Brave Woman

Adventures of a future nurse-midwife

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Umm...No.

Posted by Lucille on June 6, 2011 at 12:30 AM Comments comments (0)

I was walking to the Internet when one of the deaf guys that sometimes hangs out up front waved me over.

"What?" I asked by raising my arms.

He started making out with his hand.

I don't think so.

As we were walking back, a guy cane up to a group member. "Hello, I am a psychiatric patient. Where do you live? You are beautiful. I love you. Will you get drink with me?"

This is crazy!

Beach Day

Posted by Lucille on June 6, 2011 at 12:30 AM Comments comments (0)

We went to Sanyang again today. Lots of throwing people in the air, and a group member and I practiced our tae kwon do forms. The bus driver didn't show up (we learned later that he was taken by the police, never found out why) and the new driver didn't come until late at night, so we spent a couple hours spread out under palm trees telling stories under the African sky.


Can You Believe I Haven't Done Maternity Yet?

Posted by Lucille on June 6, 2011 at 12:30 AM Comments comments (0)

Friday was my first official day working in maternity. First we were invited to watch an IUD removal. I was glad the woman spoke English, so I could ask if it was okay for us to be in the room, and she said yes without hesitation and joked with us through the whole thing. We were supposed to watch an insertion, too, but the speculum was too short and they couldn't find her cervix, so she was transferred to Banjul.

When we got back to maternity, the Cuban doctors were in there working with one of the mothers. They'd found her baby wrapped in layers of blankets in the afternoon heat, covering its face. It moved feebly when they picked it up.

"Not so much blankets, the baby is too hot," they said, "When did you last feed it?"

The woman shook her head.

"You haven't fed it? When was it born?"

"Last night."

The Cuban doctor looked appalled, and immediately had her try to feed it, but by then it wouldn't latch on. He filled a syringe with dextrose and squirted it into the baby's mouth, instructed the mother to keep trying, and moved on to the next patient. She'd also delivered the night before and hadn't fed it, and the woman next to her was the same story. The Cuban doctor left to exchange words with the midwife, and as soon as he was gone the first woman put her baby back in the bin and covered it up. I think the infant mortality rate here is misleading. Wanted babies actually have a pretty good shot.

A woman came in eight centimeters dilated. After a little while, they decided her contractions weren't strong enough and put her on Pitocin. A little while later (I wasn't looking at the clock, but it didn't seem like more than ten minutes), they decided they still weren't strong enough (I have no idea what criteria they used to determine this, since she looked fine to me and her blood pressure was normal), and they decided to manually contract her uterus. She screamed and tried to fight them off, and they slapped her arms away. She switched to gripping the edge of the table and trying not to make noise. I left the room during this part, partially because I didn't want that image in my head, and partly because I was having trouble controlling my facial expression and I think the only thing that could make a birth situation like that harder is having a bunch of strangers staring at you looking horrified. I could still hear it, though, and I never want to hear a human being make those sounds again.

I went back in when the baby was born. The midwife proceeded to tug on the umbilical cord and a group member looked over at the baby.

"The baby's coughing."

"Hang on."

"The baby's not breathing."

"I'm coming."

After a few seconds she abandoned the cord, flipped the baby upside down by its ankles and hit it on the feet several times. She then went back to tugging out the placenta. The group member flipped the baby over her arm and got it to spit out the fluid that was in its mouth, and later opened a discussion with them about the best ways to clear a baby's airway.

After the midwife left, I offered to give the mom her baby, and she stared at her for a while looking mesmerized. I took her back after a minute because those tables aren't designed for holding a baby comfortably, but I moved the bin next to her and she leaned over it, looking into her baby's face. I stood there for a minute, trying not to disturb the stillness of the room, watching the mother watch her child.

A New Take on an Old Gig

Posted by Lucille on June 6, 2011 at 12:25 AM Comments comments (0)

There was something in our guidebook about a reinvention of the sex trade in Western Africa. Instead of rich white men coming to hook up with young girls, white middle aged women come to spend time with young African men. An older woman came over yesterday and moved into a room with a young Gambian man and we're pretty sure that's what's going on. I'd like to report that it prompted an intellectual discussion on the destructiveness of unequal power in relationships, but instead it's prompted fits of giggling after they walk by. Still pretty entertaining.

The Light Is Out

Posted by Lucille on June 6, 2011 at 12:25 AM Comments comments (0)

I was typing in the Internet cafe when someone ran in yelling, "The light is out! The light is out!"

I looked up at the light, which was definitely on, and the computers, which were still functioning.

"The light is out! The light is out!"

And then the computers died. This is how I learned that there is a man whose job is sitting in a tall chair outside the internet cafe and watching the far hill, because they lose electricity a minute before we do. He sits out there all day watching the light on the hill so he can run in and warn people to save their work. We see him every day now and we're becoming good friends. Now any time I hear someone say the light is out, I take it seriously and finish as fast as I can.

Care Package

Posted by Lucille on June 6, 2011 at 12:25 AM Comments comments (0)

I've been eagerly awaiting a care package from my mom since we got here. We usually go by the post office after work a couple times a week. Until last week there were no packages, and several other people were expecting one. Last week we went by, and they saw us coming in and said, "Yes, yes! We have three packages for you! Three packages for the health center!" We were so excited and ran up to the desk. "But they're not in the system yet, and the light is out. Come back tomorrow." We did, and none of them were for me, but people shared what they got, so the love was passed around…in the form of gum and bubbles.

It Looks Like Birth

Posted by Lucille on June 6, 2011 at 12:25 AM Comments comments (0)

They have a lot of fabrics with complex, mandala-like circle patterns. The first time I saw these with our group leader, she said, "Ooh, it looks like a cervix!" We all thought that was funny, but the idea caught on, and a week later I couldn't help thinking they looked like birth. A number of people made dresses so the mandala was centered over their bellies, and they were really quite beautiful.


Age Is Relative

Posted by Lucille on June 6, 2011 at 12:20 AM Comments comments (0)

"When are you getting married?"

Me: "I don't know. When I'm done with school and meet the right person. Maybe around twenty eight."

"What?! Twenty eight? No, it is better to have children early. That way when you're forty they're already grown."

"I don't want to start a family until after I'm done with school. But I'm definitely going to at some point."

"You have boyfriend?"

"Yes. We're going to different schools, though, so we'll probably meet other people."

"Well, why isn't he your fiancé? I think he should be your fiancé."

I told her I'd let him know.

Revolution Day

Posted by Lucille on June 6, 2011 at 12:20 AM Comments comments (0)

July 22nd is revolution day in Gambia, the celebration of the military coup that led to the current president (Jammeh) coming to power. Jammeh's image is common thoughout the Gambia. There are posters of His Excellency in most rooms at the hospital, fabric with his portrait in the market, and the midwifery conference that we went to opened with a poem that included the line, "God praise the day you took over." Someone we know was once chief of this whole area said something about not wanting Jammeh to be reelected, and was stripped of his chiefhood. (For the same reasons we always call the health clinic a hospital, we always call him 'Chief'.) The person who told us this said it in a whisper, and when we asked why, she said that if you say something bad about the president, the police can come and take you away.

There's a big parade in the capital to celebrate Revolution Day and we were invited to attend. For the most part it was like parades in the US: hot, crowded, and anticipatory. There was a 22-shot salute (I kept thinking the windows on the hotel across the street were going to shatter) and then the president rode by in the front of a hummer-limo, waving and throwing boxes of cookies into the crowd. Student and volunteer groups followed.

It turned out that the hotel across the street was the place we had wanted to stay during travel week but hadn't been able to contact, quite a pleasant coincidence, so our group leader ran over to make reservations. Our guide emphasized that we were volunteers and they agreed to give us the lowest rate, half of what they told us originally. Our guide then decided that the fastest way to get back to the ambulance was along the parade route, so we waited for a gap and then ran out under the watch of armed guards (he had asked permission, so one of them gave a quick order not to shoot) and we paraded past the president and out toward the parking lot. When we got back everyone at the lodge ran out to greet us, yelling excitedly that they'd seen us parading on TV.

Cats

Posted by Lucille on June 6, 2011 at 12:15 AM Comments comments (0)

I was walking through maternity as the Cuban doctors were doing rounds (apparently they do rounds everywhere) and decided to go with them. A kitten came up (maternity is full of cats) and started licking itself under a bedside table. I knelt to take a picture.

"Don't touch it," the Cuban doctor warned.

"Oh, I won't," I said, showing him the camera, "Does it have bacteria?"

He nodded. "It has (word I can't pronounce). It causes abortion and craziness in the brain."

"Oh," I said, laughing at the casualness with which this is said, "That doesn't sound too good."

"No," he said, laughing at the same thing. "And of course they come to Maternity. In my country we call this a problem. Here, it's called natural selection."

Still chuckling and shaking his head, he moved on to the next patient.



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HIPAA Disclaimer

Sometimes I have the privilege of being a part of intimate, powerful moments in other people’s lives. I cannot and would not share these stories, because they are not mine to tell. However, they touch my life and become part of my own story. When I share these moments here, you can trust that I have not broken anyone’s confidentiality. The characters are invented. They are not real, but could be. I take creative license to communicate the essence of my experience while respecting the privacy of others.