As told by Dr. Jhapat Bahadur Thapa, MBBS
Around nightfall, she arrived to our clinic, as many acutely ill patients do, being carried by relatives. The 22 year old woman was incredibly weak. An untrained family member delivered her baby girl approximately four hours prior to arriving at the clinic. The placenta, however, had not come out and she was bleeding profusely. Our on-call nurse midwife Sangitadidi assessed her pulse and respiratory rate. Recognizing the severity of the case, she established an IV line. She then sent the night watchman to fetch Dr. Thapa.
The birth canal was full of blood clots and was closed, with the placenta inside, inaccessible. He could not negotiate his hands through the birth canal. Given that her hemoglobin was at a life-threateningly low level of 3, the team stabilized her with intravenous fluids and referred her to the hospital in Dhangari for blood transfusion.
After a 12 hour private jeep ride that cost approximately $120, or nearly the annual per capita income of Achham, she reached the hospital. There, she received 4 units of blood and underwent a DNC to remove the placenta. She recovered and returned home in good health to her baby girl. We were able to save this mother, but it is clear that many other mothers have died even in the past month who were not so fortunate to access the clinic and reach surgical services before it was too late. We are planning a hospital to better tackle the grave situation of maternal mortality in Achham
Dr. Jhapat Thapa examining a patient