It was about the time when  I was working in syangja district hospital as a medical officer. Actually that was a great opportunity for me to know about real Nepal, the underlying deep seated problems of health and social problems in rural Nepal . I would like to share one of those memorable experiences that I gained while working there.

It was just a usual day, after seeing about 100 patients in the OPD and cases at emergency I departed for my quarter.  At about 9.00 pm , I got  a call from the maternity , the usual evening hassle. A woman had been brought from a near by village. She had delivered her baby at home few hours ago and was unable to deliver the placenta. She was bleeding continuously since then. Despite the government program to encourage the pregnant ladies to deliver at a health facility, the data still shows that more than 80% of  deliveries  are conducted at homes, unsafe and unhygienic, causing death of many mothers and infants.

Ya, it was another case of retained placenta with post partum hemorrhages. I ran to the delivery room. She had been brought in a stretcher, her saree soaked in blood and she was very weak, may be fainting, and going into a shock. I, along with the experienced nurses there resuscitated her, running saline in both arms, removed the retained placenta and with medications her bleeding stopped. But she looked very pale and weak, her heart still running fast. To my knowledge she needed blood transfusion, and would have preferred to refer her to Pokhara since we didn’t have enough facility for that.

So, I went to talk to her family, but out side the delivery room I saw her husband, smelling of alcohol and her mother in law I guess along with few other villagers. I dint know whom I was supposed to talk to. Still I tried to explain the situation and that she needs blood transfusion and needs to be transferred to Pokhara for that.  But the husband seemed to be furious for the trouble his wife was causing.  He said so much he has already done bringing her to the hospital and now it was our responsibility to manage her further. With this uncooperative husband, and the reluctant mother in law, I didn’t know what to do. The lady said she will be fine and she doesn’t want to go anywhere. I had no option so I decided to wait till morning. But with few bottles of saline she seemed a bit stable and in the morning I sent to check the blood, the hemoglobin was still low. I was a bit worried and was discussing with the matron. Then she told me” Oh dac sab, don’t worry, these women here are very strong. They won’t die so easily. She will be fine. “In the evening I could see her nursing her child with a smile in her face. And she was requesting me to discharge her the following day as her older child and livestocks were waiting for her.

I was wondering how she would be able to get the warmth and care that she needed at the moment, a healthy diet and a good rest; with such a husband to look after her most probably not. And in my mind I was thinking, in fact thanking god, for making these women so strong. But how long will these women stay strong, how much will they be able to endure. Still many mothers are dying of childbirth, dying in home or in hospital because they were brought too late, Sometimes the cause is financial and at other times it is social. Yes government is providing free delivery, allowing some small incentive which can support them with good nutrition at least in the initial phase. But if we do not address these social issues, if we do not make the people aware about the family support and care necessary to decrease the maternal mortality, it is still not easy to meet our targets.  Before many more of these young mothers lose their life and collapse for ever something has to be done to bring about awareness in our society.


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Comment by Dr Anubha Singh on May 11, 2012 at 11:43am

thank you for appreciations.

Comment by Indra Dhoj Kshetri on May 9, 2012 at 3:14pm

नेपालले मातृशिशु स्वास्थ्यमा दुई दशकदेखि निरन्तर प्रगति गर्दै गैरहेको छ । तर समस्या निमिट्यान्न भइसकेको छैन । चिकित्साकर्मीको आँखाबाट हेरिएको यो लेख राम्रो छ । यस्ता लेखले हामीलाई नयाँ जानकारी र दृश्टिकोण दिइरहनेछन् । 

Comment by JawKnockRaazaa on May 9, 2012 at 2:50pm

Superlikes@!@!@!@ :) Nicely written! :)

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