Ensure Safe Motherhood for Women in Rural Nepal

As a young medical professional, 21-year-old nurse Rita has been through quite a journey to build a good reputation in her community in Phediguth village ward of Champadevi rural municipality in Okhaldhunga district. Her recognition as a well-respected nurse also didn’t come easy.

When Rita returned home from Kathmandu after completing her training as a skilled birth attendant (SBA) in Nepal’s biggest maternity hospital, many people in her community were not sure if she was up to the task.

“People heard rumours that a big doctor had joined the birthing centre but when they met me, people just saw a local girl from the community and didn’t trust me at all in the beginning,” muses Rita. 

In a few months, Rita proved herself through her hard work by dealing with the most complicated cases and helped to deliver healthy babies at Phediguth Health Post, where One Heart Worldwide (OHW) has helped to renovate a high-quality birthing centre in partnership with Champadevi rural municipality.

“I never gave up to become a professional nurse even when I had been slapped, kicked and verbally abused so many times by grown-up adults especially when there were prolonged labour and complications. I could understand their frustrations but I did not let anything demoralise me,” says Rita.

Today, everyone respectfully calls her ‘Sister’ and many also have apologised for their mistreatment after seeing her good work. As the only SBA-trained nurse in her community, she handles most of the cases alone during birth delivery with assistance from the health post staff.

“Today, so many people come with gifts to show their gratitude but I often refuse because I know I am just doing my duty. I am especially thankful to OHW for empowering my knowledge and skills that have helped me to build new confidence as a professional nurse,” says Rita, who has successfully done 32 birth deliveries alone in less than a year.

Her village ward has no electricity due to a lack of connection to the national grid and the only option is through solar-powered electricity. As a result, there is now a power supply at the birthing centre made possible through OHW’s support for a Solar Suitcase, which is a compact, easy-to-use solar electric system that provides health facilities with efficient medical lighting and power for mobile communication and medical appliances. 

Prior to OHW’s arrival in this rural municipality ward and before taking SBA training, Rita had just joined the health post, where the birthing centre had no proper equipment or maternity beds. Most risky situations were in the evenings and nights when there was no light and she often fell down while stumbling in the dark looking for medicines and equipment in the storeroom. The birth deliveries were often done in late hours due to cases of prolonged labour, which lasted up to 10-16 hours. She recalls how the patients preferred using the floor instead of the uncomfortable maternity beds prior to the renovation.

For many years since the health post established a birthing centre (before the renovation), Rita and her team at the health post unsuccessfully lobbied the local government representatives for electricity supply. During the cold weathers, it was especially challenging because the health post couldn’t use heaters to warm the room for birthing, which often took long hours for birth deliveries.

She recalls how she had also done birth delivery in the dark. Several times she used the office tables to lay down the women during labour as the patients refused to use the maternity beds which were very uncomfortable.

As a result, most villagers refused to come to the birthing centre, which had been subject to criticism for its poor facilities.

“Now we don’t have to worry anymore as OHW has not only brought solar electricity but has also renovated rooms that are warm and cosy to protect from cold or heat. We are really thankful for the support from all the donors who support OHW for their work,” says Rita.

Many nurses working in OHW-supported birthing centres also shared similar experiences of how the upgraded facilities have helped to make their jobs easier, and are able to focus on their work without having to stress out about medical equipment, proper beds and other resources. The absence of well-equipped and facilities in the birthing centre often provoked ire in the community and the nurses were the first ones to be shouted at and often ridiculed.

Today, the local community feel at home in the birthing centre and the nurses are able to concentrate on their work to help. The nurses have a proper workspace, a clean room for birth delivery and a waiting room for the families and a separate room for counselling their patients for ANC and PNC counselling.

“The nurses are like our own sisters and give us full attention and I really like coming here to the birthing centre,” says 20-year-old Manisha, who recently became a mother and had her birth delivery in this birthing centre where Rita works.

Manisha recalls how she was never prepared to be a mother at such a young age. When she heard of her pregnancy, Manisha was nervous and afraid at the same time but lost her fears after she went for counselling from the nurse. 

“Sister Rita helped me to build my confidence and made me feel calm even when I was in severe pain due to very long labour,” says Manisha, who wished that the old generation of mothers in her community also had the same type of comprehensive maternal care.

Rita’s child was born during the first phase of the COVID19 situation and there was a strict lockdown situation then. Fortunately, the birthing centre was open and the community had a dedicated nurse to help to deliver a healthy boy.

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