The Ends of Kinship. Sienna R. Craig
with Kathmandu minimal. She did not want to raise alarm. Her paternal grandmother was withering, and she knew most of the caregiving fell to her mother. It was high tourist season, too. A week after the fateful visit with Dr. Sharma, Tsering had collected herself enough to call home. She did not tell her mother that she’d been confined to bed or that she would have to have an operation, but she did say that she felt the baby would come early. In this, she was not lying.
Tsering had avoided looking up placenta previa, but one afternoon into her third week of bed rest, she Googled it. Much of what she read just reiterated Dr. Sharma’s explanation and advice. But a paragraph on the World Health Organization’s website scared her.
Placenta previa is a life-threatening complication of pregnancy and an important public health problem worldwide. Its impact in under-resourced settings is much greater than its impact in developed countries. In under-resourced settings, there is often a lack of awareness of the danger signs of placenta previa, which can lead to delays in seeking medical care. In addition, poor transport facilities and the need to travel long distances to reach a health unit (which may have only limited resources to deal with the problem) increase the risk of hemorrhage, which is one of the leading causes of maternal death in Africa and Asia.
Tsering felt dizzy. She set her phone down and closed her eyes. Had her mother or grandmother been in her situation, they would have likely died. Instead, she had a kind doctor in a hospital, a birth plan. This was something beyond karma, wasn’t it?
A week later, a nurse pushed Tsering by wheelchair into the operating room. She saw Jamyang’s kind eyes above the surgical mask and Dr. Sharma, her raven-colored hair tucked back, her mouth covered, her expression alert with empathy and focus. Tsering stayed partially awake through the operation. Jamyang could not look behind the curtain covering her abdomen. He stared at Tsering’s face.
Incision. Extraction. Suction. She heard the nurse say, “Apgar 9. Good!” She did not know what that meant. “Sutures,” said Dr. Sharma. All this passed for Tsering in a fog. And then there was her daughter, puckered and beautiful, fists kneading the air, eyes still closed.
In the days to come, there would be hand and footprints, a birth certificate, a knitted cap in pink and white, the rawness of nipples. Tsering would tell her mother that she’d had an operation for the safety of the baby. That it was what the American doctors recommended. Her mother would understand.
As for the lost ones, these remained too, singular yet collective, like stones that line the riverbed.
FINDING THE WOMB DOOR
WRITTEN ON THE FOREHEAD
Karchung stoops over her handmade distillery: stainless-steel pots glued together with mud and ash to make a double boiler, a length of hose through which naked barley is transformed into alcohol. The operation is fueled by an open fire, crackling in the shade of a poplar tree. Karchung is fifty-something. This woman from the village of Drakmar has a narrow, weather-worn face. Her midriff is wrapped in striped woolen aprons over an old chuba. The style in which she wears her aprons, the weighty knot of turquoise around her neck, and the conch shell bracelet on her left wrist mark her as married.
Yangjin and I watch Karchung work, waiting for a break in the rhythm of her efforts to explain that we are doing a research project with women in Lo, and we would like to ask her about her family, about her experiences with pregnancy and birth. In Logé, we talk about the special ways that people from Tibet and the Himalaya have had their bodies changed by this place, over long stretches of history. We speak of blood and bone: about how lineage passes through bodies and how, from the perspective of Western science, they call this “gene.” We share that we want to learn more about the relationship between Himalayan women’s bodies and the circumstances of their family life.
Squatting beside the poplar, her spine against its trunk, Karchung takes a gulp of salt butter tea. “Life here is difficult for women and children, so I will talk with you about these things.”
We ask Karchung’s permission to write down the names of people in her household and make a list of her pregnancies and births—including miscarriages or children who died—and to draw her kinship chart. We also ask permission to collect a sample of her saliva, to measure her pulse, to take her temperature, and to find out how much iron and oxygen is in her blood. We explain that we do not need to take her blood to do this but that a small machine, put at the tip her finger, can reveal this information. “The machine will tell us some numbers,” Yangjin says. “We will write them down and tell you what they mean.” Yangjin goes on to say that this research will not benefit Karchung directly but that the information we learn may be helpful for future generations.
“What will you do with the saliva?” she asks.
“We will send it to America,” Yangjin answers. “There, the scientists will learn more about how Himalayan people live so well in our places. To learn what makes us different from other people who live by the ocean or down in the valleys.” She pulls out a small plastic vial, into which Karchung will be asked to spit.
Karchung laughs. “My son is in America. Now my saliva will go to America too! But this old ama stays here, making arak, doing the work.”
Over the next hour, we listen and take notes as Karchung shares details about her family and her household. She recounts her siblings, her husband, and his family. She recounts her eight pregnancies, including the three children who died between infancy and their toddler years. We ask her to explain what happened.
“There was a time, about ten years ago, when an old grandfather nöpa claimed many children. He took my two-year-old son and the child belonging to my cousin and his wife. Several others.”
“When you say, ‘took them,’ what do you mean?” I ask. “How did it happen?”
“He drowned them in the river,” Karchung continues.
“Why would he do that?”
“The grandfather nöpa was lonely and jealous because in [the neighboring village of] Ghiling they built a daycare center for the young children and got a beautiful Tibetan girl to take care of them while their parents worked. This grandfather nöpa thought he should also have children to keep him company. He took them through the element of water. We lost five or six young ones before he stopped.”
“How did you get him to stop taking children?”
“We did many rituals. This appeased him.” Karchung speaks with assuredness about a dynamic of causality that in other cultural contexts might be called a tragic accident: children drowning as they played unattended beside the river while their parents worked in fields. But for Karchung, the death of her child in this instance is linked to the destiny of other young children in ways that bespeak neither disease nor neglect but rather an act of ill will by an infamous being who belongs to this place.
Her story is also a claim to knowledge and what counts as an authoritative explanation for such a death. Others in the village affirm what Karchung has shared, noting that these drownings were the impetus for founding daycares throughout Lo.
Karchung explains that her second child succumbed to pox, like many others in this village in previous decades. We interpret this as measles. “In those days, we did not have vaccinations,” she says. Had there been such medicine available, maybe she would have six living children now.
The third child “died after a few days.” When we ask Karchung why this infant had died—not “What happened?” but “What was the reason for the death?”—she touches her brow, answering this question with a gesture. This happens countless times during that summer of 2012, as we interview more than eight hundred Mustang women about their reproductive lives. To touch the forehead is to acknowledge karma. Sometimes the course of a life is written here.
THE COUNTENANCE OF HARM
In mid-July 2012, deep into data collection for this project