Where are they now?

A year later, and all of us who had the opportunity to learn and practice midwifery in Uganda last summer have spread our wings as registered midwives. Natalie and I are happily reunited now as Vancouver midwives, working out of a clinic at UBC. Our other former classmates are spread around the province, providing excellent midwifery care to women in communities from Victoria to Chilliwack, to Squamish and Haida Gwai.
We are forever grateful to the Ugandan women and midwives, as well as to our UBC preceptors and instructors who taught us so much and shared their knowledge, strength, laughter and birthing experiences with us! We take all that we learned with us into practice, and it helps us in our care of local women and families.
Thanks for your support and readership!

Quinn

Come for a fun evening and fundraise!

Thanks to all of you who have read our blog throughout the summer!

If you'd like to come hear about our experiences in person, hang out with our midwifery community, have a drink, come to our get together/fundraiser on September 6th!

We're all going to get together on Thursday, September 6th at the Pint (455 Abbott Street, Vancouver)). It's a casual evening to have a drink, eat some things, we'll talk about our experiences and have some pictures and videos in the background. There will also be a silent auction filled with lots of handmade local items donated by BC artisans. There will also be a fabulous door prize of a basket filled with goodies from Uganda!

You can see all the details, and pictures of all the silent auction items here:
http://www.facebook.com/groups/456782147676093/

Tickets will be $10 for students, and $15 for non-students.
Everyone is welcome to come!

Looking forward to seeing you there....

Webale Nnyo

(by Natalie)

First and foremost, sincere apologies for the huge delay in a post - after we left from our last day in the hospital, we left on a safari and were left without internet connection everywhere we went.
As they say, time flies when you’re having fun, and boy, did time fly.
Our last week on the wards was quiet, and the last baby I caught was a perfect way to end the placement. It was a mom having a VBAC (vaginal birth after cesarean). She was getting into lots of positions of her choice, supported by her two sisters. One of the sister called me to come back as the mom started to push. The baby is barely out before it starts crying, and has the sweetest facial expression that we all can’t help but start laughing as the baby is born. It’s a moment I won’t forget, a baby being brought into the world filled with laughter.
After our placement ended in the hospital a week and a half ago, I travelled Uganda a little with Quinn, Jo, Tanya, and Clare, bringing us to today.
Today is my final night in Uganda, and it is so surreal to think that 8 weeks ago I was starting. I had been waiting to come here since I was accepted into midwifery, and I couldn’t quite believe that the moment to be here had finally come. On my first night here I kept wondering about what I would do and see, would I live up to my expectations of myself, would I be able to do it?
And, I feel so proud to say that coming to Uganda met everything I hoped for and more.
I feel so much more confident in my knowledge and skills as a midwife. It is incredible to look back and see how much I have grown in 8 weeks.
I am incredibly grateful to have met all the mothers and babies that I did, to have known their openness and kindness, to feel connected with only our eyes and hands.
Despite some tough days and difficult births, I am so glad that when I look back at this experience I am filled with a deep trust in women’s ability to give birth, their incredible strength, and the wonderful resilience of their babies...

Amina and Sarah -Part 2 !

-from Joanne

(See Hatching Babies posting for Part 1)

Amina's tiny daughter Sarah had been discharged from the nursery shortly before I finished my placement at the hospital. I was very skeptical about how this preemie would do outside of the nursery. She had been in the nursery for over a month, but still only weighed 1.2kg (up from her birthweight of 1kg). She looked tiny and gaunt and I couldn’t imagine that she would be okay at home without a feeding tube to nourish her. On the other hand, I convinced myself that at least she would be away from other babies that could make her sick. I emphasized to Amina the importance of returning to the hospital if her baby showed any signs of illness.

After two weeks away, I returned to Masaka with my mom.  It was with trepidation that I phoned Amina to see how things were going. To my relief she reported that they were both doing well. Sarah was up to 1.4kg, was seeing a doctor weekly, and was feeding on breastmilk exclusively. With her invitation, we headed to her village to have a visit and see this lovely pair! It was the first time I had seen Sarah alert, and although there is still a long road ahead, Sarah was in good health and Amina was relaxed and positive. It was such a delight to get to see these two again!

Amina with baby Sarah -7 wks old.

Sarah alert and checking out a Canadian JaJa (grandmother)!

Teaching and Learning.

-from Joanne

As we have mentioned, the UBC Student for Global Citizenship program includes both planned and spontaneous opportunities for exchanges of knowledge of expertise. In one moment I would be asking advice from a senior Ugandan midwife, in the next I was teaching a young nursing student who would then assist with the delivery and provide invaluable language help. Over our time here, Cathy and the other faculty had coordinated and delivered workshops for Ugandan staff in Masaka, Jinja, and Kampala. Some of the topics included: Postpartum hemorrhage, shoulder dystocia, neonatal resuscitation, antepartum hemorrhage, charting, delayed cord clamping, etc. As students we were also able to assist with teaching to hone our own knowledge and skills, and assist other learners.

Our placements here provided an abundance of opportunities to be both a teacher and a learner. With gratitude to all of those who contributed to our learning in Uganda, here’s some photos from a few of those moments.

Angela teaching breech delivery to midwives in Jinja. 

Cathy teaching Neonatal Resuscitation to rural midwives who had come to Masaka for training. 

Clare, medical anthropology student, helped staff midwives deliver a CME workshop at Masaka hospital on HIV Exposed Infants.

Cathy delivering workshop for midwives in Jinja.

Babil teaching an attentive nursing student in Masaka.

Cathy frequently facilitated our learning with her excellent sense of humour!

Lorna taught and supervised us in Masaka.

Cathy demonstrating maneuvers for shoulder dystocia at a workshop for midwives in Jinja.

Prossy, one of our amazing supervising midwives in Masaka, teaching Joanne counseling and medications for HIV+ mothers and newborns. 

 Quinn in Jinja : teaching a station on active management and postpartum hemmorhage.

Dr Mickey and Prossy, two of our instructors, keeping it light and fun!

Tanya teaching enthusiastic nursing students how to use a fetoscope and count fetal heart rates.

 Natalie delivered a presentation on Delayed Cord Clamping to a group in Jinja.

Tanya facilitating a station on 
Shoulder Dystocia in Jinja.

Participants estimating blood loss at our fake hemorrhage station.

Grace Jolly (right), a Ugandan midwife and trainer, teaching neonatal resuscitation to participants.

Impossible Is Nothing... (by Tanya)

We leave Murchison Falls and the dry grasslands where we spent the day watching elephants, giraffes, and herds of water buffalo, thousands of colorful birds, baboons and their babies and crocodiles sunbathing along the Nile River.

 The sun is rising and the streets are already lined with children, dressed in different colored uniforms walking the miles to school with no shoes on.  Some carry bundles of dried long grass tied together in a bunch to use a broom for their chores at school, others carry yellow plastic jugs full of water balanced effortlessly on their heads.  The older brothers and sisters hold the hands of their younger siblings. They see our white truck approach and break out into fits of giggles, wide grins flashing bright white teeth against their dark little faces, and wave frantically, yelling out “Muzungo, Muzungo!”, and I can’t help but laugh every time.

Making red bricks

The womn are home with babies tied to their backs while they work all day long. The men are found burning wood to make charcoal for cooking, packing wet red mud into triangles that will dry into bricks, carry loads of millet and plantains they have gathered in the fields on their old rusty bikes . Those not working are seen gathered together, talking amongst themselves, playing a game of pool outside, or sleeping in patches of shade. The houses vary in style depending on family income; some are made with mud with dried palm leaves for roofs, others are made of wood or red bricks with a tin roof.  

A schoolyard with uprights off in the distance

We pass hundreds of little schools, some consist of one room lined with benches that are packed with kids of all ages, others are larger, and more established schools with soccer fields. The uprights are made of logs that give them a lopsided look. Every so often I see a group of children kicking a soccer ball made of layers upon layers of plastic bags that have been rolled into a ball, but mostly the fields are empty…


A ball made of plastic bags

We come across a small building.  It is a school that educates 130 children, ages 3 to 13. As our Muzungo truck pulls in, I see a young boy who spots us and starts to jump up and down with excitement. Within seconds we are surrounded by kids who are curious as to why a truck full of Muzungos pulled into their school this morning. I get out and look for their teacher. I find her in classroom, packed with kids.  Her name is Beatrice-she has been teaching here since 1972. I tell her that we are student midwives from Canada and she cups my hands in both of her hands and with a look of sincere gratitudesays,  "Thank you for the work you do". It is a phrase we have heard often here, which seems to catch me by surprise because the work we have done feels insignificant in comparison to the work the majority of Ugandan people do every day, just to survive…

I ask her if we can give her children a couple of soccer balls; one for the small children to share and a larger one for the older children. At once she breaks into a huge smile and starts shaking my hands again and again and says “Yes, yes, yes madame, we would be forever grateful, come, please will you sign the guest book?”


We are now surrounded by 130 anxious little faces, so when I a hold up the balls and ask “Would you like a football today?” they break into screams of laughter and shout out in sweet, excitable voices “Yes please!”

One little boy stretches his arms to the sky and thanks God.

The teacher throws the balls onto the grassy field and then joins them.  The children go wild; screaming and chasing the balls around the field, kicking it to each other and throwing the ball into the air, laughing and piling onto each other as they dive onto the ball to get at it first.

130 kids go crazy over balls!

 As we stand back and witness PURE JOY, I conclude that I have never in my life seen a group of children have so much fun!

Experiencing the pure joy in giving here in Uganda is a feeling I will never forget and I thank all of you who gave me the opportunity to have this experience.


As I prepare to leave Africa, I think about the women and their families I have been allowed to care for, the student nurses,  interns, doctors and midwives I have interacted with, and I have a sense that  “Impossible Is Nothing.”

Wei Be Lei Uganda
With much love, Tanya

Boxes......

According to Wikipedia: Compartmentalization is an unconscious psychological defense mechanism used to avoid cognitive dissonance or the mental discomfort and anxiety caused by a person's having conflicting values, cognitions, emotions, beliefs, etc. within themselves.

Compartmentalization allows these conflicting ideas to co-exist by inhibiting direct or explicit acknowledgement and interaction between separate compartmentalized self states.

Although we are  making connections and memories we will remember for a lifetime, we cannot ignore that fact that our days here are filled with interactions, sights, and experiences that have a profound impact on us. Out of respect to the women we are serving and to avoid traumatizing some of you, there are some days and stories we opt to not share.

 Jo and I have been practicing the art of "compartmentalizing" some of these moments by putting our emotions in a box to re-visit at a later time......

So...here's an example of our box...

(By Tanya and Jo)