She got a new life – Case Study.

Lately I have been doing some translation of case studies for the UN. The best part of this is that you get to know so many untold stories out there that have changed the people’s life in so many ways. This one particularly, I could not help but share here. As told by one of the staff nurse of a hospital in a remote village in Nepal shares her story about a woman who went through one of the most painful moments in her life. While even translating, I couldn’t even imagine the amount of pain she must be going through during the time.

I have changed the names and places for their privacy and my own ethics.

She got a new life.

25 years old, Mrs. Ramkumari Shrestha was pregnant for the 3rd time yet she had never gone for her regular pregnancy tests at the health post which was about 5 minutes away from her house. And this happened one rainy day on 2066, Asad 2, when she suddenly started suffering from labor pain. This was not the normal labor pain she had experienced in the past and as her family had thought. Instead there was a major complication. What had happened was that the hands of the baby had come out first instead of the head. And yet no one was able to take the baby out even after couple of hours trying. They called the traditional birth attendant but even she could not help the baby and the mother. After several unsuccessful attempts they had to call for a nurse from the nearby health post. Even the nurse could do nothing and advised the family to take the mother to a hospital straight away. It was raining heavily outside and there were no neighbors around to help them and another day passed with any improvement in the situation of the mother. After 2 days of unsuccessful attempts, they are able to take her to the hospital.

She was taken to the district hospital. Due to the absence of doctors in the hospital, me along with the help of other staffs tried three times to remove the baby but couldn’t. It was raining for the past 15 days and the only form of transportation which is the airlines were not being able to operate and it looked like the weather condition would worsen for another week. In such situation, after consultation and agreement from the family, me and my friends at the hospital were ready and desperate to help the mother anyhow.

My biggest challenge and responsibility was to save the life of the mother since the baby had already died. The mother had already gone into septic shock so I opened the I.V. line and started RL. I also started giving Injection Gentamicin 80 mg ivbd, Injection ampicillin 2mg iv qid, Injection metro 500 mg iv tds and Injection diclofenec 75 mgs tds. I put the Foleys catheter and inspected the vital parameters and urine output.

After giving the initial dose of these medicines, we moved forward with removing the baby from the mother. After episiotomy, with the help of episiotomy scissors, we had to first cut the hand of the baby. We continued to remove other parts of the baby’s body in pieces. The head was big and it was difficult to remove it so we did it with the help of the sponge holder. We then removed the placenta manually by active management of third stage of labour which was taught to us in SBA training after which I gave the previous medicines again and monitored her.

I had inject her the medicine for 7 days and after which I could notice the visible improvements in her health conditions. She was able to walk around and I felt proud of my profession seeing this. After 7 days, giving her tablet metronidazole, capsule ampicillin, tab diclofenac, tab iron and tablet calcium, I discharged her.  Her health conditions had improved a lot when she came for her follow up 7 days later and it gave me immense sense of happiness and satisfaction seeing her so healthy.

What this incident taught me is that with practical use of general knowledge and skill, in such moments of confusion and disorder; we can save the invaluable lives of people. Plus, the healthcare workers in the rural need a lot of SBA training.

Anita K.C.

District Hospital.

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