Care Functions within the Kinship Network: Explaining Care Arrangements and Female Health Choices in Post-Disaster Nepal

This article investigates the relationship between kinship-based care and the phenomenon of women turning down the offer of free treatment in a hospital. As care is perceived and enacted very differently all over the world, the article aims to outline an approach to researching care and care-related health decisions that represents actors’ perspectives. It does so by comparing care-responsibilities, marriage and residence patterns in two ethnic communities. Data was gathered during six months of qualitative research in several health camps after the 2015 earthquakes in Nepal. The results show that what I call the ‘chain of care-responsibility’ (the persons taken into consideration as primary or alternative caregivers) diverges widely between ethnic Tamangs and Chhetris of the research area. The challenge of finding persons to fulfil care functions and to replace working power may lead to substantial changes in household formation including travelling kin, polygamy, or divorce. Under otherwise similar conditions, such considerations of care and replacement place Chhetri women at structural disadvantage in accepting free medical treatment as compared to Tamang living in ‘traditional’ clustered settlements. These findings suggest that referral programmes would profit from partnering with local communities to develop practical solutions to questions of care and replacement.