Day 4: Today was the hardest day yet. We got to the hospital and tried to finish our project of cleaning and organizing the unit and supplies. I have been trying to get the midwives involved so that they will buy into the system and maybe make their jobs easier and safer care for the patients. A few of them are starting to get into it. We had a laboring patient that was having her first baby. No one was giving labor support. Her family member did not touch her, the healer from her community did not touch her and the midwife ignored her.....so Pam and I started to give her labor support....we got her off the exam table and let her stand, we got her a wash cloth from our supply to cool her off, we rubbed her back.....then her family started to do the same....even the
housekeeping lady started to act like a doula. Next I had another very young girl come in labor. She had her mother with her and not much else.....she was very poor and her rag of a dress did not even have buttons left on the front and it was so thread bare you could see her body right through it. The first patient had a little bit of cervix left and the midwife took it upon herself to give her scapolamine, which pretty much knocked her out and stopped her labor! We could not believe it. She called the only OB/GYN doctor in and they decided to do a c/s.....very sad for this girl with her first baby..... she had a beautiful baby boy.
In the meantime a woman came over from the antepartum unit where she had been in preterm labor. The midwife casually walked her over and her mother followed her with a bucket and as just before she got on the exam table her mother put the bucket between her legs a loud splash happened. The baby, the amniotic fluid and the placenta and fell into the bucket... the midwife left her on the table to go get pitocin. Pam grabbed me from the stall with my other laboring patient and told me what happened. I went to check on the patient and we did not realize at that point that the baby was in the bucket. We looked around the room for the baby and then saw bubbles coming up in the amniotic fluid on the bucket. We through on gloves and pulled a 24-25 week baby boy out so he would not drown. The mother did not want to see him or hold him. She did not shed a tear. I think each woman looses so many babies in their lifetime they can not connect with them until they are born. I took the baby and wrapped him in a blanket and held him for almost an hour until he died. The midwives and student nurses were all so interested in what I was doing. I explained to them with my translator that I want him to feel warm and loved till he died. I think they were afraid he would be malformed or something. They liked seeing that he was actually a perfectly formed beautiful boy. Pam also shared with them that in the US we would have tried to save that baby. They were amazed. There was nothing to do here - no oxygen, nothing to intubate, no electricity to run ventilators. The mother did ask one question, "is there anything you can do?" I just told I was sorry but he was just too small and there was nothing to do. I helped the young mother labor till it was time to go. I wiped her down with a cool rag and wished her well.
After of 2pm meal of rice and beans and some beet and tomato salad we got motorcycle transit to Azil which is a nourishment center run by sisters from India. We went to the children their families can not feed them and they are severely malnourished. When we walked in the older kids attacked swarmed us. They were so beautiful - my heart was soaring after a hard day. There were about 80 children, infant to about age 6... hard to tell how old they were. I fed a 6 month old that looked like a one month old - probably 8 pounds. There was a 6 year old who looked 3. There was a 4 year old boy who had come in the night before with a huge burn all over his abdomen. I held and played with the babies for 2 hours and had an amazing visit with one of the sisters. If there is such a thing a saints these women are the real deal. When it was time to leave the tears just ran down my face. I wanted to bring them all home and care for them - it is just absurd the amount of suffering.