Five Minutes with... Alice Waterman, Midwife Trainer, Sierra Leone

Sierra Leone has the world’s highest rate of death amongst women giving birth. A staggering one in eight women don’t survive childbirth there – that’s fourteen women dying every single day. VSO volunteer Alice Waterman has been teaching Sierra Leonean student midwives simple life-saving skills – to prevent unnecessary deaths in the labour room.

What are the major risks for women giving birth in Sierra Leone?

In Sierra Leone it is part of everyday life for mothers and babies to die. Too many hospitals simply don’t have basic utilities like 24-hour water and electricity and suffer from a shortage of trained surgeons to perform emergency caesareans and well-trained midwives. There’s a lack of basic midwifery equipment, and traditional cultural beliefs can also compound the issue. For example, some women won’t go to a hospital when in labour unless they have been granted permission from their husbands. All these things contribute to emergency treatment being delayed and lives being lost.

How vital are midwifery skills?

Sierra Leone has such high maternal and infant mortality rates so naturally midwives play a vital role in addressing this. With only two midwifery schools in the country, many babies are delivered by poorly trained health workers. More midwives are desperately needed to support a rapidly growing population.

Describe your day to day activity

Teaching starts at 9am, in small hot rooms with little ventilation and no fans. On average there are around 70 students in a class.  Earlier in my placement there was poor electricity, so all the teaching was talk and chalk – with very little use of audio visual equipment, but we have fun in class. Students have been taught in school by rote and often ask to use my pre-prepared notes - but I encourage them to write in their own words and reflect on their own experiences. I also teach maths daily as it’s required for drug calculations. Initially students moaned – but I adopted fun methods of teaching that they can share with others, so now there’s no excuse for not being able to calculate drug doses correctly.

How do your midwifery skills contribute?

With up-to-date midwifery and neonatal skills - I have a lot of knowledge to share with students. At the start of my placement I spent time in a local government hospital observing how midwives work and make use of equipment, and taught senior staff basic life saving skills. I have also given a lot of teaching material to the school of midwifery and have left two years worth of teaching notes for future use. Students I work with – many of whom have previously worked in midwifery units before becoming student midwives say they now have a better understanding of clinical situations, and have learnt a lot of new things they didn’t know before.

Has anything surprised you?

The standard of education for most student midwives is very low, so I have scaled down how I communicate information. I have also been really surprised by how little student midwives know about childbirth, even though many of them have been working as birth attendants. This made me realise it was one of multiple factors as to why 1 in 8 women in Sierra Leone lose their lives.

What will you remember most about the placement?

The students! They are a vibrant group, colourful in the way they speak and dress, so keen to learn and a real joy to teach. In spite of the difficulties of living in Sierra Leone- the thrill of teaching student midwives who will go on to play a direct role in saving lives... makes it all worthwhile.

Alice Waterman is one of thousands of VSO volunteers making a distinct and lasting contribution to some of the poorest communities around the world.


Find out more about becoming a VSO volunteer.

Thanks to VSO supporters, see how Alice is saving lives through sharing skills overseas:

Alice Waterman


In Sierra Leone, 1 in 8 women die during childbirth, the country has the world’s highest rate of death amongst women giving birth.


VSO volunteer Alice Waterman trains midwives in basic good practices that can save lives.


New skills are immediately applied by Sierra Leonean midwives, and shared with many other midwives to prevent countless deaths.
Sierra Leone Health

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