This is one of the stories from the RCOG’s trip to Uganda to witness the work that RCOG volunteers are doing to improve women’s health in the region.
Sister Sarah Mampewo is the midwife-in-charge at Kasangati Health Centre in Uganda. She’s one of three qualified midwives at a centre that, on an average day, delivers six babies and holds an antenatal clinic for around 40 women and a postnatal clinic for 40 more.
On the day the RCOG visited, we watched Sarah’s day unfold. It started late. Usually the waiting areas would be full by 9am, but torrential rain was making it hard for the women to reach the clinic. Around 10.30 the rain cleared and the women started to arrive. By 11.30 Sister Sarah had called the doctor to examine a suspected obstructed labour. Within a few minutes he had taken the decision to conduct an emergency caesarean section and Sarah was scrubbing up to support him in surgery.
Through the window of the theatre we watched the baby being lifted from his mother. That was 1.15. It was a long minute or two before we heard his angry cry. We later found out that his mother, Violet, had been in labour for so long that the baby had become distressed and Sarah had needed to resuscitate him.
Afterwards, she told us that it was training from RCOG volunteers that had given her the confidence to undertake these procedures in stressful circumstances: ‘At first you could be quaking, you could have a tremor when you are thinking how you will get the baby up. We had the fear of pushing the tube deeper to get all the secretions out and because the baby remains flat we could think the baby is dead and we delay giving oxygen. The volunteers taught us that when you get an asphyxiated baby just be confident.’
Three hours later, Sarah is back in her whites and on the ward. In the space of half an hour or so, we watch as she scans two women, one in the advanced stages of labour and one who is at risk of miscarrying, all the while delivering instructions to the nursing assistant who is checking a drip on the other side of the curtain. She also kindly but firmly admonishes a woman who tries to convince her that she needs a caesarean to stop the pain, and she checks on her colleague running the antenatal clinic.
This was just an average day for Sister Sarah.