No mother should die giving birth!

After discussing the dismal standards of our health posts in far west since January among the team, we decided to check our health posts around Kathmandu Valley to help us understand and compare. A few calls to some enthusiastic locals, we set out to explore the health posts of Lalitpur District Area 1. Situated only 35 km away from the capital, the health posts in Sankhu, Bhattedanda and Pyutaar were neglected to such an extent it was disturbing for us to fathom the distance from the capital. The birthing centers housed in the health posts lacked the minimum health standards set by the government. The health posts are highly understaffed.

The road to Sankhu, Bahttedanda and Pyutaar is motorable but hold your breath if you are driving to these places for the first time – the ride is definitely not for the faint hearted. The health post in Sankhu is a three room structure sitting idly – one room dedicated for birthing with one iron bed and nothing in site. The other two rooms are used to store medicine and supplies and used for general checkup. One of the visiting colleagues mentioned Baitadi’s health post is better comparatively. But Baitadi is remote and this is Lalitpur Disrict I reasoned?  

Although the health post has basic supplies such as oxygen and suction pumps necessary to resuscitate new born the supplies are collecting dust due to the lack of skilled birth attendants to use these supplies. Expecting mothers prefer to give birth at home because the health post is worse off in terms of comfort and lack of skilled birth attendants – a staggering 60 per cent expecting mothers give birth at home. 

Its only when complication arise after birth or during labour that new mothers are referred to hospitals. The nearest one is 5 hours walk and with no stretcher and ambulance the trauma these expecting mothers face must be unbearable. 

The birthing center in Bhatte danda is in a better condition because it hosts a doctor and couple of skilled birth attendants. The health post in Bhatte danda operates 24 hours a day as the post receives patients from many adjoining areas but it’s a walking distance of 3-5 hours for the majority.

“This is a place for the patients, who come with hope, but the treatment here is primary care and if complications arise we do a lot of referral,” said Rajkumar Sapkota, Health Post in Charge. 

The health post in Pyutar is the worst among the three. Despite the fact that around 700 patients visit the health post during the peak of summer there is not a single health assistant to provide medical care. Absence of health assistants and skilled birth attendants means the only reason patients visit the health post is due to the sheer will of the staff to serve. The birthing center has only one room. This means mothers have to give birth and go home immediately. Sadly the new mothers here are expected to walk for hours immediately after giving birth. 

“Most births take place at night. Since there is no inverter I always deliver babies with the help of my torch light. Many times I have to hold a torch with one hand and deliver a baby with just one hand because there is no one else,” said Saraswati Timilsina, Anami. “We don’t even have a stretcher and sometimes even though the mother may benefit coming to the health post, lack of stretcher means they end up giving birth at home.”

Saraswati also mentioned that the VDC had allocated 10 stretchers for each VDC and they are waiting for the stretchers to show up. The health post does not have an ambulance and the sick are expected to walk for hours to reach the nearest hospital. 

But there is hope because the government is building a model health post in Bhatte danda but it’s a long wait for Sankhu and Pyutar. The government will only build a model health post in all VDCs (one each) if the VDCs can provide land – minimum 3 ropani. The health post in Pyutar can be relocated anywhere any time as the land is not registered under the health post. 

The visit’s objective was to scout a birthing center near to capital that can be supported by the cyclists raising funds during the Kora Cycling event in partnership with Save the Children in July 2014.  

Although, we are yet to discuss which birthing center we will promote during the cycling event the fact is there are hundreds many more health posts in worse condition waiting to be upgraded and supported with skilled human resource. A staggering 60 per cent expecting mothers are giving birth at home just 35 km away from the capital – we have a long way to go because no mother should die giving birth! This year help change the scenarios of the dismal health posts in many VDCs and talk about it – use your voice for a change.