0207

That would be 7 minutes after 2 am, for those that don't use military time. That is when my day started today. Dr. Zoolkowski has kindly lent me a dual sim cel phone while I am here, and that was the time that it went off. The ring tone is seagulls, so I thought I was having a dream about the shoreline. By the time I grabbed for the phone they had already hung up, but the call log said it was maternity so off I went. A lady had been in labour since last night and had not progressed well. When I arrived she was fully dilated but she was having trouble pushing and the head was only about ½ way down. The baby's heart was starting to dip with the contractions, and there were some concerns about early distress. The decision was whether to do a forceps or to go for a cesarean section. At 2 in the morning the resources here are less than what they would be during the day. Everyone has to be woken up and come in, and things do not tend to move quickly. Also it looked like this had been a problem for a while. On top of that a cesarean for a first time mom is a very big deal here. They do not always heal as well, and the uterus can rupture in the next pregnancy. Often women labour for days before coming in to hospital, so avoiding a cesarean can be life saving down the road. With all this in mind we did go ahead with a forceps delivery. It was not an easy one like the previous lady with 10 other children, but she now has a live baby girl, and she is recovering well.

After that, I decided to forgo my run this morning and sleep in a bit. When I arrived to do rounds there was a second lady who was not progressing in labour, only this time she was not as far along, and the cervix was not fully dilated. She had a few other children as well. We decided that she should go to cesarean. Because of how things work here, it was going to be well over an hour before the cesarean, so I went ahead and did rounds. There were no other significant concerns, and at the end of rounds I was able to do the cesarean for a baby boy. Mom and baby are well.

Pharmacy Department

Smells Delicious!

The plane came in today rather than yesterday, and there were several visitors along with some
supplies for the pharmacy. After we dropped off Dr. James Owens at his new residence we headed to the pharmacy to drop off some medications. Then Dr. Zoolkowski and I headed back to his favourite baker to pick up some bread for Thanksgiving dinner (I get to celebrate twice this year). You could smell how fresh the bread was, and we had a lovely aroma in the Land-C
ruiser all the way home.

Best Baker in Town

The MSF transport was by again today – I see where they have a strict “no assault rifle” policy for passengers.

I am starting to plan for my transition away, and am thinking of what I have to do make the handover as smooth as possible. Fortunately the people here have been through this many times, and the midwives are well trained.

Jeremiah 29:11

For I know the plans I have for you, declares the Lord, plans for welfare and not for evil, to give you a future and a hope.