Where are we in Kampala?

So, it has taken me a little while, but I finally realized that we are actually living in a poorer area of Kampala. I figured that out when our driver - yes we have our own driver - took us to the post office, past the really fancy hotels and big beautiful homes. Hmmm. Maybe all the barbed wire and cooking fires - and just plain fires burning garbage on the corners - should have been a give away. Seriously, we do have barbed wire. But most of the barbed wire has absolutely gorgeous flowers growing all over it. And if the flowers are not enough, there are usually broken beer bottles artfully arranged and cemented down on top of the high fences. We do have a security guard (aka 17 year old with a rifle) at our iron gate. But, he has a great smile and has let us take his picture! The houses are mostly corrugated iron or brick. There are alot of people around, especially alot of young men on their boda-boda's (aka motorcycles) because there is a really high unemployment rate here - 80%, and they really stare at us when we walk by - not alot of white people here. HOWEVER!!!

Africa is a place of colour. Beautiful bold colours. Bright blue, yellow, pink, red, green. People wear amazing clothing. They paint their buildings amazing colours. There are wonderful animals everywhere. Dogs in the street, goats in the street, cows in the street, rats in the street. Some alive, some dead. And did I mention - people everywhere. And everyone we meet usually smiles at us. They laugh at our attempts to speak Lugandan. They encourage us to speak with them. They try to speak English back.

Jody and I usually wake up to clear skies, the sun rising and chanting from the large Mosque on the distant hill. Then the sky gets hazy as everyone starts their morning cooking fires. And it usually clears by the time we start our walk to the hospital. The scary young guys sitting on their boda-boda's now usually say hello and ask how things are at the hospital. We are getting more adept at leaping over the open sewage stream on our trek. Women at Ward 14 (Labour ward) smile and nod at us. They are happy to see us. We are happy to see them.

Africa is good!!!


From Tina

New blog with pictures for our kids

hey - make sure to check out http://ourmomisinuganda.blogspot.com/


We wanted to make a page where we could post more pictures for our kids. Between us we have 16 children!

So, check out our other page to see more of your mom's adventures not as related to birth.

Missing you,

Your moms

Surprise twin birth with almost no supplies

A week ago I could hardly believe I could attend a woman in labour without at least some medical supplies. What about the linens we use in Canada, the blue pads which we throw out mindlessly, the fancy doppler we use to hear the heartbeat every 5 minutes when pushing? But today I caught one of a set of twins (a girl) using nothing more than two pairs of gloves on, some cotton (think of a roll of cotton balls), one needle and syringe with Oxytocin and a razor blade to cut the umbilical cords. Oh and a fabulous preceptor who when I said : 'Angela the placenta is right there, I know I feel it but it won't come' she simply replied 'oh that because its a bum not a placenta' --- right then--- and calmly delivered the breech (bum first) baby boy.

We used, as we do for every birth, the edges of our gloves to tie the umbilical cords and mom's cloths for drying the baby. Mom was fine, fed the babies minutes later was up eating and walking within 30 minutes. We gave her some donatedblankets, lovely hand knit sweaters and dolls which she seemed to love.

The sad side of not having access to any medical supplies is that of course there are more deaths here than we have in Canada and I don't want to downplay the significance of seeing babies wrapped in their mother's cloths after passing away. I don't wish for us to celebrate using nothing at the expense of mothers and babies but to simply say birth is normal and happens. With or without a doppler and blue pads.

Margaret's birth and more

I had my first catch in Uganda yesterday. It was a lovely quick birth of a fourth baby for a Ugandan woman. His mom was Margaret and I was so pleased to be at her birth. The baby was a healthy 3.7 kgs! I was given the honour of naming the baby so I chose Francis after my dad who passed away over 10 years ago. I will post a picture as soon as I can.

Since yesterday I have also attended the delivery of very preterm twins and another healthy baby girl (4.0 kgs). These births were on the low -risk part of the high risk ward which does about 80 births a day. There is so much to write that I simply can not describe here but will carry with me for years to come.

Thank-you to all who donated hats and booties and baby blankets and other donations. The moms appreciate them greatly. They are particularly helpful when the mom has nothing with her. The supplies for the hospital have been essential to us being able to do our work. Thank-you to all!

Sarah's first birth

So - Jody and I went to Ward 14 with Cathy first thing in the morning. Wouldn't you know it - a woman was delivering right away. So I had a pretty quick orientation before gloving up! The woman was a first time mom and was so focussed and very sweet. Although pushing very hard, she always had a big smile in between contractions. We found very quickly that the language difference was a challenge. Although she spoke excellent English, it was hard to find the right words for coaching with your hands gloved up and sterile/non-sterile and the handy pocket card of terms ... in your pocket!

Cathy and Angela were AMAZING preceptors and very good at being there for you while letting you just do it! And I sutured!

A lovely baby girl arrived and was named "Jody" as the mom requested I name the baby with a "J" name for a girl. We came up with Josephine or Jody and she picked "Jody." So baby girl Jody goes off to her life in Uganda and we get ready for tomorrow's adventure.

In appreciation,
Sarah

My first Day

Today was pretty incredible. I attended my first birth on ward 14. Mom was expected to go down to the high risk ward for failure to progress, a multip, that we did not expect. She was 8 cm and not progressing and the head midwife decided to try to let the mom push and push the cervix back and the same time. Thank goodness it worked and I was able to catch the baby, and suture a small second degree tear. It was incredible.
Carole Miceli

Mulago Hospital

We did an introductory tour of Mulago Hospital. It is a huge hospital, taking about 20 minutes to walk from one end to another. We put on our white lab coats. It was quite a sight - 6 white women wearing white lab coats - we didn't pass another white person on our tour. There are two places in Mulago Hospital where women can give birth. One place is called Ward 14. This is for low risk women and averages 20-30 births a day. The other place is called Lower Mulago, is for high risk women and averages 80 births a day. When we passed this ward, there were women sitting on benches, women lying on the floor, women lying on beds and women waiting on the stairs. The nurses on Lower Mulago are very committed, but lack the numbers and resources to provide the care they want to. Women in both areas dont face the choices women in Canada do. There are no "choices" around childbirth. There is no entenox, morphine, fentanyl or epidurals to help with pain. There aren't even showers or baths or support people. It is simply women labouring, on their own, in beds, side by side. There is not a choice around "what to wear". Instead, women are wrapped in an amazing variety of colour and fabric, but definitely not in a hospital gown. So, we start attending births now, learning what we can, providing hands as we can. There is so much to do.

Tina from Kampala