Benin
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 The first trip to Contonou, Benin took place in May 2005. It followed Professor Judith Hall’s initial meeting with Professor Martin Chobley from Benin and was a fact finding mission with Dr Paul Clyburn to establish how Cardiff anaesthetists could help.
Two hospitals were visited - the HOMEL in Cotonou and Abomey, a 3 hour drive outside Cotonou. Both had busy maternity departments and evidenced their maternal mortality statistic of 475 per 100 000; this contrasts with UK figures of 12 per 100 000.
 Benin is about two and a half times the size of Wales and lies along the western border of Nigeria, a population of 7.5 million people. Healthcare is a mix of private and public medicine. Basic anaesthetic drugs, anaesthetic and monitoring equipment are available, similar to what was available in the UK 25 years ago.
What is most striking is the lack of trained manpower. Benin has only 10 trained anaesthetists and 9 of these work in and around Cotonou. Most anaesthetics are delivered by poorly trained anaesthetic nurses, (approx 70) who in the main work independently. Even this number is woefully inadequate when you consider that there are around 500 anaesthetists in Wales for a population one third that of Benin. We have 140 anaesthetists in Cardiff alone.
 We got an insight into the shortage of anaesthetic skills and expertise when watching an unsupervised anaesthetic nurse give a general anaesthetic for an urgent Caesarean section. No antacid prophylaxis, no lateral tilt, no cricoid pressure, and almost no anaesthetic. The patient received a sleep dose of thiopental, vecuronium, fentanyl, and despite the presence of a full halothane vaporiser on the anaesthetic machine, nothing to keep her asleep. Although the mother suffered no more than awareness and the baby was delivered healthy, we formed the impression that had there been any complication, the anaesthetic nurse would have been unlikely to cope.
Mothers of Africa continues (with your help) to support training of anaesthetic nurses in Benin.
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