A moment during a risky surgery

 A moment during a risky surgery

"Dr. Saap, is his treatment possible?'' Vimala Kashyap of Sunsari Chatra asked me. She had sent such a video on Facebook Messenger, who is at high risk of pregnancy. As soon as I saw the video of that pregnant woman who was going through a complicated problem, I said, 'Treatment is possible.'

I had to give this answer both ethically and professionally. Because I am an obstetrician. My job is to support safe delivery. Another thing, I am human. A complex patient who is disadvantaged. To save her life, I am more motivated by my human feelings.

Vimala said, "He needs treatment, but he doesn't have anything."

"Nothing" means no money for treatment. I said in reply, 'I will do the work on my behalf for free. I will also ask for help from the hospital.

It was seven o'clock in the morning. That's all we talked about. Last week of May.

It was around 9:30 pm. The pregnant woman was brought to the hospital where I worked. His condition was critical. Can't speak well. Swollen limbs, face. The blood pressure increased suddenly. It was found from the general examination that he has anemia.

The wound from 6 years ago was healed. Overall his position was not that satisfactory. In some cases, doctors hesitate to admit and treat sensitive patients. Because even if the doctor puts 100% effort in the treatment, the result is not always positive. If something goes wrong while treating the patient, the entire blame is given to the doctor. What is the reaction? You-we have seen-suffered that. There is a widespread trend of assaulting doctors, vandalizing hospitals and paying compensation.

The pregnant woman had to visit many hospitals. Initially, she went to the district hospital in Bhojpur, but when she did not get there, she went to the BP institute in Dharan. After not even from there, she reached Koshi Hospital. In this way, all the money he had was exhausted while he was wearing the hospital bed. If the money runs out, that's fine. There was no treatment. After giving up the money, she returned home with a heavy heart.

At the same time, a local YouTube channel showed his pain, and people became interested in him. Seeing her suffering, many criticized the government, which did not provide easy treatment to Nimukha. Some scolded her husband, who did not realize his duty to treat his wife. While the husband is sluggish and unable to speak.

Emotions on one side, medicine on the other

First year nursing students of Koshi Health College came to the hospital to learn basic nursing care. They bathed the pregnant woman. He brushed her teeth, cut her nails, changed her clothes. By this time, the report of all his tests came.

Now the first task was to control his blood pressure. Medicines were started to control blood pressure. She was only 32 weeks pregnant. In such a situation, the physical development of the child may not have been done properly. Therefore, medicine was used to facilitate the child's development and respiratory system. Surgery was not done immediately to see if the pregnancy period could be prolonged.

Her condition was complicated by high blood pressure and proteinuria during pregnancy. In medical terms, it is called 'pre-eclampsia'. Studies have shown that about 6 percent of pregnant women have this type of complication. It is mentioned in various reports that about 500,000 infants and more than 70,000 pregnant women die every year due to this reason.

The maternal mortality study report conducted in Nepal in 2078 showed that 11 percent of the total maternal deaths were due to 'pre-eclampsia'. Why was his treatment not possible in Bhojpur with this data? It is clear. In this situation, both the mother and the child are at risk.

Even if the mother is treated in the ICU and the baby in the NICU, there may be a situation that cannot be saved. Medicines, oxygen and intensive care unit charges are high, i.e. even by spending a lot, it can be 'hands down to zero'. Some doctors think that it is better to refer such a patient than to touch them. But I had no such exemption. A lot of emotions were attached to his treatment. Since his condition became public on social media, there were many people who were concerned about him. However, it was more technical than emotional. My plan to control the blood pressure of that pregnant woman was not successful.

And the surgery began

It would be better for the baby than the mother if it could be extended a few days as it is difficult to protect the baby in a short period (only 32 weeks), but it was not possible. High blood pressure increased the effect on kidneys and liver. Therefore, surgery (caesarean section) had to be done on the 25th.

We got ready for surgery. We had to face other types of complications for childbirth. No matter how uncomfortable or impossible the surgery was done. But this year's work was different.

When we opened the abdomen for surgery, there was about two liters of water (ascitic fluid). In such cases it was natural to have some water (ascites) but two liters! This was the first experience. It was difficult to get the baby out because there had been an operation before and the wound had healed.

But it was possible to get the child out safely. The daughter was born crying. Her cry echoed in the operating room, even in that tension, some happiness was reflected in the operating room. The surgery was successful. Three pints of blood were given for his anemia. The blood pressure also returned to normal.

The hospital stay was a bit longer due to the complicated surgery and the daughter weighing only 1.6 kg. He was kept in the hospital for nine days. From social media to the news, his discussion and gratitude towards the group of doctors who treated him continued to be received.

Those with a supportive mind and spirit provided financial support. What happened from this was that the mothers of very poor families were provided with enough food and nutrition. Her husband and brother-in-law, who were in labor and could not speak well, had no problem eating as told. Representatives of Ramprasadarai Rural Municipality of Bhojpur, President of Lions Club of Biratnagar, State Minister of the state met them and provided financial support. His problem was solved.

But the story is not over

This story seems to have ended on a happy note. But this story did not have a 'happy ending'. Will the problem like that woman again not be faced by others? There is a provision of training for health workers, doctors or nurses for increasing efficiency and capacity. But this facility will be given priority only for those who are in government service. Private hospitals are considered to be established only for financial profit.

Neither the state, nor the society, thinks that the service workers, including doctors working or serving in private hospitals, are citizens of Nepal and provide services to the citizens of this country. Instead, they do not hesitate to say that they are there to rob. But when the patient reaches a complicated condition, then the search is for these private hospitals.