CWCH

Gooood Morning!

We just rolled out of bed this fine Hartal morning, and decided to sit down and have a little chat with all of you!  For those of you not up to speed, Hartal = no classes. We’d feel happy about it, except that it puts us really behind and then it’s up to us to try to squeeze a class in on our weekends. But, we’re getting really good at just rolling with it J

We have lots to catch you up on!

This past Friday we tagged along with Nancy- one of the other teachers here- to her clinical placement at CWCH (Children’s and Women’s Care Hospital).  We miss practicing and doing hands on work in the hospital and we were especially excited to be able to work on the Pediatrics ward. We took 4 students with us and taught them all we could about Peds- it was really fun to pass on our knowledge!

It is always a little hard stepping into a third world hospital. You know before going in, that you will be fully out of control and that you’re going to see things that are appalling and horrible.  This experience was a lot like walking into Peds in Haiti except worse. No incubators for the tiny 1kg babies, horrible “infection control” practices, using the same suction tubing for the whole hospital it seemed like, and just plain lack of good care.

   We each took two students, found a cute kid, and set to work assessing and teaching the students all the things that are unique about children. We saw a lot of children who were very malnourished, very small for their age.  One of the most positive things about this hospital is that they really support breastfeeding. Formula companies (like Nestle’) have a strong push here and in lots of underdeveloped countries. They campaign- even in super poor areas- claiming that formula is better than breast milk. These poor mothers let their milk dry up, but are too poor to properly supplement or even buy the formula, and the child is the one who suffers.

We see this back home with our first nations families who use formula but dilute it and the children end up failure to thrive. 

The hospital is situated right in the heart of the garment factory sector. We heard many stories about women who work there, whose husbands have left them, who are bitterly impoverished, and whose children suffer because of it. Friday (the day we went) is by far the busiest day because it is the first day of the weekend. There’s a huge influx of children and families- some just coming to get their immunizations done (there’s a really great immunization program at CWCH) and some in because they’re children are sick or because they are in labor. We're going to do a separate blog about the garment industry- a huge topic to cover and understand.

There weren’t to many kids in when we were there. One bigger girl who had a pretty good case of asthma or bronchiolitis we think.  We decided to do a focused respiratory assessment on her, which was good learning for the students. Then we took her Oxygen sats and they were 82%. Wasn’t much we could do except call the nurse, who didn’t seem pleased at all because she was on her lunch break.

The nursing care is shocking. No rational as to why they’re doing what they’re doing, no assessments first.  Things get done, but we’re not sure how or why or if they bring better outcomes for the kids.

So we’re here for this exact reason, to teach these nursing students to be better- to be able to care for patients at a high standard. It’s just a hard reality to digest, that the care and level of knowledge of the doctors and nurses here is so poor.

We knew the standard of nursing was low, but it doesn’t really hit you until you see it.

Nurses here are supposed to be registered, but lots aren’t and are working “unlicensed”. Some of them have no education whatsoever, some have taken some semblance of a diploma program, and some have a “BScN”- which let’s be clear, is NOT a BScN.

We’ve had lots of conversations about how nursing is viewed in Bangladesh. Again, you can read about it, and then you see it. Nurses here a viewed in a class just above prostitutes. Historically, it was these people who entered Nursing. Women who got pregnant out of wedlock, women who were prostitutes or Hijras. It was what you did if there was almost nothing else. It’s crazy to us!

Still, the students at our university get a lot of flack. It’s getting much better- they’ve started realizing that in other parts of the world, nursing is viewed as a very noble and accepted profession. The students see us “foreigners” coming to teach and see that we are very proud to be nurses. We’re also not shy to tell them the same. But they still do get treated with a lot of disrespect for choosing nursing- we have to give them a lot of support emotionally to help them understand that the choice to enter this program is worth it.

Still, for public nursing schools (ours is private), the students are required to live in “hostels”. Not like living in Rez- more like living in a nurses residence.  Because they’re required to live in hostels, they can’t get married because they’re husbands would never let them. And in another view, women who are already married can’t enter nursing because they can’t leave their husbands to live in the hostels. We don’t really understand it at all.

The nursing program is by far the hardest program in the entire university- and the students and faculty at large know it. There’s a lot of just “passing people through” even when they shouldn’t- but not in our program! Our students are kept to a high standard. It’s hard for them, and they complain a lot “ But Mam’me, But Mam’me”, but they know they’re getting an amazing education compared to any program in the country.

The sad thing is, is that for the time being it’s not sustainable. Relying on foreigners to come teach can only take the program so far. Ideally, they need Bangladeshi teachers. But it’s just not possible. There are no quality instructors to be found at this point. Karen and Alex, the directors of the program have tried earnestly to find Bangladeshi nurses to teach but to no avail. There is a HUGE lack of quality instructors across the country- lots of hospitals but no good nurses and doctors.

It’s not their fault necessarily, it’s just that education and health care have not been made priorities- they’re still in their baby stages of things. 

Even at CWCH, they have these dreams and plans to build a nursing school and a medical college and a new hospital, but there are NO quality teachers! It’s just a little short sighted, and unfortunately they don’t see the fact that the quality is poor and their knowledge base is extremely lacking.

 This ties into our “trapped on a boat” blogs- these nurses have been through so much discrimination for choosing nursing, no wonder they’re defensive and mean at times! It makes sense.

Just another little snap shot. Very brief- there’s a lot more we could say, but it makes us so thankful that we come from a country where nursing is so highly esteemed. We realize that it wasn’t always this way in Canada. Not to many years ago we were fighting the same battles to be recognized as a profession. Not to long ago, doctors dominated nurses. Now, we’re so lucky (especially on Pediatrics at VGH J ) to work alongside doctors in such a beautiful team player way. 

So, we’re thankful for what we have, thankful for Florence Nightingale, thankful for those who fought in Canada for nurses rights.

Ya Nursing!!

Xo Heidi and Ricki