SOME RISK

Monday 30th May. It’s now one whole week since I completed the course of ARV’s (PEP) I feel so much better. I didn’t quite realize how much these drugs had affected me until I finished them. I feel so much stronger and far less tired. More importantly I feel so much more positive and emotionally stable. At the end of this week I will take an HIV test which will then be repeated again in two months time. It will only be then that I can be sure that the virus has not been transmitted. However, I am feeling very positive and believe that I will be tested negative.
Bwaila continues to be both challenging and rewarding. The in-service training that I set up within the first months of arriving over three years ago but that became irregular during last year due to the withdrawal of funding has now been started up again. I am pleased and encouraged to see how well this has been received by the midwives who are enthusiastic participants. My role in this has changed somewhat as I hand over the facilitation to my Malawian colleagues and take up my new role as mentor or teacher of the teachers. Since January I have taken on the leadership of the daily ‘ward round’ on Labour Ward each morning. This is an excellent teaching opportunity attended by all cadres including students and trained staff. We discuss each case at length particularly those that are more complicated or ‘high risk.’ The participants are encouraged to assess each case and make plans for actions necessary and care needed. I particularly enjoy this type of teaching sharing all my knowledge and experience with the aim of improving the outcomes for the mothers and babies attended at Bwaila.
We are specifically looking at improving our Neonatal death rates. Birth asphyxia, which is most often caused by lack of diligent care during labour, is the main cause of neonatal deaths on our unit. We need to prevent our babies being born in poor condition thus needing resuscitation and nursery care. Many of our babies born with birth asphyxia will be the result of obstructed or prolonged labour. I have been working tirelessly both in the clinical situation and in the classroom to address this challenge. I hope that this effort will be reflected in our statistics during the next few months but more importantly that our aim to discharge healthy mothers and babies will be achieved