We are so lucky to have a beautiful walk each morning and evening as we make our way to and from Masaka Hospital. I took some pictures this morning with the intention of posting them but the computer that I'm sitting at this afternoon is not cooperating so you will have to wait for the photos to appear. We walk along a quiet road, for the most part paved, though there are many potholes. The few vehicles and boda-bodas (motorcycle taxis) swerve constantly as they try to avoid the worst of the holes. But really, there isn't much traffic on the road and much of it is lined with gigantic eucalyptus trees, their leaves swaying in the morning breeze. One of the fences we pass is covered with a flowering plant - the name escapes me at the moment but we definitely have these flowers as houseplants at home. We say "wasuzotia" to the Ugandan people we pass - a greeting that means, "how are you?". They respond with "Chendi" or "Burungi" - fine, good. The traffic is so hectic in Masaka town that it's a treat to have a quiet road to walk on as we head into a busy day at work.
Today the ward was quiet when we first arrived but by late morning the pace had sped up and it wasn't until 3:30pm that we had time for a breath and a break. Anne-Marie and I each caught a baby today. There were complications with both these births, though I think they were managed well. The woman A-M was attending was a gravida 9 (9th pregnancy) - the baby was born quickly but the placenta was retained. We used a fair bit of oxytocin to try to get the placenta out but after an hour, it was still in situ. She wasn't actively bleeding but we were quite worried that she might start to hemorrhage at any moment. Complicating the problem was a lack of normal saline on the ward. There were no bottles available. Someone had to go and beg pharmacy or the ER for a few extra bottles. Once we finally had the NS hung and running and it was apparent that the oxytocin was not effective, Cathy did a manual removal of the placenta. The woman was given demerol to help with the pain but it is an intense procedure. It was a difficult removal, the woman was in a lot of pain, pushing at Cathy with her foot. Anne-Marie and I tried as best we could to comfort her and restrain her so that Cathy could get the placenta out. She persevered and managed to remove it but we're quite certain that there are retained pieces as it did not look whole. We've left her on the ward for the night, with instructions to alert the nurses if she starts to bleed, and are hoping that she remains stable. It's so hard to know what will happen.
The woman I attended had active malaria. She was a first time mom - had a headache and fever when she presented at the hospital. A blood smear confirmed the malaria. Cathy warned us that the baby would probably need resuscitation as they can be affected by the maternal fever and perhaps the parasite crosses the placenta and infects the baby too - don't know about that - will have to ask the nurses on the ward on Thursday. The birth was a normal vaginal delivery with no tears or postpartum complications but the baby needed very active resuscitation and then had to go to the ER to have oxygen. I'm out of time, I will write more about this next I'm online. Overall, a fairly good day.
Ciao,
H
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4 comments:
What a nice way to mentally prepare for your day, and then, in the evening, unwind and unstress as you do your lovely walk. Is the climbing plant a bougainvillea?
Keep up the good work!
So nice to find an update on the computer almost every time I fire it up. Each time I see mom I take her the latest updates. I think she is more than a little awed, and I entertain myself trying to "feel" how much this experience is going to change your life. I can't think of anyone I would rather have near me in a time of fear or stress though; and I know you are a huge consolation to your 'mommas' and 'mommas to be'.
We think of you often. xoxox Lynne
NS not on the ward! thats what worries me most, then I see how much we waste in US hospitals. I feel like collecting it a jerrycan and take it to Masaka. Jerrycan thats what we used to collect water with, 20 liters on the head.
But anyway Webale nnyo for the work you guys are doing.
Herbert - it's so great to read your comments to my posts. So nice to know that someone from Masaka, who can picture all the places we're visiting, is reading along. Yes indeed, I often wished for a vat of normal saline - how strange it seems that something so inexpensive and key to providing medical care is so scarce. It's a little nerve wracking as well, as you never know when a woman might hemorrhage and you'll be faced with no way to replace her volume!
Wishing you all the best. Welaba!
Heather
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