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Reisverslag Stories to tell, babies to save
31 augustus 2017
Stories to tell, babies to save
Also the head of office left, so it’s a bit struggling. One advantage is that I could take over the furniture, so I have a bench and a table. It looks more and more like a real comfy house.
When I clean the furniture, a baby lizard crawls on the ground. I like babies, they are really cute, but this one I remove from my house.
We’re giving training to people in the healthcenters. They are enthousiastic, nobody falls asleep. One woman comes with her twin babies and a babysitter.
One of the midwives at the hospital comes to me and tell me that she applied for a higher rank. Because of the training she could tell them how to manage critical situations. If she really knows how to perform in real life will be a big question, but she got the promotion, that’s how easy it goes here!
A big group of prisoners are walking in yellow uniforms on the street. They’ve worked in the fields or coming from court or the policestation. One or two guards are ‘guiding’ them….busy with their phones, walking a long distance behind.
One of our colleagues got arrested the first week, because he couldn’t show his ID. 4 hours in jail before they could bail him out. A bit scary, I never carry any ID.
We joined a training provided by the organisation about social inclusion and gender. We really got to know people. They have a lot of statements about the west and different people, like gay people. In uganda they don’t exist according to them. Well, it is illegal, that’s true…but not exist…and not human…?
The week after we give another training about basic emergency obstetrics and neonatal rescuscitations. It’s always a surprise at what time the participants arriving, and the first day they have to get used to our way of training. But after that we have a lot of fun and they really enjoy the practical parts and the roleplay(well-played by my colleague Gerieke, she delivered so many babies herself now, we can’t count…)
Two midwives, one from the hospital and one from the healthcenter, we picked to join the training, so maybe they can take over in the future to give the training themselves.
What we didn’t know and now learn is that in every training there should be a ‘chairman’ an ‘energizer’ a religious leader, someone to take care of the food and one for timemanagement. Funny to see how they do it, because timemanagement is not really a thing here and the food we already provided. But in name it sounds great!
In the evening we play a cardgame with the other two midwives ‘ ligretto’ and they are very fanatic and enthousiastic! We will continue to arrange cardgames playnights at Gulu. At the last day the country director, the HR manager and our healthprogram assistant visit the training to see how we are doing. They are happenly surprised how we perform and how much energy the training contains. The driver who also join tells me later that after the training he thinks he can perform a delivery, so practical! He is only scared of blood…
Renee, another volunteer sometimes come to Gulu for the weekend. She wanted to take some mobile money(savings at your mobile account) the girl did it wrong, wasn’t paying attention and put 200.000(50 euro) of airtime on the phone, for calling. She couldn’t fix it back, so we lost 200.000. More and more people come and listen to the problem. We’re a bit mad, because the lady couldn’t fix it and she wanted the phone as a security. Off course we don’t give the phone and leave it with her. Than a guy comes and ask what is going on. So we explain. Than he’s telling us that he is a police officer and he will help us. He is treathening the lady that if she doesn’t fix it he will send a truck with six policemen to arrest her. Well, that’s not really what we expected by helping us, this is too much. He’s giving us his phonenumber in case she doens’t fix it. If we write down his name: Alexander, he corrects us and say’ no, it’s CAPTAIN Alexander! What a guy….at last it was solved after a few days.
I’ve got a motobike, so now I can visit the healthcenters on the bike. I try to load the bike just as everybody here: a big bag with materials for the training. I’m driving off for the first time, a dirty road from the office. It’s slippery, wet and I’m adjusting at the same time the mirrors. I’m driving at the right sight of the road(I’m used to that in Holland) then another bike is coming towards me. I’m thinking; why is that guy driving at my sight of the road? Go away! At the last moment I realize that I’m the one on the wrong sight…oops
Saturdaymorning I’m driving off with three other volunteers to a hill like an hour drive from Gulu. That is one of the few hills in the surroundings of Gulu. It’s a bit important, because it was one of the last areas where Joseph Kony and his army remained. Finally the government army was taken over. And still there is a camp with soldiers to protect that hill. On the way we have to avoid all the holes and pits in the road, good for my off the road driving skils. When we leave town we drive through beautiful landscapes between high grass, where sometimes you see a small path going to little villages with huts. On the way people wave to the weird mzungu’s. People working in the fields, women have big biceps because of the hard work. When we arrive we have to registrate and report to the highest in rank. We can’t climb it without company, no photographs allowed. On the top of the hill a beautiful vision, we can almost see Gulu.
After a meeting at the office I drive home on the bike. On the way I see one of the drivers walking home. He is a really tall handsome guy. I stop and ask him if he wants a lift home? So can you imagine the picture: a small white girl in front and on the back a big, tall black guy. His legs to tall to fit, and so we drive trough town… funny face
We make a tour with the motobikes in the weekend to fort Patiko, it’s a former slavery fort in the hills and the top of the hill should be very beautiful and it is a nice walk.
On the way suddenly a young boy on a (too big) bicycle comes from the right sight of the road to the left side. It goes too fast, so I can’t avoid that I hit him with my arm. He falls down, no harm only my arm is very painful. When I later look at it, it has al the colours of the rainbow!
When we arrive at the hill and start climbing, a group of small boys are following us and laughing at us and making jokes of my red face and heavy breathing. They run up the hill to show how they do it! On the top of the hill you see that here Uganda is flat, but nice fields where people grow all kinds of vegetables.
At home I made chips with mayonaise, really nice. When I take a ‘nice’ shower(a small bit of water, not really warm, you can bearly wash your hair under it) my hair full of foam, my eyes closed, I feel something at my feet, when I wash away the soap and look what it is I see a big cockroadge crawling at my feet, brrrrrr
I have so many stories to tell…everyday there is something going on.
The week starts with the cleaner calling that someone delivered at the corridor. When I’m running, a tiny woman stands with a baby between her legs and the placenta attached to it. The baby doesn’t cry, but after some stimulation it comes to life again. 4 deliveries today and two cesars. The midwife who has to attend the theatre isn’t in the mood for that, so she is delaying. Than someone is shouting that the baby did already come normally at the theatre and not breathing. After rescuscitation it is breathing but not well. When I take the baby to neonatal, no one is there. Possibly the whole night the ward was not covered. The ward is full with preterm babies, not even a kilo weight. I try to call nurses on their cellphones, but nobody is responding. I put the baby under the heater and give some oxygen well I’m waiting. 1,5 hour later someone arrives with her sick kid on her back(at a neonatal unit with vulnerable babies) the baby dies a few hours later.
One day I work with one of the colleagues who joined the training. Lot of deliveries, at the end of the day we assisted 12 deliveries. One a twin which were born, in the membranes, beautiful! The colleague tells me very enthousiastic that she knew now how to manage the twindelivery, starting medication after the first one. Unfortunately I also see that she still holds a baby upside down at the feet, giving suction, not giving skin to skin contact…not everything is changing directly, patience…step by step.
A young girl comes in, in bad health and malnutrition. She had a miscarriage, but the baby is still inside and she is bleeding already the whole night. Nobody paid attention at the gynaecology ward. We deliver the baby, wrap it in cloths and put it in a box so the family can take it home.
Another baby delivered by one of the interns, nothing is prepared, no checks during the night, the mother already for hours in labour. When the baby comes out it’s not breathing. It takes long before they find a razorblade to cut the cord. When I take over and rescuscitate the baby it’s too late, after time we stop, no use in continuing. The in-charge comes in and takes over after we stopped already for 10 minutes and start ventilations again( well, not really ventilating because no air is going in because she doesn’t know how to perform. Oxygen applied on a non breathing baby, but of course the baby doesn’t recover and come back to life again. In the meanwhile the mother has a big bleeding, the doctors don’t know what to do and just stand and see. Just a simple massage of the abdomen, administering of medication helps luckely and the bleeding is under control. A lot of work has to be done here before the mortality rates will go down. Nobody told the mom that her baby died, so if I tell her, she is really sad. I explain her what happend and what we tried to do to save the baby, but nothing helped. The mother is glad that she know now what happened, it’s all in Gods hands she said. She tells me at that moment that she is for two days already in labour and that she started bleeding yesterday. The midwife on duty said to her that there was no problem. Nobody checked the baby…so sad. If I look in the registration the midwife wrote down that she checked heartbeat every 30 minutes. Also nowhere found a registration that the baby died. So that is scary, because if they don’t registrate, how many babies really die here every year!? More than we know!
If I want to take an empty box to put the baby in, there is something inside. When I open it, I see 6 little kittens, just born. So throughly a delivery room here, not only for humans!
One of the attendants had a baby on her back, when the kid sees me it starts crying everytime again. Well, if your mom is telling you stories that white people are ghosts and eat children… at the market a little kid is bathing in a bucket, as soon as it sees me it’s starting crying, even I put on my nicest smile…luckely the newborns are always crying, not specially for mzungu’s. A nice thing to hear a colleague tells me that she heard women talking in postnatal and outside that they hoped the mzungu will be assisting the delivery because she is nice and knowledgeable… good for my selfrespect;-)
Almost every day the conversation comes to the question if I have children of my own, and if I want them. A big surprise if you tell them you don’t have and want. One of the colleagues tells me: If you can’t manage a family, you can’t manage a country! Luckely I don’t have plans to rule a country…!
On a quiet day I’m cutting gauze for sterilisation and rolling cotton, how peaceful. Every morning I’ m preparing deliverypackages for sterilisation. No scissors available, so no cutting. The umbilical cord is clamped with two ligatures and cut with a razorblade.
Many structural problems: malaria treatment only the first dose is supplied by the pharmacy, the next two doses the patients have to buy theirselfs. They don’t have the money for that. So many times ) is a delay in treatment, or not at all given. Sometimes colleagues test theirselfs for malaria and use the treatment. Own safety first…
I try to coach the students. Start with a proper assessment and triage, first talk to a lady before you do a vaginal exam, it’s really rude to enter in before you even don’t know her name! Ask for HIV status, that’s important for your own safety! Listen and count the fetal heartbeat, don’t estimate! ( they try to count, but multiply is difficult by head, even if I make it easy and tell them to count to 6 and multiply by ten…..) Don’t make things up, like writing down a BP or temperature when both measurements are not available. If you write down contractions, how is it possible if I didn’t see you count? Apgarscore….always 9/10 even if the baby needed ventilation…
The interns are changing, a new group arrived. The gynaecologist who is normally only once a month at the hospital is in the hospital for a week to teach them how to do deliveries and operations. They watch movies ‘how to manage a cesarean section’ and than they operate without any knowledge! After a week they have to do it theirselfs. One of the interns is asking me: marian, can you do the exam for me, you can do it better, you have so much experience…she doesn’t know and doesn’t dare. Maybe that’s for the best? This group is willing to learn and they ask a lot of questions and advice. I give a short training just in basic obstetrics complications, they really like it. Even the gynaecologist is following the training…after the training we have a meeting and he ask me to look after the interns and keep on giving training and coaching. That’s not really my job, but we are still waiting for a gynaecologist to come…
After a busy week I’m looking forward to a weekend off. Saturdaymorning: getting up( early, because of all the noise, grass cutting by the guard, children screaming, music etc) breakfast in the sun on my porch. After that cleaning, doing laundry. Power is on, so loud dutch music and singing along! To the market for groceries, internetcafe and before you know the weekend is over.
31 augustus 2017 19:18 | Door: philippe.vaucher
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31 augustus 2017 23:02 | Door: Angelique
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