Human Poverty
Time To Act Against It

By P.C. Wasti

POVERTY, hunger and malnutrition are the major challenges of the least developed countries like Nepal. According to the latest estimates, thirty eight percent of the population in Nepal remains below the poverty line. However, UNDP estimates that about fifty per cent of the population, who earn less than a dollar a day, is considered poor. According to Human Development Report of Nepal 2002, the number of absolutely poor persons has nearly doubled in the past 20 years approaching nine million mark-45 per cent of the total population in 1996.

Result

Poverty is the major cause of hunger and malnutrition and hunger and malnutrition result in poverty. This creates a vicious cycle, which must be broken by the efforts of the government.
The recent surveys show that about 50 per cent of the children of age below five years are underweight (malnourished). Seventy five per cent of the pregnant and 67 per cent of non-pregnant women are anaemic. Vitamin A Deficiency and Iodine Deficiency Disorder still remain problems among the children and women. All types of malnutrition have damaging physical and mental consequences for people, households and communities. It can reduce a person's productivity and child's cognitive development. Ultimately malnutrition hinders the economic and human development of a nation.
More income is not enough to improve nutrition because more calories may not be purchased with the increased income. Important non-food factors such as environmental hygiene and health care cannot be bought with increased income, and because much hangs on how food and non-food resources are actually used in households-particularly by women, who tend to be the main caregivers. If women are not empowered with knowledge, any increased income my not be used to maximum nutritional benefit.

Even if incremental income is used to acquire more or different foodstuffs, these may not be the foods that provide the nutrients required for a balanced diet. If costlier refined cereals are purchased with extra income, the nutritional benefits may not accrue. But if the extra income translates into a more varied diet, for example, with some meat and dairy products, fruits and vegetables, then-although calories may not increase appreciably-micro nutrient status (and with it, nutritional status) is likely to improve. Micronutrients have tended in the past to be ignored in discussing the food-income relationship.

Most studies concur in showing that calorie-income elasticity is high for households consuming very low initial per capita calories (the poorest of the poor), but lessens as mean consumption increase. Hence, the impact of income on calorie intake is unlikely to be negligible.

Intake of adequate nutrients is not enough for better nutrition. Sickness can seriously hamper the utilisation of nutrients at cellular level, reducing nutritional status and further weakens the link between income and nutrition. The link between child nutrition and income is particularly weak, firstly because young children do not need much food (and hence income is less of a constraint) and secondly because they are particularly vulnerable to growth faltering as a result of infection and disease.
Diet and disease have two-way relationship, with independent and additive effects on a child's anthropometric status. Low calories intake will thus adversely affect nutrition directly, but also indirectly through accentuating the effects of morbidity; diarrhea, for example may last longer or be more severe if dietary intake is inadequate.

Young children, particularly in the first two years of their lives, are most vulnerable to becoming malnourished, and the consequences too are serious at this time. Household income poverty may not be the most important constraint to the growth of an infant. Other capabilities, including those relating to health and care, are likely to be critical determinants. For such young children, human resources such as knowledge and time of caregivers are more important than income though it is recognised that income poverty forces difficult trade-offs and can reduce time for quality childcare.

Poverty has conventionally been measured in terms of income. Income poverty however, excludes other elements of deprivation such as a lack of access to basic resources like housing, clothing, education and health care. In recent years, a broader definition of "human poverty" has been proposed wherein poverty is seen primarily as relating to people's capabilities and opportunities.

UNDP originally recommended the use of new "Capability Poverty Measures" to reflect such a lack of basic or minimally essential human capabilities. This was actually a composite of the prevalence of underweight under-five children, the proportion of birth deliveries unattended by trained personnel, and the female illiteracy rate, which in the positive (converse) sense represent important capabilities. The poorest of the poor will be illiterate, malnourished, without access to safe water or health services, and likely to die young.

Consequence

Poverty alleviation only in terms of income doesn't assure the development in a real sense. Poverty alleviation in terms of capabilities and opportunities could give a taste of development. Now time has come to think of human poverty and act accordingly to get rid of the devastating consequences of hunger and malnutrition.

Claiming The Night

By Helen Drusine

IN Montreal, Canada, buses let women off in-between stops at night, new metro stations are surrounded by glass and emergency telephones are within easy reach. In a pilot project in two neighbourhoods, workers at nearly 200 small businesses have been trained to be able to respond to a woman in danger. Signs in the windows announce - "Here You're in Good Hands. Your Safety is Important to Us." The goal is to increase urban safety and the mobility of women and to reduce acts of aggression against women in public places. Women's autonomy is, therefore, increased and their dependence decreased.

Purpose

These projects were demonstrated to some 150 specialists on women's safety from 20 countries and the United Nations, attending the first International Seminar on Women's Safety in Montreal, Canada, from 9-11 May 2002. Its purpose was to bring together women's groups, community organisations, city governments, and national and international agencies to works on increasing women's safety in cities and communities and on integrating a gender perspective into local and national crime prevention policies.

Montreal's innovative approaches are an outgrowth of the work of Toronto's Metro Action Committee on Public Violence Against Women and Children (METRAC) in the early 1990s. Based on women's daily experiences and their awareness of what makes them feel safe or unsafe, a process of "Safety Audits" of urban sites was developed. The audit was followed by recommendations on the changes and corrective measures needed. Since 1992, more than 100 safety audits of various public spaces and municipal facilities were done and a guide for auditing women's safety in cities was produced. This guide has been translated into numerous languages and adapted for use in European and African cities.

In the Cowichan Valley in British Columbia, The Women Against Violence Society has published a resource book on planning for safer communities, entitled "Women and Community Safety." It found that nationally one in two women over the age of 16 has been physically or secually assaulted by a man at least once, and one out of every three women is assaulted by her husband or partner. It also found that 60 per cent of women are worried about walking alone in their neighbourhoods after dark, 76 per cent are worried about waiting for or using public transit after dark, 83 per cent are worried about walking alone to their car in a parking garage, and 39 per cent are worried about being home alone at night. These figures could be replicated for almost any community in the world, regardless of culture.
Other innovative approaches to women's safety discussed at the conference included the group Bantay Banay (Community Watch Groups Against Domestic Violence) formed in Cebu City in the Philippines. This group works with more than 3,000 women in some 51 cities to prevent on-going violence against women through activities such as throwing stones on the roof of the house where a fight is taking place and banging bottles or spoons to let the perpetrator know people are watching. If the fight goes too far, some women might go inside to pull the victim out, while others will inform the police and others will be ready to take her to the hospital. Police stations have a woman's desk with a female officer to help combat violence against women and a violet and pink room for abuse victims was set up at two government hospitals.

In Costa Rica, the Alianza de Mujeres Constarricenses, with some 20,000 members, is lobbying government officials to make the law against domestic violence more responsive to women's needs and is educating the police, health care workers and other professionals to be more sensitive to women victims. And, in Quito, Ecuador, a women's group created "Safety Brigades" in communities with too few police officers. Women create makeshift alarms to compensate for the lack of phones and public transportation. If a person has a problem, sounding the alarm - a button connected to an outside buzzer - will bring neighbours out armed with bats to scare off attackers.

"The purpose of this conference," said Jan Peterson, head of the Huairou Commission, an umbrella group of grassroots women's organisations around the world and a co-sponsor of the conference," is to make the problem of safety and violence against women a community and city issue, not just a women's issue. Women's safety affects everyone. If women are feeling safe, you know men will too."
The Montreal project grew out of an innovative partnership between grassroots women's groups, government and other institutions. The Comite d'Action Femmes et Securite Urbaine (CAFSU) - the Women's Urban Safety Action Committee - began nine years ago with the idea of making the community safer for women. Half of its members come from grassroots women's groups (representing some 22 women's centers with a membership close to 44,000), while the other 50 per cent come from municipal authorities, community organisations, city planners, university research groups, public transit officials, health and social services, and the police. Almost all these groups are represented by a woman.

CAFSU's primary goals are to reduce occasions of assault, to neutralise aggressors, to help men to understand their responsibility towards reducing acts of violence, to reduce women's isolation and to get local authorities to deal with these issues. A poll in 1993 showed that 66 per cent of women were afraid at night and that most were afraid on public transit. Therefore, women getting off in between stops at night permits them to walk less in areas where they might feel in danger. The ten newly renovated metro stations are surrounded by glass so that women can "see and be seen," so if a man is hanging around she can plan a defense and perhaps choose another exit. Public parks are another area where women experience fear, not just the reality of it, but the feeling of being unsafe. More visible signs and red emergency telephones have been placed at strategic locations and bushes cut back where necessary.

Experience

The CAFSU experience in Montreal is an example of how women have designed and changed their city to suit their needs. "First we want women to feel safer. If they feel safer, they will feel less fear, so they will be able to participate in activities in society. There is also a link between the safety of women and the business community. If women feel safe they will go out at night, they will patronise the theater, the movie houses, the business establishments," said Anne Michaud, President of Femmes et Villes (Women and Cities), an international network.

Habital Debate

Dental Care

By Dr. Ajay Neupane and Dr. Surita Thapa

NEPAL is one the poorest countries in the world. More than 75 per cent of population is deprived of oral health service and education. Now it is our motto and duty to educate the people regarding oral health service and education. The most common dental problems of the Nepalese are caries and gum disease.

The treatment of dental decay is too expensive in our country like other Asian countries, but if it is created at an early stage, tooth decay and loss can be checked. Dental problem is increasing in Nepal day by day due to the increase in population and lack of awareness. Headways can be made in this regard if the government reduces duty on imported dental machinery and raw materials used in this industry so that dental needs of the community can be met.

The changing eating habits of the population are also creating havoc. Sweets supari, pan (betal leaves) with other ingredients, cigarettes and soft foods are also responsible for dental problems especially if the teeth were not washed and taken care of properly and on a timely basis.
Research says that 95 per cent of dental diseases and problems faced by a common South Asian are due to the above mentioned reasons and are entirely preventable if good brushing was done in combination with fluoride tooth paste.

After a tooth problem has arisen the majority of the poor people can't get any treatment. Some go to free government hospitals for emergency pain relieving care. The usual treatment offer is extraction because of limited manpower and resources. There are not enough dentist or government resources to cover the treatment of the entire population. The only choice Nepal has is its prevention through good brushing habits with fluoride tooth paste.

The goal is to make people jump a level, for example, those who do not brush should start using Miswak. People should also be educated to improve their eating habits to fibrous food and avoiding soft foods, sweets, pan and cigarettes.

As in developed countries, which have made giant strides in public health, including dental care education through government sponsored programmes, there are several limitations of government funding in health education in Nepal.

It is recognised that dissemination of information and dental cares is imperative. But unfortunately in Nepal unlike some other developing countries the required attention has not been given to providing knowledge about dental care.

Public dental health information is of paramount importance. It can be achieved only by three-pronged attack: Information programmes on television, information through print media and school dental health education.

We believe that a great effort has to be made and that without the support of government, information media namely National Health Education and information center of Ministry of Education and Culture, it will not be possible to achieve our goals. Nepal can save millions of rupees in curative infrastructure and provide some relief to the poor at least in regard to their dental problems.

Faced with this increasing dental health problems, in the country, meager resources which make treatment impossible to achieve and the convictions that 95 per cent of dental diseases are preventable, approaching a number of tooth paste manufactures for alliance may be a good idea. Better dental health is not only preventing dental problems but also selling more tooth-paste even when the target population is poor.