Medical Camp Delivers Baby
The woman has been in labor for two, maybe three days, the story isn’t clear. All that is clear is that two hours up the trail a woman is having a difficult time delivering a baby. It’s somewhat ironic that on this morning we had just toured a recently built birthing center. Recently built, but with no equipment and no staff. As we make our way up the trail we wonder if the woman would have come to the birthing center this time, with her fourth, or was it her fifth child? Again, the story, as being told to us by more than one local we meet on the way remains unclear. We arrive in Tatopani near dusk. Tatopani in Nepali means “hot water.” This village boasts hot mineral baths that are considered a great source of healing to many. We came this way so we could relax and enjoy these waters. Right now however a very frightened Tamang woman is begging to be taken to the hospital and our midwife and pediatrician are busy trying to help her delivery a baby boy. The boy will be named Daniel after the midwife’s late husband. He is born healthy and mother and son are both well the next day.
The delay in delivery was caused by the baby being in the wrong position. Our midwife was able to ascertain this and then help to reposition the baby’s head so delivery could take place. Without this assistance we are not sure what would have happened. And, what about this birthing center we had toured before? Why is it empty and what are women like this one supposed to do when nature fails them and birthing assistance is needed? We had already conducted a one day health camp at the hospital sponsored by The Mountain Fund in Kalikasthan and a second health camp a few days later at The Mountain Fund clinic in Thulo Syabru, so by now our medical staff was getting to know the health problems and lack of facilities intimately. In all, we’d seen over 350 patients by the time we came walking in to Thambuchet.
Located in the Rasuwa District only 90 km from Kathmandu it can still take 9 or more hours to reach Thambuchet by road. As we’d first trekked from near Dunche to Thulo Syabru, conducted a health camp and then walked to Thamuchet, we’d been on the trail two days when we arrived near nightfall. We’d come this way in part because we knew there was a government health post here we wanted to check out. Our long-range plan for health care in Rasuwa includes trying to add resources to that health post. We were not aware that a brand new birthing center had just been built and was just waiting for someone to equip it and add staff. Thambuchet is ideally located for this center. Situated near a hydropower project on the floor of a valley it sits beneath the villages of Gatlang and Goljung and stone’s throw from Chilime village thus making it accessible to nearly 7,000 people. A perfect place for The Mountain Fund to establish our third base of medical operations for the district. With the government’s newly enacted policies a birthing center is perfect. In an effort to reduce infant and maternal mortality the government recently has taken steps to eliminate the village Traditional Birth Attendant, or TBA, and reward families who come to government hospitals to give birth. Nepal has one of the highest rates of maternal deaths in Asia: currently 12 women die in Nepal every day either during pregnancy or childbirth. Nine out of 10 mothers deliver their babies at home without skilled birth attendants, contributing to a high level of maternal mortality. For years, TBA’s have assisted in the birthing process in homes but most are untrained and the conditions unsanitary. The government hopes that by encouraging more women to use birthing centers with trained staff and sanitary conditions it can reduce maternal mortality. This policy makes perfect sense in urban centers where government hospitals are located but the reality for rural areas is quite a different story.
Where we are, in the Rasuwa District there is one government hospital in Dunche. While our mother in Tatopani faces a walk of several hours to reach the proposed birthing center in Thambuchet, the trip to Dunche adds several hours over some of the roughest roads in the country. It’s not practical to imagine that our mother in Tatopani could have made that trip. One can certainly argue that she could also not have walked the 2-3 hours downhill to Thambuchet either. Trained staff with a safe birthing kit could have easily
walked up to Thambuchet two days before our arrival however, saving a great deal of worry and pain.
We have permission from the District Health Office to staff and equip this now empty birthing center and will begin work right away on this project. Our goal, which is subject to your help and support, is to have the birthing center in operation by fall.