Re-establish a Healthcare Infrastructure in Nepal

Laxmi was a 20 year old new mom who's baby was born with hypothermia and asphyxia. She delivered in a birthing tent  set up by One Heart World-Wide in response to a birthing center completely damaged by the 2015 earthquakes. 

"My family brought me to Bhimtar Health Post, which is just 30 minutes away from my home. The health post had been destroyed by the earthquake so it was just a birthing tent at that time. I was immidiately examined by the nurse and she said that there was no complications and I would have a normal delivery. It took around 45 minutes and I delivered a daughter. My baby didn't have the spontaneous cry immidiately after birth. The nurse said that it was a case of asphyxia and hypothermia. Although I was in bed, I could feel the tension all around and my husband was already upset and nervous but he was counseled by the nurse to remain calm as they'd handled these types of cases before. Immidiately the nurse clamped the cord and started stimulating, drying, and suctioning the baby. After 10 minutes of suctioning, the baby started crying. They applied a cream for cord care and the baby weighed 3.5 kg. We got discharged the next day after our health condition was found to be stable. I was counseled on exclusive breast feeding, immunization, family planning and newborn care. I'm so happy that my daughter's life was saved. She wouldn't have survived if I had delivered at home. My decision to come to Bhimtar HP saved my little one's life."   ~ Laxmi 

After the April 2015 earthquakes, Nepal received an outpouring of support from local, national, and international organizations around the world.  One Heart World-Wide was one of the first organizations on the ground in the districts of Dhading and Sindhupalchok. Almost two years later, One Heart World-Wide is still on the ground supporting the reconstruction and renovation of the healthcare infrastructure in the Earthquake districts of Dhading and Sindhupalchok. 

In 2016 Earthquake districts, One Heart World-Wide: 

• Trained 1,120 community outreach providers. These community outreach providers are composed of health workers and Female Communities that travel to the villages and local communities to provide support, educate, and counsel pregnant women, their families, and the communities themselves on the risks of delivering at home, potential pregnancy complications, and the importance of seeking regular Antenal and Postnatal checkups at certified birthing centers. 
  
  
• Trained 2,762 local stakeholders. Local stakeholders are trained in the proper functioning and mantainance of the birthing centers and health facilities so that once these buildings have been renovated and upgraded by One Heart World-Wide, the stakeholders can take responsibility for maintainance and it's long term success. 
  
  
• Trained 29 medical providers in Skilled Birth Attendance.  The course follows the national SBA curriculum, which is based on WHO's Integraded Management of Pregnancy and Childbirth (IMPaC) curriculum. The program includes 4 weeks of classroom teaching followed by 4 weeks of clinical experience in a maternity ward. 
  
  
• Provided continued medical education for 154 Skilled Birth Attendants. This involves an intensive three day refresher training in emergency obstetrics, basics of skilled birth attendance, and introduces new concepts in obstetric and neonatal care, which allows the clinical staff to be better p repared to effectively recognice and deal with obstetric and neonatal complications. 
  
  
• Fully upgraded 8 health facilities into fully functioning birthing centers.  Buildings designed to be birthing centers or hospitals commonly lack basic infrastructure such as electricity, running water, and insulation. We upgrade each building to meet minimum standards: running water, solar electricity, insulation of roof, walls and windows, medical and human waste disposal sites and equip the buildings with standard equipment such as patient beds, delivery tables, medical instruments, autoclave sterilizer, etc. 
  
  
• Installed 18 Solar Suitcases. Nepal experiences regular loadshedding due to power shortages and the birthing centers therefore have a source of power that is extremely unreliable at times. We install solar suitcases in the birthing centers in order to fulfill the power needs of these birthing centers. The solar suitcases not only provide essential lighting for the delivery and waiting rooms, they also contain a fetal Doppler, mobile chargers and two sets of rechargeable headlamps. 
  
  
• Served a total of 6,418 people via health camps. These health camps served individuals that were injured during the earthquakes with a specific focus on reproductive health. 
  
  
• Completed construction of 2 maternity waiting homes, one in each district. Oftentimes pregnant women and their families will have to travel for several hours/days on foot in order to reach the closest birthing center or health facility. Traveling at such a vulnerable time in their pregnancy is already difficult and can be really expensive if they do not have a place to stay near the facility, discouraging them from making this important trip. The maternity waiting homes fulfill this need and provide a safe space for pregnant women to travel to and rest in before giving birth at the heatlh facility in the presence of of a skilled birth attendant. 

Devi is another new mom that has benefited from One Heart World-Wide's support throughout the earthquake district of Sindhupalchok. She is currently nine months and on the verge of delivering her second baby. 

" My first daughter is now 6 years old. Today I came here to do routine USG checkup and walked almost 6 hours from my village to reach the Health Post. After the USG examination, I feel assured and happy that my baby is in good condition. Now I understand the importance of this checkup and how it saves our life.  I didn't do this during my first pregnancy. There was no place to do such a checkup here and also nobody suggested us to do. The good thing is that it is free of cost otherwise it would cost me around 800 Nepali rupees if I have to do this checkup outside the health post. I am thankful to One Heart World-Wide who has made it possible for the access of USG machine to pregnant woman like us at free of cost and I am being able to know how the baby is doing inside, baby’s position, heart rate and it has made me feel connected with my little one inside the womb. ” 

Looking Forward

For the upcoming 2017 year, One Heart World-Wide has established the following priorities for both earthwuake districts of Dhading and Sindhupalchok: 

• Complete all community outreach provider training programs and SBA training programs
• Increase the number of SBA training programs
• Birthing centers: renovate some of the facilities that were only lightly damaged by the earthquake (6 have been completed and 14 additional ones have been identified)
• Assess the use made out of the two maternity waiting homes and determine whether this is something we should integrate in other districts as well
• Continue to help the local district health office design and run some media campaign about public health issues relevant to safe motherhood in the aftermath of the quake

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