One of the great regrets in my life always will be with me and may be it will go with my last breath: I was not able donate blood for a woman in Birunj. In 1999, I was in Birjung hospital conducting a research on abortion to raise policy level awareness so that abortion would be legalized. I was in the hospital and one woman was brought by her family in a cart from a village. Urmila Devi (name changed) was a mother of five at 35 years. I was with gynecologist Dr. Pradeep Sharma (name changed) of the hospital who examined the case and told the patient party that her uterus had been perforated and she needed immediate operation.

“Please make sure some of you can give blood to the blood bank, so the bank will give us the blood needed during the operation,” the doctor told her family members.

The doctor, who was working in a war footing, told me “the patient’s hemoglobin is very very low” and he was “taking a risk because if I will not operate on her in a few hours, she will die anyway.”

The report showed hemoglobin at 2 for a normal range of 12 to 16. “It was a miracle that the woman survived so far with her pregnancy,” we discussed.But after half an hour, when the patient was not brought in the operation theater, the doctor asked the staff: “Why are you not bringing the patient? It is an emergency.”

The staff looked at one other and said, “the family members declined to donate the blood saying that they were too weak to do this.”

The doctor did not say another word. By ten at night the patient died and the doctor signed the death certificate in which the cause of death was mentioned as ‘perforated uterus’.

Dr. Pradeep and I talked for a long time about this case.

“I am so sorry that the patient died for lack of blood,” I said. “I should have given my blood and you could have operated on her.”

He looked at me and said it was not the only case. “Everyday we get similar cases, how much can you personally give?”

The doctor was right but if I had donated my blood, may be that particular woman would have survived.

The patient did not die because of lack of medicine, or lack of doctors. She died because as a woman she was not valued. The fate of the mother of five children was in the hands of her family members who, however, decided that if she died “it was her own fate.”

Working in many parts of Tarai and in hill areas, I have found that though the geography and culture are different in two places, the suffering of women, the heath of women, and the value of women are the same in both places. In Tarai areas, women have to confine themselves in their households and suffer as they cannot to go anywhere and in hilly areas women have to do the entire household chores and fieldwork and suffer because she cannot rest.

I remember another incident while discussing with women of both Tarai and hill areas, where women from both places share their lives and related to their health. Hearing the life of hill women, Madeshi women took a deep breadth and remarked “how lucky  you are, you can go outside of house to work and enjoy talking to other people, we are confined to our house and even for our natural call we have to wait till night so that no one would able to see us. We eat less so that we do not have to go to toilet all the time and we drink less as well.”

But women from hilly areas had different opinion. “You are happy that you do not have to work like an ass since morning to evening and you are given food without working hard and we have to eat less because we have to eat at last. We even have a saying in hilly areas ‘do not be a bull in Tarai and do not be a woman in hilly areas.’

Women from both places are suffering from weak health and lack of nutrition because of taboos attached to her and less values given to her. On top of that some cultural practices make things worse. Women in Tarai, when pregnant, mostly suffer from night blindness (vitamin A deficiencies) and if you look at the food that grows in Tarai there is no reason that she should. But papaya is not given to the pregnant women with a thought that it may cause ‘abortion’, banana is restricted as it ‘causes placenta attached to the womb not to come out.’

The health status of women of untouchable communities in Tarai (Dom, chamar, mushahar) is so miserable that as a health personnel, I always wonder how they are able to survive. Severe malnutrition, because of lack of food and taboos, lack of resources for health care and not having ideas about family planning and vaccination, ply out in a vicious circle of pregnancy, high maternal and neonatal death and poverty. If only among them the data are gathered for maternal death and neonatal death, it will come out much more than national average. But as the women of Tarai and women of lower caste they are invisible and do not come under our statistics.

Will women from Tarai and hilly areas understand that they have right to their health? Will the political parties make sure that plight of those voiceless women are heard and will they ever go to see the places where those women live in conditions that are subhuman.Please type your text here. I remember another incident while discussing with women of both Tarai and hill areas, where women from both places share their lives and related to their health. Hearing the life of hill women, Madeshi women took a deep breadth and remarked “how lucky  you are, you can go outside of house to work and enjoy talking to other people, we are confined to our house and even for our natural call we have to wait till night so that no one would able to see us. We eat less so that we do not have to go to toilet all the time and we drink less as well.”

But women from hilly areas had different opinion. “You are happy that you do not have to work like an ass since morning to evening and you are given food without working hard and we have to eat less because we have to eat at last. We even have a saying in hilly areas ‘do not be a bull in Tarai and do not be a woman in hilly areas.’

Women from both places are suffering from weak health and lack of nutrition because of taboos attached to her and less values given to her. On top of that some cultural practices make things worse. Women in Tarai, when pregnant, mostly suffer from night blindness (vitamin A deficiencies) and if you look at the food that grows in Tarai there is no reason that she should. But papaya is not given to the pregnant women with a thought that it may cause ‘abortion’, banana is restricted as it ‘causes placenta attached to the womb not to come out.’

The health status of women of untouchable communities in Tarai (Dom, chamar, mushahar) is so miserable that as a health personnel, I always wonder how they are able to survive. Severe malnutrition, because of lack of food and taboos, lack of resources for health care and not having ideas about family planning and vaccination, ply out in a vicious circle of pregnancy, high maternal and neonatal death and poverty. If only among them the data are gathered for maternal death and neonatal death, it will come out much more than national average. But as the women of Tarai and women of lower caste they are invisible and do not come under our statistics.

Will women from Tarai and hilly areas understand that they have right to their health? Will the political parties make sure that plight of those voiceless women are heard and will they ever go to see the places where those women live in conditions that are subhuman.Please type your text here.