Journey of a Volunteer Midwife in PNG

by Leonie Semmens (Registered Midwife, Registered Nurse)

img_6124Imagine not having access to clean drinking water.  Imagine not planning for your child’s future until they are 4 or 5 years old, because the rates of severe illness or death suggest that your child will not survive past this age.  Imagine rape being a weapon of war.  Imagine having the opportunity to help in these situations.

My name’s Leonie.  I am married with three children.  I started general nursing when I was 17, straight from school and I always wanted to be a midwife, but I didn’t get accepted to hospital training.   So I had kids first and then applied to uni to study midwifery when my kids were older.  I blubbed (not just cried) through the interview because I was so nervous.  It was a few days before my 40th birthday and I thought for sure I wouldn’t get accepted.  Surprise, surprise I received a letter of offer, so started midwifery training in 2007.  I really enjoyed the training, but because I had been a nurse for over 20 years and was competent in my role as a nurse, really struggled with being a student in the workplace and not being able to perform tasks unsupervised.  I overcame this with the help of a senior midwife’s reassurance.

One of my friends from school and nursing training had been volunteering in the Democratic Republic of the Congo (DRC) with a group based in Brisbane for a few years.  They went for two weeks every year and I kept telling her that they needed a midwife on the team, because of the high rates of obstructed labours and resulting fistula’s (holes that develop between the bladder/bowel and vagina due to pressure from the baby’s head in obstructed labour.  I was to learn that more fistula’s are caused by rape with weapons in this part of the world!  These fistulas cause leakage of urine, faeces or both and the women are ostracised from their villages because of the continuous smell and their inability to contribute to daily living).

While waiting to join this group, I was accepted to go with a health group to Viet Nam in November, 2009.  There were three midwives and other health professionals, as well as non-health volunteers.  We travelled to Vung Tau on the South China Sea.  It was a great group and we also helped in the community and at a local orphanage.  We did education and worked alongside the midwives in two local hospitals.  It was two way learning with us learning from Vietnamese midwives also.

Finally, I was asked to join the African group – then known as HEAL (Health, Education, Assistance & Leadership) Africa.  I was nervous and excited, and it was expensive.  I entered a prawn peeling competition on a radio station that was to take place on Australia Day, 2010.  I won!  I peeled 17 prawns in two minutes and won $5000.  In September that year, I travelled with this team to DRC.  What an eye opener.  The HEAL Africa hospital is located in Goma, just over the Rwandan border.  It is in a compound and our accommodation was in a compound patrolled by guards’ carrying AK47’s.  The hospital had no running water and an unreliable power source.  The occupancy rate was 160%, so some patients shared beds.  Our group worked alongside local staff and facilitated education sessions.  We were ever mindful of the need for personal safety and always explored in groups of two or more.  When I look back on this time, I have good memories, but I still have sad memories.  The poverty and isolation is huge.  I plan to return to DRC with this group, but not in the near future.

One of the nurses I met in Vietnam encouraged me to apply for a position on the AVVRG (Australian Vietnam Volunteers Resource Group) team going to Ho Chi Minh City (HCMC) in 2012.  My oldest daughter, Emma, was studying nursing at the time and I encouraged her to apply also. We were both accepted and really enjoyed our time with this group in HCMC.  I spent my time between two hospitals in that have rates of more than 50 000 babies per hospital per year.  This trip was about education sessions and building a rapport with our Vietnamese colleagues.  Sometimes all that is needed is acknowledgement of the hardships that are faced in daily working lives.  Emma also had a great experience.  Thankfully she didn’t spend much working time with me, but was able to go to other hospitals and witness more exciting things for her than births!  The evenings were spent with colleagues we had got to know and other locals.  I went with this team again in 2013, with a similar experience.

In 2014, I attended the International Confederation of Midwives Conference in Prague where I accidentally heard a woman from Melbourne speak of volunteering in PNG.  I was overcome with emotion at her description of birthing and nursing practices.  My father had served in PNG during WWII and spoke little about the war, but spoke very highly of the Fuzzy Wuzzies.  As absurd as this may sound, I felt this was a way for me to give back to the people of PNG.  I applied and was accepted onto the Highland Foundation team.  Emma also applied and we went together in September 2016 to Goroka in the Eastern Highlands.  Emma is now an Intensive Care nurse, so we would have our own work to do at the hospital.  PNG is only two hours from Australia but the conditions in the hospital are the worst I have seen.  The midwives are fantastic and do the best they can with the resources they have.  One day, oxygen was desperately needed in ICU and the hospital’s supply was depleted.  This would be all over the headlines if it happened in Australia, but here, no-one thought anymore of it.

Emma and I were very aware of our personal safety and didn’t venture out the first week that we were there, until a group of Neonatal nurses arrived.  They gave us confidence to go out, but still be mindful of our safety.  I was fortunate to travel further into the highlands with this group who train Village Birth Attendants (VBA’s).  Women in remote areas who can’t travel to a hospital (although they are encouraged to before they birth) sometimes are lucky enough to have a VBA nearby to assist with the birth.  Sometimes the women or the VBA’s travel great distances for the births.  The testimonials of the VBA’s who had attended education sessions previously were amazing.  They spoke of being able to resuscitate babies since learning this at the last education session they attended.  Previously these babies would have been left to die if they weren’t breathing at birth.

We took over equipment for the hospital, some of which was put away, as the staff don’t know when they will get supplies next.  Emma is now on the planning committee to establish a new ICU at Goroka Hospital.  I worked alongside midwives in labour ward and the antenatal clinic and formed friendships with some.  I will return to PNG, but not in the next 12 months, as the election is coming up and there is much unrest with more to come.  We collect equipment to take.  A lot of the equipment that we use here is disposable, so if we can, we clean it thoroughly and take as much as our weight limits allow.

I feel very fortunate to have had these opportunities and would not be able to without my supportive family.  The resourcefulness of the women I have met really inspires and amazes me.  I get a lot out of these experiences and am ever mindful not to be paternalistic..  We take a lot for granted and are very fortunate to be where we are.  I could go on, but feel I would be getting too philosophical.