Abstract

The Eleanor Bradley Fellowship was established to enable specialist trainees from the UK to gain valuable obstetric experience in a resource limited setting. Set up in 2008, by the RCOG it facilitates placements of 12 month each.

To date there have been three consecutive fellows each based at the Mulago Hospital, Kampala. This is the national referral hospital for Uganda and has approximately 33 000 deliveries per annum. The high number of patients and poor staffing levels lead to a high maternal mortality. 186 maternal deaths occurred in 2010.

Achievements include the development of a postnatal high dependency unit which has significantly reduced maternal deaths on labour ward (p≤0.0001) and neonatal resuscitation training for over 200 midwives. The fellows initiated a training programme for recognition and management of the critically ill patient. They successfully introduced guidelines for good practice on labour ward and promoted the use of audit. Following a sepsis audit rates of infection in the department fell dramatically.

There are many benefits for the trainees; the opportunity to experience specific obstetric conditions rarely encountered in the UK benefits them clinically, while the challenges and wider life experiences encountered promote leadership skills invaluable at the consultant grade.