But Ramdaiya was declared open defecation-free two years ago after distributing toilet sets to all the wards. No latrines were built.
Sri Narayan Sada is daily wage labour, and has a family of seven but no land. His two-year-old son is scrawny, and has all the symptoms of severe malnutrition: frequent diarrhoea, swollen stomach and skeletal limbs. “I don’t know what’s wrong with my son, only the gods know,” he says.
Assistant health worker Aruna Yadav says the child is underweight and is mentally retarded. She says the father earns Rs500 a day but spends half of it on alcohol, the rest goes to buy food, but it is not enough for the whole family.
Poverty, hunger, patriarchy, caste and gender discrimination make a dangerous concoction in these villages. As a result, most girls are married before pubescence. By the time the severely undernourished girls are in their mid-teens, they have already given birth to their first child – making it risky for both mother and baby.
The young mothers have never been taught about taking care of their health, or that of their children. Most do not know the kind of diet and supplements that pregnant and lactating mothers need, and even if they did, cannot afford them.
The Nepal government is supposed to provide Rs400 per Dalit family as a ‘nutrition allowance’. But the families in Ramdaiya in Dhanusa and Monorasisuwa in Mahottari interviewed for this report had not got even that paltry amount for the past two years because they did not know how to work the system.
The government also implemented a Multi-sector Nutrition Plan to revive a successful program that saw dramatic strides in the last 20 years in raising family food intake the first two decades before the progress stalled. But the plan has got tangled up over jurisdiction under Nepal’s new federal structure.
If things were not serious enough, the Covid-19 pandemic has set back even the few inroads Nepal had made in tackling malnutrition. According to the Nepal Planning Commission, last year’s pandemic-induced lockdowns pushed 4% of Nepalis back below the poverty line.
A recent John Hopkins School of Public Health study concluded that severe malnutrition among children under five during the pandemic could kill up to 4,000 children a year in Nepal due to insufficient food caused by lost family income.