After ten years of working in the Rasuwa District, we've relocated this project to the Dhading District. Several years ago, the birthing center in the Rasuwa District had no staff and no equipment. We provided both and have operated the government owned birthing center with our staff and equipment the past three years. Now, the government is finally providing staffing to this birthing center. We can't of course predict for how long, but at the moment the staff is there. We've transferred our midwife to the Dhading District where there is a new birthing center, sans staff, and a small healthpost a few hours walk away that needs midwife support as well. We are scouting a location in one nearby area that is too far from either the aforementioned health post or the birthing center with plans to establish a combination first aid station and birthing center. At the time of this report we are in the US and headed for Nepal in two weeks to scout the location. As soon as we have it, I'll post up some photos and more details.
I regret there isn't a photo of the ultrasound to go with this report, I was sure I had some until I reached home and reviewed what was on my camera.
We recently conducted a medical camp in some Chepang Villages, located not far from Chitwan National Park. The Chepang live as both farmers and hunter-gatherers in the hills. The land they occupy can't support their food needs so half the year they are forced to forage what they can from the forest. They'd been denied citizenship for decades in Nepal and live on the fringes of society.
As we were checking patients at the medical outreach camp, a woman came in who we discovered was pregnant. This is her sixth pregnancy, she has five children now. We asked her about family planning and her shocking answer, which shows the lack of education in these villages was " I don't know how many of these babies god put inside my body but one day I am sure they will all be out and then there won't be more." That's how she really thinks it works.
We spent 3 days, saw 917 patients and will return to this village again in the fall of 2012 (and let me know if you'd like to join us) This village has no health care and camps like this are their only source of medical care.
Thanks to a very generous donor and and organization called Global Public Health we've been able to obtain a portable ultrasound for our midwife who is working at the birthing center in Thambuchet, Rasuwa District. Our midwife will be trained in the use of the ultrasound by Dr. Shrestha at Helping Hands Hospital in Kathmandu. This is a very portable unit which will allow our midwife to take it with her from village to village. Our current birthing center serves five primary villages, Goljung, Gatlang, Chilime, Tatopani and Thuman with a few smaller villages along the way. From our base in Thambuchet it can take all day walking to reach any one of these villages. The machine will enable us to detect any complications early on and arrange for the pregnant woman to get to a regional hospital in Dunche or to Kathmandu for delivery. Our rural birthing center is equipped for normal deliveries only so difficult cases need to be handled in a full hospital setting and detecting them early is really necessary given the difficulties of transportation in and out of the district..
We still need another midwife in Thambuchet. At present we have one midwife and the villages served have a population of over 7,000 with a fertility rate of 3.2. The workload for one person, particularly given the distance she must travel from village to village is overwhelming. I am adding a photo of our midwife Shwoita Lama, she's so dedicated to her work and real trooper.
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