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.