On a chilly Wednesday morning, I find myself inside an examination room. Being a student myself, I had a longtime imagination of what an examination room looks and feels like, but this one is unlike any other I have been to before.
It’s one with beds, medical equipment, birthing mothers and new born babies. Although volunteers and in some cases dolls are used, for students of the Kibuli School of Nursing and Midwifery (KSNM), this exam is done in a nearly real life labour ward.
And just like in the real world, there are no answer sheets or benches for midwives to sit on. Your actions earn you marks from the watchful invigilators (Professional Midwives).
Any slight mistake could lead to failure. Failure in this exam could in the real world translate to the death of a mother or newborn child.
☝The exam is done in a nearly real life labour ward with watchful invigilators (professional midwives) awarding marks
This exam challenges students in five key areas (stations) that are crucial in the birthing process, having not more than 10 minutes to complete each.
In simple terms, from the moment a pregnant woman steps into a labour ward, up to when the baby is handed to its mother for the first breastfeeding.
Although this may seem simple to some, consider this; there are no specific actions to perform at each station. And just like in the real world, not all mothers give birth normally or do their babies come out breathing.
So the moment you walk to a station (in the exams), you don’t know what to expect.
☝Kamusiime Gloria, an examinee gives the “OK” sign to confirm a normal heartbeat of a newborn baby
☝Moments later without notice, she is given a scenario where the baby’s heartbeat has stopped and she has to perform resuscitation.
To get a first person account of how challenging the exam is, I talked to Anek Sandrina who is pursuing a Diploma in Midwifery at KSNM.
Unlike other students who did the exam, Anek already has a certificate in midwifery, making her the perfect benchmark to find out how challenging the exam is.
According to Anek, it is the fourth station that challenged her most, also known as “The initial assessment of the mother”. Anek was given a scenario of a pregnant woman who was having convulsions (uncontrollable contractions of muscles) but with normal B.P (Blood Pressure).
☝An invigilator (with yellow file) watches as a student examinee performs “The initial examination of the mother”, a crucial step in the lead up to delivery
According to Anek, she “couldn’t take any intervention to help the mother out”.
The intense and no room for error nature of these exams is challenging, but according to Sr. Nakigudde Fatuma, a Midwifery Tutor and the Deputy In charge Clinicals at KSNM, “This is like a preparatory examination for the forthcoming state final exams which they (students) do at the end of their course”.
The purpose of these exams is to “assess whether students have understood what has been taught”, she adds. The pre-state exams consist of 4 written papers with different subject combinations as per discipline of training.
The practical puts the student’s class skills to the test in a nearly real life labour ward. All this is because in a few months’ time, these students will be handling real mothers with convulsions, and newborn babies in need of resuscitation.
So the harder they are trained and tested now, the better they will perform when faced with real challenges in the labour ward. KSNM passes out an average of 35 midwives a year with Certificates or Diplomas.
And with Uganda making great strides in as far as maternal health is concerned, it is the future responsibility of these midwives to make sure that pregnancy as a cause of death is eliminated in Uganda.
Thanks for reading, please follow Adam’s blog for more stories. Also follow me on Facebook (Walusimbi Adam Media), Twitter (@adamwalusimbi) & Instagram (@walusimbiadam).