It was a pleasant day with slight chill and bright sunshine at Bagdunda. Bagdunda is around 10 kms from the Gogunda city centre which is around 40 kms from Udaipur city, where there is no network. On Friday, when the weekly OPD happens with doctors present in the clinic, Sheetal along with her mother and neighbour dai came to the clinic. She looked sick.
She complained of pain in her abdomen and fever which was associated with chills for the last couple of days. She had a baby bump suggesting the end of the last trimester. Her vitals were taken and PV examination was done by a fellow doctor. Since it was her first visit to our clinic her ANC profiling was done. Although she had visited her nearby Anganwadi she didn’t carry any documents with her. For the fever we checked for Malaria and it was positive for both P. vivax and P. falciparum. Her PV showed she was one finger loose and had weak contractions. We made her rest on the bed, gave tablet paracetamol for fever and then started on her first Artemether and Lumafentrine dose intravenously. She was severely anemic with her Hb amounting to around 6.2 g/dL. Also her blood group is AB negative. Her husband works in Bengaluru and was there only. We started to plan for her referral.
But our dear Sheetal straight up refused it. Her mother and dai agreed but Sheetal didn’t budge. She was afraid that she would be operated upon. We tried to tell her the gravity of the situation but her fears were stronger. Earlier she had lost her 12 day old baby and had no other kid.
But now what unfolded left me awestruck and completely mesmerized. Our two nurses from the clinic offered to accompany her to the tertiary hospital along with her family members and be alongside her till the whole process of admission is done. The nurses told her that she needed the care in a tertiary hospital under the constant supervision of doctors and other staff. She was also told that she will not be operated without her explicit permission. Sheetal was in a dilemma now, her home is far away, around 10 kms from the main road where there is no network and no car goes, outside the area covered by the clinic.
On further talking to her and knowing that nurses who gave her the first treatment would accompany her she agreed to go. It felt like a huge personal win although it didn’t belong to me. Now, the two nurses left to prepare food for everyone including Sheetal and her accompanaints and two nurses and Dr. Philrose and I stayed back at the clinic to monitor her contractions and dilations. And while waiting her urine protein came positive further complicating the peri partum period. In the meantime her male family members came to go along with her. By 8 PM we all had dinner and boarded the Amrit Ambulance to leave for Udaipur. Sheetal was accompanied by her 6 family members, 2 nurses from the clinic and 2 doctors.
During the whole ride all I could wonder was how selflessly our nurses offered to accompany her. They made adjustments in their schedules for this unforeseen event. One nurse accompanied the other so that they don’t feel scared and have company at odd hours. No one asked any nurse to come along let alone two. This tiny act of offering their help by just being present is very humble. The whole evening left me stunned and their actions were beyond appreciation. Luckily, it was that day at the clinic where doctors visited to see patients and hence we were present but in case we were not there, I’m positive the events would have unfolded similarly, making me realise how central our nurses are to providing care. Clinical care is a small part role of holistic care provided to the person visiting the clinic. It then made me question the importance of presence or absence of doctors at the first point of care.
The night did not end here. There was some issue in the documents needed at the hospital. The nurse was quick on her feet and contacted the Sheetal’s father for the necessary document. Despite hastening the whole process it still took a couple of hours more. And it was 1 AM in the remote lands of Bagdunda where the stars were showing at their brightest in the sky when our stars reached their home for the night. We got to know she gave birth to a 2.6 kg baby boy with cleft lip and palate who is otherwise healthy. Arrangements are being made for his surgery to be possible at earliest. Sheetal is otherwise healthy and happy. Inspired by this course of events, her sister in law gave birth to her child in our clinic only and the dai who had accompanied Sheetal on her visit to the clinic, seeing the cleanliness, polite and friendly staff, services available and homeliness brings along with her any lady about to deliver with any sort of issue or not.
(Name changed for confidentiality purposes)
Himanshi
Travel Fellow Batch 6