Sam: My typical working day

Sam's working day: a 14-hour marathon session

“Nothing prepares you for your first time on the ward.”

I stepped into the maternity department at 8am. Several women were about to deliver at any moment, an emergency case was carried in on a stretcher, a baby was being resuscitated in the corner. The doctor looked at me and said, “When can you start?” I pulled on some rubber gloves and said, “Now.”

You hit the ground running in MSF

I knew the Masisi area was a centre of conflict; 30,000 civilians were without homes, with only basic food and sanitation. Other challenges included widespread rape, cholera due to a lack of clean water, and supplies not getting to those who need them.

You needed a strong character to survive

The ward was controlled chaos: noisy, humid, fast-paced, full of raw human emotion and pain. The team never slowed down; dealing with a room of sick and premature babies, birth complications and a fleet of ambulances queuing up to deliver emergencies – all the time.

• > Team of 2 doctors and 21 midwives/nurses
• > 15 deliveries each day
• > 70 women with high-risk pregnancies waiting to give birth

The problems are not just the overwhelming number of women and babies involved, but the lack of resources to deal with them.

You learned a lot about yourself every day

“Working on the ward pushes you to the limit.”

We provided family planning and contraception advice to all mothers. Up to 100 survivors of rape and sexual violence arrived every month, so we treated sexually transmitted infections and unwanted pregnancies.

The pressure to perform was intense

You didn't stop for a second and it tested your abilities every moment. I’d stand for 14 hours performing deliveries in almost unbearable heat, day after day. But I saw babies and their mothers surviving where they might have died.  It is highly likely that if they had given birth at home, a third of them would not have made it.

• > 19,200 women assisted in giving birth by MSF in the Congo in 2010
• > 50% of the Congo's 35 million women give birth before age 19
• > 30,000 Congolese women die in childbirth every year

I feel passionate about the right of women to give birth safely. And the nicest sound a midwife can hear is when that baby starts to cry.

All babies deserve the best start in life

“Giving birth is the same for all women…. what’s different is access to medical care”

The pain, anticipation, exhaustion, fear and excitement are the same for all women – whether in Northampton or Nairobi. What isn’t is access to trained medical staff, care, surgical interventions, drugs and materials.

The difference between life and death

We delivered free Caesarean sections to 665 women who would have died otherwise. Most of the 3,451 pregnancies we dealt with had complications, such as obstructed delivery, previous cesarean sections, twins, ruptured uterus, obstetric fistula, placenta previa, bleeding in pregnancy or after delivery and infection. We created an ambulance service, bringing women to us for life-saving treatment from all over the area. Without us, the mortality rate would have trebled.

Working with vulnerable women was a privilege

We've all been born, and I believe that no woman should risk her life in childbirth – tragically we did lose six mothers out of 3,451. But by being there, we made a huge difference to thousands of real families. And that makes me proud.

• > Women in obstructed labour, crossing front lines to reach the hospital
• > Women arriving having been raped, survivors of sexual violence
• > Many mothers having more than ten pregnancies

These complications in pregnancy - in part due to the lack of healthcare generally, but also because women often have very large families – are common in Congo and pushed me in terms of my knowledge every minute of every day. To read more about what Zawadi went through, click here.