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Stories from the Excellence in: Obstetric Skills project

In June 2016, the RCOG with Mile 91, a professional story-gathering and film-making company visited the Excellence in: Obstetric Skills project to see how it’s making a difference to the lives of mothers and babies in the Masaka region of Uganda.

Here, some of the people involved share their stories of the impact the project has made over the past 12 months.

Sister Nurse Angel Nalumumba, course delegate and trainer

Sister Nurse Angel Nalumumba, course delegate and trainerVilla Maria is the only small general hospital in the Kalungu District. Sister Angel Nalumumba, one of the nurses, has attended the RCOG’s Excellence in: Obstetric Skills course. She describes how her new skills are saving lives.

"This afternoon we accepted a primigravida. We took a quick history from her attendant who told us she has been vomiting and has had fevers for three days. We followed the ABCD to help this mother to recover. The airway was not clear and she was not able to respond. Her blood pressure was 90 over 50.  We had to resuscitate her to make her blood pressure rise. We took a blood smear and found she has severe malaria.

"We used the score chart. This patient was not responding to voice but she was responding to pain. Once we had been through the management, her scores lowered. It has been a critical condition for us. We have informed the doctor to be aware of the patient on the ward. We have been calling him for consultation about the treatment.

"Before the training I didn’t know that I should follow ABCD. I may not think that this mother needs an airway tube or this mother needs oxygen. I would struggle with other things, for example I would look for the fetal heart rate first. But now I follow ABCD and I can stabilise my patient from the beginning. When I see such things I don't get a fear now; we follow our system from our training."

Nurse Nakintu Jane, course delegate and new mum Stella

Nurse Nakintu Jane, course delegate and new mum StellaNakintu Jane is a nurse at Bukeeri health centre 3; a small rural health care facility serving 11 villages. She is currently training to be a midwife. She introduces new mum, Stella and explains how the skills she learned on the RCOG Excellence in: Obstetric Skills course helped her keep Stella and her baby alive.

"Stella came to our health facility with labour-like pains and we monitored her but she had a big baby and progress of labour was not good. We were continuing all the observations, monitoring and taking her blood pressure so that it didn’t go bad for her.

"Our facility is good but there are some things that we are missing, we do not have power. We referred Stella to Masaka Hospital because we don't have the theatre to help her. The training helped me because they taught us to put more emphasis on measuring mothers, monitoring the fetal heart rate and doing timely observations. If I didn't have that training I would have taken some time to understand what was happening.

"Had we not referred Stella I think her baby would have got distressed and died in the uterus. I know now when a mother must be referred. I can handle more cases. With these emergencies we use the ABCD, we do it methodically and help these mothers.

"We are all doing our best to make mothers safe when they come to our facilities and we've managed to get the Village Health Team to go to homes where they know there is a pregnant mother. They tell them the advantages of going to the hospital or a health facility and refer them so we can monitor their pregnancy. I don't think we have as many mothers dying at home now."

Mr Marcus Filshie FRCOG

Mr Marcus Filshie FRCOGIn 1972 Mr Marcus Filshie FRCOG travelled to Uganda to work in Mulago Hospital in Kampala. Four decades on, Mr Filshie is now funding other talented young doctors to work in Uganda.

"I had been thinking about supporting a worthwhile charitable enterprise either at home or overseas.
I gave much thought to the areas I had had the privilege of being involved with and my mind naturally gravitated to the RCOG. My wife and I had lived and worked very happily in Kampala in 1972. Therefore the idea of supporting a Fellow in Uganda was really exciting.

"The College has designed a clinical teaching course in obstetric emergencies Excellence in: Obstetric Skills and The Fellows have been focusing on training and monitoring and evaluation. I visited Kitovu Hospital in June 2016 while two courses were being conducted.

"The week was quite astounding.  Firstly, the content is exceedingly good and covered all the high risk obstetrics. Secondly the delivery of the course is outstanding, excellent teaching and lots of practical exercises. Each and every trainee said how much they enjoyed it and how they felt that they understood the difficult problems better. I talked to many health professionals who've been on previous courses and some of them have now become teachers.

"I was truly impressed by the skill, energy and morale of those who have attended the courses. I was delighted to learn that the initial outcomes was significant. This benefit proves that a modest donation to the RCOG goes a long way and so I would like to encourage any Member or Fellow of the College to consider supporting its global health work. My only regret is that I didn’t do it sooner."

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