Once all the staff had arrived and was ready, we went down stairs and greeted them. Femi discussed the importance of learning and improving on what is already done. How with people like me coming from the UK can add knowledge and suggestions that may be helpful in improving practice.
I started the conversation by congratulating them on all the hard work that they do and by acknowledging how different things are here compared to what I’m used to, with regard to equipment, support, training, not to mention electricity, water etc. I spoke about the type of things that are done in the UK and what and how small changes that can be implemented to here from these. I was keen for it to be a conversation and not a lecture so I encouraged opinions and questions. Most of them were happy to join in and keen to learn about APGARs (a simple tool used to express the condition of a baby at birth). They also wanted to be shown the obstetric wheels, and some guidance books on vaginal examination.
I also showed them the guidelines briefly, explaining how useful having these is. They are not used to having guidelines and I got the impression they thought they were a negative thing. I told them that in the UK we have hundreds of guidelines for every event and we can refer to them to remind us what we need to do. This is so that everyone knows the standards that need to be met, and everyone is doing the same thing, reducing inconsistencies that are evident in the notes I audited. I also stressed that these guidelines can be looked at by them and if there are things that they feel won’t work or need adding, then this can be addressed. I want them to feel part of the process and solution.
I also commented on the fact that I was sure that a lot of what I have written in the guidelines they already did, but as the record keeping is minimal, I can not see the evidence of this. Drawing attention to the importance of writing what you have done and when, so who ever looks at them can see and it’s not just down to memory.
The staff here are all very keen and willing and certainly have the ability to learn. I also told them that we can never say we know enough, as part of being a midwife we have to help train others coming up and also keep up to date with research and change, always reflecting and improving on our practice. After about an hour or so of talking and discussing, we called it a day.
Around 18.00 I decided to make my way home, again on foot. This time Femi asked one of the young assistants to walk with me, Tope who is 19 walked and chatted with me all the way to the hotel. As many of them do here, she wanted to carry my bags, but I always feel it’s not fair to make them carry them when I’m able to so I declined. The roads were busier than on the walk to the centre as the sun was cooling and many people were making their way home. Trucks went past (these often saying load only) full to the brim with people standing. Women at the side of the road preparing for their evening custom, the food cooked often changes. Akara and fried yam is mainly found in the evening and not in the day time.
Back at the hotel, with my happy greeting from everyone I passed, I headed for my room. I skyped home and chatted with everyone there. All of who were well and looking forward to me returning home. Then feeling hungry I called down for the menu as it had been removed from my room. David came up and said there was no chicken, so I just asked for chips as I didn’t fancy any thing available. He suggest I had egg sauce with it, not knowing what I was going to get I agreed to try it (same for most things I order here). It ended up being a curried like scrambled egg with peppers in it and I really enjoyed it.