KATHMANDU, Nepal (GPI)-- Pratima Pokharel, 65, a resident of a rural district in Nepal’s Eastern region, coughs hard. “My back hurts,” she says. “I suffer shortness of breath whenever I try to speak.” But instead of resting, the thin woman continues to cut vegetables in her kitchen in Sankhuwasabha district. She breathes heavily. “What can I do, sister?” she asks, her hand on her chest. “I wonder who would do as much hard work as I have to do. Doctors tell me that I am paying the price of my hard work.” She married her husband at the age of 15. She was in grade four. A life of hard work followed, she says. Pokharel gave birth to three children. As she raised them, she also managed to attain a Bachelor of Arts from Padma Kanya Multiple Campus, the women’s college under Tribhuvan University. Impressed by her perseverance and hard work, a former teacher asked her to teach at a school in her village. Two years later, Pokharel earned a promotion to principal. Her responsibilities at work increased. But her responsibilities at home didn’t decrease. When her children were small, Pokharel says she used to wake up at 2 a.m. every day to feed them and to massage them with oil to improve their circulation. She then moved on to other domestic chores, such as cleaning, washing clothes and cooking for the family. After completing these duties, she walked for 30 minutes to reach the school by 10 a.m. Her school day was busy too, she says. She had no time to sit and returned home tired. But she had to rush to the kitchen to prepare a meal for her family. “I think I am strong, physically and mentally, to bear the workload in both fronts,” Pokharel says. “Otherwise, I would have been dead by now.” Pokharel retired in 2008 because of respiratory and back problems after serving as principal for 23 years. “The situation would improve if and when segregation of work according to gender is not predetermined,” she says. Pokharel’s husband, Mukunda Pokharel, acknowledges that professional women have a difficult life. But he says that because of gender roles in society, men can’t help women with domestic duties even if they want to. Women who work outside the home in Nepal struggle to balance their jobs with their domestic duties. Doctors warn that grueling work schedules hurt women’s health. Local men say that even if they want to help their wives with household chores, strict gender roles prevent them from doing so. Some couples are moving from multigenerational to nuclear households to distance themselves from traditional gender roles, as social activists ask community leaders to emphasize sharing household work. Increased education levels for women and structural changes in the economy reducing dependency on agriculture have increased economic opportunities for women in Nepal, according to the 2011 Nepal Population Report by the Ministry of Health and Population. Women’s participation in formal economic activities increased from 35 percent in 1971 to 83 percent in 2004, becoming on par with that of men. Yet household work still falls disproportionately on women. Shova Gautam, a freelance journalist and human rights activist, says that strict gender roles govern household work in Nepal. “In the Nepalese society, the work division begins right in the family of birth,” she says. “Such divisions later on create negative impact on the society.” Geeta Bhandari, 35, works for Alliance Insurance Company on the outskirts of Kathmandu, Nepal’s capital. She says there isn’t a single day that she isn’t in a hurry to reach the office after finishing her work at home.