How inadequate healthcare, a lack of resources and poor communication led to the death of a young mother in Nepal
Around a quarter of Nepalis live in poverty and that level rises in rural areas. Without the money or the social status, poor families simply don’t have access to the basic provisions.
And that can mean the difference between living or dying, as BMS worker Cynthia Chadwell writes here.
Our house helper Pushpa has an older sister called Sarita, aged 38 with five children, from a village in Makwanpur district, south of Kathmandu Valley.
Although it would not be that many miles as the crow flies, the village is very remote and the people who live there have few facilities.
Sarita came to Kathmandu because she was ill. In fact, she had been ill for some time but the family took a while to sort out enough money for the bus fare; just a few hundred rupees (£2.00-3.00).
On arrival in Kathmandu, Sarita was admitted to the emergency department at a nearby hospital. She was severely dehydrated and put on a saline IV drip overnight.
The next morning, she was discharged from ‘emergency’ and admitted to the main ward.
They discovered several things: she had partial kidney failure, some problems with her womb which dated back some 16 years and some sort of bite or sting on her leg that had never fully healed.
For admission to hospital, the family paid a deposit. Family members are meant to look after their relatives in hospital, staying with them overnight as well as providing food and liaising with the hospital staff if they need help.
Therefore, Pushpa spent a week of nights in the hospital looking after her sister.
Treatment consisted of a saline IV drip and paracetamol. The family members were frustrated with the lack of communication about what was actually wrong with Sarita, what the course of treatment might be and how much it would cost.
There was some suspicion that, as they were deemed to be poor, less effort was made to help her. The family found that, if they persisted in trying get answers to these questions, they were shouted at or told the situation was under control.
Price to pay
Late one night, they decided that dialysis was necessary and, as the hospital she was in only offers dialysis during daytime hours, they moved her to another private hospital nearby.
Before discharging her, the family had to pay the balance of the bill and once again had to pay an admission fee for the new hospital. Soon after arriving there, she stopped recognising anyone and she was admitted to intensive care.
Sarita died there in hospital.
For the one and half days that Sarita was in that hospital, and for the 24 hours of that in intensive care, the bill was around 50,000 Rupees (£450).
Since the church she attended in the village is connected to one of the larger Kathmandu churches, pastors from there brought a wooden box and means of transport straight to the hospital.
Pushpa washed and dressed her sister’s body and then, after paying the hospital bill, the family went with the body straight to the church for the funeral.
Because of the issues regarding burial space, particularly in Kathmandu, they ended up cremating her by the side of the river.
Christians mostly bury their dead as burning is considered a Hindu custom, but in situations like this, expense as well as availability of space dictates what actually happens.
Hearing Sarita’s story, some ‘if only’ statements come to mind:
If only there was better healthcare available in the villages and remoter areas of Nepal.
If only the family had had the required money to bring Sarita into Kathmandu sooner.
If only she had received treatment for some of her long-term health issues earlier.
If only they had been given clear information about her condition, what treatment was possible and how much it would cost.
If only they could have made decisions based on what was best for Sarita rather than having to consider the long-term financial implications for the whole family.
If only the family hadn’t been poor…
Pray too for the many families in Nepal going through a situation like this today – that they would find affordable access to healthcare. May Christians in the country strive to make a difference, so that the poor receive the care they need and deserve.
Cynthia Chadwell (pictured) is a BMS worker in Nepal with her husband Ian and their two children Justin and Lucy.
Ian works on the International Nepal Fellowship’s partnership programme. Cynthia works as a volunteer in an education centre and helps train leaders with the children's programme at their local Nepali church.
Woman washing: Ian & Cynthia Chadwell
Inside hospital: Simone D. McCourtie / World Bank
Funeral: Michael Foley
Rural life: Martin Butterworth