Shishir Dahal (EV from Nepal)
We talked a lot about maternal health, child health, HIV, TB and malaria in the last decade. Millions of dollars were poured into the health system and thousands of health workers were mobilized. With the combined efforts of ministries, international donor agencies, NGOs and INGOs, we succeeded in achieving significant improvement in reducing maternal and childhood mortality and containing many diseases like HIV. It was a beautiful time when hundreds of local NGOs working in the field of the health sector flourished all over the country. Thousands of people got jobs. At the time of the civil war in my country, health became an industry. But with significant improvement in MDG goals their charm started fading. Nepal became less attractive for donors. Hundreds of NGOs, their workers, INGOs and their county directors were on the verge of losing their jobs.
The whole system was searching for a new glamorous health issue to tackle. Suddenly we found one. One in every 10 adult females in Nepal have their womb coming out through their vagina, i.e. utero-vaginal prolapse (Bodner-Adler et al. 2007). A huge burden. Some are very quick in jumping to the conclusion that with the level of human resources we have in Nepal, it will take 60 years to treat existent cases even when working 12 hours a day.
These new findings resonated widely, however. Nepal had found a new MDG+ goal, UV prolapse.
UV prolapse in Nepal is something like HIV for Africa. Let me explain why this should be a fancy issue: it involves women, a vulnerable group; also, it is accompanied by stigma and social exclusion just like HIV. Hesitation and embarrassment to seek medical attention for their condition often leads women to live with this terrible condition for years. In spite of all this, I fear UVP will never be an MDG+ aim. It won’t be addressed by global initiatives because priorities are set in Geneva, New York and Brussels.
Back home in Nepal a poor, stigmatized woman with her pelvic organs in her vagina probably wishes she had HIV.