By Dr Vinodhini Bhaskaran
Consultant, Obstetrician and Gynaecologist
ParkCity Medical Centre, KL

(Published in AOFOG Newsletter October 2023, Volume 4/2023 & OGSM CONNECT Newsletter December 2023, Issue 1, Council 2023/2024)

 Every obstetrician’s dream is a safe childbirth – every time, everywhere. Ever since its inception in 2014, this is what “Intensive course in obstetric emergencies”, popularly known as ICOE, has been doing: making childbirth safer by training doctors and midwives in the Asia Pacific region on safe delivery practices. As a practicing OBGYN who has always been passionate about women’s health, my pursuit for excellence in delivering the best possible care to my patients and the society has unsurprisingly led me to ICOE! My journey with ICOE since 2018 had been both enlightening and enriching where I learned so much, not just about obstetrics but also about people, culture, team building, communication and other soft skills. Every ICOE course, both local and regional, was something I looked forward to! Having previously travelled to Cambodia and Vietnam in 2019 and 2020 with the ICOE team, I was excited when the opportunity to conduct a course in Nepalcame. ICOE had been running courses in Nepal since 2018 and this was the fifth course in Nepal which also had the Training of Trainers (TOT).

Ours was a vibrant team of six – led by our team leader, the spirited Prof Dato’ Dr Zaridah Shaffie, Dr Harris Njoo Suharjono (Past president of OGSM), Prof Zaleha Abdullah Mahdy, Dr Rahmah Saaid, me Dr Vinodhini Bhaskaran and the indispensable Mr Baskeran, the ICOE admin liaison. Together with a significant number of mannequins, we flew off to Kathmandu on Merdeka day waving our Malaysian flag. Our journey was smooth. We landed at Kathmandu late night and checked into our hotel (Lavie Residence) for a good night’s rest. The hotel was conveniently located not too far from the airport. With a two and half hours’ time difference, I was up by 5 am and was welcomed with a beautiful sunrise. I had imagined Kathmandu to be surrounded by the snowcapped Himalayan range and was rather disappointed when I saw only hills! However, Kathmandu had other exciting features to offer a traveller. I went on to explore the city’s dusty streets with a couple of street dogs following me before heading to the Training the Trainers (TOT) session organised by the NESOG at Paropakar hospital, Lalithpur. The hilly city felt ancient and vaguely familiar, similar to India. After a sumptuous breakfast at our hotel, we set off for the TOT to Lalithpur which was just across the River Bagamathie. The President of NESOG, Dr Saroja Karki Pande, and the NESOG Secretary, Dr Sapana Amatya Vaidya, warmly welcomed us and had the venue appropriately organised for the course. They also ensured that we have an hourly dose of tea or coffee and are well fed. It was an interesting day where we interacted with the local Nepal trainers who were very enthusiastic to conduct the course and train sixteen new trainers. They shared their journey in ICOE, how it has had a positive impact on their practice and why they chose to become trainers. It was indeed inspiring to know how they work with very little resources and use it optimally for providing quality healthcare despite challenging situations. After the session, we prepared our stations for the next day and headed back to the hotel late afternoon. We were happy to meet the AOFOG president, Dr Pisake Lumbiganon, who joined us during our trip back to the hotel.

I managed to squeeze some time to visit the famous Pashupathinath temple. It was indeed a beautiful temple with stunning architecture. I was able to see the magnificent sunset just beside the temple. The temple, with the sunset hues, was simply remarkable! I was just in time for the evening prayers and got to witness the impressive River Arathi where they conduct a ritual to thank the river Bagamathie. Despite the huge crowd, I was able to get a nice place from a nearby Rudraksha shop thanks to my local guide, Bishal, who made way for me in the crowd. The entire ceremony was so beautiful. It was heartwarming to see people offering gratitude to nature for providing and sustaining us. I was quite surprised to know that there are crematoriums on the banks of the river. I saw several ongoing funerals. Filled with a stark contrast of reality and strangely, serenity, I plunged into a deep slumber after swallowing a full Nepalese Thali meal for dinner. The sleep helped prepare me for the hectic day ahead.

The next day started early. By 7 am, we were ready to set off to train around 26 doctors who had enrolled for the program. The course began with our usual pretests and went smoothly without a glitch. In between, we had the inauguration ceremony with the AOFOG president, Dr Pisake Lumbiganon, the NESOG president, Dr Saroja Karke Pande, and the Director of Paropakar maternity hospital, Dr Shri Prasad Adhikari, officially launching the session. We were given a sumptuous lunch which provided the energy to run the course until almost 6 pm with Prof Pisake’s wonderful sharing of WHO’s recommendations on intrapartum care for appositive childbirth experience.

We left early next day for the concluding session after a delicious masala chai at our hotel. The communication skills station and lecture were a hit with the local doctors. We were really touched when one of our local trainers, Dr Anjana Adhikari, shared her experience about being locked up in a room by a mob after a poor outcome and how communicating the right way, as she was taught in ICOE, had not only saved her but also won her appreciation from both the mobsters and the hospital admin. It was really heartening to note that we (ICOE) were making a difference or rather a significant impact on the lives of both the mothers and healthcare staff alike! The training concluded with our post-tests and as usual, the participants had scored remarkably higher with some stations having almost a perfect score of 10 & 9.

The next morning, I woke up fresh at 5 am from the soft rays of the sun. I had rested well the night before. As I drew the curtains away, I was stunned to see the magnificent snowcapped mountains staring at me right across the window! For a moment, I wondered if I was dreaming and had to pinch myself to see if that was indeed true. I made quick phone calls to the others and soon after, we snuck into the dilapidated terrace of our hotel building (which I had accidentally discovered while exploring the surroundings on the first day). We soaked in the beauty of the snowcapped peaks shimmering in the golden rays of the early morning sun. We savoured every second of that awesome moment and captured those precious memories in our cameras as selfies and wefies. It was like the universe had heard us and granted us our wish as a reward for all the good work we did in Nepal! It was indeed a surreal experience where I felt the wind whisper in my ears the iconic dialogue from the movie Om Shanti Om delivered by none other than the Bollywood king Dato’ Sharukh khan “Agar kisi cheez ko dil se chaaho to puri kyanat usey tumse milane ki koshish mein lag jaati hai”. This is nothing but Paulo coelho’s famous quote “when you want something with all your heart, the universe conspires in helping you to achieve it”. I decided to make a quick visit to the Boudhnath stupa, one of the largest spherical stupas in the world, which was at a walking distance from our hotel. The stupa was a remarkable sight with colourful flags adorning and bustling with pilgrims as it’s a very important sacred pilgrimage site for Buddhists from all over the world. I also managed to go to the Ghyoilisang peace park (Buddha Peace Park) which was beautiful and serene with fishponds before I headed back to the hotel just in time to prepare for our journey back home.