Gomati: Twenty-five years of suffering

“I never imagined that I would walk with so much comfort and ease in this very life…you are truly like a god, and you have totally changed my life.” Gomati whispers these words to herself as she walks through the hospital aisle. In one hand she is carrying a bag of things she needs for her stay at the hospital: clothes, a glass, a plate, a sari and a blouse. In the other, she carries a piece of paper that reads: “Post hysterectomy diagnosis: procedentia (total Utero-Vaginal Prolapse). The patient is stable and comfortable with no complication. Care to be taken after surgery is well explained to the patient. Follow up in one week.” The tears in her eyes, which blur her vision, slowly flow down her cheeks. She doesn’t try to hide them, instead, she looks at the people around her and smiles. The tears are filled with joy and mark the victory over a curse that has been taunting her for 25 years. She firmly holds the railing on the wall as she paces through the aisle. She thinks if she were to let go, she might fly. Not being able to remember the last time she walked with so much comfort and ease, she sits on the stairs and cries. Gomati Khadka had been suffering from procedentia — a total prolapse of the womb — for the last 25 years. She could not express the joy she felt as she left the hospital, cured from the illness she had endured for so many years. At the tender age of nine, Gomati was forced to marry a 20-yearold man. The world of her in-laws that she now had to adopt had 14 members living under the same roof. Her new home was in a far away 12 village, distant from the world she had known. She immediately found herself in charge of all the household chores, from making fire for cooking to fetching water from a spring an hour’s walk away. She had to gather fodder and carry the load twice her size for miles. Working in the fields, feeding the cattle, washing dishes and clothes, mud-painting the house and making her in-laws happy, were all part of her duties as a newly-wed daughter-in-law. Being the last member to be served food at night, she would always be anxious to get some rest. She would have to wake up early the next morning, while the moon and the stars were still visible in the sky, and start the routine again. Her tiny body yearned for rest. Sometimes she would take rests on her way back from the jungle, weary from carrying the heavy load of firewood on her back. She desperately looked forward to the festivals – an opportunity for her to visit her mother’s house for a day or two, which lifted the burden off her shoulders for a few days. Gomati was 15 years old when she became pregnant with her first child. The labour lasted for eight days, at the end of which the exhausted baby stopped moving. She was too young to have known the danger signs of pregnancy, so she did not tell anyone that the baby had not moved. Finally, a witch doctor was called to help pull the baby out. Sadly, the baby was dead. Gomati was left cursing her fate. Usually in her caste, if the baby survives, they keep the mother and baby together in a separate place during “the unclean period”. This period happens during the initial 11 days following the delivery, after which the mother resumes her chores. The family would have given her the due attention if the baby had survived, but without a baby to take care for and to breast feed, she had to immediately resume her household chores. Within a week, she was back working in the fields. One day as Gomati was returning home carrying a load of fodder, she felt something slipping out of her private part. She could not figure 13 out what was wrong. She hurried back home and took the fodder to the cattle. She then went to her room to check what had happened. She was horrified by the mass she saw. She wondered if it was a part of the baby that was left behind, or if it was a deadly disease. She panicked, but all she could do was cry in her room. Her cries echoed back from the walls around her, causing only more desperation. No one else heard her cry. She cursed her fate, and lamented on being a girl – a woman. Gomati had Utero-Vaginal Prolapse. Gomati was 47 years old when she came to our Community Service Academy Nepal (COSAN) clinic at Thumpakhar, near the China boarder, about 160km from the capital city, Kathmandu. Thumpakhar is on top of a mountain, with a breathtaking view all around. The snow-capped mountains look so close that it seems you could touch them by stretching your hand. When standing on the mountain, the cold Himalayan winds blow. There are waterfalls and streams everywhere, filling the mountain with the soft sound of water travelling downhill to meet a bigger river. Tall pine trees and seas of wild flowers overlook the Himalayas and sway to the breeze. In one of these mountains lives Gomati. Resilient Gomati. Gomati had suffered for 25 long years of her productive life with intense discomfort. A frequent dragging pain on her lower abdomen and severe backaches were just a few of the complaints she mentioned. To add to her physical pain, the mental stress of constant ill treatment had left her sad and depressed. Despite the pain, she bore three more children at home, all without complication. When she came to the COSAN screening clinic she could hardly walk. For many years she had been unable to eat a full stomach, because if she did, the increased intra-abdominal pressure made it feel like all of her internal organs would fall out. She looked thin and under-nourished. She had the biggest Utero-Vaginal Prolapse ever seen till date by our team. It looked like an inflated balloon, but was too hard and stiff to be 14 inserted into the body because of the ulcers caused by continuous friction from walking. After her surgery, for the first time in 25 years, she was able to walk freely without any discomfort. The gynecologists at the hospital who examined her were all amazed by the size of the prolapse. While Gomati was being prepared for the operation, the doctors were having a meeting to discuss the case, since it required special precautions and operating methods. It was the first time that they were operating on such a big prolapse. The extraordinary size of the prolapse did cause some concern for the team, however, seeing her in comfort after the operation made all the effort worthwhile. With the support of Asian Aid Australia, COSAN has been reaching out to women facing this unspoken illness for many years. We go to villages and conduct health camps, and help spread health awareness. These women would never come to a hospital or visit a health specialist in the city. Many women walk for hours just to get to an outreach camp and clinic.