Week 3 successfully negotiated

We are working with a group of midwives at Muhumbili National Hospital for the next two weeks. This is the public tertiary referral centre for Dar es Salaam and is a large institution with 1,500 beds, employing 300 doctors/specialists and 900 nurses and midwives.  Over 1,000 patients visit the hospital each week of which about 24% are obstetric referrals.  Interestingly an article in the East African Journal of Public Health  (Simba, Mbembati, Muserru & Lema, 2008) indicated that the majority of these referrals were inappropriate. It has been our experience that the smaller hospitals do not necessarily refer the really sick women and babies.

Entering Muhumbili National Hospital Campus
 

16 participants presented for class on Tuesday.  Having missed Monday, they asked if they could come in on Friday which was a public holiday (we were not aware of this fact until Tuesday - I'm uncertain if they only announce these events closer to the time or if they plain forgot to tell us).  Having said yes to this, they also wanted to attend on Saturday to make up for missing the first day. We are such a soft touch and enthusiasm like this just cannot go unrewarded. 

Eager participants

Creating realism

Shoulder dystocia workshop

Breech manoeuvres

Taking our education responsibilities seriously

Elegant bathroom facilities

A component of the education we provide is to go into the clinical setting with the participants. My immediate impression was that compared with Armana it was so quiet.  I have been told that the lower activity reflects the cooler months, which are June - August.  As a consequence business is much more brisk for maternity from February - April. 

Antenatal clinic waiting and parent education area

This group of midwives is fantastic. They are keen to learn and seem to enjoy having us in the clinical area with them as well. We took the opportunity to teach the midwives about the resuscitation cot that had been donated to them without any instructions, go through neonatal resuscitation and examination of the newborn on a baby that one of the participants had helped birth a couple of hours previously.  It was great as 3 midwifery students and a medical officer were there as well.

 

Consulting with an antenatal client

 Demonstrating neonatal resuscitation skills

Privacy and hand hygiene in labour ward

 Brooke was welcomed into the obstetric theatre 

There are a number of great leaders and champions for the cause in this group.  It will be sad to say "kwaheri". Two days before the final presentation of certificates then its the serious business of planning for the next program.

 

 

 

 

Ref:

Simba DO,  Naboth AA. Mbembati NAA, Museru, LM. & Lema, LEK. (2008). Referral pattern of patients received at the national referral hospital: Challenges in low income countries. East African Journal of Public Health 5(1): 6-9.