Midwife Vision’s Head of Clinical Education in HBB (Helping Babies Breathe), Sr Chacky, is off to the ICM African Regional Conference to represent Midwife Vision!

On the eve of the Team’s return to Tanzania this month (November 2019), read about how Dr Moir found his 5th trip to Tanzania and why he keeps coming back. He completed his 5th trip in July 2019.

This was my 5^th trip to Amana, an eagerly anticipated event in my annual professional calendar.  As Jan says, it is such a pleasure to feel the warmth of the greeting from the doctors and midwives at Amana, many of whom we have known from our first visit.  The labour ward, where I spent most of my time this year, is frantic and busy.  And sad as some of the events are that we see, there is rarely a moment without a smile, or a laugh, as we work alongside our Tanzanian colleagues.  The senior doctors and midwives have considerably more experience than me, dealing with emergencies and a long list of caesarean sections on a daily basis.  I was kept busy helping out, assisting with difficult births, and teaching the many students and young doctors and midwives, several of whom travel from overseas to work for a few weeks at Amana.  We learn from each other.  I saw a few women, who with a little patience and occasional assistance, who were able to have a vaginal birth rather than a caesarean section, which would have meant that all their future babies would be born by repeat caesarean section.  And on our second last day, we had a difficult breech birth, with a very unresponsive baby, who was immediately resuscitated by Jan and Chase, using exactly the simple methods that Midwife Vision is teaching to the staff here.  Within two or three minutes, we could hear the baby crying loudly from the resuscitation bench, and he was returned to his mum in great shape.  The one. 

How can you help?

 A cup of coffee cost $5 and we can buy a delivery kit for these mama’s. If you donate $5 per week it gives a gift of love to the babies and mamas.         

Its not much to us but its life changing for the mammas.  Next time you buy a cappuccino, or latte imagine one mama and baby and in that moment, you would have changed the world for one baby or one mama.

So we have finished the July 2019 trip to Tanzania with the Medical Team. By the time this article is published I will be at Medical School studying hard: on another adventure. The next trip to Tanzania that the Medical Volunteer Team will take will likely by in November 2019 and then again between February and April 2020.

Firstly, I wanted to thank all of our incredible donators! From the knitters/sewers/crocheters of beanies, booties, blankets, cacoons and Stillborn baby kits (Linus Sunshine Coast especially do a wonderful job with this), to the regular monetary donators, medical equipment donators and avid supporters on the website and beyond: THANK-YOU!!!!!!!!!!!!! (Please see the cover image for this article which is the result of all these donations and more which will be sent to Tanzania via air and/or ship in time for the Team’s return to Tanzania in November).

Thus far Midwife Vision is working hard on gaining funding and developing our plans for our SHINE Program and Midwife Vision Apps. The Midwife Vision App for Mothers is designed to help improve their help literacy and be an easy to use source of information for Android and IOS which involves videos, offline functions and multi-lingual elements that caters for women in rural and remote areas who are illiterate. The Midwife Vision App for Skilled-Birth Attendants (such as doctors, nurses, midwives and others) is designed as a healthcare tool which explains what medications to use and why, what emergencies you might encounter and how to deal with them, etc.

Both tools, Midwife Vision hopes, will gain funding and be implement by 2020. The Midwife Vision SHINE program is explained below:

SHINE

The entire SHINE Initiative is underpinned by the commitment to, and concepts of: Research, Reproduction (the able to reproduce success in different countries and regions), and Capability (the capability to provide care and achieve success) and Collaboration for the purpose of improving Maternal and Neonatal Health in Sub-Sahara Africa (from pre-conception to postnatal care).

Capability and Reproduction

Education & Training programs (Training)*

1.Pre-eclampsia/Eclampsia/Hypertensive Disorders of Pregnancy

2.Prolonged & Obstructed Labour

3.Sepsis (maternal and fetal)

4.Primary Post-partum Haemorrhage (PPH)

5.Very Early Neonatal Death (VEND)/ Helping Babies Breathe (HBB)

Augmentation of Supplies and Equipment (Tools)**

1.Medication

2.Consumables

3.Infrastructure

4.Medical and Specialist Equipment

5.Maintenance Services

Supportive Resources & Technology (Innovation)***

1.Midwife Vision SHINE App for Mothers

2.Midwife Vision SHINE App for Skilled-birth attendants (SBAs)

3.Multi-media education in Antenatal and Postnatal Clinical settings

4.SMS eHealth for Maternal and Child Health

*Each training program is underpinned by the Becker Model of Education and Training (see later).

**With the aim of providing the necessary amount and quality of equipment and supplies to support the efforts of the SHINE training and education programs. “Tools” are not to be the only or unnecessary supply of equipment and consumables.

***New ways of implementing changes in Sub-Sahara Africa to improve maternal and newborn health that are cost effective, efficient, impactful, innovative and sustainable.

The arrival of the Team into Tanzania is a culmination of many details, Visa, immunizations, anti-malarial, medical equipment, arranging flights and all the details around that.

Plus packing the medical equipment, we only take what we can’t buy or access in Tanzania and Chase liaises with Micheal our Operations Manager in Tanzania, arranging the most needed letters from Dr. Shimwela to help us through customs at the airport.

I am always filled with excitement, nervousness and mixed feelings every time we return. As we leave Australia & look forward to the 14 hours to Dubai and further 6 hours to Dar es Salaam, I love the final descent into Dar, the closely packed houses with their bright blue roofs, the trees, the churches dotted in amidst the villages and neighborhoods, people walking and riding down  little dirt tracks and then I track the roads to Amana hospital from the airport and know that in a few short hours we will be in that hospital into a whole new world.

Going through key skills and running drills in my mind – I  practice my checklist, in my head – revisit the steps for Breech deliveries, shoulder dystocia, PPH, and Neonatal resuscitation – all of which we see almost every week and  certainly at times neonatal (Baby) resuscitation – a daily occurrence …….I have a note book with my key information in it.

Running drills of the emergencies seems to settle my mind and gives me a sense of purpose and focus on the mother the baby and my fellow colleagues.

 There are always areas that I want to hone down and improve. Every trip I want to learn something, get better at stitching, better at care and finding new techniques together. The midwives are very skilled in some things and not in others. We teach each other. The training clinic is for teaching Midwives, Nurses and Medical students all the main skills required to stop the top five causes of mortality of mothers.

 And running through my mind as well, as we fly over the sprawling chaotic city of Dar as salaam …..I reflect on the many friends we have made and midwives-nurses which are as much part of our clinical professional life here as they are friends. We have many times stood shoulder-to-shoulder managing emergencies, beautiful and wonderfully peaceful deliveries, held mothers and cried who have lost a baby and held mothers and cried to celebrate her brand-new baby. Such joys and such heartache.

You can’t help but have doubts yet hope, excitement yet nervous energy …..for this land of contrasts has woven a place in our hearts.

As we return this trip – Chase, Dr. James and myself – will the effort we have put in make a difference or are we simply treading water, does it really matter what we do?

Is what Chase & I started together making any inroads into Neonatal resuscitation, saving babies one breath at a time- and the mammas who carry the babies for nine months – they deserve the best care – the best outcomes.

And after the first few minutes on the first day back  on the ward – the answer is the same- yes it does – to the one mamma and the one baby who we touch with medications, equipment, professional care, skill and most of all a mission of their survival, Happiness, by Intervention Nurturing and Education.

That’s the mission of our S.H.I.N.E program – S= Survival H= Happiness (because it’s not enough to survive – we must have healthy mammas and babies) I = intervention – skilled birth attendants with the most up to date skills – not old antiquated harmful methods, Nurturing and Education of the key birth attendants, Nurses, Midwives and Doctors.

As I sit on a chair at the house in Dar es Salaam, on the Sunday afternoon when we arrive – I watch the children across the dirt road play a game in the dirt – their laughter is the same as any child around the world and its delightful. The sounds of life unfolding on a Sunday afternoon, singing birds, chicken crowing, little three wheel mini taxis moving down the road as people return from church,  the ice-cream man comes through ringing his little bell, an old  man selling lemons sings out his wares as he walks down the street, the kids and mammas  fill their buckets across the road at a water station – voices of the men at the café talking and sharing jokes, the little charcoal fire cooking something that the mamma is selling, the old man who walks every night who has had a stroke – the rhythm is different, soothing, chaotic and very Africa. I can’t help to contrast it to home, sitting out having a nice glass of bubbles watching the sun go down on the farm, a whole world away…different rhythm, different sounds.

The hospital is as we left it – as busy as ever with so many patients so many babies being born every day. The midwives and Doctors we have known now for years greet us as old friends and within minutes we are in the thick of delivering babies and managing the myriad of details involved in the 13 bedded labour ward that sees between 80-100 babies a day being born. About 14% are caesarean sections where the mother requires an operation to get the baby out for so many reasons. Mothers pelvis might be too small, and the baby is stuck, or the mother is bleeding, the mother has high blood pressure, which is life threatening, and so many other reasons. The lifesaving operation is a gift and having Dr James on this trip as truly wonderful as he took Chase through the operation as she acted as his scrub nurse and assisted him in some four cases. For Dr James it must be so tiring, teaching each case and working with less than the best equipment – a challenge all round.

Chase exhilarated as she takes me through her day in theater with James and the Tanzanian team, the Anesthetists (midwives who do the spinals anesthetics), old man shikamoo who sterilizes all the instruments. Its here amongst these professional colleagues that Chase soaks up the opportunity knowing the time spent with James will assist her in all her classes as she starts her journey to become a Doctor.

She starts Medical school in September at the Cyprus Campus of the St George London University.

Its hard to articulate the intensity of the ward, the smells of sweat, body fluids, flies, old bins desperately needing emptying, blood dripping on the floor, and the keen cries of mother calling for us to help them and babies crying soon settled with a breast – and in amidst organised chaos, we teach midwifery students, medical students and new staff, side by side with our professional colleagues. We try and give the best care within an environment with so little in the way of supplies, lack of drugs, gloves, soap, and even basics like running water.

We come for the one: the one baby and mother we can help.

Such a privilege to deliver a baby, and so hard to capture truly the mothers smiles as they hold their babies after long arduous labours, no baths, no water, no heat packs, no pain relief of any kind, no food unless family brings it along – and when they see their baby the tears of joy flow. It’s a universal joy and one that creates an atmosphere of professional pride that a team made all the right decisions to get the baby delivered safe and the mother safe.

Every week we hold training in the Midwifery Training clinic knowing that grass roots training is key to successfully transferring new skill, as is unlearning old antiquated practises.  The Uncle Gilbert Scholarships is still running with Sister Theresa Chacky in her final years of studying “O” levels and teaching every week at the Clinic in Midwifery Education.  When she has passed her O levels Sister Theresia Chacky can then once again enter the labour ward and teach hands on. The Tanzania Government changed its rules overnight so that even if fully qualified if you don’t hold “O” Levels you cannot work professionally. I won’t comment of the rule change only to say the midwifery profession, which is desperately short worldwide especially in Third world, lost many many midwives.

We see change happening slowly. Its with much excitement that we can share with you that Amana hospital, out of 28 regional referral hospitals in Tanzania – this hospital where our training clinic is – they have seen the biggest drop in Maternal Deaths and have received an award from the Ministry of Health.

Midwife Vision feels so proud to be part of this wonderful achievement.

By Annette Meyer

Thinking back on my recent visit to Tanzania to volunteer in the labour ward at Amana hospital brings to mind all sorts of feelings and memories. The familiar smell of the building as we waited for our luggage in the humidity following the heavy rain, the constant babble of voices at the airport, and the hassles of the customs officers as they inspected the bags containing precious medical equipment that Midwife Vision was bringing into the country to help conditions for the mammas in the hospital. And then the relief as we were allowed to leave at last with our cargo.

The welcoming smile of our ever-loyal driver, Michael. So much rain, big puddles, flooded roads, a wheel chair half submerged in water in the hospital yard. Beds of mammas writhing in pain calling, “help me nursie”, “doctor”, “mamma”, “God help me”.  Midwives rushing here and there with deep concern and caring for the mammas. Midwives administering Panadol and codeine, followed by the silence of pain relief.

The welcoming smiles and cuddles of the Midwives at Amana hospital, calling “mambo Bibi” (hello grandmother), habari (hello). The cries of new born babies, sometimes with relief that they have survived the birth experience, such helpless bundles of joy, the joy of weighing the babies, dressing them in the beanies, singlets, and booties or socks that such loving volunteers have made, wrapping them in their mamma’s kanga or a warm blanket so caringly donated for those little ones who have endured a particularly long birth or a caesarian section, taking temperatures, listening to heart beats, putting antibiotic ointment in their eyes to guard against infection.

Cleaning the baby bench and spraying to discourage the flies, comforting the crying babies, waiting for their mamma’s to be stitched up before having a feed. Observing the transformation from a distressed mamma wracked with pain to a tired but relieved mamma holding her newborn with such love and pride, big smiles and Asante sana (thank you very much) to the nurses and midwives who helped her through the long hours of labour.

The aching legs from long hours of standing, emptying urine bags, washing down beds after a delivery and putting a clean Macintosh on the bed, rushing from one mamma to another, rubbing backs to relieve the pain, holding the hand of a frightened mamma who is experiencing child birth for the first time, and answering requests of the midwives who are so busy with one birth after the other.

And then at home after a busy day, a welcome shower to freshen up, a delicious meal that chef had cooked, a fun evening watching TV, and lastly the welcome bed. (until the alarm goes off next morning and it all starts again).

But would I change anything? No, not at all. Would I go again? Absolutely! It is so rewarding to help such a hard-working group of midwives, and to help those mammas and the beautiful babies. 

Capt. Jan Becker and Chase Becker along with the Team Leader, an Obstetrician and Gynaecologist, Dr James Moir, the Team is returning to Tanzania this July. The Team will be focused on completion and streamlining of surgeries and also continuing the Midwife Vision Training Clinic SHINE Program. Wish them the best of luck as they travel with over 200kg worth of equipment, knitted goods (i.e. beanies, blankets, cacoons) and other donated supplies and equipment. Midwife Vision thanks all the knitters, sewers, private donators, corporate sponsors, medical professionals including nurses and midwives who have donated medical equipment, and our avid supporters. We will let you know how it goes!

Join us in wishing Jan, Chase and the Support Team safe travels to Tanzania today.   They’re off to Amana Hospital to once again lend their much needed helping hands, and continue the education programs to improve the health of both mother and baby. Good Luck!

Congratulations to Jan on receiving an Order of Australia for her service to community health!

Check out the article below featured in the Sunshine Coast Daily acknowledging Jan and her prestigious award.

Fearless Pilot, courageous midwife honoured

by Tessa Patrick, 25th Jan 2019

JAN Becker was boarding a flight home from Tanzania when she received an email telling her she would be receiving an AM.

The coveted honour is to be bestowed on her for service to community health through neonatal organisations, and to aviation, but she will be too busy working with midwives in Sub-Saharan Africa to be there to receive it.

The nurse, co-founder and CEO of Becker Helicopters and founder of Midwife Vision, has donated her knowledge to mothers and midwives in third-world countries.

“If you have success in one part of you life, be it time, money, opportunity, skill, you should use it globally,” she said.

“The skill that I have, my skill can be of use there.”

Both mother and daughter ventured to Tanzania and saw birthing atrocities they never expected; mothers in labour bringing their own chord clamps, equipment for stitches and even clean water if they needed a drink.

Then when they returned home they had four to a bed and minimal education on how to help resuscitate a newborn.

“The first time we went I said to Chase, we’re either never coming back or we can’t stop coming back,” Mrs Becker said.

“But through the education of mums you change the face of outcomes.”

This Australia Day Jan Becker is developing a new training plan to help the midwives she works with, but she wouldn’t rather be doing anything else.

“It’s exhausting, inspiring and heartbreaking,” she said.

“We’re only there four times a year but if we give local midwives training, they’ll be able to pass on the torch.”

When she isn’t at work saving lives, she’s at her other job – managing a team of 100 employees, 30 students and 20 helicopters.

“Flying a helicopter is the most fun you can have with your pants on,” the CEO laughed.

Although her two passions couldn’t seem more opposite, the go-getter said there were more similarities than most thought.

“If you work as a midwife and fly a helicopter; there’s a checklist, a certain way you do things and if you deviate you’ll hurt someone or yourself,” she said.

“It’s a very disciplined profession but it is so rewarding.

“We fight fires, help with border patrol – in another way you’re serving the community you share the sorrow and see the happiness.

“And what I love about aviation and helicopters is training the next generation. Again, you’re passing the torch; it’s such a privilege.”

While Jan may seem like an unattainable level of superwoman, she said it was easy for people to use what they have to give back.

“We have people across Australia and New Zealand knitting us beanies to keep babies warm,” she said.

Others forgo one cup of coffee a week and donate to a $5 birthing kit, which includes clamps and fresh sheets for the women to give birth on.

“You don’t have to change the world with millions, you can do it with one cup of coffee,” Mrs Becker said.

“It’s powerful and in that one moment you’ve connected with a mother.”

Jan Becker was awarded her AM for service to community health through neonatal organisations, and to aviation.

Neonatal organisations:

• Founder, Midwife Vision, current.
• Instructor, Neonatal Resuscitation, Dar es Salaam, Tanzania, current.
• Clinical Midwife, Amana Hospital, Dar es Salaam, Tanzania, current.
• Nurse, Buderim Private Hospital, July 2013.
• Former Nurse, Nelson Polytechnic, Nelson, New Zealand.
• Former Registered Nurse, Renal and Plastic Ward, Tauranga, New Zealand.
• Former Midwife, King George V Hospital/Royal Prince Alfred Hospital.
• Former Midwife, Neonatal Intensive Care, John Spence Nursery, King George V Memorial Hospital/Royal Prince Alfred Hospital.
• Former Midwife, Kimbe Maternity, Papua New Guinea.
• Chair, Cherish Foundation and Deputy Chair, Finance and Audit Committee.

Aviation:

• Board Member and Treasurer, Helicopter Association International, since 2015.
• Co-Founder and Chief Executive Officer, Becker Helicopters, since 1996.

Awards and recognition include:

• Outstanding Alumnus, University of Sunshine Coast, 2017.
• Recipient, Telstra Queensland Business Women’s Owner Award, 2014.
• Recipient, National Telstra Medium Business Awards, 2013.
• Recipient, Queensland Premier’s Innovation Export Award, 2012.

We’re on our way!

Jan, Chase and Mike are bound for Tanzania to launch a new program initiative, “SHINE”. 

Survival  |  Happiness  |  Intervention  |  Nurturing  |  Education

Survival and Happiness because of Interventions, Nurturing and Education

SHINE is a training program dealing in the prevention and management of the Top 5 causes of maternal mortality and over the next two weeks we plan to:

• Set up the next 6 months of “SHINE” professional development
• Continue the on-going work in HOT Resus training and the Helping Babies Breathe program
• Set up the emergency trolley with the basic EmOC functions

It’s going to be a very productive two weeks!

Follow the link to find out more about our SHINE program

https://www.midwifevision.org/index.php/project/shine/