C-section Success in Far Western Nepal

19-year old Moti Kala was diagnosed with placenta previa during her fourth antenatal check up at Bayalpata Hospital. The hospital, in Achham, Far Western Nepal, is run by Nyaya Health in partnership with the Nepal Ministry of Health and Population, serving a population of 250,000 people. Until recently, this diagnosis would have meant the Nyaya Health team would refer Moti Kala to a different facility hours away, because of a lack of surgical capacity. But thanks to some exciting progress, Bayalpata Hospital was able to open the doors of its surgical unit to Moti Kala after she spent hours making the trek from her home to our hospital on foot, and successfully performing its first ever c-section delivery.

Credit: Nyaya Health
Credit: Nyaya Health

Moti Kala is only one of the many women in Achham who do not have access to the myriad of prenatal, neonatal, and maternal health care services readily available in the US. The infant mortality rate in Achham has always been very high due to this shortage, ranking within the 6th highest maternal mortality ratios globally. Since the reopening of Bayalpata Hospital in 2008, it had been one of our goals to lift the dismal maternal and infant mortality rates in the region. By providing dignified and quality maternal care to pregnant women and new mothers we also strive to improve the maternal mortality rate. To accomplish this, we have put into action a variety of programs and partnerships.

Credit: Nyaya Health
Credit: Nyaya Health

Our efforts to improve the overall quality of healthcare services available to both expecting and new mothers and their children have culminated in the successful c-section delivery of Moti Kala’s newborn baby boy. Our Chief Executive Officer, Mark Arnoldy, was appropriately optimistic about this accomplishment as he said, “This may seem like a somewhat minor benchmark in the grand scheme of our history and growth, but it has been years in the making and represents a significant shift forward in our collective ability to imagine a higher degree of care than has ever before existed on-site.” Since July 2013, the Nyaya Health team at Bayalpata Hospital has successfully delivered four babies via c-section, re imagining what is possible for rural communities globally.

First C-Section at Nyaya Health!
First C-Section at Nyaya Health!

Read more about Nyaya Health.

Justice for Women: An Introduction to Nyaya Health

Nyaya Health

This post is by Shrima Pandey, Digital Marketing; Asmita Gauchan, Digital Marketing; Sarah Rasmussen, Development Assistant

In 2006, filmmaker Roshani Andrews and her husband, Jason Andrews, traveled to Achham, Nepal hoping to document the effects of the HIV crisis. But what they witnessed there was more than just an epidemic; it was a total lack of a healthcare system — a devastating reality that the people of Achham faced daily. In the wake of a ten-year civil war, little infrastructure remained, which further isolated this community from the rest of the country. Jason and Roshani travelled over fifteen hours from the capital city of Kathmandu to this far-western district of Achham, where there are few opportunities beyond a life of hard labor in the fields.

Achhami women are left with the burden of both working in the fields and providing for their families when their husbands migrate to India in masses seeking employment. With their families’ livelihoods depending on them, women are left with little time and resources to care for themselves.

These women, and 260,000 other Achhami people were living without access to a single doctor. Jason was immediately struck by the gravity of their plight. He emailed his close friends at Yale Medical School, Duncan Maru and Sanjay Basu, saying he felt “wholly compelled but completely adrift” by the devastation he had witnessed:

I literally had 10 women a night knocking on my door asking for medical help for themselves or their children.

After that email, Jason, Duncan, and Sanjay could have walked away from the challenges posed by this region everyone else had forgotten. They were told repeatedly that building a quality health system there wasn’t possible due to lack of infrastructure, the immense poverty, the political turmoil, and for lack of precedent – no one had done it before.

Yet they pushed back, determined to build an effective, durable organization rooted in the philosophy of “nyaya” or “the realization of just systems.”

Nyaya Health’s vision was realized in 2008, when the three were joined by a growing team of leaders from Nepal, India, and the U.S. Using a small sum of funds from friends and family, the team transformed an abandoned grain shed into a beautiful clinic operated by Nepali healthcare providers.

That commitment to realization then came to define everything we do, from forming a novel public-private partnership with Nepal’s Ministry of Health to moving radically beyond a shamefully substandard approach to transparency in international development work.

One of our most successful efforts in Achham has been the female Community Health Worker (CHW) program, which employs 93 community health workers and 9 community health worker leaders. These women, whose futures were once limited and marginalized, now play a vital role in connecting the local Achhami people to the necessary and available care. As leaders in their communities, Community Health Workers accompany patients across the emotional, educational, and literal distance to health in irreplaceable ways. Through this program, women are putting the power to access healthcare straight into the hands of their communities.

To date, we have treated more than 137,000 patients at our flagship facility, Bayalpata Hospital, employed over 160 Nepali staff, attracted over $1 million dollars of investment ($105,000 from Nepal’s Ministry of Health), and have been distinguished by GiveWell as a standout organization for our ability to deliver care in an extremely poor region with unusual levels of transparency.

The right to health is being realized, and we are excited to work with Girls’ Globe to bring health to more people throughout rural Nepal.

Nyaya Health is a new featured organization and will continue to share stories about their work on Girls' Globe. Connect with Nyaya Health through Twitter and Facebook.