Friday, April 24, 2009

A night in the maternity hospital in Srinagar


There is no crowd pushing forward to gate crash, no fake excuses by attendants to get inside, no obstinate denials by the security and no bribed entries later. The gates are flung open, men smoke on the porch and the benches. The dark moonless night has fallen and Lal Ded (LD) hospital, the valley’s biggest maternity hospital, is silent except for the dogs and few far away voices.

Pale light floats through the long corridors narrowed by people leaning against the walls, some sleeping on green, blue and red Styrofoam mats, and some chatting in whispers on the wooden benches. In the labour room on the first floor, women moan rhythmically in pain, calling their mothers and fathers as they would have called them once as children. The high pitched shrieks woven together with subtle moans float through the entire floor, and attendants pace uneasily through the corridor.

Saleema Jan, 62, squatting and leaning against the wall gently rocks herself, her palm covering her forehead as she mumbles a prayer. Her daughter Mehtab Bano is inside the labour room, crying out her name in an agonizing pitch. Saleema Jan is in pain outside.

“Adamas adam phatun, yehai che, gubra, qayaamat aasan (a human growing in a human and then separating: the pain, my son, is beyond words),” says Jan, the tips of her fore finger and thumb anxiously rubbing the corners of her dry lips, her tongue flickering out to wet the tiny fissures. “If my daughter sees that I am even weaker than her, she will loose all strength and can’t face this ordeal.”

Jan remembers the old days when she was afraid of going through the pain again after giving birth to two sons. But, the desire for a daughter made her bear all the agony again. “I used to be happy that I will have another child but then I would remember this moment when every muscle twitched in pain and my hands would shiver with the thought,” she says.

Twenty years ago, the rate of Caesarean deliveries was much less. Women would bear children without surgeries and sections. Jan delivered four babies, but never by a Caesarean section. “Back then, boad operation (major operation) caesareans were looked down upon and women who delivered after cesareans were thought of as lazy and weak,” she says. “But today most deliveries are by an operation in the theatre.”

According to a report published by a doctor in 2006, 85 percent of the deliveries in LD happen by caesareans. As per the WHO guidelines, not more than 15 percent of the total deliveries should happen by caesarean. The report cites “Adequate trial of labour not given to the pregnant women” as the main reason for the high cesarean rate in the hospital.

“If a woman gets a cesarean in her first delivery, it is almost sure that her second delivery will also come by a cesarean and the chances of a third child being born to the woman are negligible,” says a female gynecologist. The gynecologist says that women now demand cesareans because they do not want to go the pain. “I write on the medical records that the cesarean was demanded,” she says. She has herself had cesareans for her deliveries.

On the second floor, above the labour room, families wait on benches, and blankets. Cups of tea pass around. There are no shrieks, no moans here. Only faint sounds of occasional steps come from inside the Operation Theatre.

Fahmeeda Akhtar, 47, waits with a soft mink blanket on her lap. Her daughter is inside too, but under the knife undergoing a caesarean. “Vani gaeses bahaar haavun aemis shur sund (Now God should show her the blossoms of this child),” Fahmeeda says, her hands buried under the tiny mink blanket. Her son- in- law has gone out to buy a baby feeder and other things they would need in the post operative ward.

There is no waiting room for attendants to wait for their patients. It looks like a hostel corridor, young boys striking up old chats.

Outside the post-operative ward, Mohammad Shafi Dar, 29, removes his ankle-high fur shoes. He wears no socks. The skin of his toes is dead and white, and his feet smell. The woman sitting next to him pouts her lips and slides a couple of feet away. “I have removed my shoes after three days. My wife had some complicacy and I have not had a wink of sleep for the last four nights,” says Dar. Dar lives in Pulwama where government doctors denied treating her wife and he had to come here in the middle of the night three days ago. “They (government doctors) have started a nursing home near the hospital and they asked us to come there and pay 18000 rupees. They said they cannot do anything if we did not come to the nursing home.” Dar became father to a son this evening. Under creases of weariness and oil, his brown face lights up with the mention of his son. “Only women have the patience to undergo the childbirth. But, we have our own responsibilities and they are also painful too. I cannot share my wife’s pain, or I would have already done,” says Dar.

The bathrooms are stained and messy, and water trickles from the tap. The ceramic is yellowed and rusted: it should have been white once. Someone forgot to flush the commode.

Inside the wards, the lights are dimmed, and patients sleep on the beds- two on a bed. On some beds, husbands sleep with wives.
The floor is packed with the attendants, some sleeping with their lips agape, some hidden under the blankets looking like a sac, some snoring loudly and other irked by the grumbled noise. It is midnight and the warm corridors, by now, are covered with bodies of slumping old fathers, frail younger sisters, ageing mothers and anxious husbands- all sleeping on each other. It is warm, quiet and cozy.

The staircase back to the labour room is like an elevator to war zone- women holding their bellies up with both their hands, walking slowly, as if walking on water. A male nursing orderly carries around a pregnant woman in a wheel chair, her head thrust back, her teeth biting on her lower lip in pain, her hair open with slight traces of an old knot.

Two male orderlies walk in and out of the labour room, carrying in drugs, injections and other supplies. Mohammad Yousuf, 37, a male nursing orderly has been working in the labour room for five years. He doesn’t tell his friends that he works here- only his immediate family knows. “What should I tell I tell my friends that I work in labour room all day? They will make fun of me,” says Yousuf. Yousuf remembers the time when he first came to the labour room and he would carry the moans and agony with him to his home and his life outside. “Back then it was different but now I have seen so much. The moment I leave this room, I forget everything. I don’t even hear the shrieks anymore here. I have become used to it,” Yousuf says. “If I remember it, then, I won’t be able to do anything. If a woman remembers it, she will never give birth again.”

A young girl rushes out of the corridor, crying for her father. Inside, life is conceived of an agonizing ordeal. “Papa, sister gave birth to a boy,” she cries.

In the side corridor, Saleema Jan is still sitting, now on a blanket, chatting with two other mothers. They talk of old times, of village nurses and of their own pain, but with smiles. All of them are all grandmothers now.


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