Ep 66 Halima Musa Abdul on resilience, innovation, and the future of midwifery in Nigeria

Ep 66 (ibit.ly/Re5V) Halima Musa Abdul on #resilience, #innovation, and the #future of #midwifery in #Nigeria

@PhDMidwives  #MidTwitter  #research #midwifery @WHOCCCardiff @cardiffuni  @VIDofM
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Compassion for midwives paper

As we journey into the heart of Nigeria, we find ourselves in the company of Dr. Halima Musa Abdul, a beacon of light in the world of midwifery. Her passion and dedication to the profession navigate us through the stark realities of maternal care in Nigeria, the pressing need for more midwives, and the uphill battle against high mortality rates. As a Senior Lecturer at Abu Zaria, she brings a wealth of knowledge and firsthand experience to the table.

We step into Halima's shoes, tracing her academic journey from the pursuit of a PhD scholarship at Cardiff University to her triumphant moments at international conferences. Sharing the immense pride and accomplishment of earning a PhD, she illuminates the path for aspiring scholars. Along the way, we delve into the resilience strategies that hold Nigerian midwives steady in the face of daunting professional challenges. Be prepared to be moved by the inspiring stories of perseverance and emotional fortitude.

Lastly, we tackle the crucial aspects of resilience, innovation, and advocacy shaping the future of midwifery in Nigeria. We discuss the need for midwives to influence policy changes, foster innovation, and be resourceful despite resource constraints. Halima leads us through this compelling conversation, outlining the significant role of research in the future of midwifery. This episode offers unparalleled insights into the praiseworthy resilience and dedication of midwives in Nigeria, and instills hope for a brighter future for midwifery in the country.

Transcript

Speaker 1: 0:15

And welcome to Through the Pinard, your conversational podcast talking to midwives around the world about the research they are doing to improve midwifery practice. This research can range from small quality improvement programs and projects to those starting partway through or just finishing their postgraduate studies, and to those that have been there, done that and got the t-shirt. So settle back and enjoy the conversation and remember you can continue the conversation on Twitter after you finish listening. Thank you very much for joining us, as per usual. Can you introduce yourself please?

Speaker 2: 0:53

Okay, my name is Dr Halimomusa Abdul, a senior lecturer in the Department of Nursing Sciences, abu Zaria, nigeria. I teach midwifery in the university because our program is a Bachelor of Nursing Science degree, so it runs for five years, so part of it. We have a midwifery curriculum embedded in the whole of the program. So I teach midwifery at 300 levels, at 400 levels and then they do their midwifery posting for the whole of 500 levels.

Speaker 1: 1:29

Right, okay, so the levels match the years that they're going through.

Speaker 2: 1:34

Yeah, yeah, yeah.

Speaker 1: 1:35

So what got you into midwifery?

Speaker 2: 1:40

Yeah, like I said, after my first during my Bachelor degrees in the university, actually I started from a basic school of nursing where I did five, where I did three years, and then after three years I went into the university to do a Bachelor of Nursing degree, which is four years for any person that had gone through a school of nursing, a basic school of nursing, yeah. So I went to direct entry. I started at 200 level. So when I was at 400 level I was passionate around. I was passionate about maternal and child care. That is all we call midwifery. I was passionate about that. And then I was like, okay, it looks like I'm going to stick to midwifery.

Speaker 2: 2:22

So during a rural posting in the community I got interested in taking childbirth, supporting midwives in taking childbirth. So I was like, wow, after my Bachelor degree I'm going to go specialise in maternal and child care. That is midwifery. So when I was going for my Masters, I went for Masters in maternal and child care. That is midwifery. So that confirms that I'm going to specialise in midwifery. So I took that route. And then when I went to my PhD, I won an international scholarship from Cardiff University to study PhD midwifery. I was to study the well-being of the Nigerian midwife, so yeah, so with that I just sealed it that, yes, I'm going to go midwifery full, and that was why I'm into midwifery yeah.

Speaker 1: 3:17

So whereabouts did you work as a midwife? You said you went rural. So did you do rural community? So what level of health care do you have in Nigeria?

Speaker 2: 3:28

Okay, we have three levels of health care we have primary, we have secondary and we have tertiary. So I work in the primary, which is the rural hospitals in the rural area. Yeah, I practice as a midwife for like four, four years or five years, because while I was at the university even then I was not a midwife, I was a nurse I got a job before I went to the university in the rural area, so I was still working and kind of going to take some childbirth and support to get some coins at the end of every month while I was still studying. So, yeah, I practiced there for like five years. So at the end of my university degree I got a job as a lecturer in the same department. So I quit. I quit working in the rural areas and then continue working as a lecturer in this current department for the last 18 years.

Speaker 1: 4:24

What do you enjoy about working as an educator the most?

Speaker 2: 4:30

I like the joy of impacting knowledge on potential midwives. I like the business of producing more midwives, because we have a terrible shortage of midwifery in Nigeria and then we have a highly unacceptable level of a totally unacceptable maternal mortality. So I think I enjoy producing midwives so that we have more midwives in circulation, so that they will support mothers during childbirth.

Speaker 1: 5:00

Yeah, what's some of the bigger changes that you've seen in education, especially in Nigeria, in midwifery education, in the type of students that come to midwifery? Has that changed? Or the level of midwifery? What's kind of changed over the last couple of decades?

Speaker 2: 5:21

Okay, we have a problem now. Now in the basic school of nursing, which is not in the university, we have a decline in the number of midwives, in the number of those persons that are trained as nurses, that are trying to become midwives. We have a reduction in the number of that because and then I try, I'm currently trying to do, I'm doing a study to find out, I'm looking at the hesitancy in the joining in midwifery education among potential nurses in Nigeria, because I realize that people are no more going for midwifery. Yeah, people are not going. Those from basic school of nursing they are not joining, they are not going straight to midwifery. There's not a strong passion that I want to go for midwifery like it used to be those days like 10, 15 years ago. There is none. So we have a few persons going and then some people are just only interested in getting the certificate, but the passion is not as strong as it used to be before. So I'm trying to, I'm doing a research now, a low key research, trying to ask students that I know that fit in my inclusion criteria to find out why.

Speaker 2: 6:30

What is the? Why are they not joining? Why is the hesitancy in joining midwifery? I'm trying to find out now, yeah. And then we have for midwifery education and tutors. We have few persons also joining and trying to specialize in midwifery. Why? Because they are looking at the value. There's no much money in midwifery. People are going to psychiatry because there's this, this hot rush around mental health, not just in the UK, so people are passionate about going to go going for mental health. So as soon as they have qualified they just go look, go to a job search, get a job in the UK and just leave the country. So we have a bigger issue around that, yeah.

Speaker 1: 7:16

And that doesn't help with retaining staff, keeping qualified staff, but also keeping younger people within country who want to go outside and explore different countries.

Speaker 2: 7:29

Exactly exactly. There's a serious issue of around skill worker migration. Why? Because people are not the level of economy in the country. That's a very serious issue and that I found out in my PhD research. And then the pay the take on pay is not enough to take them home like they usually see, so is a huge issue. So people are traveling for the monetary gains and for greener pastures as well.

Speaker 1: 8:02

And do a lot of people, because I know we're talking to some Filipino nurses that I know and Filipino midwives that it's almost expected that they will go work overseas and then send money back to support the family. So and I know that some of the midwives in Zambia who work overseas were doing the same thing Is there a similar expectation from the Nigerian midwives who do travel overseas to support family back home?

Speaker 2: 8:26

Yeah, that's. That is the key thing. Everyone is going because of the economy, economic situation, people are going for greener pastures, and then our currency is one of the miserable one of the most miserable currency in the world now. So people are rushing to to high income countries to get more pay so that they will be able to send it home to their parents and then take improve the quality of the lives of their, their siblings, their parents back home in Nigeria. So that's why everybody there's a hot rush about getting getting job in abroad, finish and then go back.

Speaker 2: 8:59

In fact, if you go abroad to study, if you, if you plan coming back when people will be like like I finished from the UK, people were super surprised how on earth will you come back to Nigeria? Why didn't you decide to stay back? I said no way, I'm going to come back because I feel my value and then I'll be able to give more here than stay in the UK. They have nothing to lose that because they have tons of qualified people there. They have expertise around, unlike here that we have. We're struggling with the quality of what we're going to be giving people and then we need to build the capacity of our own staff here, and then we need people to stay to produce, more people to help. Yeah.

Speaker 1: 9:40

And I think the United Nations has brought out a statement and a policy to it's listed a lot of low resource countries that they recommend not to employ staff from in the high resource countries so that not to exacerbate that lacking of staff from within the countries that desperately need it.

Speaker 2: 10:00

Yeah, yeah, yeah, but I don't think that law is actually working, because people are still living.

Speaker 1: 10:05

Yeah.

Speaker 2: 10:06

In the UK they are still employing people, low key. The laws are laws. Laws are just like a piece of paper. That policy is just like some piece of paper. Is at the point of implementation. That matters so they may make. Is wanting to make policy, is wanting to implement the policy so they could make policy. People may not be implementing and then behind the bars, the people may be, maybe, maybe, like sneaking and traveling and getting jobs in each of the city, jobs. So those are policies. So wanting with implementation and is wanting in making policies.

Speaker 1: 10:43

And that's it. It's very hard to do something that's going to be global, because you want people to go and support their country and they want people to also support their families. And how do you stay in? And, yeah, it's very, very difficult when the reality hits in that countries don't have to think about a lot of people don't have to think about. Yeah, so you went to. You went to Cardiff. So, with your PhD and going to Cardiff, how did you end up at Cardiff and did you have a choice of who your supervisors were for the topic that you wanted to look at?

Speaker 2: 11:18

Yeah, thank you very much for that question. Um, yeah, I. I I started a PhD in Nigeria here, but I was I wasn't. I was looking for fulfillment. I wasn't really looking for just getting a certificate in PhD, I was looking for how we fulfilled. So I kept searching and searching and searching. I had a mission at King's College, but King's College is crazy and is in central London, so I and then I had to look for scholarship because the money was too much. Just school fees was around 22,000 pounds. So I was, and it's living in central London is ridiculous.

Speaker 2: 12:02

Yeah, it is crazy. So I had to have a plan B. So I have a couple of two students that we're having a masters in, we're doing their masters in Cardiff University. My student that I taught at Tots during the undergraduate period here, so so I had a chart with one of them and they say, oh, cardiff is a good place to study. It's also a group of Russell is a Russell group of university as well. It's a group that it would be nice for me to come there.

Speaker 2: 12:28

So I was like okay, and then I started googling. Okay, even before then, before I spoke to them, I was searching for professor of music free anywhere in the UK and I saw Billy. And then I saw her research. And then I read a current research she did around resilience in 2013. So I then I read that in 2014.

Speaker 2: 12:52

And then I was like it was a new concept. I was like okay, and then during my masters, I was passionate around qualitative research. So but then back in G around, we have many people into quantitative. Nobody understand the concept of qualitative research. We have very few people that understand qualitative research. And then even them, even those persons that are, we feel they are qualified and we also encourage people to do qualitative research because, yes, we don't have to do that for now, until we have loads of people.

Speaker 2: 13:24

So when I saw her research I was like, wow, since we have an unacceptable level of maternal, let's see if we're able to care for the care of, perhaps the carer will be stronger enough to give quality, because you cannot give what you have. So I said, okay, if you are able to look at the providers of media free services, let's look at them. What's problems with them? What about them? Let's see what stresses, what problems, what issues they have around. How can we better support them? So none of the midwife voices have been heard.

Speaker 2: 13:59

So I decided to look at another retro bill is work painstakingly, and also that she was recommending, suggested for study, recommended for studies. So just suggestion for further study. She recommended that such side of study, type of study, should be replicated in low and middle in concrete results. Okay, that's fine. So I sat down one night and now calling a topic and then I wrote a bit of abstract sorry, a bit of proposal for her, and then I used most of her work to support all my assertions so I sent to her. She was like, wow, this is a good proposal, so let's see. And then she said she sent me a link to apply. So I applied for Cardiff University and then I got admission. Then the next day she sent me a link. I didn't know, I just saw online. And then I started sending messages. She was like okay, alima, you know what you're going to do. You're going to apply for this scholarship. I was like well, this is an amazing woman from another planet.

Speaker 1: 15:02

So I was like yes.

Speaker 2: 15:04

Honestly, honestly. So I just sent in my CV, I feel, in my CV. I sent my CV to her. She looked at my CV again painstakingly and rearranged it for me. Yep, I was so amazed she gave her own comment on my CV. Even I don't even know her. So I went back. I walk on the feedback she gave on my own CV. So when I finished and I sent in the application, behold, after two weeks I opened my email. I saw congratulations, we are delighted to offer you a scholarship A Cardiff.

Speaker 2: 15:37

I was screaming that day. I was like, oh my God. And then I thought Billy was super excited. Yeah, hello, she doesn't she. Billy has never met me, she doesn't even know me. She only knew I was an academician.

Speaker 2: 15:51

I was an academic back home in Nigeria and I'm a midwife trying to study the resilience of Nigeria midwife. So she was ready to support me. And then, bam, I just had it. So I went to Cardiff and you know what? I only know my husband. There's my husband's friend who they did, who is my husband is a professor of obstetric and gynecologist as well back in Nigeria. So he had a friend. They did medical school here in Nigeria. So what he's he?

Speaker 2: 16:17

He traveled abroad to live in the UK. He has been in the UK for the last 25 years, I think so. So he he actually came and picked me from the airport and then he was staying in Bridgen. I was staying with him in Bridgen. Between Bridgen and Cardiff is around 15 minutes 20 minutes by trains. Yes, so, yeah, yeah, 20 minutes.

Speaker 2: 16:39

So I was shuttling. I was shuttling Bridgen and Cardiff until I got accommodation. So when I got accommodation, I just moved from this place to my accommodation to to my flat, and that was where I remained until the end of my graduation. Yeah, and then I left Cardiff. So, yeah, so I just search. I didn't. I searched for a professor of midwifery and I saw Billy. And then, because I had students in Cardiff and I called them to tell me more about Cardiff University, and then they told me interesting stories that Cardiff is an amazing place to study. And then I read through a lot around Cardiff University that is not there's no, it's not like. It's not a porcelain and bustling city like in Bland is a quiet place to study. It's quite peaceful. So when I went there, it was really a peaceful place to study as a student.

Speaker 1: 17:31

So, yeah, how did you manage being away from your family, because you were there for the whole three years that you were doing your qualification, yeah, so how did you handle the separation and the loneliness, or did you suffer from loneliness?

Speaker 2: 17:49

Okay, yeah, I had a lot of issues, so many issues, during my PhD.

Speaker 2: 17:54

It was very troubling, honestly it was. But then I had an amazing supervisor and then I was actually studying resilience, right, so I was looking at adversity and then I was looking at resilience, so I was going through an adversity, so I was trying to marry my findings and my own life experiences. So the PhD is the most difficult in anybody can, is the craziest thing anybody can ever do in a lifetime, honestly. And then outside the PhD, I had my family, and then I had there was a lot of issues in Nigeria. Then there was a lot of kidnapping. There was a lot of killings around then, and then I even developed a panic attack during my PhD, yeah, so I had to see a psychologist and Billie was the biggest psychologist I could ever had. She kept encouraging me.

Speaker 2: 18:42

And then during my PhD, I lost my brother. My brother who was literally like my son, who was living with me, and then I came home in between to see him, but unfortunately, two weeks after I left him, he passed away. I was devastated completely. It actually affected my PhD because I became lost. I failed. I think that I failed that I didn't even stay back to not seem to be dead. So I had that guilt living with me. So I kept speaking to Billie. I was completely at my wit's end, completely. So I was just talking to Billie, she was encouraging me. She said, halima, you need to talk to. You, need people to support you. If you need help, you need to talk. So she kept encouraging me Halima, you can do it. Are you sure you don't want to take some time off? I said no, we're proof.

Speaker 2: 19:32

Getting out of this PhD. You know when you get out of your PhD, if you want to try to get back in, it takes a lot of process. I knew if I get out, it would be difficult for me to come back. So I told her that it's better I stay right here in Cardiff. I'm just going to find a way to navigate through, because we believe more in spirituality. So I was calling through the powers of God and looking for strength. So that was what kept pushing me and pushing me.

Speaker 2: 19:57

I didn't know how I was able to do that, but I know Billie was a very massive support for me and then my family was a stronger support system for me. My husband was always calling to support me While I was in the UK. He comes in and goes back and then he comes with the kids as well, yeah, so I was just managing and managing and managing and managing, yeah, and that was all. And actually my PhD didn't last for three years because of the COVID and other stuff. It was I did it for five years, right, yeah, I was supposed to actually finish it in 2020, but because COVID came around February, february, march, it came to Cardiff, it truncated everything. So I think we added around six months to one year, so I didn't finish in 2020. I finished in 2021. That was what happened.

Speaker 2: 20:52

Yeah, so the biggest support system was my supervisors. I think I had three amazing supervisors and then my family was also a stronger support, and my friends around me in Cardiff, too, a stronger support. And even I have a lot of PhD bodies that we're always looking at. Alima, because I'm always looking out for them. I worry a lot around people around my colleagues that are doing their PhD If they have an issue, because I have a research experience more than many of them before I came to Cardiff. If you're struggling with anything, just call her Alima. So when I was in BIP in, I was struggling. They were also looking out for me. I had many of the British ladies today. They were also my friend. They were also calling to check me. I think that helped me my friends, my family and my biggest support was my supervisor as well.

Speaker 1: 21:40

Yeah, so who were there? Other two supervisors?

Speaker 2: 21:44

Yeah, lucy, one, dr Lucy Warren, and another guy, dr DeKair. He's a Greece, he's from Greece, he's also a nice guy. So they were also checking on me and calling me, alima, are you sure? And then they helped me a lot. I remember when I was developing my theory during COVID, I was blank. I think I wrote almost 20 diagrams. They were not satisfied. One day I came up with something and then we sat with one of them, I sent it to her, we sat down together on the screen and then she drew it for me, practically because she knew I was struggling. I couldn't do anything. So we did it together. Alima, do you think this is okay? These colors are they okay? I said yes, and then we did it and then that was all. Then they accepted my theory and then that was it.

Speaker 1: 22:32

So let's go back to the beginning. So you're looking at resilience in Nigerian midwives. So how did you collect your data and what did you find?

Speaker 2: 22:40

Yeah, okay, I collected my data in Nigeria. I was looking at workplace adversity and then I was looking at resilience Now. So when I came home, because I was doing the grounded theory, I had to collect it twice. So I collected the first bit of the data. I look at workplace adversity. I try to understand those women.

Speaker 2: 23:04

I put on a criteria for those women that identify themselves as their resilient midwives. So I asked them who will you consider as a resilient midwife? So anybody that gave me an example, I say what example of a resilient midwife Can you name? So the name I was writing down their names. I noted those persons that consider themselves as resilience. So in my second data collection I went to look out for those persons that identify themselves that were considered as resilience, resilience and then I started interviewing them and then I asked them for that to tell me are they other midwives they feel could be considered as resilient midwife? So they pointed names. They pointed the names that previous persons have already mentioned in my list. So I went to meet them, one after the other.

Speaker 1: 23:58

And what did you find about those resilient?

Speaker 2: 24:05

Yeah, they considered resilience as being tough, which was not resilience. Yeah, they consider as being very tough, very hard. And then I asked them now what were the resilience strategies that they use? They told me one was spirituality, one was having the sense of purpose, one was self-awareness. One was an improvisation, using improvisation, in the presence of no facility. They talked about having.

Speaker 2: 24:49

They see Midwifery as a calling. Because they saw Midwifery as a sense of calling. They believed that Midwifery is their calling. So because it's their calling, they're more passionate and was able to make them cope in the presence of adversity. Yeah.

Speaker 2: 25:16

And then they talked about the power of collegiality. Supportive collegiality was very strong for them as well, which was mentioned by almost all the participants. They also talked about professional detachment Right, yes, because attending to a traumatic bat was a source of adversity for many of the midwives. So a way of coping for them was professional detachment, which is an abnormal coping, yeah, an abnormal resilience. But they said they need to do that because they have so many bats to take care of. If they don't detach from the traumatic bat, it may not help them give the next woman the cash you need. So they did a lot of professional detachment to support them.

Speaker 2: 26:05

Yeah, and they talked about the value of family support system in their coping. And then they talked about unwinding, that is, switching off after work. That helped them. And then, yeah, that was what they said I think they had around 14 of them. And then they talked about balancing up at work and then mixing up with people that value you also make the world useful as well. Yeah, and then making them coping, having a sense of coping during adversity.

Speaker 1: 26:35

What surprised you the most in what you found when you were doing your PhD from the responses that you were getting?

Speaker 2: 26:46

What surprised me most was that they talked about yeah, what surprised me most was that one of the acoping mechanism was wearing five gloves.

Speaker 2: 26:59

Okay, yeah, with midwives we have five gloves at a time because they have no time to change to attend to the women, so they wear five gloves. So once they take one of the child baths and then the next one is in labor, they remove the glove the next one because there's no time to go and change into another glove. So they wear the five of them. So they're ready to keep taking child baths across the 10 to 15 women in labor, because they could be two midwives on the night shift but there are many women to collect delivery from them. So all they need to do was to put on their five gloves so that they'll be able to navigate the 10 to 15 women on labor. So that was totally surprising for me, and then I was surprised how they do that, but that was nothing for the midwife. They said that is one of the resilience strategies to cope in the middle of shortage of resources and shortage of manpower.

Speaker 1: 28:00

Yeah, and it's that innovation. When you think about why they do that is they're trying to maintain the principles and practices that they know are necessary, but so also. Well, this is the reality of what we live in, and we have to modify to be able to do what we can do in the best situation that we can.

Speaker 2: 28:23

Exactly, I think, the second bit you've just said. They have to do what they need to do to survive it because there's so much on their plate there's nothing they can do about it. You know, there's this thing about what, michael? I don't know that, I have read about this, but it's called the street level bureaucrats by Michael Lipsky in the UK. Michael Lipsky in 1978, he talked about the street level bureaucrats, that policies like a piece of paper, at the point of implementation. You have to do what you need to do in the event of in the face of events. Why? Because that thing maybe Jim may not be the right thing.

Speaker 1: 29:04

Yeah.

Speaker 2: 29:05

They have to do what to do, so that they have to use their discretion to manage the situation at hand. So that is why they may need to wear, put on those gloves to serve, even though that is not the policy. But then they need street level bureaucrats at the street where they need to do what they need to do to support women at that time. So that's why they put on those gloves and then that may explain that and that was what I used to back up that findings.

Speaker 1: 29:29

Yeah, Because policies and guidelines are written in the ideal world with ideal situation and ideal resources available, which we know that. And it can be any country, it can be any regional, rural area. It can be anything happening. We look at climate change at the moment. We look at weather changes and patterns, we look at fires, we look at floods. That changes, the situation is no longer ideal and you have to be able to improvise.

Speaker 2: 29:58

Yeah.

Speaker 1: 29:59

So when you look at the kind of the demand that's on Nigerian midwives and working, you look at the money that you're kind of getting paid to do that. You're looking at the stress and the burnout and the moral distress that midwives are kind of going through. What has been done to try and change that, to try and keep midwives healthy and happy within?

Speaker 2: 30:28

the job. I'm afraid they've not been anything done seriously Right. So we need to keep talking. Change doesn't happen overnight. You need to keep talking. You need to also join policy makers. You need to find a way of joining politics because if you are not in the kitchen at some point you should find your way to the dining so that you should be able to make policy. You need to be able to contribute to policies to see if the change will happen.

Speaker 2: 30:59

I remember that I recommended in my PhD that midwives should we need to rise up to the equation and rise up to the location and take up political positions so that they will have a say in their own stake, in their own positions. Or else, if you keep looking at yourself, that no, midwives can't see much. You need to rise up to the equation. You need change. Sometimes you need to go to some strategic point to be able to make the change you want to see happening. So you need to talk. You need to join. Like I've said, join political positions and see if you can create that change that you want.

Speaker 1: 31:35

Yeah, what do you say is the future of Midwifery in Nigeria?

Speaker 2: 31:41

Yeah, I think Midwifery. If we have a lot of people like us that are passionate about Midwifery, I think Midwifery will change. And then I'm beginning to get linked to somebody in the council that is also doing a PhD in Midwifery right now to see how we can all work together and see how we can change the position of Midwifery in Nigeria, because Midwifery is still not valued. They all keep about nursing, nursing, nursing. But what about Midwifery? Midwifery is a beautiful career. It's on its own itself. So why won't we be valued?

Speaker 2: 32:24

We are taking care of two lives the mother and the baby, so we should be valued. What the heck we are doing so much because we are trying to support the woman through antenata at labor. We are fighting too hard to see. The mother is out of distress. Not only the mother, the baby may also be having a fit out of distress. So you need to fight hard to save the lives of two women, two lives the mother and the baby. So Midwifery should be changed. People should work together and see how their voices can be heard and therefore Midwifery to change as well.

Speaker 1: 32:55

I think that was one of the really good things that I experienced at the ICM and it was really unfortunate that you were unable to make it this year in that community of conversation on similarities but also looking at some of the amazing work some of the Midwifery advocates have done in Canada to change the system over there and being able to bring in some of the young leaders who are just amazing for when you think about what they're going to be able to do for the future. But talking about that energy and going well, they've done this. We can try this, but it's got to be in our context, it's got to be within our culture, it's got to be addressing the way that the country works, but getting Midwifery identified as its own unique profession internationally in every country, and not a subset of nursing. What would you like to see change?

Speaker 2: 33:48

Okay, yeah, so what I would need to see change is I want to see Midwifery being valued. I want to see even the pay of the midwives could be improved upon and see. And then I want to see the introduction of Midwifery models, to see child models, because Midwifery is terribly medicalized here. Yeah, maternity care is terribly medicalized here. I'm beginning to see if the model of Midwifery-led care should be adopted in many of our tertiary, even our primary. I'm trying to see if we can write I've just been working on a grant, a paper, to see if I can develop how, the possibility of implementing a Midwifery model of care in rural areas, if the midwife India could be supported and there would be an amazing Midwifery model of care there, so that everybody we go there, those complicated cases, will be moved to tertiary institution. And then I'm telling you a maternal mortality is going to be what we under control, I'm sure. Yeah.

Speaker 1: 34:58

I've got to ask you how did you celebrate your PhD when you finished it? Finally, with COVID, kind of like lockdowns and running it.

Speaker 2: 35:05

Oh. So after I passed my PhD, I think I did mine. In fact, you know what, liz? It was unbelievable, I thought I was in the dream. So after I was told, helima, you passed, I still couldn't believe it. I was selling clay because I went to the cutting floor. I think we were coming out of COVID, but I had my own. I had my defense August 2021. So what? I did it in school, but it was still on Skype. But I went with the secretary because I was straight up doing it in my room. So I went to the school to meet our research. I went to our research office, so I sat down there with my laptop. So I did it.

Speaker 2: 35:46

My Viva was the most easiest part of my PhD. Yup, because when we started, my readers was like they enjoyed my dissertation, like they enjoyed reading it. The every word was straight to the point. I'm very clear. There was minimal typo. In fact, they were so happy.

Speaker 2: 36:05

The two readers, the two external examiners. The examiners were amazing. One was from I think she was from North Inham University of North Inham, and then the other one was one of us, one of my lecturers in our school. So he was like, even before my Viva. He was already telling one of his students, one of his supervisees, that after that he has a student that is coming out for decide for her, viva, that it would be nice for you to grab her thesis after he's put out there in Oka. The Oka is like our own university repository, where they drop the thesis when it's completed. So he had already told her so.

Speaker 2: 36:53

One evening she called me, just two days before my Viva. She said Halima, don't worry, don't even worry any bit, because you have no problem. So she actually did it for me. She didn't want to tell me the conversation she had with her supervisor. She said who is my internal examiner? She just told me to Halima, don't worry, you're just going to be fine.

Speaker 2: 37:12

So and then I went to city center. I bumped into another student of my internal examiner. He now said oh wow, halima, your Viva is coming Wednesday. I said how did you know that? I know I didn't tell anybody. He said oh no, my supervisor, who is your internal examiner, has been telling us so much about how I was. Like, wow, this one has told me has leaked the secret out for me. This one has given me a spoiler already. So I was like oh, so that means my Viva is going to come. So that reduced my anxiety. So I was like, okay. So I had two information from his supervisors already because he enjoyed.

Speaker 2: 37:57

So on that day I wasn't tense at all because of the information I had. So I was calm. And then the internet was frustrating us. That day it was Zoom, but everything went wrong that morning. Oh no, honestly.

Speaker 2: 38:13

So at first we wanted to use the desktop of the research office. It wasn't working. We tried everything. It refused to work. And then I just connected to my laptop and then it started working. So then we are amazed with the way I was calm.

Speaker 2: 38:26

They didn't know that I had two information from two persons that I'm going to have my Viva beauty. So I was quiet. So when we started it was okay. I took them through where they didn't they were really interested in where. That wasn't clear to them. But my thesis was very simple and very clear. So they just asked me to go to where they didn't understand. So I took them there.

Speaker 2: 38:49

So after the Viva they told me to wait for 10 minutes and when they came back they told me Halima, congratulations, you've passed, with minor correction. I was like, can you say that again. They say Halima, you've passed with minor. I was like, oh my God, thank you so much. Billie was so excited. You could see how she was going to jump out of the green screen to come and give me a big hug. She was so happy, super happy. So she was afraid because there are areas I didn't talk too much about. But I knew they were going to ask me. But I was ready with the information. But I was thinking, because I had to write no more than 80,000 words, but because it's a quality I had so much, so I had to reduce. So I didn't say some bits so much, but I know them.

Speaker 2: 39:36

So on that day they asked me to speak about that. So because I've read them, they told me Halima, you know that theory. They asked me to ask a sociohecological model of resilience. So I mentioned a bit about it on one of some way my thesis. So they asked me to expand more, at least as you write up to two paragraphs. So I said OK. So when they asked me, I talked about it so well, so he was impressed. Now, oh, no, halima, you know that. Then you add it somewhere in your thesis. And then they told me I think that was the only correction. I had Nice and then it was so amazing. So after that day we celebrated that day. I still couldn't believe it because my friends were calling. It was a massive celebration in my school because they know me.

Speaker 2: 40:18

I come to work, I come to the office around 9 AM. I don't leave. In fact they say, halima, you're literally living in the office. I'll tell them yes, because when they leave me they come to meet me in East Gate House, our office, and then they leave me there. Then they come back on SD. I come early because my house is my flat, it's just not far from the school. They come to meet me in the morning. I'm always in the school around 8, 30 or 8. But they come around 9. They will meet me there working and then they leave around 5. But I can still till 8 or 9 in the office. I don't keep because my house is just close by and then I'm not with family, so I could spend the whole day there and yeah.

Speaker 2: 40:59

So when it came out everybody was happy. They know, halima, you deserve your hard work paid, paid off, so many things. And then I had friends that called me to go to one or two joints to have to. I think we combed the whole street. We painted the street red. The next day, all my friends were calling Halima we need to go catch the phone, we need to go there, we need to go and eat this. We need to. I think I enjoyed myself that first week, yeah. Then, when I came home, my family celebrated with me. We had a mini party at home. Yeah, it's my loved ones, yeah.

Speaker 1: 41:37

So do you know any policy changes or clinical changes that have happened as a result of your PhD? Or that's still early days to try and that's a long term problem.

Speaker 2: 41:51

Yeah, it's a long time problem. I'm still trying to organize some seminars to talk about resilience strategies, how midwives cope around, try to navigate through the hardship they face at their work front. So I'm trying to design a poster to see how if the midwives can give me some time to talk about resilience strategies, how people can cope and people are talking about. I want to talk more about supportive collegiality. I want to talk about putting down orders down. If you find out your colleagues are struggling, you need to support them. So I'm trying to work hard with in fact, I have an appointment this morning. After your meeting, I want to go and meet the director of nursing in the teaching hospital close to me to tell them that they should give me a day to talk a bit about my PhD findings to them there in the hospital.

Speaker 1: 42:39

Yeah, that would be. I think one of the hardest things is how do you support your colleagues when you're struggling yourself?

Speaker 2: 42:48

Exactly, exactly so I think we talked about compassion in our paper, which is, we talked about the need for hospital to show compassion to midwives, because they may not be able to give what they don't have If they're not being shown compassion. It would be difficult for them to give compassion to the women they care for. Yeah, so and then if the women using the facilities could see that the women are not the midwife? Because they could tell, if they are midwife and not showing compassion, they may not be trusting and they may not use the facility, and that may worsen our unnecessarily high maternal mortality. So we need to find a way around that, because it is not the responsibilities of the midwife to develop resilience on their own self.

Speaker 2: 43:33

So if they fail to develop resilience, it is not their fault, because how do you expect them to cope in the face of shortage of resources, a lot of deaths happening, no manpower to support them. Even their pay is not good enough to take them. Their take home pay is not even taking them home. So it's an issue for them to survive. Yeah, so there's a lot that need to be done. There's issues at the meso level, at the macro level. They need to be a lot to do to support this midwife. Yeah, the midwife then said they do a lot. The hospital environment need to do a lot. Then the wider political environment need to do a lot to support the midwife, to be able to give good quality and compassionate care to mothers and their babies.

Speaker 1: 44:24

How much damage or influence did COVID do to the healthcare system in Nigeria, because we hear about it in a lot of different countries and that the staff are exhausted, resources were kind of bad, staff died as well as kind of patients. How did it affect Nigeria? Because we don't hear a lot about how it affected in the various African countries from the outer kind of higher resource countries.

Speaker 2: 44:52

Yeah, I don't know the magic that happens in Nigeria. I'm not sure we recorded any much deaths from COVID. Yeah, I don't know what happened in Africa. In my own setting they kept. Anyway, they kept. There was this rumor that they kept inflating rates of people that are dying, because we are not seeing that in the hospital, like it was mentioned in the media, that social number of people are dying. But in the real case in the hospital we end getting cases. We may get people that have the COVID. They may just go through it, have the symptoms and then they are fine and back to their feet, but we didn't have people dying consistently from COVID. We may request some few cases, but it's not as bad as people are seeing.

Speaker 1: 45:40

Yeah, so what's next? You've talked about the resilience education. You've talked about the current study that you're doing. What else have you got planned for the future?

Speaker 2: 45:51

Yeah, I'm actually planning. I'm thinking of a postdoc. I'm trying to see yeah, I'm thinking of a postdoc, but I want to exhaust. I'm thinking of it for against next year. I want to see in the next six months if I'm able to come up with two papers for my PhD or three papers. I've written one already published in African Journal of Midway Free, yeah. And then I've done series of conferences. I've done seven conference papers from my PhD. I have to do this, yeah. So I want to complete two papers before the end of this year. At least I want to have three papers before the end of this year and then by next year. I'm working on the proposal to send to either UTC in Australia for my PhD, yeah, for my postdoc.

Speaker 1: 46:43

Did you end up presenting at the Virtual International Day at the Midwives about your PhD?

Speaker 2: 46:49

Yeah, I've done it lots.

Speaker 1: 46:51

So what year did you do your PhD presentation for the IDM? Because people can go to the YouTube channel and they can actually have a look at all the presentations over the last few years and actually have a look if they want to go a bit more detail on what your presentation was.

Speaker 2: 47:05

Yeah, I think I've had about two presentations from my PhD at the Virtual International Day at the Midwives, and then I had at the is it Maternity Espoir Conference in England, in London that was in 2020. Yeah, 2019.

Speaker 1: 47:30

So there's enough reading, and then we'll put the publications for your other paper and the compassionate one, the links to your research, when this episode goes out, as well as usual. Okay, thank you very much for your time.

Speaker 2: 47:44

Yeah, thank you. Thank you. I think I enjoy speaking about my PhD and I'm happy you're able to ask me some of the things and I'm happy to contribute to what you're also doing, as long as it's going to make Midwifery go further, and then Midwifery will be valued and recognised as well.

Speaker 1: 48:00

Yeah, absolutely, and I think that's kind of hopefully. What we all want is the recognition of not only the role, the specialty of the role, but how the research that we're doing is important for future generations as well. Exactly, exactly, yeah, thank you for joining us today. You'll find all the links on Twitter, instagram and on the podcast website. If you are a Midwife and you would like to share your research, your postgraduate studies or even the quality improvement projects you are doing now, then email me at throughthepinardcom, send me a tweet or send me a DM.