Well today is my half Birthday!! I am 22 ½ now. I know it is kind of funny but my family always like to have fun with it. You should figure out when you half birthday is too and have a ½ birthday celebration!
Today started out with cleaning a store room that has a whole bunch of medical supplies and I mean a lot lot of supplies. The problem is that they are all in bags and boxes and nothing is organized. Some if the stuff came back in the 90’s so you can imagine how much and long the stuff has been there. Our job is to organize all of it and separate it into useable things and unusable things. There are things like ventilator tubing, tracs, expired meds and other things that will never be used here but there is a lot of things that can be used such as IV’s and tubing, needles, caths dressings just to name a few. This room is such a mess that after working for a couple hrs you are exhausted and can’t stand the mess and dust any more. So we have been working a few hrs every morning on this big project.
After lunch and a short rest we were off to the hospital for our pm shift. When we arrived there was only one first time mom in L&D and she had just been started on pit because she had SROM’ed about 10hrs before and was not having any contractions. So the pit was started and we were to up it every 20 min until contractions started. So we had to sit and feel her tummy to feel if any contraction came and how long they were (there are no monitors here). It was very interesting to say the least to start a pit drip with no IV pump, we had to count out the drops, and with no electronic monitoring. So after upping it only once her contraction started J . A few hrs later another laboring woman came in she was on her 2nd baby and came in a 5cm. We got her all settled in the laboring bed and then let her labor down. About 1hr after that another woman, on her 4th baby came in in labor (when it rains it does poor). We only have 2 labor beds so she had to labor on the delivery table. After doing an assessment we discovered that the baby is breech with a foot presenting and bag intact. We had called the OB Dr. to consult and he came to evaluate the situation. He too confirmed that it was breech and one foot was slightly down. He decided that it the foot would go back up then we would attempt a breech delivery but if the foot continued to present then he would do a c/s. The woman was progressing very quickly she came in at 5 cm and about 1hr later she was 7-8 and then her water broke spontaneously. We quickly checked her and got heart tones and everything sounded and looked great. Things went very fast from here and with in minutes a foot was appearing. There was not time for a c/s so the Dr. would do the footling breech. It was very neat to watch and the Dr. did a good job except when it came time to deliver the head he starting pulling and pulling, I was horrified that he was pulling so hard I really though he might decapitate the baby. But my a miracle he didn’t and he had that baby out in less than one minute. (to bad there are not chiropractors here I think that baby might need one) The baby did well with apgars of 7/9 and the mom did not tear at all.
After we had that mom all cleaned up and out to the ward we went to evaluate the next laboring woman. She is the G2 P1 and was 5cm last check with a bulging bag. It had been several hrs since her last check so we decided to move her into the delivery room. Upon examination she was now a 7 with a very bulging bag. I broke her water to find thick +3 mec. We got everything ready to do suction if needed and resuscitation. It did not take her long to become complete and then the pushing started. She really did not push long at all and the head was out. I did some bulb suction at the perineum and then the body came out. With a little more bulb and some stimulation the baby had an 8/9 apgar. The mom had no lacerations so she was cleaned up and moved out to the ward.
It was now the G1 P0 woman’s time! Poor thing she was the first one to start laboring and she had to watch two other women labor beside her and deliver before her. I think she was very excited to be able to move to the delivery bed! I checked her again and she was now 8cm. It only took her around an hour to reach complete and then the pushing began. Because she was a first time mom it took her longer but she did very well. The baby came and had a cord around the neck but loose enough I was able to take it off at the perineum. Also when the baby was born we realized it also had thick mec. But a little suction with the bulb did the trick and the baby did great. This mom did have a laceration so I learned again how to stitch. It was much easier this time and everything made much more since. Linda is a great teacher! I will have to say the stitching job looked very pretty especially compared to the way the locals stitch!
Well I had prayed that we would get some births soon because it had been 3 days with no births, and well God answered out prayer and gave us 3 in 2 hrs! I am really enjoying helping the women here and learning so much. This experience is priceless.
Monday, July 28, 2008
Sunday, July 27, 2008
Death and Life
Today we worked the pm shift 3:30 to 9pm. When I walked onto the unit I noticed that the family that had the preemie baby was gone. My heart sunk as I thought of what most likely had happened. I asked the nurse at the desk and she confirmed my fear. The baby had passed away. I had mixed feeling about what had happened, crushed that all of our efforts to do what we could to help the baby were not enough and my heart ached for the family as it was their first baby and all of them were so evolved in trying to save the baby. But I also felt at peace that the baby was no longer suffering and would not have to endure the very hard life of having to live with a lot of medical problems in a place were healthcare is very limited. But I cling to the fact that I will someday in heaven I will be able to meet this little girl again and tell her how much I tried to help her and how much I cared. Death here is something that is common but I thank God that I have not had to yet deal with it face to face. (I was glad that the baby went when I was not working.) The other day we were leaving the hospital and 2 men were carrying, actually they were running, a wrapped up body on a stretcher out of the hospital. I guess when the family finds out they all start whaling so they hurry them out before the noise begins and disturbs the other patients. He had died of HIV. I know that soon enough I will have to face this reality and see the death that is so common here. I just pray that God will help me to stay strong.
On a happier note, the nurses that we got to work with on our shift were so much fun. They knew some English so it was nice to be able to communicate some. They tried to teach us some of their language which is very hard and we all had a good time laughing at our inability to pronounce their words correctly. It was very slow with no laboring pt’s so Linda and I decided to clean and organize the nurses station. It was in much need!!! I am sure that the nurses think we were crazy because whenever it is slow we find things to clean and organize, and they just sit and talk and make gauze 4x4’s. Having things clean to them is not a priority by any means. After the nursing station was clean to our satisfaction (who knows how long it will stay that way), we all got to talking again.
Linda and I had wanted to ask someone about the female circumcision that is done here so frequently and we thought this would be a good time to ask. So we brought up the question to them and we were very shocked to hear what they told us. They do what is called level 1 circumcision. It appears they remove most of the labia minora and they say the clitoris as well. (I haven’t been able to tell that the clitoris is missing) They told us that it is done when the girl is 7 or 8 years old and it is a big celebration. They said they would have their girls done despite known efforts to get them to quit. The only reason they would give for doing it was – tradition and then laughingly to prevent them from running off with other men. Of all that I have seen and heard about, this isn’t as bad as most. At first I didn’t even notice the difference. There is evidently a village person who does the procedure and without anesthesia or antiseptics. They did say it was VERY painful and they all remembered it vividly. Yea, I bet!!!!
The culture is defiantly very different here but it is interesting to learn how other people live, even though some of the practices are well to put it softly are dreadful! This is for sure cultural experience!
Well no babies on this pm shift L maybe tomorrow though!
Until next time…
On a happier note, the nurses that we got to work with on our shift were so much fun. They knew some English so it was nice to be able to communicate some. They tried to teach us some of their language which is very hard and we all had a good time laughing at our inability to pronounce their words correctly. It was very slow with no laboring pt’s so Linda and I decided to clean and organize the nurses station. It was in much need!!! I am sure that the nurses think we were crazy because whenever it is slow we find things to clean and organize, and they just sit and talk and make gauze 4x4’s. Having things clean to them is not a priority by any means. After the nursing station was clean to our satisfaction (who knows how long it will stay that way), we all got to talking again.
Linda and I had wanted to ask someone about the female circumcision that is done here so frequently and we thought this would be a good time to ask. So we brought up the question to them and we were very shocked to hear what they told us. They do what is called level 1 circumcision. It appears they remove most of the labia minora and they say the clitoris as well. (I haven’t been able to tell that the clitoris is missing) They told us that it is done when the girl is 7 or 8 years old and it is a big celebration. They said they would have their girls done despite known efforts to get them to quit. The only reason they would give for doing it was – tradition and then laughingly to prevent them from running off with other men. Of all that I have seen and heard about, this isn’t as bad as most. At first I didn’t even notice the difference. There is evidently a village person who does the procedure and without anesthesia or antiseptics. They did say it was VERY painful and they all remembered it vividly. Yea, I bet!!!!
The culture is defiantly very different here but it is interesting to learn how other people live, even though some of the practices are well to put it softly are dreadful! This is for sure cultural experience!
Well no babies on this pm shift L maybe tomorrow though!
Until next time…
Hello Friends Again
Dear Friends and Family,
Rain, rain, rain. We are growing gills. Actually it isn’t that bad. There are a few days with no rain and everyday has some time with no rain. It just comes down in buckets and makes rivers and mud.
The work here is varied. Linda and I have been spending our mornings sorting through this huge storage room with medical supplies some of which date back to the 90’s. It is an amazing amount of stuff and very dirty work.
We had several days with no babies born. I mean there weren’t any even on other shifts. They say that when it rains the women don’t come to the hospital because it is too muddy.
The preterm baby we worked so hard to save, died after 4 days. Thankfully, it didn’t happen on our shift, because I was very attached to that baby. It is probably best since she had many bowel problems that would have made life miserable for her at best.
Yesterday Linda and I were going through serious birth withdrawal so we prayed for births. We had 3 in 2 hours last night. The first Dr Esayas delivered because it was a footling breech and he wouldn’t let us do it. I sure did learn how NOT to deliver a breech. He was actually very good about it until it came time to deliver the head and then he pulled so hard I thought he was going to pull the body off of the head. I was so worred that I was hopping up and down and even told the doctor to stop while he was pulling super hard on the babies body. It was frightening! The next 2 babies I caught. The first didn’t tear but the second did and I got to do my second suturing job! Both babies had thick mec and one a cord around the neck so I am just getting all kinds of good experience.
We observed 2 of the local midwives suture and their technique is ancient history. They use 2.0 chromic gut – rope. One used 3 packages of suture on one tear. Can you imagine how much rope was in her tissue? It was unbelievable. She also used only interrupted stitches with external knots. That poor woman is going to have a very pokey, sore bottom not to mention the risk of infection with all those suture holes externally. We went and spoke to the woman (a Kenyan midwife) who trains the midwives, about this. She said she had only once seen a UK doctor suture the way we do with all internal stitches and she wants to learn so she can teach them correctly. Ah ha! The source of the problem. It is good that she is willing to learn. The midwives that have watched Linda and I suture are amazed and watch carefully. I really hope they are getting it. After teaching the teacher, I hope we can have an in-service on suturing for the OB staff.
They also cut a lot of medial lateral episiotomies for these little babies and they do it before the head is even down on the perineum. The Kenyan midwife teacher says she teaches them to not cut but they seem to be afraid they will tear up if they don’t cut. They don’t document that they do it in the log book even though there is a line for that, so no one knows just what is going on.
Two nights ago when there were no births, Linda and I were cleaning up the nurses’ station. (The paper confusion and mess is atrocious.) After we were done, we were talking with the 4 nurses present. We asked them about female circumcision. We have been very curious. They do what is called level 1 circumcision. It appears they remove most of the labia minora and they say the clitoris as well. (I haven’t been able to tell that the clitoris is missing) They told us that it is done when the girl is 7 or 8 years old and it is a big celebration. They said they would have their girls done despite known efforts to get them to quit. The only reason they would give for doing it was – tradition and then laughingly to prevent them from running off with other men. Of all that I have seen and heard about, this isn’t as bad as most. At first I didn’t even notice the difference. There is evidently a village person who does the procedure and without anesthesia or antiseptics. They did say it was VERY painful and they all remembered it vividly. Yea, I bet!!!!
The other day we were leaving the hospital via the ramp in back when 2 men rushed by us carrying a stretcher between them with a dead man wrapped up in a sheet on it. He had died of HIV. They hurry any dead out quickly because the family starts wailing loudly and they don’t want them doing it in the hospital and disturbing the other patients. I thought he was going to bounce right off the stretcher, they were running so fast.
I got to inspect their bee hives here and make suggestions. They need to purchase a few things before we can get started. The gardener showed us 3 hives that were in local hives. They were very interesting. They are made of woven reeds/leaves into a huge pod that has an opening on one end. They are probably 2 ½ feet in diameter and 4 feet long. They were hanging in the rafters of a shed. The bees here are Africanized, which means they are vicious. I did bring my bee suit fortunately and will help them get going when Paul and Petra get back from Addis Ababa with the supplies.
There are 2 local conversation tools that we find fun once we figured them out. The first is when talking and the response is yes or an acknowledgement of understanding, they gasp with an eyebrow lift. The second is when they want to say OK they shhh. I thought they were shhh ing me but they were really saying OK. It is so much fun living in another culture and discovering other ways of doing things. J
Well Hope all is going well with everyone at home and I miss you all!
God is good. All the time.
Amber
Rain, rain, rain. We are growing gills. Actually it isn’t that bad. There are a few days with no rain and everyday has some time with no rain. It just comes down in buckets and makes rivers and mud.
The work here is varied. Linda and I have been spending our mornings sorting through this huge storage room with medical supplies some of which date back to the 90’s. It is an amazing amount of stuff and very dirty work.
We had several days with no babies born. I mean there weren’t any even on other shifts. They say that when it rains the women don’t come to the hospital because it is too muddy.
The preterm baby we worked so hard to save, died after 4 days. Thankfully, it didn’t happen on our shift, because I was very attached to that baby. It is probably best since she had many bowel problems that would have made life miserable for her at best.
Yesterday Linda and I were going through serious birth withdrawal so we prayed for births. We had 3 in 2 hours last night. The first Dr Esayas delivered because it was a footling breech and he wouldn’t let us do it. I sure did learn how NOT to deliver a breech. He was actually very good about it until it came time to deliver the head and then he pulled so hard I thought he was going to pull the body off of the head. I was so worred that I was hopping up and down and even told the doctor to stop while he was pulling super hard on the babies body. It was frightening! The next 2 babies I caught. The first didn’t tear but the second did and I got to do my second suturing job! Both babies had thick mec and one a cord around the neck so I am just getting all kinds of good experience.
We observed 2 of the local midwives suture and their technique is ancient history. They use 2.0 chromic gut – rope. One used 3 packages of suture on one tear. Can you imagine how much rope was in her tissue? It was unbelievable. She also used only interrupted stitches with external knots. That poor woman is going to have a very pokey, sore bottom not to mention the risk of infection with all those suture holes externally. We went and spoke to the woman (a Kenyan midwife) who trains the midwives, about this. She said she had only once seen a UK doctor suture the way we do with all internal stitches and she wants to learn so she can teach them correctly. Ah ha! The source of the problem. It is good that she is willing to learn. The midwives that have watched Linda and I suture are amazed and watch carefully. I really hope they are getting it. After teaching the teacher, I hope we can have an in-service on suturing for the OB staff.
They also cut a lot of medial lateral episiotomies for these little babies and they do it before the head is even down on the perineum. The Kenyan midwife teacher says she teaches them to not cut but they seem to be afraid they will tear up if they don’t cut. They don’t document that they do it in the log book even though there is a line for that, so no one knows just what is going on.
Two nights ago when there were no births, Linda and I were cleaning up the nurses’ station. (The paper confusion and mess is atrocious.) After we were done, we were talking with the 4 nurses present. We asked them about female circumcision. We have been very curious. They do what is called level 1 circumcision. It appears they remove most of the labia minora and they say the clitoris as well. (I haven’t been able to tell that the clitoris is missing) They told us that it is done when the girl is 7 or 8 years old and it is a big celebration. They said they would have their girls done despite known efforts to get them to quit. The only reason they would give for doing it was – tradition and then laughingly to prevent them from running off with other men. Of all that I have seen and heard about, this isn’t as bad as most. At first I didn’t even notice the difference. There is evidently a village person who does the procedure and without anesthesia or antiseptics. They did say it was VERY painful and they all remembered it vividly. Yea, I bet!!!!
The other day we were leaving the hospital via the ramp in back when 2 men rushed by us carrying a stretcher between them with a dead man wrapped up in a sheet on it. He had died of HIV. They hurry any dead out quickly because the family starts wailing loudly and they don’t want them doing it in the hospital and disturbing the other patients. I thought he was going to bounce right off the stretcher, they were running so fast.
I got to inspect their bee hives here and make suggestions. They need to purchase a few things before we can get started. The gardener showed us 3 hives that were in local hives. They were very interesting. They are made of woven reeds/leaves into a huge pod that has an opening on one end. They are probably 2 ½ feet in diameter and 4 feet long. They were hanging in the rafters of a shed. The bees here are Africanized, which means they are vicious. I did bring my bee suit fortunately and will help them get going when Paul and Petra get back from Addis Ababa with the supplies.
There are 2 local conversation tools that we find fun once we figured them out. The first is when talking and the response is yes or an acknowledgement of understanding, they gasp with an eyebrow lift. The second is when they want to say OK they shhh. I thought they were shhh ing me but they were really saying OK. It is so much fun living in another culture and discovering other ways of doing things. J
Well Hope all is going well with everyone at home and I miss you all!
God is good. All the time.
Amber
Saturday, July 26, 2008
Episitomies, Dilation, and Feeding Tubes
We got off work around 8:30am this morning and our laboring women were at 8cm and 6cm. We were bummed that they did not deliver because we labored with them all night. We told the African midwife on for the day shift that we would go home and eat and then come back to hopefully deliver the woman who was 8cm. We had developed a bond with her and wanted to deliver her. We got back to the hospital about 2hrs later and she was on the delivery table with the baby coming. It was not even the midwife delivering her it was one of the nurses. By the time we got there the nurse had already cut a large medial- lateral episiotomy without the head even showing. The baby soon came and it weighed only 2.4 kg. It seems that all the nurses and midwifes here give the woman episiotomies even when they don’t need one and then watching them stitch her up was a even more horrific experience. Mind you I have not seen many repairs but this just looked brutal. They used very little lidocane, we actually asked them to please use some more because the woman was in so much pain and squeezing the life out of Linda’s hand. They reluctantly gave her some more. Then the repair began. All of their stitches are interrupted and the knots they use are slip knots. They used 3 packs of suture which was 2.0 catgut (which was like rope!). Her bottom was so full of suture it was painful to look at! The stitches were all knotted externally leaving pokey ends and a great opportunity for infection. When the laceration was all repaired it was not approximated well at all and was all puckered, nothing near smooth. Linda is making plans to give some in-services to the midwifes/nurses on how to suture because their technique is so bad. Hopefully they will be receptive and willing to learn.
Before we had left for the end of our shift we had requested several things to be done with the preemie infant to help her such as change her IV dressing that was soaking wet and insert a feeding tube through her nose so she could be fed though it. She did not eat well for me the whole night, she was not swallowing well and she needed nourishment. When we came back for the one delivery we were happy to see that they had preformed the tasks we had asked. The baby was still hanging in there but still doing far from good.
After sleeping for several hrs we had all the Americans over for lunch after church and then visited in the afternoon for while and then took another nap in the afternoon. That evening after sundown Linda and I decided to have a movie night so we watched a movie on my laptop, we found one plug that works in our house and an adapter for US plugs!!! After our movie it was off to bed for tomorrow was another day of work. Here they have 6 day working weeks. Linda and I are really blessed for the accommodations we have, running water most of the time and electricity to power the lights and one plug-in. We are truly living in luxury!
Before we had left for the end of our shift we had requested several things to be done with the preemie infant to help her such as change her IV dressing that was soaking wet and insert a feeding tube through her nose so she could be fed though it. She did not eat well for me the whole night, she was not swallowing well and she needed nourishment. When we came back for the one delivery we were happy to see that they had preformed the tasks we had asked. The baby was still hanging in there but still doing far from good.
After sleeping for several hrs we had all the Americans over for lunch after church and then visited in the afternoon for while and then took another nap in the afternoon. That evening after sundown Linda and I decided to have a movie night so we watched a movie on my laptop, we found one plug that works in our house and an adapter for US plugs!!! After our movie it was off to bed for tomorrow was another day of work. Here they have 6 day working weeks. Linda and I are really blessed for the accommodations we have, running water most of the time and electricity to power the lights and one plug-in. We are truly living in luxury!
Friday, July 25, 2008
Night Shift
Well tonight we are working the night shift. It is a bit busier tonight with two laboring first time moms, who were going very slow. Right now one is at 5cm and the other 2cm. I broke the water of the woman who was 5 because she had been about 4hrs with no change and had a bulging bag of water. We are hoping that this will speed things along. I am learning to do dilation checks by checking our two laboring women. I am hoping that they hurry up and dilate or they will most likely have a c/s tomorrow. We also have a preemie baby weighing only 1.8 kg the baby did not pass a stool for 48hrs and then it was decided that it had a bowel obstruction from an x-ray. The general surgeon here was going to do the surgery, that of which he had never done before and to make matters worse we don’t have an anesthesiologist so no one knew how to do the anesthesia on the baby. We did not think the baby would make it thought the surgery but by a miracle it did. (The only reason the surgery was attempted was because the parents had money to pay for the surgery and they insisted that everything be tried, so the surgery was done to create a colostomy) They baby was not doing so well after surgery, retracting, grunting and her color was awful. With no pulse ox there was no way to see what her 02 stats were so we put her on 02 and she did respond well. She started to improve and the nasal flaring and grunting stopped and the retracting we mild. I was starting to get encouraged about her survival rate. But then things started to take a turn for the worse. Her retractions worsened and the worse part is that her lungs are starting to fill up with fluid. I am not to sure how much longer she will be able to hang on. Please pray for this little baby that she will get better or go peacefully. It is so heartbreaking to see such a small baby suffering and there is nothing you can do. We don’t have the equipment or supplies to care for her like she should be. Being in the mission field is exciting and fun but you must also remember the harsh realities of limited healthcare. It truly makes me grateful for the healthcare we have in the US.
Thursday, July 24, 2008
Clinic Survival
Well I survived being out in the middle of nowhere with only 1 native nurse, operating a clinic with which had nothing but some worm medicine and some pain meds and gloves. There was a very nice clinic in this town but it burned down last week. They really to open the clinic but did not have the nursing staff because the one nurse was in training. It was quite an experience being fully immersed into the culture here; it made me feel very grateful for how we live in the US and for what we have. We cooked over a fire and had running water and electricity for about 5% of the time and when we did have water it was very cold and at random times. So I did not have a shower for two days, so I fit right in with the local people! I actually got to come back this afternoon instead of tomorrow morning, and I was very excited to find that the water was on at our house when I got back so I got a shower!!! Well right know I it is about 2:00am and Linda and I are working the night shift. Just when I thought I would be done with working nights! Well already tonight we had a woman come in that delivered at home and still had not delivered the placenta. It came right out when we got her on the delivery table and after further examination we saw that she had a laceration. So Linda told me to glove up and I would be doing my first repair. So with much coaching and guidance I sewed her up, and it looked pretty good I should say! Other than that it is very slow, just keeping a good eye on a baby that will most likely die soon, it had a bowel obstruction no stool for 48hr and vomiting up mec. They did surgery because the parents are “wealthy” but the Dr. had never done this kind of surgery before and nobody new how to do the anesthesia on an infant. We thought the baby would die during surgery but she some how survived. They gave her a colostomy so we will see how she does. We started her on O2 and she responded well to that (we have no 02 stat monitor), but she is still having retracting and grunting and her color is not so good. So keep her in your prayers that she will either go quickly or get better soon. Then the other lady we are watching is C/S of earlier today, had general anesthesia (that’s what everyone gets) and gets no pain medicine but some NSAID type which does nothing. I feel so bad for her. All the other pt’s seem to be doing fine.It is quite an experience to work here I am learning so much everyday and my present knowledge is being challenged everyday.
Well I do miss everyone and all the luxuries of the US but I am learning lots here and realizing how much we really have. I am also realizing how much I miss everything being clean!!! Everything is so very dirty and the smells are awful.
But with Gods help I will make a difference here and come back a stronger person.
Well until next time and with much love,
Amber
Monday, July 21, 2008
Challenges
We woke up today and there was still no water, so no shower today. We got ready and went to worship by 8:00 and then down to the ward by 8:30. When we walked in there was a woman on the delivery table. We asked what the situation was and found out she came in bleeding and they were waiting for the Dr. to come and do an ultrasound. The Dr. came and it was decided that she had placenta previa, so off to c/s we went. Linda and I went in to do take care of the baby when it came out. The baby did fine with apgars of 9/9. The mom had general anesthesia and it took them all of 10 min to get the baby out once the mom was out. What an experience to be in the OR here. Linda and I were trying to set up O2 incase we needed it for the baby but the O2 was on the other side of the room from where the baby was to be cared for. We tried to move the O2 closer but there was no other plug. We were running out of time, and they were started to cut so be bagged the O2 and hoped that we would not need it. Everything turned out good and the mother and baby are doing good. ( poor mother they have no pain meds for her)
At about noon we went back to the house to talk to our cook about the cooking and cleaning and ate a very good lunch that she had prepared for us. Potatoes, cooked greens and fresh baked bread. After lunch we took a quick nap and then had to be at the hospital about 3:45 to start our assigned shift from 4-9pm. We waked in and there was a woman on the table who was groaning and looking like she was pushing. But there was no one there. We went and got the nurse and asked about her and they said she came in about 1:30 with PIH and was 6cm. They gave her some diazepam and then let her labor. When we waked in she was pushing. So I quick put on some gloves and caught the baby. It was a small baby 2.4 kg but did well, lots of vernex!! She did have a 2 degree tare so I watched and learned from Linda how to repair it. After the repair back to the ward she went. Her BP was still high 180/90 so we decided to call the Dr. and get her stated on Mag. What and experience starting a mag drip here. There is no IV pump, so we had to calculate it all out and figure out how many drips a minute the IV should be at and then count it out to make sure it is the correct drops. Then trying to explain to the other nurses how often her V/S need to be taken and DTR checked was a joke. It seemed like nobody cared. So we kept and eye on her for the first 5/6hrs and then we had to go to bed and we really hoped that they would continue to take her V/S. The next morning the pt was still alive even though no DTR’s had been done and only a few V/S taken. Things are so different here it is hard to adjust. Having some previous knowledge in OB and all the meds has been a huge help, thank you LLUMC!!!
Please continue to keep us in your prayers as we face new challenges everyday, but by the grace of God we are being able to help the people here and train their medical staff to better care for the pts.
At about noon we went back to the house to talk to our cook about the cooking and cleaning and ate a very good lunch that she had prepared for us. Potatoes, cooked greens and fresh baked bread. After lunch we took a quick nap and then had to be at the hospital about 3:45 to start our assigned shift from 4-9pm. We waked in and there was a woman on the table who was groaning and looking like she was pushing. But there was no one there. We went and got the nurse and asked about her and they said she came in about 1:30 with PIH and was 6cm. They gave her some diazepam and then let her labor. When we waked in she was pushing. So I quick put on some gloves and caught the baby. It was a small baby 2.4 kg but did well, lots of vernex!! She did have a 2 degree tare so I watched and learned from Linda how to repair it. After the repair back to the ward she went. Her BP was still high 180/90 so we decided to call the Dr. and get her stated on Mag. What and experience starting a mag drip here. There is no IV pump, so we had to calculate it all out and figure out how many drips a minute the IV should be at and then count it out to make sure it is the correct drops. Then trying to explain to the other nurses how often her V/S need to be taken and DTR checked was a joke. It seemed like nobody cared. So we kept and eye on her for the first 5/6hrs and then we had to go to bed and we really hoped that they would continue to take her V/S. The next morning the pt was still alive even though no DTR’s had been done and only a few V/S taken. Things are so different here it is hard to adjust. Having some previous knowledge in OB and all the meds has been a huge help, thank you LLUMC!!!
Please continue to keep us in your prayers as we face new challenges everyday, but by the grace of God we are being able to help the people here and train their medical staff to better care for the pts.
Sunday, July 20, 2008
Heartbreak of Ethiopia
So the 20th was our first day in the hospital. We got a tour of the whole hospital and then a more detailed one later from one of the RN’s who does deliveries. The OB and woman’s ward are all in one large room with some small dividers. The RN who is in charge of the ward took us around and told us about all the cases and it was so sad to hear some of them. One woman had come in with a ruptured uterus and the baby dead and to have a hysterectomy. She was so depressed about it that she had psychosis and was refusing food and drink, so looked terrible. To make matters worse she was in a bed next to a woman with a baby. The woman did have one other child and I suggested that they bring the child to her to help her but they said that the child was to far away. They were able to more her to a private room on another ward to get her away from the other mothers an infants. But another mother who lost her baby at 3days old for reasons I was not able to gather was right between to mothers and infant, and often I would look over to her and she would be crying and just watching the mothers nurse there babies. I was just heart breaking.
Linda and I missed a birth during lunch because they were unable to get a hold of us, we are trying to fix that problem. But when we came back we helped her start breastfeeding. She had a 2kg infant and the RN who delivered her gave her a large episiotomy. So you can tell the people here need some training. Linda and I were put on the schedule for the 20th from 4-9pm because there was not midwife on and only 2 nurses for over 20 pts. The language barrier is very hard. One of the RN did speak very little English but it was still very hard. Because Linda and I did not really have anything to do because there was no laboring pt at the time we decided to clean, and boy did it need it. There was dried blood on the labor beds and delivery beds and dried mec on the scale and wall. So we scrubbed with rags and toothbrushes. We also organized the delivery room and all the supplies because you could not find anything and nobody new what supplies they even had. While Linda and I were organizing all of a sudden a woman was carried in by 4 or so men and put on the delivery table, she was complete and pushing. Linda told me to quick put on some gloves and she with me helping delivered the baby, in less than 10 min. The baby did have thick mec all over him but had agars of 8/9. The woman did well this was her 4th baby, and after about 15 after delivery she had to get up and walk to the ward to her bed, leaving bloody foot prints all the way. Then the nurse came in with mops made of rags and sticks and moped up the blood. Later we went out to check on the woman and ask if anyone a checked her fundus and no one had at it was almost 1 ½ hrs later. It was then checked and everything was good. There was blood everywhere because they just put a rag between their legs to catch the blood. I guess you use what every to got.
We also got a new admit to the med/surge ward of a middle aged woman with a compound fracture and both bones broken in her arm. The Dr. was called but he was in a he market and so we could not get a hold of him. So this woman already at 12hrs post the break just had to wait with her compound fracture for the Dr. to come at some time. He had still not come we left from our shift. So you can see the needs are great and I hope that as time goes on and the nurses let us do more and we will be able to make more of a difference and help more people. Please continue to pray for us and the people here that we will be able to use our supplies and skills to the best.
Well hope you enjoy this little peek into the life here at Gimbie and what we are doing.
Linda and I missed a birth during lunch because they were unable to get a hold of us, we are trying to fix that problem. But when we came back we helped her start breastfeeding. She had a 2kg infant and the RN who delivered her gave her a large episiotomy. So you can tell the people here need some training. Linda and I were put on the schedule for the 20th from 4-9pm because there was not midwife on and only 2 nurses for over 20 pts. The language barrier is very hard. One of the RN did speak very little English but it was still very hard. Because Linda and I did not really have anything to do because there was no laboring pt at the time we decided to clean, and boy did it need it. There was dried blood on the labor beds and delivery beds and dried mec on the scale and wall. So we scrubbed with rags and toothbrushes. We also organized the delivery room and all the supplies because you could not find anything and nobody new what supplies they even had. While Linda and I were organizing all of a sudden a woman was carried in by 4 or so men and put on the delivery table, she was complete and pushing. Linda told me to quick put on some gloves and she with me helping delivered the baby, in less than 10 min. The baby did have thick mec all over him but had agars of 8/9. The woman did well this was her 4th baby, and after about 15 after delivery she had to get up and walk to the ward to her bed, leaving bloody foot prints all the way. Then the nurse came in with mops made of rags and sticks and moped up the blood. Later we went out to check on the woman and ask if anyone a checked her fundus and no one had at it was almost 1 ½ hrs later. It was then checked and everything was good. There was blood everywhere because they just put a rag between their legs to catch the blood. I guess you use what every to got.
We also got a new admit to the med/surge ward of a middle aged woman with a compound fracture and both bones broken in her arm. The Dr. was called but he was in a he market and so we could not get a hold of him. So this woman already at 12hrs post the break just had to wait with her compound fracture for the Dr. to come at some time. He had still not come we left from our shift. So you can see the needs are great and I hope that as time goes on and the nurses let us do more and we will be able to make more of a difference and help more people. Please continue to pray for us and the people here that we will be able to use our supplies and skills to the best.
Well hope you enjoy this little peek into the life here at Gimbie and what we are doing.
Tuesday, July 15, 2008
Well everything is packed, my house, my car and my bags. I am now hoping that everything got done that needed to be done, and if it didn't then o'well because it's too late now!! My plane leaves from LA at 10:40am. I will be meeting up with the Midwife that I will be working with there in LA and our journey will begin! Please keep us in your prayers as we will be traveling for around 25-30 hrs. So until we are in Africa...
God Bless.
God Bless.
Friday, July 11, 2008
To AFRICA...
Well it's 100% official, I am going to ETHIOPIA AFRICA!! I received my visa today, have my plane ticket and now all I have to do is pack. But packing is not as easy as it sounds, for I must pack up my whole house and fit it into my car. If it won't fit it wont go! Then I have to also pack my bags to take to Africa. So yes it is a very big project!
I am really excited about this trip not only to go and help people with needed health care and to see new and exciting places, but to see God work in amazing and unthinkable ways. This trip was truly a miracle and Gods hands were all over it. Without Him it would never have been possible to pull this off in 2wks. Every day I have witnessed a new miracle making this trip possible and showing me that God is in control. So stay tuned to this blog if you want to see God work in crazy ways, because I can truly say that this is a God ordained trip!
So until Next time...
amber
I am really excited about this trip not only to go and help people with needed health care and to see new and exciting places, but to see God work in amazing and unthinkable ways. This trip was truly a miracle and Gods hands were all over it. Without Him it would never have been possible to pull this off in 2wks. Every day I have witnessed a new miracle making this trip possible and showing me that God is in control. So stay tuned to this blog if you want to see God work in crazy ways, because I can truly say that this is a God ordained trip!
So until Next time...
amber
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