A blood transfusion gave this mother and child the gift of life.

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The Times Christmas Appeal 2006

The Times December 12, 2006

A blood transfusion gave this mother and child the gift of life
Jeremy Page in Jhapa, eastern Nepal


6,000 women die in childbirth a year
Half of deaths are caused by blood loss


With a weak smile, Goma Oli gazed down at the newborn baby lying next to her on the grimy hospital bed in the Jhapa region of eastern Nepal.
At 38, the farmer’s wife knew that she was lucky to be a mother again — she had suffered six miscarriages in the past decade.

But she did not seem to realise quite how narrowly she had escaped becoming one of the average 6,000 women who die in childbirth in Nepal every year, half of them bleeding to death.

When she arrived at the Mechi Zonal hospital in a bicycle rickshaw, she had been in labour for three days and her womb was in danger of rupturing, doctors told The Times.

As with so many mothers in rural Nepal, the only option was to give her an emergency Caesarean – a risky procedure in a hospital with only rudimentary facilities in one of the world’s poorest countries.

And as often happens in such cases, Mrs Oli started bleeding so heavily during the operation that she needed an urgent blood transfusion.

Fortunately for her — and for her son — the Nepal Red Cross Society (NRCS) local blood bank was able to provide the 350ml of blood that undoubtedly saved their lives.

“We thought the baby would be dead, so we were just trying to save the mother,” said Madhu Tumbuhangphe, the hospital’s gynaecologist, who trained and worked in Britain before moving back to Nepal.

“If the Red Cross wasn’t here, it really wouldn’t have been possible.”

The NRCS — Nepal’s largest humanitarian organisation — has been collecting, storing and supplying blood and its products since 1966.

In 1991 the cash-strapped Nepalese Government mandated the NRCS to be the sole manager of blood supplies for the entire country of 27 million people — without a single penny from the budget.

Today, the NRCS, funded by the British Red Cross, has 56 blood banks and 100,000 donor units, covering much of the country and saving thousands of lives every year. But it needs another 100,000 units and a dozen more blood banks with the latest screening equipment to curb the number of preventable deaths — particularly among women in childbirth.

Nepal has a maternal mortality rate of 539 per 100,000 births — one of the highest in the world — and maternal deaths account for more than 20 per cent of all deaths in the country, more than any other factor.
That in turn contributes to an alarmingly high infant mortality rate of 64.1 per 1,000 live births — or roughly 50,000 dead babies every year.

Of those, about 30,000 babies die within 28 days. And more than 16,000 do not survive more than 24 hours.

Some of the factors behind maternal deaths are cultural — women prefer to give birth at home, without expert supervision, and often have up to seven or eight children by the time they are 25.

But almost half of all maternal deaths are caused by post-natal haemorrhaging, according to Manita Rajkarnikar, chief of the NRCS central blood transfusion service. “In the absence of access to blood transfusions, many women die unnecessarily in rural areas,” she said.

Dr Rajkarnikaris showed The Times how her centre collects blood, sorts it by group, screens it for HIV, hepatitis B and C and other viruses, and packs it into 350ml bags to be distributed around the region.

She also demonstrated how the NRCS has been working to overcome cultural taboos and encourage ordinary Nepalis to give blood.

On a shopping street in central Kathmandu, it had set up a makeshift unit in conjunction with the local business association, and, using loudhailers, was urging people to come and give blood.

More than 250 people turned up in the course of two hours. Among them was Ashok Baral, 31, who runs a Chinese clothes shop in the neighbourhood.

Asked why he was giving blood, he explained that his wife, like Mrs Oli, had needed an emergency blood transfusion while she was giving birth to their son three years ago.

“Now I’m giving it back,” he said.