Deborah Bonser and Ecstasy Danford Mlay led the first of a series of workshops as part of the Midwives Emergency Skills Training Program (MEST) in Musoma Rural District in Northeast Tanzania. In between two sets of workshops, Deborah and Ecstasy took the time to be interviewed on their experiences.
D: I am a midwife practicing in Toronto with the Midwives Clinic of East York-Don Mills. I became interested in maternal and newborn health after the birth of my daughter, which coincided with regulated midwifery in Ontario. I completed my Bachelors of Midwifery at Ryerson with the second cohort.
E: I was born in the Dodoma region in central Tanzania, and was interested in health from a young age, even being a ‘first aider’ in primary school. I completed my nursing degree at the Kilimanjaro Christian Medical Centre and then went on to do my Bachelors of Science in Midwifery. I now teach in the Muhimbili School of Midwifery.
E & D: We began working together in October 2013, along with Emmanuelle Hébert and Elizabeth Mwakalinga, to put together the curriculum for these intensive trainings. Importantly, these trainings are shorter and involve a lot of hands-on learning, which is quite different from the standard ES trainings offered in Tanzania. The curriculum itself is a blend of Canadian and Tanzanian emergency skills information and adapted to a Tanzanian context.
D: Tanzanian midwives have a broader scope of practice than Canadian midwives, because in certain rural areas there is no referral centre, so it is up to midwives to deal with eclampsia, other emergencies. What is exciting about this course is that it brings rural midwives, who are often working solo, together to network, refresh their skills, and learn from each other.
D: Sometimes not being able to speak Kiswahili has been challenging, but it has also inspired some innovations, and made the training more interactive! Participants say they will never forget how I demonstrated shoulder dystocia manoeuvres, even accidentally landing on the floor at one point, luckily without injury. We have tried to have a lot of laughter to reinforce our learning.
E: I realized that the majority of the midwives were not using the partograph as a tool to identify obstructed labour. Although this is supposed to be a basic competency for all midwives, there was a lot of confusion about how to use the partograph. Participants have really thanked us for going through it in a way they understood.
E & D: One of the most rewarding experiences has been watching how the participants really get into helping each other learn. They demonstrate the techniques and share tips from their own experiences. At the end of the training the participants exchanged contact information and agreed that when any one of them had a shoulder dystocia or breech delivery back in their workplaces they would contact the others to report how it went.
E & D: We have been talking about additional projects, such as expanding the training in Mara region to all 5 districts. By running the workshop three times, we have had the opportunity to learn from our experience and this has been very helpful in fine tuning the materials. We are just getting ready for the third group and we feel that the previous groups have helped us to improve the training, so this time it will be even better. We hope that the training will continue to evolve as other instructors have input based on their experiences. We hope to continue to be involved as the training evolves, to continue adding and editing. One characteristic which we share that we are both always looking to make improvements!