Mambo! So, I’ve skipped a day. Why, you may ask? Well a bomb went off in the town of Arusha (before you freak out, I am NOT staying in town and am safe and sound, at quite a far distance from where the explosion occurred) due to political violence. This weekend marks the “Big Election” in Arusha. Although I’m safe, I feel as though me and my group of 12 could not have chosen a better weekend to embark on a 4 day, 3 night safari where we will be far from Arusha. Regardless, work yesterday was canceled as the surrounding areas, despite being safe, were risky to enter, especially as a “muzunga” or white person. I did go to work today though, and thank goodness I did. I experienced some things that even medical students in their third years do not have the chance to witness. As soon as I entered the hospital, I was rushed into the labor ward. I came just in time to see a white, bloody head popping out of a woman’s vagina. Oh, the miracle of birth. I was the only volunteer at the hospital today who came to the room quickly enough to witness the mother’s delivery. I helped suction the mucus out of the baby’s bronchi and in its mouth (standard procedure for any baby directly post-delivery). I also pressed down onto the woman’s fundus and massaged that area of her genitals, as I learned that doing so stimulates the uterus to contract and helps in slowing any post-partum bleeding once the placenta has been removed. A uterus that is not firm is indicative of the woman being at risk for hemorrhage. After an exciting morning I returned to work with Edita, the head receptionist, where I alphabetized all patients who had been cared for by the Clinic. I took note of how slow and inefficient their system of alphabetizing was- what could’ve taken me 5 minutes using Microsoft Excel took me 5 hours using pen and paper. I’ll say it again, the clinic is very primary in that it relies on manual labor over the fast efficient technology. I took a break for some Swahili donuts and delicious, sweet chai, and then rushed back into the labour ward as a SECOND birth was about to occur. This time a woman from the Massai tribe was giving birth, and it is part of the tribe’s tradition to deliver in the squatting position. This was quite an interesting birth as the baby came out and appeared to be dead, with the umbilical cord tied around her neck. It made no noise nor ostensible movement for 30 minutes. I was aiding in suctioning, rapidly stepping on a pedal and shoving the plastic tubes up the baby’s nose and into her mouth to draw out any mucus that may be blocking her respiratory system. My heart was racing for 30 minutes and I was positive that the baby was born dead. However, she wasn’t- thank the lord. After constant resuscitation and suctioning, she began to breathe. I was taken aback by the fact that the mother was given no pain medication, the baby was given no ointment for her eyes, and most notably, that upon viewing the lack of response by her child, the mother merely sat staring at her dead-appearing kid with a poker face–no emotion whatsoever. About an hour later, a third birth occured, this time an episiodomy, which is a surgically planned incision of the perineum and posterior vaginal wall that occurs in the second stage of labor. Again, I helped with suctioning. The suction is essentially a pedal with an attached plastic, cone-shaped tube – aka a piece of crap. That day at the hospital I also witnessed a woman suffering in labor, on bedrest, and writhing in intense, excruciating pain that could not be absolved by the means of the clinic. In the US her pain surely could have been prevented to an extent, but the lack of proper anesthesia made this impossible at the Clinic. Today was by far the most interesting day I have had yet, as I was able to witness 3 births and learn of 4 (one birth occured at 6 am, before I arrived, and the mother was discharged just a few hours after). My experience today taught me that I do not want to be a gynecologist, especially in Africa where the systems are weak, materials are inadequate, and miscarriages are the norm.
