In Karnali menfolk get sterilized, wives do all the work

JUMLA, April 22: As his family size grew despite three infant deaths, it became challenging for Tek Bahadur Budha, 32, a resident of Godhe Mahadev VDC of Jumla district, to sustain his family of five. The land that Budha inherited from his father provided food for the family barely for three months and the money that Budha earned by toiling in India was never enough. [break] Three years ago, when a vasectomy camp was organized in Phoi Mahadev VDC of Kalikot district, Budha decided he no longer wanted more children. “I felt I would be able to feed my family well if I had no more children,” says Budha. “I had had six children. Three of them died soon after birth. Other three children -- all sons -- survived.” Interestingly, Budha, who took a whole night to think if it was the right time for saying no to more children, did not consider, even once, asking his wife to get sterilized instead of him. “Why would I ask her? This is our job,” says Budha. “In our village, it is the men who get sterilized. The women do not.” According to Datta Bahadur Shahi, secretary of Godhe Mahadev VDC, it is hard to find sterilized women across the Karnali region. “Let alone this village, vasectomy is a trend in this whole region,” says Shahi. “There is not a single sterilized woman in Godhe Mahadev.” Tek Bahadur Budha and his wife Malyakala with their youngest son Suraj. The District Public Health Office (DPHO) of Jumla has been organizing vasectomy camps at least thrice every year. In the first eight months of the ongoing fiscal year alone, 263 men have been sterilized. “Our aim is to sterilize at least 400 men in Jumla this year,” says Chakra Khadka, vaccines supervisor at the DPHO. “However, we have no plans to sterilize women.” The rising trend of vasectomy in Karnali region is in sharp contrast with the national figure of sterilization. According to the National Demographic and Health Survey (NDHS)-2011 report, the percentage of sterilized women is almost double the percentage of men. Around 15 per cent of married women are now sterilized in Nepal while the percentage of sterilized men is just eight. Five years ago, when the previous NDHS was conducted, the percentage of sterilized women (18) was three times the number of sterilized men (6). “Trends of sterilization are different in different places,” says Dr Senendra Uperti, director of Family Health Division (FHD). “More women than men get sterilized in Tarai districts. The opposite is the case in mid-western hills, including Karnali region. It all depends on existing social norms, values and practices of a particular geographical region. It is neither good nor bad if just males or just females undergo sterilization.” Dr Upreti says it is not the government´s policy to promote a particular type of sterilization -- vasectomy in case of Karnali. “Our role is to inform people about all available options,” says Dr Upreti. “It is the couples who decide whether husband or wife to get sterilized.” However, Roshan Lal Chaudhari, the DPHO chief in Jumla, says the difficulty in organizing minilab camps compared to vasectomy camps is also in part responsible for the higher percentage of male sterilization in Karnali region. “Organizing vasectomy camps is easier than minilab,” he says. “Minilab camp requires more technical equipment and anesthesia service.” Ramesh KC, local development officer of Jumla, however, says it is people´s mindset that has reversed the national trend of sterilization in Karnali. “Had most of local people opted for female sterilization, the government would have been forced to organize minilab camps,” says KC. “Here, the underlying reason is social not technical.” According to KC, in Karnali region, women work harder than men. “The women work in crop-fields as well apart from doing household chores,” says KC. “And, the men believe that their wives can no longer work hard if they undergo sterilization. This is why the men themselves undergo sterilization.” Maiya Kala, 25, the wife of Budha, echoes what KC explains. A typical woman of Karnali region, Maiyakala initially tried to avoid answering why her husband underwent sterilization instead of her. When prodded, she replied, “Who would do all the work if I am sterilized?” A health worker involved in conducting vasectomy camps in Jumla says that an often-unexpressed thinking of males that their wives may become promiscuous if they get sterilized also prompts men into going through the surgical method of family planning. This is reflected in the NDHS report as well. Almost 22 per cent of males in rural area believe that their wives can have multiple partners if they use contraceptives. The percentage of males who think the same is just 13 per cent in urban area, states the report.