Economic, environmental and cultural factors combine to result in a myriad of reproductive health issues which affect Nepalese women, particularly those in rural areas. Lack of education in general and awareness of reproductive health problems in particular, and a strongly patriarchal society where such ‘women’s issues’ are not discussed openly, mean that many woman are not aware of cultural practices that can be detrimental to their health, nor of the way or where to seek help when they do get sick.
Poor nutrition, poor hygiene practices, endemic gender discrimination and unsafe cultural mores result in high rates of maternal and infant morbidity and mortality, and higher than normal instances of conditions such as obstetric fistula, sexually transmitted diseases, urinary tract infections and uterine prolapse.
Uterine prolapse, where part or all of the uterus drops into the vaginal canal because of muscle and connective tissue weakness, is a particularly debilitating disorder. Sexual activity at an early age (child marriage), early and frequent childbirth, undernourishment and returning to strenuous activities such as farming too soon after delivery, cause uterine muscles to weaken. Women suffering from this condition live in constant pain, can experience difficulties in performing even the most mundane of physical tasks such as walking and sitting and face social ostracization and even abandonment because they are no longer able to be productive members of their household.
The shame many women with this condition feel, means they do not seek help at even the local health posts (where most of the medical staff are men) and suffer in silence.