Why are they crying?

On Canada Day, we saw a woman take her last breaths.

We went to Lower Mulago with our Canadian flag pins on our chests (over the heart) [nothing seems to make you more patriotic than being away from home]. I have a bad feeling in my stomach (not related to unwashed produce) but to Cathy saying earlier that something bad usually happens on the last day on Lower Mulago.

As we walked into the room, these two non-ugandan students are sitting by the door on the bench. "oh my gosh - are you from Canada?!"

We are and they are - they are pre-med doing overseas observational placement. The purpose of observing escapes me somewhat. The only thing that keeps me sane here is knowing that at the very least I can do SOMETHING.

They chat with us and say that the woman in the first bed has lost some blood and they are looking for blood for her. She is lying with her eyes shut, breathing evenly. I don't even notice that the baby is there, lying at the foot of the bed.

So, to make and long, sad story shorter and no less sad --- she very quickly goes very downhill and dies. They can't take our blood, even though they ask for special permission. It is too late, anyhow.

I wrap the baby boy with Jody in one of our donated blankets - hating that this is the story of his birth, hoping he will be okay.

I keep myself busy the only way I know how, by working, and managing to choose the most complicated woman to help. The one who refuses all vaginal exams, the one who has not been examined in 2 days of attempts. The one whose full, full bladder is not only palpable but visible from 20 feet away.

She tells me that men have damaged her, that the doctors damaged her, that she was beaten by her mother, that it happened many years ago, that it was in the last 2 days. I do a vag exam with my pinky only (seriously) - which tells me that there is a head, low, and no cervix at the front. That's it. That is all that she can take. I do a cathetar with super sonic speed for the full, full inital bladder. She pushes for an hour, about as long as Cathy says we can let her. She is okay with me, says I am a kind one - then tells me that she will have a ceasar if I do it only, that no one else can touch her. Shit. Not going to happen. There is meconium now draining with the amniotic fluid. Shit. I ask for a consult, and the consultant does the first full VE on her (she is fighting and refusing and crushing my hand) and there is caput and mec and she is on the list for section. I am relieved, because as much as I wanted this to be a healing birth for her, the writing is on the wall. The fetal heart is consistently good. 130 140 130 150 140

I do a 2nd cathetar with super sonic speed - to prep for the inevitable surgery. That 2nd cathetar drains red bloody urine. Shit.

The soundtrack of our day is the weeping and wailing of utter grief from the dead woman's family. Desperately sad and angry tones echo and the rain pours down like tears.

She asks me why those people are crying in the hall and in the breezeway.

"Why are they crying?.... Did they lose their baby?"

"I don't know," I say, " Sorry, I can't understand what they are saying"

She listens carefully and quietly. I think she has forgotten about it.

Then she says:

"I know! They are crying because Michael Jackson has died!... I, too, am sad."



I spent hours with her, and left her, prepped for surgery, next on the list to go, with a good fetal heart rate. That was all that I could do. Sometimes that is all you can do.