Just another manic Monday…….

17/05/2010

Just another manic Monday…….


So my day went like this…..

I was woken up at 5am by the monosyllabic sound of the mosque; it is then impossible to get back to sleep! It’s kind of like when you get woken up by that terrible Nokia standard tune that just automatically puts you in a rubbish mood! But worse, because its 5am!!!

Anyway it was cool because I was forced out of bed, only to discover what I have been massively missing out on for the last 6 weeks….. The most beautiful sunrise!!! And that coupled with wonderful Ethiopian coffee… made the most perfect morning!

So I walk my 140 steps across the compound to work…..

As I entered the labour ward I trip over three boxes stacked on top of one another, one labeled F3, the other F7, and the last F13, these are bed numbers! And inside are the baby’s belonging to the mothers lying on those beds!

On to the labour ward… I’m greeted with three labouring women, one breech, one cord presentation and the other premature! There are also two other’s with sever pre-eclampsia!

I took the hand over and started yet another manic day!

We have a fantastic obstetrician here, but only one! He works night and day trying like the rest of us to save the lives of hundreds of mothers and babies! But with only one doctor and one operating theatre we are stretched! Some days… like today it seems every women who comes though the door is needing emergency treatment, and when the doctor is already occupied in the only theatre then it’s really up to us to do what we can.

I carried out my first ventouse delivery today! I was petrified! IV seen it done many times, but hadn’t really thought that I would ever be on the end of the vacuum, trying to pull the baby out! But when that fetal heart is dropping below 50bpm and just not recovering, and our only doctor is busy, there is just no other option, so I guess you just do it! And so I did….! And apart from a having a sore head which is slightly cone shaped, the baby is doing well!

As an attempt to try and cure my ‘Cabin fever’ I took a trip out at lunch time to the market…..

Just outside the hospital gates I was met by a man with withered legs that were folded on to his chest, he was holding blocks of wood with a handle in each hand, he looked at me with another pair of hopeless eyes that I have become so familiar with! I walked on, moments later with curiosity I turned back to look at him, with his blocks of wood planted firmly on the ground, and his bottom swinging forward he moved in a kind of ‘M’ shape in the opposite direction.

Another thing I couldn’t help but notice was the huge amount of people suffering with elephantitis! A really nasty painful infection in the leg. I later leant that it is a real problem here, both with the amount of people suffering with it and the social exclusion that it causes. Apparently the high prevalence has something to do with the altitude, the type of soil, the penetrating sun and the simple fact that people can’t afford shoes! It’s really sad, especially when it can be so easily avoided!

The last thing that really made me think today was seeing a few of kids who had had their heads shaved, leaving just a tuff at the front! It was strange and when I inquired about it with my colleagues at the hospital I was told that the children were sick and the tuff was to help God lift them to heaven! Its mind blowing, I mean that this is the best hope they feel they have….To hope that the child goes to heaven! I can’t help but feel we are letting them down, they are children, they have mothers and fathers, they have hopes and dreams, they have imaginations and the desire to learn… they are our future, and all we can give them is the hope of heaven! It just seems so unfair!

So I returned to the only world I know right now, a terrifying world, but one which has become my home, and my friend…. The labour ward!

I’m back in for no more than two minutes and a woman gets rushed in on a stretcher! She had been discharged that morning after 3 days, following a C- section! She was vaguely responsive; I look down to see that her scar had completely opened! This lady like most had left the hospital on foot, she lived 4 hours away! It’s hardly surprising when you think of it! So what can we do? We did our best to safely deliver her baby; we cared for her in the hospital! But then that’s it! Is it enough though? I just wish we could do more!

Then another stretcher…. This time a young women having a massive antepartum hemorrhage! We rush her to theatre, with the main priority of saving her life; we will of course try to save the baby too! She had a uterine rupture and lucky for her had made it to hospital in time! And like a total miracle for the baby too! There are so many women here who end up with a ruptured uterus. They push for hours, some times days, on a cervix which is not fully dilated or with a mal-positioned baby when there is just no hope for delivery! So the uterus inevitably becomes exhausted and ruptures! It’s horrible and it’s a massive killer! Maybe with better skilled birth attendants out in the rural clinics we have a chance to reduce it, but even then what happens to all the women who don’t have the means to access the clinics?
Well we know what happens… they die! It is just so unfair!
Safe pregnancy, childbirth and motherhood are basic human rights! But there are just so many people, too many people, who don’t have it! I wish we could change that, I wish we could do more!

But there are lives we are saving, and there are futures we are giving hope to….In an otherwise forgotten corner of the world we are changing things. It’s beautiful to see and it’s a privilege to be apart of it.

A World of Possibility?....... Or an Impossible World?

So IV been here a month today…Although really I have lived a whole life…. But in another world!

I decided I would look at statistics…

According to the World Health Organization (WHO) ….

· Globally every year at least 350 000 women die due to complications in pregnancy or childbirth. More than a quarter of these figures come from Africa

· 10,000 babies per day die within the first month an equal number of babies are born dead.

· In Africa alone neonatal mortality is 45 per 1000 live births.

So here are my statistics over the last month…..

· 149 births
· 2 dead pregnant mothers
· 28 dead neonates within the 1st week of life

Now I am no mathitician ….

But according to The WHO neonatal mortality works out to be around 1 in 28.

My statistics from here are more like 1 in 5.

I’m not sure how statistics are obtained and measured but I’m pretty sure they don’t have people carrying out direct observation over a period of time! Theses figures come from records right! Now how many records are kept? Well only for those who attend health services! And we know that only around 2% of the population here are able to access adequate health services!

It’s pretty hard to obtain accurate records even within the hospital, as many births go un-recorded and records of baby’s that are born alive but die before discharge are not amended! This comes from first hand observation! And what is going on out in the rural areas? Well know one knows for sure….. But we do know that the reason people do not attend health services is not because they don’t need to, it’s because they can’t!

So I maybe wrong… and I am only going by a month of work but I reckon it is a whole lot worse than we think!

For those of you who know me so well I’m sure you’re thinking the same as me…. Statistics?? Well I guess I just find it kind of therapeutic, a sort or escapism! I guess numbers somehow aren’t as painful as actually living it… Witnessing it!

I like the majority of the west, can’t really imagine the reality behind these numbers…. So I thought if maybe I just shared the odd story with you then maybe I could bring you closer….

I guess in a selfish way I also hope by sharing my burden it will somehow be lifted, give me strength to carry on fighting for whatever it is that I’m fighting for…. A human right I guess! Because sometimes it just seems so impossible!

Two days ago I delivered a beautiful baby girl into the world …. Today I watched her leave!

During my morning ward round I noticed she was struggling, her resps were up, she had a temperature and was not feeding! I took her to the labour ward and started her on oxygen and antibiotics; I put a NG tube in to feed her and monitored her closely. During the day her condition deteriorated and she was completely dependent on oxygen.

At 6pm we had a power cut…. She was helpless and I was helpless to help her! So after some time of watching her gasp for air, her eyes blinking in and out of consciousness, I made a decision that may haunt my dreams forever but somehow felt like the right thing to do.

I stopped…. I gave up…. I pulled out all her tubes, I wrapped her in a blanket and I took her to her mother. I held her mother whilst she held her baby, her tears fell so gracefully…. as she died in her arms.

So I have joined hundreds of other aid workers around the world fighting to save the lives of the most vulnerable…. In a world of possibility! But after days like today, that world just seems so impossible!

Its like we are here with our patients but the treatments aren’t! So this beautiful baby girl will join the estimated 24,000 people who die around the world of preventable or treatable neglected diseases! (WHO).

And so in some twisted circle of life way…… we are back to statistics…. She is now a number!

Maybe because she never had the chance to discover what it means to live, to know what it means to be happy, to be sad, and to be free; then maybe she is exempted from qualifying for the most basic human right??

But I disagree……..She knew what it meant to be loved…. And in my eyes, that qualified her with the right to life!