Effects of Poverty

& Conflict on the

Children of Nepal

Noelle Tankard
Situational Report
for Current Debates in Bio Anth
• Rural poverty • Malnutrition • Growth
• Urbanization stunting
• Caste system • Inadequate Education • Early
• Population & Medical Care Mortality
growth • Disease
• Civil War • Mental
• Migration health &
substance
abuse
 • Least developed
country (142 of
177 on UN’s HDI)
• High degree of
inequality (most
stratified in Asia by
Gini coefficient:
lowest quintile
with 6%, highest
with 55%)

• Population: 25 mil
• 90% of population lives in rural areas
• 31% of population under poverty line (some rural regions above 60%)
• 40% of population lives on less than $1 per day
• Life expectancy = 63 yrs
(Kohler 2009)
 Culture & background
• Caste system, patriarchal
• Social exclusion of Dalit (low caste), ethnic
minorities, and women

• 80% Hindu
• Significant Buddhist presence
• Muslim minority

• Large amount of ethnic diversity

• Open border with India

• Skilled workers from India,
• Unskilled laborers to India
• Migration & cultural flow with Burma, Tibet
• Ownership of land important for status and
income
– Previously, necessary for citizenship and
many still believe it to be so
– Over 80% of households depend on
agricultural income
– Land rarely sold, transferred intra-family
(generally, inheritance)
– Women rarely inherit land but increasing
feminization of farming
 Children’s Health
• 12.5 mil children 2001
• 3.5 mil under 5yrs
• 50% of population under 18 yrs
• 1.7 mil child laborers
• 69% of children experience more than 1
form of severe deprivation from basic
needs
• 50% of children “stunted”
• 13% of children “wasted”
• 66% of children have parasitic infections
(half infected with more than one type)
• Infant mortality: 6.4%
• Maternal mortality: 5.4%
• Under-5 yrs mortality: 6.8%
• 70,000 children die p/yr from
preventable disease
Excluded groups, Govt list 2008

• Women
• Dalits (low caste)
• Janjatis (foreigners)
• Muslims
• Inhabitants of remote regions
• Street children & orphans
• Displaced
 The growing gap…
• Poorest regions: poverty 20% higher than
capital
• Infant mortality for Dalits 1.5x national avg
• Dalit children 1.6x less likely to attend
school
• Significant progress: incident of absolute
poverty, girls’ education, disease, child
mortality and disease
– In 2008, One of only 5 countries to
reduce child mortality since 1990
– Separate values by social and regional
groups, find the excluded groups
worse than before
 Political conflict
• 1959: “democratic” constitution adopted
but not realized

• Maoists call for democratic republic,

abolition of monarchy
• Govt response violent and severe

• Ongoing conflict between Maoists and

Government 1996 – 2006
• Maoists target schools, abducting &
conscripting children
• Royal Army also uses child soldiers
• Frequent blockades, transport
disrupted

• 2008: Nepal becomes a republic

 Infrastructure: Schools & Hospitals
• Constant blockades
• Schools targeted: attacked, used as
barracks, mass abductions of
children
• More than 100,000 children deprived
of education as more than 300 schills
shut down
• Both sides targeted hospitals
• Govt declared all health workers
performing outside of hospital
“terrorists”
• Foreign doctors deported
 Child soldiers
• Both Maoists and Royal • Study by Kohrt 2001
Army conscripted • More than 50% recruited before 14
– Soldiers, sentries, • More than 50% in combat
porters, cooks, • Depression, anxiety, PTSD
messengers
• Compared to non-conscripted
• Rehabilitation programs children, more above cut-off
(NGO) for those affiliated points: except anxiety
with Maoists – Royal Army
afraid to come forward • Studies investigating found
girls much higher rates of
issues
• Did not ask about rape
• Many identified as “still
associated” – had better mental
health scores
 Homelessness & Drugs
• Homeless vs Urban Squatters
• 5,000 homeless in Kathmandu
Rai 2002 • Homeless boys show better health than
rural village boys
• Lower rates of infection
• Better nutrition
• BUT more anxiety, depression
• Boys remain in contact with families,
return often
• 25-95% of street children use drugs
• 10% addicted
• Heroin and cheap substitutes
• Glue sniffing very common & very dangerous: long term health effects, violent
mood swings
• Spread to wealthy school girls
Child Labour
• Very common
• National law prohibiting
under-15, openly
flaunted
– 1995, 41.7% of
children 5-15
working regularly
– 55% of working
children girls
• New govt signed intl
treaty for under-18
 Girls
• Women have an “inclusion” score of
39% (compared to men at 60%)
• Young marriage
• 79.4 % of Dalit women married
before 18 (52% of high caste
women)
• Dowry system
• Rarely educated – daughters kept home
or sent to work outside of the home
• Suggestion that increase in wages
and opportunities for girls to work
would improve their quality of life
at home
• Taken to India, Saudi
Child Trafficking
Arabia, UAE, Hong • “Sex work”
Kong
• Domestic work
• lured by marriage Those who
offer or decent work manage to • Circuses
• Sold by family member return: PTSD,
Depression,
anxiety

Rarely accepted back by

family: even suspicion
Health issues:
brings great shame to
India 2nd community, ineligible for
largest AIDS marriage. (Some success
epidemic with NGO programs –
vocational training, slow
reintroductions)
• 5-7,000 girls taken to
Indian brothels each
year
 Displaced Persons

• Majority emigrated internationally (India)

• Many IDP (internally displaced persons)
• 80 - 100,000 moved to Kathmandu
• Accurate figures unavailable
• 2009, Nepali govt estimated 70,425 had
been displaced and majority returned
home
• Various NGOs estimate 50-70,000 IDP
still unable to return home
• Many IDP cut off from govt assistance

• Human Rights Watch estimates 40,000

additional, uncounted, displaced children
Development strategies
 Bibliography
Allendorf, K. (2007) So Women's Land Rights Promote Empowerment and Child Health in Nepal?, World Development 35: 1975-1988
Costello, A. M. (1989) Growth velocity and stunting in rural Nepal. Archives of Disease in Childhood, 64: 1478-1482.
Crawford, M. & M. R. Kaufman (2008) Sex trafficking in Nepal: survivor characteristics and long-term outcomes. Violence against women, 14: 905-916
Dawson, P. et al (2008) From research to national expansion 20 years' experience of community-based management of childhood pneumonia in Nepal, Bulletin of World
Health Organization 86: 339-343
Do, Q. and L. Iyer (2007) Poverty, Social Divisions, and Conflict in Nepal, Cambridge: Weatherhead Center for International Affairs, Harvard University. [Accessed 27/11/2010]
<http://dev.wcfia.harvard.edu/sites/default/files/2007_2_iyer.pdf>
Ghosh, A. et al (2009) Prevalence of undernutrition in Nepalese children, Annals of Human Biology 36: 38-45
Grantham-McGregor, S. et al (2007) Development potential in the first 5 years for children in developing countries, The Lancet 369: 60-70
Graner, E. (2001) Labor Markets and Migration in Nepal, Mountain Research and Development 21: 253-259
Huda, S. (2006) Sex trafficking in South Asia, International Journal of Gynaecology and Obstetrics 94: 374-381
Insight on Conflict [online] (2010) [Accessed 27/11/2010] <http://www.insightonconflict.org>
Internal Displacement Monitoring Centre, Norwegian Refugee Council [online] (2010) [Accessed 27/11/2010]. <http://www.internal-displacement.org>
Johnson, V. (2010) Are children's perspectives valued in changing contexts? Revisiting a rights-based evaluation in Nepal, Journal of International Development 22: 1076-1089
Jutkowitz, J. et al (1997) Drug Use in Nepal: The View from the Street, Substance Use & Misuse 32: 987-1004
Kohler, G. et al (2009) Rethinking Poverty and Social Exclusion Responses in Post-Conflict Nepal: Child Sensitive Social Protection, Children Youth and Environments 19:229-
249
Kohrt, B. et al (2009) Culture in psychiatric epidemiology: Using ethnography and multiple mediator models to assess the relationship of caste with depression and anxiety in
Nepal, Annals of Human Biology 36: 261-280
Kohrt, B. et al (2008) Comparison of Mental Health Between Former Child Soldiers and Children Never Conscripted by Armed Groups in Nepal, Journal of the American
Medical Association 300: 691-703
Koolwal, G. (2007) Son Preference and Child Labor in Nepal: The Household Impact of Sending Girls to Work, World Development 35: 881-903
Macours, K. (2010) Increasing inequality and civil conflict in Nepal, Oxford Economic Papers
Macours, K. (2006) Relative Deprivation and Civil Conflict in Nepal, Working Paper
Morrison, J. et al (2008) Utilization and management of maternal and child health funds in rural Nepal, Community Development Journal 45: 75-89
Pramod Singh, G. C. et al (2009) Factors Associated With Underweight and Stunting Among Children in Rural Terai of Eastern Nepal, Asia-Pacific Journal of Public Health 21:
144-152
Rai, A. et al (2002) Glue Sniffing: Among Street Children in the Kathmandu Valley, Kathmandu: Child Workers in Nepal. [Accessed 27/11/2010]
<http://img4.custompublish.com/getfile.php/436360.994.xqtpbawtrs/Glue sniffing.pdf?return=forut.custompublish.com>.
Singh, S. et al (2006) The state of child health and human rights in Nepal, PLOS Medicine 3: 948-952
Subedi, B. (1991) International Migration in Nepal: Towards an analytical framework, Contributions to Nepalese Studies 18: 83-102
Tsutsumi, A. et al (2008) Mental health of female survivors of human trafficking in Nepal, Social Science and Medicine 66: 1841-1847
Weiner, M. (1973) The Political Demography of Nepal, Asian Survey 13: 617-630
Worthman, C. and C. Panter-Brick (2008) Homeless street children in Nepal: Use allostatic load to assess the burden of childhood adversity, Development and
Psychopathology 20: 233-255