Another baby's life is saved in rural Nepal

Nurses Puspa Pandhak and Sumnima Khapung delivering the baby inside a jeep late at night on 3 March, after concluding that they could not reach the Tehrathum district hospital in time because of the bad road. Photo: DINESH BHATTARAI

Puspa Pandhak was just finishing her duty at a rural hospital in Tehrathum district last week when a 19-year-old woman was brought in on a stretcher, writhing in pain.

As a birth attendant nurse, Pandhak had performed more than 100 safe deliveries in the past five years, but this maternity case was the first breech she was having to deal with.

“As soon as I saw the position of the baby, we decided not to take the risk and take her to Tehrathum Hospital,” Pandhak says.

Read also: Birth and death during a pandemic, Nunuta Rai

But, as is often the case in rural Nepal, they could not get an ambulance. The condition of the mother and baby was deteriorating, and every second counted.

Luckily, a four-wheel drive jeep just happened to pass by and gave them a lift. Pandhak and fellow nurse Sumnima Khapung got on with their patient, taking along their delivery kits.

The road was bumpy and dangerous, made worse by the previous day’s heavy rain and the pitch black night. It was already 9:30PM, and they were nowhere near their destination.

“It was a rough ride, and we were being thrown about inside the car, but I tried to reassure the young expecting mother since this would be her first baby,” Pandhak recalls.

Read also: Who will save Nepal's poor new mothers, Rojita Adhikari

In the front seat, the patient’s mother and husband were panicking, and that was not helping at all. Then driver Dinesh Bhattarai also started getting unnerved, and that was not a good sign.

It was now nearly 11PM, and it did not look like they would get to the district hospital in time. Pandhak made the tough decision to stop the journey in the small bazar of Tukre.

“The trip was becoming too long due to the poor road condition and I knew we would never reach the hospital where an emergency doctor and midwife team were on standby to receive us,” Pandhak recounts. “I was very nervous, but knew that the mother was in bad shape and I needed to help somehow.”

The two nurses then decided the safest course was to deliver the baby inside the car. In a breech case, the baby’s body is upside down, which means the head is stuck. Pandhak and Khapung tried to help the mother push the baby, while aware that this could injure her.

Finally, the nurses managed to carefully pull the baby out, without the mother suffering a serious tear.

Read also: Saving one Nepali mother at a time, Aruna Uprety

“I cannot describe the elation and relief that we felt, and I am sure the mother and her relatives were much happier than us, we had delivered a healthy baby inside a cramped car, and mother was also fine,” Pandhak told us on the phone from Tehrathum.

After the enroute delivery, the jeep with one extra person on board, continued the journey to Tehrathum District Hospital. When they got there just past midnight, the emergency team could not believe what they saw.

Says Pandhak, “They were so proud of us as they took charge of mother and baby at the birthing facility. It was a nerve-wracking experience, but it all ended well.”

Pandhak and Khapung are on the frontlines of Nepal’s efforts to reduce maternal and infant mortality. Thirty years ago, 10 in 10,000 women in Nepal used to die in childbirth. That number has come down to 2 in 10,000. But progress has now flat-lined, and 1,500 mothers still die during delivery every year in the country.

Even though such individual acts of heroism never make it to the news, it is the work of Female Community Health Volunteers, dedicated Skilled Birth Attendants (SBAs) like Puspa Pandhak and Sumnima Khapung, and local governments that are helping save lives every day across Nepal.

In this case, it was also the support for renovating and equipping the birthing centre and midwife training provided by the organisation One Heart Worldwide (OHW) to Menchhhyayem Rural Municipality that helped raise the capacity of the two nurses.

OHW uses a partnership approach with rural municipalities to upgrade birthing centres through cost-sharing to encourage local ownership. When the work is complete it moves on to other districts.

“I still feel so relieved and excited that we saved the lives of the mother and baby, and it was also a life-changing moment for me,” Pandhak says. “I feel so happy to see the family so thrilled. This is the greatest reward that a nurse can ever have.”

Pandhak says it was the OHW training that gave her the confidence to make the right decision to deliver in the car and not wait to get to hospital. She adds, “The successful outcome has also given us new confidence to deal with complicated cases in future.”

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