A greater proportion of my work is currently focused on improving the functionality of health centres that provide maternity care. Essentially this means getting operating theatres up and running so caesarean sections can be performed without having to refer women to Mulago Hospital. If we can achieve our aim we hope to reduce congestion at Mulago and also prevent women from making long uncomfortable journeys when they are in labour. One such health centre, Kasangati (pictured) has a operating theatre which is not currently in use, however with a small amount of investment and a bit of rebuilding we are aiming to have the health centre functional in next couple of months (building is due to start next week). A Ugandan doctor has just been appointed to work at Kasangati during the week, which improves the long term sustainability of this project.My current work at Mulago has concentrated on patient monitoring. During my time at Mulago I have noticed that many women simply do not get their observations taken (blood pressure, heart rate, temperature and respiratory rate) and all too often I hear the words "woman found gasping" and then she dies before the doctor has had a chance to do anything. I believe that if these women are properly cared for and have their observations done regularly we can identify those women who are deteriorating and get help to them earlier. To try to assess the scale of this problem I have started an observational study that looks at the frequency of patient observations and any barriers to getting them done i.e lack of equipment and over crowding. Hopefully with the results in hand we can really try to improve patient monitoring, which is a step in the right direction to reduce maternal mortality.
