by Rebecca Rogers, Student Midwife at Oxford Brookes University and Iolanthe Student Award winner.
‘Wait-a-bit’, the name of a tree I encountered on my first day in Kenya. Get too close and you genuinely can’t help but wait a bit as you untangle yourself from the hooked thorns. Get too close to Kenya and the effect is similar: I found a place where I was forced to take stock because life looks different there.
During my elective in Kenya I spent time in a number of different care settings, getting involved with antenatal, postnatal, intrapartum and child and women’s health alongside general nursing. I saw extremes of care and extremes of care need. I saw patients prayed for by as many health care professionals as could be grabbed walking past the room, and yet elsewhere I saw death treated with detachment and the dispassionate indifference of the everyday. I saw two nurse-midwives look after around 40 mothers, involving antenatal, intrapartum and postnatal care; complex and high risk situations, and care for operative deliveries. I saw resuscitation attempts where the nurse was not sure of how to resuscitate because her training had not fully equipped her. I saw women largely ignored in labour until the head was crowning because staff were pulled in so many different directions. All of this, yet I saw a great desire for change and an active enthusiasm to work for and do the best for women’s health and the health of the community.
The first birth that I saw in Kenya took place in under two minutes. The baby was born onto the bed and the squeaking, wriggling little person was turned upside down so that the mother could see what she had got before the cord was clamped and the lively infant rushed to the resuscitare. He was suctioned, cleaned, dried, wrapped, and left while the mother delivered her placenta onto the bare mattress. She got up, stripped and changed clothes because we wanted to clean the bed and send her back to the ward with her little boy. With the woman now safely warded, we were free to resume admitting another lady. I checked the clock. We had been out of the admission room for 15 minutes.
My first week in Kenya was spent in Nguruman, a nomadic Massai region. I was able to visit a health centre as well as join my host on home visits to disabled children and their families with the Seurr Sang’ida Trust. I later spent time on the equator in Nanyuki, principally with Nanyuki Cottage Hospital, but also Nanyuki District Hospital. The Cottage Hospital is small and privately run; there are about 50 beds. Staff are well supported and the standard of care is high. Profits are used to fund health care teams, as well as resources, for medical outreach projects in the neighbouring communities. I was able to go to Chumvi, an outreach clinic north of Nanyuki. Many of the women had walked 10 or 15 km that morning to have their babies immunised for free. Care at Nanyuki District Hospital contrasts very strongly with care at the Cottage. It is a government funded hospital and consequently very busy, under-resourced and badly understaffed. The number of babies delivered per day at Nanyuki District Hospital might roughly equate to those born at the Cottage Hospital in a month. Care would be compromised because it had to be, despite hard work on the part of individuals.
This has been a very short summary of my time in Kenya: I haven’t talked properly about the people, I haven’t talked about the cultures, I haven’t talked about the generosity or the friendships that I met with there. I hope, on the other hand, that this narrative has given the reader a taster, a three minute chance to become caught in the ‘Wait-a-bit tree’.
I am so grateful first and foremost to the Iolanthe Midwifery Trust, but also to my University, Oxford Brookes, both for their financial support and also their backing and encouragement in prospect of my trip. I have valued and enjoyed my experiences so highly. Kenya has taught me so much; not just about midwifery and culture and care settings, but also things about myself, my understanding about life, faith, hope and people. There are parts of my character that have been added to, professional judgements and professional skills that have been built upon and memories that I will treasure in years to come. I would highly advocate this kind of adventure to anyone thinking about setting out. Be sure of your supports, go prepared to be massively challenged, but expect to be amazed at some wonderful things too.
Rebecca Rogers received an Iolanthe Student Award, which is supported by MIDIRS.
Article & image: Rebecca Rogers, Student Midwife & Iolanthe Student Award winner