The government has developed a long-term health plan (1997-2017) to reduce maternal mortality and promote safer maternal health in the country. The state has also made several similar international commitments. Although the country has made great strides in reducing maternal mortality in recent years, there is still a long way to go. In Nepal, on average, a young mother dies every four hours and a newborn baby every 20 minutes mainly due to the lack of health facilities and the unaffordable cost of treatment. Women in Nepal are 30 times more likely to die during childbirth than their peers in the UK. The lack of health facilities is an important reason behind this, but local traditions also play a major role.

Unkind custom

In rural Nepal, including communities in Mugu district where we conducted our research, people still practise the rigid custom of housing new mothers in filthy cowsheds, as women are considered ‘nachhune’ (untouchable) for a period of 10 days after childbirth. No bedding and mats are allowed where they are kept. So the women are forced to use old rags, jute bags and straw as their bed and blanket.

During this period, the women are not allowed to enter the ‘house’, and no one from the family (or the community) is allowed to touch her. ‘House’ is understood to mean ‘all the rooms of the residence except the ground floor where the cattle are kept. In the local tradition, women are considered untouchable even during their periods and they have to follow similar rituals.

Violating the tradition means incurring the wrath of deities and inviting trouble into the household. The consequences can be anything from illness of a family member or cattle, disease to the plants the women touch or disasters like road accidents. A woman becomes ‘chokho’ or clean only after bathing with ash and sprinkled with ‘sun-pani’—water in which a gold ornament is dipped—by another person at the end of the marked period.

Education and awareness programmes have helped get rid of the tradition to some extent, particularly among younger people. But even in cases where the younger generation resist the system, older family members do not accept their ‘modern’ ideas. The older generation are rigid about continuing with their conventional practice.

The consequence of this tradition is disastrous for women and newborn babies. Many girls and women undergo mental and physical trauma when they are made to live with animals right after childbirth. Such practice contributes to high maternal and child mortality rates due to infections, insect bites and other complications as their surroundings are extremely unhygienic. Almost all mothers suffer from chronic infection and reproductive health problems. Newly born children, fortunate enough to survive, suffer from pneumonia or are otherwise infected.

Moreover, many girls in rural areas get married in their early teens and get pregnant soon after. They are not properly aware about pregnancy and motherhood, let alone healthcare that they should get.

Raising awareness

The government is doing what it can to provide health services in the rural areas. However, apart from district health posts, there are not enough quality birthing centres in these areas. For instance, the district hospital in Mugu does not have a doctor in case a woman needs a caesarean surgery. The only available option is to fly the women to Nepalgunj or Surkhet, which most of them cannot afford.

Some NGOs and INGOs have built safer maternity health centres for the women in rural areas. One mother, Banchu BK was very happy to have her child delivered in a clean room of a birthing centre. She said; “My first child would have not died if I had such safer delivery. I am very happy to give birth to my second child in the birthing centre”. Banchu was only 15 when she gave birth to her first child, who sadly could not survive.

Due to geographical difficulties, urban centric development policy of the state, illiteracy among the people and absence of birthing centres in rural areas, pregnant women in far-flung corners of the country are facing great problems. Many are forced to live like animals due to irrational traditions that society stubbornly holds on to. Government and non-government organisations have to reach out to villagers in distant areas that are yet to benefit from development interventions and make them aware of their irrational practices.

Devkota holds an MPhil in Development Studies from Kathmandu University; Dhakal is a Development and Education scholar at Career Point University, Rajasthan