Dhangadhi: Day 2 !!!! <-- because Teja thinks !!! makes it better

August 11, 2015

I think the sky felt terrible about letting the sun scorch us yesterday so it decided to make it up to us… We woke up to the beautiful sound of rain this morning (I make it seem like it was a light shower, but no. it was a downnnnnpouuuur)! After eating some aloo paratha and drinking some “real” mango juice, the 6 of us squeezed into a tuk-tuk. Stacked high and wide, with the rain not letting up and the roads severely potholed, it was a long 5-minute drive to the Seti Zonal Hospital compound. 

When we arrived, the room where the training was held was dreary and dark as the lights had gone out from the rainstorm. The trainers in the room chatted it up as the rest of the participants trickled in for the next hour. The lights flickered back on and that triggered the start of the day -- the trainers spent the morning going over yesterdays pre-training test that they received. The feedback and discussions were in Nepali so we spent most of that time drinking chai and eating the pakoras that were served :P

The first half of the day was spent watching the master trainers explain how to properly perform each of the training modules using the new national guidelines. Since our team didn’t have first-hand knowledge of the standard of care practiced, it was really enlightening for us to see how each skill was supposed to be performed.  Seeing this session helped us better follow each of the steps and really focus on where the trainers struggles, as opposed to wrapping our heads around what the procedure was. The latter half of the day was spent watching the trainers practice - the room had multiple stations (normal delivery, manual placenta removal, caesarian tear and so and so forth). We watched and took pictures and asked questions whenever we could, and it was a really productive and data-juicy day.  Unlike yesterday, the rain and Teja’s mints kept us cool and awake.

When the training day was over, we followed Ven kumari, one of the trainers being trained, for her evening shift. We were shown around the Seti Hospital labour and delivery unit – we saw where the patients waited for their contractions to hit 10 cm, where more complicated-cased patients waited, where the women gave birth, where emergency C-sections were performed and where they recovered after their surgery. We also got a chance to see some of the equipment they used in the delivery room, such as the neonatal resuscitator and the electric vacuum for assisted delivery. Suffice to say, the conditions of the hospital were far different from what we were used to – many of their equipment were no longer functioning, the lighting and room temperature controls were poor and the smell of the hospital was a mix of urine, blood, stool and vomit. One of the most surprising things we saw was the dinky bed in the labour room that the women gave birth in. They looked uncomfortable and rickety and the women were expected to climb on to it while there was a baby’s head crowning at their vagina! It was really impressive to see how well the women (both patient and provider alike) handled the conditions they were presented with. Kavya, Kendall and Sakina went home never wanting to have babies ever, remembering the deafening cries of the women in pain, for whom nothing could be done.