Supporting frontline health worker in remote Nepal

For families living in remote communities, reaching a health facility during an emergency can be a major challenge. While many communities have access to a health facility, these health facilities may not have the necessary equipment, trained human resources or the capacity to manage major health emergencies that demand a higher level of care. In such situations, traveling to a well-equipped health facility is difficult for the patient and their family. Transportation may not be readily available, and even when a vehicle can be arranged, many families do not have adequate financial resources to cover transportation, accommodation, food, and other costs while receiving health services far away from their village. These barriers can delay access to essential healthcare during critical moments that often threaten lives.

One similar situation recently occurred at Dhainakot village, one of the remote communities where PHASE Nepal has been providing health primary health care services. A young women named Radha (pseudonym) arrived at PHASE supported clinic with lower abdominal pain and vaginal bleeding. She was at her 23 weeks pregnancy. Following her assessment, PHASE Nepal health workers identified her pregnancy to be high risk and urgently referred her to higher health facility, in this case, the district hospital.

However, as a young expecting mother hailing from a low-income household, her family were not able to afford transportation and additional expenses associated with staying with her during her treatment. Understanding urgency of the situation, PHASE Nepal used its Emergency Fund to arrange and financially support her referral. In addition to arranging and paying for her transportation, PHASE Nepal provided financial support for her caregiver's accommodation and food during her treatment. She was transported from Dhainakot to Gamgadhi, where she received further treatment and was discharged after her condition stabilized.

After few weeks, Radha returned to the health facility with heavy vaginal bleeding, abdominal pain and no fetal movement, she was identified to having another obstetric emergency. Once again PHASE Nepal arranged vehicle for her emergency referral. A PHASE Nepal health worker accompanied her throughout her journey for continued monitoring.

Unfortunately, while travelling through the difficult terrain towards the district hospital, Radha went into labour and delivered a stillborn baby during the journey. The accompanying PHASE Nepal health worker supported her during this emergency, and she was then taken to the district hospital, where she received further treatment and observation.

Although the outcome was devastating for Radha and her family, the case highlights the importance of timely referral and support when emergency care is needed. Distance, difficult terrain, limited access to prompt transportation, and financial hardship can all become significant barriers to accessing emergency healthcare in remote communities.

Through its Emergency Fund, PHASE Nepal helps reduce these barriers by supporting emergency transportation and accompanying patients when they need higher care urgently, however accessing these services is often challenging.

Phase Nepal has been able to provide such emergency support only because of the support that we received through our partners. We are grateful for everyone who has supported us so we can strengthen health services in remote Nepal and ensure that financial hardship does not become an additional barrier when families need urgent care.