Showing posts from category India.
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GMHC 2010: Maternal Health Realities: Accountability and Behavior Change
›Four days ago a young woman died giving birth in a bustling marketplace in New Delhi. Just steps away from Parliament, this woman was left to die and no emergency care was sent to her – no midwives, nurses, or doctors; just people walking around her accepting the situation as normal and an uncontrollable way of life. But this is Delhi…not a remote tribal village where the nearest health clinic is hours away (on foot).
This juxtaposition lingers on in me as I sit in the plenary session of day two at the Global Maternal Health Conference and listen to Syeda Hameed, member of the Indian Parliament Planning Commission, discuss her recent visit to a remote village where every house has 10 children living in filth, flies, and emptiness.
Although I have been working on such development issues for the last five years I do not work in the field, nor do I visit the developing world on a regular basis. Hearing these stories, coupled with my firsthand experience of witnessing poverty here in Delhi reminds me of the daily reality of those 342,900 women who die every year. This is their way of life and I think it’s poignant that today’s sessions emphasize community based care, family planning, accountability, behavior change, and culture.
“Context, context, context,” said Wendy Graham of IMMPACT at yesterday’s plenary session. I agree, the context of social and cultural norms is an underlying factor that must be taken into consideration when implementing maternal and child health (MNCH) programs. With a background in psychology, I appreciated when Dr. Zulfiqar Bhutta, of Aga Khan University, recognized the toll of poverty on the imagination and the mentality of fatalism.
That is why it is so essential to “ask the people how they feel and bring their voices into the forums where policy decisions are made,” said Hameed. It is also important to hold key players accountable and include men in MNCH activities.
During the side session Male Involvement in Reproductive and Maternal and Newborn Health six field experts (in which half the panelists and audience members were men!) discussed effective methods for increasing male participation in family planning, vasectomies, gender equality, and hospital care.
The key findings from this discussion include:- Targeted interventions that educate men about danger signs and pregnancy complications correlates with behavior change and increased facility births.
- Many young married men feel pressured to prove their fertility. A sample of men was evaluated and those who had increased education and income were more likely to delay first pregnancy.
- Vasectomy is not something men want to talk about with family planning fieldworkers; however, official recognition of the vasectomy benefits by the government did increase referrals.
- Puppet and theater shows that demonstrate gender equity behaviors provide an opportunity for dialogue. Women in this study reported increased gender equity in family planning decision-making.
Originally posted at Maternal Health Task Force, by Calyn Ostrowski of the Woodrow Wilson International Center for Scholars, Coordinator of the Maternal Health Dialogue Series in partnership with the Maternal Health Task Force and UNFPA.
Photo Credit: “Parliament Street” courtesy of flickr user ~FreeBirD®~. -
GMHC 2010: Empowering the Next Generation
›“We do not need new legislation… we need affordable, effective, and scalable solutions,” said Shn Gulamnabi Azad, Minister of Health, India, at the opening ceremony of the first-ever Global Maternal Health Conference in New Delhi. Co-hosted by the Maternal Health Task Force and the Public Health Institute of India, this three-day technical meeting builds upon the momentum of Women Deliver and the G8 summit by bringing together 700 researchers, program managers, advocates, media, and young people to exchange ideas, share data, develop strategies, and identify solutions for reducing maternal mortality.
In order to reduce India’s maternal mortality rates, Azad called for the repositioning of family planning programs to include maternal and child health and not limit the scope of services to population control as historically executed. Improving family planning and maternal health services must also address the reproductive health needs of adolescent girls, and India is currently developing a new ministry that will target gender inequality, poverty, early child marriages, as well as other critical health issues important to young girls such as the dissemination of sanitary napkins.
“Although the legal age of marriage is 18, there are districts in India where 35 percent of the population is married between the ages of 15-18,” said Azad. During the side event “Adolescent Girls: Change Agents for Healthy Mother and Child,” technical experts such as Anil Paranjap of the Indian Institute of Health Management presented evidence that girls who marry between 15-18 are five times more likely to die during childbirth than women in their early 20’s.
“We still have deep-rooted subordination that makes it very difficult for young women to realize their sexual and reproductive health rights,” said Sanam Anwar with the Oman Medical College. Interventions such as the UDAAN project – a private-public partnership between the Center for Development and Population Activities (CEDPA) and the Government of India – demonstrate promising solutions for empowering young people through the use of existing infrastructure. In collaboration with teachers, parents, principals, and students, this project successfully increased leadership skills and improved youth knowledge on menstruation, health, friendship, peer pressure, early marriage, and reproductive health, said Sudipta Mukhopadhyay of CEDPA.
Empowering “young people” to improve maternal health also requires that the community support committed new thinkers and future leaders. The Young Champions of Maternal Health Program is a unique and refreshing group of young professionals from 13 countries dedicated to improving maternal health, and I look forward to learning how this new energy will further the maternal health agenda.
Originally posted at Maternal Health Task Force, by Calyn Ostrowski of the Woodrow Wilson International Center for Scholars, Coordinator of the Maternal Health Dialogue Series in partnership with the Maternal Health Task Force and UNFPA.
Photo Credit: “Indian Girl” courtesy of flickr user Jarek Jarosz. -
‘NSB’ Blogs from the 2010 Global Maternal Health Conference in New Delhi
›The 2010 Global Maternal Health Conference kicked off today, perhaps fittingly, in India – one of the world’s fastest growing nations but one that also faces serious reproductive health challenges. The Wilson Center’s Calyn Ostrowski is in New Delhi for the conference and will be providing updates to The New Security Beat throughout the week.
Those interested can also find a schedule of events and list of participants on the conference website as well as live webcasted events on the main page. Stay tuned!
Photo Credit: “Mumbai, India, November 2009” courtesy of flickr user travelmeasia. -
Fire in the Hole: A Look Inside India’s Hidden Resource War
›August 18, 2010 // By Schuyler NullThis month’s Foreign Policy has two features on India’s ongoing internal conflict with Maoist and tribal rebels – perhaps the least known insurgency and resource conflict in the world.
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Wilson Center’s Michael Kugelman Finds the Real Culprit in Pakistan’s Water Shortage
›July 28, 2010 // By Wilson Center StaffExcerpt from Dawn:
ON Jan 15, 2006, the Karachi Port Trust (KPT) inaugurated its new fountain – the Rs320m lighted harbour structure that spews seawater hundreds of feet into the air.
Also on this day – as on most others in Karachi – several million gallons of the city’s water supply were lost to leakage, some hundred million gallons of raw sewage oozed into the sea, and scores of Karachiites failed to secure clean water.
Over the next few years, the fountain jet would produce a powerful and relentless stream of water high above Karachi. Meanwhile, down below, tens of thousands of the city’s masses would die from unsafe water.
After several fountain parts were stolen in 2008, the KPT quickly made the necessary repairs and re-launched what it deems “an extravaganza of light and water”.
In an era of rampant resource shortages, boasting about such extravagance demonstrates questionable judgment. So, too, does the willingness to lavish millions of rupees on a giant water fountain, and then to repair it fast and furiously – while across Karachi and the nation as a whole, drinking water and sanitation projects are heavily underfunded and water infrastructure stagnates in disrepair.
Continue reading on Dawn.
For more on Pakistan’s water crisis, see the Wilson Center report, “Running on Empty.”
Photo Credit: Adapted from UN map of South Asia, courtesy of Wikimedia Commons. -
Cleo Paskal: India Is Key to Climate Geopolitics
›July 27, 2010 // By Wilson Center Staff“Copenhagen was many things to many people,” said Chatham House’s Cleo Paskal, in a video interview with the Wilson Center’s Environmental Change and Security Program, but “what was very clear was that India, specifically, was playing quite a strong, clear role in deciding how alignments would be working.” We spoke to Paskal following her presentation at a recent Wilson Center event.
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A Return to Rural Unrest in Nepal?
›July 27, 2010 // By Russell SticklorIn the four years since the end of Nepal’s civil war, political progress in creating a multi-party unity government in Kathmandu has moved in fits and starts. While the effort to bring the Maoists into the fold has made some headway since 2006, continuing environmental and economic troubles in the Nepalese countryside threaten to undermine these tentative steps.
In recent months, a new threat to political stability has emerged: the Sapta Kosi Multipurpose Project, a massive, India-backed hydropower scheme in eastern Nepal currently in the early stages of development. Once operational, the controversial dam—slated to reach a height of nearly 270 meters, making it one of the tallest dams in the world—is projected to generate 3,300 megawatts of electricity.
A proposed barrage and series of canals round out the project, enabling new irrigation and flood-control infrastructure in both eastern Nepal and the Indian state of Bihar, immediately to the south. But the potential environmental impacts of the mega-project have already sparked significant backlash among some Maoist-linked ethnic groups in the region, where the reach and influence of Nepal’s fledgling unity government is tenuous at best.
“Strong” Protests Threatened Over India-Backed Mega-Dam
In June, a network of 15 groups sympathetic to the Nepalese government’s Maoist wing warned of “strong” protests if survey work on the dam continued and “the voice of the indigenous people was not heard.” A memo released by the group dismissed the Sapta Kosi project as “anti-people.”
Specific criticisms of the project have ranged from safety concerns (the dam would be built in a seismically active region) to population displacement. Maoist leaders in the region have alleged that many villages—as well as important local religious sites and valuable agricultural land—could be flooded if the project goes forward. Other Maoists say the project should be delayed until Nepal is reorganized as a federal republic, at which point the states directly impacted by Sapta Kosi could be given greater control over the project.
Meanwhile, some objections to the project have targeted Nepal’s partnership with India. According to ShanghaiNews.net, members of the Maoist opposition have insinuated that hydropower from Sapta Kosi will not be consumed domestically, but rather exported to meet the needs of energy-hungry India.
A number of prominent Nepalese and Indian environmental activists have also spoken against the project, including Medha Patkar, a well-known activist who has played a major role in many past Indian anti-dam protests. Patkar warns the project will not mitigate but instead worsen seasonal flooding, calling plans for the joint India-Nepalese dam project “inauspicious from [an] environmental, cultural and religious point of view,” according to the Water & Energy Users’ Federation-Nepal.
As Nepal Pledges Security for Dam Project, India Pushes Forward
In the past, threats against the Sapta Kosi project have caused surveillance work in the area to be suspended repeatedly. But after the latest round of warnings, the Nepalese government adopted a different tactic, pledging heightened security in the region to ensure the safety of Indian officials doing fieldwork.
In doing so, Nepal’s coalition government is throwing its limited weight around, and—to a degree—staking its reputation on its ability to prevent an outbreak of violence. Historically, Nepal’s government has been largely bypassed or ignored in matters of hydroelectric development. As Nepal Water Conservation Foundation Director Dipak Gyawali told International Rivers in a June 2010 interview:The main players are private investors, with state entities and civil society unable to stand up to them….In Nepal, we just saw local politicians burn down the office of an international hydropower company even after the project was sanctioned by their leaders in the central government.
Gyawali added that during the Nepalese civil war (1996-2006), private developers were able to build “small hydropower projects even while a Maoist insurgency was raging because they did not ride roughshod over local concerns.” Regarding Sapta Kosi, Gyawali said the government should adopt a similar approach, and “start listening to the marginalized voices.” Otherwise, he warned, the Indian-Nepalese team spearheading the project “will be faced with delays, impasse, and intractable political problems,” including the potential for Maoist violence in the region. (As noted earlier this month in New Security Beat, the Indian government has also struggled with Maoist-linked violence in recent years, as New Delhi struggles to pacify a Naxalite insurgency in eastern and central India.)
Rural Nepal’s Troubles Far Bigger Than Sapta Kosi
Maoists may be wielding Sapta Kosi as a weapon to gain political leverage both in the countryside and Kathmandu, but the proposed dam is far from the only environmental issue impacting rural lives and threatening to undermine support for the central government.
In a country where firewood still accounts for 87 percent of annual domestic energy production, deforestation has been hugely problematic across rural Nepal. As of 2010, less than 30 percent of the country’s original forest-cover now remains. The rapid removal of forest cover has reduced soil quality, exacerbated seasonal flooding, and caused degraded water quality due to high sedimentation levels.
Further, as the country’s population grows at an annual rate of 2 percent, low soil productivity and unsustainable farming practices have turned Nepal’s effort to feed itself into a constant uphill struggle. According to the World Bank, the country sports one of the world’s highest ratios of population to available arable land, paving the way for potential further food shortages.
Sustainable energy development in Nepal perhaps represents one way of slowly restoring environmental health to the country. By investing in a more reliable national power grid, the central government could reduce rural dependence on firewood for fuel, allowing the country’s forests, soil, and waters to recover even as population increases. Further, hydroelectric projects like Sapta Kosi—implemented with greater involvement from local communities—could play an important role in moving the country forward. With an estimated untapped hydroelectric potential of 43,000 megawatts, Nepal could not only meet its own energy needs by developing its waterways, but profit from hydroelectric energy exports as well.
On the other hand, the Nepalese government could—at its own peril—continue to overlook rural populations’ grievances, and the environmental degradation unfolding outside Kathmandu. If left unchecked, however, these conditions could once again make the Maoist insurgency an appealing movement, potentially reviving grassroots support for anti-government extremism.
Sources: CIA, eKantipur.com (Nepal), International Rivers, Kathmandu Post, NepalNews.com, New York Times, ShanghaiNews.net, South Asia News Agency, Taragana.com, Thaindian News, Times of India, U.S. Energy Information Administration, WaterAid, Water & Energy Users Federation-Nepal, World Bank, World Wildlife Fund.
Photo Credit: “Neither in Nepal Nor India,” courtesy of Flickr user bodhithaj. -
India’s Maoists: South Asia’s “Other” Insurgency
›July 7, 2010 // By Schuyler NullThe Indian government’s battle with Maoist and tribal rebels – which affects 22 of India’s 35 states and territories, according to Foreign Policy and in 2009 killed more people than any year since 1971 – has been largely ignored in the West. That should change, as South Asia’s “other” insurgency, fomenting in the world’s largest democracy and a key U.S. partner, offers valuable lessons about the role of resource management and stable development in preventing conflict.
