Kim, Yoona

School of Public Health

PhD

Nepal

Nepal-Understanding factors associated with of mental health problems in bereaved widows in Nepal

This research project is part of an ongoing collaboration with Nepali NGOs Transcultural Psychological Organization (TPO) and Women for Human Rights (WHR) to understand mental health issues among Nepali widows, a group of marginalized women within Nepali society.  TPO is a leading mental health NGO in Nepal that promotes psychosocial well-being and mental health through development of culturally-appropriate, community-based psychosocial support systems. WHR works for advocacy of human rights for single women in Nepal, especially for widows (who are marginalized group in society). Continuing ongoing work originally to explore health and human rights of these women, we seek to characterize factors associated with a variety of mental health disorders (depression, anxiety, PTSD) among widows (recruited through WHR) in order to generate information that can ultimately help target interventions.

PI Mentor: Pam Surkan

My GHEFP project was about providers’ perceptions on mental health needs of widowed women in Nepal. The generalized cultural context in Nepal, as I learned from previous qualitative studies conducted there, was that widowed women faced financial difficulties, behavioural restrictions, and stigma associated with loss of their husbands. Coming from a Korean family, I had second-hand understanding of similar attitudes shared by members in my own culture. I would hear someone on media say their male family member died “because he married the woman with bad luck”, when he suffered an accident. I thought I had an advantage of understanding this cultural context as I started to work on the project. 

I worked with a translator, a young, female, recent college graduate who quickly became my point person whenever I had questions about Nepal and its society. Never having travelled out of Nepal, save one trip to Bangalore, India, where she stayed a few month, she had the entire season of Friends on her computer, was fluent in American puns and jokes, and showed incredible kindness and protective instincts to me. Initially, she questioned my perception of widowed women’s lived experiences, perceptions I relayed from reading previous studies. She suggested that maybe the studies were talking about women in the rural side of Nepal? She did not see such overt discrimination and hardship among widowed women in Kathmandu. Maybe it’s a story of the past. 

As we started to conduct interviews with providers and widowed women, both my ignorance in thinking “I’ve heard this before somewhere else. I can be mindful.” and my translator’s perhaps narrow insight based on her contemporary life in Kathmandu were exposed. Widowed women, both in the city of Kathmandu and in more rural areas of Chitwan, did not always fall in the narratives previously written for them. There were of course some shared hardships. They discussed their constant worries about their children, difficulty dealing with finances and family politics revolving finances, and the discrimination from the society. However, there was also creativity, resilience, and defiance. They reinterpreted and recreated some traditions that worked against their well-being. During Teej, a festival during which husbands’ longevity and prosperity or blessings for a good husband is celebrated, widowed women gather and celebrate each other, dancing and dressing up to their heart’s content. Women started movements to wear a light blue saree instead of the all-white saree as prescribed to widows by Hindu tradition. They were loud and clear in telling us that using the term “widows” in Nepali was inappropriate and that they preferred to be referred to as single women. 

This summer in Nepal was a reminder of how valuable it is to be present. Be present to see and hear rather than just read about. Be present to experience rather than to infer from second-hand experience. I believe this reminder will ground me as I further pursue my degree and career in the field of global health. As all traveling does, traveling to another country for a global health project also made me feel like I know nothing. From that reset though, I ultimately established an understanding that would allow the project contribute to the population I worked for. For future students, I would say read everything out there and be prepared. At the same time, be open to perceive nuances, subtleties, and all things not generalizable and summarized into an abstract. Those are the most valuable assets I gained from my GHEFP experience. 


My translator/friend/guide/research assistant talking with a female community health volunteer

People

Robert Bollinger Jr., MD MPH

Director, Johns Hopkins Center for Clinical Global Health Education (CCGHE); Associate Director, Johns Hopkins Center for Global...

Caitlin Kennedy, PhD MPH,BA

Co-Director, MPH concentration in Social and Behavioral Sciences in Public Health; Associate Director, Center for Qualitative...

Stefan Baral, MD MPH,MBA,MSc

Director, Key Populations Program

Noreen Hynes, MD MPH

Director, Geographic Medicine Center of the Division of Infectious Diseases

Joanne Katz, ScD MS,BSc

Associate Chair, Director of Academic Programs

Yukari C. Manabe, MD

Associate Director of Global Health Research and Innovation
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