Emergency obstetric care saves lives in coastal villages

People put their trust on services

Akram Hosen
আট মাসের প্রসূতি তন্নিমা আখতার
UNICEF Bangladesh/2019/Habib

06 August 2019

In a squeaky-clean, newly refurbished room in the otherwise shabby building of the hospital, eight-months pregnant Tonnima Akhter is talking to Senior Nurse Anjuara Begum in a summer morning.

Anjuara, also a trained midwife, checks Tonnima’s weight and pulse and writes down the details in her notebook. She then tells Tonnima how much rest she should take and asks her to make a few changes in her eating habit. The nurse then says that everything seems to be fine and she can expect her baby in five weeks.

Several other women in different stages of pregnancy are waiting for their turn outside the brightly-lit antenatal care (ANC) room at Kalapara Upazila Health Complex in the remote coastal district of Patuakhali. Even the quickest of glances at the surroundings shows that the maternal health care service provided at the hospital maintains a standard that is hard to find in such a remote area.

“I would have to travel for three hours and cross the river by boat in this heavily-pregnant state for this simple routine checkup, if the services weren't made available at our hospital last year,” Tonnima says after coming out of the ANC room.

Tonnima, a nurse of the hospital herself, says she can afford the commute to the nearest city of Barishal but most people in the area can’t. “People are gaining trust on the service. The poor people, in particular, are benefiting.”

In another part of the hospital, Sajib Biswas, a dishevelled young man, waits anxiously at the corridor. His mother and in-laws tell him that the father should not go near the labour room because they take it as bad omen.

His wife Liza Akhter, 21, has just been taken inside the labour room with labour pain. The nurses and midwives start making entries at the partograph attached on a wall. After a few minutes, they decide that the baby can be delivered without a C-section.

Sure enough, a baby boy is born within an hour. But the nurses become concerned as the baby remains visibly unconscious due to asphyxia. The nurses then call Chinmay Howlader, health and family planning officer in the upazila. 

ডা: চিন্ময় হাওলাদার
UNICEF Bangladesh/2019/Habib

"The nurses at the hospital had received a training in Emergency Triage and Treatment which taught them what to do within the first few minutes after childbirth".

Dr. Chinmay Howlader

The doctor, who has recently received a training on emergency obstetric care, rushes to the room and finds out that the baby’s respiratory tract has to be cleared to make way for normal breathing.

After struggling for a few minutes, Chinmay successfully clears the airway and the baby starts to cry.

“Maternal and newborn health services at the hospital have been modernised to a great extent in the last one year,” the doctor says about an hour later.

He adds that the nurses at the hospital had received a training in Emergency Triage and Treatment which taught them what to do within the first few minutes after childbirth. They also know how to respond if the baby is suffering from asphyxia.

“Besides the visible improvements, there have been changes several practices. Thanks to our training, we now make sure that the new mother gets the medication needed to stop the bleeding moments after giving birth. The newborn also gets an injection to prevent infection.

“More people trust our service. In January last year, there were 14 deliveries at the hospital. But in January this year we delivered 30 babies. In February, we delivered 28 and in March 48,” Chinmay says with a proud smile.

Meanwhile, new father Sajib, who was shaken by the baby’s breathing difficulties, says, “I can't find words to express how grateful I am to the doctor and nurses.”

The 25-year-old man has a grocery store in Lalua village near the sea beach. His neighborhood often gets flooded although there is an embankment to protect the village.

“We are poor and can’t afford to travel to a city at a moment’s notice. I would have to take loans if I had to take my wife to Barishal for the checkups and delivery,” he says.