14 Questions and Answers about HPV Vaccine Against Cervical Cancer

 14 Questions and Answers about HPV Vaccine Against Cervical Cancer

What is the HPV vaccine?

The vaccine against cervical cancer is called the human papillomavirus (HPV) vaccine.

Why get it?

– To prevent cervical cancer and other diseases caused by the HPV virus

– To prevent cervical cancer, which is the most common type of cancer in women

Who should get it?

– The younger the age, the better

– Most effective in the age group of 9 to 14

– Women can also get it as per the doctor's advice

Where is it available?

This vaccine can be given in private hospitals. Currently, the government is providing it free of charge through the vaccination program campaign.

Who is the free vaccine for?

– Girls from grades 6 to 10, and girls aged 10 to 14 if they do not go to school

When will the vaccination campaign start?

– It will run for 15 days from Magh 23 to Falgun 6.

Which company's vaccine is being given?

– Nepal is currently preparing to provide the Cicoline brand vaccine made in China.

How much should be administered?

– This vaccine is only given once.

How effective is this vaccine?

– It is claimed that this vaccine is 91 percent effective. It is 100 percent safe if administered before becoming sexually active.

Where can the vaccine be administered?

– It can be administered in government and private schools and nearby health institutions in all seven provinces.

Can it be administered individually?

– Women who are not covered by the vaccination campaign can go to a private hospital to get it.

How much does it cost?

– The price of the HPV vaccine in Nepal can range from 3,000 to 10,000 rupees in the private sector.

What happens if you don't get the vaccine?

– If you don't get the vaccine, you can get infected with the HPV virus and develop cervical cancer. Every year, 2,000 people die from cervical cancer in Nepal.

Isn't this vaccine for medical trials?

The HPV vaccine is a reliable vaccine being provided in Nepal under the cervical cancer prevention program in collaboration with the Ministry of Health and the World Health Organization.

One dose of HPV vaccine is enough

The government gave free HPV vaccine to girls against cervical cancer in Bhadra last year. 10,000 girls who have completed 14 years and have not completed 15 years were given HPV vaccine from central hospitals in all seven provinces. At that time, the vaccine was given in two doses.

But in the nationwide vaccination campaign that will be launched from 22 Magh on the occasion of World Cancer Day, only one dose is being given.

The World Health Organization has recognized three vaccines against cervical cancer, out of which the vaccine being given in Nepal is of the Cicoline brand made in China. The Cicoline brand vaccine was given last Bhadra as well.

But why was the vaccine dose reduced this time?

Dr. Abhiyan Gautam, who is the head of the Child Health and Vaccination Branch, said that the dose of the vaccine was reduced on the recommendation of the new research, guidelines and the Vaccination Advisory Committee. “Research has shown that even one dose works completely,” Dr. Gautam said, “The antibodies that should be formed after vaccination are the ones that are needed to protect the body from the virus.” It turned out that one dose did not make a difference.’

In this campaign, a total of 1.688 million 768 people, including girls from grades 6 to 10 who do not go to school, including girls aged 10 to 14, will be vaccinated. A total of 1.77 million 20 vials of vaccine will be received from Gavi for that. So far, 1.5 million vials of the human papillomavirus (HPV) vaccine used against cervical cancer have been received in three phases. The remaining two will arrive in a few days, according to the Department of Health Services.

The government is conducting a vaccination campaign from Magh 23 to protect girls from cervical cancer. The HPV vaccination campaign will run for 15 days (Magh 23 to Falgun 6). 18,900 schools have been designated as vaccination centers. 8,000 centers have been designated in health institutions other than schools.

Dr. Gautam said that 27,080 health workers, 54,160 volunteers, and 15,674 supervisors will be mobilized for the vaccination campaign. "We have planned to vaccinate girls at the school level from January," Gautam told Online News. "We also vaccinate children outside of school through health institutions."

The HPV virus is contagious and spreads easily. It is mainly transmitted through skin-to-skin contact.

According to doctors, the main reasons for the virus infection are getting married at a young age, having children at a young age, having many children, having children in a short period of time, having sex with many people, having unprotected sex, smoking and drinking a lot, and not paying attention to genital hygiene.

According to doctors, 80 percent of people are infected with HPV by the time they reach the age of 30 to 45. If women and men can get vaccinated before they come into contact with the HPV virus, it will give the best results. Because the vaccine prevents infection. But if the virus has already settled in the body, it cannot make it free from infection.

The HPV vaccine also protects against cervical cancer, anal cancer, throat and genital cancer. According to doctors, the HPV vaccine, if administered before sexual intercourse, provides 90 percent protection for life.

Doctors say that since HPV-related cancers may not show any symptoms in the early stages, vaccination and regular screening are necessary. Since the government is unable to easily provide the vaccine, private organizations have been importing and distributing the vaccine at their own expense. Therefore, women are forced to pay high fees for the vaccine.

E-cigarettes are becoming a fashion among the youth, health is at risk

 E-cigarettes are becoming a fashion among the youth, health is at risk

12-year-old Sarah Griffin, who lives in the UK, suffered from asthma last September. Sarah, who has been in a coma in the hospital for a few days, is now improving. But his addiction to vape has badly damaged his lungs.

According to the BBC, one of the girl's lungs is almost completely destroyed. According to the doctor, his respiratory system has become like that of an 80-year-old instead of a 12-year-old child. Vape, which can make a 12-year-old's respiratory system look like an 80-year-old's, is now gaining popularity not only in Western countries, but also in Eastern countries. Vape (e-cigarette) has started to become a headache among tobacco products.

What is vape?

A vape is an electric cigarette that runs on a battery. People use it to heat liquids into a vapor that can be inhaled. It is considered a cancer-causing tobacco product because the inhaled vapor contains nicotine (a drug that makes tobacco addictive), flavors and toxic substances.

Vape became fashionable in Yuvapindi

Doctors say that the number of school-aged children who use vape in Nepal is increasing. Chest specialist Niraj Bam says, 'Vape has become like a fashion among young people. School and plus two age group studying in urban areas who have started adolescence are getting addicted to vape.

Psychiatrist Dr. Nirajan Bhattarai says that vape has made it easier for young people who are afraid or hesitant to smoke. Even if they want to smoke, children who are afraid and ashamed of their parents will confidently smoke in front of everyone. It has become a problem to openly smoke vape as a style. Because of this, the number of vape users is increasing, Dr. Bhattarai says.

Dr. Nirajan Bhattarai, Psychiatrist

Health risks

Dr. He says that the use of vape, which is being consumed like bomb cigarettes, will cause short-term and long-term health problems. According to him, the short-term effects may include vomiting, nausea, cough, difficulty breathing, mouth burning, and asthma and pneumonia. Long-term effects can include lung infections and damage, heart disease, cancer, and brain problems.

Dr. Bam adds, 'Nicotine products are considered harmful to health, which is why most countries have banned them. It should be banned in Nepal as well.

What do the statistics say?

According to a recent survey in the UK, one in five children between the ages of 11 and 17 use vape. This number is three times more than in 2020.

In the case of Nepal, there has been no research on this. Therefore, it is not possible to estimate how many people use vape. But many people who come to the OPD with lung problems are found to be using vape and hookah. Bam says. Because of this, he says, it will be difficult to control the use of tobacco products like vape and hookah, just as we have to gradually reduce smoking in Nepal.

Greater impact at younger ages

Dr. According to Bam, vaping poses a double threat to the younger age group. First, the various chemicals used in it, nicotine, harms the lungs. It weakens the lungs at an early age. Secondly, once you become addicted, the chances of getting addicted to cigarettes increase even more,” he says. Nicotine affects the brain development of children and adolescents. He says that in the future they will not be able to concentrate on their studies.

Dr. Neeraj Bam, thoracic specialist

Vaping is not a substitute for quitting smoking

In 2003, Hon Lik, a Chinese pharmacist who made e-cigarettes, claimed that he could easily quit smoking with its help. But e-cigarettes, which were created to help people get rid of cigarette addiction, have now become a big challenge for the world. Dr. There is no authentic research that the use of e-cigarettes helps to quit smoking. Bam says.

Is vape less dangerous than cigarettes? Dr. Bam says, 'Of the two types of poison, which one is better is the same thing. The possibility of quitting smoking through e-cigarettes is completely delusional. Harmful substances like nicotine are found in both.

How do you get addicted to vape?

Psychiatrist Dr. According to Bhattarai, vaping every day is likely to become addictive. It seems that after starting to eat under the pressure of social media, peers and friends, it gradually becomes a craving and becomes an addiction. If you start drinking tea during the day, as you get used to it, the more you consume the nicotine in the vape, the more you will become addicted. Nicotine increases the level of dopamine (hormone of pleasure). As a result, the desire to eat increases. The role of nicotine is to depend on it. Most people are taking it in the name of getting rid of smoking addiction. Who gradually becomes addicted to it,' said Dr. Bhattarai says.

Addiction treatment is possible

It is possible to get rid of vape addiction. But with family, own desire and medical treatment is necessary. Bhattarai says. In the treatment of its addiction, depending on the level of addiction, chewing gum and nicotine spray are given to reduce nicotine. After that, some medication and therapy will gradually reduce the desire for nicotine. Bhattarai says.

E-cigarette is becoming a 'gate way' to start smoking

 E-cigarette is becoming a 'gate way' to start smoking

The use of electronic cigarettes (vape) is currently being widely used all over the world. Its use is excessive among young people. Although there is no definite data in Nepal, it is also a fact among us that its use among the youth is increasing day by day. It seems to have started as a way to quit smoking or a solution to tobacco addiction. Recently, it seems that users are using it as a means of entertainment or a different identity.

According to the World Health Organization and various researches, it does not have much of a useful effect in the management of tobacco addiction, on the contrary, it is playing a role as a gateway to start smoking even in people who do not smoke.

What is e-cigarette?

It is a type of electrical device, which heats the liquid tobacco and the flavor used in it and turns it into steam. The user inhales the vapor through the 'mouthpiece' in it. E-cigarettes are available in different forms, types and flavors. E-cigarettes available at various prices are advertised as tobacco-free and tobacco-free. Similarly, the e-cigarettes available in the market are either single-use or multi-use.

What harm does it do?

Regular use of e-cigarettes causes many health complications and harms to human health. Basically, there are various problems in the respiratory system such as persistent dry cough, asthma-like symptoms, wheezing, and constant chest pain. In some cases, the effect of its steam can seriously affect the lungs and even lead to very complicated conditions. According to data, its use significantly increases the risk of various heart diseases and heart attack. Apart from the effects of the nicotine used in it, various mental problems can occur due to the side effects of the chemicals in the developing brain of young people and adults.

Challenges in public health

Unlike the purpose with which e-cigarettes were started, the current major public health challenge is the excessive use of e-cigarettes among young people and adults. If we look at the data of Australia in 2023, more than 17 percent of young people consume it. It seems that one out of every two young people will use e-cigarettes in their lifetime.

What is even more alarming is that even children of 12 years of age or below have been found to be using it regularly. In the Australian state of Victoria alone, more than 14 percent of children between the ages of 12 and 17 are caught in its clutches. Among them, 48 percent don't even smoke and after some time they are also caught in the habit of smoking. Taking these data as a basis, it is becoming a gateway for non-smokers to start smoking. In some cases, it has been found that the user children do not even have proper knowledge about its bad effects and harm.

Another challenge is the regulation of more than 200 chemical elements in it, which act as flavor. What should not be forgotten is that harmful tobacco products have been found in more than 21 percent of e-cigarettes advertised and marketed as tobacco-free.

Also read this

E-cigarettes are becoming a fashion among the youth, health is at risk

Solutions

Taking Nepal's involvement in the World Health Organization's Framework Convention for Tobacco Control as a basis, it seems that e-cigarettes should be regulated as tobacco products. However, in various countries including Australia, stricter legal provisions than those in the framework have been adopted for its regulation. Even in Nepal, as there are debates about its regulation, it seems that a strict legal system should be in view of the public health risk. It has to be properly managed in time as well as economic and social risks. It seems that there should be a complete ban on its export, production, marketing and commercialization. In addition, it seems that a clear message should be conveyed regarding the prohibition of its use in public places, schools, hotels, restaurants and other places.

It seems that there is a need to collect and research data on the use of e-cigarettes and the actual situation in Nepal from the government and non-government. Compared to other countries, it seems that it is necessary to identify the level of risk our young people are and adopt corresponding strategies.

It is the need of today to create and adopt youth-targeted health awareness and public health promotion programs involving the youth as well. Parents also need to be aware that their children are not involved in such kind of culture. In order to discourage the possible use in educational institutions, schools and hostels, it seems that it is necessary to conduct school-targeted awareness programs and to include materials about the harms and side effects of e-cigarettes in the curriculum, to increase the knowledge of children and youth and to develop the skills to avoid smoking.

How healthy is Yarsagumba?

 How healthy is Yarsagumba?

We have heard and seen that people risk their lives to pick Yarsagumba in the Himalayas of Nepal. Yarsagumba is sold in foreign countries from Nepal at the price of lakhs.

It can be understood that Yarsagumba is precious. It is full of health-enhancing, strength-enhancing and disease-fighting abilities. Many diseases that can affect the body can be cured with the correct use of Yarsagumba. It is used not only in Ayurveda but also in allopathic medicine.

Is Yarsagumba a plant or an insect?

Yarsagumba is made from a combination of Jhusilkeera and Dhusi. In summer it is like a weed, in winter it remains as an insect. There is an influx of mushroom species in Jhusilkeera. After this mound grows, it is called Yarsagumba. Therefore, it is also called a combination of flora and fauna.

Yarsagumba is the name given by the Himalayan language. Yarsa means plant and Gumbu means insect. Some people call it the second form of Sanjeevani Booti. Some have even named it the sexually stimulating Himalayan Viagra. The scientific name of Yarsagumba is 'cardiac sinuses'.

What elements are found?

Yarsagumba contains cordycepin and other chemical substances such as nucleoside, cordycepic acid, amino acid, fatty acid, polysaccharide, vitamin B12, B, B1, carbohydrate, glucose, protein, sterol, melanin.

Recent scientific research has confirmed that some of the chemical elements found in it are also useful in cancer and tumor treatment.

How is it prepared as an herb?

When living underground as an insect, the infection is caused by the spores of Ophicordiceps sinensis. After the spore enters the body of the larva, the spore turns into a filamentous cell (like a thread) and starts spreading throughout the body of the larva.

The mycelium absorbs food from the larva's body and makes it hollow and spreads its body inside the larva's body. Finally, the larva dies after attacking the head. From the head of the dead larva grows a stalk-like part, which averages two to four inches long, and is brown in color. When the snow starts to melt in the spring, people collect such stems.

During collection, the parts with insects are removed from the ground by digging with a stick or finger. And after cleaning it can be prepared as a medicine by drying it in cold for some time.

In which area is it found?

It is found at an altitude of 3,600 meters to 5,000 meters above sea level. There are 100 species of Yarsagumba all over the world, while only 21 species of Yarsagumba are found in China, 7 in India and 2 in Nepal.

Yarsagumba is found in Taplejung, Sankhuwasabha, Gorkha, Darchula, Bajhang, Bajura, Jumla, Humla, Mugu, Dolpa, Manang, Sindhupalchok, Rasuwa, Dolakha and other districts of Nepal.

Which is exported from Nepal to Korea, Taiwan, Hong Kong, Myanmar, Thailand, Singapore, Japan, UK and USA.

How did you find it?

The existence of Yarsagumba has been found in Nepal since mythological times. It was used by the Sherpas of the Himalayas. Yarchagumba, which is being used as a different herb, has not been discovered for the first time.

The credit for collecting Yarsagumba for the first time goes to Polunin Cycle and William who came to collect plants on behalf of the British Museum London in 1952. They found a very valuable yarsagumba from Chakhur Lake at an altitude of 4,200 meters and took it away.

In Tibet, it has been pounded and used as a medicine for hundreds of years. It has been used in asthma, liver, heart and kidney diseases under Chinese medicine.

At that time, its discussion was limited. There is an interesting anecdote in the spread of the discussion of Yarsagumba.

In 1993, three Chinese women athletes won the title at the World Track and Field Championships in Germany. They maintained five world records in the 1,500, 3,000 and 10,000 meter races. After the coach revealed that the secret of such a player's excellent performance is to consume Yarsagumba during daily practice, its discussion spread around the world. Along with its discussion, its price has also increased.

Legend

There is a legend that when Lakshmana was injured by an arrow in the battle between Rama and Ravana, Hanuman woke up Lakshmana by feeding him Sanjeevani booti from the northern Himalayas of Nepal. The Sanjeevani Buti is compared to the current Yarsagumba.

Uses of Yarsagumba

Earlier in Nepal, it was used locally in the Himalayan regions for the treatment of diarrhea, headache, hand and knee pain. Eating it mixed with bee honey and milk is believed to increase stamina. Also, it is believed that if its powder is eaten with boiled milk, it will fulfill the deficiency of vitamins.

However, it is now used as an anti-cancer drug, kidney, semen quality, cholesterol, metabolism regulation, back pain, blood circulation, swelling reduction and heart medicine. It is also used as a medicine for anemia, chronic asthma, tumor patients, bone marrow problems.

Yarsagumba is also used in some people who are taking radiotherapy and chemotherapy. It is also used in male and female infertility. As mentioned in WebMD, it is used for respiratory problems, lung infections, frequent urination at night, high cholesterol and ringing in the ears.

Hepatitis B virus, drug-induced kidney damage It is also used in cases. It is also used in mental problems. But how much is used in mental problems? No substantial evidence has been received.

It is also used as an aphrodisiac. Regular intake of yarsagumba by men increases the amount of ketosteroid in the urine. This element increases the production of sex hormones, including androgen and testosterone, which increase sexual arousal in men.

According to experts, if Yarsagumba is mixed with 13 other herbs and consumed continuously for three years, one becomes strong, agile and beautiful.

How much can be eaten?

Yarsagumba is available in the market in both tablet and powder forms. Yarsagumba 500 mg tablets can be mixed with milk twice a day and consumed. Similarly, dust can be taken from three to six grams.

It is only in Nepal that Yarsagumba is not registered in the Drug Administration Department. However, Yarsagumba is also found mixed in the production materials like Chewanprash as a supplement.

Side-effects

Yarsagumba is considered a safe herb and medicine. However, taking yarsagumba may cause side-effects during breastfeeding, pregnancy, blood related problems and surgery. Diarrhea, constipation and stomach related problems can sometimes occur while consuming Yarsagumba.

Tortured transportation of animals from the front of the quarantine

 Tortured transportation of animals from the front of the quarantine

An excessive amount of animals are brought in for meat on the occasion of Dashain. Especially, there is a rush of vehicles carrying buffaloes and goats.

These are the sources of meat that we eat according to taste. But if you see the condition of these animals, you and I will be shocked. My heart cries. Because these Awadh animals are tortured in a very cruel manner and dragged in the car. The cruelty is also such that, as if they are heinous criminals.

Buffaloes are transported by tying their trunks, natris and tails in one truck so that they cannot sit at all. That too is more than capacity. Don't let him eat the grain. Not for one day, but for four or five days.

When brought to Kathmandu, these animals are already weak, sick and injured. There are wounds on their bodies. Nathri's rope is tightened and her head is cut off. The tail is swollen.

Not only the horned buffalo, but also the khasiboka seems to have the same strangeness. Some are tied to the roof, some are locked in a dinky and transported under torture.

When you reach Nagadhunga at this time, you will be heartbroken by such scenes.

While transporting animals in such a cruel way is considered a crime. Animal transport standards have been made to ensure that they can be easily transported. The state has established animal quarantine in various places to monitor or monitor whether the standard is being followed. Staff have been assigned to quarantine. But there, Awadh animals are transported from the front of the quarantine, as if there is no law and order in the country.

28 buffaloes were brought in a vehicle that came from Rupandehi to Nagadhunga in Kathmandu on Tuesday. They were tied to their tails and brought in such a way that it was difficult for them to turn around. Similarly, they brought 22 goats on the roof of the passenger bus that came to Kathmandu from Sindhuli and on the coach. While animals cannot be transported in passenger vehicles.

The driver of the vehicle says that they do not know that it is not possible to bring goats by placing them on the roof of the passenger car and pulling them in the trunk. "We do not know that it is not possible to bring a goat in a passenger vehicle. He says that there is no information about what are the shipping standards and what kind of fines will be imposed if they are violated.

Even after telling them that bringing animals in this way is against the standard, they did not say that they made a mistake and that they will not bring animals in this way from now on. On the contrary, they began to abuse the animal quarantine that stopped the vehicle, 'This law applies only to farmers and the poor like us, not to the elders. What happens when you carry a little goat during Dashain? Take them to Kathmandu and cut them up and eat them.

The Animal Quarantine asked them to bring another vehicle and take the goat but they refused. Quarantine immediately sent them away after paying a fine.

In this way, quarantine could not have sent those transporting animals against the standard to Kathmandu, but they sent them after paying a fine. If only fines are paid and discounts are given to those who transport animals against the standards, this process will continue continuously. Therefore, it is necessary to pass the Animal Welfare Act as soon as possible.

In Section 290 of the Criminal Code of the Civil Code, there is a provision that cruelty to animals should not be treated and if it is done, it is punishable by imprisonment up to three months or a fine of five thousand rupees or both imprisonment and fine. But neither the standards are followed nor action is taken.

Lakshmi Ghimire, Field Officer of Animal Nepal, also reached Nagadhunga to see if the animal transportation was done according to the standards. "Even though animal rights activists are constantly raising their voice that animal transportation should be in accordance with the standards, it has not been fully implemented," she said.

Ghimire says, 'Animals transported in meat production should be treated according to standards. If the standards are not met, the meat is not healthy. It affects people. Therefore, the issue of animal welfare is directly related to people.

The Animal Department under the Ministry of Agriculture and Livestock has the first responsibility to monitor whether the animals are being transported in accordance with the standards. Animal department can monitor by keeping quarantine. Also Nepal Police can monitor and control it. Advocate Padam Bahadur Shrestha says that if the standards are not followed, the shipment can be stopped and fined as well.

Also, despite the 17 years since the animal transportation standard was made, its implementation has not been done properly. Due to the non-implementation of this standard, the buffaloes and goats that enter Kathmandu Valley for meat during Dashain are coming back safely.

Animals are being transported in a cruel way because the standards issued in 2064 are limited to paper. Even though the law prohibiting extreme torture of animals has been passed in Nepal many times, it has not been implemented.

According to the standards, every vehicle transporting animals should have a first aid box. Similarly, animals with different physical structure cannot be transported in the same vehicle. Padapadi should not be mixed with buffalo. All buffaloes, chamois must have their heads and faces facing the front of the vehicle towards the driver. Even the nose and tail cannot be tied. 6 inch thick straw, chaff or sotar should be kept in the wagons for keeping buffaloes and buffaloes.

The body of the animal must be foamed on the side of the vehicle that will be hit. Animals should have 0.84 to 1.27 square meters of space inside the vehicle. By doing this, as many as 20 animals are placed in one truck.

If we look at the transportation of animals to the capital Kathmandu via Prithvi Highway and Tribhuvan Rajpath for meat, many examples of non-compliance can be found. This highway Because of this, thousands of buffaloes and goats are brought into the capital every day, and they are transported in a painful way with extreme torture.

How to check fresh meat in Dashain?

 How to check fresh meat in Dashain?

Many meat shops in Nepal are not constructed and operated scientifically. Due to carelessness there is a risk of bacterial infection in the consumer, the larvae of lice entering the body and different types of diseases. Therefore, you have to pay special attention to some things when buying meat.

Everyone should consider the danger of getting disease instead of nutrition from meat if they get spoiled meat while buying meat. Therefore, consumers should be aware of these things for healthy meat.

Color: Fresh meat should be dark natural color. For example, beef, pork, and chicken are usually dark red, pink, and white, respectively. However, if the color of the meat is light purple instead of red, it means that it has been exposed to oxygen. But it is not dangerous or harmful.

Smell: This is considered to be the easiest way to check the freshness of meat. Fresh meat does not have any kind of smell. There is no particularly strange smell. Strange odors can often be sour, bleach, ammonia or fishy.

Touch: You can also know the quality of meat by touch. Fresh meat is hard to the touch. To check whether the meat is fresh, you should gently press the meat with your fingers. If the meat is fresh, then after a while the meat will return to its original shape, no fingerprints will remain on the meat. If it is not fresh meat, it will have fingerprints on it. If the meat feels slippery to the touch, it is a sign that the meat is rotten.

Check for excessive 'Drop Loss': Drop loss refers to the liquid material that comes out of the meat due to gravity during storage and handling. If the drop loss of meat is excessive, it indicates that the meat is not fresh.

How to check freshness of fish

Looking at the eyes: The eyes of a fresh fish are clean, shiny and slightly protruding. Stale fish have dull and sunken eyes.

Gills: The gills of fresh fish are dark red or pink in color. It is also non-slippery. If the color of the gills is pale or brown, it is a sign that the fish is old.

Smell: Fresh fish has a slight sea or pond smell. If the fish has a strong smell, it indicates that it is stale.

Vent: The vent of the fish should not protrude. This also indicates that the fish is old.

Meat check: Even fresh fish has tough meat. When it is meat, fingerprints should not remain on it. This also indicates that the fish is stale.

(Rai is a teaching assistant at the Central Technology Campus in Dharan. She has a master's degree in food technology.)

Gender Dimension of Disability

 Gender Dimension of Disability

### Unit V: Gender Dimension of Disability (9 hours)

This unit explores the gendered experiences of individuals with disabilities, with a focus on the intersectionality of gender, disability, and sexuality. It delves into the specific challenges that women with disabilities face, including violence and issues related to sexuality. The unit addresses how social, cultural, and legal frameworks shape the lived experiences of disabled women, and emphasizes the importance of recognizing their unique struggles and rights.

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### **A. Experience of Women with Disabilities**

1. **Exclusion from Feminist Agendas**

   - **Ghai (2002)**, in *Disabled Women: An Excluded Agenda of Indian Feminism*, discusses the ways in which disabled women have been marginalized both within the feminist movement and in broader society. Feminism often overlooks the specific challenges that disabled women face, such as social isolation, economic dependency, and limited access to education and employment. Ghai argues that disabled women’s experiences need to be integrated into mainstream feminist discourse in order to build an inclusive movement that addresses the needs of all women.

   

2. **Vulnerability Without Support in Nepal**

   - **Dhungana (2006)** examines the experiences of disabled women in Nepal in *The Lives of Disabled Women in Nepal: Vulnerability Without Support*. Disabled women in Nepal often face extreme vulnerability due to the lack of social support, economic independence, and adequate healthcare. They are more likely to be excluded from educational opportunities and suffer from a lack of employment prospects, making them dependent on their families or the state. Dhungana emphasizes the need for stronger social protection systems and community support for disabled women in Nepal.

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### **B. Violence Against Women with Disabilities**

1. **Silence and Paradox**

   - **Chenoweth (1996)**, in *Violence and Women With Disabilities: Silence and Paradox*, discusses how violence against women with disabilities is often ignored or underreported. Disabled women are more vulnerable to abuse due to their dependency on caregivers, social isolation, and the societal perception that they are weak or incapable. Chenoweth highlights the paradoxical situation where disabled women are often silenced and their abuse goes unnoticed or is dismissed as less significant.

   

2. **Domestic Violence and Disability**

   - **Mays (2006)** explores the intersection of disability and domestic violence in *Feminist Disability Theory: Domestic Violence Against Women with a Disability*. Disabled women are more likely to experience domestic violence, and they face unique barriers in seeking help, such as inaccessible shelters and services that do not cater to their specific needs. Mays calls for an expansion of feminist disability theory to address the prevalence of violence against disabled women and the need for inclusive, accessible services.

3. **CREA Research Report**

   - The **CREA (2011)** report, *Count Me In: Violence Against Disabled, Lesbian, and Sex-Working Women in Bangladesh, India, and Nepal*, highlights the compounded marginalization faced by disabled women who belong to other marginalized groups, such as lesbian and sex-working communities. The report reveals that these women face intersecting forms of violence and discrimination and calls for a more inclusive approach to addressing violence that takes into account these overlapping vulnerabilities.

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### **C. Disability and Sexuality**

1. **Rights and Recognition of Disabled Sexuality**

   - **Shakespeare (2000)** in *Disabled Sexuality: Toward Rights and Recognition*, advocates for the recognition of the sexual rights of disabled individuals. Disabled people, particularly women, are often desexualized by society and denied the opportunity to express their sexuality freely. Shakespeare argues that sexuality is a human right and that society must recognize the sexual agency of disabled individuals and create an environment where they can experience fulfilling sexual lives without stigma.

2. **The Sociopolitical Economy of Disability and Sexuality**

   - **Shildrick (2007)**, in *Contested Pleasures: The Sociopolitical Economy of Disability and Sexuality*, explores the complex ways in which disabled sexuality is regulated and controlled. Disabled people are often seen as asexual or hypersexual, depending on societal prejudices. Shildrick discusses how these perceptions shape the sexual experiences of disabled individuals, particularly women, and emphasizes the need for policies and practices that respect the sexual autonomy of people with disabilities.

3. **Experience of Motherhood for Disabled Women**

   - **Khanal (2012)**, in *Experience of Motherhood of Disabled Women*, explores the experiences of disabled women who are mothers. Motherhood is often seen as incompatible with disability, and disabled women who become mothers face significant challenges, including societal stigma, inadequate healthcare, and a lack of support services. Khanal emphasizes that these women’s experiences must be recognized and supported, and that disability should not be seen as a barrier to motherhood.

---

### **Conclusion**

Unit V on "Gender Dimension of Disability" emphasizes the intersection of gender and disability, focusing on the unique challenges that disabled women face. It highlights their experiences of marginalization, vulnerability to violence, and the complex relationship between disability and sexuality. The readings in this unit provide insights into the ways that disabled women are excluded from feminist discourses, subjected to violence, and denied their sexual and reproductive rights. By understanding these issues, scholars and practitioners can work toward creating more inclusive policies and practices that address the specific needs of disabled women.

---

### Key Readings:

1. **Experience of Women with Disabilities**:

   - Ghai, A. (2002). Disabled Women: An Excluded Agenda of Indian Feminism.

   - Dhungana, B. M. (2006). The Lives of Disabled Women in Nepal: Vulnerability Without Support.

2. **Violence Against Women with Disabilities**:

   - Chenoweth, L. (1996). Violence and Women With Disabilities: Silence and Paradox.

   - Mays, J. M. (2006). Feminist Disability Theory: Domestic Violence Against Women with a Disability.

   - CREA (2011). Count Me In Research Report: Violence Against Disabled, Lesbian, and Sex-Working Women in Bangladesh, India, and Nepal.

3. **Disability and Sexuality**:

   - Shakespeare, T. (2000). Disabled Sexuality: Toward Rights and Recognition.

   - Shildrick, M. (2007). Contested Pleasures: The Sociopolitical Economy of Disability and Sexuality.

   - Khanal, A. N. (2012). Experience of Motherhood of Disabled Women.

Here are **top 10 potential exam questions** based on the topics from the units you've covered:

---

### **Unit I: Understanding Ageing**

1. **Population dynamics**: Discuss the global and national trends in population ageing from 1950 to 2050. What are the political, economic, and social implications of these trends?

2. **Definitions of ageing**: Compare and contrast the varied definitions and applications of ageing, including the concept of active ageing and its determinants.

3. **Gerontology and geriatrics**: Outline the history of gerontology and geriatrics and discuss their significance in the study of ageing.

4. **Theoretical perspectives**: Evaluate different theoretical perspectives on the sociology of ageing. How do these perspectives contribute to understanding the ageing process in society?

---

### **Unit II: Legal Frameworks and Implementations**

5. **International frameworks on ageing**: Analyze the significance of international conferences such as the First and Second World Assemblies on Ageing, the Madrid International Plan of Action (MIPAA), and the UN Principles for Older Persons in shaping global ageing policies.

6. **National frameworks on ageing**: Assess the effectiveness of Nepal's **National Action Plan for Senior Citizens (2006)** and **Senior Citizens Act (2007)** in addressing the needs and rights of older people. How do these frameworks compare to global standards?

---

### **Unit III: Emerging Issues and Challenges of Ageing**

7. **Challenges of ageing populations**: Identify the key challenges posed by an ageing population globally and in Nepal. How do these challenges impact healthcare, social security, and economic stability?

8. **Elder abuse and violence**: Discuss the prevalence and forms of elder abuse and violence in Nepal. What legal and social measures are in place to protect older people, and how effective are they?

---

### **Unit IV: Understanding Disability**

9. **Beyond medical and social models**: Critically evaluate the limitations of both the medical and social models of disability. What alternative perspectives have emerged to better address the complexity of disability in contemporary society?

10. **Feminist disability theory**: Explain the contributions of feminist disability theory. How does it address the intersection of gender and disability, particularly in relation to body image, sexuality, and the experiences of disabled women?

---

These questions encourage both theoretical understanding and practical analysis of ageing and disability issues, helping you prepare for critical discussions and written exams.

Understanding Disability

 Understanding Disability

### Unit IV: Understanding Disability (9 hours)

This unit provides a critical understanding of disability from various perspectives, moving beyond the traditional medical and social models to explore international and national legal frameworks and feminist disability theory. It aims to deepen the understanding of disability as a complex socio-political issue and highlights the significance of inclusive approaches to disability in both global and local contexts. 

---

### **A. Beyond Medical and Social Models of Disability**

1. **Medical Model of Disability**

   - The medical model views disability as an individual problem caused by physical, sensory, or mental impairments. It emphasizes diagnosis, treatment, and rehabilitation. From this perspective, disability is something to be "fixed" or "cured" through medical intervention. Historically, this model dominated both policy and public perception, reinforcing the idea that people with disabilities are "sick" or "abnormal."

   

2. **Social Model of Disability**

   - In contrast, the social model argues that disability is not just a medical condition but a societal construct. According to this model, the barriers that disabled people face—such as inaccessible buildings, discriminatory practices, and exclusion from societal activities—are the real sources of their disability. **Crow (1996)** in *Including All of Our Lives: Renewing the Social Model of Disability* calls for renewing and expanding this model to address a wider range of issues, such as the experiences of people with mental health disabilities and those from marginalized communities.

   - **Shakespeare & Watson (2001)** question the limitations of the social model, arguing in *The Social Model of Disability: An Outdated Ideology?* that while it has been instrumental in shifting the focus away from impairment, it does not fully address the personal experiences of disabled individuals, particularly those who deal with chronic illness or pain.

   

3. **Critique and Expansion of Disability Models**

   - Scholars like **Taleporos & McCabe (2002)**, in *Body Image and Physical Disability—Personal Perspectives*, offer an expansion of the debate by focusing on the psychological and personal aspects of living with a disability. They argue that body image and identity are crucial areas often overlooked in both the medical and social models. While the social model highlights structural barriers, it does not always account for the internal struggles disabled people face in societies that stigmatize physical differences.

---

### **B. International and National Legal Frameworks**

1. **United Nations Convention on the Rights of Persons with Disabilities (UNCRPD, 2006)**

   - The **UNCRPD (2006)** is a groundbreaking international legal instrument that shifts the understanding of disability from a charity-based or medical model to a human rights-based approach. It seeks to ensure that people with disabilities enjoy the same rights and opportunities as everyone else. The convention covers civil, cultural, economic, political, and social rights, and emphasizes dignity, individual autonomy, and participation in society.

   - Key principles include:

     - Respect for inherent dignity and individual autonomy.

     - Non-discrimination.

     - Full and effective participation and inclusion in society.

     - Accessibility.

     - Equality of opportunity.

     - Respect for difference and acceptance of people with disabilities as part of human diversity.

   

2. **National Legal Frameworks: Nepal**

   - In Nepal, the **Disabled People's Welfare and Protection Act and Regulation** provides a legal framework to safeguard the rights and welfare of people with disabilities. Despite these legal protections, implementation has been slow, and access to education, employment, and healthcare remains limited. The **UNICEF (2001)** report, *A Situation Analysis of Disability in Nepal*, highlights the social and institutional barriers that continue to marginalize disabled people in Nepali society.

   - The Disabled People's Welfare and Protection Act seeks to address these inequalities by mandating the state to provide appropriate services, but gaps in enforcement, awareness, and resource allocation remain critical issues.

---

### **C. Feminist Disability Theory**

1. **Integrating Disability with Feminist Theory**

   - **Garland-Thomson (2002)**, in her seminal paper *Integrating Disability, Transforming Feminist Theory*, argues for the integration of disability into feminist scholarship. She points out that disability, like gender, is socially constructed and rooted in power dynamics that reinforce norms of able-bodiedness. Feminist disability theory critiques the assumption that disability is inherently negative or undesirable, challenging societal standards of beauty, normalcy, and ability.

   - The theory builds on the idea that both women and people with disabilities experience marginalization due to their perceived departure from societal norms. It also examines how gender and disability intersect to create unique experiences of oppression for disabled women. For instance, women with disabilities often face dual discrimination in healthcare, employment, and personal relationships, as their gender and disability status compound their exclusion.

2. **Feminist Disability Studies**

   - **Garland-Thomson (2001)**, in *Reshaping, Re-thinking, Re-defining: Feminist Disability Studies*, emphasizes that disability studies and feminist theory should work together to reshape society's understanding of both disability and gender. She argues that the experiences of disabled women can offer new insights into feminist concepts such as embodiment, autonomy, and agency. For example, a feminist disability perspective might examine how the medicalization of women's bodies, particularly in areas such as reproductive health, intersects with the medicalization of disability to reinforce patriarchal and ableist norms.

   - Feminist disability theory calls for an inclusive approach that recognizes the diversity of human experiences, challenging both traditional disability models and feminist discourses that fail to account for the experiences of disabled individuals.

---

### **Conclusion**

Unit IV on "Understanding Disability" expands the scope of disability studies by moving beyond the medical and social models to explore legal frameworks and feminist perspectives. The medical and social models provide important lenses, but they are limited in capturing the full experience of disability. The human rights-based approach, as emphasized by the UNCRPD, and the feminist disability theory proposed by scholars like Garland-Thomson, provide deeper and more inclusive ways to understand and address disability.

By integrating feminist theory with disability studies, this unit highlights the intersectional challenges that disabled individuals, particularly women, face in society. It also underscores the importance of implementing both international and national legal frameworks to ensure that people with disabilities are granted equal rights and opportunities in all areas of life.

---

### Key Readings:

1. **Beyond Medical and Social Models of Disability**:

   - Crow, L. (1996). Including all of our lives: Renewing the social model of disability.

   - Shakespeare, T., & Watson, N. (2001). The social model of disability: An outdated ideology?

   - Taleporos, G., & McCabe, M. P. (2002). Body image and physical disability—personal perspectives.

2. **International and National Legal Frameworks**:

   - UNCRPD (2006). Convention on the Rights of Persons with Disabilities.

   - UNICEF (2001). A situation analysis of disability in Nepal.

3. **Feminist Disability Theory**:

   - Garland-Thomson, R. (2002). Integrating disability, transforming feminist theory.

   - Garland-Thomson, R. (2001). Reshaping, re-thinking, re-defining: Feminist disability studies.

Emerging Issues and Challenges of Ageing

 Emerging Issues and Challenges of Ageing

### Unit III: Emerging Issues and Challenges of Ageing (6 hours)

This unit addresses the current and emerging issues related to ageing, focusing on the challenges of an ageing population, abuse and violence against older people, and new research agendas on ageing. It explores the complexities that come with an increasing elderly population and highlights the need for thoughtful policy responses and social awareness. Below is a detailed explanation of each section in this unit.

---

### **A. Challenges of an Ageing Population**

1. **Global Population Ageing**

   - According to the **WHO's Active Ageing: A Policy Framework (2012)**, population ageing is one of the most significant demographic trends of the 21st century. By 2050, the number of older people globally is expected to surpass the number of children, creating unprecedented social, economic, and political challenges. 

   - The transition to an ageing society presents challenges in terms of providing adequate healthcare, pension systems, social services, and infrastructure. Older adults require specific care services, which are often lacking, particularly in low- and middle-income countries like Nepal.

   

2. **Economic Implications**

   - An ageing population can strain a country’s economic resources. The **Parker & Pant (2009)** study on "Ageing in Nepal: Emerging Issues and Challenges" highlights that in Nepal, a majority of older adults depend on their families for economic support. However, with increased migration of the younger population and the erosion of traditional family support structures, this dependency becomes a significant challenge. Older people may find themselves in poverty, without adequate financial resources or social security systems.

   

3. **Healthcare Needs**

   - The ageing population has unique healthcare needs, including management of chronic diseases, access to specialized geriatric care, and mental health services. However, many developing countries, including Nepal, lack sufficient infrastructure and medical personnel trained to address these needs. This leads to gaps in care, making it difficult for older persons to receive the appropriate health interventions they require.

---

### **B. Abuse and Violence Against Older People**

1. **Elder Abuse in Nepal**

   - Elder abuse, a growing concern globally, is also a significant issue in Nepal. Abuse may take various forms, including physical, emotional, financial, and neglect. According to the **Geriatric Centre Nepal (2010)** report, cases of elder abuse are often underreported due to the stigma associated with disclosing abuse, as well as the reliance on family members for care. The **baseline study on elder abuse in the Nepali press** highlighted that elder abuse is often perpetrated by family members, caregivers, or close acquaintances, making it difficult for victims to seek help.

   

2. **Types of Abuse**

   - **Ageing Nepal (2011)** documented cases of elder abuse and neglect between 2009 and 2011. The study found that financial exploitation was one of the most common forms of abuse, with many older adults being denied their financial rights by family members or others. Physical and emotional abuse were also frequently reported, often stemming from social and economic tensions within families.

   

3. **Addressing Elder Abuse**

   - To combat elder abuse, both policy interventions and public awareness are necessary. There needs to be stronger enforcement of existing laws and regulations, such as Nepal’s **Senior Citizens Act (2007)**, which provides legal protection for older adults. Additionally, social support systems must be strengthened to provide alternative care options for older people who are vulnerable to abuse within their families.

---

### **C. New Research Agendas on Ageing**

1. **UN Research Agenda on Ageing for the 21st Century**

   - The **UN Programme on Ageing (2007)** outlined the **Research Agenda on Ageing for the 21st Century**, a joint initiative of the United Nations Programme on Ageing and the International Association of Gerontology and Geriatrics (IAGG). The agenda highlights key areas where further research is needed to address the complex issues associated with an ageing population.

   - The main objectives of this research agenda include:

     - Understanding the diverse experiences of ageing in different cultural and socio-economic contexts.

     - Examining the effects of social and economic policies on the well-being of older adults.

     - Investigating the impact of migration and globalization on the ageing process.

     - Promoting age-friendly environments and addressing social isolation among the elderly.

   

2. **Emerging Research Topics**

   - **Intergenerational Relations**: As families change due to migration and modernization, research is needed on how these shifts affect relationships between generations. In many societies, older adults rely on their children for economic and emotional support, but with the younger generation moving away for employment, these traditional support systems are being strained.

   - **Technology and Ageing**: The role of technology in improving the lives of older persons is another emerging area of research. Access to technology can help older adults stay connected with family members, access healthcare services remotely, and manage daily tasks. However, there is a growing digital divide, particularly in developing countries like Nepal, where many older adults may not have access to or familiarity with technology.

   - **Gender and Ageing**: Research has shown that the experience of ageing can differ significantly between men and women. Older women, in particular, may face greater challenges due to longer life expectancy, economic dependency, and gender-based discrimination. Studies like those in the UN research agenda emphasize the need to understand the gendered dimensions of ageing and formulate policies that address these inequalities.

---

### **Conclusion**

Unit III on "Emerging Issues and Challenges of Ageing" provides an essential understanding of the complexities surrounding an ageing population. From the challenges of healthcare and economic dependency to the critical issue of elder abuse, this unit emphasizes the urgent need for policy interventions and social support systems that cater to the unique needs of older adults.

The international research agenda highlights that more academic work is needed to address these emerging issues, focusing on intergenerational relations, gender dimensions of ageing, and the potential of technology to improve the quality of life for the elderly.

---

### Key Readings:

1. **Challenges of Ageing Population**:

   - **WHO (2012)**. Active ageing: A policy framework. pp. 33-43.

   - **Parker, S., & Pant, B. (2009)**. Ageing in Nepal: Emerging Issues and Challenges.

2. **Abuse and Violence Against Older People**:

   - **Geriatric Centre Nepal (2010)**. A baseline study on reported cases of elder abuse in Nepali press.

   - **Ageing Nepal (2011)**. Cases of elder abuse and neglect 2009-2011.

3. **New Research Agendas on Ageing**:

   - **UN Programme on Ageing (2007)**. Research agenda on ageing for the 21st century, a joint project of the United Nations Programme on Ageing and the International Association of Gerontology and Geriatrics.

Legal Frameworks and Implementations

Legal Frameworks and Implementations

 ### Unit II: Legal Frameworks and Implementations (12 hours)

This unit covers the international and national legal frameworks related to ageing and their implementations. It also examines the status of older people and the social perception of ageing, with a particular focus on Nepal. Below is a detailed analysis of each section.

---

### **A. International Conferences and Legal Frameworks**

1. **First World Assembly on Ageing (Vienna, 1982)**

   - The **First World Assembly on Ageing** was convened in Vienna in 1982, marking the first time the global community came together to address the ageing population. The assembly emphasized the need for international cooperation to ensure the well-being of older people, focusing on areas such as health, housing, and social welfare. The assembly adopted the **Vienna International Plan of Action on Ageing**, which laid down recommendations for enhancing the lives of older persons worldwide. 

   - This action plan encouraged countries to develop national policies focusing on ageing and integrate older persons into society, advocating for their health care and income security.

2. **United Nations Principles for Older Persons (1991)**

   - Adopted by the **UN General Assembly** in 1991, these principles outline five key areas where older persons should have rights:

     - **Independence**: Older persons should have access to income, healthcare, and work opportunities.

     - **Participation**: Older persons should remain integrated into society and participate in decision-making.

     - **Care**: Older persons should have access to social, legal, and healthcare services.

     - **Self-fulfillment**: They should be able to pursue personal growth.

     - **Dignity**: Their rights and freedoms should be respected.

   - These principles provided a framework for national governments to formulate policies aimed at improving the quality of life for older persons.

3. **Year of Older Persons (1999)**

   - The **United Nations International Year of Older Persons** was declared in 1999, bringing attention to the contributions and challenges of ageing populations. It aimed to promote awareness about the issues older adults face and called for a global focus on improving their quality of life.

4. **Second World Assembly on Ageing (Madrid, 2002) & Madrid International Plan of Action on Ageing (MIPAA)**

   - The **Second World Assembly on Ageing** took place in Madrid in 2002. It built upon the Vienna Plan of Action and launched the **Madrid International Plan of Action on Ageing (MIPAA)**, a comprehensive global policy framework aimed at addressing the challenges of an ageing population. MIPAA focused on three priority areas:

     - **Older persons and development**: Promoting the integration of older persons in society.

     - **Advancing health and well-being**: Improving access to healthcare and social services.

     - **Ensuring supportive environments**: Advocating for age-friendly housing and infrastructure.

   - MIPAA emphasized the importance of incorporating ageing into development policies, particularly in low- and middle-income countries.

5. **UN Resolution on the Rights of Older People (2011)**

   - In 2011, the **UN General Assembly** adopted a resolution calling for the recognition of the rights of older persons. It aimed to protect older adults from discrimination and violence and stressed the need for comprehensive legal protections at both national and international levels.

   - The resolution also called for governments to ensure that older persons have equal access to employment, social protection, and healthcare.

6. **Review of MIPAA (2012)**

   - The **MIPAA Review (2012)** assessed the progress made since the adoption of the Madrid Plan of Action. The review highlighted some of the achievements in implementing ageing-related policies but also pointed out the need for more robust efforts, particularly in addressing the vulnerabilities of older persons in developing countries.

---

### **B. National Plans and Acts on Ageing in Nepal**

1. **National Action Plan for Senior Citizens (2006)**

   - Nepal's **National Action Plan for Senior Citizens (2006)** was formulated to address the growing needs of the elderly population in Nepal. It aligns with global frameworks such as MIPAA and aims to improve the well-being of older persons by enhancing their access to social services, health care, and legal protections.

   - The plan focuses on key areas such as:

     - Establishing old-age homes and day-care centers.

     - Providing healthcare services tailored to the needs of older people.

     - Supporting income-generating activities for senior citizens.

     - Promoting the participation of older persons in social and political life.

2. **Senior Citizens Act (2007) and Senior Citizens Regulation (2009)**

   - The **Senior Citizens Act (2007)** marked a significant legal step in protecting the rights and welfare of older people in Nepal. The act provides a legal framework for the establishment of care homes, social security measures (such as pensions), and special concessions for senior citizens.

   - The **Senior Citizens Regulation (2009)** builds upon the act, specifying the rights of older persons and outlining the responsibilities of the government in providing support and services. The regulation mandates that public transport and healthcare services offer discounts and prioritization for elderly individuals.

---

### **C. Status of Older People in Nepal**

1. **Demographic Overview**

   - The elderly population in Nepal is growing due to an increase in life expectancy and a decline in fertility rates. According to **Ageing Nepal and CDPS (2012)**, older persons face several challenges, including limited access to healthcare, inadequate social protection, and dependence on family members for care. 

   - Nepal's socio-economic structure is still largely family-based, and elderly individuals often live with their children. However, this traditional support system is eroding due to migration, urbanization, and changing family dynamics.

2. **Challenges in Health and Social Care**

   - A joint study by **Ageing Nepal and CDPS (2012)** highlights that Nepal's healthcare infrastructure is not well-equipped to handle the specific needs of its ageing population. The study recommends piloting community-based care programs and improving access to geriatric services.

---

### **D. Social Perception of Ageing in Nepal**

1. **Cultural Views on Ageing**

   - In Nepal, ageing is traditionally viewed as a respected stage of life. Older people are often seen as the custodians of cultural and religious values, and respect for elders is an integral part of societal norms.

   - However, **Uprety (2010)** and other studies indicate that this respect is not always accompanied by adequate social and economic support. Some elderly people face neglect, particularly as family structures change due to modernization and migration.

2. **Work and Dependency**

   - **Beall and Goldstein (1982)** examined the work and dependency of older Sherpas in Nepal, highlighting that older people continue to contribute to their households even as they age. However, with increasing economic pressures and migration of younger family members, many elderly individuals are left without sufficient support.

3. **Elderly Homes and Social Isolation**

   - According to **Acharya (2008)**, there has been a growing trend in the establishment of elderly homes in Nepal. While these homes provide necessary shelter and care, they often lead to the social isolation of older persons, who are separated from their families and communities. The study suggests that the rise of elderly homes reflects the changing social fabric of Nepalese society, where traditional family support structures are weakening.

---

### Key Readings:

1. **International Frameworks**:

   - **UN (1982)**. Report of the world assembly on ageing, Vienna, 26 July to 6 August 1982.

   - **UN (2002)**. Political declaration and Madrid International Plan of Action and Ageing, Second World Assembly on Ageing, Madrid, Spain.

   - **UN Resolution on Rights of Older People (2011)**.

2. **National Plans and Acts**:

   - **Parker, S., & Pant, B. (2011)**. Longevity in Nepal: Health, policy and service provision challenges.

   - **Senior Citizens Act (2007)** and **Senior Citizens Regulation (2009)**.

3. **Status of Older People in Nepal**:

   - **Ageing Nepal and CDPS (2012)**. Health and social care needs assessment of elderly.

   - **Uprety, L.P. (2010)**. Effectiveness of non-contributory social pension in Nepal.

   - **Acharya, Pradeep (2008)**. Senior citizens and elderly homes: A survey from Kathmandu.

---

This unit provides a comprehensive understanding of the legal frameworks and the status of older persons both globally and in Nepal. By studying the international conferences, national action plans, and acts related to ageing, students gain insights into how various policies shape the lives of older persons. Additionally, understanding the social perception of ageing in Nepal is essential for analyzing the cultural and structural challenges faced by older people in a rapidly changing society.

Understanding Ageing

 Understanding Ageing

### Unit I: Understanding Ageing (12 hours)

This unit delves into the essential sociological understanding of ageing, examining population trends, definitions, the historical context of gerontology and geriatrics, and theoretical perspectives in the sociology of ageing. Below is a detailed breakdown of each topic:

---

### **A. Population Dynamics and Global and National Trend (1950–2050): Political, Economic, and Social Implications**

#### 1. **Global Trends (1950–2050)**

- The global population is ageing at an unprecedented rate. Between 1950 and 2050, the population of people aged 60 and above will increase significantly. According to the **Population Reference Bureau (2011)**, by 2050, it is estimated that older adults will make up more than 20% of the global population.

  

#### 2. **National Trends in Nepal**

- Nepal is also witnessing a significant shift in its age demographics. **Chalise (2006)** outlines how Nepal is becoming an ageing society, with its elderly population (those aged 60 and above) growing rapidly. This change has crucial implications for the country's economic development, healthcare infrastructure, and social welfare systems.

- The **Central Bureau of Statistics (2011)** provides a detailed overview of the population structure, indicating that the share of older adults in Nepal has steadily increased, which presents challenges such as pension sustainability, healthcare access, and family-based care systems.

#### 3. **Political, Economic, and Social Implications**

- **Political Implications**: Governments worldwide are adopting policies to address the challenges posed by an ageing population, such as pension reforms, age-friendly employment policies, and healthcare initiatives.

- **Economic Implications**: Ageing populations lead to shifts in the workforce, with fewer younger individuals supporting more older adults, thereby affecting economic productivity, public spending on pensions, and healthcare.

- **Social Implications**: Ageing societies face the challenge of caring for an increasing number of older adults, requiring changes in social support systems, intergenerational relationships, and housing arrangements.

---

### **B. Varied Definition and Application of Ageing, Active Ageing, and its Determinants**

#### 1. **Definitions of Ageing**

- The concept of ageing varies across cultures and disciplines. According to the **WHO**, older persons are typically defined as individuals aged 60 or 65 and above, though this threshold can vary by country due to differences in life expectancy and social norms.

  

#### 2. **Active Ageing**

- **Active ageing** is a concept introduced by the **World Health Organization (WHO, 2012)**, which emphasizes the importance of optimizing health, participation, and security to enhance the quality of life as people age. Active ageing encourages older individuals to remain engaged in social, economic, cultural, and civic affairs rather than simply focusing on being free of disease or disability.

  

#### 3. **Determinants of Active Ageing**

- The **WHO Active Ageing Framework** (2012) identifies several determinants that influence the ability of older adults to age actively:

  - **Health services**: Access to health care is essential to promote active ageing.

  - **Economic determinants**: Income security and employment opportunities for older adults.

  - **Social determinants**: Social support networks and opportunities for social engagement.

  - **Physical environment**: Safe housing and transport facilities.

  - **Behavioral determinants**: Lifestyle choices like physical activity and healthy eating.

  - **Personal determinants**: Genetics, personal resilience, and adaptive capabilities.

  - **Gender and culture**: Gender-based and cultural factors also influence ageing experiences.

---

### **C. History of Gerontology and Geriatrics**

#### 1. **Gerontology**

- **Gerontology** is the study of the biological, psychological, and social aspects of ageing. According to **Bengtson et al. (1997)**, gerontology emerged as a distinct field in the early 20th century, with the focus initially on the biological aspects of ageing but later expanding to include psychological and sociological dimensions. The field has evolved through three generations of theoretical development, moving from descriptive to more critical and interdisciplinary approaches.

#### 2. **Geriatrics**

- **Geriatrics** is the branch of medicine that focuses on the healthcare needs of older adults. It is concerned with the diagnosis, treatment, and prevention of diseases in ageing individuals. **Gautam (n.d.)** discusses the distinction between gerontology and geriatrics, noting that while geriatrics is primarily clinical, gerontology is more holistic, considering the social and psychological impacts of ageing.

#### 3. **Development of Gerontology and Geriatrics**

- The historical development of these fields has contributed significantly to how societies understand ageing and how older adults are treated within healthcare and social systems.

---

### **D. Theoretical Perspectives on Sociology of Ageing**

#### 1. **Disengagement Theory**

- One of the earliest sociological theories of ageing, **disengagement theory**, posits that as people age, they naturally withdraw from social roles and relationships, which is viewed as beneficial for both the individual and society.

#### 2. **Activity Theory**

- In contrast, **activity theory** argues that staying active and engaged in social roles leads to greater life satisfaction in old age. According to this perspective, older adults who maintain social, physical, and mental activities can experience a more fulfilling and productive life.

#### 3. **Age Stratification Theory**

- **Age stratification theory** examines how society is structured by age groups, and how roles and expectations change as individuals transition through different stages of life. This theory emphasizes the impact of social institutions and policies on the ageing process.

#### 4. **Life Course Perspective**

- The **life course perspective** emphasizes that ageing is a lifelong process shaped by historical, social, and cultural factors. It recognizes that earlier life experiences can influence outcomes in later life, such as health, income, and social connections.

#### 5. **Critical Gerontology**

- **Critical gerontology** challenges traditional notions of ageing and advocates for examining how structural inequalities, such as class, race, and gender, shape the experiences of older adults. It emphasizes the importance of understanding the social, political, and economic contexts that impact ageing.

#### 6. **Intersectionality in Ageing**

- **Intersectionality** in ageing studies explores how age interacts with other social categories such as gender, race, and socioeconomic status, shaping the diverse experiences of ageing.

---

### Key Readings:

1. **Global and National Trends**:

   - **Population Reference Bureau (2011). 2011 World Population Data Sheet**. Population Reference Bureau.

   - **Chalise, H. N. (2006)**. Demographic situation of population ageing in Nepal.

   - **CBS. (2011)**. Preliminary report-census 2011. Center Bureau of Statistics, Nepal.

2. **Definitions of Ageing and Active Ageing**:

   - **WHO (n.d.)**. Definition of an older or elderly person.

   - **WHO (2012)**. Active ageing: a policy framework.

3. **Gerontology and Geriatrics**:

   - **Bengtson, V. L., Burgess, E. O., & Parrott, T. M. (1997)**. Theory, explanation, and theoretical development in social gerontology.

   - **Gautam, M. K. (n.d.)**. Basic Concept of Gerontology and Geriatrics.

4. **Theoretical Perspectives on Ageing**:

   - **Marshall, V. W., & Bengtson, V. L. (2011)**. Theoretical perspectives on the sociology of aging.

   - **Bengston, V.L et al (1999)**. Handbook of Theories of Aging.

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This unit provides the foundational knowledge necessary for understanding ageing from both a sociological and interdisciplinary perspective. By exploring population trends, key concepts like active ageing, the history of gerontology and geriatrics, and theoretical frameworks, students will be equipped to critically engage with the social and policy issues related to ageing in both global and local contexts.