“It is safe to say that this baby would probably not have made it.”
It was the morning after the delivery in the maternity ward at UMN’s (United Mission to Nepal) Tansen Hospital in Palpa District of western Nepal. Jyoti sat upright in bed, her new baby girl nursing at her breast. Contentment was written all over her face. Her husband stood quietly by her side, as five year old Ganesh stole a look at his sister. The pedeatrician making rounds looked over her chart and examined the baby. She asked Jyoti how the baby had been feeding. Pleased with the mother’s report and the results of her examination she turned aside to say, “It is safe to say that this baby would probably not have made it had Jyoti not come to the hospital.”
After Ganesh there had been a miscarriage. And then came more disappointment when a still-born was delivered breech at home in the small mountain village of Sekadanda. Jyoti was afraid that the same thing would happen again, and she was not going to take any chances with this baby! At the first signs of labor she gathered her few belongings together for the journey to the hospital. She managed the 15 minute walk up the mountain to the road without much difficulty. But after 2 hours in the back seat of the bus that wound its way over the bumpy mountain road to Tansen, she was tired, sore and more than ready for the hospital bed to which she was admitted.
The ultra-sound revealed that the baby was presenting breech which the doctor’s examination confirmed. Preparations were then made so that when it came time for Jyoti to deliver, they were ready for her. The delivery proceeded without any complications. Later the same day she was able to return home to Sekadanda with her new daughter.
But Jyoti’s story might not have had this happy ending. Women like Jyoti are often left alone with the cattle in the stable when it is time to give birth in Nepal, as they are considered unclean and untouchable at the time. The instrument used to cut the cord is often the same sickle used to cut grass for the cattle. These circumstances are less then ideal even for a normal delivery!
Lowering the high infant mortality rate of 102 per 1000 live births continues to be a primary focus of health efforts in the country of Nepal. During the last year there were 168 complicated deliveries out of a total of 549 deliveries at Tansen Hospital. Diagnostic ultra-sound is being used with increasing effectiveness in cases such as Jyoti’s. Close cooperation exists between the hospital and the Palpa Community Health Project, which has made extensive use of the “family folder” in its activities. Pregnancies are tracked carefully through Maternal Child Health activities, and pregnant mothers who are considered to be at risk are referred to the hospital for further follow-up. An annual household survey which has been conducted for the last eight years indicates a significant decline in the infant and child mortality rates within the project area to less than 30 per 1000 live births.
For those desperately poor people, who like Jyoti cannot afford medical care, UMN provides financial assistance. Jyoti’s husband was asked to pay 150 Rupees ($3) as he owns no land and has work only when it is available. What they did not know was that the true cost of the care provided was 300 Rupees ($6), the difference being made up by the Medical Assistance Fund. Each year UMN seeks to help the sick and needy like Jyoti who are unable to cover the cost of their treatment.