A miracle of love
In Nepal’s west, efforts to strengthening Kangaroo Mother Care services are a reminder of the remarkable power of love and dedicated healthcare
Surkhet, Nepal: The Surkhet Provincial Hospital witnesses the birth of dozens of children within its walls each month. Among these newborns, however, there are several who are either born prematurely or have extremely low birthweight and therefore require specialized care.
Recognizing the need for improved services for these fragile little lives, the hospital – following advocacy and support from UNICEF – recently set up a Kangaroo Mother Care (KMC) section within its Neonatal Intensive Care Unit (NICU). The KMC corner is currently equipped with a reclining chair for mothers to use while holding their little ones.
In addition to the equipment, healthworkers at the hospital have also been provided opportunities to strengthen their skills in KMC, so as to serve parents and children more effectively. UNICEF, in collaboration with the Human Resource Development Center (HRDC) conducted a two-day KMC training in late March 2023 for maternal and newborn healthcare providers from health facilities across Karnali Province.
One of them was staff nurse Nirjala Nepali.
“We did provide counselling on KMC before when we discharged parents after delivery, but it wasn’t very systematic,” says Nirjala, who has worked at the hospital over three years. “It was just general advice on what to do.”
After the training, however, Nirjala feels much more assured in her ability to guide mothers and fathers in carrying out KMC. “We learned that practical demonstrations are very important in conveying the right message,” she says.
“Now, I’m able to show them exactly what to do, and explain why it is beneficial, and how important it is for them to continue the practice when they go back home.”
This certainly proved true in the case of Bimala Budha, a young mother from Jumla in the remote reaches of the country. She had been admitted to the hospital with severe labour pains, and soon after arriving, had given birth to a baby boy. However, born just 28 weeks into pregnancy, the child weighed only 1,400 grams. He was very weak, unable to feed properly, and had to be immediately transferred to the NICU.
“He was so small, I felt like I could hear his heartbeat in my own ears,” Bimala says of those terrifying first few days.
Initially, the baby received care under a radiant warmer. However, a few days after delivery, his weight dropped further to 1,300 grams. To ensure adequate nutrition, the hospital started providing expressed breast milk through cup feeding. Gradually, the baby's sucking reflex became active, and he began self-feeding on breast milk. Once her son’s condition was a bit more stable, nurse Nirjala took Bimala through the KMC technique.
“We taught her how to hold the child against her body for continued skin-to-skin contact,” Nirjala says. “Not only does this keep the baby warm, but it is also known to improve breastfeeding, improve immunity and weight gain, and create a stronger bond between the parent and child.”
Bimala remembers being initially frightened. “I was scared I would hurt him if I held him too tightly,” she says. But with Nirjala’s guidance, she soon gained confidence. “I started to like having him close to me and keeping him safe with my body.”
Over the next month, the child continued to improve, slowly gaining weight. Bimala – now on her way back to Jumla – is happy with the progress her little boy has made in such a short time, and is determined to continue KMC at home.
For Nirjala, it is happy results like these that make up the ultimate reward for her efforts. “All the challenges feel worth it when you’re able to send them off recovered and motivated like that,” she says.
