Nyaya Health

Posted by Tenzing Tekan

6:30am Wake up at sunrise. Carry water to the house from the spring and get washed and cleaned. While I am washing, the night watchman brings a paper with a question from the overnight shift Assistant Nurse-Midwife regarding a dehydrated infant. Since it is a simple intervention, I write a reply instead of going down to the clinic.

7:30am Help with washing yesterday’s dishes and preparing brunch, usually rice, lentils and potatoes. We have had difficulty finding a reliable housekeeper so the medical staff at the quarters have been sharing in housekeeping work. We are all eagerly looking forward to someone arriving from Dhangadi today. In the meantime, we have benefited from having Mr. Santosh – our lab technician – who is an excellent cook!

Walking down to the clinic

9:45am Arrive at the clinic. Usually 20-30 patients are already waiting to see me.

We register each patient, after which the health assistant (Mr. Uday) and I examine them. Most of our patients are children and women from the poor, lower castes living in the nearby hills. They have often travelled several hours to seek medical care.

Complaints range from something simple like diarrhea (which can and often is deadly due to ignorance about basic prevention and cure of dehydration) to more complex illnesses like chronic pulmonary disease (more on this later).

Santosh, our lab technician, at work

11:00am Consult with the on-site clinic management about hiring health aides urgently. One candidate claims she cleans so well that she can turn a bathroom into a kitchen! We decide to hire her on a one month trial basis. Several hours fly by due to continuous patient flow. By the end of the day we have seen 46 patients (approximately the average number we have been seeing since our clinic opened).

Dr. Thapa – the hardest working man in Sanfe Bagar – with some patients

Sometimes we are a little overwhelmed by how many patients come to seek care!

5:30pm Our final patient for the day was a 73 year old man (from my own village of Darna, Accham in fact). He has been unable to walk for the last six months due to severe swelling all over his body. He was brought by a team of 20 persons who carried him for eight hours in half-hour shifts. The persons carrying the patient do not usually ask for or receive any money as they simply consider it as fulfilling their neighborly duty. If they in turn were to get sick and need to be carried (lack of roads and nearby medical facilities make this quite a common situation to be in), their neighbors will be there to help. Our patient (below) was diagnosed with end-stage chronic congestive heart failure due to chronic obstructive pulmonary disease. Unfortunately, there was very little that either we or even an more advanced facility could do for the man.

6:30pm After advising the Assistant Nurse-Midwife about the arrangements necessary for a delivery, I make the fifteen minute walk uphill to our quarters. A little time to relax before it is time to prepare for dinner, carry some water and wash the dishes.

9:30pm We finish dinner, and I get ready for sleep.

10:00pm The night watchman brings a message from the clinic that the pregnant woman is having difficulty in delivery. I find my flashlight and walk down to the clinic.

12:15am First delivery at our clinic! The mother and baby are in perfect health. Below are pictures of the first-time mother and beautiful baby girl (weighing a healthy 6.2 pounds). Time to get some sleep and start all over again tomorrow!

Tags: Achham, Clinic operations, Delivery Services, Gender Equality, Health, Jhapat Thapa, Nepal, NGO, Nyaya, Nyaya Health, Sanfe Bagar, Tenzing Tekan