Introduction of Laparoscopic Tubal Sterilization in Nepal’s Family Planning Program

r. Badri Raj Pande’s experience1 is an example of the ‘hostile’ socio-cultural environment into which family planning program in Nepal was first introduced – and also illustration how has continued to grow flourish over years. His account reminded me some my own personal experiences early days program.It 1973 that Dr. Wheeles from Johns Hopkins University brought a set laparoscopic instruments for tubal sterilization Nepal. He demonstrated use few us obstetricians gynecologists at Paropakar Maternity Women’s Hospital (commonly referred as Prasuti Griha or Hospital) Kathmandu, where we were working time. Kanti Giri led this ground breaking effort, I among group just doctors who participated training. The successful effort resulted eventually introducing female (LFS) under local anesthesia through mobile camps communities there no hospitals trained perform operations.2-6 became ‘pioneer’ country provide LFS new permanent method controlling fertility. Over years, become most widely used contractive Nepal.7-9By way informing potential clients procedure, attending nurses would tell women small injection administered their umbilical region tube will be inserted look ‘durbin’ (telescope) then knot tied safe manner prevent pregnancy. In doing so, term ‘operation/surgery’ purposely avoided so not scared. At times ask why they did send husbands vasectomy instead them going procedure. Their common response husband had work livelihood (the women) didn’t want take any chances, risk something happening family’s source livelihood. those days, having multiple wives considered symbol affluence wealth. During our ‘camp’ Pokhara, surgeons, one person two successive days. showed up with yet third wife on day, both insisted he should get agreed, reluctantly.Over expanded, more popular remains today.9,10 While accepted only already given birth least four children, perception procedure changed considerably 2022, average number children sterilized woman about two.10 As aptly noted “Brief Communication,”1 Nepal’s made significant progress last five decades. path certainly been easy, but success story freed Nepali bear large children. government, international organizations, principally USAID International Planned Parenthood Federation, and, important all, providers nurses, counselors remain champions journey. From time until stopped clinical practice 2018, probably performed nearly 25,000 LFS. After 45 years service, feel personally thankful professionally satisfied have contributed long national journey towards improving health reproductive rights