One month in, our thoughts so far...

So we have been in Uganda for one month, which is hard to believe. Between the four of us we have caught 99 babies. We have experienced:
-8 sets of twins, one face presentation, one shoulder presentation and seven breeches (not to mention lots of post-partum hemorrhages, shoulder dystocias and resuscitations)
-babies with cleft lip and palate, ambiguous genitalia, spina bifida and polydactyl (more than 10 fingers and toes)
-moms who seized from high blood pressure
-and mostly, we have had moms who have birthed their babies without ANY complications

Our favorite moments have been (besides talking with our families):

-a mom with a baby with cleft palate who we worried wouldn’t bond with her baby and she loved that baby so much
-when Grace (our preceptor) had her finger sucked by a baby in utero (inside the mom) which made her scream
-working for 2.5 hours and delivering 12 babies in that time
-walking into a room to catch a baby, deliver a placenta and chart (while standing up, holding a b.p. cuff and other supplies) without even thinking about it


Our hardest moments (besides missing our families):

-unnecessary episiotomies (cuts to the woman’s perineum) for 4 out of 5 births in one day (not done by us of course)
- being unable to get the arms down for a breech baby that when he was finally born never had a heartbeat and wouldn’t come around no matter what we tried
-a 15 year old GIRL labouring in a blue flowered dress, scared and alone
- anytime I found a baby who didn’t make it (or a row of them on a cart)
- every mom trying to get through childbirth with malaria and/ or HIV


Our funniest moments:

-almost missing the plane in London because we needed “one last glass of wine”
-loading 11 bags, 5 carry-ons and 6 people into one “rickety van”
-discovering a breech by the preceptor pointing out the meconium (baby pooh) on my glove
-a breech that literally “flew out”


Favorite food:
-the first night of buffet at the Zebra

Worst food:
- the last night of the buffet at the Zebra

... see you in 2 weeks... xoxoxox

Carole, Jody, Sarah and Tina

African Directions - From the Zebra to the Danish NGO

From the top of the hill, look down across the pasture and over the road. See the big building with all the scaffolding. Look past it to the building with the red roof (most of the buildings have red roofs). Turn right onto the path where you see the long horned brown cow with 2 white birds. Walk down that path until you see the wall covered with the beautiful bouganvillea (most of the walls have bouganvillea). The Danish NGO is right across from that wall. Stand outside the gap in the fence and read the sign that says "Uganda Child Care", decide it's not the right place, return to your hotel and try again. Oh and by the way, it's not actually called the Danish NGO. Hope to see you there!

Tina and Jody

Two funny posts: I am so sorry and "hair" conditioning

I am so sorry

This may be the main catch phrase that we pick up from our time in Uganda.
The Ugandan people are so empathetic to clumsy people.

Like me, who missed a step entering a room and the Ugandan women who watched me spectactularly arrive, said, “oh, I am SO sorry.” They seem very very very sorry. Not just sorry that I am so clumsy, but like they are apologizing on behalf of the shoddy construction or that the architect that could have designed such a dangerous step. [Carole told me she missed the same step entering the same room]

Or, like the time that our uniforms weren’t ready in the morning for us to go to the hospital and the “concierge” guy at the hotel looked completely stricken and went “oh, I AM SO sorry. It has rained.” ....looking totally stricken..... “It must have rained on them on the line.” .....looks like he might cry.... “Oh, sorry, so sorry.” [exactly in the tone that you might use if someone’s gramma died].

The response from us is always. “Oh, it’s okay. Really. It’s okay. We’ll figure it out...” [please don’t cry].

Getting –hair- conditioned

So, my hair is getting really out of hand in Kampala. Surprise, surprise. Note to any strangers: I have (the potential for) CRAZY hair. My hair also hated Prince George. Kampala and Prince George. GO figure.

So Carole and I walked to the Mulago Hospital in Kampala one morning and I swear my shadow looked like Animal from the Muppets! Seriously. Boing boing boing.

Which I was okay with, as on the wards I wear my blue bandana. It calms the hair and absorbs the copious sweat. Bonus!

Carole and I had long talks making fun of my hair. She gave me professional advice.
Then, the funny thing was when Cathy spontaneously told me that she had hair conditioner that I could borrow. Poor Cathy, as Carole and I broke down into gales of laughter. Then, the next morning, I opened the door and the hair conditioner was perched perkily on our stoop.

So, I did actually condition my hair on separate days with both Cathy and Carole`s conditioner.
Then Carole looks at me, sighs and says ``you know what, I actually think you need hair products!``

In The Eye of the Storm

Jody, Grace and I left Masaka today to return to Kampala. Grace and I decided to spend a late afternoon shift on Lower Mulago in Kampala. We arrived on the Ward at about 3:30 pm, changed into our white uniforms, loaded up our pockets with gloves and supplies and headed to the labour room. We arrived in time to see one baby lying on a bed in a pool of amniotic fluid. There was a first year medical student, Paul, standing there. It was the first birth he had seen. The Sister was cleaning up and welcomed us. Twenty minutes later, we had our first birth. Twenty-five minutes later, we had our second birth. In the next thirty minutes, we had 3 more births. There are only 6 beds in this ward. We had forced one mom off a bed to put another mom on it who was actively pushing her baby out. The mom we had asked to move was now standing at the base of the bed, delivering her baby. We barely caught that baby. We were ripping the tops off our gloves to try to tie umbilical cords and rushing for oxytocin to prevent post partum haemorrhage. Barely ten minutes after the mom birthed standing, another mom called us from the door. Before we could reach her, with a sickening thud, her baby was expelled onto the floor. The cord tore. I grabbed onto the placenta end of the cord while Grace grabbed the baby and Paul ripped the top off his gloves so Grace could tie off the little bit of cord left attached to the baby. Then, I delivered another baby while Grace caught the first of a set of twins. I caught the second twin, a footling breech ( feet coming first) baby. Another mom was birthing in the hall. Two moms needed suturing. Another mom was bleeding. I caught a little preemie that only weighed 1.9 grams. We barely got him breathing when we were called to another bedside. We finally had to leave. It was getting dark outside, 6:50 pm. There had been 12 babies born in under 2 1/2 hours. We knew no mothers' names. We left with more babies coming. It was a storm.

Tina

A week in Kampala

Carole and I had a good week in Kampala. We worked at the Emergency Skills Workshop Monday and Tuesday. It was fun to be involved in the teaching and PPH demonstration with plastic torsos and water and red colouring. It is amazing how many people underestimate blood loss, which is profound in what could be an unhealthy, anaemic mother.


We attended 9 births this week. Carole and I alternate births whenever possible, being the super awesome 2nd attendant for each other. It is amazing how quickly your mind organizes and prioritizes. We are both getting fast at anticipating each others needs.

I am "improving" my IV skills and Carole is getting super duper awesomely quick and speedy. And I am hardly jealous at all because she just slides that IV in on my PPH mama.

We have met. again, more lovely Ugandan moms and bright eyed babes. Cathy could be a hockey goalie with her sliding in to catch the babes coming on the floor.

We are all together now in Kampala. So more adventures to come.

xo

One Moment of Pain

Jody and I arrived on the ward at Masaka Hospital Tuesday morning. There on the shelf were the wrapped bodies of 3 babies that had died. One was wrapped in paper, a tiny premature infant that had been there since the weekend. The other 2 babies were wrapped in beautiful cloths. One mother was sitting in absolute silence on her bed. Two young dads quietly entered. They had each come for their wife and their baby. They were both so very thin, their clothes hanging on them. They each took their wrapped bundle, tenderly placed their baby in a suitcase and zipped it closed. I felt an overwhelming moment of absolute sadness at the personal tragedy happening in front of me. I carefully opened the door so they could leave the ward. They thanked me for opening the door. I nearly cried.


Tina

There's a hippo outside our tent!

Jody, Grace (our preceptor) and I were camping on the shoreline of Lkae Mburu, the smallest National Park in Uganda. We had come for a 2 day, 1 night mini safari. We had already had a game drive and seen zebras, antelopes, impalas, Cape buffalo (mean nasty beasts that charge you if you get too close), monkeys and bush bucks. And oh yes, wart hogs. Think The Lion King and Pumba and you have it. So ugly they are cute, many needing a hairdressing appointment, warthogs. Hundreds. Loved them. We had also been on a boat trip and seen dozens of hippos and 2 five metre long crocodiles. We were wakened Sunday morning by an animal of some kind snorting, snuffling and booming outside of our tent. "That's a wart hog isn't it?" we asked each other. "Yeah" we agreed and drifted back to sleep. Minutes later Grace hollered "Get up, there are hippos!" Sure enough, a herd of young male hippos had been grazing around our tents and were currently in the water playing with each other. It is hard to describe what it is like watching giant beasts play with each other, but playing they were!

Tina