The neglected case of the fallen womb

"Sometimes I wish it was an infectious disease", says a frustrated public health activist in Nepal, exasperated by the amount of attention, and consequently funds, that is directed at HIV/AIDS, when the problem of the prolapsed uterus continues to be ignored. In Kathmandu, one can still see the evidence of a high voltage AIDS awareness campaign from last autumn on looming billboards. Not less than NPR 30 million (approximately USD 400,000) was spent during the campaign on bringing the illness into the open. And, while 'Let's-talk-about-AIDS' messages dot the cityscape, utero-vaginal prolapse languishes on the closely typed pages of dusty journals.

Even by conservative estimates, it is thought that hundreds of thousands of women in Nepal suffer from prolapsed uterus, as compared to the 58,000 Nepalis that have tested positive for HIV. But such is the neglect of women with prolapsed uterus that one can only propose general estimates, referring to 'hundreds of thousands' of victims with no pretence of precision, an indicator of the degree of the neglect. On numbers is predicated a response, and without them, the problem remains unquantified and, thereby, untackled. In this disregard for the problem is the story of how Nepal has, along with funds, imported its public health priorities from overseas; in it is an indictment of health policy, NGO behaviour and media.