Jenna Williams is a recent Bachelor of Nursing/Midwifery graduate from La Trobe University. She recently travelled with her mother (a qualified midwife) to Iloilo in the Philippines on a two-week midwifery placement. She writes about it below.
— Culture, different education systems, and a lack of resources dramatically affect practises in developing healthcare systems. Some practises are entirely different to what we might consider ‘best practise’ in the UK. In fact, one of the major benefits of an overseas placement such as Jenna’s is gaining perspective on just how different from one another healthcare systems can be. —
“The aim of our placements in the Philippines was to learn how local culture impacted the delivery of care. We also wanted to learn about the creative ways Filipino staff helped patients when battling a lack of resources.
We spent our first shift in the obstetric emergency room. Regardless of the treatment required, local staff attended to it with all the other patients present. We also quickly discovered women had to be on their own, as no partners or family members were allowed in.
We visited a special program for young parents too. It was a recent hospital initiative that offered support during pregnancy to girls and women between the ages of 12 and 19.
This support was most often provided in the final weeks of pregnancy. These patients were also offered education around pregnancy prevention.
We then spent time in the delivery ward where labouring women were cared for until after they’d given birth.
Women quietly supported each other through labour. Local staff actually taught us that if a woman made noise during labour, it meant that she had sinned against God. Religion was very important to the people of Iloilo.
At one point, there were 11 women labouring in this one area with only three beds between them.
Unlike in Australia, there was no separation between women giving birth normally and those with complications or risk factors — twins, preeclampsia, or hypertension for example.
The doctor assessed the women at regular intervals. Once they were in the active pushing stage, staff walked them to a different area to give birth.
We observed an emergency caesarean section here too.
We also spent some time on the postnatal ward where there were 98 women, 101 babies and only 35 beds.
Mothers remained in hospital for up to seven days. As there was a bed shortage the women and their babies had to share. There were often two, three, or even four mothers sharing one bed. Sometimes they sat on chairs, resting their heads on side of the bed with their babies in front of them.
The family normally provided the bedside care. They brought in food and clothes and helped with day-to-day hygiene. If the mother needed any medical supplies the family bought and delivered these as well.
Another difference between the Philippines and Australia was that breastfeeding was mandatory. Mothers simply weren’t allowed to use any kind of artificial supplement.
On another day, we did a shift in the NICU and the staff there were fantastic. The NICU here was, in fact, quite similar to the NICUs in Australia, but without all the modern specialised equipment.
Our placement in the Philippines had a significant effect on us. It made us realise how lucky we are to live a country that provides equal access to healthcare for everyone.
We complain about things like long hospital waiting times in Australia. But the people of the Philippines happily sit outside all day waiting for care. The whole experience offered us an entirely new perspective.”
Work the World specialise in tailoring overseas midwifery placements in Asia, Africa and Latin America. Their destinations provide eye-opening insight into the challenges associated with delivering healthcare in the developing world.