Just Do(BA) It: Patna is Good for Health

So I'll start by mentioning a crucial point that Teja left out in his last blog.

That cab ride back from the airport where it was raining? Two bags were on the roof, mine and Teja's. When it started raining, Teja freaked out about the rain getting his bag wet. So, we pulled over on the side of the highway, got out of the car, and changed kavya's what-looked-to-be-waterproof-but-wasn't-actually bag for Teja's. Nice try hiding that buddy.

But anyway, We arrived at the airport in Patna (after some truly terrifying turbulence) headed to the hotel, and met up with Dr. Acharya who was visiting with our team for less than 24 hours, and had dinner with him at the hotel. Speaking of hotels, this is probably the strangest one I've stayed in in my life. First, there is a clear window in the bathroom that is the full length of the shower, and when open, you can see clearly through from your bed to the toilet. Please tell me why that would ever be something that you'd want to use. Next, the design of the room is very kitschy, with these lamps that are shaped like bacteria, and look like something found in a 12 year olds room along with a lava lamp. But what takes the cake is the restaurant on the 1st floor, called fairy land. My words can't do it justice. Here is a picture.

Just kidding, I can't find a picture. I'm truly sorry that you won't be able to share in this experience.

We decided not to eat there (due to the noise of someone playing kids songs on the guitar) and instead headed down to the buffet restaurant on the ground floor, where we enjoyed some delicious food (although much spicier than Nepal). We were able to talk with Dr. Acharya and give him a few updates as to what some of the highlights were of our time in Nepal, and a few other things as well, like the fascinating sport of kabbadi.

On Monday, we began our first day of work in Patna! We left in the morning for the Jhpiego office, where we got to see a presentation of jhpiego's plan for pre-service education for midwives both nationally, and locally in the state of Bihar. Historically, the national government and ministry have health have placed far more importance on in-service education, but Jhpiego is one of a number of partners that have been advocating for strengthening pre-service education, believing that was a far more effective way to improve nursing from the start. The result has been the development of a highly structured system, with a hierarchy in place of national nodal centers, state nodal centers, and the schools for GNM (general nurse midwives) and ANMs (auxiliary nurse midwives) themselves. Each guideline for how a school should operate is highly structured and highly regulated, down to the specific square footage of each room, and that teachers should be making eye contact with students for a portion of the time. This will likely prove to be both beneficial and challenging for us to work within this system - challenging because there are already so many guidelines in place that we must follow, but beneficial because we know if we can design a product that fits in national guidelines, it is likely to be adopted all across the country.

New building

The school was very nice and a brand new building, meaning that it showed an example of what the vision is for how these schools should look. But, it unfortunately also meant that the skills lab wasn't quite set up as it should look, meaning here we weren't able to see a final product, but we were still able to talk with some students, faculty and administration. Something else that was great is that we got to see one of Bihar's most unique achievements in action - the virtual classroom. In this program, a teacher at the National Nodal Center in Patna lectures on a specialty topic of maternal child health to several of the ANM and GNM schools, along with performing live demonstrations on those topics that require them. This helps to combat the shortage of trained teachers at these schools, and can reinforce those topics that are most critical for nurses to know. It was cool to watch and see how this is done.

Virtual training class

Later that day, we were able to travel to another site for GNM training, and received an informative tour by one of the faculty there. It’s great to have someone be willing to say, these are what are problems are, this is what isn’t working, and start a discussion from that. The skills labs were awesome - they have so many models, all very nicely organized, so it was hard at first to see how we could make an impact.