Monday, 21 November 2016

Correspondence from Cambodia

I'm currently on a 2 week visit to Cambodia, following up on the twinning project between the Royal College of Midwives and the Cambodian Midwives Association (CMA) that ran between 2012-2015. During that time around 25 UK midwives visited Cambodia for short-term placements with the CMA or its partners (NGOs and various clinical and academic sites).  We also had six workshops, addressing various needs identified by the CMA and six visits from RCM staff (me and others).  We hosted 2 reciprocal visits to the UK and all attended the triennial International Midwives Congress in Prague in 2014 together with other twinned associations from Ugandan and Nepal.  This project was funded by UK-Aid through the Tropical Health and Education Trust (THET).

What difference, if any, did these activities make to midwifery in Cambodia? That's what I'm here to find out and also to identify any further possibilities for the RCM to continue our partnership with CMA in the future.

I'm fortunately to have lived in Cambodia in the 1990s and to have worked in Cambodian Refugee Camps in Thailand in the 1980s so the culture and language are familiar to me although, on my return after 15 years in 2013, my Khmer was a bit rusty and Phnom Penh (the capital city) had changed beyond recognition.  Costa Coffee, KFC and wifi - a whole new world!

With Margaret and Barb, both UK midwives with whom I worked in Cambodian Refugee Camps in the 1980s and who are still living here in Cambodia, supporting Khmer people.  So precious to reconnect
On this trip I'm re-visiting the places we've had programme activities in the past 4 years: Phnom Penh, Prey Veng and Kampot.  These were places the CMA wanted grow their branches but co-incidentally I used to live in Prey Veng from 1994-1996 so it's been great to reconnect with friends (western and Khmer) and see old haunts.

I've been here for 5 days and so far I've met the CMA in Phnom Penh, attended the annual conference of the Cambodian Obstetric and Gynaecologists Society (who want to develop their association in a similar way as they've been so impressed with the midwives!) and conducted a three-day field visit to Prey Veng to interview the local branch of the CMA and visit the provincial hospital and MCH clinic. This week I'll be visiting various stakeholders in Phnom Penh and making a day-trip to Kampot before holding a workshop with the CMA's executive members at the weekend.

Reunited with Lida (left) and Chea Ath (right): Vice president and President of the CMA - and bringing a bit of Uganda to Cambodia!

I hope to blog more as the trip progresses but perhaps I'll just share some quotes from the interviews I've conducted so far.  Let's hear it from the midwives themselves:
'Everyone now knows about the CMA and others want to learn from us.  Since the RCM's twinning project we've more than doubled our membership and we're going to increase our membership fees so that we have more resources to provide services to our members.  We now have Facebook groups for our executive committee and our branch leaders and we have a new branch in Mondulkiri (an underserved region). We feel proud of our activities and when we do them we want to share them on Facebook so that the RCM will feel proud of us too'
(Mrs. Chea Ath, CMA President).

'Here in Prey Veng we've seen a lot of change since the RCM workshop in 2013. Previously not all local midwives clearly understood about the role of the CMA.  Now our branch membership has increased from around 150 members in 2013 to 286 today. In 2013-2014 there were 14 maternal deaths in our province.  This has been rapidly decreasing and, to date, there have been no maternal deaths this year. Now we have multidisciplinary training every three months and midwives know how to use Magnesium Sulphate for pre-eclampsia and compression garments for post-partum haemorrhage. These save lives.  These changes are due to the efforts of many different organisations and programmes, but the RCM's twinning programme with the CMA has raised the profile of midwives in the province and has given them more encouragement to change themselves' .
 (Mrs. Samrith Sotheavy, Branch Leader of Prey Veng CMA Local Branch). 

With the lead midwife at Prey Veng Provincial Hospital and Barb Soung, who helped to establish the CMA in the 1990s and has been supporting midwifery in Cambodia in various ways for the past 20 years
'I am a midwife.  I need to be a member of the midwives association.  It's important to discuss things together.  It's our role. We feel we can ask our branch leader for support if we have problems.  After the RCM workshop I encouraged my colleagues to join the CMA.  Now all of our midwives in this clinic are  members of the CMA. The CMA provides insurance if our members get seriously ill or die. This is very important for us. In the future I hope the local branch will organise more learning and provide opportunities for the midwives to share their experiences and problems together'.
(Mrs. Cho Pahnita, Assistant Lead Midwife at Prey Veng Provincial MCH Clinic)

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