Friday, January 4, 2013

Day 20 - This time it was a baby boy!

I got up this morning and got ready for work and waited for the taxi to take us to Pasua. We waited and waited and eventually decided to call him to come get us. He arrived one hour late!

We arrived at Pasua and signed in and I got to the labour room just in time to see a women birthing her baby. The baby was breech so I could just see the soles of the baby's tiny feet emerging. The midwife tickled the baby's toes and they wriggled! I quickly went to put my bag down on the table and grab some gloves out and about 2-3 seconds after I had walked passed the Mama her water burst and sprayed about 4 meters in front of her. I was so glad I wasn't 2 seconds earlier! That could have been messy! I grabbed my gloves and returned to the Mama's side. She pushed the baby out to his shoulders over a few contractions and I held him as he came. Once his legs were out I became aware of how little he was. I asked the midwife and was told he was premature. The Mama was only 28 weeks pregnant. The birth took a little while and I was becoming concerned that the baby wouldn't survive the birth or had already passed in the past few minutes. The doctor then arrived and I stood aside. The baby's head was stuck and it took some effort for the doctor to pry (for want of a better word!) his head out. The baby didn't make a noise at first but he eventially started to weep and I felt relieved. He was still alive! The doctor and nurses worked to suction secretions from the baby's mouth so he didn't choke and to prevent the secretions from getting into he lungs and creating an infection. They also wrapped him in multiple kangas to keep him warm. While the doctor and nurses were with the baby a midwife injected the Mama with the oxytocin. She then waited for it to work and after a while encouraged the Mama to push the placenta out while she gently pulled. The placenta came out easily and in one piece. The delivery of this Mama's placenta was so much better than the last one I experienced. I really feel that Melania, the previous midwife I worked with, needs extra education on birthing the placenta.

As the baby was 12 weeks premature the Mama and baby were referred to KCMC, the largest hospital in Moshi, for continued care. KCMC has much better facilities and equipment to care for the baby. Later I asked the midwife if the baby has a very good chance of survival and she said yes as he was a good birth weight for his gestation (1.3kg) and he was alert. He had an apgar score of 8/10 which is acceptable for a baby born at full term. An ambulance arrived to transport the Mama and baby to the next hospital.

The midwife and I then cleaned up the delivery room and prepared and sterilised some delivery packs. The delivery packs included a kidney dish, two drapes, two pairs of scissors and two clamp forcseps. Each set is wrapped in a piece of fabric and then tied with string before being sterilised.

After that there was not much going on in L&D so I went to the antinatal clinic for a little while. I then retuned to L&D with one of the new students, Shezra, and while we were chatting we saw three men arrive outside the clinic on a motorbike. One of the men was unconscious. His friends carried him around the back and into the women/children ward. Within the minute they had come back out with him and took him to the mens ward. I was curious so as a cover I told Shezra I needed to go find my friends as the taxi would be there soon to pick us up. We walked through the women/children ward and there was a doctor reviewing a patient with a group of visiting student doctors. We then walked into the mens ward and there was the man laying on the bed. There were no doctors or nurses to be seen anywhere! I was surprised to see that he was not receiving any treatment at all. I didn't know what to do and no one else seemed even slightly concerned, not even the student nurse I was with. I didn't know what to do...what was culterally appropriate. Looking back on the situation I wish I had put him in the recovery position and taken his obs but it is too late now.

I had a quite afternoon of reading and napping and then I went out for dinner. I went back to Green Bamboo BBQ with Sarita, Aynsley, Debra, Daisy and Henrika. Henrika is a Finnish volunteer who arrived at TV House a few days ago. I took some photos of the bbq this time but they are not that great because I forgot my camera and had to use my phone and the bbq wasn't as full as the restaurant wasn't as busy.

We returned home and had a few drinks before going to bed. Tomorrow I am going to Arusha to visit the Tanzanite store and possibly the Maasai Museum. That should be interesting.

Lala salaama (sleep well). I love you <3

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