How can I help my wife hand express? Pumps don't seem to work and one breast is swollen

You can slowly massage the breast 1st. Alternatively, please use a warm towel and put it around the breast area so that the breast will feel warm and milk flow can be stimulated to release milk more easily. Once there are milk flowing out, you can start off with hand expression before using the pump. Hand express can be very tiring but effective when the breast is swollen. Once the breast is softer, switch it to using pump so that your hands aren't tired. Do this regularly so that the breast will know that it needs to be emptied every time.

Your wife can also try placing clean cabbage leaves onto her breast to help reduce the swelling. Like what Vanessa has mentioned, massaging and expressing by hand would help ease the swelling. Breastfeeding can be challenging. Stay by her side and help her with other tasks to show your support. Take care!