A winter working in the Western Isles

After accepting a job in the Outer Hebrides for six months, I was left staring at Google Maps at a tiny collection of islands off the western coast of Scotland.

“The Western Isles in winter?”, friends and family exclaimed. “You’ll see no daylight, it’ll be freezing. Maybe you’ll see the northern lights - oh it’ll be magical! Won’t you be lonely?” They were remarks that I was also wondering about and feeling slightly nervous.

I made the journey from Shoreham by Sea in West Sussex to Stornoway on the Isle of Lewis by car. The 1,000 km took two days and ended with the most spectacular sunset ferry crossing over The Minch with dolphins jumping alongside the boat. It’s not until you attempt the journey you realise just how remote and isolated these islands are.

My job role was to provide an obstetric ultrasound service within the maternity unit to the women on the islands of the Outer Hebrides, and to train a midwife sonographer, Rachel Dunn, in all aspects of obstetrics ultrasound.

During my first week we made the 1.5 hour car journey down to Leverburgh in Harris to catch the ferry to Berneray in order to provide a service to the women on the islands of North Uist, Benbecula, South Uist and Barra. 

The views at sunrise were amazing; we meandered through the little land masses between Harris and Berneray with a sense of peace in every direction. The drive from Berneray to the community hospital in Benbecula is just as incredible as the ferry crossing. 

White sandy beaches hug the entire coast line and every few miles you’ll see a huge rock with seals bathing in the winter sunshine. It feels very surreal that this journey is in fact for a day at work as it is so breathtakingly beautiful. 

Although it’s a long day, when we go to the southerly islands it never feels like that. The patients are lovely and it’s rewarding for us to do the journey instead of them having to do it while pregnant.

We visit the islands of Uist every three to four weeks, depending on demand, and have subsequently made the journey by plane. I never thought I’d ever fly to work, and I’m again left in awe at the sheer natural beauty of these islands, especially as we fly over the golden hills of Harris, an area I spend most of my weekends exploring by foot. There are many beautiful hikes where you can easily walk for hours through glens, around lochs, along cliff edges or sandy beaches without seeing anyone; just deer and eagles.

The weather here is wild. There are often weather warnings with risk of floods. Storms and gale force winds batter the islands regularly. This results in many ferry cancellations and road closures due to potential flooding. Last-minute disruptions to appointments due to the weather in winter are just responded to with: “Ah that's island life!”

Despite the lower number of pregnancies (due to the smaller population) compared to other places I have worked - such such as Worthing, Brighton and London - unfortunately abnormalities still occur.

We have identified and diagnosed a caesarean scar ectopic, an abdominal wall defect, acrania, an absent CSP, funnelling and opening of the cervix at 28 weeks and abnormal dopplers. Following their scans, some of these patients have subsequently flown to the mainland via air ambulance as a matter of urgency. 

We have been able to provide IVF women with early scans, saving them an arduous journey to Aberdeen, and provide early reassurance scans to women who have experienced recurrent miscarriages.

It has been a rewarding six months, I honestly haven’t met so many outgoing and caring healthcare professionals before. I remember one lunchtime a midwife walked in after a trip to the shops. She had gone out on her lunchbreak to buy some comfy pyjamas, warm socks and slippers for a patient who was urgently being flown to Glasgow, and had no family or friends in the city. The thoughtfulness and kindness within this small department deserves recognition. It has been a joy walking in to work every single day; even in the snow, ice, gales and hail!

Rachel passed her practical assessments and is now able to provide a coherent obstetric ultrasound service for the Western Isles and to the women and their families. Overall I have thoroughly enjoyed the experience; the people and the place made it worth it.