Into the Mountains- Phaplu

Views of white-capped mountains at last! 

We arrived in Phaplu on International Day of the Midwife, after a long 11-hour jeep ride from Kathmandu. As soon as we arrived we were greeted with fresh mountain air, warm Sherpa stew, and the kindness of Pema and her family. Phaplu is a small town at 2400m, surrounded by what we call mountains, and what Nepali's call hills.

Mickey in front of the new Phaplu Maternity Hospital

We spent our first day in Phaplu visiting their brand new maternity hospital, parts of which are still under construction, that just opened two weeks ago. The hospital was built with the supervision of a local doctor, Dr Mingma Sherpa, with international funding. There are between 250-300 births in Phaplu annually, however the cesarean section rate is 45% which is something that needs to be addressed. There are two doctors working in the hospital at this time, and only one performs cesarean sections. So if he is away, which he is frequently, then they have to refer women to other centres for cesarean. Most of the births are conducted by Auxiliary Nurse Midwives, who will consult with the doctors when required.

In addition to a new labour room, delivery room and two operating theatres, construction is also underway for a new postpartum ward and a NICU that will have one incubator and a nice room for the mother to be close to her baby. There is a nurse who has gone to Kathmandu to be trained in the care of the unwell/preterm infant. The plan is for here to be able to provide the care in the NICU. We discussed the importance of emphasizing basic skills like IV insertion, being able to insert a feeding tube and kangaroo mother care. Dr Mingma is quite passionate about providing these services in his community.

After our tour of the new facilities we sat in to observe immunizations. There were dozens of women waiting with their 18 month and older babies for immunizations, and to collect super cereal. The super cereal program occurs once a month. Babies and children are weighed, and each pregnant and lactating mother goes home with a 7kg bag of super cereal consisting of wheat, soya, sugar, and a micronutrient mix of vitamins, potassium and calcium.

Some women were carrying their babies in baskets with straps over their heads, others had modern front baby carriers, some back carriers with metal frames. The babies were so chubby and bright, healthy from the local agriculture and super cereal.

Entrance to the Maternity Ward 

Delivery Room

Delivery bed. 

Phaplu