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\"What happens to a community when the majority of young people move away for education? In Nubri, an ethnic Tibetan enclave in the highlands of Nepal, educational migration (the sending of children to distant institutions for schooling) has become a key component of a family management strategy that is driven by the prospect of social and economic rewards but that entails risk, uncertainty, and unforeseen consequences. The authors draw on ethnographic, demographic, and historical research to document how long-standing religious connections shape contemporary migrations, and how population growth disparities open new schooling opportunities for Buddhist highlanders. They examine parents' motives for sacrificing household labor in favor or sending children to distant schools and monasteries, a trend encapsulated in the oft-repeated phrase \"better a pen in hand than a rope across the forehead.\" The book concludes by investigating dilemmas associated with educational migration, including intergenerational skirmishes over marriage and household succession, threats to the family-based care system for the elderly, and a decline in the level of agricultural production needed to support local religious activities. Better a Pen in Hand chronicles a convergence of demographic and social processes that have led a Himalayan society to the brink of irreversible change.\"--Provided by publisher

International markets have emerged as the favoured way of achieving not only economic growth and efficiency but also political freedom and social justice. This book is a study of the social embeddedness of markets, in an era when the ideology of the 'free market' governs development as much as trade. Using a wide theoretical framework that encompasses both anthropology and geography, Katharine Rankin critiques neoliberal approaches to development, showing that the capitalist market will always be linked to local social structures and cultures of value. Market-led development, therefore, does not necessarily expand opportunity; rather it can deepen existing injustic and inequality. Using the example of a 'traditional' Newar market town located in the Kathmandu Valley in Nepal, Rankin explores how the 'value' ascribed to social prestige relates to economic opportunity. Showing how those in subordinate social locations are positioned to critique inequality, Rankin argues that planners should pursue progressive notions of development that recognise the critical resources within culture.

\"Presents an ethnographic analysis of social and political theatre in order to unpack how everyday social problems and macro-political conflict situations can be both represented and challenged through drama-based performances\"-- Provided by publisher.

National levels of personal health-care access and quality can be approximated by measuring mortality rates from causes that should not be fatal in the presence of effective medical care (ie, amenable mortality). Previous analyses of mortality amenable to health care only focused on high-income countries and faced several methodological challenges. In the present analysis, we use the highly standardised cause of death and risk factor estimates generated through the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) to improve and expand the quantification of personal health-care access and quality for 195 countries and territories from 1990 to 2015. We mapped the most widely used list of causes amenable to personal health care developed by Nolte and McKee to 32 GBD causes. We accounted for variations in cause of death certification and misclassifications through the extensive data standardisation processes and redistribution algorithms developed for GBD. To isolate the effects of personal health-care access and quality, we risk-standardised cause-specific mortality rates for each geography-year by removing the joint effects of local environmental and behavioural risks, and adding back the global levels of risk exposure as estimated for GBD 2015. We employed principal component analysis to create a single, interpretable summary measure–the Healthcare Quality and Access (HAQ) Index–on a scale of 0 to 100. The HAQ Index showed strong convergence validity as compared with other health-system indicators, including health expenditure per capita (r=0·88), an index of 11 universal health coverage interventions (r=0·83), and human resources for health per 1000 (r=0·77). We used free disposal hull analysis with bootstrapping to produce a frontier based on the relationship between the HAQ Index and the Socio-demographic Index (SDI), a measure of overall development consisting of income per capita, average years of education, and total fertility rates. This frontier allowed us to better quantify the maximum levels of personal health-care access and quality achieved across the development spectrum, and pinpoint geographies where gaps between observed and potential levels have narrowed or widened over time. Between 1990 and 2015, nearly all countries and territories saw their HAQ Index values improve; nonetheless, the difference between the highest and lowest observed HAQ Index was larger in 2015 than in 1990, ranging from 28·6 to 94·6. Of 195 geographies, 167 had statistically significant increases in HAQ Index levels since 1990, with South Korea, Turkey, Peru, China, and the Maldives recording among the largest gains by 2015. Performance on the HAQ Index and individual causes showed distinct patterns by region and level of development, yet substantial heterogeneities emerged for several causes, including cancers in highest-SDI countries; chronic kidney disease, diabetes, diarrhoeal diseases, and lower respiratory infections among middle-SDI countries; and measles and tetanus among lowest-SDI countries. While the global HAQ Index average rose from 40·7 (95% uncertainty interval, 39·0–42·8) in 1990 to 53·7 (52·2–55·4) in 2015, far less progress occurred in narrowing the gap between observed HAQ Index values and maximum levels achieved; at the global level, the difference between the observed and frontier HAQ Index only decreased from 21·2 in 1990 to 20·1 in 2015. If every country and territory had achieved the highest observed HAQ Index by their corresponding level of SDI, the global average would have been 73·8 in 2015. Several countries, particularly in eastern and western sub-Saharan Africa, reached HAQ Index values similar to or beyond their development levels, whereas others, namely in southern sub-Saharan Africa, the Middle East, and south Asia, lagged behind what geographies of similar development attained between 1990 and 2015. This novel extension of the GBD Study shows the untapped potential for personal health-care access and quality improvement across the development spectrum. Amid substantive advances in personal health care at the national level, heterogeneous patterns for individual causes in given countries or territories suggest that few places have consistently achieved optimal health-care access and quality across health-system functions and therapeutic areas. This is especially evident in middle-SDI countries, many of which have recently undergone or are currently experiencing epidemiological transitions. The HAQ Index, if paired with other measures of health-system characteristics such as intervention coverage, could provide a robust avenue for tracking progress on universal health coverage and identifying local priorities for strengthening personal health-care quality and access throughout the world. Bill & Melinda Gates Foundation.

In our rapidly urbanizing world, many hazard-prone regions face significant challenges regarding risk-informed urban development. This study addresses this issue by investigating evolving spatial interactions between natural hazards, ever-increasing urban areas, and social vulnerability in Kathmandu Valley, Nepal. The methodology considers: (1) the characterization of flood hazard and liquefaction susceptibility using pre-existing global models; (2) the simulation of future urban built-up areas using the cellular-automata SLEUTH model; and (3) the assessment of social vulnerability, using a composite index tailored for the case-study area. Results show that built-up areas in Kathmandu Valley will increase to 352 km 2 by 2050, effectively doubling the equivalent 2018 figure. The most socially vulnerable villages will account for 29% of built-up areas in 2050, 11% more than current levels. Built-up areas in the 100-year and 1000-year return period floodplains will respectively increase from 38 km 2 and 49 km 2 today to 83 km 2 and 108 km 2 in 2050. Additionally, built-up areas in liquefaction-susceptible zones will expand by 13 km 2 to 47 km 2 . This study illustrates how, where, and to which extent risks from natural hazards can evolve in socially vulnerable regions. Ultimately, it emphasizes an urgent need to implement effective policy measures for reducing tomorrow's natural-hazard risks.

Data for the Hindu Kush–Karakoram–Himalaya region from satellite laser altimetry and a global elevation model shows that glacier thinning varied by an order of magnitude across the region, with surface debris not seeming to provide effective insulation, and that the melting ice added several per cent to the annual discharge of the mountain rivers. Recalculating glacier mass loss in the Himalayas Glacier changes over the high mountains of Asia can have knock-on effects on water resources and sea levels, but it has been difficult to accurately monitor ice-mass changes. A recent gravimetric survey of mass loss in ice-covered areas around the globe — published in Nature — suggested that the high mountains of Asia were approximately in balance during the early twenty-first century. Now, Andreas Kaab and colleagues present a more detailed analysis using satellite altimetry and show a small but statistically distinguishable mass loss from the Hindu Kush–Karakoram–Himalaya region. A larger mass loss in much of the Hindu Kush–Himalaya was partly offset by a scarcely distinguishable mass loss in the Karakoram. Glaciers are among the best indicators of terrestrial climate variability, contribute importantly to water resources in many mountainous regions 1 , 2 and are a major contributor to global sea level rise 3 , 4 . In the Hindu Kush–Karakoram–Himalaya region (HKKH), a paucity of appropriate glacier data has prevented a comprehensive assessment of current regional mass balance 5 . There is, however, indirect evidence of a complex pattern of glacial responses 5 , 6 , 7 , 8 in reaction to heterogeneous climate change signals 9 . Here we use satellite laser altimetry and a global elevation model to show widespread glacier wastage in the eastern, central and south-western parts of the HKKH during 2003–08. Maximal regional thinning rates were 0.66 ± 0.09 metres per year in the Jammu–Kashmir region. Conversely, in the Karakoram, glaciers thinned only slightly by a few centimetres per year. Contrary to expectations, regionally averaged thinning rates under debris-mantled ice were similar to those of clean ice despite insulation by debris covers. The 2003–08 specific mass balance for our entire HKKH study region was −0.21 ± 0.05 m yr −1 water equivalent, significantly less negative than the estimated global average for glaciers and ice caps 4 , 10 . This difference is mainly an effect of the balanced glacier mass budget in the Karakoram. The HKKH sea level contribution amounts to one per cent of the present-day sea level rise 11 . Our 2003–08 mass budget of −12.8 ± 3.5 gigatonnes (Gt) per year is more negative than recent satellite-gravimetry-based estimates of −5 ± 3 Gt yr −1 over 2003–10 (ref. 12 ). For the mountain catchments of the Indus and Ganges basins 13 , the glacier imbalance contributed about 3.5% and about 2.0%, respectively, to the annual average river discharge 13 , and up to 10% for the Upper Indus basin 14 .

We study effects of wartime violence on social cohesion in the context of Nepal's 10-year civil war. We begin with the observation that violence increased levels of collective action like voting and community organization—a finding consistent with other recent studies of postconflict societies. We use lab-in-the-field techniques to tease apart such effects. Our causal-identification strategy exploits communities' exogenous isolation from the unpredictable path of insurgency combined with matching. We find that violence-affected communities exhibit higher levels of prosocial motivation, measured by altruistic giving, public good contributions, investment in trust-based transactions, and willingness to reciprocate trust-based investments. We find evidence to support two social transformation mechanisms: (1) a purging mechanism by which less social persons disproportionately flee communities plagued by war and (2) a collective coping mechanism by which individuals who have few options to flee band together to cope with threats.

This study aims to assess the livelihood vulnerability to climate change of ethnic minority communities in Yen Bai province, a typical mountainous region in northern Vietnam. Utilizing the Livelihood Vulnerability Index (LVI) framework developed by Hahn et al. (2009), in combination with the IPCC vulnerability structure, the research analyzes eight components related to household characteristics, health, food, water, housing and productive land, social and financial networks, livelihood strategies, and exposure to climate shocks. Data were collected through a combination of desk study and survey with 480 households from two major ethnic groups: Tay and Thai.The results indicate that the Thai group has a higher overall LVI score (0.43) compared to the Tay group (0.37), reflecting greater livelihood vulnerability. The main factors contributing to this difference are limited livelihood diversification, lower educational attainment, weaker access to healthcare, and higher dependency on climate-sensitive resources. Although both groups are highly exposed to climate-related hazards such as flash floods, landslides, and droughts, the Thai group demonstrates greater sensitivity and lower adaptive capacity. This research contributes theoretically by adapting and refining the LVI framework to suit the context of upland ethnic communities, and practically by providing empirical evidence to inform climate adaptation policies. The study highlights the need for differentiated and context-specific strategies that prioritize ethnic minority communities with high vulnerability, focusing on improving education, livelihood diversification, healthcare access, and institutional support mechanisms.

Understanding major climate risks, adaptation strategies, and factors influencing the choice of those strategies is crucial to reduce farmers’ vulnerability. Employing comprehensive data from 2822 farm households in Ethiopia and Kenya (East Africa; EA) and 1902 farm households in Bangladesh, India, and Nepal (South Asia; SA), this study investigates the main climate risks that farmers faced and the adaptation strategies they used. Among others, excessive rainfall and heightened crop pest/disease incidence are commonly observed climate-induced risks in all study areas, while cyclones and salinity are unique to Bangladesh. Drought is prevalent in Ethiopia, India, Kenya, and Nepal. Farmers in those countries responded with strategies that include change in farming practices, sustainable land management, reduce consumption, sell assets, use savings and borrowings, seek alternative employment and assistance from government or NGO. In general, farmers faced several multiple climate risks simultaneously and they responded with multiple adaptation strategies. Therefore, this study used a multivariate probit (MVP) approach to examine the factors influencing the adoption of adaptation strategies. Unlike other studies, we also tested and corrected for possible endogeneity in model estimation. All the countries mentioned have low adaptive capacity to address climate change, which is further weakened by inadequate governance and inefficient institutions. We observed significant differences in the choice of adaptation strategies between male-headed households (MHHs) and female-headed households (FHHs), as well as across countries. Generally, MHHs are more likely to seek additional employment and change agricultural practices, while FHHs and households headed by older persons tend to reduce consumption and rely on savings and borrowings. Institutional support for adaptation is much less in EA compared to SA. Training on alternative farming practices, enhancing non-farm employment options, better institutional support, and social security for older farmers are crucial for climate change adaptation in both regions.

In the aftermath of a decade-long Maoist civil war in Nepal and the recent relocation of thousands of Bhutanese refugees from Nepal to Western countries, there has been rapid growth of mental health and psychosocial support programs, including posttraumatic stress disorder treatment, for Nepalis and ethnic Nepali Bhutanese. This medical anthropology study describes the process of identifying Nepali idioms of distress and local ethnopsychology and ethnophysiology models that promote effective communication about psychological trauma in a manner that minimizes stigma for service users. Psychological trauma is shown to be a multifaceted concept that has no single linguistic corollary in the Nepali study population. Respondents articulated different categories of psychological trauma idioms in relation to impact on the heart-mind, brain-mind, body, spirit, and social status, with differences in perceived types of traumatic events, symptom sets, emotion clusters and vulnerability. Trauma survivors felt blamed for experiencing negative events, which were seen as karma transmitting past life sins or family member sins into personal loss. Some families were reluctant to seek care for psychological trauma because of the stigma of revealing this bad karma. In addition, idioms related to brain-mind dysfunction contributed to stigma, while heart-mind distress was a socially acceptable reason for seeking treatment. Different categories of trauma idioms support the need for multidisciplinary treatment with multiple points of service entry.