Thursday, 21 January 2016

If you want to go far, go together

There is a Ugandan Proverb that says: 'If you want to go fast, go alone; if you want to go far, go together'.  We've had to constantly remind ourselves of this during the past week at our MOMENTUM project workshop where the Royal College of Midwives' UK consultants came together with their Ugandan counterparts to develop a shared understanding of mentorship, explore some teaching and learning theories, consider the context of Ugandan midwifery (where maternal mortality is 438:100,000 compared to 9 in the UK and 4 in Sweden) and finalise workplans for the next 5 months.  It's all too easy for us to fly in, require our partners to drop everything to escort us around and attend our workshop, and expect our plans to be their top priority.  We can tend to be results and outcomes driven, rather than learning from our twins about the importance of relationship, of respecting cultural traditions and putting family first.  We try to remember that that building capacity and relationships comes first and the project outcomes second.  It's tough to do that though, especially when the days in-country fly past at an alarming rate.

UK midwife consultant Liz Bannon, with her counterpart from the Ugandan Nurses and Midwives Council, Mercy
UK midwife consultant Kade Mondeh, with two of the midwifery students who hope to benefit from better mentorship through their placements in our project pilot sites
Its fabulous being here with such a great team of experienced and knowledgeable RCM midwives. Everyone is getting along famously and in many ways it reminds me of my first overseas posting to Cambodian refugee camps in Thailand where I was part of a big team and made life-long friendships. Here we've eaten together most nights, debriefing from our busy days, identifying opportunities and challenges and sharing many laughs.   Due to a mix-up with bookings, my colleague Eleanor and I have left the team guest-house and de-camped to the hotel next door where we both have huge rooms but everything is dysfunctional including the water which is liquid mud and the breakfasts which offer plantain stew, goat, liver and lurid pink sausages as well as toast and eggs.  Thankfully we can laugh about it and I do occasionally sample the Ugandan options at breakfast with mixed results.  We have made it though a week's worth of Ugandan workshop lunches which are carb-heavy and rather samey but generous nonetheless.  Looking forward to going home and eating salads!
This is why I usually decline the fish

Eleanor and I will depart for the UK on Saturday evening, leaving our UK consultants to work with their twins for a further 2 weeks.  During the workshop the changes that we want to see have been identified and some of those barriers to change such as cultural beliefs which we explored using more proverbs.  We shared proverbs from the UK such as 'The leopard can't change its spots' and 'You can't teach an old dog new tricks' and the Ugandans shared one of their own: 'You can take the girl out of the village but you can't take the village out of the girl'.  Achieving change can be challenging when a culture believes that change is not possible.  However, we all agreed that we don't have to accept such sayings and that with support and friendship midwives can change the way they work and adopt new practices.  We've also had lots of singing, dancing, role play and prayers!
Brainstorming around the Lancet Midwifery Series for the Ugandan Context

Teaching how to tie a reef knot using the 4 stage technique, a simple strategy for learning on your feet at work, facilitated by RCM consultants and midwife teachers Aine Alam and Hilary Patrick,
Our first action-reflection cycles have been identified and the activities agreed upon.  Communication strategies have been drawn up for twins to communicate via E mail and Whatsapp and the M&E tools are being developed as we speak.  Bridges have been built, tea has been taken, speeches have been made and much coloured paper stuck on walls.  I'll be back in June for the next workshop and to visit each project pilot site.  Hopefully we'll find that progress is being made.  I shall close with a few more pictures from our workshop and one of the new frock!
Making workplans

Using the Lancet Midwifery Series (2014) Framework to identify what care women need in Uganda

RCM consultant Sue Deakin (left) and Global Projects Officer Eleanor Shaw (right) in disucssion with Ugandan colleagues about the skills that women need their caregivers to have in Uganda

The new frock!

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