An early start saw me at the Dora Nginza Hospital, located near the Zwide Township to the North of the city centre. Dr Mabenge, lead consultant for Obstetrics and Gynaecology, introduced me to the medical team during their morning meeting held to discuss the clinical work of the previous 24 hours. Doctors of all rank were there to listen and to participate in discussion. From there, I visited the maternity department. There was a busy midwifery-lead unit for patients described as ‘low risk’ for problems in labour, a second labour ward supported by the medical staff, and a high dependency area which also had a delivery room for the highest risk patients.
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I was the ‘hero of the day’ that day too! What a nice feeling!
Mid-morning I gave a lecture about my journey and experiences so far to the department’s doctors and midwives. What was very interesting, and lovely to see, was that they had invited some patients to listen and participate too. After all, the journey and the project is about women! Lots of questions – about family planning, traditional birth attendants and staff attitudes to change – demonstrated much enthusiasm for the topic, and we made plans for clinical teaching after the weekend.
All were well equipped but staff I met at each one voiced concern about suboptimal staffing levels. Those midwives retiring and leaving were not being replaced quickly. Physical space in which to see and manage patients was a problem, particularly in Kwazakhele – an old, single storey building from the 1970s which had originally been expected to see fewer patients than was the current experience. However, there were many positives. The ambulance system of transfers to Dora Nginza Hospital worked well and emergency protocols were clearly on display. At Motherwell Clinic, there was an ‘eclampsia box’ containing everything needed to stabilise a patient fitting in pregnancy so that quick and efficient care could be provided:
It was Friday, and payday, so as the afternoon progressed fewer and fewer staff were around….Dr Mabenge, however, was on-call, and he and I returned to Dora to do a ward round of the acute areas before we called it a day.
Meantime back at our accommodation, Ross had been keeping track of the weather. Huge storms were brewing and as it got dark with the rain pounding and wind blowing a gale, we decided to pay our plane a visit at the airport to check that it was as secure as possible.
The best we could manage, in addition to the usual tie-down procedure for the wings and tail, was tying the tail elaborately to the fence post in addition to persuading Shell Aviation to full our tanks (in the wings) full of fuel! We felt a lot better (safer) after all that was done!