At the end of the first week, I had yet to do my first catch and I was envious as Lydia had 3 and Georgia has had her first 4-handed catch. The first day on Ward 14, I tried to open a vial of oxytocin and the whole thing shattered between my thumb and forefinger. I had two very minor punctures, but Cathy sidelined me from the labour ward until it's healed. Probably wisest, but disappointing nonetheless.
Instead I went to the antepartum clinic with Sal. The clinic sees approximately 150 - 200 women a day. Just the number of women seen per day is overwhelming. At first Sal and I managed the blood pressure post. Honestly, I think that each of us took 75 - 100 bps that day. I was moved to one of the exam rooms with one of the midwives. Visits are quick. Each woman brings her piece of plastic to lay on the worn and torn mattress on the exam table. Fundal height is measured in fingerbreadths from the sternum. Fetal heart tones are listened to with a pinard horn. The rate is not measured, just the presence/absence of a fetal heart is recorded - few nurses or midwives have watches or clocks. Women have 4 prenatal visits during their pregnancy. I'm not sure when the first one is, but there are 2 after 14 wks, so that they can be given antimalarial treatment and immunized against tetanus. They are also treated for parasites and given iron supplements. The last visit is shortly before they are due.
This last weekend we spent at Mburo National Park. We stayed in very rustic bandas - had my own gecko beside my bed- which un-nerved me a bit. Perhaps it was the getting stuck in the mud when our driver chose a shortcut and we had to get out and stand by the vehicle while the van was unstucked. It was night time and our driver assured us "Don't worry, there are no lions." Okay - I was feeling close to nature and didn't sleep much that night and the lizard beside my bed didn't help. I kept thinking about Jennesse and how much she likes geckos, but I wasn't feeling the gecko love. We went on a Game Drive, on a boat in Mburo lake and on a Game Walk over the weekend and saw many animals - we have a list of over 50 animals and birds we sited. It was an amazing experience. We are now in Masaka while Georgia, Sal and Grace are back in Kampala. Both Lydia and I are looking forward to being in one place for a while.
We have spent 4 days on the labour ward in Masaka and well - Toto, we aren't in Kansas anymore. I had 3 catches this morning - two within 10 minutes of each other. There seems at times to be an endless stream of women in labour. We have seen several women with 2nd trimester losses. Two were delivered on the ward while we attended them. One had a PPH and retained placenta and Cathy successfully removed it. The other woman also had a retained placenta and needed to have it removed in the procedure room. The scarcity of supplies has been hard to deal with. We save all glove wrappers because its paper that we can use to wrap placentas in, clean away feces, etc. There are no extras here and sometimes there isn't what you need. There is no anesthetic for women in labour or for other procedures. Cesareans are performed under GA. I am amazed by how strong the women are here. Within minutes of birth, they are up having a cold water wash from the tap in the labour ward. They then walk to one of the postpartum wards - noprivate or semi-private rooms here. Both wards have 40 beds.
There have been so many experiences, it's hard to pick what to write about. Thanks to everyone who's left a comment - it helps to feel a little closer to home. The internet cafe experience here seems to be hit and miss. We would love to post and email more, but sometimes it's just too frustrating.
We are all well - so far everyone is healthy. Hopefully we can post more on the weekend. - Jan
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UBC Students for Global Citizenship
The Midwifery Education Program at the University of British Columbia (UBC) has created a global midwifery placement option for students. This year, two midwifery faculty members and a family physician will accompany the students for part of their practicum and then local midwives, nurses and physicians will continue supervision.
For the past 4 years, UBC Midwifery students have participated in this 6 - 8 week global placement at the end of the 3rd year of their midwifery education. This year Midwifery is pleased to have colleagues from Medicine and Nursing join us.
In these placements students attend births and experience the ways that health care workers deal with normal and difficult births in a low-resource setting. These skills are especially relevant to student accouchers as they prepare to respond to the critical shortage of skilled maternity providers in rural and remote areas of British Columbia. In exchange, students and faculty share ways of practice taught at UBC with the global midwifery community.
Students return energized by their global experience and have a deeper understanding about women’s health issues, women’s rights and birthing practices, and with new friendships across borders.
Uganda. Maternal mortality is high in rural Uganda. Over 510 per 100,000 women die in childbirth. There are few trained attendants to assist women in childbirth, and transportation problems as well as social customs prevent many women from attending health centres and hospitals for deliveries. Those who attend hospitals for delivery often have risk factors and complications rarely seen in Canadian maternity practice.
Students and faculty take donations of gloves, delivery instruments, medication to prevent and treat hemorrhage, and academic articles and books on continuing education topics. Midwifery faculty work in collaboration with local staff to present continuing education topics on maternity subjects requested by the local nurse-midwife managers and medical directors. This year we raised funds to buy supplies for maternity wards and to bring a Ugandan Midwife to B.C. for an educational visit this past April.
For the past 4 years, UBC Midwifery students have participated in this 6 - 8 week global placement at the end of the 3rd year of their midwifery education. This year Midwifery is pleased to have colleagues from Medicine and Nursing join us.
In these placements students attend births and experience the ways that health care workers deal with normal and difficult births in a low-resource setting. These skills are especially relevant to student accouchers as they prepare to respond to the critical shortage of skilled maternity providers in rural and remote areas of British Columbia. In exchange, students and faculty share ways of practice taught at UBC with the global midwifery community.
Students return energized by their global experience and have a deeper understanding about women’s health issues, women’s rights and birthing practices, and with new friendships across borders.
Uganda. Maternal mortality is high in rural Uganda. Over 510 per 100,000 women die in childbirth. There are few trained attendants to assist women in childbirth, and transportation problems as well as social customs prevent many women from attending health centres and hospitals for deliveries. Those who attend hospitals for delivery often have risk factors and complications rarely seen in Canadian maternity practice.
Students and faculty take donations of gloves, delivery instruments, medication to prevent and treat hemorrhage, and academic articles and books on continuing education topics. Midwifery faculty work in collaboration with local staff to present continuing education topics on maternity subjects requested by the local nurse-midwife managers and medical directors. This year we raised funds to buy supplies for maternity wards and to bring a Ugandan Midwife to B.C. for an educational visit this past April.
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1 comment:
Hi Jan, I didn't get a chance to call you before you left and wish you luck. Great idea to have the blog...I love reading about all the experiences surrounding birth and Africa. It is one of my hopes to go on a mission someday with all the kids. I am sure you are very comforting to the women who lose their babies as you were such a great comfort to me. Violet is almost 1, can you believe it? She is on a nursing strike which is maddening because I hoped she would nurse forever or at least 2 years. I am trying everything to win her back. Keep up the great work and don't get to cozy with those geckos no matter how much you miss Mike!! Love, Linda
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