Up not so bright and early after a late night! Lovely breakfast at Banda on the terrace, then off for a long walk up to kibuli hospital- negotiating bodas, buses, cars and dogs! Although fashionably late due to a wrong turn we were warmly welcomed by all the midwives and doctors. We'd just missed two deliveries, but we were instantly able to see the big differences between midwifery here and in the uk!!
Antenatal, postnatal and labour ward were separate, however there was little sense of privacy or dignity. Women must arrive in labour with their own cotton wool and a bin bag to give birth on, and no sheets are provided on the beds. They labour on their own in the antenatal ward until they are ready to push when they are moved to the delivery room to give birth flat on their backs. First impressions of the facilities and equipment- very basic resuscitation equipment (unless you count hanging a baby upside down), no pain relief options and one very small sink with no soap. Women give birth on one of three beds positioned very closely to each other.
The morning was quiet on labour ward until a woman had a retained placenta. No action was taken and there seemed no urgency to deal with the situation even leaving the woman completely unattended to complete the ward round! No compassion was shown-we found it really difficult to see such little support. Eventually after four hours a doctor arrived and a manual removal of the placenta was performed in the room with no pain relief.
After the long walk home we stopped for dinner at a delicious Ethiopian restaurant and a well drserved local beer. Amazing experiences today, bring on-tomorrow!