sunday morning, blog from 2 weeks ago......

 

Sunday morning, time for a new blog. In the weekend we don’t do the handover in the morning, I go on rounds about 10 o’clock. As there is no ANC, there are also no ultrasounds. So this gives us a weekend feeling. Today was a quiet start. Now I am sitting with my coffee on the veranda. It is cloudy, and it has been raining a lot passed night. Very good to settle the dust a bit. Because dusty it is in the streets here. Water is brown when showering.

This week has been quite busy again and some crazy things we had. There was a lady carried in by 6 man( farmers) who had delivered at home but the placenta did not come . She was brought to hospital but delivered her placenta on the road. They did cut the cord, but did not tie the cord on the baby side. God is merciful, the baby did not bleed. In these cases we are always afraid of tetanus, but luckily this mother had had antenatal care and got tetanus prophylaxis. On arrival we put her on the couch, to inspect on tears. She appeared to have a terrible diarrhea. Mean while a second woman in labour came in, with a premature twin. She arrived fully dilated, first one a breech. We tried to get the first ady out as fast s possible, but she was too feeble to move and it took ages. The twin was delivered- second cephalic. All in the same room…….. The firstborn had a good start, but became blue after a while, recovered on oxygen but unfortunately died the first night, may be a congenital heart disease ? For the first time in my life Ive seen a grown up with measles. She came-36wks pregnant- with a rash in her face, red eyes and coughing, feeling very bad. I had no clue, but the midwife told me this is measles. Because she was so ill we send her to the referral hospital. We don’t want measles on our ward and it is a medical problem, not obstetrical.  We also had to refer a baby with a cephalic hematoma, and very anaemic.

In spite of the busy week we went also on some outings, which is possible, because we are with two gynecologists now. We went to teach in a health centre in the outskirts of Bahir Dar and I then realized how big this city is. On my bike I only get around in the centre, near the clinic. This was a wide area with many new houses. In this health clinic we trained emergency obstetrics and also when to refer. Because still they keep high risk pregnant women too long in their centers .They are real eager to learn. % nurses, 2 health officers, but no midwife. They only do 12-15 deliveries a month…… After this we visited the family guidance association of Ethiopia. This exists already a long time, giving information on sexual behavior for the young people. Lately they started antenatal care and now also are going to do deliveries. The first has yet to come. It is a beautiful place, in a beautiful surrounding. They have a nice library where students can come to study, with several computers. There is a amazingly big garden, with a tennis court, volleyball and basketball field. The refurnished building for deliveries looked very nice. It is supported by IFFA and also the Dutch embassy!

Another day I made a visit to the Grace center, where women with children and no money are welcome. We had sent one of our patients and wanted to know how she is. It is a rather expanding organisation, because there is so much need. Started by two couples. Recently they rented some houses in the near region; this is where we could find our lady. We were a bit disappointed to see the shacks she is living in, but it looks clean, they bring her water and food is provided. She and the baby looked well.

That same day I went to visit Felleger hospital, the big referral-trainig hospital. It is amazingly busy there, they can not really cope. About 25 deliveries a day, people all over the place. Overcrowded rooms, in the corridor and also not so clean.  We were shown around by our colleague dr Bezezew, a very nice man, who is really trying to make the best of it with his 2 colleagues. Our deliveries are a relief to them. Neotalogy department also overcrowded and they have to improvise. No real incubators.

Friday night we had dinner in Kuriftu lodge, very posh and out of the place when you have seen al these poor people. But we had a nice dinner and even south African wine! Laterwe even set at the fireplace.

So life is good here, I am half way now!