During my visit to a tribal district in India, it took us nearly 3 hours of driving from the nearest town (over rough hilly terrain and the last leg of the journey over a non existent road) to reach a remote village to assess the health services available to the people and to assess the time taken to access the nearest health facility.
When we reached, a celebration was going on in the village with the playing of drums and people singing. I just happened to ask what was going on. I was told that a baby boy has been born and it is an occasion to celebrate.
We then proceeded to the local health facility which was supposed to be a sub-centre with facilities for institutional delivery under the care of an Auxillary Nurse Midwife (ANM). It turned out to be an old dilapidated structure with bare minimum infrastructure. There was no running water or electricity in the sub centre. I wondered if the baby just delivered had been delivered at home. when I asked the ANM accompanying us, she told us that the lady had a prolonged and difficult labor and by the time they could make arrangements to take her to the nearest hospital, she gave birth to the baby and died of post-partum bleeding. I was stunned. Her family was celebrating the arrival of the baby while getting the mother ready for cremation.
The ANM shared that the tribals sometimes take the patients and pregnant women on makeshift stretchers and beds to the nearest motorable road and then have to arrange a vehicle to take them to the nearest hospital.