This week professors Vanora Hundley and Edwin van Teijlingen from the Centre for Midwifery, Maternal & Perinatal Health (CMMPH) were invited to the Primary Healthcare Workshop in Kathmandu. This Primary Healthcare Workshop ‘Delivering Primary Health Care in hard-to-reach areas of Nepal: Opportunities & Challenges’ was organised by the non-governmental organisation PHASE and the Nepal Health Research Council (NHRC). Prof. Edwin van Teijlingen and BU Visiting Professor Padam Simkhada (who is based at Liverpool John Moores University) were invited to offer an international perspective on this workshop held in coordination with the Ministry of Health, Nepal.
Edwin made a comparison between the difficulties in access to primary care, recruiting and retention of staff in remote Nepal and his previous work on maternity care in remote and rural Scotland. He argued that some of these issues are universal, but more difficult to deal with in low-income countries like Nepal. The workshop took place at the Nepal Health Research Council.
Congratulations to CMMPH’s Dr. Jenny Hall, Senior Midwifery Lecturer, on the publication of her scientific paper ‘The Spiritual Journey of Infertile Couples: Discussing the Opportunity for Spiritual Care‘ in the journal Religions, see further details here! Jenny has co-authored this paper with academics from Portugal and Ireland.
Prof. Edwin van Teijlingen
Sara Stride ( Midwifery Lecturer Practitioner) and Associate Professor Susan Way from FHSS, travelled from the UK on the 18th April for a 5 day visit to the University of Ljubljana in Slovenia. The trip was funded through Seedcorn (Bournemouth University) and ERASMUS teaching mobility fund (British Council) to extend research and education collaboration between the two Universities.
We received a warm welcome from the Head of Midwifery Education, Dr. Polona Misvek who had helped to arrange our visit. Polona has previously visited Bournemouth University and has co-authored a number of papers with Professors Vanora Hundley and Edwin van Teijlingen.
The Seedcorn funding enabled Sara to provide a key note lecture to an audience which included midwives, student midwives and midwifery lecturers. In attendance was also the CEO of the Nurses and Midwives Association of Slovenia, Anita Prelec. The lecture related to a recent project funded by the Wellbeing of Women charity where Sara was the Principle Investigator. Other team collaborators were Professor Vanora Hundley, Associate Professor Susan Way and Dr Zoe Shepherd. The topic was entitled, ‘Updating the Understanding of Perineal Practice at the time of birth (UUPP Study)’. It was well received and generated many questions.
We have also been able to agree with the support of Polona Misvek and Anita Prelec to repeat the survey element of the research with midwives in Slovenia.
For further details regarding the teaching mobility aspect of the visit please visit the HSS Blog.
(L-R) Sara Stride, Anta Prelec and Susan Way
Audience Invitation to Key Note Speech
On the last day of BU’s Global Festival of Learning-India 2017 Prof. Edwin van Teijlingen presented the following paper: ‘Nepali migrant workers: trials & tribulations’. The Global Festival of Learning-India 2017 took place at Symbiosis School for Liberal Arts in Pune and at the India Habitat Centre in the capital Delhi. The session offered insight from various studies on Nepali migrant workers conducted by Bournemouth University staff and students.[1-3] It included preliminary results from an on-going study of Nepali migrant workers in India. The latter study is a close collaboration between Pramod Regmi and Edwin van Teijlingen) in the Faculty of Health & Social Sciences, Indian colleagues at Datta Meghe Institute of Medical Sciences, Deemed University in India (Quazi Syed Zahiruddin, Abhay M. Gaidhane), and Padam Simkhada at Liverpool John Moores University (LJMU).
The presentation also highlighted some of the key findings form our recently published paper ‘Identifying the gaps in Nepalese migrant workers’ health and well-being: A review of the literature’ in the Journal of Travel Medicine. The paper is co-authored by BU’s Pramod Regmi and Edwin van Teijlingen, and Padam Simkhada (LJMU) and our Nepali colleague Nirmal Aryal based in New Zealand.
Dr. Shweta Sinda Deshpande, who chaired the session, originated from an Indian village a few miles from the Nepali border. Moreover, she is also an anthropologist who had done fieldwork with Nepali migrant workers in India. Her informed contribution was very much welcomed by the audience.
- Simkhada, P.P., Regmi, P.R., van Teijlingen, E., Aryal, N. (2017) Identifying the gaps in Nepalese migrant workers’ health and well-being: A review of the literature, Journal of Travel Medicine 24(4): 1-9.
- Adhikary, P., Simkhada, P.P., van Teijlingen, E., Raja, AE. (2008) Health & Lifestyle of Nepalese Migrants in the UK BMC International Health & Human Rights 8(6). Web address: www.biomedcentral.com/1472-698X/8/6.
- Adhikary, P., Keen, S., van Teijlingen, E. (2011) Health Issues among Nepalese migrant workers in Middle East. Health Science Journal 5: 169-175. www.hsj.gr/volume5/issue3/532.pdf
- Aryal, N., Regmi, P.R., van Teijlingen, E., Simkhada, P., Adhikary, P., Bhatta, Y.K.D., Mann, S. (2016) Injury and Mortality in Young Nepalese Migrant Workers: A Call for Public Health Action. Asian-Pacific Journal of Public Health 28(8): 703-705.
This year BU is host to the 15th BNAC (Britain Nepal Academic Council) Nepal Study Days. This two-day event will be held next week (12-13 April) in the Executive Business Centre. The EBC is convenient due to its proximity to Bournemouth railway station. In previous years this prestigious event has been hosted by a geographically wide-spread group of universities from the University of Edinburgh to Liverpool John Moores University and from the University of Oxford to Reading University. BNAC was established in 2000 at a large meeting at the School of Oriental and African Studies (SOAS) in London of British academics and researchers interested in various aspects of Nepal.
Over twenty papers and eight posters have been accepted for next week, and there will be a specialised workshop targeted at the PhD students on ‘Capacity Building: Writing a PhD Application’. There will be sessions on post-earthquake Nepal, , history, culture & politics, sexual & reproductive health, energy as well as health & health services.
In addition, there will be a short keynote address and plenty of time for discussion. Presenters will be from across the UK with various guests coming over from Nepal. Several BU PhD students will be presenting a poster at the two-day Nepal Study Days.
Normal registration fee is £25 but members will participate for free (small charges towards cost of lunch will have to be paid). Membership costs £15 for Associate members and £30 for Ordinary members but with direct debit payment, you can enjoy a discounted rate of £12 and £24 respectively.
For details along with downloading membership form please visit this link: bnac.ac.uk/membership/
Prof. Edwin van Teijlingen
Last week saw the publication of the latest paper by Faculty of Health & Social Sciences (FHSS) staff. This paper ‘Identifying the gaps in Nepalese migrant workers’ health and well-being: a review of the literature’ was co-authored by BU’s Dr. Pramod Regmi and Prof. Edwin van Teijlingen . The authors argue that the health and well-being of migrant workers from low-income countries is often neglected in travel medicine. This article uses Nepal as a case study to highlight key issues affecting this particular group of international travellers.
Migrant workers who are generally healthy appear to be similar to tourist travellers in regarding sexual health as a key issue related to being abroad. Risky sexual behaviour increases in individuals separated from their usual sexual partners, away from their own communities and families, leading to the so-called ‘situational disinhibition’. Considering the recent media coverage of deaths and injuries among migrant workers in the Middle East, it is interesting to see that their sexual health is more prevalent in the research literature. This article reminds us that travel medicine should provide more emphasis to the health and well-being of migrant workers as a highly vulnerable group of travellers with additional impact on the health of those left behind.
Simkhada, P.P., Regmi, P.R., van Teijlingen, E., Aryal, N. (2017) Identifying the gaps in Nepalese migrant workers’ health and well-being: a review of the literature J Travel Med 24 (4): DOI: https://doi.org/10.1093/jtm/tax021
Congratulations to Dr. Jenny Hall in the Centre for Midwifery, Maternal & Perinatal Health (CMMPH) on the publication of her paper ‘Spiritual aspects of living with infertility: synthesis of qualitative studies’.  Dr. Hall co-authored this paper in the Journal of Clinical Nursing with colleagues from Ireland and Portugal.
This international team conducted review and synthesis of qualitative research to seek a deeper understanding of the spiritual aspects of patients’ experiences of infertility. They concluded that infertile couples’ experiences of infertility may offer an opportunity for spiritual care particularly related to the assessment of spiritual needs and the promotion of spiritual coping strategies. Moreover, effective holistic care should support couples in overcoming and finding meaning in this life and health condition.
Prof. Edwin van Teijlingen
FHSS has the honour of hosting the 15th BNAC (Britain-Nepal Academic Council) Nepal Study Days on 12-13 April 2017. All presentations will focus on Nepal, its diaspora and/or the Nepali cultural world. This year’s programme includes a range of issues and studies from across different disciplines. In the past decade these study days have been at universities across the UK, including Liverpool John Moores University, the University of Oxford and the University of Edinburgh.
This year several presenters of oral presentations or posters are affiliated with BU (staff, PhD students and FHSS Visiting Faculty). These include the following presentations:
- Identifying the gaps in Nepalese migrant workers’ health and well-being: A review of the literature, by Padam Simkhada, Pramod Regmi, Edwin van Teijlingen & Nirmal Aryal
- Assessing the need and type of continuing professional development (CPD) for nurses trained and working in Nepal, by Bibha Simkhada, Edwin van Teijlingen, Padam Simkhada, Sean Mackey, Rose Khatri, Chandra Kala Sharma & Sujan Marahatta
As well as the following posters
- Reflections on THET-funded maternal mental health training in Nawalparasi, by Jillian Ireland, Andrea Lawrie, David Havelock, Padam Simkhada, Edwin van Teijlingen, Bibha Simkhada, Bhimsen Devkota, Lokendra Sherchan, Ram Chandra Silwal & Shyam K. Maharjan.
- Factors affecting health facility delivery in rural Nawalparasi district of Nepal, by Preeti K Mahato, Edwin van Teijlingen, Padam Simkhada, Zoe Sheppard & Ram Chandra Silwal
- Food belief practices amongst rural and urban mothers in Nepal: A qualitative overview, by Jib Acharya, Edwin van Teijlingen, Jane Murphy & Martin Hind
Congratulations on the Faculty of Health & Social Sciences team which had its paper ‘Vital signs and other observations used to detect deterioration in pregnant women: an analysis of vital sign charts in consultant-led UK maternity units’ accepted by the International Journal of Obstetric Anesthesia (published by Elsevier).
The paper compares: (i) vital sign values used to define physiological normality; (ii) symptoms and signs used to escalate care; (iii) 24 type of chart used; and (iv) presence of explicit instructions for escalating care. The authors conclude that the wide range of ‘normal’ vital sign values in different systems used in the UK and the Channel Islands suggests a lack of equity in the processes for detecting deterioration and escalating care in hospitalised pregnant and postnatal women. Agreement regarding ‘normal’ vital sign ranges is urgently required and would assist the development of a standardised obstetric early warning system and chart. The lead author of this new paper is FHSS Visiting Professor Gary Smith, his co-authors include FHSS staff Vanora Hundley, Lisa Gale_Andrews and Edwin van Teijlingen as well as three BU Visiting Faculty: Debra Bick (King’s College London), Mike Wee (Poole Hospital NHS Foundation Trust) and Richard Isaacs (University Hospital Southampton).
Last week was a good week for FHSS from a publishing perspective. On the last day of February Sociological Research Online published a book review with Dr. Pramod Regmi as first author, which we highlighted in an earlier BU Research Blog (see more here!) . On the same the same day we received news from the Journal of Travel Medicine (published by Oxford University press) that our latest article on research in Nepal was accepted for publication. Our paper ‘Identifying the gaps in Nepalese migrant workers’ health and well-being: A review of the literature’ addresses the health and well-being of migrant health workers and ‘brings’ this to travel medicine specialists .
On Thursday our article ‘Vital signs and other observations used to detect deterioration in pregnant women: an analysis of vital sign charts in consultant-led maternity units’ was accepted by the International Journal of Obstetric Anesthesia published by Elsevier . On Friday The Lancet published correspondence from FHSS Post-Doc. Researcher Dr. Pramod Regmi and FHSS Ph.D. student Folashade Alloh, and BU Visiting Faculty Prof. Padam Simkhada under the title: ‘Mental health in BME groups with diabetes: an overlooked issue?’ . To round off the week on Friday afternoon the editorial office of Kontakt (published by Elsevier) emailed that the editorial ‘The medical and social model of childbirth’ had been accepted for publication .
Prof. Edwin van Teijlingen
- Regmi, P., van Teijlingen, E. ‘Balanced Ethics Review: A Guide for Institutional Review Board Members’ by Whitney, Simon N., Springer, (2015) ISBN: 9783319207056 (pb) (book review), Sociological Research Online 2017; 22(1) http://www.socresonline.org.uk/22/1/reviews/3.html
- Simkhada, P.P., Regmi, P.R., van Teijlingen, E., Aryal, N. Identifying the gaps in Nepalese migrant workers’ health and well-being: A review of the literature, Journal of Travel Medicine (Accepted).
- Smith, G.B., Isaacs, R., Andrews, L., Wee, M.Y.K., van Teijlingen, E., Bick, D.E., Hundley, V. Vital signs and other observations used to detect deterioration in pregnant women: an analysis of vital sign charts in consultant-led maternity units, International Journal of Obstetric Anesthesia (Accepted).
- Regmi, P., Alloh, F., Pant, P.R., Simkhada, P., van Teijlingen, E. (2017) Mental health in BME groups with diabetes: an overlooked issue? The Lancet, 389: 904-905.
- van Teijlingen, E. The medical and social model of childbirth, Kontakt (Accepted.
This week saw the publication of the latest issue of the internet-based journal Sociological Research Online. In this issue Dr. Pramod Regmi and Prof. Edwin van Teijlingen published a book review of Balanced Ethics Review: A Guide for Institutional Review Board Members written by the American academic Simon Whitney.  In doing so they continue the tradition of FHSS scholars contributing to the research ethics debate. For example, Regmi and colleagues recently had a paper accepted on their insights into research in low-income countries in the journal Developing World Bioethics. Whilst a 2012 FHSS-led paper stressed that researchers conducting research in low-income countries need to apply for research ethics approval to the relevant local authority, if national legislation requires one to do so.
Looking better a little further back, Professor Emerita Immy Holloway wrote about the researcher who may have (potentially) conflicting roles namely those of researcher and health care professional. Whilst a combination of midwifery researchers in the Centre for Midwifery, Maternal & Perinatal Health (CMMPH) highlighted the problems faced by practitioners doing research in their field of practice with perhaps the risk of blurring professional and research ethics, as balancing competing ethical concerns between protecting research participants and over-managing the ethical process can be problematic.[5-6] The latter issue of management and regulation of research ethics has recognised as getting more and more cumbersome and bureaucratic.[7-8]
Two further publications by Prof. Ashencaen Crabtree have added to the pool of FHSS publication on research ethics.[9-10] The first one, a book, addressed the problematic issue of gate-keepers in research together with the ethics of critical observation of abuse (potential or actual), as well as the ethics of advocating on behalf of research participants. The second paper covered issues around working with research participants who are regarded as ‘vulnerable’ in a study into the context of care and patient/service user experiences.
Whilst Prof. Parker has highlighted the benefits and dangers of using email and the Internet for social and health research. An even newer research approach is the use of discussion boards as sources of data, which brings its own ethical dilemmas.
In 2010-11 Prof. Parker and colleagues explored in two separate papers the contested meanings and difficulties associated with informed consent, highlighting challenges raised by an almost unquestioned acceptance of biomedical research ethics in social research and questioning whether potential ‘harm’ is different in this context.[13-14]
Prof. Hundley and colleagues discussed the ethical challenges involved in conducting a cluster randomised controlled trial, where getting informed consent can be complication. Whilst it is worth reminding researchers that in issues of informed consent during pregnancy and childbirth one has to consider the potential for harm to two participants.
- Regmi, P., van Teijlingen, E. (2017) ‘Balanced Ethics Review: A Guide for Institutional Review Board Members’ by Whitney, Simon N., Springer, (2015) ISBN: 9783319207056 (pb) (book review), Sociological Research Online 22(1) http://www.socresonline.org.uk/22/1/reviews/3.html
- Regmi, PR., Aryal, N., Kurmi, O., Pant, PR., van Teijlingen, E., Wasti, P.P. (forthcoming Informed consent in health research: challenges and barriers in low-and middle-income countries with specific reference to Nepal, Developing World Bioethics.
- van Teijlingen E.R., Simkhada, P.P. (2012) Ethical approval in developing countries is not optional, Journal of Medical Ethics 38:428-430.
- Holloway, I., Wheeler, S. (1995) Ethical Issues in Qualitative Nursing Research, Nursing Ethics 2: 223-232. http://nej.sagepub.com/content/2/3/223.full.pdf+html
- Ryan, K., Brown, B., Wilkins, C., Taylor, A., Arnold, R., Angell, C., van Teijlingen, E. (2011) Which hat am I wearing today? Practicing midwives doing research, Evidence-Based Midwifery 9(1): 4-8.
- van Teijlingen, E.R., Cheyne, H.L. (2004) Ethics in midwifery research, RCM Midwives Journal 7 (5): 208-10.
- van Teijlingen, E. (2006) Reply to Robert Dingwall’s Plenary ‘Confronting the Anti-Democrats: The unethical Nature of Ethical Regulation in Social Science, MSo (Medical Sociology online) 1: 59-60 www.medicalsociologyonline.org/archives/issue1/pdf/reply_rob.pdf
- van Teijlingen, E., Douglas, F., Torrance, N. (2008) Clinical governance and research ethics as barriers to UK low-risk population-based health research? BMC Public Health 8(396) www.biomedcentral.com/content/pdf/1471-2458-8-396.pdf
- Ashencaen Crabtree, S. (2012) Rainforest Asylum: The enduring legacy of colonial psychiatric care in Malaysia, London: Whiting & Birch.
- Ashencaen Crabtree, S. (2013) Research ethics approval processes and the moral enterprise of ethnography. Ethics & Social Welfare. Advance Access: DOI:10.1080/17496535.2012.703683
- Bond, C.S, Ahmed, O.H., Hind, M., Thomas, B., Hewitt-Taylor, J. (2013) The Conceptual and Practical Ethical Dilemmas of Using Health Discussion Board Posts as Research Data, Journal of Medical Internet Research 15(6):e112) Web address: http://www.jmir.org/2013/6/e112/
- Parker, J. (2008) Email, ethics and data collection in social work research: some reflections from a research project, Evidence & Policy: A Journal of Research, Debate & Practice, 4(1): 75-83.
- Hundley, V., Cheyne, H.C., Bland, J.M., Styles, M., Barnett, C.A. (2010) So you want to conduct a cluster randomised controlled trial? Lessons from a national cluster trial of early labour, Journal of Evaluation in Clinical Practice 16: 632-638
- Helmreich, R.J., Hundley, V., Norman, A., Ighedosa, J., Chow, E. (2007) Research in pregnant women: the challenges of informed consent, Nursing for Women’s Health 11(6): 576-585.
- Parker, J., Penhale, B., Stanley, D., (2010). Problem or safeguard? Research ethics review in social care research and the Mental Capacity Act 2005. Social Care & Neurodisability, 1(2): 22-32.
- Parker, J., Penhale, B., Stanley, D. (2011) Research ethics review: social care and social science research and the Mental Capacity Act 2005, Ethics & Social Welfare, 5(4): 380-400.
This week saw the pre-publication of ‘Core principles to reduce current variations that exist in grading of midwifery practice in the United Kingdom’ in Nurse Education in Practice. This paper is co-authored by Dr. Susan Way in the Centre for Midwifery, Maternal & Perinatal Health (CMMPH). The authors argue that these core principles could contribute to curriculum development in midwifery and other professions internationally.
Prof. Edwin van Teijlingen
- Fisher, M., Way, S., Chenery-Morris, S., Jackson, J., Bower, H. (2017) Core principles to reduce current variations that exist in grading of midwifery practice in the United Kingdom, Nurse Education in Practice (forthcoming) see: http://www.nurseeducationinpractice.com/article/S1471-5953(17)30092-6/abstract
Today we offered preliminary feedback to key stakeholders in Kathmandu as part of our research into CPD (Continuous Professional Development) for nurses in Nepal. Today’s presentation is party funded by LJMU (Liverpool John Moores University) and partly funded by BU’s Centre for Excellence in Learning (CEL). Late 2016 CEL funded the qualitative part of our research project. In this CPD project we work with representatives of the Ministry of Health , the Ministry of Education, the Nepal Nursing Association and the Nursing Council, and providers of Nursing Education (both Government-run universities and private colleges).
Today key presenter was BU Visiting Faculty Dr. Bibha Simkhada (based at LJMU). The event was opened by Associate Professor Chandra Kala Sharma, who is also the president of the Nepal Nursing Association (lighting the traditional lamp in photo right).
Our BU contributors, Dr. Catherine Angell and Prof. Edwin van Teijlingen, are both based in the Centre for Midwifery and Maternal & Perinatal Health (CMMPH). We are grateful to our collaborators in Nepal, especially Dr. Sujan Marahatta at Manmohan Memorial Institute of Health Sciences, for organising this event in our absence. The CPD research project is truly a FUSION project in the field of nursing & midwifery since it links Research in the field of Education to help improve Practice in Nepal. Further information can be found on a previous blog post, click here!
Prof. Edwin van Teijlingen
Focus groups in open air in rural Nepal, (c) Sheetal Sharma
Congratulations to Sheetal Sharma, postgraduate student in the Centre for Midwifery, Maternal & Perinatal Health (CMMPH) whose latest paper on the process of the research in her PhD fieldwork was accepted today by the Journal of Asian Midwives . Sheetal used an innovative mixed-methods evaluation which was applied to a long-running maternity intervention in rural Nepal. The intervention has been supported for nearly seven years by Green Tara Trust, a Buddhist charity based in London. Sheetal’s supervisors are supervisors are Prof. Vanora Hundley, Prof. Edwin van Teijlingen, Dr. Catherine Angell (all in CMMPH) and Prof. Padam Simkhada, who is Visiting Faculty in the Faculty of Health & Social Sciences and based at Liverpool John Moores University.
This paper is part of a larger body of health research work conducted by CMMPH in Nepal.
Sharma, S., Simkhada, P., van Teijlingen, E., Stephens J, Hundley, V., Angell, C. (2017) Evaluation of Maternity Care Intervention in Rural Nepal: Lessons learnt, Journal of Asian Midwives (accepted Jan. 2017).
Yesterday the Scottish Government has published its national maternity review ‘The Best Start – A Five Year Forward Plan for Maternity and Neonatal Care in Scotland’. The report has been widely welcomed and gained, among others, the full support from the Royal College of Midwives (RCM). Mary Ross-Davie, RCM Director for Scotland noted: “This is a defining moment for maternity services in Scotland and will be a seismic shift for our maternity services. The plan has the potential to revolutionise maternity care, to deliver safer and better services for women, babies and their families, and to improve the health of our population.”
The Best Start recognises that maternity and neonatal services matter to the health and wellbeing of Scotland’s people. The report’s underpinning is more of a social model of childbirth as it observes that “The health, development, social, and economic consequences of childbirth and the early weeks of life are profound, and the impact, both positive and negative, is felt by individual families and communities as well as across the whole of society.”
Having lived for 25 years in Scotland I am happy to have made a small contribution to this import report.
Prof. Edwin van Teijlingen
Centre for Midwifery, Maternal & Perinatal Health
The second day of THET training showed again that gender is a critical issue in Nawalparasi, southern Nepal. We asked the ANMs about things they had changed in their own practice. Several ANMs said that they had changed the way they worked. Now they see that having a baby girl can be a significant mental health issue as it causes the women a lot of stress. Interestingly, it also caused them as health workers considerable stress The ANMs said that they had started to counsel families of girl children. They say they emphasise that it is okay to have girls.
This ties in with feedback comments from yesterday in a different group of trainees. In Sunday’s training, one ANM answered when asked about stress at work, that she finds it stressful that a room falls silent when a baby girl is born. She commented that this happens when the family is obviously hoping for a boy. She added that at the very moment a baby girl is born, the family immediately falls silent. She said that this is a great source of stress to her as a health worker.
Coincidently next door to the training venue in Nawalparasi a Hindu wedding has been taking place today. This colourful spectacle represents different roles and expectations of men and women, the bride and the groom, but also the other guests here in Nepal. Weddings everywhere are ceremonies that reflect society. Seeing the wedding from close by and listening to the ANMs over these last two days, we reflected at the end of today that these ANMs are acting bravely in raising such a culturally sensitive issue in their practice, in this largely patriarchal rural society.
Flora Douglas & Edwin van Teijlingen
Today we had our first training session of the final THET mental health in maternity care project. UK volunteer Dr. Flora Douglas spoke about key aspects of health promotion and focused particularly on notions of community-based approaches. Flora is based at the University of Aberdeen and she is also a Visiting Fellow in the Centre for Midwifery, Maternal & Perinatal Health (CMMPH). This was her first visit to Nepal. She was inspired to volunteer as she had been a MSc supervisor some years ago on a project that related to the Green Tara Nepal health promotion intervention. Bournemouth University has been working with Green Tara Trust, a Buddhist charity based in London for many years.
Yesterday Flora had visited one of the 20 birthing centres in Nawalparasi, the district where the THET training takes place. Flora was very humbled by the experiences of the community-based maternity care workers in the light of many constrains. She said: “I have seen pictures of such birthing centres and read about them in the literature, but it is not until you see them first hand that you realise how staff have to work with such limited resources.
The attendees, who are nearly ANMs (auxiliary nurse midwives) were highly enthusiastic and very keen to discuss and learn. They shared some very personal and touching stories about their practice. Flora added: “I am very struck by their understanding of the importance of the social and cultural determinants of both psychical and mental health.” Many found they had learnt something in previous THET sessions in 2016 about communication with women and counselling family members about mental health, and perhaps most importantly, listening more to women. Last, but not least, Flora commented on the dedication of the participants: “At least two of the participants told me they travelled ten hours to get here for our one-day workshop. This really shocked me, particularly having seen the quality of the roads and public transport!”
Prof. Edwin van Teijlingen
Yesterday we come down from Kathmandu, the capital of Nepal, to our THET training area in Nawalparasi. Today we are starting our sixth and last training session on the Mental health training for community-based maternity care providers. Interesting we are starting training on a Sunday as Nepal is largely a Hindu country and most workers have only a one-day weekend (which is the Saturday). This BU-led project is a collaboration between the Centre for Midwifery, Maternal & Perinatal Health (CMMPH), Tribhuvan University (Nepal’s oldest university) and Liverpool John Moores University (LJMU). The project receives funding from DFID, and is managed through THET and supported locally in Nepal by a charity Green Tara Nepal.
The landscape in the photo gives an idea of how rural this part of Nepal is. Nawalparasi is situated in the south of Nepal the India border. It is also largely very flat, not like the Nepal most people envisage namely that of the Himalayans and of Mount Everest. The flatness makes a Dutchman feel at home though.
The project depends on volunteers who work in the health sector in the UK to come out and spend their time and energy preparing and delivering the training. Our project also could not work without the logistical support from Green Tara Nepal and our academic colleagues at Tribhuvan University. The last photo shows one of the UK volunteers Dr. Flora Douglas with the translator Shiwani Manandhar on the way to the training venue.
Prof. Edwin van Teijlingen (from Nepal)