National 7 (Spotlight Weekly)

Cause of concern

The number of women suffering from uterus cancer is rising

By A CORRESPONDENT

Out of 50,000 cases of cancer in Nepal, gynecological cancer accounts for the 13 percent or 6,500 of total cases. A recent study has revealed that the gynecological cancer have dramatically increased among Nepalese young women with apprehensions that it is going to be the major killer of women in a few years’ time.

A Woman at Maternity Hospital : Life under threat

A research conducted by senior gynecological cancer specialist Dr. Indra Prasad Prajapati in four districts found that many girls living in urban areas involve in the sexual activities at the age of 14-16 years. Some of them even have multiple sexual partners. Based on this sample study conducted on 1209 women in Kathmandu, Lalitpur, Bhaktapur and Kavre districts, 36 or 3 percent of the young suffer from gynecological cancer, particularly that of uterus. No nationwide research has been conducted to find out the actual situation and to determine the number of adolescents suffering from the disease. However, the sample survey has indicated that the situation is alarming.

Early marriage, changing sexual behavior, heavy work load and more child bearing increase the possibility of cancer of uterus among women in Nepal. Furthermore, the prevalence of uterus prolepses is higher among Nepalese women. Conducted by a senior cancer specialist, a study – which was published recently - disclosed that the adolescents who have multiple partners and are sexually active at the early age run heightened chances of suffering from the disease.

According to the Bhaktapur Cancer Hospital report, endometrial cancer is a malignancy of the endometrium (the inner lining of the uterus, or womb) and is the most common gynecological cancer in Nepal. Generally, most gynecological cancers are found in women aged over 50, though the incidence rates for younger women have been rising.

“Because of tradition of child marriage and high fertility, gynecological cancer is common in Nepal,” said senior gynecologist Dr. Saraswati Padhya. “We need to launch a massive campaign to address gynecological related problems,” said Dr. Padhya said at a program few months ago.

Sexual matters are still taboo in Nepalese society – whether urban or rural. And the girls who find problems in their uterus are hesitant to disclose it. “This trend is equally apparent in the urban as well as the rural areas,” said Dr Prajapati. “In the rural areas, there are problems of rampant early marriage and multiple children. In urban areas adolescents involve in sexual activities in early age increasing the possibilities of uterus cancer. Besides, most of the girls consult the doctors very late when doctors can do little.”

Cancer patient : Costly treatment

Other clinical studies have also indicated the alarming trend. A clinical study was conducted by BP Koirala Memorial Cancer Hospital - Nepal’s well-equipped modern cancer hospital - from July 1999 to January 2001. It had diagnosed 321 gynecological related cancers on 31.16 percent of all 873 clinically identified cancer patients. The study revealed that the highest incidence was among the women between the ages of 31-50 years.

“Gynecological cancer is common among different malignancies of the female reproductive system. The most common types of gynecologic malignancies are cervical cancer, ovarian cancer, and endometrial (uterus) cancer,” said a cancer specialist.

Conducted jointly by German Technical Assistant (GTZ) and the United Nation Population Fund (UNFPA) in 2002, Reproductive Morbidity - A Neglected Issue, - the clinical studies based report of the far western region - shows bleak scenario of women health. Of 3820 women who attended the clinics, 2705 made gynecological complaints, some of whom had serious problems. One in four women were diagnosed with the Pelvic Organ Prolepses.

Bhaktapur Cancer Hospital also recorded a large number of women aged between 20-60 years who had come to treat uterus cancer. According to the Hospital, the number of new patients attending in one year had gone up to 3,000 last year compared with 700 who came with similar problems three years ago. Likewise, the number of patients undergoing radiotherapy treatment, too, has gone up to over 400 from 60 four years ago. “However we desperately need infrastructure development to keep pace,” said Dr. Arati Shaha, director of the hospital.

Nepal Population Report 2001 states that Nepal’s youth population of 15-24 years occupy about 23.62 percent out of the total population of 23 million. Along with Bhaktapur Cancer Hospital, the number of patients visiting the B.P. Koirala Memorial Cancer Hospital (BPKMCH), a comprehensive cancer center supported by the government has also increased. The BPKMCH is expected to see more than 2,000 new cases this year.

According to the Nepal Family Health Survey 2001, a nationwide health survey conducted by the Ministry of Health, early marriage and childbirth is common in Nepal. The average age at marriage of females is 16.8 years for the women with the rural women getting married one year earlier than the urban ones. Likewise, 21 percent of women between 15-19 years will have already begun childbearing or become pregnant with the first child.

“Tempted by the sexually explicit shows in different cable television channels, urban adolescents are lured to sexual activities without knowing the consequences of their act,” said Dr. Niranjan Prasad Upadhayaya, a senior psychologist. “Despite all characters of modernization, Nepalese society is still based on traditional Hindu values where sex is regarded as a taboo subject.”

According to the European Commission, UNFPA: RHIYA Strategic Frame Work For Nepal report, one in five women visiting hospital for abortion related complication is an adolescent who is vulnerable to gynecological cancer.

Studies have shown that over 25 percent of women in rural areas suffer from some degree of utero-vaginal prolepses (UVP). Subhadra Acharya, 19, a young girl is going for therapy following the early identification of uterus cancer. Following the trouble with her organ, she rushed to a gynecologist. Janaki Bam, an 18-year-old girl, died of uterus cancer in Nepalgunj, 450 miles far west of capital. A student of higher secondary school, she died a few months after the diagnosis.

After suffering from uterus prolepses for ten years, Kaushala Devi, 40, a resident of Dang district 400 miles west of Kathmandu, is now suffering from first stage of cancer.

In a country where a large number of women are suffering from reproductive ill health, the new trend has rung alarm bells.

TELECOM CONFERENCE

The Embassy of Israel in Kathmandu, in collaboration with the Economic Division of the Embassy of Israel in New Delhi, organized a program about Israel's Telecommunications Industries and "Telecom Israel 2004" in Kathmandu on October 13. "The program aimed to familiarize Nepali business sector with Israel's Advanced Telecommunications Industries and "Telecom Israel 2004", a large scale international exhibition which will be held this year in Israel from 8-11 November providing a panoramic, up-to-date spectacle with special focus on the contribution of the Israeli telecommunication industry to the rapid advance of communication and information technologies," states a press release from the Embassy.

Senior officials of Government organizations, heads of Economic establishments and representatives of private companies dealing with telecommunications and IT attended the program.

Secretary at the Ministry of Information and Communication Mukunda Sharma Poudyal, speaking at the program, said that Nepal Telcom, the largest fixed lines operator and the only GSM operator in the Kingdom of Nepal, had in the past brought in GSM system from an Israeli supplier company namely - Telrad, when NTC first launched GSM service in Nepal in 1997 and it has proved to be so reliable that Nepal Telecom is still operating the whole system in the country.

Dan Ben-Eliezer, Ambassador of Israel to Nepal said that Israel has a leading edge in information technology and telecommunication and continuously attracts the world's attention and attains a position among the top competence centers worldwide.

He further said that Israel as a good friend is ready and willing to share its technical know-how with Nepal in many fields including telecommunications. He added that there is much to do in this sector and this is a time to work together to transfer the long-standing friendly relationship into the economic prosperities for peoples of the two nations. The Ambassador expressed his hope that Nepali people will attend the "Telecom Israel 2004" exhibition in Israel.

While presenting the brief outline of Telecom Development Scenario in Nepal at the program, Suresh Kumar Pudasaini, Chairman of Nepal Telecommunication Authority, thanked the Government of Israel for its effort to organize such event in Kathmandu and hoped that it will further strengthen the diplomatic relations between Nepal and Israel.

Mouneer Agbariya, First Secretary - Economic Affairs of the Embassy of Israel, New Delhi presented an overview on the Israel's Telecommunications Industries and Telecom Israel exhibition.