Monday, 28 March 2022

My journey in making a difference in the lives of childbearing women and their infants in Nepal.

Before I embarked on the journey of Australian Alumna as a nurse, I already had a rich first-hand experiential learning from grassroots women since 1996, ranging from clinical to community settings assuming different roles and responsibilities in hospitals and development agencies. Because of this, I decided to pursue my career in the public health area thus applied for the Australian Development Scholarship, which I secured for 2004. In March 2006, after completing the Master of Public Health programme at the University of New South Wales, I returned to Nepal with new analytical, insightful knowledge and enthusiasm to make a difference in the development sector issues that I was passionate about for which I had done my major project work during my master's programme. Immediately upon return, I sought an opportunity to exploit my knowledge and skills, so I joined the private college where I was lecturing for bachelor public health and Bachelor of Nursing Students. However, I was not happy with what I was doing because I wanted to act in the ground reality to make a difference in women's lives and their families. Most importantly, I was seeking an opportunity to do something altruistic and profound in my life based on my personal and professional interests. One day I came across the National Policy on Skilled Birth Attendants 2006. It mentioned that "the role of non-government sector and private sector NGOs, the private sector and communities will be encouraged to establish maternity hospitals and community based ''birthing centres'' by mobilizing their resources. These facilities could be used as midwife-led training sites." and in the same policy's long term (pre-service) strategy, it has also stated that "Ministry of Health and Population is in the process of initiating a new cadre of Professional Midwife (PM) as a crucial human resource for safe motherhood, providing service and leadership in midwifery for the country." These two statements became my inspiration to move on in my personal and professional interest to perspire. To start with forming a group of 15 female health professionals, I established the first and only nurse-led stand-alone birthing centre known as a Basic Maternity Service Centre in 2007 with our own out of pocket expenses, contributing NPR 100,000 per person. After gaining almost three years of first-hand experience of managing the centre, I realized the need for establishing a professional association to advocate and lobby with the government of Nepal to produce a midwifery workforce in the country to provide leadership in midwifery. Acknowledging this, with the group of 11 nurses working in nine different institutions, representing both clinicians and educators, I led to establish the professional association of midwives known as the Midwifery Society of Nepal in 2010. Meanwhile, I realized I lacked leadership skills while leading and managing the birthing centre. Therefore, to develop my leadership skills and explore the gender power relations in sexual and reproductive health, I applied for the Australian Leadership Award in 2010. Being strategic to my vision, mission and objective, I approached and requested Tribhuvan University Institute of Medicine Maharajgunj Nursing Campus academic associate professor, Kiran Bajracharya, to take up the President's role to agree. I also reassured her to take up two terms of three years each, and I assumed the role of join-secretary. Before I went to Australia to pursue my doctorate program, I had an opportunity to support, empower and secure the fund from UNFPA to operate the activities to advocate and lobby for a midwifery education program to start in Nepal. Subsequently, we were able to receive the global midwifery twinning project with the Royal College of Midwives (RCM) the U.K. through the International Confederation of Midwives. After being in Australia together with President, I attended the skype meeting with the RCM team, who informed us that Nepal had been awarded for the said project for three years, starting from 2012 to 2014. During my fieldwork in Nepal for seven months in 2012, I contributed my half time for my fieldwork and half time to our midwifery related matters to advocate and lobby with the concerned stakeholders to kick off the midwifery education program. Upon returning from Australia and completing my doctorate program in April 2015, I engaged in the mega-earthquake relief work establishing temporary birthing shelters in the districts (in Nuwakot, Dadhing) Sindhupalchowk) severely destroyed by the 2015 mega-earthquake while in-between my midwifery advocacy and lobby continued with concerned stakeholders. Successively, Kathmandu University started the Bachelor of Midwifery education program in 2016, followed by the National Academy of Medical Sciences in 2017, Karnali Academy of Health Sciences in 2018 and B.P. Koirala Institute of Health Sciences in 2021. As of now, two batches of midwife students have been graduated, and currently, there are 25 professional midwives in Nepal from zero in 2010 when we established the association. In 2019, I assumed the role of President of the association. From Feb 2016 to Feb 2020, for 4-year tenure, I was nominated by the Ministerial Council as a board member of Nepal Nursing Council, which is the regulatory body for both nursing and midwifery professionals. This enabled me to work on the scope of midwifery practise midwifery code of conduct and set up a national licensing examination for midwifery graduates. In the last 14 years of my journey in striving to put the government of Nepal policy for the production of dire need a critical human resource, midwife for safe motherhood into practice, my dreams are also coming true progressively. This will help uplift Nepalese women’s overall sexual and reproductive. I have been involved passionately since I embarked my career in the development sector in 1996, joining the Women’s Rehabilitation Centre (WOREC). Empowering Nepalese girls and women from the womb to the tomb has become my life dream once I started by journey in the development sector so that no girls and women have to suffer from any sex and gender-based discrimination, domination and disadvantaged in their lives. I realized that only professionals in the health sector that can do is not other than midwives as per the global evidence of the last 300 years from Sweden to the United Kingdom. This is why I have been engaging to produce a well-trained professional midwife in Nepal with perseverance. It will bring lasting change in the lives of childbearing women and their infants in Nepal even when I will be no longer in this world.


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