31, March: Patients seeking surgery for hysterectomy or prolapsed uterine at the Thapathali-based Paropakar Maternity and Women’s Hospital can heave a sigh of relief now, as the hospital has started paying services that are more economical compared to the charge of private hospitals.

Doctors at the hospital say that women having a prolapsed uterine can undergo surgery within a week under the paying service.

“Patients can undergo uterine prolapse surgery within a week under the paying service,” said Dr Shree Prasad Adhikari, director at the hospital. “Surgical waitlist for uterine prolapse has also lessened due to the start of paying service.”

Uterine prolapse occurs when the pelvic muscle and ligaments stretch and weaken and no longer provide enough support for the uterus. This is a significant public health concern in Nepal as thousands of women throughout the country suffer from this condition every year.

Doctors say extensive workload, lack of nutritious food and physical labour during pregnancy and immediately after child birth are chief culprits for high prevalence of uterine prolapse in women in the country.

Women suffering from uterine prolapse had to wait for months for uterine prolapse surgery at the hospital in the past under the regular programme.

According to the doctors at the hospital, patients have to pay double the fee for surgery under the paying service.

The hospital administration said that patients have to pay Rs20,000 for paying service, for which private hospitals charge more than Rs60,000. The hospital doesn’t charge additional amounts for beds, medicines and nursing services.

“Even if patients have to pay twice the hospital’s charge for service, it is several fold cheaper for them compared to the service of private hospitals,” added Adhikari. “Doctors serving in our hospital provide paying service after their duty hour and we pay additional for their service.”

According to Adhikari, the hospital carries out emergency surgery at any time and does not charge additional fees. Paying services are only for those who want service from doctors serving at the hospital but do not want to wait a long time for their turn, he said.

The start of the paying service has also lessened the surgical waitlist at the hospital. According to doctors, patients can undergo surgery within a month even if one does not want to pay additional under the paying service.

The hospital is also carrying out laparoscopy surgery to remove a prolapsed uterus. Around 40 laparoscopic surgeries are being carried out every week, doctors say.

“Doctors in our hospital perform paying surgery only before 9 am in the morning and after 3 pm in the evening,” said Dr Sandesh Poudel of the hospital. “We do not carry out C-section delivery under the paying service, as the service is free in our hospital. We provide the service free of cost at any time if it is an emergency.”

C-section, or caesarean delivery, is a surgical delivery procedure performed during emergencies. It is lifesaving when vaginal delivery poses a risk to the mother or baby due to obstructed labour, foetal distress or an abnormal position of the baby, doctors say. The Nepal Demographic and Health Survey-2022 carried out by the Ministry of Health and Population shows that one in five women in Nepal give birth through C-section.

As more people do not know about the paying service of the maternity hospital, the number of patients seeking services hasn’t risen as yet. Around 10 paying surgeries are being performed every week.

The hospital has also been running a birthing unit in which women can have their husbands or family members by their side during labour and child delivery. Most women say they want their husband or a close relative to be present with them during such conditions.

Such service is not available at the hospital’s labour room and most other maternity hospitals in the country, including at the hospital’s emergency ward, where dozens of women give birth every day.

Around 60 to 80 women deliver babies at the Thapathali hospital each day.