Then I returned back to the health post, because there was another case which I earlier sent for ultrasound ad was now on the way. The mother had already gone into labour on the way. After I returned from advising the family to bring at 11-12, I started to handle the second case. When the second case arrived I checked the mother and she was already dilated 6cm. I began to prepare all the equipment, including IV.

While preparing the equipment the first case arrived. The family saying the labour pain had increased, so they brought her here. So I admitted her also. There was not such a big pain, just normal labour pain, and the mother was not so scared. So I continued to treat the second case, at about 11:55 it is a breeched delivery.

The ultrasound showed that it was a breeched delivery and the family was advised to go to hospital, but instead they came back to the health post. So now I told them, I will do whatever I can, but you have to take responsibility if anything happens. Any problem can come, if anything happens to the baby, so if you are willing to take responsibility I will do otherwise please take her to the hospital. The they said, “whatever happens please do.” After that I used all my abilities and even though it was a breeched delivery, I successfully delivered the baby without complication. It was a good delivery, the baby weighted 2.5kg.

Then after delivery I did all the normal things, and in the early morning discharged them so they could go home. And the first case was still in the same condition. I was checking o her while doing the second case and there was no complications. Then again at 4am in the morning a third case arrived. The mother was already dilated 8-9cm. At 5:25am she delivered the baby normally. And after doing all the after birth care, we discharged her also. After I finished and discharged both cases, I started to check on the first mother again. The labour still looked normal and does not need to be referred, so I am not able to refer immediately. Then after her labour pain started to increase and the second stage started. Now I hoped it would be over in one or two hours.

But it did not happen as I hoped. Just in case we made the transportation ready. But still it looks normal so we tried to make delivery here. At around noon the membrane ruptured, after that we hoped the baby would be delivered. And we kept doing our part and she began to push, so we took her to the delivery room for easy sitting. But still for a long period of time the baby’s head was stuck and could not come out. Now it is impossible to refer because the head is already showing and anything could happen on the way because of the road condition. So I keep assisting her with confidence. I keep struggling with the case. It is already 2-3pm and still the baby has not been delivered. Now people start to gather outside. The front was full of people. Then outside people started to think that to take her by road would be to long and risky, so they need a shorter route which is by helicopter—and started to arrange it. But I kept doing my part inside, but the husband told me that if it is not possible to deliver here then we will bring helicopter. Even after he went, I am not able to say okay because the baby’s head had already come out.

I was still hoping I could make the delivery here. I was confidant to make it happen. Anything could happen on the way if she was taken from here, and it would cost a lot of money. The helicopter would cost 180,000 NR. But still they already booked it and made it ready. Then they said, “at 5:30pm the helicopter would arrive, we have already called it.” While they made the arrangements, I kept focusing trying to make it happen here in any way. So I kept trying, and was saying no need to bring helicopter. But they became impatient asking until when do we have to wait. Other health workers started to console her, saying leave it let them take her. But inside I do not want to let them take her away. But still I was trying, they said at 5:30 the helicopter would arrive. But at 4:25 I made the delivery. There was a complication because of the prolonged labour. There was birth aspxiya. I made him breath through dili suction. I used dili suction and electric suction until he cried. But I did not need to use the bag and mask, but I kept it close. I had prepared everything to save his life. No need to use bag and mask, dili suction and electric suction worked. The baby was 4kg because it was a big baby the prolonged labour happened.

Then after everyone became very happy. There was about 50 people and I did not have time to see all of them. Everybody was happy that mother and child were saved, and the money was saved. They started to drink juices. But I had a sleepless night and had nothing to eat. I felt very tired. Everybody was very happy. After doing the after case care around 6pm I discharged her. Then I went home. I went out at 9pm yesterday night and now at 7pm I entered my house. In this entire time I could not go once to my house or take food or anything. After I took some food, I tried to sleep. But I was unable to fall asleep the case was still running on my mind. I kept asking myself had I made any mistakes. Maybe I should refer earlier. Maybe I did big mistakes. I am able to save mother and child and a big amount of money. Plus the extra cost when they reach there, which is no small amount of money. And all those feelings make me satisfied. Sometimes I felt bad and sometimes I felt good. And again I felt proud of myself that I handled successfully this kind of complicated case.

The husband, Dammar Shrees, 29, tells the story of the birth of his first child pictured here 24 days old with his wife, Rupa Shrees, 25.

Namaste, I am Dammar Shrees. My family Rupa Shrees, you know my baby’s name is rhythm. At that time, we clear our karma. To clear that we had many hardships. At the delivering time she start to have labour pain at 5pm in the evening. Then after the SBA, whom I called sister in law, we informed her at 9pm. As she suggested to us we took her to the health post around 11pm. After we reached there she was doing all the check ups, we also kept asking her for suggestions. But mother and child situation was good. Even though everything was good the labour pain was getting lengthy, and painful. The overall time took about 24 hours. In this entire period sister did a lot of help, more then I ever expected. She handled in the best way. We were all around and getting all the information. And also I asked, if she needs to be referred please suggest to us. Sister kept consoling us, but even in the last moment the situation was not clear. And sister told us it is taking to long and we do not have proper equipment. I am doing it with what I have, do not worry. But still I kept a vehicle outside on standby mode for in case. But in the end it looks like the vehicle would not work, and we began very scared. Then after, even though we are farmers, we must have to save their lives. So we started to think about helicopter. So we started to arrange it. But god blessed us and sister supported us. Finally our happiness was delivered. I kept visiting inside the room. Like when I work in the field sweating heavily, Sister was sweating like that struggling with the heavy burden. Maybe sister is pushing herself hard because she does not want to be blamed, or maybe she is thinking about the mother’s situation. But through all that effort and struggle our happiness was delivered. That’s it Namaste. (Grandfather says something) What to say. Maybe because of our poverty our country is poor and lack of development or education, before in days past volunteers handled all of these things. There were cases. (Somebody dies) But now at least there are some facilities. Not enough facilities to have everything we want or desired, but still there are some facilities.

Why did you name the baby Rhythm?

I named the baby Rhythm. He raised our heart rate and tested our pulse. After that I called to my sister. She is living in Kathmandu and is studying CMA, I explained to her that he scared us a lot and raised our heart rate. Then she suggested to me the name Rhythem. I also liked it. I felt happy. There was too many people around at that time, it looked like a kind of ceremony. Everybody was anxious about what will happen next. And all of our heart rates were increasing. What will happen? How will it happen? Will they die or survive? What will happen? But still I do have confidence that I will save them in anyway at any cost. Even though I would have to take a loan, a normal delivery should only take 11-12 hours. It took 24 hours. Everyone of us was scared. In that way he scared all of us, raising our heart rate, so in that way we choose the name Rhythm.