Let's see the last post was about watching a Caesarian section. The day after that I started off with Andrew in pediatrics. The ward round was going on but the area was too small for us to be apart of it so Andrew decided to teach me and Anna the process of examining a child. While teaching us we got to practice the procedures as well. I learned how to listen to pneumonia with a stethoscope and access the general condition of the child.
After doing a couple rounds in pediatrics Andrew left and me and Anna could not get in with a doctor so we decided to try minor theater but no procedures were happening. We wandered around trying to find a doctor or our fellow interns to follow but could not so we ended up in labor ward again. As we walked in looking for a doctor we walked past a room where the afterbirth was just taking place. I got to experience that after the baby is born the woman gets a shot of oxytocin in her leg to initiate the after birth. During the after birth they must check to make sure all remaining parts of the placenta are removed from the uterus as it will cause bleeding. It was interesting to watch the examination of the placenta and making sure no pieces were left behind. After we watched the after birth we went and stayed with the baby that had just been born. He was in the resuscitaire with an oxygen mask on. The thing about here is that they only had the adult size oxygen mask and not an infant one. The midwife did not even strap it on so when the little boy moved the mask fell off. The midwife did not stay with the child but left so me and Anna stayed with the baby and positioned the mask to fit as much as possible. The baby first opened its eyes while I was rewrapping him in his blanket. I laughed when I saw his huge dark eyes because all I could think about was what he would say " mom the first time I opened my eyes I saw white people!" I could not help it because most young ones are scared of white people or muzungus and they cry if they come near and the fact I was the first person this little boy saw and I was white was kind of funny. But this little baby boy not even 20 minutes old was so cute and well behaved with huge dark eyes and cute little fat rolls. I kept warming him up by rubbing him and he smiled.
We left the baby because we heard another birth happening. We walked in and the woman was pushing. I could not wait to see an actual birth. I have never seen one before. The baby was cephalic presentation. I can't even describe the birth. It was fast from when the baby started crowning till the cord was cut. The baby boy was brought to resuscitator and we followed. The boy was shivering and was cold and the second resuscitator was not working properly so we put the two boys together in the one resuscitator. After warming the boy we went back to the mother and told her about her boy and that he was doing fine. After 15 minutes we were able to being the boy to his mother. The other boy however was not brought to mother as she was still bleeding. She however stopped bleeding 20 minutes later and was fine.
Now to the crazy part of this day. After staying with those babies Osborne came to labor ward and was talking with me and Anna when all of a sudden this woman screams. Anna and I rush to the room and Osborne follows and right as we walk in Osborne goes into doctor mode and asks for sterile gloves and spirit so we get them for him. The baby was breached and despite telling her not to push the mom pushed and the butt and feet came out first. If I didn't know better I would think this was a Caucasian baby it was so white. The arms were stuck above its head. The consultant came in and helped with procedure because Osborne was just an intern. The horrible thing about this whole procedure was that the umbilical cord was clamped with a clip while the head was still stuck in the cervix. When this happened you could see the baby girl trying to breathe while still in cervix. Being a premed and pushed to the back me and Anna could not say anything or get close but even one of the nurses was like that baby is trying to breathe. It was so frustrating that something so simple was not observed and done. It's the only was the baby was getting oxygen by the cord and by clamping it was trying to breath normally inside. After about 3 minutes the head finally came out but baby was completely white and still. They even showed the baby to the mother before taking it to be resuscitated. The midwife then took baby and we followed and they used suction to clear airways and would touch to stimulate the baby. I stood behind watching this none moving baby get breaths in and then suction and stimulation and repeat for over 5 minutes. I was so concerned and was literally praying for this little girl to make it. We came to learn the mother was having twins and this was the first so we went back in and the consultant was rupturing the membrane for the second baby. This is not what should be done but once again, this is Africa. We went back to little girl and she was starting to respond and trying to breathe but it was paradoxical breathing and had limited movement. We had to leave then but Osborne contact me later and said the second baby was face presentation and was a boy. Both were doing fine. I really wanted to go the next day to the NewBorn unit and check on them but we couldn't.
After this we went to the school and I taught science and English. It was so fun but I share a classroom with another class so it is very very loud and the children always want my attention or to choose them so they shout "Madame" and snap In my face, which gets very annoying but after telling them to sit down and write they do. We did dancing instead of sports this day because the field was too muddy. These kids are so good at singing and dancing and they love to show you how to do it. I had a boy always grab me to be his partner and would fight other kids who wanted to dance with me.
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