This month the PHASE blog discusses the important issue of family planning – a little discussed topic in Nepal, especially in the remote mountainous Humla region where Maila village is located. There are numerous myths and fear surrounding the use of family planning
We would like to introduce Dhani Jaisi, a 35 year old married lady from Maila village, she has five daughters and two sons. After giving birth to her sixth baby, Dhani started to take Depo Provera – a 3 monthly family planning injection, on the advice of the PHASE health workers. However, after some time, she stepped going for injection without discussing it with the health workers.
Dhani says, “I had already six children and I did not want more, so I was recommended Depo Provera – family planning injection. But I stopped going for injections because I was bleeding heavily. Due to my responsibilities in the household I could not find the time to inform health workers about either the bleeding or my decision to stop.”
Later there was a vasectomy camp organized in Maila village to provide free family planning operations to local men.
Dhani adds, “I asked my husband go for the vasectomy operation. Health staff and neighbours also advised him to go, everyone was saying to him that he already has a lot of children and if he has anymore more it will place an additional burden on his family.”
Dhani’s father-in-law was against the vasectomy. He was worried as he had only one son and felt something might happen to him during or after the operation. Dhani’s husband agreed with his father and refused to go for the operation. A few months later Dhani became pregnant again and gave birth to her 7th child, meaning she now had 5 daughters and 2 sons.
The birth of Dhani children was a challenging, in Humla the tradition of Chaupadi is practices. This is where women a made to stay outside of house during their menstrual period and the delivery of a child. Dhani was not allowed to be in her house for 21 days during the delivery of her 7th baby.
She explains: “During the time of delivery I lived in a small shed which we use to house cattle. It was rainy season and the roof of the shed leaked badly. My husband and other family members were far away in the house and did not notice the problem. My feet and body swelled because I was unable to keep myself dry throughout the delivery and in the period after. I was bleeding, I could not move and I could not breast-feed the baby.”
Dhani was suffering from post-partum haemorrhage (heavy bleeding) and she was ill because of cold and damp.
“The morning after the delivery my husband came to see me. When he saw my condition, he immediately informed the Maila sub health post. The PHASE health staff arrived soon after.” Dhani adds – “Both the staff were surprised when they saw the conditions in which I had been living. They checked my health and gave me some medicines. They advised my husband to keep me warm and dry.”
PHASE staff conduct a door-to-door community health programme three out of six days a week. During these visits, PHASE staff talked to Dhani’s husband and father-in-law and gave demonstrations about family planning, malnutrition and the negative impacts of the chaupadi tradition. After a few days, Dhani’s husband brought her to Maila health post.
Dhani’s husband says “It is our social culture to keep women outside when she is menstruating or giving birth. I also admit that I was scared to go for a vasectomy. I ran away from the camp because of fear.”
He added, pointing to his wife Dhani “This lady has suffered a lot because of my mistakes. I realize that having a lot of children is a burden on my household. I am unable to feed my seven children well. I promise; I will go for a vasectomy when there is another camp nearby.”
Dhani added “From now onwards I will take Depo – the temporary family planning injection again. If there is any more problems I will come back to the health workers for advice. If my husband gets a vasectomy then I will stop. I would like to thank the dedicated health workers in the sub-health post very much for all the advice they have patiently given my family. After a long story, we are now ready to use family planning.”
Friends, thank you for taking the time to read our story. Providing a health service in this remote area is challenging but ultimately rewarding, and slowly the health status of the area is changing. But we do still have a long way to go.
Today, Wednesday 13th March between 1pm and 8pm Global Giving USA will be matching all donations made by 30%! Please think of the people of Maila and consider offering your support – http://www.globalgiving.org/projects/himalayan-healthcare-save-lives-in-nepal/
With gratitude and hope;