Home sweet home

Hi guys

Well my travels are finally over, sorry I have not uploaded my recent blogs till today but time has ran away with me. I have returned to the land of Oz, lol.

I hope you have enjoyed reading, I have enjoyed writing, it has some how been therapeutic for me. I have had an experience of a life time, one which I think will change my outlook on life forever and one I will never forget.

It is lovely to be home, to see my wonderful hubby, family and friends in Perth - and soon to be setting off again to see those of you in the UK. Yet it feels a little bitter sweet right now, as I sit here writing this last blog in my beautiful home, with food in my fridge, water in my taps, heating on (yes pom's, it's evening and 10 degree's here!) and I'm thanking my lucky stars for what I have.

I am thankful for the opportunity I have been given and am glad to have been able to share it with you all.

Remember every day how lucky you are and how life is so different for many other people all over the world!

Thank you all for reading and hope to see you all soon.
Lot of love
Dawn
xxxxx

Story behind every hat!

Hi Guys

It's my final few days in Tanzania and the experience I have had here is hard to put into words. It's been challenging, sad, rewarding and life changing - hopefully for those I have helped, and most definitely for myself! I can't say I have enjoyed my time here as enjoy is not really the word I would use, but I have currently not hated it. I wish I could have helped more, I see so many ways that things could be improved, even with no money - improved basic nursing skills and better knowledge could save so many lives. I wish I could stay for longer and focus on just helping one hospital at a time, I wish I could come return with my awesome team of midwives and implement change. As usual though even though I am on the other side of the world politics and cultural beliefs make change very difficult. I have however made some changes, educated many professionals and left my mark - no matter how small that maybe. I hope that the nurses and doctors I have taught will be able to put into practise the skills we have taught them and continue to save more and more lives.

I wanted to share with you a few stories of women and their babies I helped along my journey.

This baby was born by emergency caesarean, it's mother had pre-eclampsia. She had an eclamptic fit and her placenta abrupted. This baby was born in very poor condition and I helped resuscitate her. Despite being possible 4 weeks early she is pretty big. The white stuff on her face is vernix (this is normal in premie babies). I am unsure whet this baby got to see her mother or indeed what happened to her. I gave this baby a knitted white hat, pink cardigan and a pink jump suit. Thank you to who ever made or gave me these. xxx

 

 

This women has just given birth about 10 minutes ago. She is in the labour room and her baby also required a serious amount of resus. To her right is another women still in labour. She has just birthed her placenta and now she has to sit on this stool to breastfeed her baby. When she has finished she will go outside to the postnatal ward and share a bed with 2-3 other women. I gave this lady a yellow knitted hat, white cardigan and booties and a white jump suit.

 

 

This baby was born to a HIV positive mother. It has a high chance of having contracted HIV from it's mother. Yet he is as beautiful as any other baby and will be loved and cherished by his mother, like an other baby. I gave this baby a blue hat, cardigan and bootie's.

 

This is Fatuma, she gave birth to her beautiful 3.5kg baby who I also resuscitated. All I had left in my bag was a 00000 (tiny baby for poms) sized pink jump suit and a very small hat. Fatuma was so pleased with her gifts she was determined for the suit and hat to fit her baby girl. She squeezed her baby into this outfit it was so funny to watch, anyone would think it was made of gold! She was also amazed when I took her picture and showed it to her. I don't think she had ever seen a photo of herself. Thank you to my amazing sister who hit the charity shops and markets with her friend for baby clothes before I left and I believe she picked up this one on her way - you made this woman's day!!!

 

Thank you all for everything you gave - you all helped make someones day xxxx

 







Children of the slums

Hi Guys

Today I visited the slums to see how most of the locals live. Boy how hard this was to see. First we went to a house which had 6 rooms, each room was no bigger than a master bedroom in a house. In each of these rooms lived a family of 4 or more. They had 2 mattresses and not much else.



In this one house (the size of one of our homes) housed more than 28 people. They shared a toilet block, which I did not look inside, but after my toilet nightmares in the villages I can only imagine what this was like!

 

 They had no kitchen so all the families used the hallway to cook in.

 

 

I spoke with some of the families and also to the land lady (via a translator - as my Swahili is getting better but not that good). I asked how much it would cost to live in this house. The land lady told me that it would cost the equivalent of $200 for rent for the year. I was shocked - my sunnies I had on my head were worth more than that! I felt terrible, what a different world we live in. Here I was in the position to pay for one families rent my just handing over my sunnies. So many things went through my head at that moment - I will never forget that moment in my life!

 

I would have loved to go to the cash point and take out enough money to pay the rent for the entire house for the whole year. However, I am well aware that this is a cruel world and as much as my giving them money would have been nice. I couldn't be sure that it would actually go towards the rent, things are very corrupt here. The land lady had a very nice little set up and there were some interesting men watching our every move! So on we went.

 

We moved on to look at many house near a very dirty river, there were kids playing near the river. They were all so pleased to see us. The families here told us that each year the river (which also was sewage) flooded and ended up in their huts (houses). The water reached incredible heights and bought with it disease and much more. The children we met were amazing, they have so little and lived in terrible conditions yet they were the happiest kids I have seen. All smiles, playful and laughing all the time. I gave out heaps of the packs I had put together and they loved them. Thank you all so much for all your donations, you really did make these children's days!

 

 

I will never forgot these slums and the children and their families who lived in them. We are all truly blessed to live where we do and we must all never forget it.

 



Feeling very grateful right now xxx

Teaching continues

Hi Guys

On return from Zanzibar we set back to work in the main city, continuing to train the local nurses and doctors at the local hospitals. The train the trainer idea was in full swing now and all our nurses were doing a great job at training other nurses and doctors.

One day I went to a hospital to assess the nurses on our course. They had to teach a skill and be assessed doing this. I went to all the maternity wards and assessed several nurses who were on our course. They all did very well, I had the props with me like a baby doll for resus and a mini Annie for adult resus etc. Then I got to the pre-eclampsia (high blood pressure) ward (yes pre-eclampsia is such a problem here they have a whole ward of women with it!). This one nurse was going to teach her fellow nurses and doctors how to manage an eclamptic fit. When I got their she was all prepared, she had all the equipment they used ready and took me over to a women who was 39 weeks pregnant and had been admitted with pre-eclampsia a few days ago. All the staff huddled around and the nurse started to provide me with a case review about this women. I was stood there wondering that this was a little strange as we were with an actual women and I was unsure how she was going to do a drill in this ward as it was extremely busy and there was no spare bed to use.

As I was considering this the women started pretending to fit!!! I was mortified, the nurse had actually asked a real women who actually had pre-eclampsia to role play her situation. All of a sudden all this equipment was being pull out and I was actually worried they were really going to use it (for real!). At one point as I was stood there I actually had to check with the nurse that the women was not actually fitting! My face must have said it all I was so shocked - morally and ethically this is something we could never do in the UK or Oz!

The poor nurse who I was assessing, bless her she thought she had failed as my face must have been a picture. Fair play for her to use her initiative though it currently lead for an interesting a real to life role play - one I will never forget! After that I felt so bad for the poor woman that I conducted an antenatal check on her and checked her blood pressure and talked through with the doctors her plan of management to ensure she was being well looked after. She was very great full - they see white people and assume they are in safe hands, so that was one good thing that came out of it.

Another day whilst working on the ward I met a 19 year old girl who was 37 weeks pregnant and had been admitted the previous day with pre-eclampsia. Her BP on admission was 160/110 (this is very high, for all you none medical people). She had also just discovered she was pregnant with twins. Whilst teaching the nurses about pre-eclampsia and assessing this woman, I checked her record (which are practically nothing) and her blood pressure was still the same. She had apparently been in hospital for 12 hrs and had 3 lots of medication and yet her BP had not actually changed. Her BP during this time had not been checked since admission, even though they all knew it was supposed to be checked 4 hrly on this ward. I found this hard to understand that despite 3 x medication nothing had changed. I tried to explain this to the nurses and they told me her BP had been checked but just not documented (Hmmm...?).

When I finally got to the bottom of things, I discovered that not only had this women not had her BP checked in 12 hrs she had also not had any further medication since admission. The nurses do not seem to talk to the women. There are so many women on the wards the nurses do not even know who they are. The have no name bands on, all share beds and have no charts on the beds. The only way they could identify the women was by pulling their charts and shouting out their name from the front of the ward. I have no ideal how they even know who's chart they are writing in or who they are giving the medication to. It was mind blowing! Eclamptic fits are so common here, I have seen many already. I wonder if just through simple management and organisation these could be reduced. I don't even think basic observations like a BP is being done and this may be all it takes to save many more lives.

Take care all and I will see you all soon. xx

Zanzibar

Hi Guys

Decided to head to Zanzibar for a weekend of R & R. However in usual Dawn style more drama's were ahead of me!

We headed down to the ferry port to catch the early ferry to make the most of our weekend. We arrived at the ferry port with plenty of time to spare - only to find out that we actually needed our pastports to go to Zanzibar! We jumped back in the bajargi (tut tut for those of you who have been to thailand)and headed back to our house to collect our passports. We had 45 minutes to get back to the house, collect our passports and get back to the ferry port - we were pushing it for sure. We got back to the ferry port with 5 minutes to spare and the ferry was still in the port - relief - well for all but 5 minutes! Got to the ticket man, who then told us we were to late, they had closed the gate and we were not getting on the ferry! TIA (this is africa, for god sake!) nothing ever runs on time, so we couldn't understand why they wouldn't let us on that ferry. After arguing with the ticket guy for 10 minutes we accepted defeat........

The guy then tried to sale us a flight (Hmmm.. now I understand!). This gus was obviously trying to rip us off - however I was the only one who could see this. The other girls thought this was an awesome idea. The guy told us it was 10 minutes to the airport and her would give us a free transfer (sure he would!). Apparently the next plane left at 10.30 - it was now 9am. the next ferry left at 1pm and took 2 hrs. The plane took 20min. I could see the advantage of this but anyone who knows me knows I hate flying and the thought of getting on a tiny plane was giving me palpatations!!!

So finally we agreed to go by plane as it was only $30 more and we headed on the 10minute journey to the airport (bulls***), 30minutes later we arrived at the airport. There was a guys who meet us at the airport and took us through the security. Not sure what they were checking for on the x-ray machine as my freind had pepper spray & a knife in her bag and I had a razor but it was like "come on through!". After getting through customs we had to pay this mystery man a departure tax (hmmm....) think that went in his pocket. We got to the departure lounge (which was a shack really), only to find we have missed the 10:30 flight (oh what a surprise!!!) the next flight was at 12:30! We had been well and turley riped off and after agruing with the airport people - we got a free coffee (great!).

Eventually it was 12:30 and we got on this tiny plane (my heart felt like it was going to jump out of my chest at this point). My friends decided to sit right behind the pilots, this would not have been my first choice but I was in no state to argue. The journey was not to bad really, the views were amazing it really did only take 20 minutes. I did get a little concerned at one point when my friend started talking to the pilot ( why is so har to understand that you do not distract the driver!!!).

Well I can say Zanzibar was well and truely worth the stress to get there. Beautiful beaches, cocktails, great food and amazing scenery. Totally loved every minute, felt very guilty to be living it up though when I thought about all the poverty I had left back in Tanzania. Gona be an interesting transition back to reality in Perth that is for sure. Pic's on FB already.

xxx

　

　

Village adventures - Part 3

Hi guys

　

The next few days we continued to visit the village hospitals and provide education and help out. By now we were getting very used to the bumpy ambulance rides and the holes in the ground for toilets! However we were still all having nightmares about using the public holes in the ground (see below). These were worse than the ones in our accommodation. Not only that but the holes were a lot smaller and I have no idea how women are supposed to aim in them. For this reason we were very careful what we drank through the day, in the hope we didn’t need the toilet! The bumpy ride home was not good for our full bladders by the end of the day. We kept joking about someone getting a bout of gastro and having to use it, that would not be a pretty sight, lol.

At the hospitals there were lots of sick kids and adults, lots of malaria and road traffic accidents (RTA). The roads are terrible here and I am not surprised that RTA’s (after malaria and HIV) is the next biggest killer here. I met so many people who had lost family members to a RTA. Yet no one drives carefully, the rules of the road do not seem to apply here. For example I have been in many a scary situation when our driver over took on a bend, I just closed my eyes and hope and prayed for the best (sorry mum!). Thankfully there are not many bends on the roads in the city (and I am back safe & sound as I write this!). The average life expectancy is 53 for women and 56 for men over here, which is incredibly young. Due to this the kids end up bringing up the kids.

We also visited the local people. They lived in mud huts which were amazingly built and very cool in the summer I’m sure. The women looked immaculately dressed with what seemed like ironed clothes, make-up and their hair looking perfect - with no running water or electricity I have no idea how they managed it. There was me with no make-up on, hair a mess and sweat patches everywhere, I felt rather embarrassed for the state of myself! The school children were the same, they had these little school uniforms which were very clean and also looked perfectly ironed. They have this metal iron thing which they put on the fire and iron their clothes on a piece of wood! Only the families with a little money (living in the better mud huts!) could afford to send their children to school so there were always heaps of kids around everywhere we went.

On the way back from one village hospital we were waving to the kids from the ambulance and they all started chasing the ambulance it was so sweet. They are also loving Ruth (the kangaroo), this is Fredie holding her.

 

Can’t believe I have been here almost 4 weeks now, feels like a life time ago I left Perth but has also gone very quick.

Miss you all xx

Village party time

Hi guys

　

 

Well the village went off last night!! Party time African village style!!

We invited a few of the nurses and doctors from the villages to our village resort for dinner. We had asked the owner to prepare some food for them. What we thought would be a few villagers, ended up being what seemed like the entire village! Everyone came, they bought their families and it ended up being about 40-50 people! They all heard the ‘white people’ were throwing a party and all camedown! They also all thought it was a free bar! Even the local nun came for a dance!



Often the language barrier can be difficult, but when you are telling them something they don’t want to hear it becomes even more difficult! We told the bar and the locals that the first drink was free and then they had to pay, however I think I only saw 2-3 people pay all night. They were also ordering drinks and putting it in their bags and taking them home! Thankfully TIA (This I Africa!) and the prices are a lot cheaper than Oz. We ended up with a $300 bill for dinner and drinks for 40-50 people all night, which divided by 4 was not to bad. We had an awesome night too, lots of African dancing and music and lots of laughs, it was well worth it.

The buffet they put on was also heaps better than rice and spinach which we had become accustomed to and with free flowing Savannah dry we couldn’t complain! Awesome night had by allJ

Miss you all xx

Village adventures - Part 2

Hi guys

The next day we set off back to the village hospitals to do some teaching (see pic of a labour ward at one of them below). I went to the maternity section to do some ‘teaching on the run’ - in neonatal resuscitation and shoulder dystocia management. Whilst teaching neonatal resus 2 women were in labour.

It is typical for no observations to be performed during or after labour - no one listens to the baby’s heart beat or checks the mothers blood pressure/pulse. Most of the time you don’t really have any idea what gestation (weeks pregnant) the baby is and nearly all the time there is meconium stained waters (baby has had a poo before birth and water goes green/brown). For this and many other reasons many babies are born and require resuscitation. I therefore used the opportunity to my advantage and went in and assisted with the birth. The baby (as I suspected) was born in very poor condition. I talked the nurse through the resus procedure which I had just been teaching her and we worked together to resus the baby. It took a while but the baby finally starting breathing on it’s own. It was amazing to teach in real life and know that you have possibly helped save a baby’s life. I am unsure if I had not been there what they would have done, as they seemed no hurry to act on the very obvious signs of this baby requiring resus - nothing is a hurry over here! This is one of the babies I helped resus.

 

So many babies die over here. In one hospital, one morning I went in and 5 babies had died overnight - it was difficult to determine the cause. I wondered had I been there to help if things would have been different? The nurse did an amazing job though, and gained huge experience in this emergency. I hope that when she is next faced with that situation she will know how to manage it better. Over the next few days this situation became a frequent event and we resuscitated many babies. See pictures below with the hats and booties I gave them - every resus’ed baby I gave a hat/bootie’s and clothes too - figured they deserved it!

 

Following this we went onto the other 2 villages and continued to do the same teaching. We managed to teach heaps of doctors and nurses in all sorts of emergencies. Whilst at one of the hospitals we visited the labour ward which consisted of 2 beds in a room. Two women were in labour, one of which had ruptured her membranes (waters had broken) 3 days ago. She was not in labour and had been contracting on and off for 2 days. Whilst there I assessed both women to make sure they were ok and there were no problems that I could assist with. I discussed with the nurse and doctor about management of ruptured membranes and the importance of antibiotic cover and augmenting the labour (inducing labour). I managed to get the doctor to prescribe antibiotic’s and then had to arrange the family to go and buy the drugs (nothing here is free!) from the hospital pharmacy and bring it back for her so we could administer. They did not want to augment the labour as it was the women’s 7^th child and they said this was risky, this would usually be done in the main hospital - a 2 hour drive. I then tried to encourage the doctor to transfer this women for this procedure rather than wait any longer as the risk of infection was too high and there were no facilities here for the baby should it be unwell. Thankfully when I returned the next day I discovered the women had been transfer.

The other women was HIV positive, she was in labour with her first baby and was very distressed and scared. She looked about 17 years old. HIV is very common here I have been told the figures are anything from 10-70% and apparently higher in the villages. I have learnt a lot about HIV management and drug therapy in pregnancy, labour and after birth and have met more HIV positive women and babies in four weeks than I have or ever will in my career. The next day when I returned this women had birthed a beautiful baby girl. I gave her a hat and some clothes and congratulated her.

Tonite we are planning a small party for some of the locals at the accommodation we are staying at. Our food usually consists of rice and spinach, tonite they are cooking a special meal! Hmmm… I will let you know how that goes.

　
Cherish your life and your children, because no mater the difficulties we face at home we have to be thank full for the awesome health care and access to drugs/experience medical professionals we are all so lucky to have, compared to here. I know several of you who know this all to well. xx

Village adventures - Part 1

Hi guys

So after a long journey up into the hills of Africa we arrived at our accommodation for the rest of the week - village style! You could call it a little African village resort. It had little bungalows set in a tropical garden and a little bar, what more could a girls want! The views were stunning, we were in the heart of Africa now with beautiful banana and coconut tress everywhere and hills that just went on and on. My room was basic and kind of clean! Thank god for wet wipes, thats all I can say. I had to give the sink a once over as it was pretty dirty. My only real complaint would have been the toilet - it was a sink in the ground. Anyone who says squatting to go to the toilet is natural - they are liars!!! It felt like the most unnatural thing in the world. I now officially apologise to all those birthing women over the years, I have encouraged to squat to give birth, lol. Here I am squatting over this sink in the ground trying not to touch anything as it stinks and doesn’t appear very clean (no way I was getting my wet wipes in there!). I look up and there are these 2 eyes looking down at me. It was a rather large lizard on the ceiling, I nearly fell in the toilet at this point.




After settling into our accommodation we set off in the local ambulance for a drive further into the villages. From here on in the tarmac rd turned to a 4x4 rd so we couldn’t go any further in our poor little Rav 4. The ambulance had been purchased for the villages by the program I am working for, to help encourage them to transfer their patients to the main hospital earlier, I was later to find that it was not used as often as it should have been!

So we set off along this rd with the 4 of us sat in the back of this ambulance, we had no seat belts (sorry mum!) and the rd just got worse and worse. We were bouncing around like were on a bouncy castle, we were laughing our heads off for the first 10 minutes, after that we were over it. There were huge pot holes and craters in the ground made from the rain which created big holes. We went up and down these big slopes and tilted to the side like it was going to tip over. It was an interesting hour long journey that was for sure. Not sure if the suspension was gone on it or not ( Dad we could have done with you help here to have a look at it for us) but it was the roughest journey I have ever had (note to self- wear sports bra tomorrow, lol).

 

One of the ozzie midwives had bought a giant kangaroo with her, whom she had named Ruth - we are doing the adventures of Ruth! She comes with us everywhere and has her photo taken in all these weird places - she was our patient in the ambulance and even Ruth who is used to bouncing all day was not happy (lol), but the locals loved her. We are using her to demonstrated the idea of kangaroo mother care (non midwives may need to goggle this concept - although prob can guess!).

We visited 3 villages and met all the local nurses and doctors at the local clinic’s/hospitals there. Each clinic was small but had 2 labour beds and 2 postnatal beds. They obviously did everything here from GP clinic’s, child health, maternity to A&E. We met some of the villagers and saw how they lived in these amazing mud huts. Everyone was so friendly and pleased to see us. I don’t think some of them had ever seen a white person as they were all staring and looked shocked to see us. The kids were especially funny laughing and staring and trying to touch us like we were aliens or something, it was funny to see. We arranged with them the training which we were going to provide for the rest of the week and then headed back to our accommodation along the same bumpy rd!

Back at base camp we sat and had a Savannah dry and watched the sun set over the hills of Africa - awesome day had by all.

　
Will blog again soon xxx
　

Pit falls of living in Tanzania

Hi guys

Without taking away from the fact that I know I am very lucky and appreciate everything I have both here in Tanzania and at home and the fact that I know I live 5 star compared to the locals. I wanted to share some funny things with you all about living here.

Firstly, my shower is in my toilet - literally. I could sit on the toilet and have a shower at the same time (see photo)! Paul this would be an amazing idea for you as you spend so much time in both the toilet and the shower you could now multi task and been ready in half the time! Think if we ever build again I will add this innovative solution for you!

My bra is a money tree (no photo of this! LOL). Because it is not safe to take a bag out we put our money down our bra’s. The other midwives with smaller boobs are pleased about this bust enhancement and also put their phones and keys down there. I, on the other hand need no extra help in this department! Almost every night I forget about the money I have hidden down my bra and get undressed only to find all this money falls to the floor! Anyone would think I’d been working at a strip bar!

Mosquito’s eat me alive every night! No mater how much mossie spray I put on I get bitten every night. I get dressed and then spray all my naked skin (which isn’t a lot due to having to cover up). I get home and I find mossie bites on my neck, on my skin where my cloths have been, any where you possible. Today’s bites include hip and buttocks. How is that even possible LOL.

Our house is two doors down from a mosque. Four times a day this man comes on a speaker phone singing some Muslim prayers, including 4.30am! I wake up every morning thinking it’s Paul talking in his sleep again!

I go to work in the hospitals and dress up like a person working in a nuclear planet and lose half my body weight in fluid!

I’m sure there are many more to tell you but that is all I can remember right now. Hope it made you chuckle.

Take care xx

 

Graduation and party time

Hi guys

Well today was the last day of our 2 week course and what a day it was.

We had a little test for the participants in the morning and then in the afternoon we had ‘graduation’. We told them all to wear their best frocks and that we would have a party. We made cakes for them and took drinks and sweets and asked them to bring in some African music.

The day went really and we had an amazing graduation party. The classroom went off! We had African dancing and they were so please with the course that at the end they presented us with a kanga (sarong) and home made card and sang/chanted for us.

It was so sad to say goodbye to them as they were all so lovely and keen/interested to learn. I am keen to go back and see them again at their hospitals and do some more shifts with them before I go home, hopefully I will have the chance.

I went back and saw the ‘yellow hat’ baby who is thankfully still alive and doing ok. Still not sure where/how it’s mum is though. They said he was doing really well as its temperature was now 35.9! It was 34.1 two days ago so I guess that is an improvement!

We are off to the villages tomorrow so will have no phone/internet signal for a week. Apparently there is nowhere to buy food there and only a BBQ type thing to cook on so all we will get is rice and spinach, interesting. I have already lost 4kg in 2 weeks so looks like I may loss a few more, easy way to diet when there is nothing to eat LOL. Louise K, I may have fitted into that bridesmaid dress after all - who needs surgery!

　

Will update you next when I can.

Take care xx

Millenium development goals

This is what we are working towards.

http://www.youtube.com/watch?v=w3pbbTx1xY8

Teaching Midwifery in Tanzania

Hi guys

Things are going well here. This week we have continued to teach the 16 participants (nurses) on our 2 week course. They are doing really well and are very pleased with what and how we are teaching them. They all seem extremely grateful for the course and all are very keen to learn. We have mainly focused on Adult and Neonatal resus and obstetric emergencies.

Yesterday I went and worked in the hospital again with the participants on the course. Whilst there I managed to assist the them to teach other nurses and doctors the things we have taught them on the course. The idea behind this course is a ‘trainer the trainer’ notion, in the effort to up-skill the staff so they can then up-skill other staff. It was an amazing day and between myself and another aussie midwife I think we managed to train about 150 nurses and doctors in Adult/Neonatal resus and obstetric emergency (see the pictures attached). It was an extremely interesting day and hard to comprehend that basic resus is not a skill they have, yet they have far more need for it than we do, with very high maternal and neonatal death rates than the western world.

Whilst I was on the neonatal ward teaching I helped care for a very tiny baby - 1.5kg. They said it was 34 weeks gestation but I think it must have been a lot younger! It was hardly breathing, very pale and looked very sick. It was left wrapped in a sheet on a cot bed. It’s mother was very sick too, so unable to help care for her baby. I managed to talk the nurses though a baby check and discuss the signs and symptoms which this baby was demonstrating which shown respiratory distress (struggling to breath). We did some basic observations including a temperature - which was very low. This baby clearly needed specialist care in a neonatal unit but I looked around the nursery and there was no real equipment to help treat this baby. I managed to assist them to set up oxygen therapy, discussed the use of antibiotic’s (which they did have) and talked to them a lot about keeping the baby warm, I gave the baby a yellow hat an boots (which one of you have knitted for them) to help improve the baby’s temp. I also talked to them about ensuring that it was fed. I got the impression that as the mother was sick the baby was not being fed but was not sure about this? It was very hard due to the language barrier and as formula is very expensive, like many things it is not available in the hospital. I tried to discuss donor milk but with such a high HIV rate that had it’s own issues. In the end they gave the baby some fluid and glucose via a syringe - that will have to do I thought! I will go back soon and check that baby is still doing OK and keep you posted.

My attempt at learning the native language Swahili is not going very well LOL. All the staff in the hospital keep taking the mick out of me as I am terrible! Think I may regret not doing a crash course before I left next week when I get down to the villages as I think there English may be as good as my Swahili!

I will post again soon. Take care and keep life in prospective. xxx

Day in the life of the hospital

Hi guys
Well I survived my first day working in a hospital, and what a day it was!
After an orientation of the entire hospital I worked for 3 hours on labour ward. The labour ward was about the size of 1 birthing room at Kings Eddies or STMH. It had 8 beds, between every second bed was a half wall (so if you were stood up you could see over it but lying down you couldn’t). Each bed was so close that whilst assisting a women to birth on my left I could touch the women to my right. There were no curtains between the beds so each women could see each other giving birth. For this reason & cultural reasons they birth alone without a support person or partner. I did not see anyone have any pain relief and am unsure if they even have any available but will find that out next week I’m sure.

During the 3 hours I was there I assisted with 5 births and tried to teach 1 nurse to stitch (as they have no training but just get on with it!). There were five other nurses there and I think about 10 babies were born in those 3 hours. The hospital has 60-70 births a day! With 4-5 midwives per shift and 1 doctor - I will never complain about staffing levels again in UK or Oz!! We literally went from one birth to another.

Picture this - “I have a hair net on, goggles, a huge white apron, face mask and gloves. It’s 35 degree’s with 85% humidity and I am sweating my ass off. I have sweat dripping down my gloves and when I take one pair off I can’t get the next set on as my hands are dipping wet.” When I finally took it all off I had droplets of water on my name badge and pocket bag I had on under the apron, my clothes were wet through! Think I lost my body weight in fluids that day!

Once the women gave birth they stood up, put on their pants and a sarong and went and sat on a wooden bench to breastfeed their baby. Within 30 minutes of giving birth they are taken to the ward (walked |I must add!) where they share a bed with 3-4 other women. If all is well was well they would probably be discharged home after 6-12 hours.

Thankfully whist I was there all mothers and babies were well. They have an interesting set up as the women stay on the ‘pre-labour ward’ until they are 7cm then they are moved to the labour ward to give birth. They either have natural vaginal births or caesarean’s - they do not do ventouse or forceps births. They do appear to do quite a few caesareans and do classical incision (for my midwifery friends - I have pictures!).

The mothers have to bring in all their own stuff for the birth - to include a syringe, cord clamp, blade (to cut the cord) and a huge role of cotton wool to mop up the mess! Nothing is supplied by the hospital. One women forgot to bring her cord clamp so we improvised with a piece of a plastic glove to tie the cord off! Worked extremely well and very cost effective I’m sureJ may have to bring that in at CMP - LOL.
They also bring in 4-5 ‘kangas’ (or to us sarongs) 2 for the baby and 2 for the mum & 1 to help mop up the mess. All of this in a little hand bag - none of this western world crap of turning up to hospital to give birth with 2 suitcases full of stuff!!

After this I went to the neonatal ward for a short while to see the tiny babies again. I gave them some of the knitted hats and booties which some of you knitted for them. They were so please with the gifts it was lovely to see - so thank you heaps for those of you that knitted stuff. With the children’s gifts and other baby clothes you have all given I have made up little gift bags (as you can see above) We have already given some away but are going to take the rest to the village which we are going to for a week on the 12^th May as they are even more deprived there.

Next week I am teaching 2 days and in the clinical areas for 2 more days so will have more to tell then I’m sure.
Thinking of you all, take care xxx
　

Gifts for the kids

Hi all,
As you can see I packaged all the lovely gifts you gave me into small little gift bags (1st photo). Today we gave some of these gifts to some local children. It started off with about 3 kids within 5 minutes we were surrounded by about 20 kids. We didn't have enough gifts to give them all but we still have heaps left at home to give to other kids like them. Hope you like the pictures. xxx

I arrived!

Hi guys, well I arrived here in Tanzania on Sunday arvo after a few hiccups getting into the country.

At immigration they quizzed me heaps about what I was doing here and couldn't understand that I was a volunteer here for 5 weeks and not getting paid. They thought I was trying to work in the country on a tourist Visa, they were also worried I would stay longer then the 5 weeks! Then I got to customs and had another drama! They x-rayed my bags and saw all the gifts I had bought for the local people - hair clips, sticker books, balls, heaps of baby cloths (everything you had all donated). They made me open my case and wanted to look at it. Then they thought I had bought it into the country to sale, they wanted to know how much it cost and again asked what I was doing here! After about 1.5 hrs they finally let me into the country. I was later told that it was likely that they may have wanted me to give them some money (bribe them) so they would let me through. Nieve that I am it did not cross my mind so we would have been waiting along time!

The house I am staying in is nice, it has a security guard, with high fencing and barb wire round for safety. We also have a cleaner and a driver too!

Monday we started our course. We have 16 midwives for a 2 week rolling course, their knowledge and level of understanding is very basic. Midwifery is not a qualification over here. You train as a nurse and are then expected to know how to be a midwife. It took over an hour to just teach them how to use a pregnany wheel and calculate a womens due date.

Today I went around the 4 main hospitals here. It was like being on another planet. On the postnatanl wards the lucky women shared a bed with another women, the unlucky ones had a mattress on the floor. In the neonatal ward the babies were all lined up along a adult bed next to one another. There was a 26 week gestsion baby just wrapped in a towel. In the UK and Oz this baby would have been in an incubator with numerous drips and tubes, oxygen and drugs keeping it alive. Here it was just wrapped in a blanket - unlikely to survive. I saw many sad things today most of them to hard to put into words.

Tomorrow I am going to work in one of these hospitals, I am extremly nervours, but if I can make a difference to just one womens experience/lives then it will be well worth it.

I will blog and let you know how I went.
Take care, be happy and remember every day how lucky you are:)

And soon my adventure begins.....