Support 300 Safe Births in the Nepal Himalaya

Chhewang Diki Lama is 40 years old. She is from ward number 1 of Prok village - a remote village in Gorkha district, 4 days walk from the nearest road.

“I am 40 years old,” she says. “I realized that I hadn’t had a monthly period for 4 months and I guessed that I was pregnant. I felt upset because I thought it was my own fault.”

She knew about the PHASE staff at the health centre, so she decided she would talk with them straight away. 

“I went to meet the PHASE health worker. After a medical check-up she confirmed that I was pregnant. It was already 4 months and she advised me that there were no options now to terminate the pregnancy so I would have to give birth to my eighth child. I was very scared. The PHASE sister gave me some medicines including iron tablets. She also advised me that at my age childbirth can be complicated. She suggested that I go to a hospital for the delivery.” 

Chhewang Diki wanted to go to a modern hospital but she had very little money and 7 other children to look after, some of whom were still small meaning she had a lot of household responsibilities. 

“My due date approached quickly,” she says. “I was very worried about my health and that I might develop dangerous symptoms and die. However, I tried to strengthen my own confidence; thinking there is a PHASE sister if anything happens to me.”

On her due date, she started to feel labour pains. She was in a lot of pain and felt very stressed and fearful. She says: 

“I asked my husband to call the PHASE sister but she was out in another village. I suffered from severe labour pains the whole day without getting any medical assistance. In the evening, around 7 o’clock, the PHASE sisters, Anjana and Deepa, rushed into my home with a big delivery bag. They examined me and confirmed that everything was normal so far. They kept supporting me and after 3 hours I succeeded in giving birth to a baby girl."

PHASE health workers Deepa and Anjana used the PHASE delivery kit bag to look after the mother and the newborn baby. They cut the umbilical cord with a sterilized blade and wrapped the baby in a towel.

“After a successful delivery they were waiting for the placenta, which came out within a very short time. They checked my blood pressure, gave me an injection in my thigh and helped me to breastfeed the baby. They checked the placenta to confirm that no pieces were left inside. They also instructed me to massage my stomach every 5 minutes, for half an hour. Finally, Anjana checked me again and said everything seemed fine.”

Chhewang Diki was very happy as she had had a normal delivery. Deepa and Anjana were still in the house when:

“Both the sisters were with me. I was breastfeeding my child and talking about my normal delivery. Suddenly, I started to feel uneasy and began to lose awareness. When Deepa saw my facial expression, she immediately asked me whether I was bleeding or not and she checked me again. I was bleeding and starting to lose consciousness. I felt my energy drain, felt drowsy and felt as if I was going to die very soon! Lord Buddha! Take me to heaven!”

This was a major emergency situation for Chhewang Diki and the PHASE health workers Deepa Pathak and Anjana Manandhar. Deepa started the treatment without sparing a second. Chhewang Diki says: 

“Deepa immediately gave me a bottle of saline water through my vein. She removed some blood clots from the womb and asked me to empty my bladder.” She said, “I was partially unconscious and could not urinate properly. Then I can remember that Anjana sister put a pipe inside to take the urine out. She put some medicine in the infusion and gave me an injection.” 

The situation in Chhewang Diki’s home was tense. However, the PHASE midwives were incredibly focused and continued to treat her. As explained earlier, there was no option of referral, so Deepa and Anjana had to do the best they could. Chhewang says:  

“After some time, I stopped bleeding and I started to feel a little bit better. The sisters checked my blood pressure again and said that it was going back to normal. They confirmed that they would continue to help me, and that I would be fine soon! Thanks to their encouragement, my strength grew, a ray of hope shone inside my home and the bond of humanity strengthened among us.” She says, “I could see true humanity in the eyes of both the sisters.”

After an hour, Chhewang Diki began to feel like herself again. She was recovering and, once again, she was able to hold her baby. Her face was shining with maternal love for her baby; she had pulled through this life-threatening situation.

“Now I was feeling much better. I was holding my baby and trying to breastfeed her. Both the staff had smiles on their faces. They gave me some medicine (vitamin A and iron tablets) for 45 days and informed me that they would be back for my checkup. I remember they looked after me the whole night without eating or drinking. They also told us to call them if I felt unwell. They left my home early, around 5 o’clock in the morning. They came back 3 times for my postnatal checks.”

Unfortunately many of the women of Prok and the surrounding villages have problems during their pregnancies, and during and after childbirth. A lack of health awareness, very scattered remote villages and a lack of health service provision are major problems.

Chhewang Diki concludes:

“I know PHASE Nepal has been working in our village for two years. I used to consult with the PHASE health workers when any of my family got sick. This time, I was pregnant because I had missed the chance to use family planning and because of that I almost died. As you know our village is very remote and scattered; we are poor and our daily household chores keep us busy every day till late at night, so we are not able to take care of our own health. We don’t have a big hospital here or enough money to fly to the city for treatment in an emergency. PHASE is the only one who cares for us. I do not know; I would be buried or in heaven if there were no PHASE sisters! I thank Deepa and Anjana a thousand times for their tireless support and dedication. I swear I will never forget either of them.”

PHASE provides 24-hour emergency services for deliveries and complicated pregnancies. PHASE health workers also spread the message about family planning services around the villages. Chhewang Diki now loves to share and spread health messages among the community. PHASE  transform lives through public health campaigns that raise awareness of health issues and healthy living among the people of Prok.  

With your help, PHASE can continue to support more women like Chhewand Diki who need professional support during childbirth – this can make a huge difference to them and their babies’ health in such isolated conditions. Thank you very much for your ongoing support!

To make a donation please visit www.globalgiving.co.uk/projects/safe-births-in-nepal

Or to learn more about our work go to www.phaseworldwide.org or our blog: http://phaseworldwide.wordpress.com/

Thanks to your kind donations, our health workers have been able to support the delivery and early neo-natal care of babies in the remote Nepali Himalaya. PHASE have also been able to provide expectant mothers living further from the health post with birthing packs which include soap, a clean blade and a plastic sheet, all of which are essential for a safe delivery.

 PHASE is encouraging women to come to the health centre for antenatal checks and safe delivery. Sitamaya has been working for PHASE for 4 years. She feels that the work of PHASE is particularly important for the more disadvantaged women in Gorkha:

Before PHASE started work in Gorkha, there were no trained health workers who could assist women in childbirth. The better off families therefore often sent the pregnant mother to stay with friends or family in the cities, near a hospital, but those from the poorest and least educated families didn't have this option. PHASE health workers have particularly changed the situation for these women, by being able to offer safe delivery care and treatment of common complications.

PHASE staff are often the only health workers in the remote villages in which we work. If expectant mothers come to our health centre it is important that our staff can deal with complex health issues. To ensure the staff have the required skill and expertise, and following our commitment to ongoing training for our staff team, four senior midwives from Rotherham hospital (Emma Carver, Joanne Lancashire, Marian Childs and Shahida Mehrban) visited our Kathmandu office earlier this year and delivered training in practical obstetric emergency care skills. It was a fantastic training course that was fun, interesting and interactive.

The obstetric unit at Rotherham has donated some training models to PHASE, which we use each year, and the midwives were able to borrow some additional training materials from Rotherham hospital. The course was specifically designed to apply to our staff's working environment and skill level – the midwives use the PHASE Nepal clinic guidelines so advice is consistent.

The training is very effective and we know that it has, on several occasions, really assisted staff in isolated areas to cope when dealing with emergencies such as breech deliveries or shoulder dystocia (when the head gets born but the shoulders get stuck). These are emergencies where the baby usually dies if there is nobody who knows how to help, so the skills PHASE health workers learn during the sessions on this course are truly lifesaving.

Things are changing in Gorkha district, and the community is becoming more aware about how to take care of their health and that of their family’s. 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 Sitamaya but PHASE needs funds to continue its vital health care projects in remote areas of the Nepali Himalaya. Whilst we know Christmas is an expensive time for a lot of families we are also very thankful for donations we receive around this time as people look to give back in celebration of all they are blessed with – if you can afford to make a donation to PHASE Worldwide this Christmas please click here:

http://www.globalgiving.co.uk/projects/safe-births-in-nepal/

Links:

• PHASE Worldwide website
• PHASE Worldwide blog
• PHASE Worldwide facebook page