As part of Amnesty’s My Body My Rights campaign, we are working with the Nepali women’s rights movement to call on the government to recognize that uterine prolapse is both the result of gender discrimination and a failure to uphold the human rights of women and girls in Nepal. Here, two Nepali activists share their stories of challenge and triumph in their long-standing work to promote women’s reproductive rights in their country.
“It was very difficult for many people to understand that the uterus can actually come out of the body.”
- Dr Aruna Uprety, public health and human rights expert and founder member of the NGO Rural Health Education Services Trust
I’ve been working in Nepal for the last 27 years. In 1995, when I was working in the Far Western Region of Nepal, I conducted a small health camp for women. In seven days, we examined 600 women and found that 150 had some form of uterine prolapse. They mainly came to complain about pain and back aches but upon examination we found that the cause was uterine prolapse.
We found many women would insert things in their vaginas so the uterus would not come out – stones, bangles – anything to stop it. I remember one case where a woman had a ring pessary inside of her for 15 years and she did not take it out. She was unaware she needed to change it every three months.
Stories like this made me start writing a lot about uterine prolapse in national and daily newspapers and advocating that the government needs plans and programmes for uterine prolapse.
Other activists also started talking and taking action. We raised the need for uterine prolapse prevention. We recognized that health workers, nurses and midwives need to know how the condition can be prevented. Once we provided training to these people we found that the cases of uterine prolapse decreased. It was a small project but one with good results.
Uterine prolapse and its causes are human rights issues and we feel that these fundamental rights are being ignored by the government. How many more years will it continue? In Nepal very young women are suffering – 20 and 21-year-olds. We need to budget money for the prevention of uterine prolapse.
Amnesty has been in the media talking about many issues so when it began talking about uterine prolapse as a human rights issue, people thought: ‘If even Amnesty International is talking about this – it must be a very big problem’. Uterine prolapse is against our constitution and through Amnesty’s report we now have a tool that can be used to talk with our government, policy makers and international governments.
“In our society, it is a taboo to talk about reproductive health in general. But now we see women are talking about uterine prolapse openly, as they know now it is treatable and preventable.” -Samita Pradhan, Executive Director, Centre for Agro Ecology and Development (CAED)
Reducing gender discrimination and upholding reproductive rights is a long-term goal for CAED. It is a challenge to make men and women at the local level understand what it means to have reproductive rights. People regard women with uterine prolapse as having a normal condition after giving birth to children, or that it is normal for a woman to bear conditions such as uterine prolapse.
It is equally challenging to make policy makers and donors understand that the problem needs to be prevented and to establish reproductive rights of women.CAED works with some 20 local women’s rights organizations across Nepal. Women at the village level are organized and are demanding for women’s health rights and health services from the government.
Until a few years ago, there was also no government unit, no officials to listen about the issue of uterine prolapse. There’s been a big change in government, they have set up a unit, a focal person at the Family Health Division under the Ministry of Health and Population. There is a space where we can discuss the issue. However, they are still focused on surgical treatment. Addressing uterine prolapse through preventive measures and from a human rights perspective remain challenges for the government of Nepal.
It’s frustrating sometimes when we have to talk about the same issue every time our government changes. Since our political situation has not been stable for many years, preparing parliamentarians with the political will is challenging. As far as I can remember, we have talked about uterine prolapse and its contributing factors and consequences to five different health ministers, secretaries and directors.
It was a big issue for Nepal and the Government of Nepal when Amnesty international started working on this. National and international NGOs have been campaigning on uterine prolapse for many years, this time it was heard loud in Nepal and outside the country as a human rights issue.