Kate Bollinger | Posted August 30th, 2010 | Uncategorized
In this interview, Aahiliya Thakur describes the panel she painted and discusses the difficulties of being a woman in her village.
The Advocacy Project (AP) recruits students to help marginalized communities tell their story and claim their rights.
In this interview, Aahiliya Thakur describes the panel she painted and discusses the difficulties of being a woman in her village.
Last week, I made my final field-visit descent from Kathmandu to Lahan, in Nepalâs lowland Terai region. We had received funding in June, during our time in Washington, DC, from the organization Zonta International for the project which I had now come to Lahan for. The intention behind the funding was to initiate a quilting project with nepali women similar to one the Advocacy Project had done with Bosnian women war survivors. Through this project, a group of women each documented their experiences through stitching a part of a quilt, which then traveled around the US as an awareness raising program.
So the idea behind the Zonta International funding was to start something similar in Nepal. We werenât sure where to start but, as it turned out, there is a very traditional form of art â dating back to the 7th century -Â called Mithila art which is localized in the eastern Terai where WRRP works. Mithila art is done by women, often painted on their homes, and was traditionally passed from generation to generation. However, in recent history, the practice started to fade. Certain groups have recently begun to revive the practice but, still, few village women practice Mithila art anymore.
Armed with this information, and the fact that WRRP has a thriving program in this area of eastern Terai, we decided to do our quilting project with uterine prolapse sufferers through Mithila art. Because most of these women had never before touched a paint brush, we hired trainers to work with the women. The trainers were local women experts in traditional Mithila art.
After a ten hour bus ride from Kathmandu, I arrived to Lahan on Sunday afternoon. WRRPâs field staff had done a wonderful job of arranging the first program to begin the next day in a nearby town called Rajbiraj. We werenât quite sure what to expect when we arrived. Would women show up? Would they be able to or want to paint? Would they be able to leave home for the requested five hours a day for a consecutive four days to attend all of the painting sessions? Â At 11 am, as requested, ten women from WRRPâs Uterine Prolapse Survivorâs Network arrived at the Rajbiraj health post â where the painting session was held. In Rajbiraj, as in Karjana â a village where we also conducted a painting program – , the women surpassed all of our expectations. They worked for hours straight, first sketching on their cloth with pencils and eventually in paint. They helped each other and gave each other advice. On the final day at Rajbiraj, the women gave everyone hugs and expressed how much they wanted to be able to work on their artwork more.
Each painting truly expressed something about these womenâs difficulties or joys â particularly with uterine prolapse. And the paintings provided them a gateway to discussing their feelings of womenâs lives in their village. Sulekha Dev, shown below, described her painting like this (translated): âIn this painting, I have made this woman who is suffering from third degree prolapse. She had the prolapse so she had difficulty in walking, eating, and speaking. She needed surgery. She was young when she was married. She lifted heavy loads.Â No one cared about her. And so she had the prolapse. When she came back after the [hysterectomy] surgery, she was still so young. She had a long life to live. She was happy. So, in this picture, she is collecting flowers to offer to the godsâŚ. She feels so healthyâŚ She feels so light.â
In the interviews we did with the women after, many discussed how they had been unsure if they would be able to paint at all. Â One woman, Phulo Devi Pahwan, said, âI have never done these kinds of paintings. I never handled a brush before the day we started this. I was wondering if I could do it or not. Now, after three or four days, my hands have become stable and it became easier.â Bijili Yadav (pictured below) said, âI used to weave baskets and prepare fuel from cow dung. But I have never done these kinds of paintings.â Many of these women expressed a strong desire to continue painting.
I leave at the end of this week for home and will take these painting panels with me. Zonta International and the Advocacy Project will build them into a quilt which will migrate around the US and raise awareness of these womenâs lives and difficulties.Â And, hopefully, the quiltâs travels will help to raise more funds so that these women can build on their newfound skills and their cultureâs long tradition of Mithila art.
Having spent the last few weeks in WRRPâs office, reading over reports, editing WRRPâs brand new web site, and working on a grant proposal, Iâve had a chance to consider the finer details of WRRPâs approach and the issue of uterine prolapse.
Since learning I would spend the summer working with WRRP, and suddenly finding myself bringing up uterine prolapse in everyday conversation, I ended up meeting two women, both over 60, â one from the US and one from the UK â who had suffered with a prolapsed uterus. This was a good lesson for me in the global prevalence of this condition. However, while uterine prolapse occurs predominantly in post-menopausal women in developed countries, in Nepal, it happens from adolescence onwards. Why?
Walking around Nepali villages, talking to local women, and seeing the work these women do, has made the answer quite clear. Women in Nepal are generally responsible for Â vast majority of the household duties; food preparation, childcare, and field work are all in their domain. It is very common here to see women carrying huge loads of grass or other goods on their heads. I often see girls moving huge rocks. And women, especially in villages, marry well before adulthood. 47% of women in Nepal are married by age 17. Also, access to health care in villages is very limited â either by finances or by geography. When women give birth, 92% of them do so at home and 90% of the births take place without a trained assistant.
In addition to all of this, women in Nepal are often the last to eat in their family. One woman I interviewed in Lahan said, âWhy should I lie? My mother-in-law was so rude. She would give me 20 kilograms of rice grains to grind and very little to eatâŚ She would only give me a small portion of the broken rice grains to eat. And then she would ask me to go work in the fields and harvest the rice. And do all other things.Â She would give to her own sons and daughters good food to eat. I would only get the discarded water from the boiled riceâŚ. In this way, I got weak.â One out of every four women in Nepal does not get enough food to eat.
These are all practices deeply rooted in Nepalâs patriarchal society. And they are also the practices that lead to the very high rates of uterine prolapse in Nepal.
The huge challenge WRRP faces is how to address an issue whose causes are inherent in the daily life people have been living and passing on to their children for generations? Fittingly, WRRPâs brochure states that it âaddresses fallen womb as an issue of reproductive rights, rather than a mere medical problem. This problem is the consequence of the sub-ordination of women and is rooted in prevalent patriarchal structuresâ.
My coworkers have described WRRPâs approach to me as multi-pronged – tackling the short-term, medium-term, and long-term solutions necessary to address the problem of uterine prolapse in Nepal. For example, WRRP provides women in dire need of help with free access to treatment services. This often entails bussing groups of women from villages to mobile surgical treatment camps, battling road strikes, blockages, and unpredictable treatment camp schedules. For great accounts of these surgical treatment camps, check out past fellow, Nicole Farkouhâs, blog. To tackle uterine prolapse over the longer term, WRRP has a very strong advocacy and education programs. They have groups of campaigners in the fields who literally go door-to-door in villages, talking to families about how to prevent uterine prolapse. And these campaigners help to organize networks of women sufferers (pidit mahila manch) to run advocacy campaigns. In one such campaign, women sufferers chained themselves to the door of a district headquarters, demanding a change in reproductive rights policy. And they were successful! More details on this are described in WRRPâs recent video production, Saving the Womb on YouTube.
All of these activities are further challenged by the cultural context in which theyâre taking place. In this context, womenâs health needs are often not a priority and topics surrounding uterine prolapse are uncomfortable subjects.
It certainly is not an easy challenge WRRP has taken on â which makes it all the more impressive that they are achieving many impressive results which make a big difference to women across Nepal.
Source for statistics:
Earth, Barbara and Sabitri Sthapit. âUterine Prolapse in Rural Nepal: Gender and Human Rights Implications. A Mandate for Developmentâ Culture, Health & Sexuality, 2002, Vol. 4, No. 3, 281-296.
This is an interview I conducted with the the help of WRRP’s program officer, Rakesh Yadav. Sita Devi Ram is a uterine prolapse sufferer in Boriya village in the Saptari District of Nepal.
One of the most essential items Iâve acquired in Nepal is my light blue umbrella. I donât leave home without it. Almost everyday the skies turn from hot and sunny (for which the sun shade function of the umbrella is essential) to a dark and cloudy grey. Fitting with the monsoon season weâre in, light drizzle to heavy rain to raucous thunder storms â lasting anywhere from a few minutes to a few days straight – is quite common. But itâs not enough. Nepal â and Kathmandu, in particular â is in the midst of a serious water crisis. Before monsoon season started in July, many Kathmandu residents only had access to water once a week. They would sit on guard with their water jugs, waiting for their local tap to come alive. The Kathmandu Post ran reports of some of these taps only spitting out black sludge when the allotted water time came.
This problem extends beyond the obvious dearth of a most basic resource.Â Lack of water means that Kathmanduâs power plants canât function to anything close to their full potential â leading to huge power shortages. In the winter, Kathmandu residents have only four hours of power a day. Four hours!Â This is hard for me to imagine because, now that monsoon season is here, we have about twenty hours of power a day.
I asked my coworkers at WRRP about their impressions of this situation. To me, it seems very drastic that a countryâs capital would have only four hours of power a day for a large part of the year. My nepali coworkers attribute the situation to three main problems. First, Kathmandu is experiencing a swelling population due both to a general population growth and to a large rural influx. A larger population and already limited water supply is not helping Kathmanduâs water situation. A second big problem is that the source of Kathmanduâs water is nearby rivers whose full supply potential is not being harnessed because of political conflict. According to my coworkers, opposition political parties are mobilizing members of local villages who will be affected if water from their nearby river is diverted to Kathmandu. The villagers are, as a result, demanding compensation for this loss. This is an understandable plight but one that is problematic for Kathmanduâs water supply. But, unfortunately, even if these rivers were able to readily supply Kathmanduâs water, it still would not be enough.
And so we come to the most commonly cited reason for Nepalâs tight water situation: climate change. According to what Iâve heard said here, the monsoon rains no longer provide the amount of rain they used to. Summer temperatures never used to be this hot. And some of the Himalayas â which used to be covered with glaciers â are now snowless year-round. The situation in the Himalayas is often talked about in the local papers, as well. With decreasing amounts of melting snow, the Indian subcontinent, which depends on the Himalayas for its water supply, might soon be in a similar situation to Kathmanduâs: without water.
So Nepalâs natural resource situation is not looking great at the moment. But, on the upside, because Kathmandu residents have to deal with resource depletion on a daily basis, the situation is very prominent in peopleâs minds â so prominent that it seemed worthy of a blog post. Nepal is becoming active in its attempt to deal with the effects of climate change â because now it seems it inevitably must.
The main focus of our time in Lahan was putting on a village nutrition fair geared towards pregnant women. As with many things that happened in the village, I wasnât entirely clear what was going on until it was actually going on. So I had many questions about the village fair beforehand. What is a “village fair”? How do villagers know to come to the fair? What if it rained at our outdoor fairÂ (not an unreasonable concern in monsoon season)? And how were we going to get to that village?
So I was happily surprised when we arrived at the fair â in a hired taxi â to a central area in the village with about twenty men already putting up a large rainbow-colored tent. The novelty of the tent set-up started drawing village members immediately â especially a large crowd of children who were eagerly sneaking into the tent at any chance they got. Once the tent was constructed, the WRRP staff began making stalls within the tent. There were six stalls in total which women would rotate through:
1. A check-in station where every woman had her blood pressure and weight checked.
2. A âpregnancy factâ stall where women learned about how babies come to be, the different stages of pregnancy mother and child go through, and the importance of avoiding heavy workloads during pregnancy (a nearly impossible assignment for many village women).
3. The ânutrition stallâ where an enormous cornucopia of fresh and local foods was laid out for pregnant women to see and imagine how they could construct their own balanced diet. This is particularly important in this village where women often rely only on the food their garden grows for all their meals â a practice which leads to malnourishment during pregnancy.
4. A uterine prolapse game stall in which womenÂ raced to put together puzzle pictures of prolapsed uteruses and shoot arrows at a wall sprinkled with answers to health trivia questions.
5. Another game stall testing knowledge of womenâs reproductive health through a snakes & ladders game.
6. A private room with a full length mirror. Most women in this village have never seen themselves in a full length mirror and nevermind having seen themselves pregnant!
7. Food stall – Each pregnant woman who attended the fair was given a delicious and nutritious meal at the end of the fair circuit.
The nutrition fair turned out to be an enormous success. After an hour of speeches by local politicians, villagers entered the fair in groups of six â a process that, given the hundreds of people who showed up, lasted for hours. The fair attracted 75 pregnant women (twice as many as we expected) and even four of their husbands. Full success!
A few hours after our arrival in Lahan, it is time to get to work. The next two days will be spent in day-long meetings with representatives (or âcampaignersâ) from nine local NGOâs who WRRP has partnered with in surrounding villages. For me, this is a great introduction into the structure of WRRP programs in the field.
Within the Lahan district, WRRP has one program office â which is where Sunita and I will be based for the next week and a half. In order to be most effective in the villages in which they work, WRRP runs its village programs in partnership with local NGOâs based in these villages. This seems to be a very effective structure as these local NGOâs are already familiar with the dynamics of running programs in their particular village. While each NGO runs independently, each has also partnered with WRRP to run uterine prolapse support and prevention programs. As such, one campaigner from each NGO has come to attend this two day meeting put on by WRRP. The focus of this meeting will be something a little different than WRRP or these campaigners have done before â designing and running village fairs. A secondary focus of the meeting will be updating the uterine prolapse school programs already in place across Lahan.
The first day of the meeting is meant to begin at 11 am but, following traditional ânepali timeâ, it gets going sometime after noon. Sunita and Rakesh, the Lahan program officer, spend the afternoon discussing their ideas for the village fair Â with the campaigners and getting feedback on what might or might not work in their particular villages. While the vast majority of these nepali discussions is lost to me, the campaigners are engaged and interested and Sunita and Rakesh are pleased with the dayâs outcome. We all retire for a welcome nightâs sleep after a healthy serving of daalbhat.
The next morning, after a cup of lemon black tea, we begin the second day of training. Today will focus on the school programs which are in place in villages across Lahan. The idea is to energize these programs through having the chidren â ages 11 to 13 â play games related to uterine prolapse. Given the generally conservative nature of nepali culture, I am surprised at how forward these programs are. The fact that graphic pictures of women with prolapsed uteruses is a normal sight to see â painted and postered on village walls, for example – highlights how much progress WRRP has made towards educating people about uterine prolapse. Related to these games, children will put together puzzles with pictures of the three stages of uterine prolapse. Other games to be played include a blind-folded version of putting the puzzle together, a whisper train with terms such as âgender empowermentâ passed along a line in whispers, cherades (trying acting out âheavy workload during pregnancyâ), and a trust fall.
Game day goes well and around mid-afternoon the meetings come to a close so that the campaigners can return to their villages by evening. Stay tuned to see how the village fair and school programs turn out later this week!
Having spent a brief 1 Â˝ days in the Kathmandu office, my co-worker at WRRP, Sunita, and I have headed off to the villages to see the WRRP programs in action. WRRP currently runs programs in 4 of Nepalâs 75 districts and each district program works in approximately 25 surrounding villages.
On this trip ,we will go visit the programs in the Lahan area. Lahan lies in southeastern Nepal in whatâs known as the Terai area and, from what I can tell, is well known for its extreme heat and delicious mangoes.
Sunita and I will take a night bus from Kathmandu to Lahan. We arrive at the Kathmandu bus stop after an umbrella-less walk through some welcome monsoon rains (Kathmandu is in the midst of a serious water crisis). The roads of Kathmandu we walk along are particularly jammed on this day although they are always a chaotic frenzy of buses, cars, taxis, motorcycles, bicycles, and pedestrians, swerving, passing, stopping, and going. With the traffic situation as such, it is not a surprise when we get to the bus stop and learn that our bus will be one or two hours late.
After an hour, the bus arrives and the journey to Lahan begins. The first stretch out of Kathmandu is a beautiful part of the trip as one leaves the city behind and enters hillsides winding along terraced rice paddies and small villages. While the scenery is beautiful, the road itself is a little unnerving. The road is wide enough for about 1 Â˝ cars. So it is somewhat worrying as our bus flies downhill, breaks screeching on the turns, to see a bus approaching in the opposite direction. But these drivers are experienced and, invariably, one bus pulls slightly aside to let the other pass and a series of friendly honks are exchanged. About an hour into the journey, one of the driverâs companions pulls down a surprisingly large TV screen from overhead and for the next two hours a Hindi film, on full volume, entertains the crowded bus. Around 10:30 pm, itâs time for a rest stop and dinner. The beauty of local nepali restaurants is that there is no need to order. You just sit down and the daalbhat of the day is brought to you. A typical daalbhat consists of a healthy serving of white rice, a vegetable dish, a lentil soup, a picked vegetable, and a slice of a fresh vegetable (usually cucumber or onion). Clean hands are essential for daalbhat because it is eaten with ones hands â a talent whose dexterity takes time to develop.
After filling up on daalbhat, most of us on the bus develop bhat laagyo. Bhat means âriceâ and laagyo is expression which relates a feeling. In essence, we are feeling our rice and are soon asleep. I awaken maybe an hour later to realize that the bus is at a dead stop. We are in a mysterious midnight traffic jam of busses on an otherwise quiet nepali road. The driver turns the bus off and most of us fall back asleep. Two hours later, I awaken in a daze to the bus engine starting and murmurs of relief. Onward ho. I fall back asleep again and maybe an hour later am awakened on a particularly bumpy stretch of road. I look out the window and realize that our rather large bus is not only driving down a small dirt road, but is completely lost. People seem to be yelling out directions to the driver, who plows on. Eventually, the bus comes to a stop and a few people step outside to go read the street signs hidden in the dark. Everyone on the bus â all nepali except for me – is giggling and cracking jokes I donât understand about our predicament. After about ten minutes, another bus comes by, stops, and gives us directions.
Again on the right path, we continue on as the sun rises and a flat and green landscape rolls by. Twelve sleepy hours after boarding the bus in Kathmandu, Sunita shakes me awake. Weâre here!
My first two weeks with the Advocacy Project were spent in Washington, DC, where the WRRPâs director, Samita Pradhan, made her first trip to the US to present at the Women Deliver 2010 Conference and to begin the process of raising global awareness of uterine prolapse through DC networks.
The Women Deliver conference was an amazing experience. Thousands of participants â the majority women â gathered from all over the world to discuss gender equity from a myriad of angles. Samita, for example, presented in a panel on âReaching Poor Women and Newborns and Delivering Equitable Solutionsâ and discussed the Situation of Nepali Women with Uterine Prolapse.
Looking back, the conference was key for the Advocacy Project and WRRP in two major ways. Firstly, it gave us more of an answer to the question which was often the first question asked about WRRPâs work, âIs uterine prolapse only an issue in Nepal?â It’s a very good question which we didn’t have a straight forward answer to…. yet.
To try to get a firmer grasp of this, we organized an informal meeting at the conference to explore the global incidence of uterine prolapse. To our delight, women from a number of nations showed up to discuss uterine prolapse in their own countries. Most notably we learned that uterine prolapse is not only prevalent in Asian countries (Nepal, India, and Bangladesh, for example), but also in Africa (Ghana and Nigeria, for example). Â And no one, from any country, knew about government efforts working to address the issue. Clearly it’s time for action!
A second important outcome of this conference, and the following week in DC, was the opportunity to connect to people and organizations who could potentially be major players in the drive to address uterine prolapse. Samita and our Advocacy Project crew met with Congresswoman Lois Capps, staff from the Foreign Relations Committee, the Senate Appropriations Committee, USAID, the US State Department, and others. And Samita gave an additional presentation, sponsored by the America-Nepal Womenâs Association, which was broadcast live on DCNepal â an online television station.
All in all, it was very clear to all of us involved that the issue of uterine prolapse gained some serious momentum during Samitaâs stay in Washington, DC and was brought to more public attention than it had been before.
It was great to have had the opportunity to start my summer work with WRRP in this way. I think itâs going to be a good summer!
This summer, I will go to Nepal as an Advocacy Project “Peace Fellow” to work with the Womenâs Reproductive Rights Program (hereafter referred to as WRRP). WRRP is an advocacy organization based in Kathmandu, Nepal whose primary focus is on a reproductive health condition called uterine prolapse – or “falling of the womb”. This is condition in which a woman’s uterus becomes dislodged. While it happens to women everywhere in the world (almost always after menopause), in Nepal it is estimated that 1 out of 10 women suffers from a prolapsed uterus. That is approximately 600,000 women. Adolescents through adults are afflicted. WRRP approaches uterine prolapse as an issue of gender discrimination as it is an issue caused by women’s malnutrition, lack of proper medical care – particularly during pregnancy-, and work overload. WRRP has done ten years of very productive work on this issue so far and I know I have a lot to learn, and hopefully to contribute, this summer.
I will spend my first two weeks of the fellowship in Washington DC where Samita Pradhan, director of the WRRP, will travel to present at the Women Deliver 2010 conference. The conference in itself should be quite an experience â thousands of men and women from all over the world will come together at the Washington DC Convention Center to discuss gender equity. Iâll be a volunteer at this conference â which will provide me with a free pass to attend. For the rest of the two weeks in DC, Iâll join Samita and the Advocacy Project crew in the many meetings they have been hard at work organizing. In mid-June,Â I will travel to Kathmandu, Nepal where I will work with WRRP for the rest of the summer.
While the Advocacy Project has described to me the type of work I’ll be doing, I know I have many surprises awaiting me in Kathmandu and the villages beyond. While I’ve been to Nepal before, I’m excited to spend time here in a new context – an advocacy context. Â This work will also, hopefully, be a valuable extension of my masters program at the Monterey Institute of International Studies, where I have just finished my first year as a graduate student in international policy studies with a focus on international development and human rights. On a personal note, I am very excited to be back in Nepal, practicing my nepali, filling up with daalbhat, and watching the monsoons roll by.
Women\'s Reproductive Rights Program, Nepal
Tagsadvocacy project Nepal
Annelieke van de Wiel
Rianne Van Doeveren