"There shouldn't be poor solutions for poor countries"

Today I met a very impressive woman called Bimala. It was at the Tribuvan University Teaching hospital where Rashmi was attending a meeting with Kiran, President of MIDSON (Midwifery Society of Nepal). They were discussing the issue of a BSc Midwifery which has been on the table for years by all accounts but I couldn't follow the conversation really as it was all in nepali. Then Bimala turned up, a nurse who cannot currently find a job so is doing some work with MIDSON. She was intelligent, articulate, had great English and told me a lot about the situation regarding maternity services in Nepal and the politics that is hindering progress. Most interesting of all for me though was her answer to my enquiry regarding the issue of privacy/dignity in the labour room. I explained that following my experience at Patan hospital I had been wondering whether in considering this to be an area for improvement I was imposing my own culture inappropriately on a Nepali culture. Her response was unequivocal and strong. In her opinion given the conservative nature of Nepali women it was a misnomer that they would suddenly abandon these values when in a hospital situation. Instead it was the respect for authority  (ie doctors/nurses) and lack of personal empowerment which allowed them to accept such practice. Bimala later wrote on her facebook page:

"The majority of women in Nepal are not empowered to speak up for their needs and rights. So though internally they are shocked and disgusted they try to cope with it by mentally establishing the idea that health care professionals are allowed to do what they do without her consent. So, these pregnant mothers are normalizing unacceptable conducts from health care professionals which in return is fostering discrimination, disrespect, and acceptance/expectation of low level care for women in general in Nepal." 

In further discussion she explained that while some public opinion suggested that such a change in culture was not possible in a developing country like Nepal she was adamant that this should not be the case. "It makes me angry when I hear people say this, ok maybe slowly slowly but it is possible! There should not be poor solutions for poor countries!"

Very interesting.