On 9 March in 2016, we, 3 professors and 7 students of Tokyo Medical and Dental University, visited at Siddhara Children and Women Hospital (SCWH) established by AMDA (Association of Medical Doctors in Asia). It was first time for me to visit Nepal and hospital. I could learn a lot of differences of medical system and nurses’ situation between in Nepal and in Japan.
The most impressive thing was the number of delivery at SCWH, especially for the number of cesareans. Because SCWH has been taking a key role in high-risk delivery in this region. There are 6-10 deliveries per day. Some pregnant women were on delivery when we looked around the hospital. Nepal government recommends hospital delivery and home delivery “Zero” is their goal, so the number of delivery at SCWH is increasing. Delivery in Japan is normally at hospital or midwife hospital. It is important for safe lives of baby and women. Therefore SCWH has a very significant role as for safety delivery. During pregnant, women are checked up 4 times in Nepal. That is also very important system for baby and pregnant women, and SCWH was very advanced in Nepal, I thought.
In addition, I was very surprised that there were a lot of nursing students during delivery and they made an effort to encourage a pregnant woman. I have not experienced natural delivery when I was an undergraduate student. The problems of delivery in Japan caused by age of pregnancy women, the number of low-birth-weight-infant are increasing, and also the rate of cesareans is increasing. These problems seem to be common in Nepal and Japan. Moreover, nurses have an important role for midwifery in Nepal. That is great different point between in Nepal and Japan. I should know the curriculum of Nepal Nurses’ education, but in Japan, nursing students have to study another course for midwife, national qualification, at least 1 more year additionally.
I felt that the meeting time that family meet their infant was very short; 1 or 2 hours at NICU firstly. But nurses explained for us that it is valuable that to be with baby and mother together is very important for baby’s growth, and so meeting time is flexible in this hospital.
Finally, I was overwhelmed that Nepal medicine, because a lot of things are very different from Japan. However, SCWH seems to be very advanced and there are very good relationship between patients and medical staffs. Good relationship is needed to be good hospital and that is the same all over the world. Nursing is also deeply related to life, culture, sanitation, electricity, infrastructure, structure, and so on. I should study these of Nepal more, and I hope to contribute to nursing development in each country, Japan and Nepal.
Thank you, all SCWH staffs and patients, for inviting us and teaching a lot of things.
There were so many cesareans that operation room number was not enough, only 3 rooms, and staffs sutured on the way to operation rooms because they had to open the operation room for next cesarean. So they seemed to be very busy, next to next operations such as cesareans and gynecological surgery. I could understand that SCWH is very important role as emergency or acute phase operation providing from this seen.
This unit was very advanced with some monitoring machines. Some babies were treated light-therapy, some were feeding because of low-birth-weight.
Additionally, the staffs mind the sanitation especially in this area, with using hand hygiene and gown.
There were many on-going deliveries and a lot of nursing students encouraging pregnant women. I would be probably glad and relief if I were pregnant and encouraged like this at this hospital even though delivery was very hard.
I failed to ask one question, but I wondered that the man who will be father is present at delivery, if it is not a cesarean operation. Recently, many fathers are together with mothers when the babies are boring in Japan. But that may be related to regions or custom deeply.
Doctoral student of Disaster Nursing
Graduate School of Health Sciences at Tokyo Medical and Dental University