Mbale Days

-From Quinn in Mbale

After the excitement of the first couple weeks in Mbale, we had some slow days last week which allowed us to catch our breaths, and get back to some of the basics we’d been missing. There were a handful of local nursing/ midwifery students on the ward, and more helping hands meant Natalie and I caught less babies, but we had plenty of opportunities to help teach the students. We also had a lot more time to spend doing labour support, something we have missed from home. Spending more time with our women last week, there were a few who really touched us both.

One first-time mother charmed us with her excellent English, as she told us about the injury she’d sustained to her leg from polio as a child. She was incredibly sweet and strong, and worked away pushing her baby down. Every once in awhile she would confirm with us “My baby is dead, or my baby is not dead?”- she had been told mistakenly that her baby was dead, when another midwife had not been able to find the baby’s heart rate. We found the Doppler ultrasound and had her listen to her baby’s heartbeat, and would remind her of the sound she’d heard whenever she asked. In the end she went for a cesarian section- because of her childhood polio, her pelvis had not formed normally, and there was not enough room for the baby to move through it. Natalie and I received the baby in the operating room, and after just a little resuscitation, he was crying and alert.

Another young mother made a real impact on me because of her strength and a refreshing sense of self confidence. She was 15, and had been in early labour since the previous day. She was sitting on a bed, waiting to be assessed. Another midwife told her to go back outside, it wasn’t time for her assessment, yet. She waited a few more minutes, while I finished another assessment, then said to me “I’m not finished!” Sure enough, she was back exactly when she had been told to return, and so I offered to assess her. “Yes!” she said, “You check!” Throughout her labour, and afterwards she remained just as assured. She requested more freezing before she was sutured, and had us tell off the neighbours who were trying to watch. Then she demanded to eat matoke, her favourite dish. It was so nice to see a mother, especially one so young, who seemed so aware of her own self-worth and was able to stand up for herself.

Friday was a busy day, as the nursing students weren’t there, and then the local midwives had a meeting to attend for 2 hours. Angela, Natalie and I womanned the ward on our own, and, of course, there were several women who seemed about to deliver. Natalie and I each caught two babies first thing in the morning, then we went to receive a baby in the OR. Luckily that baby did not require any resuscitation, so I went back to the labour ward, where I found Angela resuscitating another newly born baby on her own. I was able to lend a hand for a few minutes, until an attendant tapped me on the shoulder because her friend’s baby was coming. I barely had time to get my gloves on before her baby slipped out- with the bag of waters still intact. I had to act as both midwives for this birth, but luckily both mom and baby did very well. The day continued like that, and by the end of it, we were ready for the weekend!

Our classmates from Jinja came up to Mbale for a few days, and we all went for a hike to the nearby Sipi Falls on Sunday. It was a beautiful hike through fields and farmland, then up under and behind one of the falls, and past small houses and fields where we found friendly children playing. It was a perfect weekend, and we finished it ready for the upcoming week.

Yesterday Shannon and I went to help out at the antenatal ward. We watched the health education session, which covered lots of topics, like breastfeeding, hygiene, and especially the importance of HIV testing in pregnancy and how to reduce mother to child transmission for those who tested positive. There were probably 80 or more women in the room, who then needed to have their blood pressure and weight recorded, their bellies palpated, HIV testing and counseling, and vaccinations or medications administered. These women were there for the entire day, and we began to understand why it could be a struggle for many women to attend even the minimum 4 recommended visits.

After work yesterday, we all went for a tour of CURE, a nearby hospital specializing in pediatric neurosurgery. There they provide surgeries and other care for children who have conditions like hydrocephalus (a condition where the cerebrospinal fluid is not able to drain properly from the head, and accumulates around the brain, causing the head to be enlarged). Dr. Paddy, a friend of Angela’s from last year here in Mbale, is working there and invited us to see the hospital and then treated us all to a delicious home-cooked Ugandan meal in his home, with some of his neighbours and colleagues. We really enjoyed ourselves, and got some valuable insight into medicine, politics and hospitality in Uganda.