Global Action in Nursing

Nurse-Midwife Faith: a story of exceptional care at South Lunzu Health Centre Written by GAIN mentor Luseshelo Faith and I came across a pregnant client with severe pre-eclampsia. Faith took the lead, using the client's presenting complaint, history, physical assessment and investigations, to diagnose severe pre-eclampsia. She calmly explained the condition to the patient, developed a midwifery care plan for the patient, provided pre-referral management, including administration of hydralazine and magnesium sulphate, and referred the patient to the tertiary care center. I was so impressed with how she managed the patient with so much ease and expertise, so much so that I had to put a badge on her for outstanding service as a distinctive mark for her expertise demonstrated in the management of severe pre-eclampsia.

The experience of quality, respectful and dignified care rendered to a woman during her labor and delivery, when she is most vulnerable, in pain, and helpless, sticks with her for the rest of her life. GAIN expert nurse mentor in Malawi Help us be the difference for mothers and their newborns. Every dollar up to $75,000 matched by the GAIN Advisory Council! Donate with the fundraiser link below: ... https://givingtogether.ucsf.edu//gain-2020-fundrai/c308348

Being a midwife is one of the very few most thrilling and satisfying experiences I have had in my life. The joy of helping a mommy bring out a life is one inexplicable feeling I’ve had every time I attend to a delivery over the past 7 years and 4704 deliveries. My satisfaction is inextricably intertwined with the satisfaction of the women I assist, and it always leaps to a whole advanced level when the woman I have assisted is also satisfied with the care I have rendered to... her. The experience of quality, respectful and dignified care rendered to a woman during her labour and delivery, when she is more vulnerable, in pain and helpless sticks to her for the rest of her life. However, all this sweet experience of being a midwife takes a sour turn when one is working with inadequate resources. When one puts in all her efforts to provide quality, respectful and dignified care with improvisations which put the lives of mothers and neonates in grave danger. I had one hell of an experience yesterday and I’ve had a heavy heart ever since and I’m only writing about it now because the baby is out of harm’s way (FYI: midwives are humans too; with feelings and emotions, experiences we encounter shift in and shift out, whether good or bad, also affect us and have the ability to shape our moods and entire lives). Forty-minutes after helping a first time mommy bring out her precious gem of a very beautiful and healthy baby, upon checking her umbilical cord on which I had tied with a clean gauze bandage because the health facility and many other health facilities do not have proper cord clamps to keep babies from bleeding out from their umbilical cords. I had the shock of my life to see her bathed in her own blood with all her covers soaked with blood oozing out of her fresh umbilical cord . My heart shattered into uncountable pieces as I observed her innocent face which had turned pale due to the bleeding. With my colleagues we re-secured the cord with more yarn and made sure she wasn’t bleeding, explained her condition to her anxious mommy and granny and referred her out to an advanced nursery ward for a possible transfusion. I kept following up on her until I was told she had been transfused and doing well. This was a life nearly lost due to lack of a simple and cheap cord clamp and an essential Vitamin K prophylaxis. Going through this COVID-19 era, we’ve shifted our attention from important issues of maternal and neonatal health and misplaced a lot of our priorities. We need to balance up resource allocation to ensure mothers and babies are safe and sound. Covid-19 or not, mother’s and babies need to live and thrive. .. Fanny Simwinga is a nurse midwife and GAIN expert nurse mentor in Blantyre, Malawi

Over the weekend two of our GAIN mentors, Oveka Jana and Fanny Simwinga, initiated to save the innocent lives of newborn babies in Blantyre district health centers due to a lack of umbilical cord clamps. Within 2 days the community donated enough to purchase 2000 umbilical cord clamps! We are so impressed by the initiative of our mentors and the quick response from Blantyre district! #PleadToStopTheBleed

Among many reasons for my pride in being a midwife is the precious opportunity to witness the first breath of a human being. Midwives are essential in the birth process as they care for a woman from conception to birth of the baby. Taking time at each stage of pregnancy and childbirth to make sure that the mother and baby are doing well by giving health education, assessing the pregnant mother and intervening to any problems arising are the most important parts of my job. I ...will share one of many experiences with you during my work as a midwife. During a visit at a rural health center in Malawi to mentor a midwife working there, i found him very busy with a lot of women who came for antenatal care. I assisted by checking the blood pressure of women waiting. It was then that I encountered a pregnant woman with very high blood pressure and impending signs of eclampsia. She also told me that her previous baby was delivered while she was unconscious due to eclampsia. I made a diagnosis of severe preeclampsia, we gave the mother the first line of treatment and called for an ambulance to take her to a higher level facility. While there she was safely delivered with both the mother and baby alive. I met her on a follow up visit and she was all thankful to the midwives saying "You helped me a lot, if not for your interventions, I would have had convulsions and died" These kind of experiences make me proud to be a midwife. .. Mphatso Sayenda is a midwife and GAIN expert nurse mentor in Neno, Malawi

Being a midwife is about making a difference in the lives of mothers and newborns and this requires a lot of critical thinking and timely decision making. As a midwife, I have had both bad and good times in my clinical practice, but all these experiences have shaped me into the skilled midwife I am today. I am happy to say I could share many success stories, but let me highlight one experience where timely decision made a huge difference. During a visit to health centre wher...e I provide mentorship as part of the GAIN project, I met a women who had just given birth at the end of a night shift. I began her one-hour post-delivery assessment and found she was bleeding profusely. That morning, there was only me and the midwife mentee available for care. I called for her help as this was an emergency. We identified a post-partum hemorrhage, which required urgent and correct management. Without losing focus, I directed the mentee to insert two large IV lines and start fluids along with oxytocin to help the uterus contract. While she was doing that, I inserted a urinary catheter and continued to massage the uterus to promote contraction. We did not leave her and continued massaging the uterus for one hour until the bleeding stopped and the patient was stable. Although we do not have a lab to do many tests, we use the tools we have to help our patients. I share this memorable experience with you because a life was saved. We could not do some tests because of limited resources, but this remains a memorable experience because a life was saved. One of many reasons I am proud to be a midwife. .. Richard Malirakwenda is a midwife and GAIN expert nurse mentor in Blantyre, Malawi.