Rachel Stokes

It’s a long way from Staffordshire to Dar es Salaam, the largest city in Tanzania.

But for 38-year-old mother of two Rachel Stokes the chance to deliver care at Amana Hospital, which sees on average 80-100 births each day, was exactly the challenge she was looking for on route to becoming a midwife.

“Experiencing something completely different from UK midwifery and throwing myself in at the deep end were challenges I craved,” says Rachel, whose own experiences of the positive impact midwives can have on women and their families inspired her to study midwifery at University of Staffordshire.

Broadening Horizons

Rachel said: “The opportunity to choose an elective placement at the beginning of the third year rather than at the end inspired all of the students on the course, broadened our horizons and opened up a world beyond the local trusts in which we had been based for clinical practice.

After deliberating over which destination would offer her the best experience, Rachel and a fellow group member from the course set their sights on Tanzania.
On arrival the size of the task soon became clear.

“Culture shock began to set in, being an ethnic minority and not being able to understand much of what is being said around you offers an insight into the experiences immigrants may have in the UK,” says Rachel. “Our commute to work was an experience in itself, boarding an overcrowded un-roadworthy minibus (a Dala Dala), standing for much of the journey pressed up against other passengers, bouncing through deep pits in the road. By the time we arrived at the hospital we were already weary, sweaty and filthy with dust.”

Cultural Differences

Supervised by Sister Grace, Rachel says she wasn’t shocked by the conditions as she was orientated around the Hospital.

“The labour ward had eight beds; there was no privacy, all the women were visible to each other and to anyone passing through the ward. No bed linen was provided, beds were flat, hard couches, there was no drinking water available on the ward. The conditions did not shock me, it was as I expected and had been prepared for, however, privacy, informed consent and choice were absent for women in labour and I found this quite difficult.”

Observing deliveries on her first shift, it wasn’t long before she was on the frontline.

Rachel said: “We were hands-on delivering infants on our second day. Newborns were wrapped in a Kanga (colourful cloth) and placed on the “shelf” under a light bulb for warmth.

“Most women laboured quietly, alone, calling out only when the head was visible. We offered compassion, rubbing backs, talking softly to the women, trying to reassure them with the few Swahili words we knew and lots of nonverbal communication.”

Back in the UK

Now back in the UK, and with additional experience at Newcastle-upon-Tyne Fetal Medicine Unit, where she was part of a team delivering maternity care to women with complex medical conditions, Rachel reflects fondly on her experiences.

“We had some amazing experiences, for example observing breech delivery of twins, conducting our own deliveries, supporting each other and communicating with women.

“Ultimately we proved to ourselves that we can provide high-quality midwifery care in difficult situations and gained a huge amount of confidence in our abilities, skills and intuition.”

“Most women laboured quietly, alone, calling out only when the head was visible. We offered compassion, rubbing backs, talking softly to the women, trying to reassure them with the few Swahili words we knew and lots of nonverbal communication.”

Year of graduation

2014