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