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CHRISTMAS TIME UPDATE:Things are going well, but I am being kept very busy. We have moved away from the “busy” season, but somehow there are still ten deliveries a day and about 130 admissions! It is a bit nuts. I love the work, love teaching and learning. There are a lot of deliveries that happen prematurely. Many little ones that come out at 900 grams or less and we try our best to wrap them up against mom’s heart and feed them milk or glucose through a tube. Some of them are fighters and have made it and some not. It is a hard place to be, watching all of these people struggle. It also very interesting. Anyone who is pregnant or has just delivered comes to us, so we end up treating things like malaria, meningitis, pneumonia and my current favorite is the mother who was attacked by a hyena. She lives way out in the bush and a hyena followed her goats back to her tukul (hut) and then came inside the tukul. She was trapped inside with her 15 year old daughter and another woman until they fought the hyena off as best they could with an ax and sticks. The hyena mom arrived with a huge gash in her upper arm where the hyena had taken off a chuck, a couple of smaller puncture wounds, a torn finger and a badly broken arm. She is also about 8.5 months pregnant. She has been healing withus in the hospital for the last 3 weeks and doesn’t want to go home until she delivers her baby. I imagine she has another week or two to go before she has the little hyena baby! The OB and I brought her and another couple of patients magazines the other day–Vogue, National Geographic, anything we could find with a lot of images. I can’t imagine what it must be like to sit day after day in the hospital with so little to do.
Yesterday, I delivered a breech baby that was nice and fat. So fat that her little shoulders got stuck and I was worried she wasn’t going to come out! Normally, the head is what we worry might not fit; I had never thought that you could have a shoulder dystocia on a breech delivery. It was so strange! Eventually the fat little thing budged and her head delivered just fine and once I did a little bit of breathing for her she pinked right up and started bawling!
Things are picking up a bit more in maternity. We had 4 maternal deaths this month, which is a lot for us, but not a lot statistically speaking. A woman died from severe meningitis, another from cardiac arrest probably due to severe eclampsia, another from pneumonia, and the last from severe anemia following malaria and an ectopic pregnancy. She had a hemoglobin of 2.1 (normally in pregnancy we get worried when women have a Hgb of 10 and mine is currently about 14)–obviously she needed a blood transfusion, but we didn’t have enough blood in blood bank to give her enough transfusions. This is a common problem as donating blood is a challenging concept to teach about and is often very feared. It is an interesting place to be and requires a lot of patience and compassion on the part of the expat.
We had a lovely Christmas. We decorated a banana tree and someone brought lights from home! Our tree topper has been named Merv and is a cut out from a National Geographic of a squirrel; we made him a Santa hat. I punched holes in the Tusker bottle caps we had been saving (for some unknown reason) and strung them on the tree like you would cranberries or popcorn. The few mornings leading up to Christmas the church played it’s holiday cheer (circa 1940′s) on full blast on the worst speaker imaginable and at 530 am. Imagine waking up every morning to very loud Xmas music that you can’t even understand because it sounds like the person singing has their hands over their mouth. Basically it ruined the Christmas music cheer. We did however make a wonderful feast. I prepared to cook my grandmother’s rolls, apple pie and beef beef bourguingon for supper (using goat instead as we are very sick of beef and cooking it on the stove top for the most part instead of the rickety oven). I just want to point out that beef bourguingon is one of the most difficult things you could possibly cook and making it in the field for some reason seemed like a grand idea. I guess I was searching for a challenge beyond deliveries? Cooking in the field isn’t easy. Take away a working stove, a sink, frying pans, wooden spoons for mixing, measuring cups and teaspoons, and anything not aluminium and you basically have what we have here! NOTHING!! But for some reason cooking in camping conditions makes me and the other midwife happy, I guess we like the challenge and knowing that our expat friends will have satisfied bellies for once!
….sadly about 30 minutes after eating lunch (but at least after most of the food had been prepped) I came down with food poisoning and spent the rest of the day puking my guts out and Christmas evening lying in anguish hooked up to some lactated ringers. It wasn’t the best best Christmas ever, to say the least. The food I am told did turn out perfectly. The table was set, much like at Thanksgiving, with candles stuck in Tusker bottles, an African print table cloth, and real glass glasses for the wine (I know those of you who were here before are now jealous…we have real glasses!!!) I was excited to at least eat one of my grandmother’s rolls once I was feeling better. I did get a bite in, but the other bite was stolen right under my nose by a cheeky and talented hawk. He swooped down and stole my bread crust right out of my hand as I walked across the compound. His wings brushed my cheek and he left not a scratch, but still! I didn’t realize South Sudan was such jungle of wild beasts!
I am not blogging much right now as you may have noticed. For themost part I have just been too busy and tired to write. I will probably post stories again when I get home, which won’t be until sometime in February.
xoxoxo,
Aerlyn
