Nepal – April 5 to May 6, 2017
A small but enthusiastic team in Nepal of two instructors and two students, Yuting Hsu and Haley Pelton, visited our Nepal partners, the ‘Midwifery Society of Nepal’ (MIDSON) this spring for our annual “Students for Global citizenship’ work. Instructors were Dr. Mickey Rostoker and me, Cathy Ellis. We started our trip in Kathmandu where, with the help of Midwifery Society of Nepal, I applied for and received a temporary license to practice midwifery.
During our first week we met with members of another UBC Midwifery project, “Birth Planning Preparedness’ project in Mugu, Western Karnali Region. Both Canadian and Nepali members were present including researchers from both countries, including a MIDSON member. We reviewed our respective roles in publishing our work to date in Mugu, Nepal, and planned a small midwifery health educational program for next spring in the remote area of Rolpa.
During our first week, our students visited the Tribhuvan University Hospital Birthing Center, and were asked to re-organize the set-up, and make a short report on ways to improve the birthing center and services. They were pleased to play a role in expanding the use of this birthing center for the ‘social model of care’ in Nepal.
As usual, we spent most of our time in rural and remote communities of Nepal where we provide midwifery coaching and refresher courses. We are authorized on an ongoing basis, to train, coach and mentor with members of MIDSON in rural and remote areas. Our first destination was Solu (the southern part of Solukhumbu) where we were headed to the remote Primary Health Center of Sotang for coaching and mentoring with the local midwives. We travelled and worked with Pema Sherpa, a well-known local nurse-midwife.
We first flew to Phaplu with our students, and the same day took a dusty, bumpy jeep ride for several hours with our porters, training materials, supplies, donations, tents and luggage to the end of the road above the river. We ate supper and stayed in a newly built tin-roofed and tin-sided hotel that seemed to me like a ‘space station.’ Each cubicle had one single bed, a dirt floor and wooden door. We set out early the following morning making a short trek to the river where we boarded a bamboo raft and two groups of men pulled the raft across the river using ropes. Shortly after, we boarded another jeep for 2 hours ride up the mountain and were greeting by the jeep owner and villagers and given ‘khatas’ (light-weight ceremonial scarves) as welcome to Sotang village. We spent three days there learning about remote medical care and coaching 9 midwives and physicians and community health workers. During our time there, Mickey and the community health head of the facility set up the new donated teaching computer and showed local mothers videos in Nepali language about danger signs in infants.
We left early in the morning and walked 4 hours to the river and up to the ‘space
station’ where we ate lunch and waited for a jeep to Phaplu. The jeep faltered on the uphill many times and we got out to walk up the hills, reaching Phaplu by nighttime.
After a day’s rest, we headed by jeep to the community of Salyan, where we stayed overnight in a small village about an hour and a half walk from the Primary Health Center. We visited a new mother who had given birth a few months prior at home, her 5th child, and distributed baby clothing and blankets from our Canadian knitters. Our objective also included a visit to a partially constructed community health center where the local auxiliary nurse-midwife would soon begin to provide primary and maternal health child services. Our students prepared a short report with diagrams of the proposed layout of the center in a way that could provide privacy and ease of access to toilet and water facilities to mothers and others being seen by the nurse.
Next we travelled for our labour ward placement to Baglung at Dhaulagiri Hospital and prepared the 2- day refresher workshop for both hospital and remote nurse-midwives. We had 23 participants including 2 obstetricians, 4 rural ANM’s and 4 nursing instructors. While in Baglung, the UBC students and I attended several births and observed care provided to women by both nurse-midwives and gynecologists. Our students had the opportunity to teach local students, catch babies, suture and provide newborn care.
UBC midwifery provided a new birthing ball to Baglung Hospital, new sheets, pillows and cloth for privacy screens, and a new screen to improve respectful childbirth, as well as many baby blankets, hats, and clothes. The birthing ball was helpful when a mother having her second baby was being induced and sat on it during labour pain, resulting in more comfort and a rapid birth.
Our time in Nepal finished with the May 5 ‘International Day of the Midwife’ celebrations in Kathmandu. We spent the day in a program with our colleagues from Midwifery Society of Nepal and learned of new steps towards establishing regulated midwifery in Nepal. We appreciate our long-term relationship with our friends from the Midwifery Society of Nepal and spent time with some of these colleagues at the International Confederation of Midwives conference in Toronto.
We wish to thank the donors who helped us provide equipment, materials, supplies and many large bags of beautifully knitted and sewn baby items to mothers in these remote areas of Nepal.
Report by Cathy Ellis, RM, MSc.
Coordinator, UBC Global Midwifery Placement
University of British Columbia Midwifery Program