Ramila Thapa, Melamchi PHC, Sindhupalchowk

 
Hari Bogati

Resting her head on the walls of the low-lit post-delivery room in the Melamchi Primary Health Center (PHC) in Sindhupalchok district, Nepal, Ramila Thapa is recovering from her miscarriage.

Married two years ago, the 22-year old from Jyamire VDC was thrilled when she learned that she was pregnant for the first time. But, hailing from a remote village and being a daughter-in- law in a seven-member family, engaged in agriculture, pregnancy does not mean she can take a break from her regular duties. The Nepali tradition is such that daughters-in- law are expected to take care of overall household chores, as long as they are not sick and bedridden. And it’s normal for healthy pregnant women like Ramila to continue to help out with household  chores and also work in the fields.

Until the day of her delivery, Ramila believed that she was having a normal pregnancy. She hadn’t had any complications or other health issues.

The medical staff at the PHC said her miscarriage was the result of performing heavy tasks during pregnancy. But she also blames the incident on bad luck.

“It’s very normal for pregnant women to help out in the household chores. I might have been unlucky she said. We were very happy about having our first child. We will be more careful the next time,” said Ramila.

But at the same health post, Gyanu Bhattarai of Melamchi Municipality has a happy story to report. Basking in the warm February sun on the PHC premises, she is busy adoring her two-week old daughter. She cannot take her eyes away from her. She was visiting the PHC for her regular check-up.

Married four years ago, she and her husband were desperate for their first child. They hoped and prayed for it. They were on cloud nine when they learned Gyanu was finally pregnant.

“I cannot describe in words my happiness that I am a mother. And it is doubled by the health of my child and the fact that I had a normal delivery. The service provided by this PHC has improved a lot,” she said.

Gyanu was the first woman to make use of the new Maternity Waiting Home, constructed by OHW next door to the PHC. The center, which came into operation recently, was constructed to cater to women traveling from the rural parts of the Sindhupalchok district so they could have a safe delivery at the PHC.

“The Maternity Waiting Home has been a blessing for the women coming for delivery from the rural parts,” says Deepa Shrestha, one of the three doctors working in the PHC.

“This PHC caters to at least seven surrounding VDCs. These VDCs are remote and women have to walk for several hours to days to reach here. With the waiting home, these women can stay until they are fully recovered. They need not worry about staying at a hotel or with their relatives. This has further us to encourage women to deliver their babies at the PHC, the safest option for both the mother and child,” she said.

Melamchi, the biggest town in the Sindhupalchok district, is located only about three hour drive from Kathmandu. On the banks of the Indrawati River, the valley produces agricultural products and supplies construction materials outside the district. But despite this connection to Kathmandu, the remoteness of most of Sindhupalchok is astounding. Traveling a little farther than Melamchi, most of the VDCs in the district do not have access to electricity and reliable telecommunication—let alone access to roads.

One Heart World-Wide has been working in Sindhupalchok to improve access to, and utilization of, healthcare services to reduce the risk of maternal and neonatal deaths for almost two years.

Then, in 2015, the earthquakes hit, and Sindhupalchok health facilities suffered another blow. OHW has been able to reach several thousand lives through its earthquake support and health programs.

OHW has been renovating birthing centers, supporting health facilities with health care equipment, like USG and medicines, constructing maternity waiting homes, providing electricity to health facilities by installing solar panels and supporting the health workers, members of management committees and Female Community Health Volunteers, in close coordination with the government in Sindhupalchok.

Bhimtar Health Post is a 20-minute drive from the Melamchi PHC. Since it was completely destroyed in the earthquake, services are being provided from a temporary structure, through the support from OHW and other organizations. The reconstruction of the multi-storied building of the Health Post is ongoing.

Sabina Majhi, 21, is nervously waiting for her delivery. It was her due date when we met her.

When asked if she was feeling nervous, she answered candidly: “Yes, I am. I am healthy and walked over an hour to get here. I am nervous because this is my first pregnancy.”

Wishing Sabina regards and happiness, we tried our best to make her feel more confident. Driven by our goal to safeguard the life of mother and child during pregnancy, it gives us happiness that expecting mothers like Gauthali have improved access to health services.

Note: Names have been change for confidentiality