Saying goodbyes before we've even said hello.

Getting excited about the prospects of a midwive led
birth room for the midwives at Dhulikhel hospital

Yesterday, it felt good to work positively towards getting homes for all of the books and equipment we’ve brought with us. On the floor of our little bedsit, several piles grew for several destinations. There was no panic, or new info about airports shutting down. It was sad to hear that Everest has closed to tourists, and I wasn’t surprised to hear of the Cobra’s woolly and inadequate outcome.

Having been so impressed with the amazing work going on at the primary health post at Melamchi, (and I’ve not fully explained how this long day went) we felt it was important to continue that roll and send them new equipment and books. Laxmi, president of MIDSON, will travel past the post next week, and will drop the equipment off for us.

Piling up the wonderful donated and bought items
and books for all the centres we support.

We met three of Kathmandu University students at the MIDSON office in the afternoon. Bless them for getting the long bus journey into Kathmandu from Dhulikhel. We were to be out there on Tuesday, to meet the two midwifery cohorts, staff and obstetricians, but this had to be cancelled due to our hasty return home.

One of the books donated by midwife author, Becky Reed.
Such an inspiring book for these new midwives.

 These students are in a 4^th year of studies, so it’s actually more of an internship. They have spent time out at Melamchi, where they were ‘free’ to practice midwifery skills they are not able to practice in the hospital setting (women are all still giving birth on a bed, in lithotomy position). They told us eagerly of their desire to use a room in the hospital, that they might call ‘midwife led’. We’ll be supporting them to manifest this with the hospital managers. They also have a TENS machine donated from our last visit to them. The students practise using it in the lab, but are not allowed to use it on the women in labour. I’ll give more information for them to share with the multi-professional team, to see if the birthing women can actually benefit from this resource.

Books, balls, TENS, and other midwifery items were given to the girls for them to haul all the way back to Dhulikhel. We all felt blessed to have had this catch up time. All of these pioneering midwives face such challenges, and so many doors are still closed to them because midwifery still isn’t thoroughly understood. It’ll get better. It is getting better. But these first midwives are doing wonders, and staying so positive and strong.

Bids open for a special roll of
Nepali toilet paper.

I think I mentioned there were some purchased books already here, via a trekker friend’s luggage allowance, and these books will go to the MIDSON library that we started last year. We left more purchased and donated books and journals, as well as those, again this year. There are now 33 very useful midwifery books for MIDSON members to use as reference, or to borrow for a short time. I’ve left them with forms to fill, requesting members pay a deposit to cover any loss or damage of the books. If this system doesn’t work, and books are mislaid, we may decide to use a hospital library to donate books to in future. This would be a great shame, as we actually want to encourage members to frequent the MIDSON office, and of course, to read up to date evidence on midwifery practice.

On the 40 minute walk home, we managed a bit of gift, fabric, and food shopping. Another step more prepared for an early exit. We got back ‘home’ to wifi and no new reports of a change required to our plans. Another phew!

Walking over the decidedly unsavory Bagmati river.
You'd never guess the abuse on the senses it brings.
This photo is almost beautiful.

Today, we’ve had a lazy start. Some useful communication with the KU midwives, and we plan to meet Dr Shree Prasad from the Paropakar Women’s Hospital. We’ll give him the books and equipment for the new Birth Centre there. We heard yesterday that the six KU midwives will work at that hospital along with the 7-8 NAMS midwives. There is some anxiety felt that they’ll not be able to practice their full scope of midwifery skills, and I think Dr Prasad has the communication capacity to unite the multi-professional team towards smoother working conditions for these new midwives.  It’s such a shame we’re not able to provide the workshops we had planned.

I bought essential oils to be used at this hospital, but it would be irresponsible to gift them without providing training for their safe and correct use. So the oils will be coming back to UK with us until next year.

I’m hoping we’ll have a chance to meet up with our good friend, Rashmi Rajopadhaya later today. The thought of leaving before getting a chance to soak up her wonderful vibes and laughter, is too sad. She is, for me, The Honourary Midwife of Nepal. I bring a personal gift of good chocolate and coffee for her family, although Nepali coffee in recent years is quite exceptional.

Tomorrow we will visit the Teaching Hospital Birth Centre. This is the unit that is most similarly akin to what we expect of a MLU in UK. We’ll enjoy seeing the wonderful figures they have of normal births and women’s satisfaction from good, respectful, intrapartum care. Last year I had my hand slapped about pushing for the nurse-midwives to be included in provision of antenatal care. This area of care is still very much provided by obstetricians, and I suspect the numbers of women allocated or choosing the birth centre is not as healthy as it could be because of this. I was warned by the senior staff that change, albeit slow, was happening. Let’s see if there’s progress this year...

Leaving Tulsi, Anita and Puspa on the pavement to catch
their bus back to Dhulikhel. Such a shame we
couldn't meet the other girls in their cohort.

We’re keeping an ear on the news in UK, US, and Ireland, as well as the rest of the world. What an interesting time we are entering. I so want to be home to my parents, to ensure they’re going to be kept as safe as they can be. I can get bossy on my return, but I’ll not be visiting them before knowing I’ve not bought anything nasty out of the airports. Still no real change in gossip levels here in Nepal, although I may hear more news this afternoon.