Uterine prolapse is a condition in which the ligaments and muscles in the pelvic floor are too weak to hold the uterus, which slips into the vagina, leaving women in severe pain and often marks them as outcasts from society. According to a report conducted by the United Nations, Uterine Prolapse is the leading cause of morbidity in women of remote areas of Nepal. Lack of education, extreme poverty, heavy lifting work shortly after childbirth, as well as limited access to trained birth attendants, contribute to Uterine Prolapse prevalence. Symptoms include incontinence, vaginal bleeding, risk of infection and difficulty when undertaking common tasks like sitting or walking.
There is also considerable social stigma around the condition. Sometimes women are ostracized or described as “lazy” by families and communities when they are in too much pain to do the work expected of them. Amnesty International's research found that often women are unable or reluctant to seek healthcare, or to even talk about their pain. In most countries, uterine prolapse tends to affect post-menopausal women, whereas in Nepal it is more commonly seen in younger women, according to the UN Population Fund (UNFPA).
Nepal’s Supreme Court declared uterine prolapse a human rights issue in 2008 Amnesty International’s research found that the government has put in place a number of policies and programes to address some of the risk factors for uterine prolapse. However there is no comprehensive prevention strategy for the condition. The government response has predominantly focussed on providing treatment –almost exclusively surgery (hysterectomy) for the most severe forms of the condition. While surgery may be necessary for women with the most serious forms of uterine prolapse, to meet its human rights obligations, the government must also take measures to prevent the condition. Cases have risen following the earthquake in Nepal in April 2015 due to the difficult reconstruction efforts that are often carried out by women. Of the 1400 patients evaluated in February 2016 at this health camp, organized by 7point8Nepal in partnership with Nepal Medical College Teaching Hospital, roughly 100 suffered from severe uterine prolapse.
In addition to ensuring that women and girls have information about the condition, the prevention strategy must, as a matter of urgency, address the underlying discrimination. Immediate measures are needed to empower women and girls to make their own decisions in relation to their sexual and reproductive health and to control their exposure to the risk factors for uterine prolapse.