This blog is an account of my elective placement in Arusha, North Tanzania. Early blogs will be about the preparation leading up to the trip, this will then lead to blogs about my journey - both physical and in a professional development sense.
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Saturday, 27 July 2013

9 sleeps left...

I've started packing!
I've got 3 shifts left on delivery suite placement, 1 meeting with my link tutor, 1 carboot sale and a trillion piddly little tasks to sort out.
I've got masses of stuff to take with me as donations for the hospital and orphanage as well as cash that's been donated by some very generous people too (details here).

Now as excited as I am, I'm also very nervous. I read this book just before starting my midwifery degree and the true story made me want to experience midwifery in a developing country. The book is an account of a teenagers life from a middle class family as the Taliban take over power. It inspired me because her mother was a doctor, and under the new ruling, women couldn't work, nor could they be seen by other men...so imaging the complications that arise during childbirth?! Afghanistan is still THE unsafest place to be pregnant with 1 in 11 women not surviving childbirth (Atlas of Birth, 2012), compared to 1 in 23 in Tanzania, and 1 in 4,700 here in the UK. Yet things are improving, and women are starting to regain some of the care facilities they should be entitled to. Here is another inspiring story of a young midwife who is making a difference. And, along with the adventure I'm about to embark on, much to my mothers concern, midwifery in Afghanistan is another venture that blows my mind and I'd love to persue some day...So far everyone I've told thinks I'm crazy...and yea, I know I am!

To Do:
change GBP to USD
finish packing
dye hair
find camera charger and memory cards
wax legs
decide on a cabin bag

Monday, 22 July 2013

14 days to go...

So in exactly 2 weeks time I will be flying over Europe somewhere having started my adventure of a lifetime! I think I'm almost sorted, my to-do list is finally beginning to shrink - YIPPEEEEE although my stack of things to pack is realllly growing, praying I don't go over the luggage allowance!

My placement goodie pack arrived from Women and Children Tanzania (the elective placement organisation I am travelling with), so excited when I opened that package...
As you can see, it contained a lovely cozy hoodie, a drawstring bag, a sphygmomanometer, stethoscope, pinard, fob watch, tape measure, a selection of gloves and alcohol hand gel! What a good goodie bag that is!

And I've set up a donation page too, for anyone who wants to donate follow this link! As the page explains, I want to give a cash donation directly to the people I am working with, rather than a global organisation. This way, I'll be able to see first hand how the money will help, how it might be used, and more importantly, the people who'll benefit from it! The only deduction will be the commission for exchanging the money, other than that, it goes straight to the people who need it!

Thank you! x

Monday, 15 July 2013

21 days to go...EEEEKKKKKKK!!!!!

So I finished my last post commenting how interesting the comparison between care for poorly babies would be, well after completing my placement on a small special care baby unit (SCBU) I must admit my perspective on care here has changed already...well actually I suppose that's not quite an accurate way to put. Really it's more a case of I had views about care before starting this course, then as I've learnt things and worked with different people I've kind of adopted some of their views and thinking - as happens. Now after my time on SCBU, I've been exposed to another view which really has reminding me of what my opinion originally was. I'm sorry, that's a bit of a spaghetti junction on an explanation there! Hope you're still with me lol
As student midwives, and registered midwives too, the message about woman centred care is at the core of everything we do and learn; organisations such as the RCM, White Ribbon Alliance and WHO tell us woman centred care should be pivotal in all that we do while providing safe care...but I'm actually starting to think that's too narrow! 
One SCBU nurse told me about a situation many moons ago, where she was trying to facilitate a premature (but stable) neonate to have some time with his mother who was recovering a traumatic labour followed by a crash section and PPH. However her endeavours were in vain as this nurse was told by a midwife that she is too busy caring for the mother and doesn't have the time to think about cuddles. As the nurse was not given permission to bring the infant onto the postnatal ward, it was over 12 hours before this mother and infant got the opportunity to bond. Now it can't be denied that high risk postnatal care is demanding for any midwife but surely the priority of any woman after giving birth is to see and spent time with her child. So while I accept there may be much more complex elements to this situation than I know, in my opinion, facilitating time for mother and child to bond in those significant early hours, addressing what is the woman's priority (seeing her child) is more woman centred than just focusing on her physical well-being, and the duration of separation may also affect her physical well-being (stress causing raised BP, resulting in a higher EWS score perhaps).
Now that is one very rare occurrence, but just an example of how this placement has got me thinking about the perspectives from both sides perspectives and it has made me consider experiences I've had where perhaps care should have been family-centred on a holistic level rather than woman-centred on a medical level.
I've found this experience on SCBU eye opening and invaluable, it has really made me think about the importance of infant development and environmental factors. Consider more flexibility with care, can jobs be consolidated to reduce interfering with bonding time, things that can be done to encourage bonding, being family centred in postnatal care-not just woman centred and think about what I can do in the future to make transitional care smoother for the two teams involved. It's also made me think about how I can support women when their babies are taken straight to SCBU - I now believe I'll be able to support women better, be able to explain what the neonatal team will be doing, preparing women for what to expect when they see their child on SCBU and

So after those thoughts/impressions being consolidated, I'm wondering what care of the new family will look like in Tanzania? More-so where there is a premature or ill infant. How much of what I've learnt in the last 2 weeks will I be able to share with the midwives there, and similarly, how much more will I learn from them?

In other news - I had my birthday, I got spoilt, I smashed my money jar and banked the pennies.
 I gave blood for the first time, something I've wanted to do for a long time and decided I had to do before the big 3-0 next year so figured I best do it a) before my yellow fever jab and anti-malaria drugs and b) while I'm feeling brave!
I've paid for my placement, paid for my R&R trip to Zanzibar, got a selection of donations together for both the hospital and the orphanage which I'll be visiting. I still need to sort my travel insurance (job for later today) and have my yellow fever jab tomorrow...not looking forward to that :/ I'm currently putting together an info pack for my parents with my whole itinerary and important details that may be of use to them. My to-do list is looking interesting - as soon as I cross something off, there's usually 2 or 3 more things to add lol typical! I've got all the important things bought, and completed my toiletries shopping today...so think I'm almost ready!!! 
3 weeks today I depart...beginning to wonder whatever possessed me to fly alone?!?!