Day 3: We spent almost the whole day at the hospital. The antepartum and postpartum units were very busy. The labor unit had a couple of women out walking. I had never seen anything like the labor unit - filthy and so completely out of order, everything just a mess. Actual ants on the counter and labor "bad" which is actually an old exam table. The families have to bring towels or a sheet to put under the patient. There are no drapes to cover the patient's private parts while they lay on the table.
The families have to help clean their family members and bring a rag for the patient to put in between their legs to walk home. Their is a bucket on the ground in between the patients legs that catches all things bloody including the placenta and then they take it home to burn it with their trash each day. Birth is very somber and the women and families are very quiet.
We spent all morning emptying out the cupboards, sweeping them out and then scrubbing them out. We took all the supplies and went into an adjoining room to organize them. After 6 hours we were not even close to done. The goal was to simplify the labor room supplies and put overstock into a new cabinet in the adjacent room. We went back to the house for lunch at 2pm for rice, beans and goat stew (i ate rice and beans). Then back to the hospital we went. It was busier in the afternoon, 3 laboring moms and a miscarriage. The midwives rarely check heart tones and the women are just sent out to walk. One woman with bloody show and 9 cm was sent back out to walk! When she returned and it was time to have her baby, I just kept my hand on her and told her to breathe in Creole. The midwives and families here do not really seem to provide labor support. I just couldn't not support her, she seemed to appreciate it.
The afternoon midwives were not too happy about our being there or moving all their supplies. One came in and told us via translator that we could not leave supplies in the adjacent room because the door did not have a lock and it would get robbed. Our plans were foiled. We began to put supplies back in the labor room cupboards and needed to show the midwives how it was organized. I pulled them aside with my translator and told them how hard I saw them working and that I appreciated what good care they were providing. and that I would be there all week, so if there was anything I could help them with to let me know. That seemed to warm them up and they were very receptive to our supply reorganization. We made 3 emergency packs - one for eclampsia (women seizing from high blood pressure which is a common complication here), one for hemorrhage (most common cause of maternal death) and neonatal resuscitation (even though they rarely have oxygen or save babies). There was two pieces of equipment they were not familiar with and asked lots of questions, so it ended on a good note. We came back to the house at about 5pm and exchanged some money at the bike/auto parts shack across the street.
Comments