Seeing Life

it's pretty much official. I have decided what I'll specialize in as a nurse practitioner. this morning, Tamara and I watched a live birth. a whole new meaning has been brought to the phrase "the miracle of life". literally a miracle. I'll start from the beginning...

for the past several days, Tamara and I have been getting antsy, the shadowing opportunities have been dwindling (in short- 2 boy medical students came last week, and being male they have been given most of all the opportunities available: surgeries, hospice runs to the Masai camps, ward rounds, etc. and between them and the other medical students here, Tamara and I have been left in the computer lab for an entire week. being female and American, I've realized I have 2 strikes against me). So for the past few days, we've decided to take our own initiative. We have been visiting the labor ward, hoping to see something, anything. after 3 visits to the nurse in the ward yesterday, she finally told us that there would be an induced labor the next day (today) after church. we asked her if it would be okay if we came to watch, and she shrugged and said fine.

like persistent little kids, we arrived in the labor ward this morning promptly after church. this was it. I could feel it. sure enough, the nurse came out from the holding room and said the induction had already begun- 5% dextrose had already been administered followed by a drip IV of oxytocin. the woman was about 5-6 cm dilated and her contractions were about 10 minutes apart. finally, we had been invited into the delivery room. all within a matter of about 30 minutes from the administration of the induction drugs the baby was crowning. the poor woman didn't receive any pain killers, nor did they have stirrups, so she was holding her own legs apart and pushing as hard as she could. it was super incredible to watch. as the baby's head came out, I immediately noticed how blue it was, the umbilical cord had wrapped around its neck. with one final push, the entire baby was expelled (along with a lot of blood) and the nurse quickly worked to get the cord undone. at last, we heard the baby gasp for air and let out a long wail. we got to stay to watch how the cord is cut from the mother, and how the afterbirth is taken out. then, one of the nurses prepared an injection (with technique that would make anyone cringe) and tried to explain what it was for. we didn't quite understand, either to stop the uterus from contracting, to reduce blood loss, or to make the uterus contract one last time to expel the remnants of the afterbirth. then proceeded to give the woman the injection in the thigh, with no gloves on. sanitary.

it was absolutely incredible. I felt really bad for the new mother though, first because they immediately took the baby away to have it measured and cleaned, and then they placed it in an incubator without ever letting the mother see it. apparently, the mother gets to rest on that bed for 1-2 hours with the baby in the incubator, and then they move both of them to the post natal ward. but secondly, I felt bad because the woman had removed her kanga for the birthing process, and was thus naked, which was fine, up until the birth was over. the woman was shaking so bad because of the cold. the only thing the nurses gave her to warm up was a single sheet of hospital bedding. how uncomfortable must she have been? I won't go into much more detail about the unsanitary-ness of the whole thing, but I'm not sure that I would want to sit on that hospital bed given how many births have occurred there, and the clean-up procedure.

after the birth, Bob (a Nebraskan who has been here for 4 years working with Machame hospital to delegate money to areas needed from the direction of his Lutheran church at home) came to find someone to help him. I went with him to do an inventory of a shipment of drugs that came for a local dispensary effort. It was really interesting to see the differences between Tanzanian generic names and the names I'm used to in American pharmacies. and, no matter how dorky I sound, it was nice to be around the familiarity of drugs. yes, I miss being at work in the pharmacy. never thought I'd say it.

so overall, the best day yet at the hospital. we got to watch the baby laying in the incubator. less than 5 minutes old. it was amazing. finally, we did a computer training with the head doctor at the hospital and he was really interested in the fact that we were medical students. he made it clear that he would definitely let us in to see the cleft lip surgery next week. I'm so excited. I'll really leave here on a high note. Tonight, Tamara and I are going to go over to the guest house (where the other volunteers at the hospital are staying) to make dinner. Its fun hanging out with the other volunteers, there are 2 boys from America, 2 boys from Scotland, and 5 girls from England. all of them are in their early 20's. we have our own little community here with inside jokes and funny stories that Tanzanians wouldn't find funny.

Next weekend, we'll be in a Masai village, a once in a lifetime experience. and on August 1st, my program here ends, and I'll leave with 2 of the British girls to go to Zanzibar until I leave on August 7th. It'll be a nice little summer vacation before I get back to the US and work on trying to find a job in Cali...