Demystifying the Maoist barefoot doctors of Nepal

Abstract

Though not purposefully targeted, Nepal's decade-long violent conflict waged by the United Communist Party Nepal-Maoist (UCPN-M) has had considerable impact on the health of the population. Fairly early on the UCPN-M established its own primary health care services in the rural areas under its control. This questionnaire study included 197 Maoist health workers recruited from a wide range of backgrounds in terms of age, experience, gender, caste and ethnicity, and schooling. Many appear to be young paramedics with few skills, who received a short training during the decade long conflict. For two-thirds of them political ideology was a key motivating factor for joining, and for unemployed youths this proportion was significantly higher. Nine out of 10 considered themselves as ‘qualified’ to work as support level health workers in the future. Regression analysis shows that a significantly higher proportion of women and those with previous academic and basic type of training were willing to integrate/rehabilitate into the mainstream health sector since the conflict ended in 2006. It is important to capitalize upon this opportunity to redevelop the health services, especially in rural areas in Nepal, and to contribute to the peace process.

Keywords:

• conflict
• health worker
• integration
• motivation
• rural

Acknowledgements

The authors thank first and foremost all interviewees who gave us their time. The authors also acknowledge the Nepal Health Research Council for granting ethical approval to conduct this study. The authors extend their thanks to Professor Neil Mitchell for reviewing the initial draft of this article, and Ms. Jilly Ireland for proof-reading the final version. Finally, we thank the anonymous reviewers for their useful comments on the article initially submitted.