It’s been about six months that Meena Chaudhary has had her life back.
For five years this 24-year-old from western Nepal’s Bardiya district had been constantly leaking urine that barred her from stepping outside her house; she was unable, yet compelled to do the household chores.
Unaware of the fact that it was a disease that could be cured, Meena and her family lived with it every day.
Like Meena, thousands of women in Nepal, live with this medical condition known as obstetric fistula, a hole between the bladder and the vagina resulting into leakage of urine and stool.
Dr Kundu Yangzom, Professor and Head of Department of Obstetrics and Gynecology at Patan Academy of Health Sciences, says that in developing countries like Nepal, about 90% of fistula are caused following an obstructive or mismanaged labor. Another 10%, she adds, is uterogenic – that is, when the bladder gets injured during other gynecological surgeries.
“This kind of situation is particularly prevalent in young girls whose pelvis is not mature enough to have babies,” points out Yangzom, a fistula expert in Nepal. For 27 years, she has operated on more than 350 of the 420 (the estimate now is 600) cases reported in Nepal.
According to the recent data from the United Nations Population Fund, an estimated 200 to 400 cases of fistula are found every year. So far, there are only about 4,600 prevalent cases in the country. At least two million women in sub-Saharan Africa, South Asia and the Arab region are living with fistula, and some 50,000 to 100,000 new cases develop each year.
But in a country like Nepal racing to meet the Tier 5 of the Millennium Development Goal that aims to improve the maternal health, the Himalayan nation seems to have sidelined an aspect of maternal health affecting thousands of Nepali women silently.
In my interview with Nepal’s Health Secretary Sudha Sharma (she resigned last month), she said that the general impression compared to other health burdens such as uterine prolapses, which is highly prevalent in Nepal, fistula cases stands at a minimal level.
“For comprehensive management of all urological disorders in women related to prolapse and fistula, the government is helping the Maternity Hospital to develop itself as an urogynecological center,” Sharma gave an obvious reply.
As plans and policies are being discussed on paper and development works are being materliazed in the hospitals in city centers, women in rural Nepal are still deprived of every basic right—from health to education.
Meena and her village is a telling example. The nearest health care facility is hours away, and so women don’t bother to visit health facilities during pregnancy.
Also these communities have no skilled birth attendants; complicated deliveries could leave the mother and child dead or have women live with conditions as fistula.
And so is the reality as hundreds of women suffer in silence or die in deprivation of their right to basic health care.