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Mar 7, 2013

Family Planning in Maila village of Humla

Dr. Dilys Noble, Maila village in background
Dr. Dilys Noble, Maila village in background

Namaste Friends!

This time, we would like to talk about the tricky issue of family planning – quite a taboo topic in Nepal and especially in the remote mountain areas where Maila is located. The traditional belief is that family planning goes against the supreme power of God. Also there are myths and fear surrounding its use – especially around the relatively safe and uncomplicated male vasectomy operation.

Let us introduce Dhani Jaisi, a 35 year old married lady from Maila village. She is the mother of five daughters and two sons. After giving birth to her sixth baby, Dhani started to take Depo Provera – a 3 monthly family planning injection, on advice from the PHASE health workers. She stopped taking the injection without giving any information to the sub-health post.

Dhani says, “I had already six children and I did not want more, so I was recommended Depo Provera – family planning injection. But after some time I stopped because I was bleeding heavily. Due to my responsibilities in the household I did not manage time to inform health workers about either the bleeding or my decision to stop.”

There was a vasectomy camp organized in Maila village. The purpose was to provide free family planning operations to interested men of that area.

She adds, “I requested my husband to go for the vasectomy operation. Health staff and neighbours also advised him to go. Everyone was saying to him that he already has a lot of children and if he has more it will burden his family.”

On other hand, Dhani’s father-in-law was against the vasectomy. He was worried that he had only one son and that something might happen to him during or after the operation. Dhani’s husband agreed with his father and refused to go. And of course, a few months later, Dhani became pregnant again.

Dhani says, “I gave birth to my 7th child. I am now mother of 5 daughters and 2 sons.”

You may remember that we wrote to you previously about the tradition of Chaupadi. This is where women stay outside of house during their menstrual period and during the delivery of a child. Dhani was not allowed to be in her house for 21 days during her delivery.

She explains: “During the time of delivery I lived in a small shed which we use to house cattle. It was rainy season and the roof of the shed leaked badly. My husband and other family members were far away in the house and did not notice the problem. My feet and body swelled because of never being able to keep myself dry throughout the delivery and in the period after. I was bleeding, I could not move and I could not breast-feed the baby.”

Dhani was suffering from post-partum haemorrhage (heavy bleeding) and she was ill because of cold and wetness.

“The morning after the delivery my husband came to see me. When he saw my condition, he immediately informed the Maila sub health post. The PHASE health staff arrived soon after.” Dhani adds - “Both the staff were surprised when they saw the conditions in which I had been living. They checked my health and gave me some medicines. They advised my husband to keep me warm and dry.”

PHASE staffs conduct a door-to-door community health programme three out of six days in a week. During these visits, PHASE staff talked to Dhani’s husband and father-in-law. They talked and gave demonstrations about family planning, malnutrition, and what the negative impacts of the chaupadi tradition can be.

After some days, Dhani and her husband came to Maila health post.

Dhani’s husband says “It is our social culture to keep women outside when she is menstruating or giving birth. I also admit that I was scared to go for a vasectomy. I ran away from the camp because of fear.”

He added, pointing to his wife Dhani “This lady has suffered a lot because of my mistakes. I realize that having a lot of children is a burden on my household. I am unable to feed my seven children well. I promise; I will go for a vasectomy when there is another camp nearby.”

Dhani says “From now onwards I will take Depo – the temporary family planning injection again. If there is any problem I will come back to the health workers for advice. If my husband gets a vasectomy then I will stop.  I would like to thank the dedicated health workers in the sub-health post very much for all the advice they have patiently given my family. After a long story, we are now ready to use means for family planning.” 

Friends, thank you for taking the time to read our story. Providing a health service in this remote area is challenging but ultimately rewarding, and slowly the health status of the area is changing. But we still have a long way to go.

On Wednesday 13th March (next Wednesday) Global Giving will be matching all donations made by 30%! Please remember the people of Maila on that day and consider offering your support. Whatever you can offer will go even further!

With gratitude and hope;
PHASE Nepal Team

Dec 5, 2012

Accessing Health Service in Remote Village

Girls from Maila Village, Humla
Girls from Maila Village, Humla

In a scattered village like Maila, it is difficult to access available health service in remote Himalayas of Nepal. Friends! Meet a man from Maila this time, who lost his daughter because of remoteness of health service access. He is Ghamanda Shahi. He lives in ward number 5 of Maila Village Development Committee. Maila is the farthest village from district headquarter of Humla which is a 4 days walk away.

"I am the father of four daughters and one son. The days were passing on well and I was happy thinking that all of my children are growing up faster. One day my two daughters elder and middle got sick unexpectedly. My elder and middle daughters are 14 and 12 years respectively. At first I was thinking that this is a normal illness and it may not harm but several days went by and both daughters stopped eating. They started to have a high fever every day."

Maila village is scattered and it takes half day walk to reach the health post from some remote village. Due to remoteness, most people do not want to waste their time spending a whole day for health service and so did Ghamanda Shahi too. He adds:

"It was a critical time for me. I knew about PHASE serving from a local health post but it takes more than 3 hours walk to reach the post so I decided to take my daughters to a nearby medical shop called Gallawada. After a normal check up the shop owner gave them some medicines. We returned back to home. My daughters felt quite better."

Ghamanda's livelihood is also same as others in Maila - a poor family having steep dry lands. It is only possible growing small amount of food grains which is not sufficient for living on, however he says;

"As we have to continue our daily works, I was busy and forgot to notice about my children's wellbeing; whether my two daughters got better. They kept taking the medicines and I was hoping to see them well very soon. After 2 or 3 days, I found that they were getting worse. They started vomiting when they took their foods. At night their bodies were shook because of high fever. Again I took both of them to Gallawada medical shop. The shop owner gave some medicines and was encouraging that both will be fine soon!"

Ghamanda kept noticing his daughters' health. Both the daughters went to worse condition day by day. However he had to go for his work too. He explains:

"I was serious about my daughters' health but I was also convinced that the medicine would help my children. One gloomy day, I lost my middle daughter after 12 days of serious illness. We were all in deep pain; the entire neighbourhood knew this unexpected shock. The older daughter was also in the same condition and we were scared with her possible death too."

The rumour spread all over Maila, because there was a sudden death of a little young girl. PHASE Nepal staffs who were working in Maila Health post also became aware this and they rushed immediately Ghamanda's house.

"When PHASE health staffs rushed into my house, I explained all the incidents to them. They checked my elder daughter Kabita and advised me to take her to the health post immediately. I was scared and senseless because of fear that Kabita would die very soon. PHASE staffs tried to convince me that Kabita would be fine if I took her to health post, however, I did not take her to health post that same day."

Ghamanda thought that Kabita would also die. The health post is very far to walk; Kabita was in bad condition and could not walk herself. Neighbours also tried to convince him and they also encouraged him that they help to take Kabita to the health post. Ghamanda Says:

"The following day, some neighbours arrived to my doorstep, saying let us take Kabita to health post. Me and Kabita with some neighbours, departed for health post. Neighbours helped to carry Kabita on the way to health post. We arrived health post in mid day. PHASE health staffs were working inside clinic and they were very pleased when they saw us with my daughter."

Immediately, PHASE staffs accompanied with local CMA (Community Medicine Assistant) focused on emergency treatment of Kabita.

"PHASE staffs started to examine my daughter. They dispensed medicines and helped Kabita to take medicines; they also injected her. After examinations they advised me to leave my daughter at the health post so they could monitor her health. After two days, I saw Kabita was quite brighter, and ate little bit of food and started to speak with the staffs. I was excited to see all these. Kabita's health was improving day by day and after 5 days of intensive care by PHASE sisters, she was able to walk around herself."

Once, Kabita got the right treatment and she was able to move around, started to eat food slowly, she started to speak and smile. She overcame death!

"It was Unbelievable! Kabita recovered. I do not have words to thank PHASE staffs who took care of my daughter like she was their young sister. They gave medicines on time. They helped her eating food. After 5 days, we (father and daughter) returned home. Kabita walked home herself from the health post. I am very happy with the service provided by PHASE. I also like to say that- Do not love your work when you are sick. Do not go to traditional healer, do not stay home with illness, just go to nearby health post and you will get the right direction."

With Gratitude!
PHASE Nepal Team.

Sep 5, 2012

My suffering because of my society's preference for a son

Maila health post
Maila health post

Dear friends, namaste This time we are putting not a story directly related to our health work in Maila but a story of a woman from Maila who is suffering because of how the society takes son and daughters. It is not only the story of Ms Bedana Nepali but of the majority of the women in remote areas of Nepal. Here is the story in her own word:

"I am Mrs Bedana Nepali (untouchable lower caste) from Maila. I was married at the age of 18 and gave birth to my first daughter before my 20th birthday and 2nd daughter at the age of 22. When I gave birth to my second daughter my husband and mother in law started complaining about not giving son to them and eventually my husband married a new wife, but she also gave birth to a daughter. After that my life got miserable. My family abandoned me and I could not go back to my natal home since I had my step mother and they are very poor. I was not treated well by the community and the neighbors telling me that I was a barren woman since I could not give son to my husband's family. My friends also did not treat me well and hesitated to talk thinking they will also be barren if they got too much intimate with me. They said rather than having a daughter it would have been better if it was miscarriage or I should have killed my daughters immediately after they were born. I was so sad that I thought my daughters are sole cause of my sufferings and they will have the same fate if they are grown up in this society. I did not think of any consequences and I tried to kill my small daughter three times by pressing her neck but probably her suffering or probably mine has not ended yet so she did not die.

Though everybody in my village know this I had never got an opportunity to tell this story to anyone else. I would like to thank the nurse Ms Indira Kuwar from PHASE for listening my story and giving this opportunity to tell my story to the outer world, now after telling my story I feel better. I really hope that some day it will come where both son and daughters will be treated equally and no mothers will be treated badly for giving birth to either."

As you can imagine, there is not only need for health service but a lot more and your support has made us able to contribute a bit in the area where people have so many problem, thank you very much for your support.

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