Chandra, a female community health volunteer in Nepal, is one of 50,000 working in remote areas of the country. They focus on areas where there is limited access to health services and a shortage of doctors, auxiliary nurses, and midwives.
These volunteers play a crucial role in Plan International’s goal of providing health and nutritional support to women and children.
“My role is to support pregnant women, ensuring they have frequent check-ups and are able to have a safe delivery,” she said.
The twin earthquakes that devastated the country this year severely impacted the health system in Nepal, with 50-70 percent of the health facilities in most districts either destroyed or damaged beyond repair.
“When women and children do not have adequate access to a local hospital or health posts, there is an increased risk of maternal and neo-natal mortality,” said KK Singh, Plan’s Maternal, Newborn, and Child Health in Emergencies Specialist. “Due to the earthquake and the monsoons, pregnant women cannot access health facilities. Women often have to travel three hours by foot just to reach the health facility.”
Working in several affected districts in Nepal, Plan is distributing clean delivery kits and newborn baby kits to female community health volunteers and training the volunteers on the importance and use of these kits, so that they can provide support before, during, and after delivery.
The Risk of Emergency Deliveries Post-Earthquake
“I was in my village when I helped a 22-year-old young woman give birth,” said Chandra. “She was just beginning her three-hour walk to the local health post when she started feeling labor pain. Her husband contacted me to say they needed help. When I arrived, I saw both the mother and baby laying on the ground.”
“We immediately tore the mother’s sari and used it to clean the mother and baby. I brought them back to my home. I used the clean delivery kit and newborn baby kit provided by Plan, which allowed me to safely cut the baby’s umbilical cord and show the mother how to begin breastfeeding,” explained Chandra.
Maternal Mortality: A Dire Reality
“Delivery and childbirth has become a very risky scenario for women and children living in earthquake-affected areas,” said Singh. “Without access to health centers to facilitate adequate deliveries, mothers are dying as a result of haemorrhaging and infection. Already, maternal mortality and neo-natal mortality is high in Nepal, particularly compared to the rest of the Asia region.”
Despite progress made since 2001 to reduce maternal mortality by 47 percent in Nepal, access to maternal and newborn care was a challenge even prior to this year’s earthquakes. With just one centralized health facility based in each village development committee, access to health services was already a challenging feat.
“Government may encourage women to visit the centralized health facilities for their services and check-ups,” Singh said. “However, we recognize the struggle and challenge that the commute and travel may bring, so instead we focus on providing those services directly to the women. In our earthquake-response districts, Plan aims to reach every pregnant woman and newborn baby in their own home.”
Supporting Temporary Health Posts
Many of the remaining health posts that withstood the impact of the earthquakes are damaged and lack adequate water and sanitation facilities. As the health posts are running under temporary shelter, they also lack privacy and space.
“We are not able to run the birthing centers in the way we would like,” said one community health volunteer. “Access to clean water is limited, so the chances of water contamination is high. We struggle to wash the babies and mothers with clean, purified water.”
To lower the risk of infection and water-borne diseases amongst women and children, Plan is providing water, sanitation, and hygiene facilities in the temporary health posts through the provision of water tanks and temporary toilet facilities.