Does your friend bite?

Those of a certain age may remember Peter Sellers in the famous Pink Panther sketch 'Does your dog bite?' Does your dog bite? .  There are plenty of dogs here in Prague but thankfully none have bitten me.  However, I can't say the same about my midwifery friends!  A Ugandan midwife that I have come to know during my travels was so pleased to see me that she bit me after first giving me a bear hug and a very painful pinch.  A true sign of love apparently. I'm grateful to have been wearing a robust shirt so she didn't break my skin and realise that, however well-travelled, I still have much to learn about cross-cultural communication!

With Florence (left), Prof. Ann Thomson and RCM Wales Director Helen Rogers in Uganda, April 2014

The story of my growing friendship with Florence (the biting midwife) provides a snapshot of what our twinning project is achieving in Uganda.  Florence is the Chair of the Midwifery Chapter of the Uganda Nurses and Midwives Union. Until recently the Union focused mostly on nurses and did not provide a voice for midwives.  Florence had little power within the organisation.  As its twinning partner the RCM chose the Uganda Private Midwives Association (a rival to the Union) which had more potential for development and more capacity to manage UK volunteers.  However, our clear purpose was  to strengthen midwifery through working with all stakeholders in country.  Concurrently, the UNFPA's midwifery advisor and the Ministry of Health in Uganda had been encouraging all the midwives associations (there are at least four!) to join together and speak with one voice.  However, such discussions were politically and emotionally charged and had to be protected with armed guards, such was the strength of feeling.

In September 2012 our first project workshop brought the Association and the Union together with others invested in midwifery to assess their capacity and identify areas for development over the 3 years of the Global Midwifery Twinning Project.  This was a landmark moment for both organisations and Florence joined the meeting to make an action plan for her midwifery chapter. However, there was still tension and rivalry.  On my first visit in April 2013, together with our country directors for Wales and Northern Ireland we visited the Union but were not given access to Florence to discuss midwifery.  Meanwhile, the president of UPMA was doing her best to build bridges, inviting Florence to join in midwifery events and advocating on her behalf with the Union.  The breakthrough came in October 2013 when, as requested by UPMA, the Royal College of Midwives brought all of Uganda's midwifery stakeholders together for an advocacy workshop - you can read, see and hear about that in my earlier blog: The Sound of Singing in Kampala. Florence was a key player in that workshop and since then both Union and Assocation have been working hard to move and cooperate together. Mary and Florence have become great friends. They have attended many events together and joined up in celebrations such as International Day of the Midwife.

With Mary and Florence at the GMTP Advocacy Workshop, October 2013 in Kampala

At a landmark symposium on 4 May 2014, just before International Day of the Midwife, all midwifery associations agreed to come together in a midwifery task force to have one voice for midwifery in Uganda. Florence and Mary are both here in Prague for the International Confederation of Midwives Congress and there is plenty of love being shared.  And biting.

Last night, at my invitation, Florence and Mary attended the RCM's evening reception in the conference centre and met with midwives from Northern Ireland and Wales, their twinned countries.  Only afterwards did Florence confess she was not confident to travel alone to her hotel on the other side of Prague.  So, I found myself alone with my gnashing friend, braving the metro system and trying to keep my distance (unsuccessfully... I got plenty more pinches but thankfully no more bites).

Czech travel buddies: Midwives on the Metro

As we said goodnight she gave me several huge hugs, looked me in the eye and said 'Love, pure love, that is all I can say' then prayed several prayers of blessing over me, my husband (who she met a few weeks ago in Uganda), my extended family and all of the midwives in our project.  Florence is now fully on-board with the midwifery agenda in Uganda and the Union is realising the power of partnership.  Let's hope that as the new midwifery task force finds it feet the voice of midwives will grow stronger to influence midwifery education and regulation, developing and nurturing the midwifery associations within it.  Global Midwifery Twinning - we love it.  Gnash Gnash.

ICM's techincal midwifery advisor Pashtoon explaining the role of Midwifery Assocations as one of the three pillars in yesterdays Prague workshop