Tulasha Khanal, Auxiliary Nurse Midwife, Chatrey, Dhading

Tulasha Khanal

“Namaste, my name is Tulasha Khanal. I am 35 years old and have been working as an Auxiliary Nurse Midwife since 1999. I am currently working here in Chatrey Deurali Birthing Center in Dhading. I am living with my in-laws, husband, and my only son. Currently he is in school and my husband also works as a senior assistant health worker.

I always wanted to work in this field growing up and it has become my passion. I have the full support of my family as well as my husband. Three years ago I received Skilled Birth Attendant (SBA) training and since then, I’ve been working as an SBA/Auxiliary Nurse Midwife.  Currently, we are facing the issue of lighting for deliveries;  90% of the deliveries we do at this center are at night. We don’t have a reliable option for a steady power source and sometimes have to resort to using a simple hand torch or even our mobile phones for night deliveries.  We also have 13-19 hours of load-shedding every day in this area. (Load-shedding is the deliberate shutting down of power by the government to bypass electricity shortages). For surgical procedures such as an Episiotomy, I will sometimes have to ask individuals accompanying the patient to hold the torch for me while I perform the surgery.  While we are used to these procedures, it can be frightening and nerve-racking for these individuals and the patients themselves. They tend to get nervous and start shaking so that the light source they are holding is not steady, which forces me to perform partially in the dark. This exponentially increases the already high risk of complications, especially during serious procedures.  The responsibility of saving the mother and new born baby’s life in these conditions is a heavy responsibility and poses a serious issue that we face in these rural birthing centers. 

Just this past month we had a case with a pregnant woman named Gauri Lama.  She came in during the day and I used my judgment and past experiences to conclude that she would deliver her baby before 6PM.  Six PM came and went and she was still there, unable to push, with no sign of delivery. By 9PM she was still here and still no signs of delivery, although there had already been a Meconium stain. I started to do all the procedures that I’d learned through my training and realized that the baby had already inhaled the Meconium.  I had asked one of the sisters to help hold a light for me and by this time, the torchlight was already at low power. With a lot of difficulty, I started the emergency procedure and with much difficulty, I was able to successfully take the baby out and immediately start resuscitation. During this, the torchlight died and we were forced to start using our mobile phones for lighting.  This is just an example of one of the many cases that I’ve had to perform with very limited lighting.

Tonight, I have pregnant women who is ready to delivery but I'm very happy and much more confident because now we have new solar power inside our delivery room. This light was really very important for us. Now I can do my job in the best way with proper lighting. 

Today I feel like a kid at a candy store.  Having these solar lights will make our work so much easier and save more lives. The two beautiful bright lights will not only brighten this one room but because of the long cord, we can use them to light rooms and passages, and charge devices such as the Fetal Doppler. In an emergency, it’s difficult to use a Fetoscope to listen for the baby’s heartbeat. Now, we will be able to allow the pregnant mother and her family members to listen to the fetal heartbeat and I can instruct my assistant to listen as well. We also got two new headlamps so now I don’t have to rely on untrained individuals to hold up a light. I can focus a steady light on exactly what I need to successfully complete any procedure. The multi-mobile charger we received also makes a huge difference when working at night as I often tend to run out of charge on my phone since I use it to make frequent calls to prepare ambulances, inform my colleagues, or request help. I’ve had situations where my phone dies right in the middle of a conversation like the ones mentioned above, and there is no power to charge it back. Even just a few minutes of delays due to lack of power can have a huge impact.”