Women in Nepal have been stigmatized against, forming an ultra-patriarchal society. Women are seen as taboo during their menstrual cycles, so they cannot be around other people or in any homes. This takes away from their ability to care for their children, complete the housework that is required of them, and, most importantly, become educated. The stigma of women in Nepal prevents women from being equals to men, not just institutionally and nationally, but also in the household and community. I have used the feminist theory to evaluate the sexist nature of Nepal’s cultural, social, economic, and political determinants of health.
Because women cannot be around other people or in any homes, they usually drop out of school when they have their first menstrual cycle. This makes gender a major social and political determinant of health because women do not have equal opportunity to succeed in their lives and become educated. Most girls in Nepal drop out of school by the age of 12 because it would be too hard to catch up every time they had to be exiled for a week each month. Therefore, women must marry and completely rely on their husbands to make a living and keep a job, so they have to do everything in the house, including raising the children, housework, cooking, and ensuring their husbands’ health is good. Women are expected to do all the housework, no matter how hard it may be. The men are expected to go work for their families, which also means they may have to commute to as far as India and send back money. When the men are at home, they are expected to relax and help children with schoolwork occasionally. Women, on the other hand, are expected to do all housework, even chopping wood, no matter their physical condition. Women do not have the ability to get jobs in Nepal, and that will never be able to change unless people allow girls to continue schooling after they begin their menstrual cycles with ease. Women are expected to do all the housework and men are expected to work and relax when they are at home. How do men and children get by when women are away during their menstrual cycles? Are we really to expect that men are completely incapable of doing housework, yet still force their wives away when their bodies are doing something so natural?
Women are also required to stay away from any homes during their menstrual cycles as well. This is also a major cultural determinant of health because they have to be outside for a week at a time every month, no matter the weather. If a woman enters a home during her menstrual cycle, it is a belief that the food, people, and animals can be cursed and get very sick. Women must withstand very hot and cold temperatures, monsoon seasons, and constant rain even without monsoons. Can you imagine being outdoors during inclement weather during cramps or a bad period? To try to sustain themselves, some groups of women build forts or tents to hide under for the week. The trek to move away from villages where people are residing is very rough as well. The mountain terrain of the Himalayas is difficult enough to navigate when doing chores, but to find solitude from inclement weather and stay safe for an entire week is terrifying.
In the Chaupadi culture, it is considered disrespectful to enter someone’s house while menstruating. This results in many girls’ educations suffering. When a girl begins to menstruate, they are told that “no matter what, they stay outside, they eat outside and they sleep outside” (Greenhalgh 2016). If they enter someone’s household, they can be beaten, because it is believed that if menstruating women in the same household as men or other women will make everyone sick, including the animals. The girls must sleep outside, so many often make sheds that girls can sleep in while on their periods.
However, in more developed areas of Nepal, there is less of a strict code surrounding menstruation. In Kathmandu, girls who are menstruating cannot be near others when they are eating, they cannot enter the kitchen, and cannot touch the other people in the house. When they are menstruating and they do any of those things, they will be blamed and culturally shamed for anything bad that happens to any family members (The Guardian 2016).
Most girls that The Guardian 2016 spoke to are attempting to abolish these societal rules and regulations, which is why I chose “How are women and girls treated in Nepal?” When society forces women and girls to leave their lives and basically do nothing and be around no one for three to seven days per month, they are losing a sense of worth. Men do not have to leave their houses, leave their families, and do not have to deal with blood, cramps, and their bodies in the wilderness every month. I think this speaks mountains about Nepalese culture and what it does to women. Even in places like Kathmandu where they are still allowed to be in their homes, women are still subject to the possibility of being blamed for something that their menstruation had nothing to do with. This is a major political determinant of health because women are directly placed under men and blamed for every single thing that could go wrong, due to a stigmatization and aversion to the natural female body.
When the women are forced to leave their homes and/or be placed in solitude for the duration of their menstrual cycle, it is extremely difficult to focus on studies, attend school, and succeed overall. How can a girl be expected to do just as good as a boy in school if she is forced to leave for a week and miss those lessons? This results in many girls dropping out of school as they hit puberty, which means women in Nepal rarely have jobs. This means that economically, Nepal’s entire job market is men, and women will never have a chance to become a part of the economy until a major social change can occur where women can become educated enough to get jobs. Men are able to go to school their whole lives, then find jobs and wives.
Women are expected to do all the housework and men are expected to work and relax when they are at home. How do men and children get by when women are away during their menstrual cycles? Are we really to expect that men are completely incapable of doing housework, yet still force their wives away when their bodies are doing something so natural?
The rough terrain and lifestyle for women in Nepal accounts for most maternal deaths, aside birth complications and non-medical professional assistance in birthing. There are very few medical practitioners available in Nepal to help with births, but there are maternal clinics that women can walk to for prenatal care. Some women walk two or three hours just to get to the clinic in rough, stony mountainsides with no roads. At the clinics, women are compensated some rupees, which end up equaling less than a US dollar, and most women only go for that. Clinicians at the clinics tell women to not overextend themselves and to not carry heavy loads, but many do not agree because they do not see how work will be done without them doing so, due to the cultural standards of it being inconceivable for men to do chores.
Though few women attend visits at the clinic, maternal mortality is still very high. In 1995, per every 100,000 births, there were 660 maternal deaths. This number has shrunk to be 444 in 2005 and 258 in 2015 (UNICEF). While the amount continues to shrink, it is still a prevalent problem. The visible shrinking in maternal deaths is due to the overt campaigning for women to go to the clinics for the safest births. The main cause of maternal death is hemorrhaging, which is when a blood vessel ruptures and the mother can bleed out. Hemorrhaging can be fixed my medical professional with surgical experience, but women who experience hemorrhaging during at-home births without medical professionals have little to no chance of survival, especially in areas like Nepal that are far from hospitals.
In an ideal world, a major culture shift should occur where women would be allowed to relax in their pregnancy and be able to have easy access to medical clinics. It also would call on the men to help with household chores rather than relaxing when they are home. Finally, it would also call upon the entire society and culture to evaluate its stigma surrounding the female body. During menstruation, Nepalese women must separate themselves from everyone else and not enter any home for fear of cursing the home and the people in it. This custom is prevalent all around Nepal – not just the rural areas. In order for the country to actually take hold of this extreme public health issue, they will need to learn about the female body and place more emphasis on its importance, rather than forcing all women to work, give birth, and do everything for men.
Gender in Nepal is such a big deal because of the blatant discrimination, women do not have the possibility to be as healthy as they can. Women have to be bribed to go to maternity clinics with money, they have to commute through the Himalayas, they have to be subjected to the outdoors for a week every month, and there are not many doctors in Nepal. While men are also victims of the harsh elements, commuting on the rough terrain, and the lack of doctors, they simply do not have it as bad as Nepalese women who are exiled from their homes and communities during their menstrual cycles, which are often painful on their own, let alone being left outside the entire time. Women also have to get the proper medicinal care during their pregnancy, which is nearly impossible if they cannot afford to commute the two or three hour trek when they have to do housework for their husbands, children, and community members.
I used the feminist theory to evaluate the determinants of health in Nepal because of the overall sexism I learned about throughout this course. As I learned more and more about all the things women are subjected to just because of their bodies and what naturally occurs, I knew that the feminist theory was the best choice to evaluate from. The inequality in Nepal is specifically due to gender, and it exists in the home and community, as well as in institutions like school and on the national level. The main social determinants of health was that women are exiled during their menstrual cycles and cannot be with their families or friends. The main cultural determinant was the stigmatization of women’s bodies and how they are seen as taboo if they are in a home, and can get others sick. The main political determinant is that women do not have the same rights as men because of their bodies. The patriarchy tells people that women cannot be involved in the community, and places more emphasis on men, creating a hierarchy of the sexes. The economic determinant of health is that women’s lack of education due to their natural bodies makes the entire economy and job market fueled by men.
Overall, gender is a major social determinant of health in Nepal because women simply do not have enough rights. Natural bodily functions like menstrual cycles are seen as taboo, which forces women to have to drop out of school or have to be exiled to the rough terrain of Nepalese mountains or monsoons. Women in Nepal are treated much differently than men because they are not educated and because their bodies are seen as taboo. Women deserve rights to be seen as the same as men, but unfortunately, being a woman in Nepal is a major social, cultural, political and economic determinant of health.
Greenhalgh, Jane. “A Girl Gets Her Period And Is Banished To The Shed: #15Girls.” NPR. NPR, 17 Oct. 2015. Web. 15 July 2016.
Furuta, Marie. “Women’s Position within the Household as a Determinant of Maternal Health Care Use in Nepal.” JSTOR. Nternational Family Planning Perspectives, 1 Mar. 2006. Web. 11 Aug. 2016.
Hodal, Kate. “Nepal’s Bleeding Shame: Menstruating Women Banished to Cattle Sheds | Kate Hodal.” The Guardian. Guardian News and Media, 01 Apr. 2016. Web. 15 July 2016.
“Maternal Mortality Ratio (modeled Estimate, per 100,000 Live Births).” Data. World Bank Group, n.d. Web. 28 July 2016.
Simkhada, B. “Result Filters.” National Center for Biotechnology Information. U.S. National Library of Medicine, June 2004. Web. 08 July 2016.
“Statistics.” UNICEF. UNICEF, n.d. Web. 28 July 2016.
“‘When I Have My Period I’m Not Allowed to … ‘: Girls in Nepal Share Their Photo Diaries – in Pictures.” The Guardian. Guardian News and Media, 28 May 2016. Web. 15 July 2016.
WHO, UNICEF, UNFPA, and World Bank Group. “Maternal Mortality in 1990-2015.” Nepal (2015): n. pag. World Health Organization. Web. 28 July 2016.
“Women’s Health in Nepal.” Public Radio International. N.p., 9 June 2009. Web. 08 July 2016.