Uterine prolapse (UP) is significant public health problem among Nepalese women. The causes of the UP is complex and manifold.
According to a study conducted by UNFPA in 2013, the median age at which Nepali women first experience uterine prolapse is 26 yrs. It is still difficult to say exactly how many women in Nepal experience problem with UP. Moreover, the prevalence of UP within different districts varies significantly.
Nepal is a patriarchal male dominated society, where many girls and women are discriminated and faces gender violence in various stage of their life. Most of the girls in rural areas are exposed to early marriage. As a result, cases of early pregnancy and child birth along with improper health care during pre and post-delivery are experience and reported in most of the rural areas.
According to a World Bank report (2014), only 55.6% of births in Nepal are attended by skilled health workers. This means many pregnant mothers in rural Nepal are exposed to harmful birthing practices which increase the chances of experiencing UP later in their life.
In many rural communities, women are exposed early to heavy physical work in their house and farm. They lack adequate nutritious food and proper rest due to high prevalence of poverty. This practices also give possibilities of UP among women.
UP is still stigmatized and taken as disease to be hidden. Women and girls feel ashamed and are also discouraged to talk and share about their sexual organs and health to anyone, even their family members. This again brings them in a risk of going throughout painful situation with UP and many other sexual health problems.
A story of 68 yrs old women from Ramechhap municipality, who visited health camps was diagnosis with UP. She was actually facing UP from 46 years and was hiding due to shame and stigma associated with it.
She further narrates her story that she was married at the age of 20 and delivery her first kid at the age of 22. She noticed something hard coming down from vagina after few months. She felt ashamed to share the problems even with her husband. She gave birth to two more child but didn’t share about her falling uterus. She felt severe pain, bleeding and uneasiness to walk and sit. Later, when she was 63 years she decided to visit a health camp nearby her village where she was diagnosed by UP. Following the suggestion of health workers in the camp, she put a ring into her vagina, which made her life a bit easier but was not a complete solution for the problem.
For the second time for same problem she visited health camp organized by BSN in Saghutar village in Ramechhap municipality. This time health personal advised her to undergo surgery. She prefers to face pain with UP but was not ready to go through surgery.
BSN from its establishment has been playing crucial role on raising awareness on women and girls sexual and reproductive health and rights in the Ramechhap Municipality. In the past year it has organized health camps in the community where local women are diagnosis and provide counseling on various sexual and reproductive health like; family planning and safe abortion, uterus prolapse treatment and surgery, cervical cancer screening and also referral to city hospital for further treatment.
Such medical camps are further bringing poor and marginalized women together to acknowledge their various reproductive health problems, making confident to share their problems with health personal and also among their family members. Some of the women are empowered enough to address such problems in community, providing other women and girls various information they gain from the health camps. But still there are some hesitation observed to access services. It needs further study and program intervention to address such barriers in those communities.
BSN is open and looking forward for a long term partnership from various donor/funding agencies and like minded stakeholders to work together in sexual and reproductive health rights issues.
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