Support 300 Safe Births in the Nepal Himalaya

Although this didn't happen in the specific region this project supports it is a great example of how PHASE health workers save lives...

Ganga is a 25 year old mother from Maila village and has one 6 year old daughter, Sunita.

Soon after Sunita was born Ganga became pregnant again, but had a stillbirth late in her pregnancy. After recovering, Ganga decided that she wanted to have another child, however her husband, Tanka, had gone to work abroad and was away for the following 3 years. He returned last year and she became pregnant again.

During Tanka’s absence, Ganga had struggled to manage their little farm, especially with a young daughter to care for at home.  However she was happy to be pregnant again, and hoped that this time it would be a boy. Many Hindu Nepali women would like a male child, knowing that, as a grown man, he would bring home a daughter-in-law. A daughter-in-law would ease Ganga’s workload and look after her in old age.  A son would also perform the important death rites when she and her husband passed away.

in Maila village

Ganga visited a PHASE supported health post on only one occasion during her pregnancy (at about 5 months along).  On this occasion everything seemed fine. She didn’t go again because it was harvest time, then festivals season, and although the government Auxiliary Midwife was available, the PHASE staff were on their annual holiday.  She felt it was not really necessary to go – everything had been OK in her first pregnancy, and she hoped that there would not be a repeat of the last time.

Just two weeks ago – at just over 36 weeks into her pregnancy, Ganga was brought to the health post by her husband. She felt very unwell with a headache and abdominal pain and thought she might be in labour.  When Junila, the PHASE Auxiliary Nurse Midwife, questioned her, Ganga revealed that she had not been well for several days, and had noticed that her hands, face and feet were a bit swollen.

Birthing area – Maila Village

Ganga was indeed in labour. She had high blood pressure and, suddenly, things went very wrong – Ganga went into a generalised seizure and didn’t regain consciousness. Junila diagnosed Ganga with eclampsia, a condition which can be fatal to both mother and child, and quickly positioned Ganga on her side, in recovery position, but she knew that more was needed. Ganga required immediate treatment and immediate delivery of the baby; really she needed to be in a hospital.

Maila is a three to four days walk from the nearest functioning hospitals in Martadi or Achham. Although a closer hospital can be found in Simikot it is very unreliably staffed, and has fewer facilities and no caesarean section facilities.

Fortunately for Ganga, Junila was a trained Skilled Birth Attendant with updated training and the equipment she needed.  She recognised the condition and knew that the correct management of this complication was immediate treatment with a high dose injection of Magnesium Sulphate.

This is a risky procedure, especially in a remote location without additional professional support, as a Magnesium Sulphate overdose can lead to respiratory arrest, but Junila felt this was the only option available.  She also had the antidote, Calcium Gluconate, in case Ganga’s breathing became too weak.

She went ahead and gave the treatment.

After treatment Ganga had no more seizures and, as is often the case in such situations, her labour progressed very quickly.  A healthy little boy was born and, later, both mother and child were taken home by a delighted father, who probably didn’t even realise how close he came to being a widowed single father of their little girl.

PHASE supports government health posts in very remote locations in the Nepalese Himalayas.  Our work focuses on maternal and child health. Before PHASE began working in villages such a Maila, child and maternal mortality were much more common – our work saves lives.

PHASE can only continue to run our health posts with your support - the best way to contribute to PHASE is a regular gift – if you can spare just £5 or £10 a month please email sarah@phaseworldwide.organd we will send details of how to set this up.