Welcome Labour Room

The Story of Maternal Health in Nepal

Female Community Health Volunteer: Bina Kumari B.K.

Bina Kumari B.K. is 31 years old and is from Narayansthan S. Namunagow. She has been volunteering for seven years, and received the One Heart PAVOT training 10 months ago.

Why did she want to become a volunteer?

She said that in her village lots of women die during pregnancy, and babies die in childhood. She wants to serve them, and she doesn’t want to see the women and child dying. So that is why she became a volunteer.

What challenges do the women in her village face?

So she said, there is lots of problem of uteren prolapse in her village. And women feel shy to talk about their diseases and illnesses, like uteren prolapse and things which are related to private organ. They feel shy to share with person. For the health check up, for here, they feel shy mostly when they come for antenatal check if there is male health worker. They won’t check because they feel shy to expose in front of male. This is the health institution problem related to check ups. In their house their husband doesn’t let them go out, and mother in law says “oh you don’t have to go for check ups.” The women don’t have decision making power. That is the problem.

And then some women said, I feel bad, I cannot eat iron tablets. That is also a challenge for them, for FCHV also, because they say, “oh I cannot eat iron tablets because it cause my tummy pain, and it will make my baby large, and it will be difficult to give birth.” So that are the challenges for them.

So mainly for women it is difficult to expose in front of male health worker, and uteron prolapse is one of the problem. And then they don’t have decision making power, so all they have to do is ask husband or mother in law to go out or to go for check ups. For everything, they have to get solution or advice from the family.

When she visited with pregnant women, what does she tell them?

So she told two stories, two cases.

And in one case she said, there was one women who give birth, just 9 days ago. And she was teaching, whenever you feel pain or the labour starts call me, and I will take you to hospital, I will help you, she said. And I will go by myself with you. She also said she is from a cooperative family, mother in law was also cooperative, and they said okay I will call you. After coming back from planting millet she feel labour pain, and she gave birth soon, like that was short labour. That means that was precipitative labour. They didn’t get a chance to call her, or get chance to take her to hospital, and she gave birth at home. And after three days she had a really bad fever, really high fever. And she told her to get medical check up, go see health person. And she came to one medical store up here, she came there and the health person gave some medicine, and now she is 9 days and she is feeling well now.

And another one, she said there is one woman off…there is one woman off seven-months pregnancy. And this is her second child, and for first child she had to do cesarean section. Because the doctor says in the birth canal there is a bone, in birth canal there is enlargement of bone. Which means the baby won’t fit in that canal so you have to do cesarean section. I think that means CPD, I am not sure about that, but CPD is Cell Pelvic Disporportion. She is talking in simple words. But now that she is seven months pregnant she feels some pain in her flank region, she feels something hurting. They said previously that many it is eptopic pregnancy, that means outside of uterous pregnancy. A health worker from here advised to do UNC, that means x-ray. And she did UNC and they said baby is fine. But she still have one thing, on her tummy, lower side of tummy. And she need to go to hospital.

So when she meet the pregnant women she tell them, you have to do four antenatal check ups. And you have to eat a minimum of four meals a day, and if you are hungry you can eat more, but a minimum of four meals a day is necessary. And you have to during your 6 month antenatal visit take anti-worming tablets and TT vaccination. And don’t carry heavy loads. That is her suggestion for the pregnant women. She said she teach like that, don’t carry the heavy load and maintain your personal hiygene. She always teach those things when she visit the pregnant women.

Do you have any kids of your own? If yes, where did you give birth? Were there any complications?

So she usually used to have hypertension, during her pregnancy. So a health worker from here advise her to go to Baglung Hospital to give birth. And for birth child she give birth at Baglung Hospital. For the last child, she came back from hospital and in 15 days after delivery she had heavy bleeding, really heavy bleeding. She said it was lots of bleeding and it was all around the floor. She had a big clot from her vagina, and she was nearly dying. So they took her to the clinic, there is one clinic up in a village. And if I was not there in time, I would die. But I survived. I was unconscious, totally unconscious. And the health worker from the clinic was also afraid, and he said “I cannot do anything, take her to Baglung Hospital.” But he did IV infusion, and she get some energy from that. And she survived.

What advice does she have for young women in the community?

So she said, for the teenage girl who will start menstruation, don’t shy during menstruation, feel free to share anything, ask anything. Maintain hiygene because there is lots of chance of infection during menstruation. That is her suggestion for during menstruation. And for all women, she said don’t get married until 20, minimum your age should be twenty. If you get married before, you will get pregnant before, and it can cause death for both mother and baby. That is her main suggestion. During menstruation you have to eat nutritious food, including carbohydrate, protein, and vegetables.

She was asking me, can I include the pregnant women’s teaching also, and I said of course you can. For the pregnant women who get married after twenty years, I would teach them, I would give health messages to them, to do four health check ups, antenatal check ups, and they should eat iron tablets, and take Tetanus vaccination, and they should do birth planning and preparation ahead.  They should do all the cares, all the cares during the pregnancy. That is her messages for pregnant women. And she said there should be space between first child and second child, minimum of 5 years.

Interview was taken by Kelly McIlvenny in Narayansthan in July 2011, translated by Ang Jangmu Sherpa.

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