Home but not yet over!

The ICM Congress in Prague finished on Thursday and I have returned home for a brief weekend with my family whilst our twinned midwives from Nepal, Cambodia and Uganda visit Scotland, the north of England and Wales/Northern Ireland respectively, each to their own twinned countries.  I am enormously grateful to my RCM colleagues and some of our returned volunteer midwives for arranging both accommodation and clinical/academic visits for their twins, giving me a little window to share a sunny Sunday lunch with my extended family, walk my dog in the nearby nature reserve and catch up on some sleep.

Catching up with former colleagues from St Thomas Hospital /Kings College London at the RCM Stand

It's hard to put into words what an amazing experience it was to be with over 3,000 midwives from across the world in Prague, to reunite with friends and colleagues from the past 30 years and to share this adventure with amazing midwives from the RCM and from our twinned countries.  At times I felt like a frazzled tour guide, making sure that everyone was where they needed to be at the right time but it was just fantastic when it all came together.  One of the loveliest moments was when one of MY midwifery tutors, who has just edited the new Myles Textbook for Midwives, presented a signed copy (paid for by our project) to each of our twins.  These midwives are all teachers in their own countries and will be able to make such good use of this important resource.  I have been to the libraries in their teaching schools and many are still using 1970s and 1980s editions as it's all they have. Jacque Gerrard, RCM England's Director, gave each twin a beautiful RCM badge and the Cambodians presented Louise Silverton, Jacque and Jayne with traditional hand-woven Khmer Kramas (cotton scarves).

Author and editor Dr. Jayne Marshall presenting signed copies of the 16th edition (just published) of Myles Textbook for Midwives to our twins from Cambodia, Uganda and Nepal

Louise Silverton, RCM's Director of Midwifery, receiving her Krama

Sadly, despite all of our best efforts (Jacque sat in the visa office all day on Wednesday) we were unable to get a visa for Mary from Uganda to visit the UK so when everyone flew out of Prague on Thursday and Friday, Mary stayed behind to board a plane back to Entebbe on Saturday.  She touched us all with her gracious and godly response to such a disappointment.  I accompanied her to Catholic Mass on Thursday morning in Prague and she took great comfort from the rituals of her faith.  Thankfully we have three UK midwives currently in Uganda so I have asked them to help Mary reflect on her experience in Prague and to surround her with support.

I will be staying at a hotel in London with our twins this week as we travel to Oxford on Wednesday for the RCM's annual event and Zepherina Veitch Lecture by Professor Debra Bick, hold the final day of our GMTP workshop on Thursday and then the formal board meeting on Friday before everyone flies home at the weekend.  It will be the first time in the history of the programme that everyone is together for the board meeting and Mary hopes to join us by Skype.  I will be glad when this very busy period is over but it has been an incredible, enriching and exciting experience and feel so privileged to do the job I do with such fantastic people.

With Mary and Sarah in Prague

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

Together in Prague: Moments in History

Our Global Midwifery Twinning Project is linking midwifery associations in Uganda, Cambodia, Nepal and the UK. Yesterday was the first time all four associations had come together since the beginning of the project two years ago.

The moment all the twins arrived in Prague - two year's work and relationships coming together.  

Gathering a day before the ICM Congress began, at a workshop facilitated by an external facilitator, we began the process of telling our stories, coming to a shared understanding of where we have come from, where we are now and where we would like to go together.

Back: Jacque Gerrard, Director for RCM England; Delicia Egboh, Project Administrator, RCM UK; Cathy Warwick, Chief Exectuive, RCM UK; Louise Silverton, Director of Midwifery, RCM UK.
Middle: Ishwori Dewi Shrestra, Chief Nurse/Midwife, Ministry of Health and Population, Nepal;Sarah Namyalo, Ugandan Nurses and Midwives Council and UPMA; Yeath Thida, Midwife Educator and Cambodian Midwives Council Executive; Oung Lida, Vice President, Cambodian Midwives Assocation; Mary Garrot Musoke, President, Uganda Private Midwives Assocation; Kiran Bajrachriya, President, Midwifery Society of Nepal
Front: Joy Kemp, Global Professional Advisor, RCM UK (Me!); Lesley Page, President, RCM UK

It was a beautiful and inspiring time, getting to know one another, listening to our partner associations talking about the successes and challenges of furthering the work of midwives where they are, crying and laughing together and sharing a meal.  I was especially grateful to the three RCM directors and our president who set aside the day, in the midst of this enormously busy time, to understand the project better and to deepen the relationships with our partners.  We will have a follow up workshop in London on 12 June, after our twins have completed their UK tours!

Kiran and Mary reconnecting (Nepal and Uganda)

Jacque (England) and Mary (Uganda)

Viewing the overview of the project I have put together for the exhibition stand

Kiran presented all partners with a special Midwifery Society Calendar from Nepal

Sarah and Delicia chatting over lunch (RCM UK and Uganda)

Our meal together

We had to miss dessert in our rush to attend the 'Voices of Midwives' Event in Kampa Park - an attempt to break the World Record for the number of midwives singing together at any one time!  3000 midwives in the sunshine joined in once voice - a spine tingling moment.  Here's a little video showing Jacque Gerrard and Cathy Warwick dancing and singing, and two of our friends from Cambodia getting into the groove!Voices of Midwives singing in Prague

At the Voices of Midwives Sing-a-long: Jacque Gerrard (RCM Director for England) and me with the Cambodia Contingent: Pros, Lida, Thida and Mme. Ing Rada

Another theme of our time here has been people borrowing my glasses to read the conference programme, menus and the map of Prague, which has the most ridiculous small print.  Here's Mary and Gail sporting my £3.99 specials!

Today the congress proper started with over 3000+ midwives from all the world joining for an inspiring opening ceremony.

Amazing flag ceremony - the moment when Mary brought in the Ugandan flag.  I cried when Lida paraded with the Cambodian flag - it's so wonderful that they are here

RCM President Frances Day-Stirk giving the opening address

Those midwifery associations involved in twinning have clubbed together for a Twinning Stand in the exhibition.  It will be a focal point for anyone involved in or interested in twinning.  It proved to be a great meeting point after the opening ceremony, with midwives from Laos delighted to see our twins from Cambodia, swapping business cards and planning to meet up again in due course.

With Thida and Lida, our Cambodian twins, at the twinning stand

Our display at the twinning stand

Tomorrow the scientific sessions start in earnest.  Linked to Prague's beautiful bridges, tomorrow's first session is 'Bridging midwifery and women's health rights'.There are presentations from all of our three twinned countries so I'll be dashing around the congress centre in an atttempt to get to every one!  Hopefully this has given a flavour of this exciting and inspiring event.  More blurb from Bohemia in the next installment.

Blurb from Bohemia

Leaving home at 6am yesterday on a Bank Holiday Monday, I flew to Prague for the 30th International Confederation of Midwives Congress http://www.midwives2014.org/ - a momentous occasion when over 3000 midwives from across the world will gather together.  I am here early as our twinned midwives from Cambodia and Uganda will attending the pre-congress ICM council so I will be supporting and spending time with them as well as preparing for my presentations, workshops and our exhibition stand.  Our Nepalese twins will arrive in a few days' time.

I nearly missed my connecting flight in Vienna - we had almost touched down when we took off again at alarming speed. The captain later told us there had been a car on the runway!  The time it took to ascend, circle and land again gave me just 20 minutes between flights and I had to run from one end of the airport to the other.  Amazingly my suitcase and me both made it!

As I arrived in daylight and had no immediate deadlines I braved the public transport system with my suitcase - one bus and two metro trains later I arrived at our hotel, right by the conference centre.

Hotel Corinthia, Prague

I had intercepted an e mail from the Cambodians who were holed up, too scared to venture out, so I went straight over to meet them at their hotel and we took advantage of our free afternoon for some sightseeing. Together we negotiated the metro once more and found the centre of town, wandering around beautiful buildings and stopping for drinks in streetside cafes.

Lida and Thida hit the streets of Prague!

Tea at the Tramway Cafe

Beautiful roses in Prague - national museum at the top of the picture

They were very jetlagged after flying Phnom Penh - Bangkok - London - Prague and flagged after a couple of hours but we squeezed in a visit to the most amazing Cheese shop to introduce them to this European delight, not a feature of the Cambodian Diet.  They were amazed by the whole parma hams hanging in the store - I love seeing the world through others' eyes.

Wonderful Cheese Shop in Prague's main street

Finally we met up for dinner with Professor Lesley Page, the RCM's President, and managed to negotiate some rice for Lida even though it was not on the menu - Cambodians need to eat rice every day!  Lesley was moved to hear about their experiences of losing family in Khmer Rouge times and the long-lasting impact this has had on Cambodian society and midwifery.

Slowly the world of midwifery is gathering here in Bohemia.  I was overjoyed to see Pashtoon Azfar, founder of the Afghan Midwives Assocation and now working with the International Confederation of Midwives.  We have worked together twice in Nepal and she's an amazing midwife with a powerful message.

Unfortunately our Ugandan twins are not yet here - UK visa delays mean they could not catch their flight as planned. All of our project team and contacts are working hard in UK, Uganda and Prague to make a miracle happen.  Meanwhile, prayers and positive vibes appreciated!

At the end of a long day this was the best sight in the world.  More blurb from Bohemia soon!

My cosy bed in Bohemia

Reflections on Uganda - March 2014

I recently spent a week in Uganda with the RCM's director for Wales, Helen Rogers.  Sadly I couldn't blog whilst I was there as I got sick on day 2 and barely had energy to struggle through the days let alone blog at night.  However, we still had a productive trip and were enormously encouraged by the progress made with our Global Midwifery Twinning Project in the past year.  This time we stayed with friends rather than in a hotel: Michele and Phil Ball for the first few days then Deborah and Phillip Betts for our last weekend.  It was so nice to come back to a home at the end of the day and for me, feeling under the weather, it made all the difference to be able to wander out to the kitchen in the middle of the night!

Helen (right) with Michele Ball, UK midwife and RCM member living and working in Uganda Phillip and Deborah, working with cocoa and vanilla growers in Uganda and DR Congo (Deborah and I went to school together!

The purpose of our visit was to agree a plan for the last year of our twinning project in Uganda and to attend a workshop being run by one of our volunteers Ann Thomson, Emeritus Professor of Midwifery from the University of Manchester.  Ann had been in country for 3 weeks, working with the midwifery associations, universities, NGOs and others to advise on the national midwifery curriculum and help to develop a midwifery research framework for Uganda.  Also in country were Emma Morris, a midwife from Shrewsbury on a placement with the Uganda Nurses and Midwives Council and Zeenath Uddin, a research and clinical midwife from London undertaking training of trainers in life saving skills.  A formidable team!

Emma (GMTP volunteer) conducting training in neonatal resuscitation with Ugandan Midwives

Mary Gorete, President of the Uganda Private Midwives Association, saying goodbye to Professor Ann Thomson

Helen and I had a punishing schedule of visits to agencies and individuals connected with supporting midwifery in Uganda, always taking a member of UPMA with us to help develop their networking and negotiating skills.  Particular highlights were visits to the Mildmay Campus (especially the children's HIV ward, full of love and hope) https://www.mildmay.org/overseas/uganda/  and meeting with Jean Chamberlain and Dr. Eve from Save the Mothers, an inspirational programme (http://www.savethemothers.org)

Mildmay are increasingly realising the value of working with midwives to address issues of sexual and reproductive health  in Uganda.  We had a very fruitful meeting planning how Mildmay can work with the Midwifery Association and how GMTP can support this.

We dropped in on a local branch meeting of the UPMA in Kampala

Plans for this final year include working with many stakeholders to support Uganda's first national midwifery education conference, supporting Ugandan midwifery educators as they develop Masters courses and modules in supervision and mentorship, supporting the development of the midwifery directorate at the Uganda Nurses and Midwives Council and continuing to support midwives in clinical practice through twinning.  Exciting but challenging times!

Me handing over some baby clothes and blankets, loving knitted by my church's new knitting club.  UPMA will distribute these to mothers on International Day of the Midwife (5 May). 

Granny's Girdle comes into its own

My grandmother was a wonderful woman.  A midwife, a Dundee doctor's wife (and his dispenser), a powerhouse of energy and a model housewife who could clean something to within an inch of its life and remove any stain from anything.  She (Sadie) was one of 10 siblings and had sisters called Beldie, Katie, Maisie, Ovie and Flora.  Most of them lived well into their 90s (and Ovie is still going strong at 90+).  Katie was 102 when she finally popped out to the Chemist and popped her clogs. 

I an proud to have a few of my Granny's things  but two I treasure above the others - her preserving pan and her Girdle.  North of the border this is not a complicated item of underwear but the perfect receptacle for a batch of pancakes. The Girdle comes out on lazy Saturday mornings or days when we find ourselves with a little more time and the chance of a leisurely breakfast.

If you cook up a batch of these, spare a thought for Mrs. Sadie Duncan and the inspiration and love she brought to our lives.

Gluten and Diary Free Breakfast Scotch Pancakes (Drop Scones)

Heat and lightly grease Granny's girdle or a large non-stick frying pan.  Place a large plate and a clean tea towel in a very low oven to keep the pancakes warm as you make them. 

Place the following ingredients in a large bowl or jug:

175g gluten-free self-raising flour (Doves Farm and Asdas are both good)
1 tsp gluten-free baking powder
45g caster sugar
1 egg
200 mls soya milk (or a mixture of soya milk, plain soya yogurt and water)
20g melted sunflower (or other dairy free) margarine

Whisk until there are no lumps but don't over-mix.

Place large tablespoons of pancake mixture onto the girdle, about 4 at a time or however many you have room for.  Turn when the tops are all bubbly and no longer wet (usually about a minute).  Remove to the plate when both sides and golden and keep warm in the clean tea towel.

Serve spread lightly with sunflower margerine and maple syrup (or melt some golden syrup in the microwave so it pours).

Great with a plate of fresh fruit, soya yogurts and fresh coffee :)  Good with bacon and egg too.

For ordinary pancakes just use regular SR flour, dairy milk and butter.

You can make a really big one like Hannah, if you wish!

An old fashioned pudding - my way

Once again today we enjoyed the company of our friend and neighbour, Mr Webley, for Sunday lunch.  Roast lamb, roast potoatoes, beans, baby carrots - and instead of redcurrant jelly we had Blackberry and Apple jelly which was delicious with the lamb (sorry to my veggie friends...)!

It was a drizzly day, perfect for an old fashioned pudding.  I have a bag of apples in the shed from my friend Kerry's garden and the store cupboard provided the rest:

Gluten and Dairy Free Apple Sponge Pudding

'Butter' a pudding dish with sunflower margarine and place a generous layer of apples (peeled and chopped) in the base.  Dot over a few teaspoons of jam or jelly - I used the end of a jar of Damson jam but anything would do.  Or, a generous tablespoon of Demerara sugar with a sprinkling of cinnamon would be good.  Not cinnamon and jam together though, I don't think that would work.

For the sponge, mix together with an electric mixer:

4 oz sunflower (or any diary free) margarine
4 oz caster sugar
2 large free range eggs
4 oz Dove's Farm gluten free self-raising flour
1/2 tsp vanilla extract
1 tsp gluten-free baking powder

Spread the sponge mix over the apples and jam, and bake at 180c for approx 30-40 mins until the top is golden and the cake mix is cooked through.  Serve warm with Alpro Soya Custard or soya cream. 

Yummy!

I do like a challenge.... and I don't like cooking separately

After a spell in hospital last year and six months on high doses of steroids I was feeling lousy and very fat.  Determined to find a sustainable way to lose some weight and regain a sense of health and well-being I gave up gluten and dairy, following advice from several friends who had done so and never looked back.  Ten months on it has been the best decision I have made in a long time (along with giving up full-time work and getting a dog!)  I am 3 stone lighter, much fitter and not really missing much of what I used to eat (when I get the urge for a cheese sandwich some egg mayo on a gluten-free oatcake seems to do the trick!)

I'm not fanatical about it.  I don't think I am truly allergic to those substances - though probably intolerant.  However, if someone gives me a cup of tea with ordinary milk I drink it  - and I eat the bread in communion services!  Generally though, I avoid gluten and dairy where I can.

Tonight my daughter asked for Spaghetti Carbonara - one of her favourite dishes.  Yes, we did have a sachet of Dolmio Carbonara Sauce in the cupboard - but I wanted to keep that for a work-day when I send her round to the neighbour's with her supper in hand.  I don't like cooking two separate meals and I try to eat together as a family where we can.  So I created a version that we could both eat happily and share it with you to tickle your tastebuds if that's your thing:

Cut 4 slices bacon into strips and fry until crispy.  Set aside.

Cook 2 servings of gluten-free spaghetti (I used Morrisons).  Add a handful of frozen peas a few minutes before the end of cooking time (my concession to 5 a day).

Meanwhile, put 2 fresh egg yolks in a large bowl with 1/2 tsp Dijon mustard.  The mustard flavour goes some way to replacing the cheesiness of parmesan.  Add 75mls soya cream (Alpro soy is the best) and about 2 tbsp soya milk.  Try to use unsweetened cream and milk - the cream I used today was sweeter than I would have liked and I will try it with Alpro next time).  Whisk this all together with some seasoning.  Go easy on the salt as the bacon is salty - but lots of pepper is good!

Grate some parmesan cheese for anyone who is eating dairy.  Chop some chives.

When the pasta is cooked, drain and immediately stir into the sauce, leaving for a few minutes for the hot pasta to 'cook' the sauce.  Add in the bacon and chives and put the cheese on the table for anyone who wants it.

Nice :)

Spicy Dairy-Free Mussels with sherry and soya cream

I love mussels but never cook them at home because no one else in the house is that keen.  In fact, before tonight I have never cooked mussels but have eaten them many times in restaurants and seen them cooked on TV and in my sister's kitchen on numerous occasions.

Lingering at the Morrison's fish counter this morning I wanted squid but there was none - then I spied the bag of mussels.  I didn't know what I would do with them but I knew I wanted them!

Tonight, with the rest of the family on a sporting sojourn at the far end of the county I browsed the BBC website for Mussel recipe ideas, then adapted them to create my own.  I have to say they were the BEST mussels I have ever eaten, so share the recipe for you to try for youself.

Heat 1tbsp olive oil in a large pan with a lid.

Finely chop 1/2 large onion, 1 stick celery, 1 clove garlic and 1/2 red chilli and gently saute in the pan until soft.

Meanwhile, clean the mussels (not a difficult job).  Pull off any 'beards' and throw away any mussels that are still open and don't shut when tapped.  Rinse the mussels under cold running water.

Turn the pan up high and add the mussels.  Throw in 1/2 wine glass of dry sherry and put the lid on the pan immediately.  Steam for about 4 minutes until all the mussels are open, shaking the pan periodically.  Add 2 tbsp soya cream, salt, pepper and a handful of chopped coriander and serve in a big bowl with a spoon (for the juice) and a separate bowl for the shells.  Don't eat any mussels that remain closed.

I didn't have anything else with this - no chips, no bread etc - it didn't need it - just used the spoon to consume the yummy 'soup' at the end!