We are so pleased to report to you on One Heart World-Wide's recent work.
2014 was an extraordinary year--last year we had no maternal deaths and only 8 neonatal deaths in our most populated disrict, Baglung. In our other major program district, Dolpa, we had only one maternal death and 6 neonatal deaths. Before One Heart World-Wide arrived, Baglung saw at least 30 maternal and 300 neonatal deaths annually and Dolpa saw 15 maternal and 91 neonatal deaths annually.
Your support continues to make a tremendous difference as it helps us train and equip skilled birth attendants and community health volunteers to manage pregnancies in remote villages and establish new birthing centers in rural Nepal. Your support provides essential maternal healthcare to those who would otherwise have no access these lifesaving services. Thank you for making a difference in so many lives this year. One Heart World-Wide and the communities we serve are so grateful to you for your generosity.
Consider the below story of Tashi (pictured), who recently had a very difficult delivery in Baglung.
15-year-old Tashi suffered in labor for more than a day before trekking five hours through high mountain passes to reach a One Heart birthing center. She had four prenatal check-ups at the recommendation of a One Heart-trained community outreach volunteer and was told of the importance of a safe delivery so she was determined to make the trek to the Dunai birthing center even though neither her family nor husband could accompany her due to the demands of harvest season. After four more hours of labor at the birthing center, Tashi had to undergo an episiotomy--a surgical procedure that saved both her life and her baby's. When the baby was born blue and lifeless, the doctor and skilled birth attendant revived him by clearing his airway.Once he breathed his first breaths on his own he was placed in an incubator. Skilled birthing attendants, medical equipment, and a safe environment with electricity were all critical to the survival of both baby and mother.
There are hundreds more like Tashi in the districts we have yet to reach, which is why One Heart World-Wide is in the process of expanding our programs to reach three more districts in 2015: Dhading, Sindhupalchok, and Bhojpur. We look forward to keeping you updated as begin upgrading birthing centers and training health workers in our new districts this year!
Thank you again for your commitment to save lives in Nepal. Your support matters so much to the women who depend on it. With gratitude,
We remain so grateful to each of you for your generosity and compassion in action toward women and babies in Nepal. Your support helps to ensure One Heart World-Wide’s success as we work hard to eradicate preventable maternal and neonatal mortality in Nepal. With your help, we have reduced neonatal mortality rates in the two districts where we work by an average of 75% and maternal deaths by 89% in the Baglung district, and 50% in the (more challenging and remote) Dolpa district. The extreme remoteness of many women in Dolpa and climate present a challenge, but we are proud of the many lives saved there and we continue to work hard to train healthcare workers and educate the public around maternal healthcare. In this report, we would like to update you on just a couple of our activities in Dolpa since mid-July.
In August, we conducted trainings sessions for the Health Facility Organizing Management Committees, who are elected Nepalese governmental bodies responsible for managing the birthing centers. These trainings were held in Phoksundo and Saldang, the most difficult-to-access Birthing Centers of Northern Dolpa. Each of the 22 committee members attended the sessions, where they were coached on best practices in management for the centers, they talked through local needs and challenges, and they committed to implement the teachings they learned. In addition, both of the Health Facility Organizing Management Committees agreed to sustain the quality birthing center services, which will eventually be turned over to the communities with One Heart World-Wide stepping into an advisory role. This allows One Heart World-Wide to eventually pass complete ownership of this project to the community, and allows us to use your dollars to work in districts that still lack accessible maternal healthcare services. Until then, we will continue to work in close partnership with the Nepalese government as we train and prepare the workers and community for the transition. Community ownership, long-term sustainability, and high-quality services are our goals for each place we work.
In late July our Liku Birthing Center staff performed plays in partnership with a local club to build awareness of good maternal and neonatal healthcare practices among community members. Over three hundred people attended, and we hope it will bring about positive behavioral changes in the Liku community.
Dhani, a 20-year-old in Liku, part of the Dolpa district, was pregnant with her first baby. After 11 hours of excruciating labor, her family brought her to the Liku Birthing Center. The nursing staff at the center tended to Dhani and she delivered the next day. Shortly after the birth, Dhani experienced intense bleeding. The nurses immediately recognized the bleeding as postpartum hemorrhage, a leading cause of maternal deaths in Nepal, and they administered medication and fluids. Dhani’s life was saved and her family was so grateful that they vowed to get the word out in the community to assure that all other pregnant women deliver at the Liku birthing center. One way that the word is spreading quickly about our birthing centers is the many women and their families who use the centers and want to encourage all of their networks to use the center after their positive experiences.
In the last thee months we also trained 57 Health Worker in the Baglung district in the birth preparedness package using misoprostol to manage post-partum hemorrhage. Thank you again for making it all possible. Your support means so much to the people whose lives are saved every day.
These past three months have been dedicated to some successful trainings and visits to the communities where we work to verify the impact we are creating in these remote areas. Our team in the field met with 144 female community health volunteers from 16 different village development committees. This is done to review the Community Based Newborn Care Package. This package consists of basic knowledge provided to volunteers in the field in order to assist before and during an emergency. The package is not only a training, it also includes some basic equipment provided to our volunteers so that they can perform routine checkups on pregnant women. When a review is done, it basically retests the knowledge of volunteers and it focuses on refreshing volunteers in topics that they have most difficulties with. This revision also provides an assessment of the current situation in the field, and to make sure that our goals are being met.
We also trained 27 health workers from three new communities, Liku, Pahada and Juphal. This training includes topics related to prenatal care and providing the best service to patients coming into a health facility. Our team also supervises that health facilities are in the best condition possible to attend deliveries and reduce the risk of any infections during labor. We are strongly committed to teach health staff the basics in providing the best experience for women living in difficult areas. When health facilities are upgraded, it creates a welcoming environment for women.
We would like to share two stories from the field related to some of the pregnant women that we serve and some of the difficulties that they face in their lives.
Now, the child is in very good condition. I feel grateful to see the child playing happily and the happy and thankful faces of the family members.
We have been hard at work upgrading birthing centers in areas of high need in the District of Baglung in order to reach our goal of upgrading ten birthing centers in this district. The upgrades range from providing structural renovations and improved plumbing to equipping the centers the most basic delivery equipment to providing more advanced devices such as portable ultrasound machines. These upgrades are essential to ensure access to clean, safe deliveries in the remote areas of Nepal where we work. The birthing centers that we support are equipped to handle normal deliveries and manage certain emergencies. To demonstrate the impact that the upgrades are having so far, last month it was reported that there had been a 300% increase in deliveries at the Hatiya birthing center since it was upgraded. The upgraded facility has allowed more women to deliver at the local health post and has thus reduced the amount of unnecessary, and often dangerous, transfers over rough roads that were frequently made to referral hospitals prior to these upgrades.
Thanks to a partnership with We Care Solar, OHW is able to provide solar electricity in these birthing centers using their innovative Solar Suitcases. The lack of stable electricity at many birthing centers makes it very difficult for Skilled Birth Attendants to safely attend deliveries occurring in the middle of the night. Each Solar Suitcase is equipped with an 18-volt battery and two LED lamps that provide very bright light that is sufficient to light the way for birth attendants. In some cases the Solar Suitcase is capable of charging the battery of a portable ultrasound, making it possible to provide ultrasound services at any time of day, aiding in the early detection of pregnancy complications.
With Solar Suitcases, we are able to now provide ultrasound machines to the birthing centers in birthing centers or referral clinics. These ultrasound machines are strategically in highly populated areas as an effort to bring maternal health services closer to those mothers who need it most.
In addition to these facility upgrades, we provide trainings on how to use all the equipment. In March, OHW held a training for 30 people in the use of the ultrasound. Those trained included a combination of skilled birth attendants (SBAs), nurses and doctors that are located in the communities where the ultrasounds are placed. On a recent trip to Baglung, we installed two of the Solar Suitcases in two birthing centers and trained four SBAs on how to install, operate, and maintain them. In the next few months we will be installing seven more suitcases and training 14 more SBAs on ultrasound use and maintenance.
The best way to learn about the programs that we implement in Nepal is to have the firsthand experience. Going for the first time in March was something to remember, being able to see the impact that with your help we are able to generate has no price. The numbers can prove that our model works, but seeing the smile of women and children are best felt being there. Once a birthing center is upgraded, people in these communities not only appreciate this, but they do everything in their hands to put these center to great use, with that feeling of communal ownership. We are grateful to see the changes and the impact your money creates, and are more than happy to share the field stories with you and invite you to come with us and have the same experience. A group of donors came with us in March, and we are hoping to repeat this experience later this year. Please let us know if you want to join us in this adventure of new learnings from our programs.
As we embark on a new year, we would like to take a moment to reflect on everything that we accomplished together in the last 12 months. 2013 was a great year and we are looking forward to even bigger things in 2014 as we begin working in another district.
As you may know from our last update, this year we were in the process of upgrading two birthing centers in the Dolpa district when we came up against weather challenges that significantly delayed our progress. In the last few months of the year, our field teams did their best to make up for lost time. We are happy to announce that construction and building upgrades at the Phoksundo Birthing Center have been completed and at the Saldang site, only the water tank remains. We have also begun working on a third health post, so that it too may be upgraded to a Certified Birthing Center. We have also formed a new partnership that should help ease future transport of materials and equipment. We are currently working together to have all necessary medical equipment and remaining birthing center furnishings taken up to the Dolpa birthing centers as soon as the weather improves a bit more - most likely in March or April. In the meantime, we have also been able to sponsor three nurses to become Skilled Birth Attendants (SBAs). The SBAs now have the skills needed to manage normal deliveries each of the three birthing centers we are upgrading. Tashi will be working at the Bhijer Birthing Center, Pema will be located in Saldang and Pasang will be the resident SBA at the Phoksundo Birthing center. Each nurse completed a Skilled Birth Attendant training so that she may act as a resource for the pregnant women in her community throughout pregnancy and delivery, facilitate deliveries, and have a thorough understanding of possible complications and how to act when warning signs present themselves.
Over the past year, close to 100 births took place in the 2 birthing centers which we upgraded in 2011 and many more were successfully attended by our Skilled Birth Attendants at other locations in the district. Last year, our SBA at the Dho Tarap Birthing Center also began offering regular utlrasound check-ups, which will greatly help us to reduce emergency complications by referring patients to larger hospitals sooner when complications arise. With three new Birthing Centers and Skilled Birth Attendants, we are hopeful that deliveries attended by SBAs at Birthing Centers will be even higher in 2014!
In addition, this year 35 traditional healers and 45 Foot Soldiers of Change (Female Community Health Volunteers) have been trained on a variety of skills including newborn care, birth preparedness, ultrasound use, emergency obstetrics, and the use of a mobile health system to improve care delivery and reporting in our program areas. As a result, in Dolpa, the maternal mortality ratio has reportedly dropped nearly 40% and the reported neonatal mortality rate is down 64% from the baseline numbers from when we began working in Dolpa just two years ago.
We are very excited about the progress we are seeing in Dolpa, despite the challenges we face in working in such a remote area. We have all of you to thank for our successes and we are looking forward to many more positive outcomes in 2014!
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