Week 2: Lectures, timetables and plastic babies

After our first week of orientation, meetings, paperwork, and multiple trips to the NMC of Malawi to get registered, we were ready to meet our fellow students and get to work.

Week 2 saw us attending midwifery and reproductive health lectures with the third year students. In Malawi, the shortage of resources requires trainee nurses to learn a lot in a short time, meaning a 4 year degree course here covers nursing and midwifery – students need to learn a little about a lot, and fast! The students were amazed to discover that nursing and midwifery are separate degrees in Scotland. They asked us what would happen if we ever needed to deliver a baby…

When talking to students about their course, many of them mentioned “serving Malawi” and meeting the “needs of the nation”. There is a shortage of nurses here, and the health needs of the population are vast. As a result, Malawi needs more nurses who can handle any situation that arises, and do so without many of the resources that nurses in other countries consider mandatory.

The format of lectures and teaching style in Malawi reflects the volume of information needing to be absorbed, by the high number of students enrolled each year. The lectures we attended throughout the week were very direct and somewhat prescriptive. While the lecturer invited students to answer questions, there was none of the debate or back and forth that we’re used to back home. Lecturers are highly respected (or feared) by the students. Interaction between students and lecturers is formal, with ‘Sir’ and ‘Madam’ used for politeness. While we focus on developing problem solving skills, the approach here seems to follow more of a checklist approach. However, the knowledge and conduct of third years impressed us; they were well informed, asked pertinent questions of the lecturers, and presented some well researched seminars. This is even more impressive considering that all lectures are conducted in English, even though that is a second language for Malawians (Chichewa is usually the mother tongue).

The timetable looked pretty heavy going, with classes from 7:30am to 5pm Monday to Thursday, and an hour for lunch. Friday offered some respite with a 3pm finish. Daily 7.30am starts seemed unimaginable, but we managed it. Luckily, staying on campus meant we had a very easy commute. By the end of each day we were all exhausted.

Without fail, all week long, about three minutes into every lecture as the lecturer scanned the crowd, they’d spot the 5 ‘azungu’ amongst the students, and look visibly taken aback.  Even when we spread ourselves out amongst the other students to be a bit more sociable, we still didn’t stand much chance of blending in. Luckily everyone was very welcoming and after introductions and a few questions about our background, the lecture could continue.

A highlight of the week was attending a clinical simulation lab in the new cafeteria. Over 100 students, split into groups of 10, worked with Neo Natalie baby mannequins (filled with water to be more realistic) to practice deliveries. 

We learned about the Golden Minute after birth, what to do if a baby doesn’t cry right away, and how to perform suction. It was the first time any of us had ever delivered a plastic baby (or any baby, for that matter), and it was fun to work with the other students to perfect our technique. Knowing that it is highly unlikely we will ever need to do this in the future took the pressure off for us. Then we realised that the following week, on placement, some of the third years might actually be practicing on real live babies. Nothing like getting thrown in at the deep end to focus the mind, I suppose.

At the end of the week, we were happy to have made some new friends and had a glimpse of nursing education in Malawi. We were also very excited about starting clinicals the following Monday with the first year students, conducting health checks in local primary schools. And at least now we have a better idea of what we need to do, should we ever have to deliver a baby...