Feature Stories
Life Stories from Bajhang
UNFPA project funded by the European Commission's Humanitarian Aid department
Delivering Emergency Reproductive Health Services to Conflict-Affected Populations of Nepal
Reproductive health problems are the leading cause of ill health and death among Nepalese women of childbearing age. The country's maternal mortality ratio, 281 deaths per 100,000 live births, is one of the highest in South Asia. Care in remote districts was inadequate before the civil war began and worsened during the decade of conflict.
As an emergency measure since 2005, reproductive health services (including family planning, emergency obstetric care and treatment for prolapsed uterus) have been delivered in remote areas through mobile reproductive health camps. These have been provided by UNFPA, the United Nations Population Fund, with financial support from the European Commission's Humanitarian Aid department (ECHO) and operated by the Adventist Development and Relief Agency, Nepal (ADRA) in coordination with other local partners. Thanks to joint efforts, by the spring of 2008, 500 women suffering from uterine prolapse have undergone corrective surgery at the Nepalgunj Medical College Hospital.
Between January and March 2008, ten reproductive health camps were conducted in Bajura and Bajhang. As news of the camps' arrival spread, patients came from great distances to seek treatment - typically 300 to 400 per day. Each camp lasted four days. A total of 13,000 clients, 78 per cent of them women, received essential health services including reproductive health care. About 28 per cent of those who attended were Dalits and Janajatis.
Maina
Maina lives in Bajhang, one of the most remote districts of Nepal. Today she enjoys a normal life but not so long ago she was not sure if she would survive.
'My life was full of hurdles and difficulties.' She says 'I had never thought that I would live a happy life again,' she recounts her story.
'I have had uterine prolapse for nearly ten years. I could not tell anyone, not even my husband. I was scared he would marry another woman and leave me. Had he done so, I would have had a miserable life. He did not know because I used to push the uterus inside before sexual intercourse and I did not admit that it was painful.
Carrying heavy loads has been my every day life but it was a big problem for me. When I lift anything heavy, my uterus would start bleeding. To make things worse, we have been going in groups to fetch firewood and fodder for livestock from the jungle. Those times I used to walk at the end of the group and if my uterus created trouble, I pushed it inside. All this I did in secret and I had to be very careful. In case of bleeding, I washed my cloths at night so that no one would see the bloodstains.
Every day I faced many hurdles and excessive bleeding was only one of them. I suffered from backaches and I had white vaginal discharge. I lived in stress, always worried what would happen if anyone found out. I should have left the village then because to have sexual and reproductive health problems is considered a curse by the gods.
I thought I was going to be miserable for the rest of my life. I had to be careful with the family because we did not have money for the operation and if they had known my problem, they would have just thrown me out of the house. Sometimes, while working alone I thought about the problem and became frustrated with my own life and my inability to change anything.
One day, a volunteer from ADRA Nepal who came to our village informed me about the ongoing mobile clinics in our district. As soon as I heard that, I told my husband explaining what was wrong with my health. We contacted ADRA Nepal and learnt that the treatment is free of charge. Not only that, our transport and food was also covered. Those were the reasons why my husband agreed to take me to the Nepalgunj Medical College in Kohalpur.
I have a new life after I had the vaginal hysterectomy. Now, I am very happy and I can see the traces of happiness in my husband too. We would like to thank all those who made it possible and gave me a new life. I will tell everyone not to hide their health problems but always seek solutions.'
Gyana
'After I had my abdominal hysterectomy on March 23rd, 2008 I returned home feeling like I was the luckiest woman in the world.' Gyana lives with her husband, two sons and a daughter. She had suffered from uterine prolapse for ten years before she received help through the mobile reproductive health camp.
Gyana was hesitant to tell her family. In fact, she recalls now that she was not even sure if it was an ailment. She blamed herself for not being good in her previous life. Whatever the reason, Gyana did the family's work and she worked hard suffering physically and mentally. While lifting heavy objects and carrying goods the uterus fell out, often bleeding. She recalls cursing her life and herself. She was also afraid that if her husband found out about the problem then he would marry another girl and leave her. Therefore, she chose to keep quiet.
Gyana's family is poor so she knew very well that the treatment was out of the question also because her home, Bajhandg is so far from the closest hospital. Every time she thought about those issues, she got frustrated and did not want to live anymore.
The first ray of hope appeared with the news of a mobile health camp caming to the. Gyana's life was about to change. Gyana finally told everything to her husband and they went together for check up at the mobile reproductive health camp. After being referred to Nepalgunj Medical College Hospital, arrangements were made to cover the costs of her treatment as well as her and her husband's food and transport.
She is at home now living a normal life. She has become an articulate campaigner talking openly in the community about the need to disclose any sexual and reproductive disorders as they are treatable like any other illness.
Birama Devi
'My name is Birama Devi and my husband's name is Karan. I have two sons. My family is poor and we need to work every day. We live together with my husband's parents, his brothers, and their families. My husband is a tiller.
I married at the age of fifteen. After one year, I gave birth to my first child, a son. I gave birth to the second son when I was twenty-one. My work is to look after all the children and serve all the members of the family. In villages, the chores are numerous. I need to fetch water, firewood and fodder every day. I have to prepare meals, wash the dishes, clothes and clean the house. While working I started to feel tired very fast and I could not walk well. I had backaches while carrying loads. During sexual intercourse, I felt severe pain and I had excessive bleeding during my periods. I had uterine prolapse and I was in a big trouble.
I came to know about the mobile reproductive health camps through my neighbors and ADRA volunteers. I did not want to go at first, as I felt too shy to talk about my problem to anyone. My husband and the volunteer ultimately convinced me. I was operated at Nepalgunj Medical College Hospital free of charge. I have my life back and my blessings are with all those who made it possible.'
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