Fears grow for preg­nant Nepalese af­ter quake


As la­bor pains gripped Junu Shrestha around mid­night one day in early July, the heav­ily preg­nant vil­lager set off on foot along a muddy path de­stroyed in Nepal’s earth­quake, des­per­ate for help.

She stum­bled in the dark for two hours be­fore reach­ing a hand­ful of med­i­cal tents erected af­ter the 7.8-mag­ni­tude quake on April 25 flat­tened her lo­cal clinic.

“It was dark and scary. I didn’t know what would hap­pen,” the 21-year-old said of fi­nally reach­ing the tents with her mother-in-law in time to give birth.

“I had to keep stop­ping be­cause of the pain.”

Some 70 per­cent of pre-natal clin­ics that had been pro­vid­ing cru­cial ser­vices to preg­nant women were se­verely dam­aged in the Nepalese dis­tricts hard­est hit by the quake.

Nearly 8,900 peo­ple died and some 600,000 homes were re­duced to rub­ble in the dis­as­ter across the im­pov­er­ished Hi­malayan na­tion.

Now with mon­soon rains slow­ing re­build­ing and re­lief ef­forts, fears are mount­ing of a re­verse in the coun­try’s re­cent progress in re­duc­ing ma­ter­nal and neona­tal deaths.

More than 30,000 women have given birth in the worst-hit dis­tricts since the dis­as­ter.

But many like Shrestha, liv­ing in re­mote hilly vil­lages, have been forced to brave quake-dam­aged trails that face the risk of land­slides from af­ter­shocks and rains in or­der to reach med­i­cal help.

Many ba­bies have been still­born while pre­ma­ture de­liv­er­ies tripled in the worst-hit dis­tricts, ac­cord­ing to health ex­perts, who say the shock and trauma trig­gered by the dis­as­ter led to a surge in med­i­cal com­pli­ca­tions ex­pe­ri­enced by preg­nant women.

“In nor­mal cir­cum­stances we ex­pect that about 5 per­cent of preg­nan­cies would turn out to be pre­ma­ture de­liv­er­ies but af­ter the earth­quake we saw it was about 15 per­cent,” said Asha Pun, ma­ter­nal and new­born

health spe­cial­ist at UNICEF.

‘Quake took my home’

Shrestha con­sid­ers her­self lucky to be alive af­ter she was hit by fall­ing fur­ni­ture when the quake struck. Her fam­ily pulled her from the rub­ble of their home in Gerkhu vil­lage in Nuwakot dis­trict, around 30 kilo­me­ters ( 17 miles) north of Kathmandu.

But they could not save her 14-year-old sis­ter-in-law.

“The earth­quake took my home, it left me with in­juries and it killed my lit­tle sis­ter-in-law,” Shrestha said, burst­ing into tears.

Only five out of 21 birthing cen­ters were left stand­ing in Shrestha’s dis­trict, while many vil­lages were cut off.

“Ev­ery­thing is a chal­lenge, from get­ting to the vil­lages to equip­ping the birthing tents to en­sur­ing sup­port to our over­stretched staff who are work­ing 24/7 de­spite hav­ing suf­fered so much them­selves,” the dis­trict’s public health nurse, Sanu Maiya Rana, told AFP.

Aid agen­cies like UNICEF mo­bi­lized quickly to or­ga­nize de­liv­ery of wa­ter­proof tents and es­sen­tial sup­plies in­clud­ing an­tibi­otics, gloves and sur­gi­cal in­stru­ments.

But health work­ers still fear the dis­as­ter will wipe out years of hard work in­vested in im­prov­ing ac­cess to health care.

Nepal has been cred­ited with slash­ing its ma­ter­nal mor­tal­ity rate — by a stag­ger­ing 55 per­cent be­tween 2000 and 2013, from 430 deaths per 100,000 live births to 190 deaths. And the birthing cen­ters are a life­line for ru­ral fam­i­lies across the coun­try.

“It has taken us so long to make ma­ter­nal health a pri­or­ity and now, with the birthing cen­ters gone ... and the rains here, I am very wor­ried,” Rana told AFP.

“If the rains dam­age the roads even fur­ther, then how will women come to see us and who will en­sure that they get med­i­cal care?”

Rea­son to Hope

In Nuwakot, vil­lagers are still liv­ing un­der tar­pau­lins and sim­ple me­tal struc­tures on hill­sides four months af­ter los­ing their homes in the dis­as­ter.

With just days to go be­fore her due date, house­wife Sita Pyakurel is fear­ful of de­liv­er­ing in the re­cently erected med­i­cal tents in­stead of a clinic.

“The tent feels too flimsy to of­fer pro­tec­tion against the wind and the rain ... we al­ready have wa­ter drip­ping from the roof of our shel­ter,” the 29-year-old mother of two said.

“Now frogs have started to show up at night, and if frogs are here, then snakes can’t be far be­hind.”


In this pho­to­graph taken on July 15, Nepalese vil­lager Junu Shrestha, third left, walks with oth­ers as she ar­rives at a makeshift birthing cen­ter in the vil­lage of Gerkhu in Nuwakot, north of Kathmandu.

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