I had hoped to write a really insightful blog about work each week, help you 'experience' a little of the world of West African midwifery, but I am finding words to explain my long days off the ship hard to find.
I am trying not to continually talk about the taxi frustrations, which I desperately hope are over now, this weeks driver actually turned up and on time. Thank God for that. I am also trying not to be critical of the ways things are done here, as the midwives on the whole are doing their best in a tough environment.
There are many challenges for the midwives, some of which would even be the same in the NHS, but some unique to low resource settings. I realise how much I took for granted in the NHS - I really miss all the ready made sterile equipment packs containing everything you might need for a birth or to suture and the maternity care assistants always around to help you find things!
There is not enough equipment here so we are constantly moving blood pressure machines, fetal heart dopplers and other things between clinic, the birthing room and the ward. There are not enough beds, so some of the women end up in an overflow area in one of the VVF wards.
There are not enough midwives, yet the midwives here are responsible for everything, whether low risk or high risk (there is actually an Obstetrician here temporarily, and usually one who is on-call for caesarean sections, but this is not a permanent position so the midwives can't learn to rely on her too much).
Yesterday the midwives on the ward were looking after a one day old baby who was very unwell. They helped him breathe for 30 minutes, at which point a line needed to be drawn and the decision made to stop. We were joining the Mother's prayers for a miracle, but really a miracle would have been the baby's only hope. There is no paediatrician, there are no neonatal units, no ventilators. We just get to do our best.
Some days it doesn't feel like it is enough.