One of the great regrets in my life will always be that I was not able to donate blood for a 35-year-old mother in Birganj in 1999 who was bleeding to death after a botched abortion.

The doctor who examined her told the patient that she needed an immediate operation but only if her relatives donated blood. The woman had lost a lot of blood and it was a risky operation, but without it she would die anyway.

As it turned out, the woman’s family members declined to donate blood to save her life. The doctor was furious and went out to the corridor to scold the relatives. The mother-in-law replied: “We are not giving blood, if she dies it is her fate, what can we do?”

Six hours later, the woman died. Cause of death: internal haemorhage due to perforated uterus. The doctor tried to assure me that I couldn’t save the lives of dozens of mothers who died in his care every year because relatives would not give blood. “How can you personally donate blood to all of them?” he asked.

The doctor was right, of course. Today, on International Women’s Day, I wonder if things have really changed in Nepal. That patient in Birganj did not die because of lack of medicine, or lack of doctors. She died because she wasn’t valued as a woman and a mother of five children. Her fate was in the hands of her husband’s family who decided that if she died “it was her fate”.

I have worked in the Tarai and the hills, and I have found that Nepali women everywhere face the same discrimination. Newly-wed wives are treated like slaves by their in-laws. At least household servants earn a salary. The gender discrimination and the ostracisation is the same in the Tarai and the hills.

We thought women had to work harder in the hills, but their lives are no easier in the plains. We talked to women in Siraha and Mahottari, and found most Tarai women didn’t complain about reproductive health problems because most doctors were men.

They keep suffering in silence. I once overheard Madhesi and Pahadi women at a meeting comparing their sorrows. They were competing to compare their hardships. Hearing about the life of a woman in the mountains, a Madhesi woman said: “You are so lucky, at least you can go out and talk to other people. We can’t even go out of the house to go to the toilet, we have to wait till night.”

A woman from the hills replied: “At least you don’t have to work like a donkey fetching water up the mountain and risking your life cutting fodder from the tops of trees. A bullock in the Tarai and a woman in the hills are equally cursed.” It is clear the discrimination and suffering is common.

Women in the Tarai suffer from vitamin-A deficiency and have night blindness. Given the vegetables and fruits that grow in the Tarai this shouldn’t happen, but pregnant women can’t even eat the papayas and bananas that grow in the garden because of a belief that it will cause an abortion.

Much worse is the health status of women from the ‘untouchable’ Dom, Chamar or Mushahar castes. Severe malnutrition caused by poverty and taboos, lack of health care and ignorance about family planning trap them in a vicious circle of pregnancy, high maternal mortality and death.

When will the men who dominate the political discourse for autonomy ever understand and address the problems of the women of the mountains and Madhes and their basic human right to be treated like human beings?