Apply to Join
 Health  Nepal Project #30003

Ensure Safe Motherhood for Women in Rural Nepal

by One Heart Worldwide
Ensure Safe Motherhood for Women in Rural Nepal
Ensure Safe Motherhood for Women in Rural Nepal
Ensure Safe Motherhood for Women in Rural Nepal
Ensure Safe Motherhood for Women in Rural Nepal
Ensure Safe Motherhood for Women in Rural Nepal
Ensure Safe Motherhood for Women in Rural Nepal
Ensure Safe Motherhood for Women in Rural Nepal
Ensure Safe Motherhood for Women in Rural Nepal
Ensure Safe Motherhood for Women in Rural Nepal
Ensure Safe Motherhood for Women in Rural Nepal
Ensure Safe Motherhood for Women in Rural Nepal
Ensure Safe Motherhood for Women in Rural Nepal
Ensure Safe Motherhood for Women in Rural Nepal
Ensure Safe Motherhood for Women in Rural Nepal
Shristi S., 22 y/o, mother of one
Shristi S., 22 y/o, mother of one

“I was having acute back pain right before I went into labor. It was evening when I was carried on a stretcher and taken to the birthing center. The nurse at the birthing center said that the heartbeat of my child was not audible. I was weak and they said that I passed out after some time. We were referred to Thapathali Hospital in Kathmandu. I had a normal delivery but my baby was kept on an Intensive Care Unit for some time. I am thankful to the nurses who identified my situation, arranged the vehicle for us to travel to Kathmandu for the safety of me and my child. At one time it felt like, my boy is not going to make it, but everything worked out in the end. Now he is a healthy and playful child.”

Shristi S., 22 years, Mother of one
Ragani Rural Municipality, Okhaldhunga, Nepal

 

 

“We contemplated about traveling to Kathmandu for my delivery. I have had all the ANC check-ups, maintained my diet, and had my supplements as instructed by the nurses here. But we were nervous about delivering here. After a few months, one of the nurses at the Pokali Health Post had returned from her Skilled Birth Attendant (SBA) training. Likewise, the renovation of the birthing center was completed a few weeks after. The birthing center had a total facelift, and now looks more like a hospital. Nurses said that they have all the equipment inside the birthing center to deal with complications. We had the confidence to have the delivery locally. Everything went very well. We are very happy with the improved service. Now, we need not travel hours along the treacherous road to go to cities for deliveries because our birthing center is now capable and efficient in providing all the needed services.”

Meri S., 26 years, Mother of one
Pokali Rural Municipality, Okhaldhunga, Nepal

 

 

“I had both of my childbirths at home. None of it was smooth. I felt like I would not make it during my second delivery because my child was not coming out easily. But all thanks to my strong luck. My daughter in law is currently seven-months pregnant. I am making sure that she will have all the antenatal care check-ups, and is in absolutely perfect shape to have her delivery at the newly renovated birthing center. I am very happy for young mothers and for all of us. People did not feel safe for childbirth at the health post before, but now things have changed for good. It’s a blessing for all of us.”

Mina D., 40 years old
Pokali Rural Municipality, Okhaldhunga, Nepal

 

 

“I was seven months pregnant with twins. The leg of one of my babies, who did not make it, came out and I was rushed to the health post right after. The nurses had a tough time dealing with both the deliveries. To save both of my kids and myself, the municipality office had arranged a helicopter but due to some unknown reasons, it never came. So we had to go to Kathmandu for the delivery by road. I was extremely weak. I cannot recollect how I survived that childbirth. Though one of my children passed away, I feel very lucky to have survived and one of my babies was healthy.

If it was not for the Skilled Birth Attendant at the health post, who took care of me during that critical time, I would not have been alive to share my experience. Not only was our birthing center completely renovated, but One Heart also provided all the equipment and trainings to our nurses. Now, people like me are very confident about the quality of services the health will be providing.

Being one of the elected members of the Pokali Rural Municipality, I am advocating for maternal and neonatal health. Now that we have a good birthing center and skilled people here, we need better infrastructure for roads and ambulances at the health post so that we can act instantly in a crisis. My own experience gives me motivation to work for women and children. And I feel fortunate for being able to do so.”

Lal K.B., 24-years old, Mother of one
Pokali Rural Municipality, Okhaldhunga, Kathmandu

 

 

“I am grateful to One Heart for providing me the Skilled Birth Attendant training. It was much needed for my profession, and most importantly nedded by the community here. We seldom had childbirths at our previous birthing center, but things are changing for the better now. One Heart renovated our birthing center, provided the essential equipment, supported my scholarship to become a certified Skilled Birth Attendant (SBA), and trained me and my colleagues on Rural Ultrasound. Because of this, we are now seeing increased ANC check-ups and deliveries. We have already referred three complicated cases to bigger facilities, managed some locally, and have provided efficient childbirth services. None of this would have been possible without the support of One Heart. Now, our community feels confident about seeking services locally and I am very thankful for everything.”

Kalpana S., 33 years, ANM
Pokali Health Post, Okhaldhunga, Nepal

Meri S., 26 y/o, mother of one
Meri S., 26 y/o, mother of one
Mina D., 40 y/o
Mina D., 40 y/o
Lal K.B., 24 y/o, mother of one
Lal K.B., 24 y/o, mother of one
Kalpana S., 33 y/o, ANM
Kalpana S., 33 y/o, ANM

Links:

Share on Twitter Share on Facebook
Sarita with her children
Sarita with her children

Words & photos by: Krishna Dangi

The sight sent chills through her spine. Hima Devi M., a Skilled Birth Attendant at the Thechambu Health Post, was suspicious from the start. The case could take a complicated turn at any second and she was prepared for it. She had no time to spare. If they were to save both mother and child, they needed to act now — and fast. Hima was certain that if the case was referred to the District Hospital, the child had only a slim chance of survival, and the mother could have never made it. So, she decided to take matters into her own hands.

Reaching Thechambu

Thechambu, Taplejung, Nepal: 3428 residents & 606 households. A newly constructed road snakes through the heart of the village — currently, only two jeeps operate on this road daily, one in the early morning and one in the afternoon. No gas stations or repairs. Three shabby hotels and no restaurants. Only local noodles are served for lunch. Located only a stone’s throw away from the District Headquarters, it takes almost five and half hours to reach this village via a steep hike. Home to the Limbu tribes and clans, hardworking locals drink home-brewed rice and millet beer, an integral part of their culture and lifestyle, before calling it a day. Agriculture is the main, and possibly the only, occupation here.

Meeting Sarita M. at her place

It’s early spring. The hill is blazing with tones of red, brown, yellow and green. In a week or two, the hill will be painted shades of green again. The days are dusky and despite the mountainous breeze, the steep hike on the narrow trails leaves us drenched in sweat. Locals can be seen manning their terrace fields for the next planting of corn and potatoes.

We met Sarita, mother of two, in her field. Her husband, Bibek, was plowing with oxen while she was dropping the corn seeds at manually calculated intervals. Occasionally, she works on the uneven field with a spade. Her children were home, under the care of their mother-in-law.

Sarita’s house is a few paces down from their field. It’s a typical one-story, four-room, wood and mud house with a slanted thatch roof — with the roof space used as a storehouse. Her three-year-old daughter is seated beside her with a cup as Sarita prepares tea on her wooden-fire kitchen.

Married at the age of 14, Sarita, now 25, had her first childbirth at home without a glitch. However, she developed a life-threatening complication during her last childbirth and now just feels lucky to be alive.

The day of delivery

It was still dark out on the early February morning. Sarita woke up to a severely aching lower abdomen. She didn’t want to wake her husband up but couldn’t lie down so she spent the early hours of the morning pacing back and forth in her courtyard. Her pain became unbearable at around 10 AM. Bibek notified the Female Community Health Volunteer for a stretcher.

Hima was in the middle of One Heart Worldwide’s (OHW) Pregnant Women’s Group meeting when her cellphone blared. “You have to hurry to the birthing center. We have a woman in a serious condition,” said the caller at the other end. Hima, along with Sajina S., a SBA trained by OHW, both made it to the health post in no time. Together, they figured out that the complication involved malpresentation of the baby. Their first task was to stabilize Sarita’s vital signs using an intravenous supply of electrolytes and antibiotics. The fetal heartbeat was only 80 bpm, so they placed Sarita at the left lateral position to increase the placental supply of oxygen.

It took some time for Hima to externally rotate the baby and bring the baby into the breech position. But thanks to the helping hand of Sajina performing the episiotomy, Hima was able to perform a normal delivery. When the baby was finally out, they suffered another setback because the baby did not cry.

“At one time it was as if I could not think of what to do about it. I was fortunate that I had received SBA training from OHW recently. I checked my nervousness and assisted Hima on following the steps that I learned during the training. I am really happy that we could save both mother and child.”

Sarita, stayed at the District Hospital for three days, receiving blood transfusions while while her baby was kept in the Intensive Care Unit before being discharged.

OHW is committed to save mothers like Sarita

If it were not for the sisters, I could not have been alive. I am very grateful to them for saving my life,” says Sarita.

One Heart Worldwide’s initiative, Health Education Programs for Medical Providers, implements training packages for healthcare providers in the community, primary healthcare facilities and referral hospitals. The program provides knowledge and skills to better manage the most common conditions of pregnancy, childbirth, and newborns. These training packages include newborn care, birth preparedness, infections prevention training, SBA training, and advanced training programs for hospital staff. This approach rationalizes training along a continuum of care: from pregnancy through the newborn period and from the household level to the referral hospital level.

Thechambu Health Post received a facelift through the Health Facility Improvement program, under which One Heart Worldwide upgrades the infrastructure, medical equipment, and staffing of existing healthcare facilities to establish a network of certified birthing centers in strategic locations. In addition, we upgrade the referral hospitals into facilities where comprehensive emergency obstetric care can be accessed.

Sarita & her family in front of their family home
Sarita & her family in front of their family home
Thechambu Delivery Room After OHW renovations
Thechambu Delivery Room After OHW renovations
Thechambu Health Post
Thechambu Health Post
Thechambu Terrain
Thechambu Terrain
Sajina, SBA
Sajina, SBA

Links:

Share on Twitter Share on Facebook
Khijikati Birthing Center, Okhaldhunga
Khijikati Birthing Center, Okhaldhunga

Following a full day of dressing wounds and providing ANC care to pregnant mothers from her community, the late May afternoon was nearing its end at the Khijikati Health Post as Midwife Menuka prepared for a meeting with a group of local stakeholders. As she strung the colorful garlands to welcome her guests, Menuka saw a pregnant woman and her husband walking towards her in the distance. As the couple approached, Menuka recognized Kamala, a patient she had seen just recently for an ANC visit. Ushering her into the birthing center, Menuka assessed Kamala and realizing that she was showing signs of early labor, reviewed with the young mother what the typical process was for labor and delivery.

 

“I told her about the types of sensation she’d be likely to experience during early and active labor and asked her to let me know if she experienced anything that I didn’t explain,’’ said Menuka, leaving Kamala to rest.

 

After the meeting with the Nepali Health Facility Operation and Management, Menuka returned to find that Kamala was beginning to actively labor, so she prepped the delivery room and kept an eye on Kamala’s vitals.

 

More than three hours had passed since Kamala’s arrival at the birthing center, but even though she was clearly in labor, her contractions were irregular and Menuka was becoming concerned.  Kamala began pushing, but Menuka’s experience and the training she’d received from One Heart Worldwide left her doubtful that her patient’s efforts would have much success as the baby’s head was having trouble getting through. After several more unsuccessful attempts, Manuka realized she would need to perform an episiotomy in order for the baby to get through. 

 

Within a few minutes of the procedure, Kamala delivered an unresponsive baby boy. “We started suctioning, but the baby was still flat, explains Menuka.

 

“But as we were about to begin resuscitation, he gave a faint cry, so we continued stimulating and using suction. Then he let out a loud cry!’’ Menuka laughs dryly, “I’ve never been so happy to hear a baby cry!” She then immediately returned to Kamala’s side to reassure her that her baby boy was healthy and all would be well.”

 

“These types of complications always scare me. Every delivery is unique and comes with its own challenges,” sighed Menuka. “But now that the we have ambulance service and proper medical equipment, handling these situations is much easier than before.” 

 

One Heart Worldwide provides training to Auxiliary Nurse Midwives like Menuka, as well as structural renovations and equipment for hundreds of birthing centers across Nepal. Women like Kamala motivate and inspire us to never give up, no matter how difficult or frightening a situation may seem. 

Kamala and her little boy
Kamala and her little boy
Midwife Menuka
Midwife Menuka
Share on Twitter Share on Facebook

Atop the hills just south of the Himalayas, in Nepal’s Sankhuwasabha District, rests the small town named Siddhakali. On clear days, clusters of snow-capped mountains can be seen from Siddhakali’s main street - a narrow dirt road lined on each side with an assortment of local businesses and residences. A half kilometer down the road, opposite the local Health Post, sits the Siddhakali Birthing Center (BC). This cozy thatched-roof, clay building provides prenatal and delivery services to more women than any other BC in the district. Sunita has been working as Auxiliary Nurse Midwife (ANM) at the Siddhakali BC for nearly three decades and is one of the most well-known and respected health workers in the district. Born and raised in the area, Sunita has worked here since it first opened as a single rented room serving the six thousand people in Siddhakali and its surrounding villages.

 

Ever since her mother died shortly after giving birth to Sunita’s younger sister, she has made it her mission in life to improve the quality of maternal care in Nepal.  Sunita is currently leading the effort for Siddhakali to be recognized as one of the zero-home-delivery municipalities. “I have always wanted to be a health professional,” she explained. “My mother passed away because of a retained placenta, three days after giving birth to my sister. I was too young to remember everything in detail but I remember that after, things were never the same.” Sunita has worked her entire life to ensure women in Nepal do not have suffer to the same fate as her mother.  “Looking back, I’m glad that I have chosen to live my life helping women have safe deliveries.”

 

Sunita was honored to be the first person appointed by the Nepali Government to work at the Siddhakali BC and has thrown her heart and soul into serving the community and its mothers despite the cramped quarters of the previous space. A 2018 renovation vastly increased the capacity of the facility by upgrading its exterior, waiting room, exam and pregnancy counseling room, and completely overhauled the existing delivery room. In addition, a brand new recovery room was added to allow new mothers a comforting space to heal and bond with their new babies after delivery. The six health workers who manage the BC’s 24/7 delivery services are thrilled with their new work environment and take great pride in sharing the space with any who are in need of care.

 

Since the BC renovations were completed, Sunita believes Siddhakali is well on its way to achieving its goal to be a zero-home-delivery municipality. “Times have changed a lot since I began. I used to regularly make home visits to perform deliveries. Fortunately, we have worked hard to educate communities about the importance of attending regular ANC check-ups and giving birth in a health facility.” “It took a while,” Sunita lamented, “but now we are on our way to making Siddhakali a place where no woman will die during childbirth. Now we have the tools we need and a beautiful place where mothers will want to come and have their babies. We are so grateful to OHW for supporting us towards achieving our goals.”

 

 

 

 

In Their Own Words 

Manisha K., 24, is eight months pregnant with her second child and has arrived for a check-up. She gave birth to her first born before the Siddhakali BC upgrades were completed.

“I never imagined that it would turn out to be this good during the construction. It looks more like a ‘hospital’ with tiled floors, ceilings, lights and equipment, around here. I feel more secure about being a mother this time around. The fact that we have a qualified Skilled Birth Attendant at the BC makes a lot of difference too.” 

 

Sanju L., 20, is four months pregnant with her first child. 

 “We were thinking about going to one of the larger towns down in the plains for our delivery. I was bit skeptical about the birthing center upgrades being completed before my expected delivery date. Now, after the renovations, I feel very confident about having a safe delivery right in our local BC. With all the resources and manpower in place, I’m happy that the younger generations will not have to go through what we and our mothers did.” 

 

Dagini S., 28, has worked as a Female Community Health Volunteer for the last six years. She is both hopeful and confident about Siddhakali becoming a zero-home-delivery municipality.

“The number of women giving birth at home has decreased significantly in the last two years. Before, we had to be to be stubborn in order for people understand the importance of having regular check-ups. Now, they come to us. I am sure that we will achieve zero-home-delivery in few years.”  

 

OHW currently works in the 12 remote districts of Nepal reporting highest number of childbirth-related maternal and neonatal deaths. Through our Network of Safety program, we touch thousands of pregnancies and save numerous lives by strengthening pre-existing health care system.

Share on Twitter Share on Facebook

It was half past noon in Tumlingtar, Sankhuwasabha, as 23-year-old skilled birth attendant Romila sat in a meeting with health staff and local authorities. As they discussed ideas to improve coordination and efficiency at the facility recently renovated by One Heart World-Wide, screams brought the conversation to a halt. 

 

Romila rushed outside to find a cluster of people carrying a young woman in a stretcher high above their shoulders. After directing them towards the delivery room, Romila spoke to the woman’s husband who told her that the woman had given birth just over an hour ago at their home but the placenta had failed to deliver. She was only eighteen and although her newborn was healthy, the hour-long journey from her home in neighboring Bhojpur left her weak and short of blood. 

 

“She showed a lot of determination to be fighting against the pain,” admitted Romila. Nevertheless, her vital signs were worrying and Romila knew they had to act immediately to reduce the risk of further complication.  

Soon after their arrival, preparations began to remove the placenta manually. The young woman received several treatments in order to begin the procedure. IVs were inserted into both of her hands where she was injected with pain medicine and Ampicillin for prophylaxis. Her bladder was manually emptied using a catheter and several blood tests conducted to check her hemoglobin levels. 

Once the procedure began, it did not take much time to remove the placenta. The young woman was then taken out of the operating room where she was given hot soup and reunited with her newborn child. By the end of the day, she was back to her normal self, and after staying overnight for precautionary measures, released the next morning. 

“It was disheartening to know that the young woman did not have any Antenatal check-ups,” lamented Romila. This was the first time during her pregnancy she sought medical attention and Romila feared had it not been for the complication, the young woman would have continued to deliver at home and carry her pregnancies without seeking medical aid. But now Romila plans to use this example to show other women the importance of delivering their children under the supervision of trained professionals. “We will show her case to educate and inspire women from her village to come to the birthing center to have a safe and hygienic birth,” declared Romila.  

She continued by thanking One Heart World-Wide for the renovations on the local birthing center. “Had it not been for the renovations and new equipment,” admitted Romila, “I would not have been confident in my abilities to manage the case. Things have changed for the good, the birthing center now resembles an actual hospital.” 

She continued to assert, “We are hopeful that we will be able to inspire women to come to our new birthing center for ANC check-ups and deliveries. We are grateful to One Heart World-Wide for giving us the ability to expand our services and increase the quality of healthcare we provide to save more lives.”  

Links:

Share on Twitter Share on Facebook
 

About Project Reports

Project Reports on GlobalGiving are posted directly to globalgiving.org by Project Leaders as they are completed, generally every 3-4 months. To protect the integrity of these documents, GlobalGiving does not alter them; therefore you may find some language or formatting issues.

If you donate to this project or have donated to this project, you will get an e-mail when this project posts a report. You can also subscribe for reports via e-mail without donating.

Get Reports via Email

We'll only email you new reports and updates about this project.

Organization Information

One Heart Worldwide

Location: San Francisco, California - USA
Website:
Facebook: Facebook Page
Twitter: @OneHeartWW
Project Leader:
Michaela Hayes
San Francisco, California United States
$29,150 raised of $40,000 goal
 
95 donations
$10,850 to go
Donate Now
lock
Donating through GlobalGiving is safe, secure, and easy with many payment options to choose from. View other ways to donate

One Heart Worldwide has earned this recognition on GlobalGiving:
Add Project to Favorites

Help raise money!

Support this important cause by creating a personalized fundraising page.

Start a Fundraiser

Learn more about GlobalGiving

Teenage Science Students
Vetting +
Due Diligence

Snorkeler
Our
Impact

Woman Holding a Gift Card
Give
Gift Cards

Young Girl with a Bicycle
GlobalGiving
Guarantee

Sign up for the GlobalGiving Newsletter

WARNING: Javascript is currently disabled or is not available in your browser. GlobalGiving makes extensive use of Javascript and will not function properly with Javascript disabled. Please enable Javascript and refresh this page.