A Voice For the Voiceless
The Advocacy Project helps marginalized communities to tell their story, claim their rights and produce social change. We recruit graduate students to volunteer as Peace Fellows with partners.
The Impact of Service
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Victims
Sufferers of uterine prolapse in Nepal cover a wide range of demographic profiles. NGOs working in Nepal have diagnosed patients with UP ranging from 14-year old girls to 80-year old women (SMNF Nepal 2006). However, the problem primarily affects young mothers in rural Nepal, where 85% of Nepal’s population lives. These young women have limited access to health care and work long hours supporting rural household and community economies.
Age: Data from high income countries had until recently suggested that prolapse occurs most frequently in post-menopausal women. Research from low-income countries, however, is showing that under different socioeconomic conditions, prolapse can occur among young women and first-time mothers.
Data from two districts in Nepal found that 58% of women suffering from prolapse first experienced symptoms between the ages of 20-29, while only 2% experienced the problem after the age of 50. The earliest case of onset recorded in this study was at 14 years old (CAED 2006).
Parity: Much of the literature on UP emphasizes that multiple births can lead to prolapse. Data from Nepal, however, shows that first-time mothers are also experiencing prolapse. In a clinic in the far-western hilly region of Nepal, 37.5% of women who were diagnosed with prolapse reported having completed only one pregnancy before the onset of the condition (Bonetti et al. 2004). This evidence suggests that other factors may be more heavily influencing rates of UP in Nepal.
Ethnicity/Region: A study of ten districts in Nepal found higher prevalence rates of prolapse in hill women compared to plains women (15% compared to 5%), with ethnographic data suggesting that this is because of the more challenging nature of physical work in the hills and the lack of wheeled transport in the region (SMNF Nepal 2006).
Although Nepali women with UP represent a great range of age, parity, and ethnic indicators, they share a common denominator: most women live in rural areas, where health infrastructure is poor and where the exigencies of daily life demand of them challenging physical labor. Approximately 90% of Nepali women are engaged in agricultural work, and in the context of Nepal’s depressed rural economy, these women become vulnerable to malnutrition, unsafe motherhood, and uterine prolapse.
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