Faculty colleague visits India

Julie Flint spent 5 weeks in Indore, which is the largest city in the state of Madhya Pradesh in the region of central India.  She says:

I spent five weeks as part of a health professional team, currently working in the UK, with a group of medical doctors who had moved back home to India after leaving high level NHS jobs in the UK. The project is to establish a unique collaboration and system management strategy for a new hospital: The Royal Shanti Healthcare. 

The building work had been delayed and we were initially disappointed that the inaugural ceremony and opening activity would not be taking place on this visit; however, it proved fortuitous.  The architects and doctors who were leading the project had signed off plans and the building was almost complete but through a nursing and midwifery view, the UK team were able to identify adjustments and additions that were fundamental. Most interesting was the absence of sluice facilities for the disposal of waste and bodily fluids. Whether this ws due to doctors not recognising the requirements because in the UK it is nurses who deal with such matters or whether, as one of the team—Dr Jamjute—acknowledged ‘Culturally it is only recent years that India is seeing the need to improve toilet and waste facilities’ and, therefore, perhaps not at the forefront of planning.

Birth pools arriving at the hospital

Despite the hot and dusty building site surroundings we discussed the future educational strategies for the workforce and worked on developing evidence based (UK style) guidelines and policies to guide staff along with clinical governance systems. Inspiringly, the most important concepts they were employing were being patient centred and supporting equality within the team providing care, moving away from a hierarchical structure of professional dominance. For example they want their nurses to challenge a doctor if he/she does not adhere to the infection control policy, where in other facilities visiting doctors would do as they please and inappropriately walk around the hospital in theatre scrubs.

Being there for International Women’s Day on the 8 March 2013 gave us opportunities to be involved in many public and professional events. I chaired Dr Jamjutes’ talk at The Times of India conference giving me the opportunity to speak about the importance of education at all levels of professionals and the public. We were also there for the Hindu Holi festival which celebrates the new season of spring and the abundance of colour that comes with it. People throw coloured powder at each other and ‘play’ with colour and proved to be extremely good fun.

The coloufrul Holi festival

The intention is for the Royal Shanti Healthcare facility to have a large focus on maternity care and fertility. As a midwife visiting developing countries I always feel a little frustrated by the lack of midwifery as an independent concept. Nurses in India undertake a National BSc or vocational college qualification, and obstetrics is just one part. It is medical doctors who conduct the births and it was clearly articulated by the team that doctors can be reluctant to await, patiently, labour progress for a normal birth when performing a caesarean section means the doctors have less time commitment and can conduct more deliveries. This is shocking when the caesarean section rate in private hospitals can be 80-90%.  Thankfully, this team of doctors want to support birth a different way and they want to educate women through the Hull model of birth preparation classes that I run in my business and normalise birth and to introduce the concept of waterbirth. The development of improved obstetric nursing care or even a midwifery training course is a strong possibility and I intend to work to bring that to fruition in some way.