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.

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Hanging out in Kathmandu

I’m hanging out here in Kathmandu. I’m a routines kind of person.  And I’m develping my routines. My quiet breakfasts. Organizing to go over to the birth center. What will I be bringing with me? What will we be working on? Wandering through the town to the bus. Last week or so I learnt that buses make sense. A cab is a bargain at $3 but it was my biggest daily expense! At 15 cents, it’s hard not to get a bus. And it feels a lot safer than a taxi. It’s bigger and it sticks to the bigger roads (much less picturesque and less bumpy). So it takes longer to get to the birth center. But I’m in no hurry. I love my wander/walk through Tahity (called Tahity??) and via a mini-monkey temple called Kathesimbhu Stupa

Kathesimbhu Stupa

Kathesimbhu Stupa

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IMG_0573 and via the square with a temple that honors the tooth protecting deity

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I think this is the tooth guy but not sure. Fierce anyway

and the veggie sellers of Asan Tole, and the crazy pre-festival shoppers, to Ratna Park where the foot traffic squeezes through a toothpaste tube and up onto the footbridge where people sit and sell flip-flops and watches, and a beggar plays listlessly on a drum and someone else is begging for a kidney transplant, to my bus. They squeeze us in cozily and off we go. Kalanki is dusty, dirty and busy. I walk a few minutes towards the birth center, and today before going in, I took a few pictures of the goat market opposite. Goats to be sacrificed for the Dashain festival

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Today at the birth center, I was planning to prepare three topics for a meeting with Kiran, the president of the Midwifery Society of Nepal: 1) A presentation on Childbirth Education  (I seem, bizarrely, to be becoming an “expert” on this topic)  2) A presentation on the anti-shock garment, it’s benefits, research to support it’s use in shock secondary to postpartum hemorrhage. I really believe in this thing and hope that Kiran will be inspired to push it to the Nepali Government and 3) Some topics in evidence based maternity care. I was supposed to meet with her at 3 and worked away at my prep but then she cancelled on me till next week. That’s kind of the way things go here, so I worked with the birth center midwives on posterior babies and other topics. We’ve had a good few days at the center. A Nestle man (boo, hiss) came to present on nutrition in pregnancy, and while we were all somewhat stimulated by some of it, I was also inspired to prepare my own nutrition power point! (of course). Here are some midwives listening to the Nestle (boo, hiss) man:

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Here is more childbirth ed stuff: preparing material:

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Prena and Laxmi

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And here is a gorgeous Nepali lady smiling as she gets a depo shot!!!

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And here are two delightful midwives bravely preparing to head home on their motor bikes

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Progya and Ratna

So that’s it for today’s update folks. Happy Dashain festival.

Tourism on a rainy festival Saturday

Ferst day of the Dashain holiday which is 15 days long! It seems day 1 days 7,8,9, and 10 are the highlights. Rituals and stories seem very complicated. Durga…. one of the many mothers, is the heroine and sacrifices play a part. Lots of people travel to be with family (It’s kind of like Christmas/Seder night I think) Lots of people were out shopping. Being both Saturday and a festival, I didn’t go to the birth center but instead, dedicated myself to Kathmandu tourism. Been here 3 weeks and decided it was high time to see the monkey temple. I did a lot of walking in the rain: Up to Swayambhunath (monkeys and staring eye stupa) and then back down over the river and through the alleyways to Durbar Square which I had visited on my first day in a jet-lagged fog. Great food and alleyways clogged with festival shoppers and back wet, muddy, satisfied.

Pics:

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impossible task of cleaning

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Back at the birth center: Everybody is excited. Rashmi is VERY excited!

At the Birth Center

At the Birth Center

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View from the Birth Center

Ratna is excited by the chiu\ldbirth education materials I brought.

Ratna is excited by the childbirth education materials I brought. We are designing a great program….

Sapana is excited by a class on birth positions. Praticing giving birth on the birth stool!
Sapana is excited by a class on birth positions. Praticing giving birth on the birth stool!

A satisfied mamma

A satisfied mamma

Rashmi (and I) got VERY EXCITED thinking about all the wonderful things that are going to happen at the Birth Center.....

Rashmi (and I) got VERY EXCITED thinking about all the wonderful things that are going to happen at the Birth Center…..

Rashmi and I have spent quite a lot of time thinking, talking and planning and I have a MUCH clearer idea of what is needed and lots of very specific work to do.
We are designing a birth center brochure (3 or 4 of the young midwives and myself). We are planning a childbirth education curriculum and maybe it will be up and running within a few weeks. We are discussing reorganizing the flow of the birth center. We are discussing financial priorities. It is all very concrete and GOOD.

And I  am having fun! Thanks to all of you who are following me on this blog,,,,

(Learning, teaching, learning…. and fun)Renamed: A wild ride and more learning

Don’t want to get too obsessive about my sleep in this blog, but it’s been a major feature of my life…. Trying to sleep. The night before last I slept very well. Halleluya. I awoke, excited to feel so good! My guest house includes breakfast and it’s 2 eggs, potatoes, tomatoes, mango juice, tea and 2 pieces of toast with butter and jam. Way more food than I normally would eat, but I have been eating it all! So I have my huge breakfast and get set on my way to the birth center.

The center is about 20 minutes away by taxi. The taxis are my biggest daily expense, $3 each way. The ride is wild, scary fun, nutty, indescribable but I will try. My street which connects Poknajol to Chetrapatti, is paved, although most are not. The street is full of walkers bicycles, scooters, motorbikes, pedal rickshaws, push-carts, stray dogs (many looking much the worse for wear) and the occasional cow as well as trucks and cars (mostly taxis) and workmen with handtools doing various repair jobs in the street. I hurtle along in my vehicle as we approach Chetrapatti which is a sort of a roundabout with a temple in the middle, around which rush vehicles and pedestrians in a wild dance of weaving in a variety of directions, horns blaring constantly. We dive out onto an unpaved lane that dips downward towards the filthy river. I can practically grab pieces of fruit or a piping hot chapati as we rush by. We careen through a variety of similar turns and bumps, pass along a wider road with many pedestrians stepping out in front of vehicles as they try courageously to cross the sea of traffic, duck under a huge rusty metal bridge onto the ring road, right down a small dirt track and we reach the birth center. Deep breath. Safe and sound. What a ride for $3.

Yesterday, had a short class on oxytocin and its various functions. Then Rashmi, the head midwife showed up. She is usually so busy, but was in relaxed mood, and we chatted a lot about birth center mangaement and her challenges. Then she took me out to a super wonderful dive where we watched the women making chapatis on the fire in front of us and ate them hot hot with a spicey bean soup. Followed by spicey tea mmmmm. Good! Then back to the center for some birth drills.

Today I did a bit of a lesson with a video illustrating midwifery model of care. Very hard to get discussion with these girls. They are not used to being asked questions by the teacher and are hesitant to give wrong anwers. There are no wrong answers!. They are shy but very willing. I bought us all lunch as a treat….. they had done well. After lunch we did some more birth drill stuff. Another good day.

Here are some of the lovely girls watching the video studiously on my laptop. (The laptop has a picture of my three boys. Prena has decided that she will move to Texas and marry Amos, the oldest)

IMG_0186office workThe Birth Center has a little pharmacy