humanitarian information portal ReliefWeb.

On Instagram, COPE Nepal posted calls for individuals to share their accounts of the conditions in government quarantine facilities. Its Instagram also includes graphics and data from the four published reports and information about COVID-19 safety such as how to properly dispose of personal protective equipment (PPE).

A group of talented Nepalese university students started COPE Nepal out of a desire to help their country better respond to the COVID-19 pandemic. As Nepal transitions out of lockdown, COPE Nepal’s data collection and dissemination is important to ensure vulnerable populations are sufficiently protected from COVID-19.

Sydney Thiroux
Photo: Flickr

Nepal’s Refugee Resettlement Program
Much of the world struggles to assist refugees and other forcibly displaced people. However, Nepal stands out as a rare success story. The nation accepted more than 100,000 Bhutanese refugees since the 1990s. Nepal’s refugee resettlement program has proven to be effective. The program has relocated about 113,500 refugees to third countries. Additionally, many of the camps that emerged have shut down because they were no longer necessary. However, it is still challenging to provide refugees with their basic needs.

Origins of the Bhutanese Refugee Crisis

Ethnic Nepalis people whose origins lie in Bhutan primarily partake in Nepal’s refugee resettlement program. The Lhotshampas are Nepali people who reside in the southern portion of Bhutan and maintain a distinct culture.

The Bhutanese government initiated the One Nation, One People policy to promote the dominant Bhutanese culture. Many perceived this policy as an attempt to suppress Nepali culture in Bhutan. Additionally, this policy replaced the Nepali language with Dzongkha as the primary mode of instruction in schools. Furthermore, it forbade Nepalis from wearing their traditional clothing, forcing them to dress like the Bhutanese majority.

Bhutanese officials became wary of the substantial Lhotshampa population in the south after the 1988 census. Additionally, accusations emerged of them being illegal aliens along with instances of violence and discrimination. As a result, large numbers of ethnic Nepalis left Bhutan for refugee camps in Nepal.

Nepal’s Refugee Resettlement Program

The population of Lhotshampa refugees in Nepal has increased to more than 100,000 people. Unfortunately, talks with Bhutan failed to produce any solution. Thus, the government of Nepal developed a plan to resettle the refugees in other countries.

Nepal’s refugee resettlement program started in 2007. In addition, Nepal and eight other countries collaborated with each other. These countries are the United States, New Zealand, Norway, Canada, the Netherlands, Denmark, Australia and the United Kingdom. These nations agreed to accept Lhotshampa refugees, allowing them to lead new lives outside of refugee camps.

Organizations such as the United Nations High Commissioner for Refugees (UNHCR), the International Organization for Migration (IOM) and the government of Nepal have aided in the program’s success. UNHCR and the Nepalese government underwent efforts to provide documentation for each refugee. Photos and listings of details of each person provided an accurate number of refugees. This made monitoring the program much easier. In addition, IOM oversaw the practical side of the program. This included arranging flights and teaching refugees how to navigate through an airport.

Challenges That Those in the Camps Face

As a result of Nepal’s refugee resettlement program, the number of Lhotshampas in the country has decreased to about 6,000. Furthermore, out of the seven camps that began in the 1990s, only two remain in the Jhapa and Morang districts of eastern Nepal. While this constitutes a success, the Lhotshampas who remain in the camps still face challenges.

Many people feel isolated because they are unable to join their families abroad. Additionally, they suffer a lack of emotional support and income. As a result, many suffer from depression, substance abuse and suicide in these camps. Furthermore, the camp’s dwindling population has led to a shortage of teachers. UNHCR established a suicide prevention program and youth centers to combat these issues.

Nepal’s refugee resettlement program is effective in relocating most of the Lhotshampas refugees since the 1990s. UNHCR, IOM and the government of Nepal have allowed refugees to have the opportunity to lead new lives in other countries. Many challenges remain for those in the camps. However, the government has made significant efforts to address them.

– Nikhil Khanal
Photo: Flickr

10 Years of Helping Babies Breathe
The first few minutes of a baby’s life have a significant impact on their chances of survival and their life quality. Statistically speaking, risks for newborn deaths are at their highest at that time. A main reason for the increased risk is asphyxia, a dangerous lack of oxygen right after birth. Every year, approximately 10 million newborns are unable to breathe on their own and require immediate help. In 2010, as a response to the medical issue, Helping Babies Breathe (HBB) was born. Recently, Helping Babies Breathe celebrated its anniversary for 10 years of work. Here is some information about the successes during the 10 years of Helping Babies Breathe.

USAID: An Important Partner

A partnership of many different agencies and organizations like Save the Children, Laerdal Global Health and the World Health Organization (WHO) launched the program Helping Babies Breathe. Another very important partner in the creation of HBB was the United States government’s agency USAID. After receiving Congress-approved funds from the federal government, USAID was able to be a key figure in establishing the program. The agency contributed significantly to HBB’s success by mobilizing more than $120 million to save newborns over the last decade.

Educating People

When HBB launched, its approach to fighting newborn mortality was based on creating a global movement. The goal was to raise awareness for the complications of asphyxia and to educate and train medics around the world. Thus, HBB focused on making educational materials and necessary equipment accessible for everyone. Furthermore, it supported training people in the resuscitation of newborns. When the program began, all the partners involved agreed on one ultimate goal. The plan was to assure that every infant started life with access to at least one person with the training to resuscitate babies after birth.

When HBB taught medics all around the globe how to reduce the risks of newborn mortality, it addressed several different approaches. One of HBB’s top priorities was to increase general hygiene and, thus, prevent potential infections. Helping Babies Breathe further gave clear instructions for the evaluation of a newborn. These included understanding crying as an indicator for whether or not a baby was receiving enough oxygen and examining the baby’s breathing more thoroughly. The program also taught providers how to react in the case of a newborn not being able to breathe. In order to do so, HBB focused specifically on the method of drying the baby to facilitate breathing. It also encouraged using ventilation and chest compression if drying was not enough.

Decreasing the Number of Newborn Deaths

In the last 10 years of Helping Babies Breathe, the program has successfully increased the chances for newborn survival. HBB has trained approximately 1 million people in more than 80 countries in resuscitating babies right after birth. A study in several different countries like Tanzania and Nepal has shown the huge impact of the program on the lives of infants. The number of stillborn babies has gone down by 34% and the number of newborns that die on their first day has reduced by 30% in places that have been working with HBB.

Governmental Independence

After initially investing in equipment and training birth attendants to help babies breathe, many places no longer need HBB. Seeing how successfully the program increased newborn survival, many of the countries that HBB was working with started to include the resuscitation techniques and new standards for medical providers into their governmental budgets. Since many countries now have the knowledge and determination to fight newborn deaths on their own, HBB partner and important sponsor USAID is able to slowly stop the financial support that the agency has been giving to the program for the last 10 years.

Bianca Adelman
Photo: Wikimedia Commons

3 Inventions Saving Babies in Developing Countries
A baby’s first, sole focus should be on growing. Babies with low birth weight and pre-term babies in developing countries face a higher risk of developmental disorders and neonatal death due to lack of access to healthcare. Devices such as the Pumani bCPAP, the NIFTY cup and the Embrace Warmer are inventions saving babies throughout developing countries.

The Pumani bCPAP

The primary cause of death in preterm babies is Respiratory Distress Syndrome (RDS). As such, the lungs are one of the last organs to develop in utero. Jocelyn Brown, a bioengineering student studying in Malawi created an affordable solution: the Pumani Bubble Continuous Positive Airway Pressure Device (Pumani bCPAP). The English word “breath” translates to “pumani” in the language of Chichewa.

A traditional bCPAP device is among these inventions saving babies because it is readily available in developed countries. However, it costs $6,000 and is not affordable to people in Malawi. Brown collaborated with physicians at Queen Elizabeth Central Hospital (QECH) in Blantyre, Malawi. The hospital had access to bottled oxygen, which administers low-flow oxygen through a tube connected to nasal prongs. Unfortunately, when treating neonatal RDS, it only had a success rate of 25%. On the other hand, the Pumani bCPAP almost triples the survival rate for preterm babies and costs less than $400 to manufacture.

The device uses a type of air pump that makes this innovation affordable. The Pumani bCPAP replaces the traditional high-tech commercial flow generator with a simple aquarium pump. Aquarium pumps are easy to repair and low-cost. Furthermore, it provides the exact airflow pressure necessary for the bCPAP device.

The Saving Lives at Birth Transition grant aided in distributing the Pumani bCPAP to hospitals throughout Malawi in 2012. Additionally, funding from the global healthcare company GSK and Save the Children helped roll out the device in Tanzania, Zambia and South Africa.

The NIFTY Cup

The World Health Organization (WHO) recommends using a small cup to feed newborns who are unable to breastfeed. However, no such cup existed until Seattle Children’s hospital, PATH and Laerdal Global Health and the University of Washington worked together to develop The NIFTY Cup.

The NIFTY cup is a handheld, flexible cup made from silicone rubber. It has a design specifically for babies lacking the ability to breastfeed due to prematurity or craniofacial birth defects like a cleft palate or lip.

Mothers who do not have a NIFTY cup make do with whatever they have. Instead, mothers commonly use spoons, gravy boats, shot glasses or coffee cups. However, they can waste a lot of milk due to spillage and it is often challenging to monitor the amount the baby is drinking. Moreover, too much or too little milk can be dangerous for a newborn.

A mother is able to easily fill the NIFTY cup directly from the breast. There are volume markings on the side to monitor the amount the baby consumes. Furthermore, the cup’s design allows babies to suckle from the spout at a controlled pace. In addition, the cup is easy to clean, reusable and only costs $1.

The developers share a mission to save the lives of newborns in developing countries all around the world. PATH’s Trish Coffey said, “We know there are potentially millions of babies who need it. So we just kept at it.”

The Embrace Warmer

The Embrace Warmer is one of many inventions saving babies in developing nations as well. Four Stanford graduate students had the task of inventing a cost-effective device to treat premature and underweight babies who are unable to regulate their body temperature. The invention looks like a baby-sized sleeping bag but functions similarly to a traditional medical incubator. Additionally, it costs less than 1% of what an incubator costs. This is extremely important for developing communities in rural villages.

The inventors gathered research in a rural, poverty-stricken area of Nepal. They saw firsthand the importance of adapting the invention to make it accessible to communities that needed it the most. The team relocated and launched the first model in rural India. It is common practice in these rural areas for parents to not name their baby until it is a month. This is so parents do not get too attached to newborns in case they do not survive.

Additionally, the team developed a washable, affordable model that is seamless on the inside to avoid bacteria. Placing the wax insert into boiling water for a few minutes heats it up. The wax’s melting point is the human body temperature. Furthermore, it maintains its temperature of 98 degrees Fahrenheit for four to six hours. Fortunately, it does not require electricity. It is reusable and mothers can hold their babies while they are inside an Embrace Warmer.

The founders of Embrace debuted the invention in rural India in 2011. Then, Embrace joined forces with Thrive Health in 2015. Thrive Health is an international nonprofit with an accomplished newborn health program. Embrace Warm has aided more than 200,000 babies.

These inventions save babies’ lives in vulnerable, developing nations and aid in the reduction of population growth. Parents are more likely to have fewer children if they are confident in their survival. According to Bill Gates, “As children survive, parents feel like they’ll have enough kids to support them in their old age. And so they choose to have less children.”

– Sarah Ottosen
Photo: Flickr

USAID Programs in Nepal
Since 1951, USAID has been implementing various development programs in Nepal. With a poverty rate of 25% as of 2010, Nepal is a developing country and has benefited greatly from these programs which cover areas such as agriculture, education and environmental issues. Here are some examples of USAID programs in Nepal.

USAID’s Agriculture Programs in Nepal

An important aspect of USAID’s work in Nepal has been to improve the livelihoods of those who work in agriculture. As a rural country, agriculture accounts for about 34% of Nepal’s GDP, yet malnutrition has been a persistent issue due to low productivity and limited access to markets. As a result, 36% of children in the country suffer from stunting, which further results in a multitude of lifetime ailments.

To combat these issues, USAID has worked under the U.S. government’s Feed the Future Initiative to improve crop yields and subsequently increase profits and access to quality foods for farmers. As Nepal’s terrain is mostly mountainous, the average farm is very small, with over 50% of farms being less than 0.5 hectares. Furthermore, factors such as low-quality seeds, poor soil management and substandard infrastructure further contribute to low productivity. As a result, 83% of farmers rely on agriculture for their income, yet for 60% of them, agriculture does not meet their dietary and monetary needs.

USAID programs in Nepal have the intention of addressing these issues by engaging with various governmental entities as well as the private sector. Its Feed the Future Initiative emphasizes the production of specific crops that can produce high yields and are resistant to environmental events such as drought and waterlogging. As a result, Nepal has seen increases in rice, maize, lentil and vegetable production.

USAID’s Education Programs in Nepal

USAID has also worked to improve education standards in Nepal by providing a better quality of education for younger students. It has also worked to increase access to schools for communities that the 2015 earthquake affected.

USAID has been concerned about literacy amongst Nepali children. According to a study from 2014, 19% of third graders could not read the Nepali language, while less than 13% of them were able to read Nepali “with fluency and comprehension.” To combat this, several USAID programs in Nepal regarding education have emerged to improve reading standards. The Early Grade Reading Program has a design to increase the number of students in grades one to three who can read and write Nepali. Stretching over five years, this $53.8 million program seeks to design instructional material and standardize reading standards across the country.

After the 2015 earthquake, USAID has also been diligent in rebuilding schools that experienced destruction. Along with the Government of Nepal, USAID was instrumental in building over 1,000 schools which serviced about 93,000 students. USAID equipped these schools with learning materials, sanitation facilities and training for teachers.

Additionally, USAID Nepal has prioritized gender parity in education. Along with UNICEF, it has launched the Zero Tolerance, Gender-Based Violence Free Schools project, which aims to eliminate gender-based violence in schools and create equal education outcomes for boys and girls. The segregation of girls during their menstrual cycle and child marriage also occur in Nepal and they have a negative impact on educational outcomes.

The Zero Tolerance project is a three-year, $5 million project which reaches at least 100,000 students across 200 schools in areas of the country with high levels of gender-based violence. It seeks to promote awareness of gender-based issues in order to create safe learning environments for all students.

USAID’s Environmental Programs in Nepal

As a country with an extremely high level of biodiversity, Nepal has received attention from the U.S. government due to its vulnerability to environmental issues. In addition to this, the fact that a large portion of Nepal’s population has employment in sectors that are heavily dependent on the environment further underscores the need for biodiversity conservation.

USAID has implemented several projects with the goal of biodiversity conservation. The Program for Aquatic Natural Resources Improvement, known locally as the Paani Program, aims to protect Nepal’s many river systems. While Nepal’s waterways are crucial for the livelihoods of many people as they are the main habitat for many fish species, and provide irrigation and power dams, they also suffer from stress due to overpopulation and overuse. The Paani Program aims to instruct locals on how to efficiently manage their waterways. It has identified certain indicators of river health, such as soil fertility and water quality, and instructs locals on how to analyze the data and provide data for authorities to use.

In all, USAID programs in Nepal cover a wide range of areas regarding the country’s development. By focusing on things like agriculture, education and the environment, USAID has a commitment to improving the lives of ordinary Nepali citizens.

– Nikhil Khanal
Photo: Flickr

Malnutrition in NepalIn 2019, the malnutrition rate in Nepal was 43% for children under 5 years old. Malnutrition is defined as a lack of nutrition and can be a result of either being underfed or not eating enough nutritious foods. When children suffer from chronic malnutrition, it can result in stunting, which can permanently affect a child’s growth physically and cognitively. For the first two decades after 1990, malnutrition in Nepal decreased. Thereafter, malnutrition progress slowed down. Currently, malnutrition in Nepal is still a serious issue that needs addressing.

Malnutrition in Numbers

Nearly 66% of children between 0-5 months old are exclusively breastfed. Between 6-24 months old, only 36% of babies receive a minimum acceptable diet. Additionally, as little as 47% of these children receive diversified diets with the proper nutrients.

Mother Fights Malnutrition

To help fight malnutrition, adolescent girls, women and children, need access to better nutritious diets and associated nutritional care. According to UNICEF, “The first 1,000 days from the start of a woman’s pregnancy to a child’s second birthday offer an extraordinary window of opportunity for preventing undernutrition and its consequences.” In this critical period, preventative intervention is vital. This includes breastfeeding support,  supplementary foods for infants and micronutrient supplementation for women and children.

Bimala Chaudhary is an example of a mother who has been educated on the importance of nutrition. On a monthly basis, Chaudhary participates in a mothers’ group meeting where female community health volunteers teach mothers about how to improve both their own nutrition and the nutrition of their children. The mothers have been taught lessons that include the importance of handwashing and how to prepare nutritious porridge.

The health volunteers also visit Chaudary’s home to provide one-on-one nutritional counseling. A USAID-supported radio program called Mother Knows Best further emphasizes the lessons she learns through the women’s group. She also receives SMS messages to remind her to take her daughter for visits at the clinic in order to monitor progress.

To help the community, Chaudhary shares what she learns from the meetings with other mothers. Her end goal is to make sure no children are malnourished in the future.

Solutions

Since the 1990s, a lot of progress has been made to fight malnutrition in Nepal. The current country program (2018-2022) works to improve nutrition in Nepal. Adolescents, pregnant women, breastfeeding mothers, infants and young children receive special focus. UNICEF supports the Government of Nepal in the implementation of comprehensive nutritional strategies. These strategies include deworming children, vitamin A supplementation, iron folate supplementation and nutritional education and counseling.

The Nepal Youth Foundation has developed child malnutrition treatment centers. These Nutrition Rehabilitation Homes (NRHs) treat severely malnourished children, teach mothers about children’s health and train professionals on best nutritional practices. These homes bring in critically-underweight children for three to four weeks to help improve their health through a monitored diet. For a long-term solution, caregivers and mothers are taught how to make nutritious meals. They are then encouraged to share these lessons with their communities. Since the first NRH was opened in 1998, 15,000 malnourished children have been restored back to health.

Food for the Future

By increasing the nutritional education of communities, malnutrition in Nepal can improve. With both short and long-term solutions, organizations like UNICEF and the Nepal Youth Foundation improve the lives of mothers and children.

Sarah Kirchner
Photo: Flickr

Water in India and Nepal
With populations totaling over one billion people and high economic growth rates, the middle classes of India and Nepal are rising quickly as the 21st century progresses. However, with this rise in standard of living comes increased demand for resources. This includes one of the most precious resources on Earth – water, or “paani” in Hindi, a commonly spoken language in both India and Nepal. As Indians and Nepalis elevate themselves out of poverty, the demand for freshwater grows higher. Water in India and Nepal is used for activities ranging from cooking to leisurely use. The limited financial resources of the Indian and Nepali governments pose a significant challenge for ensuring adequate water for each nation’s urban middle classes and rural, largely subsistence farmers. Luckily, local initiatives and international partners are chipping in to solve this issue, with considerable success.

The Challenge

India is home to 1.3 billion people, and its population increases by over 10 million people per year. With an urbanization rate of 34.9% and rapidly growing, the strain on natural resources is significant. The quick expansion of India’s middle class and the problem of resource mismanagement lead to the popularization of the term “Day Zero” across India’s metropolises. “Day Zero” refers to a hypothetical future date in which Indian cities will run out of the groundwater supply required to quench the thirst of their urban populations. Unfortunately, for some Indian cities, that hypothetical scenario is already reality.

The city of Chennai, home to over 10 million people, experienced a “Day Zero” event last year. After losing access to groundwater resources, Chennai and cities like it are forced to tap into the resources of neighboring towns and villages, jeopardizing millions of farmers and their livelihoods. This also limits farmers’ chances at rising out of poverty. Some estimates suggest that by 2030 demand could outpace supply by a factor of two.

Similarly, the nation of Nepal faces rising challenges ensuring water for its people. While considerably smaller than its southern neighbor, Nepal’s population density is high, home to the same number of individuals (over 30 million) as the much larger Canada. With higher average glacial melt as a result of climate change and an increasingly thirsty economy, the Nepali government must contend with more flooding coupled with more consistent drought. Its financial issues mirror those of India, so it too must find innovative ways to conserve and replenish its water supplies. Addressing water in India and Nepal is essential for their success as emerging economies.

The Paani Foundation – India

Though many NGOs, IGOs, and state governments are currently attempting to address challenges with India’s water supply, one in particular stands out: The Paani Foundation. Founded by famous Bollywood actor Aamir Khan, The Paani Foundation assists villages in creating natural water tables and irrigation systems. It works to sculpt the land in order to limit topsoil runoff, maintain water levels during drought and improve local biodiversity. The foundation’s focus is primarily in the Indian state of Maharashtra, located west of the Arabian sea, home to 110 million people. The scale of The Paani Foundation’s work in Maharashtra is so immense that it is often recognized as the largest permaculture project in the world. The work of this NGO showcases how inexpensive and innovative solutions are working today to address the growing water challenges in India.

The Paani Programme – Nepal

Unlike the Paani Foundation, developed by a famous Bollywood actor, the Paani Programme is a cooperative between Nepali villagers, the non-profit AVKO and the United States Agency for International Development. Though the focus of this initiative centers on biodiversity conservation, this program, like India’s Paani Foundation, aims to develop irrigation and management systems that are sustainable in design and easy to maintain. The benefits of preserving biodiversity are two-fold, as resilient ecosystems that improve local wildlife numbers also contribute to the sustainable use of water supplies. With more reliable water access and more resilient ecosystems as a result of the investments of the Paani Programme, villagers across Nepal are more able to enjoy economic resilience and elevate themselves out of poverty.

With booming populations and increasingly thirsty economies, water in India and Nepal must rely on better systems to maintain its flow. Homegrown initiatives like The Paani Foundation are showcasing how local creativity can earn international praise. At the same time, programs like USAID’s Paani Programme provide an important example of the necessity of American federal interest in global poverty reduction and sustainable resource management. With “paani” being the most valuable natural resource on Earth, it’s time to give it the attention it truly deserves.

– Saarthak Madan
Photo: Wikimedia Commons

Suaahara II ProjectIn Nepal, 36% of children who are under the age of five remain underdeveloped in terms of growth and health despite progress in recent years. Through cooperation with USAID, the Nepalese Government and local private sector groups, Hellen Keller International (HKI) has provided impactful services that have helped rectify the systematic obstacles causing these health issues. Hellen Keller International is a non-profit organization that aims to reduce malnutrition. The Suaahara II project takes a pivotal role in these efforts.

What is the Suaahara II Project?

One of HKI’s most notable services is the Suaahara II project, which started in 2016 and was initially set to end in 2021. However, it will now extend to March 2023 due to COVID-19. Operating in 42 of Nepal’s districts with a $63 million budget, HKI partnered with these six organizations for the project:

  • Cooperative for Assistance and Relief Everywhere, Inc. (CARE)
  • Family Health International 360 (FHI 360)
  • Environmental and Public Health Organization (ENPHO)
  • Equal Access Nepal (EAN)
  • Nepali Technical Assistance Group (NTAG)
  • Vijaya Development Resource Center (VDRC)

Hellen Keller International’s primary role in the Suaahara II project deals with the technical assistance of child and maternal nutrition. This means that its tasks are oriented around building the skills and knowledge of health workers. This includes teaching health workers how to adequately measure and evaluate assessments; additionally, another technical facet relies on promoting governance that invests in nutrition.

A Multi-Sectoral Approach

Kenda Cunningham, a senior technical adviser for Suaahara II who works under HKI, told The Borgen Project that the Suaahara II consortium has taken a “multi-sectoral approach.” She believes in the importance of this as it pushes individuals to “learn and think beyond their sector.” The Suaahara II Project’s demonstrates its integrated strategy in the initiatives below:

  1. The WASH program focuses on water, sanitation and hygiene through WASHmarts, which are small shops dispersed across districts that sell sanitary products like soap and reusable sanitary pads. Kenda explained how this has helped “bridge a gap” so that poorer households can access hygiene enhancing products. This also allows assistance from private actors, who can expand their markets in rural areas.
  2. The Homestead Food Production program (HFP) encourages households to grow and produce micronutrient-rich foods through vegetable gardening and raising chickens, for example. As a result, 35 districts have institutionalized HFP groups.
  3. The Bhancchin Aama Radio Program is a phone-in radio program that runs twice every week. It hosts discussions among marginalized communities and demonstrations for cooking nutritious foods. It has encouraged the Nepalese to socially and behaviorally alter their health habits.

Advancements from Suaahara I

The Suaahara II project’s contribution to improved health and nutrition in Nepal is also illustrated in its progression from the Suaahara I project’s framework. In addition to understanding the changes made in household systems and at a policy level from Suaahara I, Cunningham told The Borgen Project that technological developments have elevated the Suaahara II Project’s impact in Nepal.

Specifically, smartphones expedite the data collection process when studying trends pertaining to the 2 million households across the districts. The development of new apps provided more households with access to smartphones and key information. This therefore allowed officers to transition from pursuing “a mother-child focus to a family focus” in terms of the Suaahara II project’s accommodations and services.

Challenges with Suaahara II

While the Suaahara II Project has led to institutional and social enhancements regarding health and nutrition, some districts had access to the project earlier. This created a dissonance in the rate of health improvements amongst the districts. Cunningham reported that “far western areas are much more remote and therefore disadvantaged and food insecure.”

This inconsistency was largely due to the “Federalism” that took place in Nepal in 2017, which was a decentralization process that created 42 municipalities for 42 districts. Since every municipality has a different political leader, some districts had the advantage of assistance from foreign NGOs while others did not because their leaders rejected involving foreign NGOs. In these cases, as Cunningham explained, it is like “you are creating your own NGOs from the ground up.”

Suaahara II Achievements

These obstacles, however, have not been pertinent enough to counter the consortium’s efforts in fulfilling the Suaahara II project’s objectives. For example, a primary objective for Suaahra II is to increase breastfeeding amongst babies under six months of age. Exclusive breastfeeding of children under six has increased from 62.9% in 2017 to 68.9% in 2019, according to data that Cunningham shared with The Borgen Project.

Expanding children’s access to diverse and nutritious foods is another objective that has been achieved under the Suaahara II project. The dietary diversity among women of reproductive age (WRA) has increased from 35.6% in 2017 to 45.3% in 2019, according to Cunningham. Given the efficient rate of improvement in women and children’s health, governance and equity in only the first two years of the Suaahara II project, it can be inferred that the consortium will continue to progress in achieving its targets among the Nepalese in the three years that remain.

Regarding how HKI has responded to challenges with the Suaahara II project, Cunningham said  “[We] don’t use a one size fits all approach.” The advancements in Nepal’s health and nutrition systems can be largely attributed to HKI’s multifaceted and integrated strategy, a model that could yield prosperity in the rest of the developing world.

Joy Arkeh
Photo: Flickr

ChhaupadiChhaupadi, a form of menstrual taboo, plagues the country of Nepal. Although it is a social taboo in Hindi tradition, the practice of chhaupadi is often practiced in the far-western region of Nepal and in Himalayan regions. This is because the event of menstruation, although a normal and healthy bodily function for females, is considered a form of sin and impurity. Although menstrual taboo exists in other regions of Nepal and in other South Asian countries, it is most prevalent in the Himalayan regions. Here, it is called chhaupadi, “Chhau” meaning menstruation and “padi” referring to women.

What is Chhaupadi?

Chhaupadi occurs during the female menstruation cycle. While women and girls are menstruating, they are considered impure, intouchable, and even perhaps, harbingers of bad fortune. During the menstruation cycle, any object a woman touches is deemed impure, including livestock, water resources and plants. It is believed that if touched, these objects need to be purified in some way. As a result, in regions where Chhaupadi is practiced, women are banished from their homes. During this exile, women and girls are often sent to a “chhau” shed, which is essentially a livestock shed, and the menstruating female will remain there for about four days. Girls who are experiencing menstruation for the first time may need to stay in the “chhau” for up to 14 days. Unfortunately, girls who may experience difficulties or health issues while menstruating must wait until their cycle ends before seeking medical care, which can worsen possible health problems and symptoms.

Even if women are not directly practicing menstrual exile, a 2018 study by sociologist Saruna Ghimire at Miami University found that 100% of girls are restricted by menstrual taboos during their cycles. These women are not allowed to touch food, touch the water tap or participate in normal family activities. The menstrual taboo restricts the resources available, limiting the autonomy of women and possibly damaging their self-image. Additionally, the Ghimire study found that 72% of females are subjected to menstrual exile due to Chhapuadi.

The Dangers of Menstrual Exile

Not only is the stigma associated with menstruation a problem within these communities but the actual practice of Chhaupadi poses many health risks for the women and girls involved. For instance, the temporary shelters used during Chhaupadi are unhygienic, which increases the risk of health complications such as urinary tract infections, diarrhea, dehydration and hypothermia. Additionally, women and girls living in these sheds are subject to the dangers of snake bites and other animal attacks.

Each year, at least one woman or girl dies during menstrual exile. These cases often go unnoticed by the media, leaving the beliefs of community members unchanged. Moreover, the isolation that comes with Chhaupadi poses dangerous consequences to the mental health of these females. Oftentimes, these women and girls will feel abandoned, insecure, guilty and embarrassed.

Law Prohibiting Chhapuadi

In 2017, the Nepali Government enacted a new law that prohibits Chhapuadi. Any family member that forces a female to practice Chhaupadi can be punished with a jail sentence of three months or fined 3,000 rupees, which translates to about $30. Although the Nepal Supreme Court previously banned Chhapuadi in 2005, the practice has been difficult to disintegrate as it is deeply rooted in traditional beliefs. Besides the legislative component, local police are given the task of destroying Chhapuadi shelters. At the same time, some activists argue that Chhapuadi, although rooted in the patriarchal aspects of Nepali culture, will be difficult to stop as many women choose to practice it. Yet, with the new law, women who choose to practice Chhapuadi are required to do so in a safer way, by isolating themselves from their families in a separate area or room and not a shed.

The Road Ahead

Although Chhaupadi stems from Hindu scripture, the practice is one that has existed for centuries. Thus, the actual practice of menstrual exile may not stop right away. Luckily, the Nepalese Government has made strides in reducing Chhaupadi through the law and police action, and if Chhaupadi is practiced by choice, it will be done in a much safer way.

– Caitlin Calfo
Photo: Flickr

Hunger in Nepal
In Nepal, one in four people lives below the national poverty line, earning only $0.50 a day. This makes it nearly impossible for them to afford basic needs like food, clothing and shelter. In recent years, many organizations have provided aid to Nepal to improve living conditions and lower hunger levels. Outlined below are three organizations fighting hunger in Nepal.

World Food Programme

The World Food Programme (WFP) is a humanitarian organization run by the United Nations with the goal of fighting global hunger. WFP distributes more than 15 billion rations to people affected by hunger in countries around the world. Two-thirds of the countries it serves are affected by conflict. Statistically, people in conflict-ridden countries are three times more likely to be malnourished than their counterparts living in peaceful environments.

One of the countries WFP has been working to address food security and hunger in is Nepal. Roughly 36% of Nepali children under five are stunted due to hunger, while an additional 27% are underweight, and 10% suffer from wasting due to acute malnutrition. As part of their work to address hunger in Nepal, WFP established the Zero Hunger strategy, which is a program with the goal to achieve zero hunger by 2030. This program has directly helped strengthen the government’s capacity to improve “food security, nutrition, as well as emergency preparedness and response.”

Action Against Hunger

Action Against Hunger was created to establish a stronger method for dealing with hunger. Over the past 40 years, it has provided life-saving services in more than 45 countries, one of which is Nepal. Since 2005, Action Against Hunger dedicated a team of 25 employees to address hunger in Nepal.

Nepal is very susceptible to natural disasters based on its proximity to the Himalayas. Its location causes more than 80% of the population to be at risk of storms, floods, landslides or earthquakes. A 2015 earthquake greatly affected Nepal’s Nuwakot and Rasuwa districts. In response, the team created and integrated water and sanitation reconstruction for the areas impacted.

In 2019, Action Against Hunger was able to provide treatments for severely malnourished children through two inpatient and 28 outpatient therapeutic care centers. The organization has carried out various livelihood programs that include helping Nepali citizens implement “home gardening, mushroom farming, poultry and integrated shed management” into their lives. In 2019 alone, the organization provided aid to 99,455 Nepali citizens. Among these citizens, 90,316 were reached by nutrition and health programs, 4,570 were reached by water, sanitation and hygiene programs and 4,569 were reached by food security and livelihood programs.

Feed the Future

Feed the Future was started with the intention of creating sustainable and long-term strategies that would put an end to chronic hunger and poverty across the globe. The organization now operates in twelve different countries affected by food insecurity to execute their goals.

In Nepal, almost 70% of the population works in agriculture; however, many farmers struggle to afford supplies to yield fruitful crops. Feed the Future works with the Nepali government and the agricultural private sector to “produce more diverse and nutritious foods, improve agricultural practices among farmers, and create more inclusive economic opportunities.” So far, the organization has increased nutrition access for 1.75 million children under the age of five. In 2018, it increased vegetable crop yields by 22% and raised farmers’ gross profit margins for vegetables by 17%. The organization also helped the farms it worked with generate $20 million in sales for their crops.

Eradicating Hunger

For years, Nepal has had high food insecurity and hunger due to economic hardships and natural disasters. However, organizations like the World Food Programme, Action Against Hunger and Feed the Future are making measurable and tangible differences in the lives of Nepali citizens. Through the work of these organizations and so many like them, eradicating hunger in Nepal is possible in the coming years.

Sara Holm
Photo: Flickr