In terms of maternal health the major problems were restrictions to adequate healthcare. There was a lack of knowledge about complications and about the warning signs as well as difficulties with transportation to access the limited services. In terms of complications experienced there were a high level of problems associated with prolonged/obstructed labour often with the mothers presenting, after several days abnormal labour, at the hospital with a dead baby and a ruptured uterus. Additionally, there were high rates of maternal death from post-partum haemorrhage (as throughout the world) and again Traditional Birth Attendants (TBAs) often tried to manage these with traditional and ineffective methods and often only bringing the women to hospital when they were almost dead. Malaria is also a major health issue for the local population and is also particularly detrimental in pregnancy; during my time in this area I witnessed a maternal death from cerebral malaria.
I had very few negative experiences luckily but many very positive ones. When I think back to my time there I instantly think of the fantastic national team (about 40 people employed by Doctors of the World from cleaners to HIV counsellors) they welcomed me into their team and gave me a truly memorable experience. They also worked hard to ensure the work we were doing reached the right people.
The teaching itself was such a highlight, although challenging especially with extremely low levels of education, working with the local population was really rewarding. I particularly enjoyed making the TBAs laugh mainly with my ridiculous acting (the Somali women are generally quite reserved so it was wonderful when you see them losing their inhibitions) and getting them to participate with role plays and story telling etc..
I would say to anyone wanting to do this type of work be under no illusion that you will be saving the world, but I remain hopeful that some of the work we do can makes significant changes to peoples lives and encourages further community action. All in all I trained 130 traditional birth attendants. I would definitely go back to Africa and I’d love to visit other African countries.
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