Despite unforseen weather challenges this year, we continue to make progress on our birthing center upgrades in Dolpa. The extreme weather has made travel to the sites of our birthing center projects even more difficult than usual. There are no roads in the entire district of Dolpa and therefore, all equipment and construction materials must be delivered by plane, helicopter, or carried to the site on the backs of yak or mule caravans. Due to rain, it has been unsafe for helicopters and planes to make landings in the area and trips by pack animals have been heavily delayed due to dangerous conditions.
However, our teams are up to the challenge! We have had better luck in Phoksundo than in Saldang, and we have finally completed construction at the Ringmo (Phoksundo) birthing center site. We expect to have the necessary medical equipment delivered and set up before the year's end. We have gotten price quotes and are in the process of purchasing delivery beds, infant warmers, dopplers, and a variety of medical devices to provide preventative, delivery and emergency obstetric care and newborn care at the newly upgraded birthing centers.
Saldang, the more remote of the two locations, has proven a bit more arduous, and as such, construction materials have just arrived. Construction should be underway shortly and we are hoping that all structural work will be completed by the end of the year as well.
Over the past several months, we also completed monitoring and evaluation on the implementation of the Childbirth and Newborn Care Package (CBNCP) in which we train all Female Community Health Volunteers (FCHV). Our team visited 18 health facilities and spoke with more than 100 FCHV, making this the largest follow-up of its kind ever to have been done in Dolpa, where travelling on foot can be a challenge to completing such a task. This feat is encouraging for future work in the district, as it shows that comprehensive monitoring and evaluation is possible in the region with the right amount of determination and hard work! We are setting the bar high for our teams and for other NGOs working in Dolpa. In addition, we participated in a three-day district level review of the CBNCP program. All of the health workers from peripheral level health institutions were part of the review process. We had an open discussion regarding the major bottle necks to the program's success in addition to skill refreshers. Our team reports that it was very fruitful to have representatives of all the health facilities update their knowledge and skills as well as provide feedback on the progress and impact of the program.
Our team also had the opportunity to present our work in Dolpa at the Annual District Project Advisory Committee Meeting. Many high ranking officials from the government were present, who praised our vision to work in remote locations such as Dolpa where many other organizations are hesitant to work at the moment. They provided us with valuable suggestions and asked for our assistance not only in continuing to improve the Maternal and Child Health sector in Dolpa, but also the development of health as a whole, which is of course something to strive for!
I should also mention that this month marks one of the biggest festivals of the year in Nepal - Happy Dashain!
Thank you for all of the continued support.
Early summer in Dolpa is when the majority of people there participate in the Yarchagumba harvest. Yarchagumba is a caterpillar fungus found only within a specific elevation range in parts of the Tibetan Plateau and the Himalayas that is highly coveted for its medicinal benefits. Dolpa is one of the few places that this precious fungus grows and as such, it is one of the area's most lucrative crops.
While many people have been occupied by the hard work that the season entails, OHW has been able to accomplish some great things over the past few months. Here are a few highlights:
Once the harvest is complete, the local teams will be able to start more extensive renovations on the birthing centers and planned trainings will begin, including training for the treatment Pelvic Organ Prolapse as part of a newer program we are implementing in partnership with another NGO, Karuna Shechen. We are exciting for what the next few months will bring!
In other news – two of our project’s photos have been chosen as finalists for the Photo Contest! You can find our photos under the "Give Relief" catergory. Find one (or both!) marked with our project name "Saving lives, one birth at a time" and vote by entering your email address! Voting begins on Monday, July 15th so please check back between then and July 31st to vote and PLEASE share with your networks! The photo with the most votes by noon (Eastern) on July 31st will win.
Thanks from everyone at One Heart World-Wide!
Skilled Birth Attendant Program (SBA)
One Heart handed two portable ultrasound machines to SBAs from upper Dolpa and held a training on how to use the machines. In addition to the ultrasound trainings, four nurses were selected from the region of Upper Dolpa to be trained as SBAs and received a community-based maternal newborn care package training. The maternal newborn care package includes a set of basic life saving skills that allow the trainee to be able to identify signs of emergency, prepare evacuation plans, help stabilize an emergency situation, and provide prenatal visits to a pregnant woman. Eight health workers from Upper Dolpa were trained and oriented in data collection and verbal autopsy.
Program Monitoring and Evaluation
In order to constantly monitor our program's progress we conduct evaluations on three sets of criteria:
To date, we have collected information for 1516 birth outcomes. We select 10% of the women to interview for verification of outcomes in order to assure the quality of the information that is being collected at the community level.
We are also conducting trainings for the community health volunteers on the prevention of the Pelvic Organ Prolapses* (POP) and self care. Thirty-four community health volunteers have received this trainings. This allows volunteers to identify new cases of POP. So far we have identified 61 cases. These women then receive the necessary health education and surgical referrals.
*Pelvic Organ Prolapse occurs when a pelvic organ, such as your bladder or uterus, drops (prolapses) from its typical location in the lower belly and pushes against the walls of the vagina. This can happen when the muscles that hold the pelvic organs in place become weakended or stretched from childbirth or surgery.
Help support the mothers we work with while showing your appreciation for the mothers in your life this Mother's Day! Staring April 15th, when you give your donation in honor of someone, they can receive a personalized card and One Heart World-Wide will be eligible for bonuses! It's a win-win! Plus the recipient will get a nice personalized gift showing how much you care. Give a Tribute Card today!
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This has been a very productive year for our Nepal team. This year alone we have been able to increase health facility deliveries from 1% to 10% and 25% to 48% in Dolpa and Baglung (the two districts in which we are currently working), respectively. Women receiving appropriate prenatal care have increased from 0% to 21% in Dolpa and 40% to 82% in Baglung. Additionally, skilled provider attendance at deliveries had increased from 3% to 10% and 20% to 70% in Dolpa and Baglung, respectively. Five health posts have been renovated and equipped with equipment and supplies to meet standards to be certified as birthing centers. Since opening these birthing centers, over 600 deliveries have taken place within their walls. Nine birthing centers now have solar panels installed to provide power for lights and medical equipment, where electricity is otherwise unreliable or unavailable. One Heart sponsored the training of six skilled birthing attendants. We also trained fourteen master trainers, 293 front-line health workers and 557 Female Community Health Volunteers. Your support, in conjunction with our dedicated Nepal staff and volunteers, made it possible for us to serve a population of 269,000 with 5,000 estimated pregnancies annually.
In addition to this year’s many accomplishments, One Heart is pleased to announce that we have been able to transition to a fully Nepali staff within our Nepal program. One Heart World-Wide has always held the belief that our programs should empower local communities, which allows for greater long-term program sustainability. Mr. Binay Kumar Basyal is our new Country Representative for Nepal. With an educational background in Business Administration and Rural Development and over ten years in leadership roles in the fields of health, development, and beyond, both at home in Nepal and abroad, Binay brings a strong skill set to the One Heart Nepal program.
All of us at One Heart thank you for your continued support! With your help we can continue to save lives, one birth at a time.
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It was a busy summer for the One Heart Nepal Team. Over the past few months we have held numerous trainings, and have made headway on some new and exciting projects!
So far in Dolpa district, we have trained a total of 293 community outreach providers (health workers and community health volunteers). Our three newly trained skilled birth attendant have been stationed at key health posts across the district. A pilot of our MedicMobile project, using mobile phones and SMS to deliver safe motherhood messages and check-up reminders to remote communities, is now underway. Sanitation has improved greatly with the installation of running water at the Dunai birthing center, the first in a circuit of 5 birthing centers that we hope to have completed by the end of our project. To date, we have had 117 births at the Dunai birthing center since its opening in November of 2011. We are very pleased to announce that our second birthing center, located in Dho Tarap, was inaugurated last month! Many members of the local community, including local Rinpoches and Lamas (religious leaders), local Amchis (doctors), and representatives of other NGOs working in Upper Dolpa attended the ribbon cutting ceremony. There was much excitement surrounding the opening of the birthing center and One Heart felt very welcomed by the local community.
On the way to Dho Tarap, our team visited potential sites for the next birthing center we plan to open in the very north of the district, in Saldang. Our field team met with the local people to discuss what they saw to be the major issues regarding their access to maternal and infant health services as well as the challenges they faced. After visiting with the communities and touring the sites discussed for the new clinic and satellite clinics, the team felt very confident in ability to move forward as planned. The proposed sites will be perfect for our needs and those of the community.
A large festival also took place last month – the Shey Gompa Festival (a religious festival occurring once every 12 years). It was a treat for One Heart to participate in the festival this year. In conjunction with various organizations, we organized a medical camp at the festival, during which we were able to serve more than 1,100 patients. The team also performed a role-play on maternal and neonatal life-saving skills in the local language and gave a short presentation on how to solve existing maternal and neonatal health issues and major challenges to accessing health care in Upper Dolpa. There was a huge turnout at the festival and everyone seemed to enjoy our programs. It was also a great learning opportunity for our team, as we were able to meet with the local people to find out which issues were most important to them. Unfortunately, we also learned that late in the summer there had been an outbreak of measles, which took the lives of 30 children who were unable to get treatment in time. OHW and the communities vowed to work together to face challenges to health care, such as this type of epidemic and the lack of access to preventative care that people in Upper Dolpa face.
It was a busy summer, but everyone involved in the project is excited about moving forward and what is to come next. None of it would be possible without your support, and so from the entire One Heart team, I would like to offer you all our most sincere thanks!
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