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A day in the work life of Dorothy Apio, a midwife based in Eastern Uganda


Dorothy Apio, 26, is a midwife at Iyolwa Health Centre, a rural clinic in Eastern Uganda. She lives with her husband, John, and their 12-month-old daughter Noelina

"Delivering a baby while in labour myself is probably the most challenging thing I’ve ever done in my role as a midwife. But at my clinic in rural Uganda, the truth is every day is pretty demanding.

My day can start just minutes after I’ve gone to bed as I live behind a health centre and am on call 24/7. There are normally two midwives at the clinic but my colleague is on maternity leave, so for the last five months it’s been just me. I have a 12-month-old daughter, Noelina, so if I need to do a delivery in the middle of the night, I wrap her up and put her on my back before grabbing a lamp to light the way to the clinic.

Iyolwa Health Centre where I work has no power, so doing deliveries after dark requires a paraffin lamp or the light on my mobile phone which I balance in my mouth to keep my hands free. Once, when I had forgotten to charge my phone during the day and I had no money for paraffin, I had to carry an expectant mother outside onto the concrete porch so I could see the baby coming in the moonlight.

If I am lucky enough to get an undisturbed night’s sleep, then Noelina normally wakes at 5am. My husband lives in the city during the week as he works in the construction industry so most mornings it’s just the two of us. I’ll breastfeed Noelina on the grass outside our house while having porridge or a cup of tea for breakfast.

I like to put on my pink nurses’ dress so patients can easily recognise me. I deliver an average of 35 babies a month and look after between 50-60 pre and post natal patients each week. I’ve been a qualified midwife for just two years and at the last count 51 babies that I have delivered have been named Dorothy, after me.

One of the biggest problems I face is that women leave it very late to come to me when they go into labour, probably because the clinic isn’t the safest place to give birth. The ceiling is threatening to collapse, there are bats in the roof – there is bat urine running down the walls and insects.

When I found out I was being posted to Iyolwa I thought I was being punished. It is often referred to as ‘the worst clinic in Africa’, but I do the best I can with the meagre resources we have.

As I am the only midwife, I rarely leave the clinic grounds. On Wednesdays I sometimes pop to the market across the road to get some basic essentials for myself and Noelina, but I am never gone for very long. Most days I spend my time walking between the clinic and my two-room house where I carry out chores in between deliveries.

I became a midwife as I love babies and I wanted a career where you have to act quickly and think on your feet. I delivered five babies on Christmas Day and another five on New Year’s Eve. It is so rewarding.

Unfortunately 500 women a day die from causes related to pregnancy and childbirth in Africa. Thankfully I have not lost a patient yet but I am becoming all too familiar with delivering stillborn babies, most commonly as a result of malaria or HIV. This is the most difficult part of my job. We don’t have the facilities at the clinic to perform caesareans and most people I treat don’t have the 8,000 Ugandan shillings (£2) needed for emergency transport to hospital, so fatalities are a harsh reality.

It’s hard to relax and forget about work but for my own strength and for the happiness of my daughter, I must stay strong.

If there are no women in labour, I head home at 5pm and set the fire, prepare dinner – usually beans and rice – and put Noelina to bed. Some nights my friend will visit and we chat, most nights though I listen to the news on my radio before going to bed at 9pm. I like to go to bed as early as possible as I never know when I’ll be woken up to help deliver Iyolwa’s latest arrival.”

Iyolwa Health Centre is being renovated as part of Operation Health for Comic Relief. See Dorothy in action in Comic Relief: Operation Health on BBC One, Thursday 12 March at 9pm; rednoseday.com/operationhealth



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