Progress and Persistence

I hope you are all well and enjoying the beginning of 2025. They are still saying Happy New Year here, so I say it again to you!

Sue and I have decided that I will do an update on the subject matter I teach to the Ugandan midwives today, and Sue will do an email in a few days about hers.  

At all our trainings I teach on high-risk pregnancy care, but specifically zero in on postpartum hemorrhage, preeclampsia/eclampsia and team communication in emergencies, since those are the main areas that lead to mother and baby loss in Uganda.   

After years of teaching, we see that the east and the north areas of Uganda have taken our instruction to heart and are practicing better than they ever have.  One midwife stood up confidently and told us about the 3 women she had in labor who were all at risk for a postpartum hemorrhage. Two did not hemorrhage, but she was set if they did with supplies and a plan for help from an assistant.  She then went onto describe how she saved the third mom who was on her 22nd pregnancy and had a massive hemorrhage after the birth. Because of this midwife’s good planning and quick actions, the mother survived.  Everyone clapped. I have to admit the midwives in the audience all laughed when they saw my jaw drop with the “22nd pregnancy” statement.  This woman now has 15 living children.  I cannot imagine her life, but am so proud of the midwife who planned and gave excellent care and advocacy so this mother did not die from her hemorrhage.  These stories now abound in the east and the north. 

Our 250 pounds of supplies, granted by some MN Rotary clubs, were all passed out at our conferences and all we have left is our personal luggage. Midwives applauded when we gave them headlamps to assist in seeing the cause of hemorrhage and having the ability to do repairs (if necessary) with two hands.  They also love the laminated posters (see photo) about preeclampsia, national protocols and teaching sheets. We thank the many Ugandans for hauling our stuff into conferences, hospitals, and our hotel rooms!

Despite the great progress, the work remains for more teaching, training, skills and advocacy based on this story we heard at one of the hospitals: 

“I had a patient who went to a lower center (a smaller hospital) with a severe headache. No one took her blood pressure or checked her urine for protein to rule in or out preeclampsia.  Instead, she was told to go home and take the equivalent of Tylenol.  It did not help and she came back.  The care providers put her in an ambulance, but not with Magnesium Sulfate in her system to prevent a seizure, transferred her to the big hospital where she seized and died as she was being driven through the gate.”  I wonder how many children she left behind?

So, our work remains, especially in the west. I am encouraged, but not done.  Preventable maternal death and poor outcomes will drive me until I feel our teaching is throughout the country and the Ugandan midwife leaders (of which we have a few great ones) are training their own all across this land.  

Thank you for all the support, love, prayers and help.  We feel them and God’s guidance, safety and provision each and every day we are here.

With love and gratitude, Lynn.   

The teaching poster for mothers to learn the signs and symptoms of preeclampsia: