I didn’t think I would be writing before next week but then after a day in Bwaila like today, I felt justified in telling you a little. I felt frustrated, numb, and tired. The labour ward never stopped all day. Women came and delivered left and more came. Few trained staff, a midwife and doctor from Norway who are amazing workers, and more women and babies.

We had no lignocaine from 7.30 am till 4pm. This is a local anaesthetic to give to women prior to an episiotomy (a cut to help the baby out) and it is also given when suturing. It was awful to watch them suffer the pain of being stitched with out painkillers and as awful for the midwife suturing.

This afternoon there was just three midwives and one doctor in total so when I about turned from one women, a student clinical officer said ‘madam there is a baby on the floor’
Sure enough this mother had come in, saw no beds free, put out the black plastic sheet on the floor and lay down between the narrow beds and delivered her baby alone, only minutes before we saw her. The baby was blue so I quickly kneeled onto the wet dirty floor and rubbed and dried the baby to stimulate it to breathe which it did. I then gathered what I needed to cut the cord and guide out the placenta. I then helped the mother to her feet and found her space to rest. I felt so sorry and sad that she had been alone when delivering but she had a big smile on her face and did not seem the slightest bit perturbed. This I gather can be a regular occurrence.


Equipment is of poor quality and therefore breaks or is useless for what is needed. We try to keep everything as clean or as hygienic as we can but it is so difficult. Everything is old and very rusty and because it is so busy and there is not enough domestic staff pails get filled to overflowing, packs and cord ligatures are not always made up and needles, syringes run out.


I managed one trip to the staff toilet where there was no paper luckily I was prepared and had my roll with me. The light was broken and obviously the night staff used the candle that was on the filthy sink as there were used match sticks all around the basin.

I do find it frustrating that I can’t always communicate with the women. Some speak a little English but even then it is difficult. I am learning to say ‘push’ good’ and ‘well done’ in Chichewa, it’s a start.

Going out with Jean twice next week to villages, so watch this space.