You’ve worked in public health for a long time — how did you get started in the field?
For more than 20 years I have worked in maternal, newborn, and adolescent health. My first job as a health assistant was a one-day drive and a 13-hour walk from Kathmandu, the capital of Nepal and my home. I had never been outside the city and had no idea that there was such extreme poverty and remoteness in my country. I was shocked by how different it was. People didn’t have enough food. They were dirty and I wasn’t used to that. For a few days I couldn’t eat, I couldn’t sleep, and I worried that I couldn’t do the work. My family told me to come home, but I wanted to try.
What kind of work were you doing?
Although I was a health assistant, my responsibilities often included those of a doctor. I assisted deliveries and provided medicine. I remember a woman vomiting round worms as she delivered her ninth child. Another time someone knocked on my door and said, “My wife is dying, please come.” I went to his wife, who was in labor and surrounded by children. I delivered the baby and they both survived.
That night, however, I couldn’t sleep. I worried about women having so many children and dying in childbirth. If mothers knew about family planning, they might not have so many babies. If they got antenatal, delivery, and postnatal care they would not die. I realized that information about preventive health and access to the services was what people really needed, and decided to go into public health.
“I realized that information about preventive health and access to the services was what people really needed, and decided to go into public health.”
How did you encounter JSI?
I got a job as a SUMATA (good mother) campaign coordinator. SUMATA was led by Johns Hopkins University/CCP and worked with JSI’s Nepal Family Health Program. I didn’t know much about JSI, but I sat with them for a year and was so impressed by their work. Although JSI staff sat in the government office, they kept such a humble profile that no one knew they were JSI.
When SUMATA was coming to an end, JSI had a vacancy for the safe motherhood and newborn subcommittee coordinator. The day before the application deadline, the JSI country director called me and said, “Leela, I am going through the CVs of the applicants but can’t find yours. Are you lost?” Then she added, “We are so impressed with your work and relationship with government, you must apply!”
I was reluctant because I was young and talking with the government can be very delicate. I would have to represent JSI; what if I did something wrong? But my husband encouraged me to apply, and in April 2003, I was offered the position that I would serve for nine years.
JSI has provided a wonderful platform for becoming familiar with government policy, systems, and working culture. I was involved in operational research for a pilot phase of national scale-up of misoprostol use to prevent postpartum hemorrhage during home births, which has resulted in fewer newborn deaths. Now I am project manager for the Chlorhexidine Navi Care Program, which is saving babies’ lives in Nepal. I feel so lucky that JSI trusts me enough to lead this important project!