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2009-06-26
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2009-06-25
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In Nepal, Uterine Prolapse is a reproductive health condition distinguished by the protruding of the womb out of the genitals. This disease has spread massively; a study has identified the need of treatment for 6,00,000 women who are affected by the disease, out of which two hundred thousand require immediate treatment. Uterine Prolapse, is widespread across the country and has affected women in the mountains, hills, plains and the valleys of Nepal. In addition, Uterine Prolapse makes no distinction between young and old women, and women as old as eighty have been found to be among the sufferers But families and communities still refuse to speak about the disease and it is often a secret kept within the home.
According to the latest statistics of the Government of Nepal, 85 percent of the population lives in rural areas where basic health services are very limited due to geographical, economic, social and cultural barriers. In addition, Nepal's health services were further pushed back after the decade-long people's war in which basic health services, treatment centres, machineries, and treatments were targeted. Even the health services that have reached the rural community have not been sufficient.
The reality for most Nepali women is even harsher. They are deprived of their basic rights to choose their own sexual partner, when to become pregnant, security from any kind of violence, eating when they desire food, education, treatment facilities, etc. Only a limited number of women know about their physical and mental health rights and the Government of Nepal has not effectively addressed this issue. Awareness-raising programmes on health rights have not been effectively implemented and the State has also been unable to address issues related to Uterine Prolapse despite the fact that this disease affects the lives of hundreds of thousands of women throughout the country. The Government has recently come up with a public private partnership program, but it has not been implemented yet.
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| Health of the Nepalese people is taken care not only by public sector, private practitioners, of both modern and alternatives medicine as well as by drug retailers, health volunteers and traditional healers. Most health care providers at rural level are inadequately trained and lack facilities for carrying out uterine prolapse prevention and control activities. Most of the local and international non governmental organizations that are involved are carrying out the screening activities and identify the problem, but due to lack of proper technical back-up they leave most of the women with double dilemma of living with the disease and searching for suitable treatment facility.
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Samaj Hospital is a private 55 bedded general hospital located in New Baneshwor, Kathmandu, Nepal. It was started with the objective of providing " Affordable service, Prompt service and Quality service". Hospital is already involved in Uterine Prolapse prevention and control activities and is also successfully carrying out surgery for uterine prolapse. It has a team of experienced Gynaecologists, Anaesthetists, OT staff and Nursing staff.
We have divided the program into two stage:
The first is the preventive stage, we with the supporting organizations organize the health camp, screen the women to assess the extent of the prolapse and provide pelvic floor exercise for those with 1st and 2nd degree prolapse. Ring pessary and pelvic floor exercise are needed in some cases. It is a joint programme with HELP-Nepal a non-governmental organization.
The second is the curative stage, in which women with 3rd degree uterine prolapse undergo surgery. Partial support is being provided by COSAN, FDP-Nepal and HELP-Nepal for surgery. The hospital is doing these surgeries at a very subsidized rate. Basic pelvic floor exercises are also being taught to the patients after surgery. So far we have carried out more than eighty surgeries.
So far we have been involved in treatment of patients from: Kathmandu, Lalitpur, Bhaktapur, Kavre, Nuwakot, Gorkha, Dhading, Makwanpur, Sindhuli, Ramechap, Sindhupalchowk and other districts.
We have also MOU with HELP-Nepal to jointly work with national and international doctors for best management of cystocele and rectocele.
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Overall general objective to carryout integrated women health awareness activity, and uterine prolapse prevention and control activities in rural Nepal.
Specifically the objectives are to :
- To provide orientation to local stakeholder of health promotion at the proposed Districts.
- Carryout women health and uterine prolapse awareness activity in close collaboration and cooperation of local health care provider at the programmatic districts.
- Carryout Uterine Prolapse screening camps and carryout surgery for uterine prolapse at the local Hospital or at Samaj Hospital. Make arrangements for pelvic floor exercise for those with 1st and 2nd degree prolapse.
- Document the disease prevalence for evidence so that major health stakeholders pay attention in future.
- Disseminate disease scenario information at various political and administrative levels.
- To establish link and co-ordination with line agency and local CBO, NGOs and INGO’s at the programmatic district.
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- Orientation and workshop meeting of executive committee and Project team.
- Develop and finalize orientation materials for the Programmatic District.
- Development of women health awareness, Uterine prolapse awareness and information brochures and pamphlets and awareness documentary.
- Selection of health camp sites ( 2~3 health camps in one district)
- Fixing of dates to organize health camps.
- Local information dissemination at and around selected heath camp site about the health camp.
- Organize health camps.
- Prepare for surgery of the needful cases and make provisions for pelvic floor exercise.
- Follow up of treated case.
- Record, analyze, and prepare report for dissemination
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If you want to be involved or support us in this endeavor feel
free to contact us. |
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