Pondering...

So on my way to Chobe park, I had an hour ride to the Zambia-Botswana border. A lot of time to think. I was thinking about Africa, the people, me, what I was doing here, and how would Africa play a role in my life. I first fell in love with Africa in seventh grade. We had to learn about Africa and I remember staring at the map, memorizing the country names, and picking out what countries I would visit. Botswana was one of them. I remember reading tons of books on slavery and apartheid. And from then on, Africa has always captured my heart. HIV and AIDS has also always interested me. A disease that has caused such social and economic ramifications. This country has between a third to a half of the population infected. That is incredible. I have met so many orphans. It is wiping out an entire generation. Even the children, it is not often discovered they are positive until they are malnourished and/or sick. This leaves many of them developmentally delayed. How could Africa have it so hard? Such a poor continent with such incredible disease burden that such a horrific history (and recent) of slavery and genocide. This beautiful magical place with incredible people and culture. What is different here? Mothers still care deeply about thier children, weeping for them, wanting a great future. Fathers still smile when their children laugh, cry when they're in pain. Children still dream big dreams. So what is the difference here? Why is there so much wailing, suffering, and death?

Hospital Photos

Alright so here are some pictures of the hospital...

tomorrow I'll take pictures in the pediatric ward, my favorite place!

This is the pharmacy...

This is the "hallway" to the peds and maternity wards. Leprosy ward on left.
Outside of the outpatient clinic.
Normally crowded with people on the porch but it was pouring with rain.
This is the waiting room towards the end of the day. Normally there are people literally sitting on top of each other! :)

More of Macha...

Here are more pictures from when I went exploring during lunch.....I really am in the middle of nowhere. Two hours from the closest town...only little huts from here to there! And I spent an hour trying to get that photo to load straight...so just tilt your head! haha!

More photos!

These are some photos from when I was in Lusaka, driving to Macha, and where I live!

Baby Update

So update on the baby....
Baby is still alive but has a high fever. Yesterday I asked the main doctor to take a look at him. He said he would (not enthusiastically). Later the main doctor came to pediatric rounds to ask the pediatrician to take a look at the baby. I told the doctor about what had happened the day before and he told me to come with him when we went over to the maternity clinic. When we got over there, the nurse had no clue the baby was even there. The baby didn't even have a chart made up for him. We changed his antibiotic to Ceftriaxone. But there is not a lot to do. The doctor explained to me that with neewborn failure to thrive it is most likely one of three things: anoxic brain injury, metabolic disorder, or infection. The only thing they can treat here is infection, so they give antibiotics and sees what happens. The most oxygen they can give is nasal cannula besides manual bagging. The IVs are only continuous, so not good for babies, so all antibiotics are given intramuscularly. Resources are just so limited here. Training of the nurses and medical students is poor too, but more on that later!!!

Okay happier things....

Okay more about the hospital... It is actually a series of buildings connected by outdoor walkways. The buildings are pretty much big rooms filled with patients all in a row. The beds are metal beds with peeling paint. Most patients have a family member with them to take care of them and bring them food...otherwise they dont eat. There is a men's ward, women's ward, TB ward, maternity, and pediatric ward. There are also outpatient clinics including the ART clnic (anti-retroviral therapy). In each ward, there is a large inner room and a outer room that is almost a porch. The patients with TB and are unstable or are coughing are put out on the outer room. There are salemanders or lizards crawling up the walls. The smell is well, like the psychiatry ward at harborview...enough said! There are mosquito nets above each bed. Okay more later...time to shower!

baby oh baby

Oh what a way to start off the trip. I will only tell you this story at first, because that will be enough. When I was first getting shown around, at 830, we saw a woman who was fully dilated but having no contractions. Later on in the day, during rounds, at about 11, the nurse came over to saw that even with the pitocin on at full there were no contractions. We went to go see her and decided to do a c-section. The c-section didn’t start for awhile because the doctor couldn’t place the spinal anesthesia. Finally he decided to just give her general anesthesia (ketamine). Then the doctor asks me if I can resuscitate a baby. Yikes! There were a lot of nurses around so I figured they would help….wrong. The incision wasn’t big enough and then the baby slipped back in and they couldn’t get him. The amniotic fluid was yellow rather than clear. When they got him out, he was grey. They flipped him upside down, suctioned his mouth and handed him to me. The nurses was of resuscitating is to hold the baby by their feet upside down and slap the back. Probably works sometimes, but not when you’ve used ketamine and been in stage 2 labor for 5 hours. So I start bagging and telling them to rub vigorously. They pat his head. He has a heartbeat. I had to bag him for 25 minutes before he started breathing. They immediately wanted to take him somewhere else. I said yes because I was hoping it had a warmer since he was still blue and cold. We walked outside for a 5 minute walk to the maternity ward. The nurse put him in the warmer. Then the oxygen with the canula wasn’t working. So I had to bag again. Finally oxygen working. Baby is getting warmer. Now has retractions, nasal flaring, stridor, abdominal breathing. I suction every few minutes getting yellow amniotic fluid out. After an hour, he starts having tone in his legs. After three hours, he has slight tone in his arms. No reflexes. All this time I am on my own, with a nurse popping in and watching and then leaving. I kept asking when the doctor was coming and they kept saying soon. Then they said he was went home for lunch. And they refused to call him. You can probably guess how I feel about that, so I won’t say anymore. At three and a half hours after the baby was born with still no crying or reflexes, I found the doctor, who said “oh well, probably asphyxiation. You can only give him oxygen with a canula”. And that has been my first day.

In Macha!!

I finally am done traveling!! Five hours in the back of a car to finish off the journey... Started off in Lusaka with big busy roads full of cars and people. Then the roads were smaller but still paved. Lots of police check points. People walking along the road everywhere....balancing things on their heads and babies strapped to their backs. There were guys selling scratch off cards for cell phone air time and newspapers in the middle of the road. Then the roads were no longer paved...only slightly bumpy and still 2 lanes. Then the pot holes got bigger. Then the road only became one lane. And then the road looked like it had been completely washed out. The last half of the ride was spent gripping onto the handle on the ceiling so not to bounce around. All along the road there were people and kids everywhere, waving. There were tiny little circle huts with grass roofs in circles all along the roads. It was gorgeous though. Beautiful sky...big like in eastern washington or montana. Red red dirt. Got to the hospital right before dinner. Emptied some stuff before heading over for a dinner of mac and cheese. So disappointing. :-/ There are 3 dutch girls doing research here. Not very friendly and would only speak dutch during dinner, despite speaking perfect english. boo. Hopefully that will get better. But I am so happy to be here. And I start work tomorrow at 730 am. Will load photos soon!