In Western female society, we’re used to hearing the crazy, terrifying and sometimes humorous birthing stories of our friends – days of labour, emergency C-sections, husbands pulling out smelly food in the delivery suite – kebab anyone?! But even in the midst of the most difficult births there is the presence of highly qualified staff to take over, provide reassurance, pain relief and medical help.
In rural Nepal, this highly medicalised birthing is rarely an option. Birthing centres may be several days’ trek away on poorly maintained trails, staff may lack training, confidence and equipment and the basic hygiene levels are often low. In addition, there are social barriers to institutional deliveries due to long running traditions of home birth and traditional healers. As I accompanied the CARE team to the Far West I got an insight into these challenges for myself and how the GSK-CARE initiative is working together with the local NGO, community, health workers and government to address these.
I met with a spectrum of people from the villagers through to the health workers and district health authorities, who helped me to build a picture of the challenges they face. The responses to the project have been positive and from what I can see the approach of collaborative working through accountability tools and interface meetings seems to have given both sides a voice and space to raise issues and find solutions. Nepal has many challenges and progress is often slow and frustrating but I came back from the Far West with a belief that working closely with the community is helping to drive change. And for myself, a better perspective on the importance of patience and the age-old art of active listening.