July 14, 2006

Fallen wombs are becoming a major public health problem of Nepalese women

By A CORRESPONDENT

Ratneswori Shrestha, 35, is among a few lucky women who has got opportunity to relieve herself from the problem of prolapsed uterine. Resident of Kirtipur, 10 kilometer south west of capital, it took 15 painful years for Shrestha to know that medical intervention can cure her illness.

Married at early age, Shrestha quickly gave birth to three children. As she had to carry heavy loads from early days of pregnancy and as she had to perform all kinds of heavy work in the field. This led to her uterine prolapse.

Thanks to a project run under RHIYA/PHCET, Shrestha’s disease was diagnosed and she received treatment. “I lived a very painful life for 15 years before I got the surgical treatment. I had lost hopes that I could ever be treated,” Shrestha explained.

Shrestha’s case represent only a single one of fallen womb and to a lady who was living close to capital that has all kinds of medical facilities. What would be the situation of thousands of women living in remote parts is anybody’s guess.

“All over Nepal, hundreds of women are suffering from uterine prolapse. Its prevalence among women at reproductive age, exceeds 10 percent and is as high as 24 percent among women between the ages of 45 and 49. All together, more than 600,000 women are in urgent need of medical care,” said Junko Sazaki, United Nations Population Fund (UNFPA) Representative. “I am very happy that we are now drawing special attention to this issue together, recognizing that it is social as well as health problem, with low status of women, low awareness and low accessibility posing obstruction to the solution to the problems.”

Although uterine prolapse is one of the most widespread reproductive health and social problems in Nepal, the government is yet to take serious efforts to solve it. “The government will take this issue very seriously and support the efforts taken by different agencies to treat the patients of uterine prolapse,” said Amik Sherchan, deputy prime minister who also holds the portfolio of Health and Population Ministry. “The government would like to thank UNFPA for bringing this major health issue in public debate and attention.”

For the last few years, the UNFPA has been intensifying efforts to address one of the most serious reproductive health concerns in Nepal: fallen womb. According to Dr. Rajendra Gurung, an expert with UNFPA, it is a leading cause of ill health and exists throughout Nepal. “Out of 600,000 patients of uterus prolapse, 186,000 require surgical repair,” said Dr. Gurung. “Surgery for uterine prolapse can be performed effectively and safely in low resource rural settings as well.”

Working with many non-governmental organizations, UNFPA has provided reproductive health check up and treatment to more than 31,000 women in 9 districts of Nepal. According to UNFPA, so far only 346 of them have been surgically treated for uterine prolapse.

“We need to ensure prevention and treatment, so that many deprived women, suffering from the Uterine Prolapse, can also actively participate in the peace process and social transformation. It is high time for a national campaign to be launched for the prevention and treatment of uterine prolapse,” said Sazaki.

The government officials agreed that there require certain resources. “We have been trying to generate the awareness among women regarding the issue,” said Shyam Sundar Sharma, joint secretary, Ministry of Women, Children and Social Welfare.

” Women, who suffer from fallen womb, have to face social discrimination as well. Negative perception towards women with uterine prolapse in the community is rampant. In many cases, husbands marry second wife,” said Dr. Tara Shakya, project director RHIYA/phect-Nepal.

Others see this as related to human rights. “It is necessary to understand that prolapsed uterus is an outcome of serious human rights violation of women in this country so it is the state’s obligation to support these victims of Human Rights violation,” said Dr. Renu Rajbhandari, president of Women’s Rehabilitation Center (WOREC).

“This is major public issue of women but it was neglected and ignored,” said Teeka Bhattarai, Kathmandu based researcher addressing the interaction program to mark the World’s Population Day.

As this can be prevented, what are required are the public awareness as well as more resources allocation for this problem - which is currently affecting more than half a million of Nepalese women. But, there are only a few like Shrestha who are getting the treatment.

Nepali Women Draft Inclusion Plan

With the objective of boosting the implementation of the UN Security Council Resolution 1325 in Nepal, a plan of action has been drafted on July 7. The Resolution concerns the role and participation of women for the prevention, management, and resolution of conflicts.

During a one-day workshop, organized by the UN system in Nepal, participants agreed on a series of concrete indicators aimed at creating the structures and mechanisms that will allow Nepali women to be actively involved in the ongoing peace process.

“Although drafting of the interim constitution has begun without women’s participation, and none of the newly established committees include women, it is time to work together to reverse this trend. We need to fully embrace this opportunity to commit to the ongoing process and once and for all see Nepali women take-up the roles they are entitled to,” said acting UN Resident Coordinator Junko Sazaki.

Workshop participants included a number of UN agencies, representatives from the government, members of the Women in Alliance and the Shantimalika peace network.

Based on a highly vivid and participatory working session, the resulting Plan fleshes out initiatives to be implemented in the areas of: process of constitutional and legal reform; transitional justice and reconciliation; post-conflict reconstruction and rehabilitation; gender-based violence; and monitoring and documentation.

The Plan will be presented to the donor community during a special session to be held with them next Friday 14 July.