5TH August
Lorrrrdy, was asked to deliver my first baby alone today, i.e me and the midwife instead of, me the Medical officer and the midwife. Anyhow, today mum was a 18 year old school girl, alone fully dilated and babies head on show. For some reason here, the mothers do not eat when the contractions start and so become really exhausted during labour. To day’s mother, was not only exhausted she was quite a defiant young girl. I mean Defiant in the sense that unlike the other birthing mothers she refused to listen to any advice given to her by the midwife, and when I urged her to push, she would reply ‘leave me alone’. She refused to drink any of the tea given to her and wouldn’t except a bolus of glucose. I initially thought that perhaps she was scared or something but it turns out that this girl has a rep for being a headstrong, doesn’t-listen-to anyone-type of girl, -kinda like me! Anyhow, I have made it my mission to show empathy and kindness to all of the patients here, especially the women. I allowed this girl to squeeze my hands and shout at me etc but with hindsight I understand why the Drs and Midwifes seem so uncaring here, it is not because they do not care, its because things can become quite serious quite quickly and in the absence of a big medical and surgical team there is no time for compassion until after the incidence. This was highlighted today when after I caught the baby, clamped and cut the cord, I realised that she had torn and, baby was grunting, and mother was losing consciousness and the placenta had not been delivered. NIGHTMARE. The midwife called another medical officer, who managed to help mum deliver the placenta, and I tended to the baby, I have no bloody idea to resus a neonate but I figured, if the baby couldn’t breathe and sounded like it had an obstructed airway, in England the baby is warmed and checked by a peadtricition or the midwife, in Siaya Kenya, Ronx held the baby, rapped it up in mums skirt put it over her shoulder and burped it. Baby coughed up some fluid, but was still not right, so in the absence of suction, I had to use an instrument that can only be described as a miniature bellow to suck out the fluid from the babies throat, thank fuck, it was a mucus plug that dislodged and baby screamed. Phew. I quickly checked the baby from head to toe –it had a left club foot which apparently they just bound straight here.
So mum had a tear, the medical officer, did the deep stitches and I did the outer stitches mum had no anaesthetic and was kicking, I was worried about getting a needle stick so demanded that she was anaesthesized. Anyways I did it –yay. Wouldn’t say it was the neatest job that I ever done but i did it to the best of my abilities and I just hope that mum isn’t left with incontinence.
Baby and mum were ok. And when I went to visit mum later she was really happy and thanked me. Gutted she didn’t name the baby after me thou!
Today, I also, assisted in post mortem - young man versus matatu. Dies on the spot due to a broken neck. Seeing this mans dead body lying slap bang cold dead and disfigured on a slab of metal, was odd. I ve seen lots of dead bodies and we dissect from the first year at Uni but now I come to think of things I haven’t seen any dead balck bodies, and I have no idea why seeing a dead black body would have an effect (although slight) on me. I dono gonna have to ponder on that one. Anyways I was surrounded by men and had to exert some authority as me and the medical officer were examining the body for other injuries. As I have probably said in earlier blogs the men here are totally intimidated by me, and to kind of make me feel left out or small by taking Swahili and leaving me out (these are the men who live local to the hospital, or men that visit the hospital, not any of the drs, im really just describing everyday folk here) and so I am very good now at introducing myself as Ronke the Dr from England, emphasising Dr and England (London seems to go down better thou) and this usually commands the respect that I don’t really desire but i just feel is essential, if things are gonna work.
The rest of the day was pretty much me seeing patients. Nothing to Exciting to day in the sense of pathology, but I guess that I know I really want to be a Dr because I just find consulting with patients, doing examinations, creating differential diagnosis , ordering investigations, diagnosing and trying to prescribe, a WHOLE LOT OF FUN.
Today the results of the Kenyan constitution have been announced, looks like the country have voted yes to a new
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