Exchange report - incoming students
Home university: University Teaching Hospital, Lusaka
Study programme: Midwifery
Exchange programme: INK
Semester: Spring semester 2010/2011

Arrival and registration

Early in the morning of 14.03.2011, waking up in a different country with strange people, language and the different environment seemed so unreal and it was like dreaming the reality, this was a day I was suppose to start adjusting to this new environment, find my way to Karolinska institutet for reporting and registration, we had no map for Stockholm, all we were told by our friend was we had to use Bus number three (3) has it goes to were the campus is, he told us that the Bus has the screen inside it that shows the stations and there is usually a recorded voice announcing the different stations when you reach them, this was a very reliable information that I came to prove right although in the early days it was very difficult for me to understand the pronunciation of most words and this made it difficult for me to ask whenever I wanted to find a place, in the long run this helped me know how to use the map effeciently that had picked at SOS.Whilst all these thoughts were running through my mind I had hope that lowe a guy from global friend will come to pick us up and so that we can move together to karolinska, though he was not sure if would come because on this day he only had class at 10am and we were suppose to report at 8am, fortunately the guy came as early as 7am and this was a very big relief on my part. We started off for the institute at 07:15am aboard a blue Bus no 3 from SOS to KI solna campus, we reached the campus 40minutes later and we went straight to the department of nursing education where we found Barbro, Anna staffs at KI and Hanna a student midwife from England waiting to welcome us, we were told that there are two other students from Uganda so we had to wait for them, we were offered a cup of coffee during the time we had to wait for our colleagues who came 10minutes later, after the arrival of our colleagues we were asked to go into the conference room for introduction and registration as student at KI though we didn’t finish the registration because Magdalene (the international student co-coordinator solna campus) was not in office on this Monday morning, but we managed to do the MRSA test and we had been taken to the accounts department were cheques were prepared in our names, we collected and signed for them, then went to town in one of the Banks called Handelsbanken were we had our cheques cashed in, all these activities were being facilitated and coordinated by Barbro and Anna who had been with us throughout the time we were processing all these. All of us managed to get the money and we had been given this half day to atleast go and buy things to use and rest because we didn’t have enough time to rest on the day we had arrived. Tuesday 15.03.11 was the day we had to report to our various clinical areas but in the morning we had to go back to school to meet Magdalena our coordinator and then start our clinical rotation in the afternoon and lunch was provided for us on this day.


I didnt expect much because i knew it was a bed sitter and not very different from those at my school. It was difficult to decide on where to stay when in Sweden while in Zambia because one actually doesnt know, which place is suitable and cheaper, in this case i recommend that the international student coordinator should advise the incoming students on other accomodation option rather than UAC alone. Yes i applied through the UAC, the cost of accomodation was a bit expensive in that the school where i came from we dont pay for accomodation.

Leisure time and social activities

First of all i would like to thank all the Midwifery students at KI for organising a welcome party for us, i think this was the first social activity that intergrated us into the Swedish community, i salute u all for really giving us the warmth even though it was winter, thank you so very much to student "IG" for opening your house for the party am really indebted to you guys. international student coordinator thank you for all the co ordinated activieties, you helped us know more about global friends these guys invited us to every function and gathering organised by them, linaeus palma well done.


I chose to do an exchange programme because i needed to have an experience in clinical practice in an environment/Hospitals that are well equipped and see the attitudes that people have towards work, i was as well interested in knowing if the western world had strong cultures that influence the delivery of the health care services and also see to what extent invitro fertilisation is,what effect this procedure has on the couples, how acceptable this practice is,who is allowed to have an IVF? who can perform it, is it offered in the public sector? this was actually burning within me,during my clinical rotation i actually learnt that this is a very acceptable and well received practice for both the health workers and the general public with no stigma attached to it, it is viewed as a way to help couples who fail to achieve conception on their own and all the couples i met were actually very happy about it, though this procedure is only done to couples and not single parents in Sweden, those who are single and want to have a child they have to travel outside Sweden to have an IVF. I also wanted to see and have the experience/ feel of the way the Pre-natal, Antenatal,Delivery and Postnatal activities are conducted in Sweden and weigh the relationship between the Midwives and the women, During my clinical rotation at Södersjhuset and Sundbyberg Barnmorska the practise and standard is actually the same, the relationship between midwives and the women were execellent, women trusted the midwives and they could bring out their social life so easily because of this trusting relationship between them, and this helped midwives plan so well for the care of the women, the midwives always listerned to the concerns of the women and gave advise accordingly, where there was need to refere they did so without delay. Ki has agreement with University Teaching Hospital the School were am coming from. The information was very helpful and the guidance was adequate. Yes i was told to.

Courses during the exchange period

2XX001 : Sexual and reproductive health in a global perspective
Reproductive health in a global pespective, this was an exellent course an eye opener, a course that helped me understand why there is so much difference in health care setting between the high and low income countries, the disperage in maternal and infant morbidity and motality rates in the low and high income countries. The content of the course was interllectually and professionaly selected to cover a wide range of topics that included human rights,gender,reproductive health, ethics,millenium development goals especially number 4 en 5 e.t.c. yes the course was very relevant to my professionThe teaching was good and all the teachers were very knowledgable on the courses they taught, i liked the interactional type of teaching. Two weeks in the course i learnt that Health care is actually influenced by Politicians and this prompted me to write to the secretary general of the ruling party in Zambia, on what measures the government has put in place to abate maternal and infant motality rate to achieve the the millenium development goals number 4 en 5 by 2015 since we only have 4 years to go and the motality rates are still high, unfortunately no answer has been given to me up to now.i learnt a lot of different cultures and beliefs in the end i came to realise that the world is a global village.
2EE089 : Antenatal care including fertility control, delivery, neonatal and postnatal care, theory and clinical education
Antenatal care was provided by the midwives and obstetricians only came in if a woman had developed a complication or in those women who had chronic diseases, Fertility control counseling was done on different family planning methods that are available and it was purely individual.


It was a very thrilling experience and i will dedicate my time to share this intriguing and mind shaping experience. I want to thank the sponsors of this programme and all those who dedicated their time in planning for our stay and clinical rotations, i also want to extend my heartfelt gratidutes to all my supervisors and the midwives at both Södersjkuset and Sundbyberg Barnmoska for being their for me and helping me around, to you all i say peace be with you en Tack!!! och Vi ses.

Language and Culture

I particiapted in learning svenska though am not good at it because some words are difficult to pronounce, it was a good class which comprised of students from different countries and professional background, so it acted as a social network for interaction because we were made to work in groups most of the time and we came to know each other.

Studies in general

The studies at Karolinska Institute was extremly good, the environment was conducive for learning, the relationship between the students and teachers /supervisors was very good and the interaction was excellent, i felt like i was at my home school because i interacted with all ,though not to say everyday en everybody was superb, this is in acknowledging that in every society their are bad people and spoilers its human. My experiences in Swedish hospitals I had my first day at Söderjkhuset Hospital on 15.03.11 received by Monika a Midwife who introduced me to all the staff that was on duty this afternoon and then took me for a ward round so that I could have the Anatomy of the ward (53), as we were doing the round she told me to ask questions were I was not clear so that she could explain more, I was so amazed to learn that each woman pregnant or delivered had own room with all the equipments in that particular room ranging from resuscitative to feeding equipments plus a Husband or Family member by their side.The husbands had a bed provided for them besides their laboring wives and after the Baby was born these men took a more active role in taking care of these infants to give the wife more time to rest, this is a totally different scenario from my country where male involvement is not as pronounced as it is in Sweden, in Zambia this is usually considered to be a woman´s role and the man is only involved only when a woman´s female relatives are not near and cannot manage to pay for their transport or accommodation in the area where the family lives. Here I witnessed men change Diapers and Feed their Babies while a mother looks on, they also took so much interest in the treatment their wives were receiving, this is highly recommendable and for this I can only give credit to the people that had dedicated their time and resources to achieve this core of making men get involved as much in the care of a pregnant woman till delivery and the subsequent care of a new born and I presume this has created a strong bond in these families as women feel cared for by their spouses even in this time of stress and pain. During my allocation in Södersjkhuset I came across a procedure that I had only read about in books it is called a “blood patch”, this is a procedure performed when someone has a leakage of cerebral spinal fluid (CSF) due to injury to their spine and this usually causes great pain to the patient, to me when this procedure was being performed it was like sentences in the book had read, came to life which almost seemed a dream coming to reality it was done by the senior anesthetist and it was successful. Another trend I got introduced to was the use of a Doppler ultrasound a small machine used to listen the fetal heart rate and back home we use fetal stethoscope which is a cone shaped instrument and can either be metal, plastic or wooden, the use of CTG during the active management of labour was just so stunning, how I wish we could have this in our Hospital delivery wards to help monitor the progress of labor and the fetal wellbeing, I think these instruments could help us detect abnormalities early during labor and take the necessary measures as quickly as possible to save the lives of both the laboring woman and the baby, subsequently help in the reduction of the high maternal and infant morbidity and mortality rates, that has continued to be a burden to our health system and has created so much orphans leading to high levels of street children. CommunicationProper patient care highly depends on the care givers understanding of the patients condition.• Midwives must know their patient’s condition in order to provide quality pregnancy and delivery care. • In order to achieve this, Swedish midwives prior to changing shifts, hold sessions to report on the prognosis and procedures done while caring for the patients. Issues of main concern are raised. • Ward rounds are held every morning to discuss patients’ conditions.• Obstetricians and the midwives are highly involved in the discussion. • The communication process is interactional since there is information flow from the midwife to the obstetrician and vise vasa. • e-prescribing system of record management has also impacted positively on the communication process.• Procedures and interventions executed by health care providers is quickly entered in the patient’s data base. • Data concerning every patients’ history of infirmity, complications or medicines to be purchased from a pharmacy is available in a data base. • This makes information available to health care providers at different units of the health care system. • The effective communication system seen among the health care teams in Swedish hospitals could be attributed to the health professionals’ curriculum.• The “Linkoping IPE model” was initiated in 1986 to help students develop their professional identity and to meet other health and social professions already in to their undergraduate studies(Wilhellmson, Pelling, Ludvigsson, Hammer et al, 2009). They further recommended that Problem Based Learning(PBL) be adopted for the model to be successful.• In Zambia, there exists a big gap between doctors and midwives. Midwives and nurses are highly intimidated by doctors.• Doctors feel they have the final say pertaining patients condition. Many times doctors do not consult about patients’ conditions from the immediate care providers. • Nurses are hardly involved in ward rounds. It is usually the doctors and medicine students who take part in ward rounds. Student nurses and midwives are not given the opportunity to participate. • This has hindered learning efforts of midwives and nurses.• This therefore means that doctors leave management plans for patients but do not involve the nurses who spend most of the time with the patients.• The management plan of the patients should be orchestrated in the presence of both doctors and midwives/nurses. For effective delivery of high quality pregnancy and delivery care, there should be proper understanding of every patient which can be achieved when all care givers are involved in the care.