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Education profile: One midwife’s journey to educate in developing countries

Last Updated: 19-11-2013

Midwife Brooke Jones

A young, award-winning Australian midwife is continuing her education in a bid to improve health care in the developing world and, in doing so, is working to save the world’s newest lives, writes Karen Keast.

Brooke Jones plans on making a real difference to the world in which she lives.

Just two days after completing her Bachelor of Midwifery at Curtin University in 2010, Brooke was boarding a plane to volunteer as a nurse but was instead seconded to work as a midwife at a six-week-old midwifery unit, the Aberdeen Women’s Centre, at Freetown in the West African nation of Sierra Leone.

There, the maternal and infant mortality rates were overwhelming - one in eight women were dying in childbirth and one in four babies were not living to the age of five.

Brooke’s first morning in Sierra

Leone was a baptism by fire.

“During the first birth that I was involved in, in Sierra Leone, I could tell the unborn baby was not very well in labour because of the low heart rate. However, in Sierra Leone a caesarean takes a while to happen,” she said.

“By that point you can potentially have a very unwell or a dead baby. The last thing you want in Sierra Leone is an unwell baby…you don’t have any oxygen or ICU or anywhere to refer the baby.

“A sick baby is usually the worst outcome.”

After a caesarean for obstructed labour, the baby arrived not breathing and with a very low heart rate.

Brooke wrapped the baby in her arms and ran about 100m to the maternity unit, where she and her colleagues began resuscitation on the newborn.

“It was decided if this baby wasn’t breathing in 30 minutes we would stop and let the baby die, which is the World Health Organisation guideline,” Brooke said.

“At 29 minutes she took her first breath and two hours later was breast feeding.

“The dad, who had watched the whole thing, said he believed I had saved the baby, even though in my western perspective I believed the baby deserved much better care.”

The parents named the baby after Brooke. The baby was the first of six babies to be named Brooke during her visit, despite her name translating to ‘hand washing’ in the local language.

She was the very first baby Brooke cared for and also the 100th baby to be born at the new centre.

“By the end of the first week I had been involved in the care of five newborns; four had needed cardiac compressions,” she said.

“Of the four that had cardiac compressions, only one of them died.”

Brooke said many of the mothers were anaemic and malnourished, resulting in many babies not strong enough to survive labour. That, coupled with a lack of diagnostic tools and treatment options, was contributing to the high mortality rate.

The midwife, one of a passionate group of four experienced, internationally trained midwives and 10 newly graduated Sierra Leonean midwives, handed out iron tablets and multivitamins to the local women.

Within months the group noticed a dramatic change in the strength and size of the newborns.

By the end of Brooke’s third month in Sierra Leone, the mortality rate had dropped from one in eight babies dying to one in 45.

“I felt like the luckiest midwife in the world to spend the first seven months in my career in a new maternity unit in such a challenging environment, with an incredible team who were able to make significant change,” she said.

“We assisted in over 600 births and had not a single maternal fatality. I was blown away by how simple but consistent care could make such a difference.”

Brooke, who began nursing in 2007 after completing her undergraduate degree, chose to complete the 18-month midwifery postgraduate degree after her first experience working overseas in Kenya.

“I saw a need for improved maternal and antenatal health care,” she said.

“Women and babies were often very neglected members of society because they don’t have a strong voice in the community.”

In Kenya, Brooke helped operate a free health care clinic for people living on the streets of Nairobi.

That experience single-handedly shaped the future direction of her nursing career.

“I spent time at Kibera, which is the largest slum in East Africa. It made me realise I had absolutely no idea what the world is like,” she said.

“I realised if I wanted the world to be different, I couldn’t change the whole world but I can change a little part of it.”

In the space of three years, Brooke also travelled to Thailand, through a nursing placement with Curtin University, and to India with the Sisters of Charity, where she worked with the dying and destitute in Calcutta.

After Sierra Leone, Brooke returned to Australia to begin work at Perth’s King Edward Memorial Hospital, the state’s only tertiary referral hospital for acutely unwell mothers and babies, where she has now worked for almost three years.

The 25-year-old is now undertaking her Masters in Philosophy through Curtin University, where she is exploring the professional identity of Tanzanian midwives.

Brooke’s goal is to help Australian midwives better respond to the cultural needs of midwives in developing countries, while sharing their knowledge and skills.

Last year, she visited Tanzania with a group of midwives through the Global Health Alliance of WA project, designed to provide professional development to Tanzanian nurses and midwives.

It was then she noticed that Tanzanian midwives seemed to have less of an avocation and caring approach to practice, compared to midwives in the western world, instead tending to be more task-orientated.

“When I was in Tanzania last year our role was to observe the clinical environment to work out how best we could assist in the professional development of local midwives,” she said.

“In the hospitals I was working in you would have two or three midwives looking after 20 births in a shift or a total of about 60 to 100 births a day,” she said.

“The sheer numbers make it very hard.”

Brooke, who will return to Tanzania in September to interview local midwives, hopes that by understanding the values behind how Tanzanian midwives practice, she will help better shape future education to suit the cultural needs of the midwives.

“Hopefully, building a stronger midwifery identity in Tanzania can achieve better outcomes and care,” she said.

Brooke believes education is the key to saving the world’s newest lives.

And, she said, if she goes on to complete her doctorate, it will be in an area she is extremely passionate about – neonatal resuscitation.

“Around the world about one in 10 babies will need some form of resuscitation at birth,” she said.

“In most accounts it’s very easy to provide that resuscitation to sustain the life. Resuscitation skills require basic levels of education and that has a profound effect on neonatal mortality.

“In my first morning in Tanzania I saw four babies die and three others with severe hypoxic injury before lunch time,” she said.

“Some of those deaths, in my opinion, were preventable.

“In Sierra Leone, I saw my Sierra Leonean colleagues quickly realise that they could make a difference and save lives.

“My goal would be for the midwives in Tanzania in their hospitals to feel the same.”

Brooke was last year recognised for her commitment and passion to midwifery when she was named the WA Graduate Nurse of the Year in the HESTA Australian Nursing Awards and she was a finalist in the recent national awards.

“I am not going to change the world but every woman and baby I can help to make a difference for is absolutely worth it,” she said.

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