Christmas is in the Air!

Merry Christmas!

It's December in Tanzania, which means that you can now go to the village and buy mangoes for 30 cents. And pineapples for a dollar. Sweet deal!

It also means that it's Christmas time:
and that we are busy making our stockings to hang by the window,

drinking hot cocoa at night and putting our scissor skills to work making Christmas tree decorations out of free Airplane magazine pages. Paper chains, woven hearts, snowflakes...

Yesterday, I finished knitting my stocking, so it's ready to hang and bulge with packages of home roasted peanuts, fruit, and encouragement notes.

It’s been a wonderful Christmas season. It’s been very special to spend it over here with all the girls… we are quickly becoming a close-knit family. It’s like having 16 sisters.

Also, the weather has taken it up a notch:

It’s getting very humid over here. Sweating a lot.

We’ve decided the only time you feel fresh and clean is immediately after a shower. …Within the hour you’re fully drenched again. It’s a – unique—feeling.

I wrote a silly poem about it:

“I’m dreaming of a white Christmas, just like the ones I used to know”

What does a winter kiss feel like?

I’m starting to forget

the frostbite toes

and rosy noses

and frosty inhalations.

The creak of ice

the chill of bone

all this is starting to be unknown

when I have lived in this foreign home

and all I taste is salt

and all I feel is sweat

I’m swimming in my own ocean

over here

and I’m tired of getting wet.

What does a winter kiss feel like?

I’m starting to forget.

We sing a lot of Christmas songs, are having fun finding letters from overseas on mail delivery days!! Thank you all!

We decorated the dining room with snowflakes and stars… it kind of looks like a children’s art classroom!

And of course, the hospital is amazing. We’re really enjoying it and getting more fluid with our skills.

May you have a fun, creative, love-filled, Christ-centered Christmas!

Here are some photos of us in uniform…

Here is a team photo of us looking mighty official.
And here are my roomates and I.

We are 10 to a room.... nice and cozy!

We're still loving working at the hospital... it is crazy that we have less than a month here now.

Merry Christmas and Happy New Year ....... from East Africa.

Behind the Veil

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Baby #7


Her name is Fat-Hiya Aly Salum.
She is a beautiful young girl, thin, lighter olive skin, 19 years old, and she is pregnant.

Her hair is long and whimsically braided in big sections that swell and twist and taper into thin air, like the ebb and flow of woven raw silk.
She has deep round eyes with fluffy dark eyelashes, and when she smiles, her full lips part to reveal her sweet little grin, with spaces between each tooth.

When she stands to walk around, her long legs take careful steps as her knobby knees wobble under the pain (and her top-heavy tummy), like a young foal learning to stand on its own. Her long neck cranes and her elegant limbs extend to stabilize herself in her new surroundings of metal shelves, flat beds, and the smell of antiseptic.
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She has been fully dilated for a while now, but she has taken local medicine which has toyed with her regular contraction pattern. So she has been writhing in unending pain since I saw her in the morning. Her contractions have been very strong and unnecessarily painful for hours.

It is her first pregnancy, and she is markedly fearful. Her eyes flash wide with the searing pangs that overtake her tummy... the baby is coming soon.

I keep a watch on her every time I walk past, and once I see her membranes bulging, I prepare all that is needed for delivery.

Her membranes are bulging (her amniotic sac is intact and now looks like a water balloon coming down the canal.) At this point we rupture them (for they have not broken on their own) with the tip of the cord clamp, but manage to only get a small puncture, so the water is squirting out of a small hole.

Slowly, slowly, the baby’s coming down.
It’s painful for her, often there’s a look of horror on her face that sometimes she cannot even make a sound. The perineum looks tight and I question whether it will be able to stretch.
In this moment, it dawns on me that here I am, experiencing with her probably the most excruciating moment of her life.

Everything is going okay, it’s just not that fast. It’s good that the skin is slowly stretching, letting the birth take its course, not doing anything unnecessary...
The baby’s head crowns. This is the most painful part of the whole birth, termed the “ring of fire”.
This goes on for probably 10 minutes. Her eyes plead to mine but we reassure her that everything is going great!

I cannot imagine the pain. At this point the nurses would probably do fundal pressure, pulsing hard in forceful jolts on the top of her belly to get the head out. No, I’m not going to anything of the sort. We just wait and let baby come as he wants. My goal is to watch the perineum. It looks tight, but we’re trying our best to take it slow and do all that we can to help it not tear.

The head crowns... and baby delivers soon after. What a handsome baby! He is so cute, he’s captured my heart at the very sight of him!

I am thankful for the way I could take my time for this delivery. Especially for care after the baby was born. I didn’t have to be anywhere, the labour room wasn’t busy, all I had to worry about was Fat-Hiya and her having the best first delivery experience she could have. I knew she was scared and fearful and skittish, so I stayed with her, smiled a lot, and was very gentle in everything that I did. You could literally see her nerves calming down as we became familiar faces and pillars of trust to her, offering a comforting smile and a soft touch.

We brought baby over as soon as possible and she got to lay with him. It is so beautiful to see the sweet bond established as this young girl now becomes a mom.
I cleaned her up, changed her khanga, and when I checked her for tears, I was amazed! No tearing.

I was amazed, mostly at God, that our bodies are so well-made!

She looked so tight before, I was even wondering if she would need an episiotomy, but here she is, tear-free, with only a few scrapes that will heal on their own. Praise the Lord!

It was a long day for her. Hours and hours of pain and discomfort, but now,
she has a healthy, handsome little son beside her,
and she doesn’t need stitches.
Yes, this is how it is supposed to be.
She smiled at me with her young, bashful eyes, her childish braids going this way and that.

After she had rested, and was ready to go the Postnatal Ward,
she hopped off the bed,
fished through her basket, and the next time I looked she was all intricately wrapped up in a saffron scarf,
covering her whole body and leaving only a window to
see, breathe, and talk.





Suddenly, this woman that I knew, her beautiful hairline and elegant neck, the shape of her shoulders and the look of her hair, now was hidden.
Even though you could see her features, the scarf was distorting the loveliness of her face into a contrived shape, that she didn’t even look like herself anymore.





I then realized yet another reason why the labour room is a special place.

We get to see women with their heads uncovered, before they put on their veils and become a shapeless figure out on the street.

The labour room is a place full of rawness, transparency, trust, and where guards are let down.
A place of intensity,
vulnerability,
and nakedness.

Where it is safe to show your shoulders and reveal that which has been covered.

What a privilege, what holy ground,
to be in the place where
the veil comes off,
all is known,

and new life comes into the world.

Baby on the Go...

Another new day in the Antenatal Ward, another day full of surprises.


My Danish friend and I are at the examination table to check women’s dilation.




As per usual, the ward is packed, many to a bed, and the bodies have overflowed to the floor and inbetween beds.


There is a large woman with a scrunched up face, obviously in some degree of pain. The intern doctor points innocently and says, let’s check her.

We find her card, and she hasn’t been checked since 1 am last night, and she was 2 cm dilated. It is 9 in the morning now.... so it’s been 8 hours since she was looked at.
We get her off the floor, up onto an examination table and find out that she is fully dilated now.

!!
A quickness begins in our steps and we get her bag to get over to the Labour Ward as soon as possible so she can deliver. When you’re fully dialated, nothing is stopping the baby from coming at any moment.

She gets off the table, takes two steps, and then her knees give way....down she goes to the floor.
No no no no! Don’t sit down!

On her way down, I turn around and see the baby shoot out like a waterslide!


Right onto the dirty hospital floor!

The baby, still in its complete little sac, is in slow motion as it slides in its bubble across the floor. Then there’s kind of a bungee cord retraction effect as the cord reaches its end and then rebounds back towards mom.
We all freeze there for a split-second, as time stands still.


Then, I snap out of my shock as I hear,
“Khanga! Get a clean khanga for the baby!...”
I only have examination gloves on, but the nurse is holding the baby up by one leg, so I grab a khanga and quickly let the baby rest in my arms.

Somehow, a birth-kit from the labour room arrives, and we finish the delivery on the floor. Melisa, who is conducting the delivery, tries not to bend down too far with her long skirt touching the ground, awkwardly dodging the amniotic fluid pooling around her feet.

Cord is cut, and I’m standing over mum, holding baby and getting him all clean and warm.

There is a hush over the ward; I look up at all the labouring mamas.

Their little faces are peeking out from their place on the beds or on their pieces of floor, looking on with wide eyes and anticipation.
Valiantly, I hold up baby and show him to the on-looking crowd of mamas, and smile.
The tense silence is broken by laughter.
Their furrowed brows relax into a grin.
Joy is in the house.

The mom is flat on her back, -- on the bare tile floor laced with footprints and dirt and who knows what else -- happy and exhausted.
We clean her up, mop the patch of floor where she was,
and then carry on with the rest of the morning.

Wow.




What a way to start the day.



A little go-getter baby who’s on the move and can’t wait to come into the world!

Thanksgiving

On Saturday, November 21, we had Thanksgiving.

To enjoy and acknowledge this happy, North American holiday, we decided to celebrate neither the American nor Canadian Thanksgiving Day, but somewhere straddled in between.

We had a day of family and community, involving the local Africans and families to join in on our holiday festivities. We had a breakfast of iced sweet breads and fruit, and sweet milk tea. The tables were decorated with leaves, and coconut shells were filled with pink and white plumeria flowers.

All the base came and we ate together. Families and singles, leaders and students, black and white, baby and child. It was nice.

Then we went to the beach, our team covered the small fee to pay for all who wanted to come. It was so cute, to see the young Tanzanian kids in the car to the coast. Quiet with wonder, watching before their very eyes this event take place that never has before.

It was a beautiful day, we played on the white sand, and the families spent quality time with their little ones down by the water, splishing and splashing around. That was my favorite sight, because I think this was the first time some of the kids (maybe even some of the adults) had been to the sea.

Many of the families struggle to pay in their 30 dollars a month to live here, so thinking of taking a trip to the beach (and it’s only a 20 minute ride away!), is out of the question and out of their minds.

At one point, there was a herd of goats and some cows being herded across the sand. It was quite the moment.

Then we came home, sun-kissed, and sun-grazed, had a most refreshing bucket shower and washed our sandy salty clothes.

Orissa and I had a very inspiring talk by the washing basins again. I was in a soft, repentant state because of something God had pin pointed in my heart that had reared its ugly head earlier that day. So in that place of being close and sensitive to the spirit, we had a very beautiful chat.

Rinsing my clothes, we talked of environmentalists and Christians, stewardship,

young poor churches, and churches that have abundance, purity, humility,

blessed are the poor in spirit, dominion over creation,

power of words, carelessness with words,

redemption, and more.

Finishing up the conversation, Orissa and I held each other’s arms and expressed the hope we feel because of knowing that one another is in the world.

She is seriously such a star. There is a pureness and a deepness and a shining in her eyes, a longing in her heart for dreams and life and dance.

It’s very beautiful and refreshing to be with her,

we build and create and bounce off each other. Her and I share many of the same views and heartcries for the same things.

We then had Thanksgiving dinner, cardamom rice and fried chicken. And then we shared what we were thankful for over a yummy pudding trifle (which gave our systems such a sugar shock... after being adjusted to the African non-sweet diet!)

After cleaning up, the three of us, (Taylar, Orissa, and I) laid down on the grass under the frangipani tree and watched the stars. The power went out so all was clear and still and we saw countless constellations and two brilliantly shining shooting stars soar across the sky.

After the ants found us and started to fill our hair and clothes, we brushed ourselves off and made our way to inside. I turned to see the glow of the moon and saw that he was smiling! Here on the equator, the crescent moon is horizontal, like a big pearly grin in the sky.

We then carried the conversation upstairs and wrote 10 minute poetries. Just writing for 10 minutes and then stopping. Making a poem.

I really liked it! So inspiring. Another creative outlet.

A good way to process as well, I presume.

I’d like to do it again sometime.

Here is the one I wrote,

it’s about our day.

“Tropical Thanksgiving”

Down down

down

you’ll find us

at the bottom of the stair,

at the basins

among windy linens

under the stars

covered with ants.

Vision is on our lips

dreams are in our hearts

belief is in our eyes

Life is in our words.

Come, all to the table

ye wedding guests

in tattered rags

or shining robes

you are welcome here.

Let us give thanks

to the One who knits us together

who holds the cords of Pleiades

who holds the very life to our blood.

Let us give thanks

under the stars

with a smile in the dark, a rise in our hearts,

only to see that the moon is smiling too.

Your Kingdom Come

Thursday

Thursday morning in the Labour Ward, we’re into the swing of things. As I walk swiftly past the desks enroute to find a syringe or a pair of gloves, I notice the corner where the dead babies go.

There are none.

Then, my mind flashes back to Monday morning, when we saw 3 small bundles,

the babies that had died during the night shift. I felt like my blood ran cold.

That day we prayed.

We prayed over the room, over the beds, and rebuked the spirit of death that would wish to linger and find a way in over these mama’s deliveries.

We welcomed and brought God’s presence and His Life into the Labour Ward, and refused to be okay with babies dying.

Then I realized that

in the corner where the babies go who died from the previous nightshift:

Monday morning there were 3 babies

Tuesday morning there were 2 babies

Wednesday morning there was 1 baby

and now, Thursday morning there were none.

And no babies had died while we were on shift.

Our God is amazing.

Together with Him we can push back the kingdom of darkness, and see His Kingdom come.

When Jesus died, He defeated death.

He rose and conquered the grave.

It is by this same authority that we can stand against all that which would want to steal, kill and destroy. Jesus did it all, and now He gives us the keys.

Now, all we need to do is go for it!

The kingdom of Heaven suffers violence, and violent men take it by force.

I will give you the keys to the kingdom of Heaven. Whatever you bind on earth will be bound in heaven. Whatever you loose on earth will be loosed in heaven. Matthew 18:18

Praise the Lord!

Miracle Baby and Grace

Wednesday

2 births

She has striking eyes and what look like pink lightning bolts of blush high on her cheekbones. Beneath her full, lip-lined mouth, are 5 or 6 distinct curly cues of dark afro hair at the base of her chin. She is short and stout, with a very prominent spherical belly, and her wide thighs quickly taper into knobby knees down to thin, small feet.

She looks wild and untamed, and her goat-like features remind me of an African, female version of Mr. Tumnus from Narnia.

Her name is Habiba, or later affectionately termed, Billygoat.

One instance we look over and she’s sitting, then she’s lying down, then she’s fidgeting this way and that...

Then we look over and she’s pushing. A thin greeny sac of waters has been born... her membranes are coming. The baby’s head is right behind it.

“Do you want to take this one, Fia?”

My first thought was one of hesitance, because it didn’t look so promising... with waters that are green, that is never a good sign.

But then I said, yes. Let’s do it.

So the head is coming. Intertwined with black curly hair is vernix with a greeny tinge. Like olive oil body butter from the Body Shop. As the head is presenting, the nurse with a sassy swagger comes over to us, points to the head and declares,

“Fresh stilborn.” and then she walks away.

My eyes perk up and open wide. With a flame of fire in my heart, I look across to Bek, and say,

“No he’s not. In Jesus’ Name, he’s not.”

(Can I say that?)

I start praying, taking my position as watchman and gatekeeper for this little baby.

For some reason, I wasn’t convinced that the baby was dead.

No way he’s not.

The head starts to deliver... then the shoulders, and out comes a dark blue-grey body, limp and motionless, followed by sickly green waters.

He really did look dead.

Bek and I exchange glances...

The sassy nurse starts wiping its face.

No breathing, no colour, no muscle tone, no cry, no reflexes...

I place two fingers on his small chest and feel a slow heart beat.

About 60 beats per minute. It’s supposed to be above 120 beats per minute.

“A heartbeat! He has a heart beat.”

After feeling that, I had no fear.

This baby will live. He will live! God put such a confidence in my heart. I started fervently praying.

Death: I was not going to have it. Not on my watch.

There was an unwavering strength in my spirit.

No doubt whatsoever.

We cut the cord with haste and Emily and the nurse started to suction out his mouth and throat. He had swallowed a lot of meconium (from the green amniotic waters), and it was keeping him from breathing.

I had to stay with the mom to inject a dose of oxytocin and deliver the placenta, but all the while fiercely praying under my breath. Every two minutes, I’d call, “Em, how’s he doing now??”

For a long while he was not breathing on his own. And still no muscle tone. They were doing suction, and bag and mask, filling his lungs with air, but it wasn’t until 20 or 30 minutes after, that he was strong enough to make an effort. He was blue for a long time, very slowly becoming pinky. As soon as I could, I went over and prayed with Emily as she fussed around with putting little oxygen tubes in his nostrils.

“You’re going to survive, little guy, because Jesus is here! God, we ask for your breath of life to fill his lungs. God, where your spirit is, there is only life, and we push back and cut off anything that would come and want to destroy his little life. We cancel and cut off those words of “fresh stillborn” spoken over him, and speak life and hope over him. You are going to be one that defies others!! You are a miracle baby! Where others thought you would not make it, you will!! Because Jesus is with you! Thank you Lord!”

I’m getting more and more pumped with each step of progress. He’s starting to grasp my hand, and he has some muscle tone in his arms and feet. 45 minutes have gone by. He is Miracle Baby.

Billygoat is a little distressed, like a ram tied to a fence. She needs to stay on the bed because she’s getting sutured, but she’s not been filled in on if her baby has actually lived. The last thing she knew, everyone was tense and they whisked baby away. We are smiling at her, trying to tell her he’s alive, telling her it is because of Yesu...

and then we hear him cry!

We tell her, “Your baby!! Your baby!”

I go over and check on my special little guy. Getting stronger. My defier. He’s now breathing normally, has a steady stream of oxygen, and has good colour.

I see the nurse, walk up to her, and ask her straight-up,

“Why did you say ‘fresh stillborn’? Why did you say that?”

“His colour, when he came out---”

“No, you said fresh stillborn when the head was just starting. Why did you say that? Why would you say that??”

The nurse, a little like a deer in headlights, opens her mouth and then closes it again. I think she was shocked that I would call her on what she said, perhaps flippantly.

“Because I suspected the mother took local herbs.”

Local herbs. Closely associated with the witchdoctor, or other “local” remedies, some which include poison... often the babies do not survive.

We prayed more over the baby and cut off any curses or strongholds of witchcraft. Jesus is more victorious than local herbs.

Thank you Lord for Miracle Baby!

I wrapped him up nice and snug and brought him over to mum. She was happy to see him and was relieved that he was alive and doing so well.

We take a break for lunch, I am just so thankful and pumped, and praising God.

We get back and see that a delivery is happening on the labouring side. We all have a peek, and while the delivery is finishing up, I see another woman on a bed in the corner, starting to push.

I point,

Baby!!

The nurse who I confronted before, she specifically calls my name,

“Fia, can you conduct this delivery?”

I think she likes me, even if I do ask her hard questions.

“Uhh... gloves--- gloves!” I don’t have an extra pair in my pocket this time! I run over to the bed, see a pair of gloves, quickly slip them on, and start to take action.

I prepare the kanga, baby comes nice n’ easy, ooh--slip the cord twice off her neck,

I place her up on mom’s tummy, and she’s limp and not crying.

I rub her and try to stimulate her to cry, but we need suction and bag and mask.

We have no supplies over here!

We are not on the delivery side, and we have no sterile equipment. This is a plastic mattress on the labouring side, and there are mamas everywhere.

Bek is running back and forth between births, and I yell to her,

“Bag and mask!!” as she’s running to get me a sterile cord clamp and kidney dish from the autoclave.

But after experiencing Miracle baby, I felt a perseverance in my heart start to rise up.

No, just because she’s not breathing right away, I’m not going to freak out. She will be okay.

We get the manual suction and bag and mask.

One puff, and she’s crying.

Yay!

She pinks up and becomes vigirous and hearty.

Thank you Jesus.

I got the name Grace for her,

she’s so little and darling, what a sweet pea. Cute baby girl.

She came out so gracefully, and mama didn’t even tear or anything. Another successful delivery.

What a day!

Fatuma

- Tuesday

Into the swing of things.

I am amazed at how quickly you learn when you have no choice but to move forward.

Soon after got our uniforms on, I help a small woman with a large belly up on to a delivery bed. She had little thin arms and little thin legs, and probably not more than 4 foot 11. She has a cute, thin, wispy, high little voice that she just rattles away long sentences that I cannot understand.

I stay with her, and monitor her, and I tell her (in Swahili) my name and that I’m from Canada. I can always get a smile out of them that way.

Today I can start delivering babies.

I have seen my share, and assisted with many, and now I can start, under close watch and supervision.

Her name is Fatuma, she’s 25 years old. This is her third pregnancy, she has one child that is living, and has one child that died.

She starts to push. Baby’s coming.

Everything is ready: kanga, sterile cord clamps, surgical blade, vial of oxytocin...

We stand, on watch, on guard, praying for a safe passage, for a healthy baby.

The head comes smoothly, and as her shoulders are delivered,

“Nuccal hand,” Bek says.

Instead of her hands tight in to her chest, she had a hand that managed to have one palm tucked up by her neck.

So we deliver her hand first,

her small little arm shoots valiantly forth, and then out slips the rest of the body.

Welcome to the world, baby!

A sweet little girl. Crying hearty cries, pinking up with each breath. Just like that.

Fatuma gives another thin wispy sigh, this one of exhaustion and relief.

No tears, no excessive bleeding.

What a great first delivery. Thank you Lord.

Fatuma jumps off the bed, bends over, and finds herself a fresh kanga from her bag. Wow, careful now... you DID just have a baby. I make sure she doesn’t get dizzy and fall.

But here, once you have the baby, there isn’t really such a thing as resting... grab your stuff and get off the bed for the next person.

We quickly do the paperwork as we can, and another student does the newborn exam and prays for the baby. While praying, she got the name Deborah for her, and I got the name Faith.

We ask God to give us spiritual names for the babies we deliver, as names are a part of calling out their destiny.

So here we have Deborah Faith, daughter of Fatuma, delivered by Fia.

There is a woman with wild hair on the bed against the wall.

She has delivered a baby, but her uterus is not contracting.

As a result, she is still bleeding a lot, and we deduce that there are blood clots in her uterus that is keeping it from properly shrinking back down.

The more time we wait, the more blood she loses.

This calls for the “manual expulsion of clots”, which, yes, that’s right, if the uterus is not expelling them, you reach in and grab them yourself.

Sister Limu, the no-nonsense Nurse-in-Charge, snaps on some sterile gloves whose cuffs reach up to her elbows, and dives in, much to the horror and pain of the mother.

Screams and resistance are the only weapons of defense she has, and she pleads loudly,

“Naomba, naomba!” (Please, I beg you!)

Sister Limu, determined, yet loving (in a stern type of way), pays no attention to these antics and emerges with a fistful of clots in her right hand.

I stay by this woman’s bedside and make sure she doesn’t flail off the bed.

Once more she goes in, against the wild-haired woman’s wishes, this time her limbs moving this way and that, and I steady her shoulders with my hands and try to give her a compassionate smile. Now, I am wedged between the bed and the wall and I feel a drip, drip, drip... on my shoes.

I look down, and the vinyl cover off the bed has funneled to a point and is spilling blood all on the floor and my shoes.

Finally, Sister Limu comes out with one more fist of clots, the job is done.

A traumatizing event for the woman, but a life-saving one. Now her uterus can contract and return to its normal, non-pregnant size.

I inch my way out from the wall, soon to discover that my blue uniform from the waist down is covered in fresh blood streaks.

Honestly, I’m a little impressed. It looks like a labour-room battle wound.

Sister Limu takes one look at me and says,

“Change your uniform.”

“I have nothing to change into, this is my only one.”

“Then wear your home clothes.”

It’s 12 noon and so I spend the next 3 hours running around in my yellow shirt, grey skirt, and my white, speckled, blood spattered closed-toed crocs.

Within 5 minutes, my recognition for the need of pockets overwhelms me! Where do I put my pen? My notepad? My nurse watch! How will I time births, breathings, heart rates...?

I feel naked without my uniform! Who knew no pockets would be so debilitating!

So, in my unprofessional yellow t-shirt, for the last 3 hours, I run around, help others, oversee an IV drip for Lucy (a lady due for C-Section), I get her paperwork done for the operation, and administer antibiotics intravenously. We wheel her down to the Operating Theatre, anticipating to watch the C-S, but there are not enough sterile gowns. So we have to go back.

But it’s almost time to go home anyway.

Esther

Let’s take a gander around the hospital, shall we?

This is Marchien and I, Marchien’s from Holland and she has such a sweet voice and heart. She’s with me all month.

This is the maternity wing. Antenatal/Postnatal, Labour Ward, ICU.

These are family members gathering bits of news and passing food and water over the wall to the women in the wards.

Then they take their place and wait and watch, here.

This is what inside looks like. This is where I work.

This is the Antenatal/Postnatal Ward, but the Labour Ward does not look much different.

And now, stories from the labour room...

Today is Monday.

This week we are in the Labour & Delivery Ward.

Yippee!

I couldn’t have asked for a better beginning day to start things off.

I was preparing myself for anything; chaos, shrieks and inconsolable screams, babies crying, babies dying, moms delivering on the floor because they can’t get to a bed fast enough.... I’ve heard all these stories in the past two weeks, and I was anticipating it all spontaneously happening at once.

When we arrived in the morning, we took a quick once-over to get our bearings. A few women labouring on the labour side, and one woman ready to push on the delivery side. I had never seen it so quiet.

On my way through the ward, I walk past the corner where the dead babies go. There are three little wrapped bundles. The two small ones are twins. The other is marked FSB. Fresh stillborn.

The night shift nurses were making the change-over with the day shift nurses, we meet the soon-to-be familiar faces.

Sister Rose, Doctor Rokia, Sister Bernadetta ...

It’s African for the nurses to refer to each other as “Sister”. “Sista”, really, with the accent.

You’ll also hear the word “Ness!” cried out by the patients, which is “Nurse”.

Before the day began, we had a chance to wipe down the simple rectangle delivery mattresses and the orange vinyl over-pieces that usually get pretty bloody.

We quickly become familiar with where the surgical glove boxes are situated.

1st rule of the Labour Room: always have an extra pair of sterile gloves with you. A baby could come at any moment.

2nd rule of the Labour Room: always double-glove. See Rule Number 1.

I am drawn to the woman labouring by herself in the delivery room.

There is the occasional shriek and howl... the contractions are getting strong now! I can start to see the head. She keeps saying in Swahili mixed with English,

“Oh Jesus -- oh my Lord Jesus -- Yesu -- Yesu Christo...”

?

Two questions take precedence:

Is she swearing, or is she a Christian?

I hold her hand, and tell her without words that I care.

I get asked by the nurse to put in a catheter (a full bladder interferes with delivery) and to set up an IV line for her. What a joy!

I found a good vein on the back of her hand, and got the long needle in -- first try! And the IV drip is up and running. Thank you Lord.

Words cannot explain the satisfaction I presently get from doing a successful cannula. I never thought I’d be so passionate about IV drips, but it is a skill I am working on perfecting.

Her name is Esther Francis. She’s 23 years old and this is her first pregnancy. She keeps calling on the name of the Lord... I am so curious!

The head is starting to show more.

“Sister Rose!” All the nurses are called Sister. Or rather, Sista! It’s very cute. Sister Rose is an especially kind nurse.

I quickly get oriented with retrieving the cord clamps and kidney dishes from the sterile oven, and I get everything ready.

Oxytocin? Check.

Surgical blade to cut cord? check.

Sterile gloves? check. Have an extra pair in my pocket.

Clean kanga to wrap baby in?

we find her bag, and inside is a Bible, and other Christian Swahili literature. So she IS a believer. Yay for Yesu!

We choose a nice orange folded piece of fabric.

The baby comes in a few good pushes, Sister Rose puts the baby on the stomach and

baby cries immediately.

Hongera! (Swahili for Congratulations!)

It’s a boy!

I take baby, active and alert, vivacious and crying. He’s the best baby I’ve seen so far. I take the baby and weigh him on the nearby scale, 3 kg, a nice healthy weight.

The mom is getting some stitches from a tear, and as I dry down the baby and wrap him in my special newborn way I keep making eye contact with her and smiling. I bring the baby over, and let him lay beside her on the narrow bed.

This is how it should be, Moms should get to be with their babies. It’s good for baby, it’s good for mom, it’s good for the uterus to contract and control excessive bleeding. Baby gets to be warmed by mom’s body heat as well.

So often I see the babies whisked away, get bundled up and then left on the baby bed, while the paperwork gets done. Which sometimes takes an hour or more.

As soon as the stitches are done, Esther’s up and walking. Wow. Off the bed, she waddles and grabs her bag. There are only 5 beds, and you gotta make room for the next delivery. The labour room is filling up.

I help out with the papers so it gets finished faster, and then I get to joyfully reunite Esther with her baby boy. I tell her “God bless you” in Swahili, and walk her to a rest bed (which she shares with two others) in the next ward.

Lying down on one of the delivery bed is a large woman with a beautiful face. She has big dark eyes, full eye lashes, and nice teeth.

Her belly is brimming, yet her face is somber.

The first thing she asks is,

“Why is my baby dead?”

There was no fetal heart rate, and she couldn’t feel movement since yesterday.

The labour contractions start to pick up, she was very focused through it all. The head starts to come, and with it a long gush of thin green waters.

The baby, still and lifeless lays at her mother’s feet.

We take the kanga and carefully wipe the baby’s face.

Wailing. Now she lets loose.

The mother is weeping and mourning, and tears are streaming down her face.

It was her first child. A girl.

Dead.

A day before delivery.

I see the stretch marks on her skin, on her arms and on her tummy....

all for nothing?

Those nine months of changes, of emotions, of preparation, all to labour for the wind.

And the labour, how devastating it must have been to know that all that work, all that pain, would just amount to more sorrow in its completion.

My instructor, Bek, and I delivered the placenta, and it was so weak that it almost broke.

She tore, and Bek takes on the offer to suture her. I assist her with her tools, and watch very closely.

Unlike some of the cases we’ve seen, we make sure to use enough anesthetic.

As we take the time to gently repair that which has been broken, she is streaming out loud cries in Swahili. Deep sobs and heart cries bellow out and fill the delivery room. She gets told to hush by other nurses.

I’m glad we get to be with her, to be kind and compassionate towards her. I’m happy that she is properly grieving and letting it all out, as it is African custom to swallow the pain.

I visit the baby table, and there is an unknown baby happily squirming in a wet kanga. Someone has given birth on the labouring side.

I want to exchange it with something cleaner and drier, but the baby has no label on it yet. So I hold her in my arms and wade my way through the full labouring room, searching for a mother’s face of recognition.

In the corner, about 3 meters away, I see a young girl on a bed, and her baby’s head is crowning before my very eyes. The girl is concentrated --almost relaxed-- and silent, not making any noise.

How is she doing that?

Her eyes shift to look at me.

A little frantic and my arms full of baby, I look for any white-coated lady.

No one is over on this side.

Nurse! Nurse! Sista!

I’ve got a baby in my arms and this baby is coming and not going to wait for anyone!

I tip toe through the bodies and hands and feet that now line the place to walk, and I put the baby in the wet kanga back on the table for a moment and run to help at the site.

A nurse hears my call for help, and as she quickly snaps on her sterile gloves, the head is born.

She gives a light guide to the shoulders and slip! he’s out. Just like that. Right on the bed.

If I had not been over there...

We take care of cutting the cord, placing baby with mom, and Bek helps me deliver the placenta.

Everything is going so smoothly, we have ourselves a textbook delivery.

No blood, no tears. Handsome healthy baby. First child.

Her name is Sofia. 20 years old.

Hmmm.

My name is Fia, and I am 20 years old.

We quickly do the paperwork, and I help Sofia with her things to walk to the Postnatal Ward. She casually talks over the wall to someone that could be her mother. We exchange joyful, hopeful, restful smiles.

Beaming with joy, I carry the warm little bundle of baby as peacefully and gracefully as if it was my own. The African staff think its hilarious that I’m carrying the baby as we walk past.

What a sight for a white girl to be carrying an African baby!

The main security guard in the hallway reminds me of a mom who would be a cross-guard at a children’s school at lunchtime. She’s got a smile that will melt your heart and a sparkle in her eye. We always curtsey when we say hello to her, she really likes that.

She wears a navy blue policeman hat (like the ones you draw in cartoons) and she proudly grasps a piece of metal and a rod. She walks up and down the hall, making the occasional chit-chat, and rhythmically taps the metal like a cowbell.

“Did you have a baby?,” she jokes.

The others around erupt into laughter so hard they start slapping their knees.

I smile and laugh with them. Africans are so funny that way. Jokes like this seem to never get old. They laughed about it before, and when I carry another baby tomorrow, they will slap their knee about it then, too.