Something To Ponder About

[Love Nepal]

War need not be bad for health
In Sri Lanka, health and education programs are intact despite conflict. Why can’t it be the same in Nepal?

ARUNA UPRETY in BATTICALOA, SRI LANKA

Here in eastern Sri Lanka, one year after the tsunami and amidst a fraying ceasefire, thoughts turn to a return to war in Nepal. Inevitably, one is inclined to make comparisons and the paradox is that despite a separatist civil war that is much more virulent than Nepal’s, the health care system on this island is still intact. Tensions are rising again in Sri Lanka’s northeast, too, after four years of ceasefire. But the rebels have a man in charge of their health service. There are no guns about as we go to see him and he speaks fluent English. Even more surprising, he had all the public health issues in the area at his fingertips or if he didn’t remember he would pull out a file and find the information which include assessments, research and programs. Having visited the war-torn far western regions of Nepal many times over the past 10 years of conflict I never came across a single Nepali Maoist leader who had even a fraction of the health information about the local population as this man had. No Maoist I met in Nepal ever kept any records or had reports. And while Nepal’s conflict has made an already horrific public health situation, especially maternal health, much worse, here in Sri Lanka health and education are so important that in the past, both sides have stopped fighting at exam time or during vaccination campaigns. The Sri Lankan government still pays for schools and teachers, hospitals and doctors. The Tamil Tigers allow health workers access to their territory whenever there is an inoculation drive or health survey. Except in some remote parts of northeastern Sri Lanka, the immunisation coverage in Sri Lanka is much higher by far than anywhere else in South Asia. There are some areas where health personnel lie about the success of their vaccination campaigns and in these places it is very reminiscent of Nepal. In one village in the Tiger-controlled northeast we asked the women if all the children were given polio doses. They said sometimes children were given only one dose and the health worker would fill out the card to make it look like all the doses were given so he wouldn’t have to come back. Even before the ceasefire, the midwives of Sri Lanka’s public health service were doing a good job. The result is that despite the war, Sri Lanka’s maternal mortality rate is at par with middle-income countries and much lower than other nations in the region. In Sri Lanka, less than 40 mothers die for every 100,000 live births while Nepal’s national rate is 600 and in parts of Rolpa and Jumla it is at least 1,000. The reason is Sri Lanka’s heavy investment in health and education since independence. The momentum of this success has kept public health systems intact despite disruptions caused by conflict. It is just the opposite in Nepal: health and education have suffered directly as a result of the conflict. In fact, there is a deliberate policy in Nepal to target education as a part of the conflict strategy. Sri Lanka’s emphasis on health and education are self-enforcing. Higher literacy of women (95 percent of women here are literate compared to 35 percent in Nepal) has helped reduce infant and maternal mortality. The other reason is that most Sri Lankan women give birth in hospitals where complications can be treated. In Nepal, only 10 percent of deliveries take place in hospitals. But in far and midwestern Nepal, nearly 100 percent of deliveries are at home. No two wars are alike. There are things Nepal shouldn’t learn from Sri Lanka, especially about allowing ethnic tensions to boil over into full-scale civil war. But there are things we should learn how despite the conflict there is still a strong emphasis on female literacy and public health.

Dr Aruna Uprety is working for an international aid agency in Sri Lanka.
(published in:nepalitimes.com)

[Rajiv]

Thanx to both Dr Uprety and Dr Love Nepal. A short and meaningful article indeed. Well I am skeptic about comparing Maos and LTTEs politically, the latter representing an ethnic group of ppl and fighting to establish a free state, whereas Maos want to change whole political system of the country, somewhat like editing the constitution. At the time when rest of the world is booming with modern democracy and economy, it wants communism. Leadership of LTTE and Mao is not comparable. The things that tamil tigers are doings as mentioned by the author is result of the fine leadership and I am sure every member of LTTE are aware of their principle and Aim. That is the reason why they are promoting health/education etc. And what are Maoists, mostly illiterate poor ex-villagers, taught about beside attacking and killing? I am sure even 1 per 1000 of them still do not about Maoism. May be they are rewarded for each successful attack with some money, that's it.
Disturbance in education system has become a MUST for every strikers. Bandhs are now nepalese cliché, which was actually started by the political powers in the past. How can be leaders such dickheads?? They do not need to ask an economy-expert, what does it mean to close the country's activity for a whole day, they can ask anybody of millions of us,Nepalese, whose meal of the day depends on the earning of the same day. I can not understand how did they rise up to the Parliament.
I think nothing is going to change in Nepal until current political generation starts getting pension. It is clear that we Nepalese do not lack in qualification and ability. There are many examples of Nepalese ppl, who have achieved a lot in overseas and proved that we can.

[Danfe]

very good article thanks to love nepal

[Love Nepal]

I think the response from medicus says it all on behalf of all nepalese.He is absolutely right.I would just like to add few more things:

1.LTTE's revolution started when the minority tamils were ill treated by the majority simhalis.It was sort of an ethnic uprising.But the maosists of our country started their fight just because of the political ambition of few of their leaders who saw that they had no chance of coming to the power in the multiparty democracy.Most of them have lost in the elections as a matter of fact.

2.They targeted schools so that they could recruit teachers and the students in their forces.Which they did successfully helped by the apathy of the people running our government.It has left hundreds of thousands of our brothers and sisters without education.

3.If they were good people with even a small amount of love for their country why would never even touch people involved in girl traffiking,drug dealing,smuggling and corruption??They just kill teachers,innocent villagers and their political opponents.

Its for everyone to see that we are heading towards a repeat of the chilian experience.We have a maoist rebellion and we have an autocrat who is ruling brutally in the name of crushing the maoist rebellion.Fujumori ruled for 12 years before being kicked out of chile and KG(king gyanendra) has probably 1.2 yrs before suffering the same fate.
I hope the rest of the story is also same because after Fujimori was kicked out of chile,like KG is going to be from Nepal,Chili has made great strides in economic development,hope we do the same.
And Ya medicus is absolutely right about our leaders,like we have to throw out the KG family we also have to kick out the GK(girija koirala) family.I just read today that CIAA is initiating action against his kins,i hope they begin it soon"subha kaam mein deiry kyun".We have a new bunch of eager leaders to lead us to a new Nepal so old, stupid,dumb corrupt leaders 'BUTT OUT OF OUR BELOVED NATION'.