Saving lives in Bhutan
The club raised money for maternity services in Bhutan in 2007/8. It may seem an exaggeration to say we’ve saved lives - but see the report below (dated 4 June 2009) to see the impact of the purchase of the lactate analyzer! Apologies for the graphic detail but this is the unedited report direct from Bhutan.
Report on Beckenham Soroptimists fundraising
In Bhutan, labour and delivery is a potentially dangerous time for both mother and baby. Over the last ten years great progress has been made in making the process of birthing safer for the women of Bhutan and their babies.
A major change which is happening at the moment is the construction of a large modern hospital in Thimphu: the Capital city. This will mean for the first time women will labour in a comfortable room with privacy.
As care is improving there are a number of changes in the delivery room. Once in the new hospital there will be easier access to some modern interventions. In particular, caesarean section for the safety of the baby will become a reality. In the past this operation was difficult to access (generally took 2 hours to get to theatre) and so was only used for maternal concerns. If a baby was thought to be low on oxygen in the womb, nothing could be done quickly and ultimately the baby could be stillborn or suffer brain damage.
In the new hospital, there is easy access to theatre and therefore delivery of the baby by caesarean section can be performed when the baby is thought to be at serious risk of low oxygen levels.
This will bring Bhutanmuch closer to a Western model of Obstetric Labour care, however there is a potential downside. How to assess accurately the baby at risk? For over 20 years the assessment has included elements from the womans history eg small baby, her labour eg meconium (faeces) in the amniotic fluid and the fetal heart rate. The fetal heart rate can be monitored by listening intermittently or by using a machine called a Cardiotocograph (CTG) continuously when the baby is thought to be at higher risk.
In the developed world, the history, examination and CTG are crude assessment tools and will often overcall problems. This will result in unnecessary caesarean sections for babies who are actually fine. Already in Thimphuthey have started to see caesarean section rates increase as a result of the use of the CTG.
This is where the lactate analyzer is useful. Most Western units have now started to use this technology to halt the rise of unnecessary caesarean sections. During labour if there is concern about the babys wellbeing, using an instrument in the mothers vagina like a speculum, a sample of blood is taken from the babys scalp. This is then quickly analysed in the machine and an accurate assessment of whether the baby is at risk can be made. It is based on build up of lactate acid in the muscles, which means the baby is at risk of brain damage. Many are normal and therefore delivery can be awaited to happen normally.
This equipment in now in Bhutan at the National Referral Hospital. Dr Phurb Dorji is developing a protocol for use and planning implementation once the new unit is completed. This is expected in September 2009. This could not have been done without your help and we thank you for your support.
Emma Parry
Phurb Dorji