In a village of 1,200 people, one woman’s shoulders carry a big responsibility.
Nirmala, 20, is the only lady health worker (LHW) in her village of Rahi Raro. She walks door to door, barefoot, under the scorching sun. Her trusty handbag, a basic medical kit, holds everything she needs to make her rounds — medicines and an instrument to check blood pressure.
Usually dressed in a sari and glittering in silver jewellery, the mother of three stands as a role model for many young women in her community.
“It is difficult for the women in my village to travel to Umerkot city, 150 kilometres away, to give birth or for routine checkups,” she said, fixing her veil.
Rahi Raro comes under the Union Council of Khipro in Umerkot district, which has more than 250 villages — several facing the same healthcare issues. Unfortunately, not everyone has a Nirmala.
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Nirmala’s knowledge of healthcare came through a programme initiated by Health and Nutrition Development Society (HANDS), an NGO. Their aim was to ensure basic healthcare in remote areas of Umerkot.
“We selected local women and trained them for six months as health outreach workers because they understand the problems of women in the area better than us,” explained Bilquis Rehman, the general manager of the programme. “The LHWs are called Marvis — this stands for Marginalised Areas Reproductive (health and family planning) Viable Initiatives.”
Nirmala is one of the 350 Marvis who are providing guidelines to basic maternal facilities and precautions a woman should take when she is about to give birth. Since her training, the 20-year-old has been spreading awareness in her village and others. While talking to The Express Tribune, she said that since she had started practicing and using the safe delivery kits, infant mortality had gone down. Along with her daily rounds, Nirmala is also directly linked with hospitals in Umerkot city through the telephone. She is able to call them in emergencies.
Nirmala is the only educated woman in her village, having completed her Intermediate from Chachro after she got married to Reeju, nearly six years ago. “I want my wife to educate the girls of our village and work for women empowerment,” said her husband.
“I am able to do a lot of work for my village just because my husband supports me unconditionally,” said Nirmala. “Whenever I go out to check my patients, my husband takes care of the children.”
Indira, 25, also lives in Rahi Raro. She is a mother of three sons and thinks this is a good initiative. “Everyone in the village appreciates what Nirmala is doing,” she said. “The way she works and informs us about what to do in pregnancy is very helpful.”
The local midwife of Rahi Raro, Babri Sheru, 55, also works with Nirmala. “We work as a team,” said Sheru, who has been a midwife for over 30 years. “With her education and my experience, the results are always good.”
Going all the way to the city to give birth is not an easy option for many villagers. The route, as most villages are in a desert terrain, requires a four-wheel drive vehicle.
“We charge Rs500 per delivery, while going to Umerkot city for the baby will cost a family at least Rs200 per person,” said Sheru.
To ensure that everything is normal and healthy with the mother and her baby, Nirmala keeps regular checks of the height, weight and blood pressure of the mothers who walk into her health centre. To double check, Nirmala refers to charts and forms provided to her by HANDS.
“If a woman’s weight is less than it should be, then I give her medicines like folic acid and folic sulphate,” she said.
Published in The Express Tribune, April 25th, 2015.
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