Maternal health and rural development in Nepal

GHORAHI, Nepal — Asmani Chaudhary grew up dirt poor in a village in Nepal’s Terai region, which runs along the border with India. A member of a long-disadvantaged Nepali community called Tharu, Chaudhary was raised in a mud hut that housed her entire 30-member extended family.

Now, at age 37, Chaudhary walks around the office of the organization she founded with a sense of confidence and pride. She points out the framed photographs and letters hanging on her wall: one shows her with UN Secretary General Ban Ki-moon, another is a letter from U.S. Senator Chuck Schumer thanking her for her hard work.

The photographs and letter are from when the Americans for the United Nations Population Fund recognized Chaudhary as a “2008 International Honoree for the Health and Dignity of Women.” The award honored Chaudhary’s community-based efforts to improve the health and well-being of some of Nepal’s poorest women.

Chaudhary was close to spending the rest of her life as one of those women. She was born and raised on the small lane outside her office in Ghorahi in Dang district. She took me on a walk down the road this afternoon, explaining that much remains the same for these people three decades later. The villagers living there, all from the Tharu community, are still dirt poor. She pointed out the tiny, one-room mud homes with thatch roofs as kids played in the street and roosters wandered over the grass. The people of this area continue to be disadvantaged and uneducated, she said.

When Chaudhary was a child, Tharus typically only sent one of their many children to school as the rest were needed to farm and help in the house. Most families sent their son to school. But Chaudhary got lucky – her brother was too young, and her parents therefore chose her. They sent Chaudhary to the nearby government primary school and kept her four sisters and little brother home.

Chaudhary, a slender woman with long brown hair that she wears in a braid that almost reaches her waist, finished not only primary and secondary school but also went on to university. Her sisters, who stayed home farming, were illiterate. Like most uneducated Nepali women, they got married by the time they were 16 or 17 and started having children. Chaudhary did not marry until she was a few years older and waited until she was 24 to have the first of her (only) two children.

After university, Chaudhary decided she wanted to help the women of her community and formed the Rural Women Development Centre in 1993. It now has six branches and focuses on providing rural women empowerment and employment opportunities, health education and social awareness. 

Chaudhary has also worked to bring attention to and treatment for women affected by uterine prolapse, a maternal health condition common in Nepal. Chaudhary visited a village where she met two women who had suffered from the condition; their uteri had shifted from its normal position and gradually extended outside of the body. The women tried to solve the problem by putting their own bangles inside their vaginas to hold their uteri in place. Chaudhary brought a team of doctors to the area to provide the women with safe medical treatment in the form of a ring pessary inserted into their vaginas.

Chaudhary says that she has seen a lot of improvements in Dang since she was a child, but a lot more needs to be done for marginalized and uneducated groups like the Tharu.

Addressing the health needs of Nepal’s disadvantaged, poor communities is now one of the primary objectives of President Obama’s Global Health Initiative in Nepal, USAID staff told me this week. Tomorrow, I will visit some of these villages in Dang district to learn more about their needs and see how GHI is addressing them.

Follow Hanna’s trip to Nepal on Twitter: @Hanna_India