Real-life story - Katie Skinn

In the poorer townships in Cape Town, maternity services are limited for those who don’t have access to private healthcare. I helped out at a charity run clinic that offered free consultations, antenatal check-ups and counselling for pregnant girls. Alongside a doctor and a district nurse I observed and assisted with antenatal appointments.

I also visited Khayelitsha, the biggest township in Cape Town and talked to women of all ages about the maternity care available to them. Most had never seen a midwife. In addition, I spent some time with a community of people who lived under a bridge. This included young girls who were pregnant, some with an alcohol addiction.

I wanted to see how maternity services in developing countries compared to those in the UK. In the future I would like to work as a midwife in a developing country so I wished to test myself and confirm that this was right for me. I had never exposed myself to poverty so was advised to go to an area of Africa that was relatively westernised, so it wasn’t too much of a shock.

I decided to go independently as I had a friend in Cape Town I could stay with. She was able to get a contact name of one of the doctors from the clinic, which enabled me to set up the placement. I looked at going with an organisation or a non-governmental organisation (NGO) but decided I was in a position to go independently and it would be cheaper.

I made contact with the clinic in September and went on the elective in July the following year, so it took the best part of an academic year to set up. My advice is to plan well ahead because there’ll be lots of emails and paperwork to complete, and you’ll need to ensure the placement is properly set up and will be safe.

My flights were the most expensive component but I also had to pay for travel insurance and budget for food. I was staying with a friend so I didn’t have any accommodation costs. I went for seven weeks and it cost around £1500.

Although it was a culture shock, the highlight for me was visiting the township of Khayelitsha. Actually being there and seeing the poverty for myself confirmed everything I’d thought about wanting to be a midwife in a developing country.

Seeing poverty and not being able to do anything about it was very difficult; I was asked by women what I could do to help them and I couldn’t offer them anything. My response was that I was finding out about the needs in the area and the access to care, with a view to returning in the future when I was qualified and experienced and more able to make a difference.

It was also hard that I had to raise the money for the trip myself, despite applying for various grants.

It has confirmed to me that, to be able to provide effective help for these communities, I need to be an experienced and competent healthcare professional before I return. There is no point in taking an ‘affluent western woman saving the day approach’ when what is needed is sustainable services for these communities. I have already approached a few charities who have expressed an interest in helping me set up maternity services in the future. Rather than providing limited help in one village, I would prefer to build something for many people.

If you have any contacts, friends or family in places where you could set up a placement, use them - especially abroad. It makes a lot of difference to settling into another country if someone has told you what to expect, the customs, the do and don’ts, safety issues and so on. Having a contact also makes it much easier to set something up.

Choose something you're passionate about, such as a specific area of healthcare you want to experience.

Consider going to a developing country. It will give you a larger world view, mature your own practice when you get home and make you appreciate the healthcare service we have in the UK. Even if you don’t want to work abroad in the future you will find it beneficial and future employers will be impressed too!