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Last Updated: Monday, 30 August, 2004, 00:26 GMT 01:26 UK
UK boost for Iraq maternity care
By Melissa Jackson
BBC News Online health staff

Midwives receive training
Midwives gained greater respect after the course
A team of UK doctors has helped reduce infant and maternal mortality in Iraq following a pioneering project to improve midwifery practices in the war-ravaged country.

They have taught consultants and midwives how to deal with medical emergencies that can arise during childbirth without the need for expensive equipment, which they do not have.

It is thought that hundreds of women's and children's lives have been saved since two successive training courses were held in Basra in April.

They were organised by the Management of Obstetric Emergency Trauma (MOET) and the Royal College of Obstetricians and Gynaecologists.

Nine British doctors made the 12-day-long trip, including two Iraqi doctors working in the UK, who doubled up as interpreters for those who did not speak English.

We think we have made an impact on the infant mortality rate and the number of mothers dying in childbirth
Andrew Mathieson, MOET trip co-ordinator
During lectures and practical sessions, 36 Iraqi midwives and doctors learned non-surgical ways to treat conditions like post natal haemorrhages, which can be life-threatening if they are not dealt with swiftly.

Iraq has one of the highest maternal mortality rates in the world - 53 per 1,000 live births, compared to the UK's six per 1,000.

Trip co-ordinator Andrew Mathieson, a Territorial Army major, said: "We think we have made an impact on the infant mortality rate and the number of mothers dying in childbirth.

"There are no reliable figures, but we can go on what doctors are telling us.

"They have learned how to save lives using new techniques and I would guess there are several hundred people alive now who wouldn't have been if we hadn't run the courses."

The two three-day courses were held at the British military hospital in Basra.

They now have 56 MOET-trained doctors and midwives across four Basra hospitals.

Shifting attitudes

Forty of these are consultant obstetricians, delivering up to 10 babies a day.

Unwittingly, the British team made another impact in Iraq - by changing doctors and consultants' attitudes towards midwives.

Mr Mathieson, who is also a senior lecturer in environmental health at Bristol's University of the West of England, which allowed him time off for the programme, said: "Nurses and midwives in Iraq are seen as second class citizens.

A party of Basra doctors currently on a visit to London have said what a huge difference we have made to their work
Andrew Mathieson, MOET trip co-ordinator
"They are mainly women and this is a misogynistic society."

There were two or three midwives on each of the two courses of 18.

The remainder were doctors, two-thirds of whom were women.

"We were teaching midwives the same sort of life-saving techniques as the doctors.

"Midwives are very experienced and this gave them the capability to support their experience.

"The doctors had a greater appreciation of what midwives are capable of after they had been on the course.

"So we were making in-roads into changing attitudes towards midwives."

Tears

Although under the protection of British military forces, the British doctors were effectively risking their lives by entering a country still ravaged by war and violent uprisings.

Their concentration was often broken by the rumble of gunfire nearby.

Mr Mathieson said: "These people could not understand why we were putting our lives at risk for them.

"There was a degree of scepticism at the beginning of the courses, but this turned to enthusiasm, trust and friendship by the end of it.

Andrew Mathieson
Andrew Mathieson organised the trip
"There were tears from the women doctors and midwives when we left."

Mr Mathieson returned to Basra in June to run courses to train some of the doctors from the first courses to become instructors

They have six Iraqi MOET instructors and hope to train up six more.

They hope this 12-strong team will eventually run their own training courses in Basra without the need for a British entourage.

The target is four courses a year for up to 80 midwives, nurses and doctors.

"A party of Basra doctors currently on a visit to London has said what a huge difference we have made to their work," said Mr Mathieson.

Much of the funding for the trip has come from the Coalition Provisional Authority and the British Council.

However, they need another 20,000 dollars to complete the training programme in Basra and further funds to take the project forward into Baghdad and either Jordan or Kurdistan.

Donations can be sent to MOET via e-mail at moetiniraq@hotmail.com.




SEE ALSO:
UK medical team is Basra bound
16 Apr 04  |  Health


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