My two days spent with Angela a new volunteer midwifery advisor in ST were wonderful disturbing frustrating and enlightening in equal measure Angela is a midwife of great standing and has forgotten more about midwifery than I will ever know her role is to help the referral hospital in ST and about 8 health centres improve standards of midwifery practice my visit started in the hospital.
From the outside it looked quite impressive with a new emergency care and maternity unit however it belied what lay beyond.
The maternity unit was stark cheerless and somewhat dirty and depressing the toilets and sinks were not working were over flowing with dirty water soaking the floors Angela told me that only the operating theatre sinks were in good working order.
The labour ward bed was just a wooden frame no mattress and looked like something out of Dickens there was a more modern bed which had been donated by a well meaning NGO but it was not suitable for the purpose and the midwives did not like using it which I could understand the only position women could possibly give birth on it was flat on their backs there was absolutely no privacy which is common here.
The operating theatre was reasonably equipped but as with every thing else needed a good fettle there was still blood on the table from past incumbents and as I was to find out later in the afternoon when I observed a C. Section the same blood remained on the table.
The theatre lights and other equipment were really dusty and only one bulb was working but that said the Dr's technique including the epidural were I would say on the acceptable side but the nursing care was sadly lacking the lady giving birth was conscious throughout strapped to the table and no one spoke to her they took the baby away without even showing him to mum.
His first introduction to the world was of being plucked from his mothers womb by his feet held upside down and then unceremoniously hurled at a metal tray being held by the receiving midwife fortunately she caught him OK I grant you it was covered in a green towel but it was a metal tray nevertheless.Wouldn't a pair of warm arms have been so much better and safer!!?
He was though a very healthy 4.6 Kg baby a rarity in Cambodia and despite everything he and his mum survived.
Angela was extremely worried about a lady with pre eclampsia but none of the other midwives seemed to be with her intervention she did manage to get the right treatment but the baby died however the mum lived which I am not sure she would have done so at least one family of 6 didn't loose their mum.
To counter balance the rigors of the day Thea invited Angela and her husband Chris for dinner and I have to say what a dinner fit for a queen and with the Beatles Cat Stevens and S& G to accompany us there was no better antidote to the rigours of the day.
The following day we visited Thala an island on the other side of the river to ST town to visit midwives in a health centre. We met 5/6 midwives and talked to them about their work and their training needs.
The difference between the midwives in the HC all primary midwives (1 year training ) and the ones in the hospital was quite startling as they were bright and interested although most were very inexperienced
We returned to ST by ferry accompanied by a great assortment of passengers and livestock including a couple of live pigs strapped to motorbikes imagine the din!!!
I left ST full of admiration for Angela Wendy and Ingran all health volunteers in ST they have their work cut out but were so inspirational optimistic and cheerful it was a joy to spend time with them.
It was also a wonderful to spend time with Jan and Thea who put me up in their house and Thea got up at 3 30 in the morning to see me off now that's friendship
Some pictures will follow
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