Saturday, January 31, 2009

Baby Catching!!

It has been a fabulous, interesting, scary, intense, exciting, busy week! I have returned to Ouagadougou for the weekend, with plans to go out dancing and hopefully see some more of the city. A week in Saponé makes Ouagadougou feel like a whole different country (how exciting is it that you can turn a handle and water will come out into a basin in your room, no hauling involved!!).
The poverty in Saponé slows the pace of life considerably. Not a lot of people have jobs, so just being and living is what they do, and right now, because it is so dry, cultivating isn't part of that. Time is different here, so running an hour or two late (by our standards) is on time, and not showing at all is probably just fine. In a hospital this means that scheduling the next appointment with a pregnant woman is more like giving her a two week period during which she should come back.
Most women do not know how pregnant they are, the date of their last period, or their age (people know what year they were born in, but don't bother to count how many it's been since then, for example one may ask a woman how old she is, and she would answer that she was born in 1982). Sometimes, I feel a little like a detective, measuring the fundal height or figuring out how many months old the last child is to see when a woman could possibly have gotten pregnant again. (It is not unusual for women to become pregnant a month or two after they have given birth. This is difficult for many reasons, including further malnutrition of the mom, which leads to poor milk supply for baby number one and poor sustanance for baby number two in utero.) I am mostly doing prenatals these days, and have learned to document everything properly. The accoucheuses keep leaving me to do them myself, but it is very hard because I cannot communicate adequately with the moms.
The general rule in the hospital has been, if Natalie has seen something done twice, have her do it herself the third time under observation, and then leave her to do the following ones without supervision. This does not include surgery or important injections, for which I am very thankful.
This rule did apply to baby catching though. I observed one birth, helped at another, and then I caught a baby!!! The woman came in on the back of a moped practically pushing, the accoucheuse and I put on gloves and smocks right away, and then the accoucheuse, preoccupied with getting all the instruments ready, told me to grab the head when I saw it and pull. I grabbed the head, but refused to pull then (I was frustrated that I was not to do any perennial support), and pulled gently for the next push as the head came out and up, catching the little girl under her arms as her body came sliding out. I thought it was very appropriate that the first baby I caught was also the first baby girl I've ever helped birth.
A little context about birthing at CMA, for those of you who are interested: There is one birthing room, with two tables, a counter, and a big trash can. It has one light that occasionally works, when the solar pannels work, and four grated windows. All women birth on their backs, with their butts elevated over a basin, and all women birth alone with the accoucheuse. There is no pain medication, are no forceps or vaccums, and a limitted supply of gloves and gauze. All that said, birth in this room is infinitely better than birthing in the home, and the accoucheuse and doctors are very resourceful.
In four different loads, I biked the presents that I had brought (from the States) to the hospital. The things that were the best/most helpful/biggest hits were the gloves (big enough for men's hands-very exciting), the tension metre (the clinic maternity has never had one), and the face masks. The things that made everyone laugh were the one-time use cold packs (no one had any idea what to do with these, their is no ice, so using it to ease swelling was a new concept), the thermometer that only tells temperature in F (and so was returned to me), and the condoms (which the doctors wanted to keep for themselves, having a great time informing everyone that la jolie had given them out). I was disappointed to find that condoms (for either sex) are not very available, nor popular. For the most part, doctors just encourage people to get treated for STI/Ds as soon as they can, and try to save the condoms to give to couples with one HIV positive partner. I should include here, that couples is not exactly an appropriate word, as many men have more than one wife. There is a saying here that goes, "tu as l'argent, tu n'as pas de famille" (if you have money, you have no family).
I have to go to lunch now, so I will end my post here and try to put up some more vocabulary and pictures as soon as I can. Much love!

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