JUMLA, Jan 28: Following her labor pain eight months ago, Bachu Rawat, 20, of Malikabota village of Jumla was taken to a local birthing center for delivery. Although she was admitted to the center, it could not provide necessary treatment. She was referred to the district headquarters-based hospital. Rawat, who was bleeding excessively, breathed her last on the way to the hospital.
“If they could have stopped her bleeding by any method at the birthing center alone, she would not have died. We are from a very remote village and it is not easy to reach even a birthing center during emergencies,” said Kashindra Rawat, the deceased’s husband. “But even after managing to take her to birthing center on time, she could not be saved,” he added.
Rawat further informed that the late arrival of ambulance cost his wife’s life. “The ambulance arrived late. She could not be taken to hospital on time,” he said.
Lokendra Budha of Malikathada village wanted her wife to deliver child in a local birthing center. That would save his money. However, his wife Sunkesha refused to get service from the birthing center citing lack of space, warmth, drinking water and other facilities. Lokendra had to take her to Khalanga hospital which cost a lot of money.
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“What is the use of having birthing center that’s only for the sake of name? Since no facilities are provided there, women do not like to go there. It does not even provide basic facility. There is no safety of mother and child,” Lokendra said.
Lokendra admitted his wife to Karnali Health Institution Hospital. Due to complications, the mother and child had to stay in the hospital for nearly a month after delivery of the child. The family had to incur a substantial loss of wealth during their long stay in the market area.
“Though the hospital charges were not that high, the entire expenses turned out to be very costly. I had to pay a lot for staying in hotel for so many days,” he said.
Chhaya Sarki of Jumla was also thinking to deliver her baby in a birthing center. She was told by health workers that she would have very safe delivery there. However, when she saw the center for herself during her regular check up, her heart sank. She decided never to give birth to baby in such an unhygienic place.
“It was worse than our home. At home, you get warm water if needed. They lit fire to keep the baby warm. We do get help from midwife. But in birthing center, none of these facilities are available,” said Sarki, who is expecting baby in April. “I would rather go to a hospital. Or better to deliver at home,” she added.
There are a total of 18 birthing centers in the district. As per the record of the District Health Office (DHO), 1000 to 1500 women get pregnant in Jumla every year. Only 40 percent among them generally receive maternal health services. Though there are several programs run by the government in the name of safe motherhood, locals state that the promises are limited just in words and the pathetic conditions of the birthing centers is a testimony to this.
Meanwhile, Baidhyanath Jha, chief of the DHO, admits that birthing centers have not been able to deliver proper services.
“Regular check up, ultrasound, blood and other tests are essential for a pregnant woman. Due to the lack of infrastructures and equipment, women might not have received good service. But I don’t think there is scarcity of medicines and other necessary materials,” he said. “Remoteness and lack of transportation facilities have indeed caused fatalities in many cases,” he added.
Meanwhile, a local Dhan Bahadur Malla stated that lack of ambulance service is the biggest factor behind the death of pregnant women, which is not so uncommon in the region.
“Let alone getting ambulances on time, we do not even get stretcher. Even if the stretcher is somehow available, who is going to carry it? There are no youths in the village, there are no service providers,” he said.
Carrying pregnant woman and other patients in bamboo basket is still a common practice in the villages of Jumla. According to Malla, a lot of patients succumb to their illnesses before reaching hospitals.
