Women’s Health Project in Nepal

£12,626

Bishops’ Appeal have allocated funding to CMS Ireland, in partnership with Lalitpur District Public Health Office, to provide preventative and curative steps for women with Uterine Prolapse in five villages in Laliptur District, Nepal.

Description: CMSI have been working in partnership with Sundar Dhoka Church (SD Church), Kathmandu for over 20 years. A church for people with disabilities (including leprosy) it is led by Kosh Bilash (Babukaji) & Goma Adhikari, and their son Bikash.

 

In Nepal the prevailing Hindu/Buddhist culture tends to discriminate against people with disabilities, something which their pastor Babukaji has experienced himself since he was paralysed in an accident as a young man. He now leads a church with a congregation of some 400, many of whom are disabled, and an NGO called Sundar Dhoka Saathi Sewa (SDSS) which supports people with disabilities, the sick, poor and marginalised (see appendix) who gravitate to Kathmandu from all parts of the country.

 

Using their purpose-built church, residential and training facility this support includes accommodation (up to 50 beds), help with transport, vocational training and assistance with rehabilitation. Since the devastating earthquakes in April 2015, and the even more damaging economic blockade imposed by India from Sept 2015 – Feb 2016, this work has been invaluable to many people suffering severe injuries, desperate poverty and acute hardships of many kinds.

 

As a result of this ministry, many clients enquire about spiritual matters and a large number are converted and baptised, taking their new-found faith back with them to whatever region of Nepal they came from. As a result, scores of small & growing satellite churches have now been founded all over the country.

 

The Women’s Health Project seeks to provide Preventative and Curative Steps for Women with Uterine Prolapse in 5 Village Development Committees (VDCs) of Lalitpur District (near Kathmandu) in partnership with Lalitpur District Public Health Office (DPHO).

 

Uterine Prolapse is a serious reproductive health condition distinguished by the protruding of the womb out of the genitals. It has spread massively in Nepal due to multiple causes (frequent births, heavy workloads, unattended births, poor nutrition and smoking). A recent study identified 600,000 affected women, of whom 200,000 require immediate treatment including both young and old women up to the age of 80. Many women in Nepal, however, hide the painful symptoms of uterine prolapse not only out of shame but also out of fear of scolding, beatings, isolation from families and doing household activities.

 

Lalitpur District is subdivided into 42 Village Development Committees (VDC’s), many of which are remote, unreached and lacking basic infrastructure. The District has a high incidence of women with uterine prolapse, demonstrated by a 2007 health camp in three different VDCs (Bisankhu, Dukuchap, Badikhel) when 363 out of 500 women who visited the camp were diagnosed with the condition. (Data source: “Barriers in health seeking from health facilities among women with uterine prolapse in Lalitpur District Nepal” Arjun Subed, MPh, Institute of Medicine, Maharajgunj Medical Campus, Tribhuvan University, Nepal)


Project Objectives and Activities

 

Objective 1: To provide 5 one-day orientation courses on uterine prolapse awareness to local stakeholders – one in each of five Village Developmment Committees of Lalitpur District (Ashrang, Pyutar, Gimdi, Thuladhurlung and Malta)

Activities to support Objective 1

  • Action 1: Lalitpur District Public Health Office (DPHO) will provide a facilitator to train health assistants, auxiliary health workers, auxiliary nursing midwives and female community health volunteers in uterine prolapse diagnosis and support.
  • Action 2: SDSS will provide food, accommodation, transport and allowance expenses.

 

Objective 2: To provide a uterine prolapse screening camp for 950 women for identification of patients affected by uterine prolapse.

 

Activities to support Objective 2

  • Action 1: Lalitpur DPHO will provide a gynaecologist, nurses and other necessary staff
  • Action 2: SDSS will provide food, accommodation, transportation and allowance expenses. Objective 3: To manage, coordinate and facilitate the treatment of 75 women affected with uterine prolapse accessing surgery in Kathmandu hospitals.
  • Activities to support Objective 3
  • Action 1: Surgery will be provided free of charge by the Nepal Government via local hospitals
  • Action 2: SDSS will manage clients’ accommodation, food and transport while they are in Kathmandu for surgery and treatment.Objective 4: To engage 75 families will the heart of the Gospel and to experience the love of God through living at the SDSS facilities during treatment.
  • Activities to support Objective 4
  • Action 1: Clients and their families will be invited to Church services at the SDSS site
  • Action 2: Staff at SDSS will respond to any enquiries from clients in a sensitive manner

Expected Results

  • Result 1: 75 health workers will get orientation regarding uterine prolapse from 5 VDC.
  • Result 2: About 950 women will attend the screening camp.
  • Result 3: 75 women will receive lifesaving uterine prolapse surgery.
  • Result 4: More than 1,000 people will encounter the love of Christ and have the opportunity to enquire about the gospel.


 

Monitoring and Evaluation

  • Client feedback will be collected by SDSS verbally and by questionnaires at the orientation and after treatment
  • Success-rates in surgery and recovery of patients will be recorded by SDSS staff in             collaboration with DPHO staff
  • Feedback from patients and their caregivers will be collected to monitor the management,             lodging and food arrangements provided by SDSS.

Sustainability

Because the expertise, trainers, and initiative for this programme are local, the input from Bishops Appeal and their link Parishes in Ireland is primarily for set up costs. The resources to be put in place are sustainable and will lead to more cycles of training & treatment in other remote regions of Nepal