In December 2018, we (fourth year Ubuntu Through Health students) travelled to Nepal in the hopes to ignite a new health project. Connections from Australia put us in touch with COSAN, or Community Service Academy Nepal. COSAN is a Nepalese charity based in Kathmandu that independently runs health camps for women in rural Nepal. This renowned team visits rural areas in Nepal where these women otherwise would not have any medical help – and women’s health is certainly an issue there, particularly given the beliefs and culture of Nepalese society.
We began our journey meeting with Rama, the founder of COSAN. As a retired nurse, she understood the issues that women in rural Nepal face due to their lifestyle and limited medical attention. In particular, she found that these women have high rates of cervical cancer (with no vaccine currently available in Nepal) and uterine prolapse – largely due to their lifestyles with multiple births at a young age and carrying heavy loads. Rama and her husband, Naseeb, oversee much of the work, and her two children, Angela and Ashish, are doctors that attend almost every camp despite their busy schedules. They were an inspiring family, and beyond their practical skills, their generosity and compassion deserves mention.
The key part of our trip was to attend one of these rural health camps, to witness first-hand how everything runs and understand how we could best help. We ventured from Kathmandu to Sinduhli, a rural area in south west Nepal. We made our 8-hour car journey along windy roads with the 14 other health camp workers. Ahead of us rode another truck that announced the camp to women in surrounding villages (with many staff members crammed into one Toyota Prado)!
We were blown away by the efficiency and professional work of the COSAN team. Over 760 women were seen by the team in just two days; just two doctors, six nurses and several assistants. Here women saw a doctor or nurse on the spot (for many of them, the first time they had ever seen a health practitioner). The women were screened for cervical cancer using a screening method recognised in Australia, and many treated on the spot with cryotherapy. Currently there is no national screening program for cervical cancer, and consequently the COSAN team are in high demand for their services in rural areas of the country for cervical cancer and pelvic organ prolapse screening.
During the camp, 4 women who had successfully been operated on for pelvic prolapse came to say thank you and show their appreciation for the life changing surgery COSAN were able to provide them. The joy on their faces showed us just how important the service COSAN provides is to the women in rural Nepal. We had the opportunity to sit with Angela as she took histories and examined the ladies for pelvic organ prolapse. During these consultations we heard many stories of women suffering pelvic organ prolapse for many years, even decades. Thankfully, these women received treatment with pessary rings inserted or severe cases were referred for surgery in either Kathmandu or Chitwan at two major teaching hospitals.
We also visited the College of Medical Sciences Hospital in Chitwan, where prolapse operations are currently being performed. It was an incredible experience to meet twelve women there following their operations for pelvic organ prolapse. Not only in the hospital, but also on the camp, it was beautiful to see the overwhelming gratitude of the women for the work COSAN does. Chitwan taught us a lot about the logistics of sending women for surgery in Nepal, and we were impressed by how efficient the care and post-operative follow up was, with a COSAN liaison coming to check on the women each day.
Overall, we were thoroughly impressed with the incredible work that COSAN does. There are many expenses that COSAN struggles to cover, and given this, we believe this is something that Ubuntu Through Health could assist with.
Stay tuned for more exciting updates on our Nepalese project, and for our upcoming fundraisers!