Bangladesh, Days 4–7: Mentoring midwives

Firen and Sima, a Bengali midwife, listening to fetal heart tones in the clinic.

Mentoring the Bengali midwives has been without a doubt the sweetest part of this journey. The midwives are all quite young, and they come from far corners of Bangladesh to be here on a 2 month internship rotation. Some of them have yet to pass their licensing exams. None of them are more than 2 years out of school. After their 2 months here, they will return to their hometowns to work in hospitals and clinics and homes across the country.

They are working hard at the basics. Taking blood pressures, palpation, fundal height measurement, listening to fetal heart tones, and critical thinking are skills that we are working on together. The idea that they, as midwives, are the guardians of women and women’s rights is a new concept to many of them.

Midwives organizing prenatal vitamins to hand out to patients in the clinic. Photo posted with verbal consent.

On Tuesday, we did a one-hour training session for the midwives. The session covered infection control — we talked about the importance of hand washing, wearing gloves, cleaning equipment, and appropriate use and disposal of needles.

Firen teaching the midwives about infection control. The refugee camps are very dirty. There is a lot of trash and a lot of illness. These skills are absolutely critical, especially in this environment, to prevent the spread of disease.

Angela and Autumn, our other 2 expat midwives, teaching about the proper way to give injections, including keeping needles sterile, and disposing of sharps properly. Photo posted with verbal consent.

Lipi and Aysha, both midwives, washing their hands outside the clinic before starting the day’s work! This type of mentoring is all about teaching and then reinforcing, reinforcing, reinforcing. We try to be there as much as we can at the clinics, making sure things get done the way they should. And making sure the midwives understand WHY things should be done that way. Otherwise, it doesn’t stick. Photo posted with verbal consent.

There are 21 midwives and only 3 of us expat midwives, so we are a bit short, but we do what we can. The last few days, I’ve spent a lot of time with Sima, a midwife at Jamtoli clinic.

Sima, one of the Bengali midwives. Photo posted with verbal consent.

She and I have developed a sweet, fairly seamless process of getting patients in and out of the clinic and making sure things don’t get missed, despite my nonexistent Bangla language skills. Her English is pretty good, and between that and some pantomiming, we can usually manage to understand each other.

Me scooting between clinics by tom-tom, dropping off supplies in different areas of the camps.

It’s important to note that midwifery, as a certified medical profession, is only 3 years old in Bangladesh. That means that the very first certified class of midwives graduated only 3 years ago! …When I was training to be a midwife, I benefited greatly from the experience of the many midwives who came before me (and I still do). Some of the midwives I trained with had been catching babies for decades. But these newly-minted midwives don’t have the advantages I had. In some ways, they really only have us… to help them understand how special it is to be a midwife, and to honor what that title means. So I hope that we are able to hold up our end of the bargain, and model truly compassionate, woman-centered care. Because even with the most basic of supplies and facilities, a lot can be healed with just tenderness.