9th aug

9th August

Today was grimmmm. After the fun of yesterday, this morning I was smacked down back to the reality of Kenyan medicine.
I was in the middle of consulting with a patient when one of the medical officers interrupted and asked me to insert a speculum into a woman asap.
So I finished with the patient I was with and went along to the surgical room and before me was a women gasping in pain (thats what Kenyan women do here, they don’t cry or yell, they gasp), her clothing was soaked in blood and she was dripping blood all over the floor. First thing I think of is post partum hemorrage, maybe miscarriage, turns out she had a patial spontaneous abortion yesterday, the contractions had stopped suddenly and the fetus was partial hanging out from inside of her and she was bleeding heavily.
Forget the speculum I had to manually remove the fetus from the mother and then manually remove the placenta. Mother was given no pain relief, and only 500ml of fluid (not blood cos their wasn’t any) despite her bleeding copious amounts of blood. She was really brave and I felt so sorry for her, she had no relatives with her, no one. The whole procedure took about half an hour and we were fortunate because we manged to remove all the products of conception and the placenta came out whole.
What came out of this women I just cannot describe here as it horrified me, ive seen dead fetus’ and babies but not like this.
There is no after care here in Kenya, if a women has had any type of procedure she is expected to wash herself down, make herself look presentable and make her way to her bed. I felt so bad for this women, the hospital does not provide bed wear and her lower clothing was soaked with blood which was also caked on her lower body, so I cleaned her up, as she was too weak to move. I felt even worse cleaning up this women, there was no way I could do it without probably making her feel like a dirty baby, but it had to be done.
The whole of the above was over in an hour and unsurprisingly, the women, didn’t cry or express grief, she thanked me profusely and went to her bed.
Later I asked her how she was in really broken Swahili, ‘fine, im fine’. She replied. Even later on she was sat outside in the sun with some of the other female patients laughing ang joking.
I admire Kenyan women at times and at times Im desperately sad for them. I have seen women here in absolute dire situations –nursing children dying of AIDS, broken from years of hard work, ill from the complications of HIV, losing babies, the list goes on. But these women just get the fuck on with life. They don’t show emotions, they hide the severity of their symptoms and they are so grateful for even the smallest medical attention, even if they have not actually even been helped. They have to endure the utter embarrassment of being treated by male staff, having people truge in and out of consultation rooms and surgical areas, without a care in the world for their privacy ( this actually pissing me off big time, so many times I have had to lock my consultation room door to prevent people just walking in and taking a seat, waiting for me to serve them –usually men too). What was I saying? Ah yeah, I look at these women and think, how the fuck do they do this, live this life? The women in the village just seem to be caring for children, washing clothing , cooking and collecting water, day in day out. I feel so guilty getting up at 7 when I hear them up and about at 5 am. Im off to work, going to have a varied day and they are doing the same thing, day in day out, week in week out like clockwork. Going for trips at the weekend excites me, I wanna tell these women, my friends about my day, but I cant and i don’t cos i don’t want to show off this feeling is also compounded by the fact that I am a black female who looks like these women but is running about enjoying life, sitting reading my books in the sun as these women hand wash their clothes or carry water form the well. I have asked to help a few times but they refuse to let me and so I have given up. A part of me knows that in my absence and in my presence these womens lives will be the same. The guilt is my problem as to be honest they are all content with the lives that they lead. Ive sat down with them and asked if they have ever regretted leaving school and getting pregnant so early (18 yrs) and they all respond that they want children, they want to be married and they are living the life with is expected of them. Only a hand ful of women I speak to want to go to back to school. So maybe Im the one with the problem, yes I am but its not a problem so to speak its more of a disbelieve that these women will never experience some of the things which I take for granted in London. I need to appreciate my life a whole lot more. I spend a lot of time wanting this that or the other, mulling over why I don’t have some things, why i cant be more pretty, more clever, more happy, when really im bloody alive and have so much freedom that ive taken it for granted. Epiphany city.