June 24, 2008

This morning we arose and got ready to come to the hospital.
When we were in the taxi the driver asked us what we were doing in Rwanda and then he said, "Oh, you are the ones that have given the money and supplies". Nice to know the word has gotten out. He also couldn't believe our ages, not can the nurses in the hospital--- they say that when a woman here is 40 she is old--- one of the nurses acted out hobbling along with a cane. We had to show them our passports so they would believe us!
We decided to get into the area that the supplies were stored in to get better gloves, lidocaine and shoe covers. It took a while for the key to be located and during that time we sat with the mothers nursing babies and waiting for clinic appointments. I think I understood that Tuesday is a family clinic with HIV testing and general health screening. Again we are in awe of the beautiful outfits and the traditional colorful cloths that the women wrap around themselves to signify status as a mother.
After we were able to get our supplies we went to maternite and met with some of the nurses from yesterday, some new nurses and Dr Monique. The unit was quiet except for a cesarean ready to do. Pam and I did the surgery so Dr Monique could observe us. All went well. We had a few more women circling the labor area--- they walk through the entire labor and when they are 9 or 10 centimeters they are allowed to lay down and prepare for birth. I had a delivery with Leann and started to do the repair- I showed the nurses how we soak the gauze in lidocaine and let it sit on the wound before we begin to sew and they thought that was great. I had another birth and then we admitted a woman with hypertension-- BP 220/130. The pharmacy is very short of the drugs that they wanted to treat hypertension so they tried to get a family member to go into town to try to find some medication to purchase. Meanwhile we started a medication that was not the one we wanted but since that was all we had...... The patient needed to be stablized before we could do a cesarean, and besides, the laundry for the procedure wasn't ready yet. The time goes by. Finally the decision was made to proceed and the patient was given a general anesthetic. Nothing moves quickly here-- calling neonatology is an afterthought, there is very little anticipation.
As we finished the cesarean Monique and I had a chance to visit and discuss the difference is the way that she grew up, was married, studied, etc. She is from Kenya and is here with her husband who is an architect. When I told her that we were near to Seattle she asked, "Do you know Grey's Anatomy?". Apparently she is a huge fan. I will be interested to see how everyone (mom and babe) is doing tomorrow. The nurses love the colorful surgical hats that Leann brought and anything that we can give them is a plus. They were even going to try to wash the paper gowns that we wear.