The fact that Nepal faces a shortage of fistula service providers could past history very soon. In order to address this problem, B.P. Koirala Institute of Health Sciences (BPKIHS), a hospital based in eastern Nepal, has been designated as an obstetric fistula (OF) training site. One of the most serious injuries of childbearing, OF is a hole in the birth canal, caused by prolonged, obstructed labor due to lack of timely and adequate medical care, early or closely spaced pregnancies.
The quadripartite Memorandum of Understanding (MoU) was signed between BPKIHS, government-run National Health Training Center, UNFPA and Jhpiego in Dharan on April 22, 2014. The United Nations Population Fund, in partnership with the global nonprofit health affiliate of John Hopkins University, has been working for the development of comprehensive reproductive health training sites and competency based training manuals on OF and pelvic organ prolapse since 2013.
Following the signing of the MoU, Dr. Mohan Regmi, an OF surgeon and associate professor at BPKIHS, thanked UNFPA Nepal for providing continuous support to the hospital to fight OF in Nepal.
So far there are only three public OF treatment and referral sites in Nepal —Patan Hospital, BPKIHS and Surkhet Regional Hospital. While Patan and BPKIHS provide services on a regular basis, the Surkhet hospital organizes surgery camps in collobaration with INF. A few private hospital also offering OF services.
According to a 2011 Need Assessment Report on Obstetric Fistula in Nepal by UNFPA and WOREC, an estimated 200-400 women suffer from OF every year, but these may represent only the tip of an iceberg as most of the cases remain hidden due to the lack of knowledge about its treatment, shame of having this condition and perceiving it as a curse of a previous life.