Jinja

Its Saturday morning here in Jinja. The air is humid and filled with  a haze of diesel and charcoal smoke from the cooking fires. After a slow breakfast of Spanish omelet, milky tea, and the best pineapple any of us have ever had, Shannon and I are trying to collect our thoughts from this challenging, difficult, yet amazing week. Uganda is a much louder country than Canada. The girls boarding school next to our guest house is blasting Ugandan dance music, and a training soccer team just ran by singing while keeping what looked like very fast race pace. We wake up every morning at 4:00 am to roosters, and the hospital has a resident flock of chickens that quack incessantly.

It has only been a week, but so much has happened it feels as if we have been here a month. We arrived Monday to the Jinja hospital a little nervous and hesitant-we are the first students from UBC to work here, and we had no idea what to expect. To our total delight, the midwives, residents, and nursing students have welcomed us with open arms; they are so happy to have the extra hands in such a busy hospital. The labour and delivery, post-partum, antenatal, and special care wards are all connected-we already love that we can visit our mamas the day after they give birth to check in and say hello. Sister Margaret, a regal head nurse/midwife, is an incredible teacher and compassionate care provider. On Thursday, when two of the women Shannon was monitoring began to fade, Margaret helped them up, said a quick prayer, and began dancing along with them to help them find energy and strength. It was beautiful.

We felt totally out of place on our first day, but within an hour of arriving Grace had a gorgeous catch of a primip; we have been rolling along ever since. The hospital is quite busy, but many women arrive in early labour so we spend a fair amount of time doing initial assessments and providing labour support and monitoring.  This provides much variety to our days. During a slow moment Friday, we finally solved the mystery of where to find sterile gauze and how to clean the birth supplies, and earlier in the week I walked in the room to find Shannon surrounded by nursing students devouring her every word as she explained how to find the fetal heart and do the newborn exam. Success! Its nice to confirm that a labouring woman anywhere appreciates the same things: a sip of tea, a hand to hold, pressure on the back. We are learning the particular Ugandan signs of impending birth- slapping the leg, waving the hands in the air with such gorgeous rythym, calling for their mother or God. When there is time we eat lunch of beans, matoke, rice, greens and peanut (ground-nut) sauce in the hospital canteen and bring the nurses orange fanta in glass bottles. The staff are so helpful teaching us Lugandan, and everyone loves our pictures from home. We are grateful for these moments of cross-cultural connection when faced with such a fast pace and the difficulty of working in a very under-resourced hospital.

However, when things get busy, they get busy! This week we saw so many things-placenta previa, very young mothers, twins, obstructed labour, lightening fast second stages, bleeding, cord prolapse, and tear repair with minimal light and broken needle drivers. We experienced the heartbreak of babies that didn’t make it, even with chest compressions for what felt like hours. Every morning the little morgue has had babies that didn’t make it through the night. Its been so frustrating to have bad outcomes that would not have happened if the hospital had supplies like oxygen or drugs like epinephrine available. With this said, Shannon and I are really enjoying learning to back each-other up, and often find ourselves running between delivery rooms trying to make sure everyone has enough oxytocin and an apron for delivery. We are overwhelmed at times with the intensity of learning to work in this new hospital and culture but feel deeply happy we are here.

-Elizabeth and Shannon (Jinja)