This time, meet health worker Indira Kuwar, who has been working for PHASE for 2 years and who has been in the health post of Maila for the last 7 months. She tells the story of how institutional deliveries have transformed childbirth for both the health workers and the community in Maila:
Before PHASE started work in Maila, women used to deliver their babies unattended in a cowshed, far from the house, because delivery was considered dangerous and unclean. It took some time to persuade the community to at least find an alternative clean area for delivery and to call a PHASE healthworker when a woman went into labour. By the time I started work in Maila, this practice had already changed and the Birthing Centre had been established.
There is a strong push in Nepal to increase the percentage of childbirths that happen in a health institution, as this is considered more effective and safe. There is now even a financial incentive from the government for women to attend at a health center, and the center itself gets additional payments whenever a delivery takes place there. Because of the permanent presence of qualified PHASE midwifery workers, a new health post building with a delivery room was constructed in Maila with support from UNICEF and the district government. Apart from myself and the other PHASE Auxiliary Nurse Midwife Meena, who live at the health post, there is also a governmental Maternal and Child Health worker in Maila, as well as another Auxiliary Nurse Midwife who has been employed by the local community – a real change from when PHASE first came here and the health post was closed. All the staff work together to care for women in childbirth, but some days it can be really busy:
I remember April the 14th 2012, when we were woken up at 3.30 AM in the morning by a woman and her husband who had walked the half hour across from the next village. She was in labor with her second child, and in fact the little boy was born within half an hour of them arriving at the health post. By the time we had dried and cleaned the baby, delivered the afterbirth safely, ensured that both mum and baby were well and that baby was breastfeeding, and cleaned up the delivery room, there was no point in going back to bed, so we started our morning chores: getting water from the central tap, cleaning our rooms, cooking breakfast and setting up in readiness for the day. Clearly, we were not meant to get much chance for a quiet start, as another expectant mother arrived on our doorstep at 8am! She was also in advanced labor and her little girl was safely born about an hour later. By this time it was time to open the health post, but fortunately, the locally employed health workers both arrived by 10 am, so they could take over seeing routine patients while we were cleaning up after the birth.
It was a typical busy day at the health center, with about 50 patients being seen by the government health workers and ourselves. We work from two rooms, and take it in turns to see patients, deal with the registration paperwork and dispense the drugs. Before the last patients were seen, another lady in labor arrived! This time, the locally employed ANM took the lead with the case, and again, a little girl was delivered safely after another hour or two, in time for her mum and dad to still walk back to the village they came from (about 45 minutes walk from the health post) the same evening. In this particular case, the dad was happy to carry the baby himself – some men still feel that it is unlucky to carry a newly born child, and bring a female relative along for this reason! After they left, we started sorting out and re-sterilizing our equipment for the next cases.
If we didn’t have the labor room and the option of delivering babies in the health center, a busy day like this would be almost impossible to manage safely for everyone. We would probably not have managed to attend the second morning delivery in time with clean equipment if we had had to go to the patients’ homes, and certainly the patients coming to the health center for other reasons would have had a much longer wait. It is really good that PHASE is able to support this government strategy and that the local people have taken it on board so well.
A ‘typical’ day - 3 babies safely delivered within 15 hours, and all in a mountainous area days away from a road.
Friends! Things are changing in Maila village, and the community is becoming more aware about how to take care of their own and their family’s health. They are also learning the benefits of giving birth in a clean place with the help of a trained health worker.
We value everything you have done to make this possible for us and would like to say a very sincere thank you.
It is your support that is keeping this health post open and paying for qualified workers like Indira. Please consider making another small donation, or sharing this remarkable story with your friends.
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PHASE Nepal and the people of Maila
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