Feature Stories
From hopeless plight to recovery: One woman's story in far-west Nepal
8 May 2007
When I entered the surgery room, I saw a corpse on the operation table and felt death in the room. Lying on the table was a skinny naked body with a big belly and disturbingly yellowish-green skin. The medical team around Durga moved more quietly than usual. I could feel the weight on the surgeons' shoulders, as each movement they took had purposeful precision.
After being in difficult labour for three days, Durga had arrived in Team Hospital and had gone straight to the operating table. In her remote community, where women sometimes give birth in cow sheds, it had taken her family and neighbours some time to realize her condition and the heavy snow fall, at the time, made it difficult and longer to bring her at the Team Hospital in Dadeldhura. When she reached the hospital, her uterus was ruptured and the baby was dead. Dr Davey Gin and Dr Arun did their best for hours to save her but had very little hope: "She has lost too much blood, it is very difficult to stop the bleeding and she is too weak; she came too late". When Durga was passed on to Public Health Concern Trust's surgeons a few days later, her belly had reopened and was infected. As the surgeon was cleaning her belly, she took my hand and squeezed it. It was a mess, with pus and liquid coming out, and the peritonea swollen. As the doctors cleaned inside her belly, they put in a draining device and tried to sew the wound closed. But because she was so malnourished, the tissue was too weak to hold the thread, and everything fell apart. They had to sew far on the sides of the wound to capture skin with enough strength to hold the thread and keep the belly closed, in the hope that it would heal. The next morning, she looked slightly better and the surgeons told me exactly what type of food to give her in order for her to recover. For three days, she was not allowed to take anything orally. On the fourth day she was allowed to drink liquids followed by soft foods on subsequent days, ensuring that proteins, such as eggs, lentils and meat, were always an essential part of the diet. As I looked at Durga, I saw all of Nepal's misery in her; she is very small and looked like she has been malnourished since childhood with a single bad tooth left in her mouth, a skinny body, hard working hands, injured limbs, dry skin and no education.
In the Baitadi district, Boomiraj Village District Committee, she was aware that in the past there was a health post in Guyaligain and she used to go there to get Depo (contraceptive injection that lasts three months). However, because the common side effect of irregular bleeding made her life harder, she stopped taking Depo and got pregnant when she was 36, even though she did not want to. Her husband works in India and comes back now and then without notice. She already has two daughters and a son. Although the Female Community Health Volunteer, who regularly visits her for iron distribution, advised her to go for antenatal care, she never did, mainly because alone at home she could not leave the children.
Back in the Team Hospital, one of the young doctors working on regenerating her failing health, started to lose hope again, claiming: "her kidneys don't work and she's in sepsis". In the case of sepsis, the wound does not heal but, instead, reopens and liquid leaks out. She could barely eat as anything made her vomit. She was coughing and both the doctors and I expected pneumonia. The pain in her belly made her seize every night. Durga asked me to sleep by her side which I sometimes did. At that point, I really thought she would not survive and wanted to give her a good end, knowing her life had been hard since her birth. I asked the doctor to give her morphine, to give her a break from such pain. A devoted woman had been cooking for her since the beginning, trying to balance her diet. I visited Durga every day, slept by her side a few times, waking up to get the nurse when her suffering was too great, forcing her to eat. Taking care of Durga was like a roller coaster ride, providing glimpses of hope, followed by failures and then balanced out by hope again. We washed her hair full of lice and finally shaved her. The nursing staff washed her, gave her a pedicure and manicure and put her in the sun as much as possible. But she only weighted 27kg… The doctor did not give up on her and managed to make her kidneys work a little bit. Her mood was getting better, so did our hopes. We made her walk a bit and cheered her up, I even made her laugh, making her "positive about life".
I then had to go to Kathmandu for twelve days. I worried that she would not survive and gave her a goal: "if you are over 30kg when I come back, I'll bring your children to you". I called few times and knew she was getting better. When I came back, I found her chatting with women in another ward. She is now walking and her kidneys work, which is a true miracle! She eats a bit of everything and laughs a lot. But her wound got infected again and a diagnostic culture cannot be done in the far-western region of Nepal. Luckily, some UNFPA staff is moving back and forth to Kathmandu and we are ordering cultures and chlorinated water. Durga's husband brought their two daughters to Dadeldhura, just when Durga reached 30kg, as promised. It is difficult to describe Durga's joy and relief to finally see her children.
Mireille Guiraud, UNFPA Monitoring and Evalution Officer in Dadeldhura
Back to Top
Back to Feature Stories