Sunday, January 25, 2009

la petite américaine

I returned to Ouagadougou yesterday morning after my first over-night shift at the hospital with Josione. Josione is an accucheuse in the clinic maternity, and I have been working a lot with her. She is quite large, and people like to tease her, calling her an American. Now that I have arrived, and am not that large, they call her the big American and me, the little American (I am actually quite small amongst the clinic staff, both in height and weight).
The shift itself was quiet, but the trip back was quite exciting. I rode on the back of Josione's motorcycle, one hand clutching a bag of yams and the other holding on for dear life. There is only one main road here, and it is not wide, and motorcycles do not ever have the right of way. Actually, I'm not entirely sure there are any rules, so maybe no one has the right of way. Anyway, it was exhilarating and terrifying. I survived, having learned a bunch of rich swear words and the word for helmet-casque (because I did not have one).

It has been very exciting at the hospital, though there have not been any births during my shifts. I have learned to do both prenatal and postpartum visits, which have been both fun and interesting. Generally, I do the physical check-up, while the accucheuse on duty with me does the talking in Morré. I work mostly with Josione, and we make a good team, laughing a lot. She has taught me to give injections, both vaccines and birth control. A lot of our postpartum visits involve counsiling women about possible birth control methods, which here include Deprovera, the Pill, and IUDs.

I have watched, but not preformed any HIV/AIDS tests. These tests are like pregnancy tests and only take ten minutes or so. One puts a drop of blood on the end of the stick, and if one line shows up it is negative, two means it is positive. So far, all the tests I have observed have been negative, and an accucheuse proudly informed me that these are the results of lots of hard work by the hospital to help birth HIV/AIDS negative babies.

To back up a little, I have given up trying to split my time equally between the clinic and the hospital maternities, and spend almost all my time at the clinic one. It became very difficult to get any decent experience with the male doctors, as they grew more comfortable with me and began to joke and talk to me more than teach me. It would be nice if I could have an interaction with them without myself in the way, if that makes any sense. Everyone is very nice though, and if there are things of interest which I should see, I am often sought out and shown. They are all very excited to show me a c-section, but there have been none so far. I gather that if there are any complications at all in the birth, they deliver the baby by operation.

There is an interesting mix of western and traditional birth culture in the hospital. On the one hand, it is believed that a woman should be left with her family, to labor as long as she needs to, and birth with no pain medication because pain is what makes a mother. On the other hand, operations and some medical physical interventions are thought to be the best options when something goes wrong, because that is what the Europeans and Americans do. I am saddened to think of all the great alternatives that this community once held in its birth culture, that it lost not because they were wrong or ineffective, but because they are not "modern".

French Vocabulary!

DPA (date probable d'accouchement): EDD (estimated due date)

Gloves: des gants

Blood pressure: tension artérielle

Attend: assister

Be present and helping: participer

Birth Assistant: accucheuse

Birth: accoucher

Pregnant: enciente

Stethoscope: stéthoscope

Foetus: fetus

Umbilical cold: cordon ombilical

Malaria: paludisme

A cold: un rhume

Anemia: anémie

Improve: ameliorer

Ultrasound: echographie

Family planning: plantification familiar

Weight: poid

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