Joy amid the storm: a cyclone brings the stork to 1,600 mothers shifted to safety in Odisha

Just before Cyclone Dana made landfall along Odisha’s coastline, pregnant women were shifted to hospitals in safer locations so they would have a comfortable labour and delivery. The Hindu reports on how this was done and of the joy of the families in the midst of stormy weather

Pranati Das’s modest 900-square-foot house is nestled in the heart of a vast expanse of green paddy fields. Just 10 km from the Bay of Bengal, off Odisha’s coast, the house in Kendrapara district’s Giriapahi village is abuzz with cheer. All 17 family members are celebrating the arrival of a new member: a boy, born a week ago.

The baby, 31-year-old Pranati’s third child, was born amid winds gusting over 100 km per hour and rain lashing the windows. He arrived with Cyclone Dana, classified as ‘severe’, which made landfall on October 25. Named by Qatar, ‘dana’ means generosity in Arabic. That night, the cries of nearly 1,600 newborns echoed in primary health centres (PHCs) and hospitals along the State’s coast. The mothers had been shifted to these safe spaces during the lull before the storm.

The State’s disaster managers are familiar with deliveries in public health institutions during cyclones or other natural disasters. Over the past couple of decades, shifting pregnant women to safer locations like cyclone shelters and hospitals has been a routine part of their protocol. However, a large number of women delivering babies during Cyclone Dana’s landfall has multiplied their sense of personal fulfilment.

During the cyclone, Chief Minister Mohan Charan Majhi issued orders for field-level officials to ensure all expectant mothers were admitted to public healthcare facilities. Up to 4,872 women were transferred to hospitals or Maa Gruhas (waiting facilities for pregnant women). Of the 2,865 successful deliveries, 2,367 were normal births, while 498 required life-saving caesarean sections. There were 18 women who bore twins.

There is a well-oiled machinery under the Odisha State Disaster Management Authority that looks after both the run-up to a potential catastrophe and the rescue work after. Set up post the 1999 super cyclone that claimed nearly 10,000 lives, it was the first entity to look at preventive measures. The National Disaster Management Authority was only set up in 2005. In addition, the Special Relief Commissioner looks after relief and rehabilitation.

In the safety of a health centre

The Das family’s home has only 100 square feet covered by a concrete roof; the rest is shielded from the elements by asbestos sheets. If wind speeds had reached 130 to 140 km per hour, the sheets might have blown away, forcing the family members to take refuge in a single room. In such a scenario, rushing Pranati to the nearest PHC in Talachua, 10 km away, would have been almost impossible. From a distance, the home is picture perfect. However, reaching it requires navigating a muddy path between two paddy plots, with no pedestrian trail.

Pranati’s expected date of delivery (EDD) was October 28. “The India Meteorological Department (IMD) had predicted the storm would make landfall in my area on the night of October 24 and the morning of October 25,” she says, adding that she was anxious and frightening thoughts began crossing her mind. “My mother-in-law, Janaki Das, is a midwife who has helped many women deliver their babies,” she says.

Before the family could consider how to manage her pregnancy, accredited social health activist (ASHA) worker Bandanarani Mandal visited their home. She explained the potential risks of not being admitted to the PHC. The family decided to heed the advice. Soon, a vehicle provided by the State government moved her to the PHC.

Mandal, deputed for Pranati’s village, plus Ahirajpur and Pravati villages, had identified 19 pregnant women in the area. Two women with EDD before November 5 were moved to the PHC, while others were relocated to concrete houses near accessible roads. “The idea was to keep them close to the main road for easy evacuation in case of an emergency,” she explains.

Three days before the cyclone hit, when it first formed over the Bay of Bengal, roughly 800 km from Paradip port, ASHA and anganwadi workers, and members of panchayati raj institutions, convened a meeting to identify vulnerable sections of people. They prioritised pregnant women, children, elderly women, and men.

At the PHC, Dr. Upasana Biswal, who is just starting her career, faced the critical task of monitoring five pregnant women approaching the EDD who were relocated there on October 24.

As Dana neared landfall, Pranati went into labour. The medical team sprang into action. The cyclone made landfall near Habalikhati Nature Camp in the district, about 5 km away, as the crow flies. With the landfall still under way, Pranati safely delivered a boy weighing 2.15 kg. Although slightly underweight, the newborn met all health parameters and was deemed healthy.

“It was a nerve-racking experience,” Dr. Biswal shares, from the rudimentary PHC that is not equipped to handle operations. “The IMD predictions had put us on edge. Knowing that a cyclone was about to make landfall, with our area at its centre, it naturally made us worried about our personal safety. But I had five vulnerable women depending on me,” she says, adding that within the PHC everyone just prayed that the storm would pass without causing any disaster. Around the PHC, trees were twisted under the impact of the cyclone.

Archana Pradhan, 26, faced a similar situation at Nodhabasantpur village, 30 km from Giriapahi, in the same district. Pregnant with her second child, she was confident of managing the delivery at home, a practice still prevalent among about 13% of people in Odisha, as per the National Family Health Survey 4. But as Dana approached, her confidence crumbled. “My family and neighbours all urged me to get admitted in a hospital right away,” she recalls.

Around 7 a.m. on October 25, just hours after the cyclone made landfall, Pradhan delivered a healthy girl weighing 2.6 kg at the Rajnagar community health centre (CHC), a larger facility than the Talachua PHC, which was bustling with expectant mothers. Out of the 32 women brought here, 12 had normal deliveries.

At the CHC in Salipur, Cuttack district, Reshma Begum was overjoyed as she welcomed twins, a boy and a girl. Like Pranati and Pradhan, she had weathered the cyclone without complications.

A memory like a bad dream

This year Odisha marked the 25th anniversary of the devastating 1999 super cyclone. Memories resurfaced of those who thought they were safe at home. Many, including pregnant women, had sought shelter behind walls that proved powerless against the onslaught of seawater surging from the Bay of Bengal, driven by winds exceeding 260 km per hour. Homes were swept away, entire villages erased, and people set adrift like paper boats, in a catastrophe that struck hardest along the coast. In total, 12 of Odisha’s 30 districts bore the brunt of this disaster.

Since then, the State has faced seven more cyclones, including Dana. With each disaster, lessons have been learnt and more resilient community-based disaster preparedness has been put in place. Strategies to ensure the safety of vulnerable groups, including pregnant women, have advanced steadily. Even as flights and trains were cancelled, Cyclone Dana did not cause any deaths in the State.

Umi Daniel, who had worked extensively with communities during the 1999 super cyclone, says, “In those days, there was no advisory issued, although everyone was alerted through a public address system during disasters. People were fending for themselves.”

Now, ASHA, auxiliary nursing and midwifery (ANM), and anganwadi workers are deployed in large numbers in villages for routine work in the health and education spaces. They have played a key role in identifying specific needs of people.

More to be done

“Isn’t it remarkable that not a single maternal death has been reported even as the healthcare system was put to the test by the cyclone? Over the years, we have built a resilient system focused on maternal safety,” says Sanjukta Sahoo, Odisha’s Director of Family Welfare. She says there has been a change in the mindset of people, who now opt for institutional deliveries.

The State government had compiled an extensive list of 34,080 pregnant women, including 9,877 with EDD within two weeks of the cyclone. “We took special care to reach out to each pregnant woman, persuading them through ASHA and ANM workers to come to hospitals. Some readily agreed, while others who had concrete houses took time to make a decision. But we were persistent,” says Pramod Kumar Praharaj, Chief District Medical Officer of Kendrapara.

The digital data bank on pregnancy, populated by ASHA and ANM workers, helps the government move swiftly. Health Department authorities say the trust in government facilities, usually known for poor infrastructure and overcrowding, has increased after Dana.

All leaves for doctors in Kendrapara, Bhadrak, and Balasore — three districts anticipated to be affected by Dana — were cancelled. In addition to the Chief District Medical Officers, three senior officials of the Additional Director rank were stationed in these districts. Government hospitals were equipped with 1,240 functional generators to ensure uninterrupted power and 1,265 ambulances were on standby for emergency response.

“There has been a huge improvement in Odisha’s disaster management system, which works seamlessly during calamities. However, there is still scope for improvement,” says Sneha Mishra, a civil society activist who has also worked with communities since the 1999 cyclone. When pregnant women at the five- to six-month stage of pregnancy are shifted to cyclone shelters, the toilets are unclean, for instance. The next step, she says, is to improve amenities, so women, especially those on their menstrual cycle, are well taken care of.

Published - November 02, 2024 05:12 pm IST