poverty | healthcare | nutrition | reproductive health | rural economy | rural connectivity

Martadi, Bajura's district headquarter | Photo by Preet Shah
Martadi, Bajura's district headquarter | Photo by Preet Shah


Bajura — a district left behind

Bajura, a remote district in Nepal continues to reel under extreme poverty and severe health and nutrition crisis. For people in Bajura, consequences are dire.

By Preet Shah |

Optics in urban regions of Nepal align with Nepal’s gradual progress in several socio-economic indicators. The state of infrastructures — from roads to schools — have relatively improved. The country has succeeded in reducing the Multidimensional Poverty Index (MPI) from 30.1% in 2014 to 17.4% in 2019 — a 42.2% reduction in just five years.

While Nepal has seemingly moved forward with improvements in the quality of life and national average in the socio-economic indicators and is making infrastructural efforts to catch up with the global economy, Bajura — a remote district in Sudurpashchim province remains stagnant, isolated and left behind.

Covering 2,188 sq. km. area of the country (almost 15% of the total country) where 11.5% of the land is arable while 37.8% of those land is left uncultivated, Bajura is still a remote agrarian economy. Its population — 138,998, says the preliminary 2021 census.

Based on 2011’s population and housing census data, 64.1% of the Bajura’s population lived under the poverty line followed by Kalikot (57.9%), Bajhang (56.8%) and Humla (56%), all of which are surrounding districts of Bajura. The district had the lowest HDI value (0.364) in Nepal amongst the 75 districts, based on Human Development Report 2015. 

Almost nothing has changed overtime. 

In 2017, the Poor Household Support Coordination Board Secretariat identified that about 71% of Bajura’s households lived below the poverty line while Bajura still had the lowest HDI value based on the Human Development Report 2020. Bajura still lacks market access thanks to its appalling road infrastructure. 

Roads to despair
For someone from Kathmandu, it feels like travelling back in time once you set foot in Bajura. 

When you take a road trip from the Sanfe, the closest to drive up to the Martadi, the Bajura headquarter and now a part of Badimalika Municipality, you will notice narrow road sections, barely blacktopped, once you enter Bajura.

While the roads are difficult on their own, what really impacts is the yearly landslides that wipes away the 57 km Sanfe-Martadi road section at several stretches which result in Martadi disconnected from the national road network for almost two months or more. 

Some parts of the road were severely affected by the disaster while a shorter stretch of the road was completely swept away due to erosion of the Budhiganga river embankment. The disruption often leaves prices of essential commodities skyrocketing since mules have to be used to transport goods. In worst cases, which are equally possible as soaring prices, there are rampant shortages too, agonising the people of Bajura with having to struggle hard to meet basic needs.

Taking a break | Photo by Preet Shah

The intra-district connectivity that would link one village with the other is so poor, it is difficult and extremely risky to commute in vehicles. 

“There are days when we are left with no choice but to walk eight hours up and down, with empty stomachs and under harsh weather risking ourselves and our children. It’s the only way of life we know — there are no other choices but to choose this difficult path for survival,” laments Kausi Devi Saud, a single woman from Tribeni Municipality- 4. 

For visitors, the people of Bajura may appear resilient but their resilience stems from hopelessness as they see no way out but to suffer the consequences of the debilitating state of the road infrastructure.

During the excruciating months of monsoon, the production of locally grown and manufactured goods becomes almost impossible. Not only it pushes the prices up but the inaccessibility affects survival itself. Various parts of Bajura during this period suffer acute food shortage, and while some cannot afford the necessities, the ones who can remain deprived due to the inaccessibility. 

One common example is transportation vehicles that suffer due to lack of spare parts and unavailability of maintenance service. For simplest maintenance service, the vehicle needs to be taken to Sanfebagar but mostly Dhangadi, which further prolongs any disruption.

Severe hunger problem and health crisis
Amongst many issues that ails Bajura, the health and nutrition crisis is nightmarish. The children in the village lose their lives to malnourishment each year while young mothers and their infants are at grave risk of losing lives right after birth. 

In 2022, the village of Muktikot from Swamikartik Khapar Rural Municipality-1 made headlines for acute hunger.

A survey in April 2022 at Muktikot, a village of 243 households showed that 100 out of 293 mothers were suffering from malnutrition, with 29 of them undergoing severe malnutrition. 

Girls aged 10 to 19 were in the worst condition. 

Moreover, 99 of the 192 girls tested were malnourished, while 14 were suffering from severe malnutrition. 61 children out of 200 were suffering from severe malnutrition and 16 of them were severely malnutritioned.

The problem of hunger is so acute that ‘there is not a single mother in Muktikot who hasn’t lost at least one baby’, reported a March 2022 coverage by Basanta Pratap Singh for the Kathmandu Post.

However, the urgency remains in vain. Despite the media highlighting the urgent need for action, the authorities have remained (a)pathetic.

All these despite the government's budget allocation for the ‘Integrated Multi-Regional Nutrition Plan’ to eliminate malnutrition by 2025 which has been in implementation since 2012 whereas in 2017, the government introduced a five-year long second phase of the program amounting to Rs 4.9 billion with goals to eliminate malnutrition among women, children and adolescents in the next 10 years.

While some of the organisations reach out to help places in Bajura where medical assistance is required, it again boils down to the obstacles caused by the poor road condition. 

As a result, health priorities drown amidst the poor facilities and mobility constraints for patients while the severity of illness runs high leading to fatalities, which otherwise could have been easily prevented. 

There are two main hospitals in Bajura — a district hospital in Martadi and a primary health centre in Kolti. While the district hospital offers some basic services, the other is severely resource-crunched. 

26 health posts are spread across the villages in Bajura, but they lack health workers and nurse midwives most of the month, and are beset by lack of medicines and hygiene. Poor infrastructure with no bathroom and rusted tools lie around with no signs of sanitisation in the clinic.

The people in Bajura already struggling with poor road connectivity are left with no choice but to scramble their way to Bayalpata Hospital in Accham. When patients require intense care, they are referred to Dhangadi for further medical care. Medical bills and the cost of travel leave the already impoverished people of Bajura under huge debt after any health procedure or diagnosis.

Without proper health and nutrition, there is little to no scope for people to focus on improving the local economy, employment opportunities or pursuing education.

Women face the brunt
While women already face health and nutrition risks, problems for Bajura’s women and girls are further exacerbated by several other socio-economic conditions. 

The family system in Sudurpashchim is patrilineal and patrilocal, which provides an additional dimension to the migration, especially for women. The largest number of migrants go to India, most coming from landless groups, the highly indebted, Dalit community and socially excluded groups. 

In Bajura’s case, most men are found to be working in Delhi and Uttarakhand, including for seasonal work such as providing helping hands for managing marriage events like setting up tents, serving staff, cooking and working as drivers. The trend has left many communities surviving mostly on remittance money.

The leftover working age members of the community are all women, some of whom are skilled in sewing, tailoring, knitting and beading jewellery. Women face increased workload due to the male labour migration trend while the remaining men dwell freely without bearing responsibilities.

Women in Badimalika | Photo by Preet Shah

Women are frequently heard saying, ‘We work way more than men. They drink, gamble and spend their days roaming around.’ 

With little support available, women are overburdened with work and responsibilities — collecting wood and grass from risky cliffs and edges of the hills, cooking and cleaning in addition to taking care of the elderly’s and children. They do rely on the remittance; however, it does not necessarily mean that it is regularly sent.

While the district scrambles to barely make it, the women have more suffering on their plate. Apart from an alarming lack of medical facilities leading to even death for pregnant women while being transported to the only district hospital in Martadi, the district also witnesses wider child marriage practice,  poor reproductive awareness level and lack of meaningful participation in politics.

The recent 2022 local election reflected negatively in the women’s political representation when it came to resourceful roles such as mayor and chairperson in the urban and rural municipalities respectively with all mainstream political parties fielding male candidates for the top roles. 

The reservation policy as laid down by section 17 (4) of the Local Level Election Act-2017 that mandates a political party to field a woman candidate for either chief or deputy chief at the local level have worked in favour of women to create space in the political sphere. But many argue that male leaders often onboard women representatives who lack adequate political knowledge to ensure the leaders in control can push their agenda of self-interest rather than pushing for competent women leaders.

No wonder, no female representatives were elected in the Sudurpaschim Province Assembly.

In a tough socio-economic landscape like this, intensified by extreme geographical barriers, stale-led innovative and piece-meal and adequate social assistance programmes and larger infrastructural spending in Bajura and the wider region is key to improving living standards in Bajura and the Sudurpashchim province. 

Effective health, hygiene and nutrition solutions, particularly focused on women and young adolescent girls, however should remain the urgent focus. 

Preet Shah is a former Project Manager at TEWA with expertise in overall project management, specifically in gender and social inclusion.

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