By Ashma Shrestha Basnet
HUMLA, Nepal, 25 May 2010 - Humla district, in Nepal's mountainous north-west, is one of the most remote places on the planet. This is a land whose severity makes it beautiful, but also difficult for the people who live here. They face limited access to food, education and health facilities, and frequently suffer hardships as a result.
But life is slowly improving for one of the most at-risk groups in Humla: pregnant women and new mothers. Thanks to a UNICEF-supported maternal health programme, women giving birth in Humla's remote villages - who were once stranded without access to essential medical care - now have new options and facer fewer risks.
Making birth safer
Simikot, the largest city in Humla, can be reached only on foot or by small plane. Situated about a five-hour walk from Simikot is Thehe village, accessible only via a narrow foot trail atop the steep hills. Life in the village is challenging. Hunger, malnutrition and poor sanitation are daily problems here.
Despite significant risks, women in Thehe have been delivering children at home for generations. Today, more and more pregnant women are delivering in a modern birthing centre established by UNICEF in the village last year.
Kali Bohara, 21, is one among the many women in Thehe who delivered her first baby at home. "I was assisted by my mother-in-law and other female members of the family," she recalled. "The labour pain I went through was intense and went on for two days."
A ray of hope
To deliver her second child, however, Ms. Bohara went to the new health centre. The delivery was assisted by a skilled birth attendant and a female community health volunteer - both trained to make delivery safer and to offer ante- and post-natal care.
"I was rushed to the health centre soon after the labour pains started, and I was well looked-after," said Ms. Bohara. "It is much cleaner and easier to deliver a baby at the birthing centre."
Delivering at home is deeply rooted in the country's culture and tradition. Only about 19 percent of births in Nepal are attended by skilled birth attendants. And recent studies show that in Humla district, the number of assisted births is less than half of the national average, with fewer than 9 per cent of women delivering with a skilled attendant.
To break the pattern of unsafe deliveries, UNICEF has supported the establishment of 12 birthing centres in Humla and provided training to seven skilled birth attendants. In addition, 'birth preparedness' training has also been provided to all community mobilizers, female health volunteers and village facilitators in the district, to help them create awareness in the community on critical maternal and newborn health issues.
Successful deliveries
Since the birthing centre was established, all deliveries in Thehe village have taken place there, said Sabita Buda, a skilled birth attendant. So far, there have been more than 40 deliveries at the centre.
The Government of Nepal is also assisting the effort by providing funds to cover the transportation costs of new mothers as they return home to remote regions, having delivered their babies safely at a birthing centre.
"We provide a 24-hour service," said Ms. Buda, referring to the centre in Thehe. "We have all the basic facilities available here and are able to treat many of the complications that may arise during delivery."