One of the greatest challenges Nepal faces to development is their lack of health infrastructure, and the not-so-proverbial mountains that stand in the way of creating one. With a country that is 80% “remote” a miracle solution to avail the scattered population of needed health services has not yet arisen. In the mean time, one of the most common mechanisms for providing needed services are “mobile camps.” These camps have traditionally been used for everything from vaccinations to cataract surgery, and are one main way surgical services are provided to some of the 200,000 women in Nepal who currently need hysterectomy due to UP.

In THEORY mobile camps work like this: the organizing body (either an NGO or the government) selects a site that is relatively central in an underserved area (often a district headquarters or a larger market center is selected). A date is set (usually lasting 2 days -1 week), the necessary team of doctors are contracted, and NGOs in the area are informed (unless they already know because they are organizing it) so they can start publicizing the camp and preparing women to attend. Then on the selected date, equipment is trucked in and set up, doctors arrive, and patients arrive and get in line for services. Unfortunately it rarely happens like this.

Women Crowding the Halls Outside the Gynecological Evaluation Room

The benefit of such set-ups is that crucial services get to people where facilities simply are not available. The downsides however, are many, and mostly revolve around the lack of availability of follow up care – both immediate and longer term. These challenges facing hysterectomy camps are particularly acute as post-surgical care needs are intense.

In my desire to know all things UP, I had eagerly searching for a UP camp to attend from the minute I had arrived in Nepal this summer – to no avail. Every camp I heard about was canceled for reasons ranging from roads being washed out preventing equipment transport to bureaucratic challenges. One was even canceled w/o any notice after women had arrived b/c the doctors just never showed up. Thus, during one of my visits to Gaighat my, former landlady/radical women’s health worker/political activist Savita Thamang told me there would be a UP camp beginning the following day in Gaighat, my jaw dropped and I could not believe the serendipity.

Despite my assumption that all such “mobile hysterectomy camps” were held in tents in open fields and the like, this camp was to be held at the district hospital. It turns out that government-sponsored camps are often held at district hospital facilities when available because they offer a basic level of support staff and facilities (such as hospital beds), thus reducing the load of things needing to be trucked in. However, they are still considered “camps” because specialized doctors (gynecologists and anesthesiologists) and equipment still have to be brought in. The fact that there are only 64 gynecologists in the entire country of Nepal, and an even fewer number of anesthesiologists illustrates this point, and belies much larger issues.

I held my breath until the next morning, and when I arrived at the hospital bright and early things actually were getting under way. My luck had held out and I was about to actually experience a mobile hysterectomy camp! Little did I know what I was in store for…..

Surgical Supplies Being Sorted and Cleaned