Connor and I have been trying a new approach to our hospital schedule- today we went in for the afternoon and evening, because all of the students peace out at about five and then we have more opportunities to ask questions of the nurses. We had a really nice morning! I had been tipped off about some decent instant coffee (star coffee) which I bought yesterday, and so this morning I enjoyed two cups of coffee- my first since Monmouth in London. It felt sooooo good. Connor and I spent the morning doing crosswords on the iPad and went in to the hospital after lunch. We watched two c-sections in the afternoon. The first was for a ruptured uterus, which I had never seen before. The baby was stillborn and the mother's uterus was torn in two directions and looked stiff and dark. It was shaped at that point kind of like a baseball mitt, but the surgeon closed the uterus again despite the high likelihood of future dangerous pregnancies. He hadn't discussed the possibility of a damaged uterus with the mother beforehand, so he felt that he couldn't perform a hysterectomy. Safe spacing is key in situations like this,, as is close and conscientious monitoring throughout pregnancy. The chance that the mother will take these precautions with her next pregnancy is slim, so I can't help but be concerned for her. The second c-section went very well, happily.
After our afternoon tea, we returned to the hospital to help out with labor and delivery. They had delivered sixteen babies between nine and five, and we saw many more mothers there laboring. One mother was laboring in the hallway and had her baby there, unattended. Connor ended up helping nurse Zaki with the mother while I tended to the baby. There was so much going on that it was hard to tear ourselves away for dinner, which is served between nine and ten in the evening.
Wednesday, June 29, 2011
Monday, June 27, 2011
6/27/11
Even as I write this, it's Monday, 6/27.
We decided to take the day off today to make up for working on Saturday, and it's been very nice. We bathed, did our laundry, and spent much of the afternoon catching up on this, our blog. We do it all for you, dear reader, that you may live vicariously through our adventurous spirits.
The power has been out all day at home. I guess it just happens here sometimes.
Anne Marie is just noticing all the typos in my posts.
I hope you've enjoyed the latest installment, and we miss you all in America! Enjoy a tasty cheeseburger for us.
We decided to take the day off today to make up for working on Saturday, and it's been very nice. We bathed, did our laundry, and spent much of the afternoon catching up on this, our blog. We do it all for you, dear reader, that you may live vicariously through our adventurous spirits.
The power has been out all day at home. I guess it just happens here sometimes.
Anne Marie is just noticing all the typos in my posts.
I hope you've enjoyed the latest installment, and we miss you all in America! Enjoy a tasty cheeseburger for us.
6/26/11
After a long day watching circumcisions, we were really excited about a day off. We slept in really late, watched Modern Family and Fringe on the iPad, took extra-long luxurious bucket baths, and generally relaxed hard.
One annoyance that interrupted our otherwise perfect day was a small problem with our host mom. Our house has no running water, but there's a public water source nearby that she and her adult children pay to fill these big water jugs (called "Jerry-cans"), so that we have water to cook, bathe, and wash our clothes with. Except that this week, the water has almost never been there when we need it. It's been a minor problem, it always showed up eventually, but apparently the roommates collectively had heard that she had no money to fill the cans with. The water costs 100 shillings per jerry can (that's about 4 cents), so I'd given her the 16 cents she required to fill our 4 jerry cans, but this prompted the roommates to call Michael, who should be giving her the money... anyway, long story short, he came over and talked with Jessica and us and it was super awkward and now, on Monday, things are still a bit awkward between our host mom and us. Ah well.
But otherwise, we did nothing. Awesome.
One annoyance that interrupted our otherwise perfect day was a small problem with our host mom. Our house has no running water, but there's a public water source nearby that she and her adult children pay to fill these big water jugs (called "Jerry-cans"), so that we have water to cook, bathe, and wash our clothes with. Except that this week, the water has almost never been there when we need it. It's been a minor problem, it always showed up eventually, but apparently the roommates collectively had heard that she had no money to fill the cans with. The water costs 100 shillings per jerry can (that's about 4 cents), so I'd given her the 16 cents she required to fill our 4 jerry cans, but this prompted the roommates to call Michael, who should be giving her the money... anyway, long story short, he came over and talked with Jessica and us and it was super awkward and now, on Monday, things are still a bit awkward between our host mom and us. Ah well.
But otherwise, we did nothing. Awesome.
6/24/11
I think I've been rambling for my recent posts, so I'll be brief.
It's Anne Marie's half birthday, and my 5/6 birthday!
We worked normal hours again, but we really liked our afternoon/evening schedule... we'll be doing that again.
Anne Marie will write about the craziness in Maternity with the mother that died, so I'll not write about that again... except that it really angered me how insensitive the staff was being to the mother and brother of the deceased. They were just being students, not knowing what to do with the body, but as they were screwing around with it they were laughing and smiling... all right in front of these absolutely heartbroken relatives. It really was awful.
I tried to fix the drill in the dental clinic for a few hours today. I took the whole thing apart, and as you can imagine, it was more complicated than I'd originally thought. I knew I was unlikely to fix it, and sure enough I didn't, but I did fix that little suction-y thing that dentists stick into your mouth to clear out the spit! The other stuff was broken beyond repair - plastic broken and such - plus I had no tools or knowledge. The dentist lady was nonetheless extremely grateful.
We got roped into going on an all-day circumcision outreach on Saturday. Woo hoo!
It's Anne Marie's half birthday, and my 5/6 birthday!
We worked normal hours again, but we really liked our afternoon/evening schedule... we'll be doing that again.
Anne Marie will write about the craziness in Maternity with the mother that died, so I'll not write about that again... except that it really angered me how insensitive the staff was being to the mother and brother of the deceased. They were just being students, not knowing what to do with the body, but as they were screwing around with it they were laughing and smiling... all right in front of these absolutely heartbroken relatives. It really was awful.
I tried to fix the drill in the dental clinic for a few hours today. I took the whole thing apart, and as you can imagine, it was more complicated than I'd originally thought. I knew I was unlikely to fix it, and sure enough I didn't, but I did fix that little suction-y thing that dentists stick into your mouth to clear out the spit! The other stuff was broken beyond repair - plastic broken and such - plus I had no tools or knowledge. The dentist lady was nonetheless extremely grateful.
We got roped into going on an all-day circumcision outreach on Saturday. Woo hoo!
6/25/11
Connor dragged me out the a nearby village, Bulamagi, to help with fifty circumcisions that are conducted every weekend day in this area as part of the Safe Male Circumcision outreach program. This project is funded really well by USAID. One of the perks of the whole day for me was getting to drive in a truck out to the village health clinic. Thanks, USAID! This health clinic serves one hundred thousand people. It was the size of a large house here, and had no electricity or running water. Anyway, they did LOTS of circumcisions, which I'm not really very interested in except from a public health perspective. Connor has a relationship with one of the doctors who's in charge of this project, and while we were observing the surgeries the doctors really kept pressuring Connor to perform one. It's actually a very disturbingly common occurrence for the nurses at the hospital to push us to conduct deliveries or perform procedures. I've been assisting on a lot of deliveries,, and I certainly hope that I'll be able to conduct a delivery before I leave, but I'm a little flabbergasted by the constant push to do things outside my comfort zone, which I feel is already pretty wide for a first year medical student. Notable quotes: (from a surgeon standing over a twelve year old boy who was grimacing as a large needle was inserted into his penis) "this man is a coward!" (from the same surgeon explaining why he was giving this boy a hard time) " African men know no fear of death!".
6/23/11
I don't remember much about Thursday.
In the morning, we were told by our host mom Jessica that Michael (our main ELI contact here) had somehow heard that we weren't at the hospital in the morning, and sent Juliette over to make sure we were alright. How on earth the hospital can allow patients to fall through the cracks and be generally unorganized as anything I've ever imagined, and yet realize that we weren't there in the morning, is pretty much a mystery to me. But so it was, I guess.
We went in for a normal day Thursday, and I think I spent much of it in Maternity... in fact, Thursday was the day I assisted delivering a baby! It was very messy.
After work, we went over to Anne Marie's good friend Maria's house to meet her family. Maria was a nursing student Anne Marie'd been working with in Maternity, and who left Iganga to train somewhere else on Friday. It was very nice - we looked at pictures, met her big family, had some Rolex (delicious!) and walked home. Thursday was a good day.
In the morning, we were told by our host mom Jessica that Michael (our main ELI contact here) had somehow heard that we weren't at the hospital in the morning, and sent Juliette over to make sure we were alright. How on earth the hospital can allow patients to fall through the cracks and be generally unorganized as anything I've ever imagined, and yet realize that we weren't there in the morning, is pretty much a mystery to me. But so it was, I guess.
We went in for a normal day Thursday, and I think I spent much of it in Maternity... in fact, Thursday was the day I assisted delivering a baby! It was very messy.
After work, we went over to Anne Marie's good friend Maria's house to meet her family. Maria was a nursing student Anne Marie'd been working with in Maternity, and who left Iganga to train somewhere else on Friday. It was very nice - we looked at pictures, met her big family, had some Rolex (delicious!) and walked home. Thursday was a good day.
6/22/11
Determined to have a better day than we had on Tuesday, we did.
We decided to go into the hospital in the afternoon and evening, rather than the morning and afternoon. There are so many students there during the day that it's hard to be legitimately helpful - it seems like we're just in the way half the time. But at 5:30, the hospital totally clears out. So we decided that's when we wanted to be there.
More dental clinic in the afternoon, and more Ugandans being outrageously stoic. One poor preteen, too old to scream like a child but too young to be anything but terrified, sat in the chair shaking uncontrollably, but not uttering a word. She couldn't anaestetize him, he was shaking so badly... when he came back later he'd calmed himself, and went through it with no complaint. Pretty crazy.
I went to the maternity ward for much of the evening with Anne Marie, and successfully learned a few things about obstetrics - how to determine where the fetus's head is, how it's oriented, how to do a vaginal exam and determine how dilated a woman's cervix is. It was really interesting, and really cool - the nurses in maternity are extremely helpful and knowledgeable, so I really liked that. Before I knew it it was 5:30, and the ward emptied. In fact, we found ourselves in the situation where we were the only people in the whole damn ward, with some ten or more laboring mothers. Catching one nursing student on her way out, we asked who was in charge... "You are!" Wait, what? "If we weren't here, what would happen if one of these mothers started delivering?" "They would scream for help, and probably someone would hear them." By now pretty freaked out, we started running around looking for someone, anyone qualified really, who would be there if one of these women started having a baby. We figured we could deliver a perfectly uncomplicated baby, but what if there was a hemmorhage? A tear? We weren't about to sucher one of these women back together, with no experience (and with no anaesthetic, as is the crazy policy of the maternity ward)! Luckily we found a nurse who came in with us, and normalcy was restored.
It was about now that yesterday's scenario began to replay itself. A woman was in obstructed labor. It was determined that she required a C-section. The surgeon on duty during the daytime was just leaving, and the nighttime duty surgeon was "on her way." For the entire time that we waited for her (well over an hour), I was increasingly nervous and angry. I couldn't beleive that a baby was stuck in this woman's birth canal, a medical emergency(!), and for two days in a row surgery was delayed to the point that disaster seemed inevitable. Finally the woman was carted to the operating theater, and the surgeon (after a painstakingly slow introduction to us and a generally unhurried air) began operating. The baby was removed - resuscitated - and after a few heart-wrenching minutes, began to breathe.
Anne Marie and I were really, really happy. At about 8:00 we left the hospital and grabbed some beers at a bar on main street. Sometimes, it seems, medicine works!
We decided to go into the hospital in the afternoon and evening, rather than the morning and afternoon. There are so many students there during the day that it's hard to be legitimately helpful - it seems like we're just in the way half the time. But at 5:30, the hospital totally clears out. So we decided that's when we wanted to be there.
More dental clinic in the afternoon, and more Ugandans being outrageously stoic. One poor preteen, too old to scream like a child but too young to be anything but terrified, sat in the chair shaking uncontrollably, but not uttering a word. She couldn't anaestetize him, he was shaking so badly... when he came back later he'd calmed himself, and went through it with no complaint. Pretty crazy.
I went to the maternity ward for much of the evening with Anne Marie, and successfully learned a few things about obstetrics - how to determine where the fetus's head is, how it's oriented, how to do a vaginal exam and determine how dilated a woman's cervix is. It was really interesting, and really cool - the nurses in maternity are extremely helpful and knowledgeable, so I really liked that. Before I knew it it was 5:30, and the ward emptied. In fact, we found ourselves in the situation where we were the only people in the whole damn ward, with some ten or more laboring mothers. Catching one nursing student on her way out, we asked who was in charge... "You are!" Wait, what? "If we weren't here, what would happen if one of these mothers started delivering?" "They would scream for help, and probably someone would hear them." By now pretty freaked out, we started running around looking for someone, anyone qualified really, who would be there if one of these women started having a baby. We figured we could deliver a perfectly uncomplicated baby, but what if there was a hemmorhage? A tear? We weren't about to sucher one of these women back together, with no experience (and with no anaesthetic, as is the crazy policy of the maternity ward)! Luckily we found a nurse who came in with us, and normalcy was restored.
It was about now that yesterday's scenario began to replay itself. A woman was in obstructed labor. It was determined that she required a C-section. The surgeon on duty during the daytime was just leaving, and the nighttime duty surgeon was "on her way." For the entire time that we waited for her (well over an hour), I was increasingly nervous and angry. I couldn't beleive that a baby was stuck in this woman's birth canal, a medical emergency(!), and for two days in a row surgery was delayed to the point that disaster seemed inevitable. Finally the woman was carted to the operating theater, and the surgeon (after a painstakingly slow introduction to us and a generally unhurried air) began operating. The baby was removed - resuscitated - and after a few heart-wrenching minutes, began to breathe.
Anne Marie and I were really, really happy. At about 8:00 we left the hospital and grabbed some beers at a bar on main street. Sometimes, it seems, medicine works!
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