Days 1-3

MAMBO!

I made it to Arusha in 1 piece early hours of this morning, it already feels like I've been here ages so much has happened but this post is about my time in transit and a little bit beyond! 

So I left my house Monday 11:00, that was a longer drive to Manchester airport than expected due to road works and horrific weather conditions, but made it, I got a little teary eyed when my Dad wished me Bon Voyage. Got onto the plane and felt v.nervous. The seat next to me was empty which made it a little easier to stretch out and relax-saying that I was impressed with the available leg space-much better than expected! That flight was straight forward enough, a little bumpy at times but nothing more than driving down one of the roads at home! 

2103 miles later I landed in Istanbul at 20:30 and although I'd slept on the flight I was really tired. I went through the transit door at the arrival gate and went and found a bench as it got dark. It soon got busy as the gate I was next to had a departure but that was only 23:30 so a reasonable enough time. And then I lay down! I had my headphones in which helped me doze but there was a group nearby and they were really noisy up until 03:00 Tuesday! And I decided I could never cope sleeping on a park bench, this 'cushioned' bench was making my bones numb! I rolled over so many time-right side, back, curled up, stretched out, left side, front, legs up, legs down... properly woke up about 06:00 and went to the bathroom to freshen up and go find something to drink. I then decided to find my way to the transit desk to find out about the tour, I'd read this airport can be a bit tricky so thought it best to allow plenty of time. Well I got told off for not going to the desk as soon as I arrived-how was I supposed to know?! Plus I already had my boarding pass so it didn't make much difference. Anyway then it got a whole lot confusing-she told me I had to go through passport control and go to the hotel desk. Straight forward enough, right? Queued up and got to passport control-he had no English and I had no Turkish, he asked if I was transit, I said yes and he waved me away! Didn't give any clue what or where to go just flapped to the left. So I went and joined another queue in the general direction he was waving. Got to the front and he asked where my visa was-told him I don't have one as I'm in transit-he laughed and told me I should be going through transit security not passport control. So I told him I'm going into the city, and was told to come here. So I finally got told I need a visa to do that and he pointed in the direction of the visa desk that I'd not spotted. Went there, paid $20 and got a stamp. Went back to passport control and finally got through! Went and registered for the tour at the desk and was distraught to see that right next to it was a Starbucks with big comfy armchairs that people were sleeping in-I so wished I had gone to the transit desk the night before! So I curled up in one and had another doze for about 40minutes until we were called for the tour. Onto an open top bus and away we went, the warmth outside was lovely but the air was fresh and cool and smelt sweet and spicy...well except for when we went past the sewage works! We were taken to a restaurant for breakfast-plate full of ham, feta cheese, cucumber, tomatoes, olives, bread, honey, an egg (which I don't eat) and lots of sweet tea. This gave us a chance to chat and compare journeys and adventures-I was sat with a Brazilian guy heading to London to study medicine, a New Yorker heading home after a trip to Tel Aviv, an older man who was a traveller in every sense and considered himself a citizen of the world with no fixed address, Manuel from Sweden, Mia heading home to Hong Kong and a family from South Africa who's children were fluent in 3 and 4 languages at the ages of 5 and 9 respectfully, thanks to a multi-lingual marriage!

Driving along the coast I have never seen so many ships and liners all queuing to get in and out of port! They just went on and on. We then went to the touristy centre-visited the Basilica Cistern which is an immense underground cistern built to store/provide water to one of the palaces above. Truly was an immense space with thousands of columns holding it up. Then moved onto the Hagia Sophia, which was a cathedral and the biggest structure in the country for some time, adorned with gold mosaics and fantastic chandeliers. It was the turned into a mosque and the artwork was plastered over. Since becoming a museum they've exposed some of the Christian artwork but left some Muslim details in place to show the contrast.

Across the square was the Blue Mosque, unfortunately I didn't get to see inside-really wish I had! 

Then onto lunch-lentil soup (possibly the blandest thing I've tasted), salad, grilled chicken with rice and creamed potatoes. Then something very sticky and sweet for pudding. 

After that it was 15:00 and some of us went back to the airport-I was still knackered and was feeling a bit run down-a little bit of me does wish I'd stayed out and visited the spice bazaar but with the heat too and another flight to endure I wanted to make the most of stretching out. So I had another freshen up and got changed then had a wander the full length of the airport and a nosey in some of the shops. I began to feel like a zombie  so searched for another quiet bench. And that time I really did fall to sleep properly. Woke up about 18:30 and felt like a new person. After a bit I headed to my gate for the 20:35 departure, this plane was at full capacity-the airline merged 2 flights together so half the passengers were continuing onto Mombasa. I was sat next to April and Clark, a retired couple from Los Angeles, they'd been in Istanbul for 5 days, were heading for a 12 day safari followed by a 5 day Gorilla trek in Uganda! April said she had to look after me properly as I look after so many women at such an important time-that was heartwarming! 

We took off and my heart was pounding again! As we were still climbing the plane swerved left, then right, then there was a couple of small screams and gasps as I grabbed onto the chair in front certain we were about to do a barrel roll, then there was a lot of bobbing of turbulence followed by a dip...then it just became bumpy like the flight the day before, but that was my nerves shot! I'd even started praying even though I'm an atheist! That was when I felt very lonely and wished one of my nearest and dearest were with me-someone familiar to grab their hand. There was a lot of turbulence during that flight, bobbing away. I kept trying to persuade myself that some roads at home have potholes that make journeys bumpier than this one but I wasn't fooling myself...although the attempt provided a good distraction at times. After lots of turbulence we finally touched down (a bit unexpectedly) and that was a very bumpy landing too-but there was a cheer we'd made it! Not sure whether it was a cheer just at the excitement of arriving in Tanzania, or relief of surviving...dare say it was a bit of both!

Today's the day 5,113 miles to go!

Say in the departure lounge with a pint...there's a couple sitting a few tables away eating a full English breakfast and it smells amazing! I may have to follow their example of my last English grub for the next 4 weeks! 

I am enjoying a pint though!

 My heart is racing, I'm a bit nervous with take offs and I've no-ones hand to squeeze (hope whoever sits next to me on the plane doesn't take my unprompted hand squeezing as a proposition lol). And actually I'm not nervous-that's a huge understatement! I'm absolutely papping my kegs!!!!! But now I'm not so nervous of what I'll see whilst on placement, it's the journey I've already began-travelling so far on my todd! Why did I think this was a good idea??? Lol 

Well 103 miles done and the next leg is about 2,000 miles to Istanbul where I have a 23 and a half hour stop over! So I'll probably have time to write up that mini solo adventure! 

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