When Nirmala Shrestha, an expecting mother, was taken to Bhojpur district hospital some two weeks ago, doctors told her that she would have a normal delivery. After waiting for more than 10 hours in labour pain, doctors told Nirmala’s in-laws that she would have to undergo a surgery. Since the hospital did not have an anaesthetist, Shrestha’s in-laws were told to rush her to Biratnagar.
“But before we could take her to Biratnagar, her labour pain intensified, and we took her to BP Koirala Institute of Health Sciences in Dharan. It took us eight hours to reach there,” Nabin Pradhan, husband of the 25-year-old woman, told the Post over the phone.
Shrestha gave birth to a baby boy through caesarian delivery at Dharan hospital. But doctors referred the couple’s newborn baby to Kanti Children’s Hospital in Kathmandu. After a weeklong treatment in Kathmandu, the couple returned home to Bhojpur.
According to Pradhan, he spent around Rs200,000.
“Had the C-section delivery been available at Bhojpur hospital, we would not have to spend so much of money and face such hassles,” said Pradhan.
Like in Bhojpur, over 30 government hospitals, including several district hospitals, over the country have halted cesarean deliveries since the beginning of this fiscal year, according to the Family Welfare Division under the Department of Health Services.
Officials at the Division blamed the civil servant adjustment process, which has transferred many doctors to provincial and central-level hospitals, for the halt in C-section delivery services in several hospitals.
"All gynaecologists and anaesthetists serving at district hospitals have been transferred to provinces and to the central-level hospitals," an official serving at the division told the Post on condition of anonymity.
According to the division, C-section delivery service has been hated in Gokuleshwor Hospital of Darchula; Kolti Hospital and Martadi Hospital of Bajura; Rangeli Hospital of Morang; Sarlahi District Hospital; Udayapur District Hospital; Dhankuta District Hospital and Tikapur District Hospital among others.
Lack of C-section deliveries at hospitals has put the lives of many expecting new mothers at risk, officials say. This also forces women and their families to seek services in big cities, which add to their costs.
Dr Guna Raj Awasthi, provincial health director of Sudurpaschim Province, said none of the district hospitals in the province is providing cesarean delivery service since the beginning of the new fiscal year.
"Out of the nine districts in our province, none of the district hospitals is providing C-section delivery service," said Dr Awasthi. "We are even struggling to continue the service at Seti and Mahakali Zonal Hospitals."
According to the Social Development Ministry of Karnali Province, Jajarkot District Hospital and Melkuna Hospital of Surkhet do not have even a single doctor to provide services to patients.
"We have sought help from the Ministry of Health and Population and opened a vacancy notice to hire doctors," Brish Bahadur Shahi, a senior public health administrator serving at the ministry, told the Post over the Phone. "There has been no response from the Health Ministry. Nor has anyone applied so far.”
Mahendra Prasad Shrestha, the spokesperson for the Ministry of Health and Population, said that C-section delivery services have been halted in dozens of hospitals across the country.
"Every day dozens of mayors from across the country call me, asking to send doctors," said Shrestha. "We have drawn the attention of the Prime Minister’s Office and the Council of Ministers and the Ministry of Federal Affairs and General Administration to the situation."
Dr Bhim Singh Tinkary, director at the Family Welfare Division, said that halting cesarean delivery for a long time would also affect the country’s commitment to reduce maternal and child mortality rate.
Nepal has committed to limiting maternal mortality rate to 125 per 100,000 births by 2020 and 75 for every 100,000 births by 2030 to achieve the United Nations’ Sustainable Development Goals.
The division’s recent data shows that for every 100,000 births, 229 women die during or after childbirth.
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Arjun Poudel is a health reporter for The Kathmandu Post. Before joining the Post, he worked for Sagarmatha Television, Naya Patrika, Republica and The Himalayan Times.
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