Scary Emergency Situations: Getting to a Hospital on Time
Holidays always mean lots of traveling to visit friends and family. Most of the time everything goes well and nobody gets hurt. But sometimes it does. You could develop a mysterious rash after eating a seemingly delicious shrimp. Or, God forbid, end up in an accident. All of us have our own scary holiday stories. Luckily, we are usually in a place where we can easily access high quality healthcare, nearby.
Not everyone is so lucky. Wangmo Thapa is a skilled birth attendant in the Dolpa region, high up in the Nepali mountains. There are no paved roads; it is very basic, isolated and cold up there. When I say basic, it means the following. There is no functioning cell phone or Wifi network anywhere. Once you’re out there in an emergency, there is no way to communicate; with family or friends in Kathmandu, or elsewhere. Your only option would be a very expensive satellite phone. Electricity is unreliable, and there is not even constant running water. All supplies, medical and otherwise, have to be flown in by plane, making everything impossibly expensive.
Our medical partner organizations in Nepal tell us this an ¨Oh God no¨ region; meaning that nobody wants to work out there. Most doctors or birth attendants hate working in an area this remote, cold, isolated and stripped of all modern luxury. The only one who is very committed to working in Dolpa is Wangmo. She was born and raised here. This is her home; these are her people, her family. ¨ I feel grateful when I perform maternal and child health checkups because I can help the mothers to learn more about their health status, to advise them and treat them to the best of my ability¨ she explained to me.
Wangmo walks everywhere to reach her patients; crossing mountain passes over 16,404 feet high (5000 meters) with no more than a backpack. There are no roads or trails. The only choices of transport available are either to rent a yak or a porter to carry your bag. It’s a rough life out there. With the increasing cold in the winter season, it gets harder every day for Wangmo to get around.
No Evacuation Possible
She recently treated Tsering, a 24 year old young pregnant woman from Do Tharap, a tiny isolated village high up in the Dolma mountains. With the start of her labor pain, Tsering experienced heavy eclamptic fits. Wangmo realized that she was suffering from eclampsia; seizures (convulsions) in a pregnant woman, a serious threat. Her seizures were recurrent so she closely monitored her vitals and administered a Diazepam injection to control the seizures. Unfortunately the appropriate medicine, Magnesium Sulphate, was not available locally. As the situation was getting dangerous for the mother and fetus, she referred Tsering to Nepalgunj, a town in Southern Nepal, for further treatment. At this point the ultrasound showed that the fetus was still alive.
Unfortunately, this year the weather conditions in Do Tharap have been much worse than in other years. The severe snow, wind and rainstorms, plus the fact that the village is located high up in the mountains, make it impossible for planes to land. The lack of transport to this region leads to a shortage in emergency drugs (like Magnesium Sulphate) and makes it impossible to evacuate mothers with complications in time.
For 3 days, Wangmo fought to keep Tsering and her baby alive, so that she could be evacuated. By the time Tsering finally arrived in the Nepalgunj district hospital, it was too late to save the fetus.¨I was so sad that the fetus didn't survive as I could have saved it with the appropriate drugs available. On the other hand, I am happy I was able to save the mother's life. Now I am lobbying and working hard to improve the availability of emergency drugs in the local district hospitals.¨ Wangmo reported.
I talked to Wangmo recently, just before Christmas. It just made me think how incredibly lucky I am to live in a country where I can easily find a clinic when I need to.
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