University of York 2012

Midwifery, Tanzania Dar es Salaam

I chose to spend my elective placement in Dar es Salaam, Tanzania. A couple of friends and I had always wanted to go abroad and do something completely different for our elective, and saved our student loans, Christmas and birthday presents to afford it! We did consider organising the placement ourselves because we’ve done a bit of travelling, but looking back I am so glad we went with Work the World! They organised everything for us, which took a lot of stress off during exams and essay times, and generally made everything really simple.

Marc and Alpha, the staff over in Dar, are brilliant. They speak perfect English and are a great support and really good fun. It was nice to know they were there 24/7 if you needed them for anything. We were picked up from the airport by Marc and taken to our new house. The house itself is really lovely; the rooms are spacious and comfy and it's really easy to feel at home straight away. There’s 24-hour security at the house, which really helps to make you feel safe in a very busy city.

All the other students were very welcoming and because most of them had already been in Dar for a few weeks, they were like our own personal tour guides! We also got to meet Rehema, the in-house cook, who was amazing! She’d cook something different every night and there was always something for everyone with loads left over for lunch the next day. I loved sitting around the table with everyone at dinner and sharing stories before heading out at night.

The big bonus of choosing Dar is the gorgeous swimming pool in the back garden! It was amazing to come back and sunbathe after a hectic day on placement.

We had obviously prepared ourselves for how different the hospital and maternity services would be compared to England, but I think it’s impossible to prepare yourself completely. We worked in one of the district hospitals, which is a Dala Dala ride away from the house. It's quite straight forward to get to but can take a while in the crazy Dar traffic, sometimes over an hour! It has around 100 births a day, and only 8 beds on labour ward, so as you can imagine it’s a really busy environment. There’s no chance to get to know any of the women, or communicate in the way that I have been used to and taught, which is hard to adjust to. It’s amazing to see women labouring with no pain relief, and I now appreciate the true meaning of ‘normal’ birth and what women can achieve.

We definitely saw our fair share of emergencies, some of which weren't even considered to be emergencies; vaginal breech deliveries, for example are completely normal.

It was a great experience to see how more standard emergencies are dealt with, with such a lack of resources and knowledge compared to England. We also got to see a lot on the neonatal ward, including the benefits of breastfeeding for premature babies.

Sister Grace, our supervisor on Labour Ward was pretty hard-core. She works 6 days a week, and does a round trip of 3 hours to get to work and back. It took us a while to get our heads around the way she, and all the midwives practice (there’s a lot of differences!) but by the end of the placement we could really appreciate her for the hard-working, experienced midwife that she is.

Outside of placement, Dar is a great place to get a real feel for what African living is like. There are some touristy bars which we tended to stick to, but you can go into the centre of Dar to experience the busy city life. Zanzibar is a whole other world; the most beautiful beaches you could ever imagine. I definitely recommend putting aside 3 or 4 days to go to Kendwa beach for a full moon party. Try to make the most of every free day; I’d suggest having a good read of the Lonely Planet before you get there so you don’t miss the good stuff.

I could go on for pages and pages with stories but I wouldn’t want to give too much away. Overall, the most significant thing I learnt from working in Dar was the great value of the midwife and how simple aspects of care can make a big difference to women’s overall experiences of child birth. It was important to remember throughout, that African women’s expectations of childbirth are very different to British women’s, and most of the time they were satisfied with the care they received.  It is a truly once in a life time experience, and one I would recommend to any student. I was left with my eyes wide open to the world of Midwifery and now can’t wait to qualify!

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