By Gopal Sharma
KATHMANDU, Feb 20 (Thomson Reuters Foundation) - When pregnant Nepali teenager Reena Pokharel began labour in her remote village, her family consulted a soothsayer, pressed her stomach and told her to cough to force the baby out.
After four days of painful labour, the 17-year-old delivered a girl. But with no skilled midwives present, her placenta was not immediately removed, triggering a debilitating health condition that left her unable to perform daily tasks.
"I became an outcast in my own family," Pokharel, now 46, told the Thomson Reuters Foundation.
"They said I had brought bad luck and called me an evil omen. The community would not eat or work on farms with me. My husband beat me, saying I was lazy and unlucky."
Uterine prolapse - a medical condition in which the uterus is displaced from its normal position into the vagina - affects women worldwide but is more common in Nepal, where one in 10 is affected, rights group Amnesty International said on Thursday.
Sometimes called "fallen womb", the problem is a direct result of gender discrimination that deprives women of sexual and reproductive rights, Amnesty said in a report.
This leads to limited access to healthcare, harsh working conditions during and after pregnancy, inadequate nutrition, early marriage and rapid successive births.
"This is an urgent human rights issue," said Madhu Malhotra, director of Amnesty's gender, sexuality and identity programme. "Hundreds of thousands of women are suffering needlessly in Nepal today."
She traced the country's extensive problem to ingrained discrimination against women and girls that successive governments had failed to eradicate.
Many Nepali women develop the condition in their twenties, Amnesty said, although older women are more commonly afflicted elsewhere. The sufferers were often too embarrassed to seek healthcare, or even to talk about their pain, it added.
This subjects them to social stigma and accusations of laziness by families who do not realise there is a problem.
The mountainous Himalayan nation, wedged between India and China, has been riven by conflict and instability for years. Nepal has been governed under an interim constitution since the 2008 abolition of a centuries-old monarchy.
Political infighting has fuelled the economic woes of Nepal's population of 27 million, a quarter of whom live on an income of less than $2 a day. The crisis has hit development efforts, driving thousands of young people to seek work abroad.
In 2008, the Supreme Court ruled the high incidence of the problem was a violation of reproductive rights and ordered action by the government, but six years later, efforts have fallen far short of what is needed, Amnesty said.
London-based Amnesty urged Nepal to recognise the high incidence of the problem as a human rights issue, since families traditionally grant few women a say in when to marry, whether to use contraception or have children or even how many.
The government is helping through assistance in deliveries, contraceptive distribution and free treatment, said health ministry official Kiran Regmi, who estimates that over 40,000 sufferers have been operated on in the last four or five years.
"More and more women are taking these services," Regmi said. (Writing by Nita Bhalla; Editing by Clarence Fernandez)
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