September 1, 2015
We meet with the Sunshine Coast medical trio making a huge difference to the health and wellbeing of mothers and babies in developing countries… saving lives one birth at a time.
“Chaotic, upsetting, heartbreaking, rewarding and wonderful all at the same time.”
This is how second-year medical student Chase Becker described her recent visit to the labour ward of Amana Regional Hospital in Tanzania as part of a clinical placement to the developing country.
Accompanied by her mother, highly skilled midwife Jan Becker and high profile Sunshine Coast obstetrician/gynaecologist Dr James Moir, the trio recently spent a rollercoaster two weeks at the basic hospital facility where up to 100 babies are delivered each day, many of them requiring surgical intervention and emergency care.
It isn’t the first time the plucky teenager has been part of a third-world clinical placement, having travelled to the labour wards of remote Thailand several times previously under the watchful eye of her mum.
“Mum and I originally looked at a midwifery magazine for trips to China this time and we found this one to Tanzania in Africa. Mum was looking for a hospital with a high birth rate so there would be lots for us to do so we wouldn’t be sitting around waiting for babies to be born and it certainly lived up to our expectations,” laughs Chase.
Although the mother and daughter are no strangers to working in remote and rural areas, this was the first time the duo had the advantage of travelling with a specialist of Dr Moir’s calibre, which made their placement even more valuable.
“Having James with us this time was fantastic because someone of his calibre is like gold bars to everyone over there,” says Chase.
“It was less stressful knowing we had the backup of someone so senior and James and my mum have worked together for a long time, they make a great team.”
According to Dr Moir, the Amana Regional Hospital typically delivers 80 to 100 babies per day, compared to a public hospital on the Sunshine Coast, such as Nambour General Hospital, where the delivery of 10-12 babies would be considered a busy day in the labour ward.
“The Nambour hospital might deliver 200 babies per month, which would be the same number of babies born at the hospital in Tanzania in just two days,” says Dr Moir.
Although the medical care at the hospital is similar to what is provided here in Australia, Dr Moir says it is at a very basic level.
“They don’t have the facilities to offer high end intervention. There are no facilities for high risk premmie babies and if babies are very sick they have to be transferred to the main teaching hospital in town, which is a couple of hours in the traffic,” he says. Surgical procedures are also less “high tech”, with facilities not as well equipped as in Australia.
“There is no scrub nurse in theatre, you have to open your own packs and prepare the instrument trays and then take the instruments off the tray as we perform the surgery. Many of the instruments are past their best too, but they work well with what they’ve got.”
Chase tells me it is not unusual to see up to three women sharing a bed in the maternity ward, with many sleeping on makeshift beds on the hospital floor.
“For many of the women, this is the first time they have seen a doctor during their pregnancy. I believe up to 91 per cent of women in rural Tanzania only attend one antenatal appointment after 31 weeks, which is quite late,” she says.
“I recall one woman who came in with eclampsia of pregnancy with very high blood pressure. She was frothing at the mouth and fitting. It was one of the worst cases I had seen,” recalls James.
“We don’t see those conditions as much in Australia because they are picked up at their antenatal screening.
“There are also more babies born with malformations and abnormalities. In the bigger centres they would pick those things up with ultrasounds. The most detail they would get from the basic ultrasounds at the rural hospital would be whether the baby is alive, roughly how big it is and what way it’s facing.”
Dr Moir and his team were excited about showing off a hand-held ultrasound device they brought with them from Australia. However, due to unforeseen circumstances it only arrived one day before their departure.
“Unfortunately we only had one day to show it off. But it sorted out a fair few problems very quickly in the pre-assessment room.”
Doctor Moir recalls many difficult deliveries during his time at the hospital including one woman who lost so much blood he had to perform an emergency hysterectomy to save her life. “I remember it was a particularly busy day, there were more than 30 women in the waiting room ready to be admitted. I was helping out in another theatre when I was called to assist this lady who was very very ill,” he says.
“She had already received one bag of blood but there was debate as to whether she would receive the second bag of blood in case she passed away. That is how short the supply of blood is there, they couldn’t afford to waste it. Thankfully Maria survived and made a great recovery after two more blood transfusions.”
You can feel the passion both Dr Moir and Chase have for improving the health and wellbeing of mothers and babies in underdeveloped countries and I get the feeling this is not their last trip.
“Myself and Jan have been around a long time and have seen and done a lot so it is great to be able to pass that on and it is very rewarding to be able to help in any way we can,” says Dr Moir.
“It’s amazing to see what a huge difference you can make there and how many people’s lives it affects, it’s a great feeling,” says Chase.
For more information on how you can help go to www.midwifevision.com