Gorkha, Nepal- Gita and Sonu belong to the Jagaran women’s Group in Taklung, Gorkha. They have practiced micro savings since 1999 and gained respect and influence in their community. But they lacked the influence to prevent the death of three of their group members, who died in childbirth.
Rural Nepali women are petrified at the thought of giving birth – but also have no control wether to get pregnant. Though the government promotes access to inexpensive contraception, it has failed to tell women where to obtain it; few rural women actually use it. Nepal has one of the highest maternal mortality rates in the world – a woman dies every four hours from pregnancy-related causes. Dalit women, who fare worse on all social indicators, have an average lifespan of just 42 years.
For 15 years, ADWAN has focused on empowering women through micro finance, livelihood and rights education. We were unaware of the maternal health crisis so glaringly at odds with women’s empowerment. Gita, a community health worker, and active in our partner organization ADWAN, was instrumental in brining attention to the problem. ADWAN is so excited to introduce three new workshops in partnership with Nidan (“Cure”), a public health NGO.
In September 2012, ADWAN conducted a first ever reproductive health project in Taklung in partnership with Nidan. This was the first time ever a doctor had set foot in that community. During the two-day workshop, the Nidan doctors and trainers from Marie Stopes International (MSI), a family planning agency, conducted a “Train the Trainer” workshop for 28 community health workers and women, chosen for their leadership and influence. Together, they learned how to train an additional 150 women.
The partnership and the “Train the Trainer” approach bring health care knowledge to women in remote areas in a most cost effective way. In addition, it connects women to local agencies, so they can obtain services on their own in the future.
When challenging cultural norms and bringing new information to a conservative community, lack of trust and poor communication are huge obstacles in dealing with ingrained cultural practices. Mothers-in-law, shamans and unskilled traditional midwives wield huge power over young women especially regarding childbirth and pregnancy. It takes great skill to change minds and habits, but the easy and friendly manner of the Nidan doctors easily won the women’s trust; and the women in turn opened up:
“There were twelve women with me in there {the meeting house}. Another discussion was swelling and receding in the adjacent room where Dr. Mali was talking. In that momentary period of silence, a woman started speaking in a tone of amused wonder -”, observed Dr. Giri.
In discussions and exercises women absorbed information, which could save their lives: care during pregnancy, danger signs, importance of check-ups and having a skilled birth attendant during delivery. Family planning options, birth spacing and the advantage of small families were also on the table. Since is so prevalent among rural women, the trainers explained how to prevent and manage this condition.
A young MSI nurse, Pampha Nepali, educated participants about inexpensive contraception, easy to obtain and use. After two full days of training, participants and trainers agreed this first workshop had been a resounding success. Women assured the doctors that they had understood the material and were ready to teach other women.
