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

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

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?!?!

35 days to go...

So now it's getting to the point where I'm getting nervous about the placement itself. It's crazy to think so much energy, planning and organising has gone into a single 2 week placement. I'm nervous about things I'll observe and won't agree with; I'm nervous about not having to speak up and question/challenge practices; I'm very nervous about seeing a situation where a poor outcome was simply a result of lack of resources. I'm terrified about feeling out of my depth and not having my usual pillars of support available - friends, family, my cohort; all the people I don't hesitate to routinely turn to when I need to share amazing news of a delivery just as often as I need a hug, rant and/or cry.
I tell myself these are undoubtedly normal worries and concerns for someone about to embark on such a massive change of culture alone. But then again I won't be completely alone, I'll have the other 4 lovely student midwives to turn to at times.
My professional cool-headed angel sat on my shoulder tells me it'll all be good, these worries are normal and I shouldn't waste energy worrying...but then there's the little devil on my other shoulder screaming panic in my ear as there's plenty to be worrying about, including all the things I still need to buy/do! Well right at this moment in time the angel is drowning out the devil.
So along with my fun bedtime fiction reading (Harry Potter and the Chamber of Secrets at present...and I've somehow managed to read them out of order so far), and my constant perusing of Tanzania and Zanzibar guidebooks and a Swahili phrasebook, I'm also trying to fill my brain with information about obstetric emergencies. I've kinda figured that Tanzania will test my knowledge of these and it's knowledge that will always be of massive value throughout my career. It'll also be really interesting to compare the differences in norms of practice so I kinda want to do some reading up on WHO guidance.
Soon I'm starting a placement on a SCBU ward, another thing I'm a little nervous about but it will certainly be interesting and yet another point where the comparison of care for poorly babies, or infants at greater risk of becoming ill will be particularly interesting between the 2 countries.

Done:
anti-malarial tablets ordered
paperwork and admin bits
a stack of travel toiletries received as a gift from a wonderful friend xxx
got scrubs and found shoes

To Do:
buy shoes
sort insurance
book Zanzibar trip (just waiting for some details to be confirmed then I'll be booking away!)
break open my savings jar (mixed feelings about this - it's so pretty, but it's full of cash lol)

39 days to go....

soooooo I'm clearly not going to win any prizes for being the worlds greatest blogger - I won't even have a chance of a nomination they're so infrequent!
Despite my lack of keeping this up to date, lots of exciting things have been happening. Only 39 days to go!!!!!!
Less exciting but ever so important, I had some of my jabs earlier this week :( although I'm entering into a healthcare profession, I really don't like injections. And as laughable as that may sound there are lots of us who can administer injections and perform venipuncture with ease and confidence yet regress to a terrified 5 year old when it's us on the receiving end. So yes, lots of us can empathise with the women in our care who are terrified of the needle we have to insert into their flesh. And personally I feel a little guilty for doing so, when I know I'm even more of a wuss!
The director of the company I'm travelling with Women & Children Tanzania has arranged a private FB group for those travelling to Tanzania around the same time, so I've been able to make contact with 4 lovely adventurers who'll be around. It's reassuring that although I'm venturing on my own, I'll have other people in the boat with me :) so we've been getting to know a little bit about each other and sharing hints, tips and questions about getting organised as well as trying to plan some touristy activities while we're there - need to make the most of this trip of a lifetime.
I've been busy making my Gemmis jewellery too, had lots of people buying the designs I've made as well as lots of requests/commissions. All profit going towards the trip. I've also got stuff on ebay and a huge stack of things to sell at a car boot sale in the next few weeks-just hope the weather keeps dry. And it's my birthday in just over a week, so my wish list has been full of lots of exciting travelling bits and bobs. And I tried on my whole wardrobe last week and amazed at the amount of suitable hot climate clothing that still fits :D (or I have fitted back into) so I don't need to purchase that many new items of clothing - some shoes for placement, couple of pairs of cropped pants, couple more tees and that's it really.
Oh and I passed second year! whoop! :D As student (and qualified) midwives/nurses often say, this has been a hell of a year. An absolute emotional rollercoaster where times I have thought to myself  'do I really want to do this? What's the point? Is all this hard work really going to be worth it?' and 9-5 jobs advertised have been appealing at times. But I kept on going, along with the rest of my lovely cohort who've also found this year a bit of a battle. And we've all made it. And now we're back on a non-assessed placement being reminded how wonderful this career really is, and glad that we didn't throw in the towel. And with this being a formative placement, it's allowed us to focus on aspects that either interest us as individuals or areas we want to develop our knowledge/skills. So getting to do things we want, rather than things we have to has really reignited my passion. After having such a long stint questioning my ability, I'm now feeling confident that I am progressing well, I do know things, I can share knowledge and I'm getting there. I'll never know everything and I like the thought I'll always continue to learn and develop but I do know stuff.

To do list:
sort out my indemnity insurance
finalise travel insurance
book trip and accommodation to Zanzibar
lots of little paperwork admin bits to complete
buy anti-malaria tablets
make a packing list

Such a manic March

These last few weeks have been so unbelievably manic!

I have finally broken up for the Easter holidays and it couldn't  have come soon enough, I'm ready for a little break! March and April are always busy for me, in the space of 5 weeks there is: my 2 sister's birthdays, my niece's birthday, my nephew's birthday, my Mum's birthday, Mother's Day, Easter...and that's just the routine/annual stuff! This year there's also been a community placement (which finished yesterday) and the usual reading, research and reflections to do; I've been making jewelry which I'll be selling to help towards my trip fundraising; I've been reading up on Tanzania - but to be quite honest I've been reading up on more recreational activities to try and make some decisions and plans about my R&R time (let's face it, I need a little recreational reading now and then) and I've been working hard in getting some more sponsorship for my placement which has kindly been provided by my old college. And in this 5 week window I'm also looking forward to a nice day away dress shopping as I'm going to be bridesmaid for one of my nearest and dearest chums later in the year :D

So life has been very full recently!

I've recently been put in contact with 2 other students who will be on the same placement around the same time as me which is exciting to get to know them before we're out in Arusha. And thanks to my wonderful Dad I've got the contact details of someone who can teach me some basic Swahili, so now I've broken up for Easter I'll be following that up soon...then I'll be back to the grind-stone with Uni as there's a presentation to give in a couple of weeks, then 2 essays to hand in April/May. But a well deserved little bit of time out first :)

So I hope you can see, although I've not been blogging much, things are really moving forward at quite a speed and I've been a wee bit busy. Think I should maybe sleep now...got a 4 year old's birthday party to go to tomorrow :S

Time to explain myself

AAAARRRRRRGGGGGGHHHHH
Time keeps running away! I promised another blog update and apologies that it's taken so long to actually write it!

PLANNING UPDATE:
Flights are booked and partially paid for (ie they're on a credit card)

So as promised, I thought I'd share some of the reasoning behind me heading to Tanzania. Now my personal reasons are a little bit hab-dash/here and there so please, bear with me and by the end of the blog I swear I can tie it all together!

So I've been made aware that some readers aren't familiar with the ins and outs of being a student midwife, so I want to shed a bit of light on that. As a student midwife, at least half of our 'learning time' has to be spent on placement. At my university I have a range of placements - these are where we students get the opportunity to learn and practice practical skills ranging from providing women antenatal care to delivering a baby to having the knowledge to be able to support with an emergency! Every summer we are given the opportunity to 'practice' on an elective placement, so a placement outside our usual sphere of learning to gain some experience or knowledge individuals are personally seeking. So some students go on placements in different units or areas of the country that are excelling in specific services such as home birth, bereavement counselling or supporting young mums-to-be. I knew that I wanted to do something a little extra, I don't have any big commitments in my life, so in the fortunate position to be a little selfish and think about what I want without having to consider implications to those who depend on me.

Where I live (and train to be a midwife) there is very little ethnic and cultural diversity. In the 2001 census, 96.9% of the local borough population declared themselves as White-British and only 2% of the population declared a religion other than Christianity (ONS, 2012). Now I'm talking about the town where I grew up but in my pre-midwifery adult life, I did move away and have lived in a couple of northern cities and worked around the northwest region; so although I have experience living and working in more diverse communities I wanted to gain experience of diversity during my midwifery training.

Taking an overseas elective is encouraged by the Royal College of Midwives (RCM - aka that wonderful organisation who awarded me a travel scholarship last month...also a professional organisation/trade union for midwives). An overseas elective gives the rare opportunity to see not only a different way of providing maternity care, but makes you consider the context of the maternity care. So here in the UK women are equal citizens, but in many countries women are still considered second class citizens. So as an extreme example, think about women being pregnant in a country where they legally have to abide by what their husband says they can and can't do - that could even mean he dictates she can't seek any antenatal care or that she must stay at home during childbirth, so that she can cook his meals and care for the rest of the family. Extreme to many of us Brits but reality for many women across the globe.

So people have asked me if I want to experience diversity then why don't I just go somewhere like Birmingham or London, where the units are much busier than what I'm used to and there is so much more cultural diversity. And if I want to travel to East Africa, then why don't I just wait until I've graduated and I can afford a "proper" holiday where I'll be able to relax and enjoy my time there. Well, I want to have a placement there to learn about life and midwifery in Tanzania. If I were to just go to another location in the UK then I'll still have some familiarity as we all work to similar national guidelines, going to Tanzania really is experiencing something new - there are places I may visit which don't have access to sterile equipment - I'd never experience that anywhere in the UK! And yes, it will be emotionally intense but I know I will enjoy myself on the whole, I'm the type of person who likes to immerse myself in a new culture and I'll still have time to do more recreational activities while there so best of both worlds. Also to me, going somewhere where I'll be part of the minority is completely removing myself from my comfort zone...and really, since I started studying towards midwifery I've metaphorically, constantly gone from a comfort zone to a deep end of a new pool so why not go for broke?!

And the huge crux of this decision, the whole point of this degree is working towards becoming a qualified, registered midwife. Once I qualify I'll be looking for employment along with hundreds of other newly qualified midwives. In one sense, this degree can be seen as a 3-year-long interview, and hopefully when it comes to finding a job as a midwife, the experience of finding out first hand about global maternity care and the professional development I expect it aids will hopefully help me stand out from other applicants.

And if it doesn't, well it's gonna be one hell of an adventure!!!