Wrapping up. Chapatis, tea and talk.

The staff meeting was to begin at 1:30. At 2pm people were beginning to gather. There seemed to be no agenda but we began. Everybody chatted and the agenda made itself apparent. Chapatis and spicey potatoes and cups of tea were brought in. People wandered in and out and at one point I thought I’d better give my prepared report on my visit. So I did. I wanted to avoid being rude and inappropriate, but the more I suggested the more they nudged me to be more direct. The staff received everything I said with such receptive kindness that it was humbling. Truly amazing how different behavior can be in another culture, and yet we really do understand and respect each other. There is something about the way things work here that is both frustrating and extremely refreshing at the same time. I will miss it. The slow pace is both pleasant and irritating by turns. Nothing happens and things surprise you and all of a sudden, it’s done. Birth can be like that too, can’t it?

I had my Dal Bhatt this evening, with the realization that I won’t be eating it many times more. I rode the bus on my 15 cent ride through the dirty streets knowing I would soon be breathing the marginally less polluted air of Texas. I walked through the throngs of pedestrians, narrowly missed by hooting motor bikers, knowing how much I would miss the street life, the noise and variety of Kathmandu in suburban Dallas.

Women are women, midwives are midwives, and birth is birth, but Nepali style it’s all a bit different, wonderfully so. Thank you Kathmandu. And lots of love.



Things coming together…. progress?

The sun rose to another clear day and a clear view of the mountains the day after the elections. What would happen next? After breakfast, I got organized to head out to the birth center. Everything was…. normal. How interesting. No violence, no excitement, just life, busy streets and newspaper headlines that the elections were peaceful. Results were coming in. Record voter turnout. The maoists who led the stirkes had lost badly. But rather than responding violently to defeat, it seems they were licking their wounds and moving on. The marxist-leninists and the Nepali Congress are the 2 big winners with the vast ¬†majority of votes. The maoists, with a smaller number, hold the balance of power. Other parties have mostly 5% or less. All of this seems such a mature democratic outcome and brings a dose of optimism and confidence in the future that I think is in the air.

With the birth room redecorated, the childbirth education in place and the brochure at the printers, my work here is coming to a close.The anti-shock garment project sent me in and out of offices, NGO and Government, and I did two hospital presentations on its use.The new graduate level program in midwifery will hopefully start next year, It will be the first in the country and a prerequisite for the Midwifery Society of Nepal to have membership in the International Confederation of Midwives which regulates the profession worldwide. An initial research project would raise the prestige of the program and of the profession. It may really happen that it will be an anti-shock garment project. Kiran is for it. Dr Regmi, a big cheese at the Ministry of Health is for it and will fund impementation if initial funding is found. Doesn’t that sound like concrete progress? It feels good.

Meanwhile there was a funny day last week when the world seemed to be converging on APS birth center.Volunteers and staff were hauling around dusty piles of medical equipment, sorting, chucking, organizing. That frenzied, excitable mood that happens with a big clean was all around. Some of the senior staff who come in occasionally, Rashmi, Asha, Amala, were all there. And so were the Duggars! What? Yes father Duggar and Jill Duggar from the reality TV show about the family with the 19 biological children along with TV crew, invaded the festive cleaning up atmosphere of the center. For my non-US readers, know that even if, like me, you are barely aware of television and popular culture, you cannot help hearing about the Duggars and their TV tribe in the US. Jill D is on her way to becoming a midwife and while visiting Nepal, she wanted to visit a birth center, Nepali midwives and make an episode about her aspirations. Rashmi was interviewed. Mothers, babies and midwives were filmed. A festive mood prevailed.

While this was going on, the normal day at the center was happening too. A couple came in, for what they thought was an intial prenatal appointment at 29 weeks pregnant. But no heart-beat, and measuring many weeks smaller than 29 weeks. Sadly her baby was not alive. The couple were hugged and supported. Follow-up care was arranged. They had a a quiet corner of the center as the camera crew charged around. Sometimes events coincide in strange ways. Meanings are unclear but the strangeness implies meaning of some kind. That is midwifery in Nepal and everywhere.

Here are some birth center pics and then some older tourist pictures

APS motherbaby, APS staff, and a Dugger!

APS motherbaby, APS staff, and a Duggar!

Dinah and Jill (Dugger #4 outof 19)

Dinah and Jill (Duggar #4 outof 19)

APS board dinner

APS board dinner


Annapurna just after dawn


Annapurna dawn


temple guard


god eats other god alive


Ganesh Himal


Outside “helpers”. Thoughts from a wandering Jew.

Tiptoeing through a minefield

Tiptoeing through a minefield

We are a wandering species. Wandering and shared culture is mutually strengthening. One of my personal goals on this trip is to be tipped off-balance by new experiences, different people and places, and to gain personally from this. As I wrote in one of my earliest posts (“Intercultural Understanding July 29th”¬†https://wiwok.wordpress.com/2013/07/¬† ) “I believe that help is a minefiled”. My whiteness and my American experience give my words and my ideas power that I do not intend. I am treated with a deference that is both natural hospitality and a discomfitting honor that belies a very mixed intercultural history.

Bringing ideas and teaching imply a negative assessment of midwives and APS Birth Center. A negative assessment does not mean criticism. There is no blame given. But I know it is felt. And that feeling weakens the confidence of those struggling here under very difficult circumstances. It disempowers them and makes them more dependent. So, what if I didn’t try to do what I am doing? What if all the do-gooders walked out of Nepal and left them to their own devices? Maybe they would be better off and midwifery, mothers and babies would figure out quite happily how to care for themselves. Such abstract questions are meaningless and absurd, however, in a globalised and interdependent world. The strength of technological systems deriving from corporate power are such that the marginalised, the midwives and normal birth would lose. So I continue to tiptoe around the minefield.