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Sonam Drolma and the Power of One

The story of a midwife trained by Kham Aid Foundation

by Pamela Logan

July 8, 2004

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In Yajiang (Nyachuka) County, there's a village called Sanbeihou that's spread all over the side of a steep mountain wall. In this village, is a woman named Kalsang Wangmo, age 20.  One of three daughters, she is a bit of a tom-boy who likes to wear trousers and a baseball cap turned backwards.  As the eldest, she was the first of her sisters to marry. 

A year ago last spring, she discovered that she was pregnant, an occasion of great joy to the father- and grantparents-to-be.  A strong young woman, she kept on helping her family with their crops of corn and wheat, until the night of December 28, 2003, when she was woken by her first labor pains at 3 a.m.

Someone ran to fetch Sonam Drolma, the village midwife, from her house on the other side of the village.  Unlike many societies, Tibetans do not have a strong tradition of giving assistance to the mother during labor.  Traditionally, birth is considered a messy business, and its bloody by-products are thought unclean.  Tibetan women normally go down the first floor of the house, the place where animals are kept, to give birth in the dark, upon a straw-covered dirt floor, alone.

In Sanbeihou, however, there was a real, trained midwife, Sonam Drolma, born and raised here.  Three years before, she was chosen by the village cadre to join a five week course in midwifery and home health care sponsored by Kham Aid Foundation.  In this course, she learned that deliveries should not be done in a barn, but on a clean bed, in the warm part of the house. She learned how to sterilize birthing equipment, how to care for the afterbirth and umbilical cord, and how to recognize problem pregnancies that call for a doctor.

Kalsang Wangmo's pregnancy, however, had not seemed troubled.  No one anticipated that she would have any problem at all.  The labor, at first, seemed normal.  Hours went by, the pains came on increasingly strong, until 4pm the next afternoon, when an infant boy presented himself to the midwife and the world.

But something was terribly wrong.  The little boy's body was stiff, inert, unmoving, and he would not take a breath.  To his horrified family, he seemed already dead.

In Sanbeihou, five or six new babies are born each year among the 58 families and 280 inhabitants.  The village has an ancient Tibetan name, Trazhong Gonpa - a long-vanished monastery.  The village is perched high on a mountain slope, above the Yalong River.  It is not terribly remote, at least not by Tibetan standards.  From the Yajiang County seat, one can walk the long, rising footpath to Sanbeihou in about two and a half hours.  Now they are building a motorable road, not quite open to cars, but wide enough for tractors to reach the village.

Kham is full of linguistic oddities, and Sanbeihou is odder than most, for the local speech is not any sort of Tibetan, but a variant of Sichuan Mandarin - albeit with an unusual grammar that is heard nowhere else.  This might be because Sanbeihou is located on the ancient caravan trail, the "tea road to Tibet" used by traders, settlers, missionaries, and conquerors who came through southern Kham over the last century in repeated waves.

Perhaps some time in the distant past, some of these Chinese travelers settled here, intermarried with the local Tibetan population, and introduced their language.  I say "perhaps" because no one in Sanbeihou knows how their language came to be.  They just know that Tibetan is not used here.  Some villagers cannot speak a word.

Yet, they are still Tibetan: in dress, lifestyle, and religion, Gelukpa being the lineage to which most Sanbeihou residents belong.  Their diet is perhaps better than most, for they are able to grow a variety of crops, eat meat and milk, and obtain vegetables, fruit, and other treats from the county town.  Their health is therefore probably better than most.  When they are struck by ordinary ailments like cold and diarrhea, they go to midwife Sonam Drolma for help.

Sonam Drolma received midwife training in 2001 in a five-week course held at the Kangding Maternity and Child Health Care Center, sponsored by Kham Aid.  That course was half classroom instruction, and half internship in the maternity ward.  She learned how to supervise a normal delivery, and how to treat common childhood ailments.  She knows her limits, too.  "Women come to me if they have a problem. If I think it's serious, I send or escort the woman to the county hospital."

In 2002, Sonam Drolma received more additional medical training in a program on general practice held in Litang. While she is far from being a doctor, she does have a grasp of basic first aid, giving injections, and prescribing medicines for common maladies.  She has no office, so she keeps her drugs and equipment in neatly stored inside glass-walled cabinets in the living room of her brother's house.

At age 40, Sonam Drolma is married and has three teenagers of her own.  She has delivered so many babies in Sanbeihou, that "everyone considers me like a parent," she said. Considering her rural background and the generation to which she belongs, she is remarkably well educated: she has completed grade 9. Thanks in part to her status as a village healer, she is its leading citizen, and with a reputation that has spread far and wide around the county. The village, therefore, chose her to represent them in township meetings. That's rare - usually the representative is the headman or the party secretary.

During Kalsang Wangmo's labor, Sonam Drolma saw two things that worried her: one, that the labor seemed to be going on too long, and two, that the baby was extremely large.  When the little boy came out stillborn, the family was hysterical with sorrow.  They begged the midwife to revive the child.

Sonam Drolma remembered something from her training in the Kham Aid program:  cardiopulmonary resuscitation.  She had never used it before.  But she decided to try.

Sonam Drolma put her mouth over the mouth and nose of the infant boy.  The child's tiny lungs expanded, and minutes later he was alive and breathing. The family was ecstatic at the miracle they had seen.

She said, "Since the training, we've changed a lot. Not just my family - the whole village has changed.   They are washing their clothes more often.  I have promoted hygiene, and so has the government, and now we wear much cleaner clothes."   Indeed, Sanbeihou is a tidy place, cleaner than most Tibetan villages.  "I've had two other difficult deliveries: one where I was escorting the woman to the county hospital, and the baby came while we were still on the trail.  Another time, the mother passed out for half an hour from severe bleeding."

Tashi Gyantsen, the baby that Sonam Drolma saved, with his grandmother..

And the little boy? Born at 4.5 kilos, Tashi Gyantsen is now a plump, jolly child who learns fast and seldom cries.  He is cared for by his mother, grandmother, and two adoring aunts.  When we visited them, he was racing around the living room of their big Tibetan house in a wheeled walker; though only seven months old, he was already on the verge of taking his first steps.

Meanwhile, Sonam Drolma continues to care for the people in her community.  She has delivered more than twenty babies in three years; she also vaccinates the newborns. One goal of hers is to add a room to her brother's house to be her examining room and infirmary.  The county health bureau has pledged 1000 yuan to her efforts; Kham Aid Foundation hopes to raise the remaining 7,000 yuan (about US$900).

To support our midwife program, go to how to donate.