So… I’m about to head off to Far Western Nepal (read: remote, hilly, goat tracks) on Prolapse Camp. Sounds fun, don’t you think?
For those not quite in the know, uterine prolapse is a condition where a woman’s uterus falls down, or slips out of place, even coming entirely out of the body, as a result of weakened muscles. This is obviously not the exact medical definition, but describes the essentials of something that’s pretty damn unpleasant. It occurs in women of all ages, although the older you get, the more susceptible you are. These weakened muscles are caused by hard prolonged labour, having large babies, improper delivery techniques and hard work, carrying heavy objects and the like.
Over 600,000 women in Nepal are thought to suffer from uterine prolapse. And it seems that the poorer you are and the harder life is (particularly in rural areas where women work on farms and boy do they work hard), the more susceptible you are to prolapse. Early pregnancy (child marriage is still pretty common unfortunately) or too closely-spaced pregnancies (child planning – also not that great in some areas) and going back to work too soon after giving birth are major factors.
And if you do suffer from prolapse in Nepal, there’s a high risk that your husband will divorce you, your neighbours will discriminate against you, and life probably isn’t looking too rosy. And you’re stuck with the constant pain and discomfort of the damn prolapse itself, too, which in severe cases may mean a woman becomes incontinent and highly vulnerable to infections. Really not fair.
While raising awareness about pelvic floor exercises may seem the obvious answer, you’ve got to really look at poverty and discrimination as definite factors increasing the likelihood of prolapse in women.
The good news? The Nepali Government, and some development agencies are aware of the problem and are spear tackling fallen uterus head-on. Approximately 200,000 women are in need of immediate corrective surgery (UNFPA, 2009), and surgery is offered free of charge by the Government. Good one, Nepali Government! Getting to hospitals can be tricky for women in isolated areas, but the invention of Prolapse Camps have helped to make treatment more accessible for women.
So – you now know more about uterine prolapse in Nepal than you did five minutes ago. It’s linked with poverty and discrimination. It’s pretty easy to fix – well, the immediate surgery, at any rate. Those underlying structural factors will take a fair bit more time to fix. But that simple surgery can change a life – suddenly a woman can go from being discriminated and ostracised by her family and community, to a respected figure, with renewed self-esteem and able to comfortably negotiate her way through life once more. Pretty neat, really.
(lithograph from Grey’s Anatomy in the public domain via Wikimedia Commons)