Barabati: A profile of poverty and uterine prolapse in Nepal

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Like many women, Barabati was working in the fields when she first knew that something was wrong. By her best guess she was around thirty years old at the time; just two years earlier she had given birth to her one and only child. It was April, the peak of the harvesting season, and Barabati had been cutting and tying bundles of grass. As she bent over to pick up a heavy load she felt a sudden pain in her lower abdomen. Barabati had never heard of uterine prolapse, but she immediately knew that something wasn’t right.

Despite the pain that she endured as a result of her prolapsed uterus, Barabati told no one about her symptoms. Like too many women, Barabati was afraid that if she told even her husband about her personal health problems, she would be stigmatized—maybe even blamed for bringing the condition upon herself. “If I told anyone, they would neglect me and treat me badly. They would say that I am a bad woman.”

For twenty years she bore her condition stoically, continuing to labor in the fields of the terai (plains) region of Nepal. Her silence only ended when, twenty years after her first pains, a community volunteer arrived at Barabati’s door and began to talk to her about uterine prolapse. At first Barabati denied having ever heard of this condition. Knowing the high prevalence of uterine prolapse in poor agricultural communities such as Barabati’s, the community volunteer persisted. Eventually Barabati admitted to her condition, and is now among a small group of women from her community who have shared their experiences with the community volunteer.

“Now that I have more information,” she says hopefully, “maybe I can seek treatment.”

Her optimism, however, is short lived. This is because the minimum cost of a hysterectomy to repair uterine prolapse is approximately $223 USD (15,000 rupees). Average income in Nepal is approximately $200 USD and Barabati, as a poor farmer, makes a yearly income below average.

When Barabati finds out how much the corrective surgery will cost, a look of resignation passes over her sun-darkened face. “I do not have that much money,” she says simply.

And just like that, Barabati rejoins the ranks of poor women in Nepal who must submit to a lifetime of discomfort and pain.

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