Adrienne goes Africa

The last two days have been amazingly quiet. Even now on the ward only four beds are occupied, 4 ladies in labor. And we have our “High risk room”, with two beds. Here is one lady staying already a few weeks with hypertension, she is 32 weeks now and we hope to get her to 34 weeks. The other one is a very sick lady, admitted a few days ago with severe preeclampsia. Very high blood pressures, very much edema and hardly urine production. We tried to make her deliver normally, but unfortunately she was not able to push and the baby was born by Caesarian section. Luckily in good condition. She her self was in bad condition. During the CS about 3 lt of ascites (fluid in the abdomen) was removed. We had problems to stabilize her blood pressure. Today- day 3 after the operation- she finally feels a bit better and urine production is coming. As she had no force to feed the baby, one of our midwifes who is still breastfeeding her baby expressed some milk to give this baby. She just sits in that room, amidst of all people expressing her breast. It is amazing to see how people so easily help each other. Even the other lady in this room let her family bring some clothes and food, because she had seen this is a very poor lady. Actually she worked as a day laborer until the day of admission, never had any controls in pregnancy. There seems to be no husband, no relatives, we have to try to get help for her.

For the rest life here is getting her routine. Every morning we start in the clinic at 8.30 with the morning session, all admitted patients have to be presented. Teaching moment! Then we make rounds and at 10.30 I start doing Ultrasounds. Every patient from the ANC (ante natal clinic) has to have ay least one ultrasound, the rest on indication. There are very many first cases! We discussed it this week ,it is getting far to busy, many people come from the whole town . So now we made the decision to only see the people who are referred, who are poor and from this KEBELE. Bahirdar is divided in 15 or more Kebeles, and they all have an own health center. In these health centres there is also obstetrical care, usually one midwife. As we are in the place of a health center we have to see these people. For the rest we see to many well to do ladies, who might as well go to a private clinic….. They come by car, nicely dressed and have good jobs and ask for the sex of the baby. Of course we understand they too like to come to our clinic, but it is getting to much. As for the ultrasounds, I am training two midwives to do this, because us gynecologists have better things to do than routine ultrasound… In the afternoon there is no program, but usually busy with clinical cases. Today for the first time I have an afternoon without being called to the clinic-up till now!

The house is fine, there is running water and a functioning toilet. But to shower we usually use a bucket, because the showerstream is very poor, and not heated. We have Morone here, a nice young lady who cooks and cleans for us. She is an unmarried mother with a daughter of 5, has been trained by an American expat. She cooks western style, but I ask her to make injera once and awhile .Here are many more possibilities for shopping of course. Climate is colder than it should be this time of the year, I am happy I brought my down sleeping bag!

The internet is a problem apart. They tell me here it has never been as bad as it is now. There is a resort where we go for free Wifi, but also there it doesn’t work all the time. Ghion hotel, where I stayed two years ago with Jan, has also a problem. My CDMA (dongle) is still there , but works only half of the time. So I hope I will be able to send this blog today or tomorrow, this time with some pictures.

Then about my bike. One was stolen just after I arrived. and it is difficult without, so I decided to buy another one. There came a neighbor willing to help me. He was so upset that his country people stole my bike etc etc. So next day he told me he had done some investigation and found a good second hand bike for me for 3000 birr. Seemed a good price to me. New saddle and clutches. I forgot to ask a bill , and asked Solomon the driver to get one for me. To my astonishment he came with two bills: one was of 5 years ago , he bought the bike for 1350 birr, the other one for me 3000 birr. Was I cheated? I don't know. Anyway I am happy with my bike!

visitingMota, happy to see Tenaw