Japanese midwife embarks on a new life at Lao hospital

The mortality rate of children under the age of five in Laos is unacceptably high, so I thought that if I could play a part in lowering the rate I would be very glad to do so, said Japanese midwife Ms Haruka Miyabayashi, who now works at a Lao hospital.
Ms Miyabayashi, 29, is employed by Japan Overseas Cooperation Volunteers, under the Japan International Cooperation Agency (JICA), and has been working at Thoulakhom district Hospital in Vientiane province since November 2016.
She works closely with her Lao counterparts and is helping to improve the health of mothers and children under her care.
Before coming to Laos, Ms Miyabayashi worked as a midwife at a university hospital in Japan where she cared for women during and after pregnancy and during childbirth, as well as premature babies and newborns.

Ms Haruka Miyabayashi.

She monitored women’s progress during pregnancy and helped them through delivery, while advising them how to take the stress out of pregnancy.
She also trained younger midwives and nursing students.
A couple of years ago she decided to look for work as a volunteer and found a job description that suited her with JICA.
Ms Miyabayashi has been in Laos for 16 months and not only delivers babies but also advises doctors, midwives and nurses on the care of mothers and newborns.
To begin with she found it really hard because of the huge gap in the working methods between Lao and Japanese hospitals. Another problem was communication with patients as she struggled with the Lao language.
“Thoulakhom hospital doesn't keep clinical records for every patient.
So the staff have to record all the information in the mother and child book. If you can have a central and permanent record of a patient’s condition, such as blood pressure, fetal heart sound, health issues and so on, we can identify any problems and lower the risks, which results in a much safer delivery,” she said.
“And staff also don't maintain a regular checking schedule and record the results of the checks they make. So I have advised everyone to keep records and have tried to explain why this is necessary,” she added.
Now some of the staff are keeping records and using them for reference.
She has also made an explanatory poster with pictures to indicate what pregnant women should do when they are at risk of a difficult delivery. Some staff use this poster and it helps patients to understand the process more easily.
During delivery, Ms Miyabayashi monitors the mother’s progress and discusses the situation with her colleagues.
Japan is highly developed in this field and new mothers and their babies are well cared for.
Ms Miyabayashi hopes to learn from her experiences in Laos by observing perinatal care in the Lao cultural context, so she can learn lessons that she can apply in Japan.
Her experience here has made her rethink the most important areas of care and how they can be further improved.
Ms Miyabayashi said that in Japan they focus entirely on the needs of the patient as that person is always considered to be the most important and they are given assistance as soon as it is needed.
But at Thoulakhom hospital she found that staff tended to neglect the needs of patients, mainly by taking a long lunch break or arriving late so that patients’ needs weren’t immediately attended to.
She understands that this is the Lao way but it was a challenge to be immersed in a system that was so different to that of Japan.
However, she is optimistic that conditions in Laos will change step by step and that things will improve in the future.
Aside from her work, Ms Miyabayashi enjoys learning about Lao culture. The differences between Laos and Japan are enormous, and sometimes she relishes these but at other times is baffled.
She feels honoured to be involved in the Lao medical world, to work alongside Lao people, and be immersed in Lao culture.
She finds that her colleagues are always helpful and kind and willing to share aspects of their work to help her through the day and add to her understanding.

By Patithin Phetmeuangphuan
(Latest Update March 15, 2018)