Throughout the world, mothers are strong; but mothers in Far-Western Nepal seem to be in another league all together.
In 2007, while working with Nick Simons Institute of Rural Health Care Training (NSI), I traveled to Bajhang district, a harrowing journey from Kathmandu involving a one hour flight, a sixteen hour drive on muddy, mountainous roads, and finally a two hour hike to the district headquarters. There were no doctors at the district hospital; their only staff nurse was preparing to leave. The hospital was run by village health workers and nurse mid-wives. A middle-aged woman with three children stood at the hospital entrance.
“Where were your children delivered?” I asked.
“In my goth,” she answered. (Where else do you think, lady!? was her tone.)
“Did anyone assist you—a midwife, your mother-in-law?”
“How did you cut the umbilical cord?” I asked, in surprise.
“With my hasiya, of course!” she answered, by which time she had had enough of my silly questions and wanted to get on her way.
Since 2007, slow but steady progress has been made in maternal health in the Far-West. In Bajhang, NSI supports the district hospital through the Rural Staff Support Program, providing an MDGP doctor who can carry out C-sections, training for anesthesia assistants and skilled birth attendants and other interventions to improve the working environment and skills of health care workers. On March 29, 2011 the first C-section was carried out, saving the life of a mother who would otherwise not have made the tortuous journey to the closest operating room in Dadeldhura.
In Achham District, another organization, Nyaya Health, operates Bayalpata Hospital as a public-private partnership with the Ministry of Health. In a district where there were no doctors in 2007, we now have a hospital where all services are absolutely free, including consultations, investigations, and medications. Hundreds of patients (38% Dalits) are seen every day. Mothers and children, who account for nearly 70% of our patients, walk for over two days to receive care. Since instituting the government’s Safe Motherhood Program, paying women Rs1000 for in-hospital deliveries, monthly deliveries have more than doubled. Nonetheless, the challenges persist. I am still astonished to see Achhami mothers, having delivered only two hours prior, try to leave the hospital, “We must tend to the children and animals,” they insist.
Motherhood connects women all over the world. The joy and exhaustion of holding a beautiful newborn for the first time is shared universally, from Bayalpata to Bajhang to Boston. But for women in far-Western Nepal, the stakes are far higher. Bayalpata still lacks an operating theatre, requiring dangerous transfer across mountain roads for more than seven hours for a caesarean section. It’s not surprising then to hear of pregnancy referred to as a “gamble with death.”
To fight this, Nick Simons Foundation and Nyaya Health have teamed up, with Nick Simons pledging $75,000 in matching funds to support the construction of Bayalpata’s surgical center by late 2011.
Still looking for a Mother’s Day gift? Donate in tribute to your mother and the Nick Simon’s Foundation will match your generosity, doubling your impact!
Reprinted from the Nepali Times.
Ruma Rajbhandari is a physician at Brigham and Women’s Hospital, Harvard Medical School, Boston. She volunteers with NSI and Nyaya Health