Hearing the heavy thud of the door close behind her, she heads out into the cold Tibetan night. This mother is burdened with a deep, raw feeling of uneasiness. She served the women of the region as a traditional midwife for years, before the NGO trainings started and younger women took her place. She knows that the woman attending her daughter has knowledge and skills that she did not, and that brings her comfort. However, she also knows that sometimes knowledge itself is not enough. Women deserve more, she thinks to herself, making a vow to ensure that her grand-daughters stay in school and learn as much as they can.

She turns a corner, and finds her son-in-law filling a bucket full of Yak dung to heat the house for the evening as his wife labors. Slowly, she tells him of the recommendation from the midwife that the family transport his wife to the local hospital. This husband sighs, slowly shaking his head. He feared this, he says, experiencing a tightening in his heart. He is thinking of what is required to get his wife to the hospital and find her the treatment she needs: more money than his family has, he is sure. In fact, more money than his family will earn all year, yet this is the only option. He looks at his mother-in-law, and she at him. They turn away, each knowing what they must do.

Choosing different routes back to their home, the mother and the husband each stop and ask their neighbors if they can borrow money. Everyone in the village is in this position at some point in time, as there is never enough money for emergencies in communities where families earn less than $30 a month, and the neighbors give what they can. Somehow, money is secured and they race back to their home.

Rushing through the door, the mother and the husband tell you, the midwife, of the news: they’ve secured the funds needed and a neighbor has gone to get the tractor. Together you prepare the laboring woman for the trip, wrapping her in warm clothes, feeding her a few bites of tsampa, and a few sips of warm butter tea. Walking to the tractor, everyone is muttering “om mani padme hum” or other sacred mantras under their breathe. You are praying for a safe journey to the hospital and a healthy outcome for all.

The ride in the tractor is rough, as there are no roads from the village to the main road Over each bump, you hear your laboring friend suck in her breath, or moan. You hold her tight, telling her over and over again that you are almost there. After a few long hours, you reach the main road. Now it is just a few more minutes to the clinic. There is only one more obstacle remaining: will you have enough funds to get this struggling woman the care that she needs?

Upon reaching the front door of the hospital, you find that your laboring friend now has a fever and has lost a great deal of blood during this trip. You rush to find the attending nurse or doctor as the family gets the woman on her feet and into the hospital. You see the doctor on duty, you tell him of the situation, urging him to admit her immediately. He asks how much money the family has brought with them. You tell him, knowing it is less than the amount required for emergency obstetric care, that this is a poor family. You pause, trying to determine his degree of sympathy to your case. You gently, yet urgently, advocate for the woman by reminding the doctor that he will be reimbursed by the local government in a few months when the proper paperwork for the national insurance plan has been submitted, reviewed, and approved. He pauses, and walks away. You are left with the family, who has reached the hospital entry way and are visibly anxious about their loved ones’ deteriorating condition. The doctor returns after what seems like an eternity saying that she can be admitted, but the family will have to pay extra to sleep at the hospital and to access the kitchen to cook her food. They all agree, and your friend is rushed into the surgery theater to receive the care that will hopefully save her life.

You continue to support the family, waiting outside for an update from the hospital staff to report on her status. The family paces the hall, continually praying for the safety of the laboring woman. In the wee hours of the morning, a nurse emerges from behind two wooden doors, telling you that the mother and baby are fine, sleeping, and as is custom, only the father and grandmother can see them for the first few days after delivery. She will need to stay a few additional days and the family will need to find the money to pay for this in the coming days, as well.

You all breathe a collective sigh, knowing that your efforts were not in vain. You close your eyes, and say a prayer of thanks. May all sentient beings be safe, may all sentient beings be healthy.

This story is one that could take place almost anywhere in the developing world, just change the specifics like the Yak dung and butter tea, and this midwife could be anywhere doing what she can to support laboring women. COHI is in its final stages of providing the first round of maternal child health trainings to local midwives and village doctors in Tibet. Your support is essential in order to continue trainings, and to provide equipment like birth kits and medicines.

To donate to this project, or other women’s health focused initiatives that COHI is leading, please visit COHI’s website at www.cohintl.org, or click here to donate now. Rushing through the door, the mother and the husband tell you, the midwife, of the news: they’ve secured the funds needed and a neighbor has gone to get the tractor. Together you prepare the laboring woman for the trip, wrapping her in warm clothes, feeding her a few bites of tsampa, and a few sips of warm butter tea. Walking to the tractor, everyone is muttering “om mani padme hum” or other sacred mantras under their breathe. You are praying for a safe journey to the hospital and a healthy outcome for all. The ride in the tractor is rough, as there are no roads from the village to the main road Over each bump, you hear your laboring friend suck in her breath, or moan. You hold her tight, telling her over and over again that you are almost there. After a few long hours, you reach the main road. Now it is just a few more minutes to the clinic. There is only one more obstacle remaining: will you have enough funds to get this struggling woman the care that she needs? Upon reaching the front door of the hospital, you find that your laboring friend now has a fever and has lost a great deal of blood during this trip. You rush to find the attending nurse or doctor as the family gets the woman on her feet and into the hospital. You see the doctor on duty, you tell him of the situation, urging him to admit her immediately. He asks how much money the family has brought with them. You tell him, knowing it is less than the amount required for emergency obstetric care, that this is a poor family. You pause, trying to determine his degree of sympathy to your case. You gentley, yet urgently, advocate for the woman by reminding the doctor that he will be reimbursed by the local government in a few months when the proper paperwork for the national insurance plan has been submitted, reviewed, and approved. He pauses, and walks away. You are left with the family, who has reached the hospital entry way and are visibly anxious about their loved ones’ deteriorating condition. The doctor returns after what seems like an eternity saying that she can be admitted, but the family will have to pay extra to sleep at the hospital and to access the kitchen to cook her food. They all agree, and your friend is rushed into the surgery theater to receive the care that will hopefully save her life. You continue to support the family, waiting outside for an update from the hospital staff to report on her status. The family paces the hall, continually praying for the safety of the laboring woman. In the wee hours of the morning, a nurse emerges from behind two wooden doors, telling you that the mother and baby are fine, sleeping, and as is custom, only the father and grandmother can see them for the first few days after delivery. She will need to stay a few additional days and the family will need to find the money to pay for this in the coming days, as well. You all breathe a collective sigh, knowing that your efforts were not in vain. You close your eyes, and say a prayer of thanks. May all sentient beings be safe, may all sentient beings be healthy. This story is one that could take place almost anywhere in the developing world, just change the specifics like the Yak dung and butter tea, and this midwife could be anywhere doing what she can to support laboring women. COHI is in its final stages of providing the first round of maternal child health trainings to local midwives and village doctors in Tibet. Your support is essential in order to continue trainings, and to provide equipment like birth kits and medicines.

To donate to this project, or other women’s health focused initiatives that COHI is leading, please visit COHI’s website at www.cohintl.org, or click here to donate now.