No Hospital in Sight

Terhathum, Nepal

It’s 8:45am in the Puldung village of Terhathum, a hilly region in eastern Nepal best known for its wealth of rhododendrons, Nepal’s national flower. The high altitudes and sparse population make it an ideal habitat for the rhododendron, but also make it nearly impossible for people to traverse. Manmaya has lived in Puldung her entire life and spends each morning chopping wood to fuel the fire she uses to heat her home and cook breakfast for her family. Manmaya cares for a crowded household consisting of her husband, in-laws and three children from her husband’s previous marriage. Only four months earlier, a pregnancy complication nearly took Manmaya’s life and that of child.

From the local village where Manmaya lives, the nearest hospital is an eight-hour drive over rock-strewn and mud-slicked roads that switchback through the region’s vast valleys. Since most people who live in the village do not own cars, taking the reliably unreliable public bus — whose rear seating section is dedicated to livestock — is the only option for navigating the treacherous journey.

On the verge of her due date, Manmaya wasn’t able to sleep. Several times throughout the night she awoke with a parched throat and painful sensations around her abdomen. After a night of pain and anxiety-induced insomnia, she asked her husband to take her to the nearest birthing center. Since there was no hospital within a day’s journey, they chose to go to the Poklabong Birthing Center, which One Heart Worldwide (OHW) had recently renovated, supplied, equipped, and staffed with government-certified skilled birth attendants (SBAs).

When Manmaya arrived at the birthing center she was met by Sindhu, one of the certified SBAs sponsored by OHW. Sindhu was shocked by Manmaya’s condition; she was weak, pale and the leg of her baby had already breeched the womb. Fearing she would need a cesarean section, Sindhu rushed Manmaya into the delivery room. She knew that under the present time and travel constraints, the procedure would not be possible. A conventional vaginal delivery would be their only option.

Sindhu quickly performed an ultrasound to confirm Manmaya’s baby was full-term and without signs of distress. She took both of their vitals and estimated it would take nearly an hour to manually maneuver the baby out of the birth canal. Throughout the painstaking procedure, Sindhu constantly monitored the baby’s heartbeat and ensured the umbilical cord did not come out before the baby, a potentially fatal condition known as cord prolapse.

The procedure wore on for nearly two hours. Finally, the deafening silence was broken by the sound of cries from a healthy baby girl. Sindhu breathed a sigh of relief and handed the newborn to her mother. Manmaya broke into tears as she held her child for the first time.

Sindhu credits OHW for providing her the necessary training and equipment to perform the procedure.

“Had I not completed the SBA certification course, I am not sure I would have been able to handle the case successfully. We had all of the equipment at our disposal [thanks to OHW] and will be able to save many more lives in the years to come.”

One Heart Worldwide works to provide all women like Manmaya, who live in the most rural, remote parts of the world, with access to quality maternal and neonatal healthcare services. To ensure geography does not prevent mothers from having a safe birth, OHW helps train health workers like Sindhu and build birthing centers in remote areas without access to hospitals, like in Poklabang.

Since we began our work in Nepal, OHW has reached over 100,000 pregnancies and this year alone plans to reach an additional 45,000 pregnancies.

Originally published at on July 23, 2018.

One Heart Worldwide

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We work to reduce maternal & neonatal mortality by at least 50% in the most remote, rural areas of the 🌍 with the #NetworkOfSafety.

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