HOSPITAL visitors come in all shapes and sizes, but Gillian Pearce had to look twice when a goat wandered through the maternity ward of an African hospital.

The Hillingdon-based midwife took it in her stride but wasn’t so keen on the rats.

“No, I’m not a big rat fan,” said the 53-year-old who is going back to Uganda on a Rotary Club-funded visit for the third time later this year.

Gillian is part of a team training maternity staff at Kamuli Mission Hospital in baby resuscitation and handling emergency births.

The hospital, which serves a population of 750,000 people, has one doctor and lacks basic amenities, including running water and a regular power supply.

Its remote location means people often have to walk miles for treatment and families often camp outside to cook for and feed their sick relatives.

Medical supplies and equipment are scare and family members often buy supplies at the town’s only pharmacy, which are then administered by hospital staff.

Gillian said: “We had to go back to basics to match the lack of training and medical equipment. It was challenging, but you have to be flexible enough to come up with solutions that staff can use on a day-to-day basis.

“This ranged from simple advice, like changing bed sheets between patients and regular hand-washing to drying and wrapping a new-born.

“I couldn’t fault the cleaners, though. Whatever they cleaned the floor with took the rubber off the soles of my shoes!”

Healthcare in Uganda isn’t free. The cost of delivering a baby at the 160-bed hospital is £10, rising to £35 for a caesarean. It’s a lot of money when you consider average daily income is less than £1 a day.

An important part of the team’s work was a train-the-trainer programme so that new hospital employees could pass their skills on to colleagues once the team had returned to the UK.

They used dummies and simulators for training, including Mama Natalie, a mannequin that can be strapped to a trainer's torso to simulate a pregnant womb with an unborn baby.

A second mannequin, Resusci-Anne, was used to practise resuscitating a sick new-born baby.

The hospital is responsible for more than 2,000 deliveries a year, with a mortality rate 76 babies per 1,000 births and a maternal mortality rate of 506 per 100,000.

Premature survival rates start at 34 weeks and there is one midwife per 40 women.

This compares to 4.2 per 1,000 at Hillingdon Hospital, which can provide effective neo-natal care from 24 weeks, with a midwife-patient ratio of one to 30.

Gillian says the obvious poverty is matched by sometimes frightening ingenuity, such as a baby incubator made out of a glass-fronted packing crate with light bulbs fixed to the board and a tray of water underneath to produce humidity.

Resuscitation techniques are basic, with a premature baby being tickled lightly on the chest to stimulate breathing. It has a poor success rate.

Gillian says she cannot fault the commitment of staff, who turn up every day, despite the often trying circumstances, including not being paid for three months.

Some hospitals may question the value of staff volunteering to work in developing countries, but Gillian says it benefits individuals and their employers.

She added: “It’s a valuable lesson in resources because you have to make do with what you’ve got and be flexible enough to come up with an alternative if it isn’t.

“It also teaches you to be practical and a good communicator. You come away with a better understanding of yourself and others - and that can only be a good thing.”