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Dalit Women: Health care Access and Health Outcomes

Dalit womenThe caste systems found in countries such as India and Nepal are socially hierarchical systems that divide people into five primary groups: Brahmin, Kshatriya, Vaishya, Sudra and Dalit. Those in the Dalit caste rank as the lowest and are considered societal outcasts. As a result, they suffer harsh treatment and discrimination. Due to the patriarchy in these societies in addition to widespread support for caste systems, Dalit women face high levels of discrimination. This reality creates great disparities in overall life and health outcomes.

Access to Care

Dalit women’s health outcomes largely depend on their access to health care. This access, however, is limited considering Dalit women’s low socioeconomic status. For example, in the southwest Indian state of Karnataka, which is home to over 61 million people and is the eighth-largest state in India by population, about 74.4% of Dalit women reported having issues regarding health care access. This number is about 70% at the national level, according to 2018 India’s National Family Health Survey. Partially due to this struggle in accessing health care, Dalit women have a 15-year shorter lifespan on average than upper caste women.

When they do have access to care, it can be very costly. Asia-Pacific Journal of Public Health revealed that some unlicensed private doctors exploit Dalit women and other lower-caste women by charging them high fees, forcing many of them to take out loans for treatment. This practice contributes to the cycle of poverty among Dalit women and can make access for many extremely difficult. These issues with health care access often lead to negative health outcomes considering women’s greater vulnerability to diseases such as malnutrition and anemia, as well as maternal mortality.

Mental Health Disparities

Two main issues face Dalit women in terms of mental health: firstly, mental health issues are more prevalent in their caste than for those in higher-ranking castes, and secondly, these women have less access to care. In 2020, the Journal of Global Health Reports conducted a study in which 12 Dalit participants from Nepal talked about their experiences with mental health. From the outset, the researchers made it known that Dalits in Nepal “face the greatest discrimination and have a greater prevalence of depression and anxiety when compared with high castes.”

In terms of the actual results of the study, a number of the participants stated they believe that gender-based discrimination in Nepal makes issues of mental health for Dalit women more difficult, as it causes them to “receive more stigma for mental health conditions.” The stigmas that these women receive can lead to dangerous outcomes for them. Two participants in the study stated that Dalit women are at considerable risk when they are cast out from their families, as they become homeless and therefore are more vulnerable to exploitation, rape and abuse.

Some research also indicates that Dalit and other low-caste women may have experienced worsening mental health outcomes as a result of the COVID-19 pandemic. According to a 2022 study, lower-caste women tended to have a greater fear of COVID-19 than higher-caste women. The study also found that Dalit women and women of other backward castes (OBCs) suffered from more severe anxiety and stress symptoms than higher-caste women.

Feminist Dalit Organization (FEDO)

In light of the continuing discrimination against Dalit women, several organizations are taking action to create better opportunities for this underprivileged community. Perhaps one of the most prominent is the Feminist Dalit Organization (FEDO), which is a nonprofit organization that was founded by a group of Dalit women in 1994. The organization works to address and fight back against the various inequalities experienced by affected women in Nepal.

FEDO is present in 56 of Nepal’s 75 districts, seeking to improve the lives of Dalit women by advocating for human rights and economic empowerment initiatives. This includes helping Dalit women become financially literate so that they can have opportunities to own small businesses and break the cycles of poverty found in Dalit communities throughout Asia. The work of organizations like FEDO could bring about upwards social mobility for Dalit women, therefore giving them greater access to health care services and improving their overall quality of life.

– Adam Cvik
Photo: Flickr

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The Fight for Women’s Rights in Nepal

Women's Rights in Nepal
To women in Nepal, the thought of gender equality and the solidification of women’s rights is difficult to imagine. In Nepal, people discriminate against women socially, legally, culturally and physically. In an interview with thinkEQUAL, a project by the World Bank, a woman in Nepal said that “Women have fewer rights. If there was equality, life would be easier for us.” Here is some information about women’s rights in Nepal.

Poverty and Land Ownership for Women in Nepal

Nepal, home of Mount Everest, is a small country landlocked between China and India. In Nepal, gender inequality exists in marriages, property, menstruation and occupations. It also dramatically contributes to the number of impoverished women living in the country. The number of impoverished people in Nepal has steadily decreased from 25.2% in 2011 to 21.6% in 2018. However, women and men are nowhere near equal in terms of poverty.

The Nepalese constitution provides some protection for female citizens. However, the country has not fully enforced this protection. For instance, in Nepal, only 19.7% of women own land, and of that percentage, only 11% have control over their land. Thus, many Nepalese women’s lives fall into the hands of their husbands or fathers. The concept of owning land is essential to provide and promote women’s rights in Nepal. This is because it encourages men to see women as equals rather than a sexual or monetary object.

Marriage and Labor for Women in Nepal

Oftentimes, because women have little autonomy, their families arrange marriages for them. In Nepal, child marriage is extremely common, with 37% of girls merrying before 18 years of age. The pervasiveness of child marriage further diminishes women’s rights in Nepal. Child marriage reinforces traditionally domestic practices like staying home and taking care of young children. This is because these adolescents are often quick to become pregnant.

Since these young women are busy at home with their children, this leads to great disparities in the workplace. This further contributes to women’s poverty and, at times, a lack of respect and dignity from their male counterparts. In Nepal, the female labor force is less than half of the male labor force. Only 26.3% of women are in the workforce. Additionally, the national gross domestic product leaves out a woman’s unpaid domestic work. This further devalues the work that women perform, and further entrenching the patriarchal ideal Nepal runs on.

Menstruation in Nepal

Perhaps the most common instance of gender inequality in Nepal is the surplus of period poverty. Chhaupadi, a menstrual taboo custom in Nepal and other Asian countries, still exists despite its criminalization in 2017 by the Nepalese government. Chhapaudi occurs during menstruation and has existed for hundreds of years, despite many attempts for the practice to dissolve. The word Chhaupadi comes from a Nepali word that translates to some type of impurity. The practice of Chhaupadi forbids women and girls from staying in their homes. It also forbids them from participating in family or daily activities because they are menstruating.

While they are menstruating, people consider these women toxic. Therefore, they must stay in small huts, sometimes smaller than a closet, far from family members and friends. Rocks and mud typically make up the walls of these huts. The women essentially cannot leave until menstruation is over. Yet, due to the construction of these huts and environmental circumstances, at least one female dies every year from Chhaupadi. Oftentimes, it is due to the cold temperatures, animal attacks or smoke inhalation. During menstruation, women cannot return to their homes. This is because the tradition has made them and their families fear that bad fortune will come to them. Despite the efforts for ending Chhaupadi, the tradition is deeply ingrained in the minds of Nepalese people. As many as 89% of menstruating girls face discrimination.

Organizations Helping Nepalese Women

Despite the traditions and societal structure that dampen women’s rights in Nepal, nonprofit organizations based in the U.S. and abroad are hard at work to save, support and uplift Nepalese women. Organizations like the Women’s Foundation Nepal and Womankind Worldwide are making strides for women in Nepal. As a result of the work Womankind Worldwide has done with other Nepalese-based organizations, the Nepali Congress Party has shifted its focus to female leadership, reserving two seats for Dalit (oppressed) women. Additionally, Womankind Worldwide partnered with the Feminist Dalit Organization (FEDO). As a result, three Dalit women trained by FEDO joined the Nepalese Dalit Movement.

Through the Women’s Foundation Nepal, community programs have emerged. These programs provide safe shelter and psychological and legal help to victimized women and children. Since 1995, the Women’s Foundation Nepal has run a women’s shelter that currently houses over 70 women and children.

Nepalese women need more changes to ensure their success and welfare. Until then, several organizations have taken a stand. They will continue to foster a safe, comfortable and liveable environment for Nepalese women.

– Caitlin Calfo
Photo: Flickr