We need to write her and his story so
that later it would be become mystery what she or he has done in her/his life.
Therefore, I thought about writing my own journey on how and why I became
passionate about midwifery. There are number of reasons why I became so
passionate about midwifery that propel me with perseverance, patience and
perspiration to do despite any professional politics draw back. In fact, I
love women and the nature because they are the one who give lives on this earth
and nature provides everything to sustain life on this earth. Without nature no
one can nature on this planet. Similarly, without women there would not be
culture to cultivate human society. Both nature and mother are breadth to let
us breath on this earth freely and lovingly without putting any terms and
conditions on their creation and cultivation.
My passion to work for the improvement
of sexual, reproductive and maternal health started immediately after I started
by professional career in the public health sector joining a national NGO, "Women's
Rehabilitation Centre" (WOREC) in 1996 in which recently this year in
January I had been requested by its lead co-founding member, Dr Renu
Rajbhandari to be a Board Member. I did not know even had heard about WOREC
before but while I was working for Koshi Zonal Hospital in Biratnagar (eastern
part of Nepal an hour drive by public bus from my home town, Dharan) after
graduated as a Staff Nurse from where I did my clinical nursing practice during
my Proficiency Certificate Level Nursing Program as a student from April 1992
to June 1995 (3 years) my by then Campus Chief, Aitu Maya Chhetri requested me
to join WOREC because she had been requested by her near and dear friend, Dr
Renu Rajbhandari, an Executive Director of WOREC to send a graduate nurse from
her campus.
My by then campus chief convinced me
saying that if I do not like to work at WOREC I can leave as per my own will
anytime. In 1996 this is how I came in contact with the innocent and ignorant
Nepali girls and women who were sold and psycho-sexually as well as physically
abused, assaulted and exploited in Indian brothels to whom got an opportunity
to rehabilitate them for three months as a Rehabilitation Incharge. According
to these Nepali young girls and women they were imprisoned for 6 months in
India's prison because Mumbai police forces raided the brothels where they were
working. of the total 120 girls brought in Nepal by 5 different NGOs
challenging government of Nepal 18 girls/women assigned to WOREC for
rehabilitation purpose and some of them were pregnant and some were infected
with HIV and some had kids as well. I learnt a lot of lessons hearing those
innocent and ignorant girls and women stories how they were sold by their own
relatives, uncles, brothers, fathers and else luring their young mind and
aspiration to see in their bright future that has been darken because of ill
minded men and women who were always after MONEY. I also got to learn from them
that almost all girls and women in the brothels were forced to practice sex
trade NOT by their choice but by chance and challenge to break the silence.
After 3 months rehabilitating those
innocent and ignorant Nepalese girls I was transferred to Udhyapur to work for
Women's Health Training Centre where I involved in providing sexual and
reproductive health training to community women group members and NGO workers
across Nepal from east to west. After working almost 2 years in the community
setting I left WOREC then joined Paroparkar Maternity and Women's Hospital to
gain experience in clinical setting in providing care to childbearing women and
their newborns. This provided me an opportunity to learn how childbearing women
have been treating by healthcare professionals without any dignity, respect and
love. In some instance I was moved to see and hear healthcare professionals
attitude and behaviours towards childbearing women and their family members who
were mostly socio-economically deprived and marginalised.
While working at the hospital I also got
an opportunity to involve in providing Comprehensive Family Planning training
to the government healthcare professionals through National Health Training
Centre since my passion always remain on sexual and reproductive health soon
after I joined WOREC. I also gradually started to learn and understand power
politics on sexual and reproductive issues surrounding girls and women.
After gaining three years experience
(the minimum requirement to enrol for Bachelor Nursing program) in both
clinical and public health setting I decided to pursue my further study in
nursing then I enrolled for Bachelor of Nursing program where I did my
specialisation in hospital nursing although I was not that much interested to
work in clinical setting.
Immediately after completion of my
bachelor degree I joined CARE Nepal to work in public health setting again. I
was deployed in Mahottari district, a central tarai district with deeply rooted
maithili culture domination that always remained backward in health and
socio-economic indicators despite having political power at the state level
because most of the powerful politicians from tarai district by then belong to
that district and became Health Minister several times. For the project I was
the only staff and responsible for Polio Eradication Initiative Project where I
had to closely work through District Pubic Health system with mothers/women
having under 5 children in order to ensure polio complete vaccination to their
children. This job provided me an opportunity to learn and understand women's
status in the district that has empowered me to do and work for women.
After three years working in Mahottari I
decided to pursue my further study in public health then I applied for
Australian government scholarship to do Master of Public Health. In my Master
of Public Health program I did project on Maternal Health. In order to collect
data for my project I came all the way from Australia in my own cost to
Mahottari in January 2005 and within 21 days I did survey among 671 women and
men to determine maternal health status primarily focusing on prenatal, natal
and postnatal period that helped me to understand the status of women's health
during childbirth in the district as well as knowledge, attitude and practices
relating to it. The finding of my study has provided me further insight that
has created deeper interest in me to do something significant in improving
women's health in Nepal.
After completion of my study I returned
to Nepal in April 2006 then decided not to join NGOs /INGOs to work for
development sector in grass-root levels because I realised that my effort to
change and challenge status relating to women's status is required at the
central level. In that background understanding I joined one private health
education institutions and taught Bachelor of Nursing and Bachelor of Public
Health where I was not satisfied in what I was doing. Therefore, I was
searching for a window of opportunity to do something significant. As I was
teaching Reproductive Health to the public health students one day I came
across with the government of Nepal policy relating to Safe Motherhood titled "National Policy for Skilled Birth Attendant: Supplementary to Safe Motherhood Policy 1998" that has
provided me an insight for what I suppose to do. Then I wrote a concept note to
establish the first and only nurse-midwife led private independent birthing
centre with the notion of social enterprise for its sustainability in what I am
going to do and start for women's health to improve in the country from my
level best because working in development sectors with different NGOs and INGOs
directly I got an opportunity to see and experience that none of the NGOs/INGOs
project activities are sustain despite we talk a lot about sustainaiblity. It
is because of the donor driven project approach activities it has to be
discontinued after certain period of time which is not an effective approach to
change and challenge attitude and behaviour of people within 4-5 years projects
which usually we find in a development work. I heard and read about social
enterprise and thoughts of putting into real work scenario, therefore, I
developed the Birthing Centre's Concept note in that way and shared with my
colleagues where I was working as an educator. Some of my nursing educator
colleagues were quite interested and three had decided to be on board. Besides,
I approached other nurses working at Patan Hospital's Maternity Unit and
Paropakar Women's and Maternity Hospital from where I got five senior nurses to
be on board. In this way, we were 11 female healthcare professionals who
wholeheartedly decided to put my concept of birthing centre into real world
practice.Then formally we registered our birth centre in April 2007 and started
to provide service from July the same year. The, motivational factors behind
establishment of our birthing centre can be explored in detail from my article
titled "Factors That Persuaded Nurses to Establish a Maternity Care
Centre in Nepal" published in the Midwifery Today in 2009
[1].
After gaining three years of experiential
learning at the birthing centre in 2009 I realised the importance of having one
voice of women passionate about midwifery then formed a group of another 11
women involving in providing midwifery service and teaching midwifery .to
nursing students that pushed me to take lead role for the establishment
Midwifery Society of Nepal that was formally registered in 2010 under the presidentship
of by then Associate Professor, Kiran Bajracharya at Institute of Medicine,
Tribhuvan University [2] who has been teaching midwifery subject for nurses.
After the tireless advocacy to bring midwifery workforce in the country last year in
September at the Kathmandu University (enrolled 6 students) and from this year
January Nepal Academy of Medical Sciences (enrolled 10 students) have started
Bachelor of Midwifery Education program. Last year I hired by the Ministry of
Health to help to draft Midwifery Education and Workforce Management which I
handed over after a month long exercise on it. Similarly, this year honourable Health
Minister, Mr. Gagan Thapa has nominated me to be the part of the committee
formed the under chairmanship of Prof. Goma Devi Niraula for the reformation of
nursing and midwifery profession in the country. Because of my proven contribution
for the upliftment of the status of nursing and midwifery profession in the
country recently on 28 March the Government of Nepal has nominated me a board
member of Nepal Nursing Council amongst the nurses renowned in nursing
profession in which I am a Coordinator of Midwifery Committee. However, the challenge
remains now on me to implement what we have been recommended for the Ministry
of Health to do submitting the committee report. It is my great pleasure to
share with my networks that I won the ICM Research Award 2017 for the proposal
titled "Experience of mistreatment of women during childbirth in the
peri-urban areas of the Kathmandu valley: A mixed methods study."
I became passionate about midwifery
because learning and exploring about women's issues particularly, sexual and
reproductive health and gender politics I got to understand that all the
women's and men's power lies on reproduction and production. I came to realise that
a midwife is the only cadre among healthcare professionals who are competent,
compassionate, courageous and caring who challenge to break the silence in
healthcare delivery system and whole societal system educating and empowering
women for their crucial role in life to produce and reproduce human beings Midwife means with woman who challenge gender stereotype indoctrinated outdated
thoughts ideas societal norms and values imposed on women's body and their bodily
physiological functions becoming self economically and educationally viable and
help to make other women and men to work for the betterment of whole society to
live happily and healthily I feel great in what I am doing to bring midwifery
workforce in the country to help our mothers and family so that our nation can
be prosperous like most developed countries where they have midwives as a
respected profession such as in Scandinavian countries where gender gap is very
narrow in the world and the United Kingdom, the empire where sun never set.
I feel good in what I am doing and
always love to take challenge for change because I am not doing only for my own
sake of benefit but I am doing for human society to provide dignified and
empowered mothers who can provide healthy and strong new human to our human
society.