by Work the World

Midwifery, Tanzania Dar es Salaam, Clinical Features, Guest articles

What made you choose Dar es Salaam over other destinations?


I was just about to start a job in London after only working in a small, local hospital. Obviously the jump between the two is huge, so I wanted to challenge myself beforehand and really put myself out of my comfort zone. I thought the best place to encounter a totally alien healthcare system would be Africa; and chose Dar es Salaam because I wanted to go to Zanzibar! 

We hear you were awarded a bursary as part of your fundraising efforts - tell us more!

Yes I did; I applied to a bursary from the Wellbeing of Women trust who gave me £1,000 towards my trip on the condition that I write a 3,000 word report on my return. Wellbeing of Women are a charity who fund research into women’s health, and also provide funding for obstetricians, nurses and midwives who want to perform their own research aiming to improve their understanding of women’s health issues. As part of the application process, I had to set myself some objectives for my placement and outline how I’d meet them. I actually ended up changing these whilst I was out there, as I’d been pretty naive when writing them.

What were those first objectives you had before arriving in Dar es salaam?

I wanted to understand why the maternal mobidity rate in Dar was so high through talking to the women themselves about their lifestyle practices. However, when it came to working in the hospital I quickly realised that the women I was interacting with didn’t speak any English; they were all from very rural communities. It just wasn’t possible to talk to them about dietary iron intake and the risk of maternal hemorrhage.

How were you able to interact with the women in the face of this language barrier?

Case Studies

We had Swahili lessons in the house which were really very helpful; we learnt how to introduce ourselves and basic midwifery related sentences, but it was difficult to form any true dialogue with the women. They’d respond with something we hadn’t learnt. Because of this barrier, we found body language went a long way. This became our main form of communication with the women.

Can you give some examples of this?

Case Studies

I found that this helped me particularly on the labour ward, the women here don’t get a lot of attention from the Midwives until they’ve started delivering, so just being present and talking to them - we knew the words for ‘breathe’ etc - made a difference, and the women really bounced off of that. We weren't saying much, we were literally just present and rubbing their backs every now and again, which relaxed them in a way they were not used to.

As a western midwife, how did that make you feel?  

I found it really interesting. In England, a lot of emphasis is put on the birthing experience. Of course this is a good thing - you want women going away un-traumatised! However, I do feel sometimes we put too much emphasis on this, and to see these women so overwhelmed by the fact that they’ve got a healthy baby despite any complications that might have occurred along the way reminded me of what midwifery is all about. I feel like we’re losing that a bit in the UK.

Was there any specific experience you had in the hospital that particularly stood out?

Case Studies

There was one, yes. I was working on labour ward where I was assisting in the delivery of a stillborn baby. It was assumed the woman had hemorrhaged, although there was no time to confirm this - we just had to deliver the baby.   

The cord around the baby’s neck was so tight, it wouldn’t actually come out. My supervisor couldn’t cut the cord as the hospital only had neat blades and they didn’t want to risk cutting the baby’s neck. When the baby finally came out, it did look stillborn. We began loosening the cord around the baby’s neck, the baby gave a huge gasp, we immediately checked for a heart rate, and it had one. My supervisor then had to manually palpate the baby's heart rate - and managed to resuscitate the baby successfully.

what have you gained from this experience? 

Case Studies

Confidence. I had no idea how much I was capable of until the time came to step up. I was suddenly part of all these things that I’d never dreamt of doing before. The fact that I was travelling solo and made friends for life in the space of two weeks played into this, too. It was a very empowering experience both in the hospital, and out. I don’t like flying either, and suddenly did four long-haul flights on my own and was like, actually this is alright. I’ll definitely be taking this feeling back to London. I’ve never worked in London before, I was nervous and I still am nervous, but less so. I realise what I’m capable of, and that actually, I do know what I’m doing, and it will be okay. 

We heard you and your fellow Work the World housemates got into the habit of daily debriefs after placement. How did this add to your experience?

Case Studies

Two other midwives and myself became very close as we were working with each other every day. There was so much to take in, with almost everything being different from what we were used to at home. You just have to accept what you see - some of which will be great, like the resourcefulness of staff, and some of which will be quite upsetting. Talking about this after work really helped me to process every day and take the experience as it came, a day at a time.

What about the experience made you want to become an Ambassador for Work The World?

I really want to use my experience to nudge others into thinking of doing the same. I don't think many of my peers realised exactly what I was going to do, and the incredible potential for learning. I made so many great friends, had so much fun, I’m so proud of pushing myself out of my comfort zone. I want people to realise that it’s definitely worth it, and it is possible to fundraise too.

We organise Midwifery placements across Africa, Latin America and Asia. For more information on our destinations, departments, and what to expect on the wards, head to our Midwifery page.

For more stories from students who have taken their Midwifery placement in Tanzania, read stories from other students here


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