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Where the church is the ambulance

In parts of rural Nepal, cultural and religious beliefs can sometimes mean mothers do not get the health care and support they need

A nurse checks the baby’s heartbeat. Photo: Richard Hanson/Tearfund

From: Maternal health – Footsteps 91

How to help families and communities provide crucial support for women before and during childbirth

In parts of rural Nepal, cultural and religious beliefs can sometimes mean mothers do not get the health care and support they need. Often, these beliefs mean that women who are menstruating or in labour are considered unclean. People do not want to touch, or even see them!  

If a woman in labour is considered unclean, who will transport her to a health facility? 

A church group in the District of Dailekh, Nepal, has started a simple ambulance service to reach remote communities in the mountains. Some Village Development Committees are very far from the district hospital. Even if there is a road, it might still take four hours to get the patient from the village to the road from where a vehicle can take them on to the health post or district hospital.  

The ambulance service is now well advertised in the communities. The community knows to contact the church group by mobile phone when someone needs help to get to a health post. At the moment there are usually between one and three cases a month. Most cases are accidents – for example a person who has fallen out of a tree while cutting firewood – but others are women who have started labour. 

When they started the service, the group members carried people in a basket on the back of the ‘porter’, but now the church has bought a stretcher to carry the women as this is better.  The group has shared this idea with other churches and as a result, in another district a second church has started its own ambulance service. 

One fear is that the church groups will be blamed if things don’t go well with the patient, or that there will be an accident while the patient is being carried. However, this has not happened so far, and when patients recover, they sometimes visit the church to thank the group for what they have done.  

As part of Tearfund partner Sagoal’s work with local churches, church ‘Core Groups’ have been mobilised to work with communities using the church and community mobilisation approach. If maternal health issues are highlighted as a need by the women in the community, the church Core Groups work with health workers and the community to challenge traditional viewpoints, increase the sense of value of women and reduce stigma. 

Buddhiman Shakya, Senior Coordinator in Sagoal, was interviewed by Steve Collins.

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