A Difficult Situation in a Remote Village
In the remote village of Bayal in Bajura, a woman was forced to give birth on the roadside just a year ago. Around one o'clock in the middle of the night, there was a commotion at the home of health worker Vinita Bisht Katuwal. Someone had arrived, urgently asking her to open the door. They explained that a pregnant woman on her way to the health post had gone into labor on the road. Hearing this news, Vinita immediately grabbed her delivery kit and ran into the darkness to reach the woman.
A Critical Emergency
When Vinita arrived, the woman had already delivered the baby, but the placenta had not come out. This condition is extremely dangerous and life-threatening for the mother. Vinita quickly administered a necessary injection. She waited for an hour for the placenta to be delivered, but her efforts were unsuccessful. Vinita remembers that night with fear, saying her whole body was drenched in sweat from the terror and worry for the lives of both the mother and child. Deciding not to waste any more time, she made the difficult decision to take the new mother to the basic health centre's birthing center.
A Race Against Time
Even at the birthing center, another hour of relentless effort failed to deliver the placenta. As a last resort, Vinita decided to refer the woman to the Bayalpata hospital in Achham. Finding transportation in the remote village in the middle of the night was nearly impossible. After calling for a vehicle, Vinita, with the help of a sanitation worker, carried the mother and her newborn on a stretcher to the nearest road where the vehicle could reach. Her courage that night saved the lives of both the mother and the child.
A Recurring Challenge
This was not a new experience for Vinita. Four years earlier, she had also faced a similar situation where she had to assist a delivery on the road. Back then, she was not even a staff member at the birthing center, which had no staff on duty that day. A relative of the pregnant woman came to her home, pleading for help because there was no one else. Vinita successfully assisted with a normal delivery, which made her happy.
A Dedicated Health Worker
The twenty-eight-year-old Vinita is a brave health worker from Bajura. For the past three and a half years, she has been working at the Simalkot Basic Health Center in Budhiganga Municipality. For her, assisting deliveries on the road is not a new occurrence. During her career, she has successfully assisted four such roadside deliveries. Each incident tests her professional duty and human compassion.
Service Above Self
Just recently, she helped a woman named Sirjana KC give birth on the road under difficult circumstances. Vinita had just returned from India after sinus surgery, and a cannula was still attached to her hand. Despite needing rest, she rushed to help another mother, believing she had no other choice. She could not bear the thought of what might happen if she did not go.
Overcoming Obstacles to Serve
Since her childhood, Vinita dreamed of becoming a health worker to serve her village. Even after getting married at the young age of seventeen, she did not give up on her dream. She left her village to study ANM nursing in Kathmandu. Now, her husband works in India, and she single-handedly manages her two young sons, farming, and all household responsibilities while remaining dedicated to her health work.
The Deep-Rooted Challenges
According to Vinita, remote areas face many challenges. The first is the difficult geography and lack of transportation. People are often forced to walk for hours up and down hills to reach a health facility. The second major challenge is a lack of public awareness. She explains that most locals still hold the old belief of going to a health institution only at the final moment, which increases the risk of roadside deliveries. A wrong belief that sharing news of a pregnancy early brings bad luck also creates problems.
Inadequate Infrastructure and Staffing
The most serious challenge, she says, is the lack of adequate infrastructure and staff. The building of the health post where she works is extremely small and dilapidated. She describes it as being like a small, cold shed, which makes patients more vulnerable to illness, and there is no proper space to work. Recently, after the municipality removed all its contract staff, she has been working alone, fulfilling roles from office helper to health worker. If she has to go for training, the health post must be closed down.
A Call for Support
Despite these severe conditions, she feels sad that the concerned authorities have not shown any interest. She is also a contract worker, and her salary is arranged under the Safe Motherhood Program. She works alone for a monthly salary of twenty thousand rupees. To date, Vinita has successfully assisted over one hundred and fifty deliveries. She stresses that immediate steps are needed to improve the physical infrastructure, arrange for adequate staff and equipment, and spread public awareness in the local area. She believes that if basic needs were met, health workers would not have to serve under such challenging conditions, and pregnant women would not be destined to give birth on cold, dark roads.
The Municipality's Response
The Mayor of Budhiganga Municipality, Rambahadur Baniya, says the municipality is trying to improve health services. Work is underway to provide basic health services in every ward and establish urban health centers in remote places. However, he admits that progress has not been as expected due to the difficult geography and a lack of resources. He expressed dissatisfaction, stating that a lack of necessary support from the federal and provincial governments, along with delays in staff adjustment and budget allocation, has negatively affected health services.