Despite having five of its districts on the list of the top ten districts in Nepal in terms of public health facilities, the far-west region still has shown a very high number of illegal abortions.
Achham, Baitadi, Kanchanpur, Doti, and Bajhang stand second, fourth, seventh, eighth and ninth respectively in the list of top ten districts in the country that provide excellent health services. However, the number of illegal and unsafe abortions is on the rise in all districts of the region.
As per the government’s directives, abortions should only be conducted from an authorised centre by authorised health workers.
Legal requirements mandate that the foetus be no more than 12 weeks’ old and the mental and physical condition of the woman be sound for an abortion to be legal.
“Despite laws that state that it is mandatory for facilities to only allow licensed and trained health practitioners to conduct abortion, these rules are neglected in both rural and urban areas,” Dr Ganesh Bahadur Singh of Seti Zonal Hospital, Dhangadi said.
Dr Singh added that there is a growing trend of inducing a miscarriage by taking pills and without carrying out any required medical tests. “We see many cases of women inducing miscarriages through pills without consulting a doctor, which leads to several health problems ranging from abdominal cramps to profuse bleeding during miscarriage,” he said.
The drug ‘Mifepristone’ is widely used to abort in this region. Although this drug is not allowed to be sold or bought without prescription, medical shops in rural areas sell it to anyone who asks for it.
These pills are brought from India via Nepalgunj, Mahendranagar, and Dhangadi and cost between Rs 1,000 to 3,000 per tablet in local markets in the far-west region.
Currently, there are a total of 36 health organisations licensed to carry out abortions in the far-west region. In the fiscal of 2014/15, around 642 women came to hospitals after complications arising from an illegally conducted abortion.
Dr Mohan Nath, chief of District Health Office, Bajura conceded that illegal sale of the abortion drug takes place in the region. Dr Nath added that although the Department of Drug Administration, Nepalgunj, is supposed to monitor the sale of prescription drugs, it is yet to take any action in this regard.
Menu Shrestha, department chief of the Department of Drug Administration, attributed the failure to monitor medical shops to the lack of inspectors. “It is not that we have forgotten our duty; the problem is that we lack manpower.
There are 24 districts in the region but only three inspectors.
What can the three do?” she asked, adding, “One of the three has to man the office, and it is extremely difficult for the remaining two to monitor all medical shops in all the districts.”