Screening Village Women for Prolapse in Nepal

Vision & Beneficiaries

Vision

Meet Some of Our Beneficiaries

 

Uma Kumari Limbu

Uma has suffered from uterine prolapse for 21 years. She had noticed the prolapse before the birth of her littlest son but noticed that it worsened after his birth and her uterus began coming out of her vagina. Previously, she had not sought out surgery because of economic problems and lack of familial support. Going into the operation, Uma was the only one of the four women that were not scared. She felt that even if she died on the table during the operation, it was worth the risk. She’s looking forward to the positive economic benefits that this surgery will bring, for she will be ab to work at her fullest capacity. Over a week after her operation, Uma is doing extremely well and still taking rest.

Dhanmaya Limbu

Dhanmaya’s uterine prolapse presented before she gave birth to her children. The uterine prolapse resulted in difficulty giving birth and worsened with each child. Although emotionally and physically painful, Dhanmaya could not refuse the pressure placed on her by her husband to bear more children. She gave birth to a total of five children and experienced uterine prolapse for 22 years. Her friends in her village have shared their experiences with uterine prolapse amongst themselves, many suffering from it themselves, but they do not want the surgery because they think they will die as a direct result. Dhanmaya heard about Care Women Nepal’s health camp in April and felt so passionately about it that she came and personally sought out Indira to thank her and to discuss her uterine prolapse. Over a week after her operation, she reports that her family is taking care of her and she is doing well.

Maan Kumari Basyal

35 years ago, Maan noticed that her uterus was poking out of her vagina and went to the local hospital. She had very little money and could not afford the operation. At some point, two female politicians in her village promised to help her obtain the operation. They never followed through with their promise and Maan was left hurt and disappointed – she feared that she would die before she got relief. She had told her family about her uterine prolapse, but they did not understand her problem. Only one family member, an in-law, encouraged her decision to come with Care Women Nepal for this operation. Her own daughter, out of fear, discouraged Maan against this operation because uterine prolapse “wasn’t something like cancer” and wasn’t worth the risks of undergoing surgery. Her son even called her before her operation, scolding her, “Why are you doing this?” Ultimately, she confidently made the decision for herself and is very excited to be moving forward without the pain of uterine prolapse.

Challenge

Challenge

Response

The Community-based Response

Profiles

Profiles

Meet Some of Our Beneficiaries from the Care Women Nepal Program

 

 

 

Sobha Magar

Sobha recalls how 1.5 years ago her life was significantly changed by the development of uterine prolapse. While her first and only pregnancy was without complication, she later started to feel her uterus slipping from her body when she lifted heavy loads, squatted to prepare food/ wash clothing etc. Sobha initially concealed her prolapse as she was living with her husband’s family. She sought care in private from an NGO working in the area but was only given ointment that did little to address her suffering. Sobha has lived with pain and fear every day since developing prolapse. She fears that the next time she picks up a heavy load, her uterus may fall out of her body. She fears that if she reduces her workload, she will be rejected by her family. She is concerned that if she were to undergo the surgical intervention to treat her condition, she may develop other serious health conditions such as cancer. She fears that if she were to continue to live with her husband’s family, they may treat her poorly because she is unable to work as much as she once did.

Ratna Kimari Shrestha

A year and a half ago, Ratna noticed her uterus protruding from her vagina: stage 3 uterine prolapse. She found it difficult to sleep and especially hard to work because her job includes physical labor. Every time she had to use the restroom, she would have to push her uterus back inside of her body to urinate. She turned to her husband of 43 years for support. Thankfully, he took the news easily and helped her seek medical attention. On the inside, Ratna had felt that her uterine prolapse was not only a burden for herself, but for her family as well. Now, after the operation, Ratna expresses joy that she will be able to work and there won’t be sadness in her home.

Lok Maya Rai

Lok Maya Rai started experiencing uterine prolapse 12 years ago when she was 71. She was able to get her vaginal ring pessary replaced on the first day of the CWN health camp.

Balang Mungma

Balang Mungma discovered her uterine prolapse 15 years ago while she was urinating. She has had her ring pessary changed twice since having it placed.

Shree Kumari Rai

Shree Kumari Rai began to experience uterine prolapse, like many women, after the birth of her first child. She has suffered from her condition since 1982.

Pancha Maya Tamang

Pancha Maya Tamang has been experiencing severe uterine prolapse for the past 2 years. The condition developed after she terminated a pregnancy and has significantly impacted her daily activities. Pancha Maya has 3 children and has experienced problems managing daily work in the field and household tasks after the onset of prolapse. While working, Pancha Maya is always on guard, fearing that her uterus may fall. Thankfully, Pancha Maya’s husband and family members are supportive of her condition and understanding of the challenges of accomplishing daily tasks while suffering from uterine prolapse.

Gorka Maya Rai

Gorka Maya Rai has been experiencing uterine prolapse for the last nine years. She has difficulty working and pains while walking.

Maya Kumari Limbu

Maya Kumari Limbu, 62, has been suffering from prolapse for 36 years. She was reluctant to seek care but came to the camp with her daughter-in-law who noticed the effects of prolapse.

Malati BK

Malati underwent surgery for her uterine prolapse through the Care Women Nepal program.

Indira Kumari Kafle

Indira Kumari Kafle, seated next to her husband, after receiving treatment from the Care Women Nepal program.

 

Results

Results

Team

Team

Indira Thapa, President and Founder

Indira Thapa, from Muga, Dhankuta, Nepal, founded Care Women Nepal in 1998 out of a desire to serve the women of her community. Since then, Indira has worked tirelessly to advocate for the rights of women in Nepal by hosting health camps, providing emergency relief and carrying out water and sanitation projects in Dhankuta. Indira is driven by her memories of witnessing the death of women in her village during childbirth because of a lack of access to reproductive health services. Indira is looking forward to expanding the operations of CWN by constructing a new office in Pakhribas to better serve the women of her community.

Yunesh Pratap Singh, Program Manager

Yunesh Pratap Singh has been working with Care Women Nepal in various capacities since 2012 and is looking forward to taking on a larger role within the organization as CWN’s program manager. Yunesh has obtained a Bachelors of Commerce from the Shriram College of Commerce at the University of Delhi in Delhi, and a Masters in International Relations and Diplomacy from Tribhuvan University in Kathmandu. In his spare time, Yunesh enjoys reading the news and playing cricket. Moving forward, Yunesh is looking to bolster CWN’s grassroots, hands on approach to advocacy, and working towards a Nepal in which vital social programming such as health and education is indiscriminately available to all persons.

Dinesh Thapa, Construction Manager

Dinesh Thapa recently joined the Care Women Nepal team as an associate and construction manager. Dinesh considers himself to be an entrepreneur and jack of all trades, who is not only ready to assist with the planning and execution of CWN led health camps and surgeries, but also to lead the construction of CWN’s new office in Pakhribas. Dinesh has an entrepreneurial spirit and experience in managing teams. Dinesh is looking forward to putting the skills that have developed throughout his career thus far towards advocating for the health rights of women in Dhankuta.

Kamana Pradham, Lead Volunteer

Kamana Pradhan is a mother and women’s health advocate in Dhankuta, Nepal who has volunteered at many of CWN’s past health camps. Kamana believes that CWN’s health camps have an essential role to play in addressing the high prevalence of uterine prolapse in Dhankuta. As a mother herself, Kamana feels a responsibility to advocate for the reproductive health rights of women in her community. Like Indira, she has also witnessed the death of women in Dhankuta owing to an inability to access reproductive health services.

Dr. Gyanendra Man Singh Karki

Dr. Karki specializes as an Obstetrics and Gynecological Consultant with a subspecialty in Gynecologic Laparoscopic Surgery. During his medical career, he has performed at least 5,000 surgeries to correct uterine prolapse. He can form a basic hysterectomy in 15 minutes, around half the time it takes other surgeons. Dr. Karki strongly believes that uterine prolapse is a global epidemic. Women in developing countries in Asia and Africa are affected at much higher rates than what is reported.

Dr. Anjali Rasaili, Gynecologist

Dr. Rasaili has been an OBGYN specialist for two years and has been a doctor for the last six. She prefers the surgical aspect that accompanies gynecology over obstetric cases. She also looks forward to performing laparoscopic operations in the future, which will come once her career advances. Dr. Rasaili praised the health camp and said it allowed her to provide a service to society and the women of the Nepali community, which is something that is very important to her.

Dr. Ramesh Shrestha, Gynecologist

Dr. Ramesh Shrestha has been an OBGYN specialist for two years and has been a doctor for the last six. When asked about his professional opinions regarding uterine prolapse, he spoke about how common the medical issue is in the Nepali community. Dr. Shrestha believes the prevalence is underestimated due to the lack of women who seek medical attention. While the hospital data reports a 5 percent prevalence rate in Nepal, he believes the rate of women suffering from 2nd to 4th degree prolapse (most in the 2nd and 3rd degree) may reach between 20 and 30 percent in the community. With such a daunting problem facing the women of Nepal, Dr. Shrestha suggests that increasing the availability of family planning resources and methods (as well as adequate knowledge about these resources and methods) may be the best preventative care for women in these smaller communities. There are other risk factors that many women of Nepal are exposed to including the complications that accompany giving birth to multiple children and the intense physical strain placed on the body by hard labor such as farming.

Dr. Tulasa Basnet

Dr. Tulasa Basnet has recently become an OBGYN specialist and has been a doctor for five years. She spent time working in the Kathmandu Teaching Hospital where women who had uterine prolapse were treated for free. Because of this, one to two women would undergo surgery for their uterine prolapse per day at the hospital. The cases would vary, but some were very bad and included rectal prolapse, bladder prolapse, and/or ulcers on the uterus – similar to what she sees at the CWN health camp. When she asked if she likes her specialty, she smiled and said she prefers obstetrics because there are so many good moments. There’s grateful, smiling patients and she gets to experience the intense joy of delivering a baby and handing it over to a new, loving mother.

 

Supporters

Supporters

With many thanks to…

2016 Supporters:

Helen Smith, Takahiro Inoue, Charles Fay, Yves Albert Mathilda Vervecken, Karina Kristiansen, Jess Freestone, Helen Lightner Smith, Tom Ross, and Leslie Ekings

2017 Supporters:

Eric Gonzalez, Pablo Martin, Taehoon Lim, Tyler Petit, Remi J Petit, Eric Termuende, Blake Woodward, Christopher Fenn, Jesse McGinn, Kent Bastell, Tyler Colliou, Andrew Schmaus, Clinton R. Johnson, Daniele Battiston, Jake Curley, Rachel Petit, Daulat Gulamhussein, Brett Kulak, Susan Lehman, Landyn Gill, Henry Berry, Adam Swertz, Kathleen Young, Rishav Chatterjee, Shea Silva, Timothy Mac, Christina Wagner, Martha Randell, Castillo Vianney, Julia Mascioli, Carol Yanisch, Wojciech Komor, Fergus Anderson, Kelsey R Fausett, Catherine Mathieu, Gitanjali Gnanadesikan, Elina Kahkonen, Abhijit Kulkarni, Priyankara Sanjaya, Anastasios Coulaloglou, Neil Tetkowski, Jason Gomory, William Spencer, Megan Keeling, Racquel J King, William Scott Jr., Sharon Fischer, Peter Titelman, Jiri Stavovcik, Suzanne Kay Murray Sujita Basnet, Anna Bliss, Dan England, Rayah Al-Farah, Tanumaleu Peleti, Karin Orr, Amanda Quesada, Ashley A Kosiewicz, Devin Greenleaf, Maria Aldrina, Z. Territo, Anthony H Bliss, Lisa S Bliss, Scott Allen, Sara Allen, Tara Libert, Herbert Parsons, Alison Soldano, Tim Riley, Kanako Y Allen, Cristy West, Katharine Baker, Lauren Purnell, Wendy Reeve, Ida Thyregod, Paul Smyke, Anna McGuire, Dorothy Craven, Matthew McGuire, Sarah Craven, Trevor Lee Wilson, Martha Randall, James Soldano, Richard Newton, Roy Alan Goldman, Heather Dolstra, Mary E. Bittner, H E Bittner, Kelsey Tuttle, Jennifer A Wolfe, Art Tolsma, Mollie Galioto, Tonya Tolsma, Areal Tolsma, Melissa Majano, Rita Lo, David Burton Perry, Stephanie Reid, Jocelyn Bishop, Erika Jason, Anthony Nicholson, William Lorie, Emily Stapp, Micaela Hagstrom, James R. Steadman, Jefferson Yarborough, Nola Tolsma, Iain Guest, Angelique Palomar, Kim Ingeneri, Katherine Wagner, P A Bliss-Guest, Lawrence Ingeneri, Jennifer Guest, Margaret Harvey, Sara McCracken, and Jiahui Soh

2018 Supporters:

Lee Kan Yan

 

 

Resources

Resources

News Bulletins

Health Camps Offer Relief from Prolapse in the Mountains of Nepal  October 18, 2017

Health Camp Keeps Prolapse at Bay in the Mountains of Nepal  July 27, 2015

Care Women Nepal Rescues Women from Prolapse Misery  July 14, 2014

Blogs

Rachel Petit

“Peace signs and ‘duck faces’ are universal, illness is universal, access to care is not. Care Women Nepal is working to change this reality for the women of Dhankuta. As an advocate for women’s health rights, I am truly grateful to play a small role in CWN’s work this summer.”

Morgan Moses

“Maybe that’s the thing about the human body and medicine; it can be approached differently, but the concepts are the same wherever you go. There’s just this look in an expecting mother’s eyes when she’s told everything looks good, an expression of relief, joy, and love that isn’t limited to Nepal. There’s sound and speed of a fetal heartbeat. It should be a strong and bounding 120-160 beats per minute wherever you go. There’s the doctor so engrossed in her work that I’m a little worried she’s forgotten to breathe in the last ten years. The female anatomy is the same everywhere and there’s not a place in the world where a uterus should be coming out of a vagina.”

Maya Washington

“I had the opportunity to sit in the gynecology room and watch the procedures. Women came in for any number of reasons, from full-blown uterine prolapse in which their uterus was protruding from their vagina to a simple pregnancy test. When asked if they would have been able to see a doctor, nurse or another healthcare professional if this camp were not available the answer was more often than not, no. Because this health camp is free of charge, women are more likely to walk up to 6 hours to seek medical care, as they cannot afford it otherwise.”

Lindsey Killett

“Like our trip, I was expecting to hear tragic, rough stories from the people I met. Specifically the women I met with uterine prolapse. I was also expecting a moment of time to witness the resilience, passion, love, and beauty of the people I met. There is beauty in valleys and hills no matter how dark or treacherous they may be. If there is a way up then there is always a way down. This is something I think we all have in common. Everyone has a story! Everyone has their own experiences!”

Quilts

Sini-Quilt 1 sq

Memorial square made by Harihala Budha

       

Sini-Quilt 2 sq

Collection of tiger bags made by the women active in the Bardiya Conflict Victims Cooperative

Videos