Monday, January 24, 2011

week twenty nine - Labour Ward

believe this will be the first blog that i’ll write on sunday, and upload sunday as well! (okay monday, but close enough!) a tad sunburnt at the moment from spending the day yesterday hanging out by a pool and tired from a night spent awake. why? you might ask was i awake all night long? well, African’s are party people. they also LOVE to to play LOUD music. and this loud music lasts alllllllllllll night long. therefore i was awake alllllllllll night long. but i was grateful that i could sleep in this morning. its choose your own church. so me and naomi had home church and listened to a sermon together. other than church i’ll need to get online to upload this, and then study for my test and do pre-reading for lectures tomorrow. but for now let me give you an update on this past week.

monday- lectures once again. still focusing on obstructed labour. then it was my week in the labour ward! and what a week it was. first day i delivered while the women was on all fours. usually the hospital staff do not approve of this and they very assertively request the women to be on her back. but i suppose because i was there beside her and she was in so much incredible pain laying down that they left her. during one of her contractions i felt the need to ‘check’ and see if anything was coming, and yes indeed the head was on its way, i gloved up and called for my staff and she came just in time as i was helping the little girl come into the world! a lot of more details i could include but i won’t for the sake of those reading who prefer not to hear all those yummy details! tuesday as well i delivered a beautiful baby girl, although her apgar was not good. (apgar is a score we give the baby based on how there doing after 1 min/5 min birth. the score is out of 10, with 2 points given to ‘colour/heart rate/reflex & irritability/muscle tone/respirations’) this baby had an apgar of 4. she had no cry, was terribly limp and slightly blue/gray. her heartbeat was stable and strong but for some reason her lungs would not allow her to have proper resps. while i finished up the mom some of my teammates did resus on her. we left her with a more stable resps rate but she was still on oxygen and hadn’t cried yet. the mom was amazing though. she spoke english and our first encounter of that morning was her asking me to take her to theatre (operation room) and get the baby out she said, ‘please madam i can not do it anymore, just get it out. take me to theatre’ i explained that it would be very soon and she could not go to theatre because there was a line up for theatre and by the time she got in the baby would be out, plus also they can not take someone to theatre whose baby is already fully engaged. then she says ‘ please madam just cut me, just get it out i can not do it anymore’ i explained that i could not just cut her and put my hand up her and pull it out and that the time it was taking is allowing her time to stretch so she won’t have to tear or be cut. she was not impressed but we prayed together and she seemed to trust me. well it was only twenty minutes later that her baby girl was born! it was sad leaving her not knowing how the baby would handle the rest of the day or night but the next morning i went to postnatal and she was there holding her girl! she see’s me and smiles and says ‘she cried last night!’ such a happy mommy! it is my blessing and privilege to help these women.

thursday and friday i delivered two more healthy girls. four girls in a row! thursday was so busy my staff only made it there for a moment to see me get the head out and slip the cord over the baby’s shoulder and guide the rest of her out. i’m becoming more and more confident in deliveries and enjoying being able to handle situations on my own. a hospital intern stayed with me for the rest of the delivery and helped out in the third stage of labour as it got a little complicated, but ended up good. while i was finished the delivery, a women was brought in from ANC and we were told she had a pre-mature baby and it was coming. it was delivered by one of us and was the tinniest thing i’ve ever seen. it was terrible sad to see this little life cut short. and even sadder to see the mom is utter agony over her lost child. friday was even busier. there were four students and two staff and everyone did a delivery and one student did two. there were also many born by the hospital staff as well! every where you looked babies were coming into the world! i got to learn something new as well. my lady tore pretty bad and so my staff taught me how to suture. she did the first 3 and i finished the last 5. the women was so chill about everything, which is good cuz we gave her a lot of freezing, but even with freezing you’d still feel the initial piercing of the needle and she would wince, but the best part was when her cell rang and she answered it! can you imagine ‘hello, yes i’m just being sewed up right now...’ we had that earlier this week as well, with a women wanting her ringing phone while pushing!!!! craziness.

a busy week, but a good one as well. saturday was a great day of hanging out by a pool. theres this hotel a bit out of town that you can pay to hang out by the pool and so thats what three of us did. it was lovely. took an hour and a half to get home but it was worth it! next week i’m in ANC!

till next time.....

Monday, January 17, 2011

week twenty eight- ANC

lectures again, obstructed labour! then i was in ANC for the rest of the week. tuesday i was sick so i stayed back, haven’t been sleeping well lately. sunday night i didn’t go to sleep till six am and had to get up only an hour later.... the next night wasn’t a whole lot better, sleeping on and off all night so by tuesday i think my body had had enough and i felt yucky all morning. i was asked to go and get tested at the clinic for malaria. one of the other girls also was going to get tested... mine was negative but hers positive. i’m very thankful i didn’t get malaria. i slept the remainder of that day and felt much better by evening. wednesday and thursday i went to the hospital, in ANC.

it wasn’t super busy and nothing ‘crazy’ happened but it was a good time. i got to practice more VE’s and get the hang of it, i was able to tell the doctor my findings and have him completely agree with me! that was very exciting! there was a delivery as well in ANC because the women was on the drip (medicine to help with labour) but also i think because her sister worked in ANC and she wanted to do the delivery. the next day i worked in the postnatal end of things. many of the women were still bleeding and a few babies had fevers so i spent the day monitoring everyone. it was a steady day. a little sad with three women who had lost their babies. i got to pray for one of them and just hug her and sit with her for a bit while she cried. she spoke a little bit of english so i was able to talk with her for a bit and try my best to encourage her. but what can i say to encourage a women who had just lost her child? i hope she felt the peace of God and that me just sitting with her meant something.

friday was an exciting day for our team. we found out wednesday that we were moving! there had been some challenging things at the place we lived. the location, general conditions and other things that contributed to the idea for the move. we are still in contact with the base, and there are no hard feelings so that is very good. so we spent the morning cleaning and packing and then moved into the city! its very exciting to be living in the city, closer to the hospital and shops and things. we’re now living in a compound, to be specific in a guest house ran by monks! the compound is like a village. there also nuns here! so funny but its nice. i’m really enjoying it, we have our own kitchen to use which means we are cooking our own food and we’re two to a room instead of the seven that we were in the old house. its a more homey feeling and feels good to come home to after a long day out. plus a huge blessing is we have AC! who knew eh? there’s also an orphanage in the compound and maternity clinic that we’ll hopefully be able to help out at.

saturday we celebrated Naomi’s birthday! (its really monday) we went out to buy a khanga from the team, then out to lunch at this place called Steers. its a little joint that has a few different western restaurants in one. so i got pizza and she got her chicken burger she’s been wanting. and we both got milkshakes! weird drinking milkshakes here! it was neat cuz the whole team came out for lunch, we pretty much filled up that place! then ten of us went to the mall and saw a movie, Gallagers Travels... or something like that. it was good, i’m sure those of you reading know what i’m talking about, but to us all movies are so new, i’m gonna get home and think things are new when there really a year old! it was a fun day!

sunday we had church and a free afternoon. in the evening we met to discuss the food situation because we are now preparing all our own food opposed to back at the base they prepared breakfast and dinner for us.

there will be a bit of figuring out our new area and how the team works in this place, but its a huge blessing for us and i am very grateful!

till next time.....

week twenty seven

this week has been a mish mash of a little bit of everything. it been another week of transferring over into a new phase. technically this BAS school is two schools in one, with two lecture phases. we have now entered the ‘applied lecture phase’ meaning that onceish a week we will have a day completely devoted to lectures. our lectures this time around are dealing with the problems in pregnancy and labour. our first day was this past tuesday, and we learnt about administering drugs, the different kinds of drugs and went through a case study of a women who died during labour and we were to figure out the causes leading up to her death. its different getting back into a ‘classroom’ setting, but also i feel its a nice change. we still go to the hospital on the days that we’re not in lectures and the exciting thing is that because of lectures we’ll also start getting to work in the ICU helping women who are at greater risk. i’m looking forward to being able to fully care for the women instead of when problems arise having to have a doctor intervene.

our ‘first half’ staff left tuesday around noon. it was sad to watch them leave but partly exciting to be entering this new phase of the school. i think all of us, students we’re ready for change, but we’re missing them for sure. especially after having them speak into our lives and be sharing a room with a two of them as well.

wednesday we went to the hospital, my first time with the new staff. i was in ANC (antenatal) and it went amazing. nothing crazy or out of ordinary happened but i got lots of practice in VE’s and i can actually understand what it is i’m feeling now! (i’m sure for sum you didn’t need to know that information but for me its big, because thats been something that has been very difficult to understand so the fact that now i get it! woo hoo!) i was also sent on an errand of taking two women to ultrasound. i’m now convinced they send us white girls to do these errands because the ultrasound technicians don’t like it when we come. i had to fight a little for the women to get seen. the problem being that they told me was, the machine is tired, and they were tired and they didn’t want wrong information to be found, also that we already sent six women earlier that day and there was a line up of people. i tried to tell them that we could not find the heartbeats for their babies and we needed to make sure that they were alive it was very important. they finally agreed to seeing the women but i could tell they were not happy. that wore off as they started joking around with me that the one technician ‘loved me and wanted my contact information.’ i explained that i had no phone and then he asked for my email. i said ‘umm i ‘don't think so’. they then read my name tag and made some comments about my last name, the one knocked on the wall and said ‘wall?’ and i was like, ‘yes wall as in wall’ they thought that was pretty funny! it gets a little frustrating when there is such a lack of professionalism. a few things like, lack of privacy for the patients and them making comments like ‘he loves you’ while a women is on the table having an ultrasound done is just not proper, especially coming from doctors. but this is normal here.

something i have been thinking about lately is the lack of human value that is expressed here. and what that means for a nation/country. if there is a lack of value on human life, what does that mean for a country? it means you can shove as many people as you can into a bus and drive away while someone is trying to get off. it means that women with babies and elderly have to stand in the middle of that bus while the capable people around them sit. it means that instead of calling each other by name its okay to poke and shout ‘hey you’ at someone to get there attention. it means that there is no such thing as privacy and anyone can walk in while your in the middle of a doctors appointment, no matter how personal the topic of the appointment may be. it means there is no concept of time and you can show up for things whenever you feel like it. it means women in labour can be yelled at if there being too loud. it means you can ignore a women who’s pushing her child out just because she is HIV positive. it means a lot for a country. it spurs on selfishness and people taking their eyes off the needs around them and focusing only on the needs of themselves. i can not write this and say it is true of ‘everyone’ here, but it something that i have noticed, the scary thing is, this mentality is not just here in a third world nation but its heading into our western world as well. where people care more about the money they make then how they make it. where they want to get to ‘the top’ and don’t care how they get there. where their own pride and stubbornness keep them from having a relationship with family and friends. this happens when we take Jesus out of a nation. ‘love the Lord your God with all your heart, with all your mind and all your soul, and love your neighbor as yourself’ this is what he asked.... are we doing it? its a little scary to hear how laws are changing and how corruption is taking the place of integrity and honesty in our country. in Canada and the US. it doesn’t just happen here, in Tanzania.

yes its corrupt here, the government can control the electricity and businesses can determine that they can charge a ‘white’ person more than a Tanzanian based on the idea that ‘white people are rich’. i’ve been asked many times ‘what is poverty like in your country?’ people want to know. they know what poverty is and they believe that no ‘white’ person has any clue what it is. the the truth is that poverty is everywhere. we have homeless people in Winnipeg, we have families that can’t buy enough food for their children to have adequate nutrition. and on the opposite side of things i have seen places downtown where there are citizens here who have huge houses, who can afford the proper food and they don’t have to watch their families go hungary or be sick because they can’t get the right foods. it double sided everywhere we go...

as a school we have discussed lately how we make a change. how can we go into the hospital, a group of foreigners who are only students, and make a lasting difference there? we’ve discussed this and thought about what it means to make a change, and i believe that we can’t go thinking we’re gonna change the whole world, but we can go and change lives. we can be a support for the women who normally wouldn’t get the support. we can do the checkups in ANC and see which women need immediate care and which ones can wait a little. the doctors we have worked with truly do have these women’s best interest at heart. they are there just as we are, to save lives. but the system they have is not always the best. women are seen as they come, not necessarily based on how much an emergency their situation is. they are not always checked up upon after they deliver either. its amazing to see how many situations where because of one us checking women and babies, lives were saved. fevers in babies have been taken under control, bleeding in women has been stopped because we have checked them and been able to determine the cause and stop it. women who were abandoned by family and had no food for two days while in labour, were able to eat because we saw them and were able to provide some food for them. the doctors are simply not enough to be able to spot these things, once they know they are usually helpful in offering their advice in how to care for the women. but its the diagnoses that usually goes unnoticed. if we can take notice of them and stop problems before they escalate further, than thats a change worth making in those women's lives.

yes, focusing on the person. letting them know they are valued. that they and their child and lives worth saving. and hope that by our actions it spurs others to do the same. that is how we create change. that is my little rant for the week!

thursday i spent at the clinic, working in the lab, i got to do blood group tests, (i’m A+ as i found out!), lots of urine tests and some testing for malaria and other parasites. then i spent the remainder of the morning doing antenatal check ups. friday i went to the labour ward at the hospital and delivered my seventh baby! another healthy little boy. the delivery was a little slow and the doctors kept pressing for me to do an episitomy, we stalled as long as possible to give the women a chance for stretching but the doctors would have no more of it. so an episiotomy was done. and i got to do it, a little nerve-racking and those are not fun things to do, but i’m enjoying taking more responsibility in midwifery care. just a little one was done, and with the next contraction, he was born. mom and baby we’re both doing well and another delivery was happening that was my job to be the ‘second’ in. meaning i help the person doing the delivery (first person) and then take the baby to be checked over. in this case the baby came out with no heartbeat. we immediately rushed him over to the table and started doing compressions with bag and mask on him. i squeezed the bag while my staff started the compressions. one, two, three, squeeze and repeat. others surrounded us and began praying desperately for this little life. within seconds he had a slow heartbeat. we continued, after five minuets his heart rate grew stronger but he was only taking about 8 breaths per a minute. we continued praying and pumping air into his little lungs. a nurse came and took over the bag and mask, she pumped air into him so fast i thought his lungs for sure would explode, but instead he began taking more breathes. we continued in prayer. in less than an hour this little guy went from no heartbeat to breathing with the help of oxygen tubes, to laying in the hands of his mother crying and breathing as any normal newborn! thank you Jesus!!! we saw the mighty hand of God that day, a miracle in the life of this little baby boy!

well as you have read, lots has been on my mind this week, many things have taken place that helps being here all worth it. its been a challenging week with the power going off every single day, and the change of many things in our school but God has been with us through it all and i know he’ll continue to guide us as we go from here. thanks for your prayers for me and our school. they are greatly appreciated!

till next time....

week twenty six - staff change

this week has been a mixture of everything, it started off regular though, with spending the first three days in the hospital. monday i got to deliver my sixth baby! a little boy. i was very excited, everything went smooth and the mom was doing amazing afterward.

wednesday afternoon the new staff arrived. a little overwhelming to be honest. it was kinda weird to see these familiar faces here, in Tanzania. it was good, just a little odd. then thursday we had a day off, for us but also for the staff to be able to adjust. it was productive, me and two others went downtown. got some pictures developed, went online for an hour and got subway for lunch! (very exciting!) then we walked to the post office and i got to finally pick up my two packages! very exciting!!! they were full of snacks! amazing! then headed back to the base where again the power was out. its gone out every day this week which has been slightly annoying, but i guess we should be grateful we even have electricity here. and it always comes on at night which is nice cuz then we can still sleep on the floor under the fan!

friday, new years eve, the group all went to the hospital. i stayed back cuz i wasn’t feeling well and slept the majority of the day. then in the evening we had a bonfire and did s’mores, no graham crackers but the ones they got were still pretty good. and the marshmallows are different as well, but it was still good! we played some random games and just hung out around the fire and then slowly people left to go to bed.... lame! so in the end there were six of us that were awake for midnight. we found a computer that had power (as the electricity was out again) and watched a movie and then just before twelve the power came on! HAPPY NEW YEAR!!!!!!!

it was a quiet new years but i still enjoyed it. its weird to think that we’re into a new year. and to think where i was last year this time.... its funny cuz i was somewhat preparing for this, where i am right now.

the remainder of this week has been our old staff transferring jobs and such over to our new staff. including one on ones. so theres been discussions and meetings and such and such. our staff leave on tuesday. i think it will be difficult but with everything in change it eventually becomes normal. so we’ll just wait till we go over this hump!

till next time....

week 25 - Merry Christmas!

not much to write about this past week, we spent the first two days of the week at the hospital, and then spent the next two days planning a blessing for the hospitals and clinics we’ve helped out in and delivering them. just a few goodies and a card for them to feel blessed at christmas time!

then it was christmas eve, there is a big base celebration each year so we helped decorate and cook dinner. i made decorations, including a paper snowman of course! dinner was chicken, rice, salad and a fruit salad for dessert. there was a bit of celebration with singing and a little spiel of what christmas means to us. then all of us girls in our room took our mattress on the floor and had a ‘sleepover’! it was nice to sleep under the fan and its actually turned into a thing we now all do, every night move our mattresses under the fan and every morning place them back in our beds. waking up christmas morning was good, we were woken up by Naomi’s family calling her, then after her phone call my family called! very exciting, i was not expecting that! a perfect way to start my christmas day. we had stockings and hot chocolate and some goodies for a ‘breakfast’ and then we cleaned up and packed up and a few of us headed to a hotel to spend the rest of the day! it was so nice to be able to spend christmas there, and the next morning our entire team joined us for a buffet breakfast.

after breakfast we headed to the beach, it was so busy, seems everyone had the same idea to celebrate boxing day at the beach.... not just Tanzanians either. we spent a few hours there and then headed back to the base... christmas was over....

it was a pretty low key week, next week we go to the hospital and our new three staff come.... we’ll see what happens!!

till next time...

week 24 - Debrief/holiday

well i have officially made it through our second quarter of the school! this week marked week twelve of outreach and therefore, as a team, we spent a few days hanging out, discussing the last twelve weeks and reflecting on past times. we also had a personal one on one with our staff, so they could give us feedback on what they see in us and we had an opportunity to say anything on our minds. we had wanted to spend some time away from the base as a school but all the plans were failing, so we ended up doing one day trip to a really nice hotel that had a pool area and was on the beach. we spent the day swimming and playing games and got to order a nice lunch. i was very excited because they had a ham/cheese/tomato sandwich on the menu! so of course i ordered that. my fav! it was also one of the best i’ve ever had... and after having no cheese (now that i can eat it again without the stomach aches!) in three months it was amazing!

the next day we went to a buffet breakfast as a team! amazing! its funny how excited one can get over a cup of real coffee, or a piece of french toast! but we did, we must have been some entertainment for the staff there.

that same day (wednesday) we booked into the hotel, (only a few of us) for three nights. it was amazing, AC, tiled floors (opposed to concrete), a flushing toilet, hot water and an amazing bed to sleep in that you didn’t need a mosquito net for! we spent our time watching movies, hanging out by the pool and checking internet! then on saturday morning we were picked up (5 of us) for a safari! our guide, Afra, was one of the greatest guides you could ever ask for. it was a five hour drive to the national park were we’d see the animals. we stopped halfway for a picnic lunch and then hit the road again. it was quite hot, and long but when we were a few miles from the entrance we saw our first taste of safari, elephants! right on the road side! it was pretty neat, driving even further we saw a baboon and a giraffe off in the distant. safari had begun! Afra was amazing, his english was good and he had tons of information about all the animals and Tanzanian landscape. we got into the park and the roof of our land cruiser came off and with our heads sticking out we were in the perfect place to enjoy what the African planes had to offer. giraffes, elephants, impala’s, riedbucks, zebra’s, water buffalo, warthogs, baboons and LIONS!!!!! we nearly missed the lions but the last hour on sunday Afra got a call and lions had been spotted! we drove very quickly waving our hands in the air from the top of the vehicle having a grande ol’time! we got to the site and saw nothing... we drove back and forth and back and forth and then, we saw them. there were four of them laying on the ground lounging out. you could only really spot them with the binoculars. we were getting ready to leave when Afra gets this mischievous grin on his face and says, ‘i am about to make a foul’... we were a tad confused but then he started driving off the road (apparently not allowed) and before we knew it we were within feet of the lions! so neat! it was an amazing experience, the landscape was so different compared to where we live which was good to see the difference in Tanzania.

there was an over night in a little guest house that had a flushing toilet and hot water! and a chief that was there to cook for us prepared amazing food for dinner and then lunch the next day as well! after lunch on sunday we headed back to the city, and arrived late and Afra helped us find a taxi who would take us home. it was really nice to get out and relax and see more of the country that we’re living in.

next weekend is christmas.... not sure what i think about that. its hard but i think i’m also a little in denial... i’m listening to Celine Dion christmas right now, but the fact that im sitting on my concrete floor under a LOVELY ceiling fan trying to stay cool just doesn’t really encourage the ‘christmas spirit’, but we’re trying. we’ve planned a team breakfast/morning tea (i’m sad i’m missing sticky buns) and are doing stockings and a secret santa so hopefully we’ll have a fun morning!

well till next time....