Current Issue
Spring 2014
BMM Current Issue
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FIELD NOTES
 
Uphill Battle
Health and human rights in western Nepal.
Doctor-Sahab, aunus, aunus (Doctor, come, come)!” The nurse aide has a panicked look on her face as she stands in the door to my office. Running to the delivery room, I learn that a woman has arrived from Bajura, an even more remote Nepali district to the north of the extremely remote Achham district where we work. She is screaming in pain and too weak to stand, having already lost a lot of blood.

In the delivery room, I quickly see that there is nothing to be done. Our medical director and one of our senior nurse midwives are already there, but they are not in a hurry anymore. We look in despair at the fetus on the table, dead for what must have been hours. The mother, anemic from days of blood loss and hysterical at the loss of her child, will nonetheless survive.

It had been three days since her labor had begun, and almost that long since she had last felt fetal movements. It had taken her that long just to reach the hospital. She herself was fortunate to be alive, and moreover, that we were able to transfer her to an obstetrician for postpartum care in our ambulance, merely a 6-hour drive on dangerous mountain roads … but at least she had made it that far. Here in western Nepal—with less than 1 doctor per 100,000 people— that alone is an accomplishment.
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