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.

Oh, the Struggles of a Developing-Nation Hospital.......

During the first week of working at Hospital Temeke, we discovered that the blood bank stores are empty. They don’t give blood transfusions because there simply is not any to give.

This shocked me beyond belief. The instance where one would need blood is at the hospital, but now, even being at the hospital won’t offer much promise in that department anyway. So hope you don’t bleed too much.

For those who are familiar with my passion for giving blood, I jumped at the chance to find out how we could help.

We got the low-down on where and when and how to donate, and the following week I ate a big lunch, drank lots of fluids, and walked to the Lab... just a few convenient steps from the Maternity Wards.

Usually how it works is you can only take from the blood bank if you can give it back. So, ideally, if someone is having a surgery, make sure you bring a relative along who can pay his dues in blood so that you can get yours, and live.

But what if a mother is having a postpartum hemorrhage? Uncontrollable bleeding and she’s just one of many, on a bed with a few others, admitted a few days earlier, her family waiting at home for her arrival?

What about the relative-system there? No one steps in to give for her. Nor would it even be at the top of their mind in the first place.

So, as a result, we have a hospital with two operating theaters, mothers hemorrhaging everyday, (and countless other cases in different wards), and a nonexistent blood bank.

I opened the door to the lab and told reception,

“I want to give blood.”

The few lab assistants that were there asked me what the patient’s name was that I was supplying it for.

“What? No, I just want to give.”

“But what is the patient’s name?”

“There is no name.”

....

after a few puzzled minutes, amidst the translations and broken English, a light bulb clicked on and his eyes lit up.

“Ohhhhh,

oh?

...You just want to give?”

Smiling, I nodded.

Still confused that there was no clear face behind my voluntary action, he ran up the stairs and got a bag.

They aren’t even set up for donations, because I suppose the occurrence is so rare, they just take them as they come. So they make me a seat in the corner of the only room they’re using. I sit in an office chair, and I watch a man do his work in front of me. He sits on a stool at a desk with a pile of sterile syringes, servicing the long queue of people waiting their turn to get blood taken for malaria and HIV. The line continues out the door and winds and wraps around the whole outside waiting area.

So I sit in my little office chair in the corner, and “my screening” begins.

Do you know your Hb level? - no.

He pricks my finger and I have a high level of 13. (That’s good.)

How old are you? - 20.

Do you know your blood type? - O+.

Have you given before? - yes.

Well, I guess let’s get started. The lab assistant opens the vaccuum-sealed sterile blood kit, finds my good vein and as he’s putting the needle in my arm, he asks me one last question:

Did you have anything to eat today?

Oh boy. This is so not like Canada.

What about the series of questions and stations and signatures and consent and blood pressure and history taking and if I feel well or am on medication?

Nope.

Thankfully I did eat beforehand and no I don’t have malaria and no I don’t have HIV and yes I’m feeling well.

The needle is in, and the bag is filling up.

“So, is the blood bank empty?”

He looks up at me, blankly.

“Some types are empty. Others are low.”

He’s holding the needle in my vein with his hand, and in ten minutes its over. That was fast. Usually it takes at least twenty. I guess he used a large needle... large and fast. The bigger the tap the faster it is.

I feel fine, absolutely fine until I look over and see my burgundy life, no longer in me, in a bag on the desk.

Black stars. Oh boy, do I really need to go through this again. I lay my head between my knees and resist the faint. Yes! It worked. I regain alertness and I’m okay.

“Thank you, you’re all finished.”

He takes a vile to be tested and screened,

and writes in the book,

Fia Merkeley, 20, O+, free donor.

I ask him if I can sit down for twenty minutes or so before I leave. (Canadian Blood Services protocol!)

He shows me to an empty room, and I rest and drink and eat some more food that I saved for the post-donation moment.

Refreshed, and revived, I get up and go.

Well, that’s that. 1 unit of blood in the bank.

But what a situation. And how to mend it?

This is the thing. Blood cannot be created, it can only be given.

And yet I can’t imagine the people voluntarily going out of their way to visit the hospital to donate blood.

It would be the last thing on their list... after sorting the beans, selling chapatis, washing the clothes, feeding their children, walking the miles, sweeping the walkway, finding work,

learning to read.

Plus add in the constant malaria, anemia, and prevalent HIV, and you don’t have the best blood to begin with anyway.

This is the predicament: If in Canada, where only 3% of the people who are eligible to give blood actually donate,

what does that look like in a place like this?

(For my own records:)

November 5, 2009 Hospital Temeke, 450 mL (1 unit)