Recently, I was lucky enough to undertake an elective placement abroad. I had always wanted to travel to experience midwifery in another country, but I worried that I was not confident enough to work in an area away from the comfort of my usual placement.
After much research and support from my university, I took the leap and booked a volunteer position in Moshi, Tanzania. I wanted to broaden my understanding of midwifery globally and increase my knowledge of other cultures and communities.
“I was in awe of how the midwives remained calm and dealt with the situation with the skills that they had”
After arriving in Moshi, we were taken to the local hospital to meet with the sister in charge of the maternity wards. We felt so welcomed, and she showed us around the antenatal, postnatal, and labour wards. The wards were extremely busy, with some beds containing more than one woman. We met women with varying conditions, such as preeclampsia, malaria, and anaemia.
The sister also explained that women would remain on the antenatal ward while in labour and would then be transferred when delivery was imminent. I was surprised to hear that some of the women on the ward were in labour as no one appeared in distress or pain. I also later found out that due to how expensive medication is, women labour without pain relief.
During delivery, the women gave birth without the support of family or friends and had minimal midwifery support due to staffing levels. Although I had tried to learn some Swahili, there was a language barrier that I tried to overcome with smiles and comforting gestures. Monitoring of the foetal heart was performed with a Pinard, a skill that we are taught but very rarely see used!
On our third day, we were present for an obstetric emergency. I felt uneasy, especially after seeing how minimal drugs and equipment were available. There was no emergency buzzer, and no multidisciplinary team was running to support the midwife in the room.
Although the management of the emergency was different to what I had seen in placement, I was in awe of how the midwives remained calm and dealt with the situation with the skills that they had.
The postnatal ward contained many beds with no privacy curtains. The women were chatting with each other and helping with the care of their babies. There was a real sense of community in the ward, something that I feel in the busy wards of the NHS, we are sometimes lacking. We got to know the women well, as they would stay in the postnatal ward longer than in the UK and would look forward to seeing the women who had delivered the day before.
On days off, we were able to travel around Tanzania with the support of the volunteer organisation. The country is really beautiful, and the community is filled with wonderful people. The trip was a once-in-a-lifetime experience, learning about other cultures, traditions and broadening my knowledge of midwifery outside of the UK.
The clinical experience was an eye opener and has made me appreciate our healthcare system much more. I will never undervalue the support of the multidisciplinary team and can appreciate the level of skill that is taught while training.
I felt like I learned so much from the midwives and women in Tanzania, and my awe at the strength of women and birthing people has only grown.
I know that not all are able to use their elective time abroad, but if you are contemplating taking the leap, Go for it! It really will be a once in a lifetime experience.
Carly Davis is a third-year midwifery student at London South Bank University and 2023-24 Nursing Times student editor