Tuesday, 30 March 2010

Too much wildlife!

The links to my latest blog for the RCM magazine are here and the World of Difference webpage here which describe more about what I have been doing over the last few weeks.

I am back in Freetown for a couple of weeks doing some work in the office. It is different to my life in Kamakwie, electricity 24 hours, constant internet access and supermarkets. It's nice, especially the delicious choice of salad and vegetables which it is just not possible to buy in Kamakwie. I miss the laid back feel of Kamakwie though. Drinking a cup of tea outside my house looking out at rice swamps and banana trees, listening to the neighbours kids squabbling over who will get water next from the well opposite my house, people passing the house calling out greetings in Limba and Krio, Walking to work and greeting Abibatu, Salimatou and my other neighbours as they sit outside their houses preparing food in the morning.

I am not missing the rather abundant wildlife though I had a mouse in my house (at least it wasn't a rat), a tarantula in my bathroom (I'm not a spider expert but I have only seen one like this in a zoo before) and a snake in the road outside my house (must block up the hole in the bathroom wall when I go back!). I tried to upload some new pictures today but the internet is too slow, so pictures another day.

Friday, 12 March 2010

Celebrating International Women's Day 8.3.2010

It was International Women's Day on Monday. I have been in the midwifery school this week, to celebrate IWD and highlight the impact that skilled birth attendants can have on reducing maternal and infant mortality we made a short film of a skit performed by the students, they originally acted it in January for the opening of the Midwifery School. It powerfully shows the different delays which lead to poor outcomes for women and babies in Sierra Leone, these include a lack of knowledge of the significance of danger signs by both women and untrained birth attendants, poor access to health care facilities because of the poor road network and limited availability of transport, the financial barrier and the attitude of health care professionals.

The government is implementing free healthcare for women who are pregnant or breastfeeding and children under 5 at the end of next month. I am hopeful that reducing this financial barrier in conjunction with training midwives to work in rural areas will mean that outcomes for women and babies in Sierra Leone will gradually begin to improve.

Friday, 5 March 2010

Training on emergency care in Bo

I have spent the last five days in Bo, I have barely spent much more than a week in one place since I arrived in Sierra Leone two months ago. My first two months here have flown by and I am enjoying my work immensely, I do feel a bit like a tortiose carrying it's house around as I am permanently living out of my rucksack!

I got back to Freetown last night having spent the week in Bo, at the Government Hospital, as one of the facilitators of a four day training course. The course is designed specifically for health workers providing maternal and newborn care in low resource countries by the Liverpool School of Tropical Medicine [LSTM]. It is an extremely comprehensive course aimed to equip health workers with the skills to recognise complications and effectively manage maternal and newborn emergencies in order and reduce the high number of deaths of mothers and babies.

The participants were made up of four midwives and 27 MCHAs - who although are not as highly trained as midwives are the frontline workers in Sierra Leone; they deliver a huge amount of the care of women and babies and are the ones who are working (often as the only health worker) in remote, rural areas. It is essential for them to have the skills being taught on this course both to enable them to be able to identify when a case is outside their scope of practice and needs referral but equally importantly how to manage these emergencies whilst transfer to a hospital is arranged. Transferring a woman or baby to hospital can take many hours because of the poor infrastructure and limited transport options here. Women and babies lives will be saved if these health workers can implement life saving measures.

We were 8 facilitators in all, half from in country and the others who facilitate the courses for LSTM from UK and Nigeria. I really enjoyed working with the other facilitators and there was a great team spirit throughout the week. Jen, Jo and I enjoyed walking around Bo, some fabric shopping and cold drinks together in the evenings. We were all lucky to have Alpha with us who now lives in the UK but is from Bo, he made sure we got to and from the hospital everyday and brought us delicious home cooked food from his family.

The enthusiasm and committment from the participants (many of whom are only just completing their training and were being taught many of the skills for the first time), was inspiring and enabled us to get through an intense four days of training in 30+ degree heat, trying to be heard over the noise of two generators with smiles on our faces and a real sense of achievement. Especially as the pre and post course assessments of the participants knowledge and skills showed a marked improvement.

I think Gladys who ensured we were all well fed had a large part to play in the smooth running of the four days too. She served us such huge platefuls of lunch that we were nearly able to feed half the hospital, as we all needed to share our portions. She managed to serve something different everyday and each dish was delicious, especially Jollof rice with fried chicken and pepper sauce. I'll be writing from Makeni next as I leave on sunday for work at the Midwifery School on monday. Pictures to follow, internet not fast enough right now!