Nan­ton mid­wife ex­pe­ri­enced a lot in Mid­dle East

Prairie Post (East Edition) - - Alberta - BY HEATHER CAMERON

Mar­jorie Mid­dle­ton, a mid­wife from Nan­ton, Al­berta has just re­turned from a six-week tour in Mo­sul, Iraq where she worked within Doc­tors With­out Bor­ders to pro­vide med­i­cal help to lo­cals.

“Mo­sul is a very sad place right now,” Mid­dle­ton said. “Imag­ine Cal­gary; we know it of­ten as North and South Cal­gary, right? Now, blow up all North Cal­gary. De­stroy the hos­pi­tals, the schools, and the homes. Imag­ine that ev­ery­one left North Cal­gary com­ing back af­ter such de­struc­tion. This is what Mo­sul is like: a city with half of it de­stroyed. Mo­sul is a city that peo­ple had to flee from, but now they want to re­turn to their homes. As they re­turn, though, they also need ba­sic ser­vices, which have been dec­i­mated.”

Mid­dle­ton says that all but one of the hospi­tal fa­cil­i­ties have been de­stroyed in East Mo­sul, so Doc­tors With­out Bor­ders (or Médecins Sans Fron­tières) went to a small clinic and con­verted it into a lit­tle hospi­tal. The group also added an op­er­at­ing theatre, emer­gency room, as well as in­pa­tient fa­cil­i­ties to the clinic.

“Con­flict set­tings are tricky,” Mid­dle­ton said. “Peo­ple tend to for­get that war zones aren't just about bul­let wounds and bombs. Of course, there is that, but there are also women and chil­dren. They are of­ten the quiet vic­tims. A woman in labour needs ac­cess to a safe birth, but war of­ten pre­vents that. Ba­bies need ac­cess to vac­ci­na­tion, post­na­tal care of sick­ness and in­fec­tion; again, all of­ten nearly im­pos­si­ble to ac­cess.”

The room used for birthing ba­bies, Mid­dle­ton says, is smaller than her kitchen at her home in Nan­ton, but 600 ba­bies were be­ing de­liv­ered nat­u­rally there per month. Nearly 100 cae­sarean sec­tions a month were also per­formed there.

“Médecins Sans Fron­tières works hard to pro­vide equip­ment and staff we need to pro­vide life­sav­ing care to mothers and ba­bies,” Mid­dle­ton said. “One of the big chal­lenges we were fac­ing is the re­al­iza­tion that even more peo­ple than we an­tic­i­pated needed our ser­vices. As I left, the team was work­ing to ex­pand into neigh­bour­ing build­ings so we could have more space, and thus serve more peo­ple.”

Mid­dle­ton orig­i­nally got her Nurs­ing de­gree in Leth­bridge and then re­ceived her mid­wifery qualificat­ions in Aus­tralia. She also re­ceived two ad­di­tional post­grad­u­ates in re­mote and In­dige­nous health in Aus­tralia.

“I kind of 'fell into' mid­wifery,” Mid­dle­ton said. “I was a nurse first; in fact, my first jobs were as a ma­ter­nity nurse/de­liv­ery room nurse in Leth­bridge Re­gional Hospi­tal! How­ever, whilst work­ing over­seas I dis­cov­ered the im­por­tant role of mid­wifery in the care of women. I went back to univer­sity to be­come a mid­wife so I could ex­pand my prac­tice. Over the years I have be­come more and more pas­sion­ate about women's health - and mid­wifery has been a part of that.”

Mid­dle­ton says that her work as a mid­wife re­ally be­gan in the out­back of Aus­tralia and then de­vel­oped into in­ter­na­tional work with Doc­tors With­out Bor­ders. Mid­dle­ton says she read about Doc­tors With­out Bor­ders when she was a teenager and al­ways thought she would like to be in­volved with them be­cause she liked their ap­proach to hu­man­i­tar­ian medicine then and now.

“I re­ally, re­ally love what I do, both as a nurse and as a mid­wife,” Mid­dle­ton said. “Both po­si­tions have en­abled me to work in some of the most amaz­ing roles around the world and meet the most amaz­ing peo­ple. I feel like I am con­stantly chal­lenged, and as a re­sult, am con­stantly hav­ing to learn and de­velop in my prac­tice, which I love.”

Be­gin­ning in 2009, Mid­dle­ton started work­ing with Médecins Sans Fron­tières and has worked through­out Africa, Asia, and the Mid­dle East on over 15 mis­sions, spend­ing time in Syria and Iraq this past year. In pre­vi­ous years, Mid­dle­ton has done one tour or more to Bangladesh, Afghanista­n, Pak­istan, Le­banon, Sierra Leone, South Su­dan, and Ethiopia. Mid­dle­ton has also at­tended nu­mer­ous train­ing op­por­tu­ni­ties and con­fer­ences through­out Europe & Canada.

Dur­ing her time in Mo­sul, Mid­dle­ton says that she spent a lot of time train­ing lo­cal staff. While the group was only al­lowed to work dur­ing the day, Mid­dle­ton said that she of­ten stood at a lo­cal mid­wives' or doc­tors' shoul­ders, pro­vided en­cour­age­ment and guid­ance, and ended up work­ing a lot with the more com­pli­cated cases.

“I am con­stantly amazed at how much grat­i­tude is shown for the sim­ple things,” Mid­dle­ton said. “The mothers do all the hard work in labour and birth! No mat­ter where you go in the world, mothers want their ba­bies to be born safely, and are so ap­pre­cia­tive of sup­port and care that makes this hap­pen. The care­givers in Mo­sul are of­ten mothers or mothers-in-law of the woman, and I think I have been hugged and kissed by more mothers-in-law than any­one I know. They also are so ap­pre­cia­tive.”

Mid­dle­ton, how­ever, ad­mits that the ex­pe­ri­ence of help­ing women in such ter­ri­ble cir­cum­stances can also be very over­whelm­ing.

Hav­ing never lived through what many of her pa­tients have, Mid­dle­ton does her best to be a lis­ten­ing ear, a shoul­der to lean on, and a sup­port to those who need it.

“A lot of women come af­ter be­ing told by 'pri­vate clinics' that they will re­quire a cae­sarean sec­tion, which costs more,” Mid­dle­ton said. I then of­ten have to try and pro­vide re­as­sur­ance to fam­ily and mothers that a cae­sarean will be pro­vided if nec­es­sary, but that the safe op­tion is to have birth 'the old-fash­ioned way.”

Mid­dle­ton re­calls how one young woman came into the clinic with her grand­mother in and they were both re­ally scared af­ter be­ing told by a pri­vate clinic out­side of Mo­sul had told them the baby would die if she didn't do an emer­gency C-sec­tion; all be­cause the baby was over­due by 2 days. The woman, how­ever, was al­ready in labour though and the fam­ily agreed even­tu­ally to try things Mid­dle­ton’s way to have the baby. The grand­mother threat­ened to punch Mid­dle­ton if any­thing went wrong, but ev­ery­thing went smoothly and a beau­ti­ful, healthy baby was born.

Un­for­tu­nately, not all births were suc­cess­ful.

Mid­dle­ton also re­calls one time when a mother tried to get to the clinic as fast as she could, but the baby had started to come by the time she crossed all the check­points; the baby ended up get­ting stuck. The clinic, Mid­dle­ton says, was able to save the mother’s life, but was un­able to save the baby.

“Health care in Mo­sul and other con­flict ar­eas is lim­ited,” Mid­dle­ton said. “There is very lim­ited ac­cess to pub­lic health care. If you have a lot of money, there are some pri­vate fa­cil­i­ties, but even they are hard to come by since the war. Doc­tors With­out Bor­ders is work­ing to save lives. We aim to pro­vide qual­ity, emer­gency health care to the peo­ple of Mo­sul and sur­rounds un­til such time that ser­vices can be ad­e­quately re­stored within the re­gion.”

The only re­gret Mid­dle­ton has is that the as­sign­ments are too short, but each mis­sion is long enough for her and oth­ers to re­al­ize the in­cred­i­ble need there is for med­i­cal help in con­flict re­gions.

“I'm a South­ern Al­berta farm girl; un­til my work with MSF I had never been ex­posed to the re­al­ity of con­flict set­tings,” Mid­dle­ton said. “Bombs, guns, poverty, dis­place­ment, hunger; it can be over­whelm­ing. How­ever, the over­whelm­ing need of women and chil­dren in these set­tings tends to stay in the fore­front of my mind. I can truly say it is an hon­our to work with an or­ga­ni­za­tion that is so well re­garded both na­tion­ally and glob­ally.”

Mid­dle­ton ex­tends an in­vi­ta­tion to peo­ple through­out South­ern Al­berta to contact Doc­tors With­out Bor­ders at http://www.doc­tor­swith­out­bor­ if they are in­ter­ested in work­ing for the or­ga­ni­za­tion, or in know­ing more about what they do.

“I hope that my work, and that of MSF in gen­eral, in­spires peo­ple to re­mem­ber that there are so many peo­ple around the world that need our as­sis­tance,” Mid­dle­ton said. “I also hope that I have di­rectly im­pacted on other health pro­fes­sion­als’ de­ci­sions to do hu­man­i­tar­ian work.”

Photo con­trib­uted

Mar­jorie Mid­dle­ton was busy teach­ing baby care to a nurse in Tel Marak Iraq 2017.

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