Back to my roots Africa:

We have been in Africa Tanzania for a week now…. I will be blogging about the clinical experiences soon but just had to share this wonderful weekend with my friends and the world. Despite all the hardships that can clearly be seen in parts of Africa the country and its wildlife are absolutely magnificent….Africa is rich with warm friendly people, diverse cultures and stunning wildlife. I began to feel as if my soul had returned home once I got off the aeroplane. The steamy airport….. crowds of people a disorganized chaos was all reminiscence of my times spent in Zimbabwe.



Our weekend was spent at Mikumi National Park: the park is in Morogoro Region, in the southern tourist circuit of Tanzania. This is the nearest park to the commercial capital of Tanzania, Dar Es Salam. It is about 288 km west of the city and takes about 5 hrs by car. We travelled in convoy in land cruiser troopies 8 to each vehicle that includes the driver (who is a local). The road is bitumenised all the way to the park. The park gets its name from the spindle – shaped borassus palm trees which are typical of the area. Mikumi National Park with an area of 3230sq.km is the fifth largest park. It lies between the villages of Doma and Mikumi on the Dar Es Salaam-Tunduma road. The Mkata River-flood plain, with its hardpan, ridges, swamps and black-clay grassland, the miombo woodlands on the hill to the east and west, and the rivers with their fringe of tall trees and dense thickets. Often it looked like it was going to rain…. Thankfully it didn’t; the short rains usually fall during November and December. Long rains are from March to May.



Everyone relaxed and really enjoyed the weekend, it was just not long enough…..being with the students all week, it was great to see them relax as well as us (the supervisors). We were warned that the animals wander around the grounds and to walk together and be watchful. As we sat drinking; me with a gin and tonic and as we had lunch we watched the animals arrive at the waterhole; zebra, warthog (pumba) and her babies and a small family of elephants…. It was brilliant to watch the elephants drinking and having a mud bath…..the giraffe were ambling in the background grazing on the leaves ….. what a wonderful world we live in….it was a time to reflect, re-energize and rejuvenate.



We stayed in small lodges made from mud….self contained double rooms. The windows were open spaces covered by a wired mesh similar to fly wire. We were all sharing; I was sharing with two other fantastic women…. We chose our beds unpacked our bags then out for our first adventure in the land cruisers. The usual application of sunscreen and insect repellent…. Excitement in the air…..a beautiful sunny day….the African air. It was not long before we came across our first elephants, then impala, lots of impala they are almost like our kangaroo’s…. we were all glued to the scenery trying to spot the next animal…when I called out “there’s a Kangaroo” ……on our way back to the village we came across a group of Giraffe, they are so spectacular to watch…. elegant and graceful. Alas still no Lions: The African sunset was spectacular as expected….. got back to the village…. Had a double gin and fanta as there was no tonic….tasted great… a fabulous dinner….beef stew and veg whilst watching animals at the waterhole….. later that evening the lions came to visit…some of the students were disturbed and frightened, the park employees escorted everyone back to their rooms….. it was a hot night…the electricity went off at 11pm so no more fans….. we slept under mosquito nets…it was a hot sticky night….as for me I had tooth ache so took a bucket load of pills and could feel my tooth throbbing…..but did manage to get to sleep…..



Up on Sunday morning at 0600hrs out to go for the morning safari drive; wonderful morning… a bit cloudy…weather great…cool; spotting animals… we came across a herd of elephants…. Unbelievable…the female leads the herd and the rest follow there were two calves in the herd… we spent quite a while admiring them it was so quiet you could hear them walking, they came very close to us…. Fantastic pictures…..we drove for an hour watching…. I was standing feeling the wind on my face…….feeling very much at home in one with the land…..the driver got a phone call and then began driving very fast…., we knew there was something to be seen…. We finally caught up with the other group to find a pride of lions who had very recently killed a buffalo, it was disemboweled…. There was a lioness close by well camouflaged, we all were excited and scrambled to get pictures…the safari was complete now that we had seen lions in the day….it was back for breakfast then the homeward journey back to the hotel (5hrs).



It was fantastic to see large herds of buffalo, wandering groups of elephant, wildebeast, zebra, impala, baboon, warthog, jackal and giraffe. Most spectacular was the sight of a fresh kill of a Buffalo by a pride of lions…… wow… just amazing.
Giraffes are the tallest of all living land mammals. The animal’s typical gait is rather slow, deliberate and remarkably graceful, almost as if the actions were filmed in slow motion.

Elephants have a gestation of 24months and live to about 60yrs, they weigh 3-4 tons and they eat 375kg of food….wow

I have to mention that the traffic (in Dar Es Salam) and the cars / buses are just diabolical – they are crazy drivers; how there are not more accidents I do not know…. We cringed more than a few times on our journey….. overtaking… causing the oncoming traffic to take responsibility to move out the way…..our drivers were excellent: There was a small gift shop on sight which I bought some material for the girls (Kanga) a traditional piece of cloth used for clothes: Now it is back to reality we have another week left….

spot the lion: sitting watching her kill...the pride was further back under a tree too far to take pictures:




I have written this blog on the homeward journey on the bus, as we are often stuck in traffic and hopefully I can upload it when I get back to the hotel, if the wireless is working....Watch this space for further tails and I have many…… photos will be coming soon.. it has taken me over an hour to upload these few.....it is back to work tomorrow...

I'm feeling very relieved and excited:

I am so grateful my life is filled with love, passion, abundance and excitement;
I was so relieved that my exams are over for this semester, I had forgotten how you stress when you feel under pressure to perform in examinations... I do wonder the value of examinations.... for two hours I regurgitated information, not necessarily in a organised fashioned, everything I knew relating to the topic I just vomited it onto the paper, so much so that my hand was sore from all that writing.... you know we are just not use to that type of writing any more...why don't they move with the times....we should have computers....automatic spell check, legible writing.... I did think the faster I was writing to get the information down before my time was up...my writing was getting worse... and was thankful I was not marking these papers...now that would be a nightmare....the topics were broad and I should think hard not to be subjective when marking..... Well enough about that it is finished and forgotten until I get my results;

Marking is all done....and most of the students did well.....just amazing how much you can fit into a day.....

Tomorrow I am off to Tanzania...the spare bed is full of what should be going into my suitcase....with the uniforms....nice starch white tops...and navy blue three quarter pants....emmmmm..... aprons, gowns, gloves, etc etc etc....oh and all the books we are donating to the midwifery library.....I have been reading up on all sorts of exciting treatments.... and life in Tanzania.... bought my US dollars...not that there will be much time for any shopping....and got the first aide kit.

We are going on a Safari ...the middle weekend we are there.... I am waiting in anticipation of all that we will see and experience over the next two weeks... I am sure that I will experience many things... and be ever grateful for the wonderful country we live in.... Australia....watch this space for updates.... or the report when I get back....i guess it depends on several factors...internet....and time. take care until next time;


ref pic; http://trekkertime.com/index.php/Site/Tanzania

Centred Midwifery Group Practice Inc (CeMGP)

Wow it is official….this has been a dream of mine for some time and became a reality today when the Dept of Commerce called me today to confirm our application for incorporation was successful. We are the first private Midwifery Group Practice for WA this is a huge step. I am so proud this is a fantastic achievement. We are a fantastic team of dedicated Midwives;

This idea has been mulling around in my head since returning to WA 7 years ago… however it is only since the Maternity Reform has the idea become a reality…. Women being able to access Medicare Rebates for midwifery services.

In July 2010 I talked about the idea, shared with a few people and in August asked a group of equally passionate women to come on board with this concept…..We met at my home for a day workshop and nutted out some key ideas…. One of which was the name Centred Midwifery Group Practice (CeMGP). I will not blog today the story from then till now I will save that for future blogs…. This is to share our fantastic news and say we are here….. watch this space…..for our Website, Facebook page and blog...all being designed as I type....

Our Philosophy: “We put you at the centre of your experience”. We are group of committed midwives, dedicated to providing safe, competent, continuity of care, individualised and professional midwifery care and support to the well woman and her baby throughout pregnancy, birth and early parenthood.

I am so excited I can hardly contain myself.... this is so huge it is a dream come true......more to come in the coming days.....this is just the beginning...... of a wonderful fruitful experience with women and birth.

Homebirth in the news again.......negative press: when will it stop?

Homebirth is never long out of the news: strangely enough it is usually in the negative; When will doctors learn that it is not an issue of HOMEBIRTH it is an issue of CHOICE; Choice for women not doctors;

The Weekend West's headline was "Ban pleas on 'risky homebirths' now it is hard to openly discuss the leaked draft report - yesterdays front page of the West "Two quit as row over homebirths escalates" relating to the same leaked report, now calling for the Government Funded Programme supporting homebirth for low risk women:

I can not tell you how many midwives have quit due to lack of choice for women and lack of autonomy in the work place.....it never makes the front page of the newspaper this is doctor driven against the choice for women to have midwifery led care;

It is time again for women to stand up and be counted even if you would not choose a homebirth....this is far more than having a baby at home it is about how you as a woman make choices about your body..... most women will choose what is best for their babies....and do not have to be dictated to by the medical profession about how to do it...it is our bodies, our choice our life...... this is paternalism at its best... there is no grantee in life... and unfortunately babies do die....Babies also die in hospital.....there are many iatrogenic injuries that are caused in hospitals.... women are and have been traumatised in hospitals by the health professional... so don't try to say that having a baby in hospital is any better, in fact for the low risk women it can be devastating and equally for the high risk situations,.......

I cannot respond to the draft report because it is published yet, this is scaremongering at its best; Now midwives have the right to Medicare and can provide more options for women...the doctors are playing dirty........I wonder who leaked this information?

Things you can do...is write to your local Member of Parliment... with your concerns about lack of choice.....

Remember this is about choice for place of birth....not just homebirth...making the issue about homebirth is scaremongering.....watch this space.... for the release of the report.

Picture from Bring Birth Home: http://bringbirthhome.com/about/ have a look at this website... and read her story:

My feet are not touching the ground:

This is usually a busy time of year....semester finishing, marking, getting ready for Christmas etc, etc, etc; However for me this is a particularly busy time.... semester is finishing and I have my usual marking....thankfully I love this assessment so it is easier to mark and the students also enjoy it and usually do it well, this makes marking so much easier...and as a teacher it is rewarding to read so many good papers;

I am taking on a new challenge...GLOBAL HEALTH ALLIANCE next Saturday i leave with 20 students from 5 universities (4 students from my university) in an inaugural project to Tanzania...to broaden their healthcare skills, provide care to people in the developing world, and to expand their cultural awareness.
“The placements are unique in that it is the first time the five WA universities have collaborated, as part of the GHAWA program, in sending a combined student and supervisor cohort to a developing country,”

“The trip will expose students to a unique healthcare environment which will improve their ability to work in challenging settings and help them to adapt to new cultural scenarios.”

The student nurses will travel with expert clinicians and will commence placements at Hubert Kairuki Memorial Hospital and Amana Hospital in the Tanzanian former capital of Dar Es Salaam.

We will also travel to two rural community health centres, Masaki and Masangaya Health Centres, where the students will undertake supervised clinical practice.

We are hoping that the international placements will allow the students to develop skills and knowledge in dealing with transcultural healthcare issues.



I am so excited...but as you can imagine this has increased my work load... preparing for this trip has been interesting and I don't know how I am going to fit all the protective equipment in my suitcase, together with the text books I want to donate as well as some other essentials...so watch this space for how the trip goes....but that is next Saturday....before then...I should be studying instead of writing this blog...but its called a break....

I am sitting two exams next week...Tuesday and Thursday.... finish my marking... have a couple of meetings....did I leave anything out.... ah yes there is still the surprise to announce which I anticipate to be middle next week....see the family and get on the plane..I think I also have a performance review......its called effective time keeping: or insanity:

I return after two weeks have two days to get Board of Examiners and supplementary papers out and then go to Singapore for three days of intensive teaching.... for trimester three..and two days shopping of course...can't forget that.... home for several hours then off to Canberra for another meeting... no wonder my husband and family think I have too much on my plate... but you know I have done all the Christmas shopping the grandchildren have their presents... if I get time I will wrap them before I go :)..... I will be home for the 17th December.... YEAH: enough time to sort out the Christmas dinner:

My mantra is " I have enough time in the day to get all I need to do done"
ok back to cramming now......

WE ARE FREE

Today we are free
but it is a day of mixed emotions
a day of celebration and mourning
a day of smiles and tears
a day of joy and sorrow.
On this day in 1945
We overcame the enemy
our land became ours once more
but the victory was not free
we paid dearly for our freedom
we paid with lives
the lives of our brothers in arms
So today we celebrate our freedom
with joy and smiles
but also with sorrow and tears
for those we loved and lost
Today we are free.
We wear our uniforms with pride
as we parade for our Prince
our wives, children and grandchild
but in our hearts and minds
we are still captive
captives of the memories of that time
so today we celebrate and mourn
and remember.


TODAY WE ARE FREE

Written by Maria Sutherland 1998
http://msbeliever.tripod.com/WWIIremember.html

Update for eligibility: still waiting!

Update on my application; I thought that I was very meticulous with my application but alas this was not the case; there is particular certified list of people that are required and I used a university academic which is not allowed;
the Certified List for AHPRA

Justice of the Peace, Bail Justice, Registrar or Deputy Registrar
 Commissioner for Declarations, Commissioner for Oaths, Commissioner for Affidavits (dependent on jurisdictions)
 Lawyer
 Accountant (member of the ICA, ASA, NIA or CPA)
 Registered members of the teaching profession
 Member of the police force
 Sheriff or Deputy Sheriff
 Public Notary
 Permanent staff member of AHPRA (I think it would be easier to take your certificates and copies into your local office to be certified)

Second I have written a two page letter to the Chair of the NMBA to ask why they are asking for the last 5yrs of experience (Statement of Service) instead of the 3 yrs required by the Registration Standards; I did send a letter from a manager who did deem me competent, however did not address the ANMC competencies, this was rejected for that reason. Finally why when we have successfully completed the Midwifery Practice Review (MPR) do you require a letter from a manger addressing the ANMC competencies? the goal posts keep moving;

Anyway I have resent my documents certified in the correct manner by a commissioner of declarations (a pharmacist) together with the letter asking for clarification and I have had no response to date. I have also forwarded this information onto the National ACM as evidence of issues relating to applying for eligibility; Really this process is cumbersome and unacceptable. I guess these issues will come up at the next Board meeting which I think is the 18th November; just as well I am not in a hurry, I feel for those midwives who do need this urgently;

A bottle of Red......frustration of midwifery;

I had a bottle of red...with my husband, I am trusting him to proof read this blog as I feel positively tipsy ; I have had a bad day....a meeting from hell ego’s present in the room; I feel disempowered in my current position... people not being honest with their intentions.... all it takes is open honest discussion; and a colleague received some bad news that is really unfair.... why does life have to be so unfair; I really feel that we as a profession get the rough end of the stick.....I pride myself on integrity and honesty... I get so frustrated with women who do not stand up for women’s rights (but I guess this is dependent on your point of view) and maybe everyone thinks their point of view is correct...it truly is a man’s world and when we get women in power they seem to think the most important thing is to be accepted by men...that means playing by the man’s rule..... I am really feeling for a colleague of mine who I have grown to know on a intimate basis and trust her judgement and skill as a midwife I am really saddened that situation has not worked out for her as I had hoped and with my knowledge and expertise I have not been able to help her and for that I am truly sorry. All I have to say is as long as midwives are not protected by law we are open to the rules of nurses and we are very different.

Midwives need legislation to protect them to truly ‘be with woman’. Managers who are managing midwives need to be a midwife to really understand the issues that midwives face.... ideally they also need to understand what homebirth is about and the reality of choices women make at a homebirth; this problem highlights that nurses do not understand the autonomy and bond midwives have with women....... I guess a bottle of red will allow you to say almost anything I am distressed for my colleague that life has turned out this way... and even after a bottle of red it doesn’t stop the pain of what she is feeling... and there for the Grace of God go I..... here I am about to embark on a huge adventure for women and midwifery and I wonder if it is all worthwhile, because in one instant it can all be gone...we work so hard as a midwife to advocate for women.....to facilitate their choice.... but alas in Australia there is no protection for the midwife if things go wrong...and yes babies do die.. ..often despite our best efforts and for reasons beyond our control...errors are made because we are human but they are made every day in a hospital and babies die in hospital .....that is the process of life... we do our best to reduce the errors or mistakes;

We know that we are medically dominated that it is really unacceptable....however for this to change...it needs women to stand up and be counted... if you want the birth you want then you need to say so.... stand up and tell the medical profession this is what you want.... it is only in women’s voices will you be heard and midwives can then facilitate what you want; women have the power......you only have to say....


As for my colleague I am sorry.... you have to fight to the end degree... ..For what you believe in.... as for me...I will strive to be the best I can... I am thankful for my family that supports me...even though it takes so much time away from them and to my friends...thank you for keeping me on the straight and narrow... I have to learn to stop wearing my heart on my sleeve...feeling the pain of others: Also take more time out from all these pressures;

....I will continue to do the greater good for women and midwifery.... the end result is a Midwives Act to support the choice of women and protect the midwife.....well the bottle of red is finished my husband my lovely husband has stopped me from the second bottle.... wow he is wondering what has hit him........ I have to say drinking does not solve any problems but hell, I sure felt good for a short while;

It is the next day; I have substantially edited this blog... and am very thankful I did not post it last night.....surprisingly I did not sleep well, my liver was objecting to the alcoholic abuse it received; Today I have drunk a litre of water with two paracetamol. I have to say that this is a rare occurrence drinking a bottle of wine, usually it is only a glass or two on the weekend.

I am reflective and still wondering how to take this issue further; and my husband cannot stop laughing at me:

A new day begins and the journey continues;

How to apply for eligibility:

Today I sent in my application for an eligible midwife; like anything new the process is TIME consuming and there will be teething problems: I am hoping that I have completed everything as required; You do not need insurance to apply for eligibility; I have to say that I have had to send my application to Sydney as WA is not ready for this process: Here is my step by step process:

Step 1; Go to the AHPRA website and download on the first page fourth heading ‘Registration’ on drop down menu second one down click ‘Registration Process’; left hand side blue box; fifth one down; click common registration forms; Standard Format for Curriculum Vitae:print and save this form.

Step 2; While on the AHPRA website go to the Nursing and Midwifery site and download the Registration Standards for the Eligible Midwife third from the bottom; then on the left hand side fifth from the bottom click on forms; a third of the way down the page look for the heading Notations; click on Application for addition of notation as an eligible Midwife; print and save this form.

Step 3: Now you need to read and complete the forms; to make sure you meet these requirements before you apply; I have heard that there has been a problem with Independent Midwives who do not have Midwifery Managers.... so watch this space.... I would think that maybe one way around that might be that they could sign a statutory deceleration..... as this is legally binding.... but that will be for the Board to decide....lets hope they will work it out soon...

a. Current general registration as a midwife in Australia with no restrictions
on practice; You need to add your registration number with AHPRA:

b. Midwifery experience that constitutes the equivalent of 3 years full time
post initial registration as a midwife; Here you need a letter from your current Midwifery Manager outlining that you have worked across the continuum of midwifery care, antenatal, intrapartum and postnatal this letter is dated and signed;
You also need a statement of service; this is obtained from your HR department; I rang Health Corporate Network and gave them the years I work at the government institution and they sent me a very detailed statement of service;

c. Current competence to provide pregnancy, labour, birth and post natal
care to women and their infants; this can be proven by completing the Midwifery Practice Review (ACM) or some other accredited program(I don't know of any other one apart from the ACM one.

d. Successful completion of an approved professional practice review
program for midwives working across the continuum of midwifery care; as above

e. 20 additional hours per year of continuing professional development
relating to the continuum of midwifery care; if you have MidPLUS this will be easy you will just print out your summary; If you do not have MidPLUS you will have to produce evidence of attaining these points; copy your certificates and get them certified copies; I did not send any originals of certificates they were all certified copies.

f. Formal undertaking to complete within 18 months of recognition as a
eligible midwife; or the successful completion of: I wrote a letter using this wording saying that i will formerly undertake the course when it is ready.

i. An accredited and approved program of study determined by the
Board to develop midwives’ knowledge and skills in prescribing, or
ii. A program that is substantially equivalent to such an approved
program of study. As above.

Step 4: Follow the Standard format for CV; as it is slightly different to your current one; I just cut and pasted from my regular CV. One thing that is very different is the request for clinical / procedural skills - with this one I made up a table that gave the dates of my general clinical competences such as Obstetric emergencies; suturing, IV cannulation, neonatal resuscitation etc; and added certified copies of the certificates; You must make a declaration that your CV is true and correct and sign it. The CV has to be an original not a copy;

Step 5; add payment for your application; $90.00

Step 6: you also need someone to witness your signature when you have completed the application form

Step 7; Make sure you go through the checklist it is helpful to ensure you have completed everything; although the checklist does not ask for a letter from the manager and this is a requirement; Not sure why when you provide a statement of service;

Step 8; Take a copy of what you have prepared, I find this always good practice; double check it again and then post it to the AHPRA office in your capital city; if in WA post to Sydney NSW for the interim until the office is more settled in WA, as we only came on board middle of October.

I found this process tedious especially having to photocopy and get 16 copies certified of my qualifications and certificates; the CV was not problematic but had to be changed from my usual format; the letter from the employer was not difficult nor was obtaining the statement of service you just need to allow for the time to prepare for this application; I am hoping now that I have all this information that hospitals who require credentially will not want any more than this and when you have prepared it once it is then done.... life should be easy now....NEXT STEP MEDICARE PROVIDER NUMBER:

Lets hope I have not forgotten anything and have completed the application as required... will let you know how I get on......go on be daring take the step and apply for eligibility;

For more information visit the AHPRA website;

Ref: picture; http://www.clipartof.com/details/clipart/46255.html