Posted July 2014

During September and October 2013 Dr Carey worked in Nepal training local Nepalese gynaecologists in advanced prolapse surgery. This trip was organised by the Australian for Women’s Health organisation founded by Australian gynaecologist Dr Ray Hodgson.

Prolapse is highly prevalent in Nepal where it is thought to be double the rate of developed western countries. Speculation as why there is so much prolapse in Nepal has focused on a few likely causes. 1.) It is commonplace for Nepalese women to perform heavy manual labour even from a very young age. 2.) Respiratory disease is very common in Nepal as a result of the practice of burning charcoal fires in their dwellings with often very little outside smoke ventilation. This results in chronic cough that in turns causes prolapse because of the frequent rises in intra-abdominal pressure. 3.) Access to health care during pregnancy and childbirth in rural areas is often limited leading to increased childbirth injury and the subsequent development of prolapse.

Surgical training took place in Dhulikhel, at the Dhulikhel Hospital which is a Kathmandu University Hospital. A further trip to Nepal is planned for 2014.

In addition to their prolapse work, Dr Ray Hodgson and the Australian for Women’s Health organisation have been invited by the Nepalese government to establish antenatal clinics in order to improve childbirth outcomes in Nepal.

Dr Carey found his trip to be hugely rewarding and inspirational. He was reminded of similar work undertaken in 1999 and 2001 at the Fistula Hospital in Addis Ababa, Ethiopia where he had the great privilege of working with Dr Catherine Hamlin.