Often times we’ve compared our health care standards with that of the developed world. At such times, we’ve either with huge hope concluded that we could be at par, or with blunt despair that we could not.
I was in the same dilemma when I met with Mrs ToyinSaraki at St Thomas’s hospital in London. Although my mission was different, I joined in on her own mission; to learn about what works in such a hospital and how Nigeria can hugely hope to meet that standard, specifically as related to midwives, who are key to saving lives of pregnant mothers and newborns.
In the middle of our interaction, one of the midwives working in the hospital, Abi, a Nigerian, came in to our meeting venue. Abi told us that she enjoys her work there because of the conditions - availability of training opportunities, adequate equipment, friendly working environment and constant payment of salaries. So, Abi can do her work and still have the time to go and pick her three children from school.
In Nigeria, I have met midwives. I have met who once spent her own money to free new mothers who were detained by a hospital because they couldn’t pay their bills. I have met who usually donates her own blood to pregnant women in labour or their newborns, who require blood transfusion to survive. I have spoken with Kathrine, serving under the Midwives Service Scheme (MSS), who cannot afford to travel to see her family from the remote community where she works because she had not received her allowances for 4 months.
So, when Mrs Saraki said that she came to St Thomas’ hospital to learn what works there so as to take it to Nigeria, I imagined a Nomso spending her money on her own needs, a Phoebe having easy access to blood from a functional blood bank, and a Kathrine who can afford to go and spend time with her family, just like Abi.
But how would Mrs Saraki actualise this dream?
This is as long as the distance between Nigeria and London, I thought.
“Do you see this as so big, so huge and daunting to achieve in Nigeria?” I asked her, because, to say the truth, that was exactly what I felt. I loved her response, and I still love it:
“Not to me. You know, every single program I have ever done has started with one person so I take things at the level in which I can start, and then we start. Today I’m meeting with the midwives. Five years, ten years from now I pray that the result of this meeting will be a state of the art obstetric unit, with a state of the art nursing college to go along with it. You know the people that are doing this here are just like us.”
I couldn’t expect less, and I could see why she was made the global goodwill ambassador to midwives, the first ever.
Her approach is not copying exactly how things are done abroad; her approach is to contextualise procedures and guidelines here in Nigeria. For instance, the World Health Organisation’s guideline states that a pregnant woman should deliver in a well-equipped health facility and by a skilled birth attendant.
In Nigeria, most of our health facilities are not well equipped, and they don’t come with essential birthing kits. A pregnant woman is provided with a list of what she must bring once she falls into labour. The Nigerian context is thus to provide what is called a mama kit, given to pregnant women, which contains basic birthing needs.
Mrs Saraki has mama kit in three versions: the pregnant woman’s version with the basics on the hospital list; the version used to empower midwives, which comes with oxytocin and misoprostol, and the super boosted version which contains medication and injections; that is for the use of trained midwives in rural areas.
Another instance is, if calling 999 would not work in the Nigerian context during pregnancy emergency, “how about having a friendly taxi driver whose number you have, whom you can text, who will come and take you to the hospital if you have a problem. I am looking for real life frontline solutions”.
Contextualising effective procedures is one creative way to address the challenges of midwives in Nigeria, and that helped me to understand why her dream will happen (soon).
If Nomso, Phoebe, Kathrine and other midwives here in Nigeria could be as happy as Abi in London, we will be, in line with this year’s International Day of the Midwife’s theme, ‘changing the world one family at a time’.