Saving one Nepali mother at a time

Rural Nepali mothers need more nurses like Anju Chaudhary

Nurse Anju Chaudhary

As a nurse, Anju Chaudhary has to often test the limits of her skills when dealing with complicated pregnancies that arrive at the government hospital here in Katari. 

She is also the leader of a team of nurses who are on duty for 24 hours a day, seven days a week, caring for patients.

Chaudhary has helped deliver over 1,000 babies and prevented the deaths of many mothers and newborns. But no case was as challenging as that of Sharmila Surkheti.

One morning in March, the 30-year-old Dalit woman arrived at the hospital, weak and bleeding profusely. 

“We had never seen a mother in such a near-death situation, but we were prepared, and we got into action immediately to save her life,” recalls Chaudhary.

Surkheti had already been pregnant 13 times in her young life. All six of her newborns were delivered at home, and she had undergone seven abortions. Barely a year ago, she had another baby who died at childbirth.

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

This year, she decided to try to risk her own life to try for another son but there was post partum haemorrhage after the baby was born. Her husband helped get her to Katari Hospital while leaving behind the newborn. It was a two hour walk from home.

There was no General Physician at the hospital that day so it was up to Chaudhary and her nurse team to save her life. A quick decision had to be made. They used the bundle approach in postpartum haemorrhage (PPH) management to control the bleeding.

As a chronic anaemic patient, the mother had a low haemoglobin of only 6.1, which was alarming. To save her life, the nurses planned to take Surkheti to a better-equipped hospital in Gaighat but the family could not even afford transportation.

Read also: Nepal's rural lifeline, Sonia Awale

Her blood pressure dropped alarmingly low, and the nurses immediately created an emergency fund to pay for the private ambulance to reach Gaighat.

She also needed blood transfusion, but Surkheti’s husband was malnourished and there were concerns about his health.

The nurses then found a male colleague at the hospital who agreed to donate his blood. They closely monitored the mother, and her haemoglobin improved to 8.8. The hospital’s Acting Medical Superintendent, Dr. Gaurab Shah, an MD Pathologist, also put a lot of effort into managing a blood donor.

Nurses in rural Nepal

The next day, the nurses gave her iron tablets, B complex, and vitamins and she was sent home. But during a post-natal home visit, the nurses were dismayed to see the utter poverty of the Surkheti’s family, including her husband and six children.

Read also: This is how to upgrade Nepal's rural health, Sewa Bhattarai

Given her anaemic state and being very weak, Surkheti was unable to produce milk and had been feeding biscuits to her baby which worried the nurses. The family had no money to buy formula milk. 

So the nurses started collecting cash from their own pockets and started a fundraiser through online requests and on the phone. But there was very little response, and the six nurses put in their own money to save the mother and baby. 

“The greatest gift for me was to hear the words of gratitude from the mother who survived the ordeal,” says Chaudhary modestly.

Despite her training as a Skilled Birth Attendant that she had done many years ago, Chaudhary had no knowledge of uterine balloon tamponade, which can help in the treatment of PPH. 

After graduating from her nursing education, she was transferred to Bir Hospital where she never got the chance to work with mothers and babies, as she was too busy handling injuries and accidents in the emergency department.

It was only after she moved back to Katari Hospital in Udaypur that her career path changed with the help of the non-profit One Heart Worldwide (OHW).

She received an invitation from OHW to attend its Simulation-based Mentorship Program in 2017 which allowed her to learn new skills.

“I feel fortunate that my team was there to help Surkheti, and today, both she and her baby are healthy,” she says. 

Indeed, at a time when many Nepali nurses aim to migrate abroad the nation should be thankful for the dedication and passion of nurses like Anju Chaudhary.