Midwife With Altitude: Exploring midwifery in Nepal

The next day I meet up with Rashmi and three other midwives who are all doing various different things in Nepal. Rashmi wants to put together a package of training along similar lines to UK mandatory training to update the auxiliary nurse-midwives working at the birth centre. She explains that while the nurse training is quite good there is an acute lack of practical experience. So the idea would be to focus on role playing/practical based sessions supported by some refresher theory. Ideally I hope that we may be able to achieve this with good input from the nursing staff themselves and work on a trainee becoming the trainer model. The subject of a new building is also raised as the existing building has various problems. It is an idea that warrants consideration as one way of making the centre a little more financially sustainable would be to attract families from wealthier backgrounds who could pay something towards their care which would finance the free care for lower income groups.

Afterwards Rashmi invites me and another midwife to a Nepali wedding. Dressed in jeans surrounded by brightly coloured sari's we feel rather under dressed but are welcomed by the family, immediately ushered in to have large amounts of curry and to our acute embarrassment made to partake in numerous group photos!

The next day I head over to the birth centre and introduce myself to the girls I haven't met. I spend the afternoon practising my Nepali and trying to chat to the girls about their work and the centre - the language barriers makes this harder but its fun and they spend a lot of time giggling at my Nepali pronunciation. People turn up intermittently for pharmacy items and a few women attend for the depo injection. Later Rashmi turns up and we go through the equipment which she seems happy with. We discuss the issue of encouraging women to use the centre. There are no doubt a number of factors involved but it may be some time spent walking round the local area distributing the publicity material and talking to people about APS and the services it provides may be one option, if only to help find out what stops them coming.