Every woman and girl, regardless of location or circumstance, has the fundamental right to make choices about their sexual and reproductive health. However, it was not the case for Karisma, a 16-year-old girl with severe mental disabilities, in Accham of Far Western Nepal.
Karisma was brought to the One-Stop Crisis Management Centre when she was already in her second-trimester of pregnancy, although she didn’t know about it. Her disability, coupled with a lack of awareness, and limited access to health services led to this devastating situation. It was her father who took her to the District Hospital after noticing a change in her body structure.
After a thorough medical examination, it was imminent that she needed safe abortion services immediately. The District Hospital in Accham did not have the required facilities to conduct an abortion in the second trimester - which is medically more complex. So the One-Stop Crisis Management Centre coordinated with the district police and the municipality office, and Karisma was brought to Kathmandu where the abortion was successful.
The Centre in Accham is staffed by a team of trained professionals, including doctors, nurses, counsellors, and legal experts, who work together to provide comprehensive care and support to survivors of violence - this includes essential sexual and reproductive health services like family planning and safe abortion services.
In Karisma's case, the OCMC was at the Centre, coordinating with all other stakeholders such as the municipality office, district police, and the safe house, to ensure she got to Kathmandu and back safely. They regularly followed up, especially as she was placed in a safe house during her difficult ordeal.
Dr Atul Bharadwaj has worked at this Centre in Accham for over 9 years.
“In Accham, a major challenge I have seen is that women do not know how to even identify violence - in most cases they have learned to accept it as normal,” he says. “We need widespread awareness about sexual and reproductive health rights to empower women and break this cycle of violence and this is something we try to do by working together with the community psychosocial workers, district police and the municipal office.”
27-year-old Cheena Buda Magar, is one such Community Psychosocial Worker, who goes door to door visiting families, orienting them about gender-based violence, along with other pertinent information including on sexual and reproductive health and rights. In her course of work, she identifies and refers survivors of gender based violence to the one-stop crisis management centre.
The Centre, equipped with four dedicated rooms for counselling, examination, doctor’s room, and child friendly space, then notes down the case and supports the survivor the best way possible, linking them to other survivor-centred services. Those who visit to avail the services are provided with clothes and transport fare, all covered by the center’s budget which comes through an allocation set aside by the local government.
This Centre is one of many others supported by UNFPA under the Gender-based Violence Prevention and Response Project (Phase II) 2020-2026 funded by the Swiss Agency for Development and Cooperation and the Royal Norwegian Embassy of Nepal. Under this project, UNFPA works to strengthen the capacity of gender-based violence service providers, including community-based psychosocial workers and the staff of the one-stop crisis management centres, shelter homes and safe houses in Koshi and Sudurpaschim provinces.
Healthcare workers like Dr. Bhardwaj and Cheena Buda Magar are on the frontlines, safeguarding sexual and reproductive rights. Their hard work ensures that women and girls like Karisma have the resources they require to claim their bodily autonomy and lead fulfilling lives. We must continue to invest in accessible health care services, comprehensive education, and relentless advocacy so that every woman and girl has the power and right to decide their own future.
