During our first visit to the Rupakot Health Post, a woman came in with a 10-day old baby girl. The mother had had a C-Section in Chitwan, a province in the south, and was directed to the hospital in Kathmandu, but, because of finances, the family decided to forego the doctors’ recommendations and went straight home. The mother, quite ill and recovering from the operation, was unable to make the difficult journey from her home to the hospital, about a 45 minute walk on rough terrain. The baby was brought in to the Rupakot health outpost by her grandmother. The baby weighed to 2 kilos at birth, and hadn’t gained weight in her ten days of life. She had a large mass protruding from her lower spine which was either a bifid spine or a large spinal mass. Either way, the baby’s legs were like chicken legs, just skin and bone. There was no response from the Babinskii test (where you run your finger along the foot) my dad performed. The baby was likely severely disabled neurologically below the waist. I had to leave the room. It was one of the saddest things I have seen. My dad told the grandmother to take the child and mother to the larger hospital in Besishahar, but the baby, still breastfeeding, couldn’t go without the mother, and the mother was too weak to take the long and bumpy bus ride to the city. The only other option was the ambulance which would cost about $80—more than a month’s salary. The family had to decide how to spend their money. The likelihood of the baby surviving for much longer was slim. If it contracted any infection, pneumonia or continued to not gain weight, she wouldn’t make it. If everything had gone perfectly (which is very unlikely), she would still have an incredibly difficult life. This was the decision that faced her family.
We were all very touched by this child, so a few days later we made a follow up trip to their home. Their home was located up in the hills. A rocky climb up the mountain was followed by a long walk along the ledges of paddy fields. We understood why that mother couldn’t make it to the hospital. When we arrived at the house, things continued to fall into place. The mother was her husband’s second wife. I don’t mean that her husband was divorced or a widower—both wives lived in the house with their mother- and father-in-law, the first wives’ three young children, and the new baby. The husband was working in Qatar, as many Nepali men do. Like in the US, if a man wants to divorce his wife, he must give her some property. Unlike in the US, if he does not want to give her property, he can take a second wife, as long as he provides for both women.
My dad tried to figure out what exactly was wrong with the baby. He asked how long the mother had been pregnant, and she said May-April. 11 months. We all looked at each other. Either she had miscarried without knowing and became impregnated again, or she had some reason to lie. Her husband had been gone since May, therefore, if she had gotten pregnant after May, it was not by her husband. Whether she was raped or had committed adultery was not discussed.
The living conditions were pathetic. A two-room clay hut housed the family of eight. The front of the hut was open to the outside. There were no doors or windows. Beds were straw mats on the floor. Chickens and goats walked in and out of the hut at will. Not ideal conditions in which to care for a sick disabled newborn or clean a recent postop wound. This is the sad reality of rural Nepal.
Recent Comments