Day 4 and 5

The last two days have been pretty crazy. We started our hospital practicals, which we are doing for 3 days in a different ward every day, before we start practicals at the health centers. The 3 units we are visiting is the neonatal ward (for tidlig fødte), pediatric ward (barneavdeling) and labor and delivery ward (føden). We were picked up to go to the hospital at 9, and got to there shortly after and then we sat there waiting till it was past 10 before we did anything! Apparently our tutors had to get some more papers written and signed before we could start. Me and Victoria were taken to the delivery ward for the day. One of our tutors went with us up on the 6.floor and showed us where it was. She took us into a room to meet a woman who had just given birth a couple of hours ago and quizzed us on how we were to examine the mother and baby right after birth, as well as what kind of information it was important to give to the mother. Good thing we had just finished all that theory at school, or we wouldn’t have known anything! We also met some midwife students who were men. Here there are many male midwives it seems, I guess in Norway there are hardly any.
The nurse-patient relationship is very different from Norway. It is okay to talk over the heads of the patients and we haven’t been introduced to any of them, and there is not very much privacy given. The women giving birth were in rooms with windows so that everyone could see in, and there were several giving birth together in a small room. Also most of the nurses and doctors pay no attention to us and don’t talk to us unless we ask questions, so it is quite awkward to be there. There are some exceptions though, they will tell us all about what they are doing. Its really hard not to be able to talk to the patients either. All you can do is smile, and maybe the situation isn’t really one where a smile is appropriate, so then you can’t do much to communicate.
It was hard to see the women giving birth in so much pain, stuck at these tables without any kind of pain-relief and no family there to support them. I’m not gonna go into detail about all the things we saw, but my goodness I’m glad I’m never going to be a patient in this hospital. And to think that these are the “lucky” women who get to even be in the hospital! They don’t have any equipment hardly. To monitor the women they use their hand on the stomachs to feel the contractions and listen to the heartbeat with one of those wooden stethoscopes. They didn’t use any electrical monitoring equipment. Most of the furniture was rusty and falling apart. But the nurses and midwives we did talk to where very knowledgeable, they knew so much, but they also knew they were not able to do what they knew would be the best for the patient, because of the economic situation. For instance where the delivering women discharged 6 hours after birth because they did not have room to keep them, even though they knew they should stay longer to make sure everything is fine before they leave the hospital. Also, this hospital delivers all the complicated births that they don’t allow in the health centers. So most of the deliveries there are high risk pregnancies.
We had been standing on out feet for hours just watching these women panting and groaning and throwing up and who knows what, and my stomach was not doing do great. The air was all warm and stuffy, and I got dizzy, I went out of the delivery room with Victoria and before I knew it I was on the ground! So there I go fainting again, its been a couple of years since last time, so I was almost just waiting for it to happen. I hit my head pretty hard, I can still feel it, and I’ve got some nice bruises as well, but I’m perfectly fine. I’m just glad I was on the floor in the perhaps cleanest floor in the hospital! And I had Victoria there to make sure no-one tried to give me any medicines! When all of us met together we found out one of the other students had had some problems as well, almost fainting and throwing up. It probably has to do with getting used to the food and bacteria here. It doesn’t exactly help to been in a warm, stuffy, smelly room watching medical procedures!
Today we went to the neonatal unit. We saw all the premature newborns and those who had trouble with breathing or infections. There was one tiny baby who was born in week 28, it was so skinny you could count all the ribs. There was babies with cleft lip and palate (leppe gane spalte), with infections in the umbilical cord, with sepsis (blodforgiftning) and jaundice (gulsott). There were three rooms according to the condition of the babies. One room had 15 babies and the others fewer.
They had what looked like good equipment. Some were under heating lamps, some were in little oxygen tanks, and some were under lights to treat jaundice. The rooms where incredible warm, probably well over 30 degrees, with the windows taped shut to keep it warm enough for the babies. So we had to leave the rooms and go into the corridor ones in a while to get some air. We were wearing out scrubs (sykepleie uniform) and on top of that we had to wear a purple gown which made it even warmer. These rooms were kept fairly clean and everyone had to wash their hands before they could enter. But there were coach-roaches (kakerlakker) wandering around everywhere! On the walls, on the medical equipment even onto the tables where the babies where laying. They weren’t huge ones, but still, they were everywhere. We had to push one off a table that was getting really close to a baby! But the people there didn’t seem to care too much.
It was really nice to see some of the moms interacting with their babies, they were doing everything from changing to feeding, either breastfeeding or extracting milk to give through a feeding tube. There was always babies crying, and one of the moms was constantly taking care of the other babies besides her own. She was so cute. All the moms where living in the rooms next to the NICU so they could come and feed and take care of the babies. The worst parts to watch was the doctors and nurses struggling to put in catheters and getting blood samples from the tiny hands and feet and heads!
Today two more of the students weren’t feeling good at the hospital, I guess the germs and the smells and bad air in the hospital is getting to us! I felt absolutely fine today, but tomorrow I’ll be going to the pediatric ward which is really smelly, so I hope we’ll get through that okay! Looking forward to getting out of the hospital an over to the small health centers.
Last night we went and picked up another norwegian girl that is working here in Addis at an orphanage and we went out and had dinner together at a really nice place. When we walked in the door I thought “this will be expensive”, it was so nice compared to other places I have eaten, even in Norway. But I ended up getting the nicest steak dinner with a drink for about 40 kr (about 5 punds or 7 dollars), so it was way cheaper than McDonalds in Norway :)