My name is Putali Gurung from ward number 7 of remote Uhiya VDC. I am 23 years old. I am not well educated about basic health services provided by our government. This is was my first pregnancy and I was very fearful as to whether I would be able to deliver a baby or not. However, I was also eager and happy to give birth!

One fine day during Falgun [the eleventh month in the Nepali calendar, marking the arrival of spring], I felt a pain inside me and thought it might be labour pains. I was scared and felt too shy to tell anyone in my home—although some of my female neighbours noticed and asked me about it. Finally, I told my family about the pain and they quickly agreed that I was having labour pains! My family started preparing for my delivery. Time passed slowly and I was suffering a lot. All my female neighbours tried to help me have a normal delivery, but it wasn’t possible. A whole day went by without any progress. The next day, the same thing happened. Everybody encouraged me but I couldn’t do it. My husband arranged for some shamans to visit and they sacrificed some cockerels. Yet, I was still suffering from a lot of pain. I tried hard to push but nothing happened.

On the third morning, a girl came to my home with a neighbor and introduced herself. She said that she was Indira, from an organization called PHASE Nepal. She is an Auxillary Nurse Midwife (ANM) and does a lot of work educating women about maternal health. There weren’t any government health staff at the sub-health post so she called the office assistant from the sub-health post and asked him to bring some equipment. After she got the equipment, she began the check up and said that everything seemed normal. However, since it was my third day in labour, she said that there may be complications and that I should go to the Machhaakhola birthing centre. But, my husband and the neighborhoods didn’t listen to her and just brought a shaman to the house to sacrifice a cockerel.

They started to press my stomach here and there, everywhere. Indira, the ANM, advised everyone not to press on my stomach since it hurt me and could injure the baby. She strongly advised all the villagers that I should go to Machhakhola where there were trained ANMs and Health Assistants who could help with my delivery. She stressed that it was important for my safety and that of my child. She also talked us through a lot of health related information and spoke about the importance of antenatal care (ANC) checkups and various medicines for mothers and children. It was the first time that I had heard about ANC checkups for pregnant women. I learnt that if I had had a check up during pregnancy I could have understood more about my health and that of my baby.

As Indira was talking, I remembered that, two years ago, there was a women in a similar situation to me in this village. She had complications during childbirth and, sadly, she died. So I felt that it was a good idea for me to go to Machhakhola. Later, after about two hours, Indira finally convinced my husband and he agreed to take me to Machhakhola with some other villagers. The journey to Machhakhola was not easy as the hills were steep and dangerous. However, they managed to carry me all the way on a stretcher. Unfortunately, in Machhakhola, there weren’t any ANMs and we just met a Health Assistant from the birthing centre and some other PHASE Nepal staff. They stayed with me overnight and I tried to give birth but still nothing happened. My pain was increasing a lot and I felt like I was dying.

In Machhakhola, since nothing was happening and my situation was extremely complex, they called Gorkha hospital and arranged to take me to Gorkha. A member of staff from PHASE Nepal, Hem Maya Sunuwar, arranged the entire travel plan and we rushed to Gorkha Hospital. I was in a lot of pain, yet the PHASE staff gave me a strong sense of hope. On the way to Gorkha, I kept trying but nothing happened. In the evening of fourth day, and once at the district hospital in Gorkha, I finally gave birth.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        PHASE delivers quality primary care in 13 heath posts across Humla, Bujura, Kavre, Sindhulpalchok and Gorkha regions of Nepal.  The areas we work have limited access to existing health services previously. We support additional health staff, management, medicines and equipment.  PHASE Auxiliary Nurse Midwives support health education around things like nutrition and sanitation; family planning; maternal and child health; run preventative health programmes like childhood vaccinations; respond to health-related emergencies and act as rural GP’s - treating all common health problems from typhoid fever to broken bones. 

Case Studies: how PHASE helped 

Dolma Lama, Kanchimaya Lama, Pasang Lama 

or Sukmaya Gurung during their pregnancy