She walked into the auditorium with a khanga wrapped around her chest, her large belly pointing forward, a sway in her back, and moaning loudly as the pitch of her voice raised then lowered in the throes of labor pain. The assistant led her to the table where she lay down, continuing to cry out as she rocked side to side, reaching for her lower back in discomfort. The students in the auditorium that held 300 people were mesmerized, leaning forward out of their chairs to get a better view of the drama that was unfolding. With the assistance of the midwife she delivered the baby, it’s plastic head coming through the synthetic abdomen strapped around her waist and no longer hidden by the khanga; the doll was born into the white washed room. The doctor came over to argue with the midwife over the care of the woman, and as they argued the narrator pronounced over the microphone that due to neglect, the woman who had just given birth had died from a postpartum hemorrhage. The morgue was called, two students walked in and carried out what had just been the birthing mother by wrapping her in a cloth and the drama was complete. The audience burst into applause, hooting and hollering.
Six weeks before, I myself had entered the nursing skills lab and to the surprise of my students was moaning in pain and crying out for help due to my own impending birth. The room was hot as the afternoon sun beat down through the windows. The whirring fans were no match for the intensity of the heat and as I pushed that baby out I truly felt faint from the heat as my head rested against the iron bed frame. The two students who were in on the surprise pregnancy and delivery assisted me onto the bed and demonstrated managing my birth and ensuing postpartum hemorrhage as the other students watched me with wide eyes. Up until this day I was known as being strict but fair, demanding punctuality and at times too serious. Yet today I had let my figurative hair down as I rolled around on the bed with the birth simulator tied to my abdomen, hidden underneath my scrub top, crying out for help as I pulled the fake lever to release the blood after ‘my birth’, letting the red water roll down onto the bed and drip onto the floor causing the panic it was intended to.
I came to Tanzania to teach midwifery. To find ways to cross the cultural bridges of language, systems and resources to share my love of caring for women. I am now in the club of people who know that teaching is really hard. I’m often left wondering if I got my point across, if I am making sense, if I’m being too strict or too lenient, if the students are staring at me with blank faces because they don’t understand my American accent, or the content I’m explaining, or if they are just dreaming about what they are going to have for lunch that day.
In January I was asked to advise a group of nursing/midwifery and medical students who were planning to put on a seminar in March about postpartum hemorrhage. I gladly agreed despite having no idea what this seminar would look like. Over the course of a few months, I had the opportunity to act as a consultant to the students. They led, planned, organized and executed the seminar that was intended to reach over 200 students. I was there, along with a few Tanzanian faculty, to offer input on how to teach hands on skills like suturing, knot tying, running childbirth simulations, making fake blood, and performing manual vacuum aspirations on papaya. But the seminar was theirs. The work was their own. As they each led their own skills lab station during the seminar, I walked around the room with pride and admired the creative ways they had chosen to teach each skill. They had taken empty plastic water bottles to demonstrate an empty uterus, made posters to show the likeness of a papaya to a uterus, used cardboard to make their own knot tying stations and sutured through foam as they demonstrated a locked and unlocked stitch.
When my own student, who had ‘delivered’ my baby that hot day in the skills lab six weeks ago, herself walked into the auditorium moaning in labor to demonstrate postpartum hemorrhage to what were now her students, I smiled broadly with pleasure. …with pride, mesmerized.