No Dasain in Kalikot

More than 200 women have gathered outside the district hospital in Manma, the main town in one of Nepal’s most underserved districts. It was an exhausting journey for the women who were all pregnant or carrying small babies. They are here to receive rations of fortified cereal, attend nutrition counselling and get a health check-up.

As the rest of Nepal prepares for Dasain holidays with family gatherings and feasts, here in Kalikot, families struggle to feed their children. It is a silent, gnawing hunger that leaves children stunted and mothers anaemic.

The special food not only helps prevent malnutrition in expecting mothers and children, but also acts as an incentive to attract women and caregivers to local health facilities so that they deliver in hospital and raise healthy babies.

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With red vermilion running through their hair and dressed in their best clothes, mothers as young as 14 have gathered to receive their cereal packs. No husbands accompany the pregnant wives, either because they are away working in India, or because they leave raising babies to the women.

Deep-seated patriarchy in the Karnali is one of the reasons for widespread malnutrition among children. Girls are married off early. Their bodies have not fully developed when they give birth. Children raise children.

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The teenage mothers suffer from anaemia, malnutrition and have low birth-weight babies. This leads to a cycle of malnutrition: mothers give birth to stunted infants.

The Karnali has the highest rate of chronic malnutrition in the country with 54.5% of children undernourished. Despite poor nutrition, only 47% of women receive antenatal care and only half the children get a nutritious diet.

One of the mothers here is Basanti BK, whose husband left to work in an apple farm in India promising to send his pregnant wife money. Seven months have passed and she has not heard from him.

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Basanti was married at 14 and was pregnant soon after. “I did not know what to eat, there was no one to tell me, until I went to the health post. The fortified cereal gave me strength," Basanti says. She also feeds it now to her nine-month son.

Ishara and Bindu BK were also married in their early teens, and now have three children each, whom they are raising singly since their husbands are away. To earn extra money, they break stones by the highway even when pregnant and after delivery. Bindu’s six-year-old daughter looks after her baby sister while she works.

“When I took my daughter for her first check-up, they said she was malnourished and to feed her the nutritious flour,” said Bindu, and after three months her baby is gaining weight and is healthy.

Most women like Basanti, Bindu and Ishara in the Karnali are single mothers because their husbands are away. Besides raising babies, they do all the household chores, farm, collect fodder, and also work to earn money. They face discrimination from in-laws.

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The terrace farms that wrinkle the steep mountains depend on rain. Crops are often destroyed by droughts, floods, hailstorms or landslides. Families then depend solely on cash their men send home from India. Remoteness, difficult terrain and poor roads mean higher prices for food.

The special fortified cereal is a service provided by the government with support from the United Nations World Food Programme (WFP)  targeted at Nepal’s most vulnerable families.

When they come to the health posts, staff counsel mothers about eating locally available nutritious food and they get to take home rations of the fortified cereal. Says Pippa Bradford, WFP Nepal Director: “Although food production in the Karnali is above average this year, women from single headed households and marginalised communities do not have access or the purchasing power to buy healthy food. The cereal fills the nutrition gap.”

Seetashma Thapa worked for the United Nations World Food Programme (WFP).

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