Wrapping up our Bihar trip!!!

After spending a very productive and insightful week at various clinical sites, our clinical immersion in Bihar, India came close to an end. Our team is very happy and gratified with the overall immersion experience in India, thanks to Jhpiego Bihar for making this possible. We decided to perform preliminary synthesis of our observations and insights from the trip over the weekend. Next week, a distinct panel of global health pundits will be present in Delhi for a 'call for action' meeting, hosted by Jhpiego India. Fortunately, we were given an exciting opportunity to present our clinical immersion findings to this panel on Tuesday (25 August) at Jhpiego Delhi office, sincere thanks to Mr. Tore Laerdal for bringing all these people to a single table. Hence, our agenda for the weekend was to prepare for this meeting.            

On Saturday, after having breakfast, we met in one of our rooms, worked on compiling and organizing all the scribbled notes that we have taken during our discussions with various stakeholders. After working for 4 hours, we broke for lunch and went to a fancy restaurant nearby 'Bollywood treats', which was included in the Patna to-do list mentioned on some of the travel websites. We had a hard time reaching the restaurant on foot as a heavy downpour filled the roads with water. We reached this restaurant partially drenched and waited a couple of minutes to dry our clothes. We had had a variety of food from different cuisines (pictures can be found in previous blog post!!)which were very yummy and stomach filling. Later, we headed back and prepared for the meeting with Pushkar. In the meeting which lasted for 2 hours, we discussed about our insights obtained from observations and brief overview of potential project areas. Pushkar helped us with our initial problem validation and gave us valuable advice and guidance about the process of prioritizing the list of potential project areas we have identified during our immersions. After the meeting, we spent the next few hours incorporating Pushkar's inputs into our work. Later in the night, after having dinner, we watched the Hindi movie 'Yeh Jawaani Hai Deewani' with English subtitles (subtitles are for our American friends, who are novice Hindi speakers!!). We watched if for an hour and went to bed early as we were very tired and have planned to start working early the next day.\

The next morning, we started by brainstorming on the prioritization criteria for project areas, after a prolonged discussion with heated arguments, we agreed on the criteria and their corresponding weights. We started ranking our project areas based on these criteria, to find out our winner and subsequent runner ups. We were surprised to see the prioritized needs order was way different from what we have expected. In the afternoon, we have presented our prioritized order to Pushkar, who advised us to include additional prioritization criteria to the existing list and observe the variations in the ranking order. The new order was some what consistent with our expectations, and after we got convinced with the order, we started working on our presentation. In the evening, we opted to visit the Gandhi ghat and experience the boat ride on the holy river Ganga. As Sakina wasn't feeling well, only the four of us were joined by Pushkar on our way to the Gandhi ghat. The roads leading to the ghat were very narrow and were crowded. We were anxious whether we would reach the ghat on time, but thanks to our driver who was very skillful in driving on the tightly packed streets of Patna. After reaching the ghat just in time, we were fascinated to see the speed and height of the flow, apparently this was due to heavy rains in the past few days. The boat was docked at the far end of the ghat, and we waited for couple of minutes to get on to it. The boat ride was promoted by Bihar tourism department, and the boat commonly called as 'Ganga Vihar' has a restaurant and a recreation room for the tourists.           

The setting sun and the flowing water made a wonderful scenic view. Our photographers Kavya, Kendall and Ramji were already in the job of capturing those beautiful moments. Pushkar with his DSLR and GoPro was capturing pictures of the Laerdal penguin, which travels to different countries along with the employees of Laerdal Global Health (LGH) and has its own Twitter account!! There was a tour guide on the boat explaining us about the historical sites on the banks of the river Ganga as we slowly passed them. When we were going downstream eastwards, we were able to see a bridge across the river, Mahatma Gandhi Sethu bridge, which is the longest river bridge in India extending 5,575 m connecting North Bihar and South Bihar. When we were about to reach the banks and head out of the boat, an Aarti had started at Gandhi ghat, so we watched it from the boat while Kendall was filling the customer feedback register (Tour guide requested her to give her feedback!!). After completion of the Aarti, we went back to hotel and started working on our presentation. After making significant progress with the presentation and discussing about our tomorrow's meetings, we called it a night and went to beds. 

              

LGH Penguin!!!

                 

From Paneer Samosas to Spring Roll Dosas !!

21-Aug-15, Patna, last office day

NO to Dhanapur, NO to Arrah, YES to PMCH:

We started the day by visiting jhpiego office to plan our visit to a clinical site attached to IGIMS in Dhanapur. The Jhpiego team spent some time talking to officials in Dhanapur and later decided to take us to a different clinical site at Arrah an hour travel from Patna. However, as the roads to that clinical site was blocked due to some technical reasons and we returned back to Patna to visit the PMCH OB/Gyn facilities.

PMCH: Interaction with clinical staff

As per this decision, we went to PMCH. We talked to Dr.Amrita Sharan from OB/Gyn department. We discussed various aspects of nursing education, the gaps in the current system and how it could be improved. Along with her, there were many PG students seated with her and giving their opinion on PSE education in Patna and in general.

Later, we met the Matron of OB/Gyn in PMCH to understand the various aspects of PSE education and how it works in PMCH. We came to know from her that how difficult it is for nursing students to get chance to practice in clinical site in a medical college and hospital as the PG and resident students want to practice on first priority.

Matron Meena kumari was kind enough to buy hot paneer samosas for all of us which we really cherished and few of us regretted fr saying NO to it when offered :-D

Pushkar comes from LGH, Pune:

On that evening, we met Pushkar from LGH, Pune for the first time. We had only talked to him over telephone when we were in Norway. It was exciting to meet Pushkar in person. We had a friendly chat over coffee in a CCD close to our hotel. We all later went on a walk to the Gandhi maidhan to see things near our hotel for the evening before dinner. After strolling through the Gandhi maidhan, we headed to a restaurant called "Dosa palace" nearby for dinner. It was a fun place as there was a plenty of dosa variety and ordered new types of dosas including spring roll Dosa :-) 

Sooraj Dooba Hain

After returning from Begusarai, we were glad to finally spend a whole five days in Patna (throughout our entire trip, I think that was the longest time we've been in one place). Our day started as it typically would, with us heading to the Jhpiego office in the morning to discuss what we had seen with Dr. Pallavi. I still don't understand how we could meet every day and have almost 2 hours worth of questions each time. But it is truly a testament to Dr. Pallavi's patience and knowledge when she sat with us to clarify all our doubts and provide her perspective.

And then we were off with Mimi to the Indira Gandhi Institute of Medical Sciences to visit the state nodal center. IGIMS is both a school for General Nurse Midwives and BSc nurses and the broadcasting center for the virtual trainings throughout Bihar. While touring the school, we visited the Fundamentals of Nursing lab, library, computer lab, and various classrooms.

We also met with many of the faculty at IGIMS. The perspective they presented was very valuable, as they emphasized the importance of creating models for the fundamentals of nursing. After a long discussion about the birthing models that we're currently being used to teach midwifery skills, we were able to visit the skills lab. By this time, we were pretty much used to seeing the seven stations that broke up the midwifery skills separated by curtains each with their own models. But it is always interesting to contrast the opinions of each center (which believe me, are usually quite different).

In the skills lab, we were able to visualize the complaints the faculty had with each model, ranging from the fact that the models break too easily to the fact that it is hard to assess a student's performance when using the model. It was also useful to hear what the teachers thought were the benefits of each model they had, from the fact that they were specific to a skill or that the models were very anatomically accurate.

After a quick lunch in the doctors only room at the hospital canteen (I guess we all looked like doctors and got invited in), we returned to watch a virtual training session. Turns out the session we were watching was taught by the same tutor who had taught the session we watched from NMCH on Monday. Well, it actually turns out that there is only one tutor officially running all the virtual trainings until another one can be hired. After her lecture about essential newborn care, we watched a review demonstration of the third stage of labour from the IGIMS skills lab, that was also broadcast to all the other schools.

Broadcasting Center for Virtual Trainings

Skill Demonstration for Virtual Training

After talking to the principal and understanding her opinions on the skills lab and midwifery education for the students, we decided to call it a day. Turns out the sun has basically set and we hadn't realized it until we stepped out of the school. We made our way back to the hotel in the Patna traffic, blasting Bollywood music and trying to sort through information for our presentation on Tuesday (or at least we tried to).

Song of the day: Sooraj Dooba Hain from the movie Roy
Even though I've heard the song before, for some reason, this is the time it got stuck in my (and everyone else's) head. Which you can easily tell whenever there's a silence and someone (Ramji) starts humming the song.

Seeing all these babies made us want to create our own...

Food Babieses

Traditional Norwegian Dessert

Cansu's awesome dinner. From store to table. :P

Norwegian breakfast. Salmon on Salmon on Salmon.

Momos. 

Mo momos.

Cheers.

We asked for recommendations for food in Nepal, and were told to eat at an Italian pizza place. 

I would "dahi" for this puri.

Yes we went to India and ordered Dominos.

....twice in one night. 

It's okay, it was friend in pure ghee.

A sample of my all carb diet. 

Keeping a "thali" of how much food we've eaten.