Like most women in Kalena, a small village in the Doti district of western Nepal, Saru Devi Auji works hard. Each day she wakes up at 4 a.m. to feed the cattle. She gathers wood, tends the fire, and prepares the family’s meals. She maintains her house and looks after her four children, whom she cannot afford to send to school.
In her spare time, Saru saves lives.
As part of Nepal’s national Female Community Health Volunteer (FCHV) program, Saru provides vital primary health care services to the people of Kalena.
FCHVs distribute vitamin A and deworming tablets to young children, offer family planning counseling, distribute condoms and pills, manage cases of pneumonia with first-line antibiotics, treat diarrhea with zinc and oral rehydration salts (ORS), and provide safe birth counseling to pregnant women. They also play a key part in monitoring routine immunizations and administering vaccines to fight preventable diseases like polio.
Foundation grantees Save the Children 
and CARE support the FCHV program, which now serves all 75 districts of Nepal. There are more than 48,000 community health volunteers like Saru, each responsible for as many as 150 households.
Saru became an FCHV after losing a son to diarrhea. “We didn’t know to give him water, and we didn’t have the money to take him to the hospital,” she says. “He was crying for water when he died.”
About 31 percent of Nepal’s population of 26 million live below the national poverty line, and its rates of maternal and child mortality are among the highest in the world. “The average age of an FCHV is about 40 years,” explains David Oot, associate vice president of health and nutrition at Save the Children. “Virtually all of them have experienced the death of a child.”
Saru has learned to cope with her loss by helping others avoid similar fates. “‘So I’ve lost my son,’ I thought. ‘I should do something to make sure my fellow villagers don’t go through a trauma like that.’” Through her work as an FCHV, she’s become a mother to her entire village.
Over the past two decades, volunteers like Saru have had a tremendous impact on the health of Nepal’s poor. By latest counts, in a single year, FCHVs had treated 236,000 children with pneumonia and distributed 854,000 packets of ORS and 1.8 million zinc tablets. All told, these efforts save an estimated 12,000 lives each year.
Experts predict that Nepal will reduce deaths among children under 5 by two-thirds in the next five years. For that remarkable achievement, we owe a profound debt of gratitude for the courage and compassion of women like Saru.