This morning around 4h00 the power came on, so we assumed there was another C-Section. There have been so many C-sections in the past three days or so, it’s crazy! When I got up to turn off the lights and go back to sleep, Ashley and Daniel asked me if I’d heard the yelling, which I hadn’t, so I asked them more about it. They said that there had been two episodes of yelling, one of people wailing and it sounded like it was coming from the hospital, which I told them was probably the family of a patient morning their death, and the second they said had been male voices fighting and yelling back and forth to one another, and they thought that at one point they heard Dr. Erdi yell, “Get out of here! You’re not supposed to be in here!” I told them I had no idea what actually happened, but that the first week Nicole and Charlotte were here someone snuck in and stole some of the parts from their brand new van that was donated to them so they could pick up their workers who live and Makeni and bring them to work. Most of the parts were non-essential, like AC and such, but it was still very disappointing, and they were fairly sure that whoever took the parts either was a worker or friends with a security guard, otherwise they wouldn’t have been able to get in.
At Morning Handover, I almost left. It was a very sad report, from almost every ward. Dr. Erdi even gave some short comments after the weekend reports pleading with the staff that in the future if a patient comes on a weekend or during the night that they get admitted and don’t get turned away. When patients make the decision to come and be admitted, especially when it’s the middle of the night or on a weekend when they know the hospital OPD isn’t open that it means they believe their illness is serious enough that is should be treated right away. There were too many deaths this weekend, and Dr. Erdi saw almost every single one. No wonder she gets stressed and sad sometimes.
After Morning Handover, Taylor and I were going to help Kady in wound care, but she wasn’t going to get started for a while and Dr. ABD was about to start rounds, so we followed him instead. Because Taylor is new to rounds, he went through all the patient files in detail with us, and explained what was going on and so on. I really like when he does that, it makes it so much easier to follow what’s going on versus when he just speaks to the patient in Creole and says, “Continue treatment.” I have noticed now, with the new group being here, that I understand a lot more Creole than I thought I did. At Morning Handover, Taylor and John both said afterwards that they didn’t understand hardly any of the reports given, and I was able to tell them almost everything that was said. They both seemed surprised and asked how I had picked up so much, but Creole is surprisingly easy to understand if you speak English, once you get used to the sentence structure. It’s harder to speak though, because I feel like you’re just butchering the nice English grammar I was taught in school.
After Dr. ABD finished rounds, I worked on my research until lunchtime, and then after a quick lunch went back to the hospital with Taylor. The power was still on even though it was 13h15, so we went to the theatre to see if they were in surgery. Mary, one of the midwifes, was there preparing for a C-section that would occur as soon as the mother arrived from the ward. We gowned up and went into the theatre, and when the mother came in I said, “Ooo! Twins!” because she looked so much larger than the norm for mothers here, but Mary said, “No, no, no. Single fetus, pre-eclampsia.” Dr. ABD was there, ready to perform the C-section, and I looked at him and said, “Wow, that’s going to be one big baby!” I asked Dr. ABD why pre-eclampsia and eclampsia are so dangerous, and he said that the real danger is eclampic fits, which can occur once a patient has progressed from pre-eclampsia to eclampsia. It is a condition that can present with many symptoms, such as swelling of the feet and ankles, weakness of the body, and dizziness. The real problem though, is the high blood pressure that characterizes pre-eclampsia and eclampsia. The high blood pressure can lead to fits, which can cut off oxygen to the brain of the mother, and the fetus. It can be life threatening for both, as every minute the fetus is without oxygen their chance of survival goes down, and every minute the mother’s brain is without oxygen her chances of having brain damage go up.
Once the C-section started, and the baby removed, it was completely obvious that it was twins, and that there was another baby. The problem there is that two people are supposed to be ready to take the babies, and only Mary had prepared to take one baby. When she said, “Please, can someone watch this child so I can get the other one?” no one answered! So I ran over and told her to go, and put gloves on quickly and started doing what I had seen the midwifes do with infants that are crying well after delivery: rub their back like crazy. Mary said it helps to keep them crying, and when they cry it helps clear the fluid from their lungs. When Mary brought the second twin over, it wasn’t breathing at all, and it took a long time for her to get it to cry. It seemed to be trying to take in air and couldn’t. Eventually it let out a weak cry, but not very convincing and it stopped soon after.
Later when we went to the ward to check on them, both seemed fine, but the second twin is clearly smaller. All the family was gathered around, cooing over the babies. When we came in to see the babies, Mary told them that Taylor and I had helped deliver the twins, and they wanted to know our names so that the girls could be named after us. I’m not sure if they actually will, but we were both kind of like, “Um, you don’t have to do that…”
It was around four, and things seemed to be winding down. We thought about stopping by Dr. Abel’s office to see how his day was going, but he seemed really busy so we went down to the TFC to see Abdulai and so that Taylor could see where the business office is. We didn’t really find much to do there, so we ended up back at the house to nap and read.
Dinner was awesome again, and reminded me a lot of chili! It was so good, and afterward we watched a strange movie that is all outtakes from Anchorman and therefore doesn’t have much of a plot or make sense. Now we’re just chilling before bed!
This post is dedicated to the two babies who were delivered as still births, the baby that died shortly after delivery via C-section, a mother who died of post-delivery complications, a child who died of malaria, and the two patients in male ward who died because there wasn’t blood available for them to receive, all of whom passed over the weekend.
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