Nyaya Health

Posted by Dan Schwarz

<beep> <beep> <beep>…I open my eyes groggily; the “line” (electricity) has come back. <beep> I glance at my mobile – it’s 3:19am. <beep> The beeping annoys me, but it helps to wake me up so that I can get work done in the few minutes that we have electricity. It’s the “low battery” alarm on my portable battery that is hooked into our power grid to charge

whenever the electricity comes on – when the electricity comes back on, it wakes me up to work. <beep> I sit up in bed and move over to my laptop, which I leave on a chair right next to my bed so I don’t have to go very far in the middle of the night. <beep> I press the power button, taking it out of hibernate, turn on my wifi card (saves laptop battery power to have wifi turned off), and wait as my email downloads. It has been 34 hours since the line was on, and since the rains caused some landslides yesterday closing down the local roads, we’ve been conserving the petrol for our generator for only clinical emergencies (not sure when we’ll be able to drive to purchase more petrol)….Haven’t had any power since the day before yesterday.

It’s 3:56am by the time my 164 emails sync up. <beep> The battery is still charging. I slog through my emails half-asleep, knowing that if I don’t do this right now, it could, be another 2-3 days before I have email. <beep> I send 39 emails all at once, having written them using my four laptop batteries while the power was out. <beep> I know, of course, that many of the emails will likely already be out of time sequence because the conversations have been progressing  during my e-absence, but it’s the best I can do. …As the little green progress bar shows my computer uploading the 18^th email, the line cuts off. <beeeeeeeeeeeppppppp> My battery didn’t have enough time to charge; the internet dies.

At 4:45am a woman goes into labor. In the delivery room, we struggle to see in the dark. Dr. Bibek, our Medical Director, and our Senior Nurse Midwife Urmila Basnet, deliberate about whether to do the delivery in the dark with flashlights or to turn on the generator. Urmila Sister protests that we should save the precious little petrol we have left; what if another patient comes in who needs it more? We might not be able to get more petrol for days…we have to be careful, she says. The woman seems healthy, the labor seems to be progressing well; we decide to save the petrol.

The delivery goes downhill shortly after that, and as the baby is delivered blue-tinged and barely breathing with a thready, weak pulse, Dr. Bibek screams to the Night Watchman to run to turn on the generator so we can use the resuscitation equipment. Too late of course – the baby is already delivered, barely responsive, and having suffered from a significant lack of oxygen during the complicated delivery process. We start manual ventilation and chest compressions, using a small manual suction device to remove the junk from her throat. Our suction machine sits next to us, completely silent and useless without any electricity.

Five minutes pass before our Night Watchman is able to get the generator running. The baby is still not breathing. The suction machine sputters to life, and Urmila Sister rushes to insert the suction catheter past the ventilation face mask. Minutes pass, the baby slowly starts to turn pink, starts to breathe on its own. Slowly, we start to relax, and after 30 tense minutes, the baby is suckling (weakly) at her mother’s breast. Outside, the sun is just rising over the mountains in the distance: we have made it through another night, and we still have 17L of petrol for the next emergencies. Success this time, but far too close to failure for comfort.

*             *             *

This is not the way to run a hospital. When night becomes your enemy, when patients’ lives are in danger because our doctors and nurses have to make hard decisions—mid-delivery and on one hour of sleep—about how much petrol they can spare for this patient, always worried about the next one who might “need it more” than this one? This is not the way to run a hospital; this is a struggle that should not have to be fought.

The public electricity grid where Bayalpata Hospital is located is vastly insufficient for the demand in the area and, moreover, is frequently out of service due to the monsoon rains and landslides that wipe out kilometers’ worth of electrical wires for days at a time. We have struggled over the past two years to find complex, multi-tiered energy systems using batteries, inverters, and generators, but none of these will address the underlying problem – we just don’t have good, reliable power. For that, no matter how many moment-to-moment, band-aid-style solutions we can come up with, we really need to find a long-term solution.

To accomplish this, Nyaya is setting out to fundraise enough money to outfit our Hospital with a solar-powered system that will be sufficient to power not only our “emergency” patients’ needs, but all of our patients’ needs. In this venture, we have already secured the support (both financial and technical) of the Government of Nepal, but still need to raise a lot more money.

Please join us; help us to find a better solution to our energy problems. Not normally the type to plead, in this case we will. We need to stop this, no matter what the cost. The continued challenges, the continued risks to our patients?…This has to end. My email will continue to pile up in our “off-hours,” but that can wait. …The baby girl who might not live to see the morning light? She cannot wait.

Please donate today.

Thank you.

Best regards, Dan Schwarz

Executive Director, Nyaya Health

Tags: Achham, Bayalpata, Dan Schwarz, Far West, global development, global health, healthcare, Human Rights, Nepal, Nyaya Health, rural healthcare, rural life, rural poverty