<?xml version="1.0" encoding="UTF-8"?><rss xmlns:content="http://purl.org/rss/1.0/modules/content/" version="2.0"><channel><title>IRIN - Nepal</title><link>http://www.irinnews.org/</link><description>Updated everyday</description><language>en-gb</language><lastBuildDate>Tue, 07 May 2013 09:30:53 GMT</lastBuildDate><item><title>The plight of LGBTI asylum seekers, refugees</title><pubDate>Tue, 07 May 2013 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2013/201305070711300235t.jpg" />]]>KATHMANDU 07 May 2013 (IRIN) - Refugees and asylum seekers face a host of challenges when crossing borders, but the obstacles are particularly pronounced for lesbian, gay, bisexual, transgender, or intersex (LGBTI) persons, say experts.</description><body><![CDATA[KATHMANDU 07 May 2013 (IRIN) - Refugees and asylum seekers face a host of challenges when crossing borders, but the obstacles are particularly pronounced for lesbian, gay, bisexual, transgender, or intersex (LGBTI) persons, say experts.

“LGBTI asylum seekers and refugees face a range of threats, risks and vulnerabilities throughout the displacement cycle,” Volker Türk, director of international protection at the UN Refugee Agency (UNHCR), told IRIN from Geneva.

“And while the world has come a long way since first recognizing asylum claims based on sexual orientation and gender identity in the 1980s, residual factors ranging from criminalization to disbelief result in LGBTI people suffering at the hands of a variety of actors as they flee oppression and seek safety,” he said.

A new edition of the Forced Migration Review (FMR) released on 29 April [ http://www.fmreview.org/sogi/ ] highlights many of the remaining challenges for LGBTI migrants and asylum seekers.

According to UNHCR, targeting people based on real or perceived sexual orientation and gender identity for persecution, discrimination, and harassment can stem from the belief that they are encouraging unwanted or unnatural social change. [ http://www.unhcr.org/505c18af9.html ]

LGBTI people leave home for the same reasons as everyone else: to flee war, persecution, and oppression; to seek stability, education, employment, and freedom. In situations of upheaval or conflict, sexual and gender minorities have become targets for scapegoating [ http://www.hias.org/uploaded/file/Invisible-in-the-City_full-report.pdf ] or “moral cleansing” campaigns, [ http://www.hrw.org/news/2006/01/11/nepal-police-sexual-cleansing-drive ] compounding the inherent vulnerability created by unrest, activists say.

LGBTI persecution

LGBTI people experience torture, violence, discrimination, and persecution in countries around the world, sometimes deliberately carried out by the state and often conducted with impunity.

Homosexual acts are punishable with the death penalty in five countries (Iran, Mauritania, Saudi Arabia, Sudan and Yemen), as well as some parts of Nigeria and Somalia, the International Lesbian and Gay Association, [ http://old.ilga.org/Statehomophobia/ILGA_State_Sponsored_Homophobia_2012.pdf ] the oldest and only membership-based LGBTI organization in the world, reported in 2012.

According to research by Human Rights Watch, [ http://www.hrw.org/reports/2010/12/15/we-are-buried-generation] gay Iranians [ http://www.irinnews.org/Report/25296/IRAN-IRAN-Activists-condemn-execution-of-gay-teens ] are fleeing, frequently to Turkey, due to the state-sponsored persecution they face at home, while thousands of LGBTI people have sought international protection in Europe in recent years on the basis of their sexual orientation and gender identity. [ http://www.rechten.vu.nl/nl/Images/Fleeing%20Homophobia%20report%20EN_tcm22-232205.pdf ]

And while few countries keep LGBTI-specific data, Norway and Belgium, [ http://www.rechten.vu.nl/nl/Images/Fleeing%20Homophobia%20report%20EN_tcm22-232205.pdf ] which both track asylum decisions based on sexual orientation and gender identity, have shown a steady uptick in recent years.

From 2008-2010, LGBTI asylum decisions in Belgium increased from 226-522. During the same period in Norway they increased from 3-26.

But information about abuses against LGBTI people - called “Country of Origin Information” (COI) in the asylum process - can be scant in hostile countries, argued Christian Pangilinan, a Tanzania-based refugee lawyer cited in the Forced Migration Review. [ http://www.fmreview.org/sogi/pangilinan ]

For transgender people, COI can mislead agencies, such as in Iran where authorities “allow transsexual surgery as a forced method of preventing homosexuality rather than supporting trans identities,” according to a gender expert’s FMR chapter. [ http://www.fmreview.org/sogi/bach ]

Crossing borders of geography and identity

The multiple document checks migrants might encounter can be particularly difficult for transgender or gender-variant people. While international standards for travel documents officially recognize three genders - marked M, F, or X - [ http://www.icao.int/Security/mrtd/Pages/default.aspx ] only a handful of countries have incorporated the third category, [ http://www.law.emory.edu/fileadmin/journals/eilr/26/26.1/Bochenek_Knight.pdf ] meaning that high-security travel environments, such as airports or emergency residential camps, can threaten humiliation or exclusion to people whose gender identity or expression is different from what is indicated by their documents. [ http://papers.ssrn.com/sol3/papers.cfm?abstract_id=1926681 ] [ http://www.worldwewant2015.org/node/283239 ]

Sexuality and gender are nuanced personal matters. According to research by psychologists, [ http://www.fmreview.org/sogi/shidlo-ahola ] some individuals may have had limited experience expressing or experiencing his or her deeply-felt sexual orientation or gender identity, and may outwardly appear very different than how he or she feels - to the extent of even being in a heterosexual relationship.

With the asylum process taking increasingly extended periods of time, [ http://www.unhcr.org/4381c5832.pdf] some may start the migration or asylum process with one identity, and change over time, complicating the matter both personally and administratively and exposing the individual to further discrimination or ill-treatment. [ http://www.rechten.vu.nl/nl/Images/Fleeing%20Homophobia%20report%20EN_tcm22-232205.pdf ]

UNHCR’s guidelines for claims to refugee status based on sexual orientation and gender identity take the progressive step of acknowledging that “sexual orientation and gender identity are broad concepts which create space for self-identification” which may“continue to evolve across a person’s lifetime”. [ http://www.refworld.org/docid/50348afc2.html ] Nonetheless, according to UN Office of Drugs and Crime guidelines, discriminatory attitudes regarding sexual orientation and gender identity can mean the credibility of LGBTI people is dismissed by authorities. [ http://www.unodc.org/documents/justice-and-prison-reform/Prisoners-with-special-needs.pdf ]

"That no one should be compelled to hide, change or renounce his or her identity in order to avoid persecution is a central tenet of refugee law, and this applies to sexual orientation and gender identity on equal footing with other claims,” UNHCR’s Türk told IRIN.

“There is no space for decision-makers determining refugee status to expect them to conceal who they are."

Safety and security

“There is harassment in the camp against us, sometimes beatings,”said Yoman Rai, a 19-year-old Bhutanese refugee living in a camp in Nepal. “We have a protection unit and complaint mechanism, but we are still facing problems,” he said, adding that just last month a transgender woman was beaten by other people in the camp.

Security in refugee camps is complicated and contingent on numerous, unpredictable factors. For members of the LGBTI community, vulnerabilities are exacerbated. Sexual abuse is common, but often goes unreported because the right questions are not being asked, and because survivors of sexual violence are reluctant to report [http://www.refworld.org/cgi-bin/texis/vtx/rwmain?docid=5006aa262 ] events that will “out” them to legal authorities.

Explained Rai: “Many Bhutanese are not `out’ to anyone except for the outreach workers because they still believe being LGBTI will put them in danger and negatively affect their resettlement process,” [ http://www.irinnews.org/Report/91459/NEPAL-Resettlement-of-Bhutanese-refugees-gathers-momentum ] adding that the outreach educators’ network was operated by a Nepalese LGBTI rights NGO.

Emergency shelter settings -such as relief camps or refugee housing- pose specific challenges for transgender people. Access to male-female gender-segregated facilities, such as dormitories or bathrooms, can be perilous. [ http://www.odihpn.org/humanitarian-exchange-magazine/issue-55/making-disaster-risk-reduction-and-relief-programmes-lgbtiinclusive-examples-from-nepal ] New research is exploring how immigration detention centres can respect and protect LGBTI residents, a US-based prisons expert explained in FMR. [ http://www.fmreview.org/sogi/fialho ]

For LGBTI migrants who end up in urban areas, research has shown that cities can be unwelcoming and unfamiliar and access to basic social services limited by scant local resources, exclusion of foreigners, or limitations to access including finances, language, and cultural barriers. [ http://www.hias.org/uploaded/file/Invisible-in-the-City_full-report.pdf ]

“The single most threatening factor for these migrants is isolation,”said Neil Grungras, executive director of the Organization for Refugee Asylum and Migration (ORAM), [ http://www.oraminternational.org/ ] a leading advocacy group for refugees fleeing persecution due to sexual orientation or gender identity.

With UNHCR data showing the average major refugee situation lasting 17 years, these circumstances can impinge on a significant portion of an individual’s life. [ http://www.unhcr.org/4444afcb0.pdf ]

Migrant populations are generally more at-risk for HIV due to disruption and displacement, [ http://www.unhcr.org/4ef3056d9.html ] and according to UNAIDS are often overlooked in host-country HIV policies. [ http://www.unaids.org/en/media/unaids/contentassets/dataimport/pub/briefingnote/2007/policy_brief_refugees.pdf ]

“It is critical that refugee organizations identify what the best ways of offering protection are, such as providing access to safe shelter, requesting expedited resettlement, and, if possible, working with the police and refugee communities to address specific threats of violence,” said Duncan Breen, a senior associate in the refugee protection programme at Human Rights First.

Evolving frameworks

Recent UN reports [ http://www.un.org/apps/news/story.asp?NewsID=40743#.UX8oC7Xkvzw ] and statements [ http://www.iglhrc.org/content/un-ban-ki-moon-condemns-homophobic-laws ] demonstrate increased international attention to the human rights of LGBTI people.

On the programme level, agencies have begun to adjust to include considerations of sexual orientation and gender identity.

For example, the International Organization for Migration (IOM) is implementing a “safe space” project for refugees at its four US Refugee Admissions Program Resettlement Support Centers.

Jennifer Rumbach, IOM resettlement support centre manager for South Asia, told IRIN the programme is designed to help LGBTI refugees at “every step along the way - whether during counselling, interviews, orientations, travel, or post-arrival…

“Disclosing sexual orientation and gender identity overseas works to the refugees’ benefit because it ensures we can provide appropriate and respectful services, ask questions that are critical to their resettlement experience, and try to get them any special help they need while they wait to be resettled,” she explained.

But ORAM’s Grungras warned:“We have to be extra careful to talk with refugees and migrants on their own terms - to understand them as they understand themselves, and not label them as“LGBTI” just because it fits our programmes.”

In spite of challenges such as a dearth of respectful terms used in some languages referring to sexual and gender minorities, IOM’s programmes also attempt to engage with local terminology.

“While it's important for staff to understand sexual orientation and gender identity terms used by the international community, we make special efforts to use relevant and respectful local terminology in our signs, handouts and interview and counselling scripts,” said Rumbach.

Supporting and protecting LGBTI people as they migrate requires nuance, sensitivity, and an appreciation of evolving identities, legal frameworks, and programmatic potential.

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]]></body><link>http://www.irinnews.org/Report/97989/The-plight-of-LGBTI-asylum-seekers-refugees</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2013/201305070711300235t.jpg"/></td><td valign="top">KATHMANDU 07 May 2013 (IRIN) - Refugees and asylum seekers face a host of challenges when crossing borders, but the obstacles are particularly pronounced for lesbian, gay, bisexual, transgender, or intersex (LGBTI) persons, say experts.</td></tr></table>]]></content:encoded></item><item><title>Behaviour change needed to combat malnutrition in Nepal</title><pubDate>Wed, 01 May 2013 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2011/201107210821590098t.jpg" />]]>KATHMANDU 01 May 2013 (IRIN) - More work is needed to improve nutritional behaviour in Nepal, where nearly half of children under five are chronically malnourished, experts say.</description><body><![CDATA[KATHMANDU 01 May 2013 (IRIN) - More work is needed to improve nutritional behaviour in Nepal, where nearly half of children under five are chronically malnourished, experts say. 

“Food is more than nutrients and knowledge - it is culture, practice, and what you have been told about your life since you were born,” Ramesh Adhikari, a paediatrics professor at Kathmandu Medical College, told IRIN. 

Across the country, childhood malnutrition, which results in stunting (low height-for-age, also known as chronic malnutrition) and other long-term health effects, occurs not because of food insecurity or lack of access to nutritious food, but because of behaviour in households which is preventing nutrients from getting to children, they say. 

According to a recent report [ http://www.wfp.org/content/nepal-thematic-report-food-security-and-nutrition-march-2013 ] by the World Food Programme (WFP), the prevalence of undernutrition is high even in the wealthiest households, suggesting that other factors beyond food availability and income are influencing nutrition nationwide. 

Misconceptions about the food and eating needs of pregnant women are widespread and varied across Nepal, according to a USAID literature review [ http://www.ghtechproject.com/files/1.367%20Nepal%20Nutrition%20Overview%20Rpt%208_16_10%20%20508.pdf ].

“So many families I work with believe that feeding pregnant wives a lot of food will make delivery difficult, so they even reduce the amount of food once they discover the pregnancy,” explained Keshab Dhakal, a health outreach worker in Nepal’s western Kapil Vastu District. 

Mothers attending a nutrition seminar at a health post in rural Rupendehi District in southern Nepal listed yoghurt, pumpkin, and eggs among foods they avoided while pregnant.

Said one mother, who is using complementary vitamin packets distributed by Nepal’s Health Ministry: “This is my third child. For the first two, I didn’t eat many things while pregnant. Now, with this one, I think she will be strong and clever because of the vitamins.” 

Gender bias in food distribution 

Compounding taboos, maternal malnutrition (and therefore child malnutrition) is sometimes the result of gender-based discrimination in decision-making and food-sharing. 

“Women, including mothers, usually eat less well than men. This can lead to inadequate foetal growth, ultimately leading to stunting in children by the age of two,” said Saba Mebrahtu, nutrition chief at the UN Children’s Fund (UNICEF) in Nepal. 

Many children eat off the plate of a parent, often the mother. Because of food distribution hierarchies, typically giving the male members of the family food before the females, children who eat from mothers’ plates may have limited access to nutritious food, according to studies cited in the USAID review. 

“Nutrition education for mothers and children has to start with men,” said Shanti Acharya, a female community health volunteer in Rupendehi. “It’s men who usually make the decisions regarding what to do with vegetables, for example - to sell them or eat them in the household,” she said, adding that this can mean that nutritious foods grown at home are sold more frequently than they are consumed. 

Excessive burden on mothers 

Women bear much of the burden for child care and food preparation. While WFP analysis [ http://www.wfp.org/content/nepal-thematic-report-food-security-and-nutrition-march-2013 ] shows remittances from outmigration can improve nutrition in households, especially if the household is female-headed, the absence of men also means an increase in women’s workloads, leaving less time for food preparation. 

Recognizing what experts call “unpaid care work” performed by women can balance labour distribution [ http://www.actionaid.org/sites/files/actionaid/recognise_redistribute_reduce_0.pdf ] in the household - benefiting children by putting more value on preparing their food. 

“If fathers are engaged in caring for their children, they will know more about what to feed their children, and notice when feeding and growing aren’t going as well as they should be,” said Mebrahtu, adding that Nepal’s 2013 draft strategy for infant and young child feeding addresses the beliefs of a range of people who influence the mother, including husbands, in-laws, elders, and community members. 

Malnourished children are less successful in school, grow into less productive adults, and develop chronic diseases that can put strains on the medical system according to the World Bank [ http://web.worldbank.org/WBSITE/EXTERNAL/NEWS/0,,contentMDK:20839585~pagePK:64257043~piPK:437376~theSitePK:4607,00.html ], which also warns that malnutrition is costing poor countries up to 3 percent of their yearly GDP. 

“The incentives to feed mothers and children well are clear,” said UNICEF’s Mebrahtu. “It’s just a matter of closing the information gaps and correcting misunderstandings and mistreatment.” 

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]]></body><link>http://www.irinnews.org/Report/97949/Behaviour-change-needed-to-combat-malnutrition-in-Nepal</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2011/201107210821590098t.jpg"/></td><td valign="top">KATHMANDU 01 May 2013 (IRIN) - More work is needed to improve nutritional behaviour in Nepal, where nearly half of children under five are chronically malnourished, experts say.</td></tr></table>]]></content:encoded></item><item><title>Imagining a major quake in Kathmandu</title><pubDate>Fri, 26 Apr 2013 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2013/201304261101330697t.jpg" />]]>KATHMANDU 26 April 2013 (IRIN) - It is the nightmare scenario aid workers and government officials have long feared: a massive earthquake striking Nepal’s densely populated Kathmandu Valley, with tens of thousands feared dead.</description><body><![CDATA[KATHMANDU 26 April 2013 (IRIN) - It is the nightmare scenario aid workers and government officials have long feared: a massive earthquake striking Nepal’s densely populated Kathmandu Valley, with tens of thousands feared dead.

In terms of per capita casualty risk, the valley - as the area is known locally - is the most dangerous place in the world [ http://www.geohaz.org/projects/gesi.html ].

The capital city and its surrounding suburbs of some 2.5 million people sit in one of the most seismically active areas of the world; declining or non-existent construction standards, haphazard urban development and a population growing 4 percent annually [ http://www.worldbank.org/en/news/feature/2013/04/01/managing-nepals-urban-transition ] have compounded the risk.

While disaster preparedness awareness has increased, protracted political instability [ http://www.irinnews.org/Report/95761/Analysis-Humanitarian-fallout-from-Nepal-apos-s-constitutional-stalemate ] has weakened risk reduction potential. The last major earthquake (1934) flattened Kathmandu, killing thousands and destroying 20 percent of the city’s buildings.

IRIN sat down with leading international and Nepalese experts at both the National Society for Earthquake Technology [ http://www.nset.org.np/nset2012/ ] and the Nepal Risk Reduction Consortium [ http://un.org.np/coordinationmechanism/nrrc ] to determine how such an earthquake might play out today.

1005am early May - An intensity IX (Mercalli scale measure) [ http://www.irinnews.org/Report/93862/HOW-TO-Measure-an-earthquake ] earthquake hits Kathmandu Valley when school is in session and people are at work.

1009 - Immediate aftershocks stop.  Some 60 percent of buildings have been damaged or completely collapsed. Few schools remain standing. Schoolchildren [ http://www.irinnews.org/Report/81805/NEPAL-Schoolchildren-face-earthquake-risk ] in Kathmandu are 400 times more likely to be killed by an earthquake than those in Kobe, Japan [ http://www.preventionweb.net/files/5573_gesireport.pdf ].

The US Geological Survey [ http://www.usgs.gov/ ] first reports the earthquake, information some newswires pick up, but few details emerge. Mobile phone towers are damaged severely, internet communication is down and electricity coverage is out.

1045 – Significant aftershock lasts 90 seconds. Now 80 percent of buildings are damaged or destroyed. Only a handful of healthcare facilities remain standing.

Residents work feverishly to dig out loved ones using nothing more than their bare hands. The first 72 hours are seen as critical.

A 2001 seismic risk assessment [ http://www.unisdr.org/2009/campaign/pdf/wdrc-2008-2009-information-kit.pdf ] of one of the capital’s (and country’s) main hospitals [ http://www.patanhospital.org.np/ ] identified weaknesses, which were only partially addressed as hospitals failed to get the funding they needed.

In the quake’s epicentre, only doctors and health workers who were on duty when the quake hit are able to work; others are either injured or blocked from reaching health facilities due to rubble [ http://un.org.np/sites/default/files/2010-10-19-Presentation-NSET.pdf ]. Many have died.

1200 noon - Domestic trained “light” search and rescue teams [ http://www.irinnews.org/Report/97831/Nepal-to-boost-search-and-rescue-capabilities ] (able to search the surface of a collapsed structure but not venture inside) begin their work. However, capacity is limited and many teams have not been properly trained.

Although deployed, international urban search and rescue teams are still unable to reach Kathmandu.

Access to facilities and vehicles is thwarted by rubble, and communications are spotty as only radio and satellite phones function. Foreign embassies use their radio systems to check for survivors.

The government’s National Emergency Operations Centre [ http://www.moha.gov.np/en/divisions/national-emergency-operation-center-25.html ] provides the first official - and skeletal - report on the earthquake.

3pm - Embassies attempt to direct their citizens to meeting points, but databases are not updated to reflect current numbers in the city. Travel by foot is almost impossible. First reports of looting begin. The air is still choked with dust. Parents rush towards completely or partially destroyed school buildings to search for their children, but movement is complicated by debris and safety concerns. Some fires from collapsed gas canisters and fallen electric wires spread.

5pm - International newswires carry reports on the earthquake. “A long-predicted earthquake of IX-intensity has hit the capital of Nepal. Kathmandu has suffered devastation in the initial quake and continued tremors. Humanitarian officials estimate tens of thousands missing or dead. Communications are routed through satellite phones, which are in limited supply.”

6pm - As the sun sets, air remains a thick fog of dust. Some people are able to clear space in the rubble, set up tents, light fires to cook and stay warm. Survivors who have emergency food supplies are careful to ration as well as protect them against looting.

Day 2: The government estimates the initial death toll at 150,000.

As the Oxfam Nepal country director, Scott Faiia, told IRIN: “Haiti was an island, so that meant nautical access was possible. Kathmandu is far more isolated than an island.”

There is no vehicle access to Kathmandu as countless bridges and roads into the city have been knocked out.

The airport, the only lifeline [ http://www.irinnews.org/Report/97766/Earthquake-proofing-Nepal-s-at-risk-airport ] for relief deliveries, has been damaged. C-130 military cargo planes, capable of landing on a short runway space, can land if 1,900 metres of runway remain intact, but a thorough evaluation of the airport is needed before this can happen. The assessment is under way, but with most major roads impassable, getting evaluators to the airport is taking longer than expected. Necessary repairs may take up to a week before flights can land.

There is no safe water supply in the city because pipes have been ruptured. Without an emergency, a break on a main pipe takes two days to repair on average. There are thousands of breaks throughout the city’s main lines, which do not include breaks in lines going to houses. Water tankers (trucks equipped with tanks) are full but many drivers are dead, injured, or unreachable. Those who can access and operate the tankers find all but main roads completely blocked.

With stores and markets in rubble, looting continues. Surviving police patrols are spread thin, and are pitted against residents desperate for food, water, and medical supplies.

One week: Death toll revised to 70,000

International aid workers begin building a humanitarian “hub” outside Simara in southeastern Nepal to receive relief supplies from India by rail through the Nepali border town of Birgunj, for onward transfer to Kathmandu by helicopter and, eventually, road.

Assessments have begun to give a better idea of the damage, but information is still limited. Health facilities and professionals have settled into a 24/7 routine of trying to meet acute trauma needs; facilities, staffing and supplies remain severely limited.

Critical international personnel are arriving by helicopter. Air space, frequency of flights and a memorandum of understanding to allow humanitarian workers to transit through neighbouring India without a visa are under negotiation between the two countries, even while India grapples with collateral damage from the quake. Lifesaving equipment destined for Nepal is stuck in Indian customs [ http://www.irinnews.org/Report/94648/GLOBAL-Why-international-disaster-law-matters ] in the cities of New Delhi and Kolkata.

Access is still restricted to helicopters. Heavy machinery that survived the quake is now clearing space for helipads and food drops. Embassies have evacuated most staff. Relief workers have arrived from around the world, but are stretched thin.

Of the five deep-drilled water wells around Kathmandu Valley, three are operational, so there is some water coming in, but not nearly enough. Petrol to fuel water pumps is running low because of over pumping and some looting of the fuel.

The situation around the water wells is tense as thousands queue for small amounts of water, which local government officials ration along with water purification tablets. A growing number drink untreated water, putting them at risk of disease.

Fuel for cremations is limited; there is no cold storage for bodies or body parts, which are then discarded haphazardly in burning piles around the city. The smell of burning cadavers permeates the still dusty air.

Hospitals are militarized with security forces standing guard to protect healthcare workers and patients from looting and violence. International NGOs have set up some temporary triage tents, but medical needs outstrip services.

One month

Death toll: 210,000 (and two million displaced)

Monsoon rains have begun, flooding temporary settlements, contaminating water supplies and resulting in the spread of infectious diseases.

More than 550 humanitarian relief organizations are now operating in Nepal. Some are working with communities outside Kathmandu Valley that are hosting survivors who fled the aftermath. Village food supplies are limited as populations swell. Road damage limits ground transportation. Helicopters are the only way to distribute relief goods; scant supplies make it to the hills and mountains outside Kathmandu where a number of survivors are now living with family and friends.

The government has resumed operations in temporary buildings in the south of the country along the border with India some 60km from the quake’s epicentre. Some 30 percent of civil servants died in the earthquake; another 20 percent left the capital and have not returned.

The government has replenished the ranks with some controversial appointments, sowing seeds for a potential political backlash in a country that has already gone through six heads of government in the past five years (with the most recent appointment in March), while failing to agree on a post-conflict constitution after a decade-long civil war.

People who have chronic illnesses and take medication have trouble accessing it. People living with HIV who get their anti-retroviral therapy medication in monthly disbursements from central hospitals now struggle to get supplies. Marginalized groups such as men who have sex with men (MSM) who often access vital health services through local NGOs must now go to mainstream health facilities, risking discrimination and violence [ http://www.odihpn.org/humanitarian-exchange-magazine/issue-55/making-disaster-risk-reduction-and-relief-programmes-lgbtiinclusive-examples-from-nepal ].

Risk of sexual violence against women and children increases in Nepal’s temporary settlements despite NGO “protection” efforts [ http://www.chrgj.org/press/docs/Haiti%20Sexual%20Violence%20March%202011.pdf ]. International media attention shifts focus from missing individuals to the failure of the humanitarian response.

One year - and beyond

In Haiti, two years after the earthquake some 75 percent of the rubble in the recovering capital, Port-au-Prince, had been cleared [ http://iipdigital.usembassy.gov/st/english/texttrans/2012/10/20121022137789.html#axzz2RFq5WwnS ].

Haiti’s capital covers about 39sqkm; the 30-second quake created 10 million cubic metres of rubble. Kathmandu Valley is roughly 570sqkm, or the size of Singapore.

After two years, arterial roads in Nepal are functional again, but much rubble remains.

Local government offices and NGOs have erected temporary schools, but attendance is patchy and affected by monsoon rains. With facilities overcrowded and teachers few, children attend school in shifts. Banks and some businesses are running again, but with limited road access to the valley, commodities are prohibitively expensive and many survivors continue to rely on aid rations. Long-term health effects, including a decline in mental health, continue to tax hospitals and other service providers.

Media begins to criticize aid agencies for lack of coordination, creating dependency and lack of a clear transition from emergency to recovery work.

Billions of dollars have been spent on relief efforts so far (some $3 billion were disbursed at the two-year mark in Haiti) [ http://www.lessonsfromhaiti.org/assistance-tracker/ ]; rebuilding contracts begin only one year after Nepal’s earthquake.

With so much funding and focus concentrated on Kathmandu, development elsewhere in the country has been neglected and longstanding grievances against the government and donors deepen.

Still recovering from a decade-long civil war that ended in 2006, the country has had no local elections since 1997 [ http://www.irinnews.org/report/95799/NEPAL-No-government-no-irrigation ]; a skeletal group of nationally-appointed administrators oversees everything from health administration to irrigation.

The final death toll is verified at 380,000.

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]]></body><link>http://www.irinnews.org/Report/97925/Imagining-a-major-quake-in-Kathmandu</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2013/201304261101330697t.jpg"/></td><td valign="top">KATHMANDU 26 April 2013 (IRIN) - It is the nightmare scenario aid workers and government officials have long feared: a massive earthquake striking Nepal’s densely populated Kathmandu Valley, with tens of thousands feared dead.</td></tr></table>]]></content:encoded></item><item><title>Nepal to boost search-and-rescue capabilities</title><pubDate>Thu, 11 Apr 2013 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2011/201107231623460199t.jpg" />]]>KATHMANDU 11 April 2013 (IRIN) - Experts have long predicted widespread devastation and death should a large earthquake hit Nepal, a country with vulnerable infrastructure and ill-equipped urban search-and-rescue teams. In an effort to prepare for such an event, officials have created a strategy to boost emergency responders’ skills.</description><body><![CDATA[KATHMANDU 11 April 2013 (IRIN) - Experts have long predicted widespread devastation and death should a large earthquake hit Nepal, a country with vulnerable infrastructure [ http://www.irinnews.org/Report/97568/Kathmandu-road-scheme-demolitions-heighten-seismic-risk ] and ill-equipped urban search-and-rescue teams. In an effort to prepare for such an event, officials have created a strategy to boost emergency responders’ skills.

Nepal’s Kathmandu Valley, the densely populated capital metropolitan area, has a history of major earthquakes every 70 to 80 years. The last big quake was in 1934.  And though the country has building codes for each of its 99 municipalities, enforcement is scant.

The National Society for Earthquake Technology-Nepal (NSET), a local NGO, estimates 85 percent of buildings in Kathmandu Valley could collapse in an earthquake of magnitude 7.0 Mw or greater on the moment magnitude scale [ http://www.irinnews.org/Report/93862/HOW-TO-Measure-an-earthquake ], claiming 85,000 lives.

Another 15,000 people could be saved, but only if there is an equipped, well-trained urban search and rescue team (USAR) in place, said Ramesh Guragain, NSET’s deputy director.

Training, equipment needed

The country currently has only light teams, which can search at the surface of collapsed structures, and a more limited number of medium teams, which can go into fallen buildings to save trapped persons. Heavy teams carry out the most difficult and complex search-and-rescue operations, using search dogs and other tools. The classifications are set by the UN International Search and Rescue Advisory Group (INSARAG) [ http://www.insarag.org ], which provides guidance for the preparation and deployment of search-and-rescue teams internationally.

The largest search-and-rescue deployment thus far worldwide was in Haiti [ http://www.irinnews.org/Report/87795/HAITI-Search-teams-running-out-of-time ] during the 2010 earthquake, when 60 teams were deployed. Should a similarly sized magnitude 7.0 Mw earthquake – or stronger - strike Nepal, the country does not even have oxygen masks to enable responders to search for survivors in a fire or collapsed buildings, said disaster management expert Moira Reddick, coordinator of the Nepal Risk Reduction Consortium [ http://un.org.np/coordinationmechanism/nrrc ], based in Kathmandu.


The consortium - which includes aid groups, financial institutions and the government - is working to boost emergency responders’ ability to perform search and rescue in Nepal.

The only USAR training local responders have received thus far is the Programme for Enhancement of Emergency Response (PEER) [ http://www.adpc.net/blog/?page_id=2 ], conducted by the Bangkok-based Asian Disaster Preparedness Centre. The training focused on emergency medical response and rescuing survivors from fallen buildings. Among the trained are 300 Nepalis from the army, police forces, Red Cross and local NGOs.
While this training prepared them for light and medium search and rescue, it is not enough, say NSET officials. 

“Even when we have [had] good training, we still need a team on standby, prepositioned with proper equipment and logistics,” said Guragain, NSET’s deputy director.

According to INSARAG, an equipped medium-level USAR is crucial within the first 32 hours of the disaster, when a trapped person’s chances of survival are greatest. That team needs to have enough staff to cover 24-hour shifts for one week.
“Unless we have a team on standby here, there [will] be more tragedy and destruction, and we will lose the little chance we have to save lives,” said Pitamber Aryal, disaster management director of Nepal Red Cross Society.

Finalizing strategy

Relying on international teams is the last resort, said Reddick, who used to work with the UK government, fielding and fulfilling search-and-rescue requests following earthquakes around the world.

"The first 72 hours is the frame of reference we use for search and rescue. It is very unlikely after 72 hours that anyone will be found alive and rescued from buildings," she warned.

Getting international teams into the Kathmandu Valley in the first 72 hours of a large earthquake will be “extremely” difficult due to the time required to draft a political agreement to bring in the teams, Reddick added.

“We know the situation is really fragile, and we intend to be better prepared,” Pradip Koirala, joint secretary of Ministry of Home Affairs, told IRIN. He said the government is working on boosting coordination efforts on emergency preparedness and has finalized an urban search-and rescue-strategy.

The strategy, developed in coordination with the UN, is in line with INSARAG’s guidelines [ http://www.insarag.org/images/stories/INSARAG_Guidelines_2011_-_Read_Version.pdf ], was endorsed by the high-level Central Natural Disaster Committee on 5 April and is now under review by the newly formed government.

nn/pt/rz

]]></body><link>http://www.irinnews.org/Report/97831/Nepal-to-boost-search-and-rescue-capabilities</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2011/201107231623460199t.jpg"/></td><td valign="top">KATHMANDU 11 April 2013 (IRIN) - Experts have long predicted widespread devastation and death should a large earthquake hit Nepal, a country with vulnerable infrastructure and ill-equipped urban search-and-rescue teams. In an effort to prepare for such an event, officials have created a strategy to boost emergency responders’ skills.</td></tr></table>]]></content:encoded></item><item><title>Nepal turns to renewable energy</title><pubDate>Fri, 05 Apr 2013 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2013/201304050913020244t.jpg" />]]>KATHMANDU 05 April 2013 (IRIN) - Nepal’s recently adopted policy of subsidizing renewable energy is the latest of many attempts to electrify long-deprived areas, but much more is needed, say experts.</description><body><![CDATA[KATHMANDU 05 April 2013 (IRIN) - Nepal’s recently adopted policy of subsidizing renewable energy is the latest of many attempts to electrify long-deprived areas, but much more is needed, say experts. 

More than half of the country’s households - almost all in urban and semi-urban areas - are connected to the national electricity grid. But 80 percent of the population is rural, and in these areas, less than one-third have electricity. With grid extension to the country’s hilly and mountainous areas prohibitively expensive, officials are looking to off-grid renewable alternatives. 

“Renewable, off-grid energy solutions [are] the only realistic way to provide energy in parts of the country,” according to the government’s National Rural and Renewable Energy Programme (NRREP) [ http://www.aepc.gov.np/images/pdf/NRREP%20Programme%20Document-June%202012.pdf ], a five-year framework launched in 2012. 

The new policy funds technologies sourced from hydropower, solar, biogas (a mixture of methane and carbon dioxide produced by fermenting organic matter) and - for the first time - wind. The policy also seeks to use biomass, a traditional energy source, more efficiently. 

Untapped energy 

Despite Nepal’s potential wealth in solar energy and hydropower (the highest after Brazil) and three decades of research, development of these energies has not kept pace with population growth. 

The little renewable energy that has been harnessed is poorly distributed due to crumbling infrastructure incapable of delivering, for example, parts for wind turbines. 

Such technology is almost entirely absent in the most inaccessible and deprived regions, like the country’s western Karnali Zone [ http://www.irinnews.org/Report/97693/Analysis-Rethinking-food-insecurity-in-Nepal-s-Karnali-region ], where over 80 percent of the 400,000 residents have moderate or serious problems getting enough food. More than 42 percent of people there live below the poverty line, and more than 60 percent of under-five children are too short for their age, a measure of chronic under-nutrition. 

A 2011 study [ https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&cad=rja&ved=0CDkQFjAA&url=http%3A%2F%2Fwww.aepc.gov.np%2Findex.php%3Foption%3Dcom_docman%26task%3Ddoc_download%26gid%3D503%26Itemid%3D120&ei=JM1SUZSiC874sgbtyoCACg&usg=AFQjCNGwcw3q_VT1Uo5Jg4suGqR-ErBIyA&sig2=743AddEsS2o5ToJbAe7YyA&bvm=bv.44342787,d.Yms ] described how renewable energy can improve education by extending study hours; enable life-saving communication; facilitate delivery of chilled medication and vaccines; boost yields in agriculture-dependent economies where farmers still largely rely on manual tilling [ http://www.irinnews.org/report/95998/NEPAL-Tailoring-technology-for-female-farmers ]; and even boost rural incomes through cottage industries like poultry farms. 

Slow uptake 

Most of the country’s current energy needs are met with inefficiently used biomass, including firewood (75 percent), agricultural residues (4 percent) and animal waste (6 percent). The rest is met by commercial sources, including petroleum, coal and electricity. 

Only about 12 percent of the country’s population uses electricity derived from water, wind or sun. 

Initial costs to harness such energy are high, even with the government’s subsidies. Unlike with the electrical grid, in which consumers pay only for operational costs, communities must contribute to renewable technologies’ capital costs in addition to operations and maintenance. 

Even so, renewable energy can electrify remote areas faster and more cheaply than extending the national grid, according to a soon-to-be published study from the Royal Institute of Technology in Sweden [ http://dx.doi.org/10.1016/j.renene.2013.01.057 ]. The study concluded “micro-hydro-based mini-grid technology” - a local grid that uses hydropower - is the cheapest alternative, costing 35 US cents per kilowatt versus US$1.34 to extend the national grid. 

New subsidy 

The new policy emphasizes reaching women and the “socially excluded” with targeted subsidies. 

These subsidies replace old ones that were not as specific about distinguishing where users lived, did not factor in the difficulty or cost of developing renewable energy, and did not give special concessions to women and other vulnerable groups. The new subsidies will no longer be flat-rate and will take into account the actual cost of tapping alternative energies for communities. 

Solar and micro-hydro energy subsidies will now be higher for areas less accessible by road, and subsidies for biogas [ http://www.irinnews.org/Report/75719/NEPAL-Biogas-technology-beginning-to-make-its-mark ] will be higher for communities in mountainous areas. The average subsidy for renewable energy technology will increase from 25 to 40 percent. 

Single women, the poor, those affected by disaster or conflict, and marginalized and indigenous groups now qualify for an additional one-time $29 grant. 

The policy also promotes micro-financing through private financial institutions (backed by a central government fund), which will grant loans of up to 40 percent of the technology cost. 

More to go 

But subsidies are only part of the solution, insisted Bajracharya, an energy analyst, who said legislation is also needed to support renewable energy, guarantee financing and create mechanisms to sell surplus energy to the national grid. 

Saroj Rai, senior renewable energy advisor at the SNV Netherlands Development Office for Nepal, added that capacity development, awareness and quality management are also required. 

The World Energy Outlook’s Energy Development Index [ http://www.worldenergyoutlook.org/resources/energydevelopment/measuringenergyanddevelopment/#d.en.8607 ], which measures household electricity provision, ranked Nepal near the bottom of countries evaluated in 2012. 

sm/pt/rz 

]]></body><link>http://www.irinnews.org/Report/97789/Nepal-turns-to-renewable-energy</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2013/201304050913020244t.jpg"/></td><td valign="top">KATHMANDU 05 April 2013 (IRIN) - Nepal’s recently adopted policy of subsidizing renewable energy is the latest of many attempts to electrify long-deprived areas, but much more is needed, say experts.</td></tr></table>]]></content:encoded></item><item><title>Earthquake-proofing Nepal&apos;s at-risk airport</title><pubDate>Tue, 02 Apr 2013 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2013/201303200824330223t.jpg" />]]>KATHMANDU 02 April 2013 (IRIN) - If an earthquake the magnitude of Haiti’s 2010 quake were to strike Nepal’s capital area, the country’s only international airport would be crippled, with no backup plan for receiving essential relief. But now, in response to long-standing predictions of such a catastrophe, the government has endorsed an earthquake preparedness plan for Tribhuvan International Airport (TIA); the plan is set to become public in one month.</description><body><![CDATA[KATHMANDU 02 April 2013 (IRIN) - If an earthquake the magnitude of Haiti’s 2010 quake were to strike Nepal’s capital area, the country’s only international airport would be crippled, with no backup plan for receiving essential relief. But now, in response to long-standing predictions of such a catastrophe, the government has endorsed an earthquake preparedness plan for Tribhuvan International Airport (TIA); the plan is set to become public in one month. 

Based on its most recent estimate, made in 2010, the National Society for Earthquake Technology-Nepal [ http://www.nset.org.np/nset/php/english.php ], said that if a 7.0-magnitude earthquake hit Kathmandu, it would kill an estimated 100,000 people, severely injure another 200,000, and displace 1.5 million. The disaster would damage 60 percent of homes beyond repair and wipe out almost all roads, leaving the airport as the last lifeline to transport relief supplies. 

The airport disaster response plan - prepared by the Civil Aviation Authority of Nepal (CAAN) and the TIA Civil Aviation Office, with support from the US Army Corps of Engineers (USACE), US Federal Aviation Administration and Canada’s University of British Columbia - was endorsed by the country’s National Aviation Security Committee in February. 

All governmental and nongovernmental groups will be legally bound to follow the plan’s directives following the high-level endorsement, TIA operations director Deo Chandra Lal Karn told IRIN. 

Emergency airport plan 

The plan defines the responsibilities of the country’s civil aviation authority, airport officials and government agencies, including the Ministry of Home Affairs, Department of Immigration, Nepal Oil Corporation, police and army. It also covers communication, law enforcement, fire and rescue, medical care, and determining how relief will be delivered under severe duress. 

It indicates the UN’s World Food Program (WFP) will take the lead in coordinating logistics with the government, such as finding space at the airport to run two separate emergency operations - known as humanitarian staging grounds - for an estimated 1,000 aid workers. CAAN will take overall lead. 

The plan lays out the airport’s emergency response for the first 72 hours after a disaster, including recovery of critical facilities - including runways and air traffic control - as well as flight operations, land use, and short-term storage of relief deliveries. It covers the transit of domestic and foreign humanitarian assistance for 30 days. Assuming the state oil company will be hit, it also creates a backup oil depot to bunker fuel at the airport. 

Flashback to Haiti 

Nepal’s airport has been under close scrutiny since Haiti’s earthquake crippled its only international airport, preventing aid delivery for three days. The airport was only re-opened after the US military flew in communications and air-traffic management equipment and provided aluminium matting to boost the tarmac. 

Until then, planes loaded with food, water, medicine and rescue crews struggled to enter limited Haitian air space, with flights circling for hours before landing or being diverted. 

“All the aid airplanes that flew in Haiti [ http://www.irinnews.org/Report/87758/HAITI-Bottlenecks-slow-aid-delivery ] were bottlenecked, and big airplanes were blocked or could not land easily,” said USACE project manager Patrick Fitzgerald. 

Like Haiti, Nepal has only one international airport. 

A 2011 investigation found that TIA was at high risk of incurring damage, particularly its 3,000m runway. TIA’s Karn said a major earthquake would destroy three-quarters of the runway, leaving only some 1,800m to bring in humanitarian aid. The minimum runway length for the C-130, a military cargo plane used to transport emergency supplies, to land and manoeuvre at TIA’s altitude is 1,900m. 

TIA's taxiway - where planes are unloaded and serviced - is also inconveniently positioned, which could clog life-saving air traffic during an emergency. 

Still not enough 

“We're happy to see that the airport authorities are taking disaster preparedness very seriously, as their airport could be the key lifeline for millions of people in the Kathmandu Valley,” said Brett Jones, director of the US embassy’s Disaster Risk Reduction Office in Nepal. 

But a response plan is only a piece of paper without funding, say experts. 

Implementing the plan’s directives to stockpile emergency relief supplies at the airport, lodge humanitarian workers there and build a new oil depot all depends on funding, said Karn. 

“There is still lot of funding [needed] to back up the plan. We need a tremendous amount of resources, and we haven’t got any of those resources at the moment in the country,” said Andrew Martin, head of the UN’s humanitarian support unit in Nepal. 

WFP’s Emergency and Response Unit in Kathmandu told IRIN it will present its earthquake response plan (budget of US$1 million) - part of the overall airport emergency plan - to the government and UN humanitarian coordinator this month for endorsement. 

nn/pt/rz 

]]></body><link>http://www.irinnews.org/Report/97766/Earthquake-proofing-Nepal-apos-s-at-risk-airport</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2013/201303200824330223t.jpg"/></td><td valign="top">KATHMANDU 02 April 2013 (IRIN) - If an earthquake the magnitude of Haiti’s 2010 quake were to strike Nepal’s capital area, the country’s only international airport would be crippled, with no backup plan for receiving essential relief. But now, in response to long-standing predictions of such a catastrophe, the government has endorsed an earthquake preparedness plan for Tribhuvan International Airport (TIA); the plan is set to become public in one month.</td></tr></table>]]></content:encoded></item><item><title>Analysis: Rethinking food insecurity in Nepal’s Karnali region</title><pubDate>Thu, 21 Mar 2013 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2013/201303210417370729t.jpg" />]]>KATHMANDU 21 March 2013 (IRIN) - Development assistance on its own will not resolve chronic levels of food insecurity in Nepal’s western Karnali Zone, described by many as a “silent emergency”. Rather, a more measured and integrated approach is required in some areas, including relief, say experts and government officials.</description><body><![CDATA[KATHMANDU 21 March 2013 (IRIN) - Development assistance on its own will not resolve chronic levels of food insecurity in Nepal’s western Karnali Zone, described by many as a “silent emergency”. Rather, a more measured and integrated approach is required in some areas, including relief, say experts and government officials.

“We can’t just stop relief all at once. There are still thousands of people in the Karnali that still need some form of relief assistance at least in the short-term,” Jagannath Adhikari, an agricultural scientist and author of the book Food Crisis in the Karnali, told IRIN.

Of the 400,000 people in Karnali, one of Nepal’s 14 zones and comprising five districts (Humla, Jumla, Mugu, Kalikot and Dolpa), about one third of the population is severely food insecure, while half are moderately food insecure, Adhikari said.

“Development is the goal. However, in certain areas, some component of relief is still needed,” said Hem Raj Regmi, undersecretary of Nepal’s Ministry of Agricultural Development. “We’re keen to receive more development assistance. At the same time, however, we can’t ignore these ongoing needs.”

The authorities have long stated their preference for development assistance over relief, citing its predictability and sustainability. In recent years, Nepal has increased its own development spending in the agricultural sector from US$9.4 million in 2005 to almost $13 million in 2011 - a figure expected to double in 2013, according to government data.

Malnutrition

Many believe that unless livelihoods in general are improved, food security in Karnali can never be boosted.

More than 42 percent of Karnali residents live below the poverty line, almost double the national average (25.16 percent), while all five districts rank among the lowest in the Human Development Index (HDI) [ http://hdr.undp.org/en/statistics/hdi/ ], with average scores of 0.35 - lower than Ethiopia and the Central African Republic.

At the same time, more than 60 percent of Karnali children under the age of five are stunted (low height for age), which is a measure of chronic under-nutrition, against a national average of 41 percent [ http://www.unicef.org/nepal/5476_7877.htm ].

According to the World Food Programme (WFP) [ http://www.wfp.org/countries/nepal/overview ], the region is the poorest and most food insecure in Nepal, with food production sufficient for only 3-6 months of the year. Except for Jumla District, irrigation is non-existent and there are pockets of the zone where food insecurity is running at 40 percent compared to a national average of 15 percent.

“Development is definitely the way forward, but we’re faced with a chronic situation that is not going away, with seasonal food insecurity reaching emergency levels year after year,” Nicolas Oberlin, WFP deputy country director for Nepal, explained.

He suggested that cash or food transfers might enable people to participate fully in development and put a break on outmigration.

“The answer transcends the traditional debate between emergency and development…A strong safety net component - a form of relief if you will - is required to accompany and protect development interventions, and to help achieve development objectives.”

Karnali Zone - 14.5 percent of the country’s land area - is home to just 1.3 percent of the population. Average population density is 14.5 people per square kilometre, against 157.3 for the country as a whole, according to 2012 government figures [ http://www.npc.gov.np/new/uploadedFiles/allFiles/Assessment-of-Karnali-Employment-Program.pdf ]. Many communities are reachable only on foot, with journeys taking days in some cases.

Without roads, high transportation costs prohibit market development, according to WFP. While efforts to improve road access to the area continue, local livelihoods are limited, fuelling migration, something that further undermines food security.

That said, migration to India and other parts of Nepal has allowed many Karnali residents to cope with transitory as well as chronic food insecurity over the years.

Subsidized rice

Rice grown in the Terai, Nepal’s southern agricultural heartland, is often unaffordable due to transportation costs.

According to recent market indicators [http://documents.wfp.org/stellent/groups/public/documents/ena/wfp253944.pdf ], a kilo of coarse rice which costs the equivalent of 41 US cents in Kathmandu, can cost three times that amount in mountain markets of Dolpa District without road access.

This is despite years of development expenditure in the area by the government, much of it going on rice subsidies through the Nepal Food Cooperation [ http://www.nfc.com.np/ ].

Many argue the government's decades-long rice subsidy programme has badly shaken the production of local indigenous foods that grow well in the area such as `kaguno’, barley, buckwheat, beans and finger millet, while also creating dependency on outside assistance.

They say rice subsidies should be reduced and then stopped and replaced with incentives and activities to cultivate local crops. The subsidies have undermined the ability of local people to cope with shocks, they say.

“We need to promote those traditional crops [like buckwheat] whose production has been undermined by the distribution of subsidized or free rice,” said Bashu Aryal, country programme officer of the UN’s International Fund for Agricultural Development [ http://www.ifad.org/ ]. “Seed intervention is the solution, not the distribution of rice.”

With proper support and wide-scale cultivation, many believe such crops could offer real hope of addressing long-term food insecurity in the region.

Drought fuels vulnerability

He conceded, however, that some of the remoter places in Karnali may never be food sufficient, no matter how many interventions are made.

“There is higher production potential in lower altitude areas and this should be encouraged,” Aryal said. “There is a need for food assistance in some of these pockets, but not all. The trick now is identifying which ones.”

About 45 percent of Karnali lies above 4,500m and is covered by snow most of the year; 47 percent lies between 2,500 and 4,500m, making it unsuitable for large-scale cultivation. It is estimated that only 1 percent of Karnali’s is truly arable (against a national average of 16 percent).

According to Adhikari, frequent droughts lead to a decline in local production, weaken vital food reserves and coping mechanisms, and make people more vulnerable to food insecurity.

“Food insecurity in the Karnali is highly volatile and susceptible to shocks. As a result, there may sometimes be people who need emergency food assistance when this happens, but not on a long-term basis,” said Marion Michaud, programme manager for the European Union.

"Such assistance, when appropriate, needs to be well designed and targetted to be efficient," she stressed, pointing out that may not be the case with the government's large-scale subsized rice programme.

“There are numerous challenges, including transportation, connectivity and distribution,” Michaud said.

ds/cb

]]></body><link>http://www.irinnews.org/Report/97693/Analysis-Rethinking-food-insecurity-in-Nepal-s-Karnali-region</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2013/201303210417370729t.jpg"/></td><td valign="top">KATHMANDU 21 March 2013 (IRIN) - Development assistance on its own will not resolve chronic levels of food insecurity in Nepal’s western Karnali Zone, described by many as a “silent emergency”. Rather, a more measured and integrated approach is required in some areas, including relief, say experts and government officials.</td></tr></table>]]></content:encoded></item><item><title>Analysis: Nepal’s maternal mortality decline paradox</title><pubDate>Mon, 18 Mar 2013 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2012/201206281331180868t.jpg" />]]>KATHMANDU 18 March 2013 (IRIN) - While health experts applaud Nepal’s declining maternal mortality ratio (MMR) in recent years, they say this gain is unsustainable if the country does not address its lack of qualified health staff, especially midwives, to keep women in childbirth alive.</description><body><![CDATA[KATHMANDU 18 March 2013 (IRIN) - While health experts applaud Nepal’s declining maternal mortality ratio (MMR) in recent years, they say this gain is unsustainable if the country does not address its lack of qualified health staff, especially midwives, to keep women in childbirth alive.

Between 1996 and 2006, Nepal nearly halved its MMR, from 539 deaths per 100,000 live births, to 281, according to the latest Demographic and Health Survey (DHS) [ http://www.measuredhs.com/publications/publication-fr257-dhs-final-reports.cfm ]. A 2012 UN report [ http://www.unfpa.org/webdav/site/global/shared/documents/publications/2012/Trends_in_maternal_mortality_A4-1.pdf ] estimated the 2010 MMR at 170. (The range of uncertainty went from a low estimate of 100 to a high estimate of 290.)

Observed declines since the early 1990s make Nepal, together with Bangladesh, the most recent “success story”, comparable to countries like Malaysia, Thailand and Cuba that gained ground decades earlier, Julia Hussein, lead author of a 2011 medical appraisal [ http://www.plosone.org/article/info%253Adoi%252F10.1371%252Fjournal.pone.0019898 ] of Nepal’s MMR reduction, told IRIN.

Experts are still deciphering the past decade’s declining MMR in Nepal.

“The problem we have is that the data we need to identify causes of maternal mortality reduction are not actually there,” said Hussein, who, rather, looked for changes associated with the decline. “The paradox in Nepal is that skilled birth care is still very low, yet maternal mortality is decreasing.”

Though there is generally a positive association between increasing rates of births attended by skilled birth attendants (SBAs) and a falling MMR, this correlation is not very strong for countries in sub-Saharan Africa and Asia, Hussein told IRIN.

Nepal’s success is explained by many factors, said Kabiraj Khanal, the Ministry of Health and Population’s under-secretary. “Maternal mortality has not reduced because of just one reason - different interventions have been implemented simultaneously.”

What’s working?

Top reasons identified by health practitioners were fertility declines, societal changes and government programmes to enhance both supply and demand of maternal care.

Women now give birth on average to 2.6 children versus 4.6 children 15 years ago, a decline Khanal credited to social and economic developments, including male partners migrating for work.

“Nepal has quite a strong family planning programme,” added Hussein. Half the women surveyed in the 2011 DHS reported using contraception. But, she added: “Fertility reduction can only improve maternal mortality levels to a certain extent, because eventually you are going to reach a point where women still want to have babies.”

Hussein found improvements in women’s education, empowerment, wealth, and living standards were also strongly associated with a declining MMR. Nepal’s Human Development Index, which assesses a population’s well-being by measuring poverty, education and life expectancy, increased from 0.34 in 1990 to 0.46 in 2012; female literacy jumped from 35 percent in 2001 to 57 percent a decade later.

“On the demand-side, people’s health-seeking behaviour has changed, and on the supply side, health facilities, hospitals, services, and health workforce have increased,” said Ganga Shakya, maternal and neonatal health adviser for the UK-funded government technical assistance project, Nepal Health Sector Support Programme.

Under a Safe Motherhood Programme, in 2009 the government started offering free deliveries and travel stipends of US$5.80, $11.50, and $17.30 for women to reach accredited birthing facilities in plain, hilly, and mountainous districts, respectively. Women also get close to $5 if they seek health care pre-delivery at least four times, in line with international health recommendations.  

Health facilities receive cash to procure drugs and other materials for deliveries - $11 for vaginal births, $34 for managing obstetric complications and $80 for Caesareans.

In the absence of professional midwives, pregnant women in Nepal depend on 4,000 SBAs certified in certain core midwifery skills, and counselling provided by 52,000 female community health volunteers [ http://www.irinnews.org/report/96462/NEPAL-Key-role-for-female-health-volunteers ] who are part of a government initiative launched in 1988 to fight maternal and neonatal (infants 28 days and younger) deaths.

“They [volunteers] are often seen as doctors in the remote villages… They are… constantly in touch with the poorest women who often have difficulty making long journeys to the hospitals,” said Jung Shah, a hospital director in the mid-western region’s main government health centre.

The percentage of births assisted at delivery by someone formally trained in birthing has almost doubled in the last five years to 36 percent in 2011.

Delivery assistance by an SBA in rural areas has more than doubled in the last five years, from 14 percent to 32 percent, though pregnancy in the mountains is still mostly a solitary family affair, with as few as 15 percent of women getting outside trained assistance during childbirth.

And more births are taking place in a health facility - from 18 percent in 2006 to 35 percent in 2011. In the same period, districts with at least one facility performing Caesarean sections rose from 30 to more than 50 districts, with a more drastic increase in centres offering 24-hour delivery services - from 300 to 1,200. Abortion was legalized in 2002, with 300 sites now registered nationwide.

“We are focusing on whatever women die from,” said Shilu Aryal, obstetrics and gynaecology (OB-GYN) consultant at the Family Health Division in the Health and Population Ministry.

When postpartum haemorrhage was identified as the biggest maternal killer, female volunteers distributed tablets of misoprostal (a drug that causes the uterus to contract and lessens blood loss) to women’s homes [ http://www.irinnews.org/Report/92702/HEALTH-Childbirth-made-safer ] to reduce the risk of excessive bleeding after home deliveries.

The Health Ministry also recently decided to provide blood transfusions to pregnant mothers for free, in addition to no-cost oxytocin injections (to stop bleeding) at health facilities since 2002.

What needs improvement?

While the country is on track to achieve its Millennium Development Goal of cutting MMR by three-quarters of its 1990 level (down to 134 deaths per 100,000 live births), the government is cautious.

“We will eventually reach a plateau, after which it will be difficult to further reduce our maternal mortality. At that point, we will need people skilled in midwifery,” said Senendra Raj Upreti, director of the Family Health Division.

In 2006 Nepal developed a national policy on SBAs to address the fatally low numbers of pregnancies aided by SBAs, which back then stood at 18 percent. The policy proposed measures to improve midwifery skills among nurses, doctors and auxiliary nurse midwives, (the latter receive less education and practical training than midwives). The policy foresaw providing at least three years of training to a new group of professional midwives.

Since then, the UN Population Fund (UNFPA) has drafted a Bachelor in Midwifery curriculum for Nepal and studied how to incorporate it into national academic institutions.

“Professional midwives can prevent up to 90 percent of maternal deaths where they are authorized to practice,” suggested a 2012 UNFPA study. “Investing in midwives has been identified as the quickest and the most cost-effective solution for scale-up in skilled attendance at all births” - an indicator Nepal still lags far behind in. Its goal is for 60 percent of women to give birth with the help of a skilled practitioner; the most recently recorded rate is 36 percent.

Last month, the government set up a task force on midwifery education whose chair hopes to enrol the country’s first midwives by 2014.

Health care staffing

But lack of midwives is only a small part of the larger recruitment challenge facing Nepal, especially in most remote areas where health staff are reluctant to relocate.

Neither the distribution of health workers nor their total count has budged in the past 15 years, said Aryal, the OB-GYN consultant. “[In Nepal] 15 years ago, there were 10 million people, now we have reached 30 million, but we have the same number of people working in the hospitals.”

A 2011-2015 government health human resources plan [ http://www.nhssp.org.np/human_resources/HRH%20Strategic%20Plan%20Final.pdf ] pinpointed this disparity; in the last decade the population grew by 45 percent while public health staffing increased by only 3 percent.

Nepal has 0.29 health workers for every 1,000 people, a small fraction of the World Health Organization recommended 2.3 needed to offer basic lifesaving care, including vaccinations for every 1,000 residents.

And while the private sector has expanded significantly, those facilities are mostly in urban areas (in a country where some 80 percent of the population lives in rural areas) and are unaffordable to the poor.

Nepal needs to improve its referral system in remote areas to transport women with medical complications, said Asha Pun, maternal and neonatal health specialist at the UN Children’s Fund office in Kathmandu.

Family planning access is still perilously out of reach for youths, said UNFPA’s former deputy representative in Nepal, Geetha Rana. Twenty-seven percent of married women nationwide have an unmet need for family planning, increasing to 42 percent if only counting women aged 15-19 - significant given half of all females in Nepal are married by age 18.

Hussein, the researcher, suggested improving Nepal’s death registration [ http://www.irinnews.org/Report/97389/Why-civil-registration-matters-in-Asia ] to understand what has - and has not - worked in slashing maternal deaths. “Things are reducing, but you can only learn lessons from it if you set up data collection systems that allow you to explain it.”

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]]></body><link>http://www.irinnews.org/Report/97667/Analysis-Nepal-s-maternal-mortality-decline-paradox</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2012/201206281331180868t.jpg"/></td><td valign="top">KATHMANDU 18 March 2013 (IRIN) - While health experts applaud Nepal’s declining maternal mortality ratio (MMR) in recent years, they say this gain is unsustainable if the country does not address its lack of qualified health staff, especially midwives, to keep women in childbirth alive.</td></tr></table>]]></content:encoded></item><item><title>Kathmandu road scheme, demolitions heighten seismic risk</title><pubDate>Fri, 01 Mar 2013 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2013/201302280435440831t.jpg" />]]>KATHMANDU 01 March 2013 (IRIN) - A large-scale road-widening project across Nepal’s capital city of Kathmandu, one of the most seismically active cities in the world, has placed hundreds more buildings at risk of collapse in the event of an earthquake, experts warn.</description><body><![CDATA[KATHMANDU 01 March 2013 (IRIN) - A large-scale road-widening project across Nepal’s capital city of Kathmandu, one of the most seismically active cities in the world, has placed hundreds more buildings at risk of collapse in the event of an earthquake, experts warn. 

“Many buildings have been partially demolished to make room for the roads. Now they are twice as likely to collapse during an earthquake,” Dilip Kumar Jha, vice-president of the Nepal Engineers’ Association, told IRIN. “As engineers, we’re very concerned about this.” 

International disaster experts agree. “It’s evident if you bulldoze half of a building it won’t be as safe as before,” said Moira Reddick, coordinator of the Nepal Risk Reduction Consortium (NRRC) [ http://un.org.np/coordinationmechanism/nrrc ].

According to the National Society for Earthquake Technology-Nepal (NSET) [ http://www.nset.org.np/nset2012/ ], 60 percent of all residential buildings in the Nepalese capital are already at risk of collapse due to faulty construction. 

Experts [ http://www.irinnews.org/Report/72807/NEPAL-Densely-populated-Kathmandu-facing-increased-earthquake-risk ] have long expressed concern over current building practices in Kathmandu; with many predicting a major earthquake in the near future. Nepal has had nine major earthquakes roughly every 75 years since 1255 AD. The last one in 1934, flattened Kathmandu, killing 8,000 and destroying 20 percent of the city’s buildings. 

“This is very dangerous. In some cases the frontal frames of these buildings have been removed,” said Amod Dixit, NSET’s executive director. 

“The issue is whether people have awareness and understand the choice of whether to retrofit or not,” said Reddick. 

Government plans to widen roads to ease traffic congestion got under way in 2012. The scheme aims to build or widen about 187km of roads in the Kathmandu, Lalitpur and Bhaktapur districts of Kathmandu Valley. Some 105km have already been completed. 

Building owners who have encroached (often 3-5 metres) on public land have been given one month to reduce the size of their buildings or face demolition. 

According to Ram Prasad Shrestha, an engineer at Kathmandu Valley Development, efforts to safeguard affected buildings are being made, and residents are being given adequate time to ensure repairs. 

ds/cb

]]></body><link>http://www.irinnews.org/Report/97568/Kathmandu-road-scheme-demolitions-heighten-seismic-risk</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2013/201302280435440831t.jpg"/></td><td valign="top">KATHMANDU 01 March 2013 (IRIN) - A large-scale road-widening project across Nepal’s capital city of Kathmandu, one of the most seismically active cities in the world, has placed hundreds more buildings at risk of collapse in the event of an earthquake, experts warn.</td></tr></table>]]></content:encoded></item><item><title>Analysis: Politicians, donors question donor neutrality in Nepal</title><pubDate>Tue, 26 Feb 2013 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2010/201009270515530815t.jpg" />]]>KATHMANDU 26 February 2013 (IRIN) - Dissent in Nepal over the role of ethnicity in a post-conflict state has put donor agencies under increased scrutiny, with politicians and analysts accusing them of meddling, taking sides and circumventing the government to push an agenda of “social cohesion”.</description><body><![CDATA[KATHMANDU 26 February 2013 (IRIN) - Dissent in Nepal over the role of ethnicity in a post-conflict state has put donor agencies under increased scrutiny, with politicians and analysts accusing them of meddling, taking sides and circumventing the government to push an agenda of “social cohesion”.

“We got a lot of criticism from all sides. We took the brunt [from all sections of society including marginalized groups, citizens, media and political parties] saying we interfered or didn’t do enough,” said the director of the UK government’s aid arm, Department for International Development (DFID), in Nepal, Dominic O’Neill. DFID is Nepal’s largest bilateral donor, recently increasing its annual spending by US$60 million to some $150 million in 2013.

The national debate surrounding an ethnic identity-based federalism - where power is devolved from the national government to local units determined largely along ethnic lines - has been at the core of Nepal’s transition to post-war stability, with some politicians, analysts and journalists painting Nepal’s international donors as instigators of ethnic tension.

Almost seven years since the country ended a decade-long civil war with a peace deal, efforts to birth a post-war constitution and new government are still stalled amid political infighting, which has only exacerbated the country’s ills [ http://www.irinnews.org/Report/95761/Analysis-Humanitarian-fallout-from-Nepal-apos-s-constitutional-stalemate ].

Nepal is one of world’s poorest countries with 25 percent of its 30-million people living below the poverty line, according to the World Bank. Pockets of chronic under-nutrition, especially in the country’s Far West mountainous region, exceed emergency levels, and access to safe sanitation [ http://www.uis.unesco.org/Library/Documents/statistical-yearbook-asia-pacific-country-profiles-education-2012-en.pdf ] remains perilously inaccessible for 20 million people.

“Changes are drastically needed in this country, but didn’t happen at the pace they were supposed to. Aid agencies got too involved in the peace process, political transition and democratization issues rather than development,” political analyst and professor Krishna Khanal told IRIN.

Aid agencies should have been focusing, instead, on building up national institutions rather than duplicating efforts [ http://www.irinnews.org/report/94734/Analysis-When-aid-meets-arsenic-in-Nepal ] and competing among themselves, Khanal added.

Checks and balances

After years of failed constitution-making, a new interim prime minister was appointed on 18 February; Nepal's opposition parties have refused to consider holding elections for a new constituent assembly (the previous one was dissolved in May 2012) under the incumbent Maoist-led regime.

But as recently noted by the UK-based Economist Intelligence Unit, significant hurdles remain “to end the destructive political wrangling. In the meantime, Nepal's civic functions are in effect paralysed and economic activity is depressed”.

Robert Piper, the UN resident and humanitarian coordinator in Nepal, told IRIN the current political situation is “naturally of real concern” to donor groups.

The position of chief of the Centre for Investigation of Abuse of Authority (CIAA) and national auditor-general are still vacant after seven years. In addition, there is no Public Accounts Committee - a parliamentary body that tracks spending of donor monies.

“These checks and balances are important in any democratic society,” Swiss ambassador to Nepal, Thomas Gass, told IRIN. He is also the chairperson of donor group Nepal Peace Trust Fund [ http://www.nptf.gov.np ].

Similarly, analysts and government officials make the same accountability charges against aid agencies that circumvent the government, directly implementing projects without consultation or approval.

Such a practice has become a de jure modus operandi in a country that has had five prime ministers in the last six years, according to the national umbrella group of more than 5,300 development local NGOs, the NGO Federation of Nepal (NFN) [ http://www.ngofederation.org ]. Local elections were last held in 1997, leaving local governance barren, but for the few appointed government caretakers.

Local development programming has withered as the government has been consumed by jockeying for power in Kathmandu, said Gopal Yogi, NFN’s vice-president.

“Our crucial concern is lack of locally elected bodies which would make a difference, and in their absence aid agencies are implementing their own projects without any government control.”

But even a power vacuum is no justification for going it alone, national officials told IRIN, noting that even amid political turbulence, donors have steady government counterparts.

“Aid agencies believe that it is easier implementing themselves than [going] through the government,” said Rabi Sainju, programme director of foreign aid coordination with the National Planning Commission (NPC).

Sainju said the NPC should have the final say over foreign-funded projects due to its responsibility for national development plans and budgeting.

Yet, it is not uncommon for bilateral donors to have a direct agreement with the government and start project implementation without NPC’s knowledge due to poor inter-ministerial coordination, he added.

Aid agency defence

Aid agencies say donors are simply carrying out pre-approved programmes with no intention of interference.

“We don’t want to be competing with the government in the rural areas. In all of our programmes, even if somebody hasn’t gone through [local] government, 100 percent of our activities are approved by the [national] government,” DFID’s O’Neill told IRIN.

He explained that existing local government bodies like the District Development Committees (DDC) and Village Development Committees (VDC) have limited capacity and that this reality is unlikely to change soon.

“I was in Humla and Jumla (remote hill villages in the country’s northwest) where the [local] government has very limited capacity. In these remote places where the situation is complex and [national] government has no presence, why cannot an external partner deliver services on its behalf?” asked O’Neill.

Meddling or mandate?

But donors’ intentions are suspect, say critics, when agencies direct funding towards traditionally marginalized indigenous ethnic groups that rank low in the long-standing feudal caste system, while overlooking the needs of historically privileged “high-caste” communities that are also extremely poor.

O’Neill said DFID’s support of certain ethnic groups was in accordance with the 1996 Comprehensive Peace Accord (CPA) [ http://reliefweb.int/report/nepal/full-text-comprehensive-peace-agreement-held-between-government-nepal-and-communist ]. “The fact is - yes - we have supported a lot of marginalized groups in the past. Our mandate was to do that and it is in the CPA, section 3.5. It was clear that this was recognized as an issue that needed to be dealt with as part of the peace process.”

Donors, including the UN, have funded “social inclusion” programmes to empower historically marginalized ethnic groups, which all sections of society support, say analysts.

Former foreign affairs minister Chakra Prasad Bastola told IRIN last June that while no one disagrees the caste system of preferential treatment and access needs change, foreign donors “are pushing their agenda down our throats”, and demanding instant results. “We have ambitions, but donors' ambitions for us are greater.”

The problem is not whether, but rather how, donors have supported these groups, said foreign affairs analyst Rajan Bhattarai, head of the Nepal Institute of Policy Studies (NIPS) [ http://www.nipsnepal.org ].

“The inclusion [agenda] has been narrowed down to political empowerment, distribution of powers and [job quotas] and anything that has immediate solutions instead of empowering the marginalized people from the bottom level,” he said, blaming foreign donors for a too-exclusive focus on dismantling the political basis of the caste system without financing long-term fundamental change.

Impartiality and neutrality

“We don’t promote identity federalism. We don’t promote territorial federalism. We support Nepal impartially as it explores these difficult questions and tries to find the right formula,” said the UN’s Piper.

The standards of humanitarian assistance - humanity, neutrality and impartiality - are laid out in a 1991 UN resolution [ http://www.un.org/documents/ga/res/46/a46r182.htm ] that defined impartiality as providing humanitarian assistance “without discriminating as to ethnic origin, gender, nationality, political opinions, race or religion. Relief of the suffering must be guided solely by needs, and priority must be given to the most urgent cases of distress,” while neutrality meant “not taking sides in controversies of a political, religious or ideological nature”.

“Once the people of Nepal and the government decide how it wants to progress into whatever structure, then we will support on that basis, but we don’t have an opinion on federalism,” said DFID's O'Neill.

But even if donors have aimed to remain apolitical, they became dependent on local activists (including the Nepal Federation of Indigenous Nationalities, NEFIN [ http://www.nefin.org.np/ ], a local NGO advocating ethnic-based federalism) for implementation, which politicized and tainted their mandate, said Khanal, the analyst.

Some donors perceived NEFIN becoming too political, and a number, including DFID in 2010, withdrew funding.

“Federalism was not an international donor-driven agenda but they [donors] worked too closely with organizations run by radical activists, and that indirectly affected their neutrality,” said Khanal.

Donors in Nepal insist they uphold all three criteria of humanitarian assistance in Nepal, even as they push for social inclusion.

Piper said the UN has “very deliberately” worked with the most disadvantaged groups in this country over the last decade and has done so without apology.

“But to go from that statement to the statement that international donors and the UN are, for example, actively promoting federalism, and particularly identity-based federalism, or supporting the ‘bandas’ [strikes] called by indigenous or marginalized groups, is ridiculous,” said Piper.

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]]></body><link>http://www.irinnews.org/Report/97551/Analysis-Politicians-donors-question-donor-neutrality-in-Nepal</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2010/201009270515530815t.jpg"/></td><td valign="top">KATHMANDU 26 February 2013 (IRIN) - Dissent in Nepal over the role of ethnicity in a post-conflict state has put donor agencies under increased scrutiny, with politicians and analysts accusing them of meddling, taking sides and circumventing the government to push an agenda of “social cohesion”.</td></tr></table>]]></content:encoded></item><item><title>Lack of “lube” hurts HIV prevention</title><pubDate>Thu, 21 Feb 2013 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2010/201011050533290644t.jpg" />]]>KATHMANDU 21 February 2013 (IRIN) - Safer-sex messaging on condoms is universal but the generally poor availability of lubricants, and awareness of them, is hindering HIV prevention, health activists warn.</description><body><![CDATA[KATHMANDU 21 February 2013 (IRIN) - Safer-sex messaging on condoms is universal; but the generally poor availability and awareness around lubricants is hindering HIV prevention, health activists warn. 

Some personal lubricant - or “lube”- has been shown to lower the risk of HIV transmission by decreasing the risk of condoms breaking. 

Despite preliminary proof of lube’s efficacy, far less of the product is procured and distributed than condoms, leading people to use alternative, sometimes harmful, substances during intercourse such as butter or petroleum jelly; oil-based lubricants weaken latex, making the condom more likely to break. 

Activists say, however, that a blind spot [ https://www.surveymonkey.com/s/CalltoActionLubeSafety ] in research on lubricants as a part of HIV prevention programmes means not enough is known about their impact on HIV risk. 

Availability 

A 2012 survey [ http://www.msmgf.org/files/msmgf//documents/GMHR_2012.pdf ] by The Global Forum on MSM & HIV (MSMGF), a US-based coalition focused on men who have sex with men (MSM), found that barely a quarter of the 5,000 people from 165 countries surveyed reported easy access to free lubricant. A full 25 percent said free lubricant was completely unavailable. Less than 10 percent of people living in low-income countries reported easy access. 

While condoms have been part of family planning and HIV prevention work for decades, safe personal lubricant has only recently emerged as a donor priority. For example, the US government began distributing condoms in the 1970s through its aid and diplomatic missions, but its aid arm, the US Agency for International Development, only began distributing lubricant in 2008. 

“Where health systems are less developed, it is critical to help establish and maintain supply chains and distribution systems, as well as support efforts to build and accurately forecast demand [for lube],” explained a representative from the US President’s Emergency Plan for AIDS Relief (PEPFAR): 

Acknowledging the importance of using personal lubricants with condoms, especially during anal sex, the UN Population Fund (UNFPA) decided in 2012 to include water-based lubricants in the procurement list of commodities available to governmental and non-governmental clients in low and middle-income countries [ http://www.unfpa.org/public/home/procurement/AccessRH ].

However, outside of community-care settings, the real demand for lubricant remains largely misunderstood. 

Research in Burundi found that health care providers sometimes do not provide lube to patients because they consider it to be “promoting homosexual behaviour”, highly-stigmatized there [ http://www.rectalmicrobicides.org/docs/GLAM_Tookit_Version1.0_FINAL.pdf ]. With lube requests stymied in formal health care settings, NGOs can become the sole method of access. 

“Key populations - such as MSM and sex workers - who need the lubricant the most, often get their health-related services from local NGOs, which are not often included in [HIV/AIDS] policies or broader [health] programmes,” explained Bidia Deperthes, a senior HIV adviser with UNFPA’s Comprehensive Condom Programming division in New York. 

With these NGOs frequently absent from meetings with donors, lube demand can appear falsely low. 

UNFPA, a global leader in the purchase and distribution of contraceptives, spent more than 18 percent of its 2011 budget [ http://www.unfpa.org/webdav/site/global/shared/procurement/02_about/01_statistics/procurement-statistics2011.pdf ] on male condoms, but less than 0.5 percent on personal lubricants, citing donors’ and decision-makers’ lack of understanding of the true demand for the latter as one reason. 

Alternatives 

“Before there was lube from the outreach workers, I would use butter,” said Lucky, a transgender sex worker in Kathmandu, Nepal, who said she still uses non-lube products as lubricants when NGOs run out of money to fund free lubricant. 

“The condoms would break sometimes, but at least it didn’t hurt as much,” she said. 

Silicon and water-based lubricants are “condom compatible” and do not corrode latex. Other types of lubricant, including commercially-produced petroleum-based products like Vaseline, can destroy condoms and put users at risk of HIV and other sexually transmitted diseases. 

The World Health Organization (WHO) has published a list [ http://apps.who.int/iris/bitstream/10665/76580/1/WHO_RHR_12.33_eng.pdf ] of substances commonly used as alternatives to condom-compatible lubricant that may boost the risk of condom failure. 

According to an International Rectal Microbicide Advocates (IRMA) 2009 study [ http://www.rectalmicrobicides.org/docs/Chris%20Beyrer%20MSM%20Africa%20microbicides.pdf ], most MSM throughout Africa are not using condom-compatible lubricant, a trend also seen in other regions facing a high burden of HIV. 

A microbicide is a cream, gel, douche or an enema that may help reduce a person’s risk of HIV infection vaginally or rectally. Medical studies [ http://www.plusnews.org/Report/92067/HIV-AIDS-Microbicide-gel-could-stop-spread-of-HIV-during-anal-sex ] have shown rectal microbicides can offer protection in the absence of condoms and back-up protection if a condom breaks or slips off during anal intercourse. 

Distribution and access 

The American Foundation for AIDS Research and the US-based Johns Hopkins School of Public Health have identified availability of water-based lubricant and its cost as significant barriers [ http://www.amfar.org/uploadedFiles/_amfar.org/In_The_Community/Publications/MSM-GlobalRept2012.pdf ] to lubricant access in several countries including Guyana, Ukraine and China. 

Lubricant is commercially categorized differently across countries - ranging from a medical device to a cosmetic product - meaning its manufacture, import and export can encounter legal and bureaucratic cross-border delays [ http://www.rectalmicrobicides.org/docs/Lube%20safety%20Q&A%20FINAL%20Oct%2013.pdf ] before reaching users. 

Studies have found that even assuming high costs for lubricant production and distribution, “condom-compatible” lube prevention packages [ http://www.ncbi.nlm.nih.gov/pubmed/22819663 ] that include a condom plus a safe lubricant would only amount to about 1 percent of the global HIV/AIDS budget for 2011 (US$134 million). 

Call for more research 

Scientists have noted that even in places where lubricant is readily available and widely used, little comprehensive research has been conducted on its safety [ http://www.msmgf.org/index.cfm/id/11/aid/6282/lang/en ].

A 2007 global survey [ http://www.rectalmicrobicides.org/docs/IRMAColorFinalWeb.pdf ] revealed more than 100 different types of lubricants [ http://irma-rectalmicrobicides.blogspot.com/2012/12/chemical-engineering-news-studies-raise.html ] are used worldwide during intercourse. WHO has outlined [
http://apps.who.int/iris/bitstream/10665/76580/1/WHO_RHR_12.33_eng.pdf ] how vaginal and anal intercourse may require different types of lubricant. 

“Most importantly, we need to determine the safety of sexual lubricants that are on the market already,” said Jim Pickett, chair of IRMA. 

Experts see the lack of research as a disappointment 30 years into the AIDS epidemic, and as a mandate for more studies [ http://irma-rectalmicrobicides.blogspot.ca/2013/02/irma-issues-global-call-to-action-we.html ] on lubricant. 

kk/pt/cb 

]]></body><link>http://www.irinnews.org/Report/97517/Lack-of-lube-hurts-HIV-prevention</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2010/201011050533290644t.jpg"/></td><td valign="top">KATHMANDU 21 February 2013 (IRIN) - Safer-sex messaging on condoms is universal but the generally poor availability of lubricants, and awareness of them, is hindering HIV prevention, health activists warn.</td></tr></table>]]></content:encoded></item><item><title>Analysis: Girl child soldiers face new battles in civilian life</title><pubDate>Tue, 12 Feb 2013 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2010/201009271253370112t.jpg" />]]>JOHANNESBURG 12 February 2013 (IRIN) - Girl child soldiers are often thought of only as “sex slaves”, a term that glosses over the complex roles many play within armed groups and in some national armies. This thinking contributes to their subsequent invisibility in the demobilization processes - in fact, girls are frequently the most challenging child soldiers to rehabilitate.</description><body><![CDATA[JOHANNESBURG 12 February 2013 (IRIN) - Girl child soldiers are often thought of only as “sex slaves”, a term that glosses over the complex roles many play within armed groups and in some national armies. This thinking contributes to their subsequent invisibility in the demobilization processes - in fact, girls are frequently the most challenging child soldiers to rehabilitate. 

The broad categorization of girl soldiers as victims of sexual abuse obscures the fact that they are often highly valued militarily. While sexual abuse is believed to be widespread, girls’ vulnerability may vary, as attitudes toward women differ extensively across militias: In Colombia, the Marxist-leaning groups the Revolutionary Armed Forces of Colombia (FARC) and National Liberation Army (ELN) treated female soldiers as equal to males, while right-wing paramilitary groups were known to embrace gender stereotypes. 

Some have argued that disarmament, demobilization and reintegration programmes (DDR) are ill-equipped to address the needs of girls. DDR was designed for adult male combatants, and over the years has incorporated female combatants, followed by boy soldiers and then girls. 

A January 2013 World Bank briefing, Children in Emergency and Crisis Situations, says: “The use of girls [by armed forces] has been confirmed in Colombia, DRC [Democratic Republic of Congo], East Timor, Pakistan, Sri Lanka, Uganda and West Africa. There are some 12,500 in DRC. However, girls are generally less visible and up to now have hardly benefited from demobilization and reintegration programmes for child soldiers.” 

“No one knows what has happened after a DDR process to the large majority of girls associated with the armed groups,” the briefing said. 

About 40 percent of the hundreds of thousands of child soldiers scattered across the world’s conflicts today are thought to be girls, but the numbers of girls enrolling in child soldier DDR programmes dwindles to five percent or less. 

Girls often conceal their association with armed groups, Richard Clarke, director of Child Soldiers International [ http://www.child-soldiers.org ], told IRIN. In traditional societies, enrolling in DDR could confirm a past that imperils their future: “In contexts of entrenched gender discrimination, and in situations where a girl’s ‘value’ is defined in terms of her purity and marriageability, the stigma attached to involvement in sexual activity, whether real or imputed, can result in exclusion and acute impoverishment,” he said. 

Seeking gender equality 

Then there is the uncomfortable reality that some conflicts may actually fast-track gender emancipation. 

A 2012 report [ http://uit.no/Content/307291/Post_War_Processes_Report_Final.pdf ] by Tone Bleie of the University of Tromsø’s Centre for Peace Studies (CPS) explores this issue. During Nepal’s civil war, when Maoists conscripted “one member per house”, some parents offered their daughters to spare “sons whom they considered as their life insurance.” Of the Maoists’ 23,610 combatants at the cessation of hostilities, 5,033 were believed to be female, and of them 988 were girls. 

“Female combatants developed a new sense of pride and dignity due to personal sacrifices, military courage, feats in the battlefield and prospects of promotion in the ranks,” the report says. 

In the wake of Nepal’s 2006 ceasefire, during the cantonment of Maoists rebels and the subsequent reintegration process, girls and women were returned “to [the] very low position of women in traditional Nepalese feudal society,” Desmond Molloy, a panellist at the International Research Group on Reintegration at the CPS, told IRIN. 

“Inter-cast marriage, and marriage in general, was encouraged in the cantonment. This is taboo in Nepali society and proved a major obstacle for reintegration of young girls back into society, especially when they have children, as many do. Further there is in [Nepal’s] society a perception of a promiscuous environment in the cantonment. So many young girls were viewed with suspicion by their families, rejected by their new in-laws or ostracized by the community,” Molloy said. 

Abdul Hameed Omar, programme manager for the UN Development Programme’s Interagency Rehabilitation Programme, told IRIN that acceptance of inter-cast marriages was particularly problematic. “Children have been denied birth certificates, and women have been denied their citizenship certificates. When the community knows that a woman has been part of the PLA [People’s Liberation Army], these women sometimes face a stigma,” he said. 

He said attitudes of male Maoist ex-combatants “vary widely” but that “many voiced opinions that were not in line with their previous [gender equality] beliefs during the conflict. Other male ex-combatants who played traditionally female roles during the conflict, i.e., cooking or childcare, no longer feel that these are appropriate roles for men outside of the PLA.” 

Loss of power 

Many Colombian girl soldiers, who fought as equals to their male counterparts, struggled with the double standards of civilian life. 

“For some girls, belonging to an illegal armed group gives them a sense of power and control that they may not otherwise experience living in a relatively conservative, ‘machista’ [chauvinist] society,” said Overcoming Lost Childhoods, a Care International report about rehabilitating Colombian child soldiers [ http://www.essex.ac.uk/armedcon/story_id/000760.pdf ].

By the end of Eritrea’s 30-year-long liberation war, in 1991, females comprised between 25 and 30 percent of combatants. The gender-equality ideals espoused by the Eritrean People’s Liberation Front’s (EPLF) had proved an attractive lure for female recruits, including some who were teenagers or younger. 

But “many Eritrean female ex-fighters experienced the years of war as preferable to the time that came afterwards… They had felt respected, equal and empowered, but this was all lost after the war when women were pushed towards traditional gender roles,” said the 2008 report Young Female Fighters in African Wars, Conflict and Its Consequences [ http://www.gsdrc.org/go/display&type=Document&id=3543 ].

Eritrea’s DDR programmes initially tailored economic opportunities for women to traditional gender roles - basket weaving, typing and embroidery - but this did not provide a sustainable livelihood. Training women in traditionally male trades also proved fruitless because society’s norms ultimately dictated who could get which jobs. 

“Furthermore, female ex-fighters had a hard time getting married after the war as men usually claimed that these women had lost their femininity during the war. Many male ex-fighters also divorced their fighter wives for this reason and married civilian women,” the report said. 

Duality 

Girl soldiers’ versatility - they serve as combatants, spies, domestics, porters and “bush wives” - makes them highly valued among armed groups, which can also increase their difficulty reintegrating into civilian life. 

Despite this, punishments for girls in northern Uganda, such as whipping or caning, were meted out for the smallest infractions, Linda Dale, director of Children/Youth as Peacebuilders (CAP) [ http://www.childrenyouthaspeacebuilders.ca/About%20Us/contact.html ], told IRIN. 

“There is a strong tendency to force a kind of passivity on girls while at the same time they are expected to be combatants. This duality, as well as the effect of sexual violence, makes their rehabilitation more complicated, in my view,” she said. 

The length of captivity also differed between the sexes; average internment period for girls in northern Uganda was six to seven years, while boys faced about three years, Dale said. “Because of that, the effects of the experience, and therefore the need for more assistance in re-integration, will be higher. For example, many girl returnees are illiterate because they have been out of school so long.” 

Shelly Whitman, executive director of the Roméo Dallaire Child Soldiers Initiative [ http://www.childsoldiers.org/ ], told IRIN that some girls can be seen as suffering from Stockholm syndrome, where captives develop a sympathetic association with their abusers. 

“Girls were raped but then given to or chosen by a commander to be a ‘wife’. They are confused about their experiences, their guilt, their families’ expectations and religious beliefs. Additionally, many have children fathered by their captors. They are often rejected when they return home and viewed as non-marriageable material, damaged goods. With this kind of a homecoming, it creates confusion about your identity and your self-worth,” she said. 

Invisibility 

The assumptions and expectations of people operating DDR programmes may also affect girls’ reintegration. 

Girl soldiers are often assumed to be “‘following along’, rather than girls who have been recruited and used, however informally, for military purposes… These assumptions have resulted in tens of thousands of girls being literally ‘invisible’ to DDR programmers, although the situation has improved somewhat in recent years,” said Clarke of Child Soldiers International. 

Phillip Lancaster, former head of the DDR programme for the UN Organization Mission in DRC, told IRIN, “Boys with guns are easier to see and easier to fear.” DDR programmes might “ignore girls on the assumption that they don't present the same threat.” 

“My own experience is that girls are often invisible to DDR programmes that draw narrow categories around the notion of combat,” he said. “It's tricky to avoid getting caught up in categories as soon as one starts trying to define parameters of qualification for DDR programmes, and most of the decisions tend to have a somewhat arbitrary flavour simply because of the complexity of the subject matter. 

“Most of the Congolese armed groups… draw on local community resources… The definition of girl child soldier in this setting could, in theory, extend over all the young females in a community who were supporting, supplying, informing or directly fighting with a relevant armed group.” 

go/rz

]]></body><link>http://www.irinnews.org/Report/97463/Analysis-Girl-child-soldiers-face-new-battles-in-civilian-life</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2010/201009271253370112t.jpg"/></td><td valign="top">JOHANNESBURG 12 February 2013 (IRIN) - Girl child soldiers are often thought of only as “sex slaves”, a term that glosses over the complex roles many play within armed groups and in some national armies. This thinking contributes to their subsequent invisibility in the demobilization processes - in fact, girls are frequently the most challenging child soldiers to rehabilitate.</td></tr></table>]]></content:encoded></item><item><title>Why civil registration matters in Asia</title><pubDate>Fri, 01 Feb 2013 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2009/200911221157120062t.jpg" />]]>BANGKOK 01 February 2013 (IRIN) - Stronger civil registration systems are needed in Asia, home to 60 percent of the world’s population, to ensure the legal and human rights of all, and facilitate health planning, experts say.</description><body><![CDATA[BANGKOK 01 February 2013 (IRIN) - Stronger civil registration systems are needed in Asia, home to 60 percent of the world’s population, to ensure the legal and human rights of all, and facilitate health planning, experts say.

“Civil registration is the most basic requirement for individuals to establish legal identity and to formalize family relationships, and is thus a basic responsibility of the state,” Haishan Fu, director of the statistics division at the Economic and Social Commission for Asia and the Pacific (ESCAP) in Bangkok, told IRIN. “Without a legal identity, individuals may be deprived of the right of access to key public services such as health, education, social welfare and recourse to justice.”

According to the World Health Organization [ http://www.who.int/gho/publications/world_health_statistics/EN_WHS2012_Full.pdf ], only one quarter of the world’s seven billion inhabitants live in countries with registration systems that record births and death efficiently; 85 countries have only lower quality data ;74 lack any data on causes of death.

In the world’s two most populous countries (China and India - home to more than 2.5 billion people) there is no functional civil registration system, while mortality statistics are provided by using sample registration approaches, 2012 world health statistics [ http://www.who.int/gho/publications/world_health_statistics/EN_WHS2012_Full.pdf ] reveal.

The UN Children's Fund (UNICEF) [ http://www.unicef.org/eapro/media_20119.html ] notes that 51 million children go unregistered each year globally, while in South Asia two out of three children are not registered at birth and thus have no official record of their names, family and place or date of birth.

About 60 percent of Indonesian children [ http://www.irinnews.org/Report/85952/INDONESIA-Unregistered-children-at-risk ] under-five years of age do not have birth certificates, and half are not registered anywhere, UNICEF reports, while in neighbouring Timor-Leste [ http://www.irinnews.org/Report/96384/TIMOR-LESTE-Making-inroads-on-birth-certificates ] an estimated 70 percent of children under five do not have a birth certificate - one of the lowest birth registration levels of any country in the region.

The absence of such documentation leaves children vulnerable, experts warn.

“Children also need recognition of their existence before the law, which can help protect them against illicit changes to their identity - such as their name and who their parents are,” said Amalee McCoy, regional child protection specialist for UNICEF. “No child deserves to be unregistered, and no nation can afford not to have reliable systems for registering them."

Birth certificates are critical forms of social protection for vulnerable and marginalized groups such as people in poverty, and can be an effective tool for preventing human trafficking and child marriages, ESCAP’s Fu said.

“Civil registration is at the heart of inclusive development because it provides the legal identity that enables voice, choice and protection,” she notes.

According to a 2011 report [ http://www.who.int/healthmetrics/news/chis_report.pdf ] published by the WHO Health Metrics Network (HMN), a Geneva-based network that assesses health information systems worldwide, basic foundations of a good health information system and health information workforce - including vital registration systems - remain inadequate in many countries.

A registration system is essential in a country because it creates the legal tools to establish and protect the civil rights of individuals, and creates a critical data source for the compilation of vital statistics, the report concludes.

However, without civil registration data, people who remain unregistered in a region, especially vulnerable populations such as women and children, are legally invisible to policymakers and thus exposed to exploitation, abuse and human trafficking.

Health planning

Data on fertility and causes of mortality derived from a functional registration system are essential in building national and global policies for health development.

“If children are not registered when they are born, they do not exist in the government plans. They are not eligible for immunization or for going to school. Adults do not receive appropriate health care; they do not have access to services nor legal rights. People are suffering, they are not protected and remain invisible,” said Alan Lopez, professor of global health and head of the School of Population Health at the University of Queensland.

Unregistered children and adults from ethnic minority groups such as Myanmar’s Rohingya, who are de jure stateless under Burmese law [ http://www.irinnews.org/Report/96801/Briefing-Myanmar-s-Rohingya-crisis ], by default have limited access to food and health care, leaving them susceptible to preventable diseases and malnutrition. Many are prevented from attending school and used for forced labour [ http://www.irinnews.org/Report/94672/In-Brief-40-000-Rohingya-children-in-Myanmar-unregistered ].

At the same time, the lack of death registrations - in particular for cause-specific mortality such as maternal, HIV/AIDS or malaria mortality in middle and low income countries - complicates health workers’ ability to estimate the disease burden, which is necessary for effective prevention and treatment.

“All countries have some form of a civil registration system but at different levels of quality and coverage,” ESCAP’s Fu said, adding that the best way to improve civil registration, and the most sustainable, is building on the systems already in place and identifying how civil registration can complement the other activities of governance.

“The value of regional collaboration and regional knowledge-sharing cannot be underestimated with respect to supporting the improvement of civil registration. Countries can learn from each other’s systems, particularly how they have overcome similar challenges,” she said.

The barriers for individuals registering births, deaths, marriages, adoptions, etc., are quite significant and those can include geography, cultural differences, inadequate legal frameworks and the cost of registration to the individual.

For UNICEF’s McCoy, costs attached to birth registrations, bureaucracy, and discriminatory laws against specific populations such as refugees, migrants, ethnic minorities and the stateless, are the main reasons why civil registration systems tend to fail vulnerable people.

“Systems exist in most countries - although they often still fail to reach marginalized children and families. They work best where parents are able to quickly and easily register children relatively soon after birth with little or no cost to parents," she noted.

Governments responsible

Experts agree vital registration systems are a government’s responsibility that requires long-term commitment at the highest levels of government, strong leadership and political will.

“Because civil registration is the responsibility of so many different agencies, long-term commitment is a precondition for improvement,” Fu said. “Another precondition is to involve local government, when relevant, in the improvement process because they are at the frontline of civil registration.”

Building public awareness of the value of civil registration or creating incentives, such as conditional cash transfers tied to birth registration in the family, can be crucial in improving registration rates.

In Nepal’s remote Karnali region, mothers are asked to register their newborn children as a condition to receive a cash grant for the purchase of nutritious food for children [ http://www.irinnews.org/Report/93878/NEPAL-Cash-grants-for-food-incentivize-birth-registrations ]. Birth registration is not prioritized in Nepal although it is important for children in order to receive governmental support, from health care to education.

Technology

Technology can also play a crucial role in overcoming the barriers to registration faced by people in rural or remote areas.

The Bangladeshi government, assisted by UNICEF, has launched a campaign to register birth data online in an effort to fight high levels of child marriages mainly in rural areas [ http://www.irinnews.org/report/95782/BANGLADESH-Online-birth-data-to-prevent-child-marriage ].

About a third of women in Bangladesh aged 20-24 are married by the age of 15 and birth certificates can be a tool for preventing such marriages [ http://www.irinnews.org/Report/92375/BANGLADESH-Parents-still-not-heeding-child-marriage-warnings ].

The international community has an important role to play in improving registration, by providing technical assistance and funding, and facilitating the exchange of best practices, experts and academics agree.

Lopez of Queensland University noted that the role of the international community is vital in pushing governments to provide reliable statistics - mainly through pressure to reach Millennium Development Goals [ http://www.undp.org/content/undp/en/home/mdgoverview.html ]. But “social and health policies require above all strong government leadership.”

Move to improve statistics

In a watershed moment for Asia and the Pacific in December 2012, leading statisticians and senior government officials from 46 countries gathered in Bangkok and agreed to ambitious steps to improve environment and social statistics, critical in the context of the post-2015 development agenda. Included in that was an endorsement of a strategy to improve civil registration and vital statistics (CRVS) systems in the region, noting that dysfunctional CRVS systems hamper inclusive and sustainable growth.

“There is a strong business case for the improvement of civil registration,” Fu said. “With an understanding of the benefits of improved civil registration, governments will be able to prioritize this issue.”

fm/ds/cb

]]></body><link>http://www.irinnews.org/Report/97389/Why-civil-registration-matters-in-Asia</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2009/200911221157120062t.jpg"/></td><td valign="top">BANGKOK 01 February 2013 (IRIN) - Stronger civil registration systems are needed in Asia, home to 60 percent of the world’s population, to ensure the legal and human rights of all, and facilitate health planning, experts say.</td></tr></table>]]></content:encoded></item><item><title>Analysis: The trouble with Nepal’s agriculture</title><pubDate>Wed, 23 Jan 2013 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2012/201206211119330201t.jpg" />]]>KATHMANDU 23 January 2013 (IRIN) - Agriculture in Nepal suffers from years of under-investment, limited research, and scant inputs, technology and services for farmers. Unless things change, Nepal may fall into deeper food insecurity and poverty, say analysts.</description><body><![CDATA[KATHMANDU 23 January 2013 (IRIN) - Agriculture in Nepal suffers from years of under-investment, limited research, and scant inputs, technology and services for farmers. Unless things change, Nepal may fall into deeper food insecurity and poverty, say analysts.

“Declining resource allocation to agriculture research and development will have direct implications on attaining the objective of poverty reduction, despite investment made on infrastructure,” noted a December 2012 paper by the US-headquartered International Food Policy Research Institute (IFPRI) [ http://www.ifpri.org/sites/default/files/publications/Agriculture_seed_and_innovation_in_Nepal.pdf ].

While most development plans give high priority to agriculture - which contributes 35 percent to GDP - government investment in the Ministry of Agricultural Development (MOAD) [ http://www.moad.gov.np/ ] - has declined from 3.7 percent of all government spending 10 years ago to 2.6 percent this year. Meanwhile, overall government spending has doubled since 2006.

While MOAD saw a slight increase in government and donor funding following the 2008 global and national food crisis, [ http://www.irinnews.org/In-depth/77872/72/A-global-food-crisis ] its budget dropped this year by 27 percent to US$105 million compared to last year due to political squabbling that delayed agreement on an overall government budget. A partial no-growth budget to continue only ongoing programmes was agreed last November, four months late.

All this has meant a steeper slide into poverty for 66 percent of people nationwide who survive through agriculture [ http://www.moad.gov.np/pdf/adsassessmentreport.pdf ].

The average farm size shrunk 36 percent from 1.1 hectares in 1995 to 0.7 hectares in 2010, often too small to generate income above the poverty line. “Despite overall reduction in poverty levels in the country, poverty for those self-employed in agriculture increased by 10 percentage points,” reported IFPRI.

“When investment is low, we cannot have new technology and programmes to generate employment and grow effectively,” explained Devendra Gauchan, agriculture economist and chief of the Socioeconomics and Agri-research Policy Division at the governmental Nepal Agricultural Research Council (NARC).

Extension services

Extension services are strained due to lack of staffing and funding. MOAD’s Department of Agriculture has 378 extension offices nationwide. Every agriculture outreach station serves more than 11,000 farmers; one technician is responsible for an average 1,500 farmers. In developed countries, the average is one per 400.

“We have not been able to provide farmers with the services they need,” said Yagya Raj Joshi, senior agriculture development officer at the Doti District Agriculture Development Office in the country’s Far West Region, known for its rough, mountainous terrain.

He heads a team of 30 staff, responsible for a population of 200,000 - 80 percent of whom are farmers, and 60 percent of whom still depend on increasingly erratic weather for their water.

“Our work is only small-scale,” he told IRIN, that there was no technology to transfer even if there were enough qualified experts to do it.

Most of MOAD’s budget goes on salaries and administrative costs; there is limited money for programming, said Prabhakar Pathak, joint-secretary and spokesperson at MOAD’s Gender Equity and Environment Division.

Compounding farmers’ woes, the current extension service model requires they go to district centres and sub-centres for assistance, leaving growers in remote areas most in need of support going without it, says IFPRI. “On average, rural households require more than two hours to reach their nearest markets or government service centres because of difficult terrain and a lack of transport infrastructure.”

Research

Minimal investment in research has hampered efforts to meet the challenges of increasingly volatile weather, said Gauchan, especially given Nepal’s agro-ecological diversity.

Less than 0.4 percent of the agriculture sector’s GDP is spent on research, far short of the internationally recommended 1 percent. NARC received US$11 million this year, 22 percent less than last year. Only 32 percent of the $11 million was for research. In tight times, money for equipment and maintenance of research labs and farms goes first, which has long-term repercussions, said Hari Krishna Shrestha, an agricultural economist at NARC.

Funding cuts disrupt the breeding, production and distribution of new, improved seeds to farmers [ http://www.irinnews.org/Report/94611/Analysis-Nepal-s-Monsanto-debate-spotlights-seed-sovereignty ], and prevents timely response to emerging pests.

Meanwhile, NARC’s staff numbers are declining. More than 40 percent of the scientists are nearing retirement age, while 32 percent of posts are vacant due to recruitment problems. It is especially difficult to find masters-level entomology, pathology, soil and other hard-science graduates, said NARC’s Gauchan.

Agriculture and animal sciences are niche studies, drawing in only 0.3 percent of higher education enrolment in 2009-10 [ http://www.ugcnepal.edu.np/# ]. “Young graduates are not attracted to public sector scientific organizations,” he added.

Loans hard to come by

Inputs needed to increase the land’s productivity - from seed, to fertilizer, machinery, irrigation, and finance - are scarce nationwide.

“Farmers hardly get compensation when their crops fail,” said Radha Nepal, a farmer and chairwoman of a maize seed production cooperative in Kashyauli village of south-central Palpa District. “And it is difficult for us to get loans, especially since most of our land is not held in the name of women, and our men have gone abroad.” [ http://www.irinnews.org/Report/95998/NEPAL-Tailoring-technology-for-female-farmers ]

The government’s 2012 Agriculture Development Strategy Assessment Report [ http://www.moad.gov.np/pdf/adsassessmentreport.pdf ] estimated 200,000 youth, especially from rural areas, migrated abroad for employment in 2010, leaving mostly women, children and the elderly behind. Female-headed agricultural households have increased from 12 percent in 1995 to 26 percent in 2010. Yet only 18 percent of women in rural households own houses or land, according to the 2011 census.

In the last decade, the largely government-owned Agriculture Development Bank Limited has moved away from being a primary lender in agriculture, towards housing, vehicles, and commercial development.

In a 2010 analysis, Gauchan found the share of credit provided to agriculture was only 11 percent of the bank’s total lending portfolio due to the perceived high risk of investing in subsistence agriculture.

Some 54 percent of cultivated land in Nepal is irrigated, only 7 percent of households own a pump (not taking into account whether or not that pump actually works) [ http://www.irinnews.org/report/94734/Analysis-When-aid-meets-arsenic-in-Nepal ], and a mere 1 percent own tractors, power tillers, or threshers [ http://www.cbs.gov.np/nada/index.php/catalog/37 ]. The state-owned Agriculture Inputs Company Limited estimates fertilizer demand [ http://www.irinnews.org/report/95700/NEPAL-Got-any-fertilizer ] to be 500,000 tons, of which only 150,000 was supplied last year.

“On land where we could cultivate three harvests’ worth, we have to settle with only one,” said farmer Radha Nepal. “In the past, we had neither the technology nor the knowledge, now we have them, but we don’t have access to them.”

Bleak future?

MOAD spokesperson Pathak projected a bleak future unless things change: “The agricultural growth rate will decline. The contribution of agriculture to the GDP will decrease. There won’t be food and nutrition security. Agriculture job employment will decline. Youths will be less involved in agriculture, and the speed of income going abroad will increase.”

Some of those changes have already taken root. “Nobody wants to stay in agriculture,” said Sabnam Shivakoti Aryal, a senior agriculture officer at MOAD who is helping prepare a new long-term Agriculture Development Strategy (ADS), which will outline a 20-year vision and 10-year plan for Nepal.

“People are leaving land fallow where crops worth gold and silver can grow, to work as labourers making 10,000 to 12,000 rupees [$115-$139] a month,” said Joshi, the agriculture development officer in the Far West Region.

“If agriculture investment continues to be low, our poverty reduction efforts, and Millennium Development Goal (MDG) targets may not be possible,” added Gauchan. Nepal’s latest MDG progress report [ http://planipolis.iiep.unesco.org/upload/Nepal/Nepal_MDG_2010.pdf ] found that rural poverty - 28.5 percent - was four times higher than urban poverty - 7.6 percent. The overall MDG 2015 target for poverty is 21 percent.

Many in the government have set their hopes on the forthcoming ADS, with its promise of “sustainable growth in value in an agriculture sector that is more resilient to climate change”. A draft version is expected by March 2013.

Surya Prasad Paudel, a senior livestock development officer at MOAD who is also working on the ADS, listed a few of its preliminary proposals: increasing the share of the national budget that goes to agriculture; increasing the number of extension offices to nearly 900; and gradually committing up to 2 percent of agriculture-generated GDP to research. “If we invest in agriculture today, we will see the impact in 5-10 years’ time,” said Paudel.

The government approved in January 2013 four donor-funded agriculture projects worth $134 million (to which the state is contributing $32.5 million) [ http://www.ekantipur.com/2013/01/18/business/four-projects-worth-134-million-to-give-farm-sector-shot-in-the-arm/365776.html ].

But Joshi is not optimistic. “I don’t trust them. So many strategies like the ADS have been developed,” he said, citing the last Agriculture Perspective Plan (APP) (1995-2015) [ http://himaldoc.icimod.org/record/4168/files/APROSC%20Nepalagricultureperspectiveplan630AGN.pdf ], which has seen many of its targets unmet. “I have been hearing that agriculture is the government’s priority since I was a child.”

sm/pt/cb

]]></body><link>http://www.irinnews.org/Report/97321/Analysis-The-trouble-with-Nepal-s-agriculture</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2012/201206211119330201t.jpg"/></td><td valign="top">KATHMANDU 23 January 2013 (IRIN) - Agriculture in Nepal suffers from years of under-investment, limited research, and scant inputs, technology and services for farmers. Unless things change, Nepal may fall into deeper food insecurity and poverty, say analysts.</td></tr></table>]]></content:encoded></item><item><title>Tracking dollars to fight diarrhoea in Nepal</title><pubDate>Thu, 03 Jan 2013 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2011/201109220649130156t.jpg" />]]>KATHMANDU 03 January 2013 (IRIN) - Insufficient, fragmented and misdirected investment in the water and sanitation sector has hindered the fight against diarrhoea, leaving it one of Nepal’s leading child killers despite hundreds of millions of dollars having been invested, say practitioners. </description><body><![CDATA[KATHMANDU 03 January 2013 (IRIN) - Insufficient, fragmented and misdirected investment in the water and sanitation sector has hindered the fight against diarrhoea, leaving it one of Nepal’s leading child killers despite hundreds of millions of dollars having been invested, say practitioners.

While health programming has helped reduce the severity and fatality of diarrhoea among children below the age of five [ http://measuredhs.com/publications/publication-fr257-dhs-final-reports.cfm ], the percentage of children affected by diarrhoea in Nepal has not budged in almost a decade, remaining at a stubbornly high 14 percent.

A major cholera epidemic in 2009 affected over 70,000 people in 27 of the country’s 75 districts, killing almost 380. Since then, an average 3,500 under-five children are hit by diarrhoea outbreaks every year, resulting in some 50 deaths (1.4 percent fatality rate), according to government statistics.

Some nine out of 10 deaths due to diarrhoea worldwide are traced to unsafe water, inadequate sanitation and poor hygiene, according to the UN Children’s Fund (UNICEF), all of which are lacking in Nepal.

According to the most recent census in 2011 [ http://cbs.gov.np/wp-content/uploads/2012/11/Major-Finding.pdf ], almost 40 percent of households nationwide did not have any safe way to dispose of faeces, and while 85 percent had access to an “improved” water source, it was still not necessarily safe [ http://www.irinnews.org/Report/88508/HEALTH-When-is-water-safe ], said Madhav Pahari, water, sanitation and hygiene (WASH) specialist at UNICEF’s office in Kathmandu. Less than half the population had access to soap and clean water for hand-washing.

A recent self-assessment [ http://www.moppw.gov.np/pdf/WASH-Sector-Status-Report-2011-for-WEB.pdf ] by the WASH sector in Nepal, including both governmental and non-governmental groups, blamed insufficient funding, as well as inefficient spending.

In order to achieve its targets of universal toilet coverage by 2017 and basic water and sanitation services for all, Nepal will need to double its current annual investment in the sector from US$43 million to some $85 million, concluded the 2011 assessment.

But it is not only about more money, but also more “rational” spending, said Nanda Bahadur Khanal, senior divisional engineer at the water supply and sanitation Sector Efficiency Improvement Unit of the Ministry of Urban Development (MoUD).

No coordination

Lack of coordination [ http://www.irinnews.org/report/94734/Analysis-When-aid-meets-arsenic-in-Nepal ] between the many actors has hampered effective use of funds, said Pahari.

“We have too many government entities implementing water and sanitation projects.” For rural WASH activities alone, there are three key agencies, all functioning under separate ministries and through different local bodies.

“Whose responsibility is sanitation at the broader national level?” asked Sudha Shrestha, acting chief technical adviser at the UN Human Settlements Programme (UN-HABITAT) in Nepal. “Is it the Ministry of Urban Development? Is it the Ministry of Local Development? Or is it the Ministry of Physical Planning, Works, and Transport Management? And for hygiene, is it the Ministry of Health and Population? The roles and responsibility are not explicitly defined.” 

Officials have only recently identified that in addition to last year’s $43.3 million WASH budget, another $19 million was funnelled by donors to water and sanitation projects, but not in collaboration with any government agencies and, therefore, did not appear on any official expense statements.

“Externally channelled money makes up about 30 percent of investment in the sector, but its geographical coverage is not even 5 percent,” calculated Khanal at the MoUD. “That money has not been used effectively.”

Fragmentation has often led to duplication of efforts on the ground, he added. If a water tap built by one agency stops running, instead of repairing it, locals will request a different agency to build a new water supply system.

As a result, some village development committees (VDCs) are saturated with water supply schemes, while others have none, said UNICEF’s Pahari.

Poor targeting

Water and sanitation projects too often target communities most easily reached by road or air, which are already better-off, said Shrestha at UN-HABITAT. “If I go to a district for an intervention, I will choose a place where I can get quick results.”

Even with a national sanitation average hovering around 60 percent, around 10 districts have less than 30 percent of their population accessing “improved” sanitation.

“There is a poor culture and practice of evidence-based resource allocation,” according to the government’s Water Supply, Sanitation and Hygiene, Sector Status Report 2011 [ http://www.moppw.gov.np/pdf/WASH-Sector-Status-Report-2011-for-WEB.pdf ].

“Our funding needs to prioritize unreached populations - deprived communities, remote communities, and those with weak political access,” said Khanal. “That is what we are advocating for now.”

Attention should be paid to the “sanitation-dark” stretch of districts along the central-eastern Terai flatlands bordering India from the districts of Parsa to Saptari, where over 20 percent of the country’s population resides, said Pahari. Investment for water and sanitation in these districts needs to increase at least five-fold, as estimated in the 2011 sector report.

There are also concentrated pockets of recurring diarrhoeal outbreaks in the country, particularly in the mid- and far-western hill districts of Accham, Doti, Dialekh, Bajhang, Jajarkot, and Rukum that require constant and improved disease surveillance, explained Sameer Dixit, country director of the scientific NGO Centre for Molecular Dynamics.

New data analysis is needed to improve targeting, said Purusotam Shedain, senior integrated medical officer at the Child Health Division of Nepal’s Department of Health Services (DHS). The government has identified hard-to-reach urban poor populations in a number of slum areas in Kathmandu; researchers have only begun to disaggregate national diarrhoea prevalence data by caste. A person’s family background plays a prominent factor in service access. Only with such information can the government tailor and target its services more accurately, he added.

Supply over sanitation

WASH efforts in Nepal have favoured water infrastructure projects over sanitation and hygiene interventions, added Shrestha from UN-HABITAT.

“Diarrhoeal outbreaks are related to the wider perspective of hygiene, water quality, sanitation, and the environment,” said Pahari. “The sector has not been able to address all four parameters in a systematic manner.” Pahari observed that access to improved water has been “significantly improved”, sanitation is “relatively OK”, hygiene awareness is “far from required” and environmental cleanliness is “too far to achieve”.

“Our focus, thus far, has been on getting people to defecate in a toilet,” admitted the MoUD’s Khanal, with issues around the facility’s cleanliness, food hygiene and hand-washing only slowly being addressed.

The government created a separate budget line for national sanitation and hygiene promotion only two years back, but the $3.2 million allotted for 2012 did not fulfil spending requirements of using 10 percent of the total rural water supply budget for national sanitation and hygiene promotion.

The DHS’s National Health Education, Information and Communication Centre initiated water and sanitation outreach work four years ago, Kunj Prasad Joshi, senior health education officer at the centre, told IRIN. It currently spends between $114,000-$228,000 targeting schools in seven districts. Taking the project nationwide requires 10 times more funding, he said.

“With Nepal’s population at 26.8 million, even if you estimate only 10-20 rupees expense per head, you would still need 200 to 250 million [Nepalese rupees, or $2.2-$2.8 million],” calculated Joshi.

No long-term focus

Even where hygiene awareness has spread, most development projects do not run long enough to instil lasting behaviour change, said Shrestha. “Many of our interventions are resource and time bound.” They last an average of three to five years, after which “there are no provisions to return to see how things are going.” Instead, local authorities need to institutionalize behaviour-change interventions, Shrestha added.

The same goes for changing hygiene habits and infrastructure maintenance. Although 20 percent of the water supply budget should go to repair and rehabilitation, according to policy stipulations, less than 1 percent currently does.

Around 80 percent of water supply schemes need repair, rehabilitation, or reconstruction, some of which are completely non-functional, based on the 2011 sector review.

According to the Department of Water Supply and Sewerage’s 2010 assessment [ http://dwss.gov.np/file/file_down/UBDryoNMIP_WatSan_Survey_2010_Report.pdf ], almost 2 percent of the population with toilets did not use them. Of those who did, over 20 percent were poorly managed or dirty and unhygienic.

Coverage statistics are poor indicators of water and sanitation conditions in communities, said the government’s Khanal.

Pledges

Following the first joint-sector WASH review in 2011, a follow-up consultation was held in 2012, and another national review is planned for 2013. The review initiated formal budget tracking, with a standard format to be in place by next year.

“If we could streamline investment in the sector, there may still not be enough funding, but we would need less investment than is currently demanded,” said Khanal. “We need to consider rational use of our funds. The government needs to develop a roadmap for investment priorities in the sector, and the donors, following the Paris Declaration [on Aid Effectiveness] [ http://www.oecd.org/development/aideffectiveness/34428351.pdf ] need to invest where the national government [requests].”

The 2011 review found the WASH sector lacked reliable performance monitoring. “Although more than Rs 22 billion [$250 million] has been allocated to the sector in the past six years [2004-2010], utilization effectiveness is often questioned in the absence of structured monitoring mechanisms.”

A programme document that identifies priority areas to guide WASH practitioners should also be finalized soon, Khanal added.

The Sanitation and Hygiene Master Plan [ http://www.washinschoolsmapping.com/projects/pdf/Nepal%20Government%20Sanitation%20and%20Hygiene%20Master%20Plan.pdf ] launched in 2011 exposed neglected areas. It set a target year of 2017 for universal toilet coverage, launched a nationwide open defecation-free campaign, and endorsed the creation of district, municipal and village-level coordination committees to oversee WASH interventions.

The crucial question for the sector, said Shestra, is “how to continue and maintain the movement”.

sm/pt/cb

]]></body><link>http://www.irinnews.org/Report/97164/Tracking-dollars-to-fight-diarrhoea-in-Nepal</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2011/201109220649130156t.jpg"/></td><td valign="top">KATHMANDU 03 January 2013 (IRIN) - Insufficient, fragmented and misdirected investment in the water and sanitation sector has hindered the fight against diarrhoea, leaving it one of Nepal’s leading child killers despite hundreds of millions of dollars having been invested, say practitioners. </td></tr></table>]]></content:encoded></item><item><title>Analysis: Five reasons malnutrition still kills in Nepal</title><pubDate>Fri, 14 Dec 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2010/201009270501130205t.jpg" />]]>KATHMANDU 14 December 2012 (IRIN) - The number of children in Nepal with acute malnutrition hovers near emergency levels, something that has not changed even after 15 years of efforts and millions of dollars invested, say local and international nutrition experts.</description><body><![CDATA[KATHMANDU 14 December 2012 (IRIN) - The number of children in Nepal with acute malnutrition hovers near emergency levels, something that has not changed even after 15 years of efforts and millions of dollars invested, say local and international nutrition experts.

“The prevalence was the same in 1996. If we look at the number of children affected, the situation has even deteriorated due to the population increase,” said Nicolas Oberlin, deputy country director of UN’s World Food Programme (WFP). 

Levels of wasting - acute malnutrition, or low weight-to-height ratio - hardly changed from 2006 to 2011, according to the Nepal Demographic and Health Survey 2011 (DHS) [ http://www.measuredhs.com/pubs/pdf/FR257/FR257[13April2012].pdf ].

Any global acute malnutrition rate- comprising both moderate and severe acute malnutrition-exceeding 10 percent is considered a nutrition emergency, according to medical experts. As of 2011, the Department of Health (DOH) estimated wasting affected nearly 11 percent of children under five years old, or 385,000 children. Some 2.6 percent of all under-fives – 91,000 – had severe acute malnutrition [ http://www.cmamforum.org/Pool/Resources/Nepal-CMAM-evaluation-UNICEF-11oct2012.pdf ].

In Nepal, malnutrition plays a role in 60 percent of child deaths, according to UN Children’s Fund (UNICEF). 

“We are concerned about making more children vulnerable if we don’t act fast,” Raj Kumar Pokharel, chief of the DOH nutrition section, told IRIN, acknowledging that the government, until now, has not paid enough attention. 

While most children with wasting are in the remote hills of Midwest and Far West regions, considered the poorest areas nationwide, severe acute malnutrition, the situation is worse in the southern fertile plains bordering India, known as the western Terai. There, more than 15 percent of children are estimated to be acutely malnourished due to poor sanitation, contaminated water and water-borne disease outbreaks during monsoons, according to the government.

In addition, the rate of stunting (low height-for-age, also known as chronic malnutrition) in Nepal is among the world’s highest; UNICEF reported this year [ http://www.unicef.org/sowc/files/SOWC_2012-Main_Report_EN_21Dec2011.pdf ] that Nepal has the sixth worst rate of stunting - 49 percent - among all countries that provided data. 

Below, IRIN explores five reasons experts have identified as the main culprits behind Nepal’s stubbornly high malnutrition rates. 

Poor health

Acute respiratory infections and diarrhoea, Nepal’s leading causes of deaths among children under age five, are linked to acute malnutrition, according to the Ministry of Health and Population. Diarrhoea depletes children of critical nutrients and makes them more vulnerable to infection; infections, in turn, worsen their nutritional status.

In 2011, there were 2.7 million cases of acute respiratory infection reported to the government [ http://dohs.gov.np/sites/default/files/1/files/Annual_report_2067_68_final.pdf ]. Of the 1.7 million reported cases of diarrhoea, only 38 percent of the children saw a healthcare provider [ http://www.measuredhs.com/pubs/pdf/FR257/FR257[13April2012].pdf ].

Of those who sought healthcare, half were treated with oral rehydration salts (ORS) [ http://www.irinnews.org/report/94996/GLOBAL-Follow-the-fizz-save-a-life ]. In 2012, an independent evaluation of Nepal’s health system noted [ http://www.internationalhealthpartnership.net/fileadmin/uploads/ihp/Documents/Country_Pages/Nepal/AM%20JAR%202012.pdf ] that zinc, recommended by the World Health Organization [ http://www.irinnews.org/report/94996/GLOBAL-Follow-the-fizz-save-a-life ] for diarrhoea treatment in conjunction with ORS and proven to cut diarrhoea-related deaths by some 40 percent [ http://www.ncbi.nlm.nih.gov/pubmed?cmd=Retrieve&db=PubMed&list_uids=11101480&dopt=Abstract ], was not widely distributed.

Poor sanitation 

More than three million of the country’s 30.4 million people do not have access to safe drinking water despite the country’s abundant fresh water resources. Nearly 19 million do not have access to “improved sanitation”-public standpipes, covered wells or springs, piped household connections or boreholes -according to the local NGO Forum for Water and Sanitation [ http://www.ngoforum.net ]. 

“A big cause of malnutrition is our poor health environment due to the poor hygiene practices, poor sanitation and…poor living conditions,” said nutrition expert Som Paneru, president of the Nepal Youth Foundation [ http://www.nepalyouthfoundation.org ], which runs nutrition treatment centres nationwide. 

Poor access to safe drinking water and sanitation facilities are associated with skin and diarrhoeal diseases, as well as acute respiratory infection. 

Poor early childcare practices

“The critical period [for a child] is during the 1,000 days from pregnancy up to two years of age. Whatever damage is done to physical growth and brain development during the period is very difficult to reverse,” said Saba Mebrahtu, chief of UNICEF’s nutrition section in Nepal. 

“Childcare practices are really poor, and usually we find that babies are not fed nutritious food, especially after six months,” explained government official Pokharel.

Breastfeeding within the first hour after birth and exclusive breastfeeding for the first six months can strengthen a child’s immune system for years. But only around half of babies are breastfed within the first hour -51 percent in urban areas and 44 percent in rural areas, according to the 2011 DHS. Fortunately, exclusive breastfeeding rates are improving - now 70 percent, up from 53 percent in 2006. 

Still, mothers of malnourished children lack proper healthcare before and after birth. “Most of the time, they are expected to get back to household chores like working in the farm and the kitchen just a few days after delivery, and it affects the mother’s health and nutrition,” he added.

While 88 percent of urban mothers received antenatal care from a skilled provider, only 55 percent of rural mothers did so, according to the DHS. Additionally, some 23 percent of mothers nationwide gave birth before age 18. 

Poor agriculture investments

A key challenge in fighting acute malnutrition is simultaneously addressing its many causes, said WFP’s Oberlin. 

“Some of these factors weigh more heavily in certain geographic areas, or within certain social categories. For instance, food insecurity in remote areas is a serious contributing factor, where unavailability and lack of access to food, combined with poverty, have a dramatic impact on nutrition,” he added.

A quarter of the population lives under the national poverty line, and nearly 3.5 million people have difficulty getting nutritious foods, according to WFP. 

“A lot of investment is needed now in the agricultural sector, but, unfortunately, the investment and funding by both the government and aid agencies have reduced a lot,” said Pitamber Acharya, director of Development Project Service Centre [ http://www.deprosc.org.np ], a local NGO working on agriculture and food security. 

According to the Ministry of Agriculture and Development, donor support to agriculture declined from 2002-2006. Overall government spending has more than doubled since 2006, but spending on agriculture has remained unchanged. 

Poor priority-setting

Until now, the central government has relegated malnutrition issues to a four-person nutrition unit, led by DOH’s Pokharel. The unit ranks low within health ministry’s hierarchy. 

“The way that the nutrition section has not been given prominence shows the government’s negligence over the past years, and the small team is actually doing [its] best to reduce malnutrition. But that is really a herculean task for them to cover the whole nation,” said Paneru from the Nepal Youth Foundation. 

Still emerging from a decade-long civil conflict that killed an estimated 18,000 civilians, the country has been without local government since 1997, leaving nearly 4,000 “village development committees” with only one person, appointed by the national government, to keep basic services going. 

A new constitution that would lead to local elections has yet to be approved. Promised in 2010, draft approval has been delayed four times [ http://www.irinnews.org/report/95754/NEPAL-Timeline-of-constitution-stasis ], most recently on 27 May.

Ongoing political squabbling also delayed the new fiscal budget by eight months, which held up money needed for development [ http://www.irinnews.org/Report/95761/Analysis-Humanitarian-fallout-from-Nepal-apos-s-constitutional-stalemate ], said Chandan Sapkota, an economist at the South Asia Watch on Trade, Economics and Environment office in the capital, Kathmandu. 

Change?

But agencies and the health workers are still hopeful. The government launched its first inter-ministerial national nutrition plan on 20 September. Donors have pledged close to 60 percent of the plan’s US$150 million 2014-2017 budget, while the government has set aside near $12 million for 2012-2013 nutrition interventions. 

The National Planning Commission [ http://www.npc.gov.np/new/eng/index.php ] will monitor spending for the new nutrition plan, which is expected to create a national centre for nutrition and a “food security secretariat”.

DOH’s nutrition team anticipates this will translate into improved nutrition and has proposed hiring 35 staff for the national centre, nutrition supervisors for all of the country’s 75 districts, and nutrition officers for each of the five regional health offices. 

“We have, however, yet to see how things will shape up,” said Pokharel, referring to the ongoing political deadlock. 

nn/pt/rz

]]></body><link>http://www.irinnews.org/Report/97046/Analysis-Five-reasons-malnutrition-still-kills-in-Nepal</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2010/201009270501130205t.jpg"/></td><td valign="top">KATHMANDU 14 December 2012 (IRIN) - The number of children in Nepal with acute malnutrition hovers near emergency levels, something that has not changed even after 15 years of efforts and millions of dollars invested, say local and international nutrition experts.</td></tr></table>]]></content:encoded></item><item><title>BANGLADESH-KENYA: Our Lives - A survivors&apos; guide to hard times</title><pubDate>Thu, 06 Dec 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2012/201212061756470519t.jpg" />]]>NAIROBI 06 December 2012 (IRIN) - Price Watch (Our lives)</description><body><![CDATA[NAIROBI 06 December 2012 (IRIN) - Our Lives - A survivors' guide to hard times

In-Depth Global Reports

Our Lives is a new IRIN series following 20 people in 10 countries as they try to get by in these testing times. The men and women featured - from teachers to truck drivers - describe how they cope with the rising cost of living, and explain their hopes for the future. This series will be regularly updated.

Survivors

Bangladesh
[ http://www.irinnews.org/In-Depth/96869/98/ ] Samir Uddin – Street hawker
[ http://www.irinnews.org/In-Depth/96870/98/ ] Wliar Rahman – School teacher

Kenya
[ http://www.irinnews.org/In-Depth/96886/98/ ] Jane Njeri – Displaced person
[ http://www.irinnews.org/In-Depth/96908/98/ ] Millicent Wanyama – Breadcrumb seller

Lesotho
[ http://www.irinnews.org/In-Depth/96896/98/ ] ‘Mammuso Lebakeng – Crafts trader
[ http://www.irinnews.org/In-Depth/96692/98/ ] Moloantoa Mokhomphatha – Builder

Liberia
[ http://www.irinnews.org/In-Depth/96863/98/ ] John Tamba – Teacher
[ http://www.irinnews.org/In-Depth/96862/98/ ] Lorpu Kah – Single mum

Madagascar
[ http://www.irinnews.org/In-Depth/96857/98/ ] Liliana Lova Rahoaritsalamanirinarisoa – Trainee teacher
[ http://www.irinnews.org/In-Depth/96859/98/ ] Thierry Mafisy Miharivonjy Razafindranaivo – Cook

Mali
[ http://www.irinnews.org/In-Depth/96864/98/ ] Chaka Dagnoko – Mechanic
[ http://www.irinnews.org/In-Depth/96865/98/ ] Tembely Coulibaly – Restaurateur

Nepal
[ http://www.irinnews.org/In-Depth/96868/98/ ] Kumari Magar – Maid
[ http://www.irinnews.org/In-Depth/96871/98/ ] Manbahadur Tamang – Farmer

Pakistan
[ http://www.irinnews.org/In-Depth/96861/98/ ] Aslam Rehmat – Dental assistant
[ http://www.irinnews.org/In-Depth/96860/98/ ] Rashid Minhas – Driver

South Sudan
[ http://www.irinnews.org/In-Depth/96961/98/ ] Grace Taban Genova – Home-brewer
[ http://www.irinnews.org/In-Depth/96866/98/ ] Kenyi Chaplain Paul – Security guard

Yemen
[ http://www.irinnews.org/In-Depth/96855/98/ ] Adel Aklin – Teacher
[ http://www.irinnews.org/In-Depth/96856/98/ ] Ali Abdullah al-Moudai – Community liaison officer


IRIN Films – Food for thought

Cassava in Cote di”ivoire [ http://www.irinnews.org/film/4773/FOO/Food-Security/Cassava-in-C%C3%B4te-d-Ivoire ]
Wheat in India [ http://www.irinnews.org/film/4700/Wheat-in-India ]
Lentils in Nepal [ http://www.irinnews.org/film/4701/Lentils-in-Nepal ]
Rice in Madagascar [ http://www.irinnews.org/film/4769/Rice-in-Madagascar ]
Kenya’s Unga revolution [ http://www.irinnews.org/film/4882/Kenya-s-Unga-Revolution ]
A question of dignity [ http://www.irinnews.org/film/4757/A-Question-of-Dignity ]

]]></body><link>http://www.irinnews.org/Report/96695/BANGLADESH-KENYA-Our-Lives-A-survivors-apos-guide-to-hard-times</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2012/201212061756470519t.jpg"/></td><td valign="top">NAIROBI 06 December 2012 (IRIN) - Price Watch (Our lives)</td></tr></table>]]></content:encoded></item><item><title>NEPAL: Manbahadur Tamang – Farmer, Nepal</title><pubDate>Thu, 06 Dec 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2012/201210180712380025t.jpg" />]]>KOLPATA 06 December 2012 (IRIN) - Manbahadur Tamang’s family of six are subsistence farmers in Kolpata village, Sindupalchok District, 150km southeast of the Nepali capital Kathmandu. They lost this year’s entire maize crop to heavy monsoon rains in June, and now, for the first time ever, family members have been forced to look for work as day labourers. Two teenage sons have had to drop out of school.</description><body><![CDATA[KOLPATA 06 December 2012 (IRIN) - Manbahadur Tamang’s family of six are subsistence farmers in Kolpata village, Sindupalchok District, 150km southeast of the Nepali capital Kathmandu. They lost this year’s entire maize crop to heavy monsoon rains in June, and now, for the first time ever, family members have been forced to look for work as day labourers. Two teenage sons have had to drop out of school.

“Without cash, we can’t buy food and it’s expensive nowadays. We can’t borrow any money because the interest rates are too high and the government doesn’t provide any subsidies for farmers - even when we lose everything because of the weather.

“Over the last three months, we have managed to survive but the money is not enough to support all of us.

“If I went to Kathmandu I could find work, but then I would need to rent a place and spend even more money on food. 

“I don’t know how long I can do this at my age. It’s only getting worse. My health is not good. I only hope that life in this country doesn’t get any more expensive. Prices continue to go up and yet our incomes don’t change at all.” 

“The price of rice is almost double what it was five years ago. Now I fear food prices are going to rise still further. 

“Until now, we have managed to eat regular meals and we can still afford rice. However, the prognosis doesn’t look good.

“This year has already been bad. I can only pray that things improve for the better.” 

nn/ds/cb


Name: Manbahadur Tamang

Age: 40

Location: Kolpata village, Sindupalchok District, Nepal

Does your spouse/partner live with you? Yes

What is your primary job? Farmer

What is your monthly salary? I don’t receive a monthly salary. Every six months I earn US$600-800 from each harvest. 

What is your household’s total income - including your partner’s salary, and any additional sources? My wife helps in the farming and household chores. I don’t have any other additional income. 

How many people are living in your household - what is their relationship to you? Two teenage sons, two teenage daughters and a wife.

How many are dependent on you/your partner's income - what is their relationship to you? All five members of my family are dependent on me. 

How much do you spend each month on food? Well over $50

What is your main staple - how much does it cost each month? Rice and vegetables/$50.

How much do you spend on rent? I own my own home in the village. 

How much on transport? Around $20 per month 

How much do you spend on educating your children each month? $30

After you have paid all your bills each month, how much is left? Hardly anything 

Have you or any member of the household been forced to skip meals or reduce portion sizes in the last three months? Not yet, but likely if we run out of cash.

Have you been forced to borrow money (or food) in the last three months to cover basic household needs? Yes, from the local high-caste landlords at high interest rates.

-----------------------------
For more Survivor stories, please visit our In-Depth Our Lives [ http://www.irinnews.org/In-Depth/96695/98/ ]

]]></body><link>http://www.irinnews.org/Report/96871/NEPAL-Manbahadur-Tamang-Farmer-Nepal</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2012/201210180712380025t.jpg"/></td><td valign="top">KOLPATA 06 December 2012 (IRIN) - Manbahadur Tamang’s family of six are subsistence farmers in Kolpata village, Sindupalchok District, 150km southeast of the Nepali capital Kathmandu. They lost this year’s entire maize crop to heavy monsoon rains in June, and now, for the first time ever, family members have been forced to look for work as day labourers. Two teenage sons have had to drop out of school.</td></tr></table>]]></content:encoded></item><item><title>NEPAL: Kumari Magar – Maid, Nepal</title><pubDate>Thu, 06 Dec 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2012/201211081307200744t.jpg" />]]>KATHMANDU 06 December 2012 (IRIN) - Kumari Magar, 30, earns US$90 a month cleaning houses in the Nepalese capital, Kathmandu - barely enough to live on. She stays with her brother and sister, having moved from Dolalghat village, 100km northeast of Kathmandu, six years ago to escape the hard life of a subsistence farmer.</description><body><![CDATA[KATHMANDU 06 December 2012 (IRIN) - Kumari Magar, 30, earns US$90 a month cleaning houses in the Nepalese capital, Kathmandu - barely enough to live on. She stays with her brother and sister, having moved from Dolalghat village, 100km northeast of Kathmandu, six years ago to escape the hard life of a subsistence farmer.

“Coming to Kathmandu was a mistake. I can’t save a penny. At the end of each month there isn't anything left. Most of my money goes to food, while the rest goes to rent. My brother and sister face a similar fate.

“Over the past two years, food expenses on vegetables, milk and sugar have really increased. We started skipping milk and sugar and are now eating smaller portions of vegetables.

“Sometimes, I manage to save money when my employers have parties at home and I can take the leftovers back for siblings and myself. Sometimes this food can last several days.

“As a maid, we dream of working for European and American expatriates who pay a good salary of around $150 per month. Most of us aren’t that lucky, however.

“I’m better off this way [unmarried]. If I had children they would suffer. I see my sister’s suffering already. She works so hard to take care of her children and send them to school. Her husband abandoned them.

“I need to find more work. I can’t save anything and can’t even pay back the money I borrowed from my friends four months ago.

“My employer says they are going to increase my wage by 10 percent … [But] I’m completely dependent on the mercy of my employers who can easily fire me if they are unhappy. Perhaps they will find someone who will work for even less.”
 
nn/ds/cb
 
 
Name: Kumari Magar

Age: 30

Location: Kathmandu

Does your spouse/partner live with you? I’m single.

What is your primary job? Domestic worker.

What is your monthly salary? $50

What is your household’s total income - including your partner’s salary, and any additional sources? $90

How many people are living in your household - what is their relationship to you? Two - a brother and sister.

How many are dependent on you/your partner's income - what is their relationship to you? We depend on each other. My parents depend on them and each month we try to send them some money. 

How much do you spend each month on food? $25

What is your main staple – how much does it cost each month? Rice and vegetables/$25

How much do you spend on rent? $20

How much on transport? $30

How much do you spend on educating your children each month? I don’t have any children, but I try to give my sister money to help with hers. 

After you have paid all your bills each month, how much is left? Nothing.

Have you or any member of the household been forced to skip meals or reduce portion sizes in the last three months? Yes. Four months ago, when I was sick I couldn’t work and lost income. I didn’t have enough money for food.

Have you been forced to borrow money (or food) in the last three months to cover basic household needs? Yes, from friends. I have also requested advances on my salary from my employer.

-----------------------------
For more Survivor stories, please visit our In-Depth Our Lives [ http://www.irinnews.org/In-Depth/96695/98/ ]

]]></body><link>http://www.irinnews.org/Report/96868/NEPAL-Kumari-Magar-Maid-Nepal</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2012/201211081307200744t.jpg"/></td><td valign="top">KATHMANDU 06 December 2012 (IRIN) - Kumari Magar, 30, earns US$90 a month cleaning houses in the Nepalese capital, Kathmandu - barely enough to live on. She stays with her brother and sister, having moved from Dolalghat village, 100km northeast of Kathmandu, six years ago to escape the hard life of a subsistence farmer.</td></tr></table>]]></content:encoded></item><item><title>SRI LANKA: Learning from Nepal’s search for the missing</title><pubDate>Wed, 05 Dec 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2012/201212051521520585t.jpg" />]]>JALTHAL/KILINOCHICHI 05 December 2012 (IRIN) - Nepal and Sri Lanka share few similarities in their post-conflict experiences. The former has a peace deal, a government ministry overseeing post-war reconstruction, a national programme to trace missing persons and an NGO to advocate for their families - none of which exist in Sri Lanka. But the two do have something essential in common: grieving relatives of the missing who are now searching for answers.</description><body><![CDATA[JALTHAL/KILINOCHICHI 05 December 2012 (IRIN) - Nepal and Sri Lanka share few similarities in their post-conflict experiences. The former has a peace deal, a government ministry overseeing post-war reconstruction, a national programme to trace missing persons and an NGO to advocate for their families - none of which exist in Sri Lanka. But the two do have something essential in common: grieving relatives of the missing who are now searching for answers. 

In her village of Jalthal, 550km southeast of Nepal’s capital, Kathmandu, 35-year-old Reena Mecha had for years avoided talking about her husband’s 2004 disappearance during Nepal’s civil conflict. 

“At the beginning, there was no one to talk to, no one to understand what I was going through,” Mecha told IRIN. The 2006 peace agreement that ended the decade-long conflict did little to ease her burden. It was only in November 2011 that she found comfort after joining a support group for families of the missing, coordinated by Women’s Rehabilitation Centre (WOREC) [ http://www.worecnepal.org ], a local rights group. 

Some 1,500km away, in northern Sri Lanka, 23-year-old Maheswari has embarked on a similar journey. Her brother has been missing since May 2009, when the entire family fled Kilinochchi to escape fighting between government forces and separatist rebels from the Tamil ethnic group. Some 40,000 civilians died in the final months of fighting, according to the UN. 

She and her parents have since returned. “Life is hard, I am trying my best to look for him, but I don’t know where to start or whom to ask [for] information. There are thousands of others like me here [in the former war zone],” said Maheswari, who provided only her first name. 

Thousands missing 

There are thousands still unaccounted for in both these South Asian countries. In Nepal, the tracing unit of the Nepal Red Cross, which helps reunite family members by tracking down the missing, is trying to locate 1,401 missing persons. 

Sri Lankan government data from 2011 estimated 2,635 people in the country’s former conflict zone, Northern Province, are “untraceable” (missing) [ http://www.statistics.gov.lk/PopHouSat/VitalStatistics/EVE2011_FinalReport.pdf ]. Other estimates are much higher. 

The UN Office of the High Commissioner for Human Rights has recorded 5,671 reported cases of wartime-related disappearance, not counting people who went missing in Sri Lanka in the final stages of fighting from 2008 to 2009. At the end of 2011, the International Committee of the Red Cross (ICRC) Sri Lanka had compiled a database of 15,780 cases of missing persons, some of which dated back to 1990 [ http://www.icrc.org/eng/resources/documents/annual-report/icrc-annual-report-2011.htm ].

Mecha in Nepal had one piece of advice for those like Maheswari: It will be a grim and lonely search, and your only solace will be the company of others like you. 

Frustrated by lack of answers following his father’s disappearance in 2001, Ram Kumar Bhandari formed a regional group of missing families in the country’s west in December 2007. “Someone need[ed] to take the initiative and get the voice [of the families] heard and the trauma they undergo recognized,” Bhandari said. 

By 2009 the group became the National Network of Families of Disappeared and Missing (NEFAD) in Nepal and now counts more than 800 families among its membership. 

Aside from peer support and a forum for discussion, the activist said associations like NEFAD provide political leverage. “Politicians will listen to a collective voice,” he said. 

Tracing 

The Nepali Red Cross is tracing [ http://www.irinnews.org/Report/92203/HOW-TO-Trace-missing-persons ] those missing by conducting periodic interviews with their families. Red Cross staff follow up on new leads with government and other officials. 

By contrast, in Sri Lanka, there is no national tracing programme thus far, though a local government unit in the northern Vavuniya District carries out local searches. Piencia Charles, who was instrumental in setting up this Family Tracing Unit in December 2009 (but who no longer serves in the north), told IRIN she was responding to the women she encountered daily who cried in her office. The unit’s main task is to find children, though it receives complaints about missing adults as well. 

“One of their [families’] main expectations is [to find out] what happened to their loved ones, and after repeated [home visits from us and] no new information, they can get very emotional,” Shubhadra Devkota, a tracing officer with the Nepal Red Cross told IRIN. She said families frequently question whether to continue searching. 

Back in Kilinochchi, in Sri Lanka, a church-based counsellor who requested anonymity told IRIN that families of the missing were only now coming out to seek counsel. 

She said due to how contentious the issue of disappearances still is – the number of persons missing is disputed – there are few efforts to expand or institutionalize tracing. 

“There is a long way to go here. A very long way,” the counsellor concluded. 

ap/pt/rz 

]]></body><link>http://www.irinnews.org/Report/96975/SRI-LANKA-Learning-from-Nepal-s-search-for-the-missing</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2012/201212051521520585t.jpg"/></td><td valign="top">JALTHAL/KILINOCHICHI 05 December 2012 (IRIN) - Nepal and Sri Lanka share few similarities in their post-conflict experiences. The former has a peace deal, a government ministry overseeing post-war reconstruction, a national programme to trace missing persons and an NGO to advocate for their families - none of which exist in Sri Lanka. But the two do have something essential in common: grieving relatives of the missing who are now searching for answers.</td></tr></table>]]></content:encoded></item><item><title>NEPAL: Radio stations ill-prepared for earthquakes</title><pubDate>Fri, 26 Oct 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2009/200902039t.jpg" />]]>KATHMANDU 26 October 2012 (IRIN) - Radio stations in Nepal, critical sources of emergency information, are ill-prepared to withstand or operate in the event of an earthquake, experts warn.</description><body><![CDATA[KATHMANDU 26 October 2012 (IRIN) - Radio stations in Nepal, critical sources of emergency information, are ill-prepared to withstand or operate in the event of an earthquakes, experts warn.

"If there is an earthquake now, radio broadcasters would be vulnerable given that they are stationed in earthquake-vulnerable buildings,” Man Thapa, programme manager of the UN Development Programme’s comprehensive disaster risk management programme, told IRIN.

According to the Association of the Community Radio Broadcasters Nepal (ACORAB) [ http://www.acorab.org.np ], there are 350 radio stations across the Himalayan nation, with 36 in the capital Kathmandu alone, a city located in one of the most seismically active zones in the world.

The majority in buildings [ http://www.irinnews.org/Report/81964/NEPAL-Kathmandu-hospitals-could-collapse-in-an-earthquake-experts ] are not earthquake resistant. 
Although there have been no specific studies on radio stations’ structural vulnerabilities, most experts agree that the situation is fragile.

Preparedness

With over 44 percent of the population illiterate, according to government’s Nepali Living Standards Survey (2010-2011), radio remains the most powerful information medium for the majority of Nepal’s 29 million inhabitants.

“The role of radio becomes crucial because during an earthquake, people want information first more than anything, and they look to the radio as the best means of communication,” said Ganesh Kumar Jimee, programe manager of disaster preparedness and response for the National Society for Earthquake Technology-Nepal (NSET) [ http://www.nset.org.np ], a local NGO.

Over 90 percent of the population owns a radio set and tunes into the radio stations across the country, according to a 2012 study (not available online) by Ujyaalo 90 Network [ http://ujyaaloonline.com ].

Ujyaalo has the largest community radio network, with an audience of half million in the capital and 15 million across the country. It’s also the only radio station located in an earthquake-resistant building, and it is planning a series of earthquake preparedness trainings for its reporters. 

“Very few radio stations will perhaps withstand an earthquake of a large scale. We are worried about them as most don’t even have back-up plans in case of damage to their own infrastructure,” Ujyaalo head Gopal Guragain noted. 

There is urgent need for contingency planning, such as finding alternatives locations to immediately operate radio broadcasts in case of damages to the main station, he explained. 

“Although our building may not be 100 percent earthquake-proof, our back-up plan helps us to immediately revive our broadcast in case of serious damage.” 

In the event of a major earthquake, plans are now in place to use their basement and ground floor, where a back-up transmitter and antennae have been installed and a diesel-powered generator is on standby. 

Other broadcasters have yet to implement such planning, according to ACORAB. 

“There are lots of possibilities, but nothing has been initiated by most radio stations, especially on how to keep their equipment secure and [how to ensure] the safety of their own reporters,” said ACORAB executive director Rabindra Bhattarai. 

Challenges 

While much needs to be done, Bhattarai concedes most stations don’t have the resources to implement any changes. 

Moreover, journalists have yet to be properly trained in how to report in a post-earthquake environment. 

Following a magnitude 6.9 earthquake that struck northeastern India, Nepal and Tibet in September 2011, fear mongering was a major problem. Rumours quickly spread that the quake was simply a prelude to a much larger seismic event like the one predicted for the country’s densely populated Kathmandu Valley 

In Kathmandu, 270km west of the quake's epicentre, buildings were evacuated and traffic came to a standstill. 

“At the time, broadcasters could have played a very important role in calming people with a radio message that this was only a rumour spread across social networking websites and through SMS,” he said, describing the incident as a major wake-up call for radio stations to be better prepared. 

NSET hopes that radio stations will start their own preparedness and contingency plans and that they will work together to develop their own standard operating procedures about messages to be delivered in pre- and post-earthquake situations. 

Currently, a total of 20 radio stations are broadcasting public service announcements 10 times a day, with support from NSET, about earthquake safety tips and preparedness. 

“If the system doesn’t survive, how will radio broadcasters serve the community during an earthquake disaster? This is something they have to think about very seriously,” Pitamber Aryal, director of the Nepal Red Cross Society [ http://www.nrcs.org.np ] disaster department said. 

According to the NRCS, an earthquake measuring 7 to 8 on the Richter scale in Nepal’s Kandmandu Valley could kill up to 50,000 people, injure 100,000 and destroy 60 percent of buildings, leaving 900,000 homeless. 

nn/ds/rz

]]></body><link>http://www.irinnews.org/Report/96639/NEPAL-Radio-stations-ill-prepared-for-earthquakes</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2009/200902039t.jpg"/></td><td valign="top">KATHMANDU 26 October 2012 (IRIN) - Radio stations in Nepal, critical sources of emergency information, are ill-prepared to withstand or operate in the event of an earthquake, experts warn.</td></tr></table>]]></content:encoded></item><item><title>NEPAL: Government hobbles human rights commission</title><pubDate>Thu, 18 Oct 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2012/201206281331180868t.jpg" />]]>KATHMANDU 18 October 2012 (IRIN) - Mismanagement of Nepal’s National Human Rights Commission’s (NHRC) and its lack of independence, as well as frequent changes of government and an ongoing constitutional stalemate, have weakened the group’s ability to pursue war-era crimes, say officials and activists.</description><body><![CDATA[KATHMANDU 18 October 2012 (IRIN) - Mismanagement of Nepal’s National Human Rights Commission’s (NHRC) and its lack of independence, as well as frequent changes of government and an ongoing constitutional stalemate, have weakened the group’s ability to pursue war-era crimes, say officials and activists. 

Almost 18,000 civilians died during a civil conflict between Maoist separatists and the government from 1996-2006, but so far no one has been prosecuted for war crimes. 

Established in 2000, one of the NHRC’s mandates is to make recommendations about war-time reparations to the government. Its status was upgraded in 2007 from a statutory body to a constitutional body under the 2007 interim constitution, which is the country’s only constitution since parliament recently failed to agree on a new, permanent one.  

Commissioners are appointed by a government council that includes the prime minister, the courts’ chief justice, the speaker of parliament and a main opposition leader. 

The Comprehensive Peace Agreement signed by the government and Maoist rebels in 2006, which officially ended armed conflict, pledged to form a truth and reconciliation commission (TRC) - seen by successive governments as a precursor to pursuing war crime prosecutions - within 60 days. Officials and activists are still waiting. 

“We have worked with five prime ministers over the last six years but none of them did anything to enforce legal action against perpetrators or showed interest to form TRC,” said senior NHRC official and commissioner Gauri Pradhan. 

Lack of independence 

According to the NHRC’s website, it is autonomous from the executive branch and has adequate powers of investigation, but activists and donors have decried the National Human Rights Commission Act [ http://www.nhrcnepal.org/nhrc_new/doc/newsletter/NHRC%20ACT,%202068_Unofficial%20Translation.pdf ], which was quietly passed in March 2012 without public consultation. 

The US-based Asia Foundation, until recently an NHRC donor, calls the act a “blow” to human rights which puts the commission’s financial control in the hands of the government. 

All expenses must be approved by the government, all checks will be issued by the government and the NHRC cannot alter the budget without government approval. 

“[NHRC] cannot function as an autonomous body by depending on government… financial support and annual grants,” said Rameshwar Nepal, the director of Amnesty International’s office in Nepal. 

Asia Foundation provided NHRC nearly US$100,000 in 2012 but NHRC recently returned $70,000. NHRC sources told IRIN internal feuding, including exchanges of corruption allegations, prevented commissioners from implementing programmes. Most of the unspent funds were designated for rapid response to ongoing conflict surrounding the constitution-making process [ http://www.irinnews.org/Report/95761/Analysis-Humanitarian-fallout-from-Nepal-apos-s-constitutional-stalemate ].

Inter-communal violence, for example, erupted in May during negotiations over the new constitution: Dozens were injured in the country's Far West region when supporters and opponents of proposed federal states created along ethnic lines clashed, according to local media. 

“NHRC is an important institution that deserves and requires as much support as possible. That being said, certain conditions within NHRC need to improve,” said Asia Foundation’s programme officer in Nepal, Diane Fernandez. 

Backlog 

NHRC commissioner Pradhan said things are improving, albeit slowly. “When our new team of commissioners arrived here in 2007, there were 10,000 backlog cases and we have now [conducted] 6,000 investigations.” 

The response rate by the government to NHRC’s recommendations - mostly those regarding reparations - has increased from 40 to almost 80 percent over the past five years, he said. What remains unheeded are proposals to prosecute Maoist and state security forces accused of gross human rights violations. 

Based on NHRC’s recommendations, the government has distributed more than $12 million in reparations to more than 1,000 victims (and/or their families) of torture - the exact number is still being calculated - enforced disappearances and execution. It took on average of at least two years per file claimed due to “complications” said Pradhan. 

The compensation awarded was some $4,000 for executions, $1,500 for enforced disappearances and $350 for torture, depending on circumstances, the commissioner added. 

But the process did not go far or fast enough, said Devi Sunuwar, whose daughter, Maina, was allegedly tortured and killed by army personnel in 2004 on suspicion of being a Maoist supporter. It took Sunuwar six years, after filing her claim, to receive $1,500. 

“There is no rule of law in this country… Criminals are protected and victims are shunned.” 

nn/pt/cb 

]]></body><link>http://www.irinnews.org/Report/96579/NEPAL-Government-hobbles-human-rights-commission</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2012/201206281331180868t.jpg"/></td><td valign="top">KATHMANDU 18 October 2012 (IRIN) - Mismanagement of Nepal’s National Human Rights Commission’s (NHRC) and its lack of independence, as well as frequent changes of government and an ongoing constitutional stalemate, have weakened the group’s ability to pursue war-era crimes, say officials and activists.</td></tr></table>]]></content:encoded></item><item><title>In Brief: Southeast Asia wasting too much food</title><pubDate>Tue, 09 Oct 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2010/201006290857510468t.jpg" />]]>BANGKOK 09 October 2012 (IRIN) - Food losses in Asia due to disasters or poor storage, packing and delivery are set to worsen, and governments are ill-prepared to stem the wastage, according experts recently convened by the Centre for Non-Traditional Security Studies in Singapore.</description><body><![CDATA[BANGKOK 09 October 2012 (IRIN) - Food losses in Asia due to disasters or poor storage, packing and delivery are set to worsen, and governments are ill-prepared to stem the wastage, according experts recently convened by the Centre for Non-Traditional Security Studies in Singapore. 

Possible solutions include redistributing edible wasted food to people; turning it into energy and agriculture inputs; and developing new technology to separate food waste from other rubbish. Policymakers need to take a “total supply chain approach” or else risk breaking Southeast Asia’s fragile food system, said the experts. 

“It is likely that the region wastes approximately 33 percent of food, but accurate estimates are not available due to a dearth of quantitative information.” 

Increasing urbanization means food will tend to travel farther, something that could exacerbate the food waste problem. Governments need to better fund the tracking of food waste (especially fish, vegetables and rice), they said. 

rg/pt/cb



]]></body><link>http://www.irinnews.org/Report/96485/In-Brief-Southeast-Asia-wasting-too-much-food</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2010/201006290857510468t.jpg"/></td><td valign="top">BANGKOK 09 October 2012 (IRIN) - Food losses in Asia due to disasters or poor storage, packing and delivery are set to worsen, and governments are ill-prepared to stem the wastage, according experts recently convened by the Centre for Non-Traditional Security Studies in Singapore.</td></tr></table>]]></content:encoded></item><item><title>CLIMATE CHANGE: Human Rights Watch’s Jan Egeland calls for faster progress</title><pubDate>Tue, 09 Oct 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/20069127t.jpg" />]]>BANGKOK 09 October 2012 (IRIN) - On the sidelines of a recent presentation he made in Bangkok on disaster prevention and preparedness, IRIN spoke to Jan Egeland, deputy director of Human Rights Watch, about progress on the Global Framework for Climate Services (GFCS).</description><body><![CDATA[BANGKOK 09 October 2012 (IRIN) - On the sidelines of a recent presentation [ http://www.adpc.net/2012/ ] he made in Bangkok on disaster prevention and preparedness, IRIN spoke to Jan Egeland, deputy director of Human Rights Watch, about progress on the Global Framework for Climate Services (GFCS). 

Spearheaded by the World Meteorological Organization [ http://www.wmo.int/hlt-gfcs/ ] and based on research from an expert group Egeland chaired in 2009, GFCS aims to increase and improve interactions between experts who interpret, gather and purvey climate-related information (climate service providers) and the people who use it. 

Q: How far has GFCS come in making climate information accessible for the average small farmer? 

A: The main problem of global climate services today is that it doesn’t reach the last mile to those who need it the most. So, typically, the farmer who needs to know when to sow or when to harvest in an unpredictable climate doesn’t really get that… More often he doesn’t get the information if he is in a poor and developing country, nor does the doctor who would need to know when malaria will [be] affected by rainfall, or meningitis [by] the course of the wind. 

It is also mixed how far the countries come in disaster… There is a big difference from even Vietnam to Cambodia to Nepal in that matter. Some countries are making big headway like China, India, Vietnam and Thailand… But it’s too slow. I am frustrated… We are not making faster progress. Science has come so far and there is so much you can predict now. 

Q: What are the chief obstacles to linking climate change adaptation and disaster risk management for sustainable poverty reduction? 

A: Clearly the explosive growth in the number of natural disasters [ http://www.irinnews.org/Theme/NAT/Natural-Disasters ] is one of the biggest obstacles in poverty reduction. We have seen an increase of natural disasters from around a 100 in [the] 1960s to nearly 500 per year in this decade, so it is [a] four- nearly five-fold increase... It means devastation of some of the poorest countries. It means massive displacement of people. 

Q: In addition to climate services, what else is still needed to prepare people to adapt to climate variability? 

A: We need to curb climate change. Many believe we are in the same boat, [that] we are equally hit by climate change, which is not true… Norway is not going to get hit by climate change for some time. But if you go to Sahel, go to the coast of Southeast Asia and you see… It’s the number of disasters that has increased dramatically... Monsoons and typhoons have grown tremendously. 

In Vietnam, they are talking about one metre of sea rise, which would be a complete disaster for the whole Mekong Delta. So we need to curb climate change, and here it is just horrendous to see that it is not happening… In [climate change] adaptation we could be able to do more… Quite a bit is happening... Science is making big progress but not reaching the final point and that’s a big challenge. 

rg/pt/cb

]]></body><link>http://www.irinnews.org/Report/96495/CLIMATE-CHANGE-Human-Rights-Watch-s-Jan-Egeland-calls-for-faster-progress</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/20069127t.jpg"/></td><td valign="top">BANGKOK 09 October 2012 (IRIN) - On the sidelines of a recent presentation he made in Bangkok on disaster prevention and preparedness, IRIN spoke to Jan Egeland, deputy director of Human Rights Watch, about progress on the Global Framework for Climate Services (GFCS).</td></tr></table>]]></content:encoded></item><item><title>NEPAL: Key role for female health volunteers</title><pubDate>Fri, 05 Oct 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2012/201210050911350321t.jpg" />]]>DALEIKH/KATHMANDU 05 October 2012 (IRIN) - Women working as female healthcare volunteers often provide a vital service for the poorest in mountainous Nepal, and have contributed to a steady improvement in maternal and neonatal survival rates.</description><body><![CDATA[DALEIKH/KATHMANDU 05 October 2012 (IRIN) - Women working as female healthcare volunteers often provide a vital service for the poorest in mountainous Nepal, and have contributed to a steady improvement in maternal and neonatal survival rates. 

“Without their volunteer spirit, the country’s poorest would probably face an even worse health situation,” community health activist Deepa Bohara told IRIN in Rakam Karnali village, Dailekh District, 600km northwest of Kathmandu. 

Female community health volunteers (FCHVs) operate in remote areas where there are no doctors or medical workers; there are 810 of them in Dailekh District, and 52,000 nationwide. 

Dailekh Hospital, the region’s main government health centre, often relies on information provided by FCHVs who help record and collect data on women’s and children’s health. 

“They are often seen as doctors in the remote villages… They are… constantly in touch with the poorest women who often have difficulty making long journeys to the hospitals,” hospital director Jung Shah told IRIN. 

While FCHVs cannot handle medical complications, “they play a key role in making referrals and persuading the pregnant and young mothers to visit health centres, as well as providing basic information about child care, and that makes a huge difference,” said Shah. 

FCHVs also help collect funds from local communities to enable the sick to reach hospital. 

Progress on maternal mortality 

Nepal is one of 10 developing countries to have slashed its maternal mortality ratio (MMR) by at least 75 percent between 1990 and 2010 [ http://whqlibdoc.who.int/publications/2012/9789241503631_eng.pdf ]. An estimated 170 women died in 2010 for every 100,000 live births. The estimate ranges from 100 to 290 deaths. In 1990, the estimated MMR was 770 deaths per 100,000 live births. Many believe the FCHVs are playing a key role in this. 

“It’s difficult to say accurately what percentage of lives they are saving but we are confident that without the FCHVs, the maternal health and child health [situation] would have been worse,” said family planning officer Ram Krishna Phuyal, from the Department of Education, where he oversees the FCHV programme within Kathmandu District. 

According to the country’s most recent (2011) Demographic Health Survey [ http://sgdatabase.unwomen.org/uploads/DHS%20-%202011.pdf ], the proportion of babies attended by skilled providers nearly doubled between 2006 and 2011, from 19 percent to 36 percent, while the proportion of babies delivered in a health facility increased from 18 to 28 percent during the same period. 

Under the Millennium Development Goal programme, Nepal is aiming to ensure that 60 percent of women giving birth have trained birth attendants by 2015. 

Respect 

The FCHV programme was launched in 1988 in 19 districts in the mid-west (Nepal’s poorest region), with the purpose of improving maternal and neonatal care, according to the Health Ministry. 

More than half of the volunteers have been working for more than a decade. Despite being regarded as key to the state’s public health programme, the government provides them with virtually no support. 

“I have given up expecting any benefits from the government, but it is our commitment to our communities that keeps us motivated and energetic,” said 35-year-old FCHV Sitala Majhi, in Rakam Karnali village. 

Majhi finished 10 years of schooling a decade ago, but could not find paid employment. She started visiting local households, especially those with new mothers and young children, to discuss ways of preventing diarrhoea and other diseases. “During the monsoon and summer, more children and women get sick as most of them suffer from diarrhoea. It is my job to provide necessary information on sanitation and necessary medicines,” said Majhi. 

Health Ministry officials in Kathmandu say they are trying their best to earmark more resources for FCHVs, but face budgetary constraints. 

FCHVs receive about four health training sessions per year, when they are paid US$3 towards transport costs, and $50 for a uniform. 

FCHVs say community respect, and freedom to get out of the house, helps motivate them. “It is a pride to be an FCHV because everywhere I go the local community gives me the respect that I never had. I think none of us want to miss [out on] that,” said Durga Joshi, 68, who has been an FCHV for 15 years in Nakhu just outside Kathmandu. 

nn/pt/cb 

]]></body><link>http://www.irinnews.org/Report/96462/NEPAL-Key-role-for-female-health-volunteers</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2012/201210050911350321t.jpg"/></td><td valign="top">DALEIKH/KATHMANDU 05 October 2012 (IRIN) - Women working as female healthcare volunteers often provide a vital service for the poorest in mountainous Nepal, and have contributed to a steady improvement in maternal and neonatal survival rates.</td></tr></table>]]></content:encoded></item></channel></rss>